bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics and Treatments for Pediatric Ordinary and Incarcerated Inguinal Hernia Based on Gender: 12-Year Experiences from a Single Center
Authors: Wang Kai , Tan Sarah Siyin , Xiao Yue , Wang Zengmeng , Peng Chunhui , Pang Wenbo , Wu Dongyang , Chen Yajun
Published: October 2020

Background: To describe the different characteristics of pediatric inguinal hernia in a large population for both genders based on our 12-year experience, and to accordingly recommend one of the two commonly used methods of hernia repair: the traditional open inguinal hernia repair (OIHR) and laparoscopic inguinal hernia repair (LIHR). An additional goal was to describe the characteristics of incarcerated inguinal hernia.Methods: Patients with unilateral or bilateral inguinal hernia who were admitted to our hospital and received OIHR or LIHR under general anesthesia were included. Medical records were retrospectively collected and analyzed.Results: A total of 12190 patients were included in this study. The ratio of male to female was 4.8:1. There was a total of 10646 unilateral hernias (87.3%) and 1544 bilateral hernias (12.7%), with a corresponding ratio of 6.9:1. 12444 hernia repair surgeries, 11083 (89.1%) OIHR and 1361 (10.9%) LIHR, were held. OIHR had a shorter operative time than LIHR for all unilateral and female bilateral repair, unlike for bilateral male repair. There was no difference between OIHR and LIHR for ipsilateral recurrent hernia in males. There was a difference between OIHR and LIHR for metachronous contralateral hernia.Incarcerated inguinal hernia was associated with longer operative time, hospital stay and higher hospital costs. Males and patients under 1 year were more likely to present with incarcerated hernia.Conclusions: OIHR should be considered for male patients, especially for unilateral and complete inguinal hernia. LIHR is highly recommended for female patients. For incarcerated hernia, attention should be paid to patients under 1 year old, as they can be 60 times more susceptible, and females. Surgeons should also be aware of ovary hernias in females.
A plasmid-encoded papB paralogue modulates autoaggregation of Escherichia coli transconjugants
Authors: Monarrez Ruben , Okeke Iruka
Published: October 2020

Objective: Plasmids are key to antimicrobial resistance transmission among enteric bacteria. It is becoming increasingly clear that resistance genes alone do not account for the selective advantage of plasmids and bacterial strains that harbor them. Deletion of a 32 Kb fitness-conferring region of pMB2, a conjugative resistance plasmid, produced a hyper-autoaggregation phenotype in laboratory Escherichia coli. This study sought to determine the genetic basis for hyper-autoaggregation conferred by the pMB2-derived mini-plasmid. Results: The 32 Kb fragment deleted from pMB2 included previously characterized nutrient acquisition genes as well as putative transposase and integrase genes, a 272 bp papB/ pefB-like gene, and several open-reading frames of unknown function. We cloned the papB/ pefB paralogue and found it sufficient to temper the hyper-autoaggregation phenotype. Hyper-autoaggregation conferred by the mini-plasmid did not occur in a fim-negative background. This study has identified and characterized a gene capable of down-regulating host adhesins and has shown that trans-acting papB/pefB paralogues can occur outside the context of an adhesin cluster. This plasmid-mediated modification of a bacterial host’s colonization program may optimize horizontal transfer of the mobile element bearing the genes.
Preoperative predictors of enucleation time during en bloc no-touch holmium laser enucleation of the prostate
Authors: Lin Chun-Hsuan , Li Ching-Chia , Wu Wen-Jeng , Wen Sheng-Chen
Published: October 2020

Background: To evaluate preoperative predictors of enucleation time during en bloc ‘no-touch’ holmium laser enucleation of the prostate (HoLEP)Methods: We enrolled 135 patients with symptomatic benign prostatic hyperplasia (BPH) treated with en bloc ‘no-touch’ HoLEP from July 2017 to March 2019 by a single surgeon. Preoperative, perioperative, and postoperative clinical variables were examined. Stepwise linear regression was performed to determine clinical variables associated with enucleation times. Result: The average (range) enucleation time was 46.1 (12–220) minutes, and the overall operation time was 71 (18–250) minutes. History of antiplatelet agents, history of urinary tract infection (UTI), and increasing specimen weight were each significantly associated with increasing enucleation time. No category IV complications were recorded, and all complications were evenly distributed among the groups according to the HoLEP specimen weight.Conclusion: En bloc ‘no-touch’ HoLEP was found to be an efficient and reproducible surgical method for treating BPH. Prostatic gland size was significantly associated with increased enucleation times. Similarly, history of UTI and antiplatelet agents were correlated with increased operative time.
Development and usability of educational material about workplace particulate matter exposure
Authors: Stege Thomas A. M. , Bolte John F. B. , Claassen Liesbeth , Timmermans Danielle R. M.
Published: October 2020

Background. Particulate matter (PM) exposure is an important health risk, both in daily life and in the workplace. It causes respiratory and cardiovascular diseases and results in 800,000 premature deaths per year worldwide. In earlier research, we assessed workers’ information needs regarding workplace PM exposure, the properties and effects of PM, and the rationale behind various means of protection. We also concluded that workers do not always receive appropriate risk communication tools with regards to PM, and that their PM knowledge appears to be fragmented and incomplete.Methods. We considered several concepts for use as an educational material based on evaluation criteria: ease of use, costs, appropriateness for target audiences and goals, interactivity, implementation issues, novelty, and speed. We decided to develop an educational folder, which can be used to inform employees about the properties, effects and prevention methods concerning PM. Furthermore, we decided on a test setup of a more interactive way of visualisation of exposure to PM by means of exposimeters. For the development of the folder, we based the information needs on our earlier mental models-based research. We adjusted the folder based on the results of ten semi-structured interviews evaluating its usability.Results. The semi-structured interviews yielded commentaries and suggestions for further improvement, which resulted in a number of alterations to the folder. However, in most cases the folder was deemed satisfactory.Conclusion. Based on this study, the folder we developed is suitable for a larger-scale experiment and a practical test. Further research is needed to investigate the efficacy of the folder and the application of the exposimeter in a PM risk communication system.
Evaluation of hepatic fibrosis in HIV/HCV Co-infected individuals in Yaoundé, Cameroon: Usefulness of APRI score in resource-constrained settings
Authors: Dobseu Rodolphe Steven , Nanfack Aubin Joseph , Kowo Mathurin , Ambada Georgia , Kamgaing Rachel Simo , Chenwi Collins , Fainguem Nadine , Ka’e Aude , Ngangoum Eric , Sosso Samuel Martin , Tchiegang Clergé , Ndjolo Alexis
Published: October 2020

Background: HIV infection exacerbates the prognosis of HCV infection, with a faster progression of hepatitis. Hepatic fibrosis is the major disruption of the hepatic tissue architecture characterized by anarchic deposition and excess of the extracellular matrix. The objective of this study was to evaluate hepatic fibrosis in HIV/HCV co-infected individuals as compared to HCV mono-infected.Methods: A total of 97 participants (mean age 60.2±14.3 years and 0.76 male/female sex ratio) was enrolled in a study conducted in Yaoundé, Cameroon from November 2018 to January 2019. Liver fibrosis was assessed by the APRI score (Aspartate Aminotransferase or AST/Platelet Ratio Index) which identifies the stage of fibrosis as classified by the Metavir system (F0 to F4). CD4 counts and plasmatic HIV viral load of HIV/HCV co-infected individuals were determined and the correlation between hepatic fibrosis and immuno-virological status established. Statistical analysis was done using Microsoft Excel 2016 and EpiInfo7 software.Results: A high proportion (63.6%) of HIV/HCV co-infected participants had an abnormal AST level: 73.6±45.8 IU/L as compared to 58.5±39.3 IU/L (59.3%) among HCV mono-infected participants. The frequency of thrombocytopenia was 63.6% with a mean platelet count of 137±50x103 IU/L in HIV/HCV co-infected participants as compared to 176±67x103 IU/L in HCV mono-infected participants (38.4%). The progression of hepatic fibrosis in participants with clinically significant fibrosis: F2, F3 and F4 was higher among HIV/HCV co-infected and the mean APRI score was 1.7±1.4 versus 1±0.8 among HCV mono-infected (26.7%). All participants (100%) with detectable HIV viral load had clinically significant fibrosis compared to 33.4% in those with undetectable HIV viral load (p=0.55). Only 42.9% participants with CD4>500 cells/µL had clinically significant fibrosis (p=0.72) while 100% participants with CD4<200 cells/µL had clinically significant fibrosis (p=0.58).Conclusions: A high level of AST combined with thrombocytopenia (APRI score>1.5) is an indicator of hepatic fibrosis in HIV/HCV co-infected individuals. Because of its non-invasive and less costly nature, the APRI score can be a suitable biomarker to monitor hepatic fibrosis in HIV/HCV co-infected individuals in resource constrained settings.
Splenic Infarction and Infectious Diseases in Korea
Authors: Im Jae Hyoung , Chung Moon-Hyun , Lee Hye-Jin , Kwon Hea Yoon , Baek JiHyeon , Jang Ji-Hun , Lee Jin-Soo
Published: October 2020

BackgroundThe spleen contains immune cells and exhibits a pattern of infarction different from other organs; as such, splenic infarction (SI) may provide important clues to infection. However, the nature of the relationship between SI and infectious disease(s) is not well understood. Accordingly, this retrospective study investigated the relationship between SI and infection.MethodsHospital records of patients with SI, who visited Inha University Hospital (Incheon, Republic of Korea) between January 2008 and December 2018, were reviewed. Patient data regarding clinical presentation, causative pathogens, risk factors, and radiological findings were collected and analyzed.ResultsOf 353 patients with SI, 101 with infectious conditions were enrolled in this study, and their data were analyzed to identify associations between SI and infection. Ten patients were diagnosed with infective endocarditis (IE), and 26 exhibited bacteremia without IE. Twenty-seven patients experienced systemic infection due to miscellaneous causes (negative result on conventional automated blood culture), including the following intracellular organisms: parasites (malaria [n =12], babesiosis [n =1]); bacteria (scrub typhus [n =5]); viruses (Epstein–Barr [n =1], cytomegalovirus [n =1]); and unidentified pathogen[s] (n =7). Splenomegaly was more common among patients with miscellaneous systemic infection; infarction involving other organs was rare. Thirty-eight patients had localized infections (e.g., respiratory, intra-abdominal, or skin and soft tissue infection), and most (35 of 38) had other risk factors for SI.ConclusionsIn this study, various infectious conditions were found to be associated with SI, and intracellular organisms were the most common causative pathogens. Further studies are needed to examine other possible etiologies and the underlying pathophysiological mechanisms.
Using Near-infrared Reflectance Spectroscopy (NIRS) to Predict Glucobrassicin Concentrations in Cabbage and Brussels Sprout Leaf Tissue
Authors: Renner Ilse , Fritz Vincent
Published: October 2020

BackgroundGlucobrassicin (GBS) and its hydrolysis product indole-3-carbinol are important nutritional constituents implicated in cancer chemoprevention. Dietary consumption of vegetables sources of GBS, such as cabbage and Brussels sprouts, is linked to tumor suppression, carcinogen excretion, and cancer-risk reduction. High-performance liquid-chromatography (HPLC) is the current standard GBS identification method, and quantification is based on UV-light absorption in comparison to known standards or via mass spectrometry. These analytical techniques require expensive equipment, trained laboratory personnel, hazardous chemicals, and they are labor intensive. A rapid, nondestructive, inexpensive quantification method is needed to accelerate the adoption of GBS-enhancing production systems. Such an analytical method would allow producers to quantify the quality of their products and give plant breeders a high-throughput phenotyping tool to increase the scale of their breeding programs for high GBS-accumulating varieties. Near-infrared reflectance spectroscopy (NIRS) paired with partial least squares regression (PLSR) could be a useful tool to develop such a method. ResultsHere we demonstrate that GBS concentrations of freeze-dried tissue from a wide variety of cabbage and Brussels sprouts can be predicted using partial least squares regression from NIRS data generated from wavelengths between 950 and 1650 nm. Cross-validation models had R2=0.75 with RPD=2.3 for predicting µmol GBS·100g-1 fresh weight and R2=0.80 with RPD=2.4 for predicting µmol GBS·g-1 dry weight. Inspections of equation loadings suggest the molecular associations used in modeling may be due to first overtones from O-H stretching and/or N-H stretching of amines. ConclusionsA calibration model suitable for screening GBS concentration of freeze-dried leaf tissue using NIRS-generated data paired with PLSR can be created for cabbage and Brussels sprouts. Optimal NIRS wavelength ranges for calibration remain an open question.
How fear and collectivism influence public's preventive intention towards COVID-19 infection: A study based on big data from the social media
Authors: Huang Feng , Ding Huimin , Liu Zeyu , Wu Peijing , Zhu Meng , Li Ang , Zhu Tingshao
Published: October 2020

Background: Despite worldwide calls for precautionary measures to combat COVID-19, the public's preventive intention still varies significantly among different regions. Exploring the influencing factors of the public's preventive intention is very important to curtail the spread of COVID-19. Previous studies have found that fear can effectively improve the public's preventive intention, but they ignore the impact of differences in cultural values. The present study examines the combined effect of fear and collectivism on the public's preventive intention towards COVID-19 through the analysis of social media big data.Methods: The Sina microblog posts of 108,914 active users from Chinese mainland 31 provinces were downloaded. The data was retrieved from January 11 to February 21 2020. Afterwards, we conducted a province-level analysis of the contents of downloaded posts. Three lexicons were applied to automatically recognise the scores of fear, collectivism, and preventive intention of 31 provinces. After that, a multiple regression model was established to examine the combined effect of fear and collectivism on the public's preventive intention towards COVID-19. The simple slope test and the Johnson-Neyman technique were used to test the interaction of fear and collectivism on preventive intention.Results: The study reveals that: (a) both fear and collectivism can positively predict people's preventive intention and (b) there is an interaction of fear and collectivism on people's preventive intention, where fear and collectivism reduce each other's positive influence on people's preventive intention.Conclusion: The promotion of fear on people's preventive intention may be limited and conditional, and values of collectivism can well compensate for the promotion of fear on preventive intention. These results provide scientific inspiration on how to enhance the public's preventive intention towards COVID-19 effectively.
Knowledge, attitudes and practices on influenza vaccine during pregnancy in Quito, Ecuador
Authors: Erazo Carlos E. , Erazo Carlos V. , Grijalva Mario J. , Moncayo Ana L.
Published: October 2020

Background: Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses in pregnant women and their children. In Ecuador, the coverage of seasonal influenza vaccination in pregnant women is low. The aim of this study was to assess the knowledge, attitudes and practices of pregnant women toward influenza vaccination in Quito-Ecuador.Methods: A cross-sectional study enrolled 842 women who delivered at three main public gynecological-obstetric units of the Metropolitan District of Quito. A questionnaire regarding demographics, antenatal care, risk conditions and knowledge, attitudes and practices related to influenza vaccination was administered. We examined factors associated with vaccination using log-binomial regression models.Results: A low vaccination rate (36.6%) against influenza was observed among pregnant women. The factors associated with vaccination included the recommendations from health providers (adjusted PR: 15.84; CI 95% 9.62-26.10), belief in the safety of the influenza vaccine (adjusted PR: 1.53; CI 95% 1.03-2.37) and antenatal care (adjusted PR: 1.21; CI 95% 1.01-1.47). The most common reasons for not vaccinating included the lack of recommendation from health care providers (73.9%) and lack of access to vaccine (9.0%).Conclusions: Health educational programs aimed to pregnant women and antenatal care providers have the most potential to increase influenza vaccination rates. Further studies are needed to understand the barriers of health care providers regarding influenza vaccination in Ecuador.
Permeability of the windows of the brain: Feasibility of dynamic contrast-enhanced MRI of the circumventricular organs
Authors: Verheggen Inge C.M. , de Jong Joost J.A. , Boxtel Martin P.J. van , Postma Alida A. , Verhey Frans R.J. , Jansen Jacobus F.A. , Backes Walter H.
Published: October 2020

Background: Circumventricular organs (CVOs) are small structures without a blood-brain barrier surrounding the brain ventricles that serve homeostasic functions and facilitate communication between the blood, cerebrospinal fluid and brain. Secretory CVOs release peptides and sensory CVOs regulate signal transmission. However, pathogens may enter the brain through the CVOs and trigger neuroinflammation and neurodegeneration. We investigated the feasibility of dynamic contrast-enhanced (DCE) MRI to assess the CVO permeability characteristics in vivo, and expected significant contrast uptake in these regions, due to blood-brain barrier absence.Methods: Twenty healthy, middle-aged to older males underwent brain DCE MRI. Pharmacokinetic modeling was applied to contrast concentration time-courses of CVOs, and in reference to white and gray matter. We investigated whether a significant and positive transfer from blood to brain could be measured in the CVOs, and whether this differed between secretory and sensory CVOs or from normal-appearing brain matter.Results: In both the secretory and sensory CVOs, the transfer constants were significantly positive, and all secretory CVOs had significantly higher transfer than each sensory CVO. The transfer constants in both the secretory and sensory CVOs were higher than in the white and gray matter.Conclusions: Current measurements confirm the often-held assumption of highly permeable CVOs, of which the secretory types have the strongest blood-to-brain transfer. The current study suggests that DCE MRI could be a promising technique to further assess the function of the CVOs and how pathogens can potentially enter the brain via these structures.Trial registration: Netherlands Trial Register number: NL6358, date of registration: 2017-03-24
Nurses’ and midwives’ perspectives on participation in national policy development, review and reforms in Ghana: A qualitative study
Authors: Acheampong Angela Kwartemaa , Ohene Lillian Akorfa , Asante Isabella Naana Akyaa , Kyei Josephine , Dzansi Gladys , Adjei Charles Ampong , Adjorlolo Samuel , Boateng Francis , Woolley Philomena , Nyante Felix , Aziato Lydia
Published: October 2020

Background: The World Health Organization has admonished member countries to strive towards achieving universal health coverage (UHC) through actionable health policies and strategies. Nurses and midwives have instrumental roles in achieving UHC via health policy development and implementation. However, there is a paucity of empirical data on nurses and midwives’ participation in policy development in Ghana. The current study explored nurses and midwives’ participation in policy development, reviews and reforms in Ghana.Methods: A qualitative descriptive exploratory design was adopted for this study. One-on-one individual interviews were conducted after 30 participants were purposefully selected. Data was audiotaped with permission, transcribed, and analyzed inductively using the content analysis procedures. Results: Two main themes emerged from the data: participation in policy development and perspectives on policy reviews and reforms. The findings showed that during health policy development and reviews, nurses in Ghana were overlooked and unacknowledged. Policy reforms regarding bridging the pre-service preparation gap, staff development and motivation mechanisms and influence on admission into nursing schools were raisedConclusion: The authors concluded that nurses and midwives are crucial members of the healthcare systems and their inputs in policy development and reviews would improve health delivery in Ghana.
Definitive-intent uniform megavoltage fractioned radiotherapy protocol for presumed canine intracranial gliomas: retrospective analysis of survival and prognostic factors in 38 cases (2013-2019).
Authors: DEBREUQUE MAUD , DEFORNEL PAULINE , DAVID INGRID , DELISLE FRANCOISE , DUCERVEAU MARIE-NOELLE , DEVAUCHELLE PATRICK , THIBAUD JEAN-LAURENT
Published: October 2020

Background : Radiotherapy (RT) is currently considered the treatment of choice for presumed canine intracranial gliomas. However, variable therapeutic responses are described, due to heterogeneous populations and different radiation methods or protocols. Only one study dedicated to intracranial suspected glioma highlighted prognostic criteria. Determination or confirmation of specific clinical and imaging prognostic factors may guide the therapeutic management of these tumours. The objectives were to provide data on long-term clinical outcome (including quality of life, QoL) and to determine specific prognostic factors associated with survival time. We report a single-institution retrospective study, including all dogs with suspected symptomatic primary solitary intracranial glioma, treated with a complete uniform fractionated megavoltage radiation protocol of 15x3Gy over 5 weeks, between January 2013 and February 2019. Thirty-eight client-owned dogs were included. Medical records were retrospectively evaluated for median overall survival time (MST), clinical and imaging responses. Prognostic factors on survival were researched in terms of signalment, clinical presentation, tumour imaging characteristics and response following RT. Finally, the RT’s impact on the dogs’ clinical signs and Qol were evaluated by the owners. Results: The disease-specific MST was 698 days (95% CI: 598-1135). Survival at 1 and 2 years were respectively 74.2±7.4% and 49.0±9.8%. Initial clinical signs were related to survival, as well as tumour characteristics such as cystic-pattern, mass effect and Tumour/Brain volume ratio. No significant adverse effect or radiotoxicity was observed. Conclusions: RT appears as a safe and effective treatment for canine intracranial gliomas, allowing long-term tumour control, improvement of life’s quality and management of associated clinical signs. The initial clinical signs and MRI characteristics (Tumour/Brain volume ratio, cyst-like lesion and mass effect) may help predict the prognosis.
Immediate impact of stay-at-home orders to control COVID-19 transmission on mental well-being in Bangladeshi adult population: Patterns, Explanations, and future directions
Authors: Ali Mohammad , Ahsan Gias U. , Khan Risliana , Khan Hasinur Rahman , Hossain Ahmed
Published: October 2020

Objective: We aim to evaluate the immediate impacts of COVID-19 stay-at-home orders on the mental well-being of Bangladeshi adults. We recruited 1404 healthy adults following the Bangladesh government's lockdown announcement. A questionnaire comprising the Warwick Edinburgh Mental Well-being Scale was used to define mental health.Results: The overall mean score for well-being was 42.4, indicating that 51.9% of adults suffered from poor mental health. And within that 48% of males and 57% of females were depressed. The mean scores for government workers, unemployed workers, and business employees were 45.1, 39.6, and 39.5, respectively. Confounding adjustments in multivariable linear regression models revealed that married women, unemployed and business communities, and individuals returning to villages were heavily depressed. Stay-at-home orders had significant repercussions on mental health and created a gender disparity in depression among adults. Suggestions include promoting mental health for women, unemployed, and business individuals. Married women need to be taken into special consideration as their mental well-being is worse. Older people (50 years of age and over) reported a high day-to-day variation in their mental health. These results should be factored in when discussing the mental health of adults and communities to cope with quarantine.
An automated workflow to screen alkene reductases using high-throughput thin layer chromatography
Authors: Garabedian Brett M. , Meadows Corey W. , Mingardon Florence , Guenther Joel M. , de Rond Tristan , Abourjeily Raya , Lee Taek Soon
Published: October 2020

Background: Synthetic biology efforts often require high-throughput screening tools for enzyme engineering campaigns. While innovations in chromatographic and mass spectrometry-based techniques provide relevant structural information associated with enzyme activity, these approaches can require cost-intensive instrumentation and technical expertise not broadly available. Moreover, complex workflows and analysis time can significantly impact throughput. To this end, we develop an automated, 96-well screening platform based on thin layer chromatography (TLC) and use it to monitor in vitro activity of a geranylgeranyl reductase isolated from Sulfolobus acidocaldarius (SaGGR).Results: Unreduced SaGGR products are oxidized to their corresponding epoxide and applied to thin layer silica plates by acoustic printing. These derivatives are chromatographically separated based on the number of epoxides they possess and are covalently ligated to a chromophore, allowing detection of enzyme variants with unique product distributions or enhanced reductase activity. Herein, we employ this workflow to examine farnesol reduction using a codon-saturation mutagenesis library at site Leu377 of SaGGR. We show this TLC-based screen can distinguish between 4-fold differences in enzyme activity for select mutants and validated those results by GC-MS.Conclusions: With appropriate quantitation methods, this workflow can be used to screen polyprenyl reductase activity and can be readily adapted to analyze broader catalyst libraries whose products are amenable to TLC analysis.
Tuberculosis (TB) in the refugee camps in Ethiopia: Trends of case notification, profile, and treatment outcomes, 2014 to 2017
Authors: Legesse Tsegay , Admenur Goitom , Gebregzabher Selemawit , Woldegebriel Eyob , Fantahun Bexabeh , Tsegay Yemane , Bayssa Abeyot , Darge Berihu , Denbu Yidnekachew , Michalel Hayelom , Abera Kibebew , Alemayeh Abraham , Kebede Dejene , Kassa Desta
Published: October 2020

Background: Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to improve the effectiveness of TB programs. This study aimed to investigate trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia.Methods: In this retrospective cohort study, demographic and clinical data of all TB cases registered in 25 refugee camps in Ethiopia from January 2014 to December 2017 were extracted. Multivariate logistic regression was fitted to estimate odds ratios and corresponding 95% confidence intervals for the measure of association linked with factors significantly associated with unsuccessful treatment outcomes.Results. A total of 1553 TB cases, mean age 27.7 years, were registered from 2014 to 2017. Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in number of notified TB cases (138 to 588 cases), in percentage of EPTB (23.2% to 32.7%), in contribution of children to total TB cases (18.8% to 30.1%) and to EPTB (40.6% to 65.1%), and in proportion of bacteriologically confirmed new and relapse pulmonary cases (43.8% to 64.8%). Treatment success rates for all TB cases remained lower at 72.7%-79.4%. On average 24.8% had unfavorable treatment outcome, including 11.5% not evaluated, 8.0% LTFU, 4.8% died and 0.5% treatment failed. Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive.Conclusions: There was continuous increase in notified TB cases and in percentage of childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases increased overtime. TB treatment success remained lower than the national achievement in 2017 (96%) and global target (>=90%), which needs improvement. The higher LTFU, not evaluated, and death suggests the need to strengthen adherence education and supervision. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives.
Effects of task-specific virtual reality training using a Leap Motion Controller on hemiparetic upper extremity in patients with stroke
Authors: Fong Kenneth N. K. , Tang Y. M. , Sie Karen , YU Andy K. H. , Lo Cherry C. W. , Ma Yuko W. T.
Published: October 2020

Background: Task-specific training has been proven to be effective in promoting recovery of the hemiparetic upper extremities after a stroke. This study was to develop a new and innovative task-specific VR (TS-VR) program using a Leap Motion Controller VR device and the Unity3D program for distal hand function training, and to investigate whether a two-week program of TS-VR training would promote recovery of the hemiparetic upper extremity in patients with chronic stroke.Methods: We designed the TS-VR program based on seven general hand function tasks used in the activities of daily living that require upper limb movement, such as pushing open a door and pouring water. Then, we examined the content validity of the TS-VR according to the views of an expert panel and through field testing on patients with stroke. The final version of the TS-VR was tested on 20 patients suffering from chronic stroke with upper extremity hemiparesis over 2 weeks, 5 sessions per week, 30 minutes per session. Outcomes were assessed using the Fugl-Meyer Assessment-Upper Extremity score (FMA-UE), the Wolf Motor Function Test (WMFT), and the Motor Activity Log (MAL). Data were collected at the first session (week 0), last session (week 2), and follow-up session (week 5). Patients’ arm impairments were stratified into lower- and higher-functioning groups according to the Functional Test for the Hemiplegic Upper Extremity (FTHUE).Results: Significant improvements in upper extremity functions were found after TS-VR training in FMA-UE Total score (χ2=34.219, p=0.000), FMA-UL subscore (χ2=31.2, p=0.000), FMA-Hand subscore (χ2=22.6, p=0.000), and WFMT score (χ2=27.8, p=0.000) among the three time occasions, but no significant effect on grip strength was found. Moreover, the higher-functioning group (levels 5-7 in FTHUE) benefited more from the TS-VR, as indicated in outcome measures of FMA-UL, FMA-Hand, FMA-UE Total, and WMFT respectively, as well as amount of use score in MAL, but this was not the case for those in the lower-functioning group (levels 1-4 in FTHUE).Conclusions: Our findings suggest that our new TS-VR training system was useful for upper extremity recovery in patients with chronic stroke. It has potential to be applied in clinical settings in future.
Severity of radiation pneumonitis, from clinical, dosimetric and biological features: a pilot study.
Authors: Aso Samantha , Navarro-Martin Arturo , Castillo Richard , Padrones Susana , Castillo Edward , Montes Ana , Ballarin Jose Ignacio Martinez , Cubero Noelia , Lopez Rosa , Rodriguez Laura , Palmero Ramon , Manresa Federico , Guerrero Thomas , Molina Maria
Published: October 2020

Background and objective: Radiation pneumonitis (RP) could be a lethal complication of lung cancer treatment. No reliable predictors of RP severity have been recognized. This prospective pilot study was performed to identify early predictors of high grade lung toxicity and to evaluate clinical, biological or dosimetric features associated with different grades of toxicity.Method: Sixteen patients with non-small cell lung cancer with indication of concurrent chemoradiotherapy using 60Gy/2Gy/fraction starting at cycle one of platinum based chemotherapy were included. Bronchoalveolar lavage (BAL), pulmonary function testing (PFT), and 18F-2-fluoro-2-deoxy-D-glucose positron-emission tomography was performed before radiotherapy (RT), after three weeks of treatment, and two months post-RT. For analysis, patients were grouped by grade (low [G1-G2] vs. high [G3-G5]). The two groups were compared to identify predictors of RP. Protein expression BAL and lung tissue metabolism was evaluated in two patients (RP-G1 vs. RP-G3). Categorical variables such as comorbidities, stages and locations were summarized as percentages. Radiation doses, pulmonary function values and time to RP were summarized by medians with ranges or as means with standard deviation. Longitudinal analysis PFT was performed by a T-test. Results: All 16 patients developed RP, as follows: G1 (5 pts; 31.3%); G2 (5 pts; 31.3%); G3 (5 pts; 31.3%); and G5 (1 pts; 6.1%). Patients with high grade RP presented significant decrease (p=0.02) in diffusing lung capacity for carbon monoxide (DLCO) after three weeks of RT. No correlation between dosimetric values and RP grades was observed. BAL analysis of the selected patients showed that CXCL-1, CD154, IL-1ra, IL-23, MIF, PAI-1 and IFN-g were overexpressed in the lungs of the RP-G3 patient, even before treatment. The pre-RT SUVmax value in the RP-G3 patient was non-significantly higher than in the patient with RP-G1. Conclusions: RT induces some degree of RP. Our data suggest that decrease in DLCO% is the most sensitive parameter for the early detection of RP. Moreover, we detect biological differences between the two grades of pneumonitis, highlighting the potential value of some cytokines as a prognostic marker for developing high grade lung toxicity. Further multicenter studies with larger sample size are essential to validate these findings.
Prevalence of Depression Symptoms and Associated Sociodemographic and Clinical Correlates among Syrian Refugees in Lebanon
Authors: Naal Hady , Nabulsi Dana , Arnaout Nour El , Abdouni Lina , Dimassi Hani , Harb Ranime , Saleh Shadi
Published: October 2020

Background: Since the outbreak of the Syrian war in 2011, close to 6 million Syrian refugees have escaped to Syria’s neighbouring countries, including Lebanon. Evidence suggests rising levels of mental health disorders among Syrian refugee populations. Yet, to the best of our knowledge, large-scale studies addressing the mental health of adult Syrian refugees in Lebanon are lacking.Aims: We examined the prevalence of depression symptoms, which represent a common and debilitating mental health disorder among Syrian refugee populations in Lebanon, along with their sociodemographic and clinical correlates.Methods: A cross-sectional survey design was conducted as part of a collaborative project-“Sijilli”- led by the Global Health Institute at the American University of Beirut (Beirut, Lebanon) across 4 informal tented settlements for refugees (Beirut, Bekaa, North, South) in Lebanon among adult Syrian refugees (≥18), over a period extending from 2018 to 2020. The survey inquired about participants’ sociodemographic and clinical characteristics, and screened participants for symptoms of depression through sequential methodology using the Patient Health Questionnaire (PHQ-2 and PHQ-9).Results: A total of 3255 adult Syrian refugees were enrolled in the study. Of those refugees, only 46.73% (n=1521) screened positive on the PHQ-2 and were therefore eligible to complete the PHQ-9. The PHQ-9 analysis revealed high prevalence (22%) of moderate to severe depression in the total sample, suggestive of high probability for Major Depression Disorder (MDD). Further analyses indicate that being ≥45 years of age (OR 1.61, 95% CI 1.13-2.30), a woman (OR 1.34, 95% CI 1.06-1.70), widowed (OR 2.88, 95% CI 1.31-6.32), reporting a neurological (OR 1.73, 95% CI 1.15-2.60) or a mental health condition (OR 3.98, 95% CI 1.76-8.97) are major risk factors for depression.Conclusion: Our study suggests that an estimated one in four Syrian refugees in Lebanon have probable MDD, and our findings have important public health and clinical implications on refugee health. There is a need to enhance screening efforts, to improve access and referral to mental health services, and to improve post-migration factors among Syrian refugees in Lebanon.
Estimation of the LDL Subclasses in Ischemic Stroke as a Risk Factor in a Chinese population
Authors: Duan Ruisheng , Xue Wenjun , Wang Kunpeng , Yin Nan , Hao Hongyu , Chu Hongshan , Wang Lijun , Meng Peng , Diao Le
Published: October 2020

Background: Acute ischemic stroke (AIS) is one of the leading causes of mortality and long-term disability worldwide. Our study aims to clarify the role of LDL subclasses in the occurrence of AIS and develop a risk prediction model based on these characteristics to identify high-risk people. Methods: Five hundred and sixty-six patients with AIS and 197 non-AIS controls were included in this study. Serum lipids and other baseline characteristics including fasting blood glucose (GLU), serum creatinine (Scr), and blood pressure were investigated in relation to occurrence of AIS. The LDL subfractions were classified and measured with the Lipoprint System by a polyacrylamide gel electrophoresis technique. Results: Levels of LDL-3, LDL-4 and LDL-5 subclasses were significantly higher in the AIS group compared to the non-AIS group and lower level of LDL-1 was prevalent in the AIS patients. Consistently, Spearman correlation coefficient demonstrated that sd‐demonevels, especially LDL-3 and LDL-4 levels, were significantly positively correlated with AIS. Furthermore, there is a significant positive correlation between small dense LDL (sd-LDL, that is LDL-3 to 7) levels and serum lipids including TC, LDL‐C, and TG. Increased LDL-3 and LDL-4 as well as decreased LDL-1 and LDL-2 were correlated to the occurrence of AIS, even in the people with normal LDL-C levels. A new prediction model including 12 variables can accurately predict the AIS risk in Chinese patients (AUC=0.82±0.04). Conclusions: Levels of LDL subclasses should be considered in addition to serum LDL-C in assessment and management of AIS. A new prediction model based on clinical variables including LDL subtractions can help clinicians identify high of AIS, even in the people with norm.
Home was not a Safe Haven: Women’s Experiences of Intimate Partner Violence during the COVID-19 Lockdown in Nigeria
Authors: Fawole Olufunmilayo I , Okedare Omowumi O , Reed Elizabeth
Published: October 2020

Background: Emergency situations, including epidemics, increase incidence of violence against women, especially intimate partner violence (IPV). This paper describes specific scenarios of IPV reported by women during the COVID-19 pandemic in Nigeria to provide insight for policy and programmatic efforts. Methods: This paper draws on seven de-identified case reports from organisations serving women experiencing IPV as well as media coverage of IPV cases in Nigeria, between April and May, 2020. Result: In most cases, reports identified IPV that was occurring prior to the lockdown, but increased in severity or involved new types of violence during the lockdown. The case scenarios included descriptions of many forms of IPV commonly reported, including physical, economic, psychological and sexual violence, often concurrently. Several women also reported threats of being thrown out of their homes by perpetrators, which threatens women’s ability to protect themselves from exposure to COVID-19, but could also leave women stranded with no access to transportation, social services, or other resources during the lockdown. Several women also reported IPV that involved custody of children, as well as IPV that disrupted women’s income generation. IPV was also reported in relation to economic stressors associated with the lockdown. Reports highlight how the lockdown disrupted women’s social support, hindering accessibility of formal and informal sources of help.Conclusion: The lockdowns in Nigeria may have inadvertently placed women already experiencing partner violence at risk for experiencing more severe violence, new challenges to cope with violent experiences, and other forms of violence, including violence that used the lockdown as a way to threaten women’s security and ability to protect themselves from the virus. Hence, there is need for innovative approaches to support victims, with emphasis on ways in which perpetrators of IPV may be using the threat of COVID-19 to further gain power and control over partners.
A Polymeric Diet Rich in Transforming Growth Factor Beta 2 Does Not Reduce Inflammation in Chronic 2,4,6-trinitrobenzene Sulfonic Acid Colitis in Pre-pubertal Rats
Authors: Dupont-Lucas Claire , Marion-Letellier Rachel , Pala Mathilde , Guérin Charlène , Amamou Asma , Jarbeau Marine , Bôle-Feysot Christine , Nicol Lionel , David Amelyne , Aziz Moutaz , Colasse Elodie , Savoye-Collet Céline , Savoye Guillaume
Published: October 2020

Background: Pediatric Crohn’s disease is characterized by a higher incidence of complicated phenotypes. Murine models help to better understand the dynamic process of intestinal fibrosis and test therapeutic interventions. Pre-pubertal models are lacking. We aimed to adapt a model of chronic colitis to pre-pubertal rats and test if a polymeric diet rich in TGF-β2 could reduce TNBS-induced intestinal inflammation and fibrosis. Methods: Colitis was induced in 20 five-week-old Sprague-Dawley male rats by weekly rectal injections of increasing doses of TNBS (90 mg/kg, 140 mg/kg and 180 mg/kg) for 3 weeks, while 10 controls received phosphate-buffered saline (PBS). Rats were anesthetized using ketamine and chlorpromazine. After first administration of TNBS, 10 rats were fed exclusively MODULEN IBD® powder, while remaining rats were fed breeding chow. Colitis was assessed one week after last dose of TNBS by histopathology and magnetic resonance colonography (MRC). Results: Histological inflammation and fibrosis scores were higher in TNBS group than controls (p<0.05 for both). MRC showed increased colon wall thickness in TNBS group compared to controls (p<0.01), and increased prevalence of strictures and target sign (p<0.05). Colon expression of COL1A1, CTGF, α-SMA and COX-2 did not differ between TNBS rats and controls. TNBS colitis was not associated with growth failure. Treatment with MODULEN IBD® was associated with growth failure, increased colon weight/length ratio (p<0.01), but did not affect histological scores or MRI characteristics. Colon expression of α-SMA was significantly lower in the MODULEN group vs. controls (p=0.005).Conclusion: Features of chronic colitis were confirmed in this model, based on MRC and histopathology. Treatment with MODULEN did not reverse inflammation or fibrosis.
COVID-19: Epidemiology and Preventive Measures in Jiangsu Province, China
Authors: Chen Yi , Liu Jiashu , Yang Changrui , Zhang Aihong , Ai Zisheng
Published: October 2020

Background To discuss the epidemiological features of coronavirus disease 2019(COVID-19) and prevention measures in Jiangsu Province. Methods Information on all novel coronavirus pneumonia confirmed cases in Jiangsu was collected from the official website of Jiangsu Commission of Health. All data are entered into Excel and Python3 for statistical analysis. Epidemiological characteristics of novel coronavirus pneumonia confirmed cases from January 10, 2020 to March 18th in Jiangsu province were retrospectively analyzed. Meanwhile, the preventive measures of Jiangsu Commission of Health and the people's Government of Jiangsu Province were also analyzed. Results 631 COVID-19 cases were diagnosed in Jiangsu Province, covering 13 districts in Jiangsu. Before February 1, the confirmed cases were mainly imported cases, and after February 1, community transmission cases became main part of confirmed cases. There were more male patients than females, and most patients were in the group of 30-70 years old, 49 patients (7.8%) with mild symptom and 572 patients (90.6%) with common type accounted for the majority. The cumulative mortality rate was 0% and the cure rate was 100%. Reasonable treatment, timely and effective preventive measures were taken to effectively improve cure rate and to prevent the spread of the epidemic, all measures ensure the health and life safety of the people. Conclusion The preventive measures in Jiangsu Province were timely and effective, the epidemic situation in Jiangsu Province had been well controlled and cured.
Predicting COVID-19 Disease Progression with Chest CT Images
Authors: Liang Hongqin , Qiu Xiaoming , Zhu Liqiang , Chen Lihua , Hu Xiaofei , Liu Chen , Chen Wei , Wang Jian
Published: October 2020

Background: Some mild patients can deteriorate to moderate or severe within a week with the natural progression of COVID-19.it has been crucial to early identify those mild cases and give timely treatment . The chest computed tomography (CT) has shown to be useful to assist clinical diagnosis of COVID-19.In this study, machine learning was used to develop an early-warning CT feature model for predicting mild patients with potential malignant progression.Methods：The total of 140 COVID-19 mild patients were collected. All patients at admission were divided into groups (alleviation group and exacerbation group) with or without malignant progression.The clinical and laboratory data at admission, the first CT, and the follow-up CT at critical stage of the two groups were compared with Chi-square test,.The CT features data (distribution, morphology,etc) were used to establish the prediction model by Fisher's linear discriminant method and Unconditional logistic regression algorithm. And the model was validated with 40 exception data.and the Area Under ROC curve (AUC) was used to evaluate the models.Results：The model filtered out three variables of CT features including distal air bronchogram, fibrosis,and reversed halo sign. Notably, the distal air bronchograms was less common in alleviation group, while the fibrosis and reversed halo sign were more common.The sensitivity, specificity and Youden index of unconditional logistic regression were 86.1%, 92.6% and 78.7%, For the analysis of Fisher's linear discriminant, the sensitivity, specificity and Youden index were 83.3%, 94.1% and 77.4%. The generalization ability of both models were consistent with sensitivity of 95.89%, specificity of 100%, and Youden index of 83.33%.Conclusions: The CT imaging features-based machine learning model has a high sensitivity for finding out the mild patients who are easy to deteriorate into severe/critical cases efficiently so that timely treatments came true for those patients,while largely help to relieve the medical pressure.