bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification and genetic analysis of EMS-mutagenized wheat mutants conferring lesion-mimic premature aging
Authors: Kong Weiwei , Wang Liming , Cao Pei , Li Xingfeng , Ji Jingjing , Dong Puhui , Yan Xuefang , Wang Chunping , Wang Honggang , Sun Jiaqiang
Published: August 2020

Background

Lesion-mimic and premature aging (lmpa) mutantlmpa1was identified from the ethyl methane sulfonate (EMS) mutant library in the bread wheat variety Keda 527 (KD527) background. To reveal the genetic basis oflmpa1mutant, phenotypic observations and analyses of chlorophyll content and photosynthesis were carried out inlmpa1, KD527 and their F1and F2derivatives. Further, bulked segregation analysis (BSA) in combination with a 660 K SNP array were conducted on the F2segregation population oflmpa1/Chinese spring (CS) to locate thelmpa1gene.

Results

Most agronomic traits oflmpa1were similar to those of KD527 before lesion-like spots appeared. Genetic analysis indicated that the F1plants from the crossing oflmpa1and KD527 exhibited thelmpaphenotype and the F2progenies showed a segregation of normal (wild type, WT) andlmpa, with the ratios oflmpa: WT = 124:36(χ2 = 1.008 < =3.841), indicating thatlmpais a dominant mutation. The combination of BSA and the SNP array analysis of CS,lmpa1andlmpa1/CS F2WT pool (50 plants) andlmpapool (50 plants) showed that polymorphic SNPs were enriched on chromosome 5A, within a region of 30–40 Mb, indicating that the wheat premature aging geneLmpa1was probably located on the short arm of chromosome 5A.

Conclusions

EMS-mutagenized mutantlmpa1 deriving from elite wheat line KD527 conferredlmpa.Lmpaphenotype oflmpa1 mutant is controlled by a single dominant allele designated asLmpa1, which affected wheat growth and development and reduced the thousand grain weight (tgw) of single plant in wheat. The geneLmpa1was tentatively located within the region of 30–40 Mb near to the short arm of chromosome 5A.
Chronological set of E. coli O157:H7 bovine strains establishes a role for repeat sequences and mobile genetic elements in genome diversification
Authors: Stanton Eliot , Wahlig Taylor A. , Park Dongjin , Kaspar Charles W.
Published: August 2020

Background

Enterohemorrhagic Escherichia coli O157:H7 (EHEC) is a significant foodborne pathogen that resides asymptomatically within cattle and other ruminants. The EHEC genome harbors an extensive collection of mobile genetic elements (MGE), including multiple prophage, prophage-like elements, plasmids, and insertion sequence (IS) elements.

Results

A chronological collection of EHEC strains (FRIK804, FRIK1275, and FRIK1625) isolated from a Wisconsin dairy farm (farm X) comprised a closely related clade genetically differentiated by structural alterations to the chromosome. Comparison of the FRIK804 genome with a reference EHEC strain Sakai found a unique prophage like element (PLE, indel 1) and an inversion (1.15 Mb) situated symmetrically with respect to the terminus region. Detailed analysis determined the inversion was due to homologous recombination between repeat sequences in prophage. The three farm X strains were distinguished by the presence or absence of indel 3 (61 kbp) and indel 4 (48 kbp); FRIK804 contained both of these regions, FRIK1275 lacked indel 4, and indels 3 and 4 were both absent in FRIK1625. Indel 3 was the stx2 prophage and indel 4 involved a deletion between two adjacent prophage with shared repeat sequences. Both FRIK804 and FRIK1275 produced functional phage while FRIK1625 did not, which is consistent with indel 3. Due to their involvement in recombination events, direct and inverted repeat sequences were identified, and their locations mapped to the chromosome. FRIK804 had a greater number and overall length of repeat sequences than E. coli K12 strain MG1655. Repeat sequences were most commonly associated with MGE.

Conclusions

This research demonstrated that three EHEC strains from a Wisconsin dairy farm were closely related and distinguished by variability within prophage regions and other MGE. Chromosome alterations were associated with recombination events between repeat sequences. An inventory of direct and inverted repeat sequences found a greater abundance and total length of repeat sequences in the EHEC strains compared to E. coli strain MG1655. The locations of the repeat sequences were biased towards MGE. The findings from this study expand our understanding of the precise molecular events and elements that contributed to genetic diversification of wild-type EHEC in the bovine and farm environments.
Application of the thermal time model for different Typha domingensis populations
Authors: Carhuancho León Fanny Mabel , Aguado Cortijo Pedro Luis , Morató Izquierdo María del Carmen , Castellanos Moncho María Teresa
Published: August 2020

Background

Cattail (Typha domingensisPers.) is a perennial emergent plant which is used in Green Floating Filters (GFFs), one of the most innovative systems of wastewater treatment to bioremediate eutrophic waters and produce biomass as biofuel feedstocks. The establishment of cattails in GFFs depends on the seed germination and plant responses under conditions of a new habitat. This study analysed the germination responses of four different populations of cattails through a thermal time model to know their basic parameters of germination and which population would be more adapted to the conditions tested.

Results

Seeds from the Badajoz (Ba), Cuenca (Cu), Madrid (Ma), Seville (Se) and Toledo (To) populations were exposed to different thermal regimes (constant, and alternating temperatures between 15 and 30 °C) and different darkness treatments (between 0 and 20 days with 24 h dark photoperiod, then exposed to light with 12 h light/dark photoperiod) to determine the parameters of the thermal model from germination levels in each treatment.Topopulation was used to validate the thermal time parameters of other populations. Regardless of the other parameters, no germination occurred in total darkness. The mean value of base temperature (Tb) was 16.4 ± 0.2 °C in all treatments. Optimum temperature (To) values inMaandBawere 25 °C, and those inCuandSewere 22.5 °C. The germination response decreased when the temperature approached Tband increased when it was close to To. In comparison to alternating temperatures, constant temperatures had the highest germination response and lowest thermal time (θT(50)). Darkness treatments had a direct relationship with θT(50). The population origin also affected seed germination;Cuhad the highest values of Toand germination response but had a lower θT(50), which coincides with the lowest mean ambient temperatures.

Conclusion

According to these results, the germination response of cattails was high in all populations under optimal conditions but was affected to a greater or lesser extent depending on thermal regimes, darkness treatments, and populations. The thermal time model allowed us to determine that Towas between 22.5–25 °C and thatCuis the best population regarding the germination response under the conditions tested.
Flexible fibreoptic intubation in swine – improvement for resident training and animal safety alike
Authors: Ruemmler Robert , Ziebart Alexander , Ott Thomas , Dirvonskis Dagmar , Hartmann Erik Kristoffer
Published: August 2020

Background

Efficient airway management to facilitate tracheal intubation encompasses essential skills in anaesthesiologic and intensive care. The application of flexible fibreoptic intubation in patients with difficult airways has been identified as the recommended method in various international guidelines. However, providing the opportunity to adequately train residents can be challenging. Using large animals for practice during ongoing studies could help to improve this situation, but there is no recent data on fibreoptic intubation in swine available.

Methods

Thirty male German landrace pigs were anesthetized, instrumented and randomized into two groups. The animals were either intubated conventionally using direct laryngoscopy or a single-use flexible video-endoscope. The intervention was carried out by providers with 3 months experience in conventional intubation of pigs and a brief introduction into endoscopy. Intubation attempts were supervised and aborted, when SpO2 dropped below 93%. After three failed attempts, an experienced supervisor intervened and performed the intubation. Intubation times and attempts were recorded and analysed.

Results

Flexible fibreoptic intubation showed a significantly higher success rate in first attempt endotracheal tube placement (75% vs. 47%) with less attempts overall (1.3 ± 0.6 vs. 2.1 ± 1.3,P = 0.043). Conventional intubation was faster (42 s ± 6 s vs. 67 s ± 10s,P < 0.001), but showed a higher complication rate and more desaturation episodes during the trial.

Conclusions

Flexible fibreoptic intubation in swine is feasible and appears to be a safer and more accessible method for inexperienced users to learn. This could not only improve resident training options in hospitals with animal research facilities but might also prevent airway complications and needless animal suffering.
Congenital subclavian-superior vena cava arteriovenous fistula with initial stenosis in an adult: a case report
Authors: Li Geng , Hu Xingjian , Wang Yin , Chen Si
Published: August 2020

Background

A subclavian-superior vena cava arteriovenous fistula is usually acquired and secondary to trauma or operations, while congenital causes are very rare. A congenital arteriovenous fistula leads to congestive heart failure soon after birth and is typically diagnosed in early infancy.

Case presentation

We present an unusual case of a 21-year-old female suffering from new-onset heart failure at 20 years old who was diagnosed with a congenital arteriovenous fistula from the right subclavian artery to the superior vena cava (RSA-to-SVC) with stenosis at the proximal initial site of the fistula. The patient successfully underwent transcatheter occlusion for the fistula and had a significant improvement in symptoms at the 3-month follow-up.

Conclusions

An RSA-to-SVC fistula is a very rare congenital disorder that can lead to shunt-related heart failure. If there is an indication for closure, as with the patient presented, percutaneous device closure can be considered a reasonable option.
Two-stage Bayesian hierarchical modeling for blinded and unblinded safety monitoring in randomized clinical trials
Authors: Liu Junhao , Wick Jo , Martin Renee’ H. , Meinzer Caitlyn , Roy Dooti , Gajewski Byron
Published: August 2020

Background

Monitoring and reporting of drug safety during a clinical trial is essential to its success. More recent attention to drug safety has encouraged statistical methods development for monitoring and detecting potential safety signals. This paper investigates the potential impact of the process of the blinded investigator identifying a potential safety signal, which should be further investigated by the Data and Safety Monitoring Board with an unblinded safety data analysis.

Methods

In this paper, two-stage Bayesian hierarchical models are proposed for safety signal detection following a pre-specified set of interim analyses that are applied to efficacy. At stage 1, a hierarchical blinded model uses blinded safety data to detect a potential safety signal and at stage 2, a hierarchical logistic model is applied to confirm the signal with unblinded safety data.

Results

Any interim safety monitoring analysis is usually scheduled via negotiation between the trial sponsor and the Data and Safety Monitoring Board. The proposed safety monitoring process starts once 53 subjects have been enrolled into an eight-arm phase II clinical trial for the first interim analysis. Operating characteristics describing the performance of this proposed workflow are investigated using simulations based on the different scenarios.

Conclusions

The two-stage Bayesian safety procedure in this paper provides a statistical view to monitor safety during the clinical trials. The proposed two-stage monitoring model has an excellent accuracy of detecting and flagging a potential safety signal at stage 1, and with the most important feature that further action at stage 2 could confirm the safety issue.
A novel segmental absence of intestinal musculature with small intestinal stenosis: a case report
Authors: Kashiwagi Kosuke , Jimbo Keisuke , Hosoi Kenji , Miyano Go , Kudo Takahiro , Yamataka Atsuyuki , Shimizu Toshiaki
Published: August 2020

Background

Segmental absence of intestinal musculature (SAIM) is a rare cause of intestinal obstruction and perforation due to partial or complete defects in the intestinal muscularis propria in neonates and is occasionally observed in adulthood.

Case presentation

The first case of small intestinal stenosis derived from SAIM, which was difficult to differentiate from Crohn’s disease (CD), is reported. A 4-year-old girl presented with abdominal pain, anemia, and a positive fecal occult blood test. She was initially diagnosed with CD and started on treatment. Because her gastrointestinal symptoms persisted, her previous pediatricians tried to carry out capsule endoscopy, but it was not possible because the patency capsule was retained. Therefore, she was referred to our institute and re-evaluated. The patency capsule examination was repeated to re-evaluate small intestinal passage, but it stagnated again. Abdominal ultrasonography showed a poorly deformable intestinal tract that narrowed rapidly from the dilated segment and had a thin wall with an irregular laminar structure. In addition, unlike the typical ultrasonic CD findings, the power Doppler signal enhancement at the intestinal wall and “creeping fat sign” were not found. The patient was referred for laparoscopic observation to pediatric surgeons, who confirmed a prominently dilated intestinal tract 40 cm proximal to the ileocecal valve, which was resected. Histopathological findings showed longitudinal muscle hypoplasia of the resected, dilated intestinal tract and fat replacement of the muscle layer. At the stenosis site, the muscle layer was fibrotic and showed incomplete muscle arrangement. Because of these findings, she was diagnosed with SAIM. After the surgical treatment, no gastrointestinal symptoms relapsed, and the fecal occult blood test has remained negative for 2 years. Moreover, 8 months after surgery, double-balloon endoscopy showed no abnormalities, such as a longitudinal ulcer and cobblestone appearance.

Conclusions

In the present case, SAIM involved not only intestinal ileus and perforation, but also small intestinal stenosis. Although no other reports have demonstrated the usefulness of abdominal ultrasonography for the diagnosis of SAIM, the present report suggests that ultrasonography may be useful for differentiating SAIM from CD by close observation of the area around the small intestinal stenosis.
Very low risk of lymph node metastasis in Epstein-Barr virus-associated early gastric carcinoma with lymphoid stroma
Authors: Cheng Yuqing , Zhou Xiaoli , Xu Kequn , Huang Jin , Huang Qin
Published: August 2020

Background

Epstein-Barr virus-associated early gastric carcinoma with lymphoid stroma (EBV-GCLS) is a rare variant of early gastric carcinomas. Clinicopathological features of this variant remain obscure, especially in Chinese patients. Therefore, we collected EBV-GCLS cases and studied clinicopathology and prognosis.

Methods

By a retrospective review of 595 consecutive radical gastrectomies for early gastric carcinoma from 2006 to 2018, we identified 8 (1.3%, 8/595) EBV-GCLS cases. Clinicopathologic characteristics were compared between EBV-GCLSs and 109 conventional early gastric carcinomas, which were divided into intramucosal, SM1, and SM2 subgroups. The latter 2 subgroups were classified according to the submucosal invasion depth below or over 500 μm.

Results

All 8 EBV-GCLSs occurred in male patients and invaded deep submucosa (SM2) without lymph node metastasis (LNM), four (50%) of which had synchronous non-gastric malignant tumors (3 gastric gastrointestinal stromal tumors and 1 primary clear cell renal cell carcinoma), and four (50%) arose in the proximal stomach. Compared to conventional early gastric carcinomas, EBV-GCLS was significantly more frequent with SM2 invasion, poor differentiation, and synchronous non-gastric carcinoma tumor, but not with age, gender, macroscopic type, location, size, perineural invasion, lymphovascular invasion, and pathologic stage. In invasion-depth stratified comparisons in the SM2 subgroup, the frequency of LNM in EBV-GCLS was significantly lower than that in conventional early gastric carcinomas (p < 0.05) and the 5-year survival rate of patients with EBV-GCLS was better than that with conventional early gastric carcinomas in 3 subgroups (100% vs 91.5, 85.7, 83.9%, respectively), although the differences did not reach a statistically significant level due to the small sample size. Significant differences among 4 subgroups were found in tumor grade, lymphovascular invasion, LNM, pathological stage, and synchronous tumor, but not in age, gender, macroscopic type, tumor size, location, perineural invasion.

Conclusions

Even with poor differentiation and SM2 invasion, EBV-GCLS showed very low risk of LNM and may be a candidate for endoscopic therapy such as endoscopic submucosal dissection.
Screening for domestic abuse and its relationship with demographic variables among elderly individuals referred to primary health care centers of Shiraz in 2018
Authors: Hazrati Maryam , Mashayekh Maryam , Sharifi Nasrin , Motalebi Seyedeh Ameneh
Published: August 2020

Background

Elder abuse is an important public health problem. The present study was aimed to determine the rate of domestic abuse and its relationship with demographic characteristics among elderly people referred to Primary Health Care (PHC) centers in Shiraz, Iran, 2018.

Methods

This descriptive and cross-sectional study was conducted on 400 older people aged 60 years old and above who referred to 22 PHC centers of Shiraz. The data were collected using demographic characteristics questionnaire, Katz index, the domestic elder abuse questionnaire, and elder neglect checklist through face-to-face interview and observation methods. Backward linear regression model was used for analyzing the data.

Results

The results indicated that 52.5% of the participants were female and 51.8% aged 60–69 years old. A total of 159 cases (39.8%) reflected at least one form of elder abuse or neglect. The results indicated that 21% of the participants (n = 84) were abused by their own children. Care neglect was the most reported form (42.8%), followed by psychological abuse (41.3%), emotional neglect (38.8%), and financial abuse (34.3%). The most common types of neglect were motion limitations (25%) followed by the dental problems (23.8%). The results also showed a significant relationship between domestic elder abuse and level of income (p = 0.017), having a house (p = 0.028), type of perpetrator (< 0.001), and insurance status (p = 0.027).

Conclusions

The results revealed a considerable rate of domestic abuse against elderly people, causing a serious risk for their health and security.
Assessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of age
Authors: Guo Yuqi , Li Yunpeng , Liu Xukui , Cui Yi , Zhao Yingxin , Sun Shangwen , Jia Qing , Chai Qiang , Gong Gary , Zhang Hua , Liu Zhendong
Published: August 2020

Background

Statins have been recommended by several guidelines as the primary prevention medication for cardiovascular diseases. However, the benefits of statin therapy for cerebral small vessel disease (CSVD), particularly in adults ≥75 years of age, have not been fully evaluated.

Methods

We analyzed the data from a prospective population-based cohort study and a randomized, double-blind, placebo-controlled clinical trial to determine whether statin therapy might aid in slowing the progression of CSVD in adults ≥75 years of age. For the cohort study, 827 participants were considered eligible and were included in the baseline analysis. Subsequently, 781 participants were included in follow-up analysis. For the clinical trial, 227 participants were considered eligible and were used in the baseline and follow-up analyses.

Results

The white matter hyperintensities (WMH) volume, the WMH-to-intracranial volume (ICV) ratio, the prevalence of a Fazekas scale score ≥ 2, lacunes, enlarged perivascular spaces (EPVS), and microbleeds were significantly lower in the statin group than the non-statin group at baseline in the cohort study (all P < 0.05). During the follow-up period, in both the cohort and clinical trial studies, the WMH volume and WMH-to-ICV ratio were significantly lower in the statin/rosuvastatin group than the non-statin/placebo group (all P < 0.001). Statin therapy was associated with lower risk of WMH, lacunes, and EPVS progression than the non-statin therapy group after adjustment for confounders (all P < 0.05). There was no statistically significant difference in the risk of microbleeds between the statin and non-statin therapy groups (all, P > 0.05).

Conclusions

Our findings indicated that statin therapy alleviated the progression of WMH, lacunes, and EPVS without elevating the risk of microbleeds. On the basis of the observed results, we concluded that statin therapy is an efficient and safe intervention for CSVD in adults ≥75 years of age.

Trial registration

Chictr.org.cn: ChiCTR-IOR-17013557, date of trial retrospective registration November 27, 2017 and ChiCTR-EOC-017013598, date of trial retrospective registration November 29, 2017.
Physical frailty and its associated factors among elderly nursing home residents in China
Authors: Liu Weiwei , Puts Martine , Jiang Fen , Zhou Chuyi , Tang Siyuan , Chen Sanmei
Published: August 2020

Background

Evidence is scarce on the trend in prevalence of physical frailty in China; the primary purpose of this study was to identify the prevalence and correlates of physical frailty among older nursing home residents in China.

Methods

Cross-sectional study in 20 nursing homes in Changsha, China. Physical frailty was defined based on the frailty phenotype including weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Participants with at least three affected criteria were defined as being frail. Participants with one or two affected criteria were considered as pre-frail, and those with no affected criteria were considered as robust. A total of 1004 nursing home residents aged 60 and over were included in this study. A multinomial logistic regression model was used to analyze the associations of physical frailty with its potential risk factors, including age, sex, education levels, marital status, type of institution, living status, current drinking, current smoking, regular exercise, and self-reported health.

Results

The overall prevalence of physical frailty and prefrailty was 55.6, and 38.5%, respectively. The rate of physical frailty substantially increased with age, and was higher in women than in men (69.5% vs. 30.5%). The multinomial logistic regression analysis showed that older age, being women, living in a private institution, living alone or with unknown person, having no regular exercise (≤ 2 times/week), and poor self-reported health were significantly associated with increased odds of being physically frail.

Conclusion

We demonstrated physical frailty is highly prevalent among older residents in nursing homes in China, especially in women. The potential role of those associated factors of physical frailty warrant further investigations to explore their clinical application among elderly nursing home residents.
Microbial epidemiology and risk factors for relapse in gram-negative bacteria catheter-related bloodstream infection with a pilot prospective study in patients with catheter removal receiving short-duration of antibiotic therapy
Authors: Surapat Bhitta , Montakantikul Preecha , Malathum Kumthorn , Kiertiburanakul Sasisopin , Santanirand Pitak , Chindavijak Busba
Published: August 2020

Background

Infectious Diseases Society of America (IDSA) guidelines suggest 7–14 days’ duration of antibiotic treatment for uncomplicated Gram-negative bacteria (GNB) catheter-related bloodstream infection (CRBSI). The objectives of this study were to review microbial epidemiology, to determine rate and risk factors for relapse, and to compare clinical outcomes in patients receiving long- versus short-duration antibiotic therapy.

Methods

A retrospective phase 1 study was conducted between January 2010 and October 2016 to review microbial epidemiology and to determine the incidence of and risk factors for relapse in patients with GNB CRBSI, according to the IDSA guidelines diagnostic criteria. In phase 2 of the study, patients without risk factors for relapse between November 2016 and October 2017 were prospectively recruited to receive antibiotic therapy for 7 days after catheter removal. Matched patients from the retrospective phase 1 study who had received antibiotic therapy for ≥14 days were selected as a phase 2 control group to compare outcomes.

Results

In phase 1, three most common pathogens identified among 174 cases were Pseudomonas aeruginosa (22.0%), Klebsiella pneumoniae (16.7%), and Stenotrophomonas maltophilia (13.4%). Eighty-nine episodes of infection occurred while patients were receiving antibiotic therapy. Of 140 cases, the relapse rate was 6.4%. Catheter retention was the only risk factor strongly associated with relapse (odds ratio = 145.32; 95% confidence interval 12.66–1667.37, P < 0.001). In phase 2, 11 patients with catheter removal were prospectively recruited to receive short-duration therapy. The number of patients with relapse receiving long- or short-duration therapy was 1 (3%) and 0 (0%), respectively (P = 1.000).

Conclusions

For the management of patients with uncomplicated GNB CRBSI, empiric broad-spectrum antibiotic therapy with adequate coverage of P. aeruginosa should be chosen. Catheter removal should be performed to prevent relapse and shortening the duration of treatment could be considered.

Trial registration

Thai Clinical Trial Registry: TCTR20190914001. Retrospectively registered on 13 September 2019.
Leptin receptor gene polymorphisms c.668A>G and c.1968G>C in Sudanese women with preeclampsia: a case-control study
Authors: Saad Amira , Adam Ishag , Elzaki Salah Eldin G. , Awooda Hiba A. , Hamdan Hamdan Z.
Published: August 2020

Background

Leptin receptor gene (LEPR) variants may affect the leptin levels and act as a risk factor for preeclampsia. Two LEPR gene missense variants rs1137101 (c.668A>G) and rs1805094 (c.1968G>C) were investigated in Sudanese women with preeclampsia.

Methods

A matched case-control study (122 women in each arm) was conducted in Saad Abualila Maternity Hospital in Khartoum, Sudan from May to December 2018. The cases were women with preeclampsia and the controls were healthy pregnant women. Genotyping for LEPR gene variants c.668A>G and c.1968G>C was performed using polymerase chain reaction-restriction fragment length polymorphism. Logistic regression models (adjusted for age, parity, body mass index and hemoglobin level) were conducted.

Results

Genotype frequency of LEPR gene variants c.668A>G and c.1968G>C was in accordance with Hardy–Weinberg equilibrium (P > 0.05) in the controls. Allele G in LEPRc.668A>G variant was significantly more frequent in the cases compared with the controls [43.4% vs. 10.2%; OR = 6.44; 95%CI (3.98–10.40); P < 0.001]. In variant LEPRc.668A>G, genotype AG was the prevalent genotype in the cases compared with the controls, and it was significantly associated with preeclampsia risk [37.7% vs. 15.5%; AOR = 3.48; 95%CI (1.15–10.54); P = 0.027]. Likewise, the GG genotype was the second most common genotype in the cases compared with the controls, and was associated with preeclampsia risk [24.6% vs. 2.5%; AOR = 14.19; 95%CI (1.77–113.76); P = 0.012]. None of the LEPRc.1968G>C variant genotypes were associated with preeclampsia. The CC genotype was not detected in neither the cases nor the controls. The haplotype A-G 70.1% was the prevalent haplotype in this population, and it significantly protected against preeclampsia [OR = 0.14; 95%CI (0.09–0.23); P < 0.001]. However, the haplotype G-G 26.8% was significantly associated with preeclampsia risk [OR = 6.70; 95%CI (4.16–11.05); P < 0.001]. Both variants c.668A>G and c.1968G>C were in strong linkage disequilibrium (D′ = 1, r2 = 0.012).

Conclusions

Our data indicate that the rs1137101 (c.668A>G) variant and G-G haplotype may independently associate with the development of preeclampsia.
Variations in outcomes for women admitted to hospital in early versus active labour: an observational study
Authors: Miller Yvette D. , Armanasco Ashleigh A. , McCosker Laura , Thompson Rachel
Published: August 2020

Background

There is no available evidence for the prevalence of early labour admission to hospital or its association with rates of intervention and clinical outcomes in Australia. The objectives of this study were to: estimate the prevalence of early labour admission in one hospital in Australia; compare rates of clinical intervention, length of hospital stay and clinical outcomes for women admitted in early (< 4 cm cervical dilatation) or active (≥4 cm) labour; and determine the impact of recent recommendations to define early labour as < 5 cm on the findings.

Methods

We conducted a retrospective cohort study using medical record data from a random sample of 1223 women from live singleton births recorded between July 2013 and December 2015. Analyses included women who had spontaneous onset of labour at ≥37 weeks gestation whilst not a hospital inpatient, who had not scheduled a caesarean section before labour onset or delivered prior to hospital admission. Associations between timing of hospital admission in labour and clinical intervention, outcomes and hospital stay were assessed using logistic regression.

Results

Between 32.4% (< 4 cm) and 52.9% (< 5 cm) of eligible women (N = 697) were admitted to hospital in early labour. After adjustment for potential confounders, women admitted in early labour (< 4 cm) were more likely to have their labour augmented by oxytocin (AOR = 3.57, 95% CI 2.39–5.34), an epidural (AOR = 2.27, 95% CI 1.51–3.41), a caesarean birth (AOR = 3.50, 95% CI 2.10–5.83), more vaginal examinations (AOR = 1.73, 95% CI = 1.53–1.95), and their baby admitted to special care nursery (AOR = 1.54, 95% CI = 1.01–2.35). Defining early labour as < 5 cm cervical dilatation produced additional significant associations with artificial rupture of membranes (AOR = 1.41, 95% CI = 1.02–1.95), assisted vaginal birth (AOR = 1.96, 95% CI = 1.12–3.41) neonatal resuscitation (AOR = 1.73, 95% CI = 1.01–2.99) and longer maternal hospital stay (AOR = 1.21, 95% CI = 1.04–1.40).

Conclusions

Findings provide preliminary evidence that a notable proportion of labouring women are admitted in early labour and are more likely to experience several medical procedures, neonatal resuscitation and admission to special care nursery, and longer hospital stay.
Identifying predictive biomarkers of CIMAvaxEGF success in non–small cell lung cancer patients
Authors: Lorenzo-Luaces Patricia , Sanchez Lizet , Saavedra Danay , Crombet Tania , Van der Elst Wim , Alonso Ariel , Molenberghs Geert , Lage Agustin
Published: August 2020

Background

Immunosenescence biomarkers and peripheral blood parameters are evaluated separately as possible predictive markers of immunotherapy. Here, we illustrate the use of a causal inference model to identify predictive biomarkers of CIMAvaxEGF success in the treatment of Non–Small Cell Lung Cancer Patients.

Methods

Data from a controlled clinical trial evaluating the effect of CIMAvax-EGF were analyzed retrospectively, following a causal inference approach. Pre-treatment potential predictive biomarkers included basal serum EGF concentration, peripheral blood parameters and immunosenescence biomarkers. The proportion of CD8 + CD28- T cells, CD4+ and CD8+ T cells, CD4/CD8 ratio and CD19+ B cells. The 33 patients with complete information were included. The predictive causal information (PCI) was calculated for all possible models. The model with a minimum number of predictors, but with high prediction accuracy (PCI > 0.7) was selected. Good, rare and poor responder patients were identified using the predictive probability of treatment success.

Results

The mean of PCI increased from 0.486, when only one predictor is considered, to 0.98 using the multivariate approach with all predictors. The model considering the proportion of CD4+ T cell, basal Epidermal Growth Factor (EGF) concentration, neutrophil to lymphocyte ratio, Monocytes, and Neutrophils as predictors were selected (PCI > 0.74). Patients predicted as good responders according to the pre-treatment biomarkers values treated with CIMAvax-EGF had a significant higher observed survival compared with the control group (p = 0.03). No difference was observed for bad responders.

Conclusions

Peripheral blood parameters and immunosenescence biomarkers together with basal EGF concentration in serum resulted in good predictors of the CIMAvax-EGF success in advanced NSCLC. Future research should explore molecular and genetic profile as biomarkers for CIMAvax-EGF and it combination with immune-checkpoint inhibitors. The study illustrates the application of a new methodology, based on causal inference, to evaluate multivariate pre-treatment predictors. The multivariate approach allows realistic predictions of the clinical benefit of patients and should be introduced in daily clinical practice.
Transient reduction in macular deep capillary density on optical coherence tomography angiography after phacoemulsification surgery in diabetic patients
Authors: Wang Zaowen , Wang Erqian , Chen Youxin
Published: August 2020

Background

To evaluate macular microvascular changes and associated factors in diabetic patients following uncomplicated phacoemulsification surgery.

Methods

In this prospective observational study, we enrolled diabetic patients and non-diabetic controls who underwent phacoemulsification surgery. Participants were examined at postoperative day 1 (POD1), 10 (POD10), 30 (POD30), and 90 (POD90), using macular 3x3mm OCT angiography scan (RTVue-XR Avanti; Optovue, Inc., Fremont, CA). Integrated automated algorithms were used to quantify parafoveal vessel density (VD) in superficial capillary plexus (SCP) and deep capillary plexus (DCP). To minimize measurement bias, subjects with corneal edema or capsular opacity at any postoperative visit were excluded.

Results

The study included 21 eyes of 21 diabetic patients and 21 eyes of 21 non-diabetic controls. In diabetic patients, no significant change in SCP-VD could be detected (P = 0.57); DCP-VD reduced from 50.24 ± 2.33% at POD1 to 48.33 ± 3.07% at POD30 (P = 0.019), and restored to 50.74 ± 3.44% at POD90 (P = 1.00). The DCP-VD change at POD30 in diabetic patients (− 1.90 ± 2.61%) was significantly different from that in controls (1.31 ± 2.61%) (P < 0.001). The amount of DCP-VD reduction was correlated with foveal and parafoveal thickening (r = 0.431, P = 0.051 and r = 0.514, P = 0.017, respectively), high cumulative dissipated energy (P = 0.032) and increased hemoglobin A1c concentration (P = 0.037).

Conclusions

Phacoemulsification in diabetic patients caused transient reduction in DCP-VD, which was associated with poor glycemic control, surgical trauma, and postoperative macular thickening. Our results added a new dimension to our understanding of the complex biologic effects of cataract surgery in diabetic subjects.
Characteristics, fates and complications of long-term silicone oil tamponade after pars plana vitrectomy
Authors: Abu-Yaghi Nakhleh E. , Abu Gharbieh Yazan A. , Al-Amer Ahmad M. , AlRyalat Saif Aldeen S. , Nawaiseh Mohammed B. , Darweesh Mohammad J. , Alkukhun Leen R. , Abed Alaa M. , Saleh Omar A. , Ababneh Osama H.
Published: August 2020

Background

Silicone oil tamponade has become a mainstay in treatment of advanced retinal detachment due to multiple etiologies. The aim of this study is to assess the characteristics, fates and complications of long-term silicone oil tamponade after par plana vitrectomy (PPV), and to compare the outcomes of different silicone oil viscosities used in a cohort of consecutive patients.

Methods

This is a retrospective comparative case series of eyes undergoing vitrectomy with silicone oil tamponade for retinal detachment by a single surgeon using different oil viscosities that were followed for one year with the silicone oil in situ. Visual acuity (VA), intraocular pressure (IOP) and complications associated with the follow up period were analyzed and compared.

Results

Eighty-five eyes of 85 patients were included in this study. Forty three patients had 1000 centistoke (cs) oil injected and 42 patients had 5000cs oil utilized. Demographic, cause of retinal detachment and preoperative ocular characteristics were similar in both groups. Long term complications in both groups included ocular hypertension (67.4% vs 66.7%), keratopathy due to silicone oil emulsification and migration to the anterior chamber (7.0% vs 11.9%), recurrent retinal detachment (4.7% vs 19%) and epiretinal membrane formation (7% vs 19%). In the 1000cs oil group, there was no significant difference between baseline IOP and any subsequent visit. There was a significant difference between baseline IOP and visits at day 1 (with IOP difference of 2.61 mmHg (±6.5)) (p = 0.028), 1 month (with IOP difference of 3.52 mmHg (±8.1)) (p = 0.026), 4 months (with IOP difference of 6.38 mmHg (±9.3)) (p = 0.005), and one year (with IOP difference of 4.24 mmHg (±11.1)) (p = 0.048), all higher in the post-operative period in the 5000cs oil group. Excluding the first post-operative day, no significant difference was found for VA between baseline visits and subsequent visits for either silicone oil groups.

Conclusion

In this cohort of patients with long-term silicone oil tamponade after PPV to treat retinal detachment, IOP increased significantly in patients who received 5000cs silicone oil. There was no significant difference between other complication rates in patients receiving either oil viscosities. Long term silicone oil tamponade remains a viable option in certain cases, and a vigilant follow up for complications is necessary to limit any adverse effects and improve visual and surgical outcomes.
Associations between fitness levels and self-perceived health-related quality of life in community - dwelling for a group of older females
Authors: Ihász Ferenc , Schulteisz Nikolett , Finn Kevin J. , Szabó Krisztina , Gangl Judit , Nagy Dóra , Ács Pongrác , Oláh András
Published: August 2020

Background

For older adults perceived quality of life has been linked to the ability to accomplish everyday tasks, a functional capacity which is thought to be based upon physical fitness. Although there is a relationship between physical activity and quality of life in older adults, the fitness of older adults and its relationship to quality of life needs more investigation. Therefore, the purpose of this study was to examine the associations between self-reported health-related quality of life and physical fitness in community-dwelling older females.

Methods

A cross-sectional study between four different age groups in retirement villages from two different places of the southern and western region of Hungary, among 173 women between the ages of 58 and 94 years old. We measured physical fitness using the Fullerton Test protocol and self-perceived health quality of life using the Short-Form Health Survey.

Results

Group means were different in six-minute walk distance, handgrip strength, and arm curls. The youngest group of females had higher scores of fitness in these categories as compared to the oldest grouping of women. Quality of Life were also difference across age groupings although not linear across the four age categories. Moderate level positive relationship was evident between perceived physical function and certain categories of physical fitness.

Conclusions

Sociability and self-motivation has a leading role in quality of life in elder population. It is worth putting a lot more emphasis into continuous cultural, social and most importantly into physical activity programs for elderly.
A systematic review of studies that measure parental vaccine attitudes and beliefs in childhood vaccination
Authors: Dyda Amalie , King Catherine , Dey Aditi , Leask Julie , Dunn Adam G.
Published: August 2020

Background

Acceptance of vaccines is an important predictor of vaccine uptake. This has public health implications as those who are not vaccinated are at a higher risk of infection from vaccine preventable diseases. We aimed to examine how parental attitudes and beliefs towards childhood vaccination were measured in questionnaires through a systematic review of the literature.

Methods

We systematically reviewed the literature to identify primary research studies using tools to measure vaccine attitudes and beliefs, published between January 2012 and May 2018. Studies were included if they involved a quantitative survey of the attitudes and beliefs of parents about vaccinations recommended for children. We undertook a synthesis of the results with a focus on evaluating the tools used to measure hesitancy.

Results

A total of 116 studies met the inclusion criteria, 99 used a cross sectional study design, 5 used a case control study design, 4 used a pre-post study design and 8 used mixed methods study designs. Sample sizes of included studies ranged from 49 to 12,259. The most commonly used tool was the Parent Attitudes about Childhood Vaccines (PACV) Survey (n = 7). The most common theoretical framework used was the Health Belief Model (n = 25). Questions eliciting vaccination attitudes and beliefs varied widely.

Conclusions

There was heterogeneity in the types of questionnaires used in studies investigating attitudes and beliefs about vaccination in parents. Methods to measure parental attitudes and beliefs about vaccination could be improved with validated and standardised yet flexible instruments. The use of a standard set of questions should be encouraged in this area of study.
ART use and associated factors among HIV positive caregivers of orphans and vulnerable children in Tanzania
Authors: Exavery Amon , Charles John , Barankena Asheri , Kuhlik Erica , Mubyazi Godfrey M. , Tani Kassimu , Ally Amal , Minja Epifania , Koler Alison , Kikoyo Levina , Jere Elizabeth
Published: August 2020

Background

Utilization of antiretroviral therapy (ART) is crucial for better health outcomes among people living with the human immunodeficiency virus (PLHIV). Nearly 30% of the 1.6 million PLHIV in Tanzania are not on treatment. Since HIV positive status is the only eligibility criterion for ART use, it is critical to understand the obstacles to ART access and uptake to reach universal coverage of ART among PLHIV. For the caregivers of orphans and vulnerable children (OVC) LHIV and not on ART, attempts to identify them and ensure that they initiate and continue using ART is critical for their wellbeing and their ability to care for their children.

Methods

Data are from the community-based, United States Agency for International Development (USAID)-funded Kizazi Kipya project that aims at scaling up the uptake of HIV/AIDS and other health and social services by orphans and vulnerable children (OVC) and their caregivers. HIV positive caregivers of OVC who were enrolled in the USAID Kizazi Kipya project between January 2017 and June 2018 were included in this cross-sectional study. The caregivers were drawn from 11 regions: Arusha, Iringa, Katavi, Kigoma, Mara, Mbeya, Morogoro, Ruvuma, Simiyu, Singida, and Tanga. The outcome variable was ART status (either using or not), which was enquired of each OVC caregiver LHIV at enrollment. Data analysis involved multivariable analysis using random-effects logistic regression to identify correlates of ART use.

Results

In total, 74,999 caregivers living with HIV with mean age of 44.4 years were analyzed. Of these, 96.4% were currently on ART at enrollment. In the multivariable analysis, ART use was 30% lower in urban than in rural areas (adjusted odds ratio (OR) = 0.70, 95% confidence interval (CI) 0.61–0.81). Food security improved the odds of being on ART (OR = 1.29, 95% CI 1.15–1.45). Disabled caregivers were 42% less likely than non-disabled ones to be on ART (OR = 0.58, 95% CI 0.45–0.76). Male caregivers with health insurance were 43% more likely than uninsured male caregivers to be on ART (OR = 1.43, 95% CI 1.11–1.83). Caregivers aged 40–49 years had 18% higher likelihood of being on ART than the youngest ones. Primary education level was associated with 26% increased odds of being on ART than no education (OR = 1.26, 95% CI 1.13–1.41).

Conclusions

Although nearly all the caregivers LHIV in the current study were on ART (96.4%), more efforts are needed to achieve universal coverage. The unreached segments of the population LHIV, even if small, may lead to worse health outcomes, and also spur further spread of the HIV epidemic due to unachieved viral suppression. Targeting caregivers in urban areas, food insecure households, who are uninsured, and those with mental or physical disability can improve ART coverage among caregivers LHIV.
Bibliometric analysis of global scientific literature on vaccine hesitancy in peer-reviewed journals (1990–2019)
Authors: Sweileh Waleed M.
Published: August 2020

Background

Vaccine hesitancy is a growing threat to national and global health security. The current study was undertaken to provide insights into the global scientific literature on vaccine hesitancy in peer-reviewed journals.

Method

The current study was a descriptive bibliometric study. A validated search strategy on vaccine hesitancy was implemented using SciVerse Scopus. Bibliometric indicators such as (1) annual growth of publications, (2) key players, (3) research themes, (4) pathogens/diseases encountered, (5) top-cited documents, and (6) annual growth of publications stratified by world region and by age category were presented. The study period was from 1990 to 2019.

Results

Search strategy found 2791 documents. The h-index of the retrieved literature was 89. The leading journal was Vaccine (369; 13.2%%) followed by Human Vaccines and Immunotherapeutics (129; 4.6%). Authors from the USA led with 1125 (40.3%) followed by authors from Italy (234; 8.4%) and the UK (204; 7.3%). The US CDC led with 140 (5.0%) documents followed by Emory University (USA) (81, 2.9%). The list of active authors included six from the USA while the remaining were from France, Australia, and Canada. Research themes in the retrieved literature focused on influenza, human papillomavirus, and the role of parents in immunization of their children. The region of the Americas and the European region had the greatest share of publications and showed steep growth of publications lately. Vaccine hesitancy research on adolescents was most noticed after 2007 while that on children was present all the time but escalated lately. Titles/abstracts analysis indicated that 621(22.3%) documents focused on influenza, 392 (14.0%) focused on Human papillomavirus, and 292 (10.5%) focused on measles. The top-cited documents in literature published after 2015 focused on the definition and strategies to overcome vaccine hesitancy.

Conclusion

The last decade witnessed a noticeable increase in the number of publications. Influenza vaccine and parental concerns about the human papillomavirus vaccine were the main focus of the retrieved literature. Information on vaccine hesitancy needs to be collected from all countries to build a better coalition against the anti-vaccination groups. Re-building trust in vaccines requires targeting parents by providing adequate information on the vaccines.