bluuebunny/crossref_metadata_2025 huggingface dataset:
Mapping of Female Breast Cancer Incidence and Mortality Rates to Socioeconomic Factors: From Univariate Analysis to Path Diagram Analysis
Authors: Peng Qiongle , Ren Xiaoling , Cui Bing , Cui Henggui
Published: September 2020

PURPOSE: Breast cancer is the leading cause of death in females around the world. Its occurrence and development has been linked to genetic factors, living habits and health conditions, but also by socioeconomic factors. Comparisons of incidence and mortality rates of female breast cancer are useful approaches to define cancer-related socioeconomic disparities. METHODS: International Agency for Research on Cancer's CANCERMondial clearinghouse was used to determine the incidence and mortality rates of female breast cancer data from several developed countries for 1980–2012. We subsequently investigated the effects of socioeconomic factors on breast cancer incidence and mortality rates by regression methods from univariate analysis to path diagram analysis. RESULTS: The relationship between socioeconomic factors and the occurrence and development of breast cancer did not follow a monotonic function. We found a positive, significant association of national public wealth (GDP) on the incidence and mortality of breast cancer. The path coefficients in the structuralequations model are -0.51 and -0.39, respectively. In addition to the significant relationship between individual physical and psychological characteristics, social pressure, such as unemployment rate (UR) has a significant impact on the incidence and mortality of breast cancer. The path coefficients in the structural equations model are all 0.2. The path coefficients of individual economic wealth to the incidence rate and mortality rate of breast cancer is 0.18 and 0.27, respectively. CONCLUSIONS: A significant statistical relationship between the socioeconomic development and the crude rates of female breast cancer was shown in this study. The incidence and mortality rates of breast cancer can be regulated effectively by a moderate increase in GDP, and clearly was affected by the individual’s economic wealth (GDPPC). In addition, the influence of social pressure (e.g., unemployment rate) on the incidence and mortality of breast cancer was not typical monotonous. The survival rate of breast cancer determined by the ratio of mortality rate to incidence rate also showed a similar pattern with socioeconomic factors.
Multi-State Analysis of the Impact of Childhood Starvation on the Healthy Life Expectancy of the Elderly in China
Authors: dong huiling , Wu Bingyi , Wu Qunhong
Published: September 2020

Background: Child malnutrition is not only common in developing countries, but also an important issue faced by developed countries. This study aimed to explore the influence and degree of childhood starvation on the health of the elderly population, which providing a reference for formulating health-related policies under the concept of full-life cycle health. Methods: Based on CLHLS longitudinal data in 2008, 2011 and 2014, this paper took a total of 13,185 elderly people aged 65-99 years as the target population. By IMaCH software, with age, gender, and income level as the control variables, and the healthy life expectancy of the elderly in China was measured. The[test was used to explore the differences in socio-economic status of elderly people with or without starvation in childhood. The paired t test was used to analyze the difference both of healthy life expectancy and healthy life expectancy proportion accounted for remaining life. Results: (1) Transition probabilities in health-disability, health-death and disability-death(P<0.05) all showed an upward trend with age, where the elderly who experienced starvation in childhood were higher than those without such an experience. However, the probability of disability-health recovery showed a downward trend with age, whereas the elderly who experienced starvation in childhood were lower than those without starvation(P<0.05).(2) For the elderly who experienced starvation in childhood, the health indicators of the average life expectancy, healthy life expectancy, and healthy life expectancy proportion accounted for the remaining life were lower than those of the elderly without childhood starvation (P<0.05).Conclusions: The negative impact of childhood starvation on health through the life course till old age, has a persistent negative cumulative effect on the quantity and quality of life for the elderly population; Therefore, it is important to pay attention to the nutritional status of children in poor families from the perspective of social policy-making.
Interventions to Prevent Anastomotic Leak After Esophageal Surgery: A Systematic Review and Meta-Analysis
Authors: Grigor Emma Jayne Myfanwy , Kaaki Suha , Fergusson Dean A , Maziak Donna E , Seely Andrew J E
Published: September 2020

Background: Anastomotic leakage (AL) is a common and serious complication following esophagectomy. We aimed to provide an up-to-date review and critical appraisal of interventions designed to reduce AL risk.Methods: We searched MEDLINE and Embase from 1946 to January 2019 for randomized controlled trials (RCTs) evaluating interventions to minimize esophagogastric AL. Pooled risk ratios (RR) for AL was performed using random effects. Results: Two reviewers screened 441 abstracts and identified 17 RCTs eligible for inclusion; 11 studies were meta-analyzed. Omentoplasty reduced the risk of AL significantly by 78% [RR: 0.22; 95% CI: 0.10, 0.50] compared to no omentoplasty (3 studies, n=611 patients). Early removal of NG tube reduced AL risk significantly by 88% [RR: 0.12; 95% CI: 0.02, 0.65] compared to prolonged NG tube (2 studies, n=293 patients); Stapled (vs. hand-sewn) anastomosis did not significantly reduce AL risk [RR: 0.92; 95% CI: 0.45, 1.87] compared to hand-sewn (6 studies, n=1454 patients). The quality of evidence was high for omentoplasty (vs. no omentoplasty), moderate for early removal of NG tube (vs. conventional removal), and very low for stapled anastomosis (vs. hand-sewn). Conclusions: This is the first meta-analysis to summarize the graded quality of evidence for all RCT interventions designed to reduce AL following esophagectomy. Our findings demonstrated that omentoplasty reduced the risk of AL with a high quality of evidence. Although early nasogastric tube removal reduced AL risk, there is a need for further research to strengthen the quality of evidence. Evidence profiles presented in our review may help inform the development of clinical practice recommendations.Systematic review registration: CRD42019127181
Interlayer-Exciton Based Nonvolatile Valleytronic Memory
Authors: Ye Tong , Shen Hongzhi , Ren Junwen , Li Dehui
Published: September 2020

Analogous to conventional charge-based electronics, valleytronics aims at encoding data via valley degree of freedom, enabling new routes for information processing. Long-lived interlayer excitons (IXs) in van der Waals heterostructures (HSs) stacked by transition metal dichalcogenides (TMDs) carry valley-polarized information and thus would find promising applications in valleytronic devices. Although great progress of IX based valleytronic devices has been achieved, nonvolatile valleytronic memories are still challenging. Here, we demonstrate IX based nonvolatile valleytronic memory in a WS2/WSe2 HS. The emission characteristics of IX exhibit a large excitonic/valleytronic hysteresis upon cyclic-voltage sweeping. Importantly, IX emission can be electrically switched between a bright state and a dark state with large light-intensity and helicity contrast of about 1.7 and 1.8, respectively, which can be ascribed to the chemical-doping of O2/H2O redox couple between TMDs and substrate. Taking advantage of the large hysteresis, IX can be utilized for manipulating and nonvolatile storing valley information and IX based nonvolatile valleytronic memory has been successfully demonstrated. These findings open up an avenue for nonvolatile valleytronic memory and would motivate more investigations on valleytronic devices.
A pilot study of the effect of improved hygiene kits on handwashing with soap among internally displaced persons in Ethiopia.
Authors: Thorseth Astrid Hasund , Heath Tom , Sisay Andualem , Hamo Mare , White Sian
Published: September 2020

Background Internally displaced persons (IDPs) forced to flee from their homes due to conflict and drought are at particular risk of morbidity and mortality due to diarrhoeal diseases. Regular handwashing with soap could substantially reduce the risk of these infections, but the behaviour is challenging to practice routinely while living in resource-poor, informal settlements. To mitigate these challenges, humanitarian aid organisations distribute hygiene kits including soap and handwashing infrastructure. Our study aimed to assess the effect of improved kits on handwashing behaviours among IDPs in Moyale, Ethiopia. Methods The pilot study evaluated three interventions separately; liquid soap, a good quality scented bar soap and a mirror as additions to a regular hygiene kit. The kit was distributed to all study groups, with 3 of the study groups receiving one of the interventions each. Three to six weeks after distribution, behaviour change was assessed through structured observations, surveys and focus group discussions. Results Handwashing with soap was rare at key times both in all study groups. In the group that received liquid soap, handwashing with soap was seen at 20% of key times. In the control arm this was 17%, while in the two other intervention arms prevalence was <11%. Both quantitative and qualitative data collection indicated that liquid soap encourages handwashing with soap at key times. The good quality scented bar soap and mirror were not found to have an observed effect on behaviour but were viewed as desirable by participants who also reported that the standard bar soap distributed in hygiene kits was not nice to use. Conclusion This study was to our knowledge the first randomised intervention study on handwashing among IDPs living in a non-camp setting. The study shows that improved kits have potential to make handwashing more desirable and easier to practice, and further research including formative assessments prior to the design of hygiene kits should be conducted to ensure maximal uptake. The challenges of doing research in conflict-affected regions had considerable implications on the design and implementation of this study.Trial registration The trial was registered at www.ClinicalTrials.gov 6 September 2019 (reg no: NCT04078633)
“A Four-Leaf Clover” Sign for Rapid Identification of Coagulase-Negative Staphylococci by Gram Staining From Positive Blood Culture: A Cross-Sectional Study
Authors: Matsuo Takahiro , Hayashi Kuniyoshi , Sakurai Aki , Shimizu Masumi Suzuki , Morimoto Masaya , Uehara Yuki , Mori Nobuyoshi
Published: September 2020

Background: Coagulase-negative staphylococci (CoNS) are one of the most common contaminant microorganisms isolated from blood cultures. Few studies exploring the use of Gram staining to distinguish between Staphylococcus aureus (SA) and CoNS have been reported. Here, this study aimed to explore whether morphological features of Gram staining could identify SA or CoNS.Methods: This study was conducted at St. Luke’s International Hospital from November 2016 to September 2017. The positive blood cultures for which the Gram staining showed gram-positive cocci (GPC) in clusters were included in our study. The direct smear of Gram staining obtained from positive blood culture bottles were examined within 24 hours of positivity. We have identified and characterized the following two signs: “four-leaf clover (FLC)” if 4 GPC gathered like a planar four-leaf clover and “grapes” if the GPC gathered like grapes in a three-dimensional form. The number of fields with FLC and grapes signs in 10 fields per slide with ×1,000 power was counted, and the results in a total of 20 fields with ×1,000 power were combined. We performed a logistic regression analysis to assess whether these signs could serve as factors distinguishing between SA and CoNS. The predictive ability of these signs was evaluated based on the sensitivity, specificity, positive predictive value, and negative predictive value for CoNS via receiver operating curve analysis.Results: In total, 106 blood cultures for which Gram staining showed GPC in clusters were examined; 46 (43%) were SA, and 60 (57%) were CoNS samples. The result of multivariate logistic regression analysis showed that the FLC sign was a statistically significant marker of CoNS with an odds ratio of 1.31 (95 % confidential interval (CI): 1.07–1.61, p<0.05). In aerobic bottles, sensitivity, specificity, positive predictive value, and negative predictive value for CoNS were 0.67, 0.91, 0.92, and 0.65, respectively, and the value of area under the curve was 0.79 (95% CI: 0.67–0.91).Conclusions: To our knowledge, this is the first study to show that the FLC could be a rapid and useful indicator to identify CoNS in aerobic bottles. Thus, the presence of FLC sings could help clinicians to suspect the possibility of CoNS before the final identification by cultures.
Comparison of laparoscopic pyelolithotomy and retrograde intrarenal surgery in the management of large renal pelvic stone
Authors: Cicek Mehmet Cagatay , Asi Tariq , Gunseren Kadir Omur , Kilicarslan Hakan
Published: September 2020

Background To compare the clinical outcomes of laparoscopic pyelolithotomy (LP) and retrograde intrarenal surgery (RIRS) in the management of large renal pelvic stones. Methods This study included patients who presented with a single renal pelvic stone sized ≥20 mm and who were treated primarily by laparoscopic pyelolithotomy or retrograde intrarenal surgery. The patients were grouped based on the surgical procedure they underwent. We retrospectively examined and compared the age, the longest axis and the surface area of the stone, operation time, hospitalization time, complications and stone-free rates of the two groups. Results Of the 156 patients included in the study, 44 had laparoscopic pyelolithotomy, and 112 had retrograde intrarenal surgery. Patients who received laparoscopic pyelolithotomy (13 males, 31 females) had a median age of 54 (18-79) years, while those who underwent retrograde intrarenal surgery (46 males, 66 females) had a median age of 54.5 (18-79). Patients who received laparoscopic pyelolithotomy were found to have larger median stone size (30 mm vs 24 mm, p=0.003), longer operation time (100 minutes vs 70 minutes, p=0.007), lower complication rate (2% vs 8.9%, p=0.063), longer median hospital stay (3 days vs 1 day, p<0.001) and better stone-free rate at the third month (90.9% vs 67.9%, p<0.001). Conclusion LP is a safe and efficient procedure that could be used as an alternative to retrograde intrarenal surgery in managing large renal pelvic stones.
Parasite Genetic Diversity Reflects Continued Residual Malaria Transmission in Vhembe District, A Hotspot in the Limpopo Province of South Africa
Authors: Gwarinda Hazel B. , Tessema Sofonias K. , Raman Jaishree , Greenhouse Bryan , Birkholtz Lyn-Marié
Published: September 2020

Background: South Africa aims to eliminate malaria transmission by 2023. However, despite sustained vector control efforts and case management interventions, the Vhembe District in the Limpopo Province remains a malaria transmission hotspot. To better understand Plasmodium falciparum transmission dynamics in the area, this study characterised the genetic diversity of parasites circulating within the Vhembe District.Methods: A total of 1153 falciparum-positive rapid diagnostic tests (RDTs) were randomly collected from seven clinics within the district, over three consecutive years (2016, 2017 and 2018) during the wet and dry malaria transmission seasons. Parasite genomic material was isolated from the RDTs and parasite genetic diversity was characterised using 26 neutral microsatellite markers. Differences in genetic diversity were described using a multiparameter scale of multiplicity of infection (MOI), within-host diversity metric (Fws), number of unique alleles (A), expected heterozygosity (He), multilocus linkage disequilibrium (LD) and genetic differentiation (Wright's F-statistic, FST), and were associated with temporal and geospatial variances. Results: A total of 747 (65%) samples were successfully genotyped. High genetic diversity (mean heterozygosity, He = 0.74 ± 0.03) was observed in the parasite population. This was ascribed to high allelic richness (mean A = 12.2 ± 1.2). The majority of samples (99%) had unique multi-locus genotypes, indicating high genetic diversity in the sample set. Complex infections were observed in 66% of samples (mean MOI = 2.13 ± 0.04), with 33% of infections showing high within-host diversity as described by the Fws metric. Low, but significant LD (standardised index of association, ISA = 0.08, P < 0.001) was observed that indicates recombination of distinct clones. Limited impact of temporal (FST range -0.00005 to 0.0003) and spatial (FST = –0.028 to 0.023) variation on genetic diversity existed during the sampling timeframe and study sites respectively. Conclusion: Consistent with the Vhembe District’s classification as a 'high' transmission setting within South Africa, P. falciparum diversity in the area was high and complex. This study showed that genetic diversity within the parasite population reflects the continued residual transmission observed in the Vhembe District. This finding, together with continued surveillance of P. falciparum genetic diversity in South Africa, may influence future intervention strategies by targeting the parasite to decrease transmission intensity for the country to achieve its elimination goals.
Structure of Vaginal Microbiome Community After Perineal Disinfection and Its Effects on Neonatal Oral Microbiome
Authors: Li Hongping , Nie Chuan , Xiao Bin , Chen Shaoyun , Yu Jieyang , Zhu Yuanfang
Published: September 2020

Background: Vaginal microbiota is not only an important source of bacterial colonization for neonates, but also plays a key role in maternal and neonatal health. In China, povidone iodine is used to disinfect vaginal during delivery. To date there has been no comprehensive study to investigate the vaginal microbiome composition after disinfection.Results: In this study, 27 women were recruited from Bao an Maternal and Child Health Hospital (Shenzhen, China). Vaginal samples before and after delivery were collected. Neonatal oral samples were also collected right after birth. Bacterial compositions of these study subjects were investigated using 16S rRNA sequencing of V3-V4 hyper-regions based on Hiseq 2500 platform. The results showed that vaginal microbiome during pregnancy were dominated by Lactobacillus spp. The identified microbiomes were separated into three community state types (CSTs), and a new CST (dominated by L. helveticus) was observed in this study. After disinfection, the relative abundance of Lactobacillus decreased and alpha diversity increased significantly. Moreover, most CST III and CST VI during pregnancy, both them dominated by Lactobacillus, shifted to CST IV in vaginal samples after disinfection. Additionally, the similar change pattern was observed in neonatal oral microbiome, and they overlapped with vaginal samples after disinfection in NMDS analysis.Conclusions: Perineal disinfection resulted in the decrease of genus Lactobacillus and increase of alpha diversity both in maternal vaginal microbiome and neonatal oral microbiome. In further, it is vital to understand the influence on maternal and neonatal health of vaginal microbiome community structure change after disinfection.
Rapid Detection of Toxoplasma gondii: Prevalence Investigation of T. gondii Infection Among Stray Cats and Dogs in Zhejiang Province Based on a New Loop-Mediated Isothermal Amplification-Lateral-Flow-Dipstick (LAMP-LFD) Device
Authors: Xue Yangji , Lu Shaohong , Kong Qingming , Ding Haojie , Ding Jianzu , Zheng Bin , Tong Qunbo , Zhuo Xunhui , Xie Chengzuo , Lou Di , Lv Hangjun
Published: September 2020

Background: Toxoplasma gondii (T. gondii) is worldwide spread caused Toxoplasmosis threatening warm-blooded animal and human health, especially for immunodeficient population and pregnant women. Simple and applicable diagnostic methods are urgently needed for the prevention of toxoplasmosis. The molecular diagnosis of T. gondii infection generally requires high technical skills, sophisticated equipment and a controlled lab environment.Methods: In this study, we developed a loop-mediated isothermal amplification-lateral-flow-dipstick (LAMP-LFD) assay that specifically targets the 529 bp for the detection of T. gondii infection in a new kind of portable device, which is universal, fast, user-friendliness, experimental sensitivity and low risk of aerosol contamination. Results: The detection limit of the LAMP-LFD assay is 1 fg of T. gondii DNA and no cross-reaction with other parasitic pathogens including Leishmania donovani, Plasmodium vivax, Cryptosporidium parvum, etc. In total, 318 stray cat and dog blood samples were collected from Deqing, Wenzhou, Yiwu, Lishui and Zhoushan cities in Zhejiang province, Eastern China. The current infection prevalence of T. gondii was 4.76% and 4.69% in stray cats and dogs respectively, detected by LAMP-LFD device.Conclusions: In conclusion, the established LAMP-LFD was an efficient and avoidable aerosol-contaminated device that can detect 1 fg genomic DNA of T. gondii, and suitable for T. gondii detection in the basic medical institution and even in field areas.
MiR-30c regulates metastasis and polarity reversal of tumor cell clusters by targeting MTDH in invasive micropapillary carcinoma of the breast
Authors: Han Yunwei , Li Weidong , Zhi Renyong , Ma Gui , Gao Ang , Wu Kailiang , Song Yawen , Sun Hui , Zhao Dan , Yang Yiling , Liu Fangfang , Gu Feng , Guo Xiaojing , Dong Jintang , Li Shuai , Fu Li
Published: September 2020

Purpose

Invasive micropapillary carcinoma (IMPC) of the breast has a high propensity for lymphovascular invasion and axillary lymph node metastasis and displays an ‘inside-out’ growth pattern, but the molecular mechanism of metastasis and tumor cell polarity reversal in IMPC is unclear.
Methods and Patients:

Luciferase reporter assays and western blotting were performed to confirm that the MTDH 3’UTR bound to miR-30c. Growth curves, tumor sphere formation assays, Transwell migration and invasion assays, mouse xenograft model and immunofluorescence were evaluated to investigate the effects of miR-30c and MTDH. MiRNA in situ hybridization (ISH) and immunohistochemistry (IHC) were carried out on IMPC patient tissues for miR-30c and MTDH expression, respectively.
Results

We found that miR-30c could directly target the MTDH (metadherin) 3’UTR. MiR-30c overexpression inhibited breast cancer cell proliferation, invasion and metastasis by targeting MTDH in vitro and in vivo. Moreover, miR-30c regulated IMPC cell polarity reversal by targeting MTDH. By in situ hybridization and immunohistochemistry analyses, miR-30c and MTDH were significantly correlated with tumor size, lymph nodule status and tumor grade, the ‘inside-out’ growth pattern, overall survival (OS) and disease-free survival (DFS) in IMPC patients (p < 0.05).
Conclusions

Overall, miR-30c overexpression could inhibit breast cancer cell proliferation and metastasis and regulate polarity reversal by targeting MTDH.
The influence of medical insurance and social security cards on the floating population's settlement intention
Authors: Li Yulin , Huang Lingling , Xiang Li , Dou Dongmei
Published: September 2020

Background: There are many studies on the influencing factors of floating population's intention to settle down. Medical insurance and social security cards have an important guarantee for the floating population to live a stable life in the current residence, but there are limited studies focused on the influence of medical insurance and social security cards on their settlement intention. Therefore, the purpose of this paper is to study the influence of medical insurance and social security card on the settlement intention of floating population, so as to create better living and working conditions for floating population and improve their happiness in their current place of residence. Methods: Based on the survey data of China's floating population dynamic monitoring in 2017, we explored the influence of medical insurance (urban employee basic medical insurance) and social security cards on the floating population's settlement intention with binary logistic regression and structural equation model. Additionally, this study was also to examine the comprehensive causal relationship, with social integration as the mediator variable. Results: The floating population's settlement intention on participating in urban employee basic medical insurance is 23.2 percent higher than those who did not participate. Whether to apply for personal social security cards is related to the settlement intention. The standardized regression coefficients among social insurance and security, social integration, and settlement intention are positive values, and the Z values ​​of the overall effect, indirect effect, and direct effect are all greater than 1.96, and the confidence interval of the indirect effect does not include 0. The article found that this model is a partial intermediary, with an intermediary ratio of 10.66 percent. Conclusions: The article highlights the important impact of urban workers' medical insurance and individual social security cards on the floating population. The results of this study may provide some reference for the government to formulate relevant policies.
Plasma Levels of Phosphorylated Tau 181 Are Associated With Cerebral Metabolic Dysfunction in Cognitively Impaired Individuals
Authors: Lussier Firoza Z , Benedet Andréa L. , Therriault Joseph , Pascoal Tharick A. , Tissot Cécile , Chamoun Mira , Mathotaarachchi Sulantha , Savard Melissa , Ashton Nicholas J. , Karikari Thomas K. , Rodriguez Juan Lantero , Snellman Anniina , Bezgin Gleb , Kang Min Su , Arias Jaime Fernandez , Wang Yi-Ting , Gauthier Serge , Zetterberg Henrik , Blennow Kaj , Rosa-Neto Pedro
Published: September 2020

BackgroundAlzheimer’s disease (AD) biomarkers are primarily evaluated through MRI, PET, and CSF methods in order to diagnose and monitor disease. Recently, advances in the assessment of blood-based biomarkers have shown promise for simple, inexpensive, accessible, and minimally invasive tools with diagnostic and prognostic value for AD. Most recently, plasma phosphorylated tau181 (p-tau181) has shown excellent performance. The relationship between plasma p-tau181 and cerebral metabolic dysfunction assessed by [18F]FDG PET in AD is still unknown.MethodsThis study was performed on a total of 892 individuals (297 cognitively unimpaired; 595 cognitively impaired) from the ADNI cohort. Plasma p-tau181 was assessed using single molecular array (Simoa) technology and metabolic dysfunction was indexed by [18F]FDG PET. Cross-sectional associations between plasma and CSF p-tau181 and [18F]FDG were assessed using voxelwise linear regression models, with individuals stratified by diagnostic group and by Aβ status. Associations between baseline plasma p-tau181 and longitudinal rate of brain metabolic decline were also assessed in a subset (n=389) of individuals using correlations and voxelwise regression models.ResultsPlasma p-tau181 was elevated in Aβ+ and cognitively impaired individuals as well as in APOE ε4 carriers, and was significantly associated with age, worse cognitive performance, and CSF p-tau181. Cross-sectional analyses showed strong associations between plasma p-tau181 and [18F]FDG PET in Aβ+ and cognitively impaired individuals. Voxelwise longitudinal analyses showed that baseline plasma p-tau181 concentrations were significantly associated with annual rates of metabolic decline only in cognitively impaired individuals, bilaterally in the medial and lateral temporal lobes.ConclusionsThe associations between plasma p-tau181 and reduced brain metabolism, primarily in cognitively impaired and in Aβ+ individuals, supports the use of plasma p-tau181 as a simple, low-cost, minimally invasive, and accessible tool to both assess current and predict future metabolic dysfunction associated with AD, comparatively to PET, MRI, and CSF methods.
Early infant diagnosis and associated factors among HIV exposed infants in West Shoa Zone, Ethiopia: A mixed methods study
Authors: Debelew Gurmesa Tura , Fana Bontu Berhanu , Habte Mahilet Birhanu
Published: September 2020

Background: The World Health Organization recommends testing of all HIV exposed infants at 4–6 weeks of age to optimize detection of intrauterine, intrapartum, and early postnatal HIV transmissions. However, the global coverage of early infant diagnosis remains low. With less than 25% national coverage, the progress of this early diagnosis in Ethiopia is one of the slowest in the World. Furthermore, local studies are limited to determine the status and identify the associated factors in many parts of the country in general and in West Shoa Zone in particular. Thus, this study aimed to fill this gap.Methods: A mixed method study by using retrospective record review of four years facility data of 342 mother-infant pairs supplemented by qualitative method was conducted in West Shoa Zone, Oromia Region, Ethiopia in 2018. The quantitative data related to maternal and HIV exposed infants’ cares were collected by using questionnaire. The qualitative data related to facility related barriers were collected by key-informants interview with selected mothers and service providers. Factors associated with early infant diagnosis of HIV infection were identified by using multivariable logistic regression analysis. The qualitative data were analyzed thematically and triangulated with the quantitative findings. Results: The status of early infant diagnosis was 58.5% (95%CI: 53.3%, 63.7%). Attending secondary education or above (AOR=2.41; 95%CI: 1.54, 3.28), having <4 living children (AOR=4.76, 95%CI: 02.56, 9.09), knowing HIV sero-status during or before pregnancy (AOR=6.24, 95%CI: 2.40, 10.08) and sero-status disclosure (AOR=8.30, 95%CI: 3.30, 20.60) were significantly associated with early infant diagnosis. Attending ANC visit (AOR=5.32; 95%CI: 2.53, 8.11), giving birth in health facility (AOR=62; 95%CI: 3.39, 11.85) and Neverapine provision at enrolment (AOR=6.05; 95%CI: 2.48, 14.73) were also significantly associated with early infant diagnosis of HIV infection.Conclusion: The status of early infant diagnosis in the study area is low to achieve the national target of 95% coverage by 2020. Maternal socio-demography, maternal behavior in knowing sero-status and disclosing and using services during pregnancy and delivery were among the determinants of early infant diagnosis. Promoting ANC and PMTCT cascade through behavioral interventions and fulfilling the essential equipments and supplies are required.
Cointegration Analysis and Forecasting of the Export Function of Bangladesh Using the Error Correction Model
Authors: Islam K M Saemon , Biswas Gautam Kumar
Published: September 2020

In this paper, we examined the relationship between the growth of the Gross Domestic Product of the United States, the export value index, and the export of Bangladesh over 37 years between 1980 and 2016. The results of our preliminary tests showed that there was indeed a long-run relationship between these variables. Based on our preliminary analysis, we employed an error-correction model to identify the relationship between the variables. The error-correction term with the expected negative sign was statistically significant, and it confirmed that in the case of disequilibrium, the convergence towards the equilibrium happened in the subsequent periods. Additionally, the econometric estimates exhibited that the two-period lagged values of the growth in export of Bangladesh and the growth of the Gross Domestic Product of the United States were also statistically significant.JEL Classification: C22, C5, F41
Post-Financial Crises Puzzle of Economic Growth in Low and Lower-Middle Income Countries: Evidence from Static and Dynamic Panel Estimations
Authors: shafiq Mohammad m , ADELEYE Bosede Ngozi
Published: September 2020

This paper investigates economic growth in 65 low and lower-middle-income countries from 2010 to 2017. Results from static and dynamic panel data techniques show that foreign direct investment (FDI), capital formation, and labor force significantly increase economic growth while government expenditure decreases growth. Mobile phone subscription reveals no significant impact on growth at aggregate levels. Furthermore, analyses at the income group level reveal substantial differences between the determinants of economic growth in low and lower-middle-income countries. For instance, FDI is a significant predictor of growth in low-income countries, but not in lower-middle-income countries. Similarly, government expenditure and mobile cellular subscriptions are not significant predictors in low-income countries relative to lower-middle-income countries. Interestingly, capital formation and labor force are the two common significant predictors across low and lower-income countries.
Clinical Data From the Real World: Efficacy Analysis of Ceritinib (450mg) in ALK-Rearrangement Non-Small Cell Lung Cancer Patients with Brain Metastases in China
Authors: Qiu Zhi Xin , Liu Chunrong , Wang Ke , Huang Meijuan , Yu Min , Xian Xinhong
Published: September 2020

Objectives: The real-world intracranial efficacy data of ceritinib at a dose of 450mg quaque die (QD, once a day) are still unavailable, thus this study aims to explore the intracranial efficacy of ceritinib (450mg QD) in anaplastic lymphoma kinase (ALK)-rearrangement non-small cell lung cancer (NSCLC) patients in China.Materials and Methods: The intracranial efficacy [objective response rate (ORR) and disease control rate (DCR)] was evaluated according to the Response Assessment in Neuro-Oncology (RANO) standard, along with progression-free survival (PFS) and adverse events (AEs) obtained through follow-ups.Results: A total of 57 ALK-rearrangement NSCLC patients with brain metastases (BM) were enrolled in this study. Among them, 53 patients experienced progression at baseline during or after prior crizotinib, and 24 patients received prior brain radiotherapy. The intracranial ORR and DCR were 73.7% and 93.0%, respectively. The median intracranial PFS in patients reaching the endpoint was 8.75 months; while that in all patients was not reached and predicted to be not evaluable (NE) (95% CI: 12.9-NE). The estimated 12-month event-free probability (EFP) of intracranial lesions was 68.1%. Subgroup analysis showed the estimated 12-month EFP of intracranial lesions was relatively higher in patients with prior brain radiotherapy (93.8% vs 47.1%, P=0.0006). Additionally, we reported a 74-year-old female ALK-rearrangement NSCLC patient with BM achieved continuous response (intracranial PFS: 12.9 months) to ceritinib reduced to 150mg QD due to intolerable AE and administered for 7.5 months.Conclusion: Ceritinib administered at a dose of 450mg QD to ALK-rearrangement NSCLC patients with BM in China demonstrates superior ORR and DCR, as well as PFS and EFP that are expected to be improved. Especially the estimated 12-month EFP of intracranial lesions was improved in patients with prior brain radiotherapy.
Comparative Transcriptomic Analysis of Gonad Development and Renewal of Ovoviviparous Black Rockfish (Sebastes Schlegelii)
Authors: Li Jianshaung , Wen Haishen , Lyu Likang , Li Yun , Wang Xiaojie , Zhang Ying , Yao Yijia , Qi Xin
Published: September 2020

Background: Black rockfish (Sebastes schlegelii) has an ovoviviparous reproductive pattern and long-term sperm storage, which resulting in asynchronous gonadal development between the sexes. While the comprehensive understanding of gonad development of black rockfish has not been well studied. Here, we study the gonad development and germ cell renewal by histology and RNA-seq.Results: In this study, RNA-seq was performed on both testis and ovary to characterize key pathways and genes during development and gamete maturation in black rockfish. Different expression genes (DEGs) were identified and annotated in 4 comparisons (F_III vs F_IV, F_IV vs F_V, M_III vs M_IV and M_IV vs M_V). Based on enriched analysis of DEGs in testis, 11 and 14 significantly enriched Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were mapped in M_III vs M_IV group and M_IV vs M_V group, respectively. And DEGs in ovary development periods were also classified into 10 biological function group. The results of the q-PCR expression pattern of the selected genes was significantly correlated with the RNA-Seq results, implying the reliability and accuracy of the RNA-Seq analysis.Conclusion: The categories intercellular interaction and cytoskeleton, molecule amplification and repairment in cell cycle were revealed to be crucial in testis development and spermatogenesis along with a series of metabolite biosynthesis. Our results provided a comprehensive insight into the black rockfish gonad development for further study of reproductive physiology and molecular biology in ovoviviparity.
Locoregional treatment in de novo metastatic breast cancer: a retrospective cohort study
Authors: Jianna Sun , Lingjun Kong , Nana Feng , Hong Liu , Chongxi Ren
Published: September 2020

Background: In an earlier analysis of this cohort study, local therapy based on surgical resection of the primary tumor might confer a survival benefit in women with de novo metastatic breast cancer (dnMBC). Here we report the survival outcomes of locoregional treatment (LRT), focusing on the association of surgical timings and surgical margins with survival in these patients. Methods: The retrospective study included patients with dnMBC in two Chinese tertiary hospitals, between March 1, 2007, and December 31, 2017. Overall survival (OS) was evaluated by means of a stratified log-rank test and summarized with the use of Kaplan–Meier methods. Results: A total of 153 patients were included, of whom 87 underwent LRT and 66 systemic therapy alone (STA). LRT showed a significant OS benefit over STA (HR, 0.47; 95% CI, 0.33 to 0.69; p<.0001). Median OS of LRT group and STA group were 42 months (95% CI, 35.0 to 48.9 months) and 21 months (95% CI, 16.1 to 25.9 months), respectively. The benefit was consistent across most subgroups. The OS of patients undergoing surgery was better than that of patients without surgery (HR, 0.48; 95% CI, 0.33 to 0.70; p=.0001), and there was difference in survival improvement at different surgical timings (surgery before chemotherapy, during chemotherapy and after chemotherapy) (HR, 0.79; 95% CI, 0.65 to 0.95; p=.013). The survival benefit of surgery after chemotherapy was the most, followed by surgery during chemotherapy (Median 56 months, 95% CI, 40.8 to 71.2 months). Moreover, compared with patients with positive margins, the OS of patients with negative margins was significantly improved (HR, 2.35; 95% CI, 1.65 to 3.35; p<.0001), with a median OS of 56 months (95% CI, 45.9 to 66.1 months). Conclusions: Our results suggest that LRT is associated with improved OS in women with dnMBC, and patients who had surgery after or during systemic chemotherapy with negative surgical margins, are expected to benefit more.
Combining lung ultrasound and wells score for diagnosing pulmonary embolism in critically ill COVID-19 patients
Authors: Zotzmann Viviane , Lang Corinna Nadine , Wengenmayer Tobias , Bemtgen Xavier , Schmid Bonaventura , Mueller-Peltzer Katharina , Supady Alexander , Bode Christoph , Duerschmied Daniel , Staudacher Dawid L
Published: September 2020

Introduction: Subpleural consolidations have been found in lung ultrasound in patients with COVID-19, possibly deriving from pulmonary embolism (PE). The diagnostic utility of impact of lung ultrasound in critical-ill patients with COVID-19 for PE diagnostics however is unclear.Methods: We retrospectively evaluated all SARS-CoV2-associated ARDS patients admitted to our ICU between March 8th and May 31th 2020. They were enrolled in this study, when a lung ultrasound and a computed tomography pulmonary angiography (CTPA) were documented. In addition, wells score was calculated to estimate the probability of PE. The CTPA was used as the gold standard for the detection of PE. Results: Twenty patients met the inclusion criteria. In 12/20 patients (60%) (sub-) segmental PE were detected by CT-angiography. Lung ultrasound found subpleural consolidations in 90% of patients. PE-typical large supleural consolidations with a size ≥1cm were detectable in 65% of patients and were significant more frequent in patients with PE compared to those without (p=0.035). Large consolidations predicted PE with a sensitivity of 77% and a specificity of 71%. The Wells score was significantly higher in patients with PE compared to those without (2.7±0.8 and 1.7±0.5, respectively, p=0.042) and predicted PE with an AUC of 0.81. When combining the two modalities, comparing patients with considered/probable PE using LUS plus a Wells score ≥2 to patients with possible/unlikely PE in LUS plus a Wells score <2, PE could be predicted with a sensitivity of 100% and a specificity of 80%.Conclusion: Large consolidations detected in lung ultrasound were found frequently in COVID-19 ARDS patients with pulmonary embolism. In combination with a Wells score>2, this might indicate a high-risk for PE in COVID-19.
Intramuscular Injection of Botox Induces Tendon Atrophy and Senescence of Tendon-Derived Stem Cells
Authors: Chen Peilin , Chen Ziming , Mitchell Christopher , Gao Junjie , Chen Lianzhi , Wang Allan , Leys Toby , Landao-Bossonga Euphemie , Zheng Qiujian , Wang Tao , Zheng Minghao
Published: September 2020

Background:
Botulinum toxin (Botox) injection is in widespread clinical use for the treatment of muscle spasms and tendinopathy but the mechanism of action is poorly understood.
Hypothesis:
We hypothesised that the reduction of patellar-tendon mechanical-loading following intra-muscular injection of Botox results in tendon atrophy that is at least in part mediated by the induction of senescence of tendon-derived stem cells (TDSCs).
Study Design:
Controlled laboratory study
Methods:
A total of 36 mice were randomly divided in 2 groups (18 Botox-injected and 18 vehicle-only control). Mice were injected into to right vastus lateralis of quadriceps muscles either with Botox to induce mechanical stress deprivation of the patellar tendon or with normal saline as control. At 2 weeks post-injection, animals were euthanized prior to tissues harvest for either evaluation of tendon morphology or in vitro studies. TDSCs were isolated by cell-sorting prior to determination of viability, differentiation capacity and senescence markers, as well as assessing their response to mechanical loading in a bioreactor. Finally, to examine the mechanism of tendon atrophy in vitro, key proteins in the PTEN/AKT pathway were evaluated in TDSCs in both groups.
Results:
Two weeks after Botox injection, patellar tendons displayed atrophic features including tissue volume reduction and collagen fibre misalignment and increased degradation. The colony formation assay revealed the significantly reduced colony units of TDSCs in Botox injected group compared to controls. Multipotent differentiation capacity of TDSCs has also diminished after Botox injection. To examine if mechanical deprived TDSC is capable of forming tendon tissue, we used an isolated bioreactor system to culture 3D TDSCs constructs. The result showed that TDSCs from the Botox-treated group failed to restore tenogenic differentiation after appropriate mechanical loading. Examination of PTEN/AKT signalling pathway revealed that injection of Botox into quadriceps muscle causes PTEN/AKT mediated cell senescence of TDSCs.
Conclusion:
Intramuscular injection of Botox interferes with tendon homeostasis by inducing tendon atrophy and senescence of TDSCs. Botox injection may have long-term adverse consequences for the treatment of tendinopathy.
Clinical relevance:
Intramuscular Botox injection for tendinopathy and tendon injury could cause adverse effects in human tendons and re-evaluation of its long-term efficacy is warranted.
Production of high purity 52gMn from natV targets with α beams at cyclotrons
Authors: Colombi Alessandro , Carante Mario , Barbaro Francesca , Canton Luciano , Fontana Andrea
Published: September 2020

BackgroundRadioisotope 52g Mn is of special interest for multimodal imaging (PET/MRI) applications and the main production route is based on proton/deuteron beams on Chromium (natural/enriched) targets. Using state-of-art nuclear reaction codes (Talys, Empire and Fluka), we perform a comparative study with the alternative 52g Mn production with the reaction nat V(α,x) 52g Mn. ResultsThis production channel, novel in the context of medical applications, provides a good source of 52g Mn, where very high radionuclidic purity can be maintained up to 3 weeks. Since nat V consists already of 99.75% 51 V , there is no need of enriched target material and the corresponding high-cost implications. The production of the main long-lived contaminants, i:e: 53 Mn and 54 Mn, is considered with care and the integral yields of the reactions are compared with the alternative production routes. Specifically, the production of the 54 Mn contaminant, which could be the most dangerous for clinical applications, turns out to be lower when compared with the natural Chromium target. ConclusionsThis channel turns out competitive with respect to the other considered production routes. The study also reveals poor accuracy of the relevant cross-section data set and indicates that better data and theoretical descriptions are needed for a precise evaluation of nat V(α,x) 52g Mn.
Somatic distress among Syrian refugees in Germany: analysis of a cross-sectional register-based study
Authors: Borho Andrea , Morawa Eva , Schmitt Gregor Martin , Erim Yesim
Published: September 2020

Background: Previous studies have already proven high rates of common mental disorders in Syrian refugees. Nevertheless, little is known about the patterns of somatic distress among this refugee population. For this reason, we aim to examine the prevalence, co-occurrence and risk factors of somatic distress among Syrian refugees in Germany.Methods: The study design was a register-based cross-sectional survey of 116 adult Syrian refugees with residence permission in Germany. The survey consisted of information on sociodemographic and migration-specific characteristics, health care utilization, traumatic life events, acculturative stress (Barcelona Immigration Stress Scale – BISS; subscales: perceived discrimination, intercultural contact stress, homesickness, and general psychosocial stress) and self-reported outcomes of somatic distress (Patient Health Questionnaire 15), depression (Patient Health Questionnaire – 9), generalized anxiety disorder (GAD – 7), and post-traumatic symptoms (Essen Trauma Inventory).Results: Almost half of respondents (49.1%) were identified as being at risk of somatic distress (PHQ-15 score ≥ 6), and even 24.1% being bothered by moderate to severe levels of somatic distress (PHQ-15 score ≥ 10). The most robust associations with somatic distress were found for female gender, the amount of health care utilization, multiple trauma exposures, general psychosocial stress, self-reported depression and anxiety symptoms. High comorbidities with somatic distress were shown for all common mental disorders studied.Conclusions: To date, there was no data on the specific patterns of somatic distress among Syrian refugees in Germany. The presented study reveals a significant risk of somatic distress among this displaced population and highlights implications for policy and health care providers.