bluuebunny/crossref_metadata_2025 huggingface dataset:
Suitability of discarded cashewnut (Anacardium occidentale) meal as replacement of soybean meal (Glycine max) in the diet of juvenile African catfish Clarias gariepinus (Burchell, 1822)
Authors: Iheanacho Stanley , Ogueji Emmanuel , Igberi Christiana , Avwemoya Fred , Amadi-Eke Akunna , Yaji Abubakar , Mbah Christian
Published: December 2019

The search for alternative protein sources in aquaculture nutrition is still trending as the use of costly traditional feed stuffs in aquaculture diet formulation is no longer sustainable. The present study investigated the effects of partial and total dietary inclusion of cashewnut meal on growth, haematology, carcass composition, serum biochemistry and intestinal histology of juvenile African catfish Clarias gariepinus (Burchell, 1822). Soybean meal (SBM) was substituted with cashewnut meal (CM) at 0, 50 and 100% in formulated fish diets. A total of 135 juveniles of C. gariepinus (30.25± 1.02 g; 16.08±0.34 cm) were randomly assigned to three dietary treatments (0, 50 and 100% CM based diets) at a stocking density of 45 fish per treatment and further randomised into triplicates of 15 fish per replicate. The feeding trial lasted for 56 days and fish were fed twice daily at 5% body weight. Statistical analysis was carried out for all the parameters evaluated in this study. Fish group fed 50% CM based diet had the best growth performance and haematological profile when compared to 100% CM fish group and the control group. Insignificant changes in serum biochemical parameters were observed in CM fed fish groups when compared to the control. Histological examination of fish intestinal morphology revealed no adverse changes in the cellular structure of mucosal layer and villi in 50% CM fed fish, while mild histo-morphological changes were observed in 100% CM fed fish group. Significant increases in villi length and weight were observed in fish group fed CM based diets when compared to the control. The findings of the present study revealed that partial replacement (50%) of soybean with cashewnut meal improved growth performance and haematological profile of C. gariepinus.
Asbestiform Minerals of the Franciscan Assemblage in California with a Focus on the Calaveras Dam Replacement Project
Authors: Bailey R. Mark
Published: December 2019

The San Francisco Bay Area is underlain by bedrock of the Franciscan Assemblage, which outcrops in numerous places. A significant portion of these outcrops consists of rock types that contain both regulated and unregulated asbestiform minerals, including ultra-mafic serpentinites, various greenstones, amphibolites, blueschist, and other schists (talc-tremolite, actinolite, etc.). These rocks are a legacy of tectonic activity that occurred on the west coast margin of the North American plate ∼65–150 MY ago during subduction of the East Pacific and Farallon plates. The Calaveras Dam Replacement Project (CDRP), located in Fremont, California, is an example of an area within the Franciscan Assemblage that is substantially underlain by metamorphosed oceanic sedimentary, mafic, and ultra-mafic rocks in a tectonic subduction zone mélange with highly disrupted relationships between adjoining rock bodies with different pressure/temperature metamorphic histories. In order to protect the health of workers and residents in the surrounding area, an extensive effort was taken to identify, categorize, and monitor the types, locations, and concentrations of naturally occurring asbestos at the site. Using a combination of geologic field observations and transmission electron microscopy, energy dispersive X-ray, and selected area electron diffraction analysis of airborne particulate and rock/soil samples, the CDRP was discovered to contain chrysotile-bearing serpentine. It also had as a range of amphibole-containing rocks, including blueschist, amphibolite schist, and eclogite, with at least 19 different regulated and non-regulated fibrous amphibole minerals identified. The extensive solid solution behavior of the amphiboles makes definitive identification difficult, though a scheme was created that allowed asbestos mineral fingerprinting of various areas of the project site.
Post-Stroke Patients with Moderate Function Have the Greatest Risk of Falls: A National Cohort Study
Authors: Wei Wycliffe Enli , De Silva Deidre Anne , Chang Hui Meng , Yao Jiali , Matchar David Bruce , Young Sherry Hsueh Yi , See Siew Ju , Lim Gek Hsiang , Wong Ting Hway , Venketasubramanian Narayanaswamy
Published: December 2019

Background
Stroke patients have increased risks of falls. We examined national registry data to evaluate the association between post-stroke functional level and the risk of low falls among post-stroke patients.
Methods
This retrospective cohort study analyzed data from national registries to examine the risk factors for post-stroke falls. Data for patients who suffered ischemic strokes and survived the index hospital admission was obtained from the Singapore National Stroke Registry and matched to the National Trauma Registry, from 2011 to 2015. The primary outcome measure was a low fall (fall height ≤0.5m). Competing risk analysis was performed to examine the association between functional level (by modified Rankin score [mRS] at discharge) and the risk of subsequent low falls.
Results
In all, 2,255 patients who suffered ischemic strokes had recorded mRS. The mean age was 66.6 years and 58.5% were men. By the end of 2015, 54 (2.39%) had a low fall while 93 (4.12%) died. After adjusting for potential confounders, mRS was associated with fall risk with an inverted U-shaped relationship. Compared to patients with a score of zero, the sub-distribution hazard ratio (SHR) increased to a maximum of 3.42 (95%CI:1.21-9.65, p=0.020) for patients with a score of 2. The SHR then declined to 2.45 (95%CI:0.85-7.12, p=0.098), 2.86 (95%CI:0.95-8.61, p=0.062) and 1.93 (95%CI:0.44-8.52, p=0.38) for patients with scores of 3, 4 and 5 respectively.
Conclusions
An inverted U-shaped relationship between functional status and fall risk was observed. This is consistent with the complex interplay between decreasing mobility (hence decreased opportunity to fall) and increasing susceptibility to falls. Fall prevention intervention could be targeted accordingly.
Prevalence and Mortality of Cryptococcal Disease in Adults with Advanced HIV in an Urban Tertiary Hospital in Sierra Leone: A Prospective Study
Authors: Lakoh Sulaiman , Rickman Hannah , Sesay Momodu , Kenneh Sartie , Burke Rachael M. , Baldeh Mamadu , Jiba Darlinda Fatmata , Tejan Yusuf Sheku , Boyle Sonia , Koroma Comfort , Deen Gibrilla Fadlu , Beynon Fenella
Published: December 2019

Background The global annual estimate for cryptococcal disease related deaths exceeds 180,000, with three fourth occurring in sub-Saharan Africa. The World Health Organization (WHO) recommends cryptococcal antigen (CrAg) screening in all HIV patients with CD4 count <100/µl. As there is no previous published study on the burden and impact of cryptococcal disease in Sierra Leone, research is needed to inform public health policies. We aimed to establish the seroprevalence and mortality of cryptococcal disease in adults with advanced HIV attending an urban tertiary hospital in Sierra Leone. MethodsA cross-sectional study design was used to screen consecutive adult (18 years or older) HIV patients at Connaught Hospital in Freetown, Sierra Leone with CD4 count below 100 cells/mm3 from January to April, 2018. Participants received a blood CrAg lateral flow assay (IMMY, Oklahoma, USA). All participants with a positive serum CrAg had lumbar puncture and cerebrospinal fluid (CSF) CrAg assay, and those with cryptococcal diseases had fluconazole monotherapy with eight weeks followed up. Data were entered into Excel and analysed in Stata version 13.0. Proportions, median and interquartile ranges were used to summarise the data. Fisher’s exact test was used to compare categorical variables. Results A total of 170 patients, with median age of 36 (IQR 30-43) and median CD4 count of 45 cells/mm3 (IQR 23-63) were screened. At the time of enrolment, 54% were inpatients, 51% were newly diagnosed with HIV, and 56% were either ART-naïve or newly initiated (≤ 30 days). Eight participants had a positive blood CrAg, giving a prevalence of 4.7% (95% CI: 2.4-9.2%). Of those with a positive CrAg, CSF CrAg was positive in five (62.5%). Five (62.5%) CrAg-positive participants died within the first month, while the remaining three were alive and established on ART at eight weeks. ConclusionA substantial prevalence of cryptococcal antigenaemia and poor outcome of cryptococcal disease were demonstrated in our study. The high mortality suggests a need for the HIV programme to formulate and implement policies on screening and pre-emptive fluconazole therapy for all adults with advanced HIV in Sierra Leone, and advocate for affordable access to effective antifungal therapies.
Quantitative Comparison of Two-dimensional and Three-dimensional Strain Measurement Using MRI Feature Tracking in Repair Fontan Patients and Normal Child Volunteers
Authors: Hu Liwei , Wang Qian , Gregory Barton P , Ouyang RongZhen , Sun Aimin , Guo Chen , Han Tongtong , Zhong Yumin
Published: December 2019

Purpose
The accuracy of 2D and 3D strain analyses was evaluated by comparing strain and cardiac function parameters in Fontan repair patients and normal child volunteers.
Methods
We retrospectively enrolled 32 patients with Fontan circulation and 32 child volunteers who had undergone clinical cardiac magnetic resonance (CMR) assessment of the dominant ventricle with a 1.5-Tesla MRI scanner. Global and regional strain (2D and 3D) of the dominant ventricle in both groups was assessed using CMR feature-tracking. Correlations between cardiac function and strain data were assessed using Pearson’s correlation coefficient values. The intraclass correlation coefficient (ICC) and coefficient of variation (CoV) were determined to evaluate repeatability and agreement.
Results: The 2D GLS showed significant differences between the Fontan repair patients and volunteers (-16.49 ± 5.00 vs. -19.49 ± 2.03; p = 0.002). The 2D GRS and 2D GCS showed no significant differences between two groups. 2D GRS: 38.96 ± 14.48 vs. 37.46 ± 7.77; 2D GCS: -17.64 ± 5.00 vs. -16.89 ± 2.96, respectively; p > 0.05). The 3D global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS) showed significant differences between the Fontan repair patients and volunteers (3D GRS: 36.35 ± 16.72 vs. 44.96 ± 9.98; 3D GLS: -8.86 ± 6.84 vs. -13.67 ± 2.44; 3D GCS: -13.70 ± 7.84 vs. -18.01 ± 1.78; p < 0.05, respectively). The ejection fraction (EF) and 3D GCS were significantly associated (r = -0.491, p = 0.004). The 3D GCS showed correlations with the indexed end-diastolic volume (EDV) (r = 0.523, p = 0.002) and indexed end-systolic volume (ESV) (r = 0.602, p < 0.001). 3D strain showed good reproducibility, with GCS showing the best inter-observer agreement (ICC=0.87 and CoV=5.15), followed by GLS (ICC=0.84 and CoV=5.36).
Conclusion:3D GCS is feasible, highly reproducible, and strongly correlated with conventional cardiac function measures. 3D GCS assessments may be useful for monitoring abnormal myocardial motion in patients with Fontan circulation.

Keywords Strain; Feature tracking; Fontan operation; Pediatric
Detection of Renal Hypoxia Configuration in Patients with Lupus Nephritis: A Primary Study Using Blood Oxygen Level‒Dependent MR Imaging
Authors: Zheng Zhengfeng , Wang Yanyan , Yan Tiekun , Jia Junya , Li Dong , Wei Li , Shang Wenya , Shi Huilan
Published: December 2019

Background Renal microstructure and function are closely associated with homeostasis of oxygenation. Analyzing renal blood oxygen level‒dependent (BOLD) magnetic resonance imaging (MRI) examination results will provide information on the biological status of the kidneys. The current study was performed to explore the hypoxia mode of the entire renal parenchyma in patients with lupus nephritis (LN). Methods Twenty-three adult patients with LN and eighteen healthy volunteers were recruited. R2* values were acquired through the use of the BOLD MRI analysis technique. The narrow rectangular region of interest was used to explore the hypoxia configuration in entire depths of renal parenchyma. Acquired sequential R2* data were fitted by using four categories of mathematic functions. The tendency of R2* data in both patients with LN and healthy volunteers was also compared through the use of repeated-measures analysis of variance. Results R2* data from the superficial cortex to deep medulla displayed two patterns, called a sharp uptrend style and a flat uptrend style. After sequential R2* data were fitted individually with the use of four mathematic formulas, the multiple-compartment Gaussian function showed the highest goodness of fit. Compared with two categories of R2* value styles, the R2* tendency of entire parenchyma in patients with LN was different from that in healthy volunteers. Conclusions Deep renal medullary oxygenation was not always overtly lower than oxygenation in superficial renal cortical zone. Renal parenchyma oxygenation manifestation could be described through the use of a Gaussian function model. The deoxygenation tolerance capability was damaged in patients with LN.
Shear Wave Elasticity by Tracing Total Nodule Showed High Reproducibility and Concordance with Fibrosis in Thyroid Cancer
Authors: Author) Myung Hi Yoo(New Corresponding , Author) Hye Jeong Kim(Former Corresponding , Choi In Ho , Park Suyeon , Kim Sang Jin , Park Hyeong Kyu , Byun Dong Won , Suh Kyoil
Published: December 2019

Background Although shear wave elastography (SWE) is reported to be useful in detecting malignant thyroid nodules, it shows a wide range of cut-off values of elasticity index (EI) in detecting malignant nodules. The cause of discrepancy remains unclear. Fibrosis of the tumors is known to increase the EI in SWE, and matching of SWE and surgical histopathology has not been fully illustrated in thyroid cancer. We aimed to evaluate the reproducibility of the new total nodular region of interest (ROI) method excluding the subjective features of focal circular ROI placement and to determine the lesion that causes the elevation of EI on SWE and on histopathology.
Methods A total of 29 thyroid cancers from 28 patients were included. We evaluated the reproducibility of EI in the new total nodular ROI using Q-Box Trace program and compared the EI in focal nodular ROI using a 3-mm circular area. We analyzed the correlation between fibrosis and EI.
Result The coefficient of variation (CV) of the intrarater assay was significantly lower in total nodular ROI than in focal nodular ROI within the image in rater 1 (1.7% vs. 13.4%, p<0.001) and in rater 2 (1.4% vs. 16.9%, p<0.001) and in different images in rater 1 (7.6% vs. 12.3%, p=0.040) and in rater 2 (7.5% vs. 19.8%, p=0.004). Moreover, CV of the interrater assay showed similar results (14.9% vs. 19%, p=0.030). Interrater intraclass correlation coefficient showed better agreement in total nodular ROI than in focal nodular ROI (0.863 vs. 0.783). The degree of fibrosis on histopathology showed significant correlations with EI (E Mean , p<0.001; E Max , p=0.027), and the location of fibrosis was concordant with the high EI area on SWE.
Conclusion Our study revealed that the new total nodular ROI method showed higher reproducibility and better agreement in intra- and interrater assay than the focal nodular ROI method, suggesting a valuable and standardized method in clinical practice. Moreover, our results showed that fibrosis in the histopathology increased EI on SWE and might lead to the discrepancy of the cut-off values in detecting thyroid cancer.
The predictive value of diaphragm ultrasound for weaning outcomes in critically ill children
Authors: Xue Yang , Zhang Zhen , Sheng Chu-Qiao , Li Yu-Mei , Jia Fei-Yong
Published: December 2019

Background: Multiple studies have shown that diaphragmatic ultrasound can better predict the outcome of weaning in adults. However, there are few studies focusing on children, leading to a lack of sufficient clinical evidence for the application of diaphragmatic ultrasound in children. The purpose of this study was to investigate the predictive value of diaphragm ultrasound for weaning outcomes in critically ill children.
Methods: The study included 50 cases whose mechanical ventilation (MV) time was >48 h, and all eligibles were divided into either the weaning success group (n = 39) or the weaning failure group (n = 11). Diaphragm thickness, diaphragmatic excursion (DE), and diaphragmatic thickening fraction (DTF) were measured in the zone of apposition. The maximum inspiratory pressure (PImax) was also recorded.
Results: The ventilatory treatment time ( P = 0.002) and length of PICU stay ( P = 0.013) in the weaning failure group was longer than the success group. Cut-off values of diaphragmatic measures associated with successful weaning were ≥21% for DTF with a sensitivity of 0.82 and a specificity of 0.81, whereas it was ≥0.86 cm H 2 O/kg for PImax with a sensitivity of 0.51 and a specificity of 0.82. The linear correlation analysis showed that DTF had a significant positive correlation with PImax in children ( P = 0.003).
Conclusions: Diaphragm ultrasound has potential value in predicting the weaning outcome of critically ill children. DTF and PImax presented better performance than other diaphragmatic parameters. However, DE has limited value in predicting weaning outcomes of children with MV.
Prevalence and Antifungal Susceptibility of Candida albicans Causing Vaginal discharge Among Pregnant Women in Lebanon
Authors: Ghaddar Nahed , Anastasiadis Elie , Halimeh Rawad , Ghaddar Ali , Dhar Rita , AlFouzan Wadha , Yusef Hoda , Chaar Mira El
Published: December 2019

Background: Vaginal candidiasis is frequently prevalent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the presence of Candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods: A total of 258 pregnant women at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 12 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results: Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42%, 41% and 17% of the women, respectively. C. albicans had significant positive associations with gestational diabetes while C. kreusi or C. glabrata had significant positive associations with gestational complications and vaginal discharge. The antifungal susceptibility tests of C. albicans isolates revealed 97.5%, 90%, 87.5% and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. Conclusion: The current study revealed high incidence of both C. albicans and non-C. albicans strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Whereas the susceptibility rates of C. albicans against AMB and VCZ were high, FCZ and ICZ proved comparatively less efficacious. The resistance profile of circulating C. albicans among pregnant women can predict the best outcome of appropriate prophylaxis or treatment of neonatal candidiasis. Vaginal candida colonization might lead to adverse neonatal outcome or gestational complications thus Candida screening as antennal follow up is advised.
Can the Pain Attitudes and Beliefs Scale be adapted for use in the context of osteoarthritis with general practitioners and physiotherapists?
Authors: O'Brien Daniel William , Bassett Sandra , Clair Valerie Wright St , Siegert Richard
Published: December 2019

Background: Conservative, first-line treatments (exercise, education and weight-loss if appropriate) for hip and knee joint osteoarthritis are underused despite the known benefits. Clinicians’ beliefs can affect the advice and education given to patients, in turn, this can influence the uptake of treatment. In New Zealand, most conservative OA management is prescribed by general practitioners (GPs; primary care physicians) and physiotherapists. Few questionnaires have been designed to measure GPs’ and physiotherapists’ osteoarthritis-related health, illness and treatment beliefs. This study aimed to identify if a questionnaire about low back pain beliefs, the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), can be adapted to assess GP and physiotherapists’ beliefs about osteoarthritis.
Methods: This study used a cross-sectional observational design. Data were collected anonymously from GPs and physiotherapists using an online survey. The survey included a study-specific demographic and occupational characteristics questionnaire and the PABS-PT questionnaire adapted for osteoarthritis. All data were analysed using descriptive statistics, and the PABS-PT data underwent principal factor analysis.
Results: In total, 295 clinicians (87 GPs, 208 physiotherapists) participated in this study. The principal factor analysis identified two factors or subscales (categorised as biomedical and behavioural), with a Cronbach’s alpha of 0.84 and 0.44, respectively.
Conclusions: The biomedical subscale of the PABS-PT appears appropriate for adaptation for use in the context of osteoarthritis, but the low internal consistency of the behavioural subscale suggests this subscale is not currently suitable. Future research should consider the inclusion of additional items to the behavioural subscale to improve internal consistency or look to develop a new, osteoarthritis-specific questionnaire.
The kinetic profile and clinical implication of SCC-Ag in squamous cervical cancer patients undergoing radical hysterectomy using the Simoa assay: a prospective observational study
Authors: Ye Shuang , Sun Xiaohua , Kang Bin , Wu Fei , Zheng Zhong , Xiang Libing , Lesénéchal Mylène , Heskia Fabienne , Liang Ji , Yang Huijuan
Published: December 2019

Background: To study the kinetic profile and clinicopathological implications of squamous cell carcinoma antigen (SCC-Ag) in cervical cancer patients who underwent surgery by a self-developed SCC-Ag single molecule assay (Simoa) prototype immunoassay. Methods: Participants were prospectively enrolled between 04/2016 and 06/2017. Consecutive serum samples were collected at five points: day 0 (the day before surgery), postoperative day 4, weeks 2-4, months 2-4 and months 5-7. In total, 92 patients and 352 samples were included. The kinetic change in SCC-Ag levels and their associations with clinicopathological characteristics were studied. Results: Simoa SCC-Ag was validated by comparison with the Architect assay. SCC-Ag levels measured by the Simoa assay were highly correlated with the Architect assay’s levels (Pearson’s correlation coefficient = 0.979, Passing-Bablok regression slope 0.894 (0.847 to 0.949), intercept -0.009 (-0.047 to 0.027). The median values for each time-point detected by the Simoa assay were 2.49, 0.66, 0.61, 0.72, and 0.71 ng/mL, respectively. The SCC-Ag levels decreased dramatically after surgery and then stabilized and fluctuated to some extent within six months. Patients with certain risk factors had significantly higher SCC-Ag values than their negative counterparts before surgery and at earlier time points after surgery, while no difference existed at the end of observation. Furthermore, although patients with positive lymph nodes had sustained higher SCC-Ag levels compared to those with negative lymph nodes, similar kinetic patterns of SCC-Ag levels were observed after surgery. Patients who received postoperative treatment had significantly higher SCC-Ag values than those with surgery only at diagnosis, while no difference existed after treatment. Conclusions: The Simoa SCC-Ag prototype was established for clinical settings. The SCC-Ag levels were higher in patients with risk factors, whereas the kinetic trend of SCC-Ag might be mainly affected by postoperative adjuvant therapy. These data indicate that the SCC-Ag level might be a good predictor for the status of cervical cancer, including disease aggressiveness and treatment response.
House-hold contact tuberculosis screening adherence and associated factors among tuberculosis patients attending at Health facilities in Gondar town, Northwest, Ethiopia
Authors: Shiferaw Dessie Alemnew , Mekonnen Habtamu Sewunet , Abate Addisu Taye
Published: December 2019

Background Contacting patients with tuberculosis have a substantial risk of developing the disease. Household contact screening has recently been recommended as a strategy to enhance case detection in high-burden countries. But there is no enough information in Gondar town regarding household contact screening practice among TB patients.Methods An institution-based cross-sectional study was conducted from March 1 to 30, 2019 on 404 tuberculosis patients attending at health facilities in Gondar Town. Epi-Info version 7 for data entry and SPSS version 20 for data analysis were used. Descriptive statistics were carried out to illustrate the means, standard deviations, and frequencies. Bivariable and multivariable logistic regression analyses were used to identify significantly associated variables with the dependent variable.Results From 412 study populations, 404 were completed the study with 98.06% response rate. The overall household contact TB screening adherence was 47.5% (95% CI: 43.1, 52.5). In the multivariable analysis, having certificate and above educational level (AOR=2.83, 95% CI:1.40,5.67), having sufficient knowledge about TB (AOR=8.26, 95% CI:4.34,15.71), being satisfied with health care service (AOR=3.26, 95% CI:1.58,6.76), health education given by health care workers (AOR=2.60, 95% CI:1.54,4.40),and having HIV/AIDS co-infection (AOR=3.54, 95% CI:1.70,7.39), were factors associated with household contact TB screening adherence.Conclusion Compared to other previous studies, the current finding was high but it was low as compared with WHO and Ethiopian Ministry of Health recommendations (all persons having TB contact should be screened). Educational status, knowledge on TB, satisfaction with delivered health care service, health education given by HCWs about TB and HIV/AIDS co-infection were factors associated with household contact TB screening practice. Thus, strengthening household TB contact screening and educational programs regarding the risk of getting TB infection from household contacts is crucial.
Acupuncture treatment on the motor area of the scalp for motor dysfunction in children with cerebral palsy: study protocol for a multicenter randomized controlled trial
Authors: Wang Jun , Shi Wei , Khiati Dhiaedin , Shi Bingpei , Shi Xiaojuan , Luo Dandan , Wang Yin , Deng Rencai , Huang Huayu , Li Jian , Yan Weili , Yang Hong
Published: December 2019

Background: Scalp acupuncture has been widely used as treatment for motor dysfunction in children with cerebral palsy in China. Previous studies have failed to provide high quality evidence to demonstrate the effectiveness of this treatment in children with cerebral palsy. No high quality randomized controlled trials on scalp acupuncture have been published. The aim of this study is to evaluate the effectiveness of jiao’ scalp acupuncture when combined with routine rehabilitation treatment versus routine rehabilitation treatment alone for motor dysfunction in children with cerebral palsy. Methods/design: This is a four-centred randomized controlled trial. One hundred cerebral palsy patients with motor dysfunction were enrolled. Patients will be allocated in a 1:1 ratio into either an acupuncture treatment group or a control group. Cerebral palsy patients in the control group will receive conventional rehabilitation treatment, whereas patients in the acupuncture group will receive a combination of scalp acupuncture and conventional rehabilitation treatment. Thirty-six treatment sessions will be performed over a 12-week period. The Gross Motor Function Measure and the Fine Motor Function Measure Scale will be assessed as the primary outcome measure. The Pediatric Evaluation of Disability Inventory, and the Cerebral Palsy Quality of Life Questionnaire for Children will be selected as secondary outcome measures. All assessments will be conducted at baseline, week 4 (treatment 12), week 8 ( treatment 24 ), week 12 (treatment 36), and week 24 (follow-up). Discussion: This is the first trial evaluating the efficacy and safety of scalp acupuncture as a treatment for motor dysfunction in children with cerebral palsy. The results of this trial are expected to provide relevant evidence demonstrating that scalp acupuncture can be used as an effective rehabilitation treatment method for improving motor dysfunction in children with cerebral palsy.
Oral cancer stem cells drive tumourigenesis through activation of stromal fibroblasts
Authors: Al-Magsoosi Mohanad J.N , Lambert Daniel W , Khurram Syed Ali , Whawell Simon A
Published: December 2019

Background: Cancer stem cells (CSC) are a subpopulation of cells within a tumour that are primarily responsible for tumour progression and resistance to therapy. Fibroblasts in the stromal tissue surrounding a tumour are also involved with its progression and fibroblast ‘activation’ is an independent prognostic marker in oral cancer. We hypothesise that CSCs can be isolated from oral cancer cell lines using functional assays and that they may drive tumour progression through communication with stromal fibroblasts. Methods: CSCs were isolated from oral cancer cell lines (H357 and SCC4) by their rapid adherence to fibronectin or resistance to cisplatin. Conditioned medium from both CSC and unsorted H357 and SCC4 cell lines were applied to cultures of NOFs for 24 hours. The gene and protein expression of the activation markers alpha smooth muscle action (αSMA) and interleukin-6 was assessed using qPCR and immunofluorescence. Expression of CSC markers and αSMA were examined in OSCC tissue using immunohistochemistry. Results: Cells isolated using both methods expressed significantly increased levels of stem cell markers CD24, CD44 and CD29 compared to unsorted cells. Adherent cells exhibited lower growth rate, higher colony forming efficiency and increased cisplatin resistance compared to unsorted cells. Conversely, the cisplatin-resistant cells adhered to fibronectin in greater numbers than unsorted cells. Expression of αSMA and IL-6 was increased in NOFs following exposure to either H357 or SCC4 CSC conditioned medium. In OSCC tissue there was a positive correlation between expression of αSMA and both CD24 and CD44. Conclusions: Rapid adherence to fibronectin and chemo-resistance effectively isolates a sub-population of cells from cell lines which show stem cell-like characteristics. Our data also suggests that factors released by CSC can activate fibroblasts towards a CAF-like phenotype, which together with evidence of correlation between markers of both in vivo, provides evidence of a mechanism by which such cells can drive tumour progression.
Laryngeal mask airway reduces incidence of post-operative sore throat after thyroid surgery compared with endotracheal tube: a single-blinded randomized controlled trial
Authors: Gong Yahong , Xu Xiaohan , Wang Jin , Che Lu , Wang Weijia , Yi Jie
Published: December 2019

Background: Sore throat is a remarkable complication after thyroid surgery with endotracheal tube (ETT). Many studies revealed that laryngeal mask airway (LMA) might reduce the incidence and severity of postoperative sore throat. However, little is known about the use of a flexible reinforced LMA (FLMA) in thyroid surgery. The purpose of this study was to explore the potential benefits of FLMA compared with ETT on postoperative sore throat. Methods:In thisprospective, single-blinded, randomized, controlled trial, ninety-six patients aged 20-80 years, scheduled for elective radical thyroidectomy under general anesthesia were enrolled. They were randomly divided into ETT group and FLMA group. All the included patients received total intravenous anesthesia (with propofol, fentanyl and rocuronium) and controlled mechanical ventilation during the surgery. Cuff pressure of ETT and FLMA were strictly controlled. Incidence and severity of postoperative sore throat, numbness and hoarseness at 1, 24, and 48 h after surgery was evaluated and compared between the two groups. Incidence and severity of buckling during extubation and the hemodynamic profile during intubation were also recorded and compared. Results:The incidence of sore throat and hoarseness was significantly lower in FLMA group than those in ETT group at 1h, 24h and 48h postoperatively, as well as the severity of sore throat. Compared to ETT group, there was a significantly lower incidence of buckling during extubation and less fluctuation of HR and BP at 1min and 3min after intubation in FLMA group. Conclusions:Patients undergoing thyroid surgery with FLMA had less postoperative laryngopharyngeal symptoms when compared with ETT. The use of FLMA also achieved less buckling during extubation and better hemodynamic profiles during intubation.
Drug related problems in admitted geriatric patients: The impact of clinical pharmacist interventions
Authors: Hailu Berhane Yohannes , Berhe Derbew Fikadu , Gudina Esayas Kebede , Gidey Kidu , Getachew Mestwat
Published: December 2019

Background: Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients are often excluded from premarketing trials that can further increase the occurrence of DRPs. This study was aimed to identify DRPs and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization.
Methods: A prospective observational study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems.
Results: A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR]=4.350, 95% C.I: 1.212-9.260, p = 0.020) and number of comorbidities (AOR=1.588, 95% C.I: 1.029-2.450, p = 0.037).
Conclusions: Drug related problems were substantially high among geriatric inpatients. Geriatric patients with polypharmacy and comorbidities need special attention to prevent drug related problems. Involving clinical pharmacist in the clinical team resulted in the improved acceptance rate of treatment optimization.
Characterizing the ribosomal tandem repeat and its utility as a DNA barcode in lichen-forming fungi
Authors: Bradshaw Michael , Grewe Felix , Thomas Anne , Harrison Cody H. , Lindgren Hanna , Muggia Lucia , Clair Larry L. St. , Lumbsch H. Thorsten , Leavitt Steve
Published: December 2019

Background: Regions within the nuclear ribosomal operon are a major tool for inferring evolutionary relationships and investigating diversity in fungi. In spite of the prevalent use of ribosomal markers in fungal research, central features of nuclear ribosomal DNA (nrDNA) evolution are poorly characterized for fungi in general, including lichenized fungi. The internal transcribed spacer (ITS) region of the nrDNA has been adopted as the primary DNA barcode identification marker for fungi. However, little is known about intragenomic variation in the nrDNA in symbiotic fungi. In order to better understand evolution of nrDNA and the utility of the ITS region for barcode identification of lichen-forming fungal species, we generated nearly complete nuclear ribosomal operon sequences from nine species in the Rhizoplaca melanophthalma species complex using short reads from high-throughput sequencing.
Results: We estimated copy numbers for the nrDNA operon, ranging from nine to 48 copies for members of thiscomplex, and found low levels of intragenomic variation in the standard barcode region (ITS). Monophyly of currently described species in this complex was supported in phylogenetic inferences based on the ITS, 28S, IGS, and some intronic regions; however, a phylogenetic inference based on the 18S provided much lower resolution. Phylogenetic analysis of concatenated ITS and intergenic spacer sequence data generated from 496 specimens collected worldwide revealed previously unrecognized lineages in the nrDNA phylogeny.
Conclusions: The results from our study support the general assumption that the ITS region of the nrDNA is an effective barcoding marker for fungi. For the R. melanophthalma group, the limited amount of potential intragenomic variability in the ITS region did not correspond to fixed diagnostic nucleotide position characters separating taxa within this species complex. Previously unrecognized lineages inferred from ITS sequence data may represent undescribed species-level lineages or reflect uncharacterized aspects of nrDNA evolution in the R. melanophthalma species complex.
Impact of omega-3 fatty acid oral therapy on healing of chronic venous leg ulcers in older adults: study protocol for a randomized controlled single-center trial
Authors: McDaniel Jodi , Rausch Jamie , Tan Alai
Published: December 2019

Background This trial addresses the global problem of chronic venous leg ulcers (CVLUs), wounds that cause significant infirmity for an estimated 9.7 million people annually - mainly older adults with comorbidities. Advanced therapies are needed because standard topical therapies are often ineffective or yield only short-term wound healing. Thus, we are testing a new oral therapy containing the bioactive elements of fish oil, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), for targeting and reducing the high numbers of activated polymorphonuclear leukocytes (PMN) in wound microenvironments that keep CVLUs “trapped” in a chronic inflammatory state.Methods This double-blind RCT will include 248 eligible adults ≥ 55 years of age with CVLUs receiving standard care at a large Midwest outpatient wound clinic. Participants are randomized to 2 groups: 12 weeks of daily oral therapy with EPA+DHA (1.87 g/d of EPA + 1.0 g/d of DHA) or daily oral therapy with placebo. At 0, 4, 8 and 12 weeks, across the 2 groups, we are pursuing three specific aims: Aim 1. Compare levels of EPA+DHA-derived lipid mediators, and inflammatory cytokines in blood and wound fluid; Subaim 1a. Compare inflammatory cytokine gene expression by PMNs in blood; Aim 2. Compare PMN activation in blood and wound fluid, and PMN-derived protease levels in wound fluid; Aim 3. Compare reduction in wound area, controlling for factors known to impact healing, and determine relationships with lipid mediators, cytokines and PMN activation. Subaim 3a. Compare frequency of CVLU recurrence and levels of study variables in blood between randomly assigned 2 subgroups (continuing EPA+DHA therapy versus placebo therapy beyond Week 12) within the EPA+DHA group with healed CVLUs after 3 months of therapy. Subaim 3b. Compare symptoms of pain at all time points and quality of life at first and last time points across the 2 groups and 2 subgroups.Discussion This trial will provide new evidence about the effectiveness of EPA+DHA oral therapy to target and reduce excessive PMN activation systemically and locally in patients with CVLUs. If effective, this therapy may facilitate healing and thus be a new adjunct treatment for CVLUs in the aging population.
Effect of prior receipt of antibiotics on the pathogen distribution: a retrospective observational cohort study on 27 792 patients
Authors: Li Leiqing , Xu Lingcheng , Zhu Rongsheng , Song Jiaojiao , Wang Xuanding
Published: December 2019

Background: There have been no systematic studies of microbiological differences before and after antibiotics treatment. The aim of this study was to evaluate the effect of prior receipt of antibiotics on the microorganism distribution. Methods: A retrospective, observational cohort study was conducted in a 3 200-bed tertiary, referral, teaching hospital in eastern China. During a 2-year period, all hospitalized patients treated with antimicrobial agents were enrolled in this study. Among 48 692 patients evaluated, the 27 792 (57.1%) who were sampled within two days before or after administration of the first dose of antimicrobial agents were included. Distribution of clinical specimens and the microorganism were compared between before and after antibiotic drug treatment groups. Results: Compared to specimens taken after antibiotics exposure, specimens taken before antibiotics exposure had a higher proportion of blood and urine specimens and a higher culture positive rate (all P<0.001). Higher percentages of Staphylococcus aureus (9.9% vs. 8.5%, P=0.041), non-fermenting bacteria (27.7% vs. 19.9%, P<0.001), and fungi 8.4% vs. 4.0%, P<0.001) were isolated from the group after antibiotics exposure, while the percentages of Streptococcus spp. (4.8% vs. 2.7%, P<0.001), Haemophilus influenzae (2.3% vs. 0.8%, P<0.001), and Moraxella catarrhalis (0.7% vs. 0.1%, P<0.001) were higher in the group before antibiotics exposure. Further analysis found significant differences of microbes derived from respiratory secretions, blood or urine samples. We found, after antibiotics exposure, the separation rate of non-fermenting bacteria was significantly increased (all P < 0.05), and the separation rate of Candida spp. was higher, with statistical significance in airway secretion and urine samples (both P < 0.05), but the separation rate of Staphylococcus aureus among the three groups was not affected by antibiotics. In addition, the isolation rate of Streptococcus spp. in blood and urine samples decreased significantly (both P < 0.05) after antibiotics exposure. Interestingly, no statistical difference was found for microbes isolated from body fluid specimens between the two groups. Conclusions: The outcome revealed that antibiotic-insensitive organisms such as non-fermentative bacteria and fungi were more frequently isolated after antibiotics exposure. However, this trend might be specimen dependent and was not obvious in body fluid specimens.
Aspirin Decreases Hepatocellular Carcinoma Risk in Hepatitis C Virus Carriers: A Nationwide Cohort Study
Authors: Liao Yen-Hsiang , Hsu Ren-Jun , Wang Tzu-Hwei , Wu Chen-Ta , Huang Sheng-Yao , Hsu Chung-Y. , Su Yuan-Chih , Hsu Wen-Lin , Liu Dai-Wei
Published: December 2019

Background Aspirin has been found to lower the occurrence rates of some cancers through the inhibition of the cyclooxygenase enzyme. For example, there is a well-known association between aspirin use and the occurrence of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) carriers. However, the association, if any, between aspirin use and HCC in hepatitis C virus (HCV) carriers is unknown. Therefore, this study compared the occurrence rates of HCC in HCV carriers treated with or without aspirin. Methods The participants in this retrospective cohort study consisted of people newly diagnosed with HCV in Taiwan from 2000 to 2012. Those who were treated with aspirin were defined as the control group, whereas those not treated with aspirin were defined as the comparison cohort. We used a 1:1 propensity score matching by age, sex, comorbidities, drugs, diagnosis year, and index year with covariate assessment. Results Our study sample consisted of 2980 aspirin-treated HCV carriers and 7771 non-aspirin-treated HCV carriers. After propensity score matching, each cohort consisted of 1911 HCV carriers. The adjusted hazard ratio (aHR) of HCC incidence in the aspirin users (aHR=0.56, 95% CI=0.43-0.72, p < 0.001 ) was significantly lower than that in the non-aspirin users. A Kaplan-Meier analysis showed that among the HCV carriers, the aspirin users had a lower cumulative incidence rate of HCC over the first 10 years of aspirin treatment ( p < 0.0001 ). Conclusions The HCC incidence rate was lower in the aspirin-using HCV carriers than in the non- aspirin-using HCV carriers, indicating that the effects of aspirin might occur through inhibition of the cyclooxygenase enzyme pathway. Moreover, protection from HCC was provided by less than a year of aspirin treatment, while treatment with aspirin for 1 to 2 years exhibited the greatest protective effect. We therefore encourage aspirin treatment to prevent HCC in HCV carriers.
Functional expression of a novel methanol-stable esterase by Geobacillus subterraneus DSM13552 for biocatalytic synthesis of cinnamyl acetate in a solvent-free system
Authors: Cai Xianghai , Lin Lin , Shen Yaling , wei wei , Wei Dong-zhi
Published: December 2019

Background: Esterases are widely distributed in nature and have important applications in medical, industrial and physiological. Recently, the increased demand for flavor esters has prompted the search of catalysts like lipases and esterases. Esterases from thermophiles also show thermal stability at elevated temperatures and have become enzymes of special interest in biotechnological applications. Although most of esterases catalyzed reactions are carried out in toxic and inflammable organic solvents, the solvent-free system owning many advantages such as low cost and easy downstream processing. Results: The gene estGSU753 from Geobacillus subterraneus DSM13552 was cloned, sequenced, and overexpressed into Escherichia coli BL21 (DE3). The novel gene has an open reading frame of 753 bp, and encoding 250-amino-acid esterase (EstGSU753). The sequence analysis showed that the protein contains a catalytic triad formed by Ser97, Asp196, and His226, and the Ser of the active site is located in the conserved motif Gly95-X-Ser97-X-Gly99 included in most esterases and lipases. The protein catalyzed the hydrolysis of p-nitrophenyl esters of different acyl chain lengths, and the enzyme specific activity was 70 U/mg with the optimum substrate p-nitrophenyl caprylate. The optimum pH and temperature of the recombinant enzyme were 8.0 and 60°C respectively. The resulting EstGSU753 showed remarkable stability against methanol. After the incubation at 50% methanol for 9 days, EstGSU753 retained 50% of its original activity. Even incubation at 90% methanol for 2100 minutes, EstGSU753 retained 50% of its original activity. Also, the preliminary study of the transesterification shows the potential value in synthesis of short-chain flavor esters in a solvent-free system, and more than 99% conversion was obtained in 6 h (substrate: cinnamyl alcohol, 1.0 M). Conclusions: This is the first report of esterase gene cloning from Geobacillus subterraneus with detailed enzymatic properties. This methanol-stable esterase showed potential value in industrial applications especially in the perfume industry.