bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of metabolically healthy obesity on the risk of incident gastric cancer: a population-based cohort study
Authors: Hashimoto Yoshitaka , Hamaguchi Masahide , Obora Akihiro , Kojima Takao , Fukui Michiaki 
Published: November 2019

Abstract
Background Previous meta-analyses revealed that obesity confers a risk of gastric cancer. On the other hand, metabolically healthy obese (MHO) individuals, who are healthier than metabolically abnormal obese (MAO) individuals, have lower risks of colon cancer and breast cancer. However, the association between MHO and incident gastric cancer is unclear. Methods This historical cohort study included 19,685 Japanese individuals who participated in health-checkup programs from 2003 to 2016. Each subject was classified as metabolically healthy (MH) (no metabolic abnormalities) or metabolically abnormal (MA) (one or more metabolic abnormalities), according to four metabolic factors (hypertension, impaired fasting glucose, hypertriglyceridemia and low high density lipoprotein-cholesterol). Obese (O) or non-obese (NO) was classified by a body mass index cutoff of 25.0 kg/m2. Hazard ratios of metabolic phenotypes for incident gastric cancer were calculated by the Cox proportional hazard model with adjustments for age, sex, alcohol consumption, smoking and exercise. Results Over the median follow-up period of 5.5 years, 78 participants developed gastric cancer. Five-years cumulative incident rate of gastric cancer was 0.2% (case/n = 17/8,331) in MHNO, 0.2% (1/653) in MHO, 0.5% (35/7,276) in MANO and 0.7% (25/3,425) in MAO. Compared with MHNO, the adjusted hazard ratios for development of gastric cancer were 0.69 (95%CI 0.04–3.39, p = 0.723) in MHO, 1.16 (95%CI 0.63–2.12, p = 0.636) in MANO and 2.09 (95%CI 1.10–3.97, p = 0.024) in MAO. Conclusions This study shows that individuals with MAO, but not those with MHO, had an elevated risk for incident gastric cancer.
Diagnostic Accuracy of the Xpert MTB/Rif Ultra for tuberculosis adenitis
Authors: Antel Katherine , Oosthuizen Jenna , Malherbe Francois , Louw Vernon J , Nicol Mark P , Maartens Gary , Verburgh Estelle 
Published: November 2019

Abstract
Background: The WHO recently recommended the new Xpert MTB/RIF Ultra assay (Ultra) instead of the Xpert MTB/RIF assay because Ultra has improved sensitivity. We report the diagnostic accuracy of Ultra for tuberculous adenitis in a tuberculosis and HIV endemic setting.
Methods: We obtained fine-needle aspirates (FNA) and lymph node tissue by core-needle biopsy in adult patients with peripheral lymphadenopathy of > 20 mm. Ultra and mycobacterial culture were performed on FNA and tissue specimens, with histological examination of tissue specimens. We assessed the diagnostic accuracy of Ultra against a composite reference standard of ‘definite tuberculosis’ (microbiological criteria) or ‘probable tuberculosis’ (histological and clinical criteria).
Results: We prospectively evaluated 99 participants of whom 50 were HIV positive: 21 had ‘definite tuberculosis’, 15 ‘probable tuberculosis’ and 63 did not have tuberculosis (of whom 38% had lymphoma and 19% disseminated malignancy). Using the composite reference standard the Ultra sensitivity on FNA was 70% (95% CI 51-85; 21 of 30), and on tissue was 67% (45-84; 16/24) these were far superior to the detection of acid-fast bacilli on an FNA (26%; 7/27); AFB on tissue (33%; 8/24 );or tissue culture (39%; 9/23). The detection of granulomas on histology had high senstivity (83%) but the lowest specficity. When the samples from tissue and FNA were pooled and compared to culture the sensitivity was 84% (60-97; 16/19).
Conclusions: Ultra performed on FNA or tissue of a lymph node had good sensitivity and high specificity. Ultra had a higher yield than culture and has the advantage of being a rapid test. Ultra on FNA would be an appropriate initial investigation for lymphadenopathy in tuberculosis endemic areas followed by a core biopsy for histopathology with a repeat Ultra on tissue if granulomas are present.
Inhibition of autophagy triggers melatonin-induced apoptosis in glioblastoma cells
Authors: Zhou Nan , Wei Zixuan , Qi Zengxin 
Published: November 2019

Abstract
Background: Autophagy is considered to be another restorative focus for the treatment of brain tumors. Although several research have demonstrated that melatonin induces autophagy in colon cancer and hepatoma cells, there has not been any direct evidence of whether melatonin is capable of inducing autophagy in human glioma cells. Results: In the present research, we report that melatonin or its agonist, agomelatine, induced autophagy in A172 and U87-MG glioblastoma cells for a concentration-and time-dependent way, which was significantly attenuated by treatment with luzindole, a melatonin receptor antagonist. Furthermore, by suppressing autophagy at the late-stage with bafilomycin A1 and early stage with 3-MA, we found that the melatonin-induced autophagy was activated early, and the autophagic flux was complete. Melatonin treatment alone did not induce any apoptotic changes in the glioblastoma cells, as measured by flow cytometry. Western blot studies confirmed that melatonin alone prominently upregulated the levels of Beclin 1 and LC3 II, which was accompanied by an increase in the expression of Bcl-2, whereas it had no effect on the expression of Bax in the glioblastoma cells. Remarkably, co-treatment with 3-MA and melatonin significantly enhanced the apoptotic cell population in the glioblastoma cells, along with a prominent decrease in the expression of bcl-2 and increase in the Bax expression levels, which collectively indicated that the disruption of autophagy triggers the melatonin-induced apoptosis in glioblastoma cells. Conclusions: These results provide information indicating that melatonin may act as a common upstream signal between autophagy and apoptosis, which may lead to the development of new therapeutic strategies for glioma.
Utilization of dental services and associated factors among preschool children in China
Authors: Gao Xiaoli , Ding Min , Xu Mengru , Wu Huijing , Zhang Chunzi , Wang Xing , Feng Xiping , Tai Baojun , Hu Deyu , Lin Huancai , Wang Bo , Zheng Shuguo , Liu Xuenan , Rong Wensheng , Wang Weijian , Wang Chunxiao , Si Yan 
Published: November 2019

Abstract
Background: This study sought to evaluate dental utilization among 3-,4-, and 5-year-old children in China and to use Andersen’s behavioural model to explore influencing factors, thereby providing a reference for future policy making.
Methods: This study is a cross-sectional study. Data of 40,305 children aged 3-5 years were extracted from the Fourth National Oral Health Survey, which was performed from August 2015 to December 2016.Patient data were collected using a questionnaire, whichwas answered by the child’s parents, and clinical data were collected during a clinical examination. Stratification and survey weighting were incorporated into the complex survey design. Descriptive statistics, bivariate correlations and hierarchicallogistic regression results were then analysed to find the factors associated with oral health service utilization.
Results : The oral health service utilization prevalenceduring the prior 12 months were 9.5% (95%CI: 8.1%-11.1%) among 3-year-old children, 12.1% (95%CI: 10.8%-13.5%) among 4-year-old children, and 17.5% (95%CI: 15.6%-19.4%) among 5-year-old children. “No dental diseases” (71.3%) and “dental disease was not severe” (12.4%) were the principal reasons why children had not attended a dental visit in the past 12 months. The children whose parents had a bachelor’s degree or higher(OR: 2.29, 95%CI: 1.97-2.67, p <0.001), a better oral health attitude ranging from 5 to 8(OR: 1.64, 95%CI: 1.43-1.89, p <0.001), annual per capital income more than 25,000CNY (OR: 1.40, 95%CI: 1.18-1.65, p <0.001),think their child have worse or bad oral health(OR: 3.54, 95%CI: 2.84-4.40, p <0.001), and children who often have toothaches (OR: 9.72 , 95%CI: 7.81-12.09, p <0.001) were more likely to go to the dentist in the past year.
Conclusion: The prevalenceof dental service utilization was relatively low among preschool children. It is necessary to strengthen oral health education for parents and children, thereby improving oral health knowledge as well as attitude, and promoting dental utilization.
Natural polymorphisms in HIV-1 CRF01_AE strain and profile of acquired drug resistance mutations in a long-term combination treatment cohort in northeastern China
Authors: Sun Zesong , Ouyang Jinming , Zhao Bin , An Minghui , Wang Lin , Ding Haibo , Han XiaoXu , Shang Hong 
Published: November 2019

Abstract
Background: The impacts of genetic polymorphisms on drug resistance mutations (DRMs) among various HIV-1 subtypes have long been debated. In this study, we aimed to analyze the natural polymorphisms and acquired DRM profile in HIV-1 CRF01_AE-infected patients in a large first-line antiretroviral therapy (ART) cohort in northeastern China. Methods: The natural polymorphisms of CRF01_AE were analyzed in 2034 patients from a long-term ART cohort in northeastern China. The polymorphisms in 105 treatment failure (TF) patients were compared with those in 1148 treatment success (TS) patients. The acquired DRM profile of 42 patients who experienced TF with tenofovir/lamivudine/efavirenz (TDF/3TC/EFV) treatment was analyzed by comparing the mutations at TF time point to those at baseline. The Stanford HIVdb algorithm was used to interpret the DRMs. Binomial distribution, McNemar test, Wilcoxon test and CorMut package were used to analyze the mutation rates and co-variation. Deep sequencing was used to analyze the evolutionary dynamics of co-variation. Results: Before ART, there were significantly more natural polymorphisms of 31 sites on reverse transcriptase (RT) in CRF01_AE than subtype B HIV-1 (|Z value|≥3), including five known drug resistance-associated sites (238, 118, 179, 103, and 40). However, only the polymorphism at site 75 was associated with TF (|Z value|≥3). The mutation rate at 14 sites increased significantly at TF time point compared to baseline, with the most common DRMs comprising G190S/C, K65R, K101E/N/Q, M184V/I, and V179D/I/A/T/E, ranging from 66.7% to 45.2%. Moreover, two unknown mutations (V75L and L228R) increased by 19.0% and 11.9% respectively, and they were under positive selection (Ka/Ks>1, log odds ratio [LOD]>2) and were associated with several other DRMs (cKa/Ks>1, LOD>2). Deep sequencing of longitudinal plasma samples showed that L228R occurred simultaneously or followed the appearance of Y181C. Conclusion: The high levels of natural polymorphisms in CRF01_AE had little impact on treatment outcomes. The findings regarding potential new CRF01_AE-specific minor DRMs indicate the need for more studies on the drug resistance phenotype of CRF01_AE.
Isoniazid causes heart looping disorder in zebrafish embryos by the induction of oxidative stress
Authors: WANG Hongye , Yihai Liu , Xiyi Wei , Shen Kangjie , Sha Yeqin , Dong Yuxiang , Shu Yimei , Wan Xiaojie , Ren Xiaohan , Chen Jingwen , Tingting Hu 
Published: November 2019

Abstract
Background: The cardiotoxicity of isoniazid on zebrafish embryos and its underlying mechanism is unclear.
Methods: Here, we exposed zebrafish embryos at 4 hours post-fertilization to different levels of isoniazid and recorded the morphology and number of malformed and dead embryos under the microscope.
Results: The high concentration of isoniazid group showed more malformed and dead embryos than the low concentration of isoniazid group and control group. The morphology of the heart and its alteration were visualized using transgenic zebrafish (cmlc2: GFP) and confirmed by in situ hybridization. The negative effects of isoniazid on the developing heart were characterized by lower heart rate and more heart looping disorders. Mechanistically, PCR showed decreased expression of heart-specific transcription factors when exposed to isoniazid. Oxidative stress was induced by isoniazid in cardiomyocytes, mediated by decreased activities of catalase and superoxide dismutase, which were rescued by scavengers of reactive oxygen species.
Conclusion: In conclusion, we demonstrated that isoniazid led to heart looping disturbance by the downregulation of cardiac-specific transcription factors and induction of cardiomyocyte apoptosis.
Point of care testing evaluation of lateral flow immunoassay for diagnosing of Cryptococcus Meningitis in HIV-positive patients at an urban hospital in Nairobi, Kenya, 2017
Authors: Gitonga Lawrence Kirimi , Boru Waqo Gufu , Kwena Arthur , Maritim Marybeth , Wamicwe Joyce , Ransom James Anthony 
Published: November 2019

Abstract
Objectives: The objective of this study was to evaluate the performance of lateral flow immunoassay (LFA) against latex agglutination (LA), India ink and culture in point-of-care diagnosis of Cryptococcus meningitis (CM). We conducted a cross-sectional study among HIV-positive patients with suspected CM at Mbagathi Hospital, Nairobi, April-July 2017.
Results: Of 124 capillary blood and serum and 99 cerebrospinal fluid (CSF) samples, LFA and LA had a concurrence on serum of 94.4%, kappa (0.88), sensitivity (100%) and specificity (91%). LFA and LA on CSF, was 97.9%, kappa (0.96), sensitivity (100%) and specificity (96%). LFA and India ink was 96.9%, kappa (0.94), sensitivity (100%) and specificity (94.1%). On CSF culture, concurrence was 72.7%, kappa (0.43), sensitivity (100%) and specificity (64%) and of LFA on capillary blood, serum and CSF was 100% with kappa (1.00), sensitivity and specificity of 100%
Composite genome sequence of Bacillus clausii, a probiotic commercially available as Enterogermina®, and insights into its probiotic properties
Authors: Khatri Indu , Sharma Gaurav , Subramanian Srikrishna 
Published: November 2019

Abstract
Background: Some of the spore-forming strains of Bacillus probiotics are marketed commercially as they survive harsh gastrointestinal conditions and bestow health benefits to the host.
Results: We report the composite genome of Bacillus clausii ENTPro from a commercially available probiotic Enterogermina® and compare it with the genomes of other Bacillus probiotics. We find that the members of B. clausii species harbor high heterogeneity at the species as well as genus level. The genes conferring resistance to chloramphenicol, streptomycin, rifampicin, and tetracycline in the B. clausii ENTPro strain could be identified. The genes coding for the bacteriocin gallidermin, which prevents biofilm formation in the pathogens S. aureus and S. epidermidis, were also identified. KEGG Pathway analysis suggested that the folate biosynthesis pathway, which depicts one of the important roles of probiotics in the host, is conserved completely in B. subtilis and minimally in Bacillus clausii and other probiotics.
Conclusions: We identified various antibiotic resistance, bacteriocins, stress-related, and adhesion-related domains, and industrially-relevant pathways, in the genomes of these probiotic bacteria that are likely to help them survive in the harsh gastrointestinal tract, facilitating adhesion to host epithelial cells, persistence during antibiotic treatment and combating bacterial infections.
A Simple Monochromatic Flow Cytometric Assay for Assessment of Intraerythrocytic Development of Plasmodium falciparum
Authors: Kulkeaw Kasem , Ketprasit Nutpakal , Tungtrongchitr Anchalee , Palasuwan Duangdao 
Published: November 2019

Abstract
Background Gold standard microscopic examination of P. falciparum intraerythrocytic stage remains an important process for staging and enumerating parasitized erythrocytes in culture; however, microscopy is laborious, and its accuracy is dependent upon the skill of the examiner.Methods In this study, we used ViSafe Green (VSG), which is a nucleic acid-binding fluorescent dye, to assess in vitro development of P. falciparum using flow cytometry.Results Fluorescence intensity of VSG was found to depend on the developmental stage of parasites. Specifically, multiple-nuclei-containing schizonts were observed in the VSG high population, and growing trophozoites and ring-shaped forms were observed in the VSG intermediate and VSG low populations. The VSG-based assay was found to be comparable to the microscopic examination method, and capable of detecting as few as 0.001% of the parasitemia estimated by Giemsa staining. Moreover, when applying VSG for antimalarial drug test, we were able to observe the growth inhibitory effect of dihydroartemisinin, the front-line drug for malaria therapy.Conclusions Taken together, the results of this study suggest the VSG-based flow cytometric assay to be a simple and reliable assay for assessing P. falciparum malaria development in vitro .
Vaccination accelerates hepatic erythroblastosis induced by blood-stage malaria
Authors: Delic Denis , Wunderlich Frank , Al-Quraishy Saleh , Abdel-Baki Abdel-Azeem , Dkhil Mohamed , Arauzo-Bravo Marcos 
Published: November 2019

Abstract
Background: Vaccination induces survival of otherwise lethal blood-stage infections of the experimental malaria Plasmodium chabaudi. Blood-stage malaria induces extramedullary erythropoiesis in the liver. This study investigates how vaccination affects the course of malaria-induced expression of erythrocytic genes in the liver. Methods: Female Balb/c mice were vaccinated at week 3 and week 1 before challenging with 106 P. chabaudi-parasitized erythrocytes. The non-infectious vaccine consisted of erythrocyte ghosts isolated from P. chabaudi-infected erythrocytes. Gene expression microarrays and quantitative real-time PCR were used to compare mRNA expression of different erythrocytic genes in the liver of vaccination-protected and non-protected mice during infections on days 0, 1, 4, 8, and 11 p.i.. Results: Global transcriptomics analyses reveal vaccination-induced modifications of malaria-induced increases in hepatic gene expression on days 4 and 11 p.i.. On these days, vaccination also alters hepatic expression of the erythropoiesis-involved genes Ermap, Kel, Rhd, Rhag, Slc4a1, Gypa, Add2, Ank1, Epb4.1, Epb4.2, Epb4.9, Spta1, Sptb, Tmod1, Ahsp, Acyp1, Gata1, Gfi1b, Tal1, Klf1, Epor, and Cldn13. In vaccination-protected mice, expression of these genes, except Epb4.1, is significantly higher on day 4 p.i. than in un-protected non-vaccinated mice, reaches maximal expression at peak parasitaemia on day 8 p.i., and is slowed down or even decreased towards the end of crisis phase on day 11 p.i.. After day 1 p.i., Epor expression takes about the same course as that of the other erythroid genes. Hepatic expression of Epo, however, is delayed in both vaccinated and non-vaccinated mice for the first 4 days p.i. and is maximal at significantly higher levels in vaccinated mice on day 8 p.i., before declining towards the end of crisis phase on day 11 p.i.. Conclusion: The present data indicate that vaccination accelerates malaria-induced erythroblastosis in the liver for 1-2 days. This may contribute to earlier replenishment of peripheral red blood cells by liver-derived reticulocytes, which may favour final survival of otherwise lethal blood-stage malaria, since reticulocytes are not preferred as host cells by P. chabaudi.
Some evidence that seasonal malaria chemoprevention with SPAQ did not have effect on antibodies response against pre-erythrocyte stage but on the blood-stage in Niger.
Authors: Moustapha Lamine Mahaman , Adamou Rafiou , Ibrahim Maman Laminou , Padounou Mariama Abdoulaye Louis , Diallo Abdoulaye , Courtin David , Testa Jean , NDiaye Jean Louis 
Published: November 2019

Abstract
Background: In endemic areas, children develop slowly and naturally anti-Plasmodium antibodies and become semi-immune. Seasonal Malaria Chemoprevention (SMC) with sulfadoxine-pyrimethamine + amodiaquine (SPAQ) is a new strategy to reduce malaria morbidity in young children in West Africa. However, SMC may impact on the natural acquisition of anti-Plasmodium immunity. We evaluated the effect of SMC with SPAQ on malaria antibodies levels in Niger. Methods: This survey was conducted in areas with SMC since 2014 (Zinder district), without SMC (Dosso district) and with one year SMC 2016 (Gaya district). To assess the relationship between SMC and total Ig G Ab against P. falciparum antigens, we measured antibodies levels of two P.falciparum asexual stage vaccine candidate antigens (Circum Sporozoid Protein and Glutamate-rich Protein R2) in children aged 3–59 months and compared these levels in Zinder, Dosso and Gaya by enzyme-linked immune-sorbent assay (ELISA) on the elution extracted from the RDTs positive and negative cassette. Results: A total of 229 children aged 3-59 months were included in the analysis: 71 in Zinder, 77 in Dosso, and 81 in Gaya. In Zinder (CSP=17.5 and GLURP-R2=14.3) median antibodies levels observed were higher than in Gaya (CSP=7.7 and GLURP-R2=6.5) and Dosso (CSP=4.5 and GLURP-R2=3.6) (p<0.0001). Conclusion: We have some evidence in this study that suggest SMC with SPAQ did not have effect on antibodies response against pre-erythrocyte stage but on the blood-stage. Future studies are necessary to provide better understanding of SMC effect on malaria immunity.
Surgical Site Infections in orthopaedic patients – a 10-year retrospective observational study in a Polish hospital
Authors: Kołpa Małgorzata , Słowik Róża , Wałaszek Marta , Wolak Zdzisław , Rozanska Anna , Wojkowska-Mach Jadwiga 
Published: November 2019

Abstract
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 implemented SSI prevention plan demonstrated a significant decrease (about 2.5-3 times) in SSI-D incidence in fracture reductions. 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.