bluuebunny/crossref_metadata_2025 huggingface dataset:
Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: A population level mathematical modelling approach.
Authors: Awine Timothy , Silal Sheetal P
Published: May 2020

Background Assessing the effectiveness of malaria control measures in Ghana will require taking transmission dynamics of the disease into account given the influence of climate variability in the region of interest. The impact of preventative interventions on malaria incidence and the prospects of meeting program timelines in Ghana were investigated using mathematical models based on regionally diverse climatic zones. Methods An ordinary non-linear differential equation models with their associated rate parameters were developed incorporating the transitions between various disease compartments for three ecological zones in Ghana. Models were fitted using data from the District Health Information Management System in Ghana from 2008 to 2017 and historical intervention coverage levels. To calibrate the models, Approximate Bayesian Computational sampling approach with a distance based rejection criteria was adopted. A leave-one-out approach was used to validate model parameters and the most sensitive evaluated using a multivariate regression sensitivity analysis. The impact of insecticide treated bed nets and their usage and indoor residual spraying as well as their protective efficacy on the incidence of malaria were simulated at various levels of coverage and protective effectiveness in each ecological zone to investigate the prospects of achieving goals of the malaria control strategy for 2014-2020. Results Increasing the coverage levels of both long lasting insecticide treated bed nets and indoor residual spraying activities without a corresponding increase in their recommended usage does not impact highly on averting predicted incidence of malaria. Improving upon the protective efficacy of long lasting insecticide treated bed nets through proper usage could lead to substantial reductions in the predicted incidence of malaria. Similar results were obtained with indoor residual spraying across all zones.Conclusions Projected goals set in the national strategic plan for malaria control 2014-2020 as well as WHO targets for malaria pre-elimination by 2030 are only likely to be achieved if a substantial improvement in treated bed net usage is achieved coupled with targeted deployment of indoor residual spraying with high community acceptability and efficacy. Key words: model, malaria, interventions, long lasting insecticide bednets, indoor residual spraying
Multiple Alu exonizations in 3’UTR of a primate specific isoform of CYP20A1 creates a potential miRNA sponge
Authors: Bhattacharya Aniket , Jha Vineet , Singhal Khushboo , Fatima Mahar , Singh Dayanidhi , Chaturvedi Gaura , Dholakia Dhwani , Kutum Rintu , Pandey Rajesh , Bakken Trygve E. , Seth Pankaj , Pillai Beena , Mukerji Mitali
Published: May 2020

Background: Alu repeats contribute to phylogenetic novelties in conserved regulatory networks in primates. Exaptation of Alus in transcript isoforms could nucleate large-scale mRNA-miRNA interactions and modulate cellular outcomes. Result: Using a functional genomics approach, we report a transcript isoform of an orphan gene, CYP20A1 (CYP20A1_Alu-LT) that arise through exonization of 23 Alus in 3’UTR and is expressed in higher primates. CYP20A1_Alu-LT, confirmed by 3’RACE, is an outlier in length (9kb) and is expressed in multiple cell lines. We demonstrate its presence in single nucleus RNA-seq of ~16000 human cortical neurons (including rosehip neurons). Most strikingly, miRanda predicts ~4700 miRNA recognition elements (MREs; with threshold< -25kcal/mol) for ~1000 miRNAs, which have primarily originated within the 3’UTR-Alus post exonization. CYP20A1_Alu-LT could be a potential multi- miRNA sponge as it harbours - ≥10 MREs for 140 miRNAs and has cytosolic localization. In order to test this further, we explored whether expression of CYP20A1_Alu-LT correlates with genome wide mRNAs harboring similar MRE targets. We carried out RNAseq with conjoint miRNAseq analysis in primary human neurons as we observed CYP20A1_Alu-LT to be downregulated during heat shock response and upregulated in HIV1-Tat treatment. CYP20A1_Alu-LT expression was positively correlated with 380 genes that were significantly downregulated in heat shock and upregulated in Tat and harboured MREs for a set of nine expressed miRNAs that were also enriched in CYP20A1_Alu-LT. The enrichment of MREs in the 380 genes were significant compared to random sets of expressed (p=4.716e-12) as well as differentially expressed genes (p=8.134e-12). Gene ontology revealed involvement of these genes in neuronal development and hemostasis pathways. Conclusion: We demonstrate a potential role for CYP20A1_Alu-LT as miRNA sponge due to significant enrichment of MREs within Alus in a transcript isoform specific manner. This highlights a novel component of Alu-miRNA mediated transcriptional modulation that could govern specific physiological outcomes in higher primates.
Heterotrimeric G-protein α subunit (LeGPA1) confers cold stress tolerance in Processing tomato plants (Lycopersicon esculentum Mill)
Authors: Zhang Li , Li Juju , Guo Xinyong , Zhang Zhanwen , He Ping , Wang Wenwen , Wang Mei , Wang Aiying , Zhu Jianbo
Published: May 2020

Background
Tomatoes (Lycopersicon esculentum Mill) are key foods and are also commonly explored in studies of molecular biology and evolution. The plant originates from the tropics, thus is sensitive to cold, and its growth and development are easily affected by cold stress.
Results
In this study, LeGPA1 was cloned from tomato leaves and used to generate LeGPA1-overexpressing and RNA-interference-expressing transgenic plants. The function and expression of LeGPA1 in response to cold stress were assessed. Subcellular localization analysis identified functional LeGPA1 on the plasma membrane. Spatiotemporal expression analysis revealed that endogenous LeGPA1 was highly expressed in the roots and leaves. Cold treatment positively induced the expression of LeGPA1. The overexpression of LeGPA1 conferred tolerance to cold conditions and regulated the expression of genes related to the ICE(INDUCER OF CBF EXPRESSION)- CBF(C-REPEAT-BINDING FACTOR) pathway in tomato plants. In the LeGPA1-overexpressed transgenic plants, antioxidant enzyme activity and soluble sugar and proline contents increased, and the production of reactive oxygen species and membrane lipid peroxidation decreased under cold stress.
Conclusions
This suggests that better antioxidant systems can cope with oxidative damage caused by cold stress, thereby stabilizing cell membrane structures and increasing the rate of photosynthesis. These findings provide evidence for the key role of LeGPA1 in mediating cold signal transduction in plant cells. These findings extend our knowledge of the roles of G-proteins in plants and help to clarify the mechanisms through which processing tomato plants can regulate growth and development.
Disclosure of Medical Errors: Physicians’ Knowledge, Attitudes and Practices (KAP) in an Oncology Center
Authors: Mansour Razan , Ammar Khawlah , Al-Tabba’ Amal , Arawi Thalia , Mansour Asem , Al-Hussaini Maysa
Published: May 2020

Background: Between the need for transparency in healthcare widely promoted by patient’s safety campaigns and the fear of negative consequences and malpractice threats, physicians find themselves faced with challenging decisions on whether to disclose medical errors to patients and families or not. We aim to assess the knowledge, attitudes and practices (KAP) of physicians in our center towards medical error disclosure.Methods: This is a cross-sectional self-administered questionnaire study. The questionnaire was piloted and no major modifications were made. A day-long training workshop consisting of didactic lectures, short and long case scenarios with role playing and feedback from the instructors were conducted. Physicians who attended the training workshops were invited to complete the questionnaire at the end of the training and physicians who did not attend any training were sent a copy of the questionnaire to their offices to complete. To assure anonymity and transparency of responses, we did not query names or departments.Descriptive statistics were used to present demographics and KAP. The differences between response\s of physicians who received the training and those who did not were analyzed with t-test and descriptive statistics. The 0.05 level of significance was used as a cutoff measure for statistical significance. Results: Eighty-eight physicians completed the questionnaire (55 attended training (62.50%), and 33 did not (37.50%)). 65.5% of physicians were males and mean years of experience was 16.5 years. 86.9% (n=73) of physicians were more likely to report major harm, compared to minor harm or no harm. Physicians who attended the workshop were more knowledgeable of articles of Jordan’s Law on Medical and Health Liability (66.7% vs 45.5%, p-value = 0.017) and the Law were more likely to affect their decision on error disclosure (61.8% vs 36.4%, p-value= 0.024).Conclusion: Formal training workshops on disclosing medical errors have the power to positively influence physicians’ KAP toward disclosing medical errors to patients and possibly promoting a culture of transparency in the healthcare system.
Cetuximab-Conjugated Perfluorohexane/Gold Nanoparticles for Low Intensity Focused Ultrasound Diagnosis Ablation of Thyroid Cancer Treatment
Authors: Ma Yue , Wang Lingling , Li Haixia , Cheng Wen , Zheng Xiulan , Liu Ying
Published: May 2020

Chemotherapeutic efficacy can be significantly developed nanotheranostics systems of drug delivery in tumor cells. In this work, we have demonstrated that the self-assembled by C225 conjugates Au-PFH-NPs (C-Au-PFH-NPs) for low intensity focused ultrasound diagnosis ablation of thyroid cancer treatment. C-Au-PFH-NPs have shown excellent stability in water, PBS and 20% rat serum. Transmission electron microscopy (TEM) images also exposed the effective construction of C-Au-PFH-NPs with commonly spherical sized assemblies. The incubation of the C625 thyroid carcinoma with C-Au-PFH-NPs triggers apoptosis, which was confirmed by the flowcytometry analysis. The C-Au-PFH-NPs, with remarkably displays the potent antitumor efficacy in a human thyroid carcinoma xenografts. A histopathological result reveals that precisely achieved to additional confirm these outcomes. Further, we successfully examined the efficiency of C-Au-PFH-NPs when used the thyroid carcinoma low intensity focused ultrasound diagnosis imaging (LIFUS) in vivo. These findings clearable for LIFUS agents with high performing image and different therapeutic purpose will have extensive possible for the future biomedical purposes.
Physicians’ Attitudes in Relation to End-of-Life Decisions in Neonatal Intensive Care Units: A National Multicenter Survey
Authors: Chatziioannidis Ilias , Iliodromiti Zoi , Boutsikou Theodora , Pouliakis Abraham , Giougi Evangelia , Sokou Rozeta , Vidalis Takis , Xanthos Theodoros , Cuttini Marina , Iacovidou Nicoletta
Published: May 2020

Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in neonatal intensive care units and correlate with self-reported practices of end-of-life decisions and with their background data.Methods: A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with an attitude questionnaire of 12 items measuring physicians’ views ranging from value of life to quality of life approach (scale 1 to 5).Results: Continuation of adverse prognosis neonates treatment without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to mechanical ventilation withdrawal. Physicians with a high attitude score (indicative of quality-of-life) were more likely to limit, while a low score (indicative of sanctity-of-life) was indicative for continuation of intensive care. Physicians’ educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p<0.001) affected the attitude score.Conclusions: Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief in Greek legal system reform.
Risk models and scores for metabolic syndrome: a systematic review
Authors: Ibrahim Musa Saulawa , Pang Dong , Pappas Yannis , Randhawa Gurch
Published: May 2020

Background:Metabolic syndrome is linked with increased risk of cardiovascular disease, diabetes and all-cause mortality. Despite the high number of models and scores for assessing the risk of developing MetS, there is hardly any used in practical setting. Hence, we conducted a systematic review to determine the performance of risk models and scores for predicting metabolic syndrome.Methods:We systematically searched MEDLINE, CINAHL, PUBMED and Web of Science to identify studies that either derive or validate risk prediction models or scores for predicting the risk of metabolic syndrome. Data concerning models’ statistical properties as well as details of internal or external validations were extracted. Tables were used to compare various components of models and statistical properties. Finally, PROBAST was used to assess the methodological quality (risk of bias) of included studies.Results:A total of 15102 titles were scanned, 29 full papers were analysed in detail and 24 papers were included. The studies reported about the development, validation or both of 40 MetS risk models; out of these, 24 models were studied in details. There is significant heterogeneity between studies in terms of geography/demographics, data type and methodological approach. Majority of the models or risk scores were developed or validated using data from cross-sectional studies, or routine data that were often assembled for other reasons. Various combinations of risk factors (predictors) were considered significant in the respective final model. Similarly, different criteria were used in the diagnosis of MetS, but, NCEP criteria including its modified versions were by far the most widely used (32.5%). There is generally poor reporting quality across the studies, especially concerning statistical data. Any form of internal validation is either not conducted, or not reported in nearly a fifth of the studies. Only two (2) risk models or scores were externally validatedConclusions:There is an abundance of MetS models in the literature. But, their usefulness is doubtful, due to limitations in methodology, poor reporting and lack of external validation and impact studies. Therefore, researchers in the future should focus more on externally validating/ applying such models in a different setting.Protocol: The protocol of this study can be found at https://bmjopen.bmj.com/content/9/9/e027326PROSPERO registration number CRD42019139326
The Impact of Nutritional Therapy on Resting Energy Expenditure in Malnourished Older Hospitalized Patients
Authors: Pourhassan Maryam , Daubert Diana , Wirth Rainer
Published: May 2020

Background and aims: Little is known about the effect of nutritional therapy on resting energy expenditure (REE) in malnourished older hospitalized patients. We sought to evaluate longitudinal changes in REE during nutritional therapy and to examine the different factors associated with changes in REE among these patients.Methods: Twenty-three malnourished older patients (age range 67–93, 65% women) participated in this prospective longitudinal observational study. Malnutrition was defined as Mini Nutritional Assessment Short Form (MNA-SF) < 8. REE was measured by using indirect calorimetry on hospital admission and at discharge. Body composition (i.e. fat free mass (FFM)) was assessed by bioelectrical impedance analysis. The Parker mobility score was performed to evaluate the patient's mobility. Nutritional support (i.e. high protein and/or high calorie oral nutritional supplements) was provided to all malnourished patients during hospitalization.Results: All patients were malnourished with a median MNA-SF score of 6. The median time between two REE measurements was 13 days (interquartile range: 11–15). On admission, REE was significantly lower in patients with lower FFM (P = 0.043) and decreased along with the degree of malnutrition (P = 0.008). REE (+ 212.6 kcal, P = 0.010) and REE/FFM (+ 5.6 kcal/kg, P = 0.021) increased significantly during hospitalization. In a multiple regression analysis, age, gender and BMI followed by MNA-SF score and mobility were the major independent risk factors of changes in REE.Conclusion: Low REE in malnourished older patients increased to normal after 2 weeks of nutritional treatment.
Sharing Genomic Data From Clinical Testing with Researchers: Public Expectations of Clinical Genomic Data Management in Queensland, Australia.
Authors: Vidgen Miranda Emily , Kaladharan Sid , Malacova Eva , Hurst Cameron , Waddell Nicola
Published: May 2020

Background:There has beenconsiderable investment and strategic planning to introduce genomic testing intoAustralia’s public health system. As more patients’ genomic data is being held by the public health system, there will be increased requests from researchers to access this data. However, sharing of genomic data comes with a unique set of ethical, legal and social considerations that are not necessarily reflected in current health information management policies and legislation. It is important that public policy reflects public expectations for how genomic data that is generated from clinical tests is used.To inform public policy and discussions around genomic data sharing, we sought public opinions on using genomic data contained in medical records for research purposes in the Australian state of Queensland.Methods: A total of 1,233 participants completed an online questionnaire between February and May 2019. Results:Most participants wanted to be given the choice to have their genomic data from medical records used in research. Their expectations onhow often they needed to be approached for permission on using their genomic data, depended on whether thedata was identifiable or anonymous. Participants were most concerned with genomics data sharing that could lead to discrimination (insurance and employment), data being used for marketing, data security, orcommercial use.Conclusions:Most participants were willing to share their genomic data from medical records with researchers. However,the existing policies related to this process in Queensland do not reflect public expectations for how this is achieved. Here we present options available to public health service to better reflect public expectations in clinical genomic data management and use.
Quantification of Regional Murine Ozone-Induced Lung Inflammation Using [18F]FDG MicroPET/CT Imaging
Authors: Aulakh Gurpreet Kaur , Kaur Manpreet , Brown Vanessa , Ekanayake Samantha , Khan Behlol , Fonge Humphrey
Published: May 2020

Purpose Ozone (O3) is a highly potent and reactive air pollutant, which is formed from human-related activities. It has been linked to acute and chronic respiratory diseases in humans by inducing inflammation. Our studies have found evidence that 0.05 ppm of O3, within the threshold of air quality standards, is capable of inducing acute lung injury. This study was undertaken to examine O3-induced lung damage using [18F]FDG (Fluorodeoxyglucose) microPET/CT imaging in wild-type mice. [18F]FDG is a known PET tracer for inflammation.Methods Sequential [18F]FDG microPET/CT imaging was performed at baseline (before O3 exposure), immediately following 2 h of 0.05 ppm O3 exposure (0 h), at 24 h and at 28 h post-exposure. The images were quantified to determine spatial standard uptake values of [18F]FDG in relation to tissue density and compared with baseline values.Results Immediately after O3 exposure, we detected a 72.21 ± 0.79% increase in lung [18F]FDG uptake ratio when compared to baseline measures. At 24 h post-O3 exposure, the [18F]FDG uptake becomes highly variable (S.D. in FDG = 0.0005174 units) with a 42.54 ± 0.33% increase in lung [18F]FDG compared to baseline.Conclusion We have developed a microPET/CT imaging protocol to quantify regional lung uptake of [18F]FDG to understand lung response to O3 exposure.
MiR-539 promotes development of colorectal cancer through alleviating expression of Aquaporin (AQP)-9 associated with glucose metabolism
Authors: An Yanjun , Zhao Jiandong , Zhang Yourui , Wu Wen , Hu Jiangtao , Hao Haosen , Qiao Yu , Tao Ying , An Liping
Published: May 2020

Background

AQP-9 is the key element of apoptosis, but its mechanism related to glucose metabolism in colon cancer was unclear. Therefore, the role of miR-539 in regulating expression of AQP-9 and its bio-functions were investigated.
Methods

The target gene of miR-539 was verified. The cell growth, apoptosis, and proliferation of SW480 regulated by AQP-9 and miR-539 were explored. The proteins expression associated with glucose metabolism pathway and apoptosis-related proteins were determined. Moreover, the glucose oxidase colorimetric method was used to measure the production of glucose in SW480.
Results

AQP9 was the target gene of miR-539. Interference on AQP-9 expression inhibited cell proliferation and growth of SW480, promoted its apoptosis by regulating Bcl-2 family members. Meanwhile, it caused down-expression of GOT1, GK and G6PC. Through inhibiting the expression of AQP-9 in SW480 could reduced cellular glucose production process. The above bio-functions could be achieved by utilization of miR-539 to suppress the expression of AQP-9, too.
Conclusion

Our work identified that the utilization of siRNA of AQP-9 with miR-539 could cause inhibition of proliferation, growth and induce apoptosis in SW480, which was associated with gluconeogenesis genes GOT1, GK, and G6PC in the progression of cellular glucose metabolism.
Efficacy of a new zeolite-based hemostatic gauze in a gunshot model of junctional femoral artery hemorrhage in swine
Authors: Wang Jing , Li Kaiyuan , Wang Junkang , Pan Fei , Zhang Heng , Luo Junpeng , Zhang Hongliang , Guo Chengyu , Feng Cong , Li Tanshi
Published: May 2020

Objective

This work sought to 1) establish a reliable gunshot model of junctional femoral artery rupture in swine that accurately simulates field rescue conditions, and 2) use the gunshot model to compare the efficacy and ease of application of zeolite nanometer hemostatic gauze with other hemostatic materials,
Methods

36 healthy landrace swine (body weight 50 ± 5 kg) were randomly divided into three groups which were treated with Combat Gauze (CG), FeiChuang hemostatic gauze (FG), or standard medical gauze (SG). A gunshot model of femoral artery hemorrhage in landrace swine was used with portable ultrasound to accurately position the wound. After the shooting, when mean arterial pressure (MAP) of swine decreased by at least 30% for 10 seconds, wounds were pressed with standard packing (39 g) of gauze materials for 3 minutes to stop bleeding, and then bandaged with pressure. Blood samples were taken 15 min before injury, then 10 min, 30 min, and 60 min after injury to determine hemodynamic, coagulation, and arterial blood gas indexes. Wound temperatures were taken at 5 min, 10 min, 30 min, and 60 min after injury, and survival times were recorded.
Results

The CG (11.15 ± 3.09 ml/kg) and FG (12.19 ± 3.5 ml/kg) groups had significantly less blood loss than the SG group (16.8 ± 5.14 ml/kg) (P = 0.04; P = 0.039, respectively). After gauze packing, bleeding in CG (5.85 ± 1.17 ml/kg) and FG (5.37 ± 0.93 ml/kg) groups remained significantly lower than that of SG group (6.93 ± 1.03 ml/kg) (P = 0.011; P = 0.003, respectively). Wound temperature rose with time for all groups (p = 0.000). The wound temperatures in the FG group and the CG group were significantly higher than that of the SG group, (p = 0.004 and 0.009, respectively). Survival rates and times were not significantly different among the three groups, though the FG group had the longest average survival time (SD 204.8 s), compared with SG group (SD 177.8 s) and CG (SD 187.5 s) groups. No significant differences in hemodynamics, blood gas, and coagulation were observed among the three groups.
Conclusions

The gunshot model of junctional femoral arterial hemorrhage guided by ultrasound had high accuracy for femoral arterial rupture by bullet wound, and provided consistent and reproducible field-simulation conditions for comparison of hemostatic materials. Feichuang zeolite hemostatic gauze effectively controlled bleeding without excessive heat, as found in other zeolite-based products. However, improvements to application technique, such as a packing device are needed to improve operating time.
Pathological changes of larynx in inhalational thermal injury causing laryngeal stenosis based on a canine model
Authors: Wang Cheng , Liu Bo , Wan Jiangbo , zhang Guoan
Published: May 2020

Objective

This study aimed to explore the endoscopic and histologic feature of the larynx in inhalational thermal injury and its correlation with delayed laryngeal stenosis.
Methods

A total of 18 healthy, male adult Beagle dogs were randomly divided into six groups: group C (control group), and groups 1–5. All experimental dogs inhaled 100℃ saturated steam for five seconds to induce laryngeal injury. Endoscopic and histologic examinations were conducted immediately (group 1), and at two weeks (group 2), four weeks (group 3), six weeks (group 4) and eight weeks (group 5) after injury. Endoscopic morphologies of the larynx and histologic morphologies of epiglottis, glottis and cricoid cartilage were observed and analyzed.
Results

Granulation tissue in larynx was observed in group 2, and this shrank to 2/3 and 1/3 of the size in groups 3 and 4, respectively. Microscopically, declined severity of epithelial exfoliations in different regions and patial repair in the glottis were observed. In the epiglottis, cartilage cells appeared degenerative and necrotic and had partial repair. Muscle fibers and cartilage cells were severely injured and had no repair in the glottis, but in the cricoid cartilage, they were totally normal.
Conclusion

The granulation tissue formation, uncompletely repaired tissues in the larynx found after inhalational thermal injury may indicate the process of laryngeal stenosis. The cricoid cartilage that appeared slight pathology in the present study may due to the thermal absorption and protective effect of the upper parts.
The AST/ALT (De Ritis) Ratio Independently Predicts Adverse Outcomes in Patients with Pyogenic Liver Abscess
Authors: Dai Huifang , Xu Jing
Published: May 2020

Background: An elevated aspartate aminotransaminase to alanine aminotransaminase ratio (AST/ALT) displays relationships to poor prognosis in viral hepatitis. However, the association between AST/ALT and pyogenic liver abscess (PLA) is unclear.Aim:This study delved into the relationships of AST/ALT and unfavorable results of PLA cases and ascertained AST/ALT predicting significance.Methods: In total, 240 PLA cases were consecutively recruited here and underwent a 3-month following-up. This study carried out receiver-operating characteristic (ROC) curve study, multiple-variate logistic regression analyses and univariate analysis.Results: In line with the receiver-operating curve of AST/ALT for unfavorable results, the cases fell to two subgroups with the use of a threshold of 0.97. Cases with high AST/ALT had higher risk of mortality (16.5% vs 2.9%), metastatic infection (19.1% vs 9.7%), acute hepatic failure (7.3% vs 2.2%), acute myocardial (7.3% vs 0.7%), empyema (23.7% vs 10.4%) and septic shock (13.7% vs 4.4%) than cases with low AST/ALT (all P < 0.05). after adjusting for potential confounders in our logistic model, high AST/ALT was independently associated with all unfavorable results (OR = 4.03, 95% CI = 2.12–7.66) and death (odds ratio (OR) = 6.17, 95% of confidence interval (CI) = 1.88–20.26). AST/ALT exhibited the widest area underneath ROC curve (AUC) as compared with AST, ALT in death prediction (AUC = 0.821, cutoff value = 1.31, P < 0.01) and overall unfavorable results (AUC = 0.690, cutoff value = 0.97, P < 0.01).Conclusion: AST/ALT may be a good candidate for predicting prognosis in future clinical practice of PLA.
Activation of alpha-4 beta-2 nicotinic receptor against cardiopulmonary bypass surgery induced brain injury by regulating NLRP3 pathway
Authors: Liu Xiuye , Yang Lijuan , Wang Li , Guo Qionghai
Published: May 2020

Present report evaluates the role of alpha-4 beta-2 nicotinic receptor (α4β2 nAChRs) in the development of cardiopulmonary bypass (CPB) surgery induced brain injury. Brain injury was induced by CPB and animals were treated with α4β2 nAChRs agonist (DHβE 9 mg/kg, s.c.) and α4β2 nAChRs antagonist (MLA 10 mg/kg, i.p.) 3 hr before the induction of CPB in the separate groups. Effect of α4β2 nAChRs agonist was determined on the neurological function in CPB induced brain injured rats. Level of cytokines, ROS and expression of NLRP3, ZO-1 and Occluding proteins were estimated in CPB induced brain injured rats. Effect of α4β2 nAChRs agonist was determined on the neuronal apoptosis and histopathological changes in the brain tissue. Result of the study suggest that neurological score was reversed in α4β2 nAChRs agonist treated group than CPB group. Level of cytokines and ROS was reduced in α4β2 nAChRs agonist treated group than CPB group. Neuronal apoptosis in α4β2 nAChRs agonist treated group was found to be reduced compared to CPB group of rats. Moreover Activation of α4β2 nAChRs ameliorates the altered expression of NLRP3, ZO-1 and Occluding protein in the brain tissue of CPB induced brain injured rats. In conclusion, Data of report suggest that treatment with α4β2 nAChRs agonist protects the brain injury in cardiopulmonary bypass surgery induced brain injury by regulating NLRP3 pathway.
Protocol: A multi-modal, physician-centered intervention to improve guideline-concordant prostate cancer imaging
Authors: Makarov Danil V , Ciprut Shannon , Kelly Matthew , Walter Dawn , Shedlin Michele G , Braithwaite Ronald Scott , Tenner Craig T , Gold Heather T , Zeliadt Steven , Sherman Scott E
Published: May 2020

Background Almost half of Veterans with localized prostate cancer receive inappropriate, wasteful staging imaging. Our team has explored the barriers and facilitators of guideline-concordant prostate cancer imaging and found that 1) patients with newly diagnosed prostate cancer have little concern for radiographic staging but rather focus on treatment, 2) physicians trust imaging guidelines but are apt to follow their own intuition, fear medico-legal consequences, and succumb to influence from imaging-avid colleagues. We used a theory-based approach to design a multi-level intervention strategy to promote guideline-concordant imaging to stage incident prostate cancer. Methods We designed the Prostate Cancer Imaging Stewardship (PCIS) intervention: a multi-site, stepped wedge, cluster-randomized trial to determine the effect of a physician-focused behavioral intervention on Veterans Health Administration (VHA) prostate cancer imaging use. The multi-level intervention, developed according to the Theoretical Domains Framework (TDF) and Behavior Change Wheel, combines traditional physician behavior change methods with novel methods of communication and data collection. The intervention consists of three components: 1) a system of audit and feedback to clinicians informing individual clinicians and their sites about how their behavior compares to their peers’ and to published guidelines 2) a program of academic detailing with the goal to educate providers about prostate cancer imaging, and 3) a CPRS Clinical Order Check for potentially guideline-discordant imaging orders. The intervention will be introduced to 10 participating geographically-distributed study sites. Discussion This study is a significant contribution to implementation science, providing VHA an opportunity to ensure delivery of high-quality care at the lowest cost using a theory-based approach. The study is ongoing. Preliminary data collection and recruitment have started; analysis has yet to be performed.
IL-1R2 Polymorphisms and its Interaction Associates With Osteoporosis Susceptibility in Chinese Han Population
Authors: Rong Kai , Liang Zhiquan , Xiang Wenyuan , Wang Zhan , Wen Fengli , Lu Laijin
Published: May 2020

Background: IL-1R2, serves as a negative regulator of IL-1 signaling, is involved in the pathogenesis of osteoporosis. This study aimed to determine the correlation between IL-1R2 polymorphism and osteoporosis susceptibility among the Chinese Han population.Methods: We recruited 594 osteoporosis patients and 599 healthy controls. Six single nucleotide polymorphisms (SNPs) in IL-1R2 were selected for genotyping using Agena MassARRAY platform. Odds ratio (OR) and 95% confidence interval (CI) was calculated through logistic regression analysis with adjustment for age and sex. Linkage disequilibrium analysis was plotted by Haploview v4.2. Multifactor dimension reduction (MDR) was performed to estimate the SNP-SNP interaction of IL-1R2 variants.Results: Our result revealed that rs11674595 (OR = 1.86, p = 0.020), rs2072472 (OR = 1.26, p = 0.019) and rs4851527 (OR = 0.78, p = 0.007) were related to the risk of osteoporosis. Moreover, the contribution of IL-1R2 polymorphisms to osteoporosis risk presented age, sex and BMI difference. We found the relationship of Trs11674595Ars4851527 (OR = 0.80, p = 0.015), Crs11674595Grs4851527 (OR = 1.22, p = 0.043) and Ars3218977Grs2072472 (OR = 1.25, p = 0.022) haplotypes to osteoporosis occurrence, and a potential accumulated effect of IL-1R2 SNPs (testing accuracy = 0.5783 and CVC = 10/10) on osteoporosis susceptibility.Conclusion: IL-1R2 polymorphisms (rs11674595, rs4851527, rs2072472 and rs3218977) might contribute to osteoporosis risk among the Chinese Han population. Our finding may increase our understanding of the effects of IL-1R2 polymorphisms on the predisposition of osteoporosis.
Challenges for National Deworming Policy in Indonesia: Experience From Bandung District West Java Province
Authors: Adrizain Riyadi , Setiabudi Djatnika , Faridah Lia , Fauziah Nisa , Setiabudiawan Budi
Published: May 2020

Background

The strategy of regular deworming has been the main STH control strategy recommended by the WHO for over a decade. In 2017, Indonesian government has also adapted this strategy by launching the Ministry of Health (MoH) Regulation No. 15 year 2017 regarding helminthiasis control. However, deworming effort is often hindered by various factors including poor hygiene, habits, and irregular mass drug administration in developing countries. To obtain a picture of how the deworming regulation is carried out and key challenges in Indonesia, this study investigated deworming conduct in Bandung District – one of the densest areas in Indonesia.
Methods

The main methodology was qualitative using published documents, interview and focus group discussion with related agencies such as MoH, Bandung District Health Office, primary health care and cadres (community participants).
Results

From this study, we discovered incompleteness and inconsistency of conduct – even within a relatively small area such as Bandung District. Moreover, this study also found that deworming is combined with stunting programs in some areas without proper study directly correlating the improvement of nutritional status with reduced incidence of STH.
Conclusions

This study has demonstrated the challenges sustaining a consistent nationwide campaign over a wide area such as in Indonesia. In the end, we recommended that further nationwide evaluation is required – placing emphasis on dissemination of policy to ensure more standardized conduct.
Matrine exhibits antiviral activity in a PRRSV/PCV2 co-infected mouse model
Authors: Sun Na , Zhang Hua , Sun Panpan , Khan Ajab , Guo Jianhua , Zheng Xiaozhong , Sun Yaogui , Fan Kuohai , Yin Wei , Li Hongquan
Published: May 2020

BackgroundPRRSV and PCV2 co-infection is very common in swine industry which results in huge economic losses worldwide. Although vaccination is used to prevent viral diseases, immunosuppression induced by PRRSV and PCV2 leads to vaccine failure. Our previous results have demonstrated that Matrine possessed antiviral activities against PRRSV/PCV2 co-infection in vitro. To establish a PRRSV/PCV2 co-infected KM mouse model and evaluate the antiviral activities of Matrine against PRRSV/PCV2 co-infection. A total of 144 KM mice were randomly divided into six groups with 24 mice in each group, named as: normal control, PRRSV/PCV2 co-infected group (PRRSV/PCV2 group), Ribavirin treatment positive control (Ribavirin control) and Matrine treatment groups (Matrine 40 mg/kg, Matrine 20 mg/kg and Matrine 10 mg/kg). Except normal control group, all mice in other five groups were inoculated with PRRSV, followed by PCV2 at 2 h later. At 7 days post-infection (dpi), mice in the treatment groups were intraperitoneally administered with various doses of Matrine and Ribavirin, twice a day for 5 consecutive days. ResultsPRRSV N and PCV2 CAP genes were detected by PCR in multiple tissues including heart, liver, spleen, lungs, kidneys, thymus and inguinal lymph nodes. The viral load of PCV2 was the highest in liver followed by thymus and spleen. Although PRRSV were detected in most of the tissues, but the replication of PRRSV was not significantly increased, as shown by qPCR analysis. Comparing with PCV2 infection alone, PRRSV infection significantly elevated PCV2 replication and also exacerbated PCV2 induced interstitial pneumonia. qPCR analysis demonstrated that 40 mg/ml Matrine significantly attenuated PCV2 replication in liver and alleviated virus induced interstitial pneumonia, suggesting that Matrine could directly inhibit virus replication. In addition, Matrine treatment enhanced peritoneal macrophages phagocytosis at 13 and 16 dpi, and 40 mg/kg of Matrine increased the proliferation activity of lymphocytes. Body weight gain was continuously promoted by administrating Matrine at 10 mg/kg.ConclusionMatrine possessed antiviral activities via inhibiting virus replication and regulating immune functions in mice co-infected by PRRSV/PCV2. These data provide new insight into controlling PRRSV and PCV2 infection and support further the research for developing Matrine as a new possible veterinary medicine.
Dosimetric comparison of fixed field dynamic IMRT and VMAT techniques in simultaneous integrated boost radiotherapy of Prostate Cancer
Authors: SUN Haitao , Liu Ying , Chen Along , Wang Ning
Published: May 2020

Background: As the high risk prostate cancer can be benefited from the combination of hypo-fractionated radiotherapy and pelvic conventional fraction radiotherapy, the comparison between fixed field dynamic IMRT and VMAT techniques can provide suggestion for clinical treatment. Methods: We selected 10 patients with high risk prostate cancer who received radiotherapy at Sun Yat-sen University Cancer Center from 2013 January to 2013 December. The target including the prostate, seminal vesicle and pelvic lymph nodes. With the same prescription and optimized parameters, 9 field IMRT, single arc and double arc VMAT treatment plans were designed, which are expressed by 9F, 1ARC and 2ARC respectively. The dose distribution of the targets, organs at risk (OAR), monitor units (MUs), treatment time and gamma pass ratios of dose verification were compared. Results: The D2%(69.37±0.89)Gy,D50%(66.92±0.63)Gy, HI(0.09±0.02) and CI(0.83±0.05) of PTV1 in 9F were slightly better than those of 1ARC which were (71.13±1.21) Gy, (68.50±0.76)Gy, (0.12±0.02), (0.74±0.07), except D98% , the difference were significant(p<0.05). All dosimetric indices of PTV1 in 9F and 2ARC were close and has no significant differences (p>0.05). The V95 %(99.45±0.78)% of PTV2 in 9F was slightly better than that in 1ARC (99.35±1.28)%, the difference was significant (p<0.05). All dosimetric indices of PTV2in 9F and 2ARC were close and the difference were no significant (p>0.05). The Dmean of bladder and the V67.5Gyof rectum between all three plans were similarity The Dmean of left and right femoral in 1ARC and 2ARC were lower than that in 9F, and the difference was significant (p<0.05). Other dosimetric indices of OARs in 9F were lower than those in 1ARC and 2ARC, and much lower than 1ARC, the difference were significant (p<0.05). The mean monitor units in 1ARC and 2ARC were fewer by 70.0% and 67.2% in comparison with 9F. The treatment mean time in 1ARC and 2ARC were shorter by 81.7% and 61% in comparison with 9F. The verification pass ratios of γ(3%/3mm)were 97.8% (9F), 98.9% (1ARC) and 99.4% (2ARC) respectively, the difference were significant(p<0.05). Conclusion: Compared with IMRT, VMAT improved delivery efficiency noticeably. Two arcs provided comparable tumor dosimetric coverage, but performed worse in dose sparing for bladder, rectum and small bowel. IMRT plan was better than VMAT in prostate cancer simultaneous integrated boost radiotherapy.
A novel mathematical approach to estimate the hepatic, cerebral and renal blood flow from dynamic nuclear imaging studies independently of the used radio tracer
Authors: Geist Barbara Katharina , Hamböck Martina , Berroteran-Infante Neydher , Böhmig Georg , Bugayong Stefanie , Nakuz Thomas , Nics Lukas , Pichler Verena , Rasul Sazan , Sareshgi Reza Agha Mohammadi , Traub-Weidinger Tatjana , Zacher Anna , Staudenherz Anton , Hacker Marcus , Neufeld Helmut
Published: May 2020

Background

The blood flow (BF) is a critical determinant of organ functionality. Its assessment in the course of routine nuclear medicine examinations, including planar scintigraphy and positron emission tomography (PET), can be relevant for the diagnosis and monitoring of various conditions. The aim of this study was to investigate a new mathematical approach developed to estimate the organ BF from dynamic imaging data and to analyze if this method can be applied independent of the used radio tracer or imaging modality. The new approach uses the early phase of time activity curves extracted from animal and human dynamic scintigraphy and PET scans. Independence of tracer characteristics was evaluated with major oxygen-dependent organs (kidneys, liver, brain) of a mouse model. The approach was also applied on renal scans with two different imaging modalities from a representative cohort of 32 human subjects and compared to reference values.
Results

The mean organ-specific BF determined in the mouse model revealed no significant differences between the administered radiotracers and all calculated values corresponded to normal values (kidneys: 1.0-1.1 ml/min, liver: 1.4–1.6 ml/min, brain: 0.2 ml/min). In the human study cohort, the renal BFs from the two performed imaging modalities showed a good correlation (r = 0.61, p = 0.001) and a small significant difference (p = 0.047) among each other and good correlations to the reference value obtained from blood sampling (r = 0.79 and r = 0.52).
Conclusions

A mathematical approach was developed to assess the organ BF solely from dynamic imaging scans without the necessity of additional measurements. Preliminary data suggests that several radiotracers might be feasible to estimate the BF in major oxygen-dependent organs.
A Pilot Correlation Study of Gut Microbiome between Children with Henoch-Schönlein Purpura and their Mothers
Authors: Zhao Changying , Wang Ying , Yang Junjie , Zhang Jiaming , Liu Xuemei , Zhang Hongxia , Wang Xingcui , Shen Nan , Chen Bin , Liu Yi , Zhang Lei , Gai Zhongtao
Published: May 2020

Background: Vertical microbiome transmission from mothers plays an important role inchildren with the establishment and development of gutmicrobiome.Our previous study has found that gut microbiota dysbiosis is associated with Henoch-Schönleinpurpura(HSP) in children,while it is unclear whether there is a correlation between the gut microbiome of the HSP children and their mothers. Methods: In this study, 50HSP child-mother pairs and 61 matched healthy child-mother pairs were enrolled and examined.Stool samples were collected for DNA extraction and 16S rRNA genesequencing, followed by analyses of the gut microbiota composition.Results: Significant differences were observed in the gut microbiome composition between HSP children and healthy children. Several unique biomarkers, such as Enterococcus, Fusobacterium,Veillonellaand Streptococcus were identified. A significant increase of the relative abundance of Prevotella and Megamonas were observed in HSP’s mothers (HSP-M) compared with mothers of the healthy children (H-M). HSP children’s gut microbiome is closely associated with that of their mothers, and the taxon of AcidaminococcusandRoseburiawere onlyfound in the gut microbiome of HSP children and their mothers (HSP-M+C).Conclusions: Our preliminary study revealed that the gut microbiome of HSP children are closely associated with that of their mothers, although children with HSP still possess unique bacterial biomarkers. Dysbiosis of the maternal gut microbiota may play a critical role in increasing the risk of HSP in children, which deserve further longitudinalinvestigations to uncover its mechanisms.
A Comparison of Breastfeeding Experiences between Mothers Spending the Traditional Chinese Confinement Period in a Confinement Centre or at Home
Authors: Foong Siew Cheng , Tan May Loong , Foong Wai Cheng , Ho Jacqueline J , Rahim Fairuz Fadzilah
Published: May 2020

BackgroundEthnic Chinese mothers in Malaysia adhere to 30 days of traditional post-partum practices (the “confinement period”) aimed at recuperation after delivery. Recently there has been an emergence of confinement centres (CCs), where mothers stay and receive traditional confinement care. Ethnic Chinese mothers have low breastfeeding rates. There are concerns that practices in CCs could contribute to this but no data exists. We describe mother’s breastfeeding experience at CCs and identify areas for potential improvement in breastfeeding support.MethodsEthnic Chinese mothers intending to breastfeed their healthy infants were recruited post-delivery, then telephone interviewed about their experience 1 and 6 months later. For every participant going to CCs, another mother going home was recruited. Chi-square test was used to compare groups and multiple logistic regression was used to assess the effect of confinement place on exclusive breastfeeding. Results Of 187 mothers, 88(47%) went to CCs. Significantly more were primigravida and fewer had previous breastfeeding experience. Response rates for one- and 6- month interviews were 87.5% (CC) vs 97% (home); and 77.3% (CC) versus 86.7% (home).Exclusive breastfeeding rates at 1 and 6 months were similar between the groups. Multiple logistic regressiondid not show that CCs were a factor affecting exclusive breastfeeding rates at 1 month (adjusted odds ratio (aOR) 1.66, 95% confidence interval(CI) 0.85 to 3.28) or 6 months (aOR 0.86, 95% CI 0.44 to 1.70). However, significantly more CC participants only fed expressed breastmilk. Despite 66% of CC participants reporting that their centre supported breastfeeding, only 6(8%) CC participants compared to 66(69%) of home participants slept with their baby. The proportion encountering breastfeeding difficulties were similar between groups. CC participants sought help for breastfeeding problems mainly from CC staff and support groups while home participants obtained help from friends and healthcare professionals. ConclusionsContrary to current perceptions, breastfeeding experience and breastfeeding rates were similar at CCs and home but there were gaps in how CCs supported breastfeeding. Targeted training to CC staff to support breastfeeding may result in better outcomes for mothers staying in CCs. Trial registrationNational Medical Research Register NMRR-17-1174-36384S1