bluuebunny/crossref_metadata_2025 huggingface dataset:
Anopheles gambiae populations from Burkina Faso show minimal delayed mortality after exposure to insecticide-treated nets
Authors: Hughes Angela , Lissenden Natalie , Viana Mafalda , Toé Kobié Hyacinthe , Ranson Hilary
Published: January 2020

Background

The efficacy of long-lasting insecticidal nets (LLINs) in preventing malaria in Africa is threatened by insecticide resistance. Bioassays assessing 24-hour mortality post-LLIN exposure have established that resistance to the concentration of pyrethroids used in LLINs is widespread. However, although mosquitoes may no longer be rapidly killed by LLIN exposure, a delayed mortality effect has been shown to reduce the transmission potential of mosquitoes exposed to nets. This has been postulated to partially explain the continued efficacy of LLINs against pyrethroid-resistant populations. Burkina Faso is one of a number of countries with very high malaria burdens and pyrethroid-resistant vectors, where progress in controlling this disease has stagnated. We measured the impact of LLIN exposure on mosquito longevity in an area of the country with intense pyrethroid resistance to establish whether pyrethroid exposure was still shortening mosquito lifespan in this setting.

Methods

We quantified the immediate and delayed mortality effects of LLIN exposure using standard laboratory WHO cone tests, tube bioassays and experimental hut trials on Anopheles gambiae populations originating from the Cascades region of Burkina Faso using survival analysis and a Bayesian state-space model.

Results

Following single and multiple exposures to a PermaNet 2.0 LLIN only one of the four mosquito populations tested showed evidence of delayed mortality. No delayed mortality was seen in experimental hut studies using LLINs. A delayed mortality effect was only observed in WHO tube bioassays when deltamethrin concentration was increased above the standard diagnostic dose.

Conclusions

As mosquito pyrethroid-resistance increases in intensity, delayed effects from LLIN exposure are substantially reduced or absent. Given the rapid increase in resistance occurring in malaria vectors across Africa it is important to determine whether the failure of LLINs to shorten mosquito lifespan is now a widespread phenomenon as this will have important implications for the future of this pivotal malaria control tool.
Mosquito diversity and dog heartworm prevalence in suburban areas
Authors: Spence Beaulieu Meredith R. , Federico Jennifer L. , Reiskind Michael H.
Published: January 2020

Background

Urbanization is occurring rapidly on a global scale and is altering mosquito communities, creating assemblages that are characteristically less diverse. Despite high rates of urbanization and ample examples of vector-borne diseases transmitted by multiple species, the effects of urbanization-driven mosquito diversity losses on disease transmission has not been well explored. We investigated this question using the dog heartworm, a filarial parasite vectored by numerous mosquito species.

Methods

We trapped host-seeking mosquitoes in undeveloped areas and neighborhoods of different ages in Wake County, North Carolina, USA, analyzing captured mosquitoes for heartworm DNA. We compared within-mosquito heartworm infection across land-use types by Kruskal–Wallis and likelihood ratio tests. Using zip code level data acquired from dogs in a local shelter, we performed linear regressions of within-host heartworm prevalence by within-mosquito heartworm prevalence as well as by three mosquito diversity measures. We also determined the best predictor of host-level prevalence among models including within-mosquito infection, mosquito diversity and abundance, and socioeconomic status as variables.

Results

Suburban areas had lower within-mosquito heartworm prevalence and lower likelihood of heartworm-positive mosquitoes than did undeveloped field sites, although no differences were seen between suburban and undeveloped wooded sites. No relationships were noted between within-mosquito and within-host heartworm prevalence. However, mosquito diversity metrics were positively correlated with host heartworm prevalence. Model selection revealed within-host prevalence was best predicted by a positive relationship with mosquito Shannon–Wiener diversity and a negative relationship with household income.

Conclusions

Our results demonstrate that decreases in mosquito diversity due to urbanization alter vector-borne disease risk. With regard to dog heartworm disease, this loss of mosquito diversity is associated with decreased heartworm prevalence within both the vector and the host. Although the response is likely different for diseases transmitted by one or few species, mosquito diversity losses leading to decreased transmission could be generalizable to other pathogens with multiple vectors. This study contributes to better understanding of the effects of urbanization and the role of vector diversity in multi-vectored pathosystems.
Genetic diversity of Blastocystis in kindergarten children in southern Xinjiang, China
Authors: Qi Meng , Wei Zilin , Zhang Ying , Zhang Qiyuan , Li Juanfeng , Zhang Longxian , Wang Rongjun
Published: January 2020

Background

Blastocystis is one of the most common intestinal parasites in humans and various animals worldwide. Few studies are available regarding the genetic characterization of Blastocystis infections in humans in China.

Methods

In the present study, 609 fecal samples were collected from two- to six-year-old kindergarten children in southern Xinjiang and were examined by polymerase chain reaction (PCR).

Results

The infection rate of Blastocystis was 14.3% (87/609); no significant difference was observed among counties and between sexes. Blastocystis subtypes ST1 (n = 38), ST2 (n = 8), and ST3 (n = 41) were identified by sequence analysis of the small subunit ribosomal RNA gene. Genetic polymorphisms were observed at the intra-subtype level, including seven variations for ST1 (ST1A to ST1G), four for ST2 (ST2A to ST2D), and two for ST3 (ST3A and ST3B); with ST1F and ST2B being new variations.

Conclusions

ST1 and ST3 are the two common Blastocystis subtypes in the study area. More extensive studies in both humans and animals in different regions are needed to better characterize the transmission of Blastocystis.
Comparison of performance of specific (SLEQOL) and generic (SF36) health-related quality of life questionnaires and their associations with disease status of systemic lupus erythematosus: a longitudinal study
Authors: Louthrenoo Worawit , Kasitanon Nuntana , Morand Eric , Kandane-Rathnayake Rangi
Published: January 2020

Background

The utility of generic health-related quality of life (HRQoL) questionnaires in patients with systemic lupus erythematosus (SLE) is uncertain. We compared the performance of generic (SF36) and specific (SLEQOL) HRQoL surveys by examining their associations with the Global Rating of Change (GRC) and SLE clinical indicators.

Methods

The study included SLE patients who attended a single-center rheumatology clinic between 2013 and 2017. Patients completed both specific (SLEQOL) and generic (SF36) surveys and rated their GRC compared to the previous visit using a 7-point Likert scale on the same day of routine visits. Based on GRC scores, patients’ change in HRQoL was categorized as “no change,” “deterioration,” or “improvement.” Disease activity (SLEDAI-2K), flare, and lupus low disease activity state (LLDAS) were assessed at each visit, and organ damage (SDI) was determined annually. Pairwise correlations between SLEQOL and SF36 components were examined, and associations between GRC status and SLE disease indicators were compared using generalized estimating equations (GEE).

Results

Three hundred thirty-seven patients with 2062 visits were included in the analysis. SLEQOL correlated significantly with SF36. Patients reported improvements in HRQoL in 58%, deterioration in 15%, and “no change” in 27% of all visits. Compared to the “no change” group, mean SF36 and SLEQOL scores were significantly lower in the deterioration group and higher in the improvement group. The magnitude of changes observed with SLEQOL and SF36 in the deterioration and improvement groups was similar. Patients in LLDAS had significantly higher mean scores in both SLEQOL and SF36. In contrast, patients with active disease, especially those with cutaneous, renal, central nervous system, and musculoskeletal activity, had significantly lower SLEQOL and SF36. Flare and organ damage were also associated with lower SLEQOL and SF36-PCS (physical component) but not with SF36-MCS (mental component).

Conclusion

SLEQOL and SF36 similarly describe HRQoL in SLE. Both instruments demonstrated strong associations with GRC-based deterioration or improvement as well as SLE disease status. LLDAS was associated with improved HRQoL.
Hydatid cyst of the foot: a case report
Authors: Ewnte Biniam
Published: January 2020

Background

Hydatid cyst is rarely located in soft tissues. This case of a hydatid cyst over the plantar surface of our patient’s foot is one of the rarest presentations.

Case presentation

This is a case report of a 22-year-old Somali who presented with a lump over the plantar surface of his foot of 1-year duration. The diagnosis of hydatid cyst was made intraoperatively from the typical appearance of a hydatid cyst. The cyst was completely excised. No local recurrence has been detected to date.

Conclusions

The rare location and uncommon incidence made the initial diagnosis of hydatid cyst of the foot difficult. Detection of the typical germinal membrane can guide the diagnosis of hydatid cyst in rare locations that are found incidentally.
Risk modifiers of acute respiratory distress syndrome in patients with non-pulmonary sepsis: a retrospective analysis of the FORECAST study
Authors:   on behalf of JAAM FORECAST group, Iriyama Hiroki , Abe Toshikazu , Kushimoto Shigeki , Fujishima Seitaro , Ogura Hiroshi , Shiraishi Atsushi , Saitoh Daizoh , Mayumi Toshihiko , Naito Toshio , Komori Akira , Hifumi Toru , Shiino Yasukazu , Nakada Taka-aki , Tarui Takehiko , Otomo Yasuhiro , Okamoto Kohji , Umemura Yutaka , Kotani Joji , Sakamoto Yuichiro , Sasaki Junichi , Shiraishi Shin-ichiro , Takuma Kiyotsugu , Tsuruta Ryosuke , Hagiwara Akiyoshi , Yamakawa Kazuma , Masuno Tomohiko , Takeyama Naoshi , Yamashita Norio , Ikeda Hiroto , Ueyama Masashi , Fujimi Satoshi , Gando Satoshi
Published: January 2020

Background

Predisposing conditions and risk modifiers instead of causes and risk factors have recently been used as alternatives to identify patients at a risk of acute respiratory distress syndrome (ARDS). However, data regarding risk modifiers among patients with non-pulmonary sepsis is rare.

Methods

We conducted a secondary analysis of the multicenter, prospective, Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis and Trauma (FORECAST) cohort study that was conducted in 59 intensive care units (ICUs) in Japan during January 2016–March 2017. Adult patients with severe sepsis caused by non-pulmonary infection were included, and the primary outcome was having ARDS, defined as meeting the Berlin definition on the first or fourth day of screening. Multivariate logistic regression modeling was used to identify risk modifiers associated with ARDS, and odds ratios (ORs) and their 95% confidence intervals were reported. The following explanatory variables were then assessed: age, sex, admission source, body mass index, smoking status, congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, steroid use, statin use, infection site, septic shock, and acute physiology and chronic health evaluation (APACHE) II score.

Results

After applying inclusion and exclusion criteria, 594 patients with non-pulmonary sepsis were enrolled, among whom 85 (14.3%) had ARDS. Septic shock was diagnosed in 80% of patients with ARDS and 66% of those without ARDS (p = 0.01). APACHE II scores were higher in patients with ARDS [26 (22–33)] than in those without ARDS [21 (16–28), p < 0.01]. In the multivariate logistic regression model, the following were independently associated with ARDS: ICU admission source [OR, 1.89 (1.06–3.40) for emergency department compared with hospital wards], smoking status [OR, 0.18 (0.06–0.59) for current smoking compared with never smoked], infection site [OR, 2.39 (1.04–5.40) for soft tissue infection compared with abdominal infection], and APACHE II score [OR, 1.08 (1.05–1.12) for higher compared with lower score].

Conclusions

Soft tissue infection, ICU admission from an emergency department, and a higher APACHE II score appear to be the risk modifiers of ARDS in patients with non-pulmonary sepsis.
Eosinophil granuloma due to parasite treated by laparoscopic and endoscopic cooperative surgery: a case report
Authors: Tsuji Toshikatsu , Inaki Noriyuki
Published: January 2020

Background

Gastric eosinophilic granuloma caused by parasitic infection is rare. It is often suspected to be a malignant disease and it is difficult to diagnose. We successfully diagnosed and removed a gastric eosinophilic granuloma using laparoscopic and endoscopic cooperative surgery (LECS).

Case presentation

A 35-year-old woman visited our hospital because of epigastric pain. Upper gastrointestinal endoscopy revealed a 15 mm submucosal tumor (SMT) with changes in the folds, such as enlargement and convergence, located in the greater curvature of the lower gastric body. Computed tomography (CT) showed a dense, nonenhanced area of 15 mm at the same site. SMT was suspected, but undifferentiated cancer could not be excluded. We performed laparoscopic partial gastrectomy using LECS for resection biopsy.

Histopathological examination showed an SMT 8 × 8 × 5 mm in size with an unclear boundary and necrosed insects at the core of the tumor. There was marked eosinophilic infiltration around the area. The diagnosis was gastric granuloma caused by parasitic infection.

Conclusions

It is difficult to differentiate gastric eosinophilic granuloma caused by parasitic infection from malignant disease. In this case, LECS is considered a minimally invasive and useful procedure.
Yellow fever control: current epidemiology and vaccination strategies
Authors: Chen Lin H. , Wilson Mary E.
Published: January 2020

Yellow fever (YF) outbreaks continue, have expanded into new areas and threaten large populations in South America and Africa. Predicting where epidemics might occur must take into account local mosquito populations and specific YF virus strain, as well as ecoclimatic conditions, sociopolitical and demographic factors including population size, density, and mobility, and vaccine coverage. Populations of Aedes aegypti and Aedes albopictus from different regions vary in susceptibility to and capacity to transmit YF virus. YF virus cannot be eliminated today because the virus circulates in animal reservoirs, but human disease could be eliminated with wide use of the vaccine. WHO EYE (Eliminate Yellow Fever Epidemics) is a welcome plan to control YF, with strategies to be carried out from 2017 to 2026: to expand use of YF vaccine, to prevent international spread, and to contain outbreaks rapidly. YF vaccination is the mainstay in controlling YF outbreaks, but global supply is insufficient. Therefore, dose-sparing strategies have been proposed including fractional dosing and intradermal administration. Fractional dosing has been effectively used in outbreak control but currently does not satisfy International Health Regulations; special documentation is needed for international travel. Vector control is another facet in preventing YF outbreaks, and novel methods are being considered and proposed.
What wild dogs want: habitat selection differs across life stages and orders of selection in a wide-ranging carnivore
Authors: O’Neill Helen M. K. , Durant Sarah M. , Woodroffe Rosie
Published: January 2020

Background

Habitat loss is a key threat to the survival of many species. Habitat selection studies provide key information for conservation initiatives by identifying important habitat and anthropogenic characteristics influencing the distribution of threatened species in changing landscapes. However, assumptions about the homogeneity of individual choices on habitat, regardless of life stage, are likely to result in inaccurate assessment of conservation priorities. This study addresses a knowledge gap in how animals at different life stages diverge in how they select habitat and anthropogenic features, using a free-ranging population of African wild dogs living in a human-dominated landscape in Kenya as a case study. Using GPS collar data to develop resource selection function and step selection function models, this study investigated differences between second order (selection of home range across a landscape) and third order (selection of habitat within the home range) habitat selection across four life history stages when resource requirements may vary: resident-non-denning, resident-heavily-pregnant, resident-denning and dispersing.

Results

Wild dogs showed strong second order selection for areas with low human population densities and areas close to rivers and roads. More rugged areas were also generally selected, as were areas with lower percentage tree cover. The strength of selection for habitat variables varied significantly between life stages; for example, dispersal groups were more tolerant of higher human population densities, whereas denning and pregnant packs were least tolerant of such areas.

Conclusions

Habitat selection patterns varied between individuals at different life stages and at different orders of selection. These analyses showed that denning packs and dispersal groups, the two pivotal life stages which drive wild dog population dynamics, exhibited different habitat selection to resident-non-breeding packs. Dispersal groups were relatively tolerant of higher human population densities whereas denning packs preferred rugged, remote areas. Evaluating different orders of selection was important as the above trends may not be detectable at all levels of selection for all habitat characteristics. Our analyses demonstrate that when life stage information is included in analyses across different orders of selection, it improves our understanding of how animals use their landscapes, thus providing important insights to aid conservation planning.
Patient perspectives on the pathway to psoriatic arthritis diagnosis: results from a web-based survey of patients in the United States
Authors: Ogdie Alexis , Nowell W. Benjamin , Applegate Eddie , Gavigan Kelly , Venkatachalam Shilpa , de la Cruz Marie , Flood Emuella , Schwartz Ethan J. , Romero Beverly , Hur Peter
Published: January 2020

Background

There are limited real-world data on the diagnostic experiences of patients with psoriatic arthritis (PsA), including medical care sought and potential barriers to diagnosis. We aim to describe patient experiences related to receiving a PsA diagnosis.

Methods

Ours was a mixed-method, 2-phase study. Phase 1 comprised concept elicitation and cognitive interviews with clinical experts and adults diagnosed with PsA to develop a cross sectional, web-based survey. US adults with a self-reported PsA diagnosis were recruited through a patient support community (CreakyJoints), an online patient research registry (ArthritisPower), and social media outreach. In Phase 2, the online survey collected data on sociodemographics, clinical symptoms, disease burden, and diagnosis history of survey respondents with PsA.

Results

Of the 203 respondents included, 172 (84.7%) were female, and the mean (SD) age was 51.6 (10.8) years. The time between seeking medical attention and receiving a diagnosis was < 6 months for 69 respondents, 6 months to 4 years for 68 respondents, and ≥ 5 years for 66 respondents. Most respondents sought care from general practitioners (79.8%) and rheumatologists (66.5%). Common initial symptoms that led respondents to seek medical attention were joint pain (70.0%) and stiffness (53.7%). Among the initial symptoms that led respondents to seek care, joint pain, swollen joints, and sausage-like fingers or toes (indicating dactylitis) were more common among respondents with shorter time to diagnosis, whereas stiffness, fatigue, enthesitis (indicated by foot problems, tendon and ligament pain), and back pain were more common among respondents with longer time to diagnosis. Common misdiagnoses were psychosomatic issues (26.6%) and osteoarthritis (21.7%). Respondents with shorter times to diagnosis had lower frequencies of misdiagnosis.

Conclusions

Respondents with PsA reported delays in diagnosis and misdiagnoses on their journey to a PsA diagnosis. Symptom differences, such as enthesitis and stiffness, were noted among respondents with shorter vs longer time to diagnosis. Increased understanding of diagnostic barriers may lead to earlier diagnosis and appropriate management to improve outcomes.
Testing Real-World Application of Appropriateness Criteria of Single Photon Emission Computed Tomography (SPECT) In Two Egyptian Hospitals
Authors: Abdeltawab Adham , Mansour Hazem , Rayan Mona
Published: January 2020

Background

The American College of Cardiology pioneered appropriateness criteria for single-photon emission computed tomography myocardial perfusion imaging in 2005 to account for evidence-based clinical relevance of stress perfusion imaging.

Our aim was to assess and compare appropriateness use criteria in in Kobry al Kobba military hospital and Ain Shams University hospitals.

Methods

All patients were subjected to thorough history taking, calculation of pretest probability and Framingham risk score, determination of appropriateness use criteria and stress-rest Tc 99m imaging to detect the presence of ischemia and one day Tc 99m imaging to detect viability.

Results

The study included 442 patients with mean age of 56.5 years, with male predominance (77%), 38% were diabetics and 58% had hypertension.

Seventy-eight percent of patients had appropriate tests, uncertain tests in 12% and 10% inappropriate studies. 47% of appropriate tests show positive results of SPECT.

Conclusion

We concluded that appropriateness criteria are effective in identifying appropriateness of SPECT in a diverse patient population.
Individualized Asparaginase Dosing in Childhood Acute Lymphoblastic Leukemia
Authors: Kloos Robin Q.H. , Pieters Rob , Jumelet Florine M.V. , de Groot-Kruseman Hester A. , van den Bos Cor , van der Sluis Inge M.
Published: January 2020

PURPOSE

In the DCOG ALL-11 protocol, polyethylene glycol–conjugated Escherichia coli asparaginase (PEGasparaginase) and Erwinia asparaginase treatment of pediatric acute lymphoblastic leukemia are individualized with therapeutic drug monitoring (TDM). The efficacy of TDM and its effect on asparaginase-associated toxicity are reported.

PATIENTS AND METHODS

After induction with 3 fixed intravenous doses of 1,500 IU/m2 PEGasparaginase, medium-risk patients (n = 243) received 14 individualized doses that targeted trough levels of 100-250 IU/L, standard-risk patients (n = 108) received 1 individualized dose, and high-risk patients (n = 18) received 2-5 fixed administrations (1,500 IU/m2). After a neutralizing hypersensitivity reaction, patients were started with 20,000 IU/m2 Erwinia asparaginase 3 times per week, and l-asparagine was measured to monitor asparaginase efficacy. Several asparaginase-associated toxicities were studied.

RESULTS

The final median PEGasparaginase dose was lowered to 450 IU/m2. Overall, 97% of all trough levels of nonallergic patients were > 100 IU/L. Asparagine was < 0.5 μM in 96% and 67% of the PEGasparaginase and Erwinia asparaginase levels > 100 IU/L, respectively. Ten percent developed a neutralizing hypersensitivity reaction to PEGasparaginase, of which 40% were silent inactivations. The cumulative incidence of grade 3-4 pancreatitis, central neurotoxicity, and thromboses was 12%, 4%, and 6%, respectively, and not associated with asparaginase activity levels. During medium-risk intensification, 50% had increased ALT and 3% hyperbilirubinemia (both grade 3/4 and correlated with asparaginase activity levels), and 37% had grade 3/4 hypertriglyceridemia. Hypertriglyceridemia occurred less in intensification compared with ALL-10 (37% v 47%), which is similar to ALL-11 but with higher asparaginase levels during intensification.

CONCLUSION

TDM of asparaginase results in a significant reduction of the PEGasparaginase dose with adequate asparaginase activity levels and sufficient asparagine depletion. In addition, with TDM, silent inactivation and allergic-like reactions were identified. However, the effect of reduced asparaginase activity levels on toxicity is limited.
High-Cost Cancer Treatment Across Borders in Conflict Zones: Experience of Iraqi Patients in Lebanon
Authors: Skelton Mac , Alameddine Raafat , Saifi Omran , Hammoud Miza , Zorkot Maya , Daher Marilyne , Charafeddine Maya , Temraz Sally , Shamseddine Ali , Mula-Hussain Layth , Saleem Mohammed , Namiq Kazim F. , Dewachi Omar , Abu Sitta Ghassan , Abdul-Sater Zahi , Telvizian Talar , Faraj Walid , Mukherji Deborah
Published: January 2020

PURPOSE

Conflict-induced cross-border travel for medical treatment is commonly observed in the Middle East. There has been little research conducted on the financial impact this has on patients with cancer or on how cancer centers can adapt their services to meet the needs of this population. This study examines the experience of Iraqi patients seeking care in Lebanon, aiming to understand the social and financial contexts of conflict-related cross-border travel for cancer diagnosis and treatment.

PATIENTS AND METHODS

After institutional review board approval, 60 Iraqi patients and caregivers seeking cancer care at a major tertiary referral center in Lebanon were interviewed.

RESULTS

Fifty-four respondents (90%) reported high levels of financial distress. Patients relied on the sale of possessions (48%), the sale of homes (30%), and vast networks to raise funds for treatment. Thematic analysis revealed several key drivers for undergoing cross-border treatment, including the conflict-driven exodus of Iraqi oncology specialists; the destruction of hospitals or road blockages; referrals by Iraqi physicians to Lebanese hospitals; the geographic proximity of Lebanon; and the lack of diagnostic equipment, radiotherapy machines, and reliable provision of chemotherapy in Iraqi hospitals.

CONCLUSION

As a phenomenon distinct from medical tourism, conflict-related deficiencies in health care at home force patients with limited financial resources to undergo cancer treatment in neighboring countries. We highlight the importance of shared decision making and consider the unique socioeconomic status of this population of patients when planning treatment.
The Relationship of Gastrinoma in MEN 1 to Helicobacter pylori infection
Authors: Endall Ryan , Thompson Michael , Parameswaran Venkat , Burgess John
Published: January 2020

Context

Helicobacter pylori and Multiple Endocrine Neoplasia Type 1 (MEN 1) are risk factors for hypergastrinemia. Gastrin-secreting neoplasms of the foregut mucosa are both a source of, and potentially stimulated by, hypergastrinemia.

Objective

To determine the relationship between H pylori exposure and the prevalence and severity of hypergastrinemia in patients with MEN 1.

Design, setting & patients

Cross-sectional analysis of patients with a common MEN1 gene mutation managed at a tertiary referral hospital that underwent fasting serum gastrin and H pylori serum IgG measurement.

Intervention

H pylori IgG and serum gastrin concentration, determined via immunoassay.

Main outcome measures

The prevalence and severity of hypergastrinemia and its relationship to past H pylori exposure.

Results

Thirty-four of 95 (36%) patients were H pylori IgG seropositive. H pylori seropositive patients were significantly more likely to exhibit hypergastrinemia compared with seronegative patients (relative risk [RR] 1.72, P = .023). H pylori exposure also predicted severe hypergastrinemia (RR 3.52, P = .026 and RR 9.37, P = .031 for patients with gastrin ≥ ×4 and ≥ ×8 the upper limit of normal [ULN], respectively). Gastrin concentrations ≥ ×10 ULN occurred exclusively in H pylori seropositive patients (0/61 vs 6/34, P = .001). Serum gastrin and alpha subunit were positively associated in H pylori-exposed (β = 0.69, P = .001), but not in H pylori-unexposed patients.

Conclusion

Past H pylori exposure was associated with increased prevalence and severity of hypergastrinemia in MEN 1 patients. Past H pylori-related hypergastrinemia may contribute to the pathogenesis of ongoing gastrin hypersecretion by susceptible foregut neuroendocrine tissues.
Comparison of Supraglottic Airway Devices With Endotracheal Intubation in Low-Risk Patients for Cesarean Delivery: Systematic Review and Meta-analysis
Authors: White Leigh D. , Thang Christopher , Hodsdon Anthony , Melhuish Thomas M. , Barron Fiona A. , Godsall M. Guy , Vlok Ruan
Published: January 2020

BACKGROUND:

The safety and adverse event rate of supraglottic airway (SGA) devices for cesarean delivery (CD) is poorly characterized. The primary aims of this review were to determine whether the first-pass success was higher and time to insertion for SGA was faster than endotracheal intubation for elective CD. The secondary aim was to determine the airway-related adverse event rate associated with SGA use compared to endotracheal intubation in elective CD under general anesthesia (GA).

METHODS:

Six databases were systematically searched until September 2019. Included studies reported on the use of SGA in comparison to endotracheal tube intubation. A comparative meta-analysis between SGA and endotracheal intubation was performed using RevMan 5.3 software. Dichotomous outcomes were reported using an odds ratio (OR) with 95% confidence interval (CI). The results for continuous outcomes were reported using a weighted mean difference (WMD) with 95% CI.

RESULTS:

Fourteen studies with 2236 patients compared SGA and endotracheal intubation. Overall, there was no statistically significant difference in first-attempt success rate (OR = 1.92; 95% CI, 0.85–4.32; I
2 = 0%; P = .44). There was no clinically significant difference in time to insertion (WMD = −15.80 seconds; 95% CI, −25.30 to −6.31 seconds; I
2= 100%; P = .001). Similarly, there was no difference in any adverse event rate except sore throat which was reduced with the use of an SGA (OR = 0.16; 95% CI, 0.08–0.32; I
2= 53%; P < .001).

CONCLUSIONS:

Despite the reasonable insertion success rate and safety profile of SGAs demonstrated in this meta-analysis, the analysis remains underpowered and therefore inconclusive. At present, further studies are required before the use of an SGA as the first-line airway for an elective CD can be recommended.
Exposure to Surgery and Anesthesia in Early Childhood and Subsequent Use of Attention Deficit Hyperactivity Disorder Medications
Authors: Ing Caleb , Ma Xiaoyue , Sun Ming , Lu Yewei , Wall Melanie M. , Olfson Mark , Li Guohua
Published: January 2020

BACKGROUND:

Some recent clinical studies have found that early childhood exposure to anesthesia is associated with increased risks of behavioral deficits and clinical diagnoses of attention deficit hyperactivity disorder (ADHD). While diagnoses in claims data may be subject to inaccuracies, pharmacy claims are highly accurate in reflecting medication use. This study examines the association between exposure to surgery and anesthesia and subsequent ADHD medication use.

METHODS:

Longitudinal data for children enrolled in Texas and New York Medicaid from 1999 to 2010 were used. We assessed the association between a single exposure to anesthesia before age 5 years for 1 of 4 common pediatric surgical procedures (pyloromyotomy, inguinal hernia repair, circumcisions outside the perinatal period, and tonsillectomy and/or adenoidectomy) and persistent ADHD medication use (event defined as the initial ADHD medication prescription, and persistent use defined as filling 2 or more ≥30-day prescriptions between 6 months following surgery until censoring). Exposed children (n = 42,687) were matched on propensity score (ie, the probability of receiving surgery) estimated in logistic regression including sociodemographic and clinical covariates, to children without anesthesia exposure before age 5 years (n = 213,435). Cox proportional hazards models were used to evaluate the hazard ratio (HR) of ADHD medication use following exposure. Nonpsychotropic medications served as negative controls to determine if exposed children simply had higher overall medication use.

RESULTS:

Children with a single exposure to surgery and anesthesia were 37% more likely than unexposed children to persistently use ADHD medication (HR, 1.37; 95% confidence interval [CI], 1.30–1.44). The estimated HRs for common nonpsychotropic medication use following a single anesthetic exposure were 1.06 (95% CI, 1.04–1.07) for amoxicillin, 1.10 (95% CI, 1.08–1.12) for azithromycin, and 1.08 (95% CI, 1.05–1.11) for diphenhydramine. In comparison, the risk of using other psychotropic medication to treat conditions besides ADHD was also significantly higher, with HRs of 1.37 (95% CI, 1.24–1.51) for sedative/anxiolytics, 1.40 (95% CI, 1.25–1.58) for antidepressants, 1.31 (95% CI, 1.20–1.44) for antipsychotics, and 1.24 (95% CI, 1.10–1.40) for mood stabilizers.

CONCLUSIONS:

Medicaid-enrolled children receiving anesthesia for a single common pediatric surgical procedure under age 5 years were 37% more likely to require subsequent persistent use of ADHD medications than unexposed children. Because the increased use of ADHD medication is disproportionately higher than that of nonpsychotropic medications, unmeasured confounding may not account for all of the increase in ADHD medication use. By evaluating Medicaid data, this study assesses children who may be particularly vulnerable to neurotoxic exposures.
Platform Workers of the World, Unite! The Emergence of the Transnational Federation of Couriers
Authors: Cant Callum , Mogno Clara
Published: January 2020

This article provides an introduction to the Transnational Federation of Couriers by presenting the results of ongoing processes of participant observation carried out by the authors. First, it gives an account of the formation of the TFC out of preexisting networks. Second, it moves onto a discussion of how the TFC was able to formulate a set of demands which applied across the different contexts and environments of its member organizations. Third, it discusses how the TFC has functioned in practice, focusing on collective actions and responses to deaths at work. The article finds that workers in platform capitalism have the capacity to generate new forms of collective self-organisation adequate to their recomposed technical and social composition. These forms are not limited to the level of the city or nation, but also exist on the global scale of platforms themselves.
Differences in the Synthetic Method Affected Copolymer Sequence and Membrane Properties of Sulfonated Polymers
Authors: Hosaka Ibuki , Sawano Takatoshi , Kimura Taro , Matsumoto Akinobu , Miyake Junpei , Miyatake Kenji
Published: January 2020

The versatility of the synthesis of sulfonated aromatic polymers using NiBr2 was investigated. The copolymerization of sulfo-dichlorobenzene protected with a neopentyl group was carried out with chlorine-terminated oligomer (1) or three different comonomers (2, 3, 4). The copolymerization proceeded well to obtain high molecular weight copolymers (Mn = 4.83–60.1 kDa, Mw = 24.9–133 kDa) and provided flexible membranes, comparable to those obtained with Ni(0) as a polymerization promoter. 1H NMR spectra suggested differences in the comonomer sequence between the copolymers synthesized with Ni(II) and Ni(0). The sequence was quantified as a “randomness of sulfophenylene (SP) unit” and correlated with the membrane properties. The randomness of SP unit in the sulfonated polyphenylene copolymer (SPP-QP) did not affect the phase-separated morphology under the dry-state as suggested by TEM images. SAXS analysis under humidified conditions revealed that the SPP-QP with lower randomness of SP unit formed higher periodicity in the self-assembling structures (i.e., the uniform-sized ionic clusters). The increase of the randomness of SP unit from 19% to 47% in SPP-QP caused decrease of the proton conductivity (at 80 °C and 20% RH) by a factor of 1/1.7 and decrease of the elongation (at 80 °C and 60% RH) by a factor of 1/27. Similar tendency was observed for other series of the sulfonated copolymer membranes.
Tactile and Physical Properties of Cosmetic Powders with a Shittori Feel
Authors: Tsuchiya Reiichiro , Kuhara Rieko , Kikegawa Kana , Nagatani Noboru , Nonomura Yoshimune
Published: January 2020

Shittori feel is defined as a texture that is moderately moisturized and is one of the most favorable textures for many Japanese. In this research, we studied the relationship between the tactile and physical properties of cosmetic powders to determine the specific factors that make up shittori feel. We selected nine cosmetic powders with different sizes, shapes, and touch to conduct physical and tactile evaluations. These evaluations suggested that shittori feel is a complex combination of moist and smooth feels induced by a frictional phenomenon on skin. The moist and smooth feels are perceived when the finger starts to move and when the finger rubs the powders, respectively.
The presence of the ACA box in archaeal H/ACA guide RNAs promotes atypical pseudouridylation
Authors: Majumder Mrinmoyee , Mukhopadhyay Shaoni , Kharel Parinati , Gupta Ramesh
Published: January 2020

Archaea and eukaryotes, in addition to protein-only enzymes, also possess ribonucleoproteins containing an H/ACA guide RNA plus four proteins that produce pseudouridine (Ψ). Although typical conditions for these RNA-guided reactions are known, certain variant conditions allow pseudouridylation. We used mutants of the two stem–loops of the Haloferax volcanii sR-h45 RNA that guides three pseudouridylations in 23S rRNA and their target RNAs to characterize modifications under various atypical conditions. The 5′ stem–loop produces Ψ2605 and the 3′ stem–loop produces Ψ1940 and Ψ1942. The latter two modifications require unpaired “UVUN” (V = A, C, or G) in the target and ACA box in the guide. Ψ1942 modification requires the presence of U1940 (or Ψ1940). Ψ1940 is not produced in the Ψ1942-containing substrate, suggesting a sequential modification of the two residues. The ACA box of a single stem–loop guide is not required when typically unpaired “UN” is up to 17 bases from its position in the guide, but is needed when the distance increases to 19 bases or the N is paired. However, ANA of the H box of the double stem–loop guide is needed even for the 5′ typical pseudouridylation. The most 5′ unpaired U in a string of U's is converted to Ψ, and in the absence of an unpaired U, a paired U can also be modified. Certain mutants of the Cbf5 protein affect pseudouridylation by the two stem–loops of sR-h45 differently. This study will help elucidate the conditions for production of nonconstitutive Ψ’s, determine functions for orphan H/ACA RNAs and in target designing.
Population pharmacokinetics of artesunate and dihydroartemisinin in pregnant and non-pregnant women with uncomplicated Plasmodium falciparum malaria in Burkina Faso: an open label trial
Authors: Birgersson Sofia , Valea Innocent , Tinto Halidou , Traore-Coulibaly Maminata , Toe Laeticia C. , Hoglund Richard M. , Van Geertruyden Jean-Pierre , Ward Stephen A. , D’Alessandro Umberto , Abelö Angela , Tarning Joel
Published: January 2020

Background: Malaria during pregnancy is a major health risk for both the mother and the foetus. Pregnancy has been shown to influence the pharmacokinetics of a number of different antimalarial drugs. This might lead to an under-exposure in these patients which could increase the risk of treatment failure and the development of drug resistance. The study aim was to evaluate the pharmacokinetics of artesunate and dihydroartemisinin in pregnant and non-pregnant patients using a population modelling approach.

Methods: Twenty-four women in their second and third trimester of pregnancy and twenty-four paired non-pregnant women, all with uncomplicated P. falciparum malaria, were enrolled in this study. Treatment was a fixed-dose combination of oral artesunate and mefloquine once daily for three days. Frequent blood samples were collected and concentration-time data for artesunate and dihydroartemisinin were analysed simultaneously using nonlinear mixed-effects modelling.

Results: Artesunate pharmacokinetics was best described by a transit-compartment absorption model followed by a one-compartment disposition model under the assumption of complete in vivo conversion of artesunate into dihydroartemisinin. Dihydroartemisinin pharmacokinetics was best described by a one-compartment disposition model with first-order elimination. Pregnant women had a 21% higher elimination clearance of dihydroartemisinin, compared to non-pregnant women, resulting in proportionally lower drug exposure. In addition, initial parasitaemia and liver enzyme levels (alanine aminotransferase) were found to affect the relative bioavailability of artesunate.

Conclusions: Results presented here show a substantially lower drug exposure to the antimalarial drug dihydroartemisinin during pregnancy after standard oral treatment of artesunate and mefloquine. This might result in an increased risk of treatment failure and drug resistance development, especially in low transmission settings where relative immunity is lower.

Trial registration: ClinicalTrials.gov NCT00701961 (19/06/2008)
Chronic Headache: The Only Manifestation of Cerebellar Tuberculoma
Authors: Israr Khan Diwan , Anas M , A Khan Abiha , Khan Samreen
Published: January 2020

Despite of availability of highly efficacious treatment for decades, tuberculosis remains a major global health problem in developing countries, like India where tuberculosis is an endemic disease.1 Tuberculous involvement of brain is a rare presentation of extra pulmonary tuberculosis. The infection usually gets access to the brain through hematogenous route. The disease commonly affects children with equal involvement of both sexes and has close association with HIV. The usual manifestation of the disease is fever, unexplained weight loss, nausea, vomiting, headache, seizures, behavioral changes, focal neurological deficit and gait difficulty. Here is a case of cerebellar tuberculoma in an 8 years old male presenting as chronic headache for one and half years.
Surface ModificationTo Reduce Deposition Flux of Spray Dried Noni (Morinda Citrofolia L.) Juice
Authors: Zainal Abidin Noraziani , Irwan Zubairi Saiful , Hashim Haslaniza
Published: January 2020

ABSTRACT: Spray drying is widely spread technique for drying of liquid products especially fruit juices such as noni juice. However, during spray drying of noni juice stickiness problem commonly occurs due to low molecular weight sugars (sucrose, glucose and fructose). The aim of the present research was to determine the impact of Teflon surface modification on the yield of spray dried Noni juice and deposition flux. Different exposure time of feed spray was undertaken prior to adhesion flux weight determination. Three different sets of inlet temperature (100 oC, 150 OC and 190 oC) and exposure times (of 15 min, 30 min, 60 min, 75 min, 90 min and 115 min) were tested. Samples were evaluated for contact angle, weight of adhesion flux, hygroscopicity and moisture content. There was a sudden increased in deposition flux (p<0.05) as the temperature increased. At 150 and 190°C, the weight of deposition flux was not significant (p>0.05) for both plate materials. The borosilicate plates (BP) registered up to 80% deposit removal whilst Teflon plate (TP) recorded only 20%. Physical observation of the Teflon plates showed that some areas of the plate (100 °C) were fully clear from any particles. Nevertheless, for the borosilicate glass plates, the primary adhered particles tend to retain and smeared along the plates. In addition, there was a substantially negative relationship between the contact angle and adhesion weight, (r = -0,924, p<0.01). The negative connection suggests that by increasing the contact angle, the adhesion weight will decrease and vice versa. The contact angle of the Teflon (PTEFE) surface was approximately 117.2 ± 1.4°, which provided an excellent hydrophobic surface. In this research, the powder with the lowest amount of hygroscopicity was gained at 190 oC using the Teflon plate. For that reason, surface modification was indeed amplified the surface hydrophobicity thus decreasing the deposition flux.
Chromatographic Analysis of Ethanol Extract of Funtumia elastica leaves and stem bark and their antimicrobial activity
Authors: Mathias T. , Asegbeloyin J.N. , Oyeka E.E. , Oji E.O. , Akpomie K.G.
Published: January 2020

The study evaluated the antimicrobial activity based on chromatographic analysis of ethanolic extract of Funtumia elastica leaves and stem bark. Funtumia elastica leaf and stem bark samples were air dried, grinded and extracted in ethanol by soxhlet extraction. The defatted ethanol extract was partitioned in dilute sodium hydroxide, hydrochloric acid and chloroform to obtain basic, neutral and acidic metabolites. The phytochemical test on the defatted crude extract of Funtumia elastica leaf and stem bark show the presence of tannins, alkaloids, flavonoids, saponins, terponoids, anthraquinone, phenolics and steroids. The crude extract, basic, neutral and acidic metabolites, and the fractions obtained by thin layer chromatography were screened for their antimicrobial activity at concentration of 100mg/ml against Streptococcus pneumoniae(sp), Staphylococcus aureus(sa), Salmonella typhi(st), Escherichia coli(ec) and Candida albicans(ca). The results show that the crude extract of stem with inhibition zone diameter(mm) of 22, 18, 20, 22 and 20 against (sp), (sa), (st), (ec) and (ca) respectively had better antimicrobial activity than the crude extract of leaf with inhibition zone diameter(mm) of 16,10,16,14 and 12 against (sp), (sa), (st), (ec) and (ca) respectively. Also the TLC fractions exhibited lower antimicrobial activity when compared to that of the basic metabolites. The fractions obtained by thin layer chromatography which showed promising antimicrobial activity were analysed by gas chromatography mass spectroscopy (GC/MS). The GC/MS spectra revealed thirty-nine peaks from which thirty nine compounds were identified. The identified compounds were mainly carboxylic acids and esters. The results of antimicrobial screening show that the crude extracts of the stem bark with inhibition zone diameter (mm) of 22, 18, 20, 22 and 20 were comparable to the standard drugs ciprofloxacin with inhibition zone diameter (mm) of 18, 20, 20, and 15 and gentamycin with inhibition zone diameter (mm) of 10, 20, 15, 12, and 18.