bluuebunny/crossref_metadata_2025 huggingface dataset:
Ixekizumab, With Or Without Concomitant Methotrexate, Improves Signs And Symptoms Of Psa: Week 52 Results From Spirit-P1 And Spirit-P2 Studies
Authors: Combe Bernard , Tsai Tsen-Fang , Huffstutter J. Eugene , Sprabery Aubrey Trevelin , Lin Chen-Yen , Park So Young , Kronbergs Andris , Hufford Matthew M. , Nash Peter
Published: November 2020

Background: The efficacy and safety of ixekizumab (IXE) with and without continuous concomitant methotrexate (MTX), for up to 52 weeks of treatment, was evaluated in patients with active psoriatic arthritis (PsA). Methods: Patients with active PsA who were biologic-naive (SPIRIT-P1) or had prior inadequate response to tumor necrosis factor inhibitors (SPIRIT-P2), were randomized to 80 mg IXE every 4 (IXE Q4W) or 2 weeks (IXE Q2W), after a 160-mg initial dose. In this post-hoc analysis, efficacy and safety were assessed up to Week 52 in the subgroups of patients who received: (i) IXE as monotherapy and (ii) IXE along with a stable dose of MTX (no dose tapering or increase). Efficacy outcomes included, but were not limited to, the percentage of patients achieving American College of Rheumatology (ACR) responses.Results: Out of 455 patients initially randomized to IXE, 177 (38.9%) received monotherapy, 230 (50.5%) had concomitant MTX use, and 48 (10.5%) had other concomitant medication. Overall, 183 (40.2%) received IXE with a stable dose of concomitant MTX for 1 year. At Week 52, the percentage of patients achieving ACR20/50/70 responses in IXE Q4W monotherapy versus concomitant MTX groups were 66.3% versus 55.3%, 48.4% versus 38.8%, and 35.8% versus 27.1%, respectively; these responses were generally similar with IXE Q2W. The safety profiles were similar between patients receiving IXE with or without concomitant MTX.Conclusions: In this post-hoc analysis, treatment with IXE demonstrated sustained efficacy in patients with PsA up to 1 year of treatment, with or without concomitant MTX therapy.Trial registration: ClinicalTrials.gov NCT01695239 and NCT02349295
Stable Bagging Feature Selection on Medical Data
Authors: Alelyani Salem
Published: November 2020

In the medical eld, distinguishing genes that are relevant to a specific disease, let's say colon cancer, is crucial to finding a cure and understanding its causes and subsequent complications. Usually, medical datasets are comprised of immensely complex dimensions with considerably small sample size. Thus, for domain experts, such as biologists, the task of identifying these genes have become a very challenging one, to say the least. Feature selection is a technique that aims to select these genes, or features in machine learning eld with respect to the disease. However, learning from a medical dataset to identify relevant features suers from the curse-of-dimensionality. Due to a large number of features with a small sample size, the selection usually returns a different subset each time a new sample is introduced into the dataset. This selection instability is intrinsically related to data variance. We assume that reducing data variance improves selection stability. In this paper, we propose an ensemble approach based on the bagging technique to improve feature selection stability in medical datasets via data variance reduction. We conducted an experiment using four microarray datasets each of which suers from high dimensionality and relatively small sample size. On each dataset, we applied five well-known feature selection algorithms to select varying number of features.The proposed technique shows a significant improvement in selection stability while at least maintaining the classification accuracy. The stability improvement ranges from 20 to 50 percent in all cases. This implies that the likelihood of selecting the same features increased 20 to 50 percent more. This is accompanied with the increase of classification accuracy in most cases, which signifies the stated results of stability.
A continuous data driven translational model to evaluate effectiveness of population-level health interventions: case study, smoking ban in public places on hospital admissions for acute coronary events.
Authors: Bonakdari Hossein , Pelletier Jean-Pierre , Martel-Pelletier Johanne
Published: November 2020

Background. An important task in developing accurate public health intervention evaluation methods based on historical interrupted time series (ITS) records is to determine the exact lag time between pre- and post-intervention. We propose a novel continuous transitional data-driven hybrid methodology using a non-linear approach based on a combination of stochastic and artificial intelligence methods that facilitate the evaluation of ITS data without knowledge of lag time. Understanding the influence of implemented intervention on outcome(s) is imperative for decision makers in order to manage health systems accurately and in a timely manner. Methods. To validate a developed hybrid model, we used, as an example, a published dataset based on a real health problem on the effects of the Italian smoking ban in public spaces on hospital admissions for acute coronary events. We employed a continuous methodology based on data preprocessing to identify linear and nonlinear components in which autoregressive moving average and generalized structure group method of data handling were combined to model stochastic and nonlinear components of ITS. We analyzed the rate of admission for acute coronary events from January 2002 to November 2006 using this new data-driven hybrid methodology that allowed for long-term outcome prediction. Results. Our results showed the Pearson correlation coefficient of the proposed combined transitional data-driven model exhibited an average of 17.74% enhancement from the single stochastic model and 2.05% from the nonlinear model. In addition, data demonstrated that the developed model improved the mean absolute percentage error and correlation coefficient values for which 2.77% and 0.89 were found compared to 4.02% and 0.76, respectively. Importantly, this model does not use any predefined lag time between pre- and post-intervention.Conclusions. Most of the previous studies employed the linear regression and considered a lag time to interpret the impact of intervention on public health outcome. The proposed hybrid methodology improved ITS prediction from conventional methods and could be used as a reliable alternative in public health intervention evaluation.
Gastrointestinal Manifestations of Synthetic Cannabinoids: A retrospective cohort study
Authors: Hakimian David , Benson Ariel , Khoury Tawfik , Masarawa muhaamad , Israel Sara , Salameh Shaden , Gershinsky Yoni , Shapira Barak , Muszkat Mordechai
Published: November 2020

Introduction: Synthetic cannabinoids (SC) are chemical substances which activate cannabinoid receptors similarly to tetrahydrocannabinol, but with a higher efficacy. These substances are used as illicit recreational drugs, often smoked as herbal mixtures. The continuing availability and rapid evolution of SC is an ongoing health risk. The adverse effects of SC are wide ranging, and span from mild behavioral changes to death. Knowledge regarding gastrointestinal (GI) manifestations of SC use is sparse. Results: The medical records of patients presented to hospital emergency care due to SC use between January 2014 and February 2018 were retrieved from Hadassah Mount Scopus Hospital’s computerized database. The records were reviewed for clinical outcomes and laboratory tests. Fifty-five (55) patients were identified with a hospital presentation due to SC use. Twenty-one (21) out of 55 patients (38%) reported gastrointestinal complaints. The most common complaints were abdominal pain and vomiting. Of those, 28% had recurrent emergency department presentations due to abdominal pain and 66% presented with leukocytosis. Serum lactate was elevated in 66% of patients with GI manifestations. One patient had an abnormal computerized tomography (CT) abdominal angiography scan, which was compatible with intestinal ischemia. Conclusions: The clinical spectrum of gastrointestinal manifestations in SC intoxication ranges from mild symptoms, such as abdominal pain and vomiting, to more severe ones such as intestinal ischemia. Clinicians should be aware that abdominal pain and other gastrointestinal complaints can be associated with SC use.
Participatory analysis of groundnut (Arachis hypogaea L.) cropping system and production constraints in Burkina Faso
Authors: Boubacar Sinare , Miningou Amos , Nebie Baloua , Eleblu John , Kwadwo Ofori , Traore Appolinaire , Zagre Bertin , Desmae Haile
Published: November 2020

Background: Groundnut is one of the major legume crops grown as food and cash crop across the different agroecological zones of Burkina Faso. It is ranked the 2nd important legume crop for household food, nutrition and income generation for both rural and urban zones, contributing significantly to food supply and economy of the country. Despite its importance and breeding efforts to develop improved varieties, groundnut productivity remains low. Assessing and describing the present groundnut cropping system and production constraints as well as gender dynamics in the main production areas will help in defining the groundnut breeding priorities.Methods: A Participatory Rural Appraisal study was conducted in three groundnut production regions (Central-Eastern, Central-Northern and Central-Western). In each region, 4 villages were selected with a total of 124 farmers interviewed to collect data on socio-demographics, farming systems, cropping practices and production constraints. Data analysis was carried out for qualitative and quantitative variables using STATA 14. Analysis of variance was conducted across regions and gender, and also between and within regions. Kendall's coefficients were determined for qualitative variables across regions for the constraints using the pairwise rank. Pearson's correlation was carried out to assess the relationship between variables, and the chi-square test was used to assess the difference in farmer preferences.Results: The study revealed a cropping system of groundnut in an environment largely affected by climate change and in a subsistence and extensive agriculture. There is a variation in the groundnut cropping system across the regions. Gender plays a key role in the production of the groundnut and 48.39% of women are engaged in groundnut cropping with less access to land and production resources. A yield gap between men and women was observed with men achieving more yield than women. There was a strong correlation between the use of improved varieties and technical assistance. A strong correlation was observed between farm size and production, and farm size and sex denoting an extensive production. Production constraints, although similar, were perceived and ranked differently between regions. The lack of improved varieties, absence of agricultural credit, lack of production tools, the high price of seeds, the high price of fertilizer, drought and disease are some of the important constraints affecting groundnut productivity.Conclusion: This study provides a recent view of groundnut cropping, allowing a good understanding of the farmers’ situation. The result will contribute to the refining of breeding priorities and guide further activities in groundnut breeding in Burkina Faso.
IL-17A polymorphism (rs2275913) and levels are associated with preeclampsia pathogenesis in Chinese patients
Authors: Lang Xiao , Liu Wei , Hou Yanyan , Zhao Wenxia , Yang Xingyu , Chen Lan , Yan Qi , Cheng Weiwei
Published: November 2020

Background Preeclampsia (PE) is a pregnancy-related condition that affects both the infant and the mother. Although the role of various inflammatory molecules in PE has been demonstrated, the importance of pro-inflammatory molecules such as IL-17A, IL-23 is not well understood. In the present investigation, a potential association of common genetic variants in the IL-17A and IL-23A genes with PE was investigated. Methods 115 PE clinically diagnosed patients who registered to the International Peace Maternity and Child Health Hospital were enrolled in this research. Age, sex-matched 102 pregnant women and 147 healthy Chinese women have also been included. ELISA was used to measure IL-17A and IL-23 serum levels in all enrolled subjects. Common genetic polymorphisms in IL-17A (rs 2275913, rs1974226, and rs1974226), IL-23A (rs11171806), and IL-12B (rs3212227) were genotyped using the PCR-RFLP or TaqMan probe-based method. Results Elevated serum IL-17A levels were found in PE patients compared to pregnant (P<0.0001) and healthy women (P<0.0001). However, IL-23 levels were comparable across various clinical groups. In addition, heterozygous (GA) and minor allele (A) for IL-17A (rs2275913) and IL-23A (rs11171806) were more prevalent in PE patients compared to pregnant women indicating an important role in the predisposition to PE growth. Interestingly, IL-17A (r 2275913) mutants were associated with elevated IL-17A levels relative to wild type (GG). Conclusions IL-17A (rs2275913) variants are associated with higher serum levels of cytokine, and predisposed PE development.
Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012 – 2019
Authors: Zhang Tao , Wang Shuqi , Wang Duoquan , Auburn Sarah , Lu Shenning , Xu Xian , Jiang Jingjing , Lyu Xiaofeng , Yu Chen , Tian Cuicui , Li Shizhu , Li Weidong
Published: November 2020

BackgroundAlthough autochthonous malaria cases are no longer reported in Anhui Province, China, imported malaria has become a major health concern. The proportion of reported malaria cases caused by Plasmodium ovale spp. increased to levels higher than expected during 2012 to 2019, and showed two peaks, 19.69 % in 2015 and 19.35 % in 2018.MethodsA case-based retrospective study was performed using data collected from the China Information System for Disease Control and Prevention (CISDCP) and Information System for Parasitic Disease Control and Prevention (ISPDCP) from 2012 to 2019 to assess the trends and differences between Plasmodium ovale curtisi (P. o. curtisi) and Plasmodium ovale wallikeri (P. o. wallikeri). Epidemiological characteristics were analyzed using descriptive statistics.ResultsP. ovale curtisi and P. ovale wallikeri were found to simultaneously circulate in 14 African countries. Among 128 patients infected with P. ovale spp., the proportion of mixed infection cases was 10.16%. Six cases of co-infection with P. ovale spp. and P. falciparum were noted, each presenting with two clinical attacks (the first attack was due to P. falciparum and the second was due to P. ovale spp.) at different intervals. Accurate identification of the infecting species was achieved among only 20.00% of cases of P. ovale spp. infection. At the reporting units, 32.17% and 6.96% of cases of P. ovale spp. infection were misdiagnosed as P. vivax and P. falciparum infections, respectively.ConclusionThe present results indicate that the potential of P. ovale spp. to co-infect with other Plasmodium species has been previously underestimated, as is the incidence of P. ovale spp. in countries where malaria is endemic. P. o. curtisi may have a long latency period of >3 years and potentially cause residual foci, thus posing challenges to the elimination of malaria in P. ovale spp.-endemic areas. Considering the low rate of species identification, more sensitive point-of-care detection methods need to be developed for P. ovale spp. and introduced in non-endemic areas.
Association between lipoprotein cholesterol and future cardiovascular disease and mortality in older adults: a Korean nationwide longitudinal study
Authors: Kim Seung Hee , Son Ki Young
Published: November 2020

BackgroundDyslipidemia is considered as an independent health risk factor of cardiovascular disease (CVD), a leading cause of mortality in older adults. Despite its importance, however, there have been few reports on the association between lipoprotein cholesterol and future CVD and cardiovascular (CV) mortality among elderly Asians. This study investigated the association between lipoprotein cholesterol and future CVD and CV mortality in an elderly Korean population using a large nationwide sample.MethodsFrom the cohort database of the Korean National Health Insurance Service, a total of 62,604 adults aged 65 years or more (32,584 men and 30,020 women) were included. High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) values were categorized by quartiles. Cox proportional hazard models and linear regression analyses were used to assess the association between the quartiles of lipoprotein cholesterol and CV events or CV mortality.ResultsThe mean follow-up period was 3.3 years. The incidence rates of ischemic heart disease and ischemic brain disease were 0.97 and 0.61 per 1,000 person-years, and the mortality rates from these diseases were 0.22 and 0.34 per 1,000 person-years. In a completely adjusted model, high HDL-C and LDL-C levels were not associated with the total CV events and deaths from CVD. However, high LDL-C levels were significantly associated with a lower incidence of ischemic brain disease. Furthermore, diabetic patients with high LDL-C were more likely to have higher CV mortality, whereas non-smokers with high LDL-C were less likely to be at risk of CV events.ConclusionsNeither high LDL-C nor HDL-C was significantly associated with future CV mortality in older adults aged ≥ 65 years. High LDL-C seems not a risk factor for CVD in the elderly, and further studies are needed.
Measuring body condition of lizards: a comparison between non-invasive dual-energy X-ray absorptiometry, chemical fat extraction and calculated indices
Authors: Sion Guy , Watson Maggie J. , Bouskila Amos
Published: November 2020

BackgroundCondition indices (CIs) are used in ecological studies as a way of measuring an individual animal’s health and fitness. Noninvasive CIs are estimations of a relative score of fat content or rely on a ratio of body mass compared to some measure of size, usually a linear dimension such as tarsus or snout-vent length. CIs are generally validated invasively by lethal fat extraction as in a seasonal sample of individuals in a population. Many alternatives to lethal fat extraction are costly or time consuming. As an alternative, dual-energy X-ray absorptiometry (DXA) allows for non-destructive analysis of body composition and enables multiple measurements during an animal's life time. DXA has never been used for ecological studies in a small, free-ranging lizard before, therefore we calibrated this method against a chemical extraction of fat from a sample of 6 geckos (Israeli fan toed gecko Ptyodactylus guttatus) ranging in body mass between 4.2–11.5 g. ResultsWe found that fat mass measured with DXA was significantly correlated with the mass of chemically extracted fat for specimens more than 4.8g (N=5, R2=0.995, P<0.001). Fat percentage regressed with body mass significantly predicted the DXA fat percentage (N=29, R2adj.=0.862, p<0.001). Live wet mass was significantly correlated with calculated fat mass (N=30, R2=0.984, P<0.001) for specimens more than 4.8g. Among the five calculated non-invasive CIs that we tested, the best was mass/SVL. ConclusionsWe recommend that in situations where DXA cannot be used, that the most accurate of the body condition estimators for both males and females in this species is mass/SVL (snout-vent length) for both sexes.
Nextgen Vector Surveillance Tools: sensitive, specific, cost-effective and epidemiologically relevant
Authors: Farlow Robert , Russell Tanya L , Burkot Thomas R
Published: November 2020

Background Vector surveillance provides critical data for decision-making to ensure that malaria control programs remain effective and responsive to any threats to a successful control and elimination program. The quality and quantity of data collected is dependent on the sampling tools and laboratory techniques used which may lack the sensitivity required to collect relevant data for decision-making. Here, 40 vector control experts were interviewed to assess the benefits and limitations of the current vector surveillance tools and techniques. In addition, experts shared ideas on “blue sky” indicators which encompassed ideas for novel methods to monitor presently used indicators, or to measure novel vector behaviours not presently measured. Algorithms for deploying surveillance tools and priorities for understanding vector behaviours are also needed for collecting and interpreting vector data. Results. The available tools for sampling and analysing vectors are often hampered by high labour and resource requirements (human and supplies) coupled with high outlay and operating costs and variable tool performance across species and geographic regions vector. The next generation of surveillance tools needs to address the limitations of our present tools by being more sensitive, specific and less costly to deploy to enable the collection and use of epidemiologically relevant vector data to facilitate more proactive vector control guidance. Ideas and attributes for Target Product Profiles (TPPs) generated from this analysis provide targets for research and funding to develop next generation tools.Conclusions. More efficient surveillance tools and a more complete understanding of vector behaviours and populations will provide a basis for more cost effective and successful malaria control. Understanding the vectors’ behaviours will allow interventions to be deployed that target vulnerabilities in vector behaviours and thus enable more effective control. Through defining the strengths and weaknesses of the current vector surveillance methods, a foundation and initial framework was provided to define the TPPS for the next generation of vector surveillance methods. The draft TTPs presented here aim to ensure that the next generation tools and technologies are not encumbered by the limitations of our present surveillance methods and can be readily deployed in low resource settings.
Construction and characterization of a novel glucose dehydrogenase-leucine dehydrogenase fusion enzyme for the biosynthesis of L-tert-leucine
Authors: Liao Langxing , Zhang Yonghui , Wang Yali , Fu Yousi , Zhang Aihui , Qiu Ruodian , Yang Shuhao , Fang Baishan
Published: November 2020

Background: Biosynthesis of L-tert-leucine (L-tle), a significant pharmaceutical intermediate, by a cofactor regeneration system friendly and efficiently is a worthful goal all the time. The cofactor regeneration system of leucine dehydrogenase (LeuDH) and glucose dehydrogenase (GDH) has showed great coupling catalytic efficiency in the synthesis of L-tle, however the multi-enzyme complex of GDH and LeuDH has never been constructed successfully.Results: In this work, a novel fusion enzyme (GDH-R3-LeuDH) for the efficient biosynthesis of L-tle was constructed by the fusion of LeuDH and GDH mediated with a rigid peptide linker. Compared with the free enzymes, both the environmental tolerance and thermal stability of GDH-R3-LeuDH had a great improved since the fusion structure. The fusion structure also accelerated the cofactor regeneration rate and maintained the enzyme activity, so the productivity and yeild of L-tle by GDH-R3-LeuDH was all enhanced by 2-fold. Finally, the space-time yield of L-tle catalyzing by GDH-R3-LeuDH whole cells could achieve 2136 g/L/d in a 200 mL scale system under the optimal catalysis conditions (pH 9.0, 30 °C, 0.4 mM of NAD+ and 500 mM of a substrate including trimethylpyruvic acid and glucose).Conclusions: It is the first report about the fusion of GDH and LeuDH as the multi-enzyme complex to synthesize L-tle and reach the highest space-time yield up to now. These results demonstrated the great potential of the GDH-R3-LeuDH fusion enzyme for the efficient biosynthesis of L-tle.
Impact of Diabetes Mellitus on the Early-Phase Arterial Healing After Drug-Eluting Stent Implantation
Authors: Ishihara Takayuki , Sotomi Yohei , Tsujimura Takuya , Iida Osamu , Kobayashi Tomoaki , Hamanaka Yuma , Omatsu Takashi , Sakata Yasushi , Higuchi Yoshiharu , Mano Toshiaki
Published: November 2020

Background: Early arterial healing after drug-eluting stent (DES) implantation may enable short dual-antiplatelet therapy (DAPT) strategy. The impact of diabetes mellitus (DM) on this healing has not been elucidated. We used coronary angioscopy (CAS) to compare intravascular status of DM and non-DM patients in the early phase after DES implantation.Methods: This study was a multicenter retrospective observational study. We analyzed CAS findings of 337 lesions from 270 patients evaluated 3-5 months after DES implantation. We divided the lesion into two groups: DM (n=149) and non-DM (n=188). We assessed neointimal coverage (NIC) grades (dominant, maximum and minimum), thrombus adhesion and maximum yellow color grade. NIC was graded as follows: grade 0, stent struts were not covered; grade 1, stent struts were covered by thin layer; grade 2, stent struts were buried under neointima. Yellow color was graded as grade 0, white; grade 1, light yellow; grade 2, yellow; grade 3, intensive yellow.Results: Minimum NIC grade was significantly lower in DM than in non-DM groups (p=0.002), whereas dominant and maximum NIC grades were similar between them (p=0.59 and p=0.94, respectively), as were thrombus adhesion (44.3% vs. 38.8%, p=0.32) and maximum yellow color grade (p=0.78). A multivariate analysis demonstrated that DM was an independent predictor of minimum NIC of grade 0 (odds ratio: 2.14, 95% confidence interval: 1.19-3.86, p=0.011).Conclusion: DM patients showed more uncovered struts than non-DM patients 3-5 months after DES implantation, suggesting that the recent ultra-short DAPT strategy might not be easily applied to DM patients.
Molecular characterization of methicillin-resistant Staphylococcus aureus among insulin-dependent diabetic individuals in Brazil
Authors: Teixeira Nathalia Bibiana , Fortaleza Carlos Magno Castelo Branco , de Souza Matheus Cristovam , Pereira Thais Aline Monteiro , Colenci Bibiana Prada de Camargo , Cunha Maria de Lourdes Ribeiro de Souza da
Published: November 2020

Background: People with diabetes mellitus, especially insulin-dependent diabetic patients, are a risk group for staphylococcal infections. Asymptomatic infection with Staphylococcus aureus is common and favors dissemination of the microorganism, rendering these individuals a source of infection. This study aimed to characterize the resistance profile, clonal profile and sequence type, as well as to analyze the prevalence and risk factors for nasal and oropharyngeal carriage of methicillin-susceptible (MSSA) and methicillin-resistant S. aureus (MRSA) isolated from insulin-dependent diabetic individuals in the city of Botucatu, SP, Brazil. Methods: Staphylococcus aureus was collected from the nasopharynx and oropharynx of 312 community-dwelling insulin-dependent diabetic individuals over a period of 3 years (October 2015 to December 2018). The isolates were characterized by susceptibility profiling, detection of the mecA gene, SCCmec typing, and molecular typing by PFGE and MLST. The risk factors associated with S. aureus and MRSA carriage were determined by logistic regression analysis. Results: The overall prevalence of colonization with S. aureus and MRSA was 30.4% and 4.8%, respectively. Fifteen of the 112 S. aureus isolates carried the mecA gene; SCCmec type IV was identified in 10 isolates, SCCmec type I in three, and SCCmec type II in two. Among the 15 resistant isolates (MRSA), four were susceptible to oxacillin/cefoxitin by the disc diffusion method and one MSSA isolate was resistant to sulfamethoxazole/trimethoprim. The analysis of risk factors revealed a protective effect of age and lung disease, while lower-extremity ulcers were a risk factor for S. aureus. For MRSA, only male gender was significantly associated as a risk factor in multivariate analysis. Clonal profile analysis demonstrated the formation of clusters among MRSA isolates from different patients, with the identification of ST5-IV, ST5-I, and ST8-IV. Isolates carrying ST398 were identified among MSSA and MRSA (ST398-IV). Conclusion: Our findings reinforce the importance of epidemiological studies of S. aureus carriage, especially in populations at high risk of infections such as diabetics. The data suggest widespread dissemination of MRSA in the population of insulin-dependent diabetic patients studied, as well as the emergence of important lineages among these individuals.
Is Postoperative Non-Weight-bearing Necessary? (INWN) Study protocol for a pragmatic randomised multicentre trial of operatively treated ankle fracture
Authors: Khojaly Ramy Elmahy , Niocaill Ruairi Mac , Shahab Muhammad , Nagle Matthew , Taylor Colm , Rowan Fiachra E. , Cleary May
Published: November 2020

Background:Postoperative management regimes vary following open reduction and internal fixation (ORIF) of unstable ankle fractures. There is an evolving understanding that extended periods of immobilisation and limitation of weight-bearing may lead to poorer clinical outcomes. Traditional non-weight bearing cast immobilisation may prevent loss of fixation, and this practice continues in many centres. The purpose of this trial is to investigate the safety and efficacy of immediate weight-bearing (IWB) and range of motion (ROM) exercise regimes following ORIF of unstable ankle fractures with a particular focus on functional outcomes and complication rates.Methods:A pragmatic randomised controlled multicentre trial, comparing IWB in a walking boot and ROM within 24 hours versus non-weight-bearing (NWB) and immobilisation in a cast for six weeks, following ORIF of all types of unstable adult ankle fractures (lateral malleolar, bimalleolar, trimalleolar with or without syndesmotic injury) is proposed. All patients presenting to three trauma units will be included. The exclusion criteria will be skeletal immaturity and tibial plafond fractures. The three institutional review boards have granted ethical approval. The primary outcome measure will be the functional Olerud-Molander Ankle Score (OMAS). Secondary outcomes included wound infection (deep and superficial), displacement of osteosynthesis, the full arc of ankle motion (plantar flexion and dorsal flection), RAND-36 Item Short Form Survey (SF-36) scoring, time to return to work and postoperative hospital length of stay. The trial will be reported in accordance with the CONSORT statement for reporting a pragmatic trial, and this protocol will follow the SPIRIT guidance.Discussion:Traditional management of operatively treated ankle fractures includes an extended period of non-weight bearing. There is emerging evidence that earlier weight-bearing may have equivocal outcomes and favourable patient satisfaction but with higher wound-related complications. These studies often preclude more complicated fracture patterns or patient-related factors. To our knowledge, immediate weight-bearing (IWB) following ORIF of all types of unstable ankle fractures has not been investigated in a controlled prospective manner in recent decades. This pragmatic randomised-controlled multicentre trial will investigate immediate weight-bearing following ORIF of all ankle fracture patterns in the usual condition of care. It is hoped that these results will contribute to the modern management of ankle fractures.Trial registration:The trial is retrospectively registered on the 30th of June 2019, ISRCTN - ISRCTN76410775.http://www.isrctn.com/ISRCTN76410775
Early Detection of Steroid-Induced Femoral Head Necrosis using 99mTc-Cys-Annexin V-based Apoptosis Imaging in a Rabbit Model
Authors: Wang Xiaolong , Li Jianbo , Man Da , Liu Rui , Zhao Jianmin
Published: November 2020

BackgroundAt present, the early diagnosis of femoral head necrosis mainly relies on Magnetic resonance imaging (MRI), and most early patients are difficult to make an accurate diagnosis. Therefore, to investigate the early diagnostic value of 99mTc-Cys-Annexin V Single-photon emission computed tomography (SPECT) imaging were compared with MRI in rabbit models of steroid-induced femoral head necrosis.MethodsThe animal model of steroid-induced femoral head necrosis (SIFHN) was established in 5-month-old healthy New Zealand white rabbits by injecting horse serum into ear vein and methylprednisolone into gluteal muscle, the purpose of modeling is to simulate the actual clinical situation of SIFNH. 99mTc-Cys-Annexin V SPECT imaging and MRI were performed at 2nd week, 4th week, and 6th week after modeling. After that, histopathology was used to verify the success of modeling. Apoptosis was detected by transmission electron microscopy (TEM) and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL). ResultsAt 2 weeks after the injection of hormone, 99mTc-Cys-Annexin V SPECT image showed abnormal radioactive uptake in the bilateral femoral head. And over time, the radioactivity concentration was more obvious, and the ratio of T/NT (target tissue/non-target tissues, which is the ratio of femoral head and the ipsilateral femoral shaft) was gradually increased. In the 99mTc-Cys-Annexin V SPECT imaging at each time point, T/NT ratio of the model group was significantly higher than that of the control group (P < 0.01); at 4 weeks after the injection of hormone, MRI showed an abnormal signal of osteonecrosis. At 2, 4, and 6 weeks after hormone injection, apoptosis was observed by TUNEL and TEM. Conclusions99mTc-Cys-Annexin V SPECT imaging can diagnose steroid-induced femoral head necrosis earlier than MRI, and has potential application value for non-invasively detecting early and even ultra-early stage of femoral head necrosis.
A novel circular RNA circ-LRIG3 facilitates the malignant progression of hepatocellular carcinoma by modulating the EZH2/STAT3 signaling
Authors: Sun Suofeng , Gao Jing , Zhou Shen , Li Yuan , Wang Yu , Jin Li , Li Jian , Liu Bowei , Zhang Bingyong , Han Shuangyin , Ding Hui , Li Xiuling
Published: November 2020

Background: Circular RNA (circRNA) is emerging as an important player in human diseases, especially cancer. In our previous study, we identified a series of deregulated circRNAs in hepatocellular carcinoma (HCC) by performing circRNA microarray expression profile. Here, we aimed to explore the role of circ-LRIG3 (hsa_circ_0027345) in HCC.Methods: qRT-PCR and western blot were used to asses gene and protein expression, respectively. CCK-8, EdU and Transwell assays were used to detect cell proliferation, migration and invasion. GSEA software was applied to analyze the pathway related to circ-LRIG3. Co-IP, RIP and ChIP assays were used to identify the positive feedback axis of circ-LRIG3/EZH2/STAT3. Animal study was carried to test the role of circ-LRIG3 in vivo.Results: Circ-LRIG3 was notably upregulated in HCC and promoted HCC cell proliferation, migration, invasion and reduced apoptosis. Circ-LRIG3 formed a ternary complex with EZH2 and STAT3, facilitating EZH2-induced STAT3 methylation and subsequent phosphorylation, resulting in the activation of STAT3 signaling. In turn, activated STAT3 could directly bind to circ-LRIG3 promoter to increase circ-LRIG3 transcription activity, thus forming a positive feedback loop. The animal models showed that exogenous expression of circ-LRIG3 enhanced tumorigenicity and metastasis in vivo, whereas these effects were blocked after treatment with C188-9, a specific STAT3 small-molecule inhibitor. Clinically, high circ-LRIG3 was closely linked with aggressive clinicopathological features and was identified as an independent risk prognostic factor of overall survival. Importantly, plasma circ-LRIG3 was found to be a highly sensitive and specific non-invasive diagnostic indicator for HCC. Conclusions: Our study reveals the carcinogenic role of circ-LRIG3 in HCC, which may provide a new therapeutic target for HCC patients.
Mingjing Granule, a Traditional Chinese Medicine in the treatment of neovascular age-related macular degeneration: study protocol for a randomized controlled trial
Authors: Li Yamin , Liang Lina , Snellingen Torkel , Xu Kai , Gao Yun , Zhang Fengmei , Guo Chengwei , Zuo Tao , Liang Fengming , Yao Xiaoping , Yang Xueyan
Published: November 2020

BackgroundNeovascular age-related macular degeneration (nAMD) is the most common cause of irreversible vision loss and blindness among the elderly people aged 50 and over. Although anti-vascular endothelial growth factor(anti-VEGF) therapies have resulted in improving patient outcomes, there are limitations associated with these treatments. In China, Traditional Chinese medicine(TCM) has been used to treat eye diseases for more than 2000 years. Previous studies have shown that TCM may be beneficial for nAMD patients. However, explicit evidence has not been obtained. The purpose of the present trial is to examine the efficacy and safety of the Mingjing Granule, a compound Chinese herbal medicine, for nAMD patients. Methods/DesignThis is a double-blind, placebo-controlled, randomized trial of Mingjing Granule as an add-on to intravitreous ranibizumab for nAMD. 180 nAMD patients from six hospitals in China will be enrolled according to the inclusion and exclusion criteria, and randomly allocated into two groups, 90 in each. All participants will receive a 24-week treatment and then be followed-up for another 24 weeks. The primary outcome is the mean change of best-corrected visual acuity at week 24 and 48 as compared to the baseline. The secondary outcomes include mean change in central retinal thickness, area of retinal hemorrhage and exudation, and TCM syndrome score, mean number of intravitreal ranibizumab injection and total cost of the treatment. Indexes of safety include blood regular test, urine regular test, liver function test, renal function test and electrocardiogram from baseline to week 24 and 48. Qualitative control and some standard operating processes will be formed throughout the trial. Any ocular or systemic adverse events will be treated suitably and related data will be recorded accurately and completely in the case report form.DiscussionBased on previous empirical and animal laboratory studies, this study will address the question of whether Mingjing Granule could contribute to improving efficacy, safety and efficiency with need for fewer intravitreal injections of anti-VEGF, improving compliance and visual outcomes in the management of persons with nAMD.Trial registrationChinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR2000035990. Registered on 21 August 2020.
Nano- and Micro- Carnauba Wax Emulsions versus Shellac Protective Coatings on Postharvest Citrus Quality
Authors: Miranda Marcela , Sun Xiuxiu , Ference Christopher , Plotto Anne , Bai Jinhe , Wood David , Assis Odílio Benedito Garrido , Ferreira Marcos David , Baldwin Elizabeth
Published: November 2020

Coatings are generally applied to fruit as microemulsions, but nanoemulsions are still experimental. ‘Nova’ mandarins (Citrus reticulata) were coated with shellac or carnauba (Copernica cerifera) microemulsions or an experimental carnauba nanoemulsion; these were compared with an uncoated control during storage for 7 days at 20 °C. Coatings were also tested on ‘Unique’ tangors (C. reticulata × C. sinensis) stored for 14 days at 10 °C followed by a simulated marketing period of 7 days at 20 °C. Fruit quality evaluations included weight loss, gloss, soluble solids (SS), titratable acidity (TA), pH, SS/TA ratio, internal CO2, O2, fruit juice ethanol, and other aroma volatile content. Sensory visual shine and tangerine (C. reticulata) flavor rank tests after storage were conducted, followed by an off-flavor rating. The carnauba waxes resulted in less weight loss compared with the uncoated control and shellac coating during both experiments. There were no differences in gloss measurements of ‘Nova’ mandarins; however, shellac-coated fruit ranked highest for shine in a sensory test. For ‘Unique’ tangors, initially, shellac showed the highest gloss (shine) measurement; however, at the end of storage, the nanoemulsion exhibited the highest gloss, although it was not different from that of the microemulsion. Similarly, after storage, the nanoemulsion ranked highest for visual shine, although it was not different from that of the microemulsion. There were only minor differences in SS, TA, pH, and SS/TA among treatments. The internal CO2 gas concentration and juice ethanol content generally increased and internal O2 decreased during storage. The highest levels of CO2 and ethanol were found for the shellac treatment, as was the lowest O2, indicating anaerobic respiration. There were only minor differences among the other coating treatments; however, they were only sometimes different from those of the control, which generally had the highest O2, lowest CO2, and lowest ethanol. Shellac and the carnauba microemulsion also altered the volatile profile more than the control and the nanoemulsion did, especially for ‘Unique’ tangors. For ‘Unique’ tangors, the control and nanoemulsion ranked highest for tangerine flavor and had the least off-flavor at the end of storage. Among the coatings tested, the carnauba emulsions demonstrated less water loss, imparted more sustainable gloss, and caused less ethanol production than shellac, with the nanoemulsion exhibiting higher gloss measurements, less modifications of the atmosphere and volatile profile, and, consequently, better flavor compared with the microemulsion.
A STUDY TO ASSESS THE QUALITY OF LIFE AMONG CHILDREN SUFFERING FROM THALASSEMIA WITH A VIEW TO DEVELOP A PARENTAL GUIDELINE IN THE SELECTED DAY CARE CENTRE OF KOLKATA, WEST BENGAL
Authors:   Clinical Instructor, University College of Medicine and JNMH, Kalyani, Nadia., Ghosh Sarmita
Published: November 2020

Thalassemia is an inherited blood disorder, which is characterized by decreased synthesis or absence of globin. The study was conducted to assess the quality of life among children suffering from thalassemia with a view to develop a parental guideline in the selected day care centre of Kolkata, West Bengal. A non-experimental survey approach with descriptive research design was adopted for the study. The data were collected using convenience sampling technique among 100 parents of children suffering from thalassemia and receiving blood transfusion at Institute of Blood Transfusion Medicine & Immunohaematology, Central Blood Bank, Maniktala, Kolkata. Findings revealed that out of 100 children suffering from thalassemia, 86 (86%) had good quality of life, rest 14 (14%) had satisfactory quality of life and none of them had poor quality of life. There was significant association of quality of life with selected variables like age, religion, educational status of father, educational status of mother, age of detection of thalassemia, age of starting blood transfusion at < 0.05 level of significance.
WHERE THE POWER RESIDES: A COMPARATIVE STUDY OF GUJARAT AND HIMACHAL PRADESH STATE ELECTIONS 2017
Authors:   Associate Professor Department of Political Science, ICDEOL, HPU Shimla-5., Sharda Mridula
Published: November 2020

Gujarat and Himanchal these are the two states where elections held for the State Assembly simultaneously in 2017. Both the states have different socio-economic set ups besides that in their political institutions and processes there are some common characteristics. Bi-party system, gender inequality in political arena, accommodative trend of the diverse interest within the two parties and strong party leadership are prominent features of the state politics in both the states. Paper is an attempt to analyse the trends of state politics by comparing the socio economics ecologies and their impact on the state politics in Gujarat and Himachal. Entire study is based on the secondary data and personal observations of the researchers as primary data.
USE OF GLYCOPYRROLATE AS AN ADJUNCT FOR REDUCTION OF AEROSOL TRANSMISSION OF COVID-19 DURING DENTAL PROCEDURES: A HYPOTHESIS
Authors:   Department of Periodontics, Army College of Dental Sciences, Secunderabad 500087, India., Kumar Routray Rajesh , Kanta Satapathy Kamal ,   Department of Periodontics, Army College of Dental Sciences, Secunderabad 500087, India., Nitin Samuel J. ,   Department of Periodontics, Army College of Dental Sciences, Secunderabad 500087, India., Reddy Palle Ajay ,   Department of Periodontics, Army College of Dental Sciences, Secunderabad 500087, India., Vasudevan Sanjay ,   Department of Periodontics, Army College of Dental Sciences, Secunderabad 500087, India., Kumar Gedela Rajani ,   Department of Periodontics, Army College of Dental Sciences, Secunderabad 500087, India.
Published: November 2020

COVID-19 global pandemic has become the biggest challenge by causing health crisis across the world due to its contagious nature. Salivary gland acts as a reservoir of virus due to which contaminated saliva plays a pivotal role in COVID-19 transmission among humans. Infection transmission from symptomatic patients as well as asymptomatic carriers is inevitable while performing aerosol generating procedures because contaminated aerosols have potential to float in the air for a considerable amount of time and be inhaled by dentist, dental auxiliary and other patients. Hence, it is a matter of utmost importance to keep upgrading the strategies for prevention of transmission as the outbreak of SARS-COV 2 has clearly placed the health care professionals at highest risk. As excess salivary secretion results in more aerosol contamination in dental procedures, leading to higher risk of transmission antisialogogues can be used to reduce salivary production. This new strategy will be helpful towards reducing aerosol transmission inorder to prevent and control the spread of this highly infectious disease. The aim of this present review is to propose the possible use of antisialogogues (glycopyrrolates) as an adjunct aid in reducing the risk of transmission from contaminated aerosols.
Dossier "Humanitarismo en latinoamérica: Pasado y Presente"
Authors: Gómez Oscar A. , Lucatello Simone
Published: November 2020

El humanitarismo se ha consolidado como un pilar de la gobernanza global. El apoyo a las víctimas de todo tipo de emergencias en cualquier parte del mundo es un suceso hoy por hoy común, casi cotidiano, símbolo de un compromiso compartido para con la humanidad sin importar fronteras. Desde sus orígenes en la abolición de la esclavitud y la creación de la Cruz Roja, el alcance del humanitarismo ha venido expandiéndose hasta ser acogido en el seno de la Organización de las Naciones Unidas (ONU) después del fin de la Guerra Fría. Sin embargo, este proceso ha mantenido desde sus comienzos un sesgo colonial, según el cual las crisis humanitarias ocurren en el Sur, mientras que el Norte viene al rescate. Es por ello que lo humanitario no ha sido siempre bien visto desde la periferia, considerado a veces como rescoldo de ambiciones imperiales y justificación para intervenciones con intereses particulares. De esta manera, el humanitarismo en el Sur ha resultado en resistencia y visiones alternativas de lo que constituye o no una crisis, la acción necesaria para afrontarlas y los tipos de cooperación que se necesitan o se aceptan. En este sentido, Latinoamérica es una fuente importante de lecciones sobre el futuro de lo humanitario, no solo por los dos siglos de experiencia defendiendo su independencia, sino también porque en la región coexisten las crisis y las capacidades para cooperar en su respuesta de Sur a Sur. Si aceptamos que tal coexistencia de crisis y capacidad es la “nueva normalidad” en el resto del planeta, la experiencia latinoamericana ofrece un ejemplo de re-creación de las instituciones humanitarias, haciéndolas más incluyentes y relevantes, a la vez que nuevas vulnerabilidades se hacen evidentes.