bluuebunny/crossref_metadata_2025 huggingface dataset:
Beliefs and misconceptions about contraception and condom use among adolescents in south-east Nigeria
Authors: Mbachu Chinyere Ojiugo , Agu Ifunanya Clara , Obayi Chinonso , Eze Irene , Ezumah Nkoli , Onwujekwe Obinna
Published: July 2020

Background: Misconceptions about the usefulness of condoms and other contraceptives still expose many unmarried adolescents to the risk of unwanted teenage pregnancies and sexually-transmitted infections (STIs). This study explored beliefs and misconceptions about condoms and other contraceptives among adolescents in Ebonyi state, south-east Nigeria. Method: A qualitative study was undertaken in six local government areas in Ebonyi state, southeast Nigeria. Data were collected within a period of one month from in and out-of-school adolescents aged 13 to 18 years using twelve focus group discussions (FGD). The data was analyzed using the thematic framework approach. Result: Majority of the adolescents were knowledgeable about methods of contraception, how they are used and their modes of action. They were also knowledgeable about the dual effects of condoms in prevention of pregnancy and STIs. However, some misconceptions that were expressed by some adolescents were that pregnancy could be prevented by the use of i) hard drugs, ii) laxatives, iii) white chlorine, and iv) boiled alcoholic beverages. Condoms were described by some adolescent boys as reusable. Condoms were also perceived by some adolescents to reduce sexual pleasure, and this opinion was mostly held by boys. Coitus interruptus (withdrawal method) was therefore considered more preferable than condoms for prevention of pregnancy. Conclusion: Although majority adolescents have knowledge about contraception and condom use, some misconceptions still persist. These misconceptions put many adolescents at increased risk for pregnancy and STIs which are detrimental to their health and wellbeing. Concerted efforts should be made through educational and behavior change interventions in schools and within communities to debunk persisting misconceptions about contraception, and properly educate adolescents on safe sex practices.
Effectiveness of pharmacotherapy for smoking cessation: Umbrella review and quality assessment of systematic reviews
Authors: Melka Alemu Sufa , Chojenta Catherine L , Holliday Elizabeth G , Bali Ayele G , Loxton Deborah J
Published: July 2020

Background : In the long term, smoking cessation can decrease the risk of cancer, stroke, and heart attacks and improve overall survival. This umbrella review aimed to assess the effect of pharmacological interventions on smoking cessation and to evaluate the methodological quality of previously conducted systematic reviews. Methods: Databases including the Cochrane library, PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, Scopus and Google Scholar were used to retrieve reviews. Systematic reviews that included only randomized controlled trials designed to assess pharmacotherapeutic interventions supporting abstinence from smoking were considered in this umbrella review. The methodological quality of the included reviews was assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) tool, which contains 16 domains. Two authors (AM, AB) screened the titles and abstracts of all reviews obtained by the search strategy, assessed the full text of selected articles for inclusion and extracted data independently. Two authors (AM, AB) also performed a quality appraisal independently. The findings of the studies were narrated qualitatively to describe the evidence regarding the effectiveness of pharmacotherapies for smoking cessation. Results: Ten reviews were included in this umbrella review . Most of the reviews included in this review reported that Nicotine Replacement Therapy (NRT), bupropion and varenicline and cytisine were effective for smoking cessation. The combination of a nicotine patch with other nicotine formulations was also more effective than monotherapy. Similarly, the combination of nicotine with the non-nicotine therapy varenicline was found to be more effective than varenicline alone. However, the opioid antagonist naltrexone alone was not found to be effective for smoking cessation nor in combination with nicotine replacement therapy. Based on the AMSTAR 2 rating, one review scored high quality, two scored moderate quality, four scored low quality, and three scored critically low quality. Conclusions: This review revealed that drugs approved by the US Food and Drug Administration (FDA) are effective for smoking cessation. A combination of nicotine patches with other nicotine formulations was also effective for smoking cessation compared to nicotine monotherapy.
Recruitment, experience, and retention among women with HIV and hazardous drinking enrolled a randomized clinical trial
Authors: Canidate Shantrel , Cook Christa , Varma Deepthi , Carnaby Giselle , Ennis Nicole , Stetten Nichole , Cook Robert
Published: July 2020

Background: Despite efforts by the NIH to enhance the participation of women and minorities in clinical research, women with HIV continue to remain underrepresented in alcohol intervention research. The purpose of this study is to better understand the reasons why women with HIV and hazardous drinking participated in the WHAT-IF? Study and to discuss their experience (positive or negative) in the study. Methods: Convenience and theoretical sampling were used to recruit women with HIV and hazardous drinking to complete qualitative interviews. These women had previously completed a clinical alcohol intervention trial and had consented to be contacted in the future for study-related purposes. The biopsychosocial model was used to frame the interview questions that assessed multiple determinants of drinking behavior and helped explain linkages to broader health constructs. Results: A total of 20 women with HIV and hazardous drinking completed the qualitative interview. Several factors were identified by the women as influential in their decision to participate in the WHAT-IF? study, such as the ability to quit or reduce their drinking to nonhazardous levels (biological), the ability to gain knowledge or a greater understanding of the negative effects of hazardous drinking on HIV disease progression (psychological), and peer pressure and monetary compensation (social). Also, the women identified factors (positive or negative) associated with their clinical trial experience, such as the effects of the study medication on the woman's body (biological), thoughts and feelings toward study procedures (i.e. medication, lab work, study assessments) and the length of the study (psychological), and the interactions with the WHAT-IF? Study staff (social). Conclusion: Recruiting and retaining women with HIV in alcohol intervention research remains a challenge. Findings from this study suggest that women with HIV who are hazardous drinkers may benefit from participating in research studies that could help them to reduce or quit their drinking, increase their knowledge about specific behavior changes, and earn monetary compensation. Also, positive staff interactions may be instrumental in retaining minority women in alcohol intervention research.
Firing activity of locus coeruleus noradrenergic neurons decreases in necdin-deficient mice, an animal model of Prader–Willi syndrome
Authors: Wu Rui-Ni , Hung Wei-Chen , Chen Ching-Tsuey , Tsai Li-Ping , Lai Wen-Sung , Min Ming-Yuan , Wong Shi-Bing
Published: July 2020

Background: Prader–Willi syndrome (PWS) is a neurodevelopmental disorder characterized by multiple respiratory, cognitive, endocrine, and behavioral symptoms, such as central apnea, intellectual disabilities, exaggerated stress responses, and temper tantrums. The locus coeruleus noradrenergic system (LC-NE) modulates a diverse range of behaviors, including arousal, learning, pain modulation, and stress-induced negative affective states, which are possibly correlated with the pathogenesis of PWS phenotypes. Therefore, we evaluated the LC-NE neuronal activity of necdin-deficient mice, an animal model of PWS.Methods: Heterozygous necdin-deficient mice (B6.Cg-Ndntm1ky) were bred from wild-type (WT) females to generate WT (+m/+p) and heterozygotes (+m/−p) animals, which were examined of LC-NE neuronal activity, developmental reflexes and plethysmography.Results: On slice electrophysiology, LC-NE neurons of Ndntm1ky mice with necdin deficiency showed significantly decreased spontaneous activities and impaired excitability, which was mediated by enhanced A-type voltage-dependent potassium currents. Ndntm1ky mice also exhibited the neonatal phenotypes of PWS, such as hypotonia and blunt respiratory responses to hypercapnia.Conclusions: LC-NE neuronal firing activity decreased in necdin-deficient mice, suggesting that LC, the primary source of norepinephrine in the central nervous system, is possibly involved in PWS pathogenesis.
Identification of Potential Crucial Genes in Atrial Fibrillation: A Bioinformatic Analysis
Authors: Zhang Junguo , Huang Xin , Wang Xiaojie , Gao Yanhui , Liu Li , Li Ziyi , Chen Xuejiao , Zeng Jie , Ye Zebing , Li Guowei
Published: July 2020

Background Atrial fibrillation (AF) is at least partially heritable, affecting 2-3% of the population in Europe and the USA. However, a substantial proportion of heritability is still lacking. In the present study, we aim to identify potential crucial genes associated with AF through bioinformatic analyses of public datasets. Methods Microarray data sets of GSE115574, GSE31821, GSE79768, GSE41177 and GSE14975 from the Gene Expression Omnibus (GEO) database were retrieved. After merging all microarray data and adjusting batch effect, differentially expressed genes (DEGs) were identified. Functional enrichment analyses based on Gene Ontology (GO) resource, Kyoto Encyclopedia of Genes and Genomes (KEGG) resource, Gene Set Enrichment Analysis (GSEA), Reactome Pathway Database and Disease Ontology (DO) were carried out. Protein-protein interaction (PPI) network was constructed using the STRING database. Combined with aforementioned significant bioinformatics information, potential crucial genes were subsequently selected. The comparative toxicogenomics database (CTD) was carried out to explore the interaction between potential crucial genes and AF. Result We identified 27 of DEGs with gene expression fold change (FC) ≥ 1.5 or ≤ 2/3 (|log2 FC| ≥ 0.58) and 5 with FC ≥ 2 or ≤ 0.5 (|log2 FC| ≥ 1) of AF patients compared with sinus rhythm controls. The most significantly enriched pathway was regulation of insulin-like growth factor transport and uptake by insulin-like growth factor binding proteins. IGFBP2, C1orf105, FHL2, CHGB, ATP1B4, IGFBP3, SLC26A9, CXCR4 and HTR2B were considered the potential crucial genes. CTD showed CXCR4, IGFBP2, IGFBP3 and FHL2 had higher scores with AF. Conclusions The 9 potential crucial genes, especially CXCR4, IGFBP2, IGFBP3 and FHL2 , may be associated with risk of AF. Our study provided new insights of AF into genetics, molecular pathogenesis and new therapeutic targets.
Comparison of adenocarcinoma and adenosquamous carcinoma prognoses in Chinese patients with FIGO stage IB-IIA cervical cancer following radical surgery
Authors: Zhang Xiaojing , Lv Zunfu , Xu Xiaoxian , Yin Zhuomin , Lou hanmei
Published: July 2020

Background. To compare adenocarcinoma (AC) and adenosquamous carcinoma (ASC) prognoses in patients with FIGO stage IB–IIA cervical cancer who underwent radical hysterectomy.Methods. We performed a retrospective analysis of 240 patients with AC and 130 patients with ASC. Kaplan–Meier curves, Cox regression models, and log-rank tests were used for statistical analysis.Results. Patients with ASC had higher frequencies of lymphovascular space invasion (LVSI) and serum squamous cell carcinoma antigen (SCC-Ag) > 5 ng/ml (p=0.049 and p=0.013, respectively); moreover, they were much older (P=0.029) than patients with AC. There were no clinically significant differences in overall survival (OS) between the groups. When stratified into three risk groups based on clinicopathological features, survival outcomes did not differ between patients with AC and those with ASC in any risk group. Multivariate analysis showed that lymph node metastasis (LNM) was an independent risk factor for recurrence-free survival (RFS) and OS in patients with AC and in patients with ASC. Carcinoembryonic antigen (CEA) > 5 ng/ml and SCC-Ag > 5 ng/ml were independent predictors of RFS and OS in patients with AC. In addition, among those stratified as intermediate-risk, patients with ASC who received concurrent chemoradiotherapy (CCRT) had significantly better RFS and OS (P=0.036 and P=0.047, respectively). Conclusions. We did not find evidence to suggest that AC and ASC subtypes of cervical cancer were associated with different survival outcomes. CCRT is beneficial for survival in intermediate-risk patients with ASC, but not in those with AC. Serum tumour markers can assist in evaluating prognosis and in providing additional information for patient-tailored therapy for cervical AC.
Electrochemical assessment of pigments-binding medium interactions in oil paint deterioration: a case study on indigo and Prussian blue
Authors: Doménech-Carbó Antonio , Doménech-Carbó María Teresa , Osete-Cortina Laura , Donnici Margherita , Guasch-Ferré Nuria , Gasol-Fargas Rosa M. , Iglesias-Campos Manuel Ángel
Published: July 2020

The degradation of laboratory oil paint film specimens containing indigo and Prussian blue pigments and pictorial samples from the Sant Francesc de Paula painting exhibited in the Tomàs Balvey Arxiu Museum (Cardedeu (Catalonia), Spain) has been studied by voltammetry of immobilized particles. This technique, combined with light microscopy, scanning electron microscopy-energy dispersive X-ray analysis, nanoindentation-atomic force microscopy, attenuated total reflectance-Fourier-transform infrared spectroscopy and gas chromatography-mass spectroscopy techniques permits the proposal of a dual scheme for the degradation of the pigments when naturally aged and submitted to accelerated UVA aging. Under conditions of moderate temperature, humidity and natural illumination, and low gradients of these parameters, Prussian blue acts as a radical scavenger moderating the production of reactive oxygen species produced in the oil binding medium by the action of ultraviolet radiation, resulting in the formation, in the solid state, of the solid-solution, {KFeIII[FeII(CN)6]}x{FeIII[FeIII(CN)6]}1–x, known as Berlin green, which then promotes the formation of indigo adducts with radicals. In several localized areas of the Sant Francesc de Paula paint showing strong degradation, Prussian blue acts as a promoter of the indigo oxidation to isatin, thus resulting in a considerable chromatic shift.
Direct comparison of brain [18F]FDG images acquired by SiPM-based and PMT-based PET/CT: phantom and clinical studies
Authors: Wagatsuma Kei , Sakata Muneyuki , Ishibashi Kenji , Hirayama Akira , Kawakami Hirofumi , Miwa Kenta , Suzuki Yukihisa , Ishii Kenji
Published: July 2020

Background: The silicon photomultiplier-positron emission tomography (SiPM-PET) developed by GE Healthcare has better sensitivity, spatial resolution, and timing resolution than photomultiplier tubes (PMT)-PET. The present study aimed to clarify the advantages of SiPM-PET in 18F-fluoro-2-deoxy-D-glucose ([18F]FDG) brain imaging in a head-to-head comparison with PMT-PET in phantom and clinical studies. Methods: Image contrast was calculated from images acquired from a Hoffman 3D brain phantom and image noise and uniformity were calculated from pooled images acquired from a pool phantom using SiPM- and PMT-PET. Sequential PMT-PET and SiPM-PET [18F]FDG images were acquired over a period of 10 min from 22 controls and 10 patients. All images were separately normalized to a standard [18F]FDG PET template, then mean standardized uptake values (SUVmean) and Z-score were calculated by MIMneuro and CortexID Suite, respectively. Results: Image contrast, image noise, and uniformity in SiPM-PET changed 19.2%, 3.5%, and -40.0% from PMT-PET, respectively. These physical indices of both PET scanners satisfied the criteria for acceptable image quality published by the Japanese Society of Nuclear Medicine of > 55%, ≤ 15% and ≤ 0.0249, respectively. The contrast in SiPM-PET was slightly improved using TOF. The SUVmean using SiPM-PET was significantly higher than PMT-PET and did not correlate with a time delay. Z-scores were also significantly higher in images acquired from SiPM-PET (except for the bilateral posterior cingulate) than PMT-PET because the peak signal that was extracted by the calculation of Z-score in CortexID Suite was raised. The area of hypometabolism in statistical maps was reduced and localized by SiPM-PET compared with PMT-PET regardless of whether the images were derived from controls or patients. Conclusions: The improved spatial resolution and sensitivity of SiPM-PET contributed to better image contrast and uniformity in brain [18F]FDG images. The SiPM-PET offers better quality and more accurate quantitation of brain PET images. The SUVmean and Z-score in SiPM-PET was higher than PMT-PET due to improving the PVEs. [18F]FDG images acquired using SiPM-PET will help to improve diagnostic outcomes based on statistical image analysis becausethe SiPM-PET would localize the distribution of glucose metabolism on Z-score maps.
Development of risk factor-based scoring system for detection of hypervirulent Klebsiella pneumoniae bloodstream infections.
Authors: Togawa Atsushi , Yoshimura Michinobu , Tokushige Chiemi , Matsunaga Akira , Takata Tohru , Takamatsu Yasushi
Published: July 2020

Background

Hypervirulent Klebsiella pneumoniae (HVKp) infections have distinct clinical manifestations from classical K. pneumoniae infections. The hallmark of HVKp infections are liver abscess formation and metastatic infections. Due to the severe sequelae of these complications, method to identify patients at-risk of HVKp infections should be developed.

Results

A retrospective cohort study of 222 patients with K. pneumoniae bloodstream infections (BSIs) was performed. Patient demographics, clinical manifestations, and bacterial characteristics were investigated. Ten cases of liver abscesses were identified. Characteristics such as community-onset BSIs, hypermucoviscosity phenotype, and capsular serotype K1 were identified as risk factors for HVKp infections. A scoring system was developed based on the risk factors. The area under the receiver operating characteristic curve for the scoring system was 0.90. A score of >2 points provided sensitivity and specificity of 0.70 and 0.94, respectively.

Conclusions

Simple scoring system was developed for the diagnosis of HVKp infections. The system allows early identification of patients with K. pneumoniae BSIs in whom hypervirulent infections should be evaluated. Prospective evaluation is expected.
Experience of Massive Distance Online Education for Medical Colleges and Universities in China to Counter the COVID-19 Pandemic
Authors: Zhao Jiyang , Xiao Hai , Li Yong , Wen Da , Xu Peixiang , Fu Yao , Piao Jie , Liu Jiangheng , Cao Depin , Zhong Zhaohua , Zhao Guang
Published: July 2020

Background

As the COVID-19 outbreak influenced teaching in China, Chinese medical colleges and universities carried out massive online education with the participants of more than one million students on the for-profit or non-profit big–data teaching platforms, based on existing online teaching resources and other ways such as MOOC, Micro-course, Live-course and interactive discussion.
Methods

A questionnaire survey was conducted via two rounds of 56-in-total questions on overall situations, platforms, teaching methods, training, teachers and students’ experiences, and encountered problems for 1747 teachers and 7223 students, which involved 741 courses. Comparative analysis was done on the survey results.
Results

A majority of teachers and students were satisfied with teaching platforms and effects; large commercial teaching platforms could provide better services; 67.21% of teachers and 64.67% of students preferred live teaching; only 76.84% of teachers and 58.69% of students were systematically trained; weak network, lack of training, overcrowded access to teaching platforms, lack of interaction, lack of efficient real-time evaluation and fatigue were current difficulties.
Conclusions

Good results of massive distance online education and teachers and students’ satisfaction with teaching platform performance show that online education can be used as a main means to replace traditional classroom education in emergency situations.
A synergistic bactericidal effect of low-frequency and low-intensity ultrasound combined with levofloxacin-loaded PLGA nanoparticles on M. smegmatis in macrophages
Authors: Xie Shuang , Li Gangjing , Hou Yuru , Yang Min , Li Fahui , Li Jianhu , Li Dairong , Du Yonghong
Published: July 2020

Purpose: Tuberculosis (TB) is a highly infectious disease caused by Mycobacterium tuberculosis (Mtb), which often parasites in macrophages. This study is performed to investigate the bactericidal effect and underlying mechanisms of low-frequency and low-intensity ultrasound (LFLIU) combined with levofloxacin-loaded PLGA nanoparticles (LEV-NPs) on M. smegmatis (a surrogate of Mtb) in macrophages.Methods and results: The LEV-NPs were prepared using a double emulsification method. The average diameter, zeta potential, polydispersity index, morphology, and drug release efficiency in vitro of the LEV-NPs were investigated. M. smegmatis in macrophages was treated using the LEV-NPs combined with 42 kHz ultrasound irradiation at an intensity of 0.13 W/cm2 for 10 min. The results showed that ultrasound significantly promoted the phagocytosis of nanoparticles by macrophages (p < 0.05). In addition, further ultrasound combined with the LEV-NPs promoted the production of reactive oxygen species (ROS) in macrophage, and the apoptosis rate of the macrophages was significantly higher than that of the control (p < 0.05). The transmission electronic microscope showed that the cell wall of M. smegmatis was ruptured, the cell structure was incomplete, and the bacteria received severe damage in the ultrasound combined with the LEV-NPs group. Activity assays showed that ultrasound combined with the LEV-NPs exhibited a 10-fold higher antibacterial activity against M. smegmatis residing inside macrophages compared with the free drug.Conclusion: These data demonstrated that ultrasound combined with LEV-NPs has great potential as a therapeutic agent for TB.
IL-6 gene rs12700386 Polymorphism is Associated with Increased Risk of Knee Osteoarthritis Development in Chinese Han Population: A Case-Control Study
Authors: Yang Hui , Zhou Xindie , Xu Dongmei , Chen Gang
Published: July 2020

Background: There is an association between Interleukin-6 (IL-6) polymorphism and knee osteoarthritis (OA) risk. The case-control study aims at exploring how IL-6 rs12700386 polymorphism affects the knee OA risk in Chinese Han individuals.Methods: We extracted the DNA from 763 participants, thereinto, 352 were OA patients and 411 were healthy controls. The polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assisted in genotyping the IL-6 gene polymorphism. The relative expression exhibited by IL-6 in blood samples of knee OA patients was determined via a quantitative reverse transcription PCR (qRT-PCR). Results: We found that IL-6 rs12700386 enhanced the knee OA susceptibility. Based on a subgroup analysis, the loci magnified the knee OA risk in smokers, drinkers, and subjects ≥ 55 years old or with BMI ≥ 25 kg/m2. The combination of smoking and drinking and rs12700386 genotype led to an increase in the knee OA risk, indicating an underlying interaction between gene and environment. Additionally, the rs12700386 was found to be related to increased IL-6 gene levels. Conclusion: These data indicate that rs12700386 polymorphism of IL-6 gene led to an increase in the knee OA risk specific to Chinese Han individuals.
Does The Taste of The Plain Packaged Cigarettes in Saudi Arabia Really Changed and Differ from The Branded Cigarettes or it is A Natural Sensory Change? Experimental Study
Authors: Dhim Nasser F Bin , Basyouni Mada H , Althumiri Nora A , Almubarak Rasha A. , Banjar Weam , Zamakhshary Mohammed , AlKattan Khaled M.
Published: July 2020

Background: Does the taste of the plain packaged cigarettes recently implemented in Saudi Arabia really changed and differ from the branded cigarettes or it is a natural sensory Methods: 18 adult smokers, who are currently smoking cigarettes and cleared upon physical assessment before the experiment. Participants were excluded if they were planning to quit smoking or in quitting stage or have any respiratory or cardiac disease, any taste related disorder (e.g. hypogeusia / ageusia) or any acute disease that affect taste or smell (e.g. Flu). Participants who shows any abnormal vital signs check before the study (fever, shortness of breath or elevated blood pressure). Participants received 6 sequences of different random exposures (3 puffs) to 3 plain packaged cigarettes (2 from the favorite brand and 1 other brand “control”) and 3 branded cigarettes (2 from the favorite brand and 1 other brand “control”). Participants wore Virtual Reality Goggles (VR) accompany with a special software to alter the visual reality and wore gloves to alter the touch sensation.Results: Participants were not able to identify the correct type of cigarettes (plain or branded (Estimate of fixed effect -0.01 p=0.79). Moreover, there were no differences in the ability of the participants to identify their favorite brand t(-0.63) mean=0.47 p = 0.53. Conclusion: After controlling the visual and touch sensation participants were not able to difference between branded and plain packaged cigarettes in terms of taste or inducing immediate shortness of breath or cough. Interestingly, participants were not able to identify their favorite brand.
Dental Caries in Association With Viral Load in Children Living With HIV in Phnom Penh, Cambodia
Authors: Kikuchi Kimiyo , Yasuoka Junko , Tuot Sovannary , Okawa Sumiyo , Yem Sokunthea , Chhuon Pheak , Murayama Makoto , Huot Chantheany , Yi Siyan
Published: July 2020

Background: Oral health status is known to be associated with overall health among people living with HIV. However, it is unclear whether dental caries is associated with viral load among this population. In particular, dental caries among children living with HIV needs to be better understood, as this can affect their overall health and well-being in future. This study assessed the association between dental caries and viral load among children living with HIV in Phnom Penh, Cambodia. Methods: This cross-sectional study was conducted at the National Paediatric Hospital as a baseline survey of a randomized controlled trial. The study population included children living with HIV aged 3–15 years and their primary caregivers. We collected data on the children’s oral health status by oral examination and the latest HIV viral load data stored in the patients’ information system of the hospital. Multiple logistic regression analysis was conducted to assess association between dental caries and viral load. The cut-off point of undetectable viral load was set at <40 copies/mL. Results: Data from 328 children were included in the analyses. Moreover, 68.3% had an undetectable viral load. The mean number of permanent or deciduous teeth with caries was 7.7 (standard deviation [SD], 5.0). In the regression analysis, dental caries in permanent or deciduous teeth were positively associated with detectable viral load (adjusted odds ratio [AOR]: 1.07, 95% confidence interval [CI]: 1.01, 1.14). Having received antiretroviral therapy ≥1 year and self-reported excellent adherence to the antiretroviral drug were also negatively associated with detectable viral load. Among children with detectable levels of viral load, dental caries in permanent or deciduous teeth were also positively associated with non-suppression of viral load (>1000 copies/mL) (AOR: 1.12, 95% CI: 1.03, 1.23). Conclusions: Dental caries was associated with viral load status detection among children living with HIV. This finding suggests that oral health status may affect the immune status of the children. Oral health of children living with HIV should be strengthened, and further research is needed to clarify the causal relationship between viral load and oral health status.
Secukinumab leads to shifts from stage-based towards response-based disease clusters- Comparative data from very early and established psoriatic arthritis
Authors: Kampylafka Eleni , Tascilar Koray , Lerchen Veronika , Linz Christina , Sokolova Maria , Zekovic Ana , Kleyer Arnd , Simon David , Rech Juergen , Sticherling Michael , Schett Georg , Hueber Axel
Published: July 2020

Background. Limited information exists about the very early forms of psoriatic arthritis. In particular, differences and responsiveness of patient-reported outcomes (PROs) in very early as compared to established PsA have not been investigated to date.Methods. Cross-sectional and prospective longitudinal evaluation of PROs related to pain (VAS), physical function (HAQ-DI, SF-36 physical), mental function (SF-36 mental), impact of psoriatic skin (DLQI), joint (PsAID) and global disease (VAS) in two small prospective observational studies on secukinumab 300mg over 6 months in very early disease patients (IVEPSA study; N=20) and established PsA (PSARTROS study; N=20). Cluster analysis was performed at baseline and 24-weeks follow-up.Results. While responses in pain and physical activity-related PROs to secukinumab were more pronounced in established PsA than very early disease, effects on PROs related to general health perception, as well as those related to emotional and mental well-being, were modified in a similar way in very early disease and established PsA. Cluster analysis based on global disease activity and PROs showed that baseline clusters reflected very early disease and established PsA, while after secukinumab treatment these clusters were abolished and new clusters based on differential responses to physically and mentally-oriented PROs formed.Conclusions. Inhibition of IL-17A by secukinumab leads to comprehensive improvement of general health perception and mental well-being in very early and established PsA, while overall responses in pain and physical activity are more pronounced in established disease. Most importantly, treatment restructures the original patients clusters based on disease stage and leads to the formation of new clusters that reflect their response in physical and mental-orientated PROs.Trial Registration: NCT02483234, Registered 26 June 2015, retrospectively registered
Response to treatment with Intra-articular triamcinolone hexacetonide and triamcinolone acetonide in oligo articular Juvenile Idiopathic arthritis
Authors: Masoud Rana , Jeelani Wajiha , Agbor Barbine Tchamba Agbor , Hennon Teresa , Wrotniak Brian H , Abdul-Aziz Rabheh
Published: July 2020

Background:Oligo-articular juvenile idiopathic arthritis (Oligo JIA) is the most common subtype of juvenile idiopathic arthritis. Intra-articular corticosteroid (IAC) injection is a mainstay treatment of oligo JIA providing pain relief, improving mobility and preventing further joint destruction in the majority of patients. In 2015, production of triamcinolone hexacetonide (TH) an intra-articular corticosteroid was discontinued in the United States leading to use of triamcinolone acetonide (TA) as an alternative. In this study, we compared response to treatment in children with oligo JIA who underwent therapy with intra-articular TA and TH injection.Methods:Our study is a retrospective chart review of children with oligo JIA who were treated with IAC injections with TH between January 2012 and June 2015 and TA between J uly 2015 and December 2018. The two groups were followed at John R. Oishei Children’s Hospital of Buffalo and were evaluated for response to treatment, side effects and predictors of response including duration of disease before treatment, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP). Response to treatment was defined as at least 6 months follow up without evidence of active arthritis in injected joints. Patients were considered to be non-responders if they continued to show active arthritis during their first follow up after joint injection. The primary objective was to evaluate whether there was a significant difference in rate of response between TH and TA.Results:Forty-nine patients, 38 female and 11 male with oligo JIA were included in the study. The average age was 6.7 years. A total of 111 joints were injected includin g 78 knees, 13 ankles, 9 wrists, 4 hips, 4 elbows, 2 TMJ and one subtalar joint. In the TA group, 49% (29/59) did not show response to injection compared to 27% (14/52) in the TH group. After 6 months, response rates were better for individuals injected with TH compared to TA (73% vs. 51%). In general, response to intra-articular TH was superior to TA with P = .016 using chi-square test of independence. This difference in outcome was not influenced by other variables such as duration of illness before treatment (P value 0.784) or elevated ESR and CRP. No difference in side effects between the two groups were noted.Conclusion:Our results in conjunction with prior published data suggests that TH intra-articular joint injection in oligo JIA is superior to TA, although future controlled trials are necessary for confirmation. An effective, long lasting treatment can have a great impact on the outcome of these children.
Effects of Sequential and Simultaneous Double Elicitation on Aloe-Emodin Production in Cassia Tora Root Cultures
Authors: Teptat Palin , Tansakul Pimpimon , Sakunphueak Athip
Published: July 2020

Cassia tora root cultures were established to study anthraquinone production and as an alternative source of anthraquinone. In this study, several plant defence-based techniques were used to enhance aloe-emodin production in Cassia tora root cultures. Elicitation and the initial optimisation of exposure time and culture age suggested that 100 mg/L yeast extract was the most efficient elicitor, with the highest efficiency during early to mid-stationary growth phase. The elicited root produced approximately 2.7-2.9 folds-improvement in aloe-emodin content when compared with the control. The efficiency of the elicitor tended to increase along with the exposure time. Extending the elicitation period to the end of culture cycle (9-10 days) increased the production up to 6.21 times (5.740 ± 0.584 mg/gDW). Simultaneous double elicitation and sequential double elicitation also showed their effectiveness on aloe-emodin production. Aloe-emodin production was improved up to 9.09 times higher than the control by a simultaneous add-on of 50 mg/L chitosan with 100 mg/L yeast extract. Meanwhile, sequential elicitation of 50 mg/L chitosan for 24 hours prior to elicitation by yeast extract improved the production up to 11.27 times higher than the control. Both treatment styles exhibited a particular advantage toward the extracellular accumulation, which might facilitate the use of two-phase culture or in conjunction with other enhancing techniques.
Rapid Adaptation and Continuous Performance Evaluation of SARS-CoV-2 Envelope Gene (E-gene) Real-Time RT-PCR Assays to Support the Hospital Surge in Test Demand
Authors: Ho Yolanda Iok Ieng , Wong Ann Han , Leung Eddie Chi Man , Wong River Chun Wai , Lai Raymond Wai Man
Published: July 2020

We describe timely adaption of both published WHO E-gene protocol and commercially available LightMix Modular E-gene assay to the test platform (ABI 7900 Fast real-time analyzer and TaqMan Fast One-step Virus Master Mix) available in an accredited tertiary hospital laboratory with on-going evaluation to ensure provision of quality service within time constraint. The LightMix Modular E-gene was slightly more sensitive when compared to the WHO E-gene, both analytically and diagnostically. The assay was recommended for screening of SARS-CoV-2 infection. With the availability of technically competent staff through continuous training, provision of round the clock service is feasible despite the test is of high complexity. The shorten turn-around-time of about 4 hours per batch could support surges in testing demand, which is essential to control the current SARS-CoV-2 pandemic, to prevent potential overwhelming of the healthcare system and to optimize utilization of the isolation beds.
Key facets to build up eHealth and mHealth interventions to enhance physical activity, sedentary behavior and nutrition in healthy subjects – An umbrella review
Authors: Fiedler Janis , Eckert Tobias , Wunsch Kathrin , Woll Alexander
Published: July 2020

BackgroundElectronic (eHealth) and mobile (mHealth) health interventions can provide a large coverage, and are promising tools to change health behavior (i.e. physical activity, sedentary behavior and healthy eating). However, the determinants of intervention effectiveness in primary prevention has not been explored yet. Therefore, the objectives of this umbrella review were to evaluate intervention effectiveness, to explore the impact of pre-defined determinants of effectiveness (i.e. theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions), and to provide recommendations for future research and practice in the field of primary prevention delivered via e/mHealth technology.MethodsPubMed, Scopus, Web of Science and the Cochrane Library were searched for systematic reviews and meta-analyses (reviews) published between January 1990 and May 2020. Reviews reporting on e/mHealth behavior change interventions in physical activity, sedentary behavior and/or healthy eating for healthy subjects were included if they also investigated respective theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions. Included studies were ranked concerning their methodological quality and qualitatively synthesized.ResultsThe systematic search reveled eleven systematic reviews and meta-analyses of moderate quality. The majority of original research studies within the reviews found e/mHealth interventions to be effective, but the results showed a high heterogeneity concerning assessment methods and outcomes, making them difficult to compare. Whereas theoretical foundation and behavior change techniques were suggested to be potential positive determinants of effective interventions, the impact of social context remains unclear. None of the reviews included just-in-time adaptive interventions.ConclusionFindings of this umbrella review support the use of e/mHealth to enhance physical activity and healthy eating and reduce sedentary behavior. The general lack of precise reporting and comparison of confounding variables in reviews and original research studies as well as the limited number of reviews for each health behavior constrains the generalization and interpretation of results. Further research is needed on study-level to investigate effects of versatile determinants of e/mHealth efficiency, using a theoretical foundation and additionally explore the impact of social contexts and more sophisticated approaches like just-in-time adaptive interventions.Trial registrationThe protocol for this umbrella review was a priori registered with PROSPERO: CRD42020147902.
A Systematic Review Assessing the Under-Representation of Elderly Adults in COVID-19 Trials
Authors: Prendki Virginie , Tau Noam , Avni Tomer , Falcone Marco , Huttner Angela , Kaiser Laurent , Paul Mical , Leibovici-Weissmann Yaara , Yahav Dafna
Published: July 2020

BackgroundCoronavirus disease (COVID-19) has caused a pandemic threatening millions of people worldwide. Yet studies specifically assessing the geriatric population are scarce. We aimed to examine the participation of elderly patients in therapeutic or prophylactic trials on COVID-19.MethodsIn this review, randomized controlled trials (RCTs; n=12) comparing therapeutic or prophylactic interventions registered on preprint repositories and/or published since December 2019 were analyzed. We aimed to describe the age of included patients, the presence of an upper age limit and of adjusted analyses on age, any exclusion criteria that could limit participation of elderly adults such as comorbidities, cognitive impairment, limitation of life expectancy; and the assessment of long-term outcomes such as the need of rehabilitation of institutionalization. Mean participant ages were reported and compared with observational studies.ResultsTwelve RCTs assessing drug therapy for COVID-19 were included. Mean age of patients included in RCTs was 56.3 years. An upper age limit was applied in three published trials (25%) and in 200/650 (31%) trials registered at clinicaltrials.gov. One trial reported a subgroup analysis in patients ≥65. Patients were excluded for liver-function abnormalities in eight trials, renal disease in six, cardiac disease or risk of torsade de pointes in five, and four for cognitive or mental criteria, which are frequent comorbidities in the oldest patients. Only three trials allowed a family member to provide consent. Patients enrolled in RCTs were on average 20 years younger than those included in large (n≥1000) observational studies. Seven studies had as their primary outcome a clinical endpoint, but none reported cognitive, functional or quality of life outcomes or need for rehabilitation or long-term care facility placement.ConclusionsElderly patients are clearly underrepresented in RCTs, although they comprise the population hardest hit by the COVID-19 pandemic. Long-term outcomes such as the need of rehabilitation or institutionalization were not reported. Future investigations should target specifically this vulnerable population.
“It’s worse with fellow patients… they judge you as evil”: Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda.
Authors: Ssekamatte Tonny , Isunju John Bosco , Muyanga Naomi , Buregyeya Esther , Mugambe Richard K , Wanyenze Rhoda K. , Bukenya Justine Nnakate
Published: July 2020

Background

Trans-women sex workers bear the greatest brunt of HIV and other sexually transmitted infections (STI). Trans-women are 49 times more at risk of HIV infections compared to the general population. However, they remain underserved and continue to grapple with challenges in access to and utilisation of HIV/STI prevention services. Our study explored the barriers to access and utilisation of HIV/STI prevention services and associated coping mechanisms.

Methodology

This exploratory qualitative study was conducted among trans-women sex workers in the Greater Kampala Metropolitan area, Uganda. Twenty-two in-depth interviews, six key informant interviews and nine focus group discussions were conducted to obtain data on barriers to access and utilisation of HIV and other STI prevention and care services, and coping strategies of trans-women sex workers. Data were analysed through thematic analysis under a hybrid of inductive and deductive approaches.

Results

Barriers to access and utilisation of HIV/STI prevention and care services were classified as individual, community and health system barriers. Individual barriers included internalised stigma and low socio-economic status. Health system barriers included discrimination by some healthcare providers, stigmatisation by fellow patients, stockout of lubricants drugs and other medical supplies, inadequate access to trans-specific STI drugs, and high cost of drugs. Community barriers comprised social exclusion and lack of recognition by other key population groups, and transphobia. The coping strategies included the use of substitutes such as lotions, avocado, egg white or yoghurt to cope with a lack of lubricants. Herbs were used as substitutes for STI drugs, while psychoactive substances were used to cope with stigma and discrimination, and changing the dress code to mimic gender identity.

Conclusion

Trans-women sex workers grapple with access to HIV/STI prevention and care services. Individual, community and healthcare facility level barriers hindered trans-women sex workers from access and utilisation of HIV/STI prevention and care services. There is a need to create an enabling environment in order to enhance access to and utilisation of HIV/STI prevention and care services for trans-women sex workers through sensitisation of healthcare providers, other key population groups and the community on the transgender identity.
Association Between Serum Lactate Level During Cardiopulmonary Resuscitation and Survival in Adult Out-of-Hospital Cardiac Arrest: A Multicenter Cohort Study (The Critical Study in Osaka, Japan)
Authors: Nishioka Norihiro , Kobayashi Daisuke , Izawa Junichi , Irisawa Taro , Yamada Tomoki , Yoshiya Kazuhisa , Park Changhwi , Nishimura Tetsuro , Ishibe Takuya , Yagi Yoshiki , Kiguchi Takeyuki , Kishimoto Masafumi , Inoue Toshiya , Hayashi Yasuyuki , Sogabe Taku , Morooka Takaya , Sakamoto Haruko , Suzuki Keitaro , Nakamura Fumiko , Matsuyama Tasuku , Okada Yohei , Matsui Satoshi , Hirayama Atsushi , Yoshimura Satoshi , Kimata Shunsuke , Shimazu Takeshi , Kitamura Tetsuhisa , Kawamura Takashi , Iwami Taku
Published: July 2020

Background: Serum lactate reflects hypoxic insult in many conditions, but its role as prognostic markers after cardiac arrest is still controversial. This study aimed to investigate the association between serum lactate levels during cardiopulmonary resuscitation (CPR) and survival in patients with out-of-hospital cardiac arrest (OHCA).Methods:We analyzed the data of the Osaka Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study, a prospective multicenter observational study of 14 participating institutions in Osaka Prefecture, Japan that enrolled consecutive OHCA patients. We included adult nontraumatic OHCA patients transported to the hospital with ongoing CPR from 2013 to 2017. Based on the serum lactate levels during CPR, the patients were divided into four quartiles: Q1 (lactate ≤ 10.6 mEq/L), Q2 (10.6 < lactate ≤ 14.1 mEq/L), Q3 (14.1 < lactate ≤ 18.0 mEq/L), and Q4 (lactate > 18.0 mEq/L). The primary outcome of this study was 1-month survival. Results:A total of 11,960 patients were registered and 4,978 of them were eligible for our analyses. The Q1 group had the highest 1-month survival (4.3% [53/1,245]), followed by Q2 (2.5% [31/1,245]), Q3 (1.1% [14/1,328]), and Q4 (0.5% [6/1,160]) groups. In the multivariable logistic regression analysis, the proportion of 1-month survival in the Q4 group was significantly lower than that in the Q1 group (adjusted odds ratio 0.21; 95% confidence interval 0.086 to 0.50). One-month survival decreased in a stepwise manner as the quartiles increased (p for trend <0.001). In subgroup analysis, there was a significant interaction between initial rhythm and survival (p for interaction <0.001); 1-month survival of patients with a non-shockable rhythm decreased when the lactate levels increased (p for trend <0.001), but not in patients with a shockable rhythm (p for trend =0.76).CONCLUSION:High serum lactate level during CPR was associated with poor 1-month survival in OHCA patients. Serum lactate may be one of the effective prognostic indications for OHCA during CPR, especially in patients with non-shockable rhythm.
FMT for chronic intestinal obstruction caused by constrictive pericarditis: a case report
Authors: Chen Huan , Wang ZiJie , Hu Qing , Deng Mingming , Lü MuHan , LUO GANG
Published: July 2020

A 62-year-old man presented to our department with repeated vomiting, abdominal pain, bloating, and constipation. Echocardiography and computed tomography revealed his thickened pericardium with multiple eggshell-like calcifications, and incomplete intestinal obstruction. Colonoscopy showed extensive focal erosions in the colonic mucosa. After fecal microbiota transplantation, the patient's nutritional status was improved, intestinal obstruction was relieved, and his cardiac function his was restored. This case may provide a new option for the treatment of refractory incomplete intestinal obstruction.