bluuebunny/crossref_metadata_2025 huggingface dataset:
Farmers’ management of peanut (Arachis hypogaea L.) diversity, their varietal preference traits and uses in Southern and Central Benin
Authors: LOKO Laura Estelle Yêyinou , David Montcho , Martine Zandjanakou-Tachin , Azize Orobiyi , Joelle Toffa , Elodie Hounmakou , Dieudonné Gavoedo , Alexandre Dansi
Published: March 2020

Background Peanut ( Arachis hypogaea L.) is one of the major oilseed legumes contributing to food security and poverty reduction in Benin. Unfortunately, several constraints hamper peanut production in Benin leading to a low yield. Knowing that seed is crucial for increase agricultural productivity, a good knowledge of on-farm management of grown peanut diversity and uses that allow its maintenance in traditional Beninese agriculture are prerequisites to establish an efficient breeding and conservation programs. Therefore, this study aim to document peanut varietal diversity, folk nomenclature, seed system, storage constraints, seeds pest management practices, varietal preference criteria, cultural taboos and uses in southern and central Benin. Methods Two hundred and sixteen (216) farmers were surveyed through 32 villages in southern and central Benin using research tools and techniques of rural appraisal such as field visits, group surveys and individual surveys using a questionnaire. Results Fifty-four peanut folk varieties grouped into 8 morphotypes based on the seed characteristics were registered in the study area. All local names given to peanut folk varieties by ethnic groups have meaning. The number of folk varieties maintained per village ranged from 1 to 11 (an average of 4) and varied between 1 and 4 per household. Some peanut producers reported the disappearance of some folk varieties. The drop in yield was the main reason of peanut varietal disappearance in the study area. Rodent attacks were the most important constraints of peanut production in the study area. Varietal preference criteria varied from ethnic groups with seed size and many pod/seeds per plant as the main preferred traits. Peanut seed system was mainly informal. For peanut seed conservation, farmers use various storage tools. To alleviate pest problems in stored peanut, producers used plant biocides and synthetic chemicals. Some cultural taboos and various uses (food, feed and medicinal) of peanuts have been recorded in the southern and central Benin. Conclusions Our results suggest that for boost peanut production in central and southern Benin, breeders must create high yielding peanut varieties. For the adoption of these new varieties, it is important to take in account the preference varietal criteria of each ethnic group. To a good estimation of peanut diversity in the study area, morphological and molecular characterizations were recommended.
Purification and Identification of Surface Active Amphiphilic Candidates Produced by Geotrichum candidum MK880487 Possessing Antifungal Property
Authors: Eldin Ahmed Mohy , Kamel Zeinat , Hossam Nermeen
Published: March 2020

The authors have requested that this preprint be removed from Research Square.
Anthracycline associated cardiotoxicity in a sub-Saharan African population - tertiary care experience
Authors: Abuodha Joseph Odunga , Shaikh Asim Jamal , Shah Jasmit , Jeilan Mohamed , Barasa Anders
Published: March 2020

Background Anthracyclines are associated with irreversible cardiotoxicity, with changes in echocardiographic parameters preceding clinically manifest cardiac dysfunction. We sought to evaluate the incidence of early cardiac dysfunction post anthracyclines, and associated clinical, echocardiographic and treatment parameters in a sub-Saharan African population. Methods Cancer patients aged ≥18years at anthracycline initiation with archived baseline echocardiograms, underwent repeat echocardiographic assessment. Cases (with cardiac dysfunction) had (1) >15% relative decline from baseline in global longitudinal strain (GLS), or (2) a decline in left ventricular ejection fraction (LVEF) from baseline to <53% with either (i) symptoms (assessed by the Duke Activity Status Index at follow-up echocardiogram) and LVEF decline by >5 to ≤10%, or (ii) LVEF decline >10% regardless of symptoms. Comparisons in clinical, echocardiographic and treatment parameters were made with controls (no cardiac dysfunction). Results Among 141 patients (mean age, 47.7years ± 11.2, Africans 95%, females 85.1%, breast cancer 82%), 39 (27.7%) had cardiac dysfunciton at a mean inter-echocardiogram interval of 14.9months ± 14.3, mean cumulative anthracycline dose of 244.7mg/m 2 ± 72.2, and mean DASI score was 50.0 ± 13.3. Mean cardiotoxic doxorubicin equivalence dose was 236.7mg/m 2 ± 57.4 for cases and 217.3 ± 61.9 for controls [p = 0.033, OR = 1.00 (95% CI: 0.99 - 1.01)]. The assessed clinical, echocardiographic and treatment parameters were not associated with cardiac dysfunction. Conclusion Incidence of early cardiac dysfunction after standard dose anthracyclines in an adult Sub-Saharan population is 27.7% at a mean follow-up of 14.9 months post anthracycline. Routine pre- and post-exposure cardiac assessment should be considered.
Efficacy of andrographolide in not active Progressive Multiple Sclerosis: A prospective exploratory double-blind, parallel-group, randomized, placebo-controlled trial
Authors: Ciampi Ethel , Uribe-San-Martin Reinaldo , Carcamo Claudia , Cruz Juan Pablo , Reyes Ana , Reyes Diego , Pinto Carmen , Vásquez Macarena , Burgos Rafael A. , Hancke Juan
Published: March 2020

Background: Multiple sclerosis (MS) is a chronic immune mediated disease and the progressive phase appears to have significant neurodegenerative mechanisms. The classification of the course of progressive MS (PMS) has been re-organized into categories of active vs. not active inflammatory disease and the presence vs. absence of gradual disease progression. Clinical trial experience to date in PMS with anti-inflammatory medications has shown limited effect. Andrographolide is a new class of anti-inflammatory agent, that has been proposed as a potential drug for autoimmune disorders, including MS. In the present trial, we perform an exploratory pilot study on the efficacy and safety of andrographolide (AP) compared to placebo in not active PMS. Methods: A pilot clinical trial using 140mg oral AP or placebo twice daily for 24 months in patients with not active primary or secondary progressive MS was conducted. The primary efficacy endpoint was the mean percentage brain volume change (mPBVC). Secondary efficacy endpoints included 3-month confirmed disability progression (3-CDP) and mean EDSS change. Results: Forty-four patients were randomized: 23 were assigned to the AP group, and 21 were assigned to the placebo group. The median baseline EDSS of both groups was 6.0. Annualized mPBVC was -0.679% for the AP group and -1.069% for the placebo group (mean difference: -0.39; 95% CI [-0.836-0.055], p=0.08, relative reduction: 36.5%). In the AP group, 30% had 3-CDP compared to 41% in the placebo group (HR: 0.596; 95% CI [0.200 – 1.777], p=0.06). The mean EDSS change was -0.025 in the AP group and +0.352 in the placebo group (mean difference: 0.63, p=0.042). Adverse events related to AP were mild rash and dysgeusia. Conclusions: AP was well tolerated and showed a potential effect in reducing brain atrophy and disability progression, that need to be further evaluated in a larger clinical trial. Trial registration: ClinicalTrials.gov NCT02273635
Prognostic accuracy of qSOFA score for in-hospital mortality among influenza patients in the emergency department
Authors: Chu Sheng-En , Seak Chen-June , Su Tse‐Hsuan , Chaou Chung-Hsien , Tseng Hsiao-Jung , Li Chih-Huang
Published: March 2020

Background The annual seasonal influenza pandemic is an important public health issue around the world. Early prediction of patients with potentially worse outcome is important in the emergency department (ED). However, a simple and accurate predictor is yet to be developed. In this study, we aimed to investigate the effectiveness of the quick Sequential Organ Failure Assessment (qSOFA) score as a prognostic predictor of patients with influenza in the ED. Methods This is a single-center, retrospective cohort study. All the data were retrieved from a hospital-based research database. Adult patients (age ≥ 18 at admission) with a positive influenza rapid screening test or a positive influenza virus polymerase chain reaction (PCR) from 2010 to 2016 were enrolled for data analysis. qSOFA score and Systemic Inflammatory Response Syndrome (SIRS) in the ED were both collected. The primary outcome was the utility of each score in predicting in-hospital mortality. ResultsIn the study period, 3,561 patients met the inclusion criteria. The overall in-hospital mortality was 2.7% (95 patients). When the qSOFA score was 0, 1, 2, and 3, the percentage of in-hospital mortality was 0.6%, 7.2%, 15.9%, and 25%, respectively. Accordingly, the odds ratios were 7.72, 11.92, and 22.46, respectively. The sensitivity and specificity when qSOFA score ≥ 2 was 24% and 96.2%, respectively. The area under depicted receiver operating characteristic curve (AUC) was 0.864, which is significantly higher than with SIRS criteria, where the AUC was 0.786 (p < 0.01). Conclusions The qSOFA score is a useful prognostic tool for influenza and can be applied in the ED. However, it might not be a good screening triage tool because of poor sensitivity to detect high-risk patients. The SIRS score had poor performance in influenza to predict outcomes. Further studies should be performed to define its role in influenza.
Spatial and temporal patterns of Ross River virus in South East Queensland, Australia: identification of hot spots at the rural-urban interface
Authors: Murphy Amanda K. , Clennon Julie A. , Vazquez-Prokopec Gonzalo , Jansen Cassie C. , Frentiu Francesca D. , Hafner Louise M. , Hu Wenbiao , Devine Gregor J.
Published: March 2020

Background: Ross River virus (RRV) is responsible for the most common vector-borne disease of humans reported in Australia. The virus circulates in enzootic cycles between multiple species of mosquitoes, wildlife reservoir hosts and humans. Despite regular outbreaks, ongoing morbidity and substantial economic costs, the underlying determinants of epidemics remain unclear. Public health concern about RRV has recently increased due to rising incidence rates in Australian urban centres, along with increased circulation in Pacific Island countries. Australia experienced its largest recorded outbreak of 9,544 cases in 2015, with the majority reported from South East Queensland (SEQ). We aimed to provide a detailed analysis of disease trends and explore potential links between disease patterns and transmission pathways of RRV. Methods: We assessed the spatial and temporal distribution of notified RRV cases, and associated epidemiological features in SEQ, from 2001-2016. This included fine-scale analysis of disease patterns across the suburbs of the capital city of Brisbane, and those of 8 adjacent Local Government Areas, and host spot analyses to identify locations with significantly high incidence. Results: The mean annual incidence rate for the region was 41/100,000 with a consistent seasonal peak in cases between February and May. The highest RRV incidence was in adults aged from 30-64 years (mean incidence rate: 59/100,000), and females had higher incidence rates than males (mean incidence rates: 44/100,000 and 34/100,000, respectively). Spatial patterns of disease were heterogeneous between years, and there was a wide distribution of disease across both urban and rural areas of SEQ. Overall, the highest incidence rates were reported from predominantly rural suburbs to the north of Brisbane City, with significant hot spots located in peri-urban suburbs where residential, agricultural and conserved natural land use types intersect. Conclusions: Although RRV is endemic across all of SEQ, transmission is most concentrated in areas where urban and peri-urban environments intersect. The drivers of RRV transmission across rural-urban landscapes should be prioritised for further investigation, including identification of specific vectors and hosts that mediate human spillover.
Dynamics of hepatitis C epidemic among people living with HIV in Estonia
Authors: Kase Kerstin , Avi Radko , Toompere Karolin , Rajasaar Heli , Pauskar Merit , Soodla Pilleriin , Jõgeda Ene-Ly , Zilmer Kai , Lutsar Irja , Huik Kristi
Published: March 2020

Background Estonia has a typical Eastern European HIV epidemic where the most frequent co-infection is chronic hepatitis C (HCV). We aimed to describe the changes in HCV prevalence, the distribution of HCV genotypes (GT), and HCV treatment in Estonian people living with HIV over 15 years. Methods We used data of subjects included to the Estonian HIV Cohort Study (E-HIV) before 31 st of December 2015. We compared two time periods – first, 1 st of January 2000 - 31 st of December 2008 when HIV epidemic was mostly spreading among people who inject drugs (PWID) and second, 1 st of January 2009 to 31 st of December 2015 when HIV started to emerge to general population. Results Of 4422 HIV positives 3708 (84%) had information about their HCV serostatus; 2706 (61%) were HCV seropositive, of latter 1625 (60%) were HCV RNA positive, 239 (9%) had their HCV GT determined, and 141 (5%) received treatment for HCV. HCV prevalence was 1.5 times (95% CI 1.4-1.6) higher in subjects diagnosed with HIV in first as compared to those diagnosed in second period (84% vs 56%, respectively). There were more men and the median age at HIV diagnosis was lower in HIV/HCV co-infected than in HIV mono-infected patients (70% vs 47% and 24 years vs. 30 years, respectively; both p<0.001).Conclusion There is a decrease in HCV prevalence but it remains high among HIV positive PWID, suggesting that there is need for improvement of harm reduction programs among PWID.
Development and validation of a scoring system for predicting cancer patients at risk of extended-spectrum b-lactamase-producing Enterobacteriaceae infections.
Authors: Martinez-Valencia Alvaro Jose , Martínez Brian J Gómez , Ayala Anita M Montañez , Garcia Katherin , Pedraza Ricardo Sánchez , Cetina Leydy Jiménez , Rincón Julio Cesar Gómez , Maldonado Sonia Isabel Cuervo
Published: March 2020

Background: Extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) infections are frequent and highly impact cancer patients. We developed and validated a scoring system to identify cancer patients harboring ESBL-PE at the National Institute of Cancer of Colombia. Methods: We retrospectively analyzed medical records of 1695 cancer patients. Derivation phase included 710 patients admitted between 2013 to 2015, ESBL-PE positive culture (n = 265) paired by month and hospitalization room with Non-ESBL-PE (n = 445). A crude and weighted score was developed by conditional logistic regression. The model was evaluated in a Validation cohort (n = 985) with the same eligibility criteria between 2016 to 2017. Results: The score was based on eight variables (reported with Odds Ratio and 95% confidence interval): Hospitalization ≥7 days (5.39 [2.46 - 11.80]), Hospitalization during the previous year (4 , 87 [2.99 - 7.93]), immunosuppressive therapy during the previous 3 months (2.97 [1.44-6.08]), Neutropenia (1.90 [1.12 - 3.24]), Exposure to Betalactams during previous month (1.61 [1.06 - 2.42]), Invasive devices (1.51 [1.012 - 2.25]), Neoplasia in remission (2.78 [1.25 - 1.17]), No chemotherapy during the previous 3 months (1.90 [1.22 - 2.97]). The model demonstrated an acceptable discriminatory capacity in the Derivation phase, but poor in the Validation phase (Recipient Operating Characteristic Curve: 0.68 and 0.55 respectively). Conclusions: Cancer patients have a high prevalence of risk factors for ESBL-PE infection. The scoring system did not adequately discriminate patients with ESBL-PE. In a high-risk population, other strategies should be sought to identify patients at risk of resistant ESBL-PE infection.
Socio-demographic and Clinical Variables associated with the variation of CD4 Cell Count and Body Mass Index (BMI) for HIV Positive adults receiving HAART, a joint longitudinal data analysis
Authors: Tegegne Awoke Seyoum , Ndlovu Principal Ndlovu , Zewotir Temesgen Zewotir
Published: March 2020

Objective The rate of prevalence of HIV/AIDS among adults has been increasing in Sub-Sahara African countries over the last decade. Currently, an estimated number of 722, 248 people are living with HIV, 23, 000 people are newly infected with HIV and 11,000 people are died because of AIDS related illness. The purpose of this study was to identify the most significant variables associated with the variation of CD4 cell count and body mass index (BMI) of HIV positive adults who initiated HAART at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia. Methods To analyze the long-term CD4 cells count and body mass index of HIV infected adults, a prospective follow-up study of 792 HIV-infected patients was performed. A joint model was employed to identify the variables associated with the variation of CD4 cell count and body mass index of adults receiving HAART. A random of 792 samples was taken among charts in the hospital. Results Among the main effects, Socio-demographic variables (Level of education, level of exposedness of disease to persons living together, Marital status and residence area), individuals characteristics (age and weight), economic factors (ownership of cell phone, level of income), clinical factors (baseline CD4 cell count), level of retention (time to follow ups, food and medical adherence) and economic factors(owner of cell phone) significantly affected the variables of interests. Similarly, the interaction effects of time of follow-up visits * cell phone ownership, follow-up visits * gender, age * sex significantly affected both response variables through a linear link function in current investigation. Conclusion Socio-demographic, individual and Clinical variables had significant effect on CD4 cell count and BMI in HAART medication program. Time to follow ups in the HAART program had also direct and significant effect on the variables of interest.
Epidemiological and clinical features of 201 COVID-19 patients in Changsha, China
Authors: Zhou Jian , Sun Jing-jing , Cao Zi-qin , Wang Wan-chun , Huang Kang , Zheng Fang , Xie Yuan-lin , Jiang Di-xuan , Zhou Zhi-guo
Published: March 2020

Background In December 2019, a cluster of coronavirus Disease 2019 (COVID-19) occurred in Wuhan, Hubei Province, China. With the advent of the Chinese Spring Festival, this disease spread rapidly throughout the country. The information about the clinical characteristics of COVID-19 patients outside of Wuhan is limited. Methods All of the patients with confirmed COVID-19 were admitted to the First Hospital of Changsha City, the designated hospital for COVID-19 assigned by the Changsha City Government. The clinical and epidemiological characteristics, data of laboratory, radiological picture, treatment, and outcomes records of 201 COVID-19 patients were collected using electronic medical records. Results This study population consisted of 201 hospitalized patients with laboratory-confirmed COVID-19 in Changsha by February 15, 2020. The median age of the patients was 45 years (IQR 34–59). About half (50.7%) of the patients were male, and most of the infected patients were staff (96 [47.8%]). Concerning the epidemiologic history, the number of patients linked to Wuhan was 92 (45.8%). The most common symptoms were fever (125 [62.2%]), dry cough (118 [58.7%]), fatigue (65 [32.3%]), and pharyngalgia (31 [15.4%]). One hundred and forty-four (71.6%) enrolled patients showed bilateral pneumonia. Fifty-four (26.9%) patients showed unilateral involvement, and three (1.5%) patients showed no abnormal signs or symptoms. The laboratory findings differed significantly between the Intensive Care Unit (ICU) and non-ICU groups. Compared with non-ICU patients, ICU patients had depressed white blood cell (WBC), neutrocytes, lymphocytes, and prolonged prothrombin time (PT). Moreover, higher plasma levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), alanine aminotransferase (ALA), aspartate aminotransferase (AST), creatine kinase (CK), creatine kinase-MB (CK-MB), creatinine (CREA), and lactate dehydrogenase (LDH) were detected in the ICU group. Conclusions In this single-center study of 201 COVID-19 patients in Changsha, China, 22.4% of patients were admitted to ICU. Based on our findings, we propose that the risk of cellular immune deficiency, hepatic injury, and kidney injury should be monitored. Previous reports focused on the clinical features of patients from Wuhan, China. With the global epidemic of COVID-19, we should pay more attention to the clinical and epidemiological characteristics of patients outside of Wuhan.
Barriers and facilitators for colorectal cancer screening in a low-income urban community in Mexico City
Authors: Unger-Saldaña Karla , Saldaña-Tellez Minerva , Potter Michael B. , Loon Katherine Van , Allen-Leigh Betania , Lajous Martin
Published: March 2020

Background Colorectal cancer (CRC) incidence and mortality are increasing in many middle- and lower-income countries, possibly due to a combination of changing lifestyles and improved healthcare infrastructure that facilitates diagnosis. Unfortunately, a large proportion of cases may be diagnosed at advanced stages, resulting in poor outcomes. Decreasing trends in higher income countries are likely due to improved early detection combined with best practices in CRC treatment and management. More data on implementation of better quality CRC screening programs are needed for contexts where incidence is increasing. Therefore, we sought to identify potential barriers and facilitators for future implementation of fecal immunochemical test (FIT)-based CRC screening in a public healthcare system in a middle-income country with increasing CRC incidence and mortality. Methods. Qualitative study including semi-structured individual and focus group interviews with different stakeholders of colorectal cancer screening: 30 average-risk lay people, 13 health care personnel from a local public clinic, and 7 endoscopy unit personnel from a cancer referral hospital. All interviews were transcribed verbatim for analysis. Data was analyzed using the constant comparison method, under the theoretical perspectives of the Social Ecological Model (SEM), the PRECEDE-PROCEED Model, and the Health Belief Model. Results. We found multiple barriers and facilitators for implementation of a FIT-based CRC screening program at different levels of the SEM. The main barriers in each of the SEM levels, were: 1) at the social context level: poverty, health literacy and lay beliefs related to gender, cancer, allopathic medicine, and religion; 2) at the health services organization level: the lack of CRC knowledge among health care personnel and the community perception of poor quality of health care; 3) at the individual level: a lack of CRC awareness and therefore lack of risk perception, together with fear of participating in screening activities and finding out about a serious disease. The main facilitators perceived by the participants were CRC screening information and the free provision of screening tests.Conclusions. This study’s findings suggest the need for a multi-level CRC screening program that includes complementary strategies aimed at reducing perceived barriers and enhancing facilitators, starting with: 1) free provision of screening tests, 2) education of primary health care personnel, and 3) promotion of non fear-based CRC screening awareness among the target population, taking into account their lay beliefs.
Risk factors for esophagitis after hypofractionated palliative (chemo)radiotherapy for non-small cell lung cancer
Authors: Nieder Carsten , Imingen Kristian S. , Mannsåker Bård , Yobuta Rosalba , Haukland Ellinor
Published: March 2020

Introduction Esophagitis influences quality of life and might cause treatment interruption and hospitalization. Previous studies of risk factors mainly related to curative treatment for non-small cell lung cancer (NSCLC), which often involves concomitant chemoradiation (CRT). Given the uncertainty around extrapolation of dose constraints, we analyzed risk factors in patients treated with hypofractionated palliative regimens. Patients and Methods A retrospective review of 106 patients treated with palliative radiotherapy or CRT between 2009 and 2017 was performed. Inclusion criteria: prescribed total dose 30-54 Gy, dose per fraction 2.5-4 Gy, esophageal dose >1 Gy. Uni- and multivariate analyses were performed in 97 eligible patients to identify predictive factors for acute esophagitis grade ≥1 (CTCAE 5.0). Results Forty percent of patients were treated with 15 fractions of 2.8 Gy (42 Gy) and 28% also received chemotherapy according to the CONRAD study regimen (induction and concomitant Carboplatin/Vinorelbine) published by the Norwegian Lung Cancer Group. Thirty-four percent were treated with 10 fractions of 3 Gy. Stage IV NSCLC was present in 47%. Esophagus Dmax was 39 Gy (population median) and Dmean 15 Gy. Overall 31% of patients developed esophagitis (26% grade 2-3, no grade 4-5). Several dosimetric parameters correlated with the risk of esophagitis (Dmax, Dmean, D5cc, V20, V30, V35, V40). Dmax outperformed other dosimetric variables in multivariate analysis. Furthermore, concomitant chemotherapy significantly increased the risk of esophagitis, while oral steroid medication reduced it. In patients with Dmax ≥40 Gy a reduced Dmean (≤20 Gy) was beneficial. Conclusion In order to reduce esophagitis after hypofractionated palliative treatment lower doses than those recommended in curative NSCLC settings are preferable. Besides esophageal dose, CRT is the main risk factor for esophagitis. Additional work is needed to confirm that steroids are able to modify the risk (or to rule out confounding effects of baseline variables not included in our database).
Nomogram to predict survival of pulmonary large-cell neuroendocrine carcinoma after surgery
Authors: Huang Qian , Liu Jie , Cai Huifang , Zhang Qi , Wang Lina
Published: March 2020

Background Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare primary malignant tumor with a poor prognosis, and surgery is the main treatment. However, there are no effective predictive tools to assess the prognosis of postoperative patients. Our aim is to identify prognostic factors and construct nomogram to accurately assess prognosis. Methods Patients were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Based on the results of Cox regression analysis, construct nomogram for predicting 1-, 3-, and 5-year survival. The predictive performance of nomogram was evaluated using the consistency index (C-index), the area under the receiver operating characteristics curve (AUC), and calibration plots. Results We finally screened 903 patients with pulmonary LCNEC who underwent surgery. The Cox regression analysis showed that age, SEER stage, T stage, N stage, M stage, tumor size, and chemotherapy were independent prognostic factors for overall survival (P<0.05). The C-index of the nomogram is 0.681 on the training cohort and 0.675 on the validation cohort. The AUC and calibration plots show that the nomogram has good performance. Conclusion We constructed and validated nomogram for predicting 1-, 3-, and 5-year survival of patients with pulmonary LCNEC after surgery. Our nomogram provides reference information for assessing the overall survival of these patients.
A unique type of fully covered metal stent for the management of post liver transplant anastomotic strictures
Authors: Warner Ben , Harrison Phillip , Farman Muhammad , Devlin John , Reffitt David , El-Sherif Yasser , Khorsandi Shirin E , Prachalias Andreas , Cerisuelo Miriam Cortes , Menon Krish , Jassem Wayel , Sriniva Parthi , Vilca-Melendez Hector , Heneghan Michael , Heaton Nigel , Joshi Deepak
Published: March 2020

Background: We report our experience of treating anastomotic strictures using a novel type of fully covered metal stent (FCSEMS). This stent, known as the Kaffes Stent, is short-length with an antimigration waist and easily removable due to long retrieval wires deployed within the duodenum. Methods: 62 patients who had this stent inserted were prospectively analysed. Results: 81% of patients had long-term resolution of their stricture with a significant improvement in liver function tests. Complication rates were 15% with one patient requiring biliary reconstruction. Conclusions: This type of FCSEMS is effective and safe at resolving anastomotic strictures.
The Clinical Efficacy and Adverse Effects of Entecavir plus Thymosin alpha-1 Combination Therapy versus Entecavir Monotherapy in HBV-related Cirrhosis: A Systematic Review and Meta-analysis
Authors: Peng Dan , Xing Hai-Yan , Li Chen , Wang Xian-Feng , Hou Min , Li Bin , Chen Jian-Hong
Published: March 2020

Background Previous studies have demonstrated the benefits of thymosin alpha-1 (Tα1) in anti-virus, immunological enhancement and anti-inflammation. However, it is controversial about the efficacy and safety of entecavir (ETV) plus Tα1 combination therapy versus ETV monotherapy in cirrhosis patients with hepatitis B virus (HBV) infection. Objective The systematic review and meta-analysis of randomized clincal trials (RCTs) were performed to evaluate the efficacy and safety of ETV plus Tα1 compared with ETV monotherapy in HBV-related cirrhosis. Methods A systematic search was performed via PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journals Database (VIP), and Chinese Biological Medicine database (CBM). Relative risk (RR) and standardized mean difference (SMD) with a fixed- or random- effect model were calculated. Heterogeneity were assessed with the Cochrane Q-test and I 2 values. Results Seven RCTs involving 1144 subjects were included in the systematic review and meta-analysis. Compared with ETV monotherapy, ETV plus Tα1 combination therapy led to a higher complete response (RR = 1.18; 95% CI, 1.07 - 1.30). The HBV DNA undetectable rate and HBeAg loss rate of ETV plus Tα1 therapy for 24 weeks was higher than the ETV alone (RR = 1.91; 95% CI, 1.56 - 2.35; RR = 2.05; 95% CI, 1.62 - 2.60). However, after treatment for 48 and 52 weeks, there was no significantly different between the combination therapy and ETV monotherapy (RR = 1.07; 95% CI, 0.96 - 1.18; RR = 1.17; 95% CI, 0.89 - 1.55). In comparison with ETV alone, ETV plus Tα1 improved part of biochemical parameters and liver fibrosis. There was significant heterogeneity. In addition, The ETV plus Tα1 significantly reduced adverse events compared to ETV monotherapy (RR = 0.48; 95% CI, 0.24 - 0.95). Conclusions ETV plus Tα1 combination therapy might have a higher clinical response and a lower comprehensive adverse reaction rate in HBV-related cirrhosis patients compared with ETV monotherapy. Meanwhile, the whole patients included in this meta-analysis were from chinese mainland, so that more worldwide RCTs with a large sample size are needed to verify the current findings.
Total laparoscopic partial hepatectomy versus open partial hepatectomy for primary left-sided hepatolithiasis: study protocol for a randomized controlled trial
Authors: pan bo shu , WU LI CHUN , zhou chen da , xiong ru qi , geng ping xiao , hou hui
Published: March 2020

Background : The advantages of laparoscopic left-sided hepatectomy (LLH) for treating hepatolithiasis in terms of the time to functional recovery , postoperative length of hospital stay (LOS), morbidity, long-term abdominal wall hernias, hospital costs, residual stone rate and recurrence of calculus have not been confirmed by a randomized controlled trial. The aim of this trial is to compare the safety and effectiveness of LLH to those of open left-sided hepatectomy (OLH) for the treatment of hepatolithiasis. Methods: Patients with hepatolithiasis eligible for left-sided hepatectomy will be recruited. The experimental design will produce two randomized arms (laparoscopic and open hepatectomy) at a 1:1 ratio and a prospective registry. All patients will undergo surgery in the setting of an enhanced recovery after surgery (ERAS) program. The prospective registry will be based on patients who cannot be randomized because of the explicit treatment preference of the patient or surgeon or because of ineligibility (not meeting the inclusion and exclusion criteria) for randomization in this trial. The primary outcome is the time to functional recovery. The secondary outcomes are LOS, percentage readmission, morbidity, mortality, hospital costs, long-term incidence of incisional hernias, residual stone rate and recurrence of calculus. It will be assumed that, in patients undergoing LLH, the length of hospital stay will be reduced by 1.3 days. A sample size of 44 patients in each randomization arm has been calculated as sufficient to detect a 1.3-day reduction in LOS (90% power and α = 0.05 (two-tailed)). The trial is a randomized controlled trial that will provide evidence for the merits of laparoscopic surgery in patients undergoing liver resection within an ERAS program. Discussion: Although the outcomes of LLH have been proven to be comparable to those of OLH in retrospective studies, the use of LLH remains restricted, partly due to the lack of short-and long-term informative RCTs pertaining to patients with hepatolithiasis in ERAS programs. To evaluate the surgical and long-term outcomes of LLH, we will perform a prospective RCT to compare LLH with OLH for hepatolithiasis within an ERAS program. Trial registration: ClinicalTrials.gov NCT03958825 . Keywords: Laparoscopic, open liver resection, ERAS, Hepatectomy
Treating depression with a smartphone-delivered self-help cognitive behavioural therapy for insomnia: Study protocol for a parallel group randomized controlled trial
Authors: Hui Victoria Ka-Ying , Wong Christy Yim-Fan , Ka-Yiu Eric , Ho Fiona Yan-Yee , Chan Christian S
Published: March 2020

Background Depression is a major public health concern. Emerging research has shown that cognitive behavioural therapy for insomnia (CBT-I) is effective in treating individuals with comorbid insomnia and depression. Traditional face-to-face CBT-I encounters many obstacles related to feasibility, accessibility, and help-seeking stigma. CBT-I delivered via smartphone application could be a potential solution. This paper aims to report a protocol designed to evaluate the efficacy of a self-help smartphone-based CBT-I, compared to a waitlist control, for people with major depression and insomnia. Methods A two-arm parallel randomized controlled trial is conducted in a target sample of 285 non-suicidal Hong Kong Chinese older than 17 years of age with major depression and insomnia. Participants complete an online rapid screening, followed by a telephone diagnostic interview. Those who meet the eligibility criteria are randomized in a ratio of 1:1 to receive either CBT-I immediately or to a waitlist control condition. The CBT-I consists of six weekly modules and is delivered through a smartphone application proACT-S. This smartphone app has been pilot tested and revamped to improve user experience. An online randomized algorithm is used to perform randomization to ensure allocation concealment. The primary outcomes are changes over the measurement points in sleep quality, insomnia severity, and depression severity. The secondary outcomes include changes over the measurement points in anxiety, subjective health, treatment expectancy, and acceptability of treatment. Assessments are administered at baseline, post-intervention, and 6-week follow up. The recruitment is underway. Important adverse events, if any, are documented. Multilevel linear mixed model based on intention-to-treat principle will be conducted to examine the efficacy of the CBT-I interventions. Discussion It is expected that proACT-S is an efficacious brief sleep-focused self-help treatment for people with major depression and insomnia. If proven efficacious, due to its self-help nature, proACT-S may be applicable as a community-based early intervention, reducing the burden of the public healthcare system in Hong Kong.
Acute kidney injury following on-pump or off-pump coronary artery bypass grafting in elderly patients: a retrospective propensity score matching analysis
Authors: wang rui , Wang Xian , Zhu Yifan , Chen Wen , Li Liangpeng , Chen Xin
Published: March 2020

Objectives This single-centre, retrospective propensity score matching (PSM) study designed to study the impact of cardiopulmonary bypass (CPB) on postoperative acute kidney injury (AKI) and the relationship between AKI and long-term outcomes in elderly patients undergoing coronary artery bypass grafting (CABG). Methods After PSM, 466 pairs of patients (A group, on-pump; B group, off-pump) who were aged≥70 years undergoing first isolated CABG surgery from January 2012 to December 2016 entered the study. AKI was defined and classified according to the Acute Kidney Injury Network (AKIN) criteria. The incidence and severity of in-hospital AKI was compared. The impacts of AKI on the long-term outcomes including new onset of dialysis and mortality were analyzed. Results The two PSM groups had similar baseline and procedure except whether the CPB was used or not. In hospital and 30-day mortality was of no difference(χ2=0.051, p=0.821). AKI of any severity occurred in 40.3% of all patients, with stage 1 accounting for most cases. No difference regarding the incidence and severity of AKI could be found: AKIN stage 1: 139 (29.8%) vs 131 (28.1%); AKIN stage 2: 40 (8.6%) vs 35 (7.5%); AKIN stage 3: 18 (3.9%) vs 13 (2.8%), (u=0.543, p=0.532). No difference was observed in the in-hospital new onset of dialysis (χ2=0.312, P=0.576). The use of CPB was not found to influence long-term new onset of dialysis (χ2=0.14, p=0.708) and mortality (χ2=0.099, p=0.753). Comparing with non-AKI patients, AKI patients were associated with an increased rates of new onset of dialysis (χ2=8.153, p=0.004) and mortality (χ2=6.277, p=0.012) during the follow-up. Comparing with non-AKI patients, the HR for long-term new onset of dialysis and mortality in AKI patients was 1.83 and 1.31 respectively (95%CI 1.12-2.86, p=0.007; 95%CI 1.17-2.58, p=0.015). Conclusions For elderly CABG patients, AKI was common, but deterioration of dialysis was a seldom incidence. Comparing with on-pump, off-pump did not decrease the rates or severity of AKI, long-term new onset of dialysis or mortality. AKI was associated with an increased long-term new onset of dialysis and decreased long-term survival.
Ic100: A Novel Anti-ASC Monoclonal Antibody Improves Functional Outcomes In An Animal Model Of Multiple Sclerosis
Authors: Desu Haritha L , Plastini Melanie , Illiano Placido , Bramlett Helen M , Dietrich W. Dalton , Vaccari Juan Pablo de Rivero , Brambilla Roberta , Keane Robert W.
Published: March 2020

Background The inflammasome adaptor apoptosis-associated speck-like protein containing a CARD (ASC) is involved in immune signaling by bridging the interactions between inflammasome sensors and caspase-1. Strong experimental evidence has shown that ASC -/- mice are protected from disease progression in animal models of multiple sclerosis (MS), suggesting that targeting inflammasome activation via ASC inhibition may be a promising therapeutic strategy in MS. Thus, the goal of our study is to test the efficacy of IC100, a novel humanized antibody targeting ASC, in preventing and/or suppressing disease in the experimental autoimmune encephalomyelitis (EAE) model of MS.Methods We employed the EAE model of MS where disease was induced by immunization of C57BL/6 mice with myelin oligodendrocyte glycoprotein peptide 35-55 (MOG 35-55 ). Mice were treated with vehicle or increasing doses of IC100 (10, 30 and 45 mg/kg) and clinical disease course was evaluated up to 35 days post EAE induction. Immune cell infiltration into the spinal cord and microglia responses were assessed.Results We show that IC100 treatment reduced the severity of EAE when compared to vehicle-treated controls. At a dose of 30 mg/kg, IC100 significantly reduced the number of CD4 + and CD8 + T cells and CD11b + MHCII + activated myeloid cells entering the spinal cord from the periphery, and reduced the number of total and activated microglia.Conclusions These data indicate that IC100 suppresses the immune-inflammatory response that drives EAE development and progression, thereby identifying ASC as a promising target for the treatment of MS as well as other neurological diseases with a neuroinflammatory component.
Multiple HPV infection as possible marker of neoplastic progression
Authors: Bruno Maria Teresa , Scalia Guido , Cassaro Nazario , Boemi Sara
Published: March 2020

Background : Some studies in the literature suggest a possible role of multiple HPV infections as a prognostic factor in the development and progression of cervical neoplasia. we studied the cases of single and multiple HPV infection and analyzed the correlation with negative cases, and preneoplastic and neoplastic lesions of the uterine cervix with the aim of making a contribution to the prognostic factor under discussion Methods: 921 women with clinical HPV manifestations were enrolled. Inclusion criteria were: positive at the cytology for HPV lesions, presence of preneoplastic and neoplastic lesions of the uterine cervix diagnosed by the histology examination All the patients underwent colposcopy and cervical biopsy with viral genotyping. The search for viral DNA was carried out using polymerase chain reaction. Genotype 16 is correlated with the majority of CIN2+; we divided the multiple HPV16 infections into “infections with 16 as the first genotype” (16mHPV) (e.g. HPV 16 , 31, 52) and into “ infections containing 16” (m16HPV) (e.g. HPV 31, 16 , 52), we then divided them based on the number of genotypes present: infections with 2 strains, 3 strains, 4 strains, and > 4 strains. Results: We analyzed the differences between single and multiple infections with HPV16, the patients with single infections had a higher incidence of CIN2+ (83.3%) with respect to those with multiple infections (71.4%). The 16mHPV infection was significative for CIN2/CIN3. When the prevalence of the combinations between the genotypes was studied, we found that in 16mHPV infection HPV16, 18 and HPV 16, 31 were the most common combinations of mHPV infection (50%) and the most frequent in CIN2/CIN3 The 16mHPV infection with 2 genotypes, with respect to the infections with 3 or more genotypes, was significative with an OR= 7.94 (IC% 2.55-24.73). Conclusions: Our results suggest that single HPV infections give a higher risk of SCC development with respect to multiple HPV infections. Among multiple infections, only 16mHPV infection with 2 genotypes is associated with CIN2/CIN3 in a significative way and it presents an 8 times greater risk of developing a high grade lesion.
Overexpressing the WRKY transcription factor OsWRKY97 improves drought tolerance in rice
Authors: lv Miaomiao , Hou Dejia , Ye Taozhi , Zhang Lin , Fan Jiangbo , Li Chunliu , Dong Yilun , Chen Wenqian , Rong Songhao , Sun Yihao , Xu Jinghong , Cai Liangjun , Gao Xiaoling , Zhu Jianqing , Huang Zhengjian , Xu Zhengjun , Li Lihua
Published: March 2020

Background: WRKY transcription factor (TF) is one of the largest TF families in plants and plays an important role in plant development and stress protection. However, the function of individual WRKY gene in plants are still under investigation. Here, we identified a new member of WRKY TF family, OsWRKY97 , and analyze its role in stress resistance by using a series of transgenic plant lines.Results: OsWRKY97 , which positively regulates drought tolerance in rice. OsWRKY97 was expressed in all examined tissues and could be induced by various abiotic stresses. OsWRKY97 is located in the nucleus. Compared with the wild-type (WT), OsWRKY97 -overexpressing (OE) plants enhanced the tolerance of rice to drought and osmotic stress. In addition, OE plants also showed higher sensitivity to exogenous abscisic acid (ABA). When exposed to drought stress, up-regulation OsWRKY97 increased the accumulation of ABA and reduced water loss. Furthermore, OE plants achieved higher proline content and reduced levels of malondialdehyde (MDA) and reactive oxygen species (ROS). The homeostasis of ROS was maintained via the activity of active oxygen scavenging enzyme, superoxide dismutase (SOD), catalase (CAT) and peroxidase (POD), activated by OsWRKY97Conclusions: These results indicate that OsWRKY97 plays a crucial role in the response to drought stress and may possess high potential value in improving drought tolerance in rice.
Prevalence and antimicrobial resistance of Salmonella isolated from broilers in Shandong, China
Authors: Zhao Xiaonan , Hu Ming , Zhang Qing , Zhao Cui , Zhang Yin , Li Lulu , Qi Jing , Luo Yanbo , Zhou Dong , Liu Yuqing
Published: March 2020

Background Salmonella spp. are one of the most important foodborne bacterial pathogens in human beings and animals. The prevalence of Salmonella from broilers in Shandong, China and antimicrobial susceptibility of these isolates was determined. Results From May to October 2018, 600 samples collected, 67 Salmonella isolates were recovered with an isolation rate of 11.2%. The most common serovars were S. enteritidis and S. typhimurium. The highest incidence of resistance observed were for PB (100%), and AMP (68.7%), and the MDR Salmonella isolate rate was 53.7%. Four β-lactamase genes were detected among the isolates, all the isolates carried bla TEM (67/67, 100%), followed by bla OXA (19/67, 28.4%), bla CTX-M (17/67, 25.4%), and bla PSE (7/67, 10.4%); four plasmid-mediated quinolone resistance genes were detected among the isolates, the prevalent resistance genes was aac(6’)-Ib-cr (18/67, 26.9%), followed by oqxB (9/67, 13.4%), qnrB (6/67, 9.0%), and qnrD (1/67, 1.5%); the prevalent rate of mcr -1 was 6.0%(4/67). Class 1 integrons were detected in 26.9% of these isolates and contained seven groups of resistance gene cassettes. MLST analysis revealed seven sequence types, and ST11 was the most frequent sequence types. Conclusions This study indicated that reduction of Salmonella and strict control on the use of antibiotics in more than 5000 million broilers in Shandong are the vitally important measure to keep public health.
Testosterone interrupts binding of Neurexin and Neuroligin that are expressed in a highly socialized rodent, Octodon degus.
Authors: Yagishita-Kyo Nan , Ikai Yuki , Uekita Tomoko , Shinohara Akio , Koshimoto Chihiro , Yoshikawa Keisuke , Maruyama Kei , Yagishita Sosuke
Published: March 2020

Octodon degus is said to be one of the most human-like rodents because of its improved cognitive function. Notably, it has a complicated vocal communication system. Focusing on its highly developed sociality, we cloned and characterized some sociality-related genes of degus, in order to establish degus as a highly socialized animal model in molecular biology. We cloned degus Neurexin and Neuroligin as sociality-related genes, which are genetically related to autism spectrum disorder in human. They bind to each other at synaptic cleft, and this intercellular binding is also important for regulation of social behavior. Interestingly, amino acid sequences of Neurexin and Neuroligin expressed in degus brain, are highly conserved to that of human sequences. Most notably, degus Neuroligin4 is highly similar to human Neuroligin4X, which is one of the most important autism-related genes. Mouse neuroligin4 is known to be poorly similar to human Neuroligin4X, leading to the difficulty of Neuroligin4X investigation. Furthermore, our work also indicated that testosterone directly binds to degus Neurexin and intercepts intercellular Neurexin-Neuroligin binding. This effect of testosterone is unique in that it directly affects to protein function without hormone receptor signaling. Moreover, it is of high interest that testosterone is another key molecule of the higher incidence of autism in male. These results indicated that degus has the potential for animal model of sociality, and furthermore may promote understanding toward the pathogenic mechanism of autism.