bluuebunny/crossref_metadata_2025 huggingface dataset:
Direct-seq: employing programmed gRNA scaffold for streamlined scRNA-seq in CRISPR screen
Authors: Wang Lixia , Ma Lijia
Published: June 2020

This protocol aimed to combine the single cell RNA-seq (scRNA-seq) with the CRISPR screening assay based on 10x 3’ RNA-seq platform to profile the transcriptome together with genotype at single cell resolution. To achieve this goal, an A/G mixed capture sequence and tRNA sequence are incorporated into the Tetraloop, Loop2 and Tail of the gRNA scaffold. Therefore, cDNA derived from the gRNA transcripts can be captured and barcoded by poly(dT) primer together with the endogenous mRNA and enriched by the nest PCR. With this method, the CRISPR perturbation and its transcriptional readouts can be profiled together in a streamlined workflow. This method, which we named as Direct-seq, enabled the direct genotyping and expression profiling of the CRISPR screening products at single cell resolution on versatile scRNA-seq platforms across different throughput, including 10x 3’ and 5’ RNA-seq, Fluidigim C1, SMART-seq, BGI DNBelab C4 and others.
A process for developing a sustainable and scalable approach to community engagement: Community Dialogue Approach for addressing the drivers of antibiotic resistance in Bangladesh
Authors: King Rebecca , Hicks Joseph , Rassi Christian , Shafique Muhammad , Barua Deepa , Bhowmik Prashanta , Das Mahua , Elsey Helen , Questa Kate , Fieroze Fariza , Hamade Prudence , Huque Sameena , Newell James , Huque Rumana
Published: June 2020

Background Community engagement approaches that have impacted on health outcomes are often time intensive, small-scale and require high levels of financial and human resources. They can be difficult to sustain and scale-up in low resource settings. Given the reach of health services into communities in low income countries, the health system provides a valuable and potentially sustainable entry point that would allow for scale-up of community engagement interventions. This study explores the process of developing an embedded approach to community engagement taking the global challenge of antibiotic resistance as an example.Methods The intervention was developed using a sequential mixed methods study design. This consisted of: exploring the evidence base through an umbrella review, and identifying key international standards on the appropriate use of antibiotics; undertaking detailed formative research through a) a qualitative study to explore the most appropriate mechanisms through which to embed the intervention within the existing health system and community infrastructure, and to understand patterns of knowledge, attitudes and practice regarding antibiotics and antibiotic resistance; and b) a household survey – which drew on the qualitative findings - to quantify knowledge, and reported attitudes and practice regarding antibiotics and antibiotic resistance within the target population; and c) drawing on appropriate theories regarding change mechanisms and experience of implementing community engagement interventions to co-produce the intervention processes and materials with key stakeholders at policy, health system and community level.Results A community engagement intervention was co-produced and was explicitly designed to link into existing health system and community structures and be appropriate for the cultural context, and therefore have the potential to be implemented at scale. We anticipate that taking this approach increases local ownership, as well as the likelihood that the intervention will be sustainable and scalable.Conclusions This study demonstrates the value of ensuring that a range of stakeholders co-produce the intervention, and ensuring that the intervention is designed to be appropriate for the health system, community and cultural context.
Comparison of non-schistosomal colorectal cancer and schistosomal colorectal cancer
Authors: Wang Weixia , Lu Kui , Wang Limei , Jing Hongyan , Pan Weiyu , Huang Sinian , Xu Yanchao , Bu Dacheng , Cheng Meihong , Liu Jing , Liu Jican , Shen Weidong , Zhang Yingyi , Yao Junxia , Zhu Ting
Published: June 2020

Aim: The purpose of this study was to compare clinicopathological features of patients with non-schistosomal and schistosomal colorectal cancer to explore the effect of schistosomasis on CRC patients` clinical outcomes. Methods: 351 cases of CRC were retrospectively analyzed in this study. Survival curves were constructed by using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazard regression models were performed to identify associations with outcome variables.Results: Patients with schistosomiasis (CRC-S) were significantly older (Table 3, P＜0.001) than patients without schistosomiasis (CRC-NS). However, there were no significant differences between CRC-S and CRC-NS patients in other clinicopathological features. Schistosomiasis were associated with adverse overall survival upon K-M analysis (P=0.0277). By univariate and multivariate analysis, as shown in Table 2, gender (P=0.003), TNM stage (P＜0.001), schistosomiasis (P=0.025), lymphovascular invasion (P=0.030) and cancer node (P＜0.001) were all independent predictors in the whole cohort. When patients were stratified according to clinical stage and lymph node metastasis state. Schistosomiasis was also an independent predictors in patients with stage Ⅲ-Ⅳ tumors and in patients with lymph node metastasis, but not in patients with stage Ⅰ-Ⅱ tumors and in patients without lymph node metastasis.Conclusion: Schistosomiasis was significantly correlated with OS and it was an independent prognostic factor for OS in the whole cohort. When patients were stratified according to clinical stage and lymph node metastasis state, schistosomiasis was still an independent unfavorably prognosis factor for OS in patients with stage Ⅲ-Ⅳ tumors or patients with lymph node metastasis.
Investigating the Effects of picture book on Reducing Distress Caused by Intravenous Catheterization among School-aged Children (randomized clinical trial)
Authors: Kanikzadeh Masoumeh , Tahmasebi Rahim , bahreini farideh , jahanpour faezeh
Published: June 2020

Background: Hospitalized pediatric patients experience pain, fear, and distress during intravenous catheterization. This study investigates the effects of a picture book on reducing distress caused by intravenous (IV) catheterization among school-aged children.Methods: seventy four Pediatric emergency room patients age 6-12 years old requiring Iv Infusion were enrolled in this randomized clinical trial. The intervention, providing a description of the IV catheterization procedure using a picture book, was compared to the same description of the procedure without a picture book (standard of care). Subject distress was measured using the Observation Scale of Behavior Distress Revised (OSBD_R) which assigns a score to eight observable behaviors. Before, during, and after the procedure at 15-second intervals (measured using a timer), a trained observer assigned an OSBD_R score of distress. A total score of 22 is considered maximum distress. The primary endpoint for the study was OBSD_R score difference in Phase 3 (Performing catheterization procedure, attaching and infusion therapy). Chi-square, Mann-Whitney and Wilcoxon tests were used for data analysis. Results: The mean distress score in third phases for the intervention group (0.667 ± 0.610) was significantly less than that of the control group (3.218 ± 1.799). A significant difference in distress score was observed before and after the intervention (p< 0.001).Conclusions: Children’s distress due to IV catheterization can be reduced with a simple, nonpharmacological picture book intervention. The children’s orientation on the IV catheterization plays a significant role in controlling and reducing their distress during and after the intervention. We suggested using the picture book to reduce the children distress before Intravenous Catheterization.
Hydrological Functioning of Forested Catchments, Central Himalayan Region, India.
Authors: Qazi Nuzhat Ul Qayoom
Published: June 2020

Background: Central Himalayan forested catchments provide fresh water supply and innumerable ecosystem services to millions of people. Hence, the understanding of linkages between forests and water is very crucial to recognize for availability and quality of water at catchment scale. Therefore, present study aims to understand hydrological response of two forested catchments (namely, Arnigad and Bansigad) in the Central Himalayan Region.Methods: Three-year data (March, 2008 to February, 2011) were collected from meteorological and hydrological stations installed at Arnigad and Bansigad catchments. The present paper displays mean hydrological response of forested catchments through detailed field investigation.Results : The annual hyetograph analysis revealed that the rainfall at both the catchments was highly seasonal, and wet-period (June-September) plays a key role in catchment functioning. Exceedance of rainfall threshold of ~200 mm (~10% of annual rainfall) significantly increased streamflow generation at both the catchments. At Arnigad, stream was perennial with a mean baseflow of ~83 mm per month (~ 6 % of annual baseflow) whereas, Bansigad had greater seasonality due to lack of streamflow during the pre-wet-period (March-May). Separation of hydrographs at Arnigad and Bansigad catchments i.e. stormflow (6% and 31%, respectively) and baseflow (50% and 32%, respectively) helped to understand the probability of flooding during wet-period and drought during dry-period. Forest ecosystem at Arnigad improved the hydrological functioning by: reducing stormflow (82%), and enhancing: baseflow (52%), soil moisture (13%), steady infiltration rate (22%) and lag time (~15 minutes) relative to Bansigad. These enhanced values indicated soil capability to store water at forested catchment (Arnigad) and helped to understand the volume of water (discharge) that was available during dry-period. The decrease of denudation rate (at Arnigad) by 41% resulted decrease in suspended sediment (18%) and bed load (75%) compared to Bansigad. Further, the enhancement of dissolved solids in stream resulted due to maximum organic matter generated in forest floor of Arnigad. Conclusion: This study accomplishes that rainfall during the wet-period was the main driver of hydrological functioning, whereas, forests provided substantial services by regulating water balance, soil moisture and sediment budget at Arnigad catchments through different mechanisms of forest components at catchment-scale in the Central Himalayan region.
The Effect of Social Norm-based Intervention with Observable Behaviour on Physical Activity among Adolescents: A Randomized Controlled Trial
Authors: Lee Jia Jia , Nadkarni Nivedita Vikas , Teo Irene , Ozdemir Semra
Published: June 2020

Background: To evaluate the effectiveness of providing descriptive norms messages with personal identification in promoting physical activity among adolescents by measuring step counts via a randomized controlled trial (NCT03081013). Methods: A total of 311 participants aged 13-16 were randomized into two study arms (Onymous and Anonymous Arms). Each arm consisted of 13 groups of 12 participants. During the trial, participants received weekly short message service (SMS) about their past week’s physical activity performance Participants in the Anonymous Arm received information about step counts of group members ranked from highest to lowest. Participants in the Onymous Arm received the same information with the group members’ full names. Participants’ quality of life, depression, and physical activity social support, self-efficacy and enjoyment before and after the intervention were also evaluated. This study adheres to the CONSORT guidelines. Results: The number of steps was not higher when descriptive norm message was onymous compared to when it was anonymous. Scores in quality of life, depression, social support, self-efficacy, and enjoyment of physical activity were not significantly different between both arms (p>0.05). Conclusions: Our findings indicated that the effect of providing descriptive norms messages containing personal identification on physical activity promotion was not evident in the main analysis.
Psychometric properties of the Chinese version of the aging transformation scale for elderly dementia patients
Authors: li you lai , yu bo li , sun ning , dong xin xiao , ying chen yu , lang jun han , zhou heng li
Published: June 2020

Background: The key part of home care services is the assessment of the needs of the home environment for elderly patients with dementia. The present study was conducted to evaluate the psychometric properties of a newly adapted Chinese version of an instrument designed to measure aging transformation needs among elderly patients with dementia.

Methods: A sample of 175 patients with elderly dementia was selected from ten communities in China. The 55-item aging transformation needs scale was answered by the participants. Content validity, Cronbach’s alpha, item-to-total correlation, and exploratory factor analysis were used to assess the reliability and validity of the instrument.

Results: The aging transformation needs scale has a good surface validity, content validity, and structural validity. The content validity was 0.965; 55 items had large factor loads on their corresponding principal components (≥0.5). There was a significant correlation between the aging transformation needs scale and each component (r = 0.897-0.973, all P<0.01), and 9 components also had a high correlation (r = 765～0.977, all P<0.01); the total table Cronbach's α was 0.993, the Cronbach's α of each constituent factor was 0.944～0.990, and the correlation coefficient between factor and content was >0.40 (all P<0.01).

Conclusions: Evidence was found to support the reliability and validity of the aging transformation needs scale that measures the quality of the aging transformation needs for patients with elderly dementia from an aging transformation needs perspective.
Long non-coding RNA CASC15 promotes HCC progression via modulation of Six1 targeted by miR-2355-5p
Authors: Hong Han , Sui Chengjun , Qian Tao , Xu Xiaoyong , Zhu Xiang , Fei Qiang , Yang Jiamei , Xu Minhui
Published: June 2020

Background: Long-chain non-coding RNA (LncRNA) plays a key role in the biological processes of tumors. LncRNA CASC15 has been shown to be involved in the development of a variety of tumors. The study aimed to elucidate the mechanism of lncRNA CASC15 in the progression of hepatocellular carcinomas (HCC).Methods: qRT-PCR was used to detect the expression levels of CASC15, miR-2355-5p and Six1 mRNA in HCC tissues and cells. Six1 protein expression levels were detected by Western Blot. CCK-8 experiment, colony formation experiment, Edu staining and Transwell experiment analysis were used to analyze the effects of CASC15, miR-2355-5p and Six1 on cell proliferation, cell invasion and migration. The relationship between CASC15, miR-2355-5p and Six1 was analyzed using bioinformatics analysis and Luciferase.Result: CASC15 was raised in HCC tissues and HCC cells. Down-regulation of CASC15 inhibited the growth, migration, invasion and tumor growth of HCC cells. The expression level of miR-2355-5p was reduced in HCC tissues. In addition, miR-2355-5p inhibitor induced the growth, migration and invasion of HCC cells. MiR-2355-5p was predicted to be a downstream target of CASC15. The expression level of miR-2355-5p was negatively correlated with CASC15 in HCC tumor tissues. Six1 was predicted to be a downstream target of miR-30a-5p. In vitro and in vivo results showed that CASC15/miR-2355-5p can regulate Six1.Conclusion: LncCASC15 regulated the proliferation and invasion of Six1 by binding with miR-2355-5p in HCC, suggesting that CASC15 may be a potential target for HCC.
Development of a Survival Model Based on Autophagy-Associated Genes for Predicting Prognosis of Gastric Cancer
Authors: Yang Wanli , Duan Lili , Zhao Xinhui , Niu Liaoran , Li Yiding , Wang Xiaoqian , Zhang Yujie , Zhou Wei , Liu Jinqiang , Zhao Qingchuan , Han Yu , Fan Daiming , Hong Liu
Published: June 2020

Background: Gastric cancer (GC) is one of lethal diseases worldwide. Autophagy-associated genes play a crucial role in the cellular processes of GC. Our study aimed to investigate and identify the prognostic potential of autophagy-associated genes signature in GC. Methods: RNA-seq and clinical information of GC and normal controls were downloaded from The Cancer Genome Atlas (TCGA) database. Then, the Wilcoxon signed-rank test was used to pick out the differentially expressed autophagy-associated genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to investigate the potential roles and mechanisms of autophagy-associated genes in GC. Cox proportional hazard regression analysis and Lasso regression analysis were carried out to identify the overall survival (OS) related autophagy-associated genes, which were then collected to construct a predictive model. Kaplan-Meier method and receiver operating characteristic (ROC) curve were utilized to validate the accuracy of this model. Finally, a clinical nomogram was established by combining the clinical factors and autophagy-associated genes signature. Results: A total of 28 differentially expressed autophagy-associated genes were identified. GO and KEGG analyses revealed that several important cellular processes and signaling pathways were correlated with these genes. Through Cox regression and Lasso regression analyses, we identified 4 OS-related autophagy-associated genes (GRID2, ATG4D, GABARAPL2, and CXCR4) and constructed a prognosis prediction model. GC Patients with high-risk had a worse OS than those in low-risk group (5-year OS, 27.7% vs 38.3%; P=9.524e-07). The area under the ROC curve (AUC) of the prediction model was 0.67. The nomogram was demonstrated to perform better for predicting 3-year and 5-year survival possibility for GC patients with a concordance index (C-index) of 0.70 (95% CI: 0.65-0.72). The calibration curves also presented good concordance between nomogram-predicted survival and actual survival. Conclusions: We constructed and evaluated a survival model based on the autophagy-associated genes for GC patients, which may improve the prognosis prediction in GC.
The effects of navigation and tranexamic acid in reducing the need for blood transfusion after TKA
Authors: Song Suk Kyoon , Kim Hee Chan , Chae Seung Bum , choi wonkee
Published: June 2020

Background:

We investigate the synergistic effect of the use of tranexamic acid and navigation in reducing the need for blood transfusion after total knee arthroplasty (TKA). Secondly, we compare the effects of navigation and tranexamic acid on blood transfusion reduction after TKA.
Methods:

Patients were divided into 3 groups and compared. Those who had manual TKA with the use of tranexamic acid were group 1 (N = 30), those who had navigated TKA without tranexamic acid were group 2 (N = 30), and those who had navigated TKA with tranexamic acid were group 3 (N = 30). Group 1 was studied prospectively, while group 2 and 3 were studied retrospectively. All operation was held by one operator. We measured the frequency of transfusion after the operation within the admission period. To compare the postoperative bleeding, drainage volume during two days after surgery was compared and analyzed.
Results:

Group 1 (Manual TKA with tranexamic acid) had 2 cases of transfusion (6.7%), while there were 9 cases in group 2 (Navigated TKA with no tranexamic acid) (30%), and 3 cases in group 3 (Navigated TKA with tranexamic acid) (10%). In Chi-square test, this difference was statistically significant. Average of 525.50 ± 194.91 ml of drainage was drained in two days after surgery in group 1 (Manual TKA with tranexamic acid), 611.60 ± 263.20 ml in group 2 (Navigated TKA with no tranexamic acid) and 411.42 ± 188.21 ml in group 3 (Navigated TKA with tranexamic acid). This difference was analyzed in one-way ANOVA which showed significantly different. The need for transfusion in group 2 (Navigated TKA with no tranexamic acid) was 5.86 times higher than that in group 1 (Manual TKA with tranexamic acid). The necessity of transfusion in the group 3 (Navigated TKA with tranexamic acid) was 0.199 times higher than that of the group 2 (Navigated TKA with no tranexamic acid).
Conclusion:

The combined use of navigation and tranexamic acid has no synergistic effect in reducing post TKA bleeding and the need for blood transfusion compared to tranexamic acid alone. And, use of tranexamic acid is more effective than navigation in reducing blood transfusions and blood loss after TKA.
Analysis of Paeoniflorin Treatment of Cancer Based on Bioinformatic Network and Potential Target Prediction
Authors: yongan Jiang , yu Liu Jia , Dongdong Li , Wangwang Hong , ru'en Liu
Published: June 2020

In the synthesis of chemical drugs used to treat various cancers and tumors,more and more scientists are now focusing on the development of natural extracts.Paeoniflorin,as an important compounds of the total glucosides of peony,,had therapeutic effects on a variety of cancers in vivo and in vitro experiments.The purpose of this study was to use biological information analysis to reveal the basic mechanism and potential molecular mechanism of paeoniflorin treatment.We evaluated the efficacy of paeoniflorin through Traditional Chinese Medicine Systems Pharmacology Database(TCMSP).The potential targets of paeoniflorin were identified and summarized by Comparative Toxicogenomics Database (CTD),and GeneMANIA protein interaction analysis was performed online.Also.We used WebGestalt for Gene Ontology(GO) analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) analysis and functional annotation.Finally,cytoscape was used to construct the paeoniflorin-target-pathway network to predict the results.
Investigating the Effective Factors on Implementation of World Health Organization Package of Essential Non communicable Disease Interventions for Primary Health Care in Low Resource Settings: A Scoping review
Authors: Aminpour Mina , Aryankhesal Aidin , Seyfori Nasrin
Published: June 2020

Background/objective:

Due to the widespread prevalence of non-communicable diseases, the World Health Organization has designed a package of essential interventions for non-communicable diseases for primary health care in low-resource settings. This study aimed to investigate the factors affecting the implementation of the WHO PEN for primary health care in low-resource settings.
Materials and Methods

This research was conducted through a five-step process of scoping review. We first searched for the keywords Noncommunicable Diseases, NCD, WHO PEN, PEN and other synonyms for these words to find the suitable analytical studies in databases including PubMed / MEDLINE, Scopus Cochrane Library, Web of Science, Google Scholar. The articles were then selected based on the PRISMA 2009 Flow Diagram. Finally, to analyze the content from the results section of the selected articles, we used the framework analysis method to extract the study implementation outcome and the factors affecting it.
Results

A total of 26 articles were included. Most articles are from 2016 to 2018. Most of the articles were cross-sectional and most studies evaluated the outcomes of Appropriateness and Feasibility. Identified effective factors include target population coverage, staff training, patient motivation, patient follow-up, and observance of PEN protocols.
Conclusion

Using this study, policymakers and managers of the health system will be able to implement this package (WHO PEN) more successfully.
Assessment of Vestibular and Oculomotor Function in Patients with Vestibular Migraine: A Preliminary Study
Authors: Fu Wei , Han Junliang , He Feng , Bai Ya , Wei Dong , Chang Ning , Shi Ying , Wang Yuanyuan
Published: June 2020

Background: The purpose of the study is to assess the vestibular and oculomotor function in patients with vestibular migraine(VM).And we also investigate the relationship between test resultsandeffectiveness of prophylactic medication.Methods: We recruited 41 patientswith VM. They were examinedwith vestibular-evoked myogenic potentials(VEMP), video head impulse test(vHIT) and videonystagmography(VNG), including spontaneous or positional nystagmus, gaze-evoked nystagmus, smooth pursuit and caloric irrigation testing.All VM patients were treated withprophylactic medications. Theintensity of vertigo were evaluated with dizziness handicap inventory(DHI) before and after treatment. After 6 months, we evaluate the effectiveness of prophylactic medication. We analyzed the relationship between test resultsandeffectiveness of prophylactic medication.Results:In vestibular function test,71% of VM patients showed abnormal result. 20% showed abnormal air-conducted cVEMP and 42% showed abnormal air-conducted oVEMP. 32% showed abnormal vHIT and 56% showed abnormal caloric irrigation test.The abnormal rate of oVEMP was significantly higher than cVEMP (p<0.05). And the abnormal rate of caloric irrigation test was significantly higher than vHIT(p<0.05). In oculomotor function test, 42% showed pathological result. The abnormal rate of oculomotor function test was significantly lower than vestibular function test (p<0.05). After 6 months follow-up, rate of good effectiveness was significantly higher in normal vestibular function test group compared with the abnormal vestibular function test group (p<0.05). Rate of good effectiveness was no statistically significant difference between normal oculomotor function test group and abnormal oculomotor function test group (p>0.05).Conclusions: Abnormal vestibular and oculomotor function are commonly observed in VM patients. And VM patients with abnormal vestibular function have a weak effectiveness of prophylaxis medications.
Perinatal morbidity and mortality and the impact of neonatal resuscitation day-by-day calamity evidenced by a prospective descriptive study in Guinea-Conakry
Authors: DIALLO Abdourahamane , DIALLO Ibrahima Sory , BAH Ibrahima Koussy , DIALLO Mamadou Cellou , DESSEAUVE David , SY Telly , ROTH-KLEINER Matthias
Published: June 2020

Background

Perinatal mortality represents a major health care problem in particular in low and middle-income countries, which account for 97% of all late fetal and 98% of all neonatal deaths. Our objectif was to analyse perinatal morbidity and mortality at the largest maternity clinic of Guinea, in sub-Saharan Africa.
Patients & Methods:

Prospective observational evaluation of the perinatal morbidity and mortality between May 1st and June 30th 2019 at the Clinic of Obstetrics of the University Hospital Ignace Deen in Conakry, Guinea.
Results

Of the 1189 deliveries, 98 (82‰) fetus were born dead, 58.1% of them with signs of maceration. 14.1% of all infants had low birth weight (< 2500 g) and 10.6% were macrosome (> 4000 g). The rate of preterm infants was 9.3% and 99 infants (8.3%) showed signs of post-maturity. At birth, 6.8% of all live born infants had asphyxia, 10.9% respiratory distress, 1.9% infection, 0.3% malformation, and nine infants died within the first postnatal minutes. Need for any resuscitation manoeuvres showed 304 infants (27.9%), 68.8% of them needed bag and mask ventilation and 27.0% chest compressions. Infants with bad Apgar score at 1 and 5 minutes did improve by 10 minutes thanks to respiratory support, but not due to chest compression. As there is no neonatal unit in the same hospital, 192 infants (17.6%) had to be transferred across Conakry to the only tertiary neonatal unit. Due to lack of any (para-)medical transport system for newborn infants, mortality of these neonates is very high and adds to the total perinatal mortality of 143.8 deaths/1000 deliveries.
Conclusions

Late pregnancy control is very poor in Conakry, leading to delayed referral of high-risk pregnancies to the university hospital. This goes along with high rates of stillbirths, post-term and macrosome infants with increased risk for delivery complications like postnatal adaptation problems and asphyxia. Resuscitation algorithm needs to be adapted to the local context. A hospital-based neonatal unit for primary stabilization and a medicalised neonatal transport system within Conakry needs to be implemented to decrease the high mortality rate.
Association between multi-site atherosclerotic plaques and systemic arteriosclerosis: results from the BEST study (Beijing Vascular Disease Patients Evaluation Study)
Authors: liu huan , Liu Jinbo , Huang Wei , Zhao Hongwei , zhao Na , wang Hongyu
Published: June 2020

Background Arteriosclerosis can be reflected in various aspect of the artery, including atherosclerotic plaque formation or stiffening on the arterial wall. Both arteriosclerosis and atherosclerosis are important and closely associated with cardiovascular disease (CVD). The aim of the study was to evaluate the association between systemic arteriosclerosis and multi-site atherosclerotic plaques. Methods The study was designed as an observational cross-sectional study. A total of 1178 participants (mean age 67.4 years; 52.2% male) enrolled into the observational study from 2010 to 2017. Systemic arteriosclerosis was assessed by carotid femoral artery pulse wave velocity (CF-PWV) and multi-site atherosclerotic plaques (MAP, >=2 of the below sites) were reflected in the carotid or subclavian artery, abdominal aorta and lower extremities arteries using ultrasound equipment. The associations were assessed by multivariable logistic regression. Results The prevalence of CF-PWV >12 m/s and MAP were 40.2% and 74.4%. Atherosclerotic plaques in 3 sites were more common in male compared with that in female (48.9% versus 36.9%, p<0.05). All CVD factors were worse in participants with MAP than that with <=1 site. Participants with CF-PWV>12m/s corresponded to a mean 82% probability of MAP with age and sex-adjusted. Patients with peripheral artery disease showed the highest odds ratio (OR) (3.88) for MAP, followed by smoking (2.485), CF-PWV>12m/s (2.25), dyslipidemia (1.89), male (1.84), stroke (1.64), hypoglycemic agents (1.56) and age (1.09) (all p<0.001). Conclusions MAP was highly prevalent in this cohort, with male showing a higher prevalence than female. Higher systemic arteriosclerosis was independently associated with MAP, which indicating the supplementary value of arteriosclerosis for the earlier identification and intervention on MAP.
Chirality Status Of Registered Medicines In Tanzania: A Retrospective Cross-Sectional Study
Authors: Mwamwitwa Kissa Watson , Kaibere Raphael M. , Fimbo Adam M. , Sabitii Wilber , Ntinginya Nyanda E. , Mmbaga Blandina T. , Shewiyo Danstan H. , Shearer Morven C. , Smith Andrew D. , Kaale Eliangiringa A.
Published: June 2020

Background

Medicines with a stereogenic center (asymmetric carbon) mainly presents as racemates with a mixture of equal amounts of enantiomers. One enantiomer may be active while the other inactive, alternatively one may produce side-effects and even toxicity. Worldwide there is no mandatory regulatory requirement to enforce the development of new chiral medicines as exclusively pure active single enantiomers. This has contributed to the existence of both single enantiomers and racemates on the market. Moreover, literature shows the tendency of regulatory approval of medicines towards the development of pure single enantiomers 60%, only 5–10% racemates and 30–35% as achiral. This status has not been established particularly in African countries including Tanzania. Therefore, we aimed to establish the chirality status of registered medicines in Tanzania.
Methodology:

A retrospective cross-sectional study was conducted by reviewing all human medicines registered in Tanzania for the past 15 years from 2003 to 2018. Data were extracted from TMDA-IMIS database to Microsoft excel for analysis. Medicines were assessed to determine if they were chiral (racemates or single enantiomers) or achiral.
Results

A total of 3,573 human medicines had valid registration. Most of these medicines 2,150 (60%) are chiral and 1,423 (40%) are achiral. Out of the chiral medicines, 1,591 (74%) and 559 (26%) were racemates and single enantiomers, respectively. The percentage of chiral medicines for anti-infective (35%) was significantly higher (p < 0.0001) than other pharmacological groups. A high proportion of chiral medicines within pharmacological groups were observed in systemic hormonal preparations (excluding reproductive hormones and insulin) 97.3% (36/37) and anti-infectives 80% (753/941).
Conclusion

The study revealed the existence of both chiral and achiral registered human medicines with chiral medicines predominating. The proportion of racemates within chiral medicines was significantly higher than that of single enantiomer medicines. The use of these racemates may cause harm to the public and may also contribute to antimicrobial resistance due to the potential existence of inactive and toxic enantiomers. In order to protect public health, regulatory bodies need to strengthen the control of chiral medicines by including an analysis of enantiomeric impurity.
The Clinical Features of Asymmetry Weakness in Childhood Guillain-Barre syndrome: The Outcome and 5-year Follow-up
Authors: Sun Rui-Di , Jiang jun
Published: June 2020

Objectives To compare the clinical profile and long-term outcome of children with asymmetry weakness and symmetry weakness in Guillain-Barre syndrome(GBS). Methods We retrospective analysis the clinical parameters, auxiliary examinations and long-term outcome between asymmetry weakness and symmetry weakness in childhood GBS. Results A total of 72 children were included, 12 children had asymmetry weakness. Six children were transient asymmetry weakness and six children were persistent asymmetry weakness. Compared to symmetry weakness children, asymmetry weakness had more preschool children (75% vs 25%, P=0.005), longer days on hospital(26.5(15-37) days vs 11(9-15) days, p =0.000), more mechanical ventilation in children(50% vs 8.33%, p=0.000), higher Disease severity score(DSS)at nadir of disease(4(3-5) vs 3(1-4), p=0.010), more axonal subtypes(50% vs 15%, p=0.013) and more complications(58.33% vs 8.33%, p=0.000). Eight children had sequelae and sixty-four children had good recovery. Compared to good recovery group, sequelae group had more axonal subtypes(62.5% vs 15.63%, p=0.002) and more persistent asymmetry weakness(62.5% vs 4.69%, p=0.000). Conclusions In conclusion, asymmetry weakness had two types in GBS, namely transient and persistent asymmetry weakness. Asymmetry weakness in GBS indicated more complex condition during disease than symmetry weakness. Persistent asymmetry weakness and axonal subtypes in GBS related with sequelae. Anterior horn cells in the spinal cord involvement may be the possible function in persistent asymmetry weakness combined with axonal subtypes in GBS.
A Nomogram to Predict the Probability of Relapse during Hospitalization after Minor Ischemic Stroke in Chinese Patients.
Authors: xianfeng Yu , wenwen Yin , chaojuan Huang , xin Yuan , yu Xia , wei Zhang , xia Zhou , zhongwu Sun
Published: June 2020

Background: Predicting the risk of recurrence during hospitalization in patients with minor ischemic stroke (MIS) is of great significance for clinical and treatment. Compared with early models and prognostic scores, nomogram is a better visualization tool for predicting clinical outcomes. It combines different factors to develop a graphical continuous scoring system, and accurately calculates the risk probability of adverse outcomes based on individual characteristics. Our goal is to develop and validate a nomogram for individualized prediction of hospitalization recurrence in patients with mild ischemic stroke in the Chinese population.Methods: Based on retrospective collection, a single center study was conducted in the first affiliated Hospital of Anhui Medical University from January 2014 to December 2019. The subjects were stroke patients with NIHSS≤5.In order to generate the nomogram, age, systolic blood pressure,previous heart disease, serum total bilirubin, ferritin and smoking were integrated into the model. The predictive accuracy of the nomogram model to predict the probability of unfavorable outcome was assessed by calculation of the area under the receiver operating characteristic curve (AUC–ROC). Calibration of the risk prediction model was assessed by the plot comparing the observed probability of unfavorable outcome against the predicted, and by using the Hosmer–Lemeshow test.Results: Age at admission (OR,0.946; 95% CI,-0.002 to 0.048), SBP (OR,0.012,95%CI,0.000 to 0.024), previous heart disease (OR,0.867,95%CI, 0.084 to 1.651), UA (OR,-0.003,95%CI,-0.006 to 0.001), serum total bilirubin (OR,-0.022,95%CI,-0.036 to -0.008), ferritin (OR,0.004,95%CI, 0.002 to 0.005), smoking (OR,0.494,95%CI,-0.115 to 1.103) are significant predictors of in-hospital recurrence in Chinese patients with minor ischemic stroke.The model shows good discrimination, the AUC-ROC value is 0.737 (95%CI:0.676-0.798), and has perfect calibration performance. Calibration was good (p=0.1457 for the Hosmer-Lemesshow test), which could predict the risk of recurrence of MIS patients during hospitalization.Conclusion: The nomogram developed and validated in this study can provide individualized, intuitive and accurate prediction of recurrence in Chinese patients with minor ischemic stroke during hospitalization.
A Web Based Dynamic MANA Nomogram for Predicting the Malignant Cerebral Edema
Authors: Sun Wenzhe , Li Guo , Song Yang , Zhu Zhou , Yang Zhaoxia , Chen Yuxi , Miao Jinfeng , Song Xiaoyan , Lan Yan , Qiu Xiuli , Zhu suiqiang , Fan Yebin
Published: June 2020

Background: For large hemispheric infarction (LHI), malignant cerebral edema (MCE) is a life-threatening complication with mortality approaching 80%. Establishing a convenient prediction model of MCE after LHI is vital for rapid identification of high-risk patients and understanding of the potential mechanism of MCE.Methods: 142 consecutive patients with LHI within 24h of onset from January 1, 2016 to August 31, 2019 were retrospectively collected. MCE was defined as patient death or received DHC with obvious mass effect (≥ 5mm midline shift or Basal cistern effacement). Binary logistic regression was performed to evaluated the independent predictors of MCE. Independent prognostic factors were incorporated to build dynamic MANA nomogram to predict MCE.Results: After adjustment for confounders, four independent factors were identified, including previously known atrial fibrillation (KAF), midline shift (MLS), National Institutes of Health Stroke Scale (NIHSS) and anterior cerebral artery (ACA) territory involvement. Furthermore, to facilitate the use of the nomogram for clinicians, we use “Dynnom” package to build dynamic MANA (acronym for MLS, ACA territory involvement, NIHSS and KAF) nomogram on web page (http://www.MANA-nom.com) to calculate the exact probability of developing MCE. The c-statistic of MANA nomogram was up to 0.887 ± 0.041 and AUC-ROC value in this cohort was 0.887 (95%CI, 0.828~0.934).Conclusions: Independent predictors of MCE included KAF, MLS, NIHSS, and ACA territory involvement. The dynamic MANA nomogram is a convenient, practical and effective clinical decision-making tool for predicting MCE after LHI in Chinese patients.
Detection and Characterization of Carbapenem resistant Gram-negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan
Authors: Elbadawi Hana S. , Elhag Kamal M. , Mahgoub Elsheikh , Altayb Hisham N , Ntoumi Francine , Elton Linzy , McHugh Timothy D , Osman Mohamed , Tembo John , Ippolito Giuseppe , Zumla Alimuddin , Hamid Muzamil Mahdi Abdel
Published: June 2020

Background:Antimicrobial resistance (AMR) poses a threat to global health security. Whilst over the past decade, there has been an increase in reports of nosocomial infections globally caused by carbapenem resistant Gram-negative bacilli (GNB), data from Africa have been scanty. We performed a study of carbapenem resistance genes among GNB isolated from patients treated in hospitals in Khartoum state, Sudan.Methods:A cross-sectional study was conducted at Soba University Hospital (SUH) and Institute of Endemic Diseases, University of Khartoum for the period October 2016 to February 2017. A total of 206 GNB isolates from different clinical specimens were analyzed for carbapenem resistance genes using phenotypic tests and affirmed by genes detection. Multiplex PCR was performed for each strain to detect the carbapenemase genes, including the blaNDM, blaVIM, blaIMP, blaKPC, and blaOXA-48. In addition to blaCTXM, blaTEM and blaSHV. DNA sequencing and bioinformatics analysis were used to detect genes subtypes.Findings:Of 206 isolates, 171 (83%) were confirmed resistant phenotypically and 121 (58.7%) isolates were positive for the presence of one or more carbapenemase gene. New Delhi metallo-β-lactamase (NDM) types were the most predominant genes, blaNDM 107(88.4%). Others included blaIMP 7 (5.7%), blaOXA-48 5(4.1%), blaVIM 2 (1.6%) and blaKPC 0 (0%). Co- resistance genes with NDM producing GNB were detected in 87 (81.3%) of all blaNDM positive isolates. A significant association between phenotypic and genotypic resistance was observed (P- value < 0.001). NDM-1 was the most sub type was observed in 75 isolates (70 %), other subtypes were NDM- 5 and NDM-6. Infections due to Carbapenem resistant GNB are increasing at SUH, with the blaNDM being the prevalent genes among clinical isolates and belong to the Indian lineage.Conclusions:The frequency of carbapenemase producing bacilli was found to be improperly high in Khartoum hospitals. NDM was found to be the most prevalent carbapenemase gene among clinical isolates. Close surveillance across all hospitals in Sudan is required. The relative distribution of Carbapenemase genes among GNB in nosocomial infections in Africa needs to be defined.
Use of maternal and child health services in a community with large refugee population in Nairobi, Kenya: a cross-sectional survey
Authors: Mohamed Abdinoor Haji , Musyoka Raymond Nyoka , Dalal Warren , Burke Heather , Ahmed Jamal , Eidex Rachel
Published: June 2020

Background

The population of urban refugees in the Eastleigh area of Nairobi, Kenya, is estimated at 100,000 to 150,000. Limited information on access to health care is available for this population. The health care a mother receives during pregnancy, at the time of delivery, and soon after delivery is important for the survival and well-being of both the mother and her child. The disadvantages in accessing health care and vulnerabilities of immigrant and refugee women are well documented in the literature. The purpose of our study was to assess the use of maternal and child health (MCH) services among the residents of Eastleigh and sources of services sought.
Methods

In July and August 2010, we surveyed households in Eastleigh. Households were chosen using a multistage cluster sampling design. A standard questionnaire on household demographics was administered to the household caretakers. If the household included a woman who delivered a baby or had a pregnancy that lasted at least 7 months within the past year, she responded to the MCH questionnaire separately.
Results

We gathered data from 673 households with 3,005 household members. There were 981 (32.6%) women of reproductive age (15–49 years), of whom 116 (11.8%) reported having a pregnancy or delivering in the past year. Of these 116 mothers, 104 (89.7%) made at least one antenatal care (ANC) visit, and 60 (63.2%) made at least four visits. Of 104 women who made at least one ANC visit, 23 (25.4%) first visited in the first trimester; 69 (64.2%) in the second trimester; and 13 (10.4%) in the third trimester. Compared with women who attended secondary school or higher, those with religious education only were twice as likely to get ANC in the early stages of pregnancy while those with no education were 3.33 times as likely. Fewer women (24%) sought delivery services at government health facilities than the 75% who delivered at private health facilities. Only three women delivered at home.
Conclusion

Use of MCH services was high among Eastleigh residents. Women actively sought care at numerous facilities, predominantly private ones. However, the quality of care in these private facilities requires further assessment.
What’s the “Secret Sauce”? How Implementation Variation Affects the Success of Colorectal Cancer Screening Outreach
Authors: Coury Jennifer , Miech Edward J. , Styer Patricia , Petrik Amanda F. , Coates Kelly E. , Green Beverly B. , Baldwin Laura-Mae , Shapiro Jean A. , Coronado Gloria
Published: June 2020

Background: Mailed fecal immunochemical testing (FIT) programs can improve colorectal cancer (CRC) screening rates, but health systems often vary implementation (i.e., adapt) these programs for their organizations. A health insurance plan implemented a mailed FIT program (named BeneFIT) and allowed participating health systems to adapt the program. This mixed-methods study explored which program adaptations might have achieved higher screening rates.Methods: We used a multi-method approach. First, we conducted a descriptive analysis of CRC screening rates by key health system characteristics and program adaptations. Second, we applied Configurational Comparative Methods (CCMs) to determine potential explanatory factors consistent with higher screening rates. The main outcome measure was CRC screening rates.Results: Seventeen health systems took part in at least one year of BeneFIT. The overall screening completion rate was 20% (4%–28%) in Year 1, and 25% (12%–35%) in Year 2 of the program. Health systems that used two or more adaptations had higher screening rates, and no single adaptation clearly led to higher screening rates. In Year 1, smaller systems (having <2 clinics) with phone reminders (n=2) met the implementation success threshold (≥19% screening rate) while larger systems were successful when offering a patient incentive (n=4), scrubbing mailing lists (n=4), or allowing mailed FIT returns with no other adaptations (n=1). In Year 2, large systems (>2 clinics) were successful with a phone reminder (n=4) or a patient incentive (n=3). Of the 10 systems that implemented BeneFIT in both years, seven improved in Year 2.Conclusions: Health systems can choose between many adaptations and successfully implement a health plan’s mailed FIT program. Screening completion rates are positively associated with the number of adaptations implemented by a health system. Health system size emerged as an important contextual factor, with different solutions for larger than smaller health systems.