bluuebunny/crossref_metadata_2025 huggingface dataset:
Increase of vancomycin-resistant Enterococcus faecium strain type ST117 CT71 at Charité - Universitätsmedizin Berlin, 2008 to 2018
Authors: Weber Anna , Maechler Friederike , Schwab Frank , Gastmeier Petra , Kola Axel
Published: January 2020

Background: In addition to an overall rise in vancomycin-resistant Enterococcus faecium (VREfm), an increase in certain strain types marked by sequence type (ST) and cluster type (CT) has been reported in Germany over the past few years. Outbreak analyses at Charité - Universitätsmedizin Berlin revealed the frequent occurrence of VREfm ST117 CT71 isolates in 2017 and 2018. To investigate whether ST117 CT71 have emerged in recent years or whether these strains have been circulating for a longer time, we retrospectively analyzed non-outbreak strains that occurred between 2008 and 2018 to identify frequent STs and CTs.Methods: In total, 120 VREfm isolates obtained from clinical and surveillance cultures from the years 2008, 2013, 2015, and 2018 were analyzed. Thirty isolates per year comprising the first 7 - 8 non-outbreak isolates of each quarter of the respective year were sequenced using whole genome sequencing. MLST and cgMLST were determined as well as resistance genes and virulence factors. Risk factors for VREfm ST117 were analyzed in a multivariable analysis with patient characteristics as possible confounders. Results: The percentage of VREfm of type ST117 increased from 17% in 2008 to 57% in 2018 (p=0.012). In 2008, vanA genotype accounted for 80% of all ST117 isolates compared to 6% in 2018. VanB CT71 first appeared in 2018 and predominated over all other ST117 at 43% (p<0.0001). The set of resistance genes (msrC, efmA, ermB, dfrG, aac(6')-Ii, gyrA, parC and pbp5) and virulence factors (acm, esp, hylEfm, ecbA and sgrA) in CT71 was also found in other ST117 non-CT71 strains, mainly in CT36. The study population did not differ among the different calendar years analyzed in terms of age, gender, length of stay, or ward type (each p>0.2).Conclusion: This study revealed an increase in ST117 strains from 2008 to 2018, accompanied by a shift toward CT71 strains with the vanB genotype in 2018. We did not detect resistance or virulence traits in CT71 that could confer survival advantage compared to other CTs among ST117 strains. To date, it is not clear why ST117 and in particular strain type ST117 CT71 predominates over other strains.
The prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer
Authors: Zhang Jingqi , Zhou Xiaozhou , Ding Hua , Wang Liwei , Liu Sha , Liu Yuting , Chen Zhiwen
Published: January 2020

Background A routine blood examination is one of the most rapid, convenient and inexpensive clinical examinations that can reflect a patient’s inflammatory status and other blood conditions, and the prognostic value of routine preoperative blood parameters in MIBC patients is still unclear, so we evaluated the prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer (MIBC) following radical cystectomy (RC). Methods Data on 202 patients with MIBC who underwent RC at our institution were retrospectively collected between October 2007 and August 2018. The median preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and hemoglobin (HGB) values were used as cutoffs to form the low and high NLR, low and high PLR, and low and high HGB groups, respectively. The clinicopathologic characteristics of each group were compared by chi-square and t tests. Kaplan-Meier survival and multivariate Cox regression analyses were used to analyze prognosis. Results The median NLR, PLR and HGB values were 2.42, 112 and 125g/L, respectively. Kaplan-Meier results showed that the low HGB group had poor progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). A high NLR and high PLR groups correlated only with poor OS. Multivariate Cox analyses showed that pathological T3/4 stage, positive lymph node status and low HGB were independent risk factors for PFS, CSS and OS, and age was the only independent risk factor for OS. Conclusion Preoperative peripheral blood HGB is an independent risk factor for the prognosis of MIBC patients. These data suggest that HGB may be a useful prognostic marker for MIBC patients undergoing RC.
Lessons learned, challenges and outlooks for decision-making after a decade of experience monitoring the impact of indoor residual spraying in Benin, West Africa
Authors: Akogbéto Martin C , Dagnon Fortuné , Aikpon Rock , OSSE Razaki , Salako Albert , AHOGNI Idelphonse , AKINRO Bruno , SOMINAHOUIN André , Sidick Aboubakar , Tokponnon Filémon , PADONOU Germain Gil
Published: January 2020

Background: Since 2008, Indoor Residual Spraying (IRS) has been performed in Benin in 19 districts, including 4 in southern Benin, 9 in Atacora, and 8 in Atacora, Alibori and Donga in northern Benin. However, Benin still struggles with questions about IRS cost benefit and epidemiological impact. Lessons learned and challenges from 10 years of IRS in Benin to be shared with the stakeholders involved in vector control implementation for decision-making.Methods: Entomological parameters have been assessed entomological parameters in IRS communes since 2008. In all IRS intervention communes, decreases in human biting rate (HBR) of Anopheles gambiae, blood feeding inhibition and entomological inoculation rate (EIR) as compared to control district have been measured.Results: EIR was reduced by 80-90%, which is encouraging, but should be observed with caution because: (i) the reduction may be insufficient to decrease epidemiological indicators given that the residual EIR in IRS districts is still higher than it is in some regions of stable malaria; (ii) the reduction in EIR is based on comparisons with control communes, but it is difficult to select control areas with the same environmental characteristics as intervention areas; (iii) despite the reduction, half of all mosquitoes that entered IRS-treated houses succeeded in taking human blood meals. Further, there are behaviours among Benin’s population that limit IRS efficacy, including recent data showing that >90% of people are not protected by IRS between 7-10 PM. This is due to the fact that they remain outdoors and that most people are not protected from mosquito bites after 10 PM because they either sleep outdoors without IRS protection or indoors without an ITN. Moreover, people have large amounts of clothing hanging on walls where mosquitoes can rest instead of IRS-treated walls. Finally, other components are important to consider in implementing IRS among which: (i) Vector resistance management strategies are sometimes poorly understood; this is actually different from the need to replace one insecticide with another after the emergence of resistance; (ii) African countries should prepare to finance IRS themselves.Conclusion: To curtail residual malaria transmission, additional interventions able to target vectors escaping IRS should be prioritized.
Taste and smell function in Wolfram syndrome
Authors: Alfaro Raul Andres , Doty Tasha , Narayanan Anagha , Lugar Heather , Hershey Tamara , Pepino M. Yanina Y
Published: January 2020

BACKGROUND : Wolfram syndrome is a rare genetic disease characterized by insulin-dependent diabetes, optic nerve atrophy, sensorineural hearing loss and neurodegeneration. Although olfactory dysfunction, a classical clinical marker of neurodegenerative processes, has been reported in Wolfram syndrome, its use as a clinical marker in Wolfram is limited due to data scarcity. In addition, it is unknown whether Wolfram syndrome affects the sense of taste. METHODS: Smell and taste perception were assessed in participants with Wolfram syndrome (n=40) who were 15.1 ± 6.0 years of age (range: 5.1- 28.7 years) and two sex- and age-matched control groups: one group with type 1 diabetes mellitus (T1D; n=25) and a healthy control group (HC; n=29). Smell sensitivity was assessed by measuring n-butanol detection thresholds and smell identification by using the University of Pennsylvania Smell Identification Test (UPSIT). Taste function was assessed using NIH Toolbox, which includes the assessment of sucrose (sweet) taste preference, and perceived intensity of sucrose, sodium chloride (salty), and quinine hydrochloride (bitter) both in the tip of the tongue (regional test) and the whole mouth. RESULTS: Smell sensitivity was not significantly different among groups; however, smell identification was impaired in Wolfram syndrome, as reflected by significantly lower UPSIT scores in Wolfram syndrome compared to HC and T1D (P<0.001). Compared to participants in the control groups, participants with Wolfram syndrome had a blunted perception of sweetness and saltiness when taste stimuli were applied regionally (P<0.05), but differences in perceived intensity were no longer significant among groups when taste stimuli were tasted with the whole mouth. Groups preferred similar sucrose concentrations. CONCLUSION : Wolfram syndrome was associated with olfactory dysfunction. However, the olfactory dysfunction was qualitative (related to smell identification) and not secondary to olfactory insensitivity or diabetes, suggesting is arising from dysfunction in central olfactory brain regions. In contrast to olfaction, and despite decreased perception of taste intensity in the anterior tongue, the sense of taste was overall well-conserved in individuals with Wolfram syndrome. Future longitudinal studies of taste and smell perception in Wolfram syndrome will be important to determine the use of the chemical senses as clinical markers of disease progression.
Falciparum malaria from coastal Tanzania and Zanzibar remains highly connected despite effective control efforts on the archipelago
Authors: Morgan Andrew , Brazeau Nicholas , Ngasala Billy , Mhamilawa Lwidiko , Denton Madeline , Msellem Mwinyi , Morris Ulrika , Filer Dayne , Aydemir Ozkan , Bailey Jeffrey , Parr Jonathan , Mårtensson Andreas , Bjorkman Anders , Juliano Jonathan
Published: January 2020

Background : Tanzania’s Zanzibar archipelago has made significant gains in malaria control over the last decade and is a target for malaria elimination. Despite consistent implementation of effective tools since 2002, elimination has not been achieved. Importation of parasites from outside of the archipelago is thought to be an important cause of malaria’s persistence, but this paradigm has not been studied using modern genetic tools. Methods : We used whole-genome sequencing (WGS) to investigate the impact of importation, employing population genetic analyses of Plasmodium falciparum isolates from both the archipelago and mainland Tanzania. We assessed ancestry, levels of genetic diversity and differentiation, patterns of relatedness, and patterns of selection between these two populations by leveraging recent advances in deconvolution of genomes from polyclonal malaria infections. Results : We identified significant decreases in the effective population sizes in both populations in the timeframe of decreasing malaria transmission in Tanzania. Identity by descent analysis showed that parasites in the two populations shared large sections of their genomes, on the order of 5 cM, suggesting shared ancestry within the last 10 generations. Even with limited sampling, we identified a pair of isolates between the mainland and Zanzibar that are related at the expected level of half-siblings, consistent with recent importation Conclusions : These findings suggest that importation plays an important role for malaria incidence on Zanzibar and demonstrate the value of genomic approaches for identifying corridors of parasite movement to the island.
Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer?
Authors: Purushothaman Vidya Lakshmi , Cuomo Raphael E , Garland Cedric F , Mackey Tim Ken
Published: January 2020

Background Vitamin D has been identified as a potential protective factor the development of colorectal cancer (CRC). We expect to see a stronger association of ultraviolet B (UVB) exposure and CRC crude rates with increasing age since chronic vitamin D deficiency leads to sustained molecular changes that increase cancer risk. The DINOMIT (disjunction, initiation, natural selection, overgrowth, metastasis, involution, and transition) model postulates various stages of cancer development due to vitamin D deficiency and the associated latency period. The purpose of this study is to examine this age-dependent inverse relationship globally. MethodsIn this ecological study, a series of linear and polynomial regression tests were performed between country specific UVB estimates adjusted for cloud cover and crude incidence rates of CRC for different age groups. Multiple linear regression was used to investigate the association between crude incidence rates of colorectal cancer and UVB estimate adjusting for urbanization, skin pigmentation, smoking, animal consumption, per capita GDP, and life expectancy. Statistical analysis was followed by geospatial visualization by producing choropleth maps. Results The inverse relationship between UVB exposure and CRC crude rates was stronger in older age groups at the country level. Quadratic curve fitting was preferred, and these models were statistically significant for all age groups. The inverse association between crude incidence rates of CRC and UVB exposure was statistically significant for age groups above 45 years, after controlling for covariates. Conclusion The age-dependent inverse association between UVB exposure and incidence of colorectal cancer exhibits a greater effect size among older age groups in global analyses. Studying the effect of chronic vitamin D deficiency on colorectal cancer etiology will help in understanding the necessity for population wide screening programs for vitamin D deficiency, especially in regions with inadequate UVB exposure. The study supports the need for adequate public health programs such as selective supplementation and food fortification.
Pharmacological treatment of apathy in Parkinson’s disease, review of the literature
Authors: Overvliet Geke Marianne , Vlaar Annemarie , Haan Chantal den , Lampe Indrag
Published: January 2020

Background Apathy is a highly challenging factor in the general treatment of patients with Parkinson’s disease (PD) and can present a major burden for caregivers. The objective of this study to answer the question of what is known about the current evidence-based pharmacological treatment of apathy, not combined with comorbid depression or dementia, in PD. Methods We searched for publications in online databases (PubMed, Embase.com, Cochrane Database of Systematic Reviews, CENTRAL and PsycInfo/Ebsco) and performed a review of the literature. Included trials were based on patients with PD, with a drug intervention and apathy as an outcome measurement. Patients with comorbid dementia, severe depression, or patients after deep brain stimulation were excluded. Results Out of 1767 articles, we included 10 articles with a total of 723 patients who received intervention and 311 patients who received placebo, standard care or were healthy controls. Combining the results of the studies with a focus on favourable significant outcomes and the risk of bias, we would advise rivastigmine as a treatment of apathy in patients with PD, and pramipexole or selegiline in PD patients with apathy without cognitive disturbance. An important limitation of this study is that the included studies show a broad heterogeneity. Conclusions Research is sparse on the topic of evidence-based pharmacological treatment for apathy in PD. Combining the results of the studies with a focus on favourable significant outcomes and the risk of bias, we would advise rivastigmine as a treatment of apathy in patients with PD, and pramipexole or selegiline in PD patients with apathy without cognitive disturbance.
Clinical and brain MR imaging effectively influences the ATP7B genotype of Neurologic Wilson patients
Authors: Wang Juan , Han Yongzhu , Yang Renmin , Yu Xuen , Wu Juncang
Published: January 2020

Objective To understand the relationship between the two types of mutations in patients with Wilson disease (WD) and clinical practice, and to search for the clinical biological markers of the two types of mutations. Methods The hospitalized patients, who were in the affiliated hospital of neurology institute of anhui university of traditional Chinese medicine from May 2014 to May 2019, with p. arg778leu or p. pro992leu homozygous mutation type of neurologic WD, were selected and underwent demographic, clinical manifestations, serological indicators and brain MR imaging(MRI) data were analyzed to compare the differences of the two mutant types of neurologic WD. ResultsThe group of 103 patients with neurologic WD join in this research, including p.A rg778Leu mutant WD 65 cases and p.P ro992Leu mutant WD 38 cases. The two types of mutations in the WD demographic, clinical manifestation and most serological index indifference, and brain MRI findings have significant differences, especially the p.A rg778Leu mutant WD damage the thalamus(χ2 =17.834, P<0.001), midbrain(χ2 =12.579, P<0.001) and pons(χ2 =10.605, P=0.001)p.P ro992Leu mutant WD have obvious difference, the results of multivariate analysis were also different (P<0.05). Conclusions The demography, clinical features and serology of neurologic WD have nothing to do with its gene mutation type, and the MRI manifestations of brain are related to its gene mutation type, among which the ATP7B gene p.arg778leu mutation is more likely to involve thalamus, midbrain and pons.
lncRNA-Associated ceRNA Networks in Spleen of Nocth1-correlated T-ALL Leukemia Mice
Authors: Shi Min , Wang Shaohua , Li Xiaofei , Li Yongjun
Published: January 2020

Background Acute T-lymphocytic leukemia (T-ALL) is a highly aggressive malignant tumor in leukemia. Nocth1 is considered as an major oncogene in the development of T-ALL. Increasing evidences have revealed that the occurrence and progression of T-ALL referred to abnormal gene expression, pathway activation and the regulation between these genes. However, the potential lncRNA-associated competing endogenous RNA (ceRNA) network involved in spleen of Nocth1-correlated T-ALL leukemia mice remains unclear. Methods Overexpression of Notch intracellular domain (ICN) of Notch1 by retroviral infection was used to set up mouse T-ALL model. Deep RNA-sequencing analysis was performed the expression of lncRNAs and mRNA in spleen of T-ALL mice and C57BL/6 mice.Results The deep RNA-sequencing analysis shown that 1833 lncRNAs and 4626 mRNAs were deregulated according to the P-value (p<0.05) and fold change (>2-fold) in spleen of T-ALL leukemia mice compared with that of C57BL/6 mice. Gene Ontology(GO) and KEGG pathway analysis were performed to reveal the potential roles of differentiated expressed lncRNAs. Co-expression Network was performed to reveal the regulation relationship between the differentiated expressed lncRNAs and mRNAs. CeRNA prediction constructed the lncRNA-miRNA-mRNA model to find the core ceRNA based on regression model analysis and seed sequence matching methods. Conclusion This study provided a systematic overview of the altered lncRNAs and mRNA expression, pathway and ceRNA regulation network in the pathogenesis of Nocth1-correlated T-ALL.
Full-term low birth weight infants have differentially hypermethylated DNA related to immune system and organ growth: A comparison with full-term normal birth weight infant
Authors: Hayashi Ikuyo , Yamaguchi Ken , Sumitomo Masahiro , Takakura Kenji , Nagai Narumi , Sakane Naoki
Published: January 2020

Objective: Low birth weight (LBW) is a major public health issue as it results in a higher risk of non-communicable diseases throughout life. However, the genome-wide DNA methylation patterns of LBW full-term infants (FT-LBWs) are still unclear. The aim of this exploratory study was to compare differences in DNA methylation between FT-LBWs and normal birth weight full-term infants (FT-NBWs) whose mothers were non-smokers and non-complication. Results: A total of 702 Japanese singleton pregnancies were recruited. The prevalence of preterm LBW and FT-LBW was 3.4% and 6.1%, respectively. Four FT-LBWs and five FT-NBWs were selected, genome-wide DNA methylation analysis including 862,260 methylation CpGs was performed. 483 hyper-differentially methylated genes (DMGs) and 35 hypo-DMGs were identified in FT-LBW promoter regions. Hyper-DMGs were annotated to 11 biological processes; intriguingly, “macrophage differentiation” (e.g., CASP8 ), “apoptotic mitochondrial changes” (e.g., BH3 ) , “nucleotide-excision repair” (e.g., HUS1 ) , and “negative regulation of inflammatory response” (e.g., NLRP12 and SHARPIN ) were included within the “immune system” and “DNA metabolism and repair” categories. EREG was classified into “ovarian cumulus expansion” within the “organism growth and organization” category. Our data implies that LBW itself could be associated with epigenetic modulation regarding immune system and cell mature.
Diagnostic Test Accuracy of New Generation Tympanic Thermometry in Children: A Systematic Review and Meta-analysis
Authors: Shi Dan , Zhang Liyuan , Li Haixia
Published: January 2020

Purposes: The purposes of this review were to compare sensitivity and specificity of the new generation tympanic thermometry under different cutoffs and to give the optimal cutoff. Methods: Articles were derived from a systematic search in PubMed, Web of science, and Embase, and were assessed for internal validity by QUADAS-Ⅱ. The figure of risk of bias was drew by Review Manager 5.3 and data were synthesized by MetaDisc 1.4. Results: Nineteen diagnostic studies, involving 4,639 pediatric patients, were included. The cut-offs varied from 37.0℃ to 38.0℃ among these studies. The cut-off 37.8 was with the highest sROC AUC (0.97) and Youden Index (0.83) and was deemed to be the optimal cutoff. Conclusion: New Generation Tympanic Thermometry is with high diagnostic accuracy in pediatric patients and can be an alternative for rectal measurements.
Evaluation of resistance to pyrethroid and organophosphate adulticides, and kdr genotyping in Ades aegypti populations from Roraima, the Northernmost Brazilian State
Authors: Hayd Ramão Luciano Nogueira , Carrara Luana , Lima Joel de Melo , de Almeida Nathalia Coelho Vargas , Lima José Bento Pereira , Martins Ademir Jesus
Published: January 2020

Background Roraima is the northernmost State in Brazil and makes international borders with Venezuela and Guyana. Although mostly covered by the tropical forests, the urban centers are highly infested with Ae. aegypti and endemic for dengue, Zika and chikungunya. Here we presented the levels of Ae. aegypti infestation and number of arboviruses cases between 2015 and 2018 in the studied localities. We evaluated the insecticide resistance status of Ae. aegypti populations from the capital Boa Vista, two cities in international borders: Pacaraima and Bonfim, and Rorainópolis in the limit with Amazonas State, collected in 2016 and 2018. Methods WHO like tube tests with the pyrethroid deltamethrin (0.05 and 0.12%) and the organophosphate malathion (0.7%) were conducted. Genotyping of kdr mutations, related to resistance to pyrethroids, were performed for the SNP variations in the sites 1016 and 1534 of the voltage gated sodium channel gene (Na V ) with a TaqMan qPCR approach. Results Only Ae. aegypti was present in our collection, meaning that there is still a barrier that Ae. albopictus was still not able to transpose from Amazonas toward Roraima. All Ae. aegypti populations were susceptible to 0.7% malathion in 2016, however mortality dropped to under 90% in Bonfim and Pacaraima in 2018. All populations were resistant to 0.5% deltamethrin in both years. The time that 50% of females suffered knockdown ( Kd T 50 ) under exposition to 0.5% deltamethrin was 3.3-5.9 fold longer in mosquitoes from the populations compared to Rockefeller. Only Pacaraima (2018) remained resistant to 0.12% deltamethrin. The kdr genotyping revealed the absence of the wild-type Na V S haplotype (1016Val + 1534Phe) in populations from Roraima, meaning that all tested individuals had a genetic background for resistance to pyrethroid. The double kdr Na V R2 haplotype (1016Ile + 15434Cys) was under higher frequencies in all populations except Rorainópolis, where this haplotype seems to have arrived recently. Conclusions These results are important to the knowledge about insecticide resistance status of Ae. aegypti populations from Roraima and will help to improve vector control strategies that may be applied to diverse localities with similar conditions.
The effects of different hydrostaticpressures on gene expression in vertebral cartilage endplate cells
Authors: Sun Qi , Liu Gen-Zhe , Chen Jiang , Zhu Yong-Gang
Published: January 2020

Background : The nutrients of the intervertebral disc are mainly provided through penetration from the cartilage endplate, and the stable functional status of the cartilage cells directly influences the function of the cartilage endplate. However, there is no study on gene expression in endplate cells under varying pressure conditions. Knowledge of anabolic/catabolic metabolic alterations of cartilage endplate cells in response to various magnitudes and durations of compression is important to alleviate IVD degeneration through maintenance of extracellular matrix homeostasis and the repair of endplate cartilage. The purpose of this study was to examine the effects of compression on gene expression in vertebral cartilage endplate cells in vitro through a hydrostatic pressure system. Methods : Rabbit vertebral cartilage endplate cells were exposed to hydrostatic pressure at 0.1, 0.7, 2 and 4 MPa for 4 or 24 hours. Real-time polymerase chain reaction was performed to analyze the gene expression of inflammation (iNOS, COX-2), matrix metabolism (MMP-3), anticatabolic metabolism (TIMP-1), and anabolic metabolism (aggrecan). Results : Decreased magnitude and duration showed more anticatabolic/anabolic metabolism gene expression, whereas increased duration resulted in increased catabolic gene expression. Conclusions : Low magnitude or short duration of compression demonstrated more anabolic and anticatabolic gene expression, while increased magnitude and duration showed more procatabolic gene expression.
Bridging the Intergenerational Gap: The Outcomes of a Student-Initiated, Longitudinal, Inter-professional, Inter-generational Home Visit Program
Authors: Ng Kennedy , Leung Gloria Yao Chi , Tey Angeline Jie-Yin , Chaung Jia Quan , Lee Si Min , Soundararajan Amrish , Yow Ka Shing , Ngiam Nerice Heng Wen , Lau Tang Ching , Wong Sweet Fun , Wong Chek Hooi , Koh Gerald Choon-Huat
Published: January 2020

Background The older persons consume disproportionately more healthcare resources than younger persons. Tri-Generational HomeCare (TriGen), a service-learning program, aimed to reduce hospital admission rates amongst older patients with frequent admissions. The authors evaluated the educational and patient outcomes of TriGen. Methods Teams consisting of healthcare undergraduates and lay volunteers – secondary school (SS) students - performed fortnightly home visits to patients over 6 months. Self-administered scales were used to evaluate the educational outcomes. Patients’ satisfaction and clinical outcomes were also assessed. Results 226 healthcare undergraduates and 359 SS students participated in the program from 2015 to 2018. Response rates were 80.1% and 62.4% respectively. 106 patients participated in TriGen. There was a statistically significant increase in Kogan’s Attitudes towards Old Persons scores pre- and post-intervention for healthcare undergraduates and SS students with a mean increase of 12.8 (95%CI: 9.5 – 16.2, p < 0.001) and 8.3 (95%CI: 6.2 – 10.3, p < 0.001) respectively. There was a statistically significant increase in Palmore FAQ score pre- and post-intervention for SS students. Most volunteers reported that TriGen was beneficial across all nine domains assessed. There was a statistically significant decrease in hospital admission rates (p = 0.006) and emergency department visits (p = 0.004) during the 6-month period before and after the program. 51 patients answered the patient feedback survey. Of this, more than 80% reported feeling less lonely and happier. Conclusion TriGen, a student-initiated, longitudinal, inter-generational service-learning program consisting of lay students and healthcare undergraduates can reduce ageism, develop soft skills, inculcate values amongst lay volunteers (SS students) and healthcare undergraduates. In addition, TriGen potentially reduces hospital admissions and emergency department visits, and loneliness amongst frequently admitted older patients.
The effectiveness of virtual reality-based technology on anatomy teaching: a meta-analysis of randomized controlled studies
Authors: zhao jingjie , xu xinliang , Jiang Hualin , ding yi
Published: January 2020

Virtual reality (VR) is an innovation that permits the individual to discover and operate three-dimensional (3D) environment to gain practical understanding instantly. Recently, VR has been advanced as an encouraging tool in the course of clinical college. This research aimed to examine the general efficiency of VR for teaching medical anatomy. We executed a meta-analysis of randomized regulated studies of the performance of VR anatomy education. We browsed 5 databases from the year 1990 to 2019. Ultimately, 15 randomized controlled trials with a teaching outcome measure analysis were included. Tow authors separately chosen studies, extracted information, and examined the risk of bias. The primary outcomes were examination scores of the students. Secondary outcomes were the degree of satisfaction of the students. Random-effects models were used for the pooled evaluations. Standardized mean difference (SMD) was applied to assess the systematic results. The heterogeneity was determined by I2 statistics, and then was investigated by meta-regression and subgroup analyses. In this review, we screened and included fifteen randomized controlled researches (816 students). The pooled analysis of primary outcomes showed that VR improves test scores comparing with other approaches (standardized mean difference [SMD]= 0.53; 95% CI 0.09–0.97; I2= 87.8%). The high homogeneity indicated that the studies were different from each other. Therefore, we carried out meta-regression as well as subgroup analyses using 7 variables (year, country, learners, course, intervention, comparator, and duration). We found that VR improves postintervention test score of anatomy comparing with other types of teaching methods. Although the findings have high internal validity and limited, because of that anatomy teaching in medical universities appears to becoming a dilemma, VR may act as an efficient way to improve the learners’ level of anatomy knowledge. Future research should assess other factors like degree of satisfaction, cost-effectiveness, and adverse reactions when evaluating the teaching effectiveness of VR in anatomy.
Bacterial etiology and antibiotic susceptibility of conjunctivitis patients isolates from central of Iran
Authors: Shaeri Mahdi , Nazari-Alam Ali , Moniri Rezvan , Akbari Hosein , Mansoori Mansooreh , Aghajani Ali , Fathizadeh Hadis
Published: January 2020

Background: Conjunctivitis is a very common ocular disease, which can be caused by a wide variety of microorganisms. Identification of the bacterial causes of this infection in a specific geographical area can help physicians devise more efficient therapeutic strategies for this disease in the local population. This study bacterial etiology and antibiotic susceptibility of conjunctivitis patients isolates from central of Iran.Methods: This study was performed of 180 patients referred to department of ophthalmology in Kashan University with symptoms of conjunctivitis from July 2017 to December 2017. Samples were collected from the conjunctival sac and cultured in bacterial culture mediums. Antibiotic susceptibility of the bacteria isolated was done using the Kirby-Bauer method. Methicillin resistance in staphylococci isolated from the patients was identified using PCR technique.Results: In the present study, Pseudomonas aeruginosa was most resistant to ampicillin. In the case of Staphylococcus epidermidis and Staphylococcus aureus, the highest resistance was observed against erythromycin and the least resistance was against rifampicin and linezolid. Conclusion: In this study, Staphylococcus aureus and Staphylococcus epidermidis is the most common cause of conjunctivitis in all age groups, however, this condition decreases with age and is also influenced by other factors such as season and weather conditions. The results of this study can be helpful in planning more prudent treatment strategies for patients with conjunctivitis in Kashan.
Overexpression of target enzyme gene fabI and efflux pump decrease triclosan susceptibility in Escherichia coli
Authors: Zeng Weiliang , Xu Wenya , Xu Ye , Liao Wenli , Zhao Yajie , Zheng Xiangkuo , Xu Chunquan , Zhou Tieli , Cao Jianming
Published: January 2020

Background: Escherichia coli isolates, the most opportunistic pathogen in the gut, are responsible for the most acquired infections. Triclosan is an effective disinfectant for inhibits microorganisms, but its widespread use causes its residue in urine, resulting in long-term exposure of E. coli in the intestine to triclosan environment and increasing triclosan resistance. We aim to provide the mechanism of action of E. coli isolates against triclosan and the molecular epidemiological analysis of triclosan-resistant strains.Results: Five triclosan-resistant isolates were screened out from 200 E. coli isolates by agar dilution method by to further study, interestingly, multidrug-resistant and cross-resistance phenotypes were observed in triclosan-resistant strains, but not in susceptible strains, and all except one exhibited an inhibition of efflux pump activity by efflux pump inhibition testing. Furthermore, compared with susceptible E. coli strain ATCC 25922, except fabI, increased expression were also found in efflux pump encoding genes ydcV, ydcU, ydcS, ydcT, cysP, yihV, acrB, acrD and mdfA in studied strains which had different PFGE patterns and STs types.Conclusions: These findings indicated that triclosan resistance in E. coli were mainly involved by overexpression of fabI gene, and there was a close association between overexpression of efflux pump with reducing susceptibility to triclosan. Besides, we described cross-resistance between triclosan and antibiotics may be related to the exposure time of triclosan.
A multiplex guide RNA expression system and its efficacy for plant genome engineering
Authors: Oh Youngbin , Kim Hyeonjin , Lee Bora , Kim Sang-Gyu
Published: January 2020

BackgroundThe Streptococcus pyogenes CRISPR system is composed of a Cas9 endonuclease (SpCas9) and a single-stranded guide RNA (gRNA) harboring a target-specific sequence. Theoretically, SpCas9 proteins could cleave as many targeted loci as gRNAs bind in a genome.ResultsWe introduce a PCR-free multiple gRNA cloning system for editing plant genomes. This method consists of two steps: (1) cloning annealed products of two oligonucleotides harboring target-binding sequence between tRNA and gRNA scaffold sequences in a pGRNA vector; and (2) assembling tRNA-gRNA units from several pGRNA vectors with a plant binary vector containing a SpCas9 expression cassette using the Golden Gate assembly method. We validated the editing efficiency and patterns of the multiplex gRNA expression system in wild tobacco (Nicotiana attenuata) protoplasts and in transformed plants by performing targeted deep sequencing. Two proximal cleavages by SpCas9-gRNA largely increased the editing efficiency and induced large deletions between two cleavage sites.ConclusionsThis multiplex gRNA expression system enables high-throughput production of a single binary vector and increases the efficiency of plant genome editing.
ART coverage and viral load suppression rates as correlates to HIV positivity in Kenya; Spatial-temporal analyses 2015-17
Authors: Waruru Anthony , Kimani Maureen , Wamicwe Joyce , Masamaro Kenneth , Zielinski-Gutierrez Emily , Basiye Frank , Okutoyi Salome , Ng’ang’a Lucy , Achia Thomas N. O. , Muthusi Jacques , Tobias James L. , Njuguna Stella , Mbaire Catherine , Cock Kevin M. De , Tylleskär Thorkild
Published: January 2020

IntroductionHigh antiretroviral therapy (ART) coverage and high rates of viral load suppression (VLS) should reduce transmission of HIV, and ultimately, HIV incidence and the number of new HIV diagnoses out of the number tested (HIV positivity). We used 3 years of HIV program data in Kenya to assess whether trends in the number of new HIV diagnoses were associated with ART coverage and VLS rates and spatial-temporally auto-correlated at county level.MethodsWe analyzed routine program county-level aggregate data on ART coverage and VLS (proportion of persons on ART with VL<1000 copies/mL) from 3 years (2015-2017). We examined the association between ART coverage and VLS rates to HIV positivity by fitting spatial and spatial-temporal semi-parametric Poisson regression models using R-Integrated Nested Laplace Approximation (INLA) package. We used the extended Cochran-Mantel-Haenszel stratified test of association to test for trend for rates across years and Kruskal-Wallis equality-of-populations nonparametric rank test to compare medians for continuous variables. We fit a structural equation model to assess direct and total effects between the two exogenous covariates to adjusted newly HIV-diagnosed as the endogenous variable adjusting for clustering by 47 counties. Finally, we mapped adjusted HIV positivity using QGIS version 3.2.Results and discussionA spatial-temporal model with covariates was better in explaining geographical variation in HIV positivity (deviance information criterion (DIC) 381.2), than either a non-temporal spatial model (DIC 418.6) or temporal model without covariates (DIC 449.2). Overall, the adjusted HIV positivity decreased over 3 years from median of 2.9% in 2015, [interquartile range (IQR): 1.9-3.4] to 1.5% in 2017, IQR(1.3-2.0), p=0.032. While adjusting for clustering and covariance, VLS had a direct effect on HIV positivity rates p=0.004, but ART coverage did not, p=0.843.ConclusionsFrom 2015-2017, there has been improved ART coverage and sustained VL coverage and suppression rates. We have observed a general decline of rates of HIV positivity associated with VLS rates. To assess the trends and impact of implementation of scaled-up care and treatment, spatial-temporal analyses help to identify geographic areas that need focused interventions.
A novel anatomical titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: A propensity-matched cohort study
Authors: Wu Haiyang , Shang Ranran , Liu Ximing , Song Chengjing , Chen Yanzhao , cai xianhua
Published: January 2020

Background Because of the peculiar anatomy and complex geometry of this region, surgical treatment of acetabular fractures involving quadrilateral plate is a challenge to orthopaedic surgeons. Many scholars consider that quadrilateral plate exist a absolute “dangerous zone” for screw placement and have designed a variety of buttress plates to control medial displacement of the quadrilateral surface. In order to achieve the safe and effective fixation in quadrilateral plate, we have developed a novel fixation technique using a special shaped reconstruction plate combined with several buttress screws of quadrilateral plate which was called Dynamic Anterior Plate-Screw System for Quadrilateral plate (DAPSQ) since 2005(RP group). And the long-term follow-up results have confirmed the effectiveness and safety of this technique. After 2016, a set of anatomical titanium plate(ATP group) of DAPSQ have been designed and applied for the treatment of quadrilateral plate fractures. The aim of this study was to compare the efficacy of anatomical titanium plate versus the reconstruction plate in the treatment of quadrilateral plate fractures. Methods We led a propensity-matched cohort study of quadrilateral plate fractures, and twenty-two patients were treated with anatomical titanium plate of DAPSQ in the inclusion period(2016-2018), and were matched to 22 cases in our database of RP group(2008-2016). The primary outcome measures were quality of reduction and functional outcome. Intraoperative conditions included surgical time, bleeding, and blood transfusion and the postoperative complications were also compared. Results Of these 22 consecutive patients in ATP group, the mean age was 46.7 years and the most common fracture pattern was a both-column fracture(12cases, 54.5%) according to Letournel-Judet classification. The mean follow up period was 23.1 months (range 12-37). There was no significant differences between the two groups with regards the quality of reduction using the Matta radiological criteria and functional outcomes evaluated by the modified Merle d’Aubigné score(P>0.05). Compared with the RP group, the ATP group has a short operation time(245.1 minutes vs. 286.8 minutes, P = 0.020), less intraoperative blood loss(1136.4 mL vs. 1777.3mL, P = 0.014) and transfusion(780.9 vs. 1256.8mL, P = 0.035). The complication rate was 22.7% in ATP group, and there was no significantly difference compared with the RP group(54.5%)(P>0.05). None of the cases in the two groups had quadrilateral screws entering the hip or implant failure. Conclusions The fixation of anatomical titanium plate in quadrilateral plate fractures showed similar result to the reconstruction plate, in terms of quality of reduction and functional outcome. But the utility of anatomical titanium plate had the advantages of shorter operation time, less bleeding and transfusion which is worthy to recommend.
Correlates of Ghanaian households’ use of climate-friendly and health-promoting fuels: insight from the 2014 demographic and health surveys
Authors: Dadzie Seth Sylvester , Kenney Paul Lawer , Emmanuel Nakua Kweku , Herman Agboh Nuake Kofi , Henry Duah Ofori , Veronica Dzomeku Millicent , Pascal Agbadi
Published: January 2020

Background About five of the Sustainable Development Goals (SDGs) directly calls for clean and climate-friendly household cooking fuels to help mitigate Carbon Dioxide (CO 2 ) and black carbon emissions to ensure that the global mean temperature is kept below 1.5 o C to promote good human health. In developing countries, climate-friendly and health-promoting fuels (CF&HPFs) are generally unaffordable and inaccessible. Studies on the prevalence and the predictors of household use of climate-friendly fuels and health-promoting fuels (CF&HPFs) in Ghana are few and nationally non-representative. To effectively design programs that encourage Ghanaian households to use CF&HPFs, the study estimated the proportion of households currently using CF&HPFs and delineated factors that account for their use.Methods The study used the data of the cross-sectional demographic and health surveys conducted in 2014. Chi-square test of independence was used to identify the predictors that were statistically significant related to households’ use of CF&HPFs for the multivariable model. In the multivariable model, we reported prevalence ratios using the generalized linear model (glm), setting the family to “Poisson” and the link to “log.” The estimation adjusted for the study designed and the household sampling weights.Results The main finding was that rich households were 8.85 times likely to use CF&HPFs compared to poor households. We further found that the following factors were associated with a higher probability of a Ghanaian household to use climate-friendly and health-promoting fuels for cooking: male-headed households, households’ headed by persons between 24years and 55 years, households with heads that were currently married or never married, households with heads that have attained at least a primary level education, households with less than eight members, households with at least two women, and households in Western, Central, Greater Accra, Volta, Eastern, Ashanti, Brong Ahafo, Upper East region.Conclusion Given that the most important correlate of household’s use of CF&HPFs is household wealth, we recommend that significant attention should be given to economic empowerment of citizens in policies and interventions aimed at encouraging Ghanaians to use this type of fuel.
Relationship of Vitamin D Deficiency to Cardiovascular and Metabolic Parameters in Women with Polycystic Ovary Syndrome
Authors: Butler Alexandra , Dargham Soha R , Seif Ahmed Abou , Shewehy Abeer El , Atkin Stephen L
Published: January 2020

Objective To determine if vitamin D deficiency (25-hydroxyvitamin D3 (25(OH)D3)), exacerbated the cardiovascular and metabolic characteristics in women with polycystic ovary syndrome (PCOS).Design Comparative cross-sectional analysis.Methods Demographic and metabolic data from women aged 18-40 years from the Qatar Biobank (QBB) (78 diagnosed with PCOS, 641 controls).Results Vitamin D deficiency (median (range)) was seen in both normal 14.0 (124) ng/ml and the PCOS cohorts 14.0 (62) ng/ml and did not differ between them. Whilst PCOS subjects were heavier with a more metabolic profile (greater systolic and diastolic blood pressure, higher levels of C-reactive protein, androgens, insulin and glycosylated hemoglobin (HbA1c) and decreased high density lipoprotein (HDL) levels, with endothelial dysfunction as determined by pulse wave velocity, there was no correlation (Pearson coefficient) of any these parameters with vitamin D for either the control or PCOS population.Conclusion Vitamin D deficiency was equally prevalent in women with and without PCOS and was not correlated to insulin resistance, metabolic or cardiovascular parameters, suggesting that vitamin D deficiency is not associated with the PCOS phenotype.
Gastric Artery Embolization: Studying Effects of Catheter Type and Injection Rate on Bead Distributions within a Benchtop Arterial Model
Authors: Jernigan Shaphan R , Osborne Jason A , Buckner Gregory D
Published: January 2020

Aims: To investigate the effect of catheter type and injection method on microsphere distributions, specifically vessel targeting accuracy. Materials and Methods: The study utilized three catheter types (a standard micro-catheter, a Surefire anti-reflux catheter, and an Endobar occlusion balloon catheter) and both manual and computer-controlled injection schemes. A closed-loop, dynamically pressurized surrogate arterial system was assembled to replicate arterial flow for bariatric embolization procedures. Four vessel branches immediately distal to the injection site were targeted for embolization. Embolic microspheres were injected into the model using three catheter types (a standard micro-catheter, a Surefire anti-reflux catheter, and an Endobar occlusion balloon catheter) and both manual and computer-controlled injections. Results: Across all injection methods, the catheter effect on the proportion of microspheres to target vessels (vs. non-target vessels) was significant (p=0.0051). The catheter effect on the number of non-target vessels embolized was significant (p=0.0590). Across all catheter types, the injection method effect was not statistically significant for either of two outcome measures (percent microspheres to target vessels: p=0.2652, number of non-target vessels embolized: p=0.1476). Conclusion: Catheter type had a significant effect on targeting accuracy across all injection methods. The Endobar catheter exhibited a higher targeting accuracy in pairwise comparisons with the other two injection catheters across all injection schemes and when considering the Endobar catheter with the manifold injection method vs. each of the catheters with the manual injection method; the differences were significant in 3 of 4 analyses. The injection method effect was not statistically significant across all catheter types and when considering the Endobar catheter/Endobar manifold combination vs. Endobar catheter injections with manual and pressure-replicated methods.