bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of anti-cancer and anti-tuberculosis treatments in lung cancer patients with active tuberculosis: a retrospective analysis
Authors: CHAI MEI , Shi Qingming
Published: August 2020

Background Lung tuberculosis (TB) and lung cancer have a complex relationship. Data concerning TB treatment in lung cancer patients are still incomplete. The aim of this study was to investigate the effects of anti-cancer and anti-tuberculosis treatments in lung cancer patients with active lung TB. Methods In a retrospective cohort study, lung cancer patients with active lung TB were identified between January 2013 and December 2016. Age- and sex-matched lung cancer patients without tuberculosis were selected as control subjects. Anti-cancer and anti-tuberculosis treatments were administered according to the national guidelines. The clinical courses and responses of lung cancer patients with and without active lung TB were examined and compared.Results A total of 31 consecutive lung cancer patients were diagnosed with active lung TB. Fifty-one lung cancer patients without TB were enrolled as control subjects. Most patients in the two groups were elderly, had advanced non-small cell lung cancer and had tumor burdens. The anti-cancer treatment completion rate and response rate were not different between two group (87.1% in TB treatment patients vs. 92.2% in lung cancer patients; 77.4% in TB treatment patients vs. 88.2% in lung cancer patients, respectively). The anti-tuberculosis treatment completion rate and success rate was 87.1% and 80.7%. The median survival times were not different between two groups (52 weeks in TB treatment patients vs. 57 weeks in lung cancer patients). The change in Karnofsky performance score was also not different between two groups. The most common side effect in TB treatment patients was liver injury (61.3%). The most serious side effect in TB treatment patients was leukocyte deficiency (9.7% in Grade 3). Both of side effects mentioned above were not different between two groups. Conclusion Both anti-cancer and anti-tuberculosis treatments can be safely and effectively administered in lung cancer patients with active lung TB. Attention should be paid to the risk of tuberculosis in lung cancer patients in TB high-burden countries.
Evolution of pathogen response genes associated with increased disease susceptibility during adaptation to an extreme drought in a Brassica rapa plant population
Authors: O'Hara Niamh Breda , Franks Steven J , Kane Nolan C , Tittes Silas , Rest Joshua S
Published: August 2020

BACKGROUND Pathogens are key components in natural and agricultural plant systems. There is evidence of evolutionary changes in disease susceptibility as a consequence of climate change, but we know little about the underlying genetic basis of this evolution. To address this, we took advantage of a historical seed collection of a Brassica rapa population, which we previously demonstrated evolved an increase in disease susceptibility to a necrotrophic fungal pathogen following a drought. RESULTS Previously, we combined a resurrection experiment with genome-wide sequencing of 124 pooled ancestral and descendant plants. Here, using these previously generated sequence data (Franks et al, 2016), we show that well-characterized necrotrophic fungal pathogen response (NFPR) genes have evolved, as indicated by changes in allele frequency, between ancestors and descendants, with several of them identified as extreme FST outliers. The jasmonic acid (JA) signaling pathway in particular seems to underlie the evolution of disease susceptibility, in addition to its well characterized role in plastic disease response. We identify a list of 260 genes that are both NFPR genes and are differentially expressed in response to drought, based on publicly available data. We present evidence that five of these genes evolved between ancestors and descendants, suggesting that the drought acted as the evolutionary driver, and that the accompanying increase in disease susceptibility may have been a consequence of genetic pleiotropy. CONCLUSIONS Our study provides evidence that for this population, standing variation in NFPR genes is affected by natural selection related to climate change. Our results reveal potentially important candidates that may underlie trait evolution in both crops and natural systems. Additionally, this trade-off between adaptation to biotic and abiotic stresses is an example of how climate change can have diverse and unexpected consequences.
Comparison of Out-of-pocket Expenditure and Catastrophic Health Expenditure for Severe Disease by Health Security System: based on End-stage Renal Disease in South Korea
Authors: Shin Sun Mi , Lee Hee Woo
Published: August 2020

Background: Korea's health security system named National Health Insurance and Medical Aid has revolutionized the nation's mandatory health insurance and continues to reduce excessive copayments. However, few have been studied on healthcare utilization and expenditure according to the health security system in case of severe disease. This study looked at reverse discrimination within End-stage Renal Disease between National Health Insurance and Medical Aid. Methods: Subjects were a total of 305 diagnosed with End-stage Renal Disease in Korea Health Panel from 2008 to 2013. Chi-square, t-test, and ANCOVA were conducted to identify healthcare utilization rate, out-of-pocket expenditure, and prevalence of catastrophic expenditure. Mixed effect panel analysis was used to evaluate total out-of-pocket expenditure over a 6-year trend by National Health Insurance and Medical Aid. Results: There were no significant differences in healthcare utilization rate in emergency-room visits, admission, or out-patient department visits between National Health Insurance and Medical Aid because healthcare service was essential for a serious disease such as End-stage Renal Disease. Meanwhile, each out-of-pocket expenditure for admission and out-patient department in National Health Insurance was 2.6 and 3.1 times higher than Medical Aid (P<0.05). A total of out-of-pocket expenditure including emergency-room visits, admission, out-patient department visits, and prescribed drug expenditure was 2.9 times higher in National Health Insurance than those of Medical Aid (P<0.001). Over a 6-year trend for a total of out-of-pocket expenditure, subjects with National Health Insurance spent more than those of Medical Aid (P<0.01). If total household income decile was less than the median and subjects were covered by National Health Insurance, the catastrophic health expenditure rate was 92.2%, but 58.8% in Medical Aid (P<0.001). Conclusion: Serious disease such as End-stage Renal Disease can result in reverse discrimination depending on the type of health security system. It is necessary to consider those who belong to National Health Insurance but are still poor.
Segmental artery clamping versus main renal artery clamping in nephron-sparing surgery: Updated meta-analysis
Authors: Xu Jinhong , Xu Shuxiong , Yao Biao , Xu Run , Xu YuanGao , Sun Fa , Qiu Qian , Shi Hua
Published: August 2020

Objectives Ischemia–reperfusion injury is harmful in partial nephrectomy (PN) in renal cell carcinoma. Choosing an appropriate surgical method is important to reduce ischemia–reperfusion injury. This study aimed to compare the effect of segmental artery clamping (SAC) and main renal artery clamping (MAC) on patients who underwent PN. Methods: Studies from January 2008 to November 2019 were identified by an electronic search of English and Chinese databases, including PubMed, Excerpt Medica Database, Cochrane Library, Wanfang, VIP, and Chinese National Knowledge Internet, without language restriction. Two reviewers were involved in the trial. The effects on operation time (OT), warm ischemia time (WIT), length of hospital stay (LOS), blood transfusion rate, postoperative complication rate, Clavien classification (≥3), and positive surgery margin (PSM) were evaluated using Stata software. Standardized mean difference (SMD, for continuous data) and pooled odds ratios (for count data) with 95% confidence interval (CI) were used as effect indicators. Results: Thirty-two studies were included. SAC decreased the 1-week (SMD=−0.973; 95% CI=−1.414, −0.532; P=0.000), 1-month (SMD=−0.411; 95% CI=−0.769, −0.053; P=0.025), and 3-month (affected kidney: SMD=−0.914; 95% CI=−1.662, −0.617; P=0.000) percentages of postoperative changes in renal function (estimated glomerular filtration rate) between the SAC and MAC groups. Sub-group analysis showed that the SAC group had longer OT (SMD=0.562; 95% CI=0.252, 0.871; P=0.000) than the MAC group. However, no differences were observed in the OT, WIT, LOS, blood transfusion rate, postoperative complication rate, Clavien classification (≥3), and PSM between the two groups. Conclusions: SAC is superior to MAC in terms of short-term postoperative renal function recovery. The use of SAC or MAC depends on tumor size, location, surgical modality, and surgeon’s judgments.
Considerations for the design of nutrition-sensitive production programmes in rural South Africa
Authors: Hendriks Sheryl L , Viljoen Annemarie , Marais Diana , Wenhold Friede AM , McIntyre Angela M , Ngidi Mjabuliseni S , Annandale John G , Kalaba MMatlou , Stewart Duncan
Published: August 2020

Background
Very little has been researched about the efficacy, effectiveness, feasibility, sustainability and impact of food-based approaches on the diets and nutritional status of populations at risk of hunger and food insecurity. This study contributes knowledge about the impact of food-based approaches on the diets of populations at risk of hunger and food insecurity in four of the poorest rural communities in South Africa. The study investigated the consumption and production patterns of rural households (278 in summer and 280 in winter) in four sites in the poorest municipalities in South Africa.
Methods
A multistage stratified random sampling technique was applied to identify the communities and sample households for the quantitative survey and qualitative assessments. Qualitative and quantitative data were collected between 2013 and 2015 through focus group discussions (FGDs), key informant interviews and the two-round panel survey to cover both the summer and winter seasons at each site.
Results
Home gardening led to a significant positive increase in the consumption of white roots and tubers, dark green leafy vegetables, orange-coloured fruit and other fruit in the 24 hours prior to the survey. Participation in a community garden led to significant increases in the consumption of dark green leafy vegetables and other vegetables. School gardening did not demonstrate any statistical relationships with the consumption of foods from the crop-related food groups. Crop production improved dietary diversity. Selling produce and irrigation showed a stronger improvement in dietary diversity. Seasonality affected the availability of fresh fruit and vegetables for home consumption in winter
Conclusions
Producing beyond that solely for home consumption has greater benefits for dietary diversity and a consumption-smoothing effect during the post-harvest period. Politicians and the scientific community should recognise the role that household and small-scale crop production plays in supporting household consumption and the provision of essential micronutrients despite constraints and disincentives. Production and education programmes should focus on strengthening existing good consumption patterns and promoting the consumption of foods that can improve dietary diversity.
Comparative analysis, applications, and interpretation of electronic health record-based stroke phenotyping methods
Authors: Thangaraj Phyllis , Kummer Benjamin R , Lorberbaum Tal , Elkind Mitchell S.V. , Tatonetti Nicholas P
Published: August 2020

Background: Accurate identification of acute ischemic stroke (AIS) patient cohorts is essential for a wide range of clinical investigations. Automated phenotyping methods that leverage electronic health records (EHRs) represent a fundamentally new approach cohort identification without current laborious and ungeneralizable generation of phenotyping algorithms. We systematically compared and evaluated the ability of machine learning algorithms and case-control combinations to phenotype acute ischemic stroke patients using data from an EHR.Materials and Methods: Using structured patient data from the EHR at a tertiary-care hospital system, we built and evaluated machine learning models to identify patients with AIS based on 75 different case-control and classifier combinations. We then estimated the prevalence of AIS patients across the EHR. Finally, we externally validated the ability of the models to detect AIS patients without AIS diagnosis codes using the UK Biobank.Results: Across all models, we found that the mean AUROC for detecting AIS was 0.963±0.0520 and average precision score 0.790±0.196 with minimal feature processing. Classifiers trained with cases with AIS diagnosis codes and controls with no cerebrovascular disease codes had the best average F1 score (0.832±0.0383). In the external validation, we found that the top probabilities from a model-predicted AIS cohort were significantly enriched for AIS patients without AIS diagnosis codes (60-150 fold over expected). Conclusions: Our findings support machine learning algorithms as a generalizable way to accurately identify AIS patients without using process-intensive manual feature curation. When a set of AIS patients is unavailable, diagnosis codes may be used to train classifier models.
Multi-measure assessment of adherence to Antiretroviral Therapy among children under five years living with HIV in Jinja, Uganda
Authors: Ssanyu Jacquellyn Nambi , Nakafeero Mary , Nuwaha Fred
Published: August 2020

Introduction: Adherence to Anti-Retroviral Therapy (ART) is required to achieve HIV viral load suppression. However, children under five years in Jinja, Uganda, had been shown to have low HIV suppression rates. This study aimed to determine the level of ART non-adherence among these children and the associated factors.Methods: Data for the cross-sectional study was collected from April to July, 2019 from caregivers of 206 children under five years living with HIV who were attending health facilities in Jinja and had been on ART for at least three months. Non-adherence was measured using a Visual Analog Scale that assessed both dosing and timing non-adherence, and by determining the Proportion of Days Covered by the medication. A questionnaire administered to the caregivers was used to collect the data, together with medical record review. A child was only considered adherent if they had adherence greater than 95% on all the measures. The data was analysed using Modified Poisson Regression, taking a p-value less than 0.05 as statistically significant. Results: Of the 206 children, 73.8% were older than 2 years, and 52.9% were female. Likewise, the majority of the caregivers were female (93.7%). Using the combined adherence measure, 57.3% of the children were categorized as non-adherent. School/day-care attendance, Prevalence Ratio (PR) = 1.25 (p = 0.042), the caregiver having higher than a primary school education, PR = 0.72 (p = 0.044) and satisfaction with the quality of service at the health facility, PR = 0.97 (p <0.001) were associated with non-adherence. Household food insecurity was also associated with non-adherence: PR = 1.55 (p = 0.011) for mild food insecurity, PR= 1.75 (p = 0.001) for moderate insecurity and PR = 1.48 (p = 0.015) for severe food insecurity. Conclusions: Children under five years in Jinja had a high level of ART non-adherence. It is important to engage schools to support adherence among children living with HIV. Addressing household food insecurity and improving the quality of paediatric ART services would also reduce the barriers to optimal adherence.
Development of a patient-reported outcome questionnaire for aplastic anemia and paroxysmal nocturnal hemoglobinuria (PRO-AA/PNH)
Authors: Weisshaar Kimmo , Ewald Hannah , Halter Jörg P. , Gerull Sabine , Schönfeld Sandra , Senft Yuliya , Martinez Maria , Leuppi-Taegtmeyer Anne B. , Khanna Nina , Maier Birgit , Risitano Antonio M. , de Latour Regis Peffault , Tichelli Andre , Passweg Jakob R. , Drexler Beatrice
Published: August 2020

Background: The introduction of new therapy modalities has significantly improved the outcome of aplastic anemia (AA) and paroxysmal nocturnal hemoglobinuria (PNH) patients. However, relatively little is known about the exact disease burden of AA/PNH since standardized assessments of symptoms including health-related quality of life (HRQoL) are frequently missing or inadequately designed for this rare patient group. We aimed to develop AA/PNH-specific questionnaires for self-reporting of symptoms, which could be included in electronic platforms for data collection and patient care. Methods: By scoping review, we extracted any reported symptoms in AA/PNH and their prevalence from the literature (Phase I). Consensus rounds with patients and medical experts were conducted to identify core symptoms reported in the literature and to add missing items (Phase II). Ultimately, AA/PNH-specific patient-reported outcome (PRO) questionnaires including the selected measures were designed (Phase III). Results: AA symptoms from 62 and PNH symptoms from 45 observational studies were extracted from the literature. Twenty-four patients and seven medical experts identified 11 core symptoms including HRQoL issues after three consensus rounds. Significant differences in the symptom ranking of patients versus medical experts could be observed. Therefore, patient- as well as expert-centered PRO questionnaires in AA and PNH were created following the concepts of validated instruments.Conclusion: The development of symptom self-reporting questionnaires for AA and PNH was feasible and the disease-specific PRO questionnaires can now be validated within a web-based workflow in a subsequent feasibility study.
Oncogenic miR-20b-5p contributes to malignant behaviors of breast cancer stem cells by bidirectionally regulating CCND1 and E2F1
Authors: xia liqin , li feng , qiu jun , feng zhongming , xu zihan , chen xiewan , chen zhengtang , Sun Jian-Guo
Published: August 2020

Background: Breast cancer is the leading cause of cancer mortality in women worldwide. Therefore, it is of great significance to identify the biological mechanism of tumorigenesis and explore the development of breast cancer to achieve a better prognosis for individuals suffering from breast cancer. MicroRNAs (miRNAs) have become a hot topic in cancer research, but the underlying mechanism of its involvement in cancer remains unclear. Methods: The miRNA profile between breast cancer stem cells (BCSCs, CD44+CD24-/low) and control MCF-7 breast cancer cells was obtained in a previous study. Based on biological analysis, miR-20b-5p was hypothesized to be a key factor due to the malignant behavior of BCSCs. Then, agomir-20b-5p and antagomir-20b-5p were transfected into MCF-7 and T47D breast cancer cells to detect cell migration, wound healing and proliferation, and lentivirus vectors silencing or overexpressing miR-20b-5p were transfected into T47D-CSCs to detect proliferation and apoptosis. The effect of miR-20b-5p on xenograft growth was investigated in vivo by transfection of a lentivirus-overexpression vector into T47D cells. The target genes were predicted by the online programs picTar, miRanda and TargetScan and verified by dual luciferase assay, and changes in protein expression were detected by western blot. Results: MiR-20b-5p had the highest degree in both the miRNA-gene network and miRNA-GO network to regulate BCSCs. Overexpression of miR-20b-5p significantly promoted the migration and wound healing ability of MCF-7 cells and T47D cells compared with the control (P < 0.05). In addition, miR-20b-5p facilitated the proliferation of MCF-7 cells and T47D-CSCs (P < 0.05) and inhibited the apoptosis of T47D-CSCs (P < 0.05). Moreover, miR-20b-5p promoted xenograft growth compared with the control group (P < 0.05). Accordingly, potential targets of both CCND1 and E2F1 were predicted by bioinformatics analysis. MiR-20b-5p directly targeted both CCND1 and E2F1 in a dual luciferase assay, while antagomir-20b-5p downregulated the protein levels of CCND1 and E2F1.Conclusions: Oncogenic miR-20b-5p was confirmed to promote the malignant behaviors of breast cancer cells and BCSCs. The underlying mechanism lies in that miR-20b-5p overall enhanced both CCND1 and E2F1 targets via bidirectional regulation probably involving direct downregulation and indirect upregulation.
Genetic diagnostic features after failure of initial treatment with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors among non-small-cell lung cancer patients harboring EGFR mutations
Authors: Takeda Yuichiro , Naka Go , Yamaguchi Yoh , Hashimoto Masao , Suzuki Manabu , Izumi Shinyu , Sugiyama Haruhito
Published: August 2020

Background: Osimertinib, a third - generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI), can be used as a second-line treatment for lung cancer patients harboring the T790M substitution. Although osimertinib is more effective than the first-generation EGFR-TKIs used for first-line treatment, its efficacy with respect to long-term patient survival remains unclear even upon the administration of a complete sequence of EGFR-TKI therapy, and limited information is available regarding genetic diagnostic approaches after EGFR-TKI naïve treatment. This study investigated the characteristics of EGFR-mutated lung cancer patients harboring the T790M substitution resistance to EGFR-TKIs and the advantages of rebiopsy and liquid biopsy for these patients.
Methods: The medical records of patients screened for EGFR mutations were reviewed. Upon failure of naïve treatment with EGFR-TKIs, except for osimertinib, single plexus cobas version 2 was repeatedly used to detect the T790M substitution in EGFR via tissue or liquid biopsy.
Results: From April 2016 through May 2019, 113 patients were determined to harbor EGFR mutations. Sixty patients were treated with EGFR-TKIs, among which 46 underwent tissue or liquid biopsy. Twenty-nine of these 46 (63%) patients harbored the T790M substitution. In total, 141 rebiopsies were performed. The T790M substitution was detected in 24 of 43 tissue and 11 of 98 liquid biopsies. If patients displayed an EGFR exon 19 deletion, had new lesions, and were administered gefitinib as first-line therapy, patients harboring an EGFR mutation were suspected of harboring the T790M substitution. Furthermore, the T790M substitution was detected through rebiopsy in patients with co-existing original mutations, brain metastases, tumor enlargement by ≥ 12 mm, or metastases at minor sites.
Conclusion: Repeated biopsy can help maximize the detection rate of the T790M substitution. Furthermore, the advantages of repeated tissue or liquid biopsy should be considered among patients with positive T790M factors , and these biopsies can be repeated numerous times .
Data Processing Scheme Based on Blockchain
Authors: Fu Jinhua , Xu Mixue , Huang Yongzhong , Si Xueming , Yuan Chao
Published: August 2020

In the white paper written on Bitcoin, a chain of blocks was proposed by Satoshi Nakamoto. Since then, blockchain has been rapidly developed. Blockchain is not only limited to the field of cryptocurrency but also has been extensively applied to the Internet of Things (IoT), supply chain finance, electronic evidence storage, data sharing, and e-government fields. Both the public chain and the alliance chain have been extensively developed. In the data processing field, blockchain has a particularly good application potential. The Square Kilometre Array (SKA) is a proposal consisting of a joint venture of more than ten countries, resulting in the world’s largest synthetic aperture radio telescope. In the SKA, the processing scale of the data is large, and it consists of several data processing nodes. The data will be processed in the cloud computing mode. Taking the SKA under consideration, this report proposes a data processing scheme based on blockchain for the anti-counterfeiting, anti-tampering and traceability of data. Furthermore, the authenticity and integrity of the data are assured. The primary aspects include data distribution, data operation and data sharing, which correspond to the data reception, data algorithm processing and result sharing of data operation in the SKA. With this process, the integrity, reliability and authenticity of the data are guaranteed. Additionally, smart contracts, homomorphic hashing, secure containers, aggregate signatures and one-way encrypted channels are implemented to ensure the intelligence, security and high performance of the process.
Dietary nutrient intake related to higher grade cervical intraepithelial neoplasia risk: A Chinese population-based study
Authors: Wang Zhe , Yang Aimin , Yang Jing , Zhao Weihong , Wang Zhilian , Wang Wei , Wang Jintao , Song Jinghui , Li Li , Lv Weiguo , Li Dongyan , Liu Huiqiang , Wang Chen , Hao Min
Published: August 2020

Background: Dietary nutrient intake plays a significant role in carcinogenesis. Few studies have investigated the association between dietary nutrient intake and cervical intraepithelial neoplasia (CIN) risk in China. Methods: Data on 2,304 women from an ongoing cohort comprising 40,000 women from China in 2014 were included. We randomly selected 218 out of 2304 people as subjects during 2019. All participants were surveyed through in-person interviews, physical examinations, and laboratory tests. Clinical data were obtained from physical examinations and laboratory tests. Dietary intakes were assessed using a semiquantitative food frequency questionnaire. Nutrition intakes from 26 food sources were calculated using a comprehensive validated database. Descriptive statistics were used to describe the frequency and proportion, and mean and standard deviation of the demographic characteristics. Characteristics were examined for significant differences, and Pearson chi-square tests were used for categoric variables. Logistic regression was used to obtain odds ratios (ORs) and confidence intervals (CIs) for CIN risk in each nutritional ingredient quartile relative to that in the highest quartile. Results: The food frequency questionnaire exhibited acceptable reproducibility and reasonable validity in assessing nutrient intakes among these women. After adjusting for multiple confounders, several dietary nutrients showed significant associations with CIN2+ risk. Low dietary folate intake was associated with the risk of CIN2+ (first versus fourth quartile: OR=1.55, 95% CI: 1.03-2.33). Similar results were also observed for vitamin B6 (OR=1.63, 95% CI: 1.08-2.46), vitamin C (OR=1.59, 95% CI: 1.05-2.42), niacin (OR=1.65, 95% CI: 1.08-2.51), and vitamin K (second versus fourth quartile: OR=1.60, 95% CI: 1.05-2.44).Conclusions: Low folate; vitamin B6, C, and K; and niacin intakes were associated with CIN2+ risk. Nutrients may influence the development of higher grade CIN and cervical cancer.Trial registration: The study was registered in the Chinese Clinical Trial Register (ChiCTR-ROC-15006479) (http://www.chictr.org.cn).
Transcriptome Analysis of Aedes aegypti Aag2 Cells in Response to Dengue Virus-2 Infection
Authors: Li Man-jin , Lan Ce-jie , Gao He-ting , Xing Dan , Gu Zhen-yu , Su Duo , Zhao Tong-yan , Yang Hui-ying , Li Chun-xiao
Published: August 2020

Background: Dengue virus (DENV) is a flavivirus transmitted by mosquitoes that is prevalent in tropical and subtropical countries and has four serotypes (DENV1-4). Aedes aegypti, as the main transmission vector of DENV, exhibits strong infectivity and transmission. With the aim of obtaining a better understanding of the Ae. aegypti-DENV interaction, the transcriptome changes in DENV-2-infected Aag2 cells were studied to describe the immune responses of mosquitoes using the Ae. aegypti Aag2 cell line as a model.Methods: RNAseq technology was used to sequence the transcripts of the Ae. aegypti Aag2 cell line before and after infection with DENV-2. A bioinformatics analysis was then performed to assess the biological functions of the differentially expressed genes, and the sequencing data were verified by quantitative reverse transcription-polymerase chain reaction (qRT-PCR).Results: The transcriptome analysis generated 8866 unigenes that were found in both groups, 225 unigenes that were only found in the infection group, and 683 unigenes that only existed in the control group. A total of 1199 differentially expressed genes, including 1014 upregulated and 185 downregulated genes, were identified. The bioinformatics analysis showed that the differentially expressed genes were mainly involved in the longevity regulating pathway, circadian rhythm, DNA replication, and peroxisome, purine, pyrimidine, and drug metabolism. The qRT-PCR verification results showed the same trend, which confirmed that the expression of the differentially expressed genes had changed and that the transcriptome sequencing data were reliable.Conclusions: This study investigated the changes in the transcriptome levels in the DENV-2-infected Ae. aegypti Aag2 cell line, which provides a faster and effective method for discovering genes related to Ae. aegypti pathogen susceptibility. The findings provide basic data and directions for further research on the complex mechanism underlying host-pathogen interactions.
Staging Procedures Fail to Benefit Women with Borderline Ovarian Tumours Who Want to Preserve Fertility: A Retrospective Analysis of 448 cases
Authors: Li Na , Gou Jinhai , Li Lin , Ming Xiu , Hu Tingwenyi , Li Zhengyu
Published: August 2020

Background: To evaluate the effect of clinicopathologic factors on the prognosis and fertility outcomes of BOT patients.Methods: We performed a retrospective analysis of BOT patients who underwent surgical procedures in West China Second University Hospital from 2008 to 2015. The DFS outcomes, potential prognostic factors and fertility outcomes were evaluated.Results: 448 patients were included; 52 recurrences were observed. 92 patients undergoing FSS achieved pregnancy. No significant differences in fertility outcomes were found between the staging and unstaged surgery groups. Staging surgery was not an independent prognostic factor for DFS. Laparoscopy resulted in better prognosis than laparotomy in patients with stage I tumours and a desire for fertility preservation.Conclusion: Patients with BOT fail to benefit from surgical staging. Laparoscopy is recommended for patients with stage I disease who desire to preserve fertility. Physicians should pay more attention to risk of recurrence in patients who want to preserve fertility.Keywords: Borderline Ovarian Tumour, Surgery Staging, Fertility-Sparing Surgery, Disease-Free Survival
Assessing the acceptability of a text messaging service and smartphone app to support patient adherence to medications prescribed for high blood pressure: a pilot study.
Authors: Kassavou Aikaterini , Court Charlotte A , Chauhan Jagmohan , Brimicombe James , Bhattacharya Debbi , Naughton Felix , Hardeman Wendy , Mascolo Cecilia , Sutton Stephen
Published: August 2020

Aims and objectives. This paper describes a pilot non-randomised controlled study of a highly tailored 56-days text message and smartphone app prototype intervention to increase adherence to anti-hypertensive medication in primary care. The aim of this study was to evaluate the acceptability of the intervention and obtain patients views about the intervention content, delivery mode, and the mechanisms by which the intervention supported medication adherence. Methods. Patients diagnosed with hypertension were invited to the study via general practice text messages and were recruited face to face by the researcher team. Participants were asked to test the text message intervention for 28 consecutive days and switch to the smartphone app for 28 more days. Participants completed baseline and follow up questionnaires and took part in semi-structured telephone interviews. Digital log files captured patients’ usage of the intervention. Participant transcripts were analysed using thematic analysis. Descriptive statistics were used to summarize data from questionnaires and log files. A mixed methods analysis generated data to respond to the research questions. Results. 79 patients expressed interest to participate in this study, of whom 23 (64% male, 82% above 60 years old) were recruited to take part. With one drop-out, 22 participants tested the text message delivery mode (with 20 being interviewed) and four of them (17%) switched to the app (with 3 being interviewed). All participants engaged and interacted with the text message and app notifications, and most participants found the intervention content and delivery mode acceptable. They also self-reported that the interactive elements of the intervention motivated them to take their medications as prescribed. Conclusion. This study provides evidence that the digital intervention is acceptable by hypertensive patients recruited in primary care. Future research could usefully investigate its feasibility and effectiveness using rigorous research methods.
"The inflammation link between periodontal disease and coronary atherosclerosis in patients with acute coronary syndromes - case-control study".
Authors: Wojtkowska Agnieszka , Zapolski Tomasz , Wysokinska-Miszczuk Joanna , Wysokinski Andrzej P.
Published: August 2020

Background Coronary atherosclerosis and periodontal disease, due to their prevalence, are a serious epidemiological problem. Pathophysiological evidence points to their possible common inflammatory etiopathological background. The aim of the study was to analyze the relationship between the presence and severity of periodontitis, systemic inflammation and selected parameters of myocardial injury and heart function in patients with acute myocardial infarction. Methods The study group consisted of 71 patients 54.22(7.05) - year - old hospitalized due to acute myocardial infarction. The patients underwent a coronary angiographic examination and echocardiography. The following laboratory parameters were determined: blood morphology, hsCRP, ESR, fibrinogen, troponin I, CK-MB, BNP, lipidogram, glucose, creatinine, GFR, TSH, HbA1c. Dental assessment of the patients was performed and the following indicators were included: the number of teeth preserved, approximal plaque index (API), bleeding on probing (BoP), pocket depth (PD), the number of bleeding periodontal pockets ≥ 4 mm in depth (NoPD≥4 mm), the percentage of bleeding periodontal pockets ≥ 4 mm in depth (%PD≥4 mm), clinical attachment loss (CAL). The control consisted of 40 patients 52 (± 8.43)- year-old without a history of coronary heart disease. These patients were subjected to a periodontal examination using the above parameters and classification methods. Results The BI (bleeding index) significantly correlated with fibrynogen. All indices regarding the pocket depth (PD, NoPD≥4mm,% PD4≥mm) correlated significantly with the number of leukocytes. PD and NoPD≥4mm were also associated significantly with the level of hsCRP. The BI is correlated closely with the levels of BNP. The multifactorial analysis showed that significant predictors of myocardial infarction are API and BI. The analysis showed that API and BI are important predictors of troponin levels. Linear regression analysis showed that only CAL is a significant predictor of BNP. Conclusions Patients with acute myocardial infarction have worse periodontal status compared to people without coronary heart disease. Higher severity of periodontal disease, poorer oral hygiene and increased activity of the periodontitis leads to greater manifestation of systemic inflammation in patients with acute myocardial infarction. Periodontitis is a risk factor for myocardial infarction and also affects the degree of post-infarction left ventricular damage, which means that there is an inflammatory link between these two diseases.
Correlation between immunity from BCG and the morbidity and mortality of COVID-19
Authors: Wickramasinghe Dakshitha , Wickramasinghe Nilanka , Kamburugamuwa Sohan Anjana , Arambepola Carukshi , Samarasekera Dharmabandhu N
Published: August 2020

Background To investigate the association between parameters indicating immunity from BCG at country level (presence of BCG vaccination policy, BCG coverage, age-specific incidence of tuberculosis(TB)) and the morbidity and mortality of COVID-19. Methods Country-specific data for COVID-19 cases and deaths, demographic details, BCG coverage and policy, age-specific TB incidence and income level were obtained. The crude COVID-19 cases and deaths per 100,000 population were calculated and assessed against the parameters indicating immunity from BCG using linear regression analysis. Results Univariate analysis identified higher income level of a country to be significantly associated with COVID-19 cases (p<0.0001) and deaths (p<0.0001) but not with its case fatality rate. The association between COVID-19 and TB was strongest for TB incidence in patients >65-years (Cases(rs=-0.785,p=0.0001)) and deaths (rs=-0.647,p=0.0001).Multivariate analysis identified the higher income level of a country and not having a universal BCG vaccination policy to affect the COVID-19 cases. The deaths were inversely affected by the presence of BCG vaccination policy and coverage; and positively by the TB incidence in patients >65-years. Conclusion Significant inverse correlations observed between cases and deaths of COVID-19 and BCG related parameters highlights immunity from BCG as a likely explanation for the variation in COVID-19 across countries.
The modules of mental health programs implemented in schools in low- and middle-income countries: Findings from a systematic literature review
Authors: Gimba Solomon Musa , Harris Paul , Saito Amornrat , Udah Hyacinth , Martin Averil , Wheeler Amanda J.
Published: August 2020

Background Secondary schools in low- and middle-income countries (LMICs) provide promotional, preventive, and early intervention services. Nevertheless, literature indicates that the modules of these services are either adapted or modified from existing mental health programs in developed countries. The literature also highlights the provision of non-comprehensive services (mental health promotion, prevention, and early intervention), in LMICs such as Nigeria. These findings inform the need for undertaking this systematic literature review. The aim of this review was thus to identify the modules of school-based mental health programs (SBMHP) that have been implemented in LMICs to guide the development of a culturally sensitive comprehensive mental health program for adolescents in a LMIC. Methods The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was used to guide this review. The following databases were searched in September 2018, to identify the relevant literature: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and ERIC. The search was conducted by the first author and reviewed by the authors.Results Following the screening process, a total of 11 papers were identified and reviewed for quality. The systematic review highlighted that the mental health programs provided in schools included: an introduction module, a communication and relationship module, a psychoeducation module, a cognitive skills module, a behavioral skills module, establishing social networks for recovery and help seeking behavioral activities and a summary/conclusion module.Conclusion This review sheds light on the characteristics of the programs in LMICs. Two programs were found to be universal in nature. Five programs were directed at key risk factors or at-risk groups, and four were early intervention programs. The review also revealed that only one program out of the 11 programs included modules for parents. The synthesis indicated that all the identified programs were adapted or modified from existing programs. The dearth of comprehensive programs in LMICs was also revealed. Lastly, the review revealed modules that can be useful for developing a SBMHP.
Functional disorders of the biliary tract: modern diagnostic criteria and principles of pharmacotherapy
Authors: Dicheva D. T. , Goncharenko A. Yu. , Zaborovsky A. V. , Privezentsev D. V. , Andreev D. N.
Published: August 2020

The review article presents current data on functional disorders of the biliary system, taking into account the latest recommendations of experts of the Rome Foundation (Rome Criteria IV, 2016) and the Russian Gastroenterological Association (specialized clinical recommendations, 2018). According to modern concepts, biliary dysfunction is a group of functional disorders of the biliary system caused by motor disorders and increased visceral sensitivity. According to the literature data, the prevalence of functional disorders of GB and OS is 10-15%, and violation of OS function is revealed in 30-40% of patients who underwent cholecystectomy (CE). The presence of biliary pain is an obligatory condition in the diagnosis of functional disorders of GB and OS. Bilirubin and serum transaminases (AST, ALT) levels may increase in biochemical blood analysis in patients with functional OS disorder of biliary type, and pancreatic amylase and lipase in case of functional OS disorder of pancreatic type. Ultrasound examination of abdominal organs is considered to be the priority among instrumental methods. This technique allows to exclude organic lesions of both the GB and visualized ducts, and adjacent organs (GSD, biliary tract, liver and pancreas neoplasms). Magnetic resonance cholangiopancreatography (MRCP) is used as a clarifying method, which allows to visualize the state of biliary ducts throughout. Ultrasonic cholecystography is used to assess the contractile activity of the GB. When duct dilation is detected and/or when liver/pancreatic enzyme levels are elevated in the absence of changes according to MRCP data, it is reasonable to perform an endoscopic ultrasound examination. According to the latest recommendations of the Russian Gastroenterological Association (2018), the foundation of pharmacotherapy for this group of diseases are antispasmodics and ursodeoxycholic acid (UDCA).
Hypothyroidism: a lecture for primary care physicians
Authors: Panfilova E. A. , Isaeva M. P. , Troshina E. A.
Published: August 2020

The prevalence of hypothyroidism in the population is high. The frequency of manifest hypothyroidism in the world, according to various data, is 0.2–2.0%, subclinical one – up to 10% for women and up to 3% for men, and in the older age group (over 70 years) reaches 14%, with the majority of cases of hypothyroidism accounted for primary hypothyroidism. Thus, a doctor of any specialty in his practice is likely to meet a patient with hypothyroidism: both with the established diagnosis, and face the need for differential diagnosis of various pathological conditions with hypothyroidism. This article presents a classification of hypothyroidism based on etiological aspects, describes the clinical picture of the disease, pays special attention to the so-called «masks» of hypothyroidism, which, in our view, can be useful for a doctor of any specialty, provides available methods for diagnosing this syndrome (special attention is paid to laboratory methods), as well as the goals and principles of treatment, highlights the need to monitor laboratory indicators in dynamics against the background of treatment. In addition, the features of correction of hypothyroidism during pregnancy are given. The article presents the peculiarities of selecting drug doses depending on the patient’s age and comorbidity. The distinctive feature and the purpose of this article, from our point of view, is its potential benefits not only for endocrinologists, but also for other health professionals.
Features of skin care for feet in patients with diabetes and diabetic neuropathy: the role of dexpanthenol
Authors: Svetlova O. V. , Gurieva I. V. , Voronin A. V. , Savchenko L. S.
Published: August 2020

The feet have an increased load, they are often injured, especially with diabetes. Because of the violation of innervation, patients do not notice minor injuries: abrasions, bruises, cracks, cuts. Because of the circulatory disorders associated with diabetes, the protective function of tissues decreases, and the smallest injury can lead to the formation of a long-term wound that does not heal, which turns into an ulcer when infected. Despite advances in the study of the pathogenesis of diabetes and its complications, diabetic foot ulcers are difficult to treat, can recur, and lead to amputations of the lower limbs. The main reason for pathological dryness of the foot skin in diabetes is dysfunction of the sweat glands of the skin of feet due to diabetic neuropathy. Regular skin care with specially selected products can help restore and improve the barrier function of the skin, as well as increase the moisture level of the stratum corneum. Adequate skin hydration reduces itching and the risk of infection if the skin is damaged. In most patients with diabetes, conventional cosmetics slowly eliminate dry skin of the feet. In addition, traditional remedies contain a large amount of oils and can cause unpleasant sensations, which often causes rejection of their use. In patients with DM, it is desirable to use drugs that quickly and effectively eliminate dryness and cracks. Treatment of dry skin is indicated as a prevention of diabetic foot syndrome. Taking into account the fact that the skin of patients with diabetes mellitus has a low level of humidity, we recommend daily care using moisturizing or nourishing creams or lotions. Some studies have confirmed that the use of external dry skin care products containing dexpanthenol improves the protective function of the skin, increasing the hydration of the stratum corneum.
Immunochromatographic rapid test to determine β-hemolytic streptococcus group A in patients with erysipelas
Authors: Golobokov G. S. , Levashova A. B. , Chekmeneva S. S. , Lioznov D. A.
Published: August 2020

Introduction. Traditionally, erysipelas has been associated with streptococcal infection. Taking into account the possibility of carriage of the pathogen on the mucous membranes of the upper respiratory tract, we assumed that in patients with erysipelas of various localization, β-hemolytic streptococcus of group A would be detected. Objective: Determine the effectiveness of immunochromatographic test for detecting β-hemolytic streptococcus group A in patients with erysipelas. Materials and methods: The study included 52 patients with various forms of erysipelas. The diagnosis of «Erysipelas» was established clinically. Patients were examined using routine clinical and laboratory methods. To identify the β-hemolytic streptococcus group A antigen, a smear was taken from the mucous membrane of the back wall of the pharynx and tonsils in all patients at the hospital, and a sandwich-membrane immunochromatographic test was used. In order to identify the pathogen from the source of inflammation, in the case of complicated forms of erysipelas, bacteriological method was used. Results: Immunochromatographic smear test revealed the presence of β-hemolytic streptococcus group A in 3 out of 52 patients (7%). Bacteriological examination of the contents of the wound, conducted by 16 patients (31%), did not reveal β-hemolytic streptococcus group A in any of the patients. One of these patients (with a fatal outcome) had a positive result of an immunochromatographic test (2%). In the wound discharge, 8 patients detected bacteria of the family Staphylococcaceae, including in combination with Enterococcus faecalis, Klebsiella mobilis, Proteus Mirabilis and Pseudomonas aeruginosa. In one case, Acinetobacter baumanii from the Moraxellaceae family was isolated. Conclusion: We have not established the effectiveness of the immunochromatographic test for determining β-hemolytic streptococcus group A in the emergency department of a surgical hospital in patients with erysipelas. This is probably due to the frequent use of antibacterial drugs in the prehospital phase. It is impossible to exclude the leading role of other etiological factors in the development of inflammation of soft tissues, clinically similar to streptococcal infection.