bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of fermentation conditions through response surface methodology for Indole-3-acetic acid production by Marine Sponge Callyspongia diffusa associated Pseudomonas fluorescens BCPBMS-1
Authors: Venkataraman Vasanthabharathi , Ramasamy LakshmiNarayanan , Singaram Jayalakshmi
Published: September 2020

In the Present study we focused on the production and statistical optimization of media components for Indole-3 acetic acid (IAA) production from P.fluorescens BCPBMS-1, it was isolated from Marine sponge Callyspongia diffusa . This sponge was collected from Gulf of Mannar, Southeast coast of India. We optimized the low-cost agricultural residue based medium for IAA production. In our study Soya bean husk used as a substrate for Indole-3-acetic acid (IAA) production. Fermentation variables were selected based on the Plackett-Burman design and were optimized by response surface methodology. The maximum IAA concentration 1.7474 µg/ml was predicted in medium containing 3.1064% Soya bean husk, Yeast extract 0.8323%, Salinity 9.0765 ppt, pH 6.3108 temperature 27.5524℃, incubation time 64.7475hrs. These predicted values were also verified through experiments as a result we got 1.74 µg/ml. The excellent correlation observed between predicted and measured values of this statistical model hence, this method may recommend for the industrial purpose.
Differences on Pyrexia Related Immune Responses Between COVID-19 and Influenza A Children
Authors: Kou Shanglong , Zhan Senlin , Li Xiaohe , Zhang Mingxia , Deng Guofang , Pan Yanchao , Yuan Jing
Published: September 2020

Background: Coronavirus disease-2019 has brought rapid challenge to the current health care system raising millions of infected patients globally. The clinical manifestations of asymptomatic patients especially children and young people will contribute to the management of current pandemic.Methods: To provide precise and comprehensive information on the less symptomatic COVID-19 children, total 62 hospitalized children aged 1-14 years with confirmation infection of either SARS-CoV-2 or influenza A were enrolled for past half of year from September 2019 to February 2020. The epidemiological, demographic, clinical, radiologic and laboratory findings were extracted from the electronic medical records of the patients. Results: We reported less fever (43.33% vs 100%, p<0.001) with lower body temperature (p<0.001) and hypoinflammatory responses occurred in COVID-19 children in comparison with influenza infection. We further showed the significant correlations between initial body temperature and multiple immune parameters to imply the role of thermoregulation on asymptomatic COVID-19 children. Conclusions: COVID-19 children were more likely to have mild symptoms and relatively slow progression. Furthermore, correlations between initial body temperature and immunological functional parameters suggested that non-susceptibility of children to SARS-CoV-2 virus may lie in the low sensitivity on thermal regulation of immune activation.
Long Noncoding RNA LINC00265 Promotes Proliferation of Gastric Cancer by Acting as A Competing Endogenous RNA on microRNA-144-3p Thereby Upregulating CBX4
Authors: Yang Zengxi , OuYang Xi , Zheng Liang , Dai Lizhen , Luo Wenjuan
Published: September 2020

Background:The expression levels and detailed functions of LINC00265 in gastric cancer (GC) have not yet been explored. This study aimed to measure LINC00265 expression in GC tissues and cell lines, investigate its specific roles in the aggressive characteristics of GC cells in vitro and in vivo, and elucidate the regulatory mechanisms of LINC00265 action.Materials and methods: The qRT-PCR was performed to test the RNA expression levels in GC tissues and cell lines. Cell proliferation was detected by CCK-8 and colony formation assays. Western blot assay was used to measure relevant protein expression. Luciferase reporter assays were performed to investigate the association between LINC00265 and microRNA-144-3p and CBX4.Results: LINC00265 expression was high in GC tissue samples and cell lines; LINC00265 overexpression correlated with shorter overall survival of the patients. A LINC00265 knockdown inhibited GC cell proliferation in vitro and slowed tumor growth in vivo. Mechanism investigation revealed that LINC00265 acts as a competing endogenous RNA on microRNA-144-3p (miR- 144) in GC cells. Chromobox 4 (CBX4) mRNA was identified as a direct target of miR-144-3p in GC cells. The knockdown of miR-144-3p counteracted the reduction in the malignant characteristics of GC cells by the downregulation of LINC00265.Conclusion: In conclusion, LINC00265 functions as a competing endogenous RNA targeting miR-144-3p and increases the malignancy of GC cells in vitro and in vivo by upregulating CBX4.
CDX2 and Reg IV Expression and Correlation in Gastric Cancer
Authors: Chai Dandan , Du Huifen , Li Kesheng , Zhang Xueliang , Li Xiaoqin , Zhao Xiaoning , Lian Xiaowen , Xu Yang
Published: September 2020

Background: Ectopic expression of CDX2 is associated with the development and progression of gastric cancer. Previous studies showed that CDX2 may be an upstream regulator of Reg IV expression in gastric cancer, and our previous report showed that Reg IV upregulated SOX9 expression and enhanced cell migration and invasion in gastric cancer cells. However, the regulatory roles of CDX2 have not been clarified in gastric cancer, and the correlation between CDX2 and Reg IV requires further study.Methods: CDX2 and Reg IV were examined in gastric cancer specimens and paired adjacent tissues via real-time PCR and immunohistochemistry (IHC). The association between CDX2 and Reg IV was assessed using the χ2-test and Spearman’s rank correlation. To verify their relationship, knockdown and exogenous expression of CDX2 or Reg IV were performed in AGS and MKN-45 gastric cancer cells, and their expression was subsequently analyzed via a real-time PCR and western blotting. Wound-healing and Transwell assays were used to examine migration and invasion in AGS and MKN-45 cells following CDX2 silencing or overexpression.Results: A positive correlation was observed between CDX2 and Reg IV expression at the mRNA and protein levels in gastric cancer tissues. CDX2 silencing significantly downregulated Reg IV expression, and CDX2 overexpression significantly upregulated Reg IV expression in AGS and MKN-45 cells. Neither Reg IV silencing nor overexpression had any effect on CDX2 protein expression in AGS or MKN-45 cells, even though both affected the expression of CDX2 mRNA. Functionally, CDX2 silencing significantly inhibited cell migration and invasion, and CDX2 overexpression significantly promoted cell migration and invasion in AGS and MKN-45 cells.Conclusions: Our findings demonstrate that CDX2 expression was positively correlated with that of Reg IV in gastric cancer, and CDX2 promoted cell migration and invasion through upregulation of Reg IV expression in gastric cancer cells.
Medical educators’ Beliefs about Alignment of Learning goals, Teaching and Assessment in the Context of Curriculum Changes
Authors: Karami Morteza , Hashemi Noorieh , Merrienboer Jeroen van
Published: September 2020

Background: Achieving changing needs, advancing knowledge, and innovations in higher education require constant changes of medical school curricula and brings greater clarity to the influence of the core beliefs held by medical educators. The purpose of this study was to describe medical educators’ beliefs about alignment of learning goals, teaching and assessment in the context of curriculum changes.Method: A qualitative method was used to this goal by selecting faculty participants in a purposeful sampling strategy. For the individual interviews, we invited both professors of basic sciences and clinical professors who had worked with medical students for at least five years.Result: Findings showed that gaps between theoretical contents and real world settings caused ignorance of the core competencies in learning and assessment processes. It also indicated gaps between what students learn in class and what they need to know and, especially, do in hospitals. Furthermore, the current beliefs of teachers need to be further changed to realize more integrated learning in the future.Conclusion: A change towards more active teaching methods and a whole-task approach to teaching and assessment is needed in order to help students acquire desired competencies. Thus, a shift from a discipline-based to a competency-based approach to teaching and learning is needed.
Differential effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on COVID-19
Authors: su lianjiu , zhang jiahao , jiang nanhui , yang jie , he li , xie qin , huang rong , liu fang , feng ying , Kashani Kianoush B. , lu qiaofa , sun zhongyi , peng zhiyong
Published: September 2020

BackgroundThe effect of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB) on the COVID-19 remains controversial from clinic evidence. MethodsThis is a retrospective, two-center case series of 198 consecutive COVID-19 patients with a history of hypertension. ResultsAmong 198 patients, 58 (29.3%) and 16 (8.1%) were on were on ARB and ACEI, respectively. Patients who were on ARB or ACEI/ARB had a significantly lower rate of severe illness and ARDS when compared with patients treated with ACEI alone or not receiving and RAAS blocker (P＜0.05). The Kaplan-Meier survival curve showed that patients with ARB in their antihypertensive regimen had a trend towards a higher survival rate when compared with individuals without ARB (adjusted hazard ratio, 0.27; 95% CI, 0.07-1.02; P = 0.054). The Cox-regression analysis to compared ACEI vs. ARB groups showed a significantly lower mortality rate in the ARB group (adjusted hazard ratio, 0.03; 95% CI, 0.00-0.58; P = 0.02). ConclusionsUsing of ARB was associated with a reduced rate of severe illness and ARDS, indicating their potential protective impact in COVID-19.
A Quality Assessment of Clinical Service Utilization in a Geriatrics Unit in West Africa: 2014-2018
Authors: Obehi Akoria , Osian Franklyn , Akene Blossom , Ugorji Eunice , Kubeyinje Oluwaseun , Emore Oluwaseun , Akpotor Joy
Published: September 2020

Background: Quality healthcare requires learning organizations who demonstrate commitment to evaluation and improvement. The Geriatrics Unit in the 850-bedded University of Benin Teaching Hospital (UBTH), Nigeria, was set up in 2014 to provide quality healthcare to older persons. The goal of this evaluation was to assess the extent to which that initiative met its objectives. Methods: Using the Donabedian's framework, we undertook a formative review of key service elements in the Geriatrics Unit of UBTH from April 1, 2014 to March 31, 2018, using data from routine ward documentation. Results: The unit had a multidisciplinary team of doctors, nurses, physiotherapists, occupational therapists, pharmacists, medical social workers and support staff throughout the period in focus. All records were manually kept. In-patient numbers more than doubled within the first year, from 62 to 133. Increasing utilization was also evident in bed occupancy rates that rose from 20.1% in 2014 to a peak that exceeded the maximum capacity of open beds (112%) in 2017, and required closed beds to be opened. Bed turnover rates increased from 3.7 in 2014 to 22.2 in 2017. The median average length of stay was 13.9 days. Gross mortality rate ranged between 23% and 31.8%; annual fall rates between 0.4 and 3.0 falls per thousand patient days, and discharges against medical advice (DAMA) between 0.8% and 6.1%.Conclusion: Multi-disciplinary care was maintained in the geriatrics unit, and available beds were oversubscribed within the 4 years reviewed. Opportunities for improvement include moving on to electronic patient records; increasing the number of functional beds; achieving lower mortality rates. Our findings also provide benchmarks against which future evaluations and quality improvement interventions will be measured.
Pneumocystis pneumonia in patients with primary nephrotic syndrome: analysis of 18 cases
Authors: You Xiaohan , Zhang Ji , Zhou Qiongxiu , Zhang Jianna
Published: September 2020

Background: The aim of this study was to analysis the clinical features, risk factors and outcomes of patients with primary nephrotic syndrome (PNS) who developed pneumocystis pneumonia (PCP).Methods: We systematically reviewed medical records from 18 PNS patients with PCP admitted to our hospital from April 2007 to April 2019. A total of 180 cases were randomly selected as controls from PNS inpatients without infection.Results: In PCP patients, the mean age at presentation was 48.5 years, mean duration of prednisone treatment was 3.7 months and mean prednisone dose on admission was 31.3 mg/d, the most common clinical manifestation was fever (100%) and average PaO2 on admission was 59.5 mmHg. Eight patients (44.4%) had coexisting infections, most often was cytomegalovirus (4 patients), 11 patients (61.1%) had ICU admission and 9 patients (50%) had mechanical ventilation. PCP patients had more prednisone, more immunosuppressive therapy, lower CD4+ cell counts and hemoglobin, and higher serum creatinine than those without infections (p<0.05). Logistic regression analysis showed that patients with prednisone usage and lower CD4+ cell counts were more likely to have PCP compared to controls (p<0.05). All patients survived after treatment.Conclusion: PCP was not unusual in PNS patients, and the most important risk factor was a lower CD4+ cell count, but however, these patients had a good outcome after enough treatments.
Antipsychotic Discontinuation and Suicide in Schizophrenia Patients A Nested Case-Control Study
Authors: Choi Young , Park Eun-Cheol
Published: September 2020

Background Schizophrenia patients have shorter life expectancy relative to that of the general population, and their suicide risk is reportedly higher. Although antipsychotic discontinuation rates are high, antipsychotic treatment has been associated with lower suicide mortality, and patients who do not use antipsychotics are at greater risk of suicide relative to those who use the medication. Furthermore, maintenance treatment with antipsychotic drugs protects schizophrenia patients from relapse. However, little is known about antipsychotic discontinuation, suicide risk, or the time during which suicide risk is highest following antipsychotic discontinuation. Therefore, this study investigated whether discontinuity of antipsychotics is associated with suicide in schizophrenia patients.Methods A population-based nested case-control study was conducted using the Korean National Health Insurance claims database (2002-2013). From the study population of 7,519 patients with the diagnosis of schizophrenia and at least one antipsychotics described, we identified 154 suicide cases and 760 matched controls. We calculated the days after last prescribed medication so that discontinuity of antipsychotics was defined. Conditional logistic regression were used to examine the association between discontinuity of antipsychotics and suicide adjusting for possible confounding covariates.Results Suicide risk was particularly high during the first thirty days after discharge after stopping antipsychotics compared with current user after adjusting all covariates (AOR: 4.667, 95% CI: 2.425–8.984).Conclusion Maintenance treatment with antipsychotics could help to reduce suicide risk. The results indicated that there is a need to monitor schizophrenia patients following antipsychotic discontinuation.
Bushenhuoxue formula inhibits osteoclastogenesis and bone resorption on rabbit steroid-related osteonecrosis of the femoral head by suppressing NF-κB/NFATc1 pathway
Authors: Zhang Peng , Hu Songfeng , Xu Huihui , Yuan Wenhua , Xia Chenjie , Shi Zhenyu , Xu Rui , Fang Liang , Ge Qinwen , Mao Qiang , Wang Pinger , Tong Peijian , Jin Hongting
Published: September 2020

Background: To investigate the effect and underlying mechanism of Bushenhuoxue formula (BSHXF) on steroid-related osteonecrosis of the femoral head (SONFH). Methods：Seventy-five male New Zealand white rabbits were divided into three groups: control group, model group and BSHXF group. Rabbit SONFH was induced by methylprednisolone (MPS) combined with lipopolysaccharide (LPS). At week 2 and 6 post induction, the corresponding number of rabbits were sacrificed, and the femoral heads were harvested for tissue analyses, including histopathology, mechanical test of femoral heads, micro-CT, tartrate-resistant acid phosphatase (TRAP) staining, immunohistochemistry for p-P65 and co-staining of TRAP and alkaline phosphatase (ALP). Additionally, the serum TRACP5b level was measured using enzyme-linked immunosorbent assay (ELISA). Meanwhile, we also evaluated the effect of BSHXF treatment on osteoclastogenesis in vitro. The protein level of cathepsin K (CTSK), P65, p-P65 and NFATc1 in rabbit femoral heads and RAW264.7 cells were detected, respectively.Results: At weeks 2 and 6 post induction, the elevated TRAP, p-P65 expression and reduced ALP expression were observed in the model group, with decreases in weight-bearing capacity of femoral heads and bone mass. After BSHXF treatment, the ratio of empty lacuna and the incidence of osteonecrosis in BSHXF group were markedly lower than that in model group. Micro-CT evaluation indicated that BSHXF has a preventive effect on bone loss in rabbit SONFH. In addition, BSHXF treatment increased weight-bearing capacity of femoral heads and reduced TRAP+ osteoclasts and serum TRACP5b level. Interestingly, CTSK, p-P65 and NFATc1 upregulation in necrotic femoral head could be reversed by BSHXF treatment, which also effectively inhibited RANKL-induced osteoclast differentiation and down-regulated CTSK, p-P65 and NFATc1 expression in vitro.Conclusions: BSHXF could inhibit osteoclastogenesis and bone resorption on rabbit steroid-related osteonecrosis of the femoral head by suppressing NF-κB/NFATc1 pathway.
Biotechnological Improvement of Nutritional Value of Rice straw using Fungi
Authors: Salem Mohamed F. , gaafar khalid mahmoud mohamed , elkhair Reham Nabil Abo , Abonama Osama M. , Yasseen Asmaa Abd-Elrasol , Abouelkhair Ahmed Adel
Published: September 2020

The authors have withdrawn this preprint due to author disagreement.
Effect of the Slope Angle and Its Classification on Landslide
Authors: Çellek Seda
Published: September 2020

The preparation of landslide susceptibility maps is a complex process with regards to the selection of the study field, parameters, and methods. The phase after the determination of the landslide distribution in landslide susceptibility studies is the selection of the methods and parameters to be used. However, first, as in this study, a comprehensive literature search is required. A review of approximately 1500 randomly selected publications revealed that it was necessary to select a parameter based on the area, and the research showed that, in each study, the most preferred parameter was the slope angle. Moreover, there is nearly a consensus of opinion among researchers regarding the use of the slope angle. The current research included the definitions of the slope angle put forth by different researchers, the advantages and disadvantages of its use, the different classifications that have been used, the intervals of the landslides, its use together with other parameters, and its effect on landslides. Generally, it was observed that automatic slope angle classifications have been used in the preparation of landslide maps in the literature. Therefore, there is no standard in slope angle maps nor in the class range that is referenced when preparing them. In this study, the class ranges and slope angle values of areas where landslides have occurred were determined from the literature, and of these, 40 landslides areas were selected in Turkey and their slope angle maps were created. These were evaluated according to the slope angle classes determined in the literature. The effects of the slope angle on the landslide were determined, and an understanding was gained of how important it was to be careful when determining the classification of the slope angle. When smaller class ranges were selected, different results were obtained. This showed that following parameter selection, the selection of the range of classes was vital in the preparation of landslide susceptibility maps.
Mood Symptoms and Other Maternal Factors in Pregnancy and Adverse Neonate Outcomes
Authors: Li Hua , Bowen Angela , Bowen Rudy , Muhajarine Nazeem , Balbuena Lloyd
Published: September 2020

Background Antenatal women experience a higher level of mood symptoms, which have negative effects on mothers’ mental and physical health and their newborns. The relation of maternal moods including depression and anxiety and other maternal factors in pregnancy and neonate outcomes are well-studied with inconsistent findings. Although antenatal women experience a higher level of mood instability (MI), the association between antenatal MI and neonatal outcomes has not been investigated. We aimed to address this gap and to contribute to the pregnancy-neonate outcomes literature by examining the relationship between antenatal mood symptoms and other maternal factors and neonatal outcomes.Methods A prospective cohort of women (n = 555) participated in this study at early pregnancy (T1, 17.4 ± 4.9 weeks) and late pregnancy (T2, 30.6 ± 2.7 weeks). The Edinburgh Postnatal Depression Scale (EPDS) was used to assess antenatal depressive symptoms, the EPDS anxiety subscale was utilized to measure anxiety symptoms, and mood instability was measured using a visual analogue scale. These mood states together with stress, social support, as well as healthy and unhealthy behaviours were also examined in relation to neonatal outcomes using chi-square tests and logistic regression models. Results Depression and MI were unrelated to adverse neonatal outcomes and anxiety was related to Apgar score with marginal statistical significance. Higher stress, lack of partner support, smoking, and primiparous status were associated with some adverse outcomes.Conclusions The current study identified no associations between antenatal mood symptoms and neonatal outcomes. Our findings further support and extend previous evidence on smoking abstinence or cessation, and the provision of resources for stress management and social support that could help prevent or alleviate adverse neonatal outcomes.
Disorder-induced splitting in quasiparticle
interference of Bi2Te3 Dirac electrons
Authors: Stolyarov Vasily , Sheina Valeria , Khokhlov Dmitrii , Vlaic Sergio , Pons Stéphane , Aubin Herve , Akzyanov Ramil , Vasenko Andrey , Menshchikova Tatiana , Chulkov Evgueni , Golubov Alexander , Cren Tristan , Roditchev Dimitri
Published: September 2020

Inelastic interactions of quantum systems with environment usually wash coherent effects out. In the case of Friedel oscillations, the presence of disorder leads to a fast decay of the oscillation amplitude. Here we show both experimentally and theoretically that in the three-dimensional topological insulator Bi2Te3 the finite lifetime of the Dirac electrons due to disorder causes a splitting of coherent scattering vectors which follows a peculiar evolution in energy. Not only this splitting enables evaluating the lifetime of Dirac quasiparticles in topological insulators, but this general phenomenon can be in play in other quantum systems, leading to non-trivial modifications of their coherent properties.
Retrospective analysis of the effects induced by maternal thyroid dysfunction on obstetrical complications and outcomes
Authors: Sun Manna , Wang Xinghe , Fang Yunyong , Lou Jiwu , Liu Chenning , Dai Bingmei , Chen Jingsi
Published: September 2020

Background: Abnormal concentrations of maternal thyroid hormones are risk factors for some obstetrical complications. However, the influence induced by different types of maternal thyroid dysfunction on obstetrical complications and outcomes is still controversial.Methods: A total of 17219 pregnant women were drawn for a thyroid function test, including TSH and fT4. All participants were divided into 7 groups, on the basis of their blood tested results, and their pregnancy outcomes were followed up. The isolated hypothyroxinemia group was further divided into 2 cohorts, according to whether they receive levothyroxine. Pregnant complications and outcomes in two cohorts were observed and analyzed.Results: A total of 2621 (15.22%)were identified to have abnormal thyroid function, including 1150 with subclinical hypothyroidism, 526 with gestational transient thyrotoxicosis (GTT), 419 with subclinical hyperthyroidism, 336 with isolated hypothyroxinemia, 78 with hyperthyroidism and 76 with hypothyroidism. Compare to control group, subclinical hypothyroidism, subclinical hyperthyroidism, isolated hypothyroxinemia and hypothyroidism groups presented higher incidence in one or more complications of pregnancy, while, GTT and drug-controlled hyperthyroidism had little significant effect on pregnancy complications. In isolated hypothyroxinemia group, there were no significant difference outcomes between cohorts using levothyroxine and not treatment.Conclusions: Our results showed a high incidence rate of thyroid dysfunction in pregnant women, and subclinical hypothyroidism is most common, followed by GTT. In general, pregnant women with thyroid dysfunction presented high risk of pregnancy complications. Isolated hypothyroxinemia in pregnant women is a matter of concern and treatment with levothyroxine couldn’t improve pregnancy outcomes and obstetrical complications.
“Shrinking Lung” Radiation Technique in Hodgkin’s Disease
Authors: Joseph Sanjay , King III Maurice , Jackson James , Milner Carter , Elkins Stephanie , Vijayakumar Srinivasan
Published: September 2020

We present a case of Classical Hodgkin lymphoma, nodular sclerosis subtype, Stage IIB EX presenting with a large left lung mass, mediastinal lymph nodes, night sweats, 19% weight loss, erythrocyte sedimentation rate (ESR) of 110 ml/hr and a suboptimal response to 6 cycles of ABVD (Adriamycin, Bleomycin, Vinblastine and Dacarbazine) chemotherapy. The patient then underwent radiation to the left lung followed by radiation to residual disease using what we describe as a “shrinking lung” radiation technique. A PET-CT done 8 months after radiation treatment was completed demonstrated a complete response. This case highlights the use of a traditional radiation technique in treatment of chemotherapy refractory Hodgkin’s lymphoma to achieve a complete remission.
Immunologic Biomarkers, Morbidity and Mortality Among HIV Patients Hospitalized in a Tertiary Care Hospital in the Brazilian Amazon
Authors: Mota Wellington Gama , Almeida Taynná Vernalha Rocha , Santos Daniel Silva dos , Chaves Yury Oliveira , Silva Danielle Furtado da , Orlandi Patrícia Puccinelli , Pereira Flávio Ribeiro , Magalhães Gleicienne , Baptista Bárbara Jóse , Frank Carlos Henrique Michiles , Silva Viviane Lago de Oliveira , Balieiro Antônio Alcirley da Silva , Santana Monique Freire , Gonçalves Roberta Lins , Costa Allyson Guimarães da , Santos Marcelo Cordeiro dos , Ferreira Luís Carlos de Lima , Lacerda Marcus Vinicius Guimaraes , Nogueira Paulo Afonso
Published: September 2020

Background: While antiretroviral therapy (ART) has significantly improved survival rates of people living with HIV, some regions in Brazil still show a linear trend of growth in the opportunistic infections that cause HIV-associated mortality. We aimed to describe HIV-associated morbidity and mortality among hospitalized medical patients in a tertiary care hospital in Manaus, in the Brazilian Amazon, by investigating clinical data and immunologic biomarkers in order to assess predictive factors of mortality in this patient group. Methods: We prospectively measured concentrations of cytokines Th1/Th2/Th17 and soluble CD14 (sCD14) and reviewed the laboratory parameters and opportunistic infections in outcomes of either death or discharge of eighty-three HIV/AIDS patients who were admitted in 2017-2018 to the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus. Results: The mortality in the sample studied was 20.5%. Tuberculosis (TB) showed a relative risk (RR) =1.86 (confidence interval (CI) 1.14 to 2.81: and p = 0.026), and weight loss was the symptom (RR=1.81; CI: 1.21 to 2.53 and p = 0.007) most highly associated with the death outcome in HIV/AIDS inpatients. Univariable analyses showed that the eosinophil count, platelet distribution width (PDW), and alanine aminotransferase were the only laboratory parameters that differed among patients who died. In relation to cytokines and sCD14 levels, no differences were found between those who died or were discharged. A multivariable logistic regression model was used to predict mortality and showed that individuals with no digestive syndrome (especially the absence of oropharyngeal candidiasis), nor TB are 63% to 76% less likely to die, respectively. In addition, increases in PDW values also decreased the probability of death. Curiously, patients who were discharged showed a trend towards a concomitant increase in PDW and mean platelet volume (MPV) in relation to those who died.Conclusions: Opportunistic infections continue to be major events in morbidity and mortality of HIV/AIDS patients, and the relationship between increased PDW and the likelihood of survival suggests the need for future studies on innate immune response of platelets in HIV/AIDS inpatients.
Intention to Breastfeed Among Female Students of Tertiary Institutions In Ekiti State, Southwest Nigeria.
Authors: Ogundare Olatunde Olatunde , Babatola Adefunke Olarinre , Omoyajowo Adefunke Christianah , Ajite Adebukola Bidemi , Adeniyi Adewuyi Temidayo , Fatunla Odunayo Adebukola , Olubosede Omolayo Adebukola , Taiwo Adekunle Bamidele , Oluyi Adedayo Adewumi , Ajibola Ayotunde Emmanuel , Komolafe Akinwumi Kolawole , Airemionkhale Alfred , Oluwayemi Isaac Oludare , Olatunya Oladele Simeon
Published: September 2020

Introduction: Breastfeeding is a public health practice that is critical for the survival of infants and young children. Despite the well documented advantages of breastfeeding to both the child and mother, it is surprising to note that the rate of breastfeeding especially exclusive breastfeeding is quite low in many countries. The possible reason may be because most of the efforts and activities directed at improving the breastfeeding rate and duration are targeted at pregnant women and post-partum period.This study aimed at determining the knowledge, attitude, beliefs, and future intention to breastfeed among female undergraduates in tertiary institutions in Ekiti State, South West Nigeria.Methods: The study was a prospective cross-sectional study conducted among female students of tertiary institutions in Ekiti State. By convenience sampling, female students were invited to participate in the study after giving verbal consent and those that were thirty years old and above, medical or nursing students were excluded. The questionnaire used for this study was self-administered. The proforma was designed to assess the students’ knowledge about breastfeeding, attitude, beliefs, and future intention towards breastfeeding.Data analysis was with SPSS version 25 using descriptive and inferential statistics. Results were summarized as percentages. Consensus index was calculated for the questions on the knowledge of the benefits of breastfeeding and the perception of breastfeeding.Result: One thousand, three hundred and twelve (1312) students participated in the study. Only 58% of the respondents defined exclusive breastfeeding correctly. The participants displayed a particularly good knowledge of the importance of breast milk for the brain growth as 93% of the respondents agreed that breast milk is important for the development of the infant’s brain. As much as 51% of the respondents agreed that breast milk is not needed after infancy. Only 34% of the respondents indicated their intention to breastfeed their future babies, 6.5% said no.Conclusion: This study revealed that most of the future mothers have poor knowledge and beliefs about breastfeeding as well as negative attitude toward breastfeeding, hence there is need to step up awareness about breastfeeding and its benefits among this huge population of future mothers.
Comparative Study of Histological and Histochemical Image Processing in Muscle Fibre Sections of Broiler Chicken
Authors: Achouri Abdelhamid , Melizi Mohamed , Belbedj Hamid , Azizi Abdennour
Published: September 2020

Image processing of muscular fibre has significantly improved over the last decades, from light microscopy acquisition to virtual microscopy and from manual segmentation and fibre typing to automatic. The study aims to discuss main tools used in different histoenzymological image processing ‎phases of muscle fibre, which are consecutively, acquisition, segmentation and fibre typing and theirs ‎efficacy in morphometric parameters’ determination. Firstly, the acquisition, optical microscopic image with different magnifications ‎‎(x100, x200, x250 and x400) were compared with virtual slides digitized by Slide Scanner, in ‎muscle fibre sections, for cell number counting. Secondly, the segmentation, three software ‎‎(Fiji «Digitizing pen, Mouse», Image Pro Plus 10 -semi-automatic- and Cytoinformatics LLC -automatic-) were compared ‎for image segmentation quality and fibbers number determination. Thirdly, manual fibre typing with Fiji of segmented images using three software cited previously were performed to calculate the accuracy of morphometric parameter (CSA, perimeter and DMF). Results of acquisition showed that scanner slide have ‎a better resolution and detected a higher number of cells compared to optical microscopic with ‎different magnifications. For this latter, the processing can be performed only with an ‎acceptable resolution, where the number of cells is lesser, which requires unfortunately several ‎repetitions and exhausting work. Our findings regarding segmentation indicate that ‎Cytoinformatics LLC showed the best processing time and the highest quality followed by IP ‎and Fiji. For the last step, morphometric parameter calculation showed the best accuracy using Fiji followed by Cytoinformatics and finally by IP. ‎ The findings of this study suggest that Fiji (semi-automatic) showed the best quality/price ratio (open access software) for segmentation and fibre typing, but time consuming compared to ‎ Image Pro Plus 10 (semi-automatic) and Cytoinformatics LLC‎ (automatic) which are a paid service.
Reliability of a computational model for evaluating thoracoabdominal mobility in newborns: a cross-sectional study
Authors: Gomes Danielle Cristina , Azevedo Ingrid Guerra , Araújo Ana Gabriela Figueiredo , Holanda Norrara Scarlytt de Oliveira , Magalhães Fabrício Anicio , Pereira Silvana Alves
Published: September 2020

Background: Thoracoabdominal mobility (TAM) in newborns (NB) is an important respiratory function parameter in clinical assessment. Different systems have been proposed to assess compartmental mobility in a number of pathologies and age ranges. The present study aimed to verify the inter and intra-examiner reliability of an interactive custom-made MATLAB® App for bio-photogrammetric analysis of thoracoabdominal mobility in newborns (NB) and compare the respiratory rate (RR) results between the automatic MATLAB® App and its manual counterpart. Methods: This is a cross-sectional study conducted in 27 healthy NB of both sexes (gestational age between 37 and 41 weeks and up to 72 hours of life) who did not cry during data acquisition. Chest and abdominal areas of the NB in the supine position were analyzed through 60s videos, totaling 30,714 photograms. All photograms were analyzed by three examiners on three different occasions. Analysis of variance (ANOVA) and intraclass correlation coefficient (ICC) were applied, adopting a 95% confidence interval and significance level of α = 0.05.Results: Reliability was excellent for intra (ICC 0.81 – 0.96) and inter-examiner correlations (ICC 0.84– 0.99) between the chest and abdominal areas, in both inspiration and expiration, with no differences between them.Conclusions: Evaluation of NB thoracoabdominal mobility using the custom-made MATLAB® App for bio-photogrammetric analysis exhibited good to excellent intra- and inter-examiner reliability and an excellent correlation between manual and automatic models for measuring RR. Thus, it proved to be an objective and practical tool for bedside thoracoabdominal mobility assessment in different clinical situations involving neonatal care.
Patients´ Values in Nordic General Practice; A Report From the QUALICOPC Study.
Authors: Eide Torunn Bjerve , Straand Jørund , Brænd Anja Maria
Published: September 2020

Background. Patients’ expectations and preferences are important for improving the quality of care. We have explored Nordic patients´ views of the importance of different aspects of quality in general practice. Methods. In the Nordic countries, patients were recruited in general practitioners’ (GPs´) waiting rooms and asked to fill in a questionnaire ranking the importance of 47 statements reflecting five domains concerning quality of care in general practice: communication, involvement, accessibility, continuity, and comprehensiveness. Questionnaire items rated as important or very important by ≥ 90% of participants in all countries were considered to be universally of high importance. Logistic regression was used to identify associations between assessments and patient characteristics.Results. 707 patients responded, ranging from 82 (Iceland) to 209 (Denmark) per country. 90 % or more of patients in each country rated ten statements as important or very important: six pertained to communication with the GP, three to patient involvement and one to comprehensiveness of care. No items regarding accessibility or continuity of care exceeded the 90% limit in all countries. The item most frequently rated as very important was “I understand what the GP explains”. Female patients were more likely than males (OR=2.9; 95%CI 1.5-5.5) to value that a GP treats them as a person rather than just a medical problem, and also that they receive instructions regarding what to do if things went wrong (1.7; 1.2-2.2). Older patients >65 years put less emphasis than those aged <35 on whether the GP takes them seriously (0.4; 0.3-0.5), and also on the importance of receiving instructions for what to do if something went wrong (0.5; 0.4-0.7). Patients with chronic disease were less concerned (0.6; 0.4-0.8), with receiving instructions, but valued strongly that a GP knows when to refer them (2.2; 1.5-3.3). Conclusion. Patients in all countries assigned high value to the communication with their GP. Availability was also deemed important by patients, but came secondary to good communication quality. The organisational framework for general practice organisation must allow for acceptable quality of communication as well as availability.
Fecal Calprotectin in patients with Infantile Colic: A case-control study
Authors: Khoshnevisasl Parisa , sadeghzadeh mansour , Mahmoudirad Neda , Motamed Nima
Published: September 2020

Back groundThe precise etiology of infantile colic has not been elucidated after many years of research. In this study, we aimed to determine the association of fecal calprotectin with infantile colic.MethodThis case control study was performed on colicky infants referred to pediatrics clinics in Zanjan over a 6-month period. Infantile colic was clinically defined based on wessel criteria. The control group consisted of healthy infants matched for age, sex, weight, and type of feeding with the case group. Fecal calprotectin levels were measured in both groups by the ELISA method.ResultsForty infants were divided equally into case and control groups. The cases consisted of 11 boys (55%) and 9 girls (45%) with a mean age of 63 days and in the control group there was 12 boys (60%) and 8 girls (40%) with mean age of 48 days. Fecal calprotectin was positive in 17 (85%) cases and 6 (30%) controls. This difference was statistically significant. There was no significant difference in fecal calprotectin regarding sex, age, weight and type of nutrition in both colicky infants and controlsConclusionFecal calprotectin levels in colicky infants were significantly higher than healthy infants.
Outcomes of a medical second opinion programme before knee arthroplasty: A prospective cohort study
Authors: Weigl Martin , Pietzner Jens , Kisch Rebecca , Paulus Alexander , Jansson Volkmar , Grill Eva
Published: September 2020

Background: German social legislation gives patients the right to obtain a second opinion before elective surgery and defines quality criteria for reimbursement by statutory health insurance. However, the effects of second opinions before elective surgery are largely unknown. The aim of this study was to evaluate the effects of a second opinion programme in patients recommended for knee arthroplasty.Methods: The largest statutory health insurance funds in Bavaria offered patients to whom knee arthroplasty was recommended participation in a second opinion programme with personal presentation to an experienced knee surgeon. In this cohort study, consecutive patients from this second opinion programme who signed informed consent were included from 07/10/2016 to 14/02/2020. Data were collected before and after the second opinion visit.Results: A total of 141 (66%) of 215 second opinion patients participated in the evaluation study. The second opinion physician recommended knee arthroplasty to 40% of the patients, later knee arthroplasty if the conditions worsened to 40%, and no knee arthroplasty to 20%. The frequency of undecided patients decreased from 41% to 12%. After the second opinion, the patients were more confident in their decision according to the decision confidence scale (before: 5.4 ± 3.0; after: 7.8 ± 2.5; p < 0.001). Logistic regression analyses showed that higher radiological severity of osteoarthritis on the Kellgren/Lawrence scale (p = 0.001) and lower knee-joint-specific quality of life on the KOOS questionnaire (p = 0.041) were associated with the recommendation for knee arthroplasty by the second opinion physician. The patients rated their satisfaction with the second opinion programme with a mean grade of 1.35 (± 0.60) on a scale from 1 to 5.Conclusion: The second opinion of an experienced knee surgeon frequently deviates from the initial recommendation for knee arthroplasty. The results of this study suggest that a second opinion may improve adherence to guidelines for indications of knee arthroplasty. From the patient perspective, the second opinion reduces uncertainties in their treatment decision.
Efficacy of immunohistochemical staining in detecting Helicobacter pylori in Saudi patients with minimal and atypical infection
Authors: Akeel Mohammed Abdulraheem , Elhafey Ahmed , Shehata Atef , Elmakki Erwa , Aboshouk Thanaa , Ageely Hussein , Mahfouz Mohammed Salih
Published: September 2020

Background

Gastric Helicobacter pylori infection is diagnosed based on histopathological evaluation of gastric mucosal biopsies, urease test, urea breath test, H. pylori culturing, or direct detection using polymerase chain reaction (PCR). This study aimed to evaluate the efficacy of immunohistochemical (IHC) staining in detecting H. pylori in gastric biopsies from dyspeptic patients with minimal and/or atypical infection. Gastric biopsies from 50 patients with chronic gastritis were subjected to routine haematoxylin and eosin (H&E), modified Giemsa, and IHC staining. The results of staining were compared with those of quantitative real-time PCR (qRT-PCR).
Results

The qRT-PCR analysis identified 32 (64%) H. pylori-positive cases, whereas IHC, H&E, and modified Giemsa staining identified 29 (58%), 27 (54%), and 21 (42%) positive cases. The false-positive rates of H&E and modified Giemsa staining were 16% and 14%, respectively. The sensitivity of IHC staining (87.50%) was higher than that of H&E (59.38%) and modified Giemsa (43.75%) staining. The specificity of H&E, modified Giemsa, and IHC staining was 55.56%, 61.11%, and 94.44%, respectively. IHC staining exhibited the highest diagnostic accuracy (90%), followed by H&E (58%) and modified Giemsa (50%) staining. Active gastritis, intestinal metaplasia, and lymphoid follicles were detected in 32 (64%), 4 (8%), and 22 (44%) cases, respectively, and all of these cases were H. pylori positive.
Conclusions

H. pylori can be detected using routine H&E or modified Giemsa staining. However, the high sensitivity, specificity, and diagnostic accuracy of IHC staining minimise the false-positive/negative results and enable H. pylori detection in cases with minimal or atypical infection. Moreover, IHC can be an alternative diagnostic method to qRT-PCR for detection of H. pylori in such cases.
GnRH Antagonist Versus Modified Prolonged GnRH Agonist Protocol in Polycystic Ovary Syndrome (PCOS): Analysis Using Propensity Score Matching
Authors: Xia Leizhen , Tian Lifeng , Tan Jun , Zhang Shanshan , Wu Qiong-Fang
Published: September 2020

Background: Women with polycystic ovary syndrome (PCOS) have been reported with low pregnancy rate and high OHSS risk in in vitro fertilization (IVF) programs due to the decreased endometrial receptivity and high ovarian reserve. The aim of the study was to compare the effectiveness, safety and economic cost of GnRH antagonist (GnRH-ant) and modified prolonged GnRH agonist (mGnRH-a) protocol in PCOS patients.Methods: This study was a retrospective cohort study that included 2164 women with (PCOS) undergoing assisted reproductive technology (ART) treatment from January 2014 to April 2019. Among them, 2018 women received mGnRH-a treatment and 146 women received GnRH antagonist (GnRH-ant) treatment. The two groups were matched by propensity scores with a ratio of 1:4 (GnRH-ant versus mGnRH-a) accounting for potential confounding factors. The primary outcomes were the live birth rate (LBR), incidence of moderate-to-severe OHSS and the cost of controlled ovarian hyperstimulation (COH). LBR was defined as live birth per started treatment cycle after first fresh or frozen embryo transfer.Results: Women with the mGnRH-a protocol had an increased endometrial thickness on HCG injection day, compared with GnRH-ant protocol (10.84 vs. 9.62, P<0.001), furthermore, the number of transferable embryos on day 3 (7 vs. 5, P=0.022), clinical pregnancy rate (67.81% vs. 52.74%, P=0.0007), implantation rate (56.05%, vs. 43.44%, P<0.001) and live birth rate (58.22% vs. 41.78%, P=0.0004) were also significantly higher in the mGnRH-a protocol group. However, there were no significant differences in the incidence of moderate-to-severe OHSS (4.28% vs. 2.05%, P=0.333), the incidence of severe OHSS (0.17% vs. 0%, P=1) and the cost of COH (RMB: 7736.9 vs. 8046.54, P=0.113). Conclusion: The mGnRH-a protocol has a higher live birth rate than GnRH-ant protocol with the similar safety and economic cost among infertile women with PCOS.