bluuebunny/crossref_metadata_2025 huggingface dataset:
An immunoinformatic approach driven by experimental proteomics: in silico design of a subunit candidate vaccine targeting secretory proteins of Leishmania donovani amastigotes
Authors: Khan Md Anik Ashfaq , Ami Jenifar Quaiyum , Faisal Khaledul , Chowdhury Rajashree , Ghosh Prakash , Hossain Faria , Wahed Ahmed Abd El , Mondal Dinesh
Published: March 2020

Background: Visceral leishmaniasis (VL) caused by dimorphic Leishmania species is a parasitic fatal disease with high socio-economic burden in endemic areas worldwide. Sustaining control of VL in terms of proper and prevailing immunity development is a global necessity amid unavailability of a prophylactic vaccine. Screening of experimental proteome of human disease propagating form of L. donovani (amastigote) can be more pragmatic for in silico mining of novel vaccine candidates. Methods: By using an immunoinformatic approach, CD4+ and CD8+ T cell specific epitopes from experimentally reported L. donovani proteins having secretory potential and increased abundance in amastigotes were screened. A chimera linked with a toll-like receptor 4 (TLR4) peptide adjuvant was constructed and evaluated for physicochemical characteristics, binding interaction with TLR4 in simulated physiological condition and the trend of immune response following hypothetical immunization.Results: Selected epitopes from physiologically important L. donovani proteins were found mostly conserved in L. infantum- covering theoretically more than 98% of global population. The multi-epitope chimeric vaccine was predicted as stable, antigenic and non-allergenic. Structural analysis of vaccine-TLR4 receptor docked complex and its molecular dynamics simulation suggest sufficiently stable binding interface along with prospect of non-canonical receptor activation. Simulation dynamics of immune response following hypothetical immunization indicate active and memory B as well as CD4+ T cell generation potential, and likely chance of a more Th1 polarized response.Conclusions: The methodological approach and results from this study could facilitate more informed screening and selection of candidate antigenic proteins for entry into vaccine production pipeline in future to control human VL.
A benchmark study of ab initio gene prediction methods in diverse eukaryotic organisms
Authors: Scalzitti Nicolas , Jeannin-Girardon Anne , Collet Pierre , Poch Olivier , Thompson Julie Dawn
Published: March 2020

Background: The draft genome assemblies produced by new sequencing technologies present important challenges for automatic gene prediction pipelines, leading to less accurate gene models. New benchmark methods are needed to evaluate the accuracy of gene prediction methods in the face of incomplete genome assemblies, low genome coverage and quality, complex gene structures, or a lack of suitable sequences for evidence-based annotations. Results: We describe the construction of a new benchmark, called G3PO (benchmark for Gene and Protein Prediction PrOgrams), designed to represent many of the typical challenges faced by current genome annotation projects. The benchmark is based on a carefully validated and curated set of real eukaryotic genes from 147 phylogenetically disperse organisms, and a number of test sets are defined to evaluate the effects of different features, including genome sequence quality, gene structure complexity, protein length, etc. We used the benchmark to perform an independent comparative analysis of the most widely used ab initio gene prediction programs and identified the main strengths and weaknesses of the programs. More importantly, we highlight a number of features that could be exploited in order to improve the accuracy of current prediction tools. Conclusions: The experiments showed that ab initio gene structure prediction is a very challenging task, which should be further investigated. We believe that the baseline results associated with the complex gene test sets in G3PO provide useful guidelines for future studies.
The Natural History of Infantile Neuroaxonal Dystrophy
Authors: Altuame Fadie D , Foskett Gretchen , Atwal Paldeep , Endemann Sarah , Midei Mark , Milner Peter , Salih Mustafa A , Hamad Muddathir , Al-Muhaizea Mohammad , Hashem Mais , Alkuraya Fowzan S
Published: March 2020

Background Infantile neuroaxonal dystrophy (INAD) is a rapidly progressive neurodegenerative disorder of early onset causing premature death. It results from biallelic pathogenic variants in PLA2G6 , which encodes a calcium‐independent phospholipase A2. Objective We aim to outline the natural history of INAD and provide a comprehensive description of its clinical, radiological, laboratory, and molecular findings. Materials and Methods We comprehensively analyzed the charts of 28 patients: 16 patients from Riyadh, Saudi Arabia, 8 patients from North and South America and 4 patients from Europe with a molecularly confirmed diagnosis of PLA2G6 ‐associated neurodegeneration (PLAN) and a clinical history consistent with INAD. Results In our cohort, speech impairment and loss of gross motor milestones were the earliest signs of the disease. As the disease progressed, loss of fine motor milestones and bulbar dysfunction were observed. Temporo-frontal function was among the last of the milestones to be lost. Appendicular spastic hypertonia, axial hypotonia, and hyperreflexia were common neurological findings. Other common clinical findings include nystagmus (60.7%), seizures (42.9%), gastrointestinal disease (42.9%), skeletal deformities (35.7%), and strabismus (28.6%). Cerebellar atrophy and elevations in serum AST and LDH levels were consistent features of INAD. There was a statistically significant difference when comparing patients with non-sense/truncating variants compared with missense/in-frame deletions in the time of initial concern (p = 0.04), initial loss of language (p = 0.001), initial loss of fine motor skills (p = 0.009), and initial loss of bulbar skills (p = 0.007). Conclusion INAD is an ultra-rare neurodegenerative disorder that presents in early childhood, with a relentlessly progressive clinical course. Knowledge of the natural history of INAD may serve as a resource for healthcare providers to develop a targeted care plan and may facilitate the design of clinical trials to treat this disease.
PGRMC1 effects on metabolism, genomic mutation and CpG methylation imply crucial roles in animal biology and disease
Authors: Thejer Bashar M. , Adhikary Partho P. , Teakel Sarah L. , Fang Johnny , Weston Paul A. , Gurusinghe Saliya , Anwer Ayad G. , Gosnell Martin , Jazayeri Jalal A. , Ludescher Marina , Gray Lesley-Ann , Pawlak Michael , Wallace Robyn H. , Pant Sameer D. , Wong Marie , Fischer Tamas , J. Elizabeth , Fehm Tanja N. , Neubauer Hans , Goldys Ewa M. , Quinn Jane C. , Weston Leslie A. , CAHILL Michael
Published: March 2020

Background: Progesterone receptor membrane component 1 (PGRMC1) is often elevated in cancers, and exists in alternative states of phosphorylation. A motif centered on PGRMC1 Y180 was evolutionarily acquired concurrently with the embryological gastrulation organizer that orchestrates vertebrate tissue differentiation.Results: Here, we show that mutagenic manipulation of PGRMC1 phosphorylation alters cell metabolism, genomic stability, and CpG methylation. Each of several mutants elicited distinct patterns of genomic CpG methylation. Mutation of S57A/Y180/S181A led to increased net hypermethylation, reminiscent of embryonic stem cells. Pathways enrichment analysis suggested modulation of processes related to animal cell differentiation status and tissue identity, as well as cell cycle control and ATM/ATR DNA damage repair regulation. We detected different genomic mutation rates in culture.Conclusions: A companion manuscript shows that these cell states dramatically affect protein abundances, cell and mitochondrial morphology, and glycolytic metabolism. We propose that PGRMC1 phosphorylation status modulates cellular plasticity mechanisms relevant to early embryological tissue differentiation.
A Community–Based System Dynamics Approach for Understanding Factors Affecting Mental Health and Health Seeking Behaviors in Beirut and Beqaa Regions of Lebanon
Authors: Noubani Aya , Diaconu Karin , ghandour Lilian , Koussa Maria El , Loffreda Giulia , Saleh Shadi
Published: March 2020

Background

Available evidence on mental health and psychosocial problems in Lebanon is limited. Recent quantitative data suggests a high prevalence among Syrian refugees and their Lebanese host communities, with significant treatment gaps in both populations. This study aims to determine how Lebanese host and Syrian refugee communities perceive mental health, and identify health seeking behaviors and barriers to health access in two contrasting contexts of fragility.

Methods

A comparative qualitative study design was adopted whereas a total of 36 semi-structured interviews with Lebanese host and Syrian refugees’ community members were conducted followed by a series of four participatory group model building (GMB) sessions. Participants were recruited from two contrasting fragility contexts: Beirut and Beqaa regions. During these sessions, causal loop diagrams were elicited depicting shared understandings of factors prompting the onset of mental health and psychosocial issues; health seeking behaviors, pathways and elements affecting the rate of health improvement and maintenance were also identified.

Results

Community members in both settings had similar perceptions of factors contributing to mental health. Participants named long-term effects of exposure to wars, political and social effects of conflicts and financial constraints at the household level as precipitating factors prompting the onset of mental health and psychosocial stressors. Gender and integration related challenges between communities were identified as factors that affect condition onset and associated care seeking. Pathways for health seeking were found to be shaped by trust, the advice and support of loved ones, and the need to ensure confidentiality of affected individuals. Recurrent themes in discussion included significant delays in health seeking from the formal health system and widespread social stigma, prohibitive service costs, lack of health coverage, limited awareness of mental health service availability and trust in the quality of service as major barriers to access.

Conclusion

Mental health and psychosocial support strategies need to be gender- and integration-sensitive, primarily focused on condition prevention and awareness raising in order to strengthen health-seeking behaviors.
Deep learning-based dental plaque detection on primary teeth: a comparison with clinical assessments
Authors: You Wenzhe , Hao Aimin , Li Shuai , Wang Yong , Xia Bin
Published: March 2020

Background: Dental plaque is the cause of many common oral diseases (e.g., caries, gingivitis, and periodontitis). Therefore, the detection and control of dental plaque are of great significance to children’s oral health. The objectives of this study are to design an artificial intelligence (AI) model based on deep learning to detect dental plaque on primary teeth and evaluate the diagnostic accuracy of the AI model.Methods: A conventional neural network (CNN) framework was adopted, and a total of 886 photos of primary teeth taken by an intraoral camera (1280×960 pixels; TPC Ligang, Shenzhen, China) were used to train the AI model. To validate the clinical feasibility, 98 photos of primary teeth taken by the intraoral camera were assessed by the AI model. Additionally, tooth photos were acquired using a digital camera (3216×2136 pixels, Canon EOS 60D, Japan). One experienced pediatric dentist looked at these photos and marked the regions the photos containing dental plaque. Then, a plaque-disclosing agent was applied, and the areas of dental plaque were identified. After a week, the dentist drew the dental plaque area on the 98 photos taken by the digital camera a second time to evaluate the consistency of manual diagnosis. In another round of comparison, 102 photos of primary teeth taken by the same intraoral camera were marked to denote the dental plaque area obtained both by the AI model and by the pediatric dentist to evaluate the diagnostic ability of each approach based on photos with lower-resolution (fewer pixels) than those taken by the digital camera. The mean intersection-over-union (MIoU) metric was employed to indicate the detection accuracy.Results: The MIoU for the detection of dental plaque on the tested tooth photos was 0.726 ± 0.165.The MIoU of the dentist when diagnosing the 98 photos taken by the digital camera for the first time was 0.695 ± 0.269, while after one week, the MIoU of the dentist was 0.689 ± 0.253. Compared to the dentist, the AI model demonstrated a higher MIoU (0.736 ± 0.174), and the results did not change after a week. When both the dentist and the AI model assessed the 102 photos taken by the intraoral camera. the MIoU of the pediatric dentist was 0.652 ± 0.195, and the MIoU of the AI model was 0.724 ±0.159. The results of a paired t-test found no significant difference between the AI model and human specialist (P > .05) in diagnosing dental plaque on primary teeth.Conclusions: The AI model showed clinically acceptable performance in detecting dental plaque on primary teeth compared with an experienced pediatric dentist. This finding illustrates the potential application in adopting such AI technology for helping children improve their oral health.
CD59 receptor targeted delivery of miRNA-1284 and Cisplatin-loaded liposomes for effective therapeutic efficacy against cervical cancer cells
Authors: Wang Li , Liang Ting-Ting
Published: March 2020

Co-delivery of two different therapeutics (miRNA-1284 and cisplatin (CDDP)) into the cancer cells in a single nanocarrier provides new dimension to the cancer treatment. In this study, we have designed the CD59sp-conjugated miRNA-1284/cisplatin(CDDP)-loaded liposomes for the enhanced therapeutic effect against cervical cancers. Compared with miRNA-1284/CDDP-loaded liposomes (LP-miCDDP), CD59 antibody-conjugated LP-miCDDP (CD/LP-miCDDP) showed a significantly higher cytotoxicity in HeLa cells. Notably, MiR-1284 showed a typical concentration-dependent cell killing effect in the cervical cancer cells owing to the downregulation of HMGB1. Flow cytometer analysis showed that CD/LP-miCDDP resulted in maximum apoptosis effect (~60%) compared to CDDP (~20%) or miR-1284 (~12%) treated cells indicating the superior anticancer effect in the cancer cells. Importantly, CD/LP-miCDDP significantly prolonged the blood circulation of encapsulated drug in rats with significantly higher AUC (o-t) , t 1/2 and lower CL compared to that of free CDDP. Overall, results demonstrated that targeted and synergistic co-delivery of therapeutic components could be promising in cervical cancer therapy.
Genomic sequence analysis of Dissulfurirhabdus thermomarina SH388 and proposed reassignment to Dissulfurirhabdaceae fam. nov.
Authors: Ward Lewis M , Bertran Emma , Johnston David T.
Published: March 2020

Here, we report the draft genome sequence of Dissulfurirhabdus thermomarina SH388. Improved phylogenetic and taxonomic analysis of this organism using genome-level analyses supports assignment of this organism to a novel family within the Desulfobacterota phylum. Additionally, comparative genomic and phylogenetic analyses contextualize the convergent evolution of sulfur disproportionation and potential extracellular electron transfer in this organism relative to other members of the Desulfobacterota.
Spatial Differences of Overweight and Obesity among Schoolchildren in Shandong Province, China
Authors: Han Lizhen , Fu Maosun , Liu Yihua , Jia Jinzhu , Wang Lu
Published: March 2020

Background The spatial differences and related factors of overweight and obesity among schoolchildren in Shandong province were analyzed, aiming to provide scientific basis for prevention of childhood obesity and the adoption of targeted intervention policies. Methods The sample came from Shandong province's physical examination data in 2017. A total of 10.27 million schoolchildren aged 6-18 years were included. ArcGIS software (hot spot analysis) was used to explore the spatial differences, and regional influencing factors were analyzed by multinomial logistic regression. Results The prevalence of overweight and obesity among schoolchildren aged 6-18 years were 17.93% and 6.79%, respectively. Moreover, boys/girls, urban/rural areas both showed that the former rate was higher than the latter, and the 9-11 age group was confirmed to have the highest prevalence. Regional distribution illustrated that, in Shandong province, the areas with high prevalence of overweight and obesity were mainly concentrated in the central, northern and eastern parts, and the hot spots clusters were located in Yantai and Weihai, while the low-value areas were aggregated in the western (boys) and southern (girls) regions. Further exploration revealed that total retail sales of consumer goods (CGTRS) and per capita disposable income (PCDI) were confirmed as risk factors for regional obesity level, while number of full-time teachers (FTT) was a protective factor. Conclusions The spatial differences of overweight and obesity are statistically significant and influenced by some regional factors, suggesting that relevant departments should adopt targeted interventions when relevant strategies are made.
Media Reporting on Air Pollution: Health risk and precautionary measures in national and regional newspapers
Authors: Ramondt Steven , Ramirez A. Susana
Published: March 2020

Background Exposure to air pollution is one of the primary global health risk factors, yet individuals lack the knowledge to engage in individual risk mitigation and the skills to mobilize for change necessary to reduce such risks. The news media are an important tool for influencing individual actions and support for public policies to reduce environmental threats; thus, a lack of news coverage of such issues may exacerbate knowledge deficits. This study examines the reporting of health risk and precautionary measures regarding air pollution in national and regional print news using an environmental health literacy perspective.Methods We conducted a content analysis of two national (New York Times and Washington Post) and two local newspapers (Fresno Bee and Bakersfield Californian) newspapers covering the country’s most polluted region, California’s San Joaquin Valley, during a 5-year period (2011-2015). Using a constructed week sampling approach, 276 newspaper articles were coded for information on threat, efficacy information, and information sources.Results News coverage of air pollution mostly failed to mention human health risks. Moreover, fewer than 10 percent of news stories about air pollution provided information on the precautionary measures necessary for individuals to take action to mitigate their risk. Despite being located in one of the most polluted areas in the US, local newspapers did not report significantly more threat and efficacy information. News coverage of air pollution consistently missed opportunities to raise environmental health literacy.Conclusions Although air pollution levels are high and continue to rise at alarming rates, our findings suggest that news media reporting is not conducive to raising environmental health literacy. Public health advocates and health promotion experts must develop more effective strategies for disseminating information about the health risks of air pollution, balancing the need for recognizing the structural causes of poor air quality and the actions individuals and communities can take to reduce air pollution related morbidity and mortality. National and local news media may be useful partners for such dissemination.
Uptake of provider-initiated HIV and syphilis testing among Heterosexual STD Clinic attendees in Southern China: Results from a Cross-sectional Study
Authors: Zhao Peizhen , Zheng Heping , Tang Weiming , Cheng Huanhuan , Huang Shujie , Yang Bin , Wang Cheng
Published: March 2020

Background Provider-initiated HIV and syphilis testing and counseling (PITC) services are important components of HIV and syphilis prevention programs. However, PITC guidelines have neither been formalized nor widely implemented in China. Limited studies conducted to identify the barriers to offering PITC services from sexually transmitted diseases (STD) clinic attendees’ perspective. We conducted a cross-sectional survey on heterosexual STD clinic attendees to evaluate this in China.Methods A cross-sectional survey was conducted in 2016 in Southern China. Participants completed a validated questionnaire including social-demographic information, reasons for not conducting HIV and syphilis testing, and HIV and STD infection history. In this study, we limited the participants as individuals who self-identified as heterosexual.Results A total of 1943 participants were recruited in this study. Among those participants, 60.6% (1177/1943) and 74.3% (1443/1943) conducted HIV testing and syphilis testing during the study, respectively. Of whom, 2.2% (26/1177) and 21.5% (310/1443) are found to be HIV-positive and syphilis-positive, respectively. The most common barrier to HIV and syphilis testing is a lack of awareness of HIV and syphilis infection. Condom use in the last sexual act, having paid sex during the last 6 months, and receiving HIV and STD related knowledge were positively associated with uptake of both HIV and syphilis testing.Conclusions This study highlights the need and importance of promoting provider-initiated HIV and syphilis testing and counseling services in China. Future studies on exploring innovative methods to improve the knowledge and awareness of HIV and syphilis infection among STD clinic attendees is warranted.
Predictors of lost to follow-up in a “test and treat” programme among adult women with high-risk sexual behavior in Kampala, Uganda.
Authors: Kamacooko Onesmus , Mayanja Yunia , Bagiire Daniel , Namale Gertrude , Hansen Christian Holm , Seeley Janet
Published: March 2020

Background: Immediate uptake of antiretroviral therapy (ART) after an HIV-positive diagnosis (Test and Treat) is now being implemented in Uganda. Data are limited on lost to follow-up (LTFU) in high-risk cohorts that have initiated ‘Test and Treat’. We describe LTFU in a cohort of women of high-risk sexual behaviour who initiated ART under “Test and Treat”. Methods: We performed a retrospective cohort study of participant records at the Good Health for Women Project (GHWP) clinic, a clinic in Kampala for women at high-risk of HIV-infection. We included HIV positive women ≥ 18 years who initiated ART at GHWP between August 2014 and March 2018. We defined LTFU as not taking an ART refill for ≥3 months from the last clinic appointment among those not registered as dead or transferred to another clinic. We used the Kaplan-Meier technique to estimate time to LTFU after ART initiation. Predictors of LTFU were assessed using a multivariable Cox proportional hazards model. Results: The mean (±SD) age of the 293 study participants was 30.3 (± 6.5) years, with 274 (94%) reporting paid sex while 38 (13%) had never tested for HIV before enrolment into GHWP. LTFU within the first year of ART initiation was 16% and the incidence of LTFU was estimated at 12.7 per 100 person-years (95%CI 9.90-16.3). In multivariable analysis, participants who reported sex work as their main job at ART initiation (Adjusted Hazards Ratio [aHR] =1.95, 95%CI 1.10–3.45), having baseline WHO clinical stage III or IV (aHR= 2.75, 95% CI 1.30–5.79) were more likely to be LTFU. Conclusion LTFU in this cohort is high. Follow up strategies are required to support women on Test and Treat to remain on treatment, especially those who engage in sex work and those who initiate ART at a later stage of disease. Keywords: Universal Test and Treat, Women at high-risk, lost to follow-up, loss to follow-up; sub-Saharan Africa.
Evaluation of the effect of an "Internet plus medical"-based health management service model in patients with nonalcoholic fatty liver disease
Authors: Yang Yan , Tian Cui-Huan , Dai Jun , Zhang Wei , Li Shu-Qing , Min Xiang , Wang Yan-Yan , Cao Juan
Published: March 2020

Objectives To observe the effect of an "Internet plus medical"-based health management service model in patients with nonalcoholic fatty liver disease (NAFLD) and to explore an effective model for NAFLD health management to provide a reference for NAFLD treatment and nursing.Methods A total of 519 patients with NAFLD were randomly assigned to a routine health education group (N=258) or a health management platform group (N=261). The routine health education group received routine health education, and the health management platform group was treated with the "Internet plus medical"-based health management service model to manage NAFLD. The new model provides closed-loop services for the prevention and rehabilitation of NAFLD through the process of grouping, filing, evaluating, planning, intervening, assessing stage and following up. The two groups were observed for 24 weeks. The results of basic indicators, laboratory indicators, body composition analyses, controlled attenuation parameters (CAP) and quality of life assessment questionnaires were used as evaluation indices. All data of the participants were collected and analyzed prior to and following the intervention, and the differences between the two groups were compared.Results Compared with the routine health education group, the NAFLD health management service model based on “Internet plus medical” treatment effectively reduced the weight, body mass index (BMI), CAP, aspartate transaminase (AST)/alanine aminotransferase (ALT) value, body fat content and visceral fat area of NAFLD patients (P =0.047, 0.031, 0.044, 0.037 and 0.047, respectively) and improve the quality of life of NAFLD patients in terms of physiological role, energy and general health (P=0.027, 0.001 and 0.044, respectively).Conclusions The results of the present study preliminarily confirm the validity and development prospects of the new NAFLD management service model. This finding suggests that the model is an evidence-based model of health education and management for NAFLD prevention in China.
The Experiences of Merging Health Insurance Funds in Turkey, Thailand, South Korea and Indonesia: What lessons can be learned?
Authors: Bazyar Mohammad , Yazdi-Feyzabadi Vahid , Rashidian Arash , Behzadi Anahita
Published: March 2020

Background: Fragmentation in health insurance system can obstruct reaching universal health coverage’ objectives and may lead to inequity in financial and organizational access to health care services. One possible option to overcome this challenge is merging the existing insurance funds together. This article aims to review the experience of Turkey, Thailand, South Korea and Indonesia regarding merging which can be very useful for other countries which are looking for ways of enhancing their health systems. Methods: The present study is a cross-country comparative analysis. The first criterion to choose these countries was with experience of the policy of merging. The second criterion was diversity in health insurance systems. To find the most relevant documents about the subject, different sources of information were searched including books, scientific papers, reports, policy documents and documents published by international organizations such as WHO and World Bank. We followed snowball sampling method to reach out for further documents by checking the reference list of the most relevant documents. We also contacted the authors with the most relevant articles in the selected countries to introduce and provide us with more articles or publications about the subject. Results: The experience of Turkey, Thailand, South Korea and Indonesia show that different reasons may force policy makers to move towards merging and reducing the number of health insurance funds; different stakeholders may support or oppose merging based on the interests they may have in the current fragmented health insurance system; various positive and negative consequences may occur in the health system as the result of merging. The experience of these countries also emphasize that in order to accelerate and facilitate implementation process of merger and face less operational challenges, there should be some prerequisites such as experiencing reliable economic growth to enhance benefit package and support the single national insurance scheme financially after merging. Conclusions: Merging is not the panacea to all problems of health system and other contributing health reforms should be implemented simultaneously or sequentially in other aspects of health system if merging is going to pave the way reaching universal health coverage.
A survey about the contents and features of oncology clinical pharmacy services and self-evaluations of the oncology pharmacists in China
Authors: Wang Yan-Ting , Dai Yuan-Yuan , Yang Jun , Zhou Hai-Yan , Chen Zhe , Li Guo-Hui
Published: March 2020

Background: With the growing number of oncology patients and novel anti-tumor medications, the demand of oncology clinical pharmacy services is increasing rapidly in China. However, the current status of oncology clinical pharmacy services in China were seldom reported. The purpose of the study was to investigate the contents and features of oncology clinical pharmacy services and self-evaluations of the oncology pharmacists in China, and to identify related problems for its further development. Methods: A 55-item online questionnaire was distributed to oncology-related clinical pharmacists in Chinese hospitals in January 2019. Pharmacists answered the questions on the WeChat platform. Data were analyzed using descriptive statistics. Results: The respondents of the 166 valid questionnaires were from 29 provinces (or autonomous regions or municipalities). Their average working experience for clinical pharmacy was 4.86 years. The average duration of their clinical services was 3.27 hours/day. The clinical pharmacy services consist of 15 types and their workload on each service type were identified. Pharmacists thought they were not good at establishing pharmacotherapy protocols, participating in therapeutic drug monitoring, pharmacy consultation and pharmacogenetic/pharmacogenomic service. About 80% (81.33%) of the pharmacists thought other healthcare professionals knew the nature of their work, and some services were very welcomed by clinical departments. The biggest barrier for career development of the pharmacists was insufficiency of professional skills. In most cases, the clinical service accounted for less than 30% of the overall performance evaluation of the pharmacists. Most of the participating pharmacists were not satisfied with their current salary. The overall evaluation score for their career wellbeing was 6.27 out of 10. Conclusions: The value of oncology clinical pharmacists is being increasingly recognized, but advanced services need further expansion. Increasing the time serving in clinical units, optimizing performance evaluation and strengthening their skills are possible ways for pharmacists to provide superior services. This study showed the current service of oncology clinical pharmacists in most parts of China, which may provide reference for policy makers, promote international communications and shed light on future development of oncology clinical pharmacy in China. Key words: Oncology, pharmacist, clinical pharmacy services, self-evaluation, survey, China
Black Women’s Psychosocial Experiences with Seeking Surgical Treatment for Uterine Fibroids: Implications for Clinical Practice
Authors: VanNoy Brianna N , Bowleg Lisa , Marfori Cherie , Moawad Gaby , Zota Ami R.
Published: March 2020

Background
Black women are disproportionately impacted by uterine fibroids and are more likely to undergo surgical treatment for fibroids compared with non-Black women. However, few studies have characterized the psychosocial experiences of Black women seeking treatment for fibroids. This study aimed to identify factors that shape Black women’s fibroid management decisions; explore how discrimination based on race, class, and gender feature in treatment-seeking experiences; and compare experiences by age and socioeconomic status (SES).
Methods
We conducted semi-structured interviews with 37 Black premenopausal women, undergoing either a hysterectomy or myomectomy for fibroids at an academic medical center. We used a thematic analysis to code transcripts and identify themes.
Results
Participants were predominately single, highly educated, and privately insured. Respondents reported that patient-doctor interactions, support from social networks, fertility consequences, and fear of fibroid malignancy influenced their fibroid management decisions. Their knowledge and perceptions of fibroids were also influenced by social and community norms and differed by SES; women of higher SES had greater fibroid awareness than women of lower SES. Discrimination was discussed in the context of historical inequity against Black women, with one participant questioning whether Black women were valued less in clinical settings compared with non-Black women. While several women discussed positive experiences seeking fibroids care, others expressed medical mistrust or said that alternative management options were not offered by clinicians.
Conclusions
Fibroid management decisions were influenced not only by individual-level interactions with clinicians and social networks, and concerns about fertility and fibroid malignancy, but also by broader social and historical conditions. These findings suggest that clinicians should deliver culturally-competent gynecologic care that centers the voices of Black women and acknowledges the diverse perspectives and perceptions that Black women may have when seeking fibroid treatment.
Clinical Characteristics of Patients with 2019 Coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study
Authors: Zhao Xin-Ying , Xu Xuan-Xuan , Yin Hai-Sen , Hu Qin-Ming , Xiong Tao , Tang Yuan-Yan , Yang Ai-Ying , Yu Bao-Ping , Huang Zhi-Ping
Published: March 2020

Background: Since December, 2019, the 2019 Coronavirus disease (COVID-19) from Wuhan, China, has caused outbreak in China with more than 70,000 people infected and more than 2,000 people dead. The clinical characteristics of COVID-19 patients in non-Wuhan areas of Hubei province have not been described. Methods : We retrospectively analyzed the clinical characteristics and treatment progress of 91 patients diagnosed with COVID-19 in Jingzhou Central Hospital. Results: Of the 91 patients diagnosed with COVID-19, 30 (33.0%) cases were severe and two (2.2%) patients died. The severe patients tended to be older (50.5 vs 42.0, P=0.049), and have more chronic disease (40% vs 14.75%, P=0.009), compared to mild group. Only 67.0% of the patients were quantitative polymerase chain reaction (qPCR) positive on their first tests, while typical chest computed tomographic (CT) images were obtained for each patient. The most common complaints were cough (75, 82.4%), fever (59, 64.8%), fatigue (35, 38.5%), and diarrhea (14, 15.4%). Injuries outside the respiratory tract were identified by elevated levels of aspartate aminotransferase (18, 19.8%), creatinine (5, 5.5%) and creatine kinase (14, 15.4%) in laboratory tests. In sum, 28 (30.8%) cases suffered injuries outside the respiratory system, including 50% of the critically ill patients and 21.3% of the mild patients.Conclusions: Overall, the mortality rate of patients in Jingzhou is lower than that of Wuhan. Importantly, we discovered liver, kidney, digestive tract and heart injury in COVID-19 cases besides respiratory problems. Combining Chest CT images with qPCR of throat swab samples would improve the accuracy of COVID-19 diagnose.
Hepatitis B virus infection among men who have sex with men and transgender women living with or at risk for HIV: A cross sectional study in Abuja and Lagos, Nigeria.
Authors: ADEYEMI Olusegun A. , MITCHELL Andrew , SHUTT Ashley , CROWELL Trevor A. , NDEMBI Nicaise , KOKOGHO Afoke , RAMADHANI Habib O. , ROBB Merlin L. , BARAL Stefan D. , AKE Julie A. , CHARURAT Manhattan E. , PEEL Sheila , Nowak Rebecca G
Published: March 2020

Background Despite the development of a safe and efficacious hepatitis B vaccine in 1982, the hepatitis B virus (HBV) remains a public health burden in sub-Saharan Africa. Due to shared risk factors for virus acquisition, men who have sex with men (MSM) and transgender women (TGW) living with HIV are at increased risk of HBV. We estimated the prevalence of HBV and associated factors for MSM and TGW living with or without HIV in Nigeria. Methods Since March 2013, TRUST/RV368 has recruited MSM and TGW in Abuja and Lagos, Nigeria using respondent driven sampling. Participants with HIV diagnosis, enrollment as of June 2015, and available plasma were retrospectively tested for hepatitis B surface antigen and HBV DNA. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with prevalent HBV infection. Results A total of 717 MSM and TGW had a median age of 25 years (interquartile range [IQR]: 21-27), 5% self-reported HBV vaccination, 61% were living with HIV, 10% had prevalent HBV infection and 6% were HIV-HBV co-infected. HIV mono-infected as compared to HIV-HBV co-infected had a higher median CD4 T cell count [425 (IQR: 284-541) vs. 345 (IQR: 164-363) cells/mm 3 , p=0.03] and a lower median HIV RNA viral load [4.2 (IQR: 2.3-4.9) vs. 4.7 (IQR: 3.9-5.4) log 10 copies/mL, p<0.01]. The only factor independently associated with HBV was self-report of condomless sex at last anal intercourse (OR: 2.2, 95% CI: 1.3, 3.6). HIV infection was not independently associated with HBV (OR: 1.0, 95% CI: 0.7-1.6). Conclusion HBV prevalence was moderately high but did not differ by HIV in this cohort of MSM and TGW. Condomless sex was associated with elevated HBV risk, reinforcing the need to increase communication and education on condom use among key populations in Nigeria. Evaluating use of concurrent HIV antiretroviral therapy with anti-HBV activity may confirm the attenuated HBV prevalence for those living with HIV.
Impact of immediate postpartum insertion of TCu380A on the quantity and duration of lochia discharges in Tanzania
Authors: Muganyizi Projestine Selestine , Kimario Grasiana Festus , Rwegoshora France John , Paul Patrick Ponsian , Makins Anita
Published: March 2020

Background The insertion of Intrauterine Contraceptive Device (PPIUD) for the purpose of contraception immediately after delivery is becoming popular in countries where the use of IUD for contraception has been extremely low. Since 2015, Tanzania implemented the initiative by the International Federation of Gynecology and Obstetrics (FIGO) to institutionalize PPIUD. As a result of capacity building and information delivery under the initiative, there have been increased uptake of the method. Working in this context, the focus of the study was to generate evidence on the effect of TCu380A IUD on amount and duration of lochia and equip service providers with evidence-based knowledge so as to minimize unnecessary interventions and method discontinuation.Objective Establish impact of postpartum TCu380A on amount and duration of lochia.Methods A prospective cohort study of delivered women in two teaching hospitals in Tanzania with immediate insertion of TCu380A or without use of postpartum contraception in 2018. TCu380A models; Optima (Injeflex Co. Brazil) and Pregna (Pregna International, Chakan, India) were used. Follow-up was done by weekly calls and examination at 6 th week. Lochia was estimated by Likert Scale 0-4 relative to the amount of lochia on the delivery day. An estimated 250 women sample (125 each group) would give 80% power to detect a desired difference. Data analysis was by intention to treat using SPSS.Results 275 women were analysed, 142 exposed and 133 unexposed. Medical complaints were reported by 41 (28.9%) exposed and 37 unexposed (27.8%), p=0.655. Lack of dryness by end of 6 th week was to 32 (22.5%) exposed and 8 (6.0%) unexposed, p<0.001. Exposures had higher weekly mean lochia scores throughout with varience most marked in week 5 (F=3.818, p<0.001) and week 6 (F=2.949, p=0.004).Conclusion PPIUD is associated with increased amount of lochia and slows progression to dryness within 6 weeks of delivery. The implications of excess amount and duration of lochia in care of PPIUD clients are discussed.
Quantifying the individual variability in people’s exposure to mosquito bites in Burkina Faso
Authors: Guglielmo Federica , Sanou Antoine , Churcher Thomas S , Ferguson Heather M , Ranson Hilary , Sherrard-Smith Ellie
Published: March 2020

BackgroundThe Cascades Region, Burkina Faso, has high malaria burden despite reported high insecticide treated bed net (ITN) use. Human and vector activities outside the hours when indoor interventions offer direct protection from infectious bites potentially increase exposure risk to bites from malaria-transmitting Anopheles mosquitoes. We investigate the degree of variation in human behaviour both between individuals and through time (season) to quantify how it impacts exposure to malaria vectors.MethodsPatterns in human overnight activity (18:00-06:00) to quantify time spent using an ITN across 7 successive nights in two rural communities, Niakore (N = 24 participants) and Toma (71 participants), were observed in the dry and rainy seasons, between 2017-2018. Hourly human landing Anopheles mosquito catches were conducted in Niakore specifically, and Cascades Region generally, between 2016-2017. Data were statistically combined to estimate seasonal variation in time spent outdoors and Anopheles bites received per person per night (bpppn).ResultsSubstantial variability in exposure to outdoor Anopheles bites was detected within and between communities and across seasons. In October, when Anopheles densities are highest, an individual’s risk of Anopheles bites ranged from 2.2 to 52.2 bpppn within the same week with variable risk dependent on hours spent indoors. Comparably higher outdoor human activity was observed in April and July but, due to lower Anopheles densities estimated bpppn were 0.2 – 4.7 bpppn, and 0.5 – 32.0 respectively. Males and people aged over 21 years were predicted to receive more bites in both sentinel villages.ConclusionThis work presents one of the first clear descriptions of the degree of heterogeneity in time spent outdoors between people and across the year. Appreciation of sociodemographic, cultural and entomological activities will help refine approaches to vector control.
The association between dyslipidemia and the incidence of chronic kidney disease in the general Zhejiang population: a retrospective study
Authors: Liang Xudong , Ye Meiyu , Tao Mei , Zheng Danna , Cai Ruyi , Zhu Yifan , Jin Juan , He Qiang
Published: March 2020

Background According to the "lipid nephrotoxicity hypothesis", there is now significant research being conducted in this area. By studying the role of hyperlipidemia in chronic kidney disease in the general Zhejiang population, we aimed to explore the correlation between changes in blood lipid levels and chronic kidney disease.Methods We collected and analyzed clinical data from ordinary residents who participated in the annual comprehensive physical examination with no overt kidney disease in Zhejiang Provincial People's Hospital, China from January 2011 to December 2016. According to triglyceride, total cholesterol and low-density lipoprotein levels, participants were respectively divided into 4 groups. Statistical methods were used to evaluate the correlation between different blood lipid profiles and chronic kidney disease.Results 5,183 participants were included in our study. During the six-year follow-up period, 227 participants (4.4%) developed chronic kidney disease. The odds ratio for incident chronic kidney disease was 3.14 (95%CI: 1.53–6.43) in Q3, 3.84 (95%CI: 1.90–7.76) in Q4 according to the total cholesterol group and 1.17 (95%CI: 1.04–1.32) in Q3, 1.40 (95%CI: 1.11–2.48) in Q4 according to the low-density lipoprotein group, respectively, after multivariable-adjusted analyses. According to the triglyceride grouping, the odds ratio for incident chronic kidney disease was 2.88 (95%CI: 1.29-6.43) in Q2, 2.92 (95%CI: 1.44–6.57) in Q3 and 3.08 (95%CI: 1.11–6.69) in Q4, after multivariable-adjusted analyses.Conclusion Increased triglycerides and high levels of total cholesterol and low-density lipoprotein were independently associated with an increased likelihood of eGFR decline and development of incident chronic kidney disease in the general Zhejiang population.
Adaptation and psychometric testing of the Hoarding Rating Scale (HRS): A self-administered screening scale for epidemiological study in Chinese population
Authors: Liu Tai Wa , LAM Simon Ching , Chung Man Hon , Ho Ken Hok Man
Published: March 2020

Background: Hoarding disorder is a chronic and debilitating illness associated with restrictions on activities of daily living, compromised social and occupational functioning, and adverse health outcomes. However, researchers lack a brief and self-administered screening measurement to assess compulsive hoarding in the Chinese speaking population. This study aimed to adapt and validate the Hoarding Rating Scale-Interview (HRS-I) to as a tool for screening compulsive hoarding behavior in Chinese population.Methods: This study comprised two phases. During Phase 1, the English-language HRS-I was translated into Chinese (CHRS) (comprehensible for most Chinese speaking population, e.g., Cantonese & Mandarin) and subjected to an equivalence check. In Phase 2, the CHRS was validated by examining internal consistency, stability, and construct validity. Different samples were used appropriately to verify the items and reflect the psychometric properties. Results: In Phase 1, the CHRS yielded satisfactory content (CVI/AVE = 0.93) and face validity ratings (comprehensibility = 100%, N = 20 participants of general public with age 18-72) and the English and Chinese versions were found to be equivalent (ICC = 0.887; N = 60 university students and staff). Phase 2 revealed satisfactory levels of internal consistency (α=0.86; corrected item-total correlation = 0.60–0.74; N = 820 participants of general public), 2-week test-retest reliability (ICC = 0.78; N = 60 university students), and construct validity (one-factor CFA solution matched with the hypothesized model, χ2/d.f. = 2.26, CFI = 0.99, NFI = 0.99, RMSEA = 0.049, IFI = 0.99; n = 520 participants of general public). Conclusions: This study provides sufficient evidence of the reliability and validity of the CHRS for compulsive hoarding behavior screening in the Chinese population through self-administered method.