bluuebunny/crossref_metadata_2025 huggingface dataset:
Vaccination Coverage with the Pneumococcal and Influenza Vaccine Among Persons with Chronic Diseases in Shanghai, China, 2017
Authors: Wang Yuheng , Cheng Minna , Wang Siyuan , Wu Fei , Yan Qinghua , Yang Qinping , Li Yanyun , Guo Xiang , Fu Chen , Shi Yan , Wagner Abram L. , Boulton Matthew L.
Published: January 2020

Background:Adults with chronic conditions such as heart disease, diabetes, or lung disease are more likely to develop complications from a number of vaccine-preventable diseases, including influenza and pneumonia. In this study, we use the data from a chronic disease management information system in Shanghai to estimate vaccination coverage and characterize predictors of seasonal influenza and 23-valent pneumococcal polysaccharide vaccine (PPSV23) vaccination among people with chronic disease in Shanghai.
Methods:The Shanghai Centers for Disease Control and Prevention have information systems related to chronic disease management, hospital records, and immunizations. Data from individuals with hypertension, diabetes and chronic obstructive pulmonary disease (COPD) were abstracted during July 2017. The main outcome was coverage of pneumococcal and influenza vaccination. Vaccination coverage was calculated across demographic groups. Significance in bivariate associations was assessed through Pearson’s chi-square tests, and in multivariable models through logistic regression models with a forward stepwise method to select variables.
Results:In the sample of 2,531,227 individuals ≥15 years, 22.8% were vaccinated for pneumonia from January 2013 to July 2017, and the vaccination coverage of influenza in the 2016/17 influenza season was 0.4%. Vaccination coverage was highest in those 70-79 and lowest in those younger than 60. Compared to urban areas, uptake in rural areas was higher for pneumonia vaccination (OR: 2.43, 95% CI: 2.41, 2.45), but lower for influenza vaccination (OR: 0.55, 95% CI: 0.51, 0.59). Having a greater number of chronic diseases was associated with higher likelihood of pneumonia vaccination (3 vs 1: OR: 1.68, 95% CI: 1.64, 1.71), but this relationship was not statistically significant for influenza vaccination.
Conclusions:We found low levels with of pneumococcal vaccination, and extremely low uptake of influenza vaccination among individuals with high risk conditions in Shanghai who should be priority groups targeted for vaccination. Interventions could be designed to target groups with low uptake – like younger adults, and individuals who have not yet retired.
Electroacupuncture for postoperative pain after nasal endoscopic surgery: study protocol for a pilot randomized controlled trial
Authors: Li Shanshan , Zhang Qing , Yin Xuan , Yue Hongyu , Zhang Wei , Lao Lixing , Zhang Zhangjin , Wu Huangan , Xu Shifen
Published: January 2020

Background: Postoperative pain is a common disorder that interferes with the quality of sleep after nasal endoscopic surgery and delays postoperative recovery. Acupuncture is an effective tool for pain management. However, electroacupuncture specifically for the relief of postoperative pain after nasal endoscopic surgery has not yet been studied through a randomized controlled trial. Method/Design: A pilotrandomized, sham-controlled, patient- and- assessor-blind trial is designed to evaluate the efficacy and safety of electroacupuncturein managing postoperative pain following nasal endoscopic surgery of sinusitis with nasal polyps. There will be 30participants randomly allocated to an electroacupuncture or non-invasive sham control in a 1:1 ratio. Treatment will be done within 2 hours before operation, immediately after the operation upon arrival to the recovery ward, and once daily for 3 days. The primary outcome of the Pain Numerical Rating Scale (NRS) will be analyzed using the area-under-the-curve (AUC) method. The secondary outcome measures include Heart Rate (HR) and Blood Pressure (BP) after operation, the sleep quality during the hospital stay (Actigragh),Quality of Recovery-15 (QoR-15), and the MOS item short form health survey (SF-36). ITT analysis will be used in this RCT. Discussion: This pilot randomized controlled trial will explore the feasibility of further clinical application for the management of postoperative pain using electroacupuncture treatment, and it will inform the design of a further full-scale trial. Trial Registration: Chinese Clinical Trial Registry, ChiCTR1900024183, Date: 2019-06-29. URL: http://www.chictr.org.cn/showproj.aspx?proj=40573 Keywords: Electroacupuncture; postoperative pain;nasal endoscopic surgery; RCT; randomized controlled trial; clinical trial
Epidemiological and Clinical Characteristics of Fall-related Injuries: A Retrospective Study
Authors: Mekkodathil Ahammed , El-Menyar Ayman , Kanbar Ahad , Hakim Suhail , Ahmed Khalid , Siddiqui Tariq , Al-Thani Hassan
Published: January 2020

BACKGROUND: Fall-related injuries are important public health problem worldwide. We aimed to describe the epidemiological and clinical characteristics of fall-related injuries in a level 1 trauma center.
METHOD: A retrospective analysis of Qatar Trauma Registry data was conducted on patients admitted for fall-related injuries between 2010 and 2017. Comparative analyses of data by gender, age-groups and height of falls were performed to describe the epidemiological and clinical characteristics of patients, and in-hospital outcomes.
RESULTS:
A total of 4040 patients with fall-related injuries were identified in the study duration which corresponds to the rate of 2.34 per 10,000 population in Qatar. Although the rate of fall injuries decreased over the years, the average number of patients per year still accounts for 32% of the moderate and severe injuries requiring admission. Most of the injuries were to the head (36%) followed by spines (29%) and chest (23%). Males were predominant (89%), more likely to fall at workplace, fall from a greater height and experience polytrauma than females. Working age-group (20-59 years) were the major victims (73%), more likely to fall at work place, fall from height comparing to older adults who tend to fall at home, fall from the same level. Overall in-hospital mortality was 3%. Outcomes including longer length of hospital stay and mortality were generally associated with the height of falls.CONCLUSION: Fall-related injuries remain as a significant burden in trauma center. Variations in pattern of injuries by age, gender and height of fall provide important information for targeted preventive measures
Tobacco and electronic cigarette cues for smoking and vaping: an online experimental study
Authors: Blackwell Anna K M , De-loyde Katie , Brocklebank Laura A , Maynard Olivia M , Marteau Theresa M , Hollands Gareth J , Fletcher Paul C , Attwood Angela S , Morris Richard W , Munafò Marcus R
Published: January 2020

Objective This study examined whether exposure to smoking and vaping cues the urge to smoke or vape. It extends previous studies on first-generation cigalikes (visually similar to cigarettes) and second-generation devices (visually similar to pens) by including third-generation tank system devices (larger bulky units). In an online experiment, participants were randomly assigned to view one of four videos, which included smoking, vaping (cigalike or tank system), or neutral cues. The primary outcome was urge to smoke. Secondary outcomes were urge to vape, desire to smoke and vape, and intention to quit or remain abstinent from smoking.Results UK adults varying in smoking (current or former) and vaping (user or non-user) status (n=1120) completed the study: 184 (16%) failed study attention checks meaning 936 were included in the final analysis. Urges to smoke were similar across cue groups. Urges to vape were higher following exposure to vaping compared to neutral cues. There was no clear evidence of an interaction between cue group and smoking or vaping status. The lack of cueing effects on smoking urges is inconsistent with previous research, raising questions about the ability to assess craving in online settings.
Effect of a tailored leaflet to promote diabetic retinopathy screening among young adults with type 2 diabetes: a randomised controlled trial.
Authors: Lake Amelia Jane , Browne Jessica L , Rees Gwyneth , Speight Jane
Published: January 2020

Background: Young adults with type 2 diabetes (aged 18-39 years) are at risk of early onset and rapid progression of diabetic retinopathy, the leading cause of blindness and vision loss in working age adults. Early detection via retinal screening can prevent most vision loss, yet screening rates are consistently lower among this priority population than the general diabetes population. We aimed to test the effect of a tailored, evidence-based brief health behaviour change intervention (leaflet) on self-reported screening uptake, and previously identified social cognitive determinants of retinal screening.
Methods: A pragmatic, two-arm randomised controlled trial was conducted from September 2014 to April 2015. Participants were stratified by prior screening uptake (Yes/No) and randomly allocated to intervention (leaflet) or ‘usual care’ control (no leaflet). Primary outcome was self-reported screening uptake four weeks post-intervention for ‘No’ participants who had not previously screened for diabetic retinopathy. Secondary outcome variables were changes in knowledge, attitudes, normative beliefs, intention and behavioural skills for all participants, irrespective of prior screening behaviour. To assess intervention effects on secondary outcome variables, we conducted independent samples t-tests (two-tailed) on pre-post change scores.
Results: 129 young adults (26% no prior retinal screen) completed baseline; 101 completed post-intervention. Power to determine effect on the primary outcome was curtailed by low recruitment of individuals with no prior retinal screen and loss to follow-up. Attrition was associated significantly with country of birth, language spoken at home, and marital status. Significant intervention effect was observed for one secondary outcome variable: knowledge of diabetic retinopathy (p=.03) with moderate effect (partial eta squared h2=.05); no adverse effects were reported. Control group participants received the leaflet at study completion.
Conclusions: This study confirms that a well-designed eye health and retinal screening promotion leaflet can increase knowledge of diabetic retinopathy, an important screening predictor. The study highlights the challenges of conducting ‘real-world’ health behaviour change research with this priority population, providing insights for clinicians and researchers. Strategies to recruit, engage and retain hard-to-reach populations are discussed including nonconventional alternatives to randomised controlled trial designs. Trial registration: ACTRN12614001110673, UTN No.: U1111-1161-9803. Registered 20 October 2014 - retrospectively registered https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367127
Characterization of Visceral leishmaniasis Outbreak, Marsabit County, Kenya, 2014
Authors: Kanyina Evalyne Jaquelyne Wambui
Published: January 2020

Background: Visceral leishmaniasis (VL) is caused by protozoa of the Leishmania donovani complex. Annually, an estimated 500,000 cases of VL are reported globally posing a public health challenge. The objectives of our study were to confirm and determine the magnitude of VL outbreak, characterize the outbreak clinically and epidemiologically and evaluate the county preparedness and response in Marsabit County, Kenya.
Methods: A retrospective review of laboratory registers and patients’ clinical notes was done at Marsabit County Hospital. Cases were persons with confirmed VL diagnosis either by microscopy, serology or molecular technique coming from Marsabit County from May to October 2014. Cases were interviewed using structured questionnaire to collect clinical and epidemiologic information. Blood samples were collected from cases for laboratory confirmation.
Results: A total of 136 cases were confirmed of which 77% (105) were male with a median age of 17 (IQR: 22) years and 9.6% (13) case fatality rate. All cases were admitted at Marsabit County Referral Hospital, Kenya. Medical records of 133 cases were retrieved. Of the 133 cases, 102 (77%) presented with fever, 43 (32%) with splenomegaly, 26 (20%) with hepatomegaly and 96 (72%) were managed with Sodium stibogluconate (SSG) monotherapy. Thirty four cases (26%) received Full haemogram (FHG) test and none had more than one Liver Function Tests (LFTs) in a span of six months. No VL case management training had been conducted nor VL treatment guidelines distributed among health care workers (HCWs) in the last one year.
Conclusions: VL cases were confirmed. Inadequate case monitoring and management was evident. VL case management sensitization training was conducted. The County health department should put in place one health VL surveillance and facilitate periodic case management trainings.
Total words: 275
Key words: Visceral leishmaniasis (VL), Kala-azar, VL case management, Marsabit County, Kenya
Pharmacists’ knowledge attitude and practice regarding the dispensing of antibiotics without prescription in Tanzania: an explorative cross-sectional study
Authors: Poyongo Baraka P , Sangeda Raphael Zozimus
Published: January 2020

Background:
Inappropriate use of antibiotics has been reported to contribute to the emergence and increase of antimicrobial resistance (AMR) in the world. Enforcing the dispensing of antibiotics with prescription is a way to promote the rational use of antibiotics and preventing the development and spread of AMR. The pharmacist has the responsibility to supervise the dispensing of antibiotics in pharmacies and ensure its rational use. This study assessed pharmacists’ knowledge, attitude and practice regarding the dispensing of antibiotics without prescription in Tanzania.
Methods:
An online semi-structured questionnaire was designed, tested and shared with licensed pharmacists in Tanzania through an invitation link sent in their official WhatsApp groups. An SMS alternative was used contact list from the Pharmacy Council to administer the questionnaire to pharmacists not subscribed to WhatsApp. Study data were collected and managed using REDCap electronic data capture tools hosted at Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Data were then downloaded and exported into Statistical Package for Social Sciences (SPSS) version 20 for data analysis; Chi-square test was used to test association for categorical data, where a p-value of less than 0.05 was considered statistically significant.
Results :
More than 75% of pharmacists had excellent knowledge about the legal requirements for dispensing antibiotics and of the AMR challenge. Of the interviewed pharmacists, seventy-four percent admitted to dispensing antibiotics without prescription in their daily practice. Notably, 85.7% of pharmacists with high education were more likely to dispense without prescription compared to 69.9% among bachelor holders (p-value = 0.028). The main reasons for administering antibiotics without prescription were the profitability nature of pharmacy business, a failure of the patient to get a prescription and a lack of stringent regulatory authorities. Penicillins, macrolides and fluoroquinolones were the classes of antibiotics mostly dispensed without a prescription.
Conclusion :
Even though pharmacists seem knowledgeable about AMR, they still dispense antibiotics without prescription in Tanzania. The regulatory authorities should make regular inspections in pharmacies to detect this malpractice. The community should be trained on the importance of taking laboratory tests before getting medications for their sickness by a qualified medical practitioner.
The multimodal strategy in Surgical Site Infections control and prevention in orthopaedic patients – a 10-year retrospective observational study at a Polish hospital
Authors: Kołpa Małgorzata , Słowik Róża , Wałaszek Marta , Wolak Zdzisław , Rozanska Anna , Wojkowska-Mach Jadwiga
Published: January 2020

INTRODUCTION Surgical site infections (SSIs) are among the most common healthcare-associated infections. They are associated with longer post-operative hospital stays, additional surgical procedures, treatment in intensive care units and higher mortality. MATERIAL AND METHODS Surgical site infections (SSIs) were detected in patients hospitalized in a 40-bed orthopaedics ward via continuous surveillance in 2009–2018. The total number of study patients was 15,678. The results were divided into two 5-year periods before and after the introduction of the SSI prevention plan. The study was conducted as part of a national Healthcare-Associated Infections Surveillance Programme, following the methodology recommended by the HAI-Net, European Centre for Disease Prevention and Control Program (ECDC). RESULTS 168 SSIs were detected in total, including 163 deep SSIs (SSI-D). The total SSI incidence rate was 1.1%, but in hip prosthesis: 1.2%, in knee prosthesis: 1.3%, for open reduction of fracture (FX): 1.3%, for close reduction of fracture (CR): 1.5%, and 0.8% for other procedures. 64% of SSI-D cases required rehospitalisation. A significantly reduction in incidence was found only after fracture reductions: FX and CR, respectively 2.1% vs. 0.7% (OR 3.1 95%CI 1.4-6.6, p<0.01) and 2.1 vs. 0.8% (OR 2.4 95%CI 1.0-5.9, p<0.05). SSI-Ds were usually caused by Gram-positive cocci, specially Staphylococcus aureus , 74 (45.7%); Enterobacteriaceae bacillis accounted for 14.1% and Gram-negative non-fermenting rods for 8.5%. CONCLUSIONS The implementated SSI prevention plan demonstrated a significant decrease from 2.1% to 0.7% in SSI-D incidence only in fracture reductions, without changes in epidemiology SSI incidence rates in other procedures. Depending on the epidemiological situation in the ward, it is worthwhile to surveillance of SSIs associated to different types of orthopaedic surgery to assess the risks and take preventive measures.
Identification of E2 with improved secretion and immunogenicity against CSFV in piglets
Authors: Xu Huiling , Wang Yanli , Han Guangwei , Fang Weihuan , he fang
Published: January 2020

Background: Outbreaks of Classical swine fever virus (CSFV) cause significant economic losses in the swine industry. Vaccination is the major method to prevent and control the disease. As live attenuated vaccines fail to elicit differentiable immunity between infected and vaccinated animals, subunit vaccine was considered as an alternative candidate to prevent and eradicate CSFV. Subunit vaccines present advantages in DIVA immunogenicity and safety. The technology was limited due to the low yield and the high cost with multiple and large doses. The native E2 signal peptide has not been well defined before. Here, the aim of this study is to develop a cost-effective and efficacious E2 vaccine candidate against CSFV with signal peptide and E2 sequence selection.
Results: A novel CSFV E2 sequence (E2ZJ) was identified from an epidemic strain of Zhejiang for outstanding secretion in baculovirus and enhanced immunogenicity. E2 secretion induced with the selected signal peptide, SPZJ (SP23), increase at least 50% as compared to any other signal peptides tested. Besides, unique antigenic features were identified in E2ZJ. E2ZJ elicited CSFV antibodies at the earlier stage than other E2 types tested in mice. Moreover, higher level of neutralization antibodies against both genotypes 1 and 2 CSFV with E2ZJ was detected than other E2s with the same dosage. Further, in piglets, E2ZJ successfully elicited neutralizing immunity. A single dose of 5 μg of E2ZJ was sufficient to induce protective antibodies against CSFV in piglets and provided 100% protection against lethal virus challenge.
Conclusions: Our studies provide evidence that E2ZJ guided by a novel E2 signal peptide (SPZJ) was efficiently secreted and presented significantly improved immunogenicity than conventional E2 vaccines. Moreover, a single dose of 5 μg E2ZJ is efficacious against CSFV in piglets.
Keywords: Classical swine fever virus; novel signal peptide; SPZJ-E2ZJ; subunit vaccine; protective immunity
Multivariate Network Meta-Analysis Incorporating Class Effects
Authors: Owen Rhiannon Kate , Bujkiewicz Sylwia , Tincello Douglas G , Abrams Keith R
Published: January 2020

Background: Network meta-analysis synthesises data from a number of clinical trials in order to assess the comparative efficacy of multiple healthcare interventions in similar patient populations. In situations where clinical trial data are heterogeneously reported i.e. data are missing for one or more outcomes of interest, synthesising such data can lead to disconnected networks of evidence, increased uncertainty, and potentially biased estimates which can have severe implications for decision-making. To overcome this issue, strength can be borrowed between outcomes of interest in multivariate network meta-analyses. Furthermore, in situations where there are relatively few trials informing each treatment comparison, there is a potential issue with the sparsity of data in the treatment networks, which can lead to substantial parameter uncertainty. A multivariate network meta-analysis approach can be further extended to borrow strength between interventions of the same class using hierarchical models. Methods: We extend the trivariate network meta-analysis model to incorporate the exchangeability between treatment effects belonging to the same class of intervention to increase precision in treatment effect estimates. We further incorporate a missing data framework to estimate uncertainty in trials that fail to report measures of variability in order to maximise the use of all available information for healthcare decision-making. The methods are applied to a motivating dataset in overactive bladder syndrome. The outcomes of interest were mean change from baseline in incontinence, voiding and urgency episodes. All models were tted using Bayesian Markov Chain Monte Carlo (MCMC) methods in WinBUGS. Results: All models (univariate, multivariate, and multivariate models incorporating class effects) produced similar point estimates for all treatment effects. Incorporating class effects in multivariate models often increased precision in treatment effect estimates. Conclusions: Multivariate network meta-analysis incorporating class effects allowed for the comparison of all interventions across all outcome measures to ameliorate the potential impact of outcome reporting bias, and further borrowed strength between interventions belonging to the same class of treatment to increase the precision in treatment effect estimates for healthcare policy and decision-making. Keywords: multivariate; network meta-analysis; mixed treatment comparisons; meta-analysis; class effect
Broadening Risk Profile in Familial Colorectal Cancer Type X; increased risk for five cancer types in the national Danish cohort
Authors: Therkildsen Christina , Rasmussen Maria , Smith-Hansen Lars , Kallemose Thomas , Lindberg Lars Joachim , Nilbert Mef
Published: January 2020

Background Familial colorectal cancer type X (FCCTX) is a phenotypically defined subset of hereditary colorectal cancer with unknown and potentially heterogeneous genetic aetiology. Though FCCTX has been characterized as a colorectal cancer-specific syndrome, we aimed to estimate the risk for extra-colorectal cancer in the Danish FCCTX cohort. Methods Through the national hereditary non-polyposis colorectal cancer (HNPCC) register, 213 families fulfilling the Amsterdam I criteria and showing retained mismatch repair (MMR) function were identified. In here, sex and age-specific incidence rate ratios (IRR) were calculated for 30 extra-colorectal cancer types in comparison with the general Danish population. Results In total, 494 extra-colorectal cancers developed with significantly increased risks for the urinary tract, breasts, stomach, pancreas, and eye. The age spans, during which increased risks were observed, were 30-49 years for gastric cancer, 30-69 years for female breast cancer, 50-69 years for ocular melanoma and above age 70 for pancreatic cancer and urothelial cancer. Conclusions These risk estimates suggest an increased risk of several extra-colorectal cancer types, which calls for awareness during genetic counselling and follow-up. The cancers that occur at increased risk may indicate unidentified disease-predisposing genetic variants in this phenotypically defined subset of hereditary colorectal cancer.
Initial Surgical versus Non-Surgical treatments for advanced hypopharyngeal cancer: a meta-analysis with trial sequential analysis
Authors: Cui Jie , Wang Liping , Piao Jinsong , Huang Haiyan , Chen Weiquan , Chen Zhen , Yang Hong , Tan Xiaojun , Li Jiansheng , Liu Genglong
Published: January 2020

Background There is no consensus whether either initial surgical or non-surgical treatments should be the standard treatment pattern to advanced hypopharyngeal cancer. The aim of the meta-analysis was systematically and quantitatively to compare the relative efficacy between initial surgical and non-surgical therapies in patients with advanced-stage hypopharyngeal carcinoma.Methods A comprehensive search was performed in PubMed, the ISI Web of Knowledge, the Cochrane Library, and Embase databases from inception through to April 10, 2019.Citation screening, data abstraction and quality assessment were performed in duplicate. Meta-analysis with trial sequential analysis (TSA) were used to assess the primary and secondary outcomes. In addition, we used the Grading of Recommendations Assessment Development and Evaluation (GRADE) to evaluate the certainty of the body of evidence.Results A total of 17 trials was appraised with 2539 patients that were in compliance with inclusion and exclusion criterion. Pooled analyses indicated patients receiving primary surgical and non-surgical therapy did not significantly differ in overall survival (OS) (relative risk [RR] = 1.04, 95% confidence interval [CI] = 0.94 to 1.15), with TSA inconclusive. Additionally, patients treated with primary surgical experienced an increased disease free survival (DFS) probability compared with non-surgical treatment (RR 1.20, 95% CI=1.05 to1.37), while TSA is inconclusive. Notably, non-surgical management did have a beneficial efficacy on larynx preservation (RR 0.48, 95% CI=0.33 to 0.70), and TSA also provided conclusive evidence. GRADE indicated the level of evidence was low or very low for primary or secondary outcomes.Conclusion The results of our meta-analysis indicated compared to surgical treatments, non-surgical therapy for patients with advanced hypopharyngeal carcinoma appear to equivalent efficacy, and it offers an opportunity to preserve laryngeal function. Due to inconclusive evidence by TSA, further investigation with larger randomized clinical trials (RCTs) using modern approaches should be undertaken to verify the results of this meta-analysis.
Non-communicable diseases are key to further narrow gender gap in life expectancy in Shanghai, China
Authors: Chen Hanyi , Zhou Yi , Sun Lianghong , Chen Yichen , Qu Xiaobin , Chen Hua , Rajbhandari-Thapa Janani , Xiao Shaotan
Published: January 2020

Background To address change in gender gap of life expectancy (GGLE) in Shanghai from 1973 to 2018, and to identify the major causes of death and age groups associated with the change overtime. Methods Retrospective demographic analysis with application of Joinpoint regression to evaluate the temporal trend in GGLE and using life table technique and decomposition method to express changes in GGLE. Results Trend of GGLE in Shanghai experienced two phases ie., a decrease from 8.4 to 4.2 years in the descent phase (1973-1999) and a fluctuation between 4.0 and 4.9 years in the plateau phase (1999-2018). The reduced age-specific mortality rates tended to concentrate to a narrower age range, from age 0-9 and above 30 years in the descent phase to age above 55 years in the plateau phase. Gastroesophageal and liver cancer, communicable, chronic respiratory and digestive diseases were once the major contributors to narrow GGLE in the descent phase. While importance should be attached to a widening effect on GGLE by lung cancer, cardiovascular diseases, other neoplasms like colorectal and pancreatic cancer and diabetes in recent plateau phase. Conclusions Non-communicable diseases (NCDs) have made GGLE enter a plateau phase from a descent phase in Shanghai China. Public efforts to reduce excess mortalities for male NCDs, cancers, cardiovascular diseases, chronic respiratory diseases and diabetes in particular and health policies focused on the middle-aged and elderly population might further narrow GGLE and ensure improvement in health and health equity in Shanghai China.
Alveolar MMP28 is Associated With Clinical Outcomes and Measures of Lung Injury in Acute Respiratory Distress Syndrome
Authors: Morrell Eric , Mikacenic Carmen , Gong Ke-Qin , Kosamo Susanna , Stapleton Renee D. , Wurfel Mark M. , Manicone Anne M.
Published: January 2020

Background Excessive inflammation leading to increased alveolar-capillary barrier permeability remains the pathogenic model for acute respiratory distress syndrome (ARDS). Alveolar macrophage (AM) polarization has been shown to modify the activity of various matrix metalloproteinases (MMPs) that have downstream effects on key ARDS cytokines/chemokines, however the relationship between AMs, MMP28 (the newest member of the MMP family), and ARDS clinical outcomes is unknown.Methods We analyzed bronchoalveolar lavage fluid (BALF) and peripheral blood from subjects previously enrolled in a phase-II trial of omega-3 fatty acids for the treatment of ARDS ( n = 76). In a subset of these patients ( n = 25), we tested for assocations between AM- and peripheral blood monocyte (PBM)-specific MMP28 gene expression and clincal outcomes [ventilator-free days (VFDs), P a O 2 /F i O 2 ratio (P/F ratio), and sequential organ failure assessment score (SOFA)]. We tested for assocations between soluble BALF or plasma MMP28 concentrations and ARDS clinical outcomes and inflammatory mediator concentrations in the entire cohort.Results Increased AM MMP28 gene expression was significantly associated with worse VFDs and P/F ratio ( p < 0.05). Higher BALF MMP28 concentrations were associated with worse P/F, but not VFDs. Increased BALF MMP28 concentrations were associated with increased % neutrophils as well as BALF total protein, IL-6, IL-17A, and MCP-1 concentrations (all p < 0.05). Plasma MMP28 concentrations were not associated with any clinical outcome. Increased PBM MMP28 gene expression was associated with worse P/F ratio but not VFDs.Conclusions Higher AM MMP28 gene expression and BALF MMP28 concentrations are associated with poor clinical outcomes and with increased alveolar inflammatory mediators in patients with ARDS.
Evaluation of a PRImary-ORthopaedic (PRIOR) low back pain care model in Hong Kong: a pilot study
Authors: Choi Shirley Yue Kwan , Law Sheung Wai , Wong William WL , Lau Jamie , Ko Shaau Yiu , Lin Sibei , Hui Eric , Wong Samuel Yeung Shan , Sit Regina Wing Shan
Published: January 2020

Introduction: Low back pain (LBP) is a common and disabling condition with significant socioeconomic burden. A LBP care delivery model with collaborative input from primary care physicians, orthopaedic surgeons and allied health professionals has been implemented in one of the local tertiary hospital to streamline LBP care.Objective: To evaluate the preliminary effectiveness of the primary-orthopaedic (PRIOR) LBP care model.Methods: This was a 6-month quasi-experimental study with pre and post assessment. Participants (N=30) with chronic LBP were recruited and stratified by physiotherapists at the triage station located at Orthopaedic Special Outpatient Clinic. Eligible participants were referred to attend primary physicians with trained musculoskeletal skills for risk-matched treatment at Family Medicine Clinic. Patient-specific outcomes included the acceptance rate, Roland Morris Disability (RMD) scores, the self-pain efficacy scores (PSE) scores and the Euro-Qol-5D. The health service outcomes included the waiting time, discharge rate, adherence rate and healthcare resources utilization. Results: Of the 33 participants screened, 30 were eligible and enrolled for the study, the recruitment rate was 91% (X2=0.569, p=0.451). At 6 months, participants reported overall improvement of the RMD scores (β coefficient -4.3, 95% confidence interval CI -5.9 to – 2.7, P<0.001) and PSEQ scores (β coefficient 7.3, 95% CI 3.0-12.0, P=0.002). The waiting time of the FM clinic was 11.6 ±1.6 weeks, the overall discharge rate was 73%, and the adherence rate was 87%.Conclusions: The study suggested that the PRIOR LBP model could potentially improve the clinical outcomes of LBP patients and enhance the overall LBP health service delivery.
TNF Produced by Inflammatory Blood Mononuclear Cells Directly Contributes to Cartilage Damage in Arthritis
Authors: Yarilina Anna , Melim Terry , Kaymakcalan Zehra
Published: January 2020

Background Anti-TNF therapies are effective at preventing inflammation and structural damage in rheumatoid arthritis (RA). However, the role of TNF in cartilage destruction in RA is not well understood. Therefore, we studied the effects of TNF on cartilage and compared TNF production by different cell types involved in joint pathology.Methods Primary human chondrocytes and cartilage explants were cultured with recombinant TNF. Bovine cartilage was co-cultured with activated human peripheral blood mononuclear cells (PBMCs) or fibroblast-like synoviocytes (FLS). Expression of cytokines and metalloproteinases (MMPs) was assessed by qPCR and MSD, and proteoglycan depletion from cartilage was assessed using histomorphometry and colorimetric detection in tissue culture supernatants. D2E7 was used to block TNF both in vitro and in vivo in a human TNF transgenic (hTNF-Tg) mouse model of arthritis.Results TNF elicited strong pro-inflammatory and catabolic effects on isolated human chondrocytes and cartilage explants leading to upregulation of IL-6 and MMPs, as well as proteoglycan depletion from bovine cartilage explants. In an effort to identify cellular sources of TNF, we challenged chondrocytes, FLS and PBMCs with inflammatory stimuli present in RA joints and found that PBMC that were used to model inflammatory cell infiltration produced significantly higher levels of TNF. Moreover, co-culture with activated PBMCs resulted in proteoglycan depletion from bovine cartilage explants. In sharp contrast with stromal cells, TNF failed to induce high amounts of IL-6 and MMPs in PBMCs, suggesting that different cell populations play distinct roles in the triggering and propagation of joint destruction. TNF blockade protected cartilage from damage both in co-culture systems and in a hTNF-Tg mouse model of arthritis.ConclusionsOur data demonstrate that TNF directly triggers a catabolic program in human chondrocytes leading to cartilage damage and further suggest that neutralization of TNF produced by immune cells infiltrating the inflamed joints, decreases catabolic activity of chondrocytes and fibroblasts, which, in turn, contributes to the cartilage protective effects of anti-TNF biologics in arthritis.
Secular trends in testosterone- findings from a large state-mandate care provider
Authors: Chodick Gabriel , Epstein Shdema , Shalev Varda
Published: January 2020

Background Several studies from the US and Europe have shown a population-level decline in serum testosterone in men from 1970's to early 2000's. However, to the best of our knowledge, no study examining population-level decline in testosterone has been published in more recent years. The study objective was therefore to examine secular trends in testosterone levels among Israeli men in the first and second decades of the 21 st century,Methods All incident total testosterone performed between1/2006 and 3/2019 among 102,334 male members of a large health organization.Results A prominent trend of age-independent decline in the testosterone levels for most age groups. The results were highly significant ( Common.EditSubmissionSteps.Transform.EquationText )Conclusions The results show a highly significant age-independent decline in total testosterone that is unlikely to be explained by increasing rates of obesity.
Parasite load and genotype are associated with clinical outcome of piroplasm infected equines
Authors: Tirosh-Levy Sharon , Stienman Amir , Levy Hadas , Katz Yotam , Shtilman Margarita , Gottlieb Yuval
Published: January 2020

Background: Equine piroplasmosis (EP) is a highly endemic protozoan disease of horses worldwide. While most horses in endemic areas are subclinically infected, the mechanisms leading to clinical outcome are vastly unknown. Moreover, since clinical signs of disease are not specific, and the prevalence in endemic areas is high, it is difficult to determine if EP is the cause of disease. To identify possible mechanisms leading to the clinical outcome in an endemic area, we compared parasite loads and genotypes in clinically and subclinically infected horses.Methods: Blood was collected from horses with clinical signs consistent with EP, and from apparently healthy horses from various locations. Packed cell volume (PCV) and total solids (TS) were measured from each sample. Quantitative and diagnostic PCR were used to quantify and classify EP infection in clinical and subclinical horses.Results: For both parasites, clinical cases were associated with low mean packed cell volume (PCV) and high mean parasite load (P<0.001), enabling to determine a cutoff value between clinically and subclinically infected horses. Theileria equi of subclinical horses classified into three different 18S rRNA genotypes: D (=23), A (n=12) and C (n=5), while all clinical cases classified as genotype A. The sequences of T. equi equi merozoite antigen-1 (ema-1) gene were fairly conserved and all classified as genotype A. The ema-2 sequences were analyzed with all currently published sequences and were mostly classified into one genotype (A) among the three resolved genotypes. Babesia caballi rhoptry associated protein-1 (rap-1) was classified into sub-genotypes A1 (n=14) and A2 (n=5) with no association to clinical outcome. Classification of the 18S rRNA gene (sub-genotypes B1 and B2) was in agreement with the rap-1 classification.Conclusions: The results of this study suggest that quantification of parasite loads of infected horses may be used to distinguish between clinical and subclinical cases. Additionally, we identified T. equi 18S rRNA genotype A to be associated with clinical disease. This finding emphasizes the importance of in-depth genetic characterization of T. equi genotypes to identify possible markers for virulence.
(w)HOL(e)ISTIC gene ontology and pathway analysis of data using open source web tools
Authors: Fleming Damarius S. , Miller Laura
Published: January 2020

Objective Downstream analysis of next generation sequencing (NGS) experiments provides researchers a means of deciphering their results. These downstream analyses elucidate clusters of genes or networks of biological interest under the conditions being studied. One convention for examining gene interactions is to conduct downstream investigations based on gene ontology (GO), pathway, and network analyses of statistically significant genes of interest. Unfortunately, the software available for these types of analyses is expensive, not species specific, and subject to gaps in annotation. These difficulties can cause studies to omit this downstream step, limiting the utility of the data. In order to facilitate pathway and network analyses of candidate gene lists from NGS studies, a workflow was constructed based on the use of open-sourced freely available software and genomic databases termed the “(w)HOL(e)ISTIC GO enrichment” approach.Results Overlap of multiple open-source software was used to annotate, analyze, and visualize biological networks. It is a 3-stage process in which stage 1 (Annotation) is the generation of alias identifiers. Stage 2 (Analysis) is a two-part process generating ontologies and networks with statistical inferences. Stage 2 relies on information from databases such as Reactome, KEGG, and InterPro. Stage 3 (Visualization) allows for figure creation.
Isolation and Identification of Kidney-derived Pathogenic Escherichia coli from Red Panda (Ailurus fulgens)
Authors: Liu Songrui , Li Yunli , Yue Chanjuan , Zhang Dongsheng , Su Xiaoyan , Yan Xia , Yang Kuixing , Chen Xin , Zhuo Guifu , Cai Tong , Liu Jiangfeng , Peng Xi , Hou Rong
Published: January 2020

Background Disease prevention and control is a significant part during the ex-situ conservation of the red panda (Ailurus fulgens) with bacterial infection being one of the important threats to the health of the captive population. So far, there was no systematic and detailed publications about the red panda-related E. coli disease. This study was conducted for the purpose of determining the cause of death, etiology and pathogenesis on a red panda through clinical symptoms, complete blood count, biochemical analysis, pathological diagnosis, antimicrobial susceptibility test, mouse pathogenicity test, and bacterial whole genome sequencing.Results A bacterial strain confirmed as Uropathogenic Escherichia coli (UPEC) was isolated from one captive dead red panda, which is resistant to most of the β-lactam drugs and a small number of aminoglycoside medications. The mouse pathogenicity test results showed the strains isolated postmortem from mice were the same as from the dead red panda, and the pathological findings were similar to the red panda while they were not completely the same. These pathological differences between red panda and mice may be related to the routes of infection and perhaps species differences and tolerance. The whole genome sequencing results showed that the isolated strain contained P pili, type I pili and iron uptake system related factors, which were closely related to its nephrotoxicity. Conclusion The red panda died of bacterial infection which was identified as Uropathogenic Escherichia coli. The pathogenic mechanisms of the strain are closely related to the expression of specific virulence genes.
Bioinformatics of Thymidine metabolism in camels and Trypanosoma evansi: nucleoside deoxyribosyltransferase (NDRT) as a drug target
Authors: Kandeel Mahmoud , Al-Taher Abdulla
Published: January 2020

Background Trypanosoma evansi (T. evansi), the causative agent for surra or camel trypanosomiasis, is characterized by the widest geographic distribution and infects the widest range of hosts among the known trypanosomes. The recent zoonotic importance and increasing reports of drug resistance necessitate the discovery of new drug targets. Drug discovery process entails finding an interesting difference between the host and the parasite. Results In this study, the thymidine metabolic pathways were compared in camel and T. evansi. Metabolic maps, protein sequence comparisons, domain and motifs contents analysis, phylogenetic relations and 3D structure models were used in comparisons. A unique difference in thymidine metabolism was at the level of recycling of thymidine which was performed by thymidine phosphorylase in camel, while this role is T. evansi was associated with nucleoside deoxyribosyltransferase (NDRT), which is a unique enzyme for the trypanosome and was absent in camel. Thymidine in T. evansi seems to be governed by thymine through NDRT. In contrast to camel, in which thymidine can be produced from thymidylate by the action of 5'-nucleotidase. Conclusions NDRT can be regarded as a drug target against T. evansi for its strict presence in the parasite but not in the host.
Antiviral effect of copper chloride on feline calicivirus and Synergy with Ribavirin in vitro
Authors: li dengliang , Cui Zhanding , Li Guohua , Zhang Liangting , Zhang Ying , Zhao Han , Zhang Shuang , Guo Yanbing , Zhao Yanli , Men Fanxing , Zhao Shihui , Shao Jiang , Du Dongju , Huang Hailong , Wang Kai , Hu Guixue , Li Tiansong , Zhao Yongkun
Published: January 2020

Background: Feline calicivirus (FCV) is a common pathogen causing widely prevalent upper respiratory disease for kitten and felines in recent years. Due to the substantial genetic variability of the viral genes, existing vaccines cannot provide complete protection. Therefore, researches on FCV antiviral drugs have received much attention. Results: In this study, we found that copper chloride had dose-dependent antiviral effects against FCV in F81 cells. We also found that the combination of copper chloride and ribavirin had a synergistic effect against FCV in the F81 cells. In contrast, the combination of and horse anti-FCV immunoglobulin F(ab’)2 showed an antagonistic effect, likely because the copper chloride has an effect on the F(ab’)2 immunoglobulin; however, further research is needed to clarify this supposition.Conclusions: In summary, we found that copper chloride had low cytotoxicity and significant antiviral effects against FCV in F81 cells, providing a new drug candidate for the prevention and treatment of FCV infection.
Comparison of general maternal and neonatal conditions and clinical outcomes between embryo transfer and natural conception
Authors: Pan Haiyan , Zhang Xingshan , Rao Jiawei , Lin Bing , He JieYun , Wang Xingjie , Han Fengqiong , Zhang Jinfeng
Published: January 2020

Objective: To examine the differences between pregnant women who underwent embryo transfer (ET) and those who conceived naturally, as well as differences in their respective babies, and to determine the causes for these differences, to provide recommendations for women who are planning to undergo ET.Methods: A retrospective cohort study was performed of women who had received ET and those who had natural conception (NC) who received medical services during pregnancy and had their babies delivered at the Shunde Women and Children's Hospital of Guangdong Medical University, China between January 2016 and December 2018. Each case in an ET group of 321 women was randomly matched with three cases of NC (963 cases) who delivered on the same day. The demographic information, past history, pregnancy and delivery history, and maternal and neonatal outcomes of the two groups were compared using univariate analysis.Results: Age, occupation, duration of hospitalization, number of pregnancies, number of miscarriages, induced abortion, ectopic pregnancy, gestational diabetes mellitus, preeclampsia, gestational anemia, pregnancy risk, mode of fetal delivery, and number of births were significantly different between the two groups (all P<0.05). However, there were no significant differences in the disease, allergy and blood transfusion histories of the pregnant women, or differences in prevalence of gestational hypothyroidism, gestational respiratory infection, premature rupture of membrane, placental abruption, fetal death, stillbirth, amniotic fluid volume and amniotic fluid clarity between the two groups (all P>0.05).The percentages for low birth weight and premature birth were significantly higher in the ET group than in the NC group, while the incidence of nuchal cord was higher in the NC group (all P>0.05). In contrast, infant gender and prevalence of fetal macrosomia, fetal anomaly, neonatal asphyxia, and extremely low birth weight were not significantly different between the two groups (all P>0.05).Conclusions: The clinical outcomes of mothers and the birth status of infants were better in the NC group than in the ET group. Maternal health must be closely monitored and improved in the ET group to reduce the incidence of gestational comorbidity and enhance the quality of fetal life.