bluuebunny/crossref_metadata_2025 huggingface dataset:
The growing use of the WHO Safe Childbirth Checklist: Lessons learned at the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon
Authors: DOHBIT Julius Sama , WOKS Namanou Ines Emma , KOUDJINE Carlin Héméry , TAFEN Willy , FOUMANE Pascal , ASSUMPTA Lucienne BELLA , OGU Rosemary Nkemdilim , III Fru Fobuzshi ANGWAFO
Published: September 2019

Background: Safe childbirth remains a daunting challenge, particularly in low-resource settings where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 782 per 100,000 live births in 2011 is significantly high. Adherence to good practice standards by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth checklist was designed as a tool to improve the quality of care provided to women giving birth. This checklist was implemented at the Yaounde Gyneco-Obsteric and Pediatric Hospital. Quantitative and qualitative assessment of its utilization is essential to secure a change in attitudes and practice and engender improvement in maternal health.
Objective: Evaluate the change in attitudes and practice of nurses and compare outcomes in cases where it was and was not used, 6 months after introduction of the safe childbirth checklist in a maternity setting.
Methods: A cross sectional and retrospective study was conducted over a 6 month period (January – June 2018). Predesigned questionnaires were used to collect qualitative data from personnel of the Gynecology and Obstetrics unit who used the safe childbirth checklist and quantitative data from patient delivery records. Data analysis was done using SPSS version 23.0. Chi square test was used to compare categorical variables, while the student test was used to compare continuous variables.
Results: Of the 1001 files retrieved from the archives, 25 were excluded. The checklist was used in 828/976 (84.8%) files. We observed an increasing trend in the usage rate, with a peak at 93.9% recorded during the last 2 months. Pages 2 and 3 were least completed, in <10% of cases during the first 5 months. A significant reduction in the onset of pre-eclampsia and eclampsia was noted with the use of the checklist (2·1% Vs 5·4%, p = 0·017). Fifty percent of the staff reported that the checklist increased workload while 37.5% mentioned laziness and absence of checklists in some files as a hindrance to its proper use.
Conclusion: The use of the safe childbirth checklist improved progressively with a simultaneous reduction in obstetrical and neonatal complications overtime.
Keywords: Checklist, childbirth, Obstetrical complications
Sentinel surveillance of child maltreatment cases presenting to Canadian emergency departments
Authors: Campeau Aimée , Tonmyr Lil , Gulbransen Erik , Hébert Martine , McFaull Steven , Skinner Robin
Published: September 2019

Background: The Canadian Hospitals Injury Reporting Prevention Program (CHIRPP) is a sentinel surveillance program that collects and analyzes data on injuries and poisonings of people presenting to emergency departments (EDs) at 11 pediatric and eight general hospitals (currently) across Canada. To date, CHIRPP is an understudied source of child maltreatment (CM) surveillance data. This study: (1) describes CM cases identified in the CHIRPP database between1997/98 to 2010/11; (2) assesses the level of CM case capture over the 14-year period and; (3) uses content analysis to identify additional information captured in text fields.

Methods: We reviewed cases of children under 16 whose injuries were reported as resulting from CM from 1997/98 to 2010/11. A time trend analysis of cases to assess capture was conducted and content analysis was applied to develop a codebook to assess information from text fields in CHIRPP. The frequency of types of CM and other variables identified from text fields were calculated. Finally, the frequency of types of CM were presented by age and gender.

Results: A total of 2 200 CM cases were identified. There was a significant decrease in the capture of CM cases between 1999 and 2005. Physical abuse was the most prevalent type (57%), followed by sexual assault (31%), unspecified maltreatment (7%), injury as the result of exposure to family violence (3%) and neglect (2%). Text fields provided additional information including perpetrator characteristics, the use of drugs and/or alcohol during the injury event, information regarding the involvement of non-health care professionals, whether maltreatment occurred during a visitation period with a parent and, whether the child was removed from their home.

Conclusions: The findings from this initial study indicate that CHIRPP could be a complimentary source of CM data. As an injury surveillance system, physical abuse and sexual assault were better captured than other types of CM. Text field data provided unique information on a number of additional details surrounding the injury event, including risk factors.
Increasing questionnaire response: evidence from a nested RCT within a longitudinal birth cohort study
Authors: Goodwin Michaela , Walsh Tanya , Whittaker William , Emsley Richard , Sutton Matthew , Tickle Martin , Kelly Michael , Pretty Iain
Published: September 2019

Background: Adequate response rates are essential when using questionnaires in research, as these can affect the validity of studies and the ability to generalise the findings to a wider population. Aims: The study measured the response rate to questionnaires in a large longitudinal epidemiological study and sought to determine if any of the changes made throughout data collection had a positive impact on the response to questionnaires and readdressed any imbalance seen in response by participants level of deprivation. Methods: Data were taken from a prospective, comparative study, designed to examine the effects of the reintroduction of water fluoridation on children’s oral health over a five-year period. Response rates were analysed for the first year of data collection from this sample. During this year changes were made to the questionnaire layout and cover letter to attempt to increase response rates. Additionally a nested randomised control trial compared the effect on response rates of three different participant reminders to complete questionnaires were trialled. Results: Data were available for 1824 individuals. The assessment of different reminders indicated that while sending the whole questionnaire again to non responders, resulted in the highest level of response (25%), calling participants was the only method that appeared to address the imbalance in IMD between responders (29.5, 95%CI 16.9-42.0) and non-responders (26.8, 95%CI 23.5-30.2) t(12.994) -0.446, p=0.663. Conclusions: Low response rates were recorded within this large, longitudinal study giving rise to concerns about response bias. In order to address these biases, data can be weighted in order to compensate for the skew in those taking part compared to the population. Resending the entire questionnaire again is the most effective way of reminding participants to complete the questionnaire. As this is a less labour intensive method than for example, calling participants more time can then be spent targeting groups who are underrepresented in the study such as those most deprived.
Roles and Expectations of Male Partners from PMTCT services in Chiradzulu Malawi: A Qualitative Study
Authors: Kansinjiro Beatrice M'baya , Nyondo-Mipando Alinane Linda
Published: September 2019

Introduction: Prevention of mother to child transmission of HIV (PMTCT) is the main measure for curbing HIV infection in children. Male involvement (MI) greatly influences uptake and adherence to PMTCT services yet the level remain low in Sub Saharan Africa. Lack of well stipulated roles for men in PMTCT is one of the main barriers to MI. Studies on MI have focused on women and Health care workers (HCW), thereby making men silent partners. The main aim of the study was to explore the roles and expectations of male partners in PMTCT services in Malawi. Methods: This was a descriptive qualitative study that involved men whose partners were either pregnant or breastfeeding a child, health care workers working in PMTCT services for over six months and traditional leaders. We conducted 9 in-depth interviews and 12 key informant interviews from January to March 2018. All interviews were audio-recorded, transcribed and translated. Thematic analysis was employed to analyze data. Results: Male partners play supportive, HIV prevention behaviour change and decision-making roles in PMTCT services. Health assessment and health promotion activities are the male specific services required in PMTCT services and these should be delivered at both health facility and community levels. Conclusion: Male partners in PMTCT have expectations that need to be met at both health facility and community levels. There is need to have male-tailored package of health services that are directly provided to men along with PMTCT services at different levels in order to promote MI. The services should be provided in an atmosphere that allows and accepts male partners to exercise their roles in PMTCT services.
Clinician perspectives on models of care for pediatric weight management services in Australia: A mixed-methods study
Authors: Cohen Jennifer , Alexander Shirley , Signorelli Christina , Williams Kathryn , Sim Kyra A , Chennariyil Lenina , Baur Louise A
Published: September 2019

Introduction For children with moderate to severe obesity, secondary and tertiary level services provide a platform for a more intensive approach toward weight management. Clinician and health care managers’ (HCM) views are imperative for informing the nature of future services to treat such children. Methods This concurrent mixed-methods study utilized questionnaires and semi-structured focus groups with clinicians, and one-on-one semi-structured interviews with HCMs, who worked in six secondary or tertiary pediatric weight management clinics across five public hospitals in New South Wales, Australia. The Theoretical Domains Framework was employed to underpin the development of the interview guides. The recorded interviews were transcribed verbatim and coded line-by-line, noting the key emerging themes. The results from the questionnaire were analyzed using descriptive statistics. Results Clinicians (n=27) provided multiple approaches to weight management, tailored to families and patients. Clinicians more often provided general healthy eating advice over a specific diet approach. Four-fifths used body mass index percentile change as a measure of success, as well as behavioral outcomes such as improvements in physical activity levels, screen time and sleep quality. Use of a combination of group and individual sessions were thought to improve engagement and reduce attrition rates. Clinicians and HCMs recommended integrating clinics into community centres and providing specific programs for sub-groups such as children from culturally and linguistically diverse communities or children with development delay. Many clinicians and HCMs stressed the importance of pediatric weight clinics using a holistic approach to treatment. Research into clinical outcomes for services was recommended to enable the development of a business case for further funding of pediatric weight management services. Conclusion Addressing common barriers to current pediatric weight management services, and designing future models of care based on key stakeholders’ preferences, are critical to achieving optimal care provision for this high risk population.
“INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes”
Authors: Alba Juan Jesus Fernández , Pazos Estefania Soto , Cortes Rocio Moreno , Sanchez Angel Vilar , Macias Carmen Gonzalez , Lara Maria Castillo , Corral Luis Moreno , Bueno Jose Antonio Sainz
Published: September 2019

Background Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polihydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to limit fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers.Methods This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios.Results 231 pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWT21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st.(RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%).Conclusions In pregnant women with GDM, the ability of customized fetal growth curves to identify the newborns with alterations in nutritional status exceeds that of INTERGROWTH21st.
Maternal and neonatal outcome of births in alongside midwifery units: A cohort study from a tertiary center in Germany
Authors: Merz Waltraut Maria , Tascon-Padron Laura , Puth Marie-Therese , Heep Andrea , Tietjen Sophia L. , Schmid Matthias , Gembruch Ulrich
Published: September 2019

Background For healthy women entering birth after uneventful pregnancy, midwife-led models of care have the potential to reduce interventions and increase the vaginal birth rate without compromising the maternal or health of the neonate. In Germany, 98.4% of women are giving birth in consultant-led obstetric units. Alongside midwifery units (AMU) have been established in 2003. We compared the outcome of all births in the AMU at our hospital from 2010 to 2017 with a matched group of low-risk women who gave birth during the same period of time in standard obstetric care. Methods We used a retrospective cohort study design. The study group consists of all women admitted to labor ward who had registered for birth in AMU. For the control group, low-risk women were selected; additionally, matching was performed for parity. Mode of birth, postpartum hemorrhage, and obstetric injury was chosen as primary outcome parameter for the mother. For the neonate, a composite primary outcome (5-minute Apgar <7 or umbilical cord arterial pH < 7.20 or transfer to specialist neonatal care) was defined. Secondary outcomes included epidural analgesia, duration of the second stage of labor, and episiotomy rate. Non-inferiority was assessed, and multiple logistic regression analysis was performed. Results 612 women were admitted for labor in AMU, the control group consisted of 612 women giving birth in standard obstetric care. Women in the study group were on average older and had a higher BMI; birthweight was on average 95 g higher. Except for birth injuries, non-inferiority could be established for the primary outcomes. Secondary outcomes occurred less common in the study group, including a shorter duration of the second stage of labor. Overall, 50.3% of women were transferred to standard obstetric care. Regression analysis revealed effects of parity, age and birthweight on the chance of transfer. Conclusion Our investigation confirms comparable maternal and neonatal outcome with less interventions for women giving birth in AMU at our institution. Currently, obstetric services in Germany are almost exclusively provided by consultant-led units. Our results support the integration of AMU as complementary models of care for low-risk women.
Trends in the consumption rates of benzodiazepines and benzodiazepine-related drugs in the Health Region of Lleida from 2002 to 2015
Authors: Torres-Bondia Francisco , De Batlle Jordi , Galvan Leonardo , Buti Miquel , Barbé-Illa Ferran , Piñol Gerard
Published: September 2019

Background: To determine the trend in the consumption prevalence of benzodiazepines (BZDs) and drugs related to BZDs (Z-drugs) in the population of the Health Region of Lleida to explore patterns of use and characteristics associated between 2002 and 2015. Methods: Retrospective community cohort study carried out between 2002 and 2015 consisting of individuals from a Health Region of 358,157 inhabitants in 2015. The consumption of BZDs was evaluated using prescription billing data from the Public Health System . All types of BZDs and their analogues that have been approved by the drug agency were included. Trends regarding age and sex were investigated. Results: A total of 249,471 individuals generated 338,148 dispensations. Overall, 53% were women, and the mean age was 60 years. The prevalence of BZD use in 2015 was 14.2%—18.8% in women and 9.6% in men—and was 36% in those over 65 years. According to the half-life of BZDs, the prevalence of short-intermediate BZD use was 9.7%, 5.5% for intermediate-long BZDs, and 0.8% for Z-drugs. The evolution in consumption showed a progressive decline, from 15.3% in 2002 to 14.2% in 2015, which is attributed to a decrease in consumption of intermediate-long BZDs (8.0% vs. 5.5%) and Z-drugs (1.4% vs. 0.8%). Conclusion: The prescription prevalence of BZDs and Z-drugs was high, although a small reduction was observed during this time period. The population over 65 was the most prevalent in their consumption despite cognitive risk and falls. Integral actions are required to lower their prescription rate.
Genome-wide identification and analysis of WRKY gene family in jute (Corchorus capsularis)
Authors: Zhang Lilan , Wan Xuebei , Xu Yi , Niyitanga Sylvain , Qi Jianmin , Zhang Liwu
Published: September 2019

Background WRKY transcription factor is a kind of transcription factor which plays an important role in plant response to biotic, abiotic stress, plant growth and development. However, little information was available about the WRKY genes in jute ( Corchorus capsularis ).Results In the present study, 43 jute WRKY (CcWRKY) genes were identified by using Pfam database domain search and BLAST homology alignment based on the transcriptome data of jute. And the gene structure, phylogeny, conserved domain and three-dimensional structure of protein were also analyzed by GSDS2.0, MEGA7.0, DNAMAN5.0, WebLogo 3 and SWISS-MODEL bioinformatics tools. According to the WRKY conserved domain features and the evolution analysis with Arabidopsis thaliana , 43 members were divided into three classes: I, II and III containing 9, 28, 6 members, respectively. According to the evolutionary relationship, class II further divided into five subclasses: II-a (2), II-b (7), II-c (7), II-d (6) and II-e (6). Genetic structure analysis showed that exon and intron number of CcWRKY genes had high variability (3-11 exons), even within the same subgroup. Most of the CcWRKY genes were expressed in different tissues, but they were mainly expressed in stem bark and stem stick. After GA 3 stress, the expression of most WRKY genes in GA 3 -sensitive variety "Aidianyehuangma" was significantly different from that of normal variety "Huangma 179". These results indicated that CcWRKY genes play an important role in gibberellin biosynthesis pathway and fiber development.Conclusions CcWRKY proteins are highly conserved, the length of the gene sequence and the number of introns varied widely, all WRKY genes showed a variety of expression patterns in different tissues, most of the WRKY genes responded to GA 3 stress, which play an important role in gibberellin biosynthesis pathway and bast fiber development.
Glycogen synthase kinase 3 (GSK-3) controls T-cell motility and interactions with antigen presenting cells
Authors: Taylor Alison , Rudd Christopher E.
Published: September 2019

Objective: The threonine/serine kinase glycogen synthase kinase 3 (GSK-3) targets multiple substrates in T-cells, regulating the expression of Tbet and PD-1 on T-cells. However, it has been unclear whether GSK-3 can affect the motility of T-cells and their interactions with antigen presenting cells.
Results: Here, we show that GSK-3 can regulate T-cell motility. Inhibition of GSK-3, by small molecule SB415286, reduced T-cell motility in terms of distance and displacement. Although SB415286 reduced the number of contacts, the dwell times of established contacts did not differ between T-cells treated with SB415286. These data indicate show that the inhibition of GSK-3 can influence the motility of T-cells and interactions with other cells without affecting the dwell times of cells that make productive contacts.
Hepatitis B and C Virus, Human Immunodeficiency Virus Co-infection among Pregnant Women in Semi-rural Health District, Cameroon
Authors: NGOUNOUH christian TAHEU , Taheu Christian Ngounouh , Nguwoh Philippe Salomon , Bazu Armelle Diane Pouanse , Ewoele Esther Celeste , Egoume Laure Genévieve , Mbende Jean Otélé , Assam Jean Paul Assam , Assoumou Marie Claire Okomo , Moyou Roger Somo , Fokam Joseph
Published: September 2019

Background In Cameroon, Human Immunodeficiency Virus (HIV), Hepatitis B (HBV) and C virus (HCV) are highly endemic to the pregnant woman. These viruses pose a high risk of vertical transmission and have been reported as the most important causes of maternal mortality. The aim objective of this study was to determine the hepatitis B, C and HIV virus co-infection among pregnant women in the Bafia health district.Methods A cross-sectional study was conducted from may to july 2018 in 145 pregnant women attending the health district of Bafia. HIV was diagnosed and confirmed using the Determine and Oraquick HIV1/2, HBV by NOVA test (HBV Multi Panel One Step) and HCV by ACCURATE test. Statistical analysis was performed using the Epi info software version 7.2.1.0. Furthermore, statistical association was performed using Odds Ratio (OR) and Fisher Exact test where appropriate, with corresponding 95% confidence interval (CI). The probability was considered statistical significant for all values p<0.05.Results The average age was 25 ± 5.96 years and the seroprevalence of HIV, HBV and HCV was 6.90% (10/145), 10.34% (15/145) and 33.79% (49/145), respectively. Those aged 24-32 years had peaks of infection, with 9.84% (6/61) and 45.90% (28/61) of HIV, Odds Ratio (OR): 2.18 [95%CI: 0.58-8.09], p= 0.39 and HCV, OR: 2.54 [95%CI: 1.25-5.15], p= 0.008 respectively. However, the peak of HBV (HBsAg) infection (35.29% [6/17]) was in the age group 33-41 years, p= 0.001 and carriage rate of HBeAg was only observed in those aged 15-23 years (5.97% [4/67], p=0.30). No cases of co-infection were observed between HBsAg carrier rates (p= 0.56), HBeAg (p= 0.65) and HIV. Meanwhile, 10.20% (5/49) of pregnant women were co-infected with HCV/HIV, OR: 2.06 [95%CI: 0.56-7.51], p= 0.26 and this co-infection was observed among those aged 24-32 years (8.20% [5/61], p= 0.02).Conclusion Seroprevalence of HIV, HBV and HCV in pregnant women remain high in the Bafia health district, reflecting a significant risk of vertical transmission, especially HIV/HCV co-infection. The prevention strategies of these three viruses would primarily target pregnant women aged over 24 years in health care areas with a typology similar to that of Bafia.
Effect of periodontal therapy on the systemic inflammation and metabolic markers in patients undergoing hemodialysis or/and peritoneal dialysis: a systematic review and meta-analysis
Authors: Yue Hui , Xu Xinxin , Liu Qin , Li Xiaozhi , Xiao Yiting , Hu Bo
Published: September 2019

Background: This systematic review aimed to investigate whether periodontal treatment can reduce the systemic inflammatory levels and improve the metabolic levels in patients undergoing hemodialysis (HD) or/and peritoneal dialysis (PD).
Methods: Electronic databases (PubMed, EMBASE, CENTRAL, NCKI, and WFPD) were searched up to July 2019. The risk of bias within studies was assessed through the Cochrane Collaboration' s risk assessment tool. The systemic inflammatory and metabolic measures were the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumor necrosis factor-α (TNF-a), the albumin (Alb), and lipid metabolic levels. Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate.
Results: Five studies were eligible for this systematic review. The result of four studies revealed a significant difference in the CRP level after periodontal treatment in patients receiving HD or/and PD. Two studies reported the IL-6 and the Alb level after periodontal treatment but revealed no significant difference. No MAs could be performed on the TNF- a level and the lipid metabolic markers.
Conclusions: Periodontal treatment may moderately reduce the serum of CRP levels in HD or/and PD patients. For the TNF-a, IL-6, Alb levels and lipid metabolic markers, no sufficient evidence supports the difference after periodontal treatment. Therefore, larger scales and high-quality randomized-controlled trials (RCTs) are required to assess the effect of periodontal treatment on systemic inflammatory and metabolic parameters in HD or/and PD patients.
Overexpression of miR-222-3p promotes proliferation and inhibits apoptosis in diffuse large B-cell lymphoma cells via suppressing PPP2R2A
Authors: Sun Shanshan , Wang Hui , Ji Mingyou
Published: September 2019

Background This study aimed to investigate the mechanism of microRNA-222-3p (miR-222-3p) on the progression of diffuse large B-cell lymphoma (DLBCL) cells.Methods DLBCL tissue was isolated from DLBCL patients during surgery. OCI-LY10 and U2932 cells were cultured. Then, qRT-PCR, Western blot, luciferase reporter gene assay, RNA pull-down assay, MTT assay, colony formation analysis, flow cytometry as well as Transwell assay were used to observe the effect of miR-222-3p on proliferation, migration, invasion and apoptosis of DLBCL cells. Furthermore, the tumor growth affected by miR-222-3p was further investigated based on animal experiment.Results Compared with the control group, the expression level of miR-222-3p was up-regulated in DLBCL group. The luciferase reporter gene and RNA pull down assay showed that PPP2R2A 3’-untranslated region (3’-UTR) carried the directly binding site of miR-222-3p. Furthermore, MTT assay, colony formation, qRT-PCR and Western blot showed that miR-222-3p promoted the DLBCL cell proliferation and invasion, and inhibited apoptosis. Finally, the mice experiment showed that miR-222-3p mimics inhibited PPP2R2A expression and promoted tumor growth in vivo.Conclusions Upregulation of miR-222-3p might take part in the progression of DLBCL by suppressing PPP2R2A expression. Furthermore, miR-222-3p promoted the DLBCL cell proliferation and invasion, and inhibited apoptosis.
The early diagnostic value of combined detection of plasma miR-181b, miR-196a and miR-210 in pancreatic cancer
Authors: Liu Gongpan , Shao Cunhua , Li Anyun , Zhang Xiaobin , Guo Xingjun , Li Jiangong
Published: September 2019

Background This study aimed to investigate the effect of combination of plasma miR-181b, miR-196a and miR-210 on early diagnosis of pancreatic cancer (PC).Methods In our study, the plasma was isolated from patients with PC and healthy individuals, respectively. The expressions of miR-181b, miR-196a and miR-210 were detected by qRT-PCR. Moreover, the level of carbohydrate antigen 199 (CA199) was measured by electrochemiluminescence (ECL) assay. Furthermore, the area under the receiver operating characteristic (ROC) curve (AUC) was used to analyze the diagnostic efficacy of miR-181b, miR-196a, miR-210 and CA199, as well as the combination of thses miRNAs in early PC patients and healthy individuals.Results The expressions of miR-181b, miR-196a and miR-210 were significantly upregulated in PC patients. In addition, the level of CA199 was also significantly upregulated in the plasma of PC patients. The expressions of miR-181b, miR-196a and miR-210 were closely associated with lymph nodes metastasis, clinical stage and vascular invasion, but had no correlation with the patient's age, gender and tumor size. Moreover, miR-181b, miR-196a and miR-210 have lower AUC than CA199 in PC patients. The combinations miR-181b + miR-196a, miR-181b + miR-210, miR-196a + miR-210 also have lower AUC than CA199 in PC patients. It is worth noting that the combinations miR-181b + miR-196a + miR-210 have higher AUC than CA199 in PC.Conclusions Our study demonstrated that the combination of plasma miR-181b, miR-196a and miR-210 had good value for PC early diagnosis.
Long noncoding RNA UCA1 facilitates cell proliferation and inhibits apoptosis via activating PI3K/Akt pathway in retinoblastoma
Authors: Yuan Zhongfang , Li Zhaona
Published: September 2019

Background This study aimed to explored the effect of lncRNA-UCA1 on retinoblastoma (RB) and its potential molecular mechanisms.Methods In our study, the expression of lncRNA-UCA1 was measured by qRT-RCR in both RB tissues and RB HXO-RB44 and Y79 cells. The relationship between lncRNA-UCA1 expression and clinical parameters in RB patients were evaluated. Cell proliferation, cell clones, apoptosis and cell cycle of HXO-RB44 and Y79 cells were measured by cell counting kit-8 (CCK-8) assay, colony formation assay and flow cytometry, respectively. In addition, the expressions of PCNA, Caspase-3, survivin, p16, p21, CDK2, PI3K, p-PI3K, Akt, p-Akt and S6k in HXO-RB44 and Y79 cells were measured by western blot.Results lncRNA-UCA1 was highly expressed in both RB tissues and RB HXO-RB44 and Y79 cells. Moreover, the expression of lncRNA-UCA1 in RB patients was remarkedly correlated with tumor size, optic nerve invasion and pathologic grade. lncRNA-UCA1 markedly facilitated cell proliferation and cell cycle procession, as well as inhibited cell apoptosis in HXO-RB44 and Y79 cells. lncRNA-UCA1 dramatically increased the expression of S6k and the phosphorylation of PI3K and Akt in RB cells. LY294002 (PI3K inhibitor) reversed the effects of lncRNA-UCA1 on RB cell proliferation, apoptosis and cell cycle procession.Conclusions Our study indicated that lncRNA-UCA1 could promote cell proliferation and cell cycle procession, as well as inhibit cell apoptosis in RB via activating PI3K/Akt pathway.
Functional polymorphisms in the MED13L and SLC4A7 genes are associated with pregnancy-induced hypertension
Authors: Zhou Ying , Li Xun , Hu Shimin , Zhou Shujin , Tan Hongzhuan
Published: September 2019

Background: Pregnancy-induced hypertension (PIH), including gestational hypertension (GH) and preeclampsia (PE), might share pathophysiologic mechanisms and genetic risk factors with hypertension. This study aimed to investigate whether genetic risk factors for hypertension also been associated with PIH.
Methods: This is a case control candidate gene association study. A total of 84 cases with GH, 108 cases with PE, and 192 age-matched (±1 year) controls were recruited from the Liuyang Municipal Hospital of Maternal and Child Health, Hunan Province of China. Three candidate single nucleotide polymorphisms (SNPs) which have been found to be associated with hypertension or blood pressure (BP) were chosen. The associations between SNPs and GH and PE were analyzed by multiple logistic regression models after adjusting for fetal sex and primipara.
Results: GG genotype at mediator complex subunit 13-like (MED13L) rs11067763 was a protective factor for developing GH (GG vs. AA + AG, OR = 0.376, 95%CI = 0.158-0.892) and PE (GG vs. AA + AG, OR = 0.489, 95%CI = 0.245-0.979) in recessive model. AA genotype at solute carrier family 4 member 7 (SLC4A7) rs820430 was a risk factor for developing GH (AA vs. GG + AG, OR = 3.562, 95%CI = 1.343-9.447) and PE (AA vs. GG + AG, OR = 3.351, 95%CI = 1.352-8.303) in recessive model. But no significant association was observed between cytochrome P450 family 21 subfamily A member 2 (CYP21A2) rs2021783 and the GH/PE groups.
Conclusions: PIH and hypertension are likely to share genetic risk factors. The associations both between variants of MED13L rs11067763 and GH/PE and between variants of SLC4A7 rs820430 and GH/PE were significant.
Network analyses of circular RNAs expression profiles and their hub genes in pancreatic ductal adenocarcinoma
Authors: Tang Yanyan , Zhang Ping
Published: September 2019

Pancreatic ductal adenocarcinoma (PDAC) is one of the most common malignant tumor in digestive system. CircRNAs involve in lots of biological processes through interacting with miRNAs and their targeted mRNA. We obtained the circRNA gene expression profiles from Gene Expression Omnibus (GEO) and identified differentially expressed genes (DEGs) between PDAC samples and paracancerous tissues. Bioinformatics analyses, including GO analysis, KEGG pathway analysis and PPI network analysis, were conducted for further investigation. We also constructed circRNA‑microRNA-mRNA co-expression network. A total 291 differentially expressed circRNAs were screened out. The GO enrichment analysis revealed that up-regulated DEGs were mainly involved metabolic process, biological regulation, and gene expression, and down-regulated DEGs were involved in cell communication, single-organism process, and signal transduction. The KEGG pathway analysis, the upregulated circRNAs were enriched cGMP-PKG signaling pathway, and HTLV-I infection, while the downregulated circRNAs were enriched in protein processing in endoplasmic reticulum, insulin signaling pathway, regulation of actin cytoskeleton, etc. Four genes were identified from PPI network as both hub genes and module genes, and their circRNA‑miRNA-mRNA regulatory network also be constructed. Our study indicated possible involvement of dysregulated circRNAs in the development of PDAC and promoted our understanding of the underlying molecular mechanisms.
Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis
Authors: Tenorio Carmen Hidalgo , Gálvez Juan , Martínez-Marcos Francisco Javier , Plata-Ciezar Antonio , Torre-Lima Javier De La , López-Cortés Luis Eduardo , Noureddine Mariam , Reguera José M. , Vinuesa David , García Maria Victoria , Ojeda Guillermo , Luque Rafael , Lomas José Manuel , Lepe Jose Antonio , de Alarcón Arístides
Published: September 2019

Background: S. aureus(SA) infective endocarditis (IE)has a very high mortality, attributed to the age and comorbidities of patients, inadequate or delayed antibiotic treatment, and methicillin resistance, among other causes. The main study objective was to analyze epidemiological and clinical differences between IE by methicillin-resistantversusmethicillin-susceptible SA (MRSA vs. MSSA)and to examine prognostic factors for SA endocarditis, including methicillin resistance and vancomycin minimum inhibitory concentration (MIC) values >1 ug/mL to MRSA. Methods: Patientswith SA endocarditis were consecutively and prospectively recruited from the Andalusia endocarditis cohort between 1984 and January 2017. Results: We studied 437 patients with SA endocarditis, which was MRSA in 13.5% of cases. A greater likelihood of history of COPD (OR 3.19; 95% CI 1.41-7.23), invasive procedures, or recognized infection focus in the three months before IE onset (OR 2.9; 95% CI 1.14-7.65) and of diagnostic delay (OR 3.94; 95% CI 1.64-9.5) was observed in patients with MRSA versusMSSA endocarditis. The one-year mortality rate due to SA endocarditis was 44.3% and associated with decade of endocarditis onset (1985-1999) (OR 8.391; 95% CI (2.82-24.9); 2000-2009 (OR 6.4; 95% CI 2.92-14.06); active neoplasm (OR 6.63; 95% CI 1.7-25.5) and sepsis (OR 2.28; 95% CI 1.053-4.9). Methicillin resistance was not associated with higher IE-related mortality (49.7 vs. 43.1%; p= 0.32). Conclusion: MRSA IE is associated with COPD, previous invasive procedure or recognized infection focus, and nosocomial or healthcare-related origin.Methicillin resistance does not appear to be a decisive prognostic factor for SA IE.
The S68G polymorphism is a compensatory mutation associated with the drug resistance mutation K65R in CRF01_AE strains
Authors: Li Shengjia , Ouyang Jinming , Zhao Bin , An Minghui , Wang Lin , Ding Haibo , Zhang Min , Shang Hong , Han Xiaoxu
Published: September 2019

Background: The rate of S68G mutation in human immunodeficiency virus type 1 (HIV-1) reverse transcriptase has increased and is closely related to the K65R mutation among treatment-failure CRF01_AE-infected patients. We aim to explore the temporal association of S68G and K65R mutations among treatment-failure CRF01_AE-infected patients and disclose the role of the S68G mutation on nucleotide/nucleoside reverse transcriptase inhibitor (NRTI) susceptibility and viral replication with the K65R double mutation. Methods: Occurrence of S68G and K65R mutations was evaluated among HIV-1 of various subtypes in the global HIV Drug Resistance Database. The temporal association of S68G and K65R mutations was analyzed by next-generation sequencing (NGS). The impact of the S68G mutation on NRTI susceptibility and replication adaptability was analyzed with pseudovirus phenotypic resistance assays and growth competition assays, respectively. Results: The frequency of the S68G mutation increased significantly in all HIV subtypes and circulating recombinant forms in treatment-experienced patients (except for subtype F), as did the frequency of the K65R/S68G double mutation. NGS revealed that the S68G mutation occurred following K65R mutation among three out of four patients. No significant difference in fold-change for tenofovir, lamivudine or efavirenz was detected between K65R and K65R/S68G mutations in phenotypic resistance assays. The K65R/S68G double mutant outgrew the K65R mutant within 13 days of co-culture for any input ratio among all patients. Conclusions: S68G might be a natural polymorphism and compensatory mutation of K65R selected by NRTIs among the CRF01_AE strain of HIV-1, which does not affect NRTI susceptibility, but improves the replication adaptability on K65R mutants.
Prevalence of diarrhoea and associated risk factors among children under five years old in Pader district, Northern Uganda
Authors: Omona Stephen , Malinga Geoffrey Maxwell , Opoke Robert , Openy Geoffrey , Opiro Robert
Published: September 2019

Background: Diarrhoea remains a major cause of morbidity and mortality in children < 5 years in sub-Saharan Africa. Uganda has the worst mortality rate in children < 5 years among the three East African countries, with 22% of these deaths attributed to diarrhoea. For proper planning and implementation of control interventions, an understanding of the prevalence and determinants of the disease is crucial. This study assessed the prevalence of diarrhoea and related risk factors among children aged < 5 years in Pajule sub-county in Pader district in northern Uganda. Methods: A cross-sectional survey was conducted covering 244 randomly selected households having children < 5 years old in the study area. A semi-structured questionnaire was used to interview the households about diarrhoeal history in their children in the last two weeks preceding the survey, and on the risk factors predisposing children to diarrhoeal infections. Descriptive statistics was used to summarize the risk factors whereas bivariate and multivariate logistic regression analyses (95% confidence interval and p < 0.05) were used to identify the risk factors associated with childhood diarrhoea.Results: We found a prevalence of diarrhoea of 29.1% among children < 5 years of age in Pajule sub-county during the two weeks preceding the survey. Multivariate logistic regression revealed significant associations between diarrhoeal prevalence and use of unprotected water sources (adjusted Odd Ratio, aOR=2.866, 95% CI: [1.431 – 5.741]), presence of animals in respondents’ homes (aOR=3.950, 95%CI: [1.399 – 11.156]) and infrequent hand washing practices (aOR=2.737, 95% CI: [1.304 – 5.743]). Conclusion: The present study identified a high prevalence of diarrhoea among children < 5 years of age in Pajule sub-county, higher than the Ugandan national average. Extensive use of unprotected water sources, animals’ presence in homes and poor hand washing practices had significant associations with diarrhoeal occurrence. These findings underscore the need for continuous community health promotion emphasizing good hand washing practices and interventions that target improvement of hygiene practices at homes as the best methods for fighting childhood diarrhoea in the study area.
Investigation of the presence of NDM-1, VIM-1 and OXA-1 genes in MDR strains of Klebsiella pneumoniae isolated from clinical specimens
Authors: Taleb Melika , Hosseini Farzaneh
Published: September 2019

Background:Klebsiella pneumoniae has emerged as a significant opportunistic pathogen responsible for nosocomial infections. This bacteria is frequently resistant to multiple classes of antibiotics such as the family of beta-lactam antibiotics. The aim of this study was the molecular evaluation of resistant strains of Klebsiella pneumonia isolation of multiple resistant drugs from clinical specimens.Methods:60 clinical isolates of Klebsiella pneumoniae were isolated and identified by staining and biochemical tests during fall season from a laboratory in Tehran. Antimicrobial susceptibility testing was carried out using a disk diffusion method with CLSI standards. All isolates were examined by PCR test for the presence of NDM-1, VIM-1, and OXA-1 genes.Results:The highest resistance in the strains was related to antibiotic ampicillin (90%), followed by the highest resistance to ciprofloxacin (70%), cefixime (66.66%), trimethoprim-sulfamethoxazole (65%), piperacillin (50%). Also, most susceptibilities were to ampicillin antibiotics (85%), gentamicin (70%), piperacillin-tazobactam (60%) and amikacin (56.66%). Out of the 60 isolated strains, 3 isolates (5%) had the VIM-1 enzyme gene, 2 isolates (3.3%) had the OXA-1 enzyme gene and no isolates were found with the NDM-1 enzyme gene. Conclusion:The high levels of antibiotic resistance among the organisms that cause clinical infections suggest that the mechanisms involved in the development of resistance and the evaluation of antimicrobial activity of new drugs in vitro can help the process of effective treatment of these infections.
Evaluation of the surveillance system for invasive meningococcal disease (IMD) in the Netherlands, 2004 – 2016
Authors: Brandwagt Diederik A.H. , Ende Arie van der , Ruijs Helma (W.) L.M. , de Melker Hester E. , Knol Mirjam J.
Published: September 2019

Background Enhanced surveillance for confirmed cases of invasive meningococcal disease (IMD) was introduced in the Netherlands in 2003, in which reference laboratory data (NRLBM) are linked with notification data (OSIRIS). The quality of surveillance information is important for public health decision making. Our objective was to describe the system and evaluate it for data completeness and timeliness. Methods Cases reported in the surveillance system from 2004 to 2016 were included. For the notification data, we used information on serogroup, vaccination status, mortality, and country of infection as indicators for record completeness. Notification times to regional and national level were calculated using the reported dates available in the notification database.  Results A total of 2,123 cases were reported in the years 2004-2016, of which 1.968 (93%) were reported by the reference laboratory and 1.995 (94%) in the notification system. Of all cases, 1.840 cases (87%) were reported in both systems and could be linked. The serogroup was known in 86% of the notified cases, and was significantly higher (94%) in the years 2013-2016. Information on vaccination status, mortality and country of infection was available in 88%, 99% and 97% of notified cases, respectively. Regional notification of cases occurred within one working day for 86% of cases and 98% were notified nationally within three days.  Conclusions A well performing IMD surveillance system was demonstrated and serogroup completeness has improved over the years. Underlining the need for reporting to both the clinical and laboratory surveillance system remains important to further improve the overall performance in supporting public health response and vaccination policy.
Active Mycobacterium tuberculosis Infection at a Comprehensive Cancer Center, 2006–2014
Authors: Kmeid Joumana , Kulkarni Prathit A. , Batista Marjorie V. , Chaer Firas El , Prayag Amrita , Ariza-Heredia Ella J. , Mulanovich Victor E. , Chemaly Roy F.
Published: September 2019

Background: Morbidity and mortality from Mycobacterium tuberculosis (Mtb) infection remain significant in cancer patients. We evaluated clinical characteristics, management, and outcomes in patients with active Mtb infection at our institution who had cancer or suspicion of cancer. Methods: We retrospectively examined medical records of all patients with laboratory-confirmed active Mtb infection diagnosed between 2006 and 2014. Results: A total of 52 patients with laboratory-confirmed active Mtb infection were identified during the study period, resulting in an average rate of 6 new cases per year. Thirty-two (62%) patients had underlying cancer, while 20 (38%) patients did not have cancer but were referred to the institution because of suspicion of underlying malignancy. Among patients with cancer, 18 (56%) had solid tumors; 8 (25%) had active hematologic malignancies; and 6 (19%) had undergone hematopoietic-cell transplantation (HCT). Patients with and without cancer were overall similar with the exception of median age (61 years in cancer patients compared to 53 years in noncancer patients). Pulmonary disease was identified in 32 (62%) patients, extrapulmonary disease in 10 (19%) patients, and disseminated disease in 10 (19%) patients. Chemotherapy was delayed in 53% of patients who were to receive such treatment. Eleven patients (all of whom had cancer) died; 3 of these deaths were attributable to Mtb infection. Conclusions: Although not common, tuberculosis remains an important infection in patients with cancer. Approximately one-third of patients were referred to our institution for suspicion of cancer but were ultimately diagnosed with active Mtb infection rather than malignancy.