bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbiota modification in hematology: still at the bench or ready for the bedside?
Authors: Severyn Christopher J. , Brewster Ryan , Andermann Tessa M. 
Published: November 2019

AbstractGrowing evidence suggests that human microbiota likely influence diverse processes including hematopoiesis, chemotherapy metabolism, and efficacy, as well as overall survival in patients with hematologic malignancies and other cancers. Both host genetic susceptibility and host-microbiota interactions may impact cancer risk and response to treatment; however, microbiota have the potential to be uniquely modifiable and accessible targets for treatment. Here, we focus on strategies to modify microbiota composition and function in patients with cancer. First, we evaluate the use of fecal microbiota transplant to restore microbial equilibrium following perturbation by antibiotics and chemotherapy, and as a treatment of complications of hematopoietic stem cell transplantation (HSCT), such as graft-versus-host disease and colonization with multidrug-resistant organisms. We then address the potential use of both probiotics and dietary prebiotic compounds in targeted modulation of the microbiota intended to improve outcomes in hematologic diseases. With each type of therapy, we highlight the role that abnormal, or dysbiotic, microbiota play in disease, treatment efficacy, and toxicity and evaluate their potential promise as emerging strategies for microbiota manipulation in patients with hematologic malignancies and in those undergoing HSCT.
Safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy in the management of renal stones ≤ 2 cm: a single-center experience
Authors: Salih Elsayed M. , Elsotohi Ibrahim , Elhelaly Hisham , Elsalhy Mohamed , Mourad Mourad M. 
Published: November 2019

AbstractBackgroundThe goal for using smaller caliber instruments in PNL was to reduce the access-related complications and to decrease morbidity. The objective of this study was to evaluate the safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy (MIPNL) in the treatment of renal stones ≤ 20 mm.ResultsSixty-seven patients completed the study protocol. The mean age was 41.10 ± 13.99 years (range 18–68 years). There were 43 (64%) male and 24 (36%) females. The mean stone size was ranged from 78.5 to 439.6 mm2(mean ± SD 172.48 ± 69.54 mm2). The overall SFR was (82%). Twelve (18%) needed post-MIPNL auxiliary procedure, in the form of second MIPNL in 3 (4.5%) cases, SWL in 7 (10%), and RIRS in 2 (3%) cases. The intraoperative complication was present in four patients (5%) include bleeding necessitate blood transfusion in one patient (1.5%) and renal collecting system perforation 3 (4.5%). The postoperative complication was urine leakage 5 (7.5) and fever in 6 (9%) of patients.ConclusionChinese MIPNL is safe and effective method for treatment of renal stone ≤ 20 mm size with satisfactory SFR and low complication rate when SWL failed or contraindicated. It is considered a feasible treatment alternative to standard PNL, in the absence of flexible URS or miniature nephroscope.
Genome draft of the Arabidopsis relative Pachycladon cheesemanii reveals novel strategies to tolerate New Zealand’s high ultraviolet B radiation environment
Authors: Dong Yanni , Gupta Saurabh , Sievers Rixta , Wargent Jason J. , Wheeler David , Putterill Joanna , Macknight Richard , Gechev Tsanko , Mueller-Roeber Bernd , Dijkwel Paul P. 
Published: November 2019

Abstract

Background
Pachycladon cheesemanii is a close relative of Arabidopsis thaliana and is an allotetraploid perennial herb which is widespread in the South Island of New Zealand. It grows at altitudes of up to 1000 m where it is subject to relatively high levels of ultraviolet (UV)-B radiation. To gain first insights into how Pachycladon copes with UV-B stress, we sequenced its genome and compared the UV-B tolerance of two Pachycladon accessions with those of two A. thaliana accessions from different altitudes.

Results
A high-quality draft genome of P. cheesemanii was assembled with a high percentage of conserved single-copy plant orthologs. Synteny analysis with genomes from other species of the Brassicaceae family found a close phylogenetic relationship of P. cheesemanii with Boechera stricta from Brassicaceae lineage I. While UV-B radiation caused a greater growth reduction in the A. thaliana accessions than in the P. cheesemanii accessions, growth was not reduced in one P. cheesemanii accession. The homologues of A. thaliana UV-B radiation response genes were duplicated in P. cheesemanii, and an expression analysis of those genes indicated that the tolerance mechanism in P. cheesemanii appears to differ from that in A. thaliana.

Conclusion
Although the P. cheesemanii genome shows close similarity with that of A. thaliana, it appears to have evolved novel strategies allowing the plant to tolerate relatively high UV-B radiation.
Barriers from calling ambulance after recognizing stroke differed in adults younger or older than 75 years old in China
Authors:   on behalf of the FAST-RIGHT Investigators and Coordinators, Li Shengde , Cui Li-Ying , Anderson Craig , Gao Chunpeng , Yu Chengdong , Shan Guangliang , Wang Longde , Peng Bin 
Published: November 2019

Abstract

Background
As health behavior varies with increasing age, we aimed to examine the potential barriers in calling emergency medical services (EMS) after recognizing a stroke among 40–74- and 75–99-year-old adults.

Methods
Data were obtained from a cross-sectional community-based study (FAST-RIGHT) that was conducted from January 2017 to May 2017 and involved adults (age ≥ 40 years) across 69 administrative areas in China. A subgroup of residents (153675) who recognized stroke symptoms was analyzed. Multivariable logistic regression models were performed in the 40–74 and 75–99 age groups, separately, to determine the factors associated with wait-and-see behaviors at the onset of a stroke.

Results
In the 40–74 and 75–99 age groups, the rates of participants who chose “Self-observation at home” were 3.0% (3912) and 3.5% (738), respectively; the rates of “Wait for family, then go to hospital” were 31.7% (42071) and 33.1% (6957), respectively. Rural residence, living with one’s spouse, low income (< 731 US $ per annum), having a single avenue to learn about stroke, and having friends with stroke were factors associated with waiting for one’s family in both groups. However, unlike in the 40–74 age group, sex, number of children, family history, and stroke history did not influence the behaviors at stroke onset in the 75–99 age group.

Conclusions
Different barriers from recognizing stroke and calling an ambulance exist in the 40–74 and 75–99 age groups in this specific population. Different strategies that mainly focus on changing the “Wait for family” behavior and emphasize on immediately calling EMS are recommended for both age groups.
Spectrum of clinical features and neuroimaging findings in acute cerebral infarction patients with unusual ipsilateral motor impairment– a series of 22 cases
Authors: Tan Zhe-Ren , Zhang Chen , Tian Fa-Fa 
Published: November 2019

Abstract

Background
Cerebral infarction occurs when the arteries to brain are obstructed, and motor impairment contralateral to responsible lesion is commonly recognized. Few studies have profiled the characteristics of cases with ipsilateral motor impairment. We sought to characterize clinical features of patients with motor dysfunction caused by ipsilateral ischemic stroke.

Methods
We retrieved and analyzed the medical data for patients with ipsilateral cerebral infarction. Patients were regarded as having ipsilateral cerebral infarction if motor impairment is ipsilateral to recent stroke lesions.

Results
Only 22 patients with unusual ipsilateral cerebral infarction were included in this study. Ipsilateral limb paralysis was observed in all cases, and one case showed central facioplegia. Majority of patients with limb paralysis (90.9%, 20/22) presented with mild muscle strength deficits (MRC grading of 4 or more). Most of the patients (72.7%, 16/22) had a past history of stroke, and previous strokes were contralateral to the side of the recent stroke in 14 out of 16 patients (87.5%). No history of stroke or cerebral injury was identified in seven patients. With aspect of MRI findings, recent infarct lesions of all cases were located along the corticospinal tract.

Conclusions
History of stroke plays an important role in the pathogenesis of ipsilateral motor impairment, and cortical reorganization in the unaffected hemisphere may contribute to the compensation of motor function after stroke. Besides that, some cases with first stroke may be due to impairment of ipsilateral uncrossed corticospinal fibers.
Awareness and attitudes toward corneal donation among applicants and staff of a driver, vehicle and licensing authority (DVLA) in Ghana
Authors: Lartey Seth , Antwi-Adjei Ellen K. , Agyapong Solomon , Mohammed Abdul-Kabir , Mensah Derrick N. O. , Genego Edward S. 
Published: November 2019

AbstractBackgroundCorneal transplantations are surgeries performed for irreparable corneal diseases and damage. However, there is a gap between the number of potential recipients and the number of donor corneas available. The main aim of the study was to determine the awareness and attitudes toward corneal donation among applicants and staff of DVLA, Kumasi-Ghana.MethodsA descriptive cross-sectional study was conducted. One hundred participants were selected using convenient sampling method. A structured questionnaire was used to elicit responses from participants concerning awareness and attitudes toward corneal transplant.ResultsThe mean ± SD age of the participants was 32.05 ± 11.48 years and age range, 18-67 years. Males were 66% whilst females constituted 34%. 32.7% of the participants were aware of corneal donation. Majority of the participants were Christians (83.1%) and Singles (63%). Television was the source of information with the highest preponderance (49.4%). 67.3% were willing to donate their corneas after death. 63.9% were willing to indicate their donor statuses on drivers’ license form which had a significant association with willingness to donate cornea after death (p < 0.05,x2 = 12.187).ConclusionThere is a poor level of awareness (32.7%) of transplant and donation amongst the study population but a good level of willingness to donate organs (67%). Consent via driving license would seem to be a good potential mode of obtaining consent to supplement the harvesting of adequate tissues for transplant if adequate awareness is created.
Optimal allocation of HIV resources among geographical regions
Authors: Kedziora David J. , Stuart Robyn M. , Pearson Jonathan , Latypov Alisher , Dierst-Davies Rhodri , Duda Maksym , Avaliani Nata , Wilson David P. , Kerr Cliff C. 
Published: November 2019

Abstract

Background
Health resources are limited, which means spending should be focused on the people, places and programs that matter most. Choosing the mix of programs to maximize a health outcome is termed allocative efficiency. Here, we extend the methodology of allocative efficiency to answer the question of how resources should be distributed among different geographic regions.

Methods
We describe a novel geographical optimization algorithm, which has been implemented as an extension to the Optima HIV model. This algorithm identifies an optimal funding of services and programs across regions, such as multiple countries or multiple districts within a country. The algorithm consists of three steps: (1) calibrating the model to each region, (2) determining the optimal allocation for each region across a range of different budget levels, and (3) finding the budget level in each region that minimizes the outcome (such as reducing new HIV infections and/or HIV-related deaths), subject to the constraint of fixed total budget across all regions. As a case study, we applied this method to determine an illustrative allocation of HIV program funding across three representative oblasts (regions) in Ukraine (Mykolayiv, Poltava, and Zhytomyr) to minimize the number of new HIV infections.

Results
Geographical optimization was found to identify solutions with better outcomes than would be possible by considering region-specific allocations alone. In the case of Ukraine, prior to optimization (i.e. with status quo spending), a total of 244,000 HIV-related disability-adjusted life years (DALYs) were estimated to occur from 2016 to 2030 across the three oblasts. With optimization within (but not between) oblasts, this was estimated to be reduced to 181,000. With geographical optimization (i.e., allowing reallocation of funds between oblasts), this was estimated to be further reduced to 173,000.

Conclusions
With the increasing availability of region- and even facility-level data, geographical optimization is likely to play an increasingly important role in health economic decision making. Although the largest gains are typically due to reallocating resources to the most effective interventions, especially treatment, further gains can be achieved by optimally reallocating resources between regions. Finally, the methods described here are not restricted to geographical optimization, and can be applied to other problems where competing resources need to be allocated with constraints, such as between diseases.
Sheng Mai San protects H9C2 cells against hyperglycemia-induced apoptosis
Authors: Pang Bing , Shi Li-Wei , Du Li-juan , Li Yun-Chu , Zhang Mei-Zhen , Ni Qing 
Published: November 2019

Abstract

Background
Sheng Mai San (SMS) has been proven to exhibit cardio-protective effects. This study aimed to explore the molecular mechanisms of SMS on hyperglycaemia (HG)-induced apoptosis in H9C2 cells.

Methods
HG-induced H9C2 cells were established as the experimental model, and then treated with SMS at 25, 50, and 100 μg/mL. H9C2 cell viability and apoptosis were quantified using MTT and Annexin V-FITC assays, respectively. Furthermore, Bcl-2/Bax signalling pathway protein expression and Fas and FasL gene expression levels were quantified using western blotting and RT-PCR, respectively.

Results
SMS treatments at 25, 50, 100 μg/mL significantly improved H9C2 cell viability and inhibited H9C2 cell apoptosis (p < 0.05). Compared to the HG group, SMS treatment at 25, 50, and 100 μg/mL significantly downregulated p53 and Bax expression and upregulated Bcl-2 expression (p < 0.05). Moreover, SMS treatment at 100 μg/mL significantly downregulated Fas and FasL expression level (p < 0.05) when compared to the HG group.

Conclusion
SMS protects H9C2 cells from HG-induced apoptosis probably by downregulating p53 expression and upregulating the Bcl-2/Bax ratio. It may also be associated with the inhibition of the Fas/FasL signalling pathway.
Potential cost-savings from the use of the biosimilars filgrastim, infliximab and insulin glargine in Canada: a retrospective analysis
Authors: Mansell Kerry , Bhimji Hishaam , Eurich Dean , Mansell Holly 
Published: November 2019

Abstract

Background
In 2014 and 2015, biosimilars for the drugs filgrastim, infliximab, and insulin glargine were approved for use in Canada. The introduction of biosimilars in Canada could provide significant cost savings for the Canadian healthcare system over originator biologic drugs, however it is known that the use of biosimilars varies widely across the world. The aim of this study was to estimate the use of biosimilars in Canada and potential cost-savings from their use.

Methods
We performed a retrospective analysis of Canadian drug purchases for filgrastim, infliximab, and insulin glargine from July 2016 to June 2018. This was a cross-sectional study and the time horizon was limited to the study period. As a result, no discounting of effects over time was included. Canadian drugstore and hospital purchases data, obtained from IQVIA™, were used to estimate the costs per unit and unit volume for biosimilars and originator biologic drugs within each province. Potential cost-savings were calculated as a product of the units of reference originator product purchased and the cost difference between the originator biologic and its corresponding biosimilar.

Results
The purchase of biosimilars varied by each province in Canada, ranging from a low of 0.1% to a high of 81.6% of purchases. In total, $1,048,663,876 Canadian dollars in savings could have been realized with 100% use of biosimilars over the originator products during this 2 year time period. The potential savings are highest in the province of Ontario ($349 million); however, even in smaller markets (PEI and Newfoundland), $28 million could have potentially been saved. Infliximab accounted for the vast majority of the potential cost-savings, whereas the purchases of the biosimilar filgrastim outpaced that of the originator drug in some provinces. In sensitivity analyses assuming only 80% of originator units would be eligible for use as a biosimilar, $838 million dollars in cost savings over this two-year time period would still have been realized.

Conclusions
The overall use of biosimilar drugs in Canada is low. Policy makers, healthcare providers, and patients need to be informed of potential savings by increased use of biosimilars, particularly in an increasingly costly healthcare system.
Community participation and private sector engagement are fundamental to achieving universal health coverage and health security in Africa: reflections from the second Africa health forum
Authors: Olu Olushayo , Drameh-Avognon Pamela , Asamoah-Odei Emil , Kasolo Francis , Valdez Thomas , Kabaniha Grace , Karamagi Humphrey , Good Suvajee , O’Malley Helena , Yoti Zabulon , Razakazoa Nirina , Minkoulou Etienne , Dangou Jean-Marie , Mbola Mbassi Symplice , Castellon Mariano Salazar , Cabore Joseph , Moeti Matshidiso 
Published: November 2019

Abstract

Background
Inadequate access to quality health care services due to weak health systems and recurrent public health emergencies are impediments to the attainment of Universal Health Coverage and health security in Africa. To discuss these challenges and deliberate on plausible solutions, the World Health Organization Regional Office for Africa, in collaboration with the Government of Cabo Verde, convened the second Africa Health Forum in Praia, Cabo Verde on 26–28 March 2019, under the theme Achieving Universal Health Coverage and Health Security: The Africa We Want to See.

Methods
The Forum was conducted through technical sessions consisting of high-level, moderated panel discussions on specific themes, some of them preceded by keynote addresses. There were booth exhibitions by Member States, World Health Organization and other organizations to facilitate information exchanges. A Communiqué highlighting the recommendations of the Forum was issued during the closing ceremony. More than 750 participants attended. Relevant information from the report of the Forum and notes by the authors were extracted and synthesized into these proceedings.

Conclusions
The Forum participants agreed that the role of community engagement and participation in the attainment of Universal Health Coverage, health security and ultimately the Sustainable Development Goals cannot be overemphasized. The public sector of Africa alone cannot achieve these three interrelated goals; other partners, such as the private sector, must be engaged. Technological innovations will be a key driver of the attainment of these goals; hence, there is need to harness the comparative advantages that they offer. Attainment of the three goals is also intertwined – achieving one paves the way for achieving the others. Thus, there is need for integrated public health approaches in the planning and implementation of interventions aimed at achieving them.

Recommendations
To ensure that the recommendations of this Forum are translated into concrete actions in a sustainable manner, we call on African Ministers of Health to ensure their integration into national health sector policies and strategic documents and to provide the necessary leadership required for their implementation. We also call on partners to mainstream these recommendations into their ongoing support to World Health Organization African Member States.
A comprehensive analysis of drug resistance molecular markers and Plasmodium falciparum genetic diversity in two malaria endemic sites in Mali
Authors: Diakité Seidina A. S. , Traoré Karim , Sanogo Ibrahim , Clark Taane G. , Campino Susana , Sangaré Modibo , Dabitao Djeneba , Dara Antoine , Konaté Drissa S. , Doucouré Fousseyni , Cissé Amadou , Keita Bourama , Doumbouya Mory , Guindo Merepen A. , Toure Mahamoudou B. , Sogoba Nafomon , Doumbia Seydou , Awandare Gordon A. , Diakité Mahamadou 
Published: November 2019

Abstract

Background
Drug resistance is one of the greatest challenges of malaria control programme in Mali. Recent advances in next-generation sequencing (NGS) technologies provide new and effective ways of tracking drug-resistant malaria parasites in Africa. The diversity and the prevalence of Plasmodium falciparum drug-resistance molecular markers were assessed in Dangassa and Nioro-du-Sahel in Mali, two sites with distinct malaria transmission patterns. Dangassa has an intense seasonal malaria transmission, whereas Nioro-du-Sahel has an unstable and short seasonal malaria transmission.

Methods
Up to 270 dried blood spot samples (214 in Dangassa and 56 in Nioro-du-Sahel) were collected from P. falciparum positive patients in 2016. Samples were analysed on the Agena MassARRAY® iPLEX platform. Specific codons were targeted in Pfcrt, Pfmdr1, Pfdhfr, and Pfdhps, Pfarps10, Pfferredoxin, Pfexonuclease and Pfmdr2 genes. The Sanger’s 101-SNPs-barcode method was used to assess the genetic diversity of P. falciparum and to determine the parasite species.

Results
The Pfcrt_76T chloroquine-resistance genotype was found at a rate of 64.4% in Dangassa and 45.2% in Nioro-du-Sahel (p = 0.025). The Pfdhfr_51I-59R-108N pyrimethamine-resistance genotype was 14.1% and 19.6%, respectively in Dangassa and Nioro-du-Sahel. Mutations in the Pfdhps_S436-A437-K540-A581-613A sulfadoxine-resistance gene was significantly more prevalent in Dangassa as compared to Nioro-du-Sahel (p = 0.035). Up to 17.8% of the isolates from Dangassa vs 7% from Nioro-du-Sahel harboured at least two codon substitutions in this haplotype. The amodiaquine-resistance Pfmdr1_N86Y mutation was identified in only three samples (two in Dangassa and one in Nioro-du-Sahel). The lumefantrine-reduced susceptibility Pfmdr1_Y184F mutation was found in 39.9% and 48.2% of samples in Dangassa and Nioro-du-Sahel, respectively. One piperaquine-resistance Exo_E415G mutation was found in Dangassa, while no artemisinin resistance genetic-background were identified. A high P. falciparum diversity was observed, but no clear genetic aggregation was found at either study sites. Higher multiplicity of infection was observed in Dangassa with both COIL (p = 0.04) and Real McCOIL (p = 0.02) methods relative to Nioro-du-Sahel.

Conclusions
This study reveals high prevalence of chloroquine and pyrimethamine-resistance markers as well as high codon substitution rate in the sulfadoxine-resistance gene. High genetic diversity of P. falciparum was observed. These observations suggest that the use of artemisinins is relevant in both Dangassa and Nioro-du-Sahel.