bluuebunny/crossref_metadata_2025_split huggingface dataset:
De novo combination antiviral therapy in e antigen‐negative chronic hepatitis B virus‐infected paediatric patients with advanced fibrosis
Authors: Dong Yi , Li Meina , Zhu Shishu , Gao Xue , Zhao Pan 
Published: August 2020

AbstractTo date, studies that focus on treatment of e antigen‐negative chronic hepatitis B virus‐infected children with advanced fibrosis are extremely limited. This puts these patients at risk of rapid disease progression. Our study aimed to investigate the efficacy of combination antiviral therapy in this population. We prospectively enrolled treatment‐naı̈ve paediatric patients between 1 year and 12 years of age who had e antigen‐negative chronic hepatitis B and histologically proven advanced fibrosis. All patients received de novo combination therapy with lamivudine (LAM) and interferon‐α (IFN) for 12 months and then were clinically followed up. The main outcome measure was rate of serum hepatitis B surface antigen (HBsAg) loss at month 12 of treatment. A total of 14 paediatric patients were enrolled, including 9 boys and 5 girls. All patients achieved undetectable HBV DNA levels at month 9 of treatment. A total of 5 patients (35.7%) achieved HBsAg loss at month 12 and finally developed HBsAg seroconversion. Four patients who did not clear HBsAg underwent second liver biopsy, and histological evaluation revealed significant improvements in all of them. As a serum fibrosis marker, aspartate aminotransferase‐to‐platelet ratio index after 12‐month treatment in the 14 patients showed a significant improvement compared with that at baseline (P = .0021). No serious adverse events were observed during the study. Combination antiviral therapy is beneficial to e antigen‐negative chronic hepatitis B virus‐infected paediatric patients with advanced fibrosis. Further studies with larger cohorts are required.
Estimating chronic hepatitis C prevalence in British Columbia and Ontario, Canada, using population‐based cohort studies
Authors: Hamadeh Abdullah , Haines Alex , Feng Zeny , Thein Hla‐Hla , Janjua Naveed Z. , Krahn Murray , Wong William W. L. 
Published: August 2020

AbstractPatients identified as having chronic hepatitis C (CHC) infection can be effectively and rapidly treated using direct‐acting antiviral agents. However, there remains a substantial burden of subclinical undetected infection. This study estimates the prevalence and undiagnosed proportion of CHC in British Columbia (BC) and Ontario, Canada, using a model‐based approach, informed by provincial population‐level health administrative data. A two‐step approach was used: Step 1) Two population‐based retrospective analyses of administrative health data for a cohort of British Columbians and a cohort of Ontarians with CHC were conducted to generate population‐level statistics of CHC‐related health events; Step 2) using a validated natural history model of hepatitis C virus (HCV) infection, the historical prevalence of CHC was back‐calculated from the data collected in Step 1. Our retrospective study found that, in BC and Ontario, the number of newly diagnosed CHC cases is declining yearly while the complications of the disease are increasing yearly. BC had a 2014 CHC prevalence of 1.04% (95% CI: 0.84%‐1.44%), with 33.3% (95% CI: 25.5%‐42.0%) of CHC cases undiagnosed. Ontario had a 2014 CHC prevalence of 0.91% (95% CI: 0.83%‐1.02%) with 36.0% (95% CI: 31.2%‐38.9%) of CHC cases undiagnosed. Our study offers robust estimates based on the integration of a validated natural history model with population‐level health administrative data on HCV‐related events, which can provide vital evidence for policymakers to develop appropriate policies to achieve elimination targets. Our approach can also be applied to produce robust region‐specific estimates in other countries.
HCV micro‐elimination in two prisons in Milan, Italy: A model of care
Authors: Giuliani Ruggero , Casigliani Virginia , Fornili Marco , Sebastiani Teresa , Freo Elisabetta , Arzilli Guglielmo , Scardina Giuditta , Baglietto Laura , Tavoschi Lara , Ranieri Roberto 
Published: August 2020

AbstractPeople in prison represent a high‐risk population for HCV infection control. With the advent of new direct antiviral agents (DAAs) HCV micro‐elimination in prison setting became a feasible strategy. We assessed the impact of an intervention for HCV testing and treatment in 2017 and 2018 in a jail (San Vittore,SV) and a prison for sentenced individuals (Opera,OP). A dedicated protocol was applied and implemented over the two years. We collected data on demographics, HCV testing and treatment on all inmates present on 31 October 2017 and 2018. In the two facilities, there were 2,366 and 2,369 inmates in 2017 and 2018 respectively; the majority were men (95.6%; 96.4%) and Italians (57.0%; 61.9%) with a median age of 41 years. Prevalence of lifetime reported drug use remained high (46.5%; 44.2%). HCV screening coverage was 89% in both years, while HCV RNA test coverage increased (90.6%; 99.0%). HCV seroprevalence remained stable (10.1%; 9.2%). In 2017 among inmates with HCV chronic infection 90 (42.4%) individuals had started DAAs treatment and 106 (54.6%) in 2018; of whom 38 (17.9%) and 74 (38.1%) achieved the SVR. The viremic pool decreased significantly over time (SV,24.4%; 15.4%;OP, 16.1%; <1%). Among inmates with HCV‐positive serology in 2018, 121 (81.0%) were never linked to care before incarceration. Our study showed how a targeted and well‐implemented HCV test‐and‐treat intervention in prison was feasible and effective in achieving micro‐elimination. Viral hepatitis elimination agenda may help drawing interest onto this neglected population and bringing prison health higher up in the global public health agenda.
Estimating paediatric hepatitis C prevalence in the United States
Authors: Rahal Harman , Boutros Sandra , Farhat Mohamad , Kullar Ravina , Rahal Kabir , Saab Sammy 
Published: August 2020

AbstractOver 70 million individuals are infected with hepatitis C virus (HCV) worldwide. Yet most prevalence data are in the adult population, with little focus on paediatrics, partially due to the scarcity of public data. The objective of this paper is to examine HCV prevalence in children by estimating prevalence rates among women, given the assumption that most cases are vertically transmitted. Between 2001 and 2017, maternal HCV infection affected ~ 0.24% of all births, with prevalence increasing by at least 261%. On average, approximately 0.01% of the total number of live births were infected with HCV, with a 245% increase in the number of children born with the infection. HCV epidemiology has evolved, with women of childbearing age representing a greater proportion of infected individuals in the United States, and infants born to infected mothers being at risk. We therefore recommend a greater public health focus of HCV on the paediatric population.
Hepatitis A virus survival on drug paraphernalia
Authors: Medrzycki Magdalena , Kamili Saleem , Purdy Michael A. 
Published: August 2020

AbstractThe ongoing hepatitis A outbreaks in multiple states in the United States have concerned public health authorities since March 2017. The outbreaks have spread throughout 30 states and include primarily persons who use drugs, including persons who inject drugs (PWID) and persons experiencing homelessness. Contaminated drug injection paraphernalia and sharing of these items could potentially aid in transmission of hepatitis A virus (HAV) among these populations. We examined HAV survival on drug paraphernalia frequently shared among PWIDs. The effect of low pH on HAV survival using citric acid, which is frequently used by PWIDs during dose preparation, was investigated. We compared the plaque assay results with those concurrently obtained by qRT‐PCR to establish whether HAV RNA levels could be used as surrogates for plaque assay results. HAV suspended in minimal essential media at room temperature infected FRhK4 cells for more than 17 weeks. HAV remained viable in syringes/needles for up to 10 weeks depending on the gauge of the needles and the syringe dead volumes, and on cookers, tourniquets and cotton balls/filter surfaces for up to 4 weeks. HAV retained its infectivity for more than 10 weeks at pH as low as 2. In conclusion, our findings show that HAV survives and remains infective in or on injection drug use equipment for 1 to 10 weeks depending on the type of paraphernalia examined and environmental conditions. These findings suggest that contaminated drug paraphernalia can potentially facilitate the transmission of HAV within populations who share these items.
A noncanonical GATA transcription factor of Entamoeba histolytica modulates genes involved in phagocytosis
Authors: Huerta Miriam , Reyes Luz , García‐Rivera Guillermina , Bañuelos Cecilia , Betanzos Abigail , Díaz‐Hernández Mitzi , Galindo Ausencio , Bolaños Jeni , Cárdenas Helios , Azuara‐Liceaga Elisa , Chávez‐Munguía Bibiana , Orozco Esther 
Published: August 2020

AbstractIn this paper, we explored the presence of GATA in Entamoeba histolytica and their function as regulators of phagocytosis‐related genes. Bioinformatics analyses evidenced a single 579 bp sequence encoding for a protein (EhGATA), smaller than GATA factors of other organisms. EhGATA appeared phylogenetically close to Dictyostelium discoideum and Schistosoma mansoni GATA proteins. Its sequence predicts the presence of a zinc‐finger DNA binding domain and an AT‐Hook motif; it also has two nuclear localization signals. By transmission electron and confocal microscopy, anti‐EhGATA antibodies revealed the protein in the cytoplasm and nucleus, and 65% of nuclear signal was in the heterochromatin. EhGATA recombinant protein and trophozoites nuclear extracts bound to GATA‐DNA consensus sequence. By in silico scrutiny, 1,610 gene promoters containing GATA‐binding sequences appeared, including Ehadh and Ehvps32 promoters, whose genes participate in phagocytosis. Chromatin immunoprecipitation assays showed that EhGATA interact with Ehadh and Ehvps32 promoters. In EhGATA‐overexpressing trophozoites (NeoGATA), the Ehadh and Ehvps32 mRNAs amount was modified, strongly supporting that EhGATA could regulate their transcription. NeoGATA trophozoites exhibited rounded shapes, high proliferation rates, and diminished erythrophagocytosis. Our results provide new insights into the role of EhGATA as a noncanonical transcription factor, regulating genes associated with phagocytosis.
Electromagnetic interference effect of dental equipment on cardiac implantable electrical devices: A systematic review
Authors: Niu Yuting , Chen Yufei , Li Wenjing , Xie Ruiqin , Deng Xuliang 
Published: August 2020

AbstractBackgroundThe electromagnet interference (EMI) effect resulting from using dental equipment near cardiovascular implantable electronic devices (CIEDs) is controversial based on in vitro and in vivo studies. We aimed to summarize the available evidence to investigate the safety of using dental equipment on patients with CIEDs.MethodsAn electronic search was performed in PubMed, Embase, MEDLINE Ovid, and the Cochrane Library for relevant studies published between January 2000 and May 2020. The search strategy centered on terms related to dental devices and CIEDs. Two independent reviewers determined the final inclusion of the studies in the systematic review. The EMI effect was summarized based on different dental instruments detected in in vitro or in vivo studies.ResultsThe primary search identified 84 articles, and 18 studies were finally included in this systematic review after exclusions. Most in vitro studies (n = 12) reported background noise or severe EMI affecting CIED function at a close distance from the lead tip or at a high sensitivity setting of CIEDs. In in vivo studies (n = 6), EMI that altered CIED function was not detected at clinical distance and sensitivity settings. The summary, based on electronic apex locators, ultrasonic devices, and electric pulp testers, demonstrated the compatibility of these common dental devices with CIEDs.ConclusionsThis systematic review indicates that most dental instruments can be used safely in routine dental practice. The EMI effect of dental equipment depends on the exposure distance and lead‐related parameters of the CIEDs.
Diagnostic concordance between pediatric emergency department physicians and dermatologists in a tertiary hospital in Mexico
Authors: Alba‐Rojas Erika L. , Morán‐Villaseñor Edna , Campos‐Cabrera Blanca L. , Aguirre‐Martínez Iliana L. , Vega‐Rangel Rosa V. , Cazares‐Ramírez Eduardo , Medina‐Vera Isabel , García‐Romero María Teresa 
Published: August 2020

AbstractBackground and ObjectivesSkin diseases are a common reason for emergency department (ED) consultations; however, few studies have focused on pediatric patients. Diagnostic consistency between ED physicians and dermatologists varies from 43% to 58%, meaning many patients seeking emergency care may receive incorrect diagnoses and treatments. We aimed to determine the diagnostic concordance between ED physicians and pediatric dermatologists.MethodsWe conducted a prospective study including all pediatric patients (<18 years) who were seen for a skin condition at the ED from December 1, 2017, to June 1, 2018, and consented to participate. We classified diagnoses according to their etiology. Patients were diagnosed by ED trainees and attending physicians, followed by blinded pediatric dermatology trainees and attending physicians. We evaluated concordance using Fleiss's kappa coefficient (κ) with a 95% confidence interval. We further stratified the data by level of training.ResultsWe included 185 patients. Inflammatory conditions were the most common reason for consultation, followed by infections; 10 patients required hospitalization. Concordance between diagnoses given at the ED and at the dermatology clinic was moderate (κ 0.472, 95% CI: 0.389‐0.455) with 62.7% agreement. Concordance between different diagnostic categories was lowest for autoimmune disorders and drug reactions (κ 0.392 with 95% CI: 0.248‐0.536 and κ 0.258 with 95% CI: 0.114‐0.402).ConclusionsDiagnostic concordance between ED physicians and dermatologists was moderate and differed according to training level and diagnoses. Dermatological education for ED providers, specifically focusing on autoimmune disorders and drug reactions, may improve diagnostic accuracy and patient care.
Use of a T'LIFT transabdominal organ retraction device in two‐portal laparoscopic ovariectomy in dogs
Authors: Delaune Tiare , Matres‐Lorenzo Luis , Bernardé Antoine , Bernard Fabrice 
Published: August 2020

AbstractObjectiveTo describe the use of the T'LIFT transabdominal organ retraction device to suspend ovaries during canine laparoscopic ovariectomy (LapOVE) and compare its use to a transabdominal suspension suture (TSS).DesignRandomized clinical trial.AnimalsClient‐owned intact bitches (n = 30).MethodsDogs were randomly assigned either to group T, in which LapOVE was performed with the T'LIFT, or to group S, in which a TSS was used. Laparoscopic ovariectomy was performed by using a standard two‐portal protocol. Signalment (age, weight, body condition score [BCS], fat score of the ovarian pedicle [FSOP]), overall operative time, ovarian resection time, and perioperative complications were compared between groups.ResultsNo significant differences were found between groups regarding age, weight, BCS, or FSOP. Surgical times were not significantly different between groups. No significant differences in major or minor complications were recorded. Overall operative time was significantly shorter for the last half of the cases compared with the first half, for the overall population, and within each group. Ovarian resection time for the last cases was significantly shorter compared with that for the first ones only in group T.ConclusionThe T'LIFT was used to suspend ovaries for two‐portal LapOVE, with no major complications noted. There was no significant difference in surgical times or complications compared with transabdominal suturing.Clinical significanceThe T'LIFT can be considered as an alternative to transabdominal suture for ovarian suspension in dogs undergoing LapOVE.
Fake News Travels Fast: Exploring Misinformation Circulated Around Wu Lei’s Coronavirus Case
Authors: Li Bo , Scott Olan 
Published: August 2020

This commentary analyzes how misinformation related to a coronavirus case of a star soccer player (i.e., Wu Lei) was spread widely on Chinese digital media and accepted by sports fans as the truth. The paper first examines the mechanisms by exploring how misinformation emerged and was disseminated. Then, the paper explores how social media and the fast-growing self-media in China exacerbate tendencies toward misinformation during the news production process, which poses a new threat to legacy media and journalists’ profession. The paper concludes by discussing new challenges faced by Chinese sports journalists in the new digital era after COVID-19.
Sports Television and the Continuing Search for Alternative Programming
Authors: Buehler Branden 
Published: August 2020

The American sports television industry has scrambled to adjust to the loss of live sporting events in the wake of the coronavirus pandemic—a scramble clearly evidenced in programming schedules suddenly filled with replays of older event telecasts. However, rather than focusing on the apparent novelty of this type of substitute coronavirus programming, this article, instead, argues that the loss of live sporting events represents the amplification of a problem that television networks have already been grappling with for years: how to fill an ever greater number of outlets with sufficient year-round programming given a finite number of live events. With that in mind, this article proposes that many of the programming strategies that networks have turned to in the midst of the pandemic, including the expanded coverage of transactions (e.g., coverage of National Football League free agency) and the increased scheduling of documentaries (e.g., The Last Dance), have been familiar extensions of previously established alternative programming solutions.
Novel approach to estimate tuberculosis transmission in primary care clinics in sub-Saharan Africa: protocol of a prospective study
Authors: Zürcher Kathrin , Morrow Carl , Riou Julien , Ballif Marie , Koch Anastasia Sideris , Bertschinger Simon , Liu Xin , Sharma Manuja , Middelkoop Keren , Warner Digby , Wood Robin , Egger Matthias , Fenner Lukas 
Published: August 2020

IntroductionTuberculosis (TB) transmission is difficult to measure, and its drivers are not well understood. The effectiveness of infection control measures at healthcare clinics and the most appropriate intervention strategies to interrupt transmission are unclear. We propose a novel approach using clinical, environmental and position-tracking data to study the risk of TB transmission at primary care clinics in TB and HIV high burden settings in sub-Saharan Africa.Methods and analysisWe describe a novel and rapid study design to assess risk factors for airborne TB transmission at primary care clinics in high-burden settings. The study protocol combines a range of different measurements. We will collect anonymous data on the number of patients, waiting times and patient movements using video sensors. Also, we will collect acoustic sound recordings to determine the frequency and intensity of coughing. Environmental data will include indoor carbon dioxide levels (CO2 in parts per million) and relative humidity. We will also extract routinely collected clinical data from the clinic records. The number of Mycobacterium tuberculosis particles in the air will be ascertained from dried filter units using highly sensitive digital droplet PCR. We will calculate rebreathed air volume based on people density and CO2 levels and develop a mathematical model to estimate the risk of TB transmission. The mathematical model can then be used to estimate the effect of possible interventions such as separating patient flows or improving ventilation in reducing transmission. The feasibility of our approach was recently demonstrated in a pilot study in a primary care clinic in Cape Town, South Africa.Ethics and disseminationThe study was approved by the University of Cape Town (HREC/REF no. 228/2019), the City of Cape Town (ID-8139) and the Ethics Committee of the Canton Bern (2019-02131), Switzerland. The results will be disseminated in international peer-reviewed journals.
Exploration of rural physicians’ lived experience of practising outside their usual scope of practice to provide access to essential medical care (clinical courage): an international phenomenological study
Authors: Konkin Jill , Grave Laura , Cockburn Ella , Couper Ian , Stewart Ruth Alison , Campbell David , Walters Lucie 
Published: August 2020

ObjectivesRural doctors describe consistent pressure to provide extended care beyond the limits of their formal training in order to meet the needs of the patients and communities they serve. This study explored the lived experience of rural doctors when they practise outside their usual scope of practice to provide medical care for people who would otherwise not have access to essential clinical services.DesignA hermeneutic phenomenological study.SettingAn international rural medicine conference.ParticipantsAll doctors attending the conference who practised medicine in rural/remote areas in a predominantly English-speaking community were eligible to participate; 27 doctors were recruited.InterventionsSemi-structured interviews were conducted. The transcripts were initially read and analysed by individual researchers before they were read aloud to the group to explore meanings more fully. Two researchers then reviewed the transcripts to develop the results section which was then rechecked by the broader group.Primary outcome measureAn understanding of the lived experiences of clinical courage.ResultsParticipants provided in-depth descriptions of experiences we have termedclinical courage. This phenomenon included the following features: Standing up to serve anybody and everybody in the community; Accepting uncertainty and persistently seeking to prepare; Deliberately understanding and marshalling resources in the context; Humbly seeking to know one’s own limits; Clearing the cognitive hurdle when something needs to be done for your patient; Collegial support to stand up again.ConclusionThis study elucidated six features of the phenomenon ofclinical couragethrough the narratives of the lived experience of rural generalist doctors.