bluuebunny/crossref_metadata_2025 huggingface dataset:
Genomic content of chemosensory genes correlates with host range in wood-boring beetles (Dendroctonus ponderosae, Agrilus planipennis, and Anoplophora glabripennis)
Authors: Andersson Martin N. , Keeling Christopher I. , Mitchell Robert F.
Published: September 2019

Background
Olfaction and gustation underlie behaviors that are crucial for insect fitness, such as host and mate selection. The detection of semiochemicals is mediated via proteins from large and rapidly evolving chemosensory gene families; however, the links between a species’ ecology and the diversification of these genes remain poorly understood. Hence, we annotated the chemosensory genes from genomes of wood-boring coleopterans, and compared the gene repertoires from stenophagous species with those from polyphagous species.

Results
We annotated 86 odorant receptors (ORs), 60 gustatory receptors (GRs), 57 ionotropic receptors (IRs), 4 sensory neuron membrane proteins (SNMPs), 36 odorant binding proteins (OBPs), and 11 chemosensory proteins (CSPs) in the mountain pine beetle (Dendroctonus ponderosae), and 47 ORs, 30 GRs, 31 IRs, 4 SNMPs, 12 OBPs, and 14 CSPs in the emerald ash borer (Agrilus planipennis). Four SNMPs and 17 CSPs were annotated in the polyphagous wood-borer Anoplophora glabripennis. The gene repertoires in the stenophagous D. ponderosae and A. planipennis are reduced compared with those in the polyphagous A. glabripennis and T. castaneum, which is largely manifested through small gene lineage expansions and entire lineage losses. Alternative splicing of GR genes was limited in D. ponderosae and apparently absent in A. planipennis, which also seems to have lost one carbon dioxide receptor (GR1). A. planipennis has two SNMPs, which are related to SNMP3 in T. castaneum. D. ponderosae has two alternatively spliced OBP genes, a novel OBP “tetramer”, and as many as eleven IR75 members. Simple orthology was generally rare in beetles; however, we found one clade with orthologues of putative bitter-taste GRs (named the "GR215 clade"), and conservation of IR60a from Drosophila melanogaster.

Conclusions
Our genome annotations represent important quantitative and qualitative improvements of the original datasets derived from transcriptomes of D. ponderosae and A. planipennis, facilitating evolutionary analysis of chemosensory genes in the Coleoptera where only a few genomes were previously annotated. Our analysis suggests a correlation between chemosensory gene content and host specificity in beetles. Future studies should include additional species to consolidate this correlation, and functionally characterize identified proteins as an important step towards improved control of these pests.
A Retrospective Study of the Clinical Phenotype and Predictors of Survival in non-Caucasian Hispanic Patients with Amyotrophic Lateral Sclerosis.
Authors: Sánchez-Martínez Claudia Marisol , Choreño-Parra José Alberto , Nuñez-Orozco Lilia , Placencia-Álvarez Noel Isaías , Alvis-Cataño Laura Marcela , Guadarrama-Ortiz Parmenides
Published: September 2019

Background. Little is known about the clinical phenotype of amyotrophic lateral sclerosis (ALS) in non-Caucasian populations. Here, we aimed to describe the clinical characteristics, prognostic factors and survival of Mexican patients with ALS.
Methods. We conducted a retrospective study by reviewing the medical records of patients with ALS that attended and were regularly followed at a third level hospital in Mexico City from 2000 to 2015. We calculated absolute and relative frequencies of the clinical characteristics from all the participants. We also estimated correlation coefficients between clinical features and overall survival. Additionally, survival rates were compared for all participants grouped according to different clinical features using the Kaplan-Meier method and the log-rank test.
Results. We enrolled 45 ALS patients, 53.33% had spinal-onset ALS and 46.66% presented bulbar ALS. The male/female ratio was 0.8. The mean age at onset of symptoms was 58.11 years. Mean survival time from onset was 64.73 ± 34.83 months. Cumulative survival rate after 5 years of disease onset was 44.44%. Age at onset and age at diagnosis inversely correlated with overall survival time. Also, we found that bulbar-onset, short diagnostic delay, percutaneous endoscopic gastrostomy, mechanical ventilation, and lower total cholesterol serum levels were associated with short survival.
Conclusions. The clinical characteristics of Mexican ALS patients differ from the disease phenotype observed in Caucasians. Nonetheless, the predictive value of certain well-recognized prognostic factors remains consistent in our population. The current study provides relevant information for a better understanding of prognostic factors in ALS patients from Mexico and other Latin American countries.
Weight Management Merits Attention in women with infertility: A Cross-Sectional Study on the Association of Anthropometric Indices with Hormonal Imbalance in a Ghanaian Population
Authors: Owiredu William K.B.A. , Ofori Peter Ntim , Turpin Cornelius Archer , Obirikorang Christian , Acheampong Emmanuel , Anto Enoch Odame , Owiredu Eddie-Williams , Adu Evans Asamoah
Published: September 2019

Objective: This study determined the association of anthropometric indices with hormonal imbalance among infertile women in a Ghanaian population.
Results: Follicle stimulating hormone (FSH) levels (18.47 vs 8.67, p-value =0.002), and luteinizing hormone (LH) (12.43 vs 8.01, p-value =0.044) were higher in women with primary infertility compared with women presenting with secondary infertility. Waist circumference (WC) and waist-to-height ratio (WHtR) showed significant negative partial correlation with prolactin in both primary and secondary infertile women. Also a significant negative partial correlation was observed between BMI and prolactin in secondary infertile women only. Waist-to-hip ratio (WHR) showed a positive association with LH in both primary and secondary infertility. WHR also showed significant positive correlation to LH/FSH ratio in secondary infertility whereas body adiposity index (BAI) showed a negative correlation to LH/FSH ratio. In a correlation analysis of anthropometric measures with hormonal profile and causes of infertility as a fixed factor, the association between anthropometric indices and fertility hormones was largely dependent on the underlying causes of infertility.
Efficacy of ultrasound-guided rectus sheath block, butorphanol for single-incision laparoscopic cholecystectomy: A prospective, randomized, clinical trial
Authors: Fu Huimin , Zhong Chaochao , Gao Yongtao , Xu Xingguo
Published: September 2019

Background: Whether rectus sheath block (RSB) combined with butorphanol can relieve incision pain and visceral pain in patients undergoing single-incision laparoscopic cholecystectomy (SILC) remains unknown. The goal of this study was to assess the efficacy of ultrasound-guided bilateral RSB, butorphanol on postoperative analgesia in patients undergoing SILC. Methods: All 116 patients who met the criteria were randomly divided into four groups: (Ⅰ) (n=29) general anesthesia combined with patient controlled intravenous analgesia (PCIA) (sufentanil 100ug); (Ⅱ) (n=29) general anesthesia combined with PCIA (butorphanol 8mg); (Ⅲ) (n=29) ultrasound-guided RSB combined with PCIA (sufentanil 100ug). (Ⅳ) (n=29) RSB combined with PCIA (butorphanol 8mg). Outcomes included visual analog scale (VAS) scores of incisional and visceral pain at rest and cough at 2,6,12 and 24h postoperatively, if a patient’s pain score＞3, then butorphanol 2mg was administered intravenously. the dose of butorphanol and opioids, the pressing numbers of PCIA, the length of hospital stay and the incidence of postoperative adverse events. Results: Both rest and cough pain scores were lower during first 2,6 hours in group Ⅲ than groupⅠ, similarly, group Ⅳwas significantly lower than groupⅡ. GroupⅠneeded more butorphanol as rescue analgesic for pain relief than group Ⅲ, group Ⅳ was better than group Ⅱ. In the above pairwise comparisons, it was clear that group Ⅲ and group Ⅳ had lower VAS scores. VAS scores of visceral pain was lower in groupⅡ at 2, 6 and 12 h after surgery compared with the groupⅠ. In the both groups Ⅲ and Ⅳ, the group Ⅳ was also lower than groupⅢ. Overall, RSB combined with PCIA (butorphanol 8mg) is the best match. Conclusions: Ultrasound-guided RSB combined with butorphanol can provide sufficient pain treatment after SILC. Trial registration: The study was registered prospectively with the Chinese Clinical Trial Registry（reg no.ChiCTR1900020738), obtained ethics committee of Affiliated Hospital of Nantong University approval (approved number: 2018-K067).
Endoscopic treatment of leaks and strictures after laparoscopic one anastomosis gastric bypass
Authors: Younis Fadi , Shnell Mati , Gluck Nathan , Abu-Abeid Subhi , Eldar Shai , Fishman Sigal
Published: September 2019

Background: Laparoscopic one anastomosis gastric bypass has become a prominent bariatric procedure. Yet, early and late complications, primarily leaks and strictures, are not uncommon. This study summarizes our experience with endoscopic treatment of laparoscopic one anastomosis gastric bypass complications. Methods: This is a retrospective study of consecutive patients referred to our hospital from 2015 to 2017 with post laparoscopic one anastomosis gastric bypass complications. Therapy was tailored to each case, including fully covered self-expandable metal stents, fibrin glue, septotomy, internal drainage with pigtail stents, through-the-scope and pneumatic dilation. Success was defined as resuming oral nutrition without enteral or parenteral support or further surgical intervention. Results: Nine patients presented with acute or early leaks: 5 (55.6%) had staple-line leaks, 3 (33.3%) had anastomotic leaks and 1 (11.1%) had both. All were treated with stents. Adjunctive endoscopic drainage was applied in 4 patients (44.4%). Overall 5 patients (55.6%) with acute/ early leaks recovered completely, including all 3 patients with anastomotic leak and the patient with both leaks but only 1/5 with staple line leak (20%). Complication rate in the leak group reached 22.2%. Eight patients presented with strictures, 7 at the anastomosis and one due to remnant stomach misalignment. All anastomotic strictures were dilated successfully. However, the patient with the pouch stricture required conversion to Roux-en-Y gastric bypass after 3 failed attempts of dilatation. Conclusion: Endoscopic treatments of laparoscopic one anastomosis gastric bypass complications are relatively effective and safe. Anastomosis-related complications are more amenable to endoscopic treatment compared to staple line leaks.
Comparing the sciatic nerve block quality of anterior and posterior approaches: A randomised trial
Authors: Yektaş Abdulkadir , Balkan Bedih
Published: September 2019

Background: The co-administration of sciatic nerve and femoral nerve blocks may provide anaesthesia and analgesia in patients undergoing lower extremity surgeries. Several approaches to sciatic nerve block have been described, including anterior and posterior approaches. Methods: Our study included 58 patients, randomly assigned to receive either an anterior (Group A, n = 29) or posterior (Group P, n = 29) approach. After the blocks were performed, we determined sensory and motor block start and end times, the time to first intraoperative fentanyl administration, the total dose of fentanyl required, the time to first diclofenac sodium administration, and the total dose of diclofenac sodium required. The date of trial registration was retrospectively registered in 11.07.2018Results: Comparison of the two groups revealed that Group P exhibited significantly shorter times to starting the sensory block (12.88±4.87 min for Group A, 7.70±2.05 min for Goup P) p=0.01 and first fentanyl administration (29.20±27.79 min for Group A, 4.05±7.47 min for Group P) p=<0.01, and a significantly lower total dose of fentanyl required (147.75±122.30 min for Group A, 27.75±53.91 min for Group P) p=0.01. Patient satisfaction (p=<0.01), anesthesia quality (p=0.006), and surgical quality (p=0.047) were significantly higher in Group P.Conclusions: For patients without pain secondary to fractures, the posterior approach to sciatic nerve block is preferable. If patients have pain secondary to fractures, the anterior approach is preferable so as to avoid repositioning.
Daiobotanpito combined with antibiotic therapy for treatment of acute diverticulitis: a study protocol for a randomized controlled trial
Authors: Ogawa-Ochiai Keiko , Yoshimura Keinichi , Shirai Akiko , Sakai Seisho , Moriyama Hideki , Nakamura Keishi , Murayama Toshinori , Ishikawa Hideki
Published: September 2019

Background: Colonic diverticular disease has been increasing in prevalence due to the rapidly aging global population, but standard treatment has not changed dramatically in recent years. Daiobotanpito (DBT; Da Huang Mu Dan Tang in Chinese) has been used in medical treatment of acute abdominal abscesses, such as appendicitis or diverticulitis in traditional Japanese (Kampo) medicine for many years, based on more than 3000 years of experience. Prior to this study, a retrospective open-label trial was conducted to compare patients with acute diverticulitis who received oral DBT combined with intravenous antibiotics with those who received intravenous antibiotic alone; it showed a positive effect of DBT on acute diverticulitis. We aim to investigate whether moderate to severe acute diverticulitis shows greater improvement with intravenous antibiotics plus orally administered DBT compared with intravenous antibiotics with placebo. Methods: This is a two-group, randomized, double-blind, placebo-controlled, multi-center trial, which is designed to evaluate the efficacy and safety of DBT for moderate to severe diverticulitis patients treated with intravenous antibiotics. Eligible participants will be randomized to either a treatment group receiving a 10-day oral DBT regimen plus conventional therapy or a control group receiving a 10-day placebo regimen plus conventional therapy. The primary outcome will be the rate of fever reduction within 3 days or/and abdominal pain relief within 4 days. Secondary endpoints will include hospitalization days, changes in inflammatory response (CRP, WBC, neutrophil count), thermal type, number of days before beginning food intake, recurrence rate (observation for 1 year after registration), and adverse event expression rate. Assessments will be performed at baseline and on the day of discharge. The recurrence rate will be recorded at 1 year after registration. Discussion: This study is expected to provide evidence to support the clinical benefits of DBT in the treatment of acute diverticulitis. It may also provide evidence regarding the efficacy and safety of DBT in the recurrence of acute diverticulitis. Trial registration: UMIN000027381, registered on April 27th, 2017 https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000031377, and changed to jRCTs041180063, registered on July 30th, 2019; https://jrct.niph.go.jp/en-latest-detail/jRCTs041180063
Inhibition of PI3K/AKT molecular pathway mediated by membrane estrogen receptor GPER accounts for cryptotanshinone induced antiproliferative effect on breast cancer SKBR-3 cells
Authors: Shi Danning , ZHAO PIWEN , CUI LIXIA , SUN LIPING , LI HONGBO , NIU JIANZHAO , CHEN MENG
Published: September 2019

Background : Breast cancer is the most frequently diagnosed cancer among women and the second leading cause of cancer death. Especially nuclear estrogen receptor (nER) negative breast cancer is always with much poor prognosis. In recent years, it was reported that membrane G protein coupled estrogen receptor (GPER), a newly recognized estrogen receptor took essential part in the development and treatment of breast cancer, especially nER negative breast cancer. The present study aimed to investigate the anti nER negative breast cancer effect and its possible molecular pathway of cryptotanshinone (CPT), an important active compound of traditional Chinese medicine Danshen.Methods: The following in vitro tests were performed in nER negative but GPER positive breast cancer SKBR-3 cells. The effect of CPT on cell proliferation rate and cell cycle distribution was evaluated by MTT cell viability test and flow cytometry assay. The role of PI3K/AKT pathway and the mediated function of GPER were tested by western blot and immunofluorescence. Technique of gene silence and the specific GPER agonist G-1 and antagonist G-15 were employed in the experiments to further verify the function of GPER in mediating the anticancer role of CPT. Results: The results showed that proliferation of SKBR-3 cells could be blocked by CPT in a time and dose dependent manner. CPT also exerted antiproliferative activities by arresting cell cycle progression in G1 phase and down regulating the expression level of cyclin A, cyclin B, cyclin D and cyclin-dependent kinase 2 (CDK2). The antiproliferative effect of CPT was further enhanced by G1 and attenuated by G15. Results of western blot and immunofluorescence both showed that PI3K and p-AKT protein expression could be down regulated by CPT and such effects were mediated by GPER which is further demonstrated by GPER gene silence test.Conclusion: Our present study shows that the antiproliferative action of CPT on SKBR-3 cells is realized by inhibition of GPER mediated PI3K/AKT pathway. These findings deserve further validation for serving as useful therapeutic targets.
Diversity and bioactivities of fungal endophytes from Distylium chinense, a rare waterlogging tolerant plant endemic to the Three Gorges Reservoir
Authors: Duan Xiaoxiang , Xu Fangfang , Qin Dan , Gao Tiancong , Shen Weiyun , Zuo Shihao , Yu Baohong , Xu Jieru , Peng Yajun , Dong Jinyan
Published: September 2019

Background The present study focuses on diversity and biological activities of the endophytic fungal community from Distylium chinense , a rare waterlogging tolerant plant endemic to the Three Gorges Reservoir. This study has been explored the characteristics of endophytic fungi in waterlogged environment including both aquatic and terrestrial fungi, and they may produce new metabolites under complex and extreme conditions, which may possess bioactive property. Therefore, the antioxidant, antimicrobial and anticancer activities of all endophytes isolated from this study have been investigated. Moreover, the active metabolites of the most broad-spectrum bioactive strain have also been studied.Results A total of 154 fungal endophytes were isolated from roots and stems. They were categorized into 30 morphotypes based on cultural characteristics and were affiliated with 27 different taxa. Among these, the most abundant fungal orders included Diaporthales (34.4%) and Botryosphaeriales (30.5%), which were predominantly represented by the species Phomopsis sp. (24.7%) and Neofusicoccum parvum (23.4%). Fermentation extracts were evaluated, screening for antioxidant, antimicrobial and anticancer activities. Among the 154 isolates tested, 99 (64.3%) displayed significant antioxidant activity, 153 (99.4%) exhibited inclusive antimicrobial activity against at least one tested microorganism and 27 (17.5%) showed exclusive anticancer activity against one or more cancer cell lines. Specifically, the crude extract of Irpex lacteus DR10-1 exhibited note-worthy bioactivities. Further chemical investigation on DR10-1 strain resulted in the isolation and identification of two known bioactive metabolites, indole-3-carboxylic acid ( 1 ) and indole-3-carboxaldehyde ( 2 ), indicating their potential roles in plant growth promotion and human medicinal value.Conclusions These results indicated that diverse endophytic fungal population inhabits D. chinense . The isolated endophyte DR10-1 ( Irpex lacteus ) has the potential to be a source of novel antioxidant/antimicrobial/anticancer compounds. The findings of the present study not only provide a sustainable resource for the utilization of endophytic fungi in D. chinense but also provides an important basis for further understanding of fungal communities in medicinal plants.
Latent tuberculosis infection in HIV-infected adults of Kinshasa, DR Congo
Authors: Kadima José , Lutumba Pascal , Kaswa Michel , Maketa Vivi , Matangila Junior , Matee Mecky
Published: September 2019

Background The World Health Organization (WHO) End Tuberculosis Strategy calls for a 90% reduction in tuberculosis (TB) deaths and an 80% reduction in the incidence rate between 2015 and 2035. The 2018 WHO guidelines recognize the need for high-burden countries to implement outreach and treatment for the most vulnerable patients with latent TB infection (LTBI) in addition to treating patients with the active disease. The Democratic Republic of Congo (DR Congo) is among the countries bearing the highest burden of TB. However, additional data on LTBI is required for effective policy and strategy against the disease. Accordingly, the aim of this study is to estimate the prevalence of LTBI in HIV-infected adults in Kinshasa, DR Congo. Methods Over two hundred HIV-infected adult residents of Kinshasa were screened using both TUBERTEST®, which is a tuberculin skin test (TST), and QuantiFERON-TB Gold Plus® (QFT-Plus), which is an interferon gamma release assay. LTBI was screened using TST, QFT-Plus, and a combination of the two tests. The agreement between TST and QFT-Plus was calculated using Cohen’s Kappa coefficient. Results A total of 248 HIV-infected persons were enrolled in the study. Seventy-six patients (30.7% IC 95%: 25.2-36.7) had a positive TST result. Sixty-four (25.8% IC 95%: 20.7-31.6) had a positive QFT-Plus test result. The Kappa coefficient between TST and QFT-Plus was 0.225. Conclusions The prevalence of LTBI among HIV positive adults in Kinshasa was high considering either the positive TST or the positive QFT-Plus. However, the two tests had poor agreement.
Clinical and biochemical manifestations of systemic lupus erythematosus at first diagnosis within Chinese patients
Authors: xie changhao , zhang li li , wang yuan yuan , li zhi jun , chen lin jie , zhao ping , jiang chao , fan xiao yun , li ji qin
Published: September 2019

Bankground: The objective of this paper was to describe the first symptoms associated with systemic lupus erythematosus (SLE), including clinical manifestations, laboratory findings, prognoses, differences between men and women at the time of first diagnosis of SLE. Methods : We enrolled 223 patients with initial diagnosis of SLE. Their initial symptoms, demographic, clinical and laboratory data，prognoses and causes of death were analyzed retrospectively. Clinical manifestations and laboratory profiles were compared between male and female patients. Results: Compared with female patients, male patients had an earlier age of onset, a higher incidence of neuropsychiatric involvements, a lower incidence of leukocytopenia , and a higher score of SLE Disease Activity Index (SLEDAI）at diagnosis. Fever and malar rash were most frequent presentations at onset of SLE. The most common clinical manifestation at first diagnosis was fever, followed by arthralgia, malar rash, Raynaud ’ s phenomenon, arthritis. The liver function abnormalities included increased ALT,AST,ALP and γ-GGT.ANA were found in 100% of patients, followed by anti-dsDNA(LIA) in 72.1%, anti-Ro60 in 67.8%, anti-Ro52 in 62.3%, anti-nucleosomes in 55.7%. Conclusions: We identified clinical and serological manifestations of Chinese SLE patients at first diagnosis. Male patients showed a distinctive manifestation including younger age of onset，a higher incidence of CNS manifestations, a higher score of SLEDAI compared to females.
A cross-sectional, non-interventional study of the correlation between insight and adherence in schizophrenia in Nepal
Authors: Stokes Imogen Henrietta , Lama Uddhav , Khattri Jai Bahadar
Published: September 2019

Background: There is a significant lack of research in the Nepalese study population on adherence in patients with schizophrenia. This cross-sectional, non-interventional study aims to re-examine the recognised correlation between insight and adherence in this population, whilst exploring the association between patient demographics and adherence to help bring understanding to how familial and environmental factors may impact adherence. Methods: Patients were recruited upon attendance to outpatient’s appointments and admission to the psychiatry department of Manipal Teaching Hospital. A self-report questionnaire was used to collect data on patient demographics, including age, ethnicity, religion, employment status, current living arrangements and education level; the Birchwood Insight Scale (BIS); and the Drug Attitude Inventory (DAI-10) score. Descriptive statistics on the demographics, BIS and DAI-10 were collated using SPSS. An analysis of variance of DAI-10 scores according to participant demographics was performed using a one-way ANOVA analysis. Correlation between the BIS and BIS subscales and the DAI-10 was tested using Pearson’s 2-tailed analysis at 0.01 significance level.Results: 19 participants consented to participate in this study with 100% data obtained. 57.9% unemployed, 63.2% living with parents and 47.4% had only a basic education. 36.8% of participants had poor insight; 84.2% of participants had poor insight into their symptoms; 78.9% of participants had poor insight into their illness and 36.8% had poor insight into their need for treatment. 52.7% of participants were poor adherers. No significant differences in DAI-10 scores were found between demographic groups. A positive correlation was found between the total BIS score and DAI-10 score (Pearson correlation coefficient of 0.585; P value = 0.009). Furthermore, the awareness of need for treatment subscale score and the DAI-10 score found a correlation coefficient of 0.609 (P value = 0.006). Conclusions: In conclusion, this study found prevalent non-adherence to medication and demonstrated that insight correlates with adherence. Although study findings did not suggest that patient demographics were associated with non-adherence, it is important to consider the possibility that these high rates of non-adherence have other contributing factors; overcoming rural health inequality, cultural beliefs regarding psychiatric illness and unaffordability remain the great challenges for the Nepalese population.
Suicidal ideation, attempt, and determinants among medical students
Authors: Desalegn Getachew Tesfaw , Wondie Mesele , Dereje Saron , Addisu Adanech
Published: September 2019

Background Suicidal ideation and attempt are highly prevalent among medical students compared to the general population and negatively impacts the quality of life, physical, and mental well being of students. However, research into suicidal ideation and attempt among medical students in low and middle-income countries are limited. Therefore, this study aimed to explore the suicide ideation and attempt and associated factors among medical students in Ethiopia.Methods An institution based cross-sectional study was conducted from March to June 2019 at the University of Gondar among medical students. A simple random sampling technique used to get study units by their identification card. Suicide ideation and attempt were assessed by using World Health Organization Composite International Diagnostic Interview (CIDI) to assess suicide ideation and attempt. Data were collected using self-administered questionnaires. Binary logistic regression analysis was used to identify associated factors between suicidal ideation and attempt with the explanatory variables at p-value <0.05 was considered statistically significant.Results The prevalence of suicidal ideation and attempt among study participants was found to be 14% and 7.4% with 95% CI (10.9, 18.1) and (5.1, 10.2), respectively. In multivariate logistic regression; female sex (AOR: 5.21, 95% CI: 2.42, 11.20), depression (AOR: 10.12, 95% CI; 4.80, 21.52), current khat chewing (AOR: 4.46, 95% CI; 132, 15.02), and poor social support (AOR: 4.46, 95% CI: 1.43, 13.87) were factors significantly associated with suicidal ideation. Being female (AOR: 8.08, 95% CI: 3.04, 21.39), depression (AOR: 10.66, 95% CI; 4.01, 28.01 ) and history of mental illness (AOR: 5.53, 95% CI; 1.20, 25.50) were factors significantly associated with suicidal attempt.Conclusion In the current study, the prevalence of suicidal ideation among medical students was low compared to other studies, but the suicidal attempt was high. The University of Gondar better to instate a screening program for every medical student for early diagnosis and intervention of suicide ideation and attempt.
Psychiatric disorders risk in patients with iron deficiency anemia and association with iron supplementation medications: a nationwide database analysis
Authors: Lee Herng-Sheng , Chao Hsin-Hao , Huang Wan-Ting , Chen Solomon Chih-Cheng , Yang Hsin-Yi
Published: September 2019

Background It has been shown that iron deficiency anemia (IDA) is associated with psychosocial consequences and psychiatric morbidity. However, the association between adults with IDA and psychiatric disorders has not been clarified. The purpose of this study is to investigate the psychiatric disorders morbidity of IDA in comparison with non-IDA group and to examine the risk of psychiatric disorders in IDA patients treated with iron supplementary.Methods All study subjects aged ≥ 20 years with newly diagnosed IDA in the Taiwan National Health Insurance Database during 2000-2012 were enrolled. We matched IDA and non-IDA subjects according to age and gender in a 1:2 ratio. Our primary outcome was diagnosis of psychiatric disorders and the patients were monitored until the end of 2013. The Cox proportional hazards regression model was used to evaluate the risk of psychiatric disorders events to occur in IDA.Results The adjusted hazard ratios (aHR) of psychiatric disorders was 1.49 (95% CI = 1.43 – 1.56) in the IDA group compared with the non-IDA group. Among the different type of psychiatric disorders occurrence, the IDA group was associated with significantly higher incidence and risks of dementia, anxiety disorders, depression, sleep disorders and psychotic disorders (p < 0.05). Furthermore, iron supplementation use to IDA subjects was associated with significantly lower risk of psychiatric disorders compared with IDA patients without iron supplementation.Conclusions Our study indicates that IDA had an increased risk of psychiatric disorders, regardless of other confounders. Moreover, in IDA patients, iron supplementation use could reduce the risk of psychiatric disorders, especially sleep disorders.
Comparison of relationships among French adult siblings with or without schizophrenia using the ASRQ-S: mediating effect on emotional distress
Authors: Plessis Léa , Wilquin Hélène , Pavani Jean-Baptiste , Bouteyre Evelyne
Published: September 2019

Background: Good sibling relationships in adulthood are known to be a protective factor for mental health. The present study examined and compared the relationships of siblings with either a healthy brother or sister or one experiencing schizophrenia. Methods: In the first phase, we ran a statistical comparison of the two sibling groups on the quality of their sibling relationships, emotional distress, and self-esteem. In the second phase, we looked at whether the quality of the sibling relationship modifies the impact of having a brother or sister with SZ on emotional distress and self-esteem. Results: Results showed that sibling relationships in schizophrenia are less warm and are characterized by heightened rivalry and conflict. In addition, analysis revealed a mediating effect of sibling relationship on the emotional distress of siblings with a brother/sister diagnosed with schizophrenia. Conclusion: More needs to be done to enhance the mental health of adults who have a brother or sister with schizophrenia, notably via their sibling relationships.
A systematic review of the overlap of fluid biomarkers in delirium and advanced cancer-related syndromes
Authors: Amgarth-Duff Ingrid , Hosie Annmarie , Caplan Gideon , Agar Meera
Published: September 2019

Objective Delirium is a serious and distressing neurocognitive disorder of physiological aetiology that is common in advanced cancer. Understanding of delirium pathophysiology is largely hypothetical, with some evidence for involvement of inflammatory systems, neurotransmitter alterations and glucose metabolism. To date, there has been limited empirical consideration of the distinction between delirium pathophysiology and that of the underlying disease, for example, cancer where these mechanisms are also common in advanced cancer syndromes such as pain and fatigue. This systematic review explores biomarker overlap in delirium, specific advanced cancer-related syndromes and prediction of cancer prognosis. Methods A systematic literature search was conducted, using MEDLINE, PubMed, Embase, CINAHL, CENTRAL and Web of Science, to identify body fluid biomarkers in delirium, cancer prognosis and advanced cancer-related syndromes of interest. Studies were excluded if they reported delirium tremens only; did not measure delirium using a validated tool; the sample had less than 75% of participants with advanced cancer; measured tissue, genetic or animal biomarkers, or were conducted post-mortem. Articles were screened for inclusion independently by two authors, and data extraction and an in-depth quality assessment conducted by one author, and checked by two others. Results The 151 included studies were conducted in diverse settings in 32 countries between 1985 and 2017, involving 28130 participants with a mean age of 69.3 years. Seventy-one studies investigated delirium biomarkers, and 80 studies investigated biomarkers of an advanced cancer-related syndrome or cancer prognosis. Overall, 41 biomarkers were studied in relation to both delirium and either an advanced cancer-related syndrome or prognosis; and of these, 24 biomarkers were positively associated with either delirium or advanced cancer syndromes/prognosis in at least one study. The quality assessment showed large inconsistency in reporting. Conclusion There is considerable overlap in the biomarkers in delirium and advanced cancer-related syndromes. Improving the design of delirium biomarker studies and considering appropriate comparator/controls will help to better understanding the discrete pathophysiology of delirium in the context of co-existing illness.
Profile of proinflammatory cytokines in children with Mycoplasma pneumoniae pneumonia
Authors: Dai Ge , Sun Huiming , Wang Ting , Huang Li , Wang Meijuan , Hao Chuangli , Wang Yuqing , Zhu Canhong , Ji Wei , Chen Zhengrong , Yan Yongdong
Published: September 2019

Background: To explore the profile and clinical significance of proinflammatory cytokines in serum and bronchoalveolar lavage fluid (BALF) of children with Mycoplasma pneumoniae pneumonia(MPP) and to elucidate the etiology and pathogenesis of severe MPP (SMPP). Methods: A cohort of 108 children with MPP was divided into SMPP (n=56) and non-severe MPP (NSMPP) (n=52). A total of 40 cases of hospitalized children, who underwent elective surgery, were selected as control group. The levels of proinflammatory cytokines in the serum and BALF were measured by ELISA(Enzyme-linked immunosorbent assay). Results: Compared to the control group, the MPP children showed that the levels of peripheral blood (PB) TNF-a, IFN-g, GM-CSF, IL-17, IL-18, IL-36a, sB7-H1, and sB7-H3 were much higher at the acute phase (P<0.05). Also, they were significantly higher in the SMPP group than that in the NSMPP group (P<0.05). Furthermore, in the SMPP group, the levels of TNF-a, IFN-g, GM-CSF, IL-1b, IL-2, IL-8, IL-36, MPO, MMP-9, NE, sB7-H3 in BALF were significantly higher at acute phase as compared to the control group (P<0.05). sB7-H3 was positively correlated with major proinflammatory cytokines in both PB and BALF specimens. The level of sB7-H3 in PB was >8000 pg/mL was an independent risk factor for SMPP. Conclusions: Excessive inflammation plays a critical role in the occurrence and development of MPP, especially SMPP, and sB7-H3 is an independent risk factor of SMPP.
Endogenous endophthalmitis caused by group B streptococcus; case reports and review of 35 reported cases
Authors: Yoshida Masaaki , Yokokura Shunji , Nishida Takashi , Mochizuki Kiyofumi , Suzuki Takashi , Maruyama Kazuichi , Otomo Takaaki , Nishiguchi Koji M , Kunikata Hiroshi , Nakazawa Toru
Published: September 2019

Background: Group B streptococcus (GBS), a gram-positive coccus that occasionally causes neonatal sepsis or invasive infection in the elderly, has been considered a rare cause of endogenous bacterial endophthalmitis (EBE). However, the number of invasive GBS infections is increasing, particularly in elderly patients with underlying conditions such as diabetes mellitus (DM), cardiovascular disease and cancer. We report 6 cases of EBE caused by GBS and review the literature. Methods: Retrospective case series and literature review Results: In the current case series, 6 eyes of 6 patients developed EBE caused by GBS. The average age was 73.5 years. The focus of infection included the urinary tract, cellulitis, arthritis, peritonitis, catheter-associated infection and endocarditis. Four patients had DM. While all 6 strains were sensitive to β-lactams (penicillins and cephems), 4 strains were resistant to levofloxacin (no data for 1 isolate). Each case was treated with the systemic antibiotic to which the individual strain was sensitive. All cases showed poor visual acuity at presentation (decimal visual acuity: less than 0.03). Vitrectomy with intravitreal antibiotics injection was performed in 4 cases. Visual acuity recovered in 4 cases and did not recover in 2 cases, even after vitrectomy. The literature review of 53 eyes of 41 patients revealed that 60% of eyes finally lost all vision, and death occurred in 2 cases. Initial visual acuity of less than counting fingers was associated with a final outcome of lost vision. Of 41 patients, 13 (32%) had DM as an underlying medical condition. The most common extra-ocular infection site was endocarditis (37%). Conclusions: DM is common in patients with EBE caused by GBS. While the 4 cases in the current report had a relatively good visual acuity outcome, despite poor initial visual acuity, the literature review indicated that EBE caused by GBS is generally a severe condition with a poor prognosis. The current study also indicates the importance of considering the possibility of endocarditis on encountering EBE caused by GBS.
The Effect of Pharmacological Dilation on Calculation of Targeted and Ideal IOL Power Using Multivariable Formulas
Authors: Simon Noah C , Farooq Asim V. , Zhang Michael H. , Riaz Kamran M.
Published: September 2019

Background/Aims To examine the effect of pharmacologic dilation on biometric parameters measured by the Lenstar LS 900, and whether these changes affect the power of the calculated intraocular lens (IOL) using multivariable formulas in an undilated versus pharmacologically dilated state. Methods Prospective study of 98 phakic eyes from 53 patients. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), and keratometry (K) readings were measured. The first set of measurements was taken prior to dilation. After dilation (pupil diameter ≥6.0mm), a second set of measurements was taken. The Barrett, Olsen, Hill-RBF, Haigis, SRK/T, and Holladay I formulas were used to calculate IOL power before and after dilation. Two calculation methods were used: Method A used a commonly available IOL targeted to achieve the lowest myopic spheroequivalent residual refraction (LMP); Method B calculated ideal IOL power for emmetropia (IPE). Results Statistically significant increases were seen in CCT (p<0.01), ACD (p<0.01), and AL (p<0.01) whereas a statistically significant decrease was seen in LT (p<0.01) post dilation. Using Method A, the percentage of eyes which would have received an IOL with 0.5 D or 1.0 D of higher power, if post-dilation measurements were used, were 25.5%, 30.6%, 20.4% and 23.5% for Barrett, Olsen, Hill-RBF and Haigis, respectively. Using Method B, only Haigis and Olsen had a statistically significant increase in ideal IOL power. Conclusions Pharmacologic dilation can be associated with an increase in non-custom IOL dioptric power when using multivariable formulas, which may lead to a myopic surprise.
Studies of the correlation between dual-source CT measured thyroid iodine concentrations, contents and thyroid function
Authors: Li ZhengTeng , Pan Dongmei , Zhai Rui , Wang Min
Published: September 2019

Background The aim of this study is to investigate the correlation between dual-source CT measured iodine concentration, total iodine content and blood measured thyroid parameters.Methods Dual-source CT was used to scan the neck of thyroid patients. The mean iodine concentration and thyroid tissue volume were measured to calculate the total iodine content of thyroid. Relevant test of triiodothyronine (FT3), total triiodothyronine (TT3), total thyroxine (TT4), free thyroxine (FT4), and thyroid hormone (TSH) were conducted. The correlation of thyroid mean iodine concentration and total iodine content with blood measured thyroid function was analyzed.Result The total iodine content in thyroid was positively correlated with FT3, but negatively correlated with TSH. The mean iodine concentration of thyroid was positively correlated with both FT3 and TT3.Conclusion The thyroid iodine content measured by dual-source CT can be used to determine the human iodine nutritional status and evaluate thyroid functions, which will provide help for the diagnosis and treatment of thyroid diseases.
Knowledge and practices regarding tuberculosis infection control among nurses in Ibadan, South-West Nigeria: a cross-sectional study
Authors: Akande Patrick
Published: September 2019

Background: Nurses are particularly vulnerable to nosocomial tuberculosis (TB) infection because, being in the frontline of patient care, they are frequently exposed to patients with infectious TB disease. Although cost-effective measures are available for TB infection control (TBIC), they are often poorly implemented. Knowledge of TBIC is known to positively influence the practice of the measures. There is however limited data on the knowledge and practice of TBIC among nurses in Nigeria. This study was aimed at determining the levels of TBIC-related knowledge and practices of nurses in Ibadan, and associated socio-demographic factors. Methods: This cross-sectional study utilized a self-administered questionnaire to collect data from 200 nurses in two secondary health facilities, in May 2014. STATA version 13 was used to analyze data: mean knowledge and practice scores of the nurses and logistic regression to explore their association with socio-demographic factors. Results: The respondents had mean knowledge and practice scores of 68.2% and 79.9% respectively. Using cut-off points of 80% and 100% for good knowledge and practice scores respectively, small proportions of the nurses had good scores- knowledge (10.5%) and practice (6%). Knowledge was found not to be significantly associated with the socio-demographic factors. Work experience was the only factor that was significantly associated with practice, with the less experienced nurses (=<18 years of experience) having greater odds of obtaining good practice scores than the more experienced ones (OR 4.0, 95%CI 0.06-0.94). Also, there was no significant association between knowledge and practice scores. No structured TBIC training had been conducted at this time. Conclusions: The study revealed that small proportions of the nurses had good knowledge and practice scores. The findings from this study will be useful for the planning of interventions to improve TBIC among nurses and other healthcare workers, and to benchmark monitoring and evaluation of the interventions. It is recommended that the nurses should be trained on TBIC to equip them with necessary knowledge and skills. This, together with appropriate TBIC policy directives, availability of TBIC equipment/supplies and facility architectural remodeling will contribute to optimal implementation of TB preventive measures. Keywords: tuberculosis, infection, control, knowledge, practice, nurses
An exploration of the experiences of GP registrar supervisors in small rural communities: a qualitative study
Authors: Couch Danielle , O’Sullivan Belinda , Russell Deborah , McGrail Matthew , Wallace Glen , Bentley Michael
Published: September 2019

Background: In Australia registrar training to become a general practitioner (GP) involves three to four years of supervised learning with at least 50% of GP registrars training wholly in rural areas. These rural placements are important for developing the broad skills needed for effective rural practice. Having enough rural GP supervisors is essential to enable rural GP training to occur. We aimed to explore what makes GPs’ participate in supervising or not, their experiences of supervising, and the impact of their practice context. Methods: Semi-structured interviews were undertaken with 25 GPs based in rural Tasmania, all in towns of <25,000 population, to explore the GPs’ professional backgrounds, their experiences of supervising GP registrars, their practice context and their decisions about supervising GP registrars or not. Thematic analysis was undertaken; key ideas, concepts and experiences were identified and then reviewed and further refined to core themes. Results: Supervising was perceived to positively impact on quality of clinical care, reduce busy-ness and improve patient access to primary care. It was energising for GPs working in rural contexts. Rural GPs noted business factors as impacting both the decision to participate in supervision and the experience of participating: including uncertainty of registrar supply, discontinuity of registrar supply within rotational training systems, registrar competence and business income generation. Conclusions: Supervising is strongly positive for rural GPs and a potential factor related to their work satisfaction but increasing supervision capacity in rural areas may depend on supervision policies and systems which promote more viable supervision models tailored to the business needs of rural GPs and their practice context.
Women’s experience of unplanned out-of-hospital birth in paramedic care
Authors: Flanagan Belinda , Lord Bill , Reed Rachel , Crimmins Gail
Published: September 2019

Background Healthcare literature describes predisposing factors, clinical risk, maternal and neonatal clinical outcomes of unplanned out-of-hospital birth; however, there is little quality research available that explores the experiences of mothers who birth prior to arrival at hospital. Methods This study utilised a narrative inquiry methodology to explore the experiences of women who birth in paramedic care. Results The inquiry was underscored by twenty-two narrative interviews of women who birthed in paramedic care in Queensland, Australia between 2011-2016. This data identified factors that contributed to the planned hospital birth occurring in the out-of-hospital setting. Women in this study began their story by discussing previous birth experience and their knowledge, expectations and personal beliefs concerning the birth process. Specific to the actual birth event, women reported feeling empowered, confident and exhilarated. However, some participants also identified concerns with paramedics practice; lack of privacy, poor interpersonal skills, and a lack of consent for certain procedures. Conclusions This study identified several factors and a subset of factors that contributed to their experiences of the planned hospital birth occurring in the out-of-hospital setting. Women described opportunities for improvement in the care provided by paramedics, specifically some deficiencies in technical and interpersonal skills.