bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluations of knowledge, skills and practices of insulin storage and injection handling techniques of patients in Ethiopian primary hospitals
Authors: Netere Adeladlew Kassie , Ashete Eyayaw , Gebreyohannes Eyob Alemayehu , Belachew Sewunet Admasu
Published: May 2020

Background: Insulin is an effective drug for blood sugar controls. Nonetheless, it is very sensitive and destroyed with many external factors if not properly handled. Diabetic patients could be benefited if adhered and properly implemented insulin delivery recommendations. Lack of knowledge, skill, and irrational practices on appropriate insulin delivery techniques can result in therapeutic failure and increases costs of therapy. The primary aim of this study was to evaluate the knowledge, skills and practices of insulin storage and injection technique of patients. Methods: Interview based cross-sectional study was conducted in conveniently selected participants in Northwest Ethiopian primary hospitals from March 1, 2019 to May30, 2019. Knowledge levels were assessed with dichotomous outcomes and practice was measured by administering a 4-point Likert scale structured questionnaire through face-to-face interviews. Finally, a five-point item observational (demonstration) techniques checklist assessed patients’ skills. Results: Of the total 166 participants, 54.8% were males and the mean age was 38.46±13.8 years. The overall patients’ median knowledge and practice levels on insulin storage and handling techniques were moderately adequate (64.3%) and fair (55.4%) respectively. In patients’ skill assessments, 94.6% showed injection sites, 70% indicated injection site rotations, and 60.75% practiced injection sites rotations. Education X2(3) =18.89, p<0.001; years of insulin therapy X2(3) =11.71, p=0.008; and years of disease X2(3) =10.67, p=0.014 had a significant effect on patients’ knowledge level. Education X2(3) =25.86, p<0.001; occupation X2(4) =23.24, p<0.001; and years of disease X2(3) =15.85, p=0.001; years of disease X2(3) =8.55, p=0.036 and patients knowledge levels X2(2) =19.26, p<0.001 were found to have a significant effect on the patients’ practice level. A Mann-Whitney U test also disclosed that residency; ways to get insulin and mocked injection technique during first training had significant effects on patients’ knowledge levels. Conclusion: The current study revealed that patients’ had a moderately adequate knowledge and fair practices levels on insulin storage and handling techniques. In addition, patients demonstrated poorly the administration skills, which were critical steps. The engagements of healthcare professionals and stakeholders in developments of instructions and guidelines are as important as educating and changing the poor knowledge and administration techniques of patients.
‘She must cover up whilst the baby is feeding’: Experiences and attitudes about breastfeeding among female and male informal workers in India and South Africa.
Authors: Horwood Christiane , Surie Aditi , Haskins Lyn , Luthuli Silondile , Hinton Rachael , Chowdhury Antara , Rollins Nigel
Published: May 2020

Background: Worldwide, over 740 million women make their living in the informal economy and do not benefit from formal employment benefits, such as maternity leave, that can improve infant feeding practices. Returning to work is one of the biggest challenges women face to maintaining breastfeeding. This study aimed to explore interactions between informal work and breastfeeding practices. Methods: The study used a qualitative research design. Purposive and snowball sampling was employed. Focus group discussions (FGDs) were conducted among men and women working in different types of informal jobs, in India and South Africa. Data was analysed using a thematic approach and the framework method. Results: Between March and July 2017, 14 FGDs were conducted in South Africa and nine in India. Most women were knowledgeable about the benefits of breastfeeding and reported initiating breastfeeding. However, pressures of family responsibilities and household financial obligations often forced mothers to return to work soon after childbirth. Upon return to work many mothers changed their infant feeding practices, adding breastmilk substitutes like formula milk, buffalo milk, and non-nutritive fluids like Rooibos tea. Some mothers expressed breastmilk to feed the infant while working but many mothers raised concerns about breastmilk becoming ‘spoilt’. Breastfeeding in the workplace was challenging as the work environment was described as unsafe and unhygienic for breastfeeding and childcare. Mothers also described being unable to complete their work tasks while caring for an infant. In contrast, the flexibility of informal work allowed some mothers to successfully balance competing priorities of child care and work. Sociocultural challenges influenced breastfeeding practices. For example, men in both countries expressed mixed views about breastfeeding. Breastfeeding was perceived as good for both mother and child, however it was culturally unacceptable for women to breastfeed in public. This affected the ability of working mothers to breastfeed outside the home and contributed to a lack of respect for women who chose to breastfeed in the workplace. Conclusion: Mothers working in the informal sector face multiple challenges to maintaining breastfeeding. Interventions are required to support optimal feeding and child care if global nutrition and development goals are to be met.
Prevalence of reduced visual acuity among school-aged children and adolescents in 6 districts of Changsha city: a population-based survey
Authors: Liao Menglian , cai zehuai , Khan Muhammad Ahmad , Miao Wenjie , Lin Ding , Tang Qiongyan
Published: May 2020

Background: To calculate and evaluate the prevalence of reduced uncorrected distant visual acuity (UCDVA) in primary and secondary school students in 6 districts of Changsha, Hunan, China. Methods: A population-based retrospective study was conducted in 239 schools in 6 districts of Changsha. After routine eye examination to rule out diseases that can affect refraction, 250,980 eligible students from elementary, middle and high schools were enrolled in the survey. Then the uncorrected distant and near visual acuity of each eye were measured. Categories of schools, districts, grades, eye exercises and sports time were also documented and analyzed. Results: The overall prevalence of reduced UCDVA was 51.8% (95% confidence interval [CI]: 51.6%-52.0%) in 6 districts of Changsha. Results of individual districts were as follows: Furong district 59.9%(95% CI: 57.9%-61.8%), Tianxin district 62.3%(95% CI: 60.5%-64.0%), Wangcheng district 47.8%(95% CI: 46.8%-48.8%), Kaifu district 58.5%(95% CI: 58.0%-58.9%), Yuhua district 47.0%(95% CI: 46.7%-47.4%) and Yuelu district 52.6%(95% CI: 52.3%-52.9%). The proportion of normal VA is seen to decrease from primary grade 3. The proportion of mildly reduced UCDVA is higher in primary grade 1 and 2. The proportion of moderately reduced UCDVA remains similar during 12 grades. The proportion of severely reduced UCDVA increases with grades. Multivariate analysis shows that the prevalence of reduced UCDVA is higher in key schools (odds ratio [OR]= 1.47, 95% CI 1.44-1.50) than non-key schools. Conclusions: According to the existing data analysis results, the prevalence of reduced UCDVA among primary and secondary school students in Changsha is very high. Some effective measures need to be taken to prevent it.
Awareness, treatment, and control of hypertension and related factors in adult Iranian Population
Authors: Mirzaei Mohsen , Mirzaei Masoud , Bagheri-Fahraji Behnam , Dehghani Ali
Published: May 2020

Background: Hypertension, known as the silent killer, is a major risk factor for cardiovascular disease. Awareness and treatment hypertension is not appropriate in the world, and this has led to an increase in mortality and morbidity caused by uncontrolled hypertension.This study aims to estimate awareness, treated, and controlled hypertensive and relevant predictors in an adult Iranian population.Methods: This cross-sectional study was conducted on 10000 adults aged 20-69 years in Yazd, Iran. They were selected through multi-stage random cluster sampling in 2015-2016.Blood pressure was measured three-time with standard protocol by trained health workers. Those with a positive history of hypertension and using anti-hypertensive drugs, prescribed by a physician, were considered hypertensive. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic BP of ≥90 mmHg. Uncontrolled hypertension was defined in accordance with recommended treatment targets by the Joint National Committee (JNC7). Logistic regression was used to assess the predictors of hypertension awareness, treatment and control.Results: The prevalence of hypertension was 37.3%, and the prevalence of pre-hypertension was 46.4%. 49.7% of People with hypertension were aware of their disease, and 71.5% of them were using antihypertensive drugs prescribed by physicians. Blood pressure was controlled in 38.9% of the treated patients. In the adjusted model, older age, female sex, and history of diabetes mellitus were positively associated with higher awareness. High physical activity, tobacco smoking, and diabetes are the only predictors of treated high blood pressure. Younger age, female sex, and higher education were determinants of controlled hypertension. Having health insurance was significantly correlated with awareness and control of hypertension.Conclusion: Hypertension is a public health problem in this population, which is not well controlled. Half of the patients were unaware. Intervention for increased screening coverage is needed. It should plan to raise public awareness about hypertension and improve hypertension control under supervision of physicians. Implement a family physician program is recommended in the health system.
Sympathetic Ophthalmia Two Weeks After 23-Gauge Vitrectomy
Authors: Khatib Bahaeddin El , Patel Menka S. , Hacopian Alexander , Dalal Monica , Sen H. Nida , Patronas Marena
Published: May 2020

Sympathetic Ophthalmia (SO) is a rare disease that presents as a bilateral, diffuse, granulomatous panuveitis. Sympathetic Ophthalmia is a clinical diagnosis with history of penetrating ocular injury in the inciting eye and presence of panuveitis in the sympathizing eye. Though early enucleation is believed to minimize the risk, there have been reports of SO even after enucleation of inciting eyes. The possible association between vitrectomy and SO has been initially proposed by Gass [9] and later studied extensively in a large cohort in the UK with an estimated SO risk of 1 in 799 vitrectomies [11]. There have been several case series and reports of SO following vitrectomy, however only three documented cases of SO following vitrectomy without use of silicone oil. These cases demonstrated an onset of SO ranging between 4 weeks to 2 months. We present a patient with SO in the sympathizing eye presenting 16 days after an uncomplicated 23-gauge (23G) sutureless pars plana vitrectomy (PPV) without the use of silicone oil.
HIV positive status disclosure to a sexual partner: the influence of marital status and partner communication
Authors: ADENIYI OLADELE VINCENT , Nwogwugwu Charlotte , Ajayi Anthony Idowu , Lambert John
Published: May 2020

Background Disclosure of HIV serostatus to sexual partner does not only facilitate partner's support and testing, but it also correlates with better treatment outcomes. We drew from a cross-sectional survey data conducted among postpartum women with HIV to examine the rate of serostatus disclosure to sexual partners, the influence of relationship status, and knowing one's partner's status on disclosure and reasons for non-disclosure.Methods We conducted telephonic interviews with a final sample of 485 postpartum women with HIV drawn from the East London Prospective Cohort study database between January and May 2018. Disclosure of HIV status to partner was based on self-reporting. We fitted adjusted and unadjusted logistic regression models and also conducted descriptive statistical analyses.Results Overall, 82.5% of the respondents had disclosed their status to their partners. After adjusting for important covariates (age, education level, employment status, number of years since HIV diagnosis, alcohol use and smoking behaviour), being married [adjusted odd ratio (AOR): 2.66; 95% confidence interval (CI):1.17–6.05] and knowing one's partner's status [AOR: 46.91; 95% CI:19.50-112.81] were significantly associated with a higher odds of having disclosed HIV status to sexual partners. Fear of rejection, stigma or being judged, new or casual relationships, and having a violent partner were the main reasons for not disclosing HIV status to sexual partners.Conclusion We found a relatively high rate of HIV status disclosure in the cohort. Being married and having open communication with a partner about HIV status are important factors facilitating disclosure to sexual partners.
The Association of Hair Coloring During Pregnancy with Pregnancy and Neonate Outcomes: A Cross-Sectional Study
Authors: Shishavan Maryamalsadat Kazemi , Sayyah-Melli Manizheh , Rashid Mohammad Reza , Gharabaghi Parvin Mostafa , Ghojazadeh Morteza , Rahmani Vahideh , Tahmasebi Zohreh
Published: May 2020

Background: Hair colorant use has spread globally and rapidly in recent years. Concerns have arisen about the safety of hair dyes usage during pregnancy. The primary goal of this study was to examine the association between hair coloring during pregnancy, intrapartum, and neonatal outcomes.Methods: This explorative cross-sectional study was carried out at Talegani Teaching Hospital of Tabriz University of Medical Sciences from Jan 2017 to Dec 2019. Three trained midwives inquired mothers about the hair coloring history on the admission to the labor room and recorded intrapartum, and neonatal outcomes. Chi-Square test of independence with post hoc tests and Logistic regression analysis were used for data analysis. Odds Ratios with a 95% confidence interval and contributing effect sizes were reported. The significance level was set at α ≤ 0.05Results: We studied 2040 women aged 14 to 48 years. Most of the participants (75.24%) dyed their hair during pregnancy, and the majority (62.67%) colored their hair in the third trimester. There was no statistically significant association between hair coloring and neonate 1-minute (p=0.23) and 5-minute Apgar score (p=0.99). The logistic regression model did not confirm a rise in overall neonatal complications (NC) associated with hair coloring at any time during the pregnancy (OR:0.027 p<0.001). Higher rates of Low birth weight (LBW) were seen among those dyed their hair in the preconception period and third trimester compared to the woman who colored their hair in the first and second trimester (p<0.001).Conclusions: We observed associations between hair coloring and LBW, but there were no increased odds for NC. The evidence for recommending hair dye safety during pregnancy is still limited. Perinatal health professionals should advise their patients on possible adverse outcomes and inform them about the uncertainties about hair dyes.
Application of double needle-double layer continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy
Authors: Zhang Xinsheng , zhang weibin , yuan menglang , shi xiaomeng , CHEN HONGYI , feng zhen , chen zihao , liu dunbo , yan enjun , ren shuangyi
Published: May 2020

Background

Retrospectively register the clinical data of distal gastric cancer patients who received surgical treatment, discuss the safety and feasibility of double needle-double layer continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy.
Methods

Review the clinical data of 41 patients with distal gastric cancer from the gastroenterology department of the Second Affiliated Hospital of Dalian Medical University, from September 2018 to August 2019, were accepted the totally laparoscopic distal gastrectomy. During the operation, the method of double needle-double layer continuous manual suture was used for Billroth I type anastomosis to complete digestive tract reconstruction. The peri-operative clinical information and postoperative follow-up information were collected for analysis, and the clinical application value was evaluated.
Results

General Information: Male (n = 27),Female(n = 14)༌Age(65.02 ± 9.94)years, BMI(23.52 ± 2.56)kg/m2; Tumor location: Antrum(32,78.0%), Angle (6,14.6%), Body (3,7.3%); Clinical stage: I (27,65.9%), II (7,17.1%), III (7,17.1%); Operative information: Operation time (154.51 ± 33.37)min, Anastomosis time (26.88 ± 5.11) min; Intraoperative bleeding (66.34 ± 48.81) ml; First postoperative ambulation (1.07 ± 0.26) d, First postoperative flatus(3.07 ± 1.08)d, First postoperative diet(3.41 ± 1.07)d༌Postoperative hospital stay(8.76 ± 6.64)d, Total hospitalization cost (70804.00 ± 14282.05)RMB yuan; Differentiation degree: High and high-moderate(3,7.32%), Moderate and poor-moderate (24,58.54%)༌Poor differentiation (14,34.15%); Dissected lymph node (32.76 ± 13.16), Positive lymph node (2.39 ± 4.06); Pathological stage: IA (20,48.78%), IB (3,7.32%), IIA (4,9.76%), IIB (5,12.20%), IIIA (1,2.44%), IIIB (3,7.32%), IIIC (5,12.20%); Complications(n = 4): Lung infection(1,2.44%)༌Anastomotic leakage (1,2.44%༉༌Gastroparesis (2,4.88%༉;
Conclusion

It is safe and feasible in clinical treatment to apply the method of double needle-double layer continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy.
Prefrontal dopamine D1 receptor manipulation influences anxiety behavior and induces neuroinflammation within the hippocampus
Authors: Beyer Dominik K E , Mattukat Annika , Freund Nadja
Published: May 2020

Background - Prefrontal dopamine D1 receptor (D1R) mediates behavior related to anxiety, reward and memory, and is involved in inflammatory processes, all of which are affected in bipolar disorder. Patients with bipolar disorder show alternations in the dopamingergic and immune system. Interleukin-6 (IL-6), a pro-inflammatory cytokine, is increased in plasma samples, imaging studies and post mortem tissue. Manipulation of the D1R in the medial prefrontal cortex (mPFC) e.g. results in BD-like behavior. The purpose of the study is the investigation of the influence of D1R over-expression and its termination on the immune system and anxiety behavior in rats.Methods – Expression of the gene for D1R in glutamatergic neurons within the mPFC of male, adult rats was manipulated through an inducible (Tet.On) lentiviral vector. Anxiety behavior was studied in the elevated plus maze and marble burying test in ‘ON’ (D1R over-expression) and ‘OFF’ (termination of D1R over-expression) states. IL-6-positive cells were counted to identify the inflammatory state within several subregions of the hippocampus.Results - D1R ‘OFF’ subjects buried more marbles compared to D1R ‘ON’ and their respective control animals indicating an increased anxiety behavior. D1R ‘OFF’ animals reflected an elevated pro-inflammatory state in the hippocampus, in the CA3 and dentate gyrus especially. Consistently, inflammatory state in the whole hippocampus and anxiety behavior correlated positively, indicating a connection between anxiety and inflammatory state of the hippocampus.Conclusions – Behavioral and molecular findings support the association of D1R’s impact on anxiety and inflammation. In addition, by confirming an involvement of IL-6, the new animal model for bipolar disorder has been further validated.
Correlations between gender, age and the risk of withdrawal from peritoneal dialysis
Authors: Zhang Min Yan , He Miao , Wan Sheng , Ding Qiong Yan , Liu Lei , Xiong Fei , Hu Lin Yang
Published: May 2020

Background With the increasing incidence of end stage renal disease(ESRD),peritoneal dialysis(PD) has become the preferred method of kidney replacement therapy for an increasing number of patients with end stage renal disease due to its many advantages.The intent of this study was to explore the correlations between sex, age and risk of withdrawal from peritoneal dialysis.Methods All patients who underwent PD catheterization and initiated PD at Wuhan No.1 Hospital between 2013 and 2018 were screened.Clinical information of these patients was collected and compared according to gender and age,then was applied to the Cox proportional hazards model to determine the impact of factors of withdrawal from peritoneal dialysis.Results ①Hazard ratios(HRs) of withdrawal of PD associate with gender and age at initiation were 0.736(P = 0.289)、1.151༈P = 0.489༉respectively.Nonetheless,male patients under 60 years old had a 1.58-fold higher risk of withdrawal than others(HR 0.63,P = 0.031).②The withdrawal risk of patients with total Creatinine clearance rate (Ccr) above 60L/W was 82.4% higher than that of patients who did not meet the standard (HR 1.82,P = 0.005).③The withdrawal risk of patients with high D/P Creatinine༈Cr༉value which was calculated from peritoneal equilibration test(PET) were 2.06 times higher than low-average and high-average transport patients(HR2.06,P = 0.008).④Patients with serum albumin above 35 g/L were intended to withdraw from PD than those below 35 g/L (HR 0.56,P = 0.006).Conclusions There were significant differences in total KT/V, total Ccr,serum creatinine(Scr) and blood Urea nitrogen(BUN)among patients with PD of different gender and age.The analysis showed that male patients under 60 years old, Ccr, value of D/Pcr and serum albumin had a high correlation with the technical survival rates.While gender or age at PD initiation were not associated with technique survival,male patients under 60 years old had a 1.58-fold higher risk of withdrawal from PD than others.The outcome that the withdrawal risk of patients with Ccr above 60L/W was 82.4% higher than other patients who did not meet the standard suggested that Ccr was not suitable as an index for evaluating the adequacy of PD,especially for men under 60 years old.And patients with high D/Pcr value or with serum albumin under 35 g/L were related risk factors for technique survival.
Person-Centred Maternity Care in a Poor-Resource Setting: Evidence from a Cross-Sectional Study in Enugu State, Nigeria
Authors: Ogbuabor Daniel Chukwuemeka , Nwankwor Chikezie
Published: May 2020

Background Women are not getting adequate person-centred maternity care (PCMC) in low-income and middle-income countries despite being important in reducing maternal morbidity and mortality. This study assessed perceptions and predictors of PCMC among childbearing women in Enugu State, South-east Nigeria.Methods The study was conducted in two health districts in Enugu State using a descriptive, cross-sectional survey design. We conveniently selected 450 childbearing women, within 9 weeks post-partum, from 11 health facilities purposively selected based on high maternal and child health attendance. Data was collected from women using an interviewer administered 30-item PCMC scale (scores 0–90) consisting of: dignity and respect (6 items, scores 0–18), communication and autonomy (9 items, scores 0–27), and supportive care (15 items, scores 0–45). We categorized full PCMC and each sub-scale into “low, medium and high” using 25th and 75th percentile of the summative scores. The questionnaire also collected data on women characteristics, facility characteristics and service type. Data were analysed using descriptive statistics, t- tests, analysis of variance and Generalized Linear Models.Results Women had medium scores on full PCMC scale and sub-scales. The lowest score was in communication and autonomy. A quarter of women perceived PCMC as high. Marrying at age 20–29 years (β = 5.83, ρ = 0.002), self-employed women (β = -10.23, ρ = 0.004), starting antenatal care in the third trimester (β = -7.93, ρ = 0.008), high participation in household decisions (β = -4.98, ρ = 0.011), domestic violence experience (β = 5.41, ρ = 0.002), delivery at health centre (β = 7.09, ρ = 0.000), delivery at private/mission hospital (β = 17.47, ρ = 0.000), delivery by non-skilled attendant (β = -9.61, ρ = 0.001); delivery by community health workers (β = -7.65, ρ = 0.001), and experience of pregnancy complication (β = 6.20, ρ = 0.028) predicted PCMC.Conclusions Person-centred maternity care was generally inadequate. Improving PCMC would entail sustaining dignified care, enhancing provider-patient communication, addressing facility-level drivers, increasing women’s personal empowerment and self-employment, timely initiation of antenatal care, and paying attention to women with pregnancy complication.
The Relationship between Breastfeeding and Parental Socioeconomic Status: an analysis of the Korea National Health and Nutrition Examination Survey ( 2013 ~ 2017 )
Authors: Lee Jusuk , Kim Taehong
Published: May 2020

Background: The importance of breastfeeding is well known. One of important factors affecting breastfeeding is socioeconomic status. We investigated the relationship between socioeconomic status and breastfeeding to promote future breastfeeding projects.Methods: Data were collected from the 2013 - 2017 Korea National Health and Nutrition Examination Survey (KNHANES). We evaluated the demographic information and parents’ socioeconomic status of 814 children, aged 12 ~ 60months.Results: Of the 814 children, 743 (92.2%) were breastfed. In univariate analysis, parents’ age and education level were related to breastfeeding (P < 0.05). In logistic regression analysis, mothers’ education level (≤ 13 years: odd ratio[OR], 8.57; 95% confidence interval [CI], 2.73-26.87), mothers’ income level (third quartile: OR, 2.94; 95% CI, 1.2-7.23), fathers’ age (20s: OR, 0.3; 95% CI, 0.09-0.98), fathers’ education level (10-12years: OR 4.85; 95% CI, 1.4-16.76 and 13years: OR, 18.55; 95% CI, 5.23-65.81), fathers’ income (third quartile: OR, 2.72; 95% CI 1.02-7.22) were associated with breastfeeding (P < 0.05).Conclusion: Higher parental income and education level and fathers’ age were positively associated with breastfeeding in Korea. The establishment of future breastfeeding projects should be considered target parents in Korea and other countries.
Identification, Evolution, Expression, and Docking Studies of Fatty Acid Desaturase Genes in Wheat (Triticum aestivum L.)
Authors: Hajiahmadi Zahra , Abedi Amin , Wei Hui , Sun Weibo , Ruan Honghua , Zhuge Qiang , Movahedi Ali
Published: May 2020

Backgrounds: Fatty acid desaturases (FADs) introduce a double bond into the fatty acids acyl chain resulting in unsaturated fatty acids which have important roles in plant development and response to biotic and abiotic stresses. Wheat germ oil, one of the important by-products of wheat, can be a good alternative for edible oils with clinical advantages due to the high amount of unsaturated fatty acids. Therefore, genome-wide analysis of wheat FAD gene family (TaFADs) has been performed.Results: 68 FAD genes were identified from the wheat genome. Based on the phylogenetic analysis, wheat FADs clustered into five subfamilies, including FAB2, FAD2/FAD6, FAD4, DES/SLD, and FAD3/FAD7/FAD8. The TaFADs were distributed on chromosomes 2A-7B with 0 to 10 introns. The Ka/Ks ratio was less than one for most of the duplicated pair genes revealed that the function of the genes has been maintained during the evolution. Several cis-acting elements related to hormones and stresses in the TaFADs promoters indicated the role of these genes in plant development and responses to environmental stresses. Likewise, 72 SSRs and 91 miRNAs in 36 and 47 TaFADs have been identified. According to RNA-seq data analysis, the highest expression in all developmental stages and tissues was related to TaFAB2.5, TaFAB2.12, TaFAB2.15, TaFAB2.17, TaFAB2.20, TaFAD2.1, TaFAD2.6, and TaFAD2.8 genes while the highest expression in response to temperature stress was related to TaFAD2.6, TaFAD2.8, TaFAB2.15, TaFAB2.17, and TaFAB2.20. Furthermore, docking simulations revealed several residues in the active site of TaFAD2.6 and TaFAD2.8 in close contact with the docked oleic acid that could be useful in future site-directed mutagenesis studies to increase the catalytic efficiency of them and subsequently improve agronomic quality and tolerance of wheat against environmental stresses. Conclusions:This study provides comprehensive information that can lead to the detection of candidate genes for wheat genetic modification.
Rare injury - acetabular fracture combined with ipsilateral intertrochanteric fracture: treatment and outcome in patients with at least 6 years of follow-up
Authors: Liu Bo , Ma Wenhui , Liu Sikai , Chen Xiao , Li Mengnan , Huo Jia , Li Huijie , Han Yongtai
Published: May 2020

Background

Fractures involving both the acetabulum and the ipsilateral femoral trochanter are rarely reported. The aims of our study were to identify the etiological characteristics, summarize the treatment methods, and analyze the mid- to long-term prognosis for this kind of rare injury.
Methods

A total of 18 patients who were treated in our hospital for a combination of ipsilateral acetabular fracture and intertrochanteric fracture from 2003 to 2013 was retrospectively analyzed. The etiology, fracture classifications, treatment and prognosis of patients were identified.
Results

We followed up with patients for 6.2 years to 16 years. In this study, injuries occurred most commonly via traffic accidents, followed by falls from a tall height and crushing injury. Six patients had posterior dislocation of the hip joint. Evans type 3 fracture and Letournel type 1 fracture were the most common fractures among these patients. All patients received internal fixation for their intertrochanteric fracture. Some patients also received internal fixation for their acetabular fracture. However, for the other patients, acetabular fractures were treated conservatively or with fracture fragment resection. One elderly (87 years) female patient had pulmonary disease and died at 24 days postoperatively. In other patients, fractures all achieved bony healing. Twelve patients achieved excellent and good results (Harris score ≥ 80 points), and 5 patients achieved fair and poor results (Harris score < 80 points). The proportion of patients who achieved an excellent-good Harris score was 70.6%. Dislocation of the hip was found to be an independent risk factor (HR = 9.194, 95% CI = 1.024–82.515) for poor patient outcomes.
Conclusion

The detailed characteristics of patients with acetabular fracture and ipsilateral intertrochanteric fracture were identified in this study. For patients who undergo surgical treatment, fracture healing is usually achieved. However, the occurrence of complications, especially avascular necrosis, is the major cause of poor prognosis. Dislocation of the hip joint at the time of injury is considered to be an important risk factor for poor prognosis.
The Application of Multidisciplinary Cooperative Complete Management Mode in the Management of Multi-Drug Resistant Tuberculosis Patients
Authors: Lang Yazhen
Published: May 2020

Objective: This study aims to explore the effect of multi-disciplinary cooperative complete management mode in the treatment of multi-drug resistant tuberculosis (MDR-TB).Methods: 280 patients were randomly classified into the observation group (n = 140) and the control group (n = 140). The control group was applied with the routine management mode, while the observation group was applied with the multi-disciplinary cooperative complete management one. The treatment compliance, life quality, treatment completion rate as well as the patient satisfaction in the two groups were observed.Results: The treatment compliance of the observation group was better than that of the control group (P༜0.05). The life quality of the observation group was higher than those of the control group (P༜0.05). The treatment completion rate of the observation group was higher than that of the control group (P༜0.05). The patient satisfaction of the observation group was better than that of the control group (P༜0.05).Conclusion: The application of multi-disciplinary cooperative management mode to MDR-TB patients can enhance their treatment compliance, life quality, treatment completion rate and satisfaction degree.
Nephroprotective effect of mesenchymal stem cells in therapy of kidney disease induced by toxicant
Authors: Zhou Tianbiao , Lin Shujun , Liao Chunling , Lin Wenshan , Zhong Hongzhen
Published: May 2020

Background

Renal damage caused by drug toxicity is becoming more and more common in clinic. How to avoid and treat kidney damage caused by drug toxicity is essential to maintain patient health and reduce social economic burden. In this study, we performed a meta-analysis to assess the nephroprotective effect of mesenchymal stem cells (MSCs) in therapy of kidney disease induced by toxicant.
Methods

Cochrane Library, Embase, ISI Web of Science and PubMed databases were searched up to Dec 31, 2019 to identify the studies and extract the data to assess the efficacy of MSCs for kidney disease induced by toxicant using Cochrane Review Manager Version 5.3.
Results

27 studies were eligible and recruited for this meta-analysis. The results showed that the difference of Scr between MSCs treatment group and control group was notable for 2 days, 4 days, 5 days, 6–8 days, 10–15 days, ≥ 42 days (2 days: WMD =-0.88, 95%CI: -1.34, -0.42, P = 0.0002; 4 days: WMD=-0.69, 95%CI: -0.99, -0.39, P < 0.00001; 5 days: WMD=-0.46, 95%CI: -0.67, -0.25, P < 0.0001; 6–8 days: WMD=-0.51, 95%CI: -0.79, -0.22, P = 0.0005; 10–15 days: WMD =-0.38, 95%CI: -0.56, -0.20, P < 0.0001; ≥42 days: WMD =-0.22, 95%CI: -0.39, -0.06, P = 0.007). Furthermore, the difference of BUN between MSCs treatment group and control group was notable for 2–3 days, 4–5 days, 6–8 days, ≥ 28 days. The results also indicated that MSCs treatment can alleviate the inflammatory cells, necrotic tubule, regenerative tubules, renal interstitial fibrosis in kidney disease induced by toxicant.
Conclusion

MSCs might be a promising therapeutic agent for kidney disease induced by toxicant.
Sex-Specific Effects of Microglia-Like Cell Engraftment During Experimental Autoimmune Encephalomyelitis
Authors: Han Jinming , Zhu Keying , Zhou Kai , Hakim Ramil , Sankavaram Sreenivasa Raghavan , Blomgren Klas , Lund Harald , Zhang Xing-Mei , Harris Robert A.
Published: May 2020

BackgroundMultiple Sclerosis (MS) is a chronic neuroinflammatory disorder of the central nervous system (CNS) that usually presents in young adults and predominantly in females. Microglia, a major resident immune cell in the CNS, are critical players in both CNS homeostasis and disease. We have previously demonstrated that microglia can be efficiently depleted by the administration of tamoxifen in Cx3cr1CreER/+Rosa26DTA/+ mice, with ensuing repopulation deriving from both the proliferation of residual CNS resident microglia and the engraftment of peripheral monocyte-derived microglia-like cells. MethodsTamoxifen was administered to Cx3cr1CreER/+Rosa26DTA/+ and Cx3cr1CreER/+ female and male mice. Experimental autoimmune encephalomyelitis (EAE), a widely used animal model of MS, was induced by active immunization with myelin oligodendrocyte glycoprotein one month after tamoxifen injections in Cx3cr1CreER/+Rosa26DTA/+ mice and Cx3cr1CreER/+ mice, a time point when the CNS niche was colonized by microglia derived from both CNS microglia and peripherally-derived macrophages. CNS myeloid cell compositions during acute and chronic EAE were measured by flow cytometry.ResultsWe demonstrate that engraftment of microglia-like cells following microglial depletion exacerbated EAE in Cx3cr1CreER/+Rosa26DTA/+ female mice as assessed by clinical symptoms and the expression of CNS inflammatory factors, but these findings were not evident in male mice. Higher major histocompatibility complex class II expression and cytokine production in the female CNS contributed to the sex-dependent EAE severity in mice following engraftment of microglia-like cells. ConclusionThe engraftment of microglia-like cells following microglial depletion exacerbated EAE in females. An underestimated yet marked sex-dependent microglial activation pattern may exist in the injured CNS during EAE.
Establishment of an animal model of chronic osteomyelitis with Staphylococcus aureus by ligating the femoral artery of rats
Authors: Jian-bo Feng , Li-dan Yang , Yu-qi Wang , Chen-cheng Li , Lang-bo Yu , Chun-tao Zhao , Jin-yue Liu , Wen-bin He , Hao Xiang , Jie-fan Hong , Xiao-min Wang , -jiachen Peng
Published: May 2020

Background

Osteomyelitis caused by Staphylococcus aureus (S. aureus) is an important post-operation complication, especially after fracture internal fixation and artificial joint replacement. Animal models play an indispensable role in exploring the pathogenesis of osteomyelitis. Most models use internal fixation, bacterial suspension and vascular sclerosing agent to destroy blood vessels. Vascular sclerosing agents not only damage blood vessels but also lead to local inflammatory immune disorders, which is different from simple vascular disease and osteomyelitis caused by ischemia in clinical practice.
Methods

The experimental animals were randomly divided into three groups: femoral artery ligation group, vascular sclerosing agent group and non-infection aseptic operation group. In the femoral artery ligation group, the femoral artery was ligated to reduce the blood flow of the affected limb to simulate the clinical ischemic state and increase the susceptibility, then the Kirschner needle with S. aureus biofilm was implanted into the tibia of rats, and the bone defect was sealed with aseptic paraffin. The non-infection aseptic operation group and the infection model group caused by vascular sclerosing agent have been used as the blank and positive control group. After operation, survival rate, body temperature and incision healing were monitored. Four weeks later, radiological and pathological changes of all animals were evaluated, and the secretions from osteomyelitis experienced etiological separation and cultivation.
Results

The chronic osteomyelitis model was established successfully by ligating femoral artery and implanting Kirschner needle covered with S. aureus biofilm. Signs of chronic osteomyelitis were observed in all rats of femoral artery ligation infection group and positive control group. No signs of infection and chronic osteomyelitis were found in the non-infection aseptic operation control group.
Conclusion

The method of ligating the femoral artery and implanting Kirschner needle with S. aureus biofilm into the tibia of rats can effectively establish a stable and reproducible chronic osteomyelitis model which is closer to the clinical pathogenesis and natural route of infection. This model could be useful for the study of pathogenesis and therapeutics of chronic osteomyelitis with S. aureus.
Diarrhoeal Diseases in Children Under Five Years Exhibited Space-Time Disparities and Priority Areas for Control Interventions in Rwanda
Authors: NSHIMIYIMANA LADISLAS , Onyambu Peris Monchari , Rutayisire Erigene
Published: May 2020

Background: The Diarrhoeal diseases remain to be a public health concern despite the existence of preventive measures and developing are the most affected. It affects more children less than five years compared to the rest of the population. The burden of childhood diarrhoea varies with geographical area and time bound. A part from this variation, the link between climate change and diarrhoea among under-five children has not been well understood. This study aims to determine the trends, spatial temporal and seasonal characteristics of diarrhoea diseases among Rwandan under-five children using routine Health Management Information System (HMIS) data from 2014 to 2018. Methods: Data on cases of diarrhoeal diseases in children under-five years were extracted from HMIS for a period of 5 years. The Rwanda Meteorology Agency provided climatology data including daily minimum and maximum temperature, and daily rainfall. Incidence rate were calculated to examine the trend, and excess hazard was assessed to determine the risk and likelihood for the occurrence of cases. Linear regression was used to assess relationship between climatology variables and the occurrence of diarrhoea. Results: 1,012,827 new diarrhoeal diseases episodes were reported. Excess risk was noticed in 40% of country’s districts. We found a statistically significant positive and negative relationship between diarrhoeal disease, and maximum temperature and mean monthly rainfall respectively (p<0.001). Increase in one millimeter of rainfall was associated with decrease of 14 cases of diarrhoea while increase of one degree Celsius of maximum temperature was associated with an increase of 15 diarrhoea cases. Conclusion: More districts with risk of diarrhoea were remarked which require targeted control intervention. Furthermore, significant association between diarrhoea case and climate dynamics was observed. This call for the public attention to climate changes which affect health especially children aged less than five years. Key words: Diarrhoeal, children under five, spatiotemporal, temperature, rainfall
The efficacy of levocarnitine treatment in relieving fatigue in patients with cirrhosis but without overt hepatic encephalopathy: a prospective non-randomized controlled study
Authors: Abe Kazumichi , Fujita Masashi , Hayashi Manabu , Takahashi Atsushi , Ohira Hiromasa
Published: May 2020

Background In recent years, levocarnitine has been reported to be an effective treatment in patients with liver cirrhosis, but its mechanism is not fully understood. In the present study, we prospectively examined the efficacy of levocarnitine in relieving symptoms of fatigue in patients with cirrhosis but without overt hepatic encephalopathy. Methods Twenty-one cirrhotic patients who were able to undergo fatigue symptom evaluations at our institution were enrolled. A total of 12 cirrhotic patients underwent levocarnitine treatment (1200-1800 mg/day), and 9 patients did not undergo levocarnitine treatment. Patient age, sex, and Child–Pugh (C-P) class, complications and the etiology of cirrhosis were assessed. As primary end-points, we investigated whether the levocarnitine treatment exerted any beneficial effects by assessing the symptoms of fatigue [8-item Short-Form Health Survey (SF-8) and Fisk Fatigue Severity Scores (FFSSs)] at baseline and 3 months after treatment. Furthermore, as exploratory secondary end-points, we investigated whether the levocarnitine treatment exerted effects on ameliorating oxidative stress by assessing the serum thioredoxin (TRX) and urinary 8-hydroxydeoxyguanosine (8-OhdG) levels. Results The median age of the patients was 73 years. Three males and 18 females had C-P classes A and B (14 and 7 patients, respectively), and 3 patients (14.3%) had a history of hepatocellular carcinoma treatment. A total of 6 cases of diabetes (28.6%), 6 cases of ascites (28.6%), and 4 cases of varices (19.0%) were identified. There were no significant differences in the clinical laboratory values between the two groups. The FFSS and SF-8 scores were significantly improved in the patients with cirrhosis who underwent levocarnitine treatment ( P <0.01) but not in patients who did not undergo levocarnitine treatment. Furthermore, three months after the levocarnitine treatment, the serum carnitine concentrations were significantly increased and the serum thioredoxin levels were decreased in the patients with cirrhosis who underwent levocarnitine treatment ( P <0.005). Conclusion These results suggest that levocarnitine treatment may relieve symptoms of fatigue in cirrhotic patients by reducing oxidative stress.
Identification of novel missense mutations in a large number of recent SARS-CoV-2 genome sequences
Authors: Cai Hugh Y , Cai Kimberly K , Li Julang
Published: May 2020

Background. SARS-CoV-2 infection has spread to over 200 countries since it was first reported in December of 2019. Significant country-specific variations in infection and mortality rate have been noted. Although country-specific differences in public health response have had a large impact on infection rate control, it is currently unclear as to whether evolution of the virus itself has also contributed to variations in infection and mortality rate. Previous studies on SARS-CoV-2 mutations were based on the analysis of ~ 160 SARS-CoV-2 sequences available until mid-February 2020. 2, 3, 4, 5 By mid-April, > 550 SARS-CoV-2 sequences had been deposited in GenBank, and over 8,200 in the GISAID database. Methods. We performed a sequence analysis on 474 SARS-CoV-2 genomes submitted to GenBank up to April 11, 2020 by multiple alignment using Map to a Reference Assembly and Variants/SNP identification. The results were verified on a larger scale, 8,126 hCoV-19 (SARS-CoV-2) sequences from GISAID database. Results. We identified 5 recently emerged mutations in many isolates (up to 40%). Our analysis highlights 5 frequent new mutations that have emerged since late February 2020. These mutations are: one each missense (non-synonymous) mutation in orf1ab (C1059T), orf3 (G25563T) and orf8 (C27964T), one in 5’UTR (C241T), one in a non-coding region (G29553A). The final mutation (G29553A) was found to be almost exclusive to the US isolates. The first 3 mutations are non-synonymous, leading to amino acid substitutions in the viral protein sequence. Except for C241T, all the novel mutations identified are absent in the isolates from Italy and Spain in the SARS-CoV-2 genomes deposited in GenBank and GISAID. Conclusion. The results of current study indicate that new mutations are emerging as COVID-19 pandemic are spreading to different countries and that geography specific mutants exist. The findings of current study lay the foundation for further investigation into the impact of SARS-CoV-2 mutations on disease incidence, severity, and host immune response. In addition, it may also provide insights into vaccine development and serological response detection for the virus.
Inhibition of the Otub1/c-Maf axis by the herbal acevaltrate induces myeloma cell apoptosis
Authors: Sun Tong , Xu Yujia , Xu Zhuan , Cao Biyin , Zhang Zubin , Wang Qi , Kong Yan , MAO XINLIANG
Published: May 2020

Background : The oncogenic transcript factor c-Maf is stabilized by the deubiquitinase Otub1 and promotes myeloma cell proliferation and confers to chemoresistance. Inhibition of the Otub1/c-Maf axis is a promising therapeutic target, but there are no inhibitors reported on this specific axis. Methods: A luciferase assay was applied to screen potential inhibitors of the Otub1/c-Maf axis. Annexin V staining/flow cytometry was applied to evaluate cell apoptosis. Immunoprecipitation was applied to examine protein ubiquitination and interaction. Xenograft models in nude mice were used to evaluate anti-myeloma activity. Results: acevaltrate (AVT), isolated from Valeriana glechomifolia, was identified based on a bioactive screen against Otub1/c-Maf/luciferase. AVT disrupts the interaction of Otub1/c-Maf thus inhibiting Otub1 activity and leading to c-Maf polyubiquitination and subsequent degradation in proteasomes. Consistently, AVT inhibits c-Maf transcriptional activity and downregulates the expression of its target genes key for myeloma growth and survival. Moreover, AVT displays potent anti-myeloma activity by triggering myeloma cell apoptosis in vitro and impairing myeloma xenograft growth in vivo but presents no marked toxicity. Conclusions: The natural product AVT inhibits the Otub1/c-Maf axis and displays potent anti-myeloma activity. Given its great safety and efficacy, AVT could be further developed for MM treatment.