bluuebunny/crossref_metadata_2025 huggingface dataset:
A Health Care Professionals Training Needs Assessment for Oncology in Uganda
Authors: Byamugisha Josaphat , Munabi Ian G , Mubuuke Aloysius G. , Mwaka Amos D. , Kagawa Mike , Okullo Isaac , Niyonzima Nixon , Lusiba Pastan , Ainembabazi Peruth , Kankunda Caroline , Muhumuza Dennis D. , Orem Jackson , Atwine Diana , Ibingira Charles
Published: May 2020

Background
Cancer incidence and mortality in sub-Saharan Africa are increasing and do account for significant premature death. The expertise of the health care providers is critical to down staging cancer at diagnosis and improving survival in low- and middle-income countries. We set out to determine the training needs of health care providers for a comprehensive oncology services package in selected hospitals in Uganda, in order to inform capacity development intervention to improve cancer outcomes in the East African region.
Methods
This was a cross-sectional survey using the WHO Hennessey-Hicks questionnaire to identify the training needs of health workers involved in cancer care, across 22 hospitals in Uganda. Data were captured in real time using the open data kit platform from which the data was exported to Stata Version 15 for analysis using the Wilcoxon sign rank test and Somers-Delta.
Results
There were 199 respondent health professionals who were predominately female (146/199, 73.37%), with an average age of 38.97 years. There were 158/199 (79.40%) nurses, 24/199 (12.06%) medical doctors and 17/199 (8.54%) allied health professionals. Overall the research and audit domain had the highest ranking for all the health workers (Somers-D = 0.60). The respondent’s level of education had a significant effect on the observed ranking (P-value = 0.03). Most of the continuing medical education (CME) topic suggested by the participants were in the clinical task related category.
Conclusion
The “research and audit” domain was identified as the priority area for training interventions to improve oncology services in Uganda. There are opportunities for addressing the identified training needs with an expanded cancer CME program content, peer support networks and tailored training for the individual health care provider.
P2X7 on Mast Cells Participates in Peripheral Pain and Serves as A Potential Target for Salicylic Acid and Aspirin Analgesia
Authors: Jiang Yucui , Ye Fan , Du Ying , Tang Zongxiang
Published: May 2020

Background Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. ATP is an important molecule closely related to many important physiological and pathologic functions. ATP-gated cation channel P2X receptors are widely distributed in various tissues of body, including nervous system and immune system. As an important member of P2X receptors, P2X7 is not only involved in pain, epilepsy, Parkinson’s diseases, but also in the formation of blood, respiratory and digestive diseases. In this study, we investigated the role of P2X receptors in mast cells for peripheral pain and the analgesic mechanism of salicylic acid and aspirin. Methods P2X receptors were examined and identified in mouse peritoneal mast cells by RT-PCR, intracellular calcium measurement and electrophysiology. The inflammatory mediators released from the activated mast cell were examined by real-time PCR and ELISA. Paw swelling, mechanical stimulation threshold and histopathological changes were tested to evaluate the peripheral pain in mice.Results The results showed that P2X1, P2X4, P2X7 receptors were expressed in mouse peritoneal mast cells. Mast cell was activated in a concentration-dependent manner by extracellular ATP, and the activation could be blocked by specific ion channel antagonists. In addition, high concentrations of ATP also induced mast cells to release inflammatory mediators such as histamine, IL-1β and CCL3 through P2X7 receptor. Furthermore, peripheral pain of the extracellular high concentration ATP to induce could be alleviated by P2X7 blockers or mast cell defects. We also found that salicylic acid and its derivation aspirin could inhibit high concentration ATP-induced inward current, release of inflammatory factors in mast cells, as well as the peripheral pain caused by high concentration ATP. Conclusions Together with these, we concluded that extracellular ATP with high concentration could not only activate neurons directly, but also activate P2X7 receptor on mast cells, and induce peripheral pain via neuro-immune crosstalk. Additionally, salicylic and aspirin could inhibit the activity of P2X7, therefore, P2X7 receptor may be one of the potential targets for salicylic acid and aspirin analgesia.
The chronic periodontitis in patients with acute coronary syndromes. The inflammation link between periodontal disease and coronary atherosclerosis
Authors: Wojtkowska Agnieszka , Zapolski Tomasz , Wysokinska-Miszczuk Joanna , Wysokinski Andrzej P.
Published: May 2020

Background
Coronary atherosclerosis and periodontal disease, due to their prevalence, are a serious epidemiological problem. Pathophysiological evidence points to their possible common inflammatory etiopathological background. The aim of the study was to analyze the relationship between the presence and severity of periodontitis, systemic inflammation and selected parameters of myocardial injury and heart function in patients with acute myocardial infarction.
Methods
The study group consisted of 71 patients 54.22(7.05) - year - old hospitalized due to acute myocardial infarction. The patients underwent a coronary angiographic examination and echocardiography. The following laboratory parameters were determined: blood morphology, hsCRP, ESR, fibrinogen, troponin I, CK-MB, BNP, lipidogram, glucose, creatinine, GFR, TSH, HbA1c. Dental assessment of the patients was performed and the following indicators were included: the number of teeth preserved, approximal plaque index (API), bleeding on probing (BoP), pocket depth (PD), the number of bleeding periodontal pockets ≥ 4 mm in depth (NoPD ≥ 4 mm), the percentage of bleeding periodontal pockets ≥ 4 mm in depth (%PD ≥ 4 mm), clinical attachment loss (CAL). The severity of periodontal disease and periodontological treatment needs were determined using the Community Periodontal Index of Treatment Needs (CPITN).
Results
The BI (bleeding index) significantly correlated with fibrynogen. All indices regarding the pocket depth (PD, NoPD ≥ 4 mm,% PD4 ≥ mm) correlated significantly with the number of leukocytes. PD and NoPD ≥ 4 mm were also associated significantly with the level of hsCRP. The BI is correlated closely with the levels of BNP. The multifactorial analysis showed that significant predictors of myocardial infarction are API and BI. The analysis showed that API and BI are important predictors of troponin levels. Linear regression analysis showed that only CAL is a significant predictor of BNP.
Conclusions
Patients with acute myocardial infarction have worse periodontal status in the AAP and CPITN classification compared to people without coronary heart disease. Higher severity of periodontal disease, poorer oral hygiene and increased activity of the periodontitis leads to greater manifestation of systemic inflammation in patients with acute myocardial infarction. Periodontitis is a risk factor for myocardial infarction and also affects the degree of post-infarction left ventricular damage, which means that there is an inflammatory link between these two diseases.
Combined Vibrational Spectroscopic and Elemental Studies of 18th Century Transylvanian Stove Tiles
Authors: Bratu Ioan , Marutoiu Constantin , Hernanz Antonio , Nemes Olivia Florena , Tiplic M , Edwards Howell G. M.
Published: May 2020

Three Transylvanian fragments of some 18th century Saxon tiles obtained from excavations in the Central Railway Station Square in Sibiu (Romania) have been studied by Raman microscopy, FTIR, SEM-EDX and XRF techniques. A lead-rich aluminosilicate was found to have been used as enamel/glaze for the tile fragments. An analysis of the band components of the Raman spectra of the enamel of one fragment in the 400–1200 cm− 1 spectral region indicates that their processing temperature was in the 600–800 °C range, in good agreement with the temperature obtained from FTIR spectra of the other two tile fragments.
Risk factors of cytomegalovirus infection or reactivation in ulcerative colitis patients
Authors: Qin Ya-fei , Kong De-jun , Wang Hong-da , Hao Jing-peng , Hu Yong-hao , Zhang Bao-ren , Li Xiang , Zhao Yi-ming , Yu Ding-ding , Jin Wang , Li Guang-ming , Wang Hao
Published: May 2020

Background

To identify the risk factors for cytomegalovirus (CMV)infection or reactivation in ulcerative colitis (UC) patients.
Method

PubMed, Cochrane Library, EMBASE, Web of Science and CNKI were retrieved from the inception of electronic databases to February 2020. All analyses were performed using Stata/SE 15.1 version (StataCorp).
Result

22 papers were included. There was significant difference in severe UC (OR = 1.465, 95% CI: 1.107 to 1.939, P = 0.008), pancolitis (OR = 2.108, 95% CI: 1.586 to 2.800, P = 0.0001), age of onset (MD = 6.212, 95% CI: 2.552 to 9.971, P = 0.001), glucocorticoid (OR = 4.175, 95% CI: 3.076 to 5.666, P = 0.001), immunosuppressant (OR = 2.038, 95% CI: 1.259 to 3.301, P = 0.004), 5-ASA (OR = 0.674, 95% CI: 0.492 to 0.924, P = 0.014). However, no significant difference was detected in disease duration, infliximab.
Conclusion

Severe UC, pancolitis, glucocorticoid, immunosuppressive therapy and age of onset are the risk factors of CMV infection or reactivation in UC patients, we should closely monitor if UC patients with the above indicators and give timely symptomatic treatment to prevent the disease from worsening.
Mutant huntingtin reduces vesicular zinc level by inhibiting the binding of Sp1 to ZnT3 promoter
Authors: Niu Li , Yang Shiming , Wang Weixi , Ye Cui-fang , Li He
Published: May 2020

Background
Synaptic dysfunction caused by mutant huntingtin greatly contributes to Huntington’s disease (HD) pathogenesis. HD patients show cognitive impairment as well as uncontrolled movements. Vesicular zinc is closely linked to modulating synaptic transmission and maintaining cognitive ability. However, whether does mutant huntingtin affect zinc homeostasis in the brain or not? This will be of great significance for further revealing the pathogenesis of HD.
Methods
N171-HD82Q transgenic mice and cultured BHK cells expressing N-terminal mutant huntingtin fragment containing 160 glutamines (160Q BHK cells) were used to investigate the effect of mutant huntingtin on zinc homeostasis and its molecular mechanisms.
Results
Herein, we have demonstrated that the density of synaptic vesicular zinc decreases in the cortex, striatum and hippocampus of N171-82Q mice. Given that vesicular zinc concentration depends on the abundance of zinc transporter 3 (ZnT3) on the membrane of synaptic vesicles, ZnT3 expression is detected in the brain of N171-82Q mice and 160Q BHK cells. Mutant huntingtin leads to a dramatical decrease in ZnT3 mRNA and protein levels in the three brain regions of these mice aged from 14 to 20 weeks. Significantly, Sp1 activates ZnT3 transcription via its binding to the GC boxes in ZnT3 promoter. Nevertheless, mutant huntingtin inhibits the binding of Sp1 to the promoter of ZnT3 gene and down-regulates ZnT3 expression. Furthermore, the overexpression of Sp1 ameliorates inhibition of ZnT3 gene transcription by mutant huntingtin.
Conclusions
Collectively, this first study to reveal a significant loss of synaptic vesicular zinc and ZnT3 expression caused by mutant huntingtin in the early stage of HD. Our findings have revealed the molecular mechanism underlying this change. Mutant huntingtin inhibits the binding of Sp1 to ZnT3 gene promoter to reduce ZnT3 expression. The imbalance of vesicular zinc homeostasis may be closely associated with synaptic dysfunction and cognitive deficits in HD. This work sheds novel mechanistic insights into the pathogenesis of HD and promises a potential therapeutic strategy for HD.
Treatment Strategy of Hemorrhagic Traumatic Shock Patients in High Altitude Area: A Systematic Review
Authors: Zhou Liang , Zhou Siru , Li Mingxia , Dong Chenghai , Ouyang Ganlin , Wang Chunhui , Qi Hailin
Published: May 2020

Background

Because of the influence of hypoxia, the degree of shock of patients with traumatic hemorrhagic shock (HTS) in high altitude area will be aggravated in a short period of time. There is a difference in treatment strategy compared with the low altitude area. At present, the relevant literature reports are growing. However, there is no systematic review of these clinical evidences. Therefore, this study aims to synthesize existing literature on the treatment strategy of HTS patients in high altitude area.
Methods

By searching PubMed, Medline, Embase, CNKI, CBMdisc, VIP and the Cochrane Database of Systematic Reviews, searched from inception until March 1, 2020. The clinical trial of HTS patients at high altitude, which was conducted by qualitative analysis to extract data, classify, summarize and arrange information.
Results

Overall, 254 articles were identified, of which 13 relevant articles were identified following screening. Clinical practice and rationale for treatment decisions mainly involve the following 6 aspects: (1) effective prehospital treatment (hemostasis, bandaging, ventilation and establishment of venous access, etc.); (2) long time and low concentration oxygen supply; (3) limited rehydration, the amount of rehydration being 1–2 times of the patient's blood loss; (4) the microcirculation of patients was improved by drug intervention and rewarming; (5) lanatoside C or cedilanid was used to improve the cardiopulmonary function of patients; (6) 5% sodium bicarbonate was used to improve the acid-base balance of patients. In addition, ARDS, MOF and PTPI are the main complications leading to death.
Conclusions

The level of oxygen supply, rehydration and other treatment strategies for HTS patients in high altitude area are different from those in low altitude areas. The dynamic changes of physiological indexes in the process of treatment are important signs of adjusting the treatment plan. Effective prehospital first aid and rapid medical transport have a positive effect on patients' later rehabilitation.
Prevalence of Malnutrition Inflammation Complex Syndrome among Patients on Maintenance Haemodialysis in Tanzania: A Cross-Sectional Study
Authors: Bramania Puneet Kishore , Ruggajo Paschal , Bramania Rimal , Mahmoud Muhiddin , Furia Francis Fredrick
Published: May 2020

Background: Malnutrition, inflammation and combination thereof are predictors of poor outcomes in haemodialysis patients. Malnutrition Inflammation Complex Syndrome (MICS) is an accelerator of atherosclerosis and portends high mortality. Early recognition and treatment of MICS may help to improve the clinical outlook of such patients. This study investigated on the prevalence of MICS and its associated factors among patients on maintenance haemodialysis at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. Methods: This was a cross-sectional descriptive study done among 160 adult patients on maintenance haemodialysis at MNH in 2019. All participants provided written informed consent. Questionnaires were used to collect data and some laboratory investigations were done. The Malnutrition Inflammation Score was used to access MICS and its severity. Data analysis was done using the SPSS 20 software.Results: Of the 160 patients included in the study, 111 (69.4%) were male. The mean age (±SD) of patients and mean duration (±SD) on haemodialysis were 52.2(13.3) years and 22(18) months respectively. MICS was prevalent in 46.3% (mild in 24.4% and moderate to severe in 21.9%). Long-term haemodialysis (>4years) was an independent predictor of MICS [Adjusted Odds Ratio, AOR 5.04 (95% CI: 1.33–19.2), p<0.05]. Hypercholesterolaemia was a negative predictor of MICS [AOR 0.11 (95% CI: 0.01-0.97), p<0.05]. Patients with MICS had significantly lower mean body mass index, albumin, total cholesterol, transferrin, haemoglobin and serum creatinine levels. Nutritional status and inflammation significantly associated with MICS; adequacy of dialysis did not correlate with MICS.Conclusion: Malnutrition Inflammation Complex Syndrome is relatively common among patients on haemodialysis in Dar es Salaam, Tanzania. Our study has shown longer duration on haemodialysis to be associated with the occurrence of MICS; to the contrary, having hypercholesterolaemia seems to be protective against MICS rhyming well with the concept of reverse epidemiology. Patients on haemodialysis should to be regularly assessed and accordingly treated for malnutrition and inflammation which if left unattended, compounds morbidity and mortality among these patients.
Changes in clinicopathological features of primary nephrotic syndrome in children over a 10 years period: Research Paper
Authors: Guo Haiyan , Li Qian , Yu Lichun , Chen Yuan , Wang Jing , Su Yue , Sun Shunzhen
Published: May 2020

Background

Primary nephrotic syndrome (PNS) is a common chronic disease in childhood and results in heavy illness burden. The aim of this study is to investigate the change in the clinicopathological features of children with NS worldwide.
Methods

Children with PNS were divided into two groups according to the date of admission. Group A was admitted from January 1, 2006 to December 31, 2010 and group B from January 1, 2011 to December 31, 2015. Clinical manifestations and pathological features of the children in both groups were retrospectively analyzed.
Results

This study includes 1072 patients. There were 783 cases of steroid-sensitive nephrotic syndrome (SSNS), 241 cases of steroid-resistant nephrotic syndrome (SRNS), and 48 cases of unknown steroid effects. The incidence of complications in group B was significantly higher than that in group A, especially for infections. A total of 136 (12.96%) patients underwent renal biopsy. The most common lesions were minimal change disease (44.12%). The rate of mesangial proliferative glomerulonephritis (MsPGN) significantly decreased and that of membranous nephropathy (MN) increased over the years. A total of 292 (27.24%) patients were administered immunosuppressants. The administration of Tripterygium was decreased, whereas the using of Tacrolimus increased over the years.
Conclusion

There have been changes in the incidence of complications, pathological features, and immunosuppressants in children with PNS over 10 years.
Causal association pathways between fetuin-A and kidney function: A mediation Analysis
Authors: Bassey Philip Etabee Macdonald , Numthavaj Pawin , Rattanasiri Sasivimol , Srit Piyamitr , McEvoy Mark , Thakkinstian Ammarin
Published: May 2020

BackgroundBody mass index (BMI), uric acid (UA) diabetes mellitus (DM) and hypertension (HT) are known risk factors of declined kidney function, and are associated with fetuin-A. However, the causal pathways of these associations are unclear. We therefore used cohort data to explore possible causal pathways of fetuin-A and kidney function. MethodologyWe used data of the Electricity Generating Authority of Thailand cohort 2009 (n= 2305). A causal pathway was constructed, which considered fetuin-A as study factor, BMI, UA, DM, and HT as mediators, and eGFR as the outcome. A generalized-structural equation model (GSEM) with 1000-replication bootstrapping was applied to assess the causal effects adjusting for covariates. ResultsThe fetuin-A → eGFR pathway showed a direct association of fetuin-A on eGFR with the coefficient of -0.0072 (95% CI: -0.0119, -0.0025). In addition, the indirect effects of fetuin-A→ BMI → eGFR was also significant with the coefficient of 0.00086 (0.00025, 0.0016; implying that every one unit of BMI increased, resulting from increasing fetuin-A, would significantly increase eGFR 0.00086 (0.00025, 0.0016) mL/min/1.73m2. There was a negative effect of fetuin-A on eGFR through BMI and UA pathway (Fetuin-A→BMI→UA→eGFR ) as well as the HT pathway (Fetuin-A→BMI→HT→eGFR ) with average casual mediation effects (ACME) of -0.00132 (-0.00177, -0.00092) and -0.00139 (-0.00237, -0.00069). Fetuin-AàDMàHTàeGFR was also statistically significant with the ACME of -0.00223 (-0.00535, -0.00066).ConclusionOur study has shed some light on the possible role of fetuin-A in the etiology of declining renal function through the mediatory roles of BMI, UA, DM and HT in the various complex causal pathways leading to declining kidney function in our study cohort. Further studies are however recommended to examine the pathomechanisms involved in the mediational processes of these studied risk factors in the etiology of declining kidney function.
Role of MMP-9 in Epithelial-Mesenchymal Transition of Thyroid Cancer
Authors: Li Yuanchun , He Jing , Wang Feng , Wang Xin , Yang Fan , Zhao Chunyang , Feng Chunling , Li Tiejun
Published: May 2020

Background The purpose of this study is to explore the role and mechanism of MMP-9 in the EMT process of thyroid cancer (TC), so as to provide a basis for clinical exploration of invasion and metastasis process of TC, looking for biological markers of tumor metastasis and molecular intervention therapy.Methods Western Blot and RT-PCR were employed to detect the expression of MMP-9 in human normal thyroid cell line HT-ori3 and human TC cell lines IHH-4 (PTC), FTC-133 and 8505C. Expression levels of EMT-related markers: epithelial cell marker E-cadherin and stromal cell marker Vimentin in TGF-1-induced TC cell lines were detected by Western Blot and RT-PCR, respectively. The effects of MMP-9 down-regulation on cell invasion and metastasis were investigated by wound-healing assay and cell invasion experiment.Results The protein and mRNA expression levels of MMP-9 in TC cell lines were increased compared with human normal thyroid cell line HT-ori3. When TGF-β1 was added, the expression of EMT and Vimentin increased while the expression of E-cadherin decreased. Compared with the control group, the TC cells stably transfected with MMP-9 shRNA showed inhibited EMT, decreased Vimentin expression and increased E-cadherin expression. The induction of TGF-β1 did not promote the occurrence of EMT in TC cells which were stably transformed with MMP-9 shRNA. The addition of TGF-β1 to TC cells increased the ability of the cells to migrate and invade. Compared with the control group, the migration and invasion ability of TC cells stably transfected with MMP-9 shRNA was significantly reduced, and the induction of TGF-β1 could not restore the migration and invasion ability of cells without MMP-9.Conclusions In conclusion, we found that MMP-9 can be used as a biomarker for TC, which can promote the EMT process of TGF-β1 induced TC, and thus affecting the cell migration and invasion ability.
The accuracy and safety of CT-guided iodine-125 seeds implantation assisted by 3D non-coplanar template for retroperitoneal recurrent carcinoma.
Authors: Jiang Weijuan , Jiang Ping , Wei Shuhua , Jiang Yuliang , Ji Zhe , Sun Haitao , Fan Jinghong , Li Weiyan , Shao Yuxia , Wang Junjie
Published: May 2020

Purpose
To investigate the accuracy, dosimetric parameters and safety of 3D-printing non co-planar template (3D-PNCT) assisted CT-guidance for radioactive iodine-125 (125I) seed implantation brachytherapy (RSI-BT) for retroperitoneal recurrent carcinomas.
Methods and materials:
We enrolled 15 patients with 17 retroperitoneal recurrent carcinomas after external beam radiotherapy (EBRT). All patients received CT-guided 125I RSI-BT assisted by 3D-PNCT successfully. We compared the original needles insertion position, angular and the needle tips distance deviations of preoperative plan with that of intra-operative in brachytherapy treatment-planning system (B-TPS). The dosimetric parameters of RSI-BT were evaluated on preoperative plan, intra-operative real-time plan and postoperative plan, including D90, D100, V100, V150 and V200. The quality assurance of RSI-BT evaluated on conformal index (CI), external index (EI), homogeneity index (HI) of the targets were compared among preoperative plan, intra-operative real-time plan and postoperative plan. The peri-operation complications and re-radiation related toxicity were assessed.
Results
The median follow-up was 8.2 months (range 1-18.5months). One patient lost follow-up after RSI-BT. 14 patients were assessed for response rate and toxicity. The mean entrance point distance deviation for all 165 needles was 4.50 ± 4.10 mm (range, 0–30). The mean angular deviation was 2.70 ± 3.00 degrees (range, 0–20). The needles tip distances deviation was 6.90 ± 6.00 mm (range, -30-28). D90 for preoperative plan, intra-operative plan and postoperative plan were 140.55 ± 23.93, 124.25 ± 28.04,128.98 ± 22.75. There was significant difference between D90 of preoperative plan with that of intraoperative plan (p = 0.036). Four patients reached CR, three patients reached PR, three patients were SD and three patients was PD. Four patients with middle pain became moderate, two with moderate pain relived completely after RSI-BT. The others parameters showed no differences among preoperative plan, intraoperative plan and postoperative plan. The perioperative complications were observed in four patients, including three patients of grade 1 and one patient of grade 2. No ≥ grade 3 side-effects were observed.
Conclusion
CT-guided 125I RSI-BT assisted by 3D-PNCT was a safe, accurate and feasible strategy for recurrent carcinomas located in retroperitoneal regions.
Mechanical Chest Compression Devices in the Helicopter Emergency Medical Service in Switzerland
Authors: Pietsch Urs , Reiser David , Wenzel Volker , Knapp Jürgen , Tissi Mario , Theiler Lorenz , Rauch Simon , Albrecht Roland
Published: May 2020

Background
Over the past years, several emergency medical service providers have introduced mechanical chest compression devices (MCDs) in their protocols for cardiopulmonary resuscitation (CPR). Especially in helicopter emergency medical systems (HEMS), which have limitations regarding loading weight and space and typically operate in rural and remote areas, whether MCDs have benefits for patients is still unknown. The aim of this study was to evaluate the use of MCDs in a large Swiss HEMS system.
Materials and Methods
We conducted a retrospective observational study of all HEMS missions of Swiss Air rescue Rega between January 2014 and June 2016 with the use an MCD (Autopulse®). Details of MCD use and patient outcome are reported from the medical operation journals and the hospitals’ discharge letters.
Results
MCDs were used in 626 HEMS missions and 590 patients (94%) could be included. 478 (81%) were primary missions and 112 (19%) were interhospital transfers. 49 of the patients in primary missions were loaded under ongoing CPR with MCDs. In the patients loaded after return of spontaneous circulation (ROSC), 20 (7%) experienced a second CA during the flight. In interhospital transfers 102 (91%) only needed standby use of the MCD. Five (4.5%) patients were loaded into the helicopter with ongoing CPR. Five (4.5%) patients went into CA during flight and the MCD had to be activated.
Conclusion
We conclude that equipping HEMS with MCDs may be beneficial, with non-trauma patients potentially benefitting more than trauma patients.
Willingness to Perform Induced Abortion and Associated Factors Among Graduating Midwifery, Medical, Nursing, and Public Health Officer Students of University of Gondar, Northwest Ethiopia: Institution based Cross sectional study
Authors: Enyew Mihretu Molla
Published: May 2020

Background: In developing countries, abortion is often unsafe and a signiﬁcant cause of maternal morbidity and mortality accounting for about 8% (4.7%–13.2%) of maternal mortality worldwide. Internationally, safe abortion services are recognized as reducing maternal mortality, and liberalized abortion laws are associated with reduced mortality resulting from unsafe abortion procedures. However, health care providers have moral, social and gender-based reservations that affects their willingness towards providing induced abortion services. The purpose of this study was to assess willingness to perform induced abortion and associated factors among graduating Midwifery, Medical, Nursing, and Public health officer students of University of Gondar. Methods: Institution based cross sectional study was conducted from March 29 to May 30, 2019. All graduating students available during data collection period were considered as study population. Stratified simple random sampling technique was used to select 424 study participants. Pre tested, semi- structured, self-administered questionnaire was used to collect data. Data analysis was done using SPSS version 20. Ethical clearance was obtained from School of midwifery under the delegation of institutional review board of university of Gondar.Results: 290 students out of 424 students were willing to perform induced abortion for indications supported by Ethiopian abortion law, making a proportion of 68.4% (95%Cl: 64.2, 72.9). Sex (Being male (AOR = 4.89, 95%CI: 3.02, 7.89)), religion (being orthodox than protestant (AOR = 10.41, 95%CI: 3.02, 21.57)), being Muslim than protestant (AOR = 5.73, 95%CI: 1.37, 15.92)) and having once or less a week religious attendance (AOR=2.00, 95% CI: 1.20, 3.34) were factors associated with willingness towards performing induced abortion.Conclusions: According to this study willingness of students towards providing induced abortion services was good. However female students, protestant followers and those students with more than once a week religious attendance should be encouraged in abortion care provisions.
Inhaler devices in asthma and COPD patients – A prospective cross-sectional study on inhaler preferences and error rates
Authors: Schreiber Jens , Roessler Tina , Luecke Eva
Published: May 2020

Background: Inhalation therapy is the backbone of asthma and COPD control. However, inhaler adherence and device mishandling continue to be a problem in real life. Some studies have shown that using a patient-preferred inhaler may reduce device handling errors and improve adherence to prescribed chronic inhaler drug therapy. The aim of this study was to compare the preferences for commonly used inhaler devices in Germany in patients with chronic obstructive respiratory disease. We also pursued the question which properties of an inhaler device are particularly important to the user and what effects age, gender and type of disease (asthma or COPD) may have on device preference and handling errors.Methods: Prospective, open-label cross-sectional study in which 105 patients with asthma (58%) or COPD (42%) participated. Validated checklists were used to objectively assess inhaler technique and errors with 10 different placebo devices. For each device, patients were asked to test the handling, to assess the device properties and to name the device that they would most or least prefer.Results:Across the 10 placebo inhaler devices tested, patients needed an average of 1.22 attempts to error-free use. The device with the lowest mean number of attempts was the Turbohaler® (1.02), followed by the Nexthaler® (1.04), the Diskus® (1.07) and the Spiromax® (1.10). Patients over 60 years vs. younger age (p=0.002) and COPD vs. asthma patients (p=0.016) required more attempts to ensure correct use. 41% of the study participants chose one of the devices they already used as the most preferred inhaler. Overall, 20% opted for the Spiromax®, 15% for the Nexthaler® and 14% for the Turbohaler® or a pMDI. The least preferred device was the Elpenhaler® (0%). From a selection of 7 predefined inhaler attributes, patients stated easy handling as the most important for them. This was followed by short inhalation time and low inhalation resistance. Conclusions: Patient preference may vary between inhaler devices. The lowest number of attempts to error-free use was reported for the Turbohaler® and the Nexthaler®. The Spiromax® and the Nexthaler® achieved the best overall ratings and were the devices most preferred by patients.
In vitro biosynthesis of Ag, Au and Te-containing nanostructures by Exiguobacterium cell-free extracts
Authors: Orizola J. , Ríos-Silva M. , Muñoz-Villagrán C. , Vargas E. , Vásquez C. , Arenas Felipe
Published: May 2020

Background: The bacterial genus Exiguobacterium includes several species that inhabit environments with a wide range of temperature, salinity, and pH. This is why the microorganisms from this genus are known generically as polyextremophiles. Several environmental isolates have been explored and characterized for enzyme production as well as for bioremediation purposes. In this line, toxic metal(loid) reduction by these microorganisms represents an approach to decontaminate soluble metal ions via their transformation into less toxic, insoluble derivatives. Microbial-mediated metal(loid) reduction frequently results in the synthesis of nanoscale structures—nanostructures (NS) —. Thus, microorganisms could be used as an ecofriendly way to get NS.Results: We analyzed the tolerance of Exiguobacterium acetylicum MF03, E. aurantiacum MF06, and E. profundum MF08 to silver(I), gold(III), and tellurium(IV) compounds. Specifically, we explored the ability of cell-free extracts from these bacteria to reduce these toxicants and synthesize NS in vitro, both in the presence or absence of oxygen.All isolates exhibited higher tolerance to these toxicants in anaerobiosis. While in the absence of oxygen they showed high tellurite- and silver-reducing activity at pH 9.0, whereas AuCl4- which was reduced at pH 7.0 in both conditions. Given these results, cell-free extracts were used to synthesize NS containing silver, gold or tellurium, characterizing their size, morphology and chemical composition. Silver and tellurium NS exhibited smaller size under anaerobiosis and their morphology was circular (silver NS), starred (tellurium NS) or amorphous (gold NS). Conclusions: This nanostructure-synthesizing ability makes these isolates interesting candidates to get NS with biotechnological potential.
Allergic rhinitis, asthma and gastro-esophageal reflux disease: a cross-sectional study on their reciprocal relations
Authors: Kakaje Ameer , Alhalabi Mohammad Marwan , Alyousbashi Ayham , Ghareeb Ayham
Published: May 2020

Allergic rhinitis (AR) is a very common medical condition worldwide which affects the quality of life of many for long periods throughout the year. It has many symptoms such as sneezing, a sore throat, globus pharyngeus, rhinorrhoea, congestion, and postnasal drip that may overlap with laryngopharyngeal reflux (LPR) which is a different medical condition. LPR can be considered as an extra oesophageal manifestation of gastro-oesophageal reflux disease (GORD) or a different entity altogether. LPR can go under-diagnosed as there is no definitive diagnostic tool. LPR can impose a real challenge as it may occur for years without diagnosis which can affect the quality of life even more. Having AR can also increase the chance of having asthma which is also in turn correlated with having GORD. Although AR and LPR are not life-threatening, they are persistent medical conditions, meaning they affect the everyday life and causing unnecessary distress. In this study we evaluate their correlation in Syria in the Middle East as there are not many studies on this topic. We found responders with LPR symptoms do have more AR symptoms (P<0.001) and that AR and LPR are correlated with having asthma. We also found that AR and LPR correlation is independent from having asthma P<0.0001 but with subjects with asthma, no such a correlation was found.
Evolution of SARS-CoV-2 spike glycoprotein
Authors: Wrobel Antoni , Benton Donald , Xu Pengqi , Roustan Chloë , Martin Stephen , Rosenthal Peter , Skehel John , Gamblin Steven
Published: May 2020

The spike glycoprotein (S) of SARS-CoV-2 mediates attachment of the virus to cell surface receptors and fusion between virus and cell membranes1. The receptor for SARS-CoV-2, like that for SARS-CoV, is the human cell-surface membrane protein ACE22–4. Membrane fusion activity, as for other class-1 fusion glycoproteins, requires S to be proteolytically cleaved into S1 and S2 that remain associated following cleavage4–7. SARS-CoV-2 is thought to have emerged from bats, possibly via a secondary host8,9. To better understand the transmission of SARS-CoV-2 we have determined the structure of its furin-cleaved S by cryoEM, which shows that cleavage at this polybasic amino-acid site increases the structural plasticity of the receptor binding region and facilitates the adoption of an open conformation that is required for it to bind to the ACE2 receptor. To investigate relationships between S proteins of SARS-CoV-2 and of the most closely related bat virus, RaTG138, we have determined and compared their structures and characterised biochemically their affinities for ACE2 and their relative stabilities. Whilst the overall structures are similar, there are key differences likely pertinent to virus infectivity. These include a more stable pre-cleavage form of human S, about 1000-fold tighter binding of SARS-CoV-2 to human receptor, and a higher proportion of S in the conformation required for binding ACE2 upon protease cleavage.
Solar Cycle Related Variation in Solar Differential Rotation and Meridional Flow in Cycle 24
Authors: Imada Shinsuke , Matoba Kengo , Fujiyama Masashi , Iijima Haruhisa
Published: May 2020

We studied temporal variation of the differential rotation and poleward meridional circulation during solar cycle 24 using the magnetic element feature tracking technique. We used line-of-sight magnetograms obtained using the Helioseismic and Magnetic Imager aboard the Solar Dynamics Observatory from May 01, 2010 to March 26, 2020 (for almost the entire period of solar cycle 24, Carrington Rotation from 2096 to 2229) and tracked the magnetic element features every 1 hour. We also estimated the differential rotation and poleward meridional flow velocity profiles. The observed profiles are consistent with those of previous studies on different cycles. Typical properties resulting from torsional oscillations can also be observed from solar cycle 24. The amplitude of the variation was approximately $\pm$10 m s$^{-1}$. Interestingly, we found that the average meridional flow observed in solar cycle 24 is faster than that observed in solar cycle 23. In particular, during the declining phase of the cycle, the meridional flow of the middle latitude is accelerated from 10 to 17 m s$^{-1}$, which is almost half of the meridional flow itself. The faster meridional flow in solar cycle 24 might be the result of the weakest cycle during the last 100 years.
Laryngopharyngeal Reflux Disease in War-torn Syria and its Association with Smoking and other Risks.
Authors: Kakaje Ameer , Alhalabi Mohammad Marwan , Alyousbashi Ayham , Hamid Aya , Mahmoud Yousef
Published: May 2020

Backgrounds: Syria has entered its ninth year of conflict and as its medical sector facing major hurdles, laryngopharyngeal reflux (LPR) is often overlooked although it has an association with worsening quality of life and affecting many aspects as it is chronic and left untreated although it can lead to many complications such as dysphonia. This study is to evaluate LPR prevalence and its association with different aspects such as cigarette, and shisha smoking, and the effect of war on LPR.Methods: Cross-sectional study by using online questionnaires that included demographics, smoking, war related questions and reflux symptom index (RSI) were used online in many cities around Syria.Findings: This research included 734 responders with 75.5% being female and the mean age being 23.97 years. 31.9% of subjects had symptoms suggestive of LPR. Participants were Syrians and we included every responder who agreed and did not neglect any question. We only found that being distressed from war noises was associated with positive LPR symptoms [P=0.009 (OR, 1.562; 95% CI 1.117-2.183)], but losing someone or changing place of living due to war were not associated with LPR. LPR was associated with cigarette smoking (P<0.05). Finally, having asthma, and male gender in the younger population were associated with LPR (P<0.05). No clear association with age, or shisha and no significant associations were found with consanguinity, marital status, educational level and SES.Interpretations: About one third had LPR symptoms. War distress from war noise, cigarette smoking, asthma, and allergic were significantly correlated with LPR.
Human Laminin-111 and Laminin-211 protein therapy prevents muscle disease progression in an immune deficient mouse model of LAMA2-CMD
Authors: Barraza-Flores Pamela , Hermann Hailey J. , Bates Christina R. , Allen Tyler G. , Grunert Timothy T. , Burkin Dean J.
Published: May 2020

Background Laminin-α2 related Congenital Muscular dystrophy (LAMA2-CMD) is a devastating genetic disease caused by mutations in the LAMA2 gene. These mutations result in progressive muscle wasting and inflammation leading to delayed milestones, and reduced lifespan in affected patients. There is currently no cure or treatment for LAMA2-CMD. Preclinical studies have demonstrated that mouse Laminin-111 can serve as an effective protein replacement therapy in a mouse model of LAMA2-CMD. Methods In this study, we generated a novel immunocompromised dy W mouse model of LAMA2-CMD to study the role the immune system plays in muscle disease progression. We used this immune deficient dy W mouse model to test the therapeutic benefits of recombinant human laminin-111 and laminin-211 protein therapy on Laminin-α2 deficient muscle disease progression. Results We show that immune deficient Laminin-α2 null mice demonstrate subtle differences in muscle regeneration compared to immune competent animals during early disease stages, but overall exhibit a comparable muscle disease progression. We found human laminin-111 and laminin-211 could serve as effective protein replacement strategies with mice showing improvements in muscle pathology and function. We observed that human laminin-111 and laminin-211 exhibit differences on satellite and myoblast cell populations and differentially affect muscle repair. Conclusions This study describes the generation of a novel immune deficient mouse model that allows investigation of the role the immune system plays in LAMA2-CMD. This model can be used to assess the therapeutic potential of heterologous therapies that would illicit an immune response. Using this model, we show that recombinant human Laminin-111 can serve as effective protein replacement therapy for the treatment of LAMA2-CMD.
Seroprevalence of Toxoplasmosis Infection in Diabetic Pregnant Women from Sanandaj, Kurdistan, West of Iran
Authors: Shakiba Nadia , Farhadifar Fariba , Bahmani nasrin , Zareei Mojde
Published: May 2020

Background: Toxoplasma gondii is an opportunistic parasitic protozoan, which is a causative agent of serious complications such as abortion in pregnant women or fetal still birth.
The aim of this study was evaluating the seroprevalence of toxoplasmosis infection in diabetic pregnant women from Sanandaj, Kurdistan, west of Iran.
Methods: In this study 136 serum samples from diabetic pregnant women were collected from referred to the Toohid hospital diabetes center during June 2018 to October 2019 in Sanandaj, Kurdistan, west of Iran. IgM and IgG titers were evaluated by ELISA(enzyme-linked immunosorbent assay) method. The collected data were analyzed by SPSS 19 software and using Chi-Square and Fisher tests.
Results: The ELISA method showed 35(25.7%) and 7(5.1%) of diabetic pregnant women were positive for IgG and IgM T.gondii antibodies respectively. There was statistically significant relationship between toxoplasma infection and education, gestational age and number of parity.
Conclusion: The results of this study showed that public awareness and education about toxoplasmosis and its transmission routes before pregnancy may be effective in preventing congenital toxoplasmosis.
Analysis on risk factors for neck shortening after internal fixation for Pauwels type II femoral neck fracture in young patients
Authors: Zhao Fulong , Guo Lijuan , wang xuefei , Zhang Yakui
Published: May 2020

Background:Femoral neck shortening can occur in in young patients receiving internal fixation for Pauwels type II femoral neck fracture. The risk factors for neck shortening, which can affect hip function, are not clear. This study aimed to retrospectively identify risk factors for neck shortening after internal fixation with parallel partially threaded cannulated cancellous screws for Pauwels type II femoral neck fracture in relatively young patients. Methods: Clinical data from 122 cases with Pauwels type II femoral neck fracture from February 2014 to February 2019 were reviewed and analyzed, and causes of neck shortening were statistically analyzed. And the chi-squared test or Fisher’s exact test was used to compare indicators. Multivariate analysis was conducted with non-conditional logistic regression analysis. Results: Statistically significant differences were found in age, sex, BMD, BMI, fracture type, posterior medial cortex comminution, and reduction quality between patients with femoral neck shortening and those without femoral neck shortening. Logistic regression analysis showed that fracture type, posterior medial cortex comminution, and reduction quality were the main risk factors for neck shortening. Conclusion：Fracture type, posterior medial cortex comminution, and reduction quality can be used as important reference indexes to predict the possibility of neck shortening after internal fixation with parallel, partially threaded, cannulated cancellous screws for Pauwels type II femoral neck fracture in young patients.BMD and BMI may be also risk factors. Key words: Young patients, Femoral neck fracture, Internal fixation, Neck shortening, Risk factors
Detection of high and low-risk HPV DNA in archived breast carcinoma tissues from Ethiopian women
Authors: Gebregzabher Endale Hadgu , Seifu Daniel , Tigneh Wondemagegnhu , Bokretsion Yonas , Bekele Abebe , Abebe Markos , Lillsunde-Larsson Gabriella , Karlsson Christina , Karlsson Mats G
Published: May 2020

Background: HPV have been implicated in the development of cancer of the cervix, mouth and throat, anus, penis, vulva, or vagina, but it has not been much considered as a cause of breast cancer. However, a growing number of investigations have linked breast cancer to viral infections. High-risk HPV types, predominantly (HPV-16, -18, -31, -33, -35, -39, -45, -51, -52, -56, -58, and -59) are established as carcinogens in humans, while HPV-68 is probably carcinogenic. In this study we aimed to detect 19 high risk and 9 low risk HPVs from archived breast tumor tissue among Ethiopian women.Methods: In this study, 75 breast cancer patients from Tikur Anbassa Specialized Hospital in Addis Ababa (Ethiopia) were included. HPV detection and genotyping were done using the novel Anyplex™ II HPV-28 Detection Assay at the Orebro University Hospital, Sweden. The AnyplexTMII PCR System detects 19 high-risk HPV types (16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 69, 73, 82) and 9 low-risk HPV types(6, 11, 40, 42, 43, 44, 54, 61, 70). IHC for p16 was done in automated system using the Dako Autostainer Link.Results: Out of the 75 valid tests 2 were found to be positive (2.7%) for HPV. One of the cases were positive for high risk HPV16 genotype while the other were positive both for high risk HPV39 and low risk HPV6. The cell cycle protein p16 was highly expressed in the case positive for the high risk HPV16 but it was not expressed in the case positive for HPV39.Conclusion: With limited number of cases positive for HPV in this study, it is our conclusion that cervical cancer prevention strategies may help protection of breast cancer only in small groups of patients. Due to limitation of the number of participants in the study as well as possible other mechanisms of carcinogenesis, our observation should be reconfirmed using a larger set of patients and in case-control design.