bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence, Pattern and Outcome of Pediatric Lassa Fever Disease (LFD) in a Tertiary Hospital, Southeast Nigeria
Authors: Orji Maria-Lauretta , Onyire Nnamdi , Unigwe Uche , Ajayi Nnennaya , Nwidi Demian , Odey Elizabeth , Agboeze Joseph , Ojide Chiedozie , Ujunwa Fortune , Onwe Emeka , Onoh Robinson , Madume Precious
Published: May 2020

The prevalence and case fatality rates of Pediatric Lassa fever disease (LFD) are not well documented. This study was aimed at determining the prevalence, pattern and outcome of Pediatric LFD. It was a prospective observational study. A total of 183 subjects that met the criteria for LFD suspects were recruited consecutively and subjected to Lassa virus PCR test. Structured questionnaire was used to collect information. Of the 183 children recruited, 24 tested positive to Lassa virus PCR, giving a positivity rate of 13.1%. Mean duration of illness at presentation was 8.54 ± 3.83 days. Fever, abdominal pain and vomiting were the three highest presenting complaints. Seven out of 24 children died giving a case fatality rate (CFR) of 29.2%. Subjects with bleeding, poor urine output, convulsions and unconsciousness were more likely to die of LFD. Positivity and CFR of LFD are high. Improved case finding and prompt treatment is advocated.
Use of Isoelectric Point for Fast Identification of Anti-SARS CoV-2 Coronavirus Proteins
Authors: Mallik Kanad
Published: May 2020

A novel approach has been suggested to use isoelectric points of viral and human proteins to quickly identify proteins that are effective in not allowing virus particles to attach to human receptor cells by virtue of their electrical charge. The method has been applied to SARS CoV-2 to suggest potentially important human proteins that can be suitable for making anti-viral drugs.
How to Analyze Cancer Progression in COVID-19 Pandemic?
Authors: Bhattacharjee Atanu , Vishwakarma Gajendra K. , Banerjee Souvik , Shukla Sharvari
Published: May 2020

The constant news about the corona virus is scary. It is not possible to separate treatment for Cancer due to COVID-19. An effective treatment comparison strategy is needed. We need to have a handy tool to understand cancer progression in this unprecedented scenario. Linking different events of cancer progression is the need of the hour. It is a methodological challenge. We provide the solutions to overcome the issue with interval between two consecutive events in motivating head and neck cancer (HNC) data.
Microgravity, Bone Homeostasis, and Insulin-like Growth Factor-1
Authors: Smith John Kelly
Published: May 2020

Astronauts at are risk of losing 1.0 – 1.5% of their bone mass for every month they spend in space despite their adherence to high impact exercise training programs designed to preserve the musculoskeletal system. This article reviews the basics of bone formation and resorption and details how exposure to microgravity or simulated microgravity affects the structure and function of osteoblasts, osteocytes, osteoclasts, and their mesenchymal and hematologic stem cell precursors. It details the critical roles that insulin-like growth facor-1 and its receptor IGFR1 play in maintaining bone homeostasis and how exposure of bone cells to microgravity affects the function of these growth factors. Lastly, it discusses the potential of tumor necrosis factor-related apoptosis-inducing ligand, syncytin-A, and sclerostin inhibitors and recombinant IGF-1 as a bone-saving treatment for astronauts in space and during their colonization of the Moon.
A Comprehensive Review on the Effect of Plant Metabolites on Coronaviruses: Focusing on Their Molecular Docking Score and IC50 Values
Authors: Farshi Parastou , Ceren Kaya Eda , Hashempour-Baltork Fataneh , Khosravi-Darani Kianoush
Published: May 2020

Coronaviruses such as SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), and newly emerged SARS-CoV-2, also called 2019-nCoV and COVID 19, have caused worldwide outbreaks in different time periods. There are many studies about chemical and natural drugs to treat these coronaviruses by inhibiting their proteases or their protein receptors through binding to amino acid residues. Plants secondary and primary metabolites are considered as potential drugs to inhibit various types of coronaviruses. IC50 value (the concentration in which there is 50% loss in enzyme activity) and molecular docking score and binding energy are parameters to understand the metabolites ability to inhibit the specific virus. In this study we did review on more than 110 papers on plant metabolites effect on different coronaviruses. Secondary plant metabolites such as polyphenols (flavonoids, coumarins, stilbenes), alkaloids, terpenoids, organosulfur compounds saponins, saikosaponins, lectins, essential oils, nicotianamine and primary metabolites such as vitamins.
PRODUCTION OF TILAPIA IN BIOFLOC WITH DIFFERENT SALT CONDICTIONS: AN EVALUATION OF BODY COMPOSITION AND ORGANOLEPTIC PROPERTIES
Authors: Silva Thales Serrano , Piana Pitágoras Augusto
Published: May 2020

Biofloc systems for aquaculture production are excellent options to attend the increasing demand for fish. Despite the advantages, these systems lead to accumulation of nitrogenous residues that need to be avoided, which can be achieved by the addition of salts to the water. However, salts may interfere with the body composition and the organoleptic properties of fish. Therefore, we evaluate the body composition and acceptability of tilapia fillets produced under different salt conditions. Body composition was measured by moisture, ethereal extract, crude protein and minerals, and tested by Permutational Multivariate Analysis of Variance (PERMANOVA). To infer on acceptability, a sensorial analysis was performed to produce preference scales of aroma, appearance, texture, flavor and off-flavor attributes. These were summarized with Principal Coordinates Analysis and tested by PERMANOVA. The body composition shows no significance difference between salts conditions. However, the organoleptic properties according to the participants were peculiar and showed lower influence of the salt condition. In the order of preference, the most accepted fish was cultivated in a conventional system (ponds without salinity). Therefore, salt conditions in biofloc systems did not significantly change the body composition of the fish, but subtle reduced their acceptability.
SPONTANEOUS SPAWNING OF BRAZILIAN SARDINE IN CAPTIVITY
Authors: MAGNOTTI Caio Cesar Franca , STERZELECKI Fabio Carneiro , CIPRIANO Filipe Santos , PEDROTTI Fabiola Santiago , ROCHA Vanessa Martins , CERQUEIRA Vinicius Ronzani
Published: May 2020

In one year, 76 first generation (F1) Brazilian sardine Sardinella brasiliensis breeders spawned 84 times spontaneously in captivity. This is the first report for the genus Sardinella. Following the pattern found in the natural environment, the number of spawns, as well as fertilization and hatching rates were higher in spring, summer and fall than in winter. Until now, winter spawning was only presumed to occur in a natural environment. Water temperature, and not photoperiod, was positively correlated with reproductive performance.
Exploring Patient-Reported Barriers to Advance Care Planning in Family Practice
Authors: Bernard Carrie , Tan Amy , Slaven Marissa , Elston Dawn , Heyland Daren K. , Howard Michelle
Published: May 2020

Background: Although patient-centred care has become increasingly important across all medical specialties, when it comes to end of life care, research has shown that treatments ordered are not often concordant with people’s expressed preferences. Patient and family engagement in Advance Care Planning (ACP) in the primary care setting could improve the concordance between patients’ wishes and the healthcare received when patients cannot speak for themselves. The aim of this study was to better understand the barriers faced by older patients regarding talking to their family members and family physicians about ACP. Methods: In this multi-site cross-sectional study, three free text questions regarding reasons patients found it difficult to discuss ACP with their families or their family physicians were part of a self-administered questionnaire about patients’ knowledge of and engagement in ACP. The questionnaire, which included closed ended questions followed by three probing open ended questions, was distributed in 20 family practices across 3 provinces in Canada. The free text responses were analyzed using thematic analysis and form the basis of this paper.Results: 102 participants provided an analyzable response to the survey when asked why they haven’t talked to someone about ACP. 254 answered the question about talking to their physician and 340 answered the question about talking to family members. Eight distinct themes emerged from the free text response analysis: 1. They were too young for ACP; 2. The topic is too emotional; 3. The MD should be responsible for bringing up ACP 4. A fear of negatively impacting the patient-physician relationship; 5. Not enough time in appointments; 6. Concern about family dynamics; 7. It’s not a priority; and 8. A lack of knowledge about ACP.Conclusions: Patients in our sample described many barriers to ACP discussions, including concerns about the effect these discussions may have on relationships with both family members and family physicians, and issues relating to patients’ knowledge and interpretation of the importance, responsibility for, or relevance of ACP itself. Family physicians may be uniquely placed to leverage the longitudinal, person- centred relationship they have with patients to mitigate some of these barriers.
Modelling Local Patterns of Child Mortality Risk. A Bayesian Spatio-Temporal Analysis.
Authors: Lome-Hurtado Alejandro , Mendoza Jacques Lartigue , Trujillo Juan C.
Published: May 2020

Background: Globally, child mortality rate is still high; however, this figure is susceptible to be reduced implementing proper spatially-targeted health public policies. Due to its alarming rate in comparison to North American standards, child mortality is a particular health concern in Mexico. Despite this fact, there remains a dearth of studies that address its spatio-temporal identification in the country. The aims of this study are i) to model the evolution of child mortality risk at the municipality level in Greater Mexico City, (ii) to identify municipalities with high, medium, and low risk over time, and (iii) using municipality trends, to ascertain potential high-risk municipalities. Methods: In order to control for the space-time patterns of data, the study performs a Bayesian spatio-temporal analysis. This methodology permits the modelling of the geographical variation of child mortality risk across municipalities, within the studied time span. Results: The analysis shows that most of the high-risk municipalities were in the east, along with a few in the north and west areas of Greater Mexico City. In some of them, it is possible to distinguish an increasing trend in child mortality risk. The outcomes highlight municipalities currently presenting a medium risk but liable to become high risk, given their trend, after the studied period. Finally, the likelihood of child mortality risk illustrates an overall decreasing tendency throughout the 7-year studied period. Conclusions: The identification of high-risk municipalities and risk trends may provide a useful input for policy-makers seeking to reduce the incidence of child mortality. The results provide evidence that support the use of geographical targeting in policy interventions.
The disease stage-associated imbalance of Th1/Th2 and Th17/Treg in uterine cervical cancer patients and their recovery with the reduction of tumor burden
Authors: Lin Wei , Zhang Hua-ling , Niu Zhao-yuan , Wang Zhen , Kong Yan , Yang Xing-sheng , Yuan Fang
Published: May 2020

Background: Nearly all uterine cervical cancer (UCC) cases result from human papillomavirus (HPV) infection. After high-risk HPV infection, most HPV infections are naturally cleared by humoral and cell-mediated immune responses. Thus, cervical lesions of only few patients progress into cervical cancer via cervical intraepithelial neoplasia (CIN) and lead to persistent oncogenic HPV infection. This suggests that immunoregulation plays an instrumental role in the carcinogenesis. However, there was a few studies on the relation between the immunologic dissonance and clinical characteristics of UCC patients. Method: We examined the related immune cells (Th1, Th2, Th17, and Treg cells) by flow cytometric analysis and analyzed their relations with UCC stages, tumor size, differentiation, histology type, lymph node metastases, and vasoinvasion. Next, we quantified the Th1, Th2, Th17, and Treg cells before and after the operation both in UCC and CIN patients. Results: When compared with stage I patients, decreased levels of circulating Th1 cells and elevated levels of Th2, Th17, and Treg cells were detected in stage II patients. In addition, the imbalance of Th1/Th2 and Th17/Treg cells was related to the tumor size, lymph node metastases, and vasoinvasion. We found that immunological cell levels normalized after the operations. In general, immunological cell levels in CIN patients normalized sooner than in UCC patients. Conclusions: Our findings suggested that peripheral immunological cell levels reflect the patient’s condition.
Predictors of undesirable treatment outcome of severe acute malnutrition inpatient children in Addis Ababa, Ethiopia: a retrospective cohort study
Authors: Negussie Absalat Serawit , Tadesse Amare Worku
Published: May 2020

Background: Globally, in 2018, malnutrition contributed to 45% of all child deaths. These early child deaths are due to conditions that could be prevented or treated with basic interventions. Hence, this study intends to provide a quantitative example of factors associated with undesirable treatment outcomes of severe acute malnutrition (SAM). Methods: We studied a retrospective cohort of 304 children aged 6-59 months with complicated SAM admitted to Yekatit 12 teaching hospital from 2013- 2016 . We extracted data from hospital records on nutritional status, socio-demographic factors and medical conditions during admission. The analysis was carried out with SPSS version 20.The Kaplan-Meier estimator was employed to analyze the recovery rate of the children undergoing treatment for SAM and Cox regression was used to adjust for confounding effects of other variables. Result: From overall of 304 under-five children with SAM, 133 (51.4%) were males and 126 (48.6%) were females. Marasmus was the most common type of severe acute malnutrition 132(51%). The recovery, death and defaulter rate were 70.4%, 12.2% and 8.2% respectively. The main predictors of undesirable outcome were found to be presence of HIV antibody (AHR=3.208; 95% CI: [1.045-9.846]) and sepsis (AHR= 7.677, 95% CI: [2.320-25.404])Conclusion: The study revealed that the overall treatment outcomes were below the SPHERE standard recommendation and the main predictors of death in children receiving in-patient treatment for SAM were HIV and sepsis. Intervention to reduce death should focus cases with comorbidities especially HIV and sepsis.
Effect of acupuncture on women with poor ovarian response: study protocol for a multicenter randomized controlled trial
Authors: Fang yigong , Xu huanfang , Zheng chensi , He liyun , Su tongsheng , Wang huidan , Li yu , Zhao cui , Zhang cuilian , Bai yang , Tong guoqing , Chen li , Zhao fang , Yang huisheng , Hao mingzhao , Yin yaqian , Yang li , Liu baoyan
Published: May 2020

Background: Poor ovarian response (POR), a manifestation of low ovarian reserve and ovarian aging, leads to a significantly reduced pregnancy rate after in vitro fertilization-embryo transfer. Acupuncture has been increasingly used for improving ovarian reserve. The purpose of this study is to evaluate the effect of acupuncture on increasing the number of retrieved oocytes after controlled ovarian hyperstimulation in women with POR.Methods: This is a multicenter randomized controlled trial. A total of 140 women with POR will be randomly assigned to receive acupuncture or non-treatment for 12 weeks before controlled ovarian hyperstimulation. The primary outcome will be the number of retrieved oocytes. The secondary outcomes include antral follicle count , serum level of anti-müllerian hormone, basal serum levels of follicle stimulating hormone, luteinizing hormone and estradiol, the score of the self-rating anxiety scale, the fertilization rate, the cleavage rate, the available embryo rate and the high-quality embryo rate. The safety of acupuncture will also be assessed.Discussion: The results of this trial will help to identify the effectiveness of acupuncture in the treatment of POR. This may provide a new treatment option for POR patients and their physicians.Trial registration: AMCTR-IPR-18000198. Registered on 10 August 2018, http://www.acmctr.org/showproj.aspx?proj=289
Health information needs regarding diabetes mellitus in China: an Internet-based analysis
Authors: Wang Hao Tian , Wang Tian-Hao , Zhou Xiao-Feng , Ni Yuan , Pan Zhi-Gang
Published: May 2020

Background Today, most people use the Internet to seek online health-related information from general public health-related websites and discussion groups .However, there are no Internet-based analyses of health information needs pertaining to diabetes in China until now. with the development of artificial intelligence,we can analyzed these online health-related information and provide references for health providers to improve their health service. Methods we have done a study of statistically analyzing the questions about diabetes collected from 39 health website, the number of which is 151,589. We have divided these questions into 9 categories using a convolutional neural network Results The diabetes problems of consumer are presented as follows, diagnosis: 34.95%, treatment: 25.17%, lifestyle: 21.09%, complication: 8.00%, maternity-related:5.00%, prognosis: 2.59%, health provider choosing: 1.40%, prevention: 1.23%, others: 0.58%, The elderly are more concerned about the treatment and complications of diabetes, while the young are more concerned about the maternity-related and prognosis of diabetes.The diabetes drugs most frequently mentioned by consumers are insulin, metformin and Xiaoke pills，The most concerned complication is caidiovascular disease and diabetic eye disease. Conclusion Diabetes health education should focus on how to prevent diabetes and the contents of health education should be different for differernt age groups;on diabetes treatment, the use of insulin and oral hypoglycemic drugs education should be strengthened.
Health-related quality of life among 13–14 year old adolescents with overweight - a mixed methods approach
Authors: Sundar Turid Kristin Bigum , Riiser Kirsti , Småstuen Milada , Opheim Randi , Løndal Knut , Glavin Kari , Helseth Sølvi
Published: May 2020

Background: Overweight and obesity are public concerns with risk of adverse health outcomes. Health-related quality of life (HRQoL) is lower in adolescents than children in general. An increase in body mass index (BMI) is associated with a decrease in HRQoL. The purpose of this study was to measure and explore the HRQoL among adolescents with overweight or obesity who had participated in an intervention study, Young & Active, with the aim of increasing physical activity (PA), reducing BMI and promoting HRQoL. Methods: Mixed methods, with a convergent design, were used to investigate how different methodological approaches could expand our understanding of the adolescents’ HRQoL. Quantitative post-intervention data on HRQoL were collected among the 84 intervention participants, aged 13–14 years, using the KIDSCREEN 52 questionnaire. The data were compared with a Norwegian reference population of 244 individuals, and analysed using a non-parametric Mann-Whitney test. Qualitative semi-structured interviews were conducted with 21 adolescents from the intervention. A directed approach to content analysis was adopted, using the ten sub-scales from KIDSCREEN 52. Results: HRQoL in the intervention sample was significantly reduced on the sub-scale of physical well-being compared to the reference population. The reference population scored significantly lower than the intervention sample on the sub-scale of parent relation and home life. No significant differences were found on the other sub-scales. The qualitative data supported the quantitative findings on the sub-scale of physical well-being, but showed that perceptions of fitness, energy level or health could vary. Regarding parent relations, the interviewees extended this to include relationships to other family members as equally important. Most of the interviewees expressed a negative view of their bodies, but not their clothing or accessories. This may explain why no statistically significant differences were found on these aspects in the results from the KIDSCREEN questionnaire.Conclusion: The use of the KIDSCREEN 52 instrument gave important indications about the adolescents’ HRQoL and need for additional follow up. The qualitative data provided an in-depth understanding that nuanced the findings and widened our knowledge of the adolescents HRQoL. Combining methods enabled a comprehensive approach to research on HRQoL.
The regulatory role of the RANKL/RANK/OPG signaling pathway in the mechanisms of tooth eruption in patients with impacted teeth
Authors: Brodetska Ludmila , Natrus Larysa , Lisakovska Olha , Kaniura Olexandr , Iakovenko Liudmyla , Skrypnyk Irina , Flis Petro
Published: May 2020

Background: Tooth impaction is a common problem in orthodontic practice and in some cases accompanied by pain and pathological changes of surrounding teeth. Understanding the cellular and molecular mechanisms underlying tooth impaction allows finding the most effective orthodontic treatment for patients with impacted teeth (IT). RANK (receptor activator of NF-κB) / RANKL (RANK ligand) / OPG (osteoprotegerin) signaling pathway controls bone resorption and may be involved in the regulation of tooth eruption. The aim of the study was to evaluate the bone remodeling based on the assessment of the RANKL/RANK/OPG status in patients with IT. Methods: Bone samples from 18 patients (mean age 25.27±3.34) were divided into 3 groups: 1 – bone tissue of healthy persons (control group); 2 – bone tissue taken near the healthy tooth in patients with tooth impaction; 3 – bone tissue taken near the IT. Levels of RANKL, RANK, OPG, osteocalcin (OC), NF-κB p65 subunit, NFATc1 and caspase-3 were determined by Western blotting. The difference between groups was assessed by one-way ANOVA. P-values less than 0.05 were considered statistically significant.Results: We established a 1.73-fold elevation of RANK level in the IT area vs. control, indicating the recruitment of preosteoclasts. An increase in RANKL, OPG and OC content was demonstrated (by 1.46, 1.48, and 1.42 fold respectively), reflecting high activity of osteoblasts near the IT. Despite the activation of the RANKL/RANK/OPG system in the impaction area, NF-κB and NFATc1 levels did not change compared vs. control, indicating a blocked/delayed process of osteoclastogenesis. We found a decrease in the content of procaspase-3 (1.28-fold), while the level of its active form p17 increased by 2.26 fold near the healthy tooth in patients with IT compared with control. In the area of ​​IT we observed an increase in procaspase-3 and p17 levels (1.32 and 1.78 fold). This reflects impairments of caspase-3 activation and accumulation of its inactive form in the IT area that may contribute to the tooth eruption failure.Conclusions: Tooth impaction may be associated with the disturbances in the caspase-3 cascade activation and the imbalance in the RANKL/RANK/OPG system, and as a result, blocked bone resorption.
The effect of a 5-year hand hygiene initiative based on the WHO Multimodal Hand Hygiene Improvement Strategy: an interrupted time-series study.
Authors: Suzuki Yumi , Morino Motoko , Morita Ichizo , Yamamoto Shigenori
Published: May 2020

Background: A World Health Organization (WHO) guideline-based multimodal hand hygiene (HH) initiative was introduced hospital-wide to a nonteaching Japanese hospital for 5 years. The objective of this study was to assess the effect of this initiative in terms of changes in alcohol-based hand rub (ABHR) consumption and the Hand Hygiene Self-Assessment Framework (HHSAF) score.Methods: The consumption of monthly hospital-wide ABHR was calculated in L per 1000 patient days (PDs). The change in ABHR consumption was analysed by an interrupted time series analysis with a pre-implementation period of 36 months and an implementation period of 60 months. The correlation between annual ABHR consumption and the HHSAF score was estimated using Pearson’s correlation coefficients.Results: The annual ABHR consumption was 4.0 (L/1000 PDs) to 4.4 in the pre-implementation period and 10.4 to 34.4 in the implementation period. The HHSAF score was 117.5 (out of 500) in the pre-implementation period and 267.5 to 445 in the implementation period. A statistically significant increase in the monthly ABHR consumption (change in slope: + 0.479 L/1000 PDs, p < 0.01) was observed with the implementation of the initiative. Annual ABHR consumption was strongly correlated with the annual HHSAF score (r = 0.971, p < 0.01).Conclusions: A 5-year WHO-based HH initiative significantly increased ABHR consumption. Our study suggested that the HHSAF assessment can be a good process measure to improve HH in a single facility, as ABHR consumption increased with the HHSAF score.
Perceptions and experiences of men and women towards acceptability and use of contraceptives in underserved areas of Karachi, Pakistan: A Midline Qualitative Assessment of Sukh Initiative, Karachi Pakistan
Authors: Saleem Sarah , Rizvi Narjis , Feroz Anam , Reza Sayyeda , Jessani Saleem , Abrejo Farina
Published: May 2020

Background: Family planning (FP) is an essential component of Sustainable Development Goals (SDG) and contributes directly to SDG targets 3.7 and 5.6. In Pakistan, contraceptive use has remained stagnant over the past 5 years. This change has been very slow when compared to the FP2020 pledge. The Sukh initiative project was conceived and implemented to alleviate these challenges by providing access to quality contraceptive methods in some underserved areas of Karachi, Pakistan. A qualitative study was conducted to understand the perceptions and experiences of men and women towards acceptability and contraceptive use.Methods: A qualitative study was conducted at ten Sukh stations located in four towns of Karachi. Focus group discussions (FGDs) were conducted with Married Women of Reproductive Age (MWRA) and married men who received FP services through the Sukh initiative. Study participants were purposively sampled for focus group discussions (FGDs). Interview data was manually transcribed and analyzed using thematic analysis.Results: A total of 20 FDGs (Men=10 FGDs; MWRA=10 FGDs) were conducted. Three overarching themes were identified: (I) Appropriateness and means to promote contraceptive use; (II) Equity and Accessibility to contraceptives; and (III) Perspective on available FP services. Generally, both men and women were informed about FP methods but women were more cognizant of FP information. The Door to Door services by community health workers in Sukh initiative areas was largely appreciated both by women and men as it has made the accessibility and availability of the information and services easy. Women suggested that the Sukh initiative should bring some strategies that can help men broaden their perspective towards FP. The study informed that the men feel left out from the FP programs. Therefore, male participants expressed keen interest in initiatives for men in their communities that would cater to their FP needs.Conclusions: This qualitative study provided a unique opportunity to understand the perceptions of men and women towards the phenomena of contraceptive use. The study identified the need for trained and qualified female and male healthcare providers and well-established health facilities alongside door-to-door services.
Evaluation of Buccal Damage Associated With Acute Inhalation Exposure to 2,4-Dichlorophenoxyacetic Acid (2,4-D) in Mice
Authors: Parizi José Luiz Santos , Tolardo Amanda Jodas , Lisboa Ana Carolina Gomes , Barravieira Bruna , Mello Fabíola de Azevedo , Rossi Renata Calciolari , Nai Gisele Alborghetti
Published: May 2020

Background The herbicide dichlorophenoxyacetic acid (2,4-D) is one of the most widely used crop spraying products in the world. Some pesticides induce the degranulation of mast cells and increase allergic responses. This is the first study to evaluate the damage to the oral mucosa after an experimental simulation of environmental inhalation exposure to the 2,4-D herbicide. The aim of this study was evaluate the possible oral damage caused by acute inhalation exposure to the herbicide 2,4-D. Methods A total of 80 Swiss male mice were divided into 4 groups (n = 20) and evaluated at different time intervals (24 h, 48 h, 72 h and 8 days), with 5 animals / period. The animals were divided into the following groups: SG: nebulization with sodium chloride solution; LCG: pesticide nebulization with 3.71 x 10 -3 grams of active ingredient per hectare (g.i.a. / ha); MCG: pesticide nebulization with 6.19 x 10 -3 g.i.a. /ha; and HCG: pesticide nebulization with 9.28 x 10 -3 g.i.a. /ha. The tongues of the mice were collected for histopathological analysis. Results There was a difference between the exposure concentrations in relation to tissue congestion intensity (p = 0.002) and mast cell counts (p = 0.002), a difference in the evaluation of the interaction between the exposure concentrations and nebulization time in the dorsum epithelium thickness (p = 0.013), and a significant correlation between the epithelial thickness and the number of nucleoli organizing regions on the dorsum of the tongue (p = 0.048). Conclusions Even after acute exposure, the herbicide 2,4-D had the potential to damage the oral epithelium, especially at higher doses.
The ProBio Trial: Molecular Biomarkers for Advancing Personalized Treatment Decision in Patients with Metastatic Castration-Resistant Prostate Cancer
Authors: Crippa Alessio , De Laere Bram , Discacciati Andrea , Larsson Berit , Connor Jason T. , Gabriel Erin E , Thellenberg Camilla , Jänes Elin , Enblad Gunilla , Ullen Anders , Hjälm-Eriksson Marie , Oldenburg Jan , Ost Piet , Lindberg Johan , Eklund Martin , Grönberg Henrik
Published: May 2020

Background: Multiple therapies exist for patients with metastatic castration-resistant prostate cancer (mCRPC). However, their improvement on progression free survival (PFS) remains modest, potentially explained by tumour molecular heterogeneity. Several prognostic molecular biomarkers have been identified for mCRPC that may have predictive potential to guide treatment selection and prolong PFS. We designed a platform trial to test this hypothesis.Methods: The Prostate-Biomarker (ProBio) study is a multi-center, outcome-adaptive, multi-arm, biomarker-driven platform trial for tailoring treatment decisions for men with mCRPC. Treatment decisions in the experimental arms are based on biomarker signatures defined as mutations in certain genes/pathways suggested in the scientific literature to be important for treatment response in mCRPC. The biomarker signatures are determined by targeted sequencing of circulating tumor and germline DNA using a panel specifically designed for mCRPC.Discussion: Patients are stratified based on the sequencing results and randomized to either current clinical practice (control), where the treating physician decides treatment, or to molecularly driven treatment selection based on the biomarker profile. Outcome-adaptive randomization is implemented to early identify promising treatments for a biomarker signature. Biomarker signature-treatment combinations graduate from the platform when they demonstrate 85% probability of improving PFS compared to the control arm. Graduated combinations are further evaluated in a seamless confirmatory trial with fixed randomization. The platform design allows for new drugs and biomarkers to be introduced in the study.Conclusions: The ProBio design allows promising treatment-biomarker combinations to quickly graduate from the platform and be confirmed for rapid implementation in clinical care.Trial registration: ClinicalTrials.gov Identifier: NCT03903835Date of registration: April 4, 2019URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT03903835Status: Recruiting
Long-Term Transmission Patterns and Public Health Policies Leading to Malaria Elimination in Panamá
Authors: Hurtado Lisbeth , Cumbrera Alberto , Rigg Chystrie , Perea Milixa , Santamaría Ana María , Chaves Luis Fernando , Moreno Dianik , Romero Luis , Lasso Jose , Caceres Lorenzo , Saldaña Azael , Calzada Jose Eduardo
Published: May 2020

Background: The present study provides a countrywide perspective of the malaria situation in Panama over a long-term framework, with the purpose of identifying historical malaria resurgence events and their potential causes. Methods: A descriptive-ecological study was conducted by analyzing demographic and epidemiological annual malaria time series data in Panamá (1884 – 2019) using several data sources. Malaria intensity indicators were calculated during the study period. We also analyze the effects of El Niño Southern Oscillation on malaria transmission using a retrospective analysis of malaria cases between 1957 and 2019. Results: Several factors were identified responsible for malaria resurgence in Panama, mostly related with Malaria Control Programme weakening. During the past 20 years (2000 – 2019) malaria has progressively increased its prevalence within indigenous settlements, with a predominance of male cases and a high proportion (15% of total cases) in children less than 5 years old. During this period a significant and increasing proportion of the P. falciparum total cases were imported. Our retrospective analysis (1957 - 2019) evidenced that ENSO has a significant impact on malaria transmission dynamics in Panama. Conclusions: Data analysis confirmed that although authorities have been successful in focalizing malaria transmission in the country, there are still neglected issues to be solved and important intercultural barriers that need to be addressed in order to achieve elimination of the disease by 2022. This information will be useful for targeting strategies by the National Malaria Control Programme.
Modern contraceptive use among female refugee adolescents in Northern Uganda: prevalence and associated factors
Authors: Bakesiima Ritah , Cleeve Amanda , Larsson Elin , Tumwine James K. , Ndeezi Grace , Danielsson Kristina Gemzell , Nabirye Rose Chalo , Kashesya Jolly Beyeza
Published: May 2020

Background: Adolescent pregnancies are persistently high among refugees. The pregnancies have been attributed to low contraceptive use in this population. The aim of this study was to determine the prevalence and factors associated with modern contraceptive use among female refugee adolescents in Northern Uganda. Methods: This was a cross sectional study using both descriptive and analytical techniques. The study was carried out in Palabek refugee settlement in Northern Uganda from May to July 2019. A total of 839 refugee adolescents who were sexually active or in-union were consecutively enrolled. Interviewer administered questionnaires were used for data collection. Results: Modern contraceptive prevalence was 8.7% (95% CI: 7.0 to 10.8). The injectable was the most commonly used modern contraceptive method [42.5% (95% CI: 31.5 to 54.3)], and most of the participants had used the contraceptives for six months or less (59.7%). Reasons for not using modern contraceptives included fear of side effects (39.3%), partner prohibition (16.4%), and the desire to become pregnant (7.0%). Participants who were married (OR=0.11, 95% CI: 0.04 to 0.35, p<0.001), cohabiting (OR=0.43, 95% CI: 0.20 to 0.93, p=0.032) or having an older partner (OR=0.93, 95% CI: 0.86 to 0.99, p=0.046) were less likely to use modern contraceptives.Conclusion: Modern contraceptive use among female refugee adolescents was very low, and few reported a desire to become pregnant, leaving them vulnerable to unplanned pregnancies. Least likely to use modern contraceptives were participants who were married/cohabiting and those having older partners implying a gender power imbalance in fertility decision making. There is an urgent need for innovations to address the gender and power imbalances within relationships, which could shape fertility decision-making and increase modern contraceptive use among refugee adolescents.
Reaching hard-to-reach men through home-based couple HIV testing among pregnant women and their male partners in Western Kenya: A qualitative study
Authors: Krakowiak Daisy , Makabong’o Pamela , Goyette Marielle , Kinuthia John , Osoti Alfred Onyango , Asila Victor , Gone Molly Ann , Mark Jennifer , Farquhar Carey
Published: May 2020

Background Globally only 79% of adults living with HIV (human immunodeficiency virus) know their status and men in sub-Saharan Africa are considered a particularly hard-to-reach population for HIV testing. Home-based HIV couple testing during the antenatal period is a safe and effective method that has been used to test male partners of pregnant women. The goal of this qualitative study was to identify elements that made couple testing successful and describe important characteristics of this home-based intervention from couples’ perspectives. Methods Couples who received scheduled home-based couple testing during pregnancy in Kisumu, Kenya, were purposively sampled based on HIV status from January to May 2015. An interviewer administered all of the in-depth interviews and two coders were directly involved in the data analysis and reconciled codes several times in the process. Results Twenty-one couples were enrolled: 9 concordant HIV-negative couples, 8 HIV discordant couples, 3 HIV concordant HIV-positive couples, and 1 whose concordance status was unknown. Median age at the time of home-based couple testing was 24 and 28 years for women and men, respectively. Median relationship duration was 3 years and couples had a median of two pregnancies. The major themes that emerged were that home-based couple testing 1) removed the female burden of requesting couple testing, 2) overcame logistical barriers associated with clinic-based testing, 3) encouraged participants to overcome their fear of testing and disclosure, 4) provided privacy in the home, and 5) provided quality time with the health advisors. Importantly, some women appreciated individual testing at the clinic before couple testing and some couples preferred skilled, anonymous health advisors delivering the intervention rather than known community health workers. Conclusions The results of this qualitative study suggest that home-based couple testing during pregnancy overcame many of the barriers that limit men’s access to and uptake of clinic-based testing. It encouraged participants to overcome their fear of testing and disclosure through a setting that afforded privacy and quality time with skilled health advisors. These qualitative results may help design effective partner and couple HIV testing programs in the antenatal setting and alongside or within other assisted partner notification services. Trial Registration: Clinicaltrials.gov registry: NCT01784783. Registered prospectively on June 15, 2012.
Increased dose primary thromboprophylaxis in ambulatory patients with advanced pancreatic ductal adenocarcinoma, a single centre cohort study.
Authors: Maraveyas Anthony , Haque Farzana , Muazzam Iqtedar Ahmed , Ilyas Waqas , Bozas George
Published: May 2020

Background: Advanced pancreatic ductal adenocarcinoma (aPDAC) patients have a lifetime all type thromboembolic event (ATTE) rate of 25- 35%. Efficacy and safety of increased dose primary thromboprophylaxis (IDPTP) with low molecular heparin (LMWH) given for 3 months has been shown in two prospective randomized trials. Objectives: To report on efficacy -reduction of all type thromboembolic events (ATTE)-, safety -incidence of Major Bleeding (MB)- and compliance in a single-centre cohort of receiving first line chemotherapy and LMWH-IDPTP. Methods: From May 2009 to October 2016, eighty two patients received IDPTP –LMWH with dalteparin. Schedule: 55kg and below: 7500 IU, between 55 and 80kg: 10,000 IU, above 80kg: 12,500 IU. MB is reported using the International Society of Thrombosis and Haemostasis (ISTH) criteria. ATTE was defined as any arterial or venous event, incidental or clinically symptomatic, including visceral VTE. Results: Mean and median time on dalteparin was 10.2 (95%CI 8.1, 12.4) and 8.0 (95%CI 6.2, 9.7) months respectively. ATTE was observed in 7 (8.5%) of patients, with a median time on IDPTP of 6.2 months (95% CI 10.0, 13.2). MB was seen in 10 (12.2%) patients with a median time on IDPTP of 4.5 months (95% CI 1.6--7.4). Six major bleeds (60%) were the direct or indirect result of aPDAC. Eighty-one patients had died at the time of data collection with a median overall survival time of 8.7 months (95%CI 6.4, 11.0). Thromboembolism and bleeding were late events. No impact of thromboembolism or bleeding on overall survival was observed. Conclusions: IDPTP-dalteparin was associated with lower ATTE occurrence rates than expected and comparable major bleeding rates. ATTE and MB were late events; the majority of MB was from direct or indirect result of locally progressing aPDAC. Since these conditions can frequently arise in aPDAC, IDPTP should be regularly reviewed beyond 3 months.
Human epididymis protein 4 is a new biomarker to predict the prognosis of progressive fibrosing interstitial lung disease
Authors: Nishiyama Naoki , Masuo Masahiro , Nukui Yoshihisa , Tateishi Tomoya , Kishino Mitsuhiro , Tateishi Ukihide , Morota Kaori , Ohbo Kazuyuki , Miyazaki Yasunari
Published: May 2020

BACKGROUND The clinical course and prognosis of progressive fibrosing interstitial lung diseases ( PF-ILDs) vary from individual to individual. Predictive serum biomarkers for the management of the disease are needed. Serum human epididymis protein 4 (HE4) has been reported to be elevated in patients with IPF, yet its clinical utility has not been elucidated. We evaluated whether serum HE4 could be a biomarker for patients with PF-ILD. METHODS Serum HE4 was measured in a retrospective study that consisted of 34 patients with PF-ILD and 40 healthy volunteers. The relationship between serum HE4 levels and clinical parameters or prognosis was investigated. To validate the significance of the results, a prospective observational study that consisted of 37 patients with PF-ILD and 40 control patients without PF-ILD was performed.RESULTS Serum HE4 was higher in patients with PF-ILD than in health volunteers ( P < 0.01). A correlation of the serum HE4 levels with the extent of honeycombing on chest high-resolution computed tomography was identified (r = 0.41, P = 0.015). In multivariate analysis by the Cox proportional hazard model, higher HE4 levels (> 238 pmol/l) were associated with elevated mortality risk (HR 7.27, 95% CI 1.56-34.0, P = 0.01 in the derivation cohort; HR 44.3, 95% CI 4.19-468, P < 0.01 in validation cohort). CONCLUSIONS Serum HE4 levels may serve as a new diagnostic and prognostic biomarker for patients with PF-ILD.
Methodological framework for radiomics applications in Hodgkin Lymphoma
Authors: Sollini Martina , Kirienko Margarita , Cavinato Lara , Ricci Francesca , Biroli Matteo , Ieva Francesca , Calderoni Letizia , Tabacchi Elena , Nanni Cristina , Zinzani Pier Luigi , Fanti Stefano , Guidetti Anna , Alessi Alessandra , Corradini Paolo , Seregni Ettore , Stella Carmelo Carlo , Chiti Arturo
Published: May 2020

Background According to published data radiomics features differ between lesions of refractory/relapsing HL patients from those of long-term responders. However, several methodological aspects have not been elucidated yet.Purpose The study aimed at setting up a methodological framework in radiomics applications in Hodgkin Lymphoma (HL), especially at: a) developing a novel feature selection approach; b) evaluating radiomic intra-patient lesions’ similarity; c) classifying relapsing refractory (R/R) vs non-(R/R) patients.Methods We retrospectively included 85 patients (male:female=52:33; median age 35 years, range 19-74). LIFEx (www.lifexsoft.org) was used for [18F]FDG-PET/CT segmentation and feature extraction. Features were a-priori selected if they were highly correlated or uncorrelated to the volume. Principal component analysis-transformed features were used to build the fingerprints, that were tested to assess lesions’ similarity, using the silhouette. For intra-patient similarity analysis, we used patients having multiple lesions only. To classify patients as non-R/R and R/R, the fingerprint considering one single lesion (fingerprint_One) and all lesions (fingerprint_All) was tested using Random Undersamplig Boosting of Tree Ensemble (RUBTE). Results HL fingerprints included up to 15 features. Intra-patient lesion similarity analysis resulted in mean/median silhouette values below 0.5 (low similarity especially in the non-R/R group). In the test set, the fingerprint_One classification accuracy was 62% (78% sensitivity and 53% specificity); the classification by RUBTE using fingerprint_All resulted in 82% accuracy (70% sensitivity and 88% specificity). Conclusions Lesion similarity analysis was developed, and it allowed to demonstrate that HL lesions were not homogeneous within patients in terms of radiomics signature. Therefore, a random target lesion selection should not be adopted for radiomics applications. Moreover, the classifier to predict R/R vs non-R/R, performed the best when all the lesions were used.