bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Short-Term Outcome of Osteotomy Combining with Soft Tissue Surgery in the Treatment of Symptomatic Children with Flexible Flatfoot
Authors: Yi Li , Xiaojun Liang , Hong-Mou Zhao
Published: November 2020

Category:

Hindfoot; Other

Introduction/Purpose:

To evaluate the short-term curative effect of clinical results and imaging of osteotomy and soft tissue surgery for the treatment of children with flexible flatfoot.

Methods:

From July 2014 to October 2016, 28 patients (47 feet) with flexible flatfoot were treated with osteotomy combining with soft tissue surgery, included 16 males (26 feet) and 12 females (21 feet) with the average age of (11.7+-2.1) years old ranging from 9 to 14 years old. The VAS score, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, Maryland score were evaluated before and after the operation to study the clinical effect. Patient satisfaction was also investigated at the end of the follow-up. The talo-navicular coverage angle (TNCA), the talo-1st metatarsal angle (T1MA), the talo-2nd metatarsal angle (T2MA) in the weight-bearing anteroposterior view and the calcaneal inclination angle (Pitch angle), the talo-1st metatarsal angle (Meary’s angle), the talo-calcaneal angle (Kite angle) and final follow-up time to study the imaging data.

Results:

Superficial tissue infection occurred in 2 cases (3 feet) after surgery, wound healing was achieved through debridement and short-term oral antibiotics. The average VAS score of the final follow-up was significantly lower than that before surgery (P < 0.01). The average AOFAS score and the average Maryland score were significantly higher than pre-operation (P < 0.01). Patient satisfaction at the last follow-up: very satisfaction 20 (71.43%), satisfaction 7 (25%), general 1 (3.57%). The the talo-navicular coverage angle (TCA) ,the talo-1st metatarsal angle (T1MA), the talo-2nd metatarsal angle (T2MA) in the weight-bearing anteroposterior view of the final follow-up were significantly improved compared with preoperation (P＜0.01), the Pitch Angle, Meary’s Angle and Kite Angle in the weight-bearing lateral view ere significantly improved compared with preoperation (P＜0.05).

Conclusion:

Osteotomy combined with soft tissue surgery has good short-term effect on children’s flexible flatfoot, and the effect of correction of malformation is obvious, but the medium-term and long-term effects need to be further studied.
Pneumatic Vitreolysis With Intravitreal Air for Focal Vitreomacular Traction
Authors: Seamone Mark E. , Rubin Uriel , Grewal Parampal S. , Greve Mark
Published: November 2020

Purpose:

To determine whether pneumatic vitreolysis with intravitreal air is effective for focal vitreomacular traction (VMT).

Methods:

We conducted a retrospective consecutive case series of 20 eyes from 19 individuals with focal VMT who underwent pneumatic vitreolysis with intravitreal air (January 2017 to November 2018). We analyzed patients via spectral-domain optical coherence tomography before intravitreal air injection and at 1 month. The primary outcome measure was release of VMT.

Results:

We observed release of VMT in 55% of individuals. An analysis limited to phakic eyes demonstrated release of VMT in 69%, and 65% developed improved best-corrected visual acuity. Individuals with persistent VMT and visual improvement had a significant reduction in angle of vitreoretinal insertion ( P < .01), area under VMT ( P < .05), and subfoveal cyst area ( P < .05).

Conclusions:

Intravitreal air is an effective treatment for focal VMT. In individuals with persistent VMT, visual-acuity improvement was associated with a reduction in overall VMT.
The roles of the gut microbiota–miRNA interaction in the host pathophysiology
Authors: Li Meihong , Chen Wei-Dong , Wang Yan-Dong
Published: November 2020

The gut microbiota regulates the biological processes of organisms acting like ‘another’ genome, affecting the health and disease of the host. MicroRNAs, as important physiological regulators, have been found to be involved in health and disease. Recently, the gut microbiota has been reported to affect host health by regulating host miRNAs. For example, Fusobacterium nucleatum could aggravate chemoresistance of colorectal cancer by decreasing the expression of miR-18a* and miR-4802. What’s more, miRNAs can shape the gut microbiota composition, ultimately affecting the host's physiology and disease. miR-515-5p and miR-1226-5p could promote the growth of Fusobacterium nucleatum (Fn) and Escherichia coli (E.coli), which have been reported to drive colorectal cancer. Here, we will review current findings of the interactions between the gut microbiota and microRNAs and discuss how the gut microbiota–microRNA interactions affect host pathophysiology including intestinal, neurological, cardiovascular, and immune health and diseases.
Assessment of knowledge, practice and attitude towards prostate cancer screening among male patients aged 40 years and above at Kitwe Teaching Hospital, Zambia
Authors: Gift Sakala , Nancy Kasongo , Victor Mwanakasale
Published: November 2020

Background

Prostate cancer is a leading cause of cancer death in men. Evaluating knowledge, practice and attitudes towards the condition is important to identify key areas where interventions can be instituted.

Methods

This was a hospital-based descriptive cross-sectional study aimed at assessing knowledge, practice and attitude towards prostate cancer screening among male patients aged 40 years and above at Kitwe Teaching Hospital, Zambia.

Results

A total of 200 men took part in the study (response rate = 100%). Of the 200 respondents, 67 (33.5%) had heard about prostate cancer and 58 (29%) expressed knowledge of prostate cancer out of which 37 (63.8%) had low knowledge. Twenty-six participants (13%) were screened for prostate cancer in the last 2 years. 98.5% of the participants had a positive attitude towards prostate cancer screening. Binary logistic regression results showed that advanced age (p = 0.017), having secondary or tertiary education (p = 0.041), increased knowledge (p = 0.023) and family history of cancer (p = 0.003) increased prostate cancer screening practice. After multivariate analysis, participants with increased knowledge (p = 0.001) and family history of cancer (p = 0.002) were more likely to practice prostate cancer screening.

Conclusion

The study revealed low knowledge of prostate cancer, low prostate cancer screening practice and positive attitude of men towards prostate cancer screening. These findings indicate a need for increased public sensitization campaigns on prostate cancer and its screening tests to improve public understanding about the disease with the aim of early detection.
Correction to: CRISPR-Based Diagnosis of Infectious and Noninfectious Diseases
Authors: vangah Somayeh Jolany , Katalani Camellia , Boone Hannah A. , Hajizade Abbas , Sijercic Adna , Ahmadian Gholamreza
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
Prediction of enhancer–promoter interactions using the cross-cell type information and domain adversarial neural network
Authors: Jing Fang , Zhang Shao-Wu , Zhang Shihua
Published: November 2020

Background

Enhancer–promoter interactions (EPIs) play key roles in transcriptional regulation and disease progression. Although several computational methods have been developed to predict such interactions, their performances are not satisfactory when training and testing data from different cell lines. Currently, it is still unclear what extent a across cell line prediction can be made based on sequence-level information.

Results

In this work, we present a novel Sequence-based method (called SEPT) to predict the enhancer–promoter interactions in new cell line by using the cross-cell information and Transfer learning. SEPT first learns the features of enhancer and promoter from DNA sequences with convolutional neural network (CNN), then designing the gradient reversal layer of transfer learning to reduce the cell line specific features meanwhile retaining the features associated with EPIs. When the locations of enhancers and promoters are provided in new cell line, SEPT can successfully recognize EPIs in this new cell line based on labeled data of other cell lines. The experiment results show that SEPT can effectively learn the latent import EPIs-related features between cell lines and achieves the best prediction performance in terms of AUC (the area under the receiver operating curves).

Conclusions

SEPT is an effective method for predicting the EPIs in new cell line. Domain adversarial architecture of transfer learning used in SEPT can learn the latent EPIs shared features among cell lines from all other existing labeled data. It can be expected that SEPT will be of interest to researchers concerned with biological interaction prediction.
Design and methodology of the Aging Nephropathy Study (AGNES): a prospective cohort study of elderly patients with chronic kidney disease
Authors: Coelho Venceslau A. , Santos Giovani GN. , Avesani Carla M. , Bezerra Cicero Italo L. , Silva Luana Cristina A. , Lauar Julia C. , Lindholm Bengt , Stenvinkel Peter , Jacob-Filho Wilson , Noronha Irene L. , Zatz Roberto , Moysés Rosa M. A. , Elias Rosilene M.
Published: November 2020

Background

Renal replacement therapy (RRT) is usually indicated for patients with chronic kidney disease (CKD) with glomerular filtration rate below 10 ml/ml/min/1.73m2. However, the need for RRT and timing of dialysis initiation are debatable for patients aged 70 years or older. We here describe the study design and methodology of the Aging Nephropathy Study (AGNES) protocol that aims at evaluating to what extent geriatric-related conditions such as frailty, cognitive dysfunction, and presence of comorbidities have an impact on survival and RRT initiation in this group of patients. In this manuscript we provide detailed information about the AGNES study design and methodology.

Methods

AGNES is a prospective observational cohort that aim to investigate clinical, biochemical and demographic factors associated with RRT initiation and mortality of patients with CKD stage 4 or 5 who are aged 70 years and older. We plan to include 200 patients over 5 years. Clinically stable outpatients on conservative management for at least 6 months will be recruited from the Nephrogeriatric Clinic at theHospital das Clinicas da Universidade de Sao Paulo, Brazil. Eligible patients are submitted to a full clinical examination, geriatric assessment, and blood test at baseline. Following the baseline visit the patients are being monitored during an observational follow up period of at least 12 months during which patients will be contacted in the clinic at their regular follow up or by phone until either RRT initiation or death occurs. This cohort includes evaluation of cognition by the education-adjusted 10-point Cognitive Screener (10-CS), frailty by Fried index score, a complete nutritional assessment (by body composition assessment, global subjective assessment and dietary intake), comorbidities by Charlson comorbidity index and biochemical markers including FGF-23 and Klotho.

Discussion

The AGNES cohort, a real-world study of current clinical practice in elderly patients with advanced CKD prior to dialysis initiation, will shed light into progression of CKD and its complications, indications of RRT and factors determining survival. This investigation will elucidate to what extent geriatric conditions, nutritional status and clinical factors are associated with survival, quality of life and RRT initiation in elderly CKD patients not yet on dialysis.

Trial registration

Registered onClinicalTrials.govon 18 October 2019 (NCT04132492).
Birth weight and renal markers in children aged 5–10 years in Cameroon: a cross-sectional study
Authors: Kaze Francois Folefack , Nguefack Seraphin , Asong Constantine Menkoh , Assob Jules Clement Nguedia , Nansseu Jobert Richie , Kowo Mathurin Pierre , Nzana Victorine , Kalla Ginette Claude Mireille , Halle Marie Patrice
Published: November 2020

Background

A relationship exists between birth weight (BW) and glomerular filtration rate (GFR) in postnatal kidney. Willing to fill a gap of knowledge in sub-Saharan Africa, we assessed the effect of BW on blood pressure (BP), proteinuria and GFR among Cameroonians children.

Methods

This was a cross-sectional hospital-based study from January to April 2018 at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH). We recruited low BW (LBW) [< 2500 g], normal BW (NBW) [2500-3999 g] and high BW (HBW) [> 4000 g] children, aged 5–10 years, born and followed-up at YGOPH. We collected socio-demographic, clinical (weight, height, BP), laboratory (proteinuria, creatinine), maternal and birth data. The estimated GFR was calculated using the Schwartz equation.

Results

We included 80 children (61.2% boys) with 21 (26.2%) LBW, 45 (56.2%) NBW and 14 (15.5%) HBW; the median (interquartile range) age was 7.3 (6.3–8.1) years and 17 (21.2%) were overweight/obese. Two (2.5%) children, all with a NBW (4.4%), had an elevated BP whereas 2 (2.5%) other children, all with a LBW (9.5%), had hypertension (p = 0.233). Seven (8.7%) children had proteinuria with 19, 2.2 and 14.3% having LBW, NBW and HBW, respectively (p = 0.051). Equivalent figures were 18 (22.5%), 14.3, 24.2 and 28.6% for decreased GFR, respectively (p = 0.818). There was a trend towards an inverse relationship between BW and BP, proteinuria and GFR (p > 0.05).

Conclusion

Proteinuria is more pronounced in childhood with a history of LBW and HBW while LBW children are more prone to develop hypertension. Regular follow-up is needed to implement early nephroprotective measures among children with abnormal BW.
“Real-world” effect of a peer counselor on breastfeeding outcomes in an urban prenatal clinic in the United States
Authors: Martinez Noelle G. , Strohbach Angelina , Hu Fengling , Yee Lynn M.
Published: November 2020

Background

One approach for improving breastfeeding support and alleviating breastfeeding disparities is the implementation of a clinic-based peer counselor. Our objective was to assess the “real life” effects of an autonomous peer counselor who provides tailored support to low-income, minority women based on individual needs rather than a pre-determined research protocol.

Methods

This is a secondary analysis of a prospective cohort study of women receiving publicly funded prenatal care during the 6 months before and after introduction of a peer counselor in a single prenatal clinic. The peer counselor provided one-on-one antenatal and postpartum lactation support. Electronic medical record and survey data were collected. The primary outcome was breastfeeding continuation at 6 weeks postpartum. Secondary outcomes included breastfeeding comfort, confidence, and training satisfaction, any breastfeeding, and total breastfeeding duration. Bivariable and multivariable analyses were performed.

Results

Peer counselor exposure was not associated with the primary outcome of continued breastfeeding at 6 weeks (55.6% with peer counselor versus 49.1% without; aOR 1.26, 95% CI 0.69–2.31). However, women with peer counselor exposure were more likely to be satisfied with breastfeeding training at the time of delivery (98.2% vs. 83.6%, p = 0.006) and were more likely to have performed any breastfeeding (89.8% vs. 78.9%, p = 0.04), which remained significant on multivariable analysis (aOR 2.85, 95% CI 1.11–7.32).

Conclusions

Peer counselor interventions are a promising approach to increase breastfeeding initiation. Further research is required to inform the most efficacious approach while also allowing peer counselors to operate independently and in line with the specific needs of their clients.
Fear of childbirth among pregnant women attending antenatal care in Arba Minch town, southern Ethiopia: a cross-sectional study
Authors: Gelaw Tiruset , Ketema Teklemariam Gultie , Beyene Kassaw , Gurara Mekdes Kondale , Ukke Gebresilasea Gendisha
Published: November 2020

Background

Fear of childbirth is one of the life challenges the women encounter during pregnancy. It is an important source of distress for the women and their families and also increases the odds of obstetric complications during childbirth. The aim of this study was to assess the magnitude of fear of childbirth and associated factors among pregnant women attending antenatal care at public health facilities in Arba Minch town, southern Ethiopia.

Methods

Institution-based cross-sectional study was carried out among pregnant women who attended antenatal care at public health facilities in Arba Minch from November 1st − 30th 2019. A systematic random sampling technique was employed to include the participants. Data were collected through a face-to-face interview by using a structured and pretested questionnaire. Wijma Delivery Expectancy Questionnaire was used to score fear of childbirth. Epi Data version 3.1 and Statistical Package for the Social Sciences version 25.0 software were used for data management. Descriptive and analytic analyses were done and statistical significance was declared at a p-value < 0.05 and 95% confidence level in multivariable analysis.

Results

A total of 387 pregnant women have participated in this study. Forty (10.3%) of the pregnant women had a low degree fear, 154(39.8%) had a moderate degree fear, 98(25.3%) had a high degree fear, and 95(24.5%) had severe degree fear of childbirth. Unplanned pregnancy (AOR = 2.30, 95% CI: 1.12, 4.74), current pregnancy-related complications (AOR = 6.24, 95% CI: 2.72, 14.29), and poor social support (AOR = 1.93, 95%CI: 1.01, 3.68) were factors significantly associated with severe degree fear of childbirth.

Conclusions

Almost three-fourth of the pregnant women in this study area had moderate to severe degree fear of childbirth. Tailoring counseling during antenatal care visits is needed to address those women who are at a high risk of considerable childbirth fear and its health consequences.
Willingness to use HIV prevention methods among vaccine efficacy trial participants in Soweto, South Africa: discretion is important
Authors: Laher Fatima , Salami Taibat , Hornschuh Stefanie , Makhale Lerato M. , Khunwane Mamakiri , Andrasik Michele P. , Gray Glenda E. , Van Tieu Hong , Dietrich Janan J.
Published: November 2020

Background

Despite multiple available HIV prevention methods, the HIV epidemic continues to affect South Africa the most. We sought to understand willingness to use actual and hypothetical HIV prevention methods among participants enrolled in a preventative HIV vaccine efficacy trial in Soweto, South Africa.

Methods

We conducted a qualitative study with 38 self-reporting HIV-uninfected and consenting 18–35 year olds participating in the HVTN 702 vaccine efficacy trial in Soweto. Using a semi-structured interview guide, five focus group discussions (FGDs) were held, stratified by age, gender and sexual orientation. The FGDs were composed of: (i) 10 heterosexual women aged 18–24 years; (ii) 9 heterosexual and bisexual women aged 25–35 years; (iii & iv) heterosexual men aged 25–35 years with 7 in both groups; and (v) 5 men aged 18–35 years who have sex with men. FGDs were audio-recorded, transcribed verbatim, translated into English and analysed using thematic analysis.

Results

We present five main themes: (i) long-lasting methods are preferable; (ii) condoms are well-known but not preferred for use; (iii) administration route of HIV prevention method is a consideration for the user; (iv) ideal HIV prevention methods should blend into the lifestyle of the user; and the perception that (v) visible prevention methods indicate sexual indiscretion.

Conclusions

The participants’ candour about barriers to condom and daily oral pre-exposure prophylaxis (PrEP) use, and expressed preferences for long-lasting, discreet, lifestyle-friendly methods reveal a gap in the biomedical prevention market aiming to reduce sexually acquired HIV in South Africa. Product developers should consider long-acting injectable formulations, such as vaccines, passive antibodies and chemoprophylaxis, for HIV prevention technologies. Future innovations in HIV prevention products may need to address the desire for the method to blend easily into lifestyles, such as food-medication formulations.
Propionibacterium acnes-associated sarcoidosis complicated by acute bird-related hypersensitivity pneumonitis
Authors: Sawahata Michiru , Sakamoto Noritaka , Yamasawa Hideaki , Iijima Yuki , Kawata Hirotoshi , Yamaguchi Tetsuo , Uchida Keisuke , Eishi Yoshinobu , Bando Masashi , Hagiwara Koichi
Published: November 2020

Background

The number of reports on sarcoidosis complicated by hypersensitivity pneumonitis (HP) is limited, and most describe cases complicated by chronic bird-related HP. Here, we present for the first time a case with Propionibacterium acnes-associated sarcoidosis complicated by acute bird-related HP.

Case presentation

A 62-year-old man with a past medical history of sarcoidosis was admitted to our department, and chest computed tomography showed diffuse ground-glass opacities, which appeared as he rapidly increased the number of pigeons he kept for a competition. Random transbronchial lung biopsy revealed well-formed non-caseating epithelioid granulomas, which contained positively stained substances on immunohistochemistry using the PAB antibody, a specific monoclonal antibody against P. acnes lipoteichoic acid. Poorly formed non-caseating granulomas without positively stained substances were also detected.

Conclusion

We describe the successful identification of this exceptionally rare case of sarcoidosis complicated by acute bird-related HP in which two morphologically and immunohistologically different types of granulomas were present in the same lung.
A patients’ view of OA: the Global Osteoarthritis Patient Perception Survey (GOAPPS), a pilot study
Authors: Vitaloni Marianna , Botto-van Bemden Angie , Sciortino Rosa , Carné Xavier , Quintero Maritza , Santos-Moreno Pedro , Espinosa Rolando , Rillo Oscar , Monfort Jordi , de Abajo Francisco , Oswald Elizabeth , Matucci Marco , du Souich Patrick , Möller Ingrid , Romera Baures Montserrat , Vinci Arlene , Scotton Deborah , Bibas Marco , Eakin Guy , Verges Josep
Published: November 2020

Background

Globally, osteoarthritis (OA) is the third condition associated with disability. There is still poor treatment in OA but science holds the key to finding better treatments and a cure. It is essential to learn what’s important to patients from them to implement the most effective OA management. The OA Patients Task Force, conducted the Global OA Patient Perception Survey (GOAPPS)-the first global survey made by patients to analize the quality of life (QoL) & patient perceptions of care. The goal was to collect data on OA patients’ perception of OA to understand patients’ needs and expectations to improve OA management.

Methods

Observational, cross-sectional study by online survey data collection from six countries, translated into three languages. The questionnaire was comprised of 3 sections: patient demographics and clinical symptomology characteristics; relationship with physicians: perception of attention, treatment, and information provided; and OA impact on daily activity and QoL. The results of the survey were evaluated using the Limited Data Set. The survey results were analyzed using descriptive statistics to characterize the patients’ answers. Additionally, Cronbach’s alpha was calculated to determine internal consistency validity.

Results

A total of 1512 surveys were completed in 6 countries. 84.2% of respondents reported pain/tenderness and 91.1% experienced limitations to physical activities. 42.3% of patients were not satisfied with their current OA treatment. 86% had comorbidities, especially hypertension, and obesity. 51.3 and 78% would like access to additional drug or additional non-drug/non-surgical treatments respectively. 48.2% of patients perceived their QoL to be affected by OA. The Cronbach’s alpha was 0.61.

Conclusions

OA has a significant impact on patients’ daily activities and their desire to play an active role in managing this disease. Patients are seeking additional treatments, especially no pharmacological/no surgical treatments stressing the need for investing in clinical research, implementing OA preventive measures, and managing interventions to improve the healthcare value chain in OA.
Clinical predictors of surgical outcomes of severe carpal tunnel syndrome patients: utility of palmar stimulation in a nerve conduction study
Authors: Sasaki Yuichi , Terao Tohru , Saito Emiko , Ohara Keiichiro , Michishita Shotaro , Kato Naoki , Tani Satoshi , Murayama Yuichi
Published: November 2020

Background

Carpal tunnel syndrome is a common peripheral nerve compression disorder. However, there is no established opinion regarding the predictors of symptom improvement after surgery. This study aimed to identify the predictors of surgical outcomes of severe carpal tunnel syndrome patients.

Methods

In the patients who underwent a carpal tunnel syndrome surgery, we selected the patients who had a preoperative Bland’s classification of grade 5 or 6, and assessed for the changes in Bland’s classification grade before and after surgery. Those who showed improvement from preoperative grades 5–6 to postoperative grades 1–4 comprised the improvement group. In contrast, those who did not show improvement and had postoperative grades 5 or 6 comprised the non-improvement group. In a nerve conduction study, amplitudes of the compound muscle action potential and sensory nerve action potential of the palms were assessed between the improvement and non-improvement groups.

Results

Among the 60 hands of 46 patients who had a preoperative Bland’s classification of grade 5 or 6, 49 hands of 37 patients comprised the improvement group, and 11 hands of 9 patients comprised the non-improvement group. The amplitudes of the compound muscle action potential and sensory nerve action potential of the palms before surgery were significantly higher in the improvement group. The degree of improvement in Bland’s classification grade was correlated with the degree of clinical symptom improvement.

Conclusions

Amplitudes of compound muscle action potential and sensory nerve action potential before surgery induced by palmar stimulation can predict improvements in nerve conduction study scores and clinical findings after surgical treatment.
Isoperistaltic versus antiperistaltic uncut Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: a propensity score matched analysis
Authors: Hangtian Cui , Huabing Huang , Tianhang Luo , Xiaoyi Yin , Guoen Fang
Published: November 2020

Background

The uncut Roux-en-y anastomosis (URYA) has some clinical advantages after distal gastrectomy (DG). Little evidence exists regarding the influence of peristalsis on this anastomosis. We aimed to evaluate short-term outcomes of isoperistaltic URYA (iso-URYA) comparing with antiperistaltic URYA (anti-URYA) after DG.

Method

Patients who underwent URYA for gastric cancer (GC) between January 2016 and December 2018 were selected from Shanghai Changhai Hospital, Navy Medical University. Short-term outcomes were compared between iso-URYA group and anti-URYA group after 1:1 propensity score matching (PSM).

Result

A total of 612 patients were selected. 392 patients underwent iso-URYA and 220 patients underwent anti-URYA. After PSM, 183 patients for each group were included in the final analysis. No differences were found between them in terms of short-term complications, nutritional status and quality of life 1 year after surgery. Endoscopic examination showed that anti-URYA group had more severe gastritis (P = 0.036). In addition, the recanalization rate was significantly higher when the afferent loop was blocked by stapler.

Conclusion

The iso-URYA and anti-URYA group present similar results in short term outcomes. Ligation blocking afferent loop leads to lower recanalization rate.
Proteomic analysis of bladder biopsies from interstitial cystitis/bladder pain syndrome patients with and without Hunner’s lesions reveals differences in expression of inflammatory and structural proteins
Authors: Ward Elijah P. , Bartolone Sarah N. , Chancellor Michael B. , Peters Kenneth M. , Lamb Laura E.
Published: November 2020

Background

Interstitial cystitis/bladder pain syndrome is a bladder disease usually characterized by pain, urgency, and frequency. Interstitial cystitis is currently classified into two subtypes, with and without Hunner’s lesions. However, the underlying etiology of interstitial cystitis and its subtypes are largely unknown.

Methods

To better understand the biological changes in the bladder of interstitial cystitis/bladder pain syndrome patients, we directly analyzed bladder tissue of interstitial cystitis patients, both those with Hunner’s lesions and those without. Proteins in the bladder biopsies were analyzed using nanoscale high-performance liquid chromatography-tandem mass spectrometry. Disease subgroups were compared and significantly expressed proteins were mapped using STRING to determine protein associations and functions.

Results

We found that patients with Hunner’s lesions had significant increases in inflammatory and endoplasmic reticulum stress proteins, with a decrease in cellular adhesive proteins, compared to patients without Hunner’s lesions. These patients also exhibited a decrease in proteins associated with the Rap1 signaling pathway, which regulates cell proliferation and wound healing. When comparing diseased and non-disease-apparent tissue in patients with Hunner’s lesions, diseased tissue exhibited a decrease in ubiquitination proteins.

Conclusions

In summary, there are significant differences in protein expression found in the bladders of interstitial cystitis patients with and without Hunner’s lesions, indicating a disturbance in proteins associated with cellular adhesion, proliferation, protein processing, and wound healing.
Prevalence of pressure ulcers among hospitalized adult patients in Ethiopia: a systematic review and meta-analysis
Authors: Shiferaw Wondimeneh Shibabaw , Aynalem Yared Asmare , Akalu Tadesse Yirga
Published: November 2020

Background

Globally, PUs are recognized as one of the five most frequent causes of harm to clients. With millions affected globally, the national pooled prevalence of pressure ulcers in Ethiopia remains unknown. Hence, this review and meta-analysis aimed to determine the prevalence of pressure ulcers among hospitalized clients in Ethiopia.

Methods

Studies were retrieved through search engines in PubMed, Scopus, WHO Afro Library, Google Scholar, Africa Journals Online, and Web of Science. Heterogeneity between-studies were checked using the I2test. A funnel plot and Egger’s regression test was used to assess the presence of publication bias. The random-effect model was fitted to estimate summary effects and 95% confidence intervals (CIs) across studies. The analyses were performed using STATA™ Version 14 software.

Results

The pooled prevalence of pressure ulcer in Ethiopia was assessed using seven studies involving a total of 1881 participants. The pooled prevalence of pressure ulcers in Ethiopia was 11.7% (95% CI: 7.28, 16.13). The subgroup analysis showed that the estimated magnitude of pressure ulcers was 15.89% (95% CI: 13.32, 18.46); among studies, their sample size was greater than or equal to 250.

Conclusion

The current review reported that the pooled prevalence of pressure ulcers in Ethiopia was relatively high. Hence, policymaker and healthcare providers should give attention to reduce the magnitude of pressure ulcers. Furthermore, further a meta-analysis study could be conducted to identify individual and health care service-related factors related to the occurrence of pressure ulcers.
Evaluation of 24 protocols for the production of platelet-rich fibrin
Authors: Miron Richard J. , Chai Jihua , Fujioka-Kobayashi Masako , Sculean Anton , Zhang Yufeng
Published: November 2020

Background

The aim of this study was to evaluate 24 protocols for the production of platelet rich fibrin (PRF) produced via horizontal centrifugation to better understand cell separation following protocols at various times and speeds.

Methods

All protocols were compared utilizing a recent method to quantify cells in PRF in 1 mL sequential layers pipetted from the upper layer downwards until all 10 mL were harvested. In total, 960 complete blood counts (CBCs) were investigated. Both solid and liquid-based PRF protocols were investigated following 24 protocols involving 6 relative centrifugal force (RCF) values (100, 200, 400, 700, 1000 and 1200g) at 4 centrifugation times (3, 5, 8 and 12 min).

Results

In general, platelets could more easily accumulate in the upper 4 layers when compared to leukocytes owing to their lower cellular density. Protocol time seemed to have a greater impact on the final cell layer separation when compared to the effect of speed. Protocols of greater than 8 min at 400gled to no leukocyte accumulation in the upper PRF layers (found specifically within the buffy coat). Protocols at or below 200gwere unable to effectively accumulate platelets/leukocytes. The optimal centrifugation speed and time for solid-PRF ranged between 400 and 700gfor 8 min. It was noted that variability in patient baseline platelet/leukocyte/erythrocyte counts (hematocrit) significantly affected cell layer separation. This finding was more pronounced at lower centrifugation speeds.

Conclusions

Within the investigated ranges, a protocol of 700gfor 8 min presented the highest yield of platelets/leukocytes evenly distributed throughout the upper PRF layers.
The feasibility and effectiveness of a blended-learning course for detecting and avoiding bias in medical data: a pilot study
Authors: Koch Cora , Brich Jochen
Published: November 2020

Background

Conflicts of interest (COIs), including those arising from interactions with pharmaceutical companies, may lead to bias in medical data. Although medical students are now requesting more education on COIs and bias, they are still not adequately taught during medical school, and few published courses on this topic exist.The objective of our study was therefore to evaluate the feasibility and effectiveness of a blended-learning course for detecting and avoiding bias in medical data, with a special focus on COIs.

Methods

We developed a blended learning course on bias detection, COIs, and risk communication. It was piloted in the Fall Semester of 2019/2020 using a pre/post-test design. The primary outcome was a gain in bias detection skills, tested by a novel key feature test. Secondary outcomes were (i) skepticism (tested using an attitude questionnaire), (ii) the intention to manage COIs in a professional way so as to avoid bias (tested using a situational judgment test) and (iii) the course evaluation by the students.

Results

Seventeen students participated in the study. The key feature test showed a significant improvement in bias detection skills at post-testing, with a difference in means of 3.1 points (95%-CI: 1.7–4.4,p-value: < 0.001; highest possible score: 16 points). The mean score after the course was 6.21 (SD: 2.62). The attitude questionnaire and situational judgment test also showed an improvement in skepticism and intentions to manage COIs, respectively. Students evaluated the course as having been worthwhile (Median: 5, IQR: 0.75, Likert-Scale 1–6, 6 = fully applicable).

Conclusions

The blended learning format of the course was feasible and effective. The results suggest a relevant learning gain; however, the low mean score on the key feature test after the course reflects the difficulty of the subject matter. Although a single course has the potential to induce significant short-term improvements in bias detection skills, the complexity of this important subject necessitates its longitudinal integration into medical curricula. This concept should include specific courses such as that presented here as well as an integration of the topic into clinical courses to improve context-related understanding of COIs and medical data bias.
Simulator-based ultrasound training for identification of endotracheal tube placement in a neonatal intensive care unit using point of care ultrasound
Authors: Ali Khushboo Qaim , Soofi Sajid Bashir , Hussain Ali Shabbir , Ansari Uzair , Morris Shaun , Tessaro Mark Oliver , Ariff Shabina , Merali Hasan
Published: November 2020

Background

Simulators are an extensively utilized teaching tool in clinical settings. Simulation enables learners to practice and improve their skills in a safe and controlled environment before using these skills on patients. We evaluated the effect of a training session utilizing a novel intubation ultrasound simulator on the accuracy of provider detection of tracheal versus esophageal neonatal endotracheal tube (ETT) placement using point-of-care ultrasound (POCUS). We also investigated whether the time to POCUS image interpretation decreased with repeated simulator attempts.

Methods

Sixty neonatal health care providers participated in a three-hour simulator-based training session in the neonatal intensive care unit (NICU) of Aga Khan University Hospital (AKUH), Karachi, Pakistan. Participants included neonatologists, neonatal fellows, pediatric residents and senior nursing staff. The training utilized a novel low-cost simulator made with gelatin, water and psyllium fiber. Training consisted of a didactic session, practice with the simulator, and practice with intubated NICU patients. At the end of training, participants underwent an objective structured assessment of technical skills (OSATS) and ten rounds of simulator-based testing of their ability to use POCUS to differentiate between simulated tracheal and esophageal intubations.

Results

The majority of the participants in the training had an average of 7.0 years (SD 4.9) of clinical experience. After controlling for gender, profession, years of practice and POCUS knowledge, linear mixed model and mixed effects logistic regression demonstrated marginal improvement in POCUS interpretation over repeated simulator testing. The mean time-to-interpretation decreased from 24.7 (SD 20.3) seconds for test 1 to 10.1 (SD 4.5) seconds for Test 10,p < 0.001. There was an average reduction of 1.3 s (β = − 1.3; 95% CI: − 1.66 to − 1.0) in time-to-interpretation with repeated simulator testing after adjusting for the covariates listed above.

Conclusion

We found a three-hour simulator-based training session had a significant impact on technical skills and performance of neonatal health care providers in identification of ETT position using POCUS. Further research is needed to examine whether these skills are transferable to intubated newborns in various health settings.

Trial registration

ClinicalTrials.gov Identifier:NCT03533218. Registered May 2018.
At the intersection of precision medicine and population health: an implementation-effectiveness study of family health history based systematic risk assessment in primary care
Authors: Orlando Lori A. , Wu R. Ryanne , Myers Rachel A. , Neuner Joan , McCarty Catherine , Haller Irina V. , Harry Melissa , Fulda Kimberly G. , Dimmock David , Rakhra-Burris Teji , Buchanan Adam , Ginsburg Geoffrey S.
Published: November 2020

Background

Risk assessment is a precision medicine technique that can be used to enhance population health when applied to prevention. Several barriers limit the uptake of risk assessment in health care systems; and little is known about the potential impact that adoption of systematic risk assessment for screening and prevention in the primary care population might have. Here we present results of a first of its kind multi-institutional study of a precision medicine tool for systematic risk assessment.

Methods

We undertook an implementation-effectiveness trial of systematic risk assessment of primary care patients in 19 primary care clinics at four geographically and culturally diverse healthcare systems. All adult English or Spanish speaking patients were invited to enter personal and family health history data into MeTree, a patient-facing family health history driven risk assessment program, for 27 medical conditions. Risk assessment recommendations followed evidence-based guidelines for identifying and managing those at increased disease risk.

Results

One thousand eight hundred eighty-nine participants completed MeTree, entering information onN = 25,967 individuals. Mean relatives entered = 13.7 (SD 7.9), range 7–74.N = 1443 (76.4%) participants received increased risk recommendations: 597 (31.6%) for monogenic hereditary conditions, 508 (26.9%) for familial-level risk, and 1056 (56.1%) for risk of a common chronic disease. There were 6617 recommendations given across the 1443 participants. In multivariate analysis, only the total number of relatives entered was significantly associated with receiving a recommendation.

Conclusions

A significant percentage of the general primary care population meet criteria for more intensive risk management. In particular 46% for monogenic hereditary and familial level disease risk. Adopting strategies to facilitate systematic risk assessment in primary care could have a significant impact on populations within the U.S. and even beyond.

Trial registration

Clinicaltrials.govnumberNCT01956773,registered 10/8/2013.
Quick and improved immune responses to inactivated H9N2 avian influenza vaccine by purified active fraction of Albizia julibrissin saponins
Authors: Sun Hongxiang , Fei Liyan , Zhu Binnian , Shi Minghua
Published: November 2020

Background

H9N2 Low pathogenic avian influenza virus (LPAIV) raises public health concerns and its eradication in poultry becomes even more important in preventing influenza. AJSAF is a purified active saponin fraction from the stem bark of Albizzia julibrissin. In this study, AJSAF was evaluated for the adjuvant potentials on immune responses to inactivated H9N2 avian influenza virus vaccine (IH9V) in mice and chicken in comparison with commercially oil-adjuvant.

Results

AJSAF significantly induced faster and higher H9 subtype avian influenza virus antigen (H9–Ag)-specific IgG, IgG1, IgG2a and IgG2b antibody titers in mice and haemagglutination inhibition (HI) and IgY antibody levels in chicken immunized with IH9V. AJSAF also markedly promoted Con A-, LPS- and H9–Ag-stimulated splenocyte proliferation and natural killer cell activity. Furthermore, AJSAF significantly induced the production of both Th1 (IL-2 and IFN-γ) and Th2 (IL-10) cytokines, and up-regulated the mRNA expression levels of Th1 and Th2 cytokines and transcription factors in splenocytes from the IH9V-immunized mice. Although oil-formulated inactivated H9N2 avian influenza vaccine (CH9V) also elicited higher H9–Ag-specific IgG and IgG1 in mice and HI antibody titer in chicken, this robust humoral response was later produced. Moreover, serum IgG2a and IgG2b antibody titers in CH9V-immunized mice were significantly lower than those of IH9V alone group.

Conclusions

AJSAF could improve antigen-specific humoral and cellular immune responses, and simultaneously trigger a Th1/Th2 response to IH9V. AJSAF might be a safe and efficacious adjuvant candidate for H9N2 avian influenza vaccine.
Genomic analysis of circular RNAs in heart
Authors: Dong Kunzhe , He Xiangqin , Su Huabo , Fulton David J. R. , Zhou Jiliang
Published: November 2020

Background

Heart failure is a leading cause of human morbidity and mortality. Circular RNAs (circRNAs) are a newly discovered class of RNA that have been found to have important physiological and pathological roles. In the current study, we de novo analyzed existing whole transcriptome data from 5 normal and 5 dilated cardiomyopathy (DCM) human heart samples and compared the results with circRNAs that have been previously reported in human, mouse and rat hearts.

Results

Our analysis identifies a list of cardiac circRNAs that are reliably detected in multiple studies. We have also defined the top 30 most abundant circRNAs in healthy human hearts which include some with previously unrecognized cardiac roles such as circHIPK3_11 and circTULP4_1. We further found that many circRNAs are dysregulated in DCM, particularly transcripts originating from DCM-related gene loci, such as TTN and RYR2. In addition, we predict the potential of cardiac circRNAs to sponge miRNAs that have reported roles in heart disease. We found that circALMS1_6 has the highest potential to bind miR-133, a microRNA that can regulate cardiac remodeling. Interestingly, we detected a novel class of circRNAs, referred to as read-though (rt)-circRNAs which are produced from exons of two different neighboring genes. Specifically, rt-circRNAs from SCAF8 and TIAM2 were observed to be dysregulated in DCM and these rt-circRNAs have the potential to sponge multiple heart disease-related miRNAs.

Conclusions

In summary, this study provides a valuable resource for exploring the function of circRNAs in human heart disease and establishes a functional paradigm for identifying novel circRNAs in other tissues.
Socio-economic behavioural indicators of falciparum malaria parasitaemia and moderate to severe anaemia among pregnant women attending antenatal clinics in Lagos, Southwest Nigeria
Authors: Olukosi Adeola Y. , Olakiigbe Abiodun , Ajibaye Olusola , Orok Bassey A. , Aina Olugbenga O. , Akindele Samuel K. , Akinyele Olajumoke O. , Onajole Adebayo T. , Awolola Samson T. , Arowolo Tolulope , Afolabi Bamigboye M.
Published: November 2020

Background

Incidence of malaria and anaemia are of public health importance especially in pregnant women in endemic regions, due to the negative health consequences to the mother and fetus. This study aimed to assess the pattern of falciparum malaria infection and anaemia, based on malaria prevention methods practiced by participants.

Methods

A semi-structured tool was used to capture information on demographic, socio-economic and malaria prevention practices from 113 pregnant women attending antenatal clinics in 2 peri-urban health facilities in Lagos, southwest Nigeria. Malaria microscopy was conducted and haematocrit was measured. Logistic regression analysis was performed on the data collated from the survey.

Results

The prevalence of anaemia among pregnant women was 87.2%. The mean (± sd) packed cell volume (PCV) (%) of the 22 (19.5%) infected subjects (26.8 ± 6.6), was significantly lower (t = −2.60, P value = 0.007) than that of the 91 (80.5%) uninfected subjects (30.8 ± 6.0). The prevalence of infection was highest in the 3rd trimester (n = 40, 35.4%) at 27.5% (11/40) and among those in their first pregnancy (n = 32, 28.3%) at 25.0% (8/32). There was a significant difference (t = −2.23, P-value = 0.01) in the mean PCV % of pregnant women who consumed herbal teas in pregnancy (28.2 ± 5.2) compared to those who did not (30.8 ± 6.6). Regression analysis showed that first pregnancy, anti-malarial use and insecticide-treated nets use the night before study had increased odds of malaria infection in participants (OR = 1.35, P = 0.006, 95% CI 0.52−2.49; OR = 2.3, P = 0.005, 95% CI 0.14−0.41; OR = 1.92, P = 0.001, 95% CI 0.62−5.98) while intermittent preventive treatment (IPT) participation and formal education were strongly and significantly associated with lower risk of parasitaemia (OR = 0.95, P = 0.025, 95% CI 0.41−2.26; OR = 0.44, P = 0.005, 95% CI 0.34−10.50).

Conclusion

Interventions that will reduce malaria and moderate to severe anaemia, especially in a first pregnancy, should include education on the correct use of long-lasting insecticide-treated bed nets (LLIN), IPT and the dangers of herbal teas in pregnancy.