bluuebunny/crossref_metadata_2025 huggingface dataset:
Epigenética: la relación del medio ambiente con el genoma y su influencia en la salud mental.
Authors: Casavilca-Zambrano Sandro , Cancino-Maldonado Karina , Jaramillo-Valverde Luis , Guio Heinner
Published: December 2019

El estudio del genoma humano, cuando efectuado solo a través de la información secuencial de ADN, no explica del todo el alto nivel de variación inter-individual usualmente observado. Es la epigenética la que permite explicar aquellas variaciones de expresión génica como un proceso reversible y hereditario en el corto plazo, bajo la influencia del medio ambiente durante diversas etapas del desarrollo y la edad adulta, sin modificar la secuencia genética. Las alteraciones epigenéticas están siendo ya incorporadas como elementos valiosos en la posible identificación de biomarcadores. Además, debido a su naturaleza reversible, pueden constituirse en factores de mejoría de síntomas de enfermedad mediante el uso de enfoques terapéuticos. El presente artículo explica los mecanismos de inhibición de la expresión génica, su relación con el medio ambiente, la dieta y su influencia en la evolución, la ocurrencia de enfermedades, la conducta humana y la salud mental.
Mini-Open Achilles Tendon Rupture Repair
Authors: Wagner Emilio , Wagner Pablo
Published: December 2019

Background:

We present a mini-open Achilles tendon rupture repair technique, which does not open the paratenon and avoids the sural nerve. We perform it to recover the normal working length of the gastrocnemius-soleus complex musculotendinous unit as well as possible, trying to avoid soft-tissue complications.

Description:

This repair is performed via a 3-cm-long incision that is placed 4 cm proximal to the Achilles tendon gap. Through this incision, the interval between the superficial fascia of the leg and the paratenon is developed. Distally, 2 small incisions are made in order to introduce into the calcaneus 2 bone anchors loaded with nonabsorbable sutures. These sutures are retrieved from the distal attachment site through the interval between the fascia and the paratenon with specifically designed suture passers, and obtained through the proximal incision. The sutures are then woven through the proximal stump of the Achilles tendon, the first ones in a Bunnell and the last ones in a crisscross manner, recovering the physiological equinus of the ankle
1
. The fascia and skin are closed appropriately.

Alternatives:

Percutaneous surgical repair techniques.

Open surgical repair techniques.

Orthopaedic nonoperative treatment.

Rationale:

This surgical technique differs from other available mini-open techniques in that it respects the rupture hematoma, accessing the tendon far from the rupture site; it does not violate the paratenon; and because of the placement in a safe anatomical interval, it does not injure the sural nerve. Because of the mini-open approach of the technique, soft-tissue complications are rare, and thus indications for this technique can be expanded over those of open surgical techniques.

Expected Outcomes:

Patients can expect a nearly complete recovery of gastrocnemius-soleus function, after an appropriate rehabilitation period. Soft-tissue complications are rare, and therefore early rehabilitation can be performed. The rehabilitation lasts for 5 months to achieve a high level of physical function. A low rerupture rate (2%) can also be expected
2
. The average return to work is 56 days.

Important Tips:

Try to operate within 10 days of the rupture to avoid scar formation at the rupture site.

Plan the surgical procedure according to the level of the rupture in order to ensure the suture passers are long enough to span the rupture site from the proximal incision up to the calcaneus.

Ensure the bone anchors are placed in the middle of the total height of the calcaneus, avoiding the enthesis, and align the anchors to be perpendicular to the axis of the calcaneus.

Follow the proximal suturing technique in order to obtain the best resistance of the repair. Taking care not to overtighten consecutive sutures, restore the appropriate level of physiological equinus.
Diagnostic evaluation of IgM ELISA and IgM Immunofluorescence assay for the diagnosis of Acute Scrub Typhus in central Nepal
Authors: Gautam Rajendra , Parajuli Keshab , Tshokey Tshokey , Stenos John , Sherchand Jeevan Bahadur
Published: December 2019

Introduction Scrub typhus is an acute febrile illness caused by the obligate intracellular bacterium,Orientia tsutsugamushi. Given their affordability and ease of use, antibody based diagnostic assays can be important diagnostic tools for early detection of scrub typhus fever in resource poor countries like Nepal. Immunochromatography (ICT) and IgM ELISA are two of the routinely employed antibody based assays for diagnosis of Scrub typhus fever in Nepal, although the recommended gold standard diagnostic test is IgM Immunofluorescence assay (IFA). This study evaluated the InBios Scrub Typhus Detect™ Immunoglobulin M (IgM) ELISA and IgM Immunofluorescence assays in single serum sample at the time of admission. Methodology Study participants (1585 suspected cases), were enrolled based on acute febrile illness with suspected scrub typhus cases in central Nepal from April 2017 to March 2018. Blood sample was collected from the suspected patients of scrub typhus, presenting with acute febrile illness. IgM antibody to Orientia tsusugamushi was detected by using Scrub Typhus Detect™ Kit (In Bios International, USA) and an in-house IgM IFA (Australian Rickettsial Reference Laboratory, Geelong, Australia. The IFA assay was performed with the Gilliam, Karp, Kato strains and O. chuto antigens following the ARRL protocol. Result Statistical analysis of ELISA IgM results when compared to reference test, IgM IFA results demonstrated the following characteristics, sensitivity 84.0% (95%CI: 79.73%-87.68%), specificity 94.82% (95% CI: 93.43%-95.99%), positive likelihood ratio 16.21% (95% CI: 12.71%-20.67%), negative likelihood ratio 0.17% (95% CI: 0.13-0.21%), disease prevalence 22.08% (95% CI: 20.06%-24.21%), positive predictive value 82.12% (95% CI: 78.28-85.42%) and negative predictive value 95.44% (95% CI: 94.27%-96.38%) respectively. Conclusion The study indicated that the IgM ELISA has the sensitivity 84.0% (95% CI: 79.73%-87.68%) and specificity 94.82% (95% CI: 93.43%-95.99%). Although IgM IFA is considered the gold standard test for the diagnosis of scrub typhus cases, it is relatively expensive, requires trained personal and a microscope with fluorescence filters. Scrub typhus IgM ELISA with appropriate OD cut–off values may be the best alternative test and possible viable option for resource limited endemic countries like Nepal.
International Randomised Controlled Trial for the Treatment of Newly Diagnosed Ewing Sarcoma Family of Tumours – EURO EWING 2012 Protocol
Authors: Birmingham Jennifer Anne , Moroz Veronica , Marec-Berard Perrine , Gaspar Nathalie , Laurence Valerie , Martin-Broto Javier , Sastre Ana , Gelderblom Hans , Owens Cormac , kaiser Sophie , Fernández-Pinto Melissa , Fenwick Nicola , Evans Abigail , Strauss Sandra , Whelan Jeremy , Wheatley Keith , Brennan Bernadette
Published: December 2019

Background Despite multiple randomised trials in newly diagnosed Ewing sarcoma family of tumours (ESFT), over many years, and involving many international co-operative groups, the outcomes for all stages of disease have plateaued. Internationally, the standard treatment of ESFT is not defined, and there is a need to add new agents other than conventional chemotherapy to improve outcomes. This trial will compare two different induction/consolidation chemotherapy regimens vincristine, ifosfamide, doxorubicin and etoposide (VIDE) induction and vincristine, actinomycin D, ifosfamide or cyclophosphamide, or Busulfan and Mephalan (VAI/VAC/BuMel) consolidation compared with vincristine, doxorubicin, cyclophosphamide, ifosfamide and etoposide (VDC/IE) induction and ifosfamide and etoposide, vincristine and cyclophosphamide, vincristine, actinomycin D and ifosfamide, or Busulfan and Mephalan (IE/VC/VAI/ BuMel) consolidation- randomisation 1 (R1). A second randomisation (R2) will determine whether the addition of zoledronic acid to consolidation chemotherapy, as assigned at R1, is associated with improved clinical outcome. Methods EURO EWING 2012 is an international, multicentre, phase III, open-label randomised controlled trial. There are two randomisations: R1 and R2. Patients are randomised at two different time points, at entry to the trial (R1) and following local control therapy (R2). The primary outcome measure is event-free survival. The secondary outcome measures include overall survival, adverse events and toxicity, histological response of the primary tumour, response of the primary tumour, regional lymph nodes and/or metastases, and achievement of local control at the end of treatment. Discussion This study will establish which is the "standard regimen" of chemotherapy, taking into account both clinical outcomes and toxicity. This will form the chemotherapy backbone for future interventional studies where we may want to add new targeted agents. It will also determine the role of zoledronic acid, in conjunction with the separate EE2008 trial. Any trial in ESFT needs to take into account the rarity of the tumour and that international co-operation is needed to provide answers in a timely manner. Trial registration Registered with EudraCT number 2012-002107-17 on 26th February 2012. Registered with ISRCTN number 54540667 on 4th November 2013.
Conventional Computed Tomographic Calcium Scoring vs Full Chest CTCS for Lung Cancer Screening: A Cost-Effectiveness Analysis
Authors: Jiang Boxiang , Linden Philip A. , Gupta Amit , Jarrett Craig , Worrell Stephanie G. , Ho Vanessa P. , Perry Yaron , Towe Christopher W.
Published: December 2019

Background Conventional CTCS images the mid/lower chest for coronary artery disease (CAD). Because many CAD patients are also at risk for lung malignancy, CTCS often discovers incidental pulmonary nodules (IPN). CTCS excludes the upper chest, where malignancy is common. Full-chest CTCS (FCT) may be a cost-effective screening tool for IPN. Methods A decision tree was created to compare a FCT to CTCS in a hypothetical patient cohort with suspected CAD. (Figure) The design compares the effects of missed cancers on CTCS with the cost of working up non-malignant nodules on FCT. The model was informed by results of the National Lung Screening Trial and literature review, including the rate of malignancy among patients receiving CTCS and the rate of malignancy in upper vs lower portions of the lung. The analysis outcomes are Quality-Adjusted Life Year (QALY) and incremental cost-effectiveness ratio (ICER), which is generally considered beneficial when <$50,000/QALY. Results Literature review suggests that rate of IPNs in the upper portion of the lung varied from 47-76%. Our model assumed that IPNs occur in upper and lower portions of the lung with equal frequency. The model also assumes an equal malignancy potential in upper lung IPNs despite data that malignancy occurs 61-66% in upper lung fields. In the base case analysis, a FCT will lead to an increase of 0.03 QALYs comparing to conventional CTCS (14.54 vs 14.51 QALY, respectively), which translates into an QALY increase of 16 days. The associated incremental cost for FCT is $278 ($1,027 vs $748, FCT vs CTCS respectively. The incremental cost-effectiveness ratio (ICER) is $10,289/QALY, suggesting significant benefit. Sensitivity analysis shows this benefit increases proportional to the rate of malignancy in upper lung fields. Conclusion Conventional CTCS may be a missed opportunity to screen for upper lung field cancers in high risk patients. The ICER of FCT is better than screening for breast cancer screening (mammograms $80k/QALY) and colon cancer (colonoscopy $6k/QALY). Prospective studies are appropriate to define protocols for FCT.
Risk factors for poor treatment outcomes of 2,266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study
Authors: Van Le Hong , Phu Phan Trieu , Vinh Dao Nguyen , Son Vo Thanh , Hanh Nguyen Thi , Nhat Le Thanh Hoang , Lan Nguyen Huu , Vinh Truong Van , Trang Nguyen Thi Mai , Ha Dang Thi Minh , Thwaites Guy , Thuong Nguyen Thuy Thuong
Published: December 2019

Background: Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcomes. Predictors of poor outcomes vary in different regions. Vietnam is among the top 30 high burden of MDR-TB countries. We describe demographic characteristics and identify risk factors for poor outcome among patients with MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam. Methods: This retrospective study included 2,266 patients who initiated MDR-TB treatment between 2011-2015 in HCMC. Treatment outcomes were available for 2,240 patients. Data was collected from standardized paper-based treatment cards and electronic records. A Kruskal Wallis test was used to assess changes in median age and body mass index (BMI) over time, and a Wilcoxon test was used to compare the median BMI of patients with and without diabetes mellitus. Chi squared test was used to compare categorical variables. Multivariate logistic regression with multiple imputation for missing data was used to identify risk factors for poor outcomes. Statistical analysis was performed using R program. Results: Among 2,266 eligible cases, 60.2% had failed on a category I or II treatment regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. The notification rate increased 24.7% from 2011-2015. The treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (adjusted odds ratio (aOR): 2.94), advanced age (aOR: 1.45 for every increase of 5 years for patients 60 years or older), having history of MDR-TB treatment (aOR: 5.53), sputum smear grade scanty or 1+ (aOR: 1.47), smear grade 2+ or 3+ (aOR: 2.06), low BMI (aOR: 0.83 for every increase of 1kg/m2 of BMI for patients with BMI<21). Conclusion: The number of patients diagnosed with MDR-TB in HCMC increased by almost a quarter between 2011-2015. Patients with HIV, high smear grade, malnutrition or a history of previous MDR-TB treatment are at greatest risk of poor treatment outcome.
Husbands’ experience and perception of supporting their wives during childbirth in Tanzania
Authors: Kashaija Denis Kampayana , Mselle Lilian Teddy , Mkoka Dickson Ally
Published: December 2019

Background : In order improve the quality of birth care and women satisfaction with birthing process it is recommended that every woman should be offered the option to experience labour and childbirth with a companion of her choice. Involving husbands as decision makers in the household may a play role in reducing maternal mortality which is unacceptably high despite the targeted goal to reduce these mortality as targeted in the MDGs by 2015. This is still addressed in the Sustainable Development Goals (SDGs) of 2015/30. This study aimed to explore the experiences and perceptions of husbands’ support of their wives during pregnancy, labour and deliveries in Tanzania. Methods: Qualitative descriptive study design was employed; involving men aged between 24 and 63 years. Participants were selected purposefully at the clinic and in labour ward of SekouToure Regional Referral Hospital (SRRH). The in-depth interview, guided by semi structured interview guide was used to collect the audio recorded and hand written information. Data were analysed using qualitative content analysis Results; Nine (9) semi-structured interviews were conducted with husbands of women attended for antenatal care and those came for deliveries. Four themes emerged; Demonstrating care, love and affection, adopting modern life style, observing women’s right and meeting social economic difficulties. Husbands’ support to their partners is a good behaviour practiced during matrimonial lives. Husbands who support their partners during pregnancy and delivery consider themselves as being modern men as they at home take duties beside their usual tasks to let their wives have adequate time to rest during pregnancy. Poor road infrastructure makes difficult to get transport to the healthcare facility especially when labour is imminent. Also ward infrastructure is not supportive to accommodate husbands when they accompany their wives to the healthcare facility. Conclusion s; The healthcare settings in low income countries need to accommodate men during the routine antenatal and intranatal care for the positive outcome of labour and delivery. Exploratory research should be conducted to understand how education and urbanisation affects men involvement in maternal and child health specifically in the low income countries.
Clinical outcomes of prophylactic compression sutures for treatment of uterine atony during the cesarean delivery of twins
Authors: Kim Mi-La , Hur Yoon-Mi , Ryu Hyejin , Lee Min Jin , Seong Seok Ju , Shin Joong Sik
Published: December 2019

Background : Twin pregnancy has a high risk for developing uterine atony (UA). This study aimed to evaluate efficacy and clinical outcomes of prophylactic compression sutures to treat UA during twin cesarean section (CS). Methods : All patient records of twin deliveries by CS after gestational age of 24 weeks in a large maternity hospital in South Korea between January 2013 and June 2018 were reviewed. Patients with monochorionic monoamniotic twins were excluded from data analysis. In total, 953 women were eligible for data analysis. Results : Of the 953 patients, compression sutures were applied to 147 cases with postpartum bleeding that were refractory to uterine massage and uterotonics. Out of the 147, two patients (1.4%) proceeded to additional uterine artery ligation to achieve hemostasis, yielding a success rate of 98.6%. The rate of transfusion after the first 24 hours of delivery in the suture group was not significantly different from that in the non-suture group, suggesting that both groups achieved hemostasis at an equal rate after the first 24 hours of delivery. The difference in the operation time between the two groups was only 8.5 minutes. The rate of subsequent pregnancy among the patients who received compression sutures was 44.4%. Conclusions : Overall, our findings suggest that with early and fast implementation of compression sutures, UA can be treated in the setting of twin cesarean delivery without significantly increasing maternal morbidity.
Evaluations of knowledge, skills and practices of insulin storage and injection handling techniques of patients in Ethiopian primary hospitals
Authors: Netere Adeladlew Kassie , Ashete Eyayaw , Gebreyohannes Eyob Alemayehu , Belachew Sewunet Admasu
Published: December 2019

Background: Diabetes mellitus is a group of metabolic disorders and resulting from deficits in insulin secretion, insulin action, or both. Insulin therapy is primarily required to attain the recommended goal of blood sugar. The primary aim of this study was to evaluate the knowledge, skills and practices of insulin storage and injection technique of patients. Methods : An interview based cross-sectional study was conducted in conveniently selected participants in Northwest Ethiopian primary hospitals from March, 1, 2019 to May, 30, 2019. Knowledge and practice were measured by administering structured questionnaire with a Likert scale of 1–5 through face-to-face interviews and skills were assessed by five observational (demonstration) techniques from a total of 166 clients. Results: Of the total 166 participants, 54.8% were males and the mean age was 38.46±13.8 years . The overall knowledge (65.4%.) and practice (53.89%) rate on insulin storage and handling techniques were showed moderate knowledge and fair practices. About 94.6% of participants correctly shown insulin injection sites. One-way ANOVA showed that the level of education [F (3, 162) = 7.283, p<0.001], ways of instruction of insulin injection [F (2, 163) =3.32, p = 0.039], insulin therapy duration [F (3,162) = 3.59, p= 0.015] and assessing insulin storage [F (2,163) = 4.45, p = 0.013] had a significant effect on level of knowledge. Similarly, knowledge level [F (2,163) = 14.17, p < 0.001], educational status [F (3,162) = 10.57, p <0.001], occupation type [F (4,161) = 5.43, p <0.001], time since insulin therapy [F (3, 162) = 5.46, p = 0.001] and diagnosis [F (3,162) = 3.36, p= 0.02] had a significant effect on patients’ insulin storage and administration practices. Conclusion: Patient had marginal knowledge and practices on insulin storage and administration techniques. The patients’ skills on the important and critical steps of administrations are poor. The engagements of healthcare professionals and stakeholders should be in developments of instructions and guidelines are very crucial in addition to focusing on educating and changing their wrong perceptions, believes and attitudes towards storage and administering techniques.
miR-Island: an ultrafast and memory-efficient tool for plant miRNA annotation and expression analysis
Authors: Gao Tiantian , Meng Xin , Zhang Wei , Jin Weibo
Published: December 2019

Background Next-generation sequencing of small RNAs has yielded an abundance of microRNA (miRNA) profiling data for diverse plant species. Many programs have been developed for plant miRNA annotation based on sequencing data, but these programs typically require computers with powerful hardware configurations. At present, few ultrafast computational tools are available for this type of data analysis on standard personal computers. Results We present miR-Island, an ultrafast tool for plant miRNA identification from deep sequencing data. Two important strategies contribute to the speed of the miR-Island program: (1) extracting precursor candidates using a pseudogenome and (2) using parallel processing for RNA secondary structure prediction. In our analysis, the pseudogenomic strategy reduced the time required for miRNA precursor extraction from 85 seconds to 19 seconds in Salvia miltiorrhiza , and parallel processing significantly reduced the time for the secondary structure prediction of 3957 S. miltiorrhiza miRNA precursors from 90 seconds to 32 seconds. miR-Island completed miRNA annotation for Arabidopsis in 18 minutes on a standard personal computer, which was less than 50% of the time for ShortStack and 9% of that for miRDeep-P. In terms of accuracy, miR-Island identified 128 miRNAs, which included 68 known miRNAs in miRBase. ShortStack predicted 55 total miRNAs, including 38 known miRNAs in miRBase. Of the 175 total miRNAs predicted by miRDeep-P, only 57 miRNAs were registered in miRBase. Agreement between miR-Island and ShortStack was moderate (kappa = 0.47). For the prediction of miRNAs from three other plant datasets, miR-Island spent approximately <50% of the ShortStack run time and <2.5% of the miRDeep-P run time. When the three programs were run on contig-level S. miltiorrhiza data, miR-Island, miRDeep-P and ShortStack finished the prediction in 17 minutes, 11 hours and 40 minutes, respectively. Conclusion Unlike other approaches, miR-Island is an ultrafast and memory-efficient tool for plant miRNA annotation and quantification on standard personal computer using the strategies of pseudo genome and multiple threads. In addition, miR-Island is a single command Perl script that is convenient to use for miRNA annotation and quantification. miR-Island was implemented in Linux and is available under the GPL GPU license from https://github.com/janeyurigao/miR-Island.
Application of voxel-based morphometric measurement to brain magnetic resonance imaging in children with non-cyanotic congenital heart disease
Authors: Jia Xuan , MA XIAOHUI , LIANG JIAWEI , ZHOU HAICHUN
Published: December 2019

Background Congenital heart disease（CHD） is a cardiovascular malformation caused by abnormal heart and/or vascular development in the fetus. In children with CHD, abnormalities in the development and function of the nervous system are common. At present, there is a lack of research on the preoperative neurological development and injury of young children with non-cyanotic CHD. The objective of the current study is to determine the changes in white matter, gray matter, and cerebrospinal fluid (CSF) by magnetic resonance imaging (MRI) in children with noncyanotic CHD as compared with healthy controls. MethodsChildren diagnosed with non-cyanotic CHD on ultrasonography (n=54) and healthy control subjects (n=35) aged 1–3 years. Brain MRI was performed prior to surgery for CHD. The SPM v12 software was used to calculate the volumes of the gray matter, white matter, CSF, and the whole brain (sum of the gray-matter, white-matter, and CSF volumes). Volume differences between the two groups were analyzed. Voxelbased morphometry was used to compare specific brain regions with statistically significant atrophy.ResultsCompared with the control group, the study group had significantly reduced whole-brain white-matter volume (P<0.05), but similar whole-brain graymatter, CSF, and whole-brain volumes(P>0.05). As compared with the healthy controls, children with non-cyanotic CHD had mild atrophy in the white matter of the anterior central gyrus, the posterior central gyrus and the pulvinar. ConclusionsChildren with non-cyanotic CHD show decreased white-matter volume before surgery, and this volume reduction is mainly concentrated in the somatosensory and somatic motor nerve regions.
Health professionals’ adherence to evidence-based obesity guidelines: a cohort study.
Authors: Garrido Nuria Trujillo , Bernal Mariangeles , Cano Maria José Santi
Published: December 2019

BACKGROUND The prevalence of obesity is on the increase worldwide and yet scientific evidence shows that primary care professionals are not adequately addressing overweight and obesity. In this study, we evaluate how obesity guidelines are being implemented in routine clinical practice. METHODS The study obtained the following data on a cohort of 209 obese patients attending primary care consultations: electronic medical records, body mass index (BMI), waist circumference (WC), cardiovascular risk factors, comorbidities and whether or not their health professional adhered to obesity evidence-based guidelines. RESULTS 57.9% of the participants were women and their average age was 65.8 ± 12.7 years. Only 25.4% of the medical records met all the criteria established in the therapeutic guidelines regarding diet prescription. This percentage was significantly higher in males than females (36.4% vs 17.4, p = 0.002). 1.4% met the criteria for physical activity and 1.5% for behavioural change activities. In the multivariate analysis, the variable associated with the most favourable BMI and WC figures, after adjusting for age, was a follow up by health professionals on physical activity (β=0.347, p=0.027, CI=0.429-6.868; β=0.367, p=0.024, CI=1.256-17.556) during routine check-ups with women. CONCLUSIONS We detected low adherence to the evidence-based guidelines among professionals. Recording dietetic prescription and physical exercise in the patient's medical record is associated with a better control of obesity. This data suggest that primary health care should be improved for obese patient.
A Randomised Dose-Response Study of Prophylactic Methoxamine Infusion for Preventing Spinal-induced Hypotension during Cesarean Delivery
Authors: Fu Feng , Tang Yu-wen , Chen Hong , Jiao Cui-cui , Ma Na , Chen Xinzhong
Published: December 2019

Background: α-receptor agonists have been reported to be safe and effective for treating or preventing spinal-induced hypotension during cesarean delivery. As a pure α 1 adrenergic agonist, methoxamine has the advantage of reducing myocardial oxygen consumption and protecting the heart in obstetric patients compared to phenylephrine. Prophylactic infusion of vasopressor appears to be superior to bolus administration. The aim of this study was to determine the optimal prophylactic methoxamine infusion dose that would be effective for preventing spinal-induced hypotension in 50% (ED 50 ) and 95% (ED 95 ) of parturients. Methods : Eighty parturients with a singleton pregnancy scheduled for elective cesarean delivery were randomly allocated to receive prophylactic methoxamine infusion at one of four different fixed-rates: 1μg/kg/min (group M1), 2μg/kg/min (group M2), 3μg/kg/min (group M3), or 4μg/kg/min (group M4). An adequate response was defined as absence of hypotension (maternal SBP <80% of baseline). The values for ED50 and ED95 of prophylactic methoxamine infusion were determined by probit regression model. The outcomes of maternal hemodynamics and fetal status were compared among the groups. Results: The calculated ED 50 and ED 95 (95% confidence interval) of prophylactic methoxamine infusion dose were 2.178 (95% CI 1.564 to 2.680) μg/kg/min and 4.821 (95% CI 3.951 to 7.017) μg/kg/min, respectively. The incidence of hypotension decreased with increasing methoxamine infusion dose (15/20, 11/20, 7/20 and 2/20 in group M1, M2, M3 and M4 respectively, P < 0.001). 1-minute Apgar scores and umbilical arterial PaO2 were lower but umbilical arterial PaCO2 was higher in Group M1. No difference was found in the other incidence of adverse effects and neonatal outcomes among groups. Conclusions: Under the conditions of this study, when prophylactic methoxamine infusion was given at a fixed-rate based on body weight for preventing spinal-induced hypotension in obstetric patients, the values for ED 50 and ED 95 were 2.178μg/kg/min and 4.821μg/kg/min respectively.
Gut microbial-related metabolite trimethylamine-N-oxide and its precursor L-carnitine are associated with spontaneous preterm birth: a nested case-control study
Authors: Chen Xing , Huang Ning , Liu Chaoqun , Chen Yue , Huang Lulu , Zhu Xiujuan , Cao Dehao , Wang Jin , Ye Juan , Hou Qingzhi , Li mujun , Mo Zengnan , Yang Xiaobo
Published: December 2019

Background: Gut microbiota has been proven to disease susceptibility and may lead to increased risk of preterm birth. To date, the link of gut microbial-related metabolite trimethylamine-N-oxide (TMAO), L-carnitine, and betaine, with spontaneous preterm birth (sPTB) has not been established. This study aimed to investigate the association of TMAO, L-carnitine and betaine, with sPTB risk. Methods: A nested case-control study was designed including 129 sPTB cases and 258 controls based on Guangxi Birth Cohort Study. TMAO, L-carnitine, and betaine level in maternal serum were determined by liquid chromatography with mass spectrometry. Conditional logistic regression analyses were used to examine the association between maternal serum metabolites and sPTB. Stratified analyses were further conducted according to BMI and preterm prelabor rupture of membranes. Spline analyses were performed to explore the dose-response relationship between the metabolites and sPTB.Results: Statistically significant association with decreased sPTB risk was observed for the highest L-carnitine (OR: 0.47; 95% CI: 0.23, 0.95). In risk analyses stratified by BMI, similar results were observed in normal weight gravida (BMI: 18.5~23.9 kg/cm2). The significant subtype-specific association with TMAO (OR: 0.43; 95% CI: 0.20, 0.93) and L-carnitine (OR: 0.45; 95% CI: 0.21, 0.97) were observed for preterm labor but not PPROM. Spline regression analysis indicated non-linear associations with TMAO and sPTB risk (P for nonlinearity: 0.057). Significant associations of TMAO with sPTB were observed in normal weight gravida (P = 0.028) and preterm labor subtype (P = 0.025). No statistically significant associations with sPTB risk were observed for betaine (P > 0.05).Conclusions: TMAO and L-carnitine levels in maternal serum are inversely linked with sPTB risk. Discovery of the association between gut-microbiota initiated TMAO metabolism and sPTB may open new avenues for diagnose and therapy.
Association of serum calcium concentrations with renal impairment in Chinese patients with newly diagnosed multiple myeloma: A Retrospective Study
Authors: Cheng Jun , Zhao Yi , zhang Wen , Li Xiayu , Lv Rong , Li heng , Jianghua Chen
Published: December 2019

Background Renal impairment(RI) is a common complication of multiple myeloma. Few studies have been conducted to determine the association between the serum calcium concentration and the occurrence of RI in MM patients.MethodsIn this retrospective study, we included 568 patients with newly diagnosed MM who participated in an ongoing retrospective cohort study. The serum calcium concentrations and the presence of RI at baseline in MM patients were evaluated. Patient data were collected at baseline and multiple regression analyses were used to estimate independent relationships. We further used a two piecewise linear regression model to identify non-linear relationships.Results The serum calcium concentration was independent associated with the presence of RI and the serum creatinine levels in MM patients in basic or fully adjusted analyses. Hypercalcemia was independent associated with a high risk of RI occurrence in MM patients. The serum calcium concentration was significantly associated with the presence of RI in a non-linear relationship with a turning point of 2.3 mmol/L. There was a positive correlation between the serum calcium concentration and the presence of RI when the serum calcium concentrations was >2.3mmol/L (p<0.05); however, these associations were no longer statistically significant when the serum calcium concentration was<2.3mmol/L in fully adjusted analyses (p>0.05). The test for interactions was not statistically significant.Conclusions The serum calcium concentration was independent associated with the presence of RI in patients with MM. There was a nonlinear relationship between the serum calcium concentration and the presence of RI. The serum calcium concentration was positively related with the presence of RI when the albumin-adjusted serum calcium concentration was >2.3mmol/L. Our study suggested that we should take measures to reduce the blood calcium concentration earlier rather than waiting for hypercalcemia to occur.
Homoprejudiced violence among Chinese men who have sex with men: A cross-sectional analysis in Guangzhou, China
Authors: Wu Dan , Yang Eileen , Huang Wenting , Tang Weiming , Xu Huifang , Liu Chuncheng , Baral Stefan , Day Suzanne , Tucker Joseph D.
Published: December 2019

Background Homoprejudiced violence, defined as physical, verbal, psychological and cyber aggression against others because of their actual or perceived sexual orientation, is an important public health issue. Most homoprejudiced violence research has been conducted in high-income countries. This study aimed to examine the experience and perpetration of homoprejudiced violence among men who have sex with men (MSM) in Guangzhou, China.Methods MSM in a large Chinese city, Guangzhou, completed an online survey instrument that was distributed through community-based organizations. Descriptive analysis was conducted to describe the sample characteristics. Multivariable logistic regression analyses, controlling for age, residence, occupation, marriage, education and income, were carried out to explore associated factors.Results A total of 777 men completed the survey and most (64.9%) were under the age of 30. Three-hundred-ninety-nine (51.4%) reported experiencing homoprejudiced violence, while 205 (25.9%) reported initiating homoprejudiced violence against others. Compared to respondents who self-identified as gay, respondents who were heterosexual were 0.6 times (AOR=0.6, 95% CI: 0.4-0.9) as likely to have experienced homoprejudiced violence, whereas those who were unsure about their sexual orientation were 2.6 times (AOR=2.6, 95% CI: 1.2-5.5) more likely to have experienced homoprejudiced violence before. Furthermore, a strong association (AOR=2,4. 95% CI: 1.6-3.5) was identified between experiencing homoprejudiced violence and initiating violence. MSM who had disclosed their sexual orientation to people other than their partners were more likely to have experienced homoprejudiced violence (AOR=1.8, 95% CI:1.3-2.5).Conclusions These findings suggest the importance of anti-homoprejudiced violence interventions focused on decreasing violence against MSM. Further research and actions are needed.
Identification of favorable SNP alleles related to fruit traits in diverse apple germplasm
Authors: Han A Reum , Kim Seon-Ae , Kim Gi Hoon , Choi Cheol
Published: December 2019

Background: The Apple (Malus × domestica Borkh.) is a valuable fruit crop worldwide, and receives considerable attention as one of the model plants of the Rosaceae family. The primary purpose of apple breeding programs is to generate novel apple cultivars with fruit quality traits that have high commercial value. To advance fruit-tree breeding systems, it is necessary to investigate the association between genomes and targeted traits. Genome-wide association studies (GWAS) are promising to analyze the associations between the genome and traits in fruit tree crops.Results: In this study, we evaluated 10 major fruit quality traits including titratable acidity (TA), soluble solids content (SSC), and skin color from 301 apple germplasms for four years (2015-2018). GWAS analysis was performed using SNP data generated via genotyping by sequencing (GBS) and identified SNPs significantly related to the fruit quality traits. For TA, significant association loci were detected on chromosome 16 and genes in the candidate regions related to malate transporter. The GWAS loci of SSC was found on chromosome 15, where genes related to sucrose synthase and transporter are located. Significant SNPs associated with fruit skin color were identified on genetic region near the MYB10 gene on chromosome 9, which regulates anthocyanin biosynthesis. SNPs identified by the GWAS were further confirmed with high resolution melting (HRM) analysis to discover specific polymorphisms in the melting curve.Conclusion: Overall, these results could identify several candidate genes and SNP markers associated with the fruit quality traits, thus validation of these SNPs enabled marker-assisted selection (MAS). The candidate SNPs and genes observed in this study will contribute to a better understanding of genetic basis for the important fruit quality traits and provide tools for generation of novel cultivars with the quality traits for advancement of apple industry.
Invisible contaminants and food security in former coal mined areas of Santa Catarina, southern Brazil
Authors: Blanco Graziela Dias , Sühs Rafael Barbizan , Brizola Escarlet , Corrêa Patrícia Figueiredo , Campos Mari Lucia , Hanazaki Natalia
Published: December 2019

Background Mining activities have environmental impacts due to sediment movement and contamination of areas, and also pose risks to people's food security. In Brazil, the major part of coal mining activities is done in the southern region, in the Santa Catarina Carboniferous region. In this region, former mined areas contaminated with heavy metals frequently occur nearby inhabited zones. Heavy metals are contaminants that does not have odor, color, or taste, and are therefore difficult to detect. We aimed to verify whether people use plants from contaminated mined areas, and to understand which factors influence plant use.Methods We did semi-structured interviews with residents from 14 areas nearby abandoned mines in the main municipalities of the Santa Catarina Carboniferous region.Results Out of the 196 interviewed residents, 127 (65%) reported collecting plants for medicinal and food use, directly from contaminated mined areas. Long-term residents, as well as those who noticed more environmental changes (positive and negative), cited more plants used, and had more detailed knowledge of plant use in their communities. When asked if they were aware of the possible contamination of mined areas, 85% said they knew about it. However, only 10% associated negative health effects with the use of plant species collected in contaminated mined areas.Conclusions Our study demonstrates that people living nearby contaminated areas use and consume plants, and also evidences a lack of information about contamination and a lack of participatory actions that include local communities in contaminated area restoration strategies. This situation poses a risk to the food security of the people living nearby former coal mined areas.
Urban ecology of arboviral mosquito vectors along the Kenyan coast
Authors: Karisa Jonathan , Muriu Simon , Omuoyo Donwilliams , Karia Boniface , Ngari Moses , Nyamwaya Doris , Rono Martin , Warimwe George , Mwangangi Joseph , Mbogo Charles M.
Published: December 2019

Background The emergence and re-emergence of arboviral infections particularly Chikungunya, dengue hemorrhagic fever, Rift Valley fever, and yellow fever in humans around the world threatens global health. The purpose of this study was to determine the urban ecology of the common arboviral mosquito vectors in urban Coastal Kenya areas.Materials and Methods The current study was conducted in urban settings of Kilifi and Mombasa counties in coastal Kenya in 2016 to 2017. Adult mosquitoes were collected both indoors and outdoors by CDC light traps and BG-Sentinel traps respectively. All blood fed mosquitoes were tested for blood meal sources by an Enzyme Linked Immunosorbent Assay (ELISA). Mosquito larvae were collected using standard dippers and pipettes. Egg survivorship in dry soil was evaluated by collecting of soil samples from dry potential breeding habitats, watering them for hatching and rearing of the eventual larvae to adults. Mosquitoes were screened for Flavivirus, Alphavirus and Phlebovirus arboviruses using Reverse Transcriptase Quantitative Polymerase Chain Reaction (RT qPCR).Results A total of 3,264 adult mosquitoes belonging to ten species of Culex (Cx.), Aedes (Ae) and Anopheles (An.) were collected. Overall, the predominant species were Cx. quinquefasciatus 72.4% (n=2,364) and Ae. aegypti, 25.7%, (n=838). A total of 415 breeding habitat types were identified indoors (n=317) and outdoors (n=98). The most productive habitat types in both indoors and outdoors were: assorted small containers, water tanks, drainages, drums and jericans. Overall, 62% (n=18) of the soil samples collected from the two sites (Kilifi and Malindi) were positive for larvae which were used as proxy to measure the presence of eggs. The mosquitoes had high preference for human blood (29.81%) and chicken (3.73%) but none had fed on either goat or bovine. Of 259 mosquitoes tested for viral infection, 11.6% were positive for Flavivirus only.Conclusion Peri-domestic containers were identified to be the key breeding areas of arboviral vectors.
Microglial physiological properties and interactions with synapses are altered at presymptomatic stages in a mouse model of Huntington's disease pathology
Authors: Savage Julie , St-Pierre Marie-Kim , Carrier Micaël , Hajj Hassan El , Novak Sammy , Sanchez Maria Gabriela , Cicchetti Francesca , Tremblay Marie-Eve
Published: December 2019

Background: Huntington’s disease (HD) is a dominantly inherited neurodegenerative disorder that affects cognitive and motor abilities by primarily targeting the striatum and cerebral cortex. HD is caused by a mutation elongating the CAG repeats within the Huntingtin gene, resulting in HTT protein misfolding. Although the genetic cause of HD has been established, the specific susceptibility of neurons within various brain structures has remained elusive. Microglia, which are the brain’s resident macrophages, have emerged as important players in neurodegeneration. Nevertheless, few studies have examined their implication in HD. Methods: To provide novel insights, we investigated the maturation and dysfunction of striatal microglia using the R6/2 mouse model of HD. This transgenic model, which presents with 120+/-5 CAG repeats, displays progressive motor deficits beginning at 6 weeks of age, with full incapacitation by 13 weeks. We studied microglial morphology, phagocytic capacity, and synaptic contacts in the striatum of R6/2 versus wild-type (WT) littermates at 3, 10 and 13 weeks of age, using a combination of light and transmission electron microscopy. We also reconstructed dendrites and determined synaptic density within the striatum of R6/2 and WT littermates, at nanoscale resolution using focused ion beam-scanning electron microscopy. Results: At 3 weeks of age, prior to any known motor deficits, light microscopy studies revealed that microglia in R6/2 animals displayed a mature morphological phenotype, not reached by microglia in WT animals until 7-10 weeks of age. Microglia from R6/2 mice across all ages investigated also demonstrated increased phagocytosis, as revealed by light microscopy and transmission electron microscopy. Furthermore, microglial processes from 10-week old R6/2 mice made fewer contacts with synaptic structures than those of 3-week old R6/2 mice and age-matched WT littermates. While synaptic density was not affected by genotype at 3 weeks of age, it only increased with maturation in WT mice between 3 and 10 weeks of age. The location of synapses was lastly modified from targeting dendritic spines to trunks at 3 and 10 weeks of age in R6/2 mice versus WT controls. Conclusions: These findings suggest that microglia may play an intimate role in synaptic alteration and loss during HD pathogenesis.
Identification of odorant-binding proteins in the reproductive system of Athetis dissimilis using transcriptome analysis
Authors: Song Yueqin , Sun Huizhong , Zhao Jingyun
Published: December 2019

Odorant-binding proteins (OBPs) are prevalent in the antennal transcriptomes of different orders of insects. Studies on OBPs have focused on their role in the insect chemosensory system, but knowledge of their functions in the insect testis is limited. We sequenced the transcriptomes of the Athetis dissimilis reproductive organs and analyzed the expressive of OBPs in different tissues. We identified a total of 54 OBPs including 23 OBPs in the transcriptomes of testis and ovaries, and 31 OBPs in antennal transcriptomes. Through fluorescence qPCR, the 23 identified OBPs were found to be highly expressed in both female and male antennae compared to the reproductive organs. Of the identified OBPs, 5/23 showed comparable expression in female and male antennae; 3/23 were more highly expressed in males compared to females; and 15/23 OBPs were more highly expressed in females compared to males. A total of 24 OBPs were highly expressed in the testis of A. dissimilis whilst expression in the ovaries was low. These findings highlight the functional diversity of OBPs in insects and can facilitate further studies on the OBPs in A. dissimilis and lepidopteran species.