bluuebunny/crossref_metadata_2025 huggingface dataset:
La elaboración de un folder sobre cáncer de la próstata
Authors: De Moraes Maria Cecilia Leite , Oliveira Robson Da Costa , Silva Maria Jesus
Published: April 2020

Introducción: El cáncer de próstata es una importante patología, con baja letalidad cuando se diagnostica prematuramente. Para ello, uno de los procedimientos necesarios es la realización del examen de tacto rectal, que trae resistencia entre los hombres. Cuestiones simbólicas y culturales fomentan la vergüenza y el prejuicio. Con el objetivo de tratar la cuestión, un equipo multidisciplinario de salud elaboró un folder para tratar el tema. Objetivo: describir el proceso de elaboración un folder sobre el cáncer de próstata. Métodos: Se trabajó con investigación-acción, utilizando delineamientos exploratorio y descriptivo. La información fue obtenida a través de artículos disponibles online, en el período entre 2011 y 2015, en las bases de datos: Scielo, Lilacs y Google Académico. Resultados: Se puntúa como resultado el interés y la utilización del material, que fue puesto a disposición en un evento sobre cáncer de próstata. El material se agotó rápidamente. Conclusiones: Se destaca que más estudios serán necesarios para canalizar los folletos como material de educación y promoción de salud.
Microbiologie de l’œuf et des ovoproduits
Authors: BARON F. , JAN S.
Published: April 2020

Le risque de contamination par les microorganismes, et notamment par Salmonella, est une préoccupation majeure de la filière œufs et ovoproduits.
Le contenu des œufs provenant d’élevages sains est en général stérile mais il peut toutefois être contaminé par une flore diversifiée contenant des microorganismes d’altération et parfois pathogènes. L’œuf dispose cependant d’un arsenal remarquable de défenses destinées à préserver l’embryon de toute invasion microbienne au cours de son développement. Cet article fait le point sur l’origine des contaminations de l’œuf et les mécanismes de défense anti-microbienne. Les mesures permettant de limiter la présence et le développement des microorganismes dans l’œuf sont discutées, au niveau de l’élevage, du stockage et du conditionnement.
Le cassage entraîne systématiquement la contamination du blanc et du jaune par contact avec les coquilles souillées, conduisant ainsi à des ovoproduits très périssables. De nombreux microorganismes peuvent ainsi contaminer les ovoproduits. La maîtrise de leur qualité microbiologique est un impératif, en particulier lorsqu’ils sont intégrés dans des aliments crus ou peu cuits. Les moyens de maîtrise sont discutés et plus particulièrement le respect des bonnes pratiques d’hygiène et la maîtrise des procédés de stabilisation. L’importance de la maîtrise des températures pour le contrôle des microorganismes pathogènes et d’altération, dans les ovoproduits et dans les œufs, est particulièrement soulignée.
Feasibility of Innovative Tools and Methods to Improve Household Surveys in Complex Urban Settings: Multiple Methods Analysis of the Surveys for Urban Equity (SUE) Study in Kathmandu, Dhaka and Hanoi
Authors: Thomson Dana , Bhattarai Radheshyam , Khanal Sudeepa , Manandhar Shraddha , Dhungel Rajeev , Gajurel Subash , Hicks Joseph P , Duc Duong Minh , Ferdoush Junnatul , Ferdous Tarana , Urmy Nushrat Jahan , Shawon Riffat Ara , Long Khuong Quynh , Poudel Ak Narayan , Cartwright Chris , Wallace Hilary , Ensor Tim , Baral Sushil , Mashreky Saidur , Huque Rumana , Minh Hoang Van , Elsey Helen
Published: April 2020

Background: The methods used in low- and middle-income countries (LMICs) household surveys have not changed in four decades; however, LMIC societies have changed substantially. This mismatch may result in unintentional exclusion of vulnerable and mobile urban populations. We compare three survey method innovations with standard survey methods in Kathmandu, Dhaka, and Hanoi, and summarize feasibility of our innovative methods in terms of time, cost, skill requirements, and experiences. Methods: We used descriptive statistics and regression techniques to compare respondent characteristics in samples drawn with innovative versus standard survey designs and household definitions, adjusting for sample probability weights and clustering. Feasibility of innovative methods was evaluated using a thematic framework analysis of focus group discussions with survey field staff, and via survey planner budgets. Results: We found that a common household definition excluded single adult (46.9%) and migrant headed households (6.7%), as well as non-married (8.5%), unemployed (10.5%), disabled (9.3%), and studying (14.3%) adults. Further, standard two-stage sampling resulted in fewer single adult and non-family households than an innovative one-stage design; however, two-stage sampling resulted in more tent and shack dwellers. Our survey innovations provided good value for money and field staff experiences were neutral or positive. Staff recommended streamlining field tools and pairing technical and survey content experts during fieldwork. Conclusions: This evidence of unintentional exclusion of vulnerable and mobile urban populations in LMIC household surveys is deeply concerning, and underscores the need to modernize survey methods and practices.
The Market Orientation of Smallholder South African Farmers in a Disaster Context: An Input-side Perspective within a Seed Systems Approach
Authors: Nwafor Christopher Ugochukwu
Published: April 2020

Market-orientation is widely applied to understand the expected interaction of smallholder farmers with input and output markets. Commonly used interchangeably with market participation, it is fast becoming a key milestone for attaining smallholder commercialization. This study introduces the term into the disaster resilience, seed systems and livelihoods context. Using a mixed methods approach, 120 smallholder farmers in a drought-affected district of South Africa were sampled, and information collected for analysis. The result shows that most of the farmers rely on purchased seeds and fertilizers for crop production, and on average sold 62% of their farm produce. A market orientation index (MOI) of 55% was estimated, showing that the farmers were market oriented. The farm size, quantities of seeds and fertilizer purchased, value of crop produced, amount received from crop sales, distance to markets and access to credit were found significant in determining their market orientation. Policy interventions were made to improve access to irrigation, seed varieties and extension delivery in the area. The finding has implications for development efforts at rebuilding after a natural disaster, as well as sourcing food aid from local smallholder farmers by humanitarian actors.
Osmanlı Devleti’nde İlk Daimi Elçilikler ve Diplomasiye Olan Etkileri
Authors: GUNCE Suheda
Published: April 2020

Osmanlı Devleti’nin kuruluşundan itibaren yürüttüğü diplomasi, daima tek taraflı ve karşılıksız olmuştur. Bu durum, Osmanlıların siyaseten ve dinen kendilerini diğer devletlerden daha üstün bir noktada görmeleri ile ilgilidir. Ancak on sekizinci yüzyıldan itibaren Batı’da yaşanan gelişmeler, Batının daha ön plana geçmesine imkân tanımış ve Osmanlı Devleti bu gelişmelerden belli bir noktada habersiz kalmıştır. Bu durum, Osmanlı Devleti’nin karşılıksız/tek taraflı diplomasisinin bir sonucu olarak Batı ile herhangi bir iletişim kanalı kurmaması neticesinde meydana gelmiştir. Dolayısıyla bu sorunu aşma ve sağlıklı bir iletişimi gerçekleştirme ihtiyacı doğmuştur. Bu ihtiyaç, daimi elçiliklerin açılması ile giderilmeye çalışılmıştır. Daimi elçiliklerin açılması, Osmanlı Devleti’nin kuruluşundan itibaren yürüttüğü karşılıksız diplomasiden, muvazene diplomasisine geçişinin bir başlangıcı olarak görülmüştür. Bu nedenle söz konusu diplomasinin uygun bir şekilde yürütülmesinde daimi elçilikler oldukça önemli bir rol oynamıştır. Bu makalede, Osmanlı Devleti’nde daimi elçiliklerin açılmasının temel sebepleri ve elçiliklerin diplomasiye olan etkilerinin ne boyutta olduğu incelenecektir. Ayrıca elçiler tarafından ele alınan sefaretnamelerin önemi üzerinde de durulacaktır.
Revisión rápida del uso de cubrebocas quirúrgicos en ámbito comunitario e infecciones respiratorias agudas
Authors: Stern Dalia , López-Olmedo Nancy , Pérez-Ferrer Carolina , González-Morales Romina , Canto-Osorio Francisco , Barrientos-Gutiérrez Tonatiuh
Published: April 2020

Objetivo. Evaluar la efectividad del uso de cubrebocas quirúrgico en ámbitos comunitarios para reducir la probabilidad de contagio por SARS-CoV-2 u otra infección respiratoria aguda viral, en comparación con no usar cubrebocas. Material y métodos. Se utilizó la metodología de revisiones rápidas de Cochrane. La estrategia de búsqueda abarcó una base de datos académica y pre-prints hasta el 1 de abril de 2020. Los títulos y resúmenes fueron revisados por un investigador. La revisión de textos completos fue dividida entre tres investigadores. Los resultados fueron sintetizados de forma narrativa. Resultados. Se identificaron 713 manuscritos, de los cuales 21 cumplieron los criterios de inclusión. De seis revisiones sistemáticas, cuatro no encontraron reducciones en la probabilidad de contagio y seis estudios experimentales en hogares no encontraron diferencias en la probabilidad de contagio asociado con el uso de cubrebocas. Únicamente un estudio de modelaje estimó una reducción de 20% en la incidencia de enfermedad respiratoria, asumiendo que 10 a 50% de la población hace uso correcto de cubrebocas quirúrgicos. Conclusiones. La evidencia científica no es concluyente para recomendar o desalentar el uso de cubrebocas a nivel poblacional. Considerando los potenciales efectos negativos, las recomendaciones gubernamentales deberían esperar a los resultados de los experimentos naturales en países que han recomendado la utilización poblacional de cubrebocas.
Stress analysis of implant-supported removable partial denture with anterior fixed prostheses and conventional implant supported overdentures in the edentulous mandible
Authors: Ozel Gulsum Sayin , Inan Ozgur , Ozyilmaz Ozgun Yusuf
Published: April 2020

Background: Recently, a new alternative treatment protocols without complex surgical or grafting procedures has become popular in clinical dentistry. A new treatment concept is implant-supported removable partial dentures retained with anterior fixed prosthesis in edentulous mandible. The purpose of this study was to compare this new design implant supported removable partial dentures, with a conventional locater and bar attached implant overdenture prostheses retained by two or four implants via photoelastic stress analysis. Methods: This study was designed to evaluate the force transmission of commercially available titanium implants inserted into edentulous mandibles composed of photoelastic resin within two to four implants using two different types of prosthesis: overdentures and implant-retained removable partial dentures. In all models, implants were placed parallel to each other and the midline. A 300 N load was applied to the first premolars. Loading and stress distributions were photographed after the completion of the prostheses. Results: In the models with two implant-retained removable partial dentures, the stress distribution was found to be lower than that with the four implant-retained removable partial dentures. The locator, a stud attachment, showed the most equitable stress distribution for overdenture models. Despite this, non-splinted implants caused high stresses around the distal implant on the loading side. Conclusions: When models were compared, the stress loads were transmitted to other implants by splinting. Implant-supported removable partial dentures with an anterior fixed prosthetic design may serve as an acceptable and affordable alternative treatment option. These dentures appear to be advantageous in terms of stress transmission considering effects such as ease of use, esthetic requirements, patient requests, and reduction in the area covered by the prosthesis.
Conditional cash transfers, uptake of maternal and child health services, and health outcomes in western rural ChinaConditional cash transfers, uptake of maternal and child health services, and health outcomes in western rural China
Authors: Zhou Huan , Wu Yuju , Liu Chengfang , Sun Chang , Shi Yaojiang , Zhang Linxiu , Medina Alexis , Rozelle Scott
Published: April 2020

Background: Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that the low uptake of MCH services may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that conditional cash transfers (CCT) have on the uptake of MCH services and ultimately, on child health outcomes. The objective of this study is to examine the relationship between CCT, uptake of MCH services, and health outcomes among children in poor rural areas of western China.Methods: We designated two different sets of comparison villages and households that were used as comparison against which outcomes of the treated households could be assessed. In 2014 we conducted a large-scale survey of 1,522 households at 75 villages (including 25 treatment and 50 comparison) from nine nationally-designated poverty counties in two provinces of China. In each village, 21 households were selected based on their eligibility status for the CCT program. Difference-in-difference analyses were used to assess the impact of CCT on outcomes in terms of both Intention-to-treat (ITT) and average-treatment-effects-on-the-treated (ATT).Results: Overall, the uptake of MCH services in the sample households were low, especially in terms of post-partum care visits, early breast feeding, exclusive breast feeding, and physical examination of the baby. The uptake of the seven types of MCH services in the CCT treatment villages were significantly higher than that in the comparison villages. Results from both the ITT and ATT analyses showed the CCT program had a positive, although small, impact on the uptake of MCH services and the knowledge of mothers about MCH health issues. Nonetheless, the CCT program had no noticeable effect on child health outcomes.Conclusions: The CCT program generated modest improvements in the uptake of MCH services and mothers’ knowledge of MCH services in poor rural areas of Western China. These improvements, however, did not translate into substantial improvements in child health outcomes for two possible reasons: poor CCT implementation and the low quality of rural health facilities.
Multi-HLA class II tetramer analyses of citrulline-reactive T cells and early treatment response in rheumatoid arthritis
Authors: Gerstner Christina , Turcinov Sara , Hensvold Aase H , Chemin Karine , Uchtenhagen Hannes , Ramwadhdoebe Tamara H , Dubnovitsky Anatoly , Kozhukh Genadiy , Rönnblom Lars , Kwok William W , Achour Adnane , Catrina Anca I , Baarsen Lisa G. M. van , Malmström Vivianne
Published: April 2020

Background: HLA class II tetramers can be used for ex vivo enumeration and phenotypic characterization of antigen-specific CD4+ T cells. They are increasingly applied in settings like allergy, vaccination and autoimmune diseases. Rheumatoid arthritis (RA) is a chronic autoimmune disorder for which many autoantigens have been described.Results: Using multi-parameter flow cytometry, we developed a multi-HLA class II tetramer approach to simultaneously study several antigen specificities in RA patient samples. We focused on previously described citrullinated HLA-DRB1*04:01-restricted T cell epitopes from α-enolase, fibrinogen-b, vimentin as well as cartilage intermediate layer protein (CILP). First, we examined inter-assay variability and the sensitivity of the assay in peripheral blood from healthy donors (n=7). Next, we confirmed the robustness and sensitivity in a cohort of RA patients with repeat blood draws (n=14). We then applied our method in two different settings. We assessed lymphoid tissue from seropositive arthralgia (n=5) and early RA patients (n=5) and could demonstrate autoreactive T cells in individuals at risk of developing RA. Lastly, we studied peripheral blood from early RA patients (n=10) and found that the group of patients achieving minimum disease activity (DAS28 <2.6) at 6 months follow-up displayed a decrease in the frequency of citrulline-specific T cells. Conclusions: Our study demonstrates the development of a sensitive tetramer panel allowing simultaneous characterization of antigen-specific T cells in ex vivo patient samples including RA ‘at risk’ subjects. This multi-tetramer approach can be useful for longitudinal immune-monitoring in any disease with known HLA-restriction element and several candidate antigens.
Effect Of Smoking On Treatment Outcome Among Tuberculosis Patients In Malaysia; A Multicentre Study
Authors: Khan Amer Hayat , Sulaiman Syed Azhar Syed , Hassali Mohamed Azmi , Khan Kashif Ullah , Ming Long Chiau , Mateen Umer , Malik Obaid Ullah
Published: April 2020

Background: Smoking plays a key role in the development of tuberculosis (TB) infection and is also a predictor of poor TB treatment prognosis and outcomes. Current study was conducted to determine the prevalence of smoking and to assess the effects of smoking on treatment outcomes among TB patients.Methods: A multi-center retrospective study design was used to collect data from TB patients in four different states of Malaysia, namely Penang, Sabah, Sarawak, and Selangor. The study included medical records of TB patients admitted to the selected hospitals in the period from January 2006 to March 2009. Medical records with incomplete data were not included. Patient demographics and clinical data were collected using a validated data collection form.Results:Of all patients with TB (9337), the prevalence of smokers was 4313 (46.2%). Among smoker’s, 3584 (83.1%) were associated with pulmonary TB, while 729 (16.9%) were associated with Extra-pulmonary TB. Male gender (OR= 1.43, 95% CI 1.30-1.58), Chinese ethnicity (OR= 1.23, 95% CI 1.02-1.49), Sarawak indigenous ethnicity (OR= 0.74, 95% CI 0.58-0.95), urban residents (OR= 1.46, 95% CI 1.33-1.61), employed individuals (OR= 1.21, 95% CI 1.09-1.34), alcoholics (OR= 4.91, 95% CI 4.04-5.96), drug abusers (OR= 7.43, 95% CI 5.70-9.60) and presence of co-morbid condition (OR= 1.27, 95% CI 1.16-1.40) showed significant association with smoking habits. This study found that 3236 (75.0 %) patients were successfully treated in the smoker group, while 4004 (79.7 %) patients were non-smokers. The proportion of death rate 283 (6.6%), defaulters 284 (6.6%) and treatment interruption 204 (4.7%) was high in the smoker's group.Conclusions:Smoking had a strong influence on TB and is a major barrier towards treatment success (OR= 0.76, 95% CI 0.69-0.84, p< 0.001). Therefore, the findings point out that smoking cessations are an effective way to decrease treatment failure and drug resistance.
Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience.
Authors: Iflaifel Mais HM , Lim Rosemary , Ryan Kath M , Crowley Clare
Published: April 2020

Background Traditional approaches to safety management in health care have focused primarily on counting errors and understanding how things go wrong. Resilient Health Care (RHC) provides an alternative complementary perspective of learning from incidents and understanding how, most of the time, work is safe. The aim of this review was to identify how RHC is conceptualised, described and interpreted in the published literature, to describe the methods used to study RHC, and to identify factors that develop RHC. Methods Electronic searches of PubMed, Scopus and Cochrane databases were performed to identify relevant peer-reviewed studies, and a hand search undertaken for studies published in books that explained how RHC as a concept has been interpreted, what methods have been used to study it, and what factors have been important to its development. Studies were evaluated independently by two researchers. Data was synthesised using a thematic approach. Results Thirty-six studies were included; they shared similar descriptions of RHC which was the ability to adjust its functioning prior to, during, or following events and thereby sustain required operations under both expected and unexpected conditions. Qualitative methods were mainly used to study RHC. Two types of data sources have been used: direct (e.g. focus groups and surveys) and indirect (e.g. observations and simulations) data sources. Most of the tools for studying RHC were developed based on predefined resilient constructs and have been categorised into three categories: performance variability and Work As Done, cornerstone capabilities for resilience, and integration with other safety management paradigms. Tools for studying RHC currently exist but have yet to be fully implemented. Effective team relationships, trade-offs and health care ‘resilience’ training of health care professionals were factors used to develop RHC. Conclusions Although there was consistency in the conceptualisation of RHC, methods used to study and the factors used to develop it, several questions remain to be answered before a gold standard strategy for studying RHC can confidently be identified. These include operationalising RHC assessment methods in multi-level and diverse settings and developing, testing and evaluating interventions to address the wider safety implications of RHC amidst organisational and institutional change.
Missed Opportunities for Family Planning Counselling among HIV-Positive Women Receiving HIV Care in Uganda
Authors: Author) JULIET NABIRYE(Former Corresponding , Author) Joseph KB Matovu(New Corresponding , Bwanika John Baptist , Makumbi Fredrick , Wanyenze Rhoda K.
Published: April 2020

Introduction: HIV-positive women who are still in the reproductive years need adequate sexual and reproductive health information to make informed reproductive health choices. However, many HIV-positive women who interface with the health system continue to miss out on this information. We sought to: a) determine the proportion of HIV-positive women enrolled in HIV care who missed family planning (FP) counselling; and b) assess if any association existed between receipt of FP counselling and current use of modern contraception to inform programming. Methods: Data were drawn from a quantitative national cross-sectional survey of 5,198 HIV-positive women receiving HIV care at 245 HIV clinics in Uganda; conducted between August and November 2016. Family planning counselling was defined as provision of FP information (i.e. available FP methods and choices) to an HIV-positive woman by a health provider during ANC, at the time of delivery or at the PNC visit. Analyses on receipt of FP counselling were done on 2,760 HIV-positive women aged 15-49 years who were not currently pregnant and did not intend to have children in the future. We used a modified Poisson regression model to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counselling and current use of modern contraception, controlling for potential confounders. Analyses were performed using STATA statistical software, version 14.1.Results: Overall, 2,104 (76.2%) HIV-positive women reported that they received FP counselling at any of the three critical time-points. Of the 24% (n=656) who did not, 37.9% missed FP counselling at ANC; 41% missed FP counselling during delivery; while 54% missed FP counselling at the post-natal care visit. HIV-positive women who received any FP counselling were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.21; 95% Confidence Interval [CI]: 1.10, 1.33). Conclusion: Nearly one-quarter of HIV-positive women did not receive any form of FP counselling when they interfaced with the healthcare system. This presents a missed opportunity for prevention of unintended pregnancies, and suggests a need for the integration of FP counselling into HIV care at all critical time-points.
The development of early ascites is associated with shorter overall survival in patients with hepatocellular carcinoma treated with drug-eluting embolic chemoembolization
Authors: Pipa-Muniz María , Sanmartino Susana , Mesa Alicia , Alvarez-Navascués Carmen , González-Diéguez Maria Luisa , Cadahía Valle , Rodríguez José Eduardo , Vega Florentino , Rodríguez Manuel , Costilla-García Serafín Marcos , Calvo Maria Varela
Published: April 2020

Background: A single-centre cohort study was performed to identify the independent factors associated withthe overall survival (OS) of hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization with drug-eluting beads (DEB-TACE). Methods : A total of 216 HCC patients who underwent DEB-TACE from October 2008 to October 2015 at a tertiary hospital were consecutively recruited. The analysis of prognostic factors associated with overall survival after DEB-TACE, stressing the role of post-TACE events, was performed. Results: The objective response (OR) rate (Modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria) to the first DEB-TACE (DEB-TACE-1) was 70.3%; the median OS from DEB-TACE-1 was 27 months (95% confidence interval (CI), 24-30). In the multivariate analysis, tumor size, AFP < 100 ng/mL and serum alkaline phosphatase were independent factors for survival following DEB-TACE-1. The most important clinical event associated with poor survival was the development of early ascites after DEB-TACE-1 (median OS, 17 months), which was closely related to the history of ascites, albumin and hemoglobin but not to tumour load or to response to therapy. Conclusions : Early ascites post-DEB-TACE is associated with the survival of patients despite adequate liver function and the use of a supra-selective technical approach. History of ascites, albumin and hemoglobin are major determinants of the development of early ascites post-DEB-TACE.
The Effect of Different Estradiol Levels on Carotid Artery Distensibility During a Long Agonist IVF Protocol
Authors: Leppänen Jonna , Randell Kaisa , Schwab Ursula , Pihlajamäki Jussi , Keski-Nisula Leea , Laitinen Tomi , Heinonen Seppo
Published: April 2020

BACKGROUND:This study was made to figure out, does low and high estradiol levels during in vitro fertilization (IVF) cycles have a different effect on carotid artery distensibility (Cdis), carotid artery diameter (Cdia), blood pressure and metabolic factors? Can the stimulation protocol be considered safe to women’s vasculature? METHODS: We studied 28 women having a long agonist protocol IVF-treatment in Kuopio University Hospital during the years 2011-2016. Patients were examined at three time points: in the beginning of their own period (low estradiol), during the gonadotrophin releasing hormone (GnRH) analogue downregulation (low estradiol) and during the follicle stimulating hormone (FSH) stimulation (high estradiol). Women served as their own controls and their menstrual phase (2- to 5-day period after the beginning of menstruation with low estrogen) was used as the reference. Cdis and Cdia were assessed using ultrasound. Blood pressure, weight, estradiol levels and lipids were monitored. RESULTS : Cdis, Cdia, systolic and diastolic blood pressures peaked during the GnRH-analogue treatment with the lowest estradiol levels. Cdis, Cdia and systolic blood pressures declined by 11% (P=0.002) , 3,8% (P<0.001) and 2,5 % (P=0.026) during the FSH-stimulation when the estradiol levels were high. Cdis correlated significantly (P<0.05) with systolic blood pressure, diastolic blood pressure and triglycerides in high estrogenic environment and with diastolic blood pressure (P<0.05) when estrogen profiles were low. CONCLUSIONS: Carotid artery stiffens during the high estradiol levels compared to low levels and this was not explained by the higher diameter of the carotid artery, hyperlipidemia or blood pressure profiles. All the changes in Cdis and Cdia are variations of normal, and if there is no history of cardiovascular problems, it can be considered, that the stimulation protocol is not hazardous to vasculature.
Effect of the cagW-based gene vaccine on the immunologic properties of BALB/c mouse: an efficient candidate for Helicobacter pylori DNA vaccine
Authors: Chehelgerdi Mohammad , Doosti Abbas
Published: April 2020

Background Helicobacter pylori ( H. pylori ) infect more than half of the world population, and they cause different serious diseases such as gastric carcinomas. This study aims to design a vaccine on the basis of cagW against H. pylori infection. After pcDNA3.1 (+)- cagW -CS-NPs complex is produced, it will be administered into the muscles of healthy BALB/c mice in order to study the effect of this DNA vaccine on the interleukin status of mice, representing its effect on the immune system. After that, the results will be compared with the control groups comprising the administration of cagW -pCDNA3.1 (+) vaccine, the administration of chitosan and the administration of PBS in the muscles of mice. Methods The cagW gene of H. pylori was amplified by employing PCR, whose product was then cloned into the pcDNA3.1 (+) vector, and this cloning was confirmed by PCR and BamHI/EcoRV restriction enzyme digestion. CagW gene DNA vaccine was encapsulated in chitosan nanoparticles (pcDNA3.1 (+)- cagW -CS-NPs) using a complex co-acervation method. The stability and in vitro expression of chitosan nanoparticles were studied by DNase I digestion and transfection, and the immune responses elicited in specific pathogen-free (SPF) mice by the pcDNA3.1 (+)-cagW-CS-NPs were evaluated. Apart from that, the protective potential pcDNA3.1 (+)- cagW -CS-NPs was evaluated by challenging with H.pylori . Results The pcDNA3.1 (+)- cagW -CS-NPs comprises cagW gene of H. pylori that is encapsulated in chitosan nanoparticles, produced with good morphology, high stability, a mean diameter of 117.7 nm, and a zeta potential of + 5.64 mV. Moreover, it was confirmed that chitosan encapsulation protects the DNA plasmid from DNase I digestion, and the immunofluorescence assay showed that the cagW gene could express in HDF cells and maintain good bioactivity at the same time. In comparison to the mice immunized with the control plasmid, in vivo immunization revealed that mice immunized with pcDNA3.1 (+)- cagW -NPs showed better immune responses and prolonged release of the plasmid DNA. Conclusions This research proves chitosan-DNA nanoparticles as potent immunization candidates against H. pylori infection and paves the way for further developments in novel vaccines encapsulated in chitosan nanoparticles.
Indocyanine green fluorescence imaging to assess bowel perfusion during totally laparoscopic surgery for colon cancer
Authors: Su Hao , Wu Hongliang , Mandula Bao , Luo Shou , Wang Xuewei , Zhao Chuanduo , Liu Qian , Wang Xishan , Zhou Zhixiang , Zhou Haitao
Published: April 2020

Aim: To retrospectively evaluate the feasibility and safety of intraoperative assessment of bowel perfusion in totally laparoscopic surgery for colon cancer using indocyanine green fluorescence imaging (IGFI).Methods: From October 2017 to June 2019, consecutive patients with colon cancer who underwent totally laparoscopic surgery were enrolled retrospectively and grouped into the IGFI group (n=84) and control group (n=105). In the IGFI group, indocyanine green (ICG) was injected intravenously, and the bowel perfusion was observed using a fluorescence camera system prior to and after completion of the anastomosis.Results: The two groups were demographically comparable. The IGFI group exhibited a significantly shorter operative time (p=0.0374) while intraoperative blood loss did not significantly differ among the groups (p=0.062). In the IGFI group, average time to perfusion fluorescence was 48.4±14.0 s after ICG injection, and four patients (4.8%) were required to choose a more proximal point of resection due to the lack of adequate fluorescence at the point previously selected. There were no differences in terms of pathological outcomes, postoperative recovery and the postoperative complication rates between the groups (p＞0.05). Conclusion: IGFI shows promise as a safe and feasible tool to assess bowel perfusion during a totally laparoscopic surgery for colon cancer and may reduce the operative time.
Health system’s readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey
Authors: Ghimire Umesh , Shrestha Nipun , Adhikari Bipin , Meheta Suresh , Pokharel Yashashwi , Mishra Shiva Raj
Published: April 2020

Background: The burgeoning rise of non-communicable diseases (NCDs) is posing serious challenges in resource constrained health facilities of Nepal. The main objective of this study was to assess the readiness of health facilities for cardiovascular diseases (CVDs), diabetes and chronic respiratory diseases (CRDs) services in Nepal. Methods: This study utilized data from the Nepal Health Facility Survey 2015. General readiness of 940 health facilities along with disease specific readiness for CVDs, diabetes and CRDs were assessed using service availability and readiness assessment manual of the World Health Organization (WHO). Health facilities were categorized into public and private facilities. Results: Out of a total of 940 health facilities assessed, private facilities showed higher availability of items of general service readiness, except for standard precautions for infection prevention, compared to public facilities. The multivariable adjusted regression coefficients for CVDs (β=2.87, 95%CI: 2.42-3.39), diabetes (β =3.02, 95%CI: 2.03-4.49) and CRDs (β=15.95, 95%CI: 4.61-55.13) at private facilities were higher than the public hospitals. Health facilities located in hills had higher readiness index for CVDs (β=1.99, 95%CI: 1.02 - 1.39). Service readiness for CVDs (β=1.13, 95%CI: 1.04-1.23) and diabetes (β=1.78, 95%CI: 1.23-2.59) were higher in the urban municipalities than in rural municipalities. Finally, disease related services readiness index was sub-optimal with some degree of variation at the province level in Nepal. Compared to province 1, Province 2 (β=0.83, 95%CI: 0.73-0.95), and province 4 (β =1.24, 95%CI: 1.07-1.43) and province 5 (β =1.17, 95%CI: 1.02-1.34) had higher readiness index for CVDs.Conclusions: This study found sub-optimal readiness of services related to three NCDs at the public facilities in Nepal. Compared to public facilities, private facilities showed higher readiness score for CVDs, diabetes and CRDs. To cope up with the growing burden of NCDs, urgent improvement in health services, particularly in public facilities are critical to manage common NCDs.
Sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation: An exploratory randomized controlled trial
Authors: Li Chunzhu , Peng Jiali , Sun Yu , Hu Rong , Wang Hao , Yan Jia , Jiang Hong
Published: April 2020

Background: Awake fiberoptic bronchoscope intubation (AFOBI) is the gold standard technique for the management of patients with difficult airways. Adequate sedation and analgesia are essential for successful AFOBI. The aim of this study was to evaluate the sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation.Methods: Patients undergoing head and neck surgery under general anesthesia with predicted difficult airways were included. Participants were randomly assigned to 6 different groups (n = 6): groups 1-3 were intravenous (IV), while groups 4-6 were intranasal (IN) (group 1: dexmedetomidine (DEX) 1 μg/kg + fentanyl (FEN) 1 μg/kg; groups 2-3: DEX 1 μg/kg + FEN 0.7 μg/kg + ketamine (KTM) 0.1/0.2 mg/kg; group 4: DEX 1.5 μg/kg + FEN 1.4 μg/kg; and groups 5-6: DEX 1 μg/kg + FEN 1 μg/kg + KTM 0.4/0.6 mg/kg). The visual analog scale (VAS) score during intubation, time required for the modified observer’s assessment of alertness/sedation scale (OAA/S) score to reach above 2 and for the bispectral index (BIS) to decrease to 60-80, motor activity assessment scale (MAAS) score, changes in vital signs and adverse effects were recorded.Results: Among the IV groups, the VAS score of group 1 (5.65 ± 2.11) was higher than those of group 2 (1.89 ± 2.16, P = 0.012) and group 3 (1.15 ± 0.98, P = 0.001). Among the IN groups, the VAS score was lower in group 6 (0.86 ± 1.27) than in group 4 (7.20 ± 2.70, P < 0.001) and group 5 (3.93 ± 2.73, P = 0.031). Participants in group 5 and group 6 were less likely to cough when intubated than those in group 4 (P = 0.002), while the differences among IV groups were not significant. There were no significant differences in the other endpoints.Conclusions: Our study indicates that the addition of subanesthetic doses of ketamine, either intravenous or intranasal, could reduce the fentanyl and dexmedetomidine consumption used in AFOBI and provide better sedative and analgesic effects.Trial registration: Chinese Clinical Trial Registry (www.chictr.org.cn; ChiCTR1900021185), prospectively registered on February 1st, 2019.
Nobiletin Down-regulates SKP2-p21/p27-CDK2 Axis to Inhibit Tumor Progression and Shows Synergistic Effect with Palbociclib on Renal Cell Carcinoma
Authors: Chen Tingting , Liu Liu , Hu Xiaoyan , Wang Kai , Zhou Tao , Luo Xi , Li Longkun , Fu Weihua , Xu Jie
Published: April 2020

Background: Natural extracts can enhance the efficacy and sensitivity of chemotherapeutic drugs, including nobiletin. However, the possible role and underlying mechanisms of nobiletin in cancer including Renal cell carcinoma (RCC) are still unclear.Methods：Cell proliferation, cell cycle and apoptosis analysis, colony-forming assays, immunoblotting analysis and qRT-PCR analysis were performed to investigate how nobiletin inhibits RCC cell proliferation in vitro. Nude mouse model was used to measure in vivo efficacy of nobiletin and its combination with palbociclib.Results：Nobiletin induced G1 phase cell cycle arrest, apoptosis, and proliferative inhibition in RCC Cells. Mechanistically, nobiletin inhibited activation of oncogene SKP2, leading to the accumulation of tumor suppressors and apoptosis-inducing substrates such as p21 and p27 to inhibit cell proliferation, eventually inhibit tumor formation. Intriguingly, we further found that sensitivity of palbociclib was associated with SKP2 protein level. Furthermore, in vitro and vivo results, dual inhibition of nobiletin and palbociclib showed synergistic lethality.Conclusion：Combination nobiletin and palbociclib may serve as a potential therapeutic strategy for renal cancer.
Detect it so you can treat it: a case series and proposed checklist to detect neurotoxicity in checkpoint therapy
Authors: Bolz Saskia , Ramakrishnan Thivyah , Fleischer Michael , Livingstone Elisabeth , Stolte Benjamin , Thimm Andreas , Kizina Kathrin , Ugurel Selma , Kleinschnitz Christoph , Glas Martin , Zimmer Lisa , Hagenacker Tim
Published: April 2020

Background: Checkpoint inhibitors show impressive and durable responses in various cancer types and provide new avenues for cancer immunotherapy. However, these drugs have a variety of adverse events. Common autoimmune-related adverse effects include fatigue, hepatitis, skin rash, endocrine deficiencies, and colitis. Neurotoxicity has been reported, but its incidence and course remain unclear.Methods: To illustrate the broad spectrum of neurotoxicity, we exemplarily report the neurological adverse events of five patients with melanoma and one patient with differentiated thyroid cancer who received checkpoint inhibitors at Essen University Hospital (Essen, Germany).Results: After treatment with ipilimumab, nivolumab or pembrolizumab, neurotoxic effects included hypophysitis-associated neck pain and headache, Guillain-Barré syndrome, transverse myelitis, acute brachial plexus neuritis, and ocular myasthenia gravis.Conclusions: Checkpoint inhibitor therapy remains a success story; however, neurological immune-related adverse events may cause severe life-threatening conditions. We propose a checklist for the early detection of neurological adverse events during routine clinical treatment to prevent more severe courses of checkpoint inhibitor-induced neurotoxicity.
Neutral Polysaccharide from Panax notoginseng enhanced cyclophosphamide antitumor efficacy in hepatoma H22-bearing mice
Authors: Liu Yanhong , Qin Huayan , Zhong Yuanyuan , Li Shuang , Wang Huajing , Wang Hong , Chen Liling , Tang Xiang , Li Yalin , Qian Zhongyi , Li Huaiyu , Zhang Lei , Chen Tong
Published: April 2020

Background: Our previous studies demonstrated that the administration of crude Polysaccharide from Panax notoginseng (CPPN) can effectively prolong the lifespan of tumor-bearing mice via boosting host immune system as well as a weak cytotoxicity against hepatocellular carcinoma (HCC). In the present study, Neutral Polysaccharide (NPPN) were further purified from crude polysaccharide isolated from panax notoginseng. The effects of NPPN on the immune function and hematopoietic function of mice with low immunity and myelosuppression induced by cyclophosphamide (CTX) were investigated. The effect of NPPN combined with CTX on the tumor inhibition rate of the H22 tumor-bearing mice and the impact of NPPN on the proliferation of H22 liver cancer cells in vitro were investigated.Methods: CPPN was obtained by water extraction and alcohol precipitation method, and further purified by DEAE Sepharose Fast Flow ion exchange resin column. NPPN was added to the immunosuppressed with myelosuppression mice induced by CTX. Thymus index, spleen index, lymphocyte proliferation stimulation index by adding of concanavalin A, determination of serum hemolysin, NK cell activity assay, mice carbon clearance experiment, blood count tests were detected. The tumor inhibition rate of the H22 tumor-bearing mice treated with NPPN combined with CTX was recorded.Results: NPPN and 4 kinds of acid polysaccharide from Panax notoginseng (APPN) were successfully isolated from the CPPN by DEAE Sepharose Fast Flow ion exchange resin column. NPPN inhibited the growth of H22 cells and significantly increase the tumor inhibition rate of the H22 tumor-bearing mice combined with CTX. The elevation of the cellular and humoral immunity levels as well as a variety of blood count tests indicators of immunosuppressive with myelosuppression mice may contribute to the antitumor activity of NPPN.Conclusion: NPPN has potential antitumor activity for the treatment of liver cancer combined with cyclophosphamide.
The concept of a cementless isoelastic monoblock cup made of highly cross-linked polyethylene infused with vitamin E: Clinical outcome and radiological analyses of migration and wear using EBRA at mid-term follow-up
Authors: Afghanyar Yama , Joser Sebastian , Tecle Jonas , Drees Philipp , Dargel Jens , Rehbein Philipp , Kutzner Karl Philipp
Published: April 2020

Background The newest generation of cementless titanium coated, isoelastic monoblock cup with vitamin E-blended highly cross-linked polyethylene (HXLPE) has been introduced to the market in 2009. Aim of the present study was to obtain mid-term data including the analyses of migration and wear. Methods The present prospective study investigated 101 primary total hip arthroplasty (THA) cases in 96 patients at a single institution. Patients were allowed full weight-bearing on the first day postoperatively. Harris hip score (HHS) as well as pain and satisfication on visual analogue scale (VAS) were assessed during a mean follow-up of 79.0 months. Migration and wear were assessed using Einzel-Bild-Roentgen-Analyse (EBRA) software. Additionally, radiological alterations in the acetabular bone and complications were documented. Results At mid-term follow-up (mean 79.0 months (range: 51.8 – 101.7)), HHS was 91.1 (range 38.0 – 100.0), satisfaction on VAS was 9.6 (range 6.0 – 10.0), rest pain on VAS was 0.2 (range 0.0 – 4.0), and load pain on VAS was 0.6 (range 0.0 – 9.0). Mean migration was 0.86 mm (range: 0.0 – 2.56) after 24 months and 1.34 mm (range: 0.09 – 3.14) after 5 years. Mean annual migration rate was 0.22 (range: -0.24 – 1.34) at 5 years. Mean total wear was 0.4 mm (range: 0.03 – 1.0) at 5 years. The mean annual wear rate was 0.06 mm per year (range: 0.0 – 0.17). Radiographic analysis showed osteolysis in none of the cases and no revision surgeries had to be performed. Conclusion The concept of vitamin-E blended HXLPE in cementless isoelastic monoblock cups prevents osteolysis, aseptic loosening and the need of revision surgery at mid-term. Values for cup migration and wear stay well below the benchmarks which are considered predictive for potential future failure.
MiRNA-6089 inhibits rheumatoid arthritis fibroblast-like synoviocytes proliferation and induces apoptosis by targeting CCR4
Authors: Lin Suxian , Zhang Zhiyong , Wang Shengnan , Lu Yang , Yang Meilv , Chen Ping , Wang Mudan
Published: April 2020

Background: Growing data have indicated that fibroblast-like synoviocytes (FLS) and miRNAs are implicated in the pathogenesis of rheumatoid arthritis (RA). This study was aimed to evaluate the function of miR-6089 in the regulation of RA-FLSs. Methods: The expression of miR-6089 was measured by quantitative real time PCR (qRT-PCR). The RA-FLSs were transfected with si-CCR4 plasmids or miR-6089 mimic, and subjected to CCK-8 and flow cytometry to analyze proliferation and apoptosis. The concentrations of MMP-1, TNF-α and IL-6 in RA-FLSs supernatant were detected using ELISA. The protein expression of caspase-3, -8 and -9 was detected using western blot.Results: The levels of miR-6089 were detected to be significantly lower in the synovial tissues and FLSs of RA than in the synovial tissues and FLSs of healthy controls. The miR-6089 up-regulation in RA-FLSs significantly inhibited the proliferation and promoted cell apoptosis accompany with an increase protein expression of caspase-3, -8 and -9. Furthermore, CCR4 was determined to directly target miR-6089, and its expression was significantly increased in the synovial tissues of RA than in the synovial tissues of healthy controls. Moreover, CCR4 overexpression effectively reversed the effect on proliferation and apoptosis induced by miR-6089 in RA-FLSs. Conclusion: Our results revealed that miR-6089 may be a potential target for RA prevention and therapy of RA.
Hypertrophic adipocyte-derived exosomal miR-802-5p contributes to insulin resistance in cardiac myocytes through targeting HSP60
Authors: Wen Zhongyuan , Li Junfeng , Fu Yalin , Zheng Yuyang , Ma Mingke , Wang Changhua
Published: April 2020

Epicardial adipose tissue (EAT) is implicated in insulin resistance, which has been recognized as a strongest predictor of the development of diabetic cardiomyopathy and subsequent heart failure. However, the underlying mechanism remains incompletely understood. Herein, we investigated the effect of hypertrophic adipocytes on cardiac insulin resistance. We found that hypertrophic adipocyte-derived exosomes (h-Exo) induced insulin resistance in NRVMs. Furthermore, h-Exo high-expressed miR-802-5p. Insulin sensitivity of NRVMs was impaired by miR-802-5p mimic but improved by its inhibitor. TargetScan and luciferase reporter assays revealed that heat shock protein 60 (HSP60) was a direct target of miR-802-5p. Both h-Exo and miR-802-5p mimic could downregulate HSP60 protein levels. In addition, HSP60 silencing induced insulin resistance and mitigated the insulin-sensitizing effects of adiponectin. HSP60 depletion also significantly increased the expression levels of CHOP, a marker of the unfolded protein response (UPR), and enhanced oxidative stress, accompanied by the increased phosphorylation of JNK and IRS-1 Ser307. Inhibition of both miR-802-5p and endocytosis abolished the impacts of HSP60 knockdown on the UPR and oxidative stress. In summary, hypertrophic adipocyte-derived exosomal miR-802-5p caused cardiac insulin resistance in NRVMs through downregulating HSP60. These findings provide a novel mechanism by which EAT impairs cardiac function.