bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in D-Dimer after initiation of antiretroviral therapy in adults living with HIV in Kenya
Authors: Teasdale Chloe A , Hernandez Cecilia , Zerbe Allison , Chege Duncan , Hawken Mark , El-Sadr Wafaa M
Published: June 2020

Background: Increased coagulation biomarkers are associated with poor outcomes among people living with HIV(PLHIV). There are few data available from African cohorts demonstrating the effect of antiretroviral therapy (ART) on coagulation biomarkers.Methods: From March 2014 to October 2014, ART-naïve PLHIV initiating non-nucleoside reverse transcriptase inhibitor-based ART were recruited from seven clinics in western Kenya and followed for up to 12 months. Demographics, clinical history and blood specimens were collected. Logistic regression models adjusted for intrasite clustering examined associations between HIV viral load and D-Dimer at baseline. Mixed linear effects models were used to estimate mean change from baseline to six months overall, and by baseline viral load, sex and TB status at enrollment. Mean change in D-dimer at six months is reported on the log10 scale and as percentage change from baseline.Results: Among 611 PLHIV enrolled, 66% were female, median age was 34 years (interquartile range (IQR) 29-43 years), 31 (5%) participants had tuberculosis and median viral load was 113,500 copies/mL (IQR: 23,600-399,000). At baseline, 311 (50.9%) PLHIV had elevated D-dimer (>500 ng/mL) and median D-dimer was 516.4 ng/mL (IQR: 302.7-926.6) (log baseline D-dimer: 2.7, IQR: 2.5-3.0). Higher baseline D-dimer was significantly associated with higher viral load (p<0.0001), female sex (p=0.02) and tuberculosis (p=-0.02). After six months on ART, 518 (84.8%) PLHIV had achieved viral load <1,000 copies/mL and median D-dimer was 390.0 (IQR: 236.6-656.9) (log D-dimer: 2.6, IQR: 2.4-2.8). Mean change in log D-dimer from baseline to six months was -0.12 (95%CI -0.15, - 0.09) (p<0.0001) indicating at 31.3% decline (95%CI -40.0, -23.0) in D-dimer levels over the first six months on ART. D-dimer decline after ART initiation was significantly greater among PLHIV with tuberculosis at treatment initiation (-172.1%, 95%CI -259.0, -106.3; p<0.0001) and those with log viral load >6.0 copies/mL (-91.1%, 95%CI -136.7, -54.2; p<0.01). Conclusions: In this large Kenyan cohort of PLHIV, women, those with tuberculosis and higher viral load had elevated baseline D-dimer. ART initiation and viral load suppression among ART-naïve PLHIV in Kenya were associated with significant decrease in D-dimer at six months in this large African cohort.
What methods are used to promote patient and family involvement in healthcare regulation? A case study across four countries
Authors: Wiig Siri , Rutz Suzanne , Boyd Alan , Churruca Kate , Kleefstra Sophia , Haraldseid-Driftland Cecilie , Braithwaite Jeffrey , O'Hara Jane , de Bovenkamp Hester van
Published: June 2020

Background: In the regulation of healthcare, the subject of patient and family involvement figures increasingly prominently on the agenda. However, the literature on involving patients and families in regulation is still in its infancy. A systematic analysis of how patient and family involvement in regulation is accomplished across different health systems is lacking. We provide such an overview by mapping and classifying methods of patient and family involvement in regulatory practice in four countries; Norway, England, the Netherlands, and Australia. We thus provide a knowledge base that enables discussions about possible types of involvement, and advantages and difficulties of involvement encountered in practice. Methods: The research design was a multiple case study of patient and family involvement in regulation in four countries. The authors collected 1) academic literature if available and 2) documents of regulators that describe user involvement. Based on the data collected, the authors from each country completed a pre-agreed template to describe the involvement methods. The following information was extracted and included where available: 1) Method of involvement, 2) Type of regulatory activity, 3) Purpose of involvement, 4) Who is involved and 5) Lessons learnt.Results: Our mapping of involvement strategies showed a range of methods being used in regulation, which we classified into four categories: individual proactive, individual reactive, collective proactive, and collective reactive methods. Reported advantages included: increased quality of regulation, increased legitimacy, perceived justice for those affected, and empowerment. Difficulties were also reported concerning: how to incorporate the input of users in decisions, the fact that not all users want to be involved, time and costs required, organizational procedures standing in the way of involvement, and dealing with emotions. Conclusions: Our mapping of user involvement strategies establishes a broad variety of ways to involve patients and families. The four categories can serve as inspiration to regulators in healthcare. The paper shows that stimulating involvement in regulation is a challenging and complex task. The fact that regulators are experimenting with different methods can be viewed positively in this regard.
An epidemiological review of tuberculosis in Sabah, Malaysia, 2012-2018
Authors: Goroh Michelle , Rajahram Giri , Avoi Richard , Boogaard Christel van den , William Timothy , Ralph Anna P , Lowbridge Christopher
Published: June 2020

Background: Tuberculosis (TB) is of high public health importance in Malaysia. Sabah State, located on the island of Borneo, has previously reported a particularly high burden of disease and faces unique contextual challenges compared with peninsular Malaysia. The aim of this study is to describe the epidemiology of TB in Sabah to identify risk groups and hot spots of TB transmission.Methods: We conducted a retrospective review of TB cases notified in Sabah, Malaysia, between 2012 and 2018. Using data from the state’s ‘myTB’ notification database, we calculated the case notification rate and described trends in the epidemiology, diagnostic practices and treatment outcomes of TB in Sabah within this period. Results: Between 2012 and 2018 there were 33,193 cases of TB reported in Sabah (128 cases per 100,000 population). We identified several geographic hotspots, including districts with >200 cases per 100,000 population per year. TB rates increased with age and were highest in older males. Children <15 years accounted for only 4.6% of cases. Moderate or advanced disease on chest x-ray and sputum smear positivity was high (58% and 81% of cases respectively), suggesting frequent late diagnosis. Multi-drug Resistant (MDR) TB prevalence was low (0.3% of TB cases), however, rapid diagnostic test coverage was low (1.2%) and only 18% of all cases had a positive culture result. Treatment success was 83% in those with drug-sensitive TB and 30% in cases of MDR-TB. Conclusion: Between 2012 and 2018, Sabah State accounted for 20% of Malaysia’s TB notifications, despite representing only 10% of Malaysia’s population. We found hotspots of TB in urbanised population hubs and points of migration, as well as evidence of late presentation and diagnosis. Ensuring universal health coverage and expansion of GeneXpert® coverage is recommended to reduce barriers to care and early diagnosis and treatment for TB.
Changes in Oxidation-antioxidation Function on the Thymus of Chickens Infected with Reticuloendotheliosis Virus
Authors: Yang Dahan , Zhao Chenhui , Zhang Meixi , Zhang Shujun , Zhai Jie , Gao XueLi , Liu Chaonan , Lv Xiaoping , Zheng Shimin
Published: June 2020

Background
Reticuloendotheliosis virus (REV) is a retrovirus that causes severe immunosuppression in infected poultry. Under oxidative stress,the animals grow slowly. In addition, long-term oxidative stress can impair immune function, as well as accelerate the aging and death of the animal.This study aimed to elucidate the pathogenesis of REV from the perspective of changes in oxidative-antioxidative function following REV infection.
Results
In specific pathogen free chickens infected with REV, the levels of H2O2 and MDA in the thymus increased, the levels of T-AOC, SOD, CAT, and GPx1 decreased, and there was a reduction in CAT and Gpx1 mRNA expression, compared with the control group. The thymus index was also significantly reduced. Morphological analysis showed that after REV infection, there was an increase in thymic reticular endothelial cells, inflammatory cell infiltration, mitochondrial swelling, and destruction of the nuclear structure.
Conclusions
These results indicate that an increase in oxidative substances within the thymus, enhanced lipid peroxidation, a markedly decrease in antioxidant function, atrophy of the thymus, and immunosuppression in REV-infected chickens.
Relaxometric learning: a pattern recognition method for T2 relaxation curves based on machine learning supported by an analytical framework
Authors: Date Yasuhiro , Wei Feifei , Tsuboi Yuuri , Ito Kengo , Sakata Kenji , Kikuchi Jun
Published: June 2020

Nuclear magnetic resonance (NMR)-based relaxometry is widely used in various fields of research because of its advantages such as simple sample preparation, easy handling, and relatively low cost compared with metabolomics approaches. However, there have been no reports on the application of the T2 relaxation curves in metabolomics studies involving the evaluation of metabolic mixtures, such as geographical origin determination and feature extraction by pattern recognition and data mining. In this study, we describe a data mining method for relaxometric data (i.e., relaxometric learning). This method is based on a machine learning algorithm supported by the analytical framework optimized for the relaxation curve analyses. In the analytical framework, we incorporated a variable optimization approach and bootstrap resampling-based matrixing to enhance the classification performance and balance the sample size between groups, respectively. The relaxometric learning enabled the extraction of features related to the physical properties of fish muscle and the determination of the geographical origin of the fish by improving the classification performance. Our results suggest that relaxometric learning is a powerful and versatile alternative to conventional metabolomics approaches for evaluating fleshiness of chemical mixtures in food and for other biological and chemical research requiring a nondestructive, cost-effective, and time-saving method.
Nature of dispensing errors in selected hospitals providing free healthcare: A multi-center study in Sri Lanka
Authors: Dilsha R.A.N. , Kularathne H.M.I.P. , Mujammil M.T.M. , Irshad S.M.M. , Samaranayake Nithushi
Published: June 2020

Background
Dispensing errors may result in patient harm. Dispensing errors are preventable if we knew its nature, but only very little information is available on these errors that occur in limited resourced settings where healthcare is provided free of charge. Therefore, the purpose of this study was to determine the types and prevalence of dispensing errors in selected hospitals in Sri Lanka.
Methods
A prospective, cross sectional and multi-centered study (in one tertiary care and two secondary care hospitals) was conducted among 420 patients attending medical, surgical, diabetes and pediatric clinics of study hospitals, proportioned according to population size, and selected through a systematic random sampling. A prescription audit was conducted. Dispensing errors were categorized as content, labelling, documentation, concomitant, and other errors based on definitions developed in-house. The total number of dispensing errors identified was used as the denominator for calculating percentages.
Results
A total of 420 prescriptions (1849 medicines) were analyzed (Hospital-01, 248 prescriptions with 1010 medicines; Hospital-02, 84 prescriptions with 400 medicines; Hospital-03, 88 prescriptions with 439 medicines), where 16,689 dispensing errors were detected. However, most frequent were labelling errors (63.1%). There were 4.9% content errors, 21% concomitant errors, 10.6% documentation errors, and 0.4% of other errors. No omissions or deteriorated medicines were detected.
Conclusions
Dispensing errors happen in Sri Lankan hospitals that operate with limited resources and provide free healthcare to citizens. However, most were labeling errors with little chance of immediate harm. Content errors were minimal. More emphasis on error-proofing the dispensing process could improve medication safety in these hospitals.
Clinical Features of Hypertensive Patients With Covid-19 Compared With a Normotensive Group
Authors: wang shuang , zhang qiang , zheng zhao bin , wang peng , ye hua hong , jing xiao qing , zhang jun hua , fan da yu , jia ping , zhang zhong dan , luo ting ting , zhu shi sheng
Published: June 2020

Background: The novel coronavirus (COVID-19), which began in Wuhan, China, in December 2019, has spread worldwide and poses a great threat to human health. Among COVID-19 patients, those with hypertension have been reported to have higher morbidity and mortality. This study was conducted to provide the international community with a deeper understanding of COVID-19 with hypertension.Methods: A total of 188 COVID-19 patients were studied from January to March 2020. The epidemiology, clinical features, and laboratory data of hypertensive patients with COVID-19 were collected, retrospectively analyzed, and compared with a normotensive group. The use of anti-hypertensive drugs, general treatment, and clinical outcomes of hypertensive patients were also analyzed.Results: The median ages in hypertensive patients with mild and severe COVID-19 were both significantly greater than the median age in the normotensive group. But there was no significant gender difference between the hypertensive and normotensive groups. All patients had lived in the Wuhan area. Common symptoms of all of the patients included fever, cough, and fatigue. Chest CT scans showed bilateral patchy shadows or ground glass opacity in the lungs of all of the patients. All (98 [100%]) of the hypertensive patients received antiviral therapy (Arbidol was used alone or in combination with Ribavirin), antibiotic therapy (85 [86.7%]), and corticosteroids (31 [31.6%]). It has been suggested that the combination of Arbidol and Ribavirin as initial therapy for hypertensive patients with COVID-19 is effective and safe. There were no significant differences in laboratory data between the mild cases in the hypertensive and the normotensive groups. In the severe cases, the hypertensive patients had higher plasma levels of D-dimer, C-reactive protein (CRP), and Interleukin-6 (IL-6) (P < 0.05). Furthermore, the hypertensive patients who were treated with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) had no statistically significant differences between the mild and severe groups (p > 0.05).Conclusion: In this study, we demonstrated that the hypertensive patients who were treated with ACEI/ARB did not have an increased risk of developing severe COVID-19. Arbidol and Ribavirin played an important role in the treatment of the viral pneumonia. Hypertensive patients with severe viral pneumonia had stronger inflammatory responses than non-hypertensive patients.
Perceptions of motivation and willingness to participate in randomized clinical trials in emergency obstetric and newborn care among survivors of severe obstetric complications
Authors: Kaye Daniel Kabonge , Chongwe Gershom , Sewankambo Nelson K. , Ali Joseph , Hyder Adnan A. , Kass Nancy E
Published: June 2020

Background

Previous studies have shown that participants in emergency research may not understand the research and therefore may not make informed decisions to participate. Little is documented about motivation for research participation in randomized clinical trials in emergency obstetric and newborn care. Conducted among survivors of severe obstetric complications, this study sought to assess beliefs, perceptions and values as well as motivation and willingness for participation in research.
Methods

This was a qualitative study conducted among 18 survivors of severe obstetric complications who were attending the post-natal clinic of Kawempe National Referral Hospital, Uganda. The participants were contacted 6–8 weeks after surviving severe obstetric complications during pregnancy or childbirth. Eighteen in-depth interviews were conducted from June 1 to July 6, 2019. The issues explored included interviewees’ perceptions and beliefs regarding 1) what constitutes clinical trial research in emergence obstetric and newborn care, 2) the purpose and necessity to conduct such research, 3) how emergency research-related information should be delivered to potential participants and their caregivers, 4) why women would be willing and motivated to participate in this type of research, and 5) the potential benefits and risks to research participants. Data were analyzed according to themes using the constant comparative method.
Findings:

Many respondents were potentially willing to participate in research during obstetric emergencies, even when there was no possibility of material or therapeutic benefit, provided there was reasonable assurance that there would be no harm to them or (more especially) to their babies. Both solidarity and communitarian consent were important influences on motivation to participate in clinical trials in emergency obstetric care. Motivation to participate in research was partly related to the desire to access care, to contribute to knowledge about pregnancy complications, to possibility of material or therapeutic benefit, to perceived low level of risk particularly to the baby, to trust in the investigators and to opportunity to receive research results.
Conclusion

Solidarity, communitarian consent, perceived level of potential risk, possibility of benefit and trust in the investigators were the major potential motivators for participation in research in the emergency obstetric and newborn care context.
Land conversion changes soil microbial community structure and diversity
Authors: Zhang Tong , Liu Yufei , Sui Xin , Song Fuqiang
Published: June 2020

Background: To study the impact of land-use change on soil microbial community structure and diversity in Northeast China, three typical land-use types (plough, grassland, and forest), from grassland change to forest land and grassland change to plough, in the Qiqihar region of Heilongjiang Province were taken as research objects. Methods: MiSeq high-throughput sequencing technology based on bacterial 16S rRNA and fungal ITS rRNA was used to study the above community structure of soil bacteria and fungi and to explore the relationship between soil bacteria and soil environmental factors. Results: The results showed that there was no significant difference in soil bacterial community diversity and fungal community diversity after the grassland was completely changed to forest land. The dominant bacterial phylum changed from Actinobacteria to Acidobacteria, the dominant fungal phylum changed from Ascomycetes to Basidiomycetes, and the ECM functional group increased significantly. After the grassland was changed to plough, there was no significant difference in the diversity of soil bacterial communities, and the diversity of fungal communities increased significantly. The dominant phylum changed from Actinomycetes to Proteobacteria. The dominant phylum was still Ascomycetes, and the functional groups of pathogens and parasites increased significantly. CCA showed that soil pH, MC, NO3--N, TP and AP were important factors affecting the composition of soil microbial communities, and changes in land-use patterns changed the physical and chemical properties of soils, thereby affecting the structure and diversity of microbial communities. Conclusions: Our research results clarify the impact of changes in land use on the characteristics of soil microbial communities and provide basic data on the healthy use of land.
Ocular and Corneal Aberrations changes in controlled randomized clinical trial MiSight® Assessment Study Spain (MASS)
Authors: LOPES-FERREIRA DANIELA , Ruiz-Pomeda Alicia , Peréz-Sanchéz Belén , Queirós António , Villa-Collar César
Published: June 2020

BackgroundTo compare ocular and corneal inherent aberrations in the naked eyes of randomly selected children fitted with MiSight contact lenses (CL) for myopia control, versus children corrected with single-vision spectacles (control), over a 24-months period.MethodsChildren aged 8 to 12 years, with myopia (-0.75 to -4.00 D sphere) and astigmatism (< -1.00 D cylinder), were assigned to the lens study group (MiSight) or the control group (single-vision spectacles). Axial length (AL) was measured by biometry, corneal RMS (RMS_C), corneal high order RMS (HO_RMS_C), corneal low order RMS (LO_RMS_C), ocular total RMS (RMS_T), ocular total high order RMS (HO_RMS_T), ocular total low order RMS (LO_RMS_T), corneal spherical aberration (SA_C) and ocular total SA (SA_T) were calculated by aberrometric measures at the baseline, and on 12- and 24-months visits. A 5 mm diameter was defined for the analysis in all visits for all subjects. Only the dominant eye was analyzed.ResultsSeventy-four subjects completed the clinical trial: 41 subjects from the MiSight group (age: 11.01 ± 1.23 years) and 33 from the single-vision group (age: 10.12 ± 1.38 years). In the control group, axial length changed significantly (0.444 ± 0.049 mm, p < 0.001) after 2 years. Also RMS_T (0.565 ± 0.199 µm, p = 0.029) and LO_RMS_T (0.461 ± 0.175 µm, p = 0.047) registered significant changes after 24-months in the control group. In the MiSight group, only axial length changed significantly (0.284 ± 0.025 mm, p < 0.001) after 2 years. The SA_C and SA_T did not reveal significant changes between visits or between groups.ConclusionsThe wear of MiSight CL did not induce significant changes in aberrations in anterior cornea and contrary of control group the total ocular RMS and low order RMS did not significantly caused by significantly lower eye growth and myopia progression,Trial registration: ClinicalTrials.gov Identifier: NCT01917110.
Coronavirus disease 2019 screening in adult patients hospitalized due to pneumonia in a single hospital in Japan.
Authors: Komagamine Junpei , Yabuki Taku
Published: June 2020

Background: In Japan, the number of patients with coronavirus disease (COVID-19) has increased since the first case was confirmed in January 2020, reaching more than ten thousand cases as of April 30, 2020. Nonetheless, a true prevalence of COVID-19 in Japan remains unknown due to testing restrictions and a lack of epidemiological research for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Methods: We investigated 37 consecutive pneumonia patients hospitalized in our hospital located in Utsunomiya, Japan, from February 25 to May 16, 2020. Both nasopharyngeal swabs and sputum were obtained and sent for SARS-CoV-2 PCR testing. The percentage of positive results for SARS-CoV-2 in the screened patients was determined.Results: None of the patients reported in this study had contact with COVID-19 patients. Of the 37 screened patients, none had positive SARS-CoV-2 test results. None were clinically diagnosed with COVID-19. Conclusions: Our findings suggest that COVID-19 was not prevalent in this region during this period. Further studies are needed to determine an accurate number or prevalence of COVID-19 in other regions of Japan.
The influence of gingival phenotype in the morphology of the central maxillary interdental papilla
Authors: Belák Šimon , Žižka Radovan , Starosta Martin , Zapletalová Jana , Šedý Jiří , Štefanatný Michal
Published: June 2020

BackgroundPreservation of interdental papilla is an essential part of the functional and esthetic rehabilitation of dental treatment. It was described that thicker gingival tissues are more resistant to recession. The main objective of this investigation was to analyze if the gingival phenotype represents a potential risk factor affecting interdental papilla fill, height, or width in an esthetic region between central maxillary incisors. The secondary goals were: 1) analyze parameters describing papilla and the influence of a wide papilla basis for the vertical papillary dimension; 2) the correlation between different non-invasive measurements of gingival thickness; 3) comparison among both sexes.MethodsTogether, 54 periodontally healthy students (20–30 years old) were included in the study. Gingival thickness was measured using Pirop Ultrasonic Biometer. Phenotype was also assessed by gingival probe transparency. Papilla parameters - height and width of the interdental papilla were measured, and the degree of papilla recession was classified.ResultsNo significant correlation between papilla height, width, or papilla fill and gingival probe transparency or gingival thickness was found. Both methods of assessments of gingival phenotype showed a significant relationship. There was a significant correlation of papilla height and papilla fill. Papillae, which filled the interdental space completely, seem to be shorter. A strong positive association between papilla height and papilla width was revealed. Papillae were significantly higher in males.ConclusionThe appearance of interdental papillae could be influenced by various factors. Within the limitations of this study, results showed no significant correlation between the morphology of interdental papillae and soft tissue thickness. It seems that there is an influence of a wide papilla basis for its vertical dimension.
Global value chains and economic development: what impact on the Moroccan economy?
Authors: Lotfi Ismail , Lotfi Bilal
Published: June 2020

Globalization has changed the way goods and services are produced. The activities that form the value chains of many products and services are increasingly fragmented across the globe and between firms. But the question is how we get positive economic and social benefits by taking part in these global value chains. In the case of Morocco, it appears that the current form of its integration in Global Value Chains (GVCs) has only a limited effect on economic growth in the long-term. Indeed, despite the continued growth of Moroccan exports since 2011, the local added value in these exports has not increased so much. Consequently, the current stage of Morocco in GVCs does not allow improvement of per capita income and employment rates. In this respect, moving upmarket in GVCs and discovering of a new, more complex sector is no minor detail, but proves to be an absolute necessity for the territorial development of Morocco.
Higher Mortality and Infection Rate in a Region or Country Suggest a Longer Time of COVID-19 Disease Pandemic
Authors: Gu Tianshu , Yao Lan , Sun Tong , Day Sara W. , Howard Scott C. , Graff J. Carolyn , Jiao Yan , Chen Hong , Sun Dianjun , Aleya Lotfi , Gu Weikuan , Wang Yongjun
Published: June 2020

In view of the fact that the 2019-nCoV has spread to most countries in the world, it is necessary to make scientific and well-founded predictions of the current pandemic situation caused by the virus worldwide, which are conducive to public, social and government responses that mitigate and appropriately address the pandemic. We collected data from provinces with more than 200 cases in China and from eight other countries. Our analyses showed that the disease duration has no correlation with the number of patients, with r = 0.184. The number of deaths was not correlated to the disease duration, with r = 0.242. However, a positive correlation between the days of disease duration and infection rate, with a r = 0.626. Furthermore, there is a strong positive correlation between the disease duration and total death rate, with a r = 0.707. Using death rate of first 25 days, we obtained a positive relationship with a r value of 0.597. Based on the data from first 25 days, the minimum and maximum days of COVID-19 pandemic duration of eight countries was estimated between days of 37 and 114 days.
Survey on neutralizing antibodies against Zika virus eighteen months post-outbreak in two southern Thailand communities
Authors: Densathaporn Theerut , Sangthong Rassamee , Sakolnapa Monvaris , Surasombatpattana Smonrapat , Kemapunmanus Marisa , Masrinoul Promsin , Yoksan Sutee , McNeil Edward B , Chongsuvivatwong Virasakdi
Published: June 2020

Background In 2016 and 2017, Zika virus (ZIKV) infection outbreaks occurred in two communities in southern Thailand. This re-immerging infection can widely spread by mosquito bites and cause serious complications in a central nervous system, especially in babies. Thus they should be protected. This study aims to (1) To determine the prevalence of neutralizing ZIKV antibodies in the post-outbreak areas among the general population and pregnancy women residing at various distances from the houses of the nearest index patients; (2) To examine the cross-neutralizing capacity of antibodies against ZIKV on other flaviviruses commonly found in the study areas; (3) To identify factors associated with the presence of neutralizing ZIKV antibodies. Methods The two post-outbreak communities were visited at 18 months after the outbreaks. We enrolled (1) 18 confirmed ZIKV infected (index) cases, (2) sample of 554 neighbors in the outbreak areas who lived at various distances from the index patients’ houses, (3) 190 residents of non-outbreak areas, and (4) all pregnant women regardless of gestational age residing in the study areas (n = 805). All serum specimens underwent the plaque reduction neutralization test (PRNT). Ten randomly selected ZIKV seropositive and ten randomly selected seronegative specimens were tested for dengue virus serotypes 1-4 (DENV1-4) and Japanese encephalitis virus (JEV) antibodies using PRNT. Serum titer above 1:10 was considered positive. Multiple logistic regression was used to assess factors associated with seropositivity. Results Out of all 18 index cases, 17 remained seropositive. The seroprevalence (95% CI) in the two outbreak areas were 66.5% (59.1-73.9%) and 45.6% (38.8-52.5%) in general population, and 41.0% (36.1-46.0%) and 23.5% (19.4-21.9%) in pregnant women. Multivariate analysis showed that seropositivity was independent of the distance gradient from the index’s houses. However, being elderly, poorly educated, and living far from a plantation was associated with seropositivity. DENV1-4 and JEV neutralizing antibodies were present in nearly all ZIKV-positive and negative subsamples. Conclusion Protective herd immunity for ZIKV infection is inadequate, especially among pregnant women in the two post-outbreak areas in southern Thailand.
Prevalence and determinants of intimate partner violence against mothers of children under-five years in central Malawi
Authors: Chilanga Emmanuel , Collin-Vezina Delphine , Khan Mohammad Nuruzzaman , Riley Liam
Published: June 2020

Background: Intimate partner violence (IPV) against women is a pervasive and significant public health problem. The phenomenon is linked to adverse health effects for women and children. Mothers of young children in Malawi can be particularly at risk because of gender-based power imbalances. The objectives of this study were to examine the prevalence and the risk factors of IPV perpetrated by the current or recent partner against mothers of children under five years of age in rural Malawi.Methods: A multistage cross-sectional study design was used. A sample of 538 mothers of young children was randomly selected from postnatal clinics in Dowa district. The WHO's Violence against women instrument was used to collect data. Logistic regressions were used to determine risk factors that were associated with IPV against mothers. Results: The prevalence of IPV controlling behavior, psychological, physical, and sexual violence were 74.7%, 49.4%, 43.7% and 73.2% respectively. In multivariate analyses, mothers whose partners had extra marital affairs were more likely to experience controlling behavior (AOR: 4.97, 95% CI: 2.59-8.55, P<0.001), psychological (AOR: 2.14, 95% CI: 1.486-3.472, P<0.001) and physical (AOR: 2.29, 95% CI: 1.48-3.94, P<0.001) violence than mothers whose partners did not have extra marital affairs. Mothers whose partners consume alcohol were more likely to experience sexual violence (AOR: 2.00, 95% CI: 1.17-3.41, P<0.001) than mothers whose partners did not drink. Finally, mothers who spent more than 30 minutes drawing water were at greater risk of experiencing IPV than mothers who spent less than 30 minutes.Conclusion: This study found a significantly higher prevalence of IPV against mothers in rural Malawi compared to the national prevalence. Programs aimed at reducing the partners’ potential risk behaviors identified in this study are recommended. Public health programs that support increased household access to safe water are also recommended to help mitigate IPV against mothers.
Exosomal miR-29b of Aqueous Humour Mediated Variation of Ca2+ in Diabetes and Cataract Patients
Authors: Gao Chao , Liu Xin , Fan Fan , Yang Jianing , Zhou Xiyue , Mei Hengjun , Lin Xiaolei , Luo Yi
Published: June 2020

Background: Ca2+ was supposed to play an important role in the formation of cataract. Considering our increasing knowledge of exosomes, exosomal miRNAs isolated from aqueous humour may play an important role in the mechanism of diabetes and cataracts. In this study, we aimed to investigate the role of exosomal miR-29b and Ca2+ in regulating the function of human lens epithelial cells. Methods: Exosomes were isolated from human aqueous humour by ultracentrifugation, and visualized by nanoparticle tracking and transmission electron microscopy. Exosomal miRNA sequencing was performed to identify differentially expressed miRNAs between diabetes and cataracts group (DMC) and age-related cataracts group (ARC). TargetScan was used to predict potential target of certain miRNA. The expression of CACNA1C mRNA was determined by quantitative real-time PCR and CACNA1C protein was determined by Western blotting. Concentration of Ca2+ of human aqueous humour and cell culture supernatant was detected by the Calcium Assay Kit. Cell Counting Kit-8 was used to determine cell viability. Results: Exosomes could be isolated from human aqueous humour, which had a typical cup-shaped phenotype and a particle size distribution in accordance with micro extracellular vesicles. Exosomal miRNA sequencing revealed that miR-29b was significantly downregulated in diabetes and cataracts group (DMC) compared with age-related cataracts group (ARC). Ca2+ concentration of human aqueous humour in DMC was higher than that in ARC. Cell culture supernatant transfected with miR-29b inhibitors had a higher concentration of Ca2+ than that transfected with miR-29b mimics. miR-29b reduced the viability of human lens epithelium cells (HLECs) by up-regulating CACNA1C expression.Conclusions: Exosomes isolated from human aqueous humour contained abundant miRNAs. A significantly expressed miRNA, miR-29b, could affect the concentration of Ca2+ and regulate HLEC processes by up-regulating CACNA1C.
Clinical study on primary screening of oral cancer and precancerous lesions by oral cytology
Authors: Sukegawa Shintaro , Ono Sawako , Nakano Keisuke , Takabatake Kiyofumi , Kawai Hotaka , Nagatsuka Hitoshi , Furuki Yoshihiko
Published: June 2020

Background
This study was conducted to compare histological diagnostic accuracy between conventional method and liquid-based cytology (LBC) method and to clarify the effectiveness of cytology.
Methods
Histological diagnoses of 251 cases were classified as negative (no malignancy lesion, inflammation, and mild/moderate dysplasia) and positive [oral intraepithelial neoplasia/carcinoma in situ (OIN/CIS) and squamous cell carcinoma (SCC)]. Cytological diagnoses were classified as negative for intraepithelial lesion or malignancy (NILM), oral low-grade squamous intraepithelial lesion (OLSIL), oral high-grade squamous intraepithelial lesion (OHSIL), or SCC. Cytological diagnostic results were compared with histology results.
Results
Of NILM cytology cases, the most frequent case was negative [LBC n = 50 (90.9%), conventional n = 22 (95.7%)]. Among OLSIL cytodiagnoses, the most common was negative (LBC n = 34; 75.6%, conventional n = 14; 70.0%). Among OHSIL cytodiagnoses (LBC n = 51, conventional n = 23), SCC was the most frequent (LBC n = 31; 60.8%, conventional n = 7; 30.4%). Negative cases were common (LBC n = 13; 25.5%, conventional n = 14; 60.9%). Among SCC cytodiagnoses SCC was the most common (LBC n = 16; 88.9%, conventional n = 14; 87.5%). Regarding the diagnostic results of cytology, assuming HSIL and SCC as cytologically positive, the LBC method/conventional method showed a sensitivity of 79.4%/76.7%, specificity of 85.1%/69.2%, false positive rate of 14.9%/30.7%, and false negative rate of 20.6%/23.3%.
Conclusions
LBC method was superior to conventional method in cytodiagnosis. It was especially superior for LSIL and HSIL. Because of the false positive and false negative cytodiagnoses, it is necessary to make a comprehensive diagnosis considering the clinical findings.
Oral Health Status and Patterns of Dental Service Utilization of Adolescents in Lesotho, Southern Africa
Authors: Jessani Abbas , Quadri Faeq , El-Rabbany Abdul , Hooper Kirsten , Lim Hyun Ja , Ndobe Eketsang , Brondani Mario , Laronde Denise
Published: June 2020

Objectives: To identify the unmet dental treatment needs and patterns of dental service utilization by adolescents in the Kingdom of Lesotho, Southern Africa, and characterize the best predictors for perceived oral health status and dental visits for these adolescents. Method: A self-reported 40-item oral health survey was administered, and clinical oral examinations were conducted in public schools in Maseru from August 10 to August 25, 2016. Associations between psychosocial factors with oral health status and dental service utilization were evaluated using simple, bivariate and multivariate regressions. Results: Five hundred and twenty-six survey responses and examinations were gathered. The mean age of participants was 16.4 years of age, with a range between 12 and 19 years of age. More than two thirds (68%; n=355) of participants were female. The majority reported their quality of life (84%) and general health to be good/excellent (81%). While 95% reported that oral health was very important, only 11% reported their personal dental health as excellent. Three percent reported having a regular family dentist, with the majority (85%) receiving dental care in a hospital or medical clinic setting; only 14% had seen a dental professional within the previous 2 years. The majority of participants did not have dental insurance (78%). Clinical examination revealed tooth decay on 30% of mandibular and maxillary molars; 65% had some form of gingivitis. In multivariate analysis, not having dental education and access to a regular dentist were the strongest predictors of not visiting a dentist within the last year. Conclusion: Our results suggest that access to oral health care is limited in Lesotho. Dental decay on molars was prevalent. Further patient oral health education and regular dental care may make an impact on this population.
Clinical Efficacy of Arthroscopic Therapy With Infrapatellar Fat Pad Cell Concentrates in Treating Knee Cartilage Lesion: a Randomized Controlled Trial
Authors: Zhou Yiqin , Li Haobo , Xiang Dong , Shao Jiahua , Fu Qiwei , Han Yaguang , Zhu Jun , Chen Yi , Qian Qirong
Published: June 2020

Background: Toevaluatethe clinical efficacy of arthroscopic therapy with infrapatellar fat pad cell concentrates in treating knee cartilage lesion, we launched a prospective randomized single-blind clinical study of controlled method.Methods: 60 cases from Shanghai Changzheng Hospital during April 2018 to December 2019 were chosen and randomlydivided into 2 groups equally. Patients in the experiment group were treated throughknee arthroscopy with knee infrapatellar fat pad cell concentrates containing mesenchymal stem cells, while patients in the control group were treated through regular knee arthroscopic therapy. VAS and WOMAC scores were assessed at pre-operation, and 6 weeks, 12 weeks, 6 months, 12 months after intervention. MORCART scores were assessed at pre-operation and 12 months after intervention.Results: 29 cases in the experiment group and 28 cases in the control group were followed up. No significant difference in VAS, WOMAC, and MOCART scores were found between the two groups before surgery(P>0.05). The WOMAC-Total and WOMAC-Function scores ofexperiment groupwere significantly lower than those of control group 6 months, 12 months after surgery(P<0.05). The VAS-Rest and VAS-Motion scoresofexperiment group were found significantly lower than those of control group 12 months after surgery(P<0.05).The MOCART scores of experiment group were found significant higher compared with control group12 months after surgery(P<0.05). No significant difference in WOMAC-Stiffness scores were found between the two groups.Conclusions:The short-term results of our study are encouraging and demonstrate that knee arthroscopy with infrapatellar fat pad cell concentrates containing mesenchymal stem cells is safe, and provides assistance in reducing pain and improvingfunction in patients with knee cartilage lesion.Trial registration: ChiCTR1800015379. Registered on 27 March 2018, http://www.chictr.org.cn/showproj.aspx?proj=25901.
Propensity Score Adjusted Comparison of Three-Factor versus Four-Factor Prothrombin Complex Concentrate for Emergent Warfarin Reversal: A Retrospective Cohort Study
Authors: Margraf David , Seaburg Scott , Beilman Gregory , Wolfson Julian , Gipson Jonathan , Chapman Scott A
Published: June 2020

Background
Prothrombin Complex Concentrates are prescribed for emergent warfarin reversal (EWR). Few direct comparisons with three-factor prothrombin complex concentrate (PCC3) and four-factor prothrombin complex concentrate (PCC4) exist. Patients in an academic level one trauma center who received PCC3 or PCC4 for EWR were identified. Patient characteristics, PCC dose and time of dose, pre- and post-INR and time of measurement, plasma and vitamin K doses, and patient outcomes were collected. Patients whose pre-PCC International Normalized Ratio (INR) was > 6 hours before PCC dose or the pre-post PCC INR was > 12 hours were excluded. The primary outcome was achieving an INR ≤ 1.5 post PCC. Secondary outcomes were the change in INR over time, post PCC INR, thromboembolic events (TE), and death during hospital stay. Logistic regression modelled the primary outcome with and without a propensity score adjustment accounting for age, sex, actual body weight, dose, initial INR value, and time between INR measurements. Data are reported as median (IQR) or n (%) with p < 0.05 considered significant.
Results
Eighty patients were included (PCC3 = 57, PCC4 = 23). More PCC4 patients achieved goal INR (87.0% vs. 31.6%, odds ratio (OR) = 14.4, 95% CI: 3.80-54.93, p < 0.001). The result was similar after adjusting for possible confounders (AOR = 10.7, 95% CI: 2.17–51.24, p < 0.001). The post-PCC INR was lower in the PCC4 group (1.3 (1.3–1.5) vs. 1.7 (1.5-2.0), p < 0.001. The INR change was greater for PCC4 (2.3 (1.3–3.3) vs. 1.1 (0.6-2.0), p = 0.003). Death during hospital stay (p = 0.52) and TE (p = 1.00) were not significantly different.
Conclusions
PCC4 was associated with a higher achievement of goal INR than PCC3. This relationship was observed in the unadjusted, propensity score adjusted, and time stratified results.
Presence of Fermentable Oligo-, Di-, Monosaccharides, and Polyols (FODMAPs) in commonly eaten foods: Extension of a database to indicate dietary FODMAP content and calculation of intake in the general population from food diary data
Authors: Liljebo Therese , Störsrud Stine , Andreasson Anna
Published: June 2020

Background: FODMAPs (Fermentable Oligo-, Di-, Monosaccharides And Polyols) are known for their health benefits but their fermentation may trigger gastrointestinal symptoms and a low-FODMAP diet is a commonly used intervention for functional gastrointestinal disorders. The use of direct measures of FODMAP is labour intensive and expensive and to facilitate the assessment of FODMAP intake in research and clinical work, a nutritional content database with good quality estimates on FODMAP values is needed. Further, the average intake of FODMAP in a general population would be a useful reference and knowledge the most commonly eaten foods containing FODMAPs would facilitate clinical work utilising FODMAP diet interventions. Methods: A nutritional content database was extended with published FODMAP content data. The database was used to calculate FODMAP intake from four-day food diaries from 117 individuals from the general population in Sweden and the most common food items containing FODMAPs were identified. Results: FODMAP content for 1060 food items were added to the database resulting in 1805 listed FODMAP values. Mean intake of total FODMAP in the diaries was 19g (fructose: 15.2g; fructan: 3.5g; lactose: 14.1g; galacto-oligosaccharides (GOS) 0.43g and polyols 1.3g per day. Overall the most common eaten food items containing FODMAPs were rye and wheat based foods. Conclusion: Intake of FODMAPs as calculated using the extended database were in line with previous studies supporting its use of the database both research and in clinical interventions. The lists of the most commonly eaten FODMAP food items are provided and may be used to facilitate FODMAP diet interventions.
Existence of Differential Belief Profiles of COVID-19 Narratives: The Role of Trust in Science
Authors: Agley Jon , Xiao Yunyu
Published: June 2020

BackgroundThe global spread of coronavirus disease 2019 (COVID-19) has been mirrored by diffusion of misinformation and conspiracy theories about its origins (such as 5G cellular networks) and the motivations of preventive measures like vaccination, social distancing, and face masks (for example, as a political ploy). These beliefs have resulted in substantive, negative real-world outcomes but remain largely unstudied.MethodsThis was a cross-sectional, online survey (n=660). Participants were asked about the believability of five selected COVID-19 narratives, their political orientation, their religious commitment, and their trust in science (a 21-item scale), along with sociodemographic items. Data were assessed descriptively, then latent profile analysis was used to identify subgroups with similar believability profiles. Bivariate (ANOVA) analyses were run, then multivariable, multivariate logistic regression was used to identify factors associated with membership in specific COVID-19 narrative believability profiles.ResultsFor the full sample, believability of the narratives varied, from a low of 1.94 (SD=1.72) for the 5G narrative to a high of 4.56 (SD=1.64) for the zoonotic (scientific consensus) narrative. Four distinct belief profiles emerged, with the preponderance (70%) of the sample falling into Profile 1, which believed the scientifically accepted narrative (zoonotic origin) but not the misinformed or conspiratorial narratives. Other profiles did not disbelieve the zoonotic explanation, but rather believed additional misinformation to varying degrees. Controlling for sociodemographics, political orientation and religious commitment were marginally, and typically non-significantly, associated with COVID-19 belief profile membership. However, trust in science was a strong, significant predictor of profile membership, with lower trust being substantively associated with belonging to Profiles 2 through 4.ConclusionsBelief in misinformation or conspiratorial narratives may not be mutually exclusive from belief in the narrative reflecting scientific consensus; that is, profiles were distinguished not by belief in the zoonotic narrative, but rather by concomitant belief or disbelief in additional narratives. Additional, renewed dissemination of scientifically accepted narratives may not attenuate belief in misinformation. However, prophylaxis of COVID-19 misinformation might be achieved by taking concrete steps to improve trust in science and scientists, such as building understanding of the scientific process and supporting open science initiatives.