bluuebunny/crossref_metadata_2025 huggingface dataset:
A Simple Fask Protocol as an Effective Screening Tool for Patients With Abdominal Distention
Authors: Lien Wan-Ching , Chen Jia-Yu , Wang Pei-Hsiu , Ling Dean-An , Lee An-Fu , Ko Ying-Chih , Hsiao Yu-Tse , Wu Chien-Kai , Chang Wei-Tien , Huang Chien-Hua , Wang Hsiu-Po
Published: August 2020

Background: The retrospective study aimed to investigate the effect of point-of-care ultrasound (PoCUS) by a designated protocol for patients with abdominal distention.Methods: Non-traumatic adult patients with abdominal distention were included at the emergency department (ED) of the National Taiwan University Hospital between July 2015 and July 2017. A sonographic scanning protocol (FASK, the focused assessment with sonography in trauma plus the renal US) was included in the post-graduate year and residency US training. The primary outcome included the diagnostic accuracy of the FASK protocol. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the protocol were calculated that discharge/admission diagnosis was as the standard. The secondary outcomes included ED LOS and the rate of ED discharge using the FASK protocol.Results: A total of 512 patients were included. The accuracy of the FASK protocol was 99.0% (507/512), whatever the level of the performer. The sensitivity, specificity, PPV, and NPV were 99.4% (95% CIs, 98.2-99.9%), 100% (95% CIs, 100%), 99.6% (95% CIs, 98.6-100%), and 99% (95% CIs, 97.7-99.7%), respectively. 397 patients (78%) were discharged with the median LOS of 126 minutes (IQR, 84-236 minutes) after receiving PoCUS and proper management. PoCUS was performed approximately 3 hours earlier than CT (median, 179 minutes; IQR, 90-468 minutes; p<0.0001).Conclusions: A simple FASK protocol could be an effective screening tool for non-critical patients with abdominal distention. Being an adjunct of physical examination and management, PoCUS exhibited characteristics of efficacy, timeliness, and safety.Trial registration: NCT04149041 at ClinicalTrials.gov.
HIV Prevalence Trends and Disparities by Gender and Urban-rural Residence Among Adolescents in Sub-saharan Africa
Authors: Cane Reka Maulide , Melesse Dessalegn , Kayeyi Nkomba , Manu Abubakar , Wado Yohannes Dibaba , Barros Aluisio , Boerma Ties
Published: August 2020

Background

In sub-Saharan Africa HIV transmission is a major challenge in adolescents, especially among girls and those living in urban settings. Major international efforts have aimed at reducing sexual transmission. This analysis aims to assess the trends in HIV prevalence by gender in adolescents, as well as urban-rural disparities.
Methods

HIV prevalence data were obtained for 30 countries with a national survey since 2010 and for 23 countries with one survey circa 2005 and a recent survey circa 2015. Countries were grouped into 2% or higher and lower than 2% HIV prevalence among girls 15–19 years in the first survey. Country medians and average annual rates of changes were used to summarize the trends. Data on HIV incidence at ages 15–24 and prevalence at 5–9 and 10–14 years were reviewed from 11 recent national surveys. Trends in urban-rural disparities in HIV prevalence and selected indicators of sexual and HIV testing behaviours were assessed for females and males 15–24 years, using the same surveys.
Results

HIV prevalence among girls 15–19 years declined in the higher HIV prevalence group from 5.7–2.6% during 2005–2015, corresponding with an average annual rate of reduction of 6.5% per year. Among boys, the median HIV prevalence declined from 2.1–1.2% in the higher prevalence group. Smaller changes were observed in the lower prevalence country group where median HIV prevalence among girls decreased from 0.7–0.4% (average annual rate of reduction 5.9%). Girl – boy differences at 10–14 years were small with a country median HIV of 1.0% and 1.3%, respectively. Urban females and males 15–24 had at least 1.5 times higher HIV prevalence than their rural counterparts, and all experienced similar declines during 2005–2015. Condom use and HIV testing increased among adolescents in both higher and lower prevalence countries, but indicators of sexual activity showed little change over time.
Conclusions

HIV prevalence declined in almost all countries during the last decade, in both urban and rural settings, for both sexes. The urban-rural gap persisted and HIV transmission to girls, but not boys, is still a major challenge in eastern and southern African countries.
The Diagnostic Trap Occurred in Two COVID-19 Cases Combined Pneumocystis Pneumonia in Patient with AIDS
Authors: Guo Wei , Wang Maomao , Ming Fangzhao , Tang Weiming , Liang Ke
Published: August 2020

Background : The limited knowledge on the diagnosis of Coronavirus disease 2019 (COVID-19) at the early stage of the pandemic may lead to misdiagnoses, especially when the nucleic acid inspection cannot meet the mass requirement. This condition is even actual for people who are living with HIV/AIDS (PLWHA), for the latter is vulnerable to variable infections. Case Presentation : In this short communication, we introduced two HIV infected individuals who had PCP but was misdiagnosed as COVID-19 initially, and finally infected with SARS-CoV-2 in hospital in Wuhan, China. Eventually, both patients improved soon after they were switched to the treatment of SMZ/TMP.Conclusions : We suggested that the hospitalized COVID-19 cases should be screened with HIV and other pathogens, to prevent that PLWHA who have PCP from being misdiagnosed as COVID-19.
Prevalence of Bacterial Contamination and Antimicrobial Susceptibility Pattern among Blood and Blood Components collected with and without diverging method at Armed Forces Comprehensive Specialized Hospital, Addis Ababa, Ethiopia
Authors: Tsegaye Wondwossen , Bitew Adane , Gize Addisu
Published: August 2020

Background: Transfusion of bacterial contaminated blood and blood components could be a cause of morbidity and mortality. Understanding the mechanism of blood contamination is important in developing infection control strategy.Methods: A comparative cross-sectional study was done 376 blood and blood components collected with and without diverging method in Armed Forces Comprehensive Specialized Hospital. Then, Culturing of collected blood and blood components were inoculated in broth then subcultured on agar plate. And then, the drugs sensitivity test was done for each isolate. Bivariate analysis and multivariate logistic regression were used to infer association.Results: The overall prevalence of bacterial contamination among blood and blood components were 17 (4.5%). The prevalence of bacterial contamination of blood and blood components collected with the non-diverging and diverging method was 14 (7.4%) and 3 (1.6 %) respectively with P value of 0.05. Staphylococcus epidermidis were the most dominate isolates. Gram positive isolates showed more than 74% sensitive for antibiotics and also became more than 9% resistant. Most gram negative isolates became sensitive but Pseudomonas aeruginosa showed resistant for Gentamicin. 29.4% (n= 5/17) isolated bacteria were multidrug resistant.Conclusion: There was a difference between bacterial contamination in blood and blood components collected between diverging and non-diverging blood collection methods.
Metagenomic Sequencing of Stage 3 Periodontitis Reveals Phenotype-Specific Taxonomic and Functional Features of the Subgingival Microbiome
Authors: Altabtbaei Khaled , Maney Pooja , Ganesan Sukirth M , Dabdoub Shareef M , Nagaraja Haikady N , Kumar Purnima S
Published: August 2020

Background: The search for microbial biomarkers of periodontitis has been hampered by our ability to separate disease-specific associations from those that are common to all forms of periodontitis. Here, we present the first functional characterization of the microbiomes of three common clinical phenotypes of this disease: Localized aggressive periodontitis (LAP), generalized aggressive periodontitis (GAP) and chronic periodontitis (CP). Methods: We collected subgingival plaque samples from sites with disease of 59 subjects with Stage 3 periodontitis and 25 periodontally healthy individuals and used shotgun metagenomics to characterize the aggregate of bacterial genes. Results: Beta-dispersion metrics demonstrated that no two individuals with disease, especially those with chronic disease, are alike (the Anna Karenina Principle), indicating that microbial modulation therapies will have to incorporate patient-specific parameters for efficacy. We discovered broad patterns of microbial dysbiosis that spanned the three disease phenotypes, as well as disease-specific indicators unique to each phenotype. Genes common to all forms of periodontitis encoded pathways that facilitate life in an oxygen-poor, protein and heme-rich, pro-oxidant environment, and enhance capacity for attachment and biofilm formation, while genes encoding the acetate switch, c-type cytochrome and molybdenum cofactor biosynthesis, iron-sulfur clusters, and formate dehydrogenase were unique to LAP. These can serve as potential biomarkers for molecular identification of clinical phenotypes and clarify the role of the microbiome in disease pathogenesis. We also discovered that clinical phenotypes of disease resolved variance in the microbiome with greater clarity than the newly established grading system. Importantly, we observed that one-third of the metagenome of LAP is unique to this phenotype while GAP shares significant functional and taxonomic features with both LAP and CP, suggesting either attenuation of an aggressive disease or an early-onset chronic disease. Conclusion: Within the limitations of a small sample size and a cross-sectional study design, the distinctive features of the microbiomes associated with LAP and CP strongly persuade us that these are discrete disease entities, while calling into question whether GAP is a separate disease entity, or an artifact induced by cross-sectional study designs.
Awake Prone Positioning Does Not Reduce the Risk of Intubation in COVID-19 Treated with High-Flow Nasal Oxygen Therapy. A Multicenter, Adjusted Cohort Study
Authors: Ferrando Carlos , Mellado-Artigas Ricard , Gea Alfredo , Arruti Egoitz , Aldecoa César , Adalia Ramón , Ramasco Fernando , Monedero Pablo , Maseda Emilio , Tamayo Gonzalo , Hernández-Sanz María L. , Mercadal Jordi , Martín-Grande Ascensión , Kacmarek Robert M. , Villar Jesús , Suárez-Sipmann Fernando
Published: August 2020

Background: Awake prone positioning (awake-PP) in non-intubated coronavirus disease 2019 (COVID-19) patients could avoid endotracheal intubation, reduce the use of critical care resources, and improve survival. We aimed to examine whether the combination of high-flow nasal oxygen therapy (HFNO) with awake-PP prevents the need for intubation when compared to HFNO alone.Methods: Prospective, multicentre, adjusted observational cohort study in consecutive COVID-19 patients with acute respiratory failure (ARF) receiving respiratory support with HFNO from 12 March to 9 June, 2020. Patients were classified as HFNO with or without awake-PP. Logistic models were fitted to predict treatment at baseline using the following variables: age, sex, obesity, non-respiratory sequential organ failure assessment score, APACHE-II, C-reactive protein, days from symptoms onset to HFNO initiation, respiratory rate and peripheral oxyhemoglobin saturation. We compared data on demographics, vital signs, laboratory markers, need for invasive mechanical ventilation, days to intubation, ICU length of stay, and ICU mortality between HFNO patients with and without awake-PP.Results: A total of 1076 patients with COVID-19 ARF were admitted, of which 199 patients received HFNO and were analyzed. Fifty-five (27.6%) were pronated during HFNO; 60 (41%) and 22 (40%) patients from the HFNO and HFNO+awake-PP groups were intubated. The use of awake-PP as an adjunctive therapy to HFNO did not reduce the risk of intubation [RR 0.87 (95%CI: 0.53–1.43), p=0.60]. Patients treated with HFNO+awake-PP showed a trend for delay in intubation compared to HFNO alone [median 1 (interquartile range, IQR 1.0-2.5) vs 2 IQR 1.0-3.0] days, (p=0.055), but awake-PP did not affect 28-day mortality [RR 1.04 (95%CI: 0.40–2.72), p=0.92].Conclusion: In patients with COVID-19 ARF treated with HFNO, the use of awake-PP did not reduce the need for intubation or affect mortality.
Prognosis-Related Autophagy Genes in Female Lung Adenocarcinoma
Authors: Liu Zhongxiang , Tang Haicheng , Jiang Yongqian , Zhan Xiaopeng , Kang Sheng , Zhang Koudong , Lin Li
Published: August 2020

Background: To screen the prognosis-related autophagy genes of female lung adenocarcinoma by the transcriptome data and clinical data from TCGA database.Methods: In this study, Screen meaningful female lung adenocarcinoma differential genes in TCGA, use univariate COX proportional regression model to select genes related to prognosis, and establish the best risk model. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were applied for carrying out bioinformatics analysis of gene function.Results: The gene expression and clinical data of 260 female lung adenocarcinoma patient samples were downloaded from TCGA. 12 down-regulated genes: NRG3, DLC1, NLRC4, DAPK2, HSPB8, PPP1R15A, FOS, NRG1, PRKCQ, GRID1, MAP1LC3C, GABARAPL1. Up-regulated 15 genes: PARP1, BNIP3, P4HB, ATIC, IKBKE, ITGB4, VMP1, PTK6, EIF4EBP1, GAPDH, ATG9B, ERO1A, TMEM74, CDKN2A, BIRC5. GO and KEGG analysis showed that these genes were significantly associated with autophagy and mitochondria (animals). Multi-factor COX analysis of autophagy-related genes showed that ITGA6, ERO1A, FKBP1A, BAK1, CCR2, FADD, EDEM1, ATG10, ATG4A, DLC1, VAMP7, ST13 were identified as independent prognostic indicators. According to the multivariate COX proportional hazard regression model, there was a significant difference in the survival rate observed between the high-risk group (n=124) and the low-risk group (n=126) during the 10-year follow-up (p<0.05). Univariate COX analysis showed that tumor stage, T, M and N stages, and risk score were all related to the survival rate of female lung adenocarcinoma patients. Multivariate COX analysis found that autophagy-related risk scores were independent predictors, with an AUC value of 0.842. At last, there are autophagy genes differentially expressed among various clinicopathological parameters: ATG4A, BAK1, CCR2, DLC1, ERO1A, FKBP1A, ITGA6.Conclusion: The risk score can be used as an independent prognostic indicator for female patients with lung adenocarcinoma. The autophagy genes ITGA6, ERO1A, FKBP1A, BAK1, CCR2, FADD, EDEM1, ATG10, ATG4A, DLC1, VAMP7, ST13 were identified as prognostic genes in female lung adenocarcinoma, which may be the targets of treatment in the future.
Testing Attitudes, Social Desirability and Behavioral Regulations as Moderators of Implicit-Explicit Exercise Cognition Discrepancies in Iranian Students
Authors: Berry Tanya , Taymoori Parvaneh , Shirzadi Kohestan , Pashaei Tahereh , Bahamani Afshin
Published: August 2020

Background: Although there is interest among regarding implicit-explicit exercise cognition discrepancies, there is mixed evidence regarding what moderates the relationship between implicitly and explicitly measured constructs. This study examined this issue with evaluations of exercise relative to health or appearance in a sample of Iranian adolescents. Methods: Participants were 471 students enrolled in grades 9 to 12 from Kurdistan, Iran, of whom 269 (54.9%) were female. The possible moderators included behavioral regulations, explicit attitudes, and social desirability. All students completed questionnaire measures of physical activity behavior, attitudes, social desieality and behavioral regulation. They also completed two Go/No Go Association tasks to measure implicit evaluations of exercise relative to health and apperarance. Results. Attitude was a significant moderator of discrepancies between implicit evaluations of exercise with health and health motives. Interjected regulation moderated implicit-explicit appearance discrepancies in the health models. Participants with low social desirability and negative implicit appearance scores had the highest appearance motivation. Conclusions: Investigating implicit-explicit discrepancies provides insight into the development of interventions targeting exercise behavior among Iranian adolescents.
Land Use Mix and Physical Activity in Older Adults: A Longitudinal Study Examining Changes in Land Use Mix in Two Dutch Cohorts
Authors: Noordzij J. Mark , Beenackers M.A. , Groeniger J. Oude , Timmermans E.J. , Motoc I. , Huisman M. , Lenthe F.J. van
Published: August 2020

BACKGROUNDWith urbanization and aging increasing in coming decades, societies face the challenge of keeping aging populations active. Land use mix (LUM) has been associated with cycling and walking, but whether changes in LUM relate to changes in cycling/walking is less known. OBJECTIVESOur objective was to study the effect of LUM on cycling/walking in two Dutch aging cohorts using data with 10 years of follow-up. METHODSData from 1,114 respondents from the Longitudinal Aging Study Amsterdam (LASA) and 1,561 respondents from the Health and Living Conditions of the Population of Eindhoven and Surroundings (GLOBE) study were linked to LUM in 1000-meter sausage network buffers at three time-points. Cycling/walking outcomes were harmonized to include average minutes spent cycling/walking per week. Data was pooled and limited to respondents that did not relocate between follow-up waves. Associations between LUM and cycling/walking were estimated using a Random Effects Within-Between (REWB) model that allows for the estimation of both within and between effects. Sensitivity analyses were performed on smaller (500-meter) and larger (1600-meter) buffers. RESULTSWe found evidence of between-individual associations of LUM in 1000-meter buffers and walking (β: 11.10, 95% CI: 0.08 ; 21.12), but no evidence of within-associations in 1000-meter buffers. Sensitivity analyses using 500-meter buffers showed similar between-associations, but negative within-associations (β: -35.67, 95% CI: -68.85 ; -2.49). We did not find evidence of between-individual associations of LUM in any buffer size and cycling, but did find evidence of negative within-associations between LUM in 1600-meter buffers and cycling (β: -7.49, 95% CI: -14.31 ; -0.66). DISCUSSIONOur study found evidence of positive associations between LUM and average walking time, but also some evidence of negative associations between a change in LUM and cycling/walking. LUM appears to be related to cycling/walking, but the effect of changes in LUM on cycling/walking is unclear.
Conditioned medium from primary cytotrophoblasts, primary placenta-derived mesenchymal stem cells, or placental tissue promoted HUVECs angiogenesis in vitro
Authors: Ma Haiying , Jiang Shenglu , Du Lili , Liu Jinfang , Xu Xiaoyan , Lu Xiaomei , Ma Ling , Zhu Hua , Wei Jun , YU Yanqiu
Published: August 2020

Background As a large capillary network, the human placenta plays an important role throughout pregnancy. Placental vascular development is complex and delicate and involves many types of placental cells, such as trophoblasts, and mesenchymal stem cells. There has been no systematic, comparative study on the roles of these two groups of placental cells and the whole placental tissue in the placental angiogenesis. In this study, primary cytotrophoblasts (CTBs) from early-pregnancy and primary human placenta-derived mesenchymal stem cells (hPDMSCs) from different stages of pregnancy were selected as the cell research objects, and full-term placental tissue was selected as the tissue research object to detect the effects of their conditioned medium (CM) on HUVECs angiogenesis.Methods We successfully isolated primary hPDMSCs and CTBs, collected CM from these placental cells and placental tissue, and then evaluated the effects of the CM on a series of angiogenic processes in HUVECs in vitro. Furthermore, we measured the levels of angiogenic factors in the CM of placental cells or tissue by an angiogenesis antibody array.Results The results showed that not only placental cells but also placental tissue, to some extent, promoted HUVECs angiogenesis in vitro by promoting proliferation, adhesion, migration, invasion, and tube formation. We also found that primary placental cells in early pregnancy, whether CTBs or hPDMSCs, played more significant roles than those in middle and full-term pregnancy. The effect of CM from placental tissue was better than that of CM from a single placental cell type. The semiquantitative angiogenesis antibody array showed that, in placental tissue-derived CM, 18 of the 43 angiogenic factors had obvious spots, and the levels of 5 factors (including CXCL-5, GRO, IL-6, IL-8, and MCP-1) were the highest. The levels of these 18 angiogenic factors in placental tissue were higher than those in any single placental cell type.Conclusions CM obtained from placental cells (primary CTBs or hPDMSCs) or placental tissue contained proangiogenic factors and promoted HUVECs angiogenesis in vitro. Therefore, our research is helpful to better understand placental angiogenesis regulation and provides theoretical support for the clinical application of placental components, especially placental tissue-derived CM, in vascular tissue engineering and clinical treatments.
Physician education mix and patient case-mix in hospital
Authors: Tang Chengxiang , Liu Gordon , Jiang Jiayi , Zhao Hanqing
Published: August 2020

Background

Previous literature pays little attention on relationship between hospital case-mix and physicians’ human capital, while it is truly important topic in studies about health workforce. A multi-tiered medical education system resulted in substantial variation in physician education mix in hospital. We first exploit this heterogeneity in physician human capital across hospitals to explore its role as one of determinants of hospital case-mix.
Methods

The hospital case-mix index (CMI) from DRGs system is dependent variable. The school years of medical education is used to measure variation in physician human capital, that can be aggregated and averaged by each hospital. The study uses both descriptive analysis and regression modelling to investigate this association.
Results

Descriptive results show a positive relationship between physician human capital and patient case-mix in hospital. The model results illustrated that hospitals have higher level of physician education tend to have more serious case mix. In specific, when average medical school years increased by one, the hospital CMI increased by nearly 0.05.
Conclusion

The study findings highlight the importance and influences of physicians’ education mix in patients’ outcomes and healthcare delivery. We argue that physician groups with lower human capital are more likely to manage case volume with lower CMI. For future health care studies in some unstandardized health care system, it is important to control for physician-level variation in education.
Hypoxia-induced Tie1 Drives Stemness and Cisplatin Resistance in Non-small Cell Lung Carcinoma Cells
Authors: Li Chaojie , Yang Nannan , Chen Zhijin , Xia Ning , Shan Qungang , Wang Ziyin , Lu Jian , Shang Mingyi , Wang Zhongmin
Published: August 2020

Background: Drug resistance and metastasis involving hypoxic tumor environment and persistent stem cell populations are detrimental to the survival of patients with non-small cell lung carcinoma (NSCLC). Tie1 is upregulated in hypoxia and is believed to counteract the effectiveness of platinum agents, by promoting the stemness properties in cells. We have investigated the association of Tie1 with HIF-1α and cisplatin resistance in NSCLC cell lines. Methods: Expression of Tie1 in a pulmonary microvascular endothelial cell line (HPMEC) and in NSCLC cell lines was detected using qRT-PCR and western blot. The effect of Tie1 on cell stemness and migration was examined by sphere-forming assay and transwell assay in NSCLC cells with Tie1 silenced. The regulation of Tie1 by HIF-1α was evaluated by a dual-luciferase reporter assay and chromatinImmune precipitation (ChIP) analysis.Results: We found that hypoxia could induce stemness and cisplatin resistance in vitro. Tie1 was expressed at low levels in NSCLC cells when compared with human pulmonary microvascular endothelial cells, however, its expression was increased by hypoxia. Additionally, Tie1 knockdown could reduce the stemness properties and increase sensitivity to cisplatin in vitro and in a xenograft mouse model. The promoter of Tie1 contains two predicted hypoxia-response elements (HREs). We mutated both HRE sites and conducted chromatin immune-precipitation and promoter luciferase reporter assays and were able to conclude that the induction of Tie1 by hypoxia was HIF-1α-dependent. Conclusions: Our findings indicated that Tie1 is upregulated in a hypoxic environment by HIF-1α and contributes to tumorigenesis and cisplatin resistance through the promotion of stemness in NSCLC cells.
Mild Traumatic Brain Injury is Associated With Effect of Inflammation on Structural Changes of Default Mode Network in Those Developing Chronic Pain 
Authors: Niu Xuan , Bai Lijun , Sun Yingxiang , Wang Yuan , Bai Guanghui , Yin Bo , Wang Shan , Gan Shuoqiu , Jia Xiaoyan , Liu Hongjuan
Published: August 2020

Background：Mild traumatic brain injury (mTBI) is higher prevalence (more than 50%) to develop chronic posttraumatic headache (CPTH) compared with moderate or severe TBI. However, the underlying neural mechanism for CPTH remains unclear. This study aimed to investigate the inflammation level and cortical volume changes in patients with acute PTH (APTH) and further examine their potential in identifying patients who finally developing CPTH at follow-up.Methods：77 mTBI patients initially underwent neuropsychological measurements, 9-plex panel of serum cytokines and MRI scans within 7 days post-injury (T-1) and 54 (70.1%) of patients follow-up at 3-month (T-2). 42 matched healthy controls completed the same protocol at T-1 once. Results：MTBI patients with APTH presented significantly increased GM volume mainly in the right dorsal anterior cingulate cortex (dACC) and dorsal posterior cingulate cortex (dPCC), of which the dPCC volume can predict much worse impact of headache on patients’ lives by HIT-6 (β = 0.389, P = 0.007). Serum levels of C-C motif chemokine ligand 2 (CCL2) were also elevated in these patients, and its effect on the impact of headache on quality of life was partially mediated by the dPCC volume (mean [SE] indirect effect, 0.088 [0.0462], 95% CI, 0.01-0.164). Longitudinal analysis showed that the dACC and dPCC volumes as well as CCL2 levels persistently increased in patients developing CPTH 3 month postinjury. Conclusion：The findings suggested that structural remodelling of DMN brain regions were involved in the progression from acute to chronic PTH following mTBI, which also mediated the effect of inflammation processes on pain modulation.Trial registration: ClinicalTrial.gov ID: NCT02868684; registered 16 August 2016.
Treatment Outcomes and Predictive Factors for Multidrug-Resistant TB and HIV Coinfection in Rio De Janeiro State, Brazil
Authors: Bhering Marcela Lopes , Duarte Raquel , Kritski Afrânio
Published: August 2020

Background: This study aims to identify and compare factors associated with the unfavorable treatment of MDR-TB patients with HIV coinfection in the State of Rio de Janeiro (RJ), Brazil.Methods: A retrospective cohort study with data from TB-MDR patients notified between 2000 and 2016 in RJ. Clinical and epidemiological characteristics and treatment outcomes of patients with HIV positive, negative, and unknown were compared. Bivariate and multivariate Cox hazard regression analysis was conducted to identify factors associated with unfavorable treatment results in patients MDR-TB / HIV positive. Results: Of 2,269 cases, 1,999 (88.1%) had a negative result for HIV, 156 (6.9%) positive and 114 (5.0%) unknown. The proportion of unfavourable outcomes was 43.7% among HIV negative, 52.6% among HIV positive and 43.9% among HIV unknown. Regarding MDR-TB / HIV positive cases, the unfavorable outcomes more prevalent were loss to follow up (24.4%) and death (23.1%). Previous MDR-TB treatment was associated with unsuccess and death. Illicit drugs use was a risk factor for unsuccess and loss to follow up. The six-month culture conversion was a protective factor for unsuccess and death. Administration of antiretroviral therapy was a protective factor for unsuccess, death and failure. The risk of XDR-TB cases for failure was six times higher than that of MDR-TB patients. All XDR-TB / HIV positive cases had unfavorable outcomes.Conclusions: Early identification and immediate initiation of appropriate treatment are key to reducing unfavorable outcomes among MDR-TB / HIV positive. The high proportions of loss to follow-up and death may reflect difficulties in monitoring treatment, due to poor integration between the TB and HIV programs. In addition, none of XDR-TB / HIV positive patient had therapeutic success, highlighting the urgency to incorporate new drugs for the treatment of multidrug-resistant TB by Brazil's Ministry of Health.
Consumption of Ultra-Processed Foods and Drinks and Colorectal, Breast and Prostate Cancer in the Multicase-Control Study (MCC)-Spain
Authors: Romaguera Dora , Fernández-Barrés Silvia , Gracia-Levadán Esther , Vendrell Eva , Azpiri Mikel , Ruiz-Moreno Emma , Martin Vicente , Gomez-Acebo Ines , Obon Mireia , Molinuevo Amaia , Fresan Ujué , Molina-Barcelo Ana , Olmedo-Requena Rocio , Tardon Adonina , Aguacil Juan , Solans Marta , Huerta José M , Ruiz-Dominguez José Manuel , Aragones Nuria , Fenández-Villa Tania , Dierssen-Sotos Trinidad , Moreno Victor , Guevara-Eslava Marcela , Vanaclocha-Espi Mercedes , Lozano-Lorca Macarena , Fenandez-Tardon Guillermo , Castaño-Vinyals Gemma , Perez-Gomez Beatriz , Molina Antonio , Llorca Javier , Gil Leire , Castilla Jesús , Pollan Marina , Kogevinas Manolis , Amiano Pilar
Published: August 2020

Background: Consumption of ultra-processed products has increased worldwide and some of their components have been suggested to be carcinogenic. We studied whether the consumption of ultra-processed foods and drinks was associated with breast, colorectal and prostate cancers.Methods: Multicentric population-based case-control study (MCC-Spain) conducted in 12 Spanish provinces. Participants were men and women between 20-85 years of age with diagnoses of colorectal (n=1852), breast (n=1486) or prostate cancer (n=953), and population-based controls (n=3543) frequency-matches by age, sex and region. Dietary intake was collected using a validated food frequency questionnaire. Foods and drinks were categorized according to their degree of processing based on the NOVA classification. Unconditional multivariable logistic regression was used to evaluate the association between ultra-processed food and drink consumption and colorectal, breast and prostate cancer.Results: In multiple adjusted models, consumption of ultra-processed foods and drinks was associated with higher risk of colorectal cancer (OR for an increment of 10% in consumption: 1.11; 95% CI 1.04 to 1.18). The corresponding odds for breast (OR 1.03; 95% CI 0.96 to 1.11) or prostate cancer (OR 1.02; 95% CI 0.93 to 1.12) were indicative of no association. Conclusions: Results of this large population-based case-control study suggest an association between the consumption of ultra-processed foods and drinks and colorectal cancer. Food policy and public health should include a focus on food processing when formulating dietary guidelines.
Safety and Family Satisfaction of a Home-Delivered Chemotherapy Program for Children with Cancer
Authors: De Zen Lucia , Rizzo Irene Del , Ronfani Luca , Barbieri Francesca , Rabusin Marco , Dall’Amico Roberto , Barbi Egidio , Robazza Margherita
Published: August 2020

Background. Home chemotherapy programs for children with cancer are safe and feasible but have hardly worked in Italy, and there is conflicting evidence on their impact on the quality of life. In Friuli Venezia Giulia, Italy, a home chemotherapy program was implemented between 2011 and 2019. This study investigates safety, feasibility and satisfaction of parents. Methods. Patients between 0 and 18 years diagnosed with malignancy were included. Deceased patients and patients whose families moved abroad or interrupted contact with the service were excluded. Adverse effects comprised immediate deterioration of the patient’s condition, equipment failure, errors in drug storage, dose or patient identification and personnel safety issues. Parental satisfaction was explored through an email survey of 32 Likert-type and short open questions. Results. Thirty-five patients received 419 doses of intravenous chemotherapy at home (cytarabine, vincristine, vinblastine). No adverse events were reported. Twenty-three families out of 25 eligible completed the survey. Most reported being “very satisfied” with the possibility of maintaining a work/domestic routine and reducing time and financial burden of hospital access. Most were “very satisfied” with the opportunity for their child of being less troubled by the treatment. Besides, most reported being “very satisfied” with the chance for healthy siblings of maintaining their routine and coping with their brother/sister’s disease. Most perceived the program as safe. All families recommended extending the program to all children in the region. Conclusions. This study supports home chemotherapy as safe and effective, positively influencing the quality of life for children and families.
Clinical Effects of Assessing Electronic Patient-Reported Outcomes Monitoring Symptomatic Toxicities During Breast Cancer Therapy – A Nationwide and Population-Based Study
Authors: Pappot Helle , Baeksted Christina W. , Nissen Aase , Knoop Ann , Mitchell Sandra A. , Christensen Jane , Hjollund Niels Henrik , Johansen Christoffer
Published: August 2020

The involvement of cancer patients in symptom reporting talks into our cultural narrative of empowerment and participation in decisions in health of both patients and professionals. Electronic Patient Reported Outcomes (ePRO) is a tool applied for use in such interaction. Based on limited evidence and few empirical studies, health systems are rapidly implementing this instrument in managing patients in active treatment and in follow-up. In a cluster randomized trial of all Danish oncology departments treating breast cancer with adjuvant chemotherapy, we applied ePRO in 347 patients consecutively recruited. Our primary outcome, which was at least one treatment adjustment, was not significantly influenced using ePRO, 34% in the ePRO arm and 41% in the usual care arm received at least one treatment adjustment, p=0,095. Number of hospitalizations and events of febrile neutropenia was not influenced by the intervention. We believe that one of the main reasons for this finding could be the application of PRO in a well-regulated treatment setting within a public health care system where the most impacting symptomatic toxicities are already taken care off.ClinicalTrials.gov Identifier: NCT02996201, registered 19 December 2016, retrospectively registered.
CD3-(CD56 or 16)+ natural killer cell distribution in blood from healthy adults and patients with ANCA-associated vasculitis
Authors: Merkt Wolfgang , Salzer Ulrich , Thiel Jens , Jandova Ilona , Bergner Raoul , Venhoff Ana Cecilia , Venhoff Nils
Published: August 2020

BackgroundCytotoxic Natural Killer (NK) cells are an important target of new drugs entering the clinics, including checkpoint inhibitors and cell-depleting therapeutic antibodies. Still, basic blood NK cell parameters are poorly defined in healthy adults and in chronic inflammatory diseases like ANCA-associated vasculitis (AAV) which may alter the distribution of lymphocytes. The aims of this study were 1) to establish reference values of NK cell counts and percentages in healthy adults; 2) to describe these parameters in AAV; and 3) to investigate whether NK cell counts and percentages may be used as activity biomarker in the care of AAV patients, as suggested by a preceding study.MethodsCD3-(CD56 or 16)+ NK cell counts and percentages were determined in 120 healthy adults. Lymphocyte subset data from two German vasculitis centers were retrospectively analyzed (in total 407 measurements, including 201/49/157 measurements from 64/16/39 patients with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA), respectively).ResultsCD3-(CD56 or 16)+ NK cell counts and percentages in healthy adults were highly variable, not Gaussian distributed and independent of age and sex. NK cell percentages ranged from 1.9 to 37.9% of lymphocytes, and were significantly more dispersed in AAV (0.3 to 57.6%). We further found that NK cell counts and percentages were different between AAV entities. However, during active disease, NK cell counts were consistently low in each AAV entity compared to healthy donors. NK cells were especially low in inactive EGPA. In 18% of EGPA patients we observed percentages of 1% or below which may be interpreted as temporary NK cell deficiency. Findings on differences between active and inactive GPA were discrepant between vasculitis centers.ConclusionsNK cell counts and percentages in blood are highly variable. This variability is further enhanced in systemic inflammatory diseases, and includes patients with temporary NK cell deficiency, in particular in EGPA. NK cell counts and percentages can presently not be recommended as biomarker in clinical care of AAV patients.
Embracing Blended Learning Approach for Professional Growth of in-service School Teachers Post Pandemic of COVID-19
Authors: Saboowala Rabiya , Manghirmalani-Mishra Pooja
Published: August 2020

The impact of the pandemic has been felt through all sectors of the global society including the field of education. The pandemic is a strong indication of the fact that things will not be the same as they were before. Similarly, the educational institutes that were working regularly would also undergo a change in the methodologies that they will adopt post-pandemic. Many research scholars and educationalists believe that a blended learning approach will become a reality as a dominant pedagogy for the teaching-learning process. The current situation demands a proactive strategy where not only students but teachers are also considered as learners while talking about their professional growth through seminars, conferences and refresher courses. The present study lays emphasis on embracing the blended learning approach in professional development training courses for school teachers which will provide an opportunity to inculcate educational programs across disciplines in Indian as well as global communities. The study consists of 169 in-service school teachers from India. Simple random technique of sampling was use to collect data. The attitude of school teachers towards blended learning and its six dimensions viz. learning flexibility, online learning, study management, technology, classroom learning and online interaction was studied. Also, the effect of gender and location of educational institutes where they teach was considered. Analysis for the testing research hypothesis was done using the IBM Statistical Package for Social Scientists (SPSS-26). The results indicated that both male and female teachers have similar attitudes towards blended learning but their attitudes varied while considering the six dimensions. Also, it was found that school teachers teaching in urban areas had a more positive attitude towards blended learning and its dimensions as compared to those teaching in rural areas. Implementation of blended learning for professional growth of school teachers post pandemic will push the boundaries of learning by creating opportunities for collaboration of various educational societies throughout the globe, enhance constructivist learning and also help in following social norms set to fight against COVID-19.
All-Trans Retinoic Acid, A Derivative of Vitamin A, Improved Intestinal Epithelial Barrier Function Through PFKP
Authors: Xie Yongwu , Huang Shuyu , Liu Ting , Sun Huiyan , Ren Haoyan , Xie Chunqi
Published: August 2020

Objective: Mucosal Healing, relied on the coordinated activity of IECs for improvement of intestinal barrier function, is the critical goal in treatment of IBD. All-trans retinoic acid (ATRA) is known to regulates cell proliferation and differentiation. The aims of the present study were to investigate the effects of ATRA on the intestinal differentiation. Methods: We collected the clinical sample from the patients to analyze the vitamin A, TEER, western blotting and real-time PCR were performed to detect the effect of vitamin A on PFKP expression and intestinal epithelial cell differentiation. Results: In this study, we showed that increased TEER and decrease paracellular permeability of IECs were induced by ATRA in dose-dependent manner, which is attributed to enhanced MUC2 expression, a marker of goblet cell by western blotting, real-time PCR and TEER assay, while no significant difference of villin was found to alter. The further results show that ATRA suppressed PFKP expression in IECs, while overexpression of PFKP could reverse the promotion of ATRA on MUC2 expression, implying ATRA-induced MUC2 expression in PFKP-dependent manner and in dose-dependent way. The clinical sample analysis suggested vitamin A is not significant associated with gender, and replenishment of vitamin A is critical for intestinal differentiation. Conclusion: ATRA improved intestinal epithelial differentiation via PFKP-mediated Muc2 expression. The findings suggest that ATRA could serve as a novel therapeutic agent to ameliorate development of inflammatory bowel disease. Keywords : All-trans Retinoic Acid; Muc2; Differentiation; PFKP; Intestinal Barrier Function
Three Successful Pregnancies in a Patient With Glycogen Storage Disease Type 0
Authors: Grünert Sarah Catharina , Rosenbaum-Fabian Stefanie , Hannibal Luciana , Schumann Anke , Spiekerkötter Ute
Published: August 2020

BackgroundGlycogen storage disease type 0 (GSD 0) is a rare inborn error of metabolism due to deficiency of the enzyme glycogen synthase (EC 2.4.1.11). Patients with this disorder are unable to store glucose as glycogen in the liver. GSD 0 is therefore characterized by ketotic fasting hypoglycemia in combination with postprandial hyperglycemia and hyperlactatemia. So far, only one pregnancy has been described in a woman with GSD 0. Case presentationWe herein report a 32 year-old patient GSD 0 with three successful pregnancies. The diagnosis of GSD 0 was made in early childhood due to characteristic symptoms. The patient had two healthy children at the time of her first visit in our metabolic centre. The diet was optimised prior to her third pregnancy with a protein-rich diet including cornstarch and protein supplements. Pregnancy was confirmed at week 6 of gestation. Dietary management was difficult during pregnancy, especially in the first trimester due to severe nausea. Labour was induced at 37 weeks of gestation due to cholestasis of pregnancy, and the patient delivered a healthy baby girl. Perinatally, the mother received a high glucose infusion to stabilize blood glucose levels. The neonate also required a glucose infusion postnatally because of impaired glucose homeostasis. Similar to diabetic fetopathy, recurrent maternal hyperglycemia may result in hyperinsulinism of the child and trigger neonatal hypoglycemia.ConclusionsAll four pregnancies in women with GSD 0 described to date occurred with minor complications and resulted in healthy offspring, which underpins the good prognosis and rather benign character of this rare metabolic disease. Careful monitoring during pregnancy and delivery is, however, necessary to minimize the risk of recurrent hypoglycemia for both mother and child.
Mating Behaviour and Fertility of Layer Breeders in Natural Mating Colony Cages: LED Light Environmental Effects
Authors: Shi Haipeng , Li Baoming , Tong Qin , Zheng Weichao , Zeng Dan
Published: August 2020

Background: Natural mating colony cages for parent-stock layer breeders, instead of conventional cages with artificial insemination, have been widely adopted by many commercial farms in China. However, the fertility rate of this system is unstable and varies greatly among different cage tiers. We speculated that the difference in fertility rate might be caused by uneven illumination because vision appears to play a central role in hens’ behaviour, including mating, which is an important factor that affects the reproductive performance of hens. The objectives of this study was to investigate the effects of 4 LED light colours (white: WL, red: RL, yellow-orange: YO, blue-green: BG) with 2 light intensities (10 lux, 25 lux) in each colour on mating frequency and fertility for layer breeders in natural mating colony cages. Results: A total of 32 identical cages were involved in the 8 treatments, with 4 replicates for each treatment and 5 males and 45 females per cage. The results showed significant effects of age, light colour, light intensity and colour-intensity interaction on the frequency of mating behaviour, integrity of matings and fertility. Overall, flocks treated with WL and RL and a higher light intensity in natural mating colony cages during the laying period showed a more frequently mating behaviour, a large proportion of relatively complete matings and a higher fertility. All components of mating behaviour and fertility declined from 30 through 40 to 50 wks of age, but no significant correlation was found between fertility and mating behaviour. Conclusions: In summary, the results of this study illustrate that different LED light colour and light intensity influenced the mating behaviour and fertility of layer breeders. WL and RL and a higher light intensity could increase the frequency of mating behaviour, the proportion of complete matings and fertility. No significant correlation was found between fertility and mating behaviour. Such knowledge can help to understand mating behaviour in natural mating colony cages and provide a basis for the optimization of light environment regulation.
SARS-CoV-2 cellular immune response in uninfected health care workers with prolonged and close exposure to COVID-19 patients
Authors: Vallejo Alejandro , Vizcarra Pilar , Quereda Carmen , Moreno Ana , Casado Jose L
Published: August 2020

Health care workers (HCW) are at an increased risk since they are directly exposed to SARS-CoV-2 infected patients, nevertheless, some remained without the development of anti-SARS-CoV-2 antibodies, suggesting lesser susceptibility to infection1-5. This study aimed to ascertain a potential specific cellular immune response to SARS-CoV-2 in these largely exposed HCWs.In this cross-sectional, case-control study, we analyzed 39 exposed uninfected HCWs and 17 convalescent HCWs. Cellular immune response was evaluated after SARS-CoV-2 stimulation with peptide pools (proteins S, M, and N), using bead-based multiplex assay (12 cytokines).Overall, 94.8% of uninfected HCWs had some degree of specific cellular response to SARS-CoV-2 structural proteins that could be classified, according to the number of cytokine production, as strong (61.5%), partial (33.3%), and weak/no response (5.1%). Strong responders showed a higher anti-inflammatory cytokine production (IL5 and IL10, p<0.001 and 0.002, respectively), and similar (IFN-γ and TNF-α, p=0.435 and 0.532, respectively) or higher (IL12, p=0.021) pro-inflammatory production compared to convalescents, resulted in a predominantly Th2 response. This study demonstrated a consistent and polyfunctional immune cellular response after stimulation with SARS-CoV-2 peptides in extensively exposed individuals that should be considered to establish the infection susceptibility, the impact in herd immunity, and the risk of relapses.