bluuebunny/crossref_metadata_2025 huggingface dataset:
Johne’s disease in Irish dairy herds: considerations for an effective national control programme
Authors: Jordan A. G. , Citer L. R. , McAloon C. G. , Graham D. A. , Sergeant E. S. G. , More S. J.
Published: August 2020

The Irish dairy industry has established a reputation for the production of safe and healthy dairy products and is seeking to further expand its export market for high value dairy products. To support its reputation, stakeholders aim to control Johne’s disease. To assist decision-makers determine the most appropriate design for an Irish programme, a narrative review of the scientific literature on the epidemiology of Johne’s disease, and selected control programmes throughout the world was undertaken. Two modelling studies specifically commissioned by Animal Health Ireland to assess testing methods used to demonstrate confidence of freedom in herds and to evaluate a range of possible surveillance strategies provided additional information. The majority of control programmes tend to be voluntary, because of the unique epidemiology of Johne’s disease and limited support for traditional regulatory approaches. While acknowledging that test performance and sub-clinical sero-negative shedders contributes to the spread of infection, a range of socio-political issues also exist that influence programme activities. The paper provides a rationale for the inclusion of a Veterinary Risk Assessment and Management Plan (VRAMP), including voluntary whole herd testing to identify infected herds and to support assurance-based trading through repeated rounds of negative testing, national surveillance for herd-level case-detection, and improved understanding of biosecurity management practices. Identification and promotion of drivers for industry and producer engagement in Ireland is likely to guide the future evolution of the Irish Johne’s Control Programme (IJCP) and further enhance its success. The provision of training, education and extension activities may encourage farmers to adopt relevant farm management practices and help them recognize that they are ultimately responsible for their herd’s health and biosecurity.
On a system of fractional coupled hybrid Hadamard differential equations with terminal conditions
Authors: Buvaneswari Karthikeyan , Karthikeyan Panjaiyan , Baleanu Dumitru
Published: August 2020

In this manuscript, we study the existence of solutions for a coupled system of nonlinear hybrid differential equations of fractional order involving Hadamard derivative with nonlocal boundary conditions. By using suitable fixed point theorems we establish sufficient conditions for the existence result. An example is provided to illustrate our main result.
“Microbiota, symbiosis and individuality summer school” meeting report
Authors: Ronai Isobel , Greslehner Gregor P. , Boem Federico , Carlisle Judith , Stencel Adrian , Suárez Javier , Bayir Saliha , Bretting Wiebke , Formosinho Joana , Guerrero Anna C. , Morgan William H. , Prigot-Maurice Cybèle , Rodeck Salome , Vasse Marie , Wallis Jacqueline M. , Zacks Oryan
Published: August 2020

How does microbiota research impact our understanding of biological individuality? We summarize the interdisciplinary summer school on “Microbiota, symbiosis and individuality: conceptual and philosophical issues” (July 2019), which was supported by a European Research Council starting grant project “Immunity, DEvelopment, and the Microbiota” (IDEM). The summer school centered around interdisciplinary group work on four facets of microbiota research: holobionts, individuality, causation, and human health. The conceptual discussion of cutting-edge empirical research provided new insights into microbiota and highlights the value of incorporating into meetings experts from other disciplines, such as philosophy and history of science.
Osteogenesis imperfecta—pathophysiology and therapeutic options
Authors: Etich Julia , Leßmeier Lennart , Rehberg Mirko , Sill Helge , Zaucke Frank , Netzer Christian , Semler Oliver
Published: August 2020

Osteogenesis imperfecta (OI) is a rare congenital disease with a wide spectrum of severity characterized by skeletal deformity and increased bone fragility as well as additional, variable extraskeletal symptoms. Here, we present an overview of the genetic heterogeneity and pathophysiological background of OI as well as OI-related bone fragility disorders and highlight current therapeutic options.

The most common form of OI is caused by mutations in the two collagen type I genes. Stop mutations usually lead to reduced collagen amount resulting in a mild phenotype, while missense mutations mainly provoke structural alterations in the collagen protein and entail a more severe phenotype. Numerous other causal genes have been identified during the last decade that are involved in collagen biosynthesis, modification and secretion, the differentiation and function of osteoblasts, and the maintenance of bone homeostasis.

Management of patients with OI involves medical treatment by bisphosphonates as the most promising therapy to inhibit bone resorption and thereby facilitate bone formation. Surgical treatment ensures pain reduction and healing without an increase of deformities. Timely remobilization and regular strengthening of the muscles by physiotherapy are crucial to improve mobility, prevent muscle wasting and avoid bone resorption caused by immobilization. Identification of the pathomechanism for SERPINF1 mutations led to the development of a tailored mechanism-based therapy using denosumab, and unraveling further pathomechanisms will likely open new avenues for innovative treatment approaches.
A study protocol for a randomized controlled trial of a cross-systems service delivery model to improve identification and care for HIV, STIs and substance use among justice-involved young adults
Authors: Elkington Katherine S. , O’Grady Megan A. , Tross Susan , Wilson Patrick , Watkins Jillian , Lebron Lenore , Cohall Renee , Cohall Alwyn
Published: August 2020

Background

Justice-involved young adults (JIYA) aged 18–24 are at significant risk for HIV and problematic substance use (SU) but are unlikely to know their HIV status or be linked to HIV or SU treatment and care. Intensive efforts to increase screening and improve linkage to HIV and SU services for JIYA are needed that address youth as well as justice and health/behavioral health system-level barriers.

Methods

MoveUp is a four-session intervention that integrates evidence-based protocols to promote HIV and STI testing, HIV and SU behavioral risk reduction and engagement in treatment for JIYA. MoveUp is delivered onsite at an alternative sentencing program (ASP) by HIV testing outreach workers from a youth-focused medical and HIV treatment program.N = 450 youth are randomized following baseline assessment into two groups: MoveUp or standard of care. Youth are followed for 12 months following the intervention; unprotected sexual behavior, substance use, HIV and STI testing as well as treatment linkage will be assessed at 3, 6, 9 and 12-months.

Discussion

This study is one of the first to systematically test an integrated screen/testing, prevention intervention and linkage-to-care services program (MoveUp), using evidence-based approaches to address the overlapping HIV/STI and substance use epidemics in JIYA by providing on-site services to identify HIV/STI and SU risk and treatment need within justice-settings as well as linkage to services in the community. This approach, capitalizing on health and justice partnerships, represents an innovation that can capitalize on missed opportunities for engaging JIYA in health care.
Adipocyte-conditioned medium induces resistance of breast cancer cells to lapatinib
Authors: Geneste A. , Duong M. N. , Molina L. , Conilh L. , Beaumel S. , Cleret A. , Chettab K. , Lachat M. , Jordheim L. P. , Matera E. L. , Dumontet C.
Published: August 2020

Background

The existence of a cross-talk between peritumoral adipocytes and cancer cells has been increasingly investigated. Several studies have shown that these adipocytes protect tumor cells from the effect of anticancer agents.

Methods

To investigate a potential protective effect of adipocyte-conditioned medium on HER2 positive breast cancer cells exposed to tyrosine kinase inhibitors (TKI) such as lapatinib, we analyzed the sensitivity of HER2 positive breast cancer models in vitro and in vivo on SCID mice in the presence or absence of adipocytes or adipocyte-conditioned medium.

Results

Conditioned medium from differentiated adipocytes reduced the in vitro sensitivity of the HER2+ cell lines BT474 and SKBR3 to TKI. Particularly, conditioned medium abrogated P27 induction in tumor cells by lapatinib but this was observed only when conditioned medium was present during exposure to lapatinib. In addition, resistance was induced with adipocytes derived from murine NIH3T3 or human hMAD cells but not with fibroblasts or preadipocytes. In vivo studies demonstrated that the contact of the tumors with adipose tissue reduced sensitivity to lapatinib. Soluble factors involved in this resistance were found to be thermolabile. Pharmacological modulation of lipolysis in adipocytes during preparation of conditioned media showed that various lipolysis inhibitors abolished the protective effect of conditioned media on tumor cells, suggesting a role for adipocyte lipolysis in the induction of resistance of tumor cells to TKI.

Conclusions

Overall, our results suggest that contact of tumor cells with proximal adipose tissue induces resistance to anti HER2 small molecule inhibitors through the production of soluble thermolabile factors, and that this effect can be abrogated using lipolysis inhibitors.
Regional climate modeling for Asia
Authors: Lee Dong-Kyou , Cha Dong-Hyun
Published: August 2020

The regional climate model (RCM) with higher resolution and sophisticated physical processes can reproduce and project fine-scale climate information, which cannot be captured by the global climate model (GCM). Therefore, we developed the Seoul National University Regional Climate Model (SNURCM) in the 1990s to simulate the intrinsic and detailed climate prevailing in Asia. In this study, we reviewed the developmental processes of the SNURCM and its application researches. In the simulation of regional climate over Asia, systematic errors can be generated because of natural characteristics such as complex land-surface conditions and topography, warm ocean conditions, and strong seasonal monsoon circulation and convection. Numerous methods and techniques have been applied to reduce these errors and improve the SNURCM. For long-term simulations without climate drift, the spectral nudging technique as well as the traditional relaxation method was employed for the boundary conditions. To represent reasonable interactions between earth systems, a simple ocean model and an advanced land-surface model were implemented into the SNURCM. Physical schemes for precipitation and vertical diffusion developed for short-term numerical weather prediction models were optimized or improved for long-term simulation. The SNURCM has been applied to future climate projection, reproduction of extreme climate, and seasonal forecasting. Furthermore, the model has served as a part of the multi-model comparison program and an ensemble of international research programs.
Effects of calcitriol on oxidative burst, phagocytic function, and leukocyte cytokine production in shelter dogs
Authors: Jaffey Jared A. , Bessette Mariah , Tao Zenan , Bradley-Siemens Nancy , Thompson Melissa
Published: August 2020

Background

The active metabolite of vitamin D, calcitriol, has been shown across many different species to augment innate immune responses and dampen aberrant proinflammatory cytokine production. Community acquired infections are common in shelters and consume limited shelter resources, impact adoption rates, and can result in unnecessary euthanasia. Prophylactic oral vitamin D supplementation decreases the incidence and severity of upper and lower respiratory tract infections in humans. Before a clinical trial investigating the clinical benefit of oral vitamin D supplementation in shelter dogs can be pursued, an in vitro study evaluating the immunomodulatory effects of calcitriol in blood from shelter dogs is warranted. Therefore, the objective of this study was to determine if incubation of whole blood obtained from apparently healthy dogs housed in a shelter for ≥7 days with calcitriol would alter granulocyte/monocyte (GM) oxidative burst and phagocytic function as well as pathogen-associated molecular pattern (PAMP)-stimulated leukocyte production of tumor necrosis factor (TNF)-α, and interleukin (IL)-6, and IL-10.

Results

Ten dogs housed in a shelter for ≥7 days were enrolled in a prospective cohort study. Whole blood from these dogs was incubated with calcitriol (10− 7 M) or diluent (control) for 24 h. Subsequent to this incubation, phagocytosis of opsonized-Escherichia coli(E. coli) andE. coli-induced oxidative burst were evaluated via flow cytometry. In addition, leukocyte production of TNF-α, IL-6, and IL-10 were measured using a canine-specific multiplex bead assay. Calcitriol significantly decreased leukocyte TNF-α production (p = 0.009) and increased IL-10 production (p = 0.002). Tumor necrosis factor-α-to-IL-10 ratio was significantly decreased with calcitriol (p = 0.017), while IL-6 production as well as GM oxidative burst and phagocytic function were not significantly affected.

Conclusions

These data indicate that calcitriol attenuates proinflammatory immune responses without affecting GM oxidative burst or phagocytic function in vitro in whole blood obtained from apparently healthy shelter dogs.
Cerebral autoregulation and neurovascular coupling are progressively impaired during septic shock: an experimental study
Authors: Ferlini Lorenzo , Su Fuhong , Creteur Jacques , Taccone Fabio Silvio , Gaspard Nicolas
Published: August 2020

Background

Alteration of the mechanisms of cerebral blood flow (CBF) regulation might contribute to the pathophysiology of sepsis-associated encephalopathy (SAE). However, previous clinical studies on dynamic cerebral autoregulation (dCA) in sepsis had several cofounders. Furthermore, little is known on the potential impairment of neurovascular coupling (NVC) in sepsis. The aim of our study was to determine the presence and time course of dCA and NVC alterations in a clinically relevant animal model and their potential impact on the development of SAE.

Methods

Thirty-six anesthetized, mechanically ventilated female sheep were randomized to sham procedures (sham,n= 15), sepsis (n= 14), or septic shock (n= 7). Blood pressure, CBF, and electrocorticography were continuously recorded. Pearson’s correlation coefficient Lxa and transfer function analysis were used to estimate dCA. NVC was assessed by the analysis of CBF variations induced by cortical gamma activity (Eγ) peaks and by the magnitude-squared coherence (MSC) between the spontaneous fluctuations of CBF and Eγ. Cortical function was estimated by the alpha-delta ratio. Wilcoxon signed rank and rank sum tests, Friedman tests, and RMANOVA test were used as appropriate.

Results

Sepsis and sham animals did not differ neither in dCA nor in NVC parameters. A significant impairment of dCA occurred only after septic shock (Lxa,p= 0.03, TFA gainp= 0.03, phasep= 0.01). Similarly, NVC was altered during septic shock, as indicated by a lower MSC in the frequency band 0.03–0.06 Hz (p< 0.001). dCA and NVC impairments were associated with cortical dysfunction (reduction in the alpha-delta ratio (p= 0.03)).

Conclusions

A progressive loss of dCA and NVC occurs during septic shock and is associated with cortical dysfunction. These findings indicate that the alteration of mechanisms controlling cortical perfusion plays a late role in the pathophysiology of SAE and suggest that alterations of CBF regulation mechanisms in less severe phases of sepsis reported in clinical studies might be due to patients’ comorbidities or other confounders. Furthermore, a mean arterial pressure targeting therapy aiming to optimize dCA might not be sufficient to prevent neuronal dysfunction in sepsis since it would not improve NVC.
Essential tremor: the most common form of cerebellar degeneration?
Authors: Louis Elan D. , Faust Phyllis L.
Published: August 2020

Background

The degenerative cerebellar ataxias comprise a large and heterogeneous group of neurological diseases whose hallmark clinical feature is ataxia, and which are accompanied, to variable degrees, by other features that are attributable to cerebellar dysfunction. Essential tremor (ET) is an exceptionally common neurological disease whose primary motor feature is action tremor, although patients often manifest intention tremor, mild gait ataxia and several other features of cerebellar dysfunction.

Main Body

In this paper, we review the abundant evidence derived from clinical, neuroimaging and postmortem studies, linking ET to cerebellar dysfunction. Furthermore, we review the combination of clinical, natural history and postmortem features suggesting that ET is neurodegenerative. We then compare the prevalence of ET (400 – 900 cases per 100,000) to that of the other cerebellar degenerations (ranging from<0.5 – 9 cases per 100,000, and in composite likely to be on the order of 20 cases per 100,000) and conclude that ET is 20 to 45 times more prevalent than all other forms of cerebellar degeneration combined.

Conclusion

Given the data we present, it is logical to conclude that ET is, by far, the most common form of cerebellar degeneration.
Afferent limb syndrome after total proctocolectomy and ileal pouch-anal canal anastomosis
Authors: Matsuda Keiji , Hashiguchi Yojiro , Asako Kentaro , Okada Yuka , Ohno Kohei , Tsukamoto Mitsuo , Fukushima Yoshihisa , Shimada Ryu , Ozawa Tsuyoshi , Hayama Tamuro , Nozawa Keijiro , Fukagawa Takeo , Sasajima Yuko
Published: August 2020

Background

Small bowel obstruction (SBO) is a common postoperative complication of ulcerative colitis (UC). There have been a few recent reports of afferent limb syndrome (ALS) as a rare occurrence in cases of SBO. We present a case of ALS with recurrent SBO that was successfully managed surgically.

Case presentation

When this male patient was 55 years old, he underwent laparoscopy-assisted anus-preserving total proctocolectomy, the creation of a J-type ileal pouch, ileal pouch-anal canal anastomosis (IPAA), and creation of ileostomy for intractable UC. Three months later, ileostomy closure was performed. The first onset of SBO was observed 5 months after ileostomy closure. SBO occurred repeatedly, and the patient was hospitalized nine times in approximately 2 years. Each SBO was improved by non-surgical treatment. A computed tomography (CT) scan revealed that the afferent limb was narrowing and twisted, and gastrografin enema confirmed narrowing at the proximal portion of the pouch inlet. Endoscopy showed a sharp angulation at the pouch inlet. We suspected ALS and decided on a surgical policy and performed pouchopexy and ileopexy to the retroperitoneum by suturing with excision of the remaining blind end of the ileum. Endoscopy 3 days after surgery showed neither twist nor stricture in the fixed ileal pouch or the afferent limb. At the time of writing, the patient remains free of SBO symptoms.

Conclusion

Clinicians should consider ALS when examining a patient with recurrent intermittent SBO after IPAA surgery. When ALS is suspected, the patient is indicated for surgery such as surgical pexy.
Intraductal tubulopapillary neoplasms with rupture of the distal main pancreatic duct: a case report
Authors: Shimizu Yuji , Ashida Ryo , Sugiura Teiichi , Okamura Yukiyasu , Ito Takaaki , Yamamoto Yusuke , Ohgi Katsuhisa , Sasaki Keiko , Uesaka Katsuhiko
Published: August 2020

Background

Intraductal tubulopapillary neoplasm (ITPN) is a rare and newly described entity defined as an intraductal, grossly visible, tubule-forming epithelial neoplasm with high-grade dysplasia and ductal differentiation without overt production of mucin. Because of its rarity, the clinical and molecular aspects of ITPN have not been fully investigated.

Case presentation

A 73-year-old woman presented to a local hospital with epigastric discomfort and pain. Abdominal multidetector-row computed tomography (MDCT) revealed a 2.5-cm hypovascular tumor in the pancreatic body with distal pancreatic duct dilatation and a slightly low-density area spreading over the ventral side of the pancreatic body. Endoscopic ultrasonography and fine-needle biopsy of the tumor revealed adenocarcinoma of the pancreas. She was referred to our hospital 2 months later. MDCT performed at our hospital showed no significant change in the tumor size or pancreatic duct dilatation. However, the low-density area at the ventral side of the pancreas had shrunk; therefore, this finding was considered to have been an inflammatory change. Under a preoperative diagnosis of resectable pancreatic ductal adenocarcinoma, distal pancreatectomy was performed. The final diagnosis was ITPN with associated invasive carcinoma. Macroscopically and microscopically, the main pancreatic duct (MPD) had ruptured at the distal side of the tumor, and the fistula connected the MPD and extrapancreatic scar tissue.

Conclusions

ITPN with rupture of the pancreatic duct is extremely rare. In the present case, a sudden increase in the pancreatic duct internal pressure or acute inflammation likely caused the rupture of the MPD.
Obstructive rectal endometriosis treated by robot-assisted laparoscopic surgery: a case report
Authors: Kuriyama Naotaka , Ando Koji , Hu Qingjiang , Miyashita Yu , Fujimoto Yoshiaki , Jogo Tomoko , Hokonohara Kentaro , Nakanishi Ryota , Hisamatsu Yuichi , Kimura Yasue , Tsurumaru Daisuke , Kohashi Kenichi , Oda Yoshinao , Oki Eiji , Nishimura Masataka , Mori Masaki
Published: August 2020

Background

Rectal endometriosis is a rare disease. A definitive diagnosis prior to surgery is often difficult. We encountered a patient with rectal sub-obstructive endometriosis that was treated by robot-assisted laparoscopic low anterior resection.

Case presentation

A 43-year-old woman visited our hospital with suspected stenosis caused by upper rectal cancer. She had a 2-year history of constipation. We were unable to confirm the diagnosis through detailed examinations, including laparoscopy. Robot-assisted laparoscopic low anterior resection with D3 lymph node dissection was performed for both diagnosis and treatment. The postoperative specimen showed a submucosal tumor. The pathological examination confirmed rectal endometriosis.

Conclusions

We herein describe a rare case of obstructive rectal endometriosis that we were unable to diagnose preoperatively. Robotic surgery was useful in this case, which involved extensive pelvic adhesion.
Antidiabetic effect of Wedelia chinensis leaf extract in alloxan induced Swiss albino diabetic mice
Authors: Bari Md. Wasim , Islam Md. Monirul , Khatun Mahbuba , Sultana Mst Julia , Ahmed Rabbi , Islam Ariful , Hossain Md. Ismail , Rahman Md. Matiar , Islam Mohammad Amirul
Published: August 2020

Background

Wedelia chinensis (W. chinensis)is a beneficial medicinal herb used in folk medicine to treat many chronic diseases. The present study is aimed to evaluate the antidiabetic property of methanolic extract ofW. chinensisleaf (MEWL) in alloxan induced Swiss albino diabetic mice.

Methods

Methanol was used as a solvent to obtainW. chinensisleaf extract. In vitro antidiabetic property of MEWL was revealed by α-amylase and α-glucosidase inhibition assays. To explore in vivo antidiabetic properties of MEWL, diabetes was induced in Swiss albino mice by intraperitoneal injection of alloxan at dose of 80 mg/kg body weight (BW). All Swiss albino mice (normal mice and diabetic mice) were divided into five groups and orally treated with normal pellet diet and water (normal control and diabetic control), glibenclamide 5 mg/kg BW and MEWL (100 and 200 mg/kg BW). Effects of MEWL on blood glucose levels, activity of liver function enzymes associated with diabetes and serum levels of lipid parameters were evaluated.

Results

In α-amylase inhibition assay, 48.39% inhibition in the activity of α-amylase was observed at 500 μg/ml concentration of MEWL. Moreover, 39.37% inhibition of α-glucosidase activity was observed at 10 μg/ml concentration of MEWL. The results of in vivo antidiabetic assays showed that MEWL significantly (p < 0.01) decreased blood glucose level and ameliorated parameters of lipid profile (TG, TC, LDL, VLDL and HDL) in diabetic mice. MEWL treatments for 21 days also reduced the activity of SGPT and SGOT enzymes, and CRP levels in the serum of diabetic mice significantly (p < 0.01) compared to that of untreated diabetic mice.

Conclusion

The present study demonstrated thatW. chinensisleaf extract effectively subsidized the hyperglycemic effect along with restoring the lipid profile parameters in diabetic mice and might be used as an alternative medicine for the management of diabetes.
Analysis of difficulty in placement of pulmonary artery catheter through the left internal jugular vein
Authors: Tomita Akiko , Takada Shoko , Fujimoto Tomoko , Iwasaki Mitsuo , Hayashi Yukio
Published: August 2020

Purpose

The left internal jugular vein may be an alternative route for the placement of a pulmonary artery catheter when the right jugular vein is not available. Although the placement through the left internal jugular vein is expected to be more difficult, little has been written regarding difficulties in achieving proper placement of the catheter through the left internal jugular vein.

Methods

This prospective and observational study includes patients undergoing cardiac surgery with the catheter placement by monitoring the pressure waveform for 2 years. We measured the time required for the catheter to pass through the tricuspid and pulmonary valves, respectively. The data were analyzed by Mann-Whitney. P < 0.05 was considered significant.

Results

The catheter placement through the right and left internal jugular vein was done in 285 (group R) and 10 patients (group L), respectively. The time duration through the tricuspid valve in group L was significantly longer than that in group P (8 [5–14] s vs 70 [19.8–138] s, median [range], P < 0.01), whereas the time duration through the pulmonary valve was comparable between the two groups (15 [10–27.75] s vs 15 [10.25–19] s, median [range], P = 0.62).

Conclusion

These results indicate that the difficulty in the catheter placement through the left jugular vein may be to pass through the tricuspid valve, not the pulmonary valve.
Ethnobotany, ethnopharmacology, and phytochemistry of traditional medicinal plants used in the management of symptoms of tuberculosis in East Africa: a systematic review
Authors: Obakiro Samuel Baker , Kiprop Ambrose , Kowino Isaac , Kigondu Elizabeth , Odero Mark Peter , Omara Timothy , Bunalema Lydia
Published: August 2020

Objective

Many studies on the treatment of tuberculosis (TB) using herbal medicines have been undertaken in recent decades in East Africa. The details, however, are highly fragmented. The purpose of this study was to provide a comprehensive overview of the reported medicinal plants used to manage TB symptoms, and to analyze scientific reports on their effectiveness and safety.

Method

A comprehensive literature search was performed in the major electronic databases regarding medicinal plants used in the management of TB in East Africa. A total of 44 reports were retrieved, and data were collected on various aspects of the medicinal plants such as botanical name, family, local names, part(s) used, method of preparation, efficacy, toxicity, and phytochemistry. The data were summarized into percentages and frequencies which were presented as tables and graphs.

Results

A total of 195 species of plants belonging to 68 families and 144 genera were identified. Most encountered species were from Fabaceae (42.6%), Lamiaceae (19.1%), Asteraceae (16.2%), and Euphorbiaceae (14.7%) families. Only 36 medicinal plants (18.5%) have been screened for antimycobacterial activity. Out of these, 31 (86.1%) were reported to be bioactive with minimum inhibitory concentrations ranging from 47 to 12,500 μg/ml. Most tested plant extracts were found to have acceptable acute toxicity profiles with cytotoxic concentrations on normal mammalian cells greater than 200 μg/ml. The most commonly reported phytochemicals were flavonoids, terpenoids, alkaloids, saponins, cardiac glycosides, and phenols. OnlyTetradenia riparia,Warburgia ugandensis, andZanthoxylum leprieuriihave further undergone isolation and characterization of the pure bioactive compounds.

Conclusion

East Africa has a rich diversity of medicinal plants that have been reported to be effective in the management of symptoms of TB. More validation studies are required to promote the discovery of antimycobacterial drugs and to provide evidence for standardization of herbal medicine use.
Retinal nerve fiber layer and ganglion cell layer changes using optical coherence tomography in patients with chronic migraine: a case-control study
Authors: Labib Dalia M. , Hegazy Montaser , Esmat Soheir Mohamed , Ali Enas Abdel Hamid , Talaat Foraysa
Published: August 2020

Background

Migraine is a prevalent, chronic, and multifactorial neurovascular disease.

Objectives

Our work aimed to investigate if the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness are affected in patients with chronic migraine to improve the understanding of the etiology and pathophysiology of migraine.

Subjects and methods

A case-control study conducted on 30 patients with chronic migraine and 30 aged and sex-matched healthy controls. Subjects underwent full neurological and ophthalmological history, ophthalmological examination, and measuring RNFL and GCL thickness using the spectral domain-optical coherence tomography (SD-OCT).

Results

RNFL thinning (average, superior, inferior, nasal, and temporal) was significantly more in patients with chronic migraine than healthy control (P = 0.001, 0.022, 0.045, 0.034, and 0.001, respectively). No statistically significant difference was found between chronic migraine patients and healthy controls regarding GCL thickness (average, superior, and inferior) (P value ˃ 0.05).

The average RNFL thickness was significantly thinner in migraine with aura (MwA) than migraine without aura (MwoA) (P = 0.006). The average GCL thickness was thinner in MwA than MwoA (P = 0.039). No statistically significant difference was found between the eyes on the side of the headache and the eyes of the contralateral side regarding RNFL and GCL thickness (P value ˃ 0.05). Age at onset, disease duration, headache frequency, and headache intensity showed an insignificant correlation with OCT parameters.

Conclusion

Retinal changes could be an association with chronic migraine that may be used as a biomarker.
A novel feature extraction methodology using Siamese convolutional neural networks for intrusion detection
Authors: Moustakidis Serafeim , Karlsson Patrik
Published: August 2020

Intrusion detection systems (IDS) can play a significant role in detecting security threats or malicious attacks that aim to steal information and/or corrupt network protocols. To deal with the dynamic and complex nature of cyber-attacks, advanced intelligent tools have been applied resulting into powerful and automated IDS that rely on the latest advances of machine learning (ML) and deep learning (DL). Most of the reported effort has been devoted on building complex ML/DL architectures adopting a brute force approach towards the maximization of their detection capacity. However, just a limited number of studies have focused on the identification or extraction of user-friendly risk indicators that could be easily used by security experts. Many papers have explored various dimensionality reduction algorithms, however a large number of selected features is still required to detect the attacks successfully, which humans cannot intuitively or immediately understand. To enhance user’s trust and understanding on data without sacrificing on accuracy, this paper contributes to the transformation of the available data collected by IDS into a single actionable and easy-to-understand risk indicator. To achieve this, a novel feature extraction pipeline was implemented consisting of the following components: (i) a fuzzy allocation scheme that transforms raw data to fuzzy class memberships, (ii) a novel modality transformation mechanism for converting feature vectors to images (Vec2im) and (iii) a dimensionality reduction module that makes use of Siamese convolutional neural networks that finally reduces the input data dimensionality into a 1-d feature space. The performance of the proposed methodology was validated with respect to detection accuracy, dimensionality reduction performance and execution time on the NSL-KDD dataset via a thorough comparative analysis that demonstrated its effectiveness (86.64% testing accuracy using only one feature) over a number of well-known feature selection (FS) and extraction techniques. The output of the proposed feature extraction pipeline could be potentially used by security experts as an indicator of malicious activity, whereas the generated images could be further utilized and/or integrated as a visual analytics tool in existing IDS.
Perceived benefits and barriers towards exercise among healthcare providers in Ain Shams University Hospitals, Egypt
Authors: Gabal Hebat-Allah M. S. , Wahdan Maha M. , Eldin Waleed Salah
Published: August 2020

Background

Physical inactivity is considered a problem with great impact on morbidity and mortality. There is a necessity to combat this behavior through an assessment of barriers and benefits perceived by subjects.

Objectives

The current study aimed to measure exercise intention, in addition to identifying physical exercise predictors, including perceived barriers and benefits among healthcare providers (HCPs) in Ain Shams University Hospitals.

Methods

A cross-sectional study was performed on a sample (n = 327) of healthcare providers (physicians and nurses) in Ain Shams University Hospitals in Cairo, Egypt, using anonymous self-administrated questionnaires and relevant scales.

Results

Out of 327 healthcare providers approached, 52.6% of them were males and the mean age of participants was (29.34 ± 7.84 years). Physical exercise was reported by 44.6% of participants. The most significant factors associated with physical exercise engagement were male gender, participants with lower body mass index (BMI), and those with higher perceived “life enhancement subscale” benefit score and lower perceived exercise milieu and physical exertion barriers subscale scores. Exercisers showed significantly higher total overall (benefits and barriers) score compared to non-exercisers. Physicians showed a significantly higher total score compared to nurses.

Conclusion and recommendations

The prevalence of regular exercise is low and inversely related to the female gender, BMI, Exercise milieu, and Physical exertion barriers subscale scores, and directly related to life enhancement benefit subscale score. Health education program about the benefits and barriers of exercise is recommended to encourage healthcare personnel to follow a healthy lifestyle as a role model to their patients and to act as health promoters to them.
Performance of bone mineral density and trabecular bone score in assessment of bone quality in Egyptian male patients with ankylosing spondylitis
Authors: Adel Yasmin , El Adalany Mohamed Ali , Bassiouni Sherine Abdel Rahman Abdel Karim
Published: August 2020

Background

Osteoporosis is a common complication of ankylosing spondylitis (AS) even in the early stages of disease; however, previously published studies have demonstrated large discrepancies in the reported incidence of osteoporosis, based on measurement of bone mineral density (BMD). The aim of the present study was to compare bone quality using trabecular bone score (TBS) between AS patients and healthy controls and to evaluate factors associated with TBS in patients with AS.

Results

Ankylosing spondylitis patients had significantly lower BMD and T score at the neck of femur and lower total hip BMD than controls (BMD p = 0.010 and 0.032 respectively), (T score p = 0.006 and p = 0.025 respectively). The mean TBS was significantly lower in AS patients than in controls (p < 0.001). Lumbar spine TBS was directly correlated with BMI (p = 0.029) and BMD at the neck of femur (p = 0.016) and BMD of total hip (p = 0.007) while inversely correlated with the Bath AS Metrology Index (BASMI) (p = 0.026), the modified Stoke AS Spinal Score (mSASS) (p = 0.029), ESR (p = 0.031), and CRP (p = 0.033).

Conclusion

TBS evaluation detected lower bone quality in the lumbar spine in patients with AS when compared with matched controls, while lumbar BMD failed to identify it. These findings encourage the use of TBS as a beneficial tool to recognize the risk of axial osteoporosis as early as possible in AS patients. Also, we recommend its use for regular follow up of drug treatment for those patients.
Effects of genomic copy number variants penetrant for schizophrenia on cortical thickness and surface area in healthy individuals: analysis of the UK Biobank
Authors: Caseras Xavier , Kirov George , Kendall Kimberley M. , Rees Elliott , Legge Sophie E. , Bracher-Smith Matthew , Escott-Price Valentina , Murphy Kevin
Published: August 2020

Background

Schizophrenia is a highly heritable disorder with undetermined neurobiological causes. Understanding the impact on brain anatomy of carrying genetic risk for the disorder will contribute to uncovering its neurobiological underpinnings.

Aims

To examine the effect of rare copy number variants (CNVs) associated with schizophrenia on brain cortical anatomy in a sample of unaffected participants from the UK Biobank.

Method

We used regression analyses to compare cortical thickness and surface area (total and across gyri) between 120 unaffected carriers of rare CNVs associated with schizophrenia and 16 670 participants without any pathogenic CNV. A measure of cortical thickness and surface area covariance across gyri was also compared between groups.

Results

Carrier status was associated with reduced surface area (β = −0.020 mm2,P< 0.001) and less robustly with increased cortical thickness (β = 0.015 mm,P= 0.035), and with increased covariance in thickness (carriersz= 0.31v.non-carriersz= 0.22,P< 0.0005). Associations were mainly present in frontal and parietal areas and driven by a limited number of rare risk alleles included in our analyses (mainly 15q11.2 deletion for surface area and 16p13.11 duplication for thickness covariance).

Conclusions

Results for surface area conformed with previous clinical findings, supporting surface area reductions as an indicator of genetic liability for schizophrenia. Results for cortical thickness, though, argued against its validity as a potential risk marker. Increased structural thickness covariance across gyri also appears related to risk for schizophrenia. The heterogeneity found across the effects of rare risk alleles suggests potential different neurobiological gateways into schizophrenia's phenotype.
Exploration of PCORnet Data Resources for Assessing Use of Molecular-Guided Cancer Treatment
Authors: Carnahan Ryan M. , Waitman Lemuel R. , Charlton Mary E. , Schroeder Mary C. , Bossler Aaron D. , Campbell W. Scott , Campbell James R. , McDowell Bradley D. , Smith Nicholas C. , Gryzlak Brian M. , Chrischilles Elizabeth A.
Published: August 2020

PURPOSE

Examine the ability of PCORnet data resources to investigate molecular-guided cancer treatment.

PATIENTS AND METHODS

Patients (N = 86,154) had single primary solid tumors (diagnosed 2013-2017) from hospital oncology registries linked to the PCORnet Common Data Model (CDM) at 11 medical institutions. Molecular and anatomic test procedures and oral and infused therapies were identified with Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, RxNorm Concept Unique Identifier, and National Drug Codes from CDM tables. Chart review (2 institutions, n = 213) for advanced colorectal cancer and Medicare claims linkages (7 institutions, n = 1,731) for breast cancer explored options for increasing electronic data capture.

RESULTS

Molecular testing prevalence detected via analyte-specific molecular CPT/HCPCS codes was 5.5% (n = 4,784); for the nonspecific anatomic pathology codes, for which only some testing is performed to guide therapy selection, it was an additional 44.8% (n = 38,610). Molecular-guided therapy prevalence was 5% (n = 4,289). Testing and treatment were most common with stage IV disease and varied across cancer types and study institutions (testing, 0%-10.4%; treatment, 0.8%-8.4%). Therapy-concordant test results were found in charts for all 36 treated patients with colorectal cancer at the 2 institutions, 3 (8.3%) of whom received treatment outside the institution. Breast cancer Medicare claims linkage increased rates of identified testing from 62.7%-98.9% and treatment from 3.9%-8.2%.

CONCLUSION

Although a minority of patients received molecular-guided therapies, the majority had testing that could guide cancer treatment. Claims data extended electronic data capture for therapies and test orders but often was uninformative for types of test ordered. Test results continue to require text data curation from narrative pathology reports.
Chemotherapy Treatment Modifications During the COVID-19 Outbreak at a Community Cancer Center in New York City
Authors: Lin Dong D. , Meghal Trishala , Murthy Pooja , Mo Lan , D’Silva Ashley , Huang Yiwu , Xu Yiqing
Published: August 2020

PURPOSE

As a result of their immunocompromised status associated with disease and treatment, patients with cancer face a profound threat for higher rates of complications and mortality if they contract the coronavirus disease 2019 infection. Medical oncology communities have developed treatment modifications to balance the risk of contracting the virus with the benefit of improving cancer-related outcomes.

METHODS

We systemically examined our community cancer center database to display patterns of change and to unveil factors that have been considered with each decision. We studied a cohort of 282 patients receiving treatment and found that 159 patients (56.4%) had treatment modifications.

RESULTS

The incidence of treatment modification was observed in patients undergoing adjuvant and neoadjuvant (41.4%), palliative (62.9%), or injectable endocrine or bone-modulating only (76.0%) treatments. Modifications were applied to regimens with myelosuppressive (56.5%), immunosuppressive (69.2%), and immunomodulating (61.5%) potentials. These modifications also affected intravenous (54.9%) and subcutaneous injectable treatments (62.5%) more than oral treatments (15.8%). Treatment modifications in 112 patients (70.4%) were recommended by providers, and 47 (29.6%) were initiated by patients. The most common strategy of modification was to skip or postpone a scheduled treatment (49%). Among treatment with no modifications, treatment regimens were maintained in patients who tolerated treatment well (37.0%), in treatments with curative intent (22%), and in symptomatic patients who required treatment (14%).

CONCLUSION

Our observation and analysis suggested that the primary goal of treatment modification was to decrease potential exposure. The pattern also reflected the negative impact of the pandemic on health care providers who initiated these changes. Providers have to consider individualized recommendations incorporating multiple factors, such as tolerance, potential toxicity, treatment nature and route, and disease severity.
Social Media Perceptions of Surgical Cancer Care in the Era of COVID-19: A Global Cross-Sectional Study
Authors: Keil Evan J. , Navarro Sergio M. , Shaikh Hashim , Yao Lilian E. , Tuttle Todd M.
Published: August 2020

PURPOSE

The rapid dissemination of information through social media renders a profound lens to evaluate perceptions of emerging topics, especially in the context of a global pandemic. The primary objective of this cross-sectional study was to elucidate trends on social media in the setting of surgical cancer care affected by the COVID-19 pandemic across the globe.

METHODS

A public search of Twitter from April 1 to 30, 2020, was conducted, which yielded 996 posts related to COVID-19 and cancer. Two authors (E.J.K. and H.S.) individually reviewed all posts and recorded the post category, engagement, author category, and geographic location. Data were then analyzed through descriptive analyses. Only English-language posts were included, and any noncancer- or non-COVID–related posts were excluded from the analysis.

RESULTS

A total of 734 unique authors from 26 different countries wrote 996 relevant posts that averaged 12.0 likes, 4.7 retweets, and 0.5 hashtags per post. Only 2.3% (23 of 996) of posts included a video. Authors of the included tweets most frequently were friends and families of patients (183; 18.4%), academic institutions or organizations (182; 18.3%), and physicians (138; 13.9%). Topics of importance were cancellations of surgeries (299; 40.1%), COVID-19 education (211; 121.2%), and research studies (93; 9.3%). The United Kingdom and the United States made up 81.5% of the cohort, followed by Canada (6.6%) and India (2.4%). Of posts where a specific type of surgery was identified (196), the most common type mentioned was breast cancer (50; 25.5%), followed by lung cancer (37; 18.9%) and urologic cancer (22; 11.2%).

CONCLUSION

This analysis provides insight into the resulting impacts of COVID-19 on the global discussion of surgical cancer care.
Cost-Effectiveness of the International Late Effects of Childhood Cancer Guideline Harmonization Group Screening Guidelines to Prevent Heart Failure in Survivors of Childhood Cancer
Authors: Ehrhardt Matthew J. , Ward Zachary J. , Liu Qi , Chaudhry Aeysha , Nohria Anju , Border William , Fulbright Joy M. , Mulrooney Daniel A. , Oeffinger Kevin C. , Nathan Paul C. , Leisenring Wendy M. , Constine Louis S. , Gibson Todd M. , Chow Eric J. , Howell Rebecca M. , Robison Leslie L. , Armstrong Gregory T. , Hudson Melissa M. , Diller Lisa , Yasui Yutaka , Armenian Saro H. , Yeh Jennifer M.
Published: August 2020

PURPOSE

Survivors of childhood cancer treated with anthracyclines and/or chest-directed radiation are at increased risk for heart failure (HF). The International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) recommends risk-based screening echocardiograms, but evidence supporting its frequency and cost-effectiveness is limited.

PATIENTS AND METHODS

Using the Childhood Cancer Survivor Study and St Jude Lifetime Cohort, we developed a microsimulation model of the clinical course of HF. We estimated long-term health outcomes and economic impact of screening according to IGHG-defined risk groups (low [doxorubicin-equivalent anthracycline dose of 1-99 mg/m2 and/or radiotherapy < 15 Gy], moderate [100 to < 250 mg/m2 or 15 to < 35 Gy], or high [≥ 250 mg/m2 or ≥ 35 Gy or both ≥ 100 mg/m2 and ≥ 15 Gy]). We compared 1-, 2-, 5-, and 10-year interval-based screening with no screening. Screening performance and treatment effectiveness were estimated based on published studies. Costs and quality-of-life weights were based on national averages and published reports. Outcomes included lifetime HF risk, quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness ratios (ICERs). Strategies with ICERs < $100,000 per QALY gained were considered cost-effective.

RESULTS

Among the IGHG risk groups, cumulative lifetime risks of HF without screening were 36.7% (high risk), 24.7% (moderate risk), and 16.9% (low risk). Routine screening reduced this risk by 4% to 11%, depending on frequency. Screening every 2, 5, and 10 years was cost-effective for high-risk survivors, and every 5 and 10 years for moderate-risk survivors. In contrast, ICERs were > $175,000 per QALY gained for all strategies for low-risk survivors, representing approximately 40% of those for whom screening is currently recommended.

CONCLUSION

Our findings suggest that refinement of recommended screening strategies for IGHG high- and low-risk survivors is needed, including careful reconsideration of discontinuing asymptomatic left ventricular dysfunction and HF screening in low-risk survivors.