[Experimental] List of manuscripts available for review volunteers
8 manuscripts available for review volunteers
November 22, 2017
West Nile Virus (WNV) is a disease transmitted by mosquitoes. It has become endemic across the continental United States following its arrival in 1999. Recent work is often limited by the simple assumption that the disease cases increase with mosquito numbers. However, spikes in numbers of cases do not always correlate with higher numbers of mosquitoes. Our objective is to examine the important factors, which influence the abundance of mosquitoes and the numbers of infected humans, independently. We developed statistical models to elucidate factors influencing mosquito abundances and numbers of disease cases, including time lag effects. We found that mosquito birth and mortality rates, day length, Missouri river gage height, dew point, and snowfall are influential factors in controlling mosquito numbers. The numbers of human disease cases were related to mosquito abundances, a fraction of mosquito expectorate virus, and bird competence index. In addition to identifying key factors controlling mosquito abundances and the numbers of disease case, the study results suggest that these developed models can be used to predict the onsets and human disease cases. From these findings, this study will lead to a broader understanding of disease dynamics and suggest a new strategy for the prevention and control of WNV.
November 20, 2017

Background. Different anticancer drugs are used in combination or alone to treat breast cancer depending upon the status of the patient. Oncologists need to know a drug’s efficacy; therefore, they compare different chemotherapies by considering side effects and overall survival so that suitable drugs can be prescribed. We present a comparison of adjuvant chemotherapies treating breast cancer with docetaxel plus cyclophosphamide (TC) and doxorubicin plus cyclophosphamide (AC) showing pathological markers and overall survival.

Method. For 4 to 8 cycles, (after every 21 days) out of 358 patients, 189 received TC (140 ml/m2 of docetaxel (IV) plus 1000 mg/m2 of cyclophosphamide) and 169 women were treated with AC (50/100 ml/m2 of doxorubicin (IV) plus 1000 mg/m2 of cyclophosphamide. On the basis of patients’ assessment by pathological markers, side effects of docetaxel, doxorubicin and cyclophosphamide are listed in our database using R programming language. The common factors and side effects given in MedlinePlus, NIH US database and from our database are separated to be included in comparison for this study. Statistically, we used Chi-Square Test for Homogeneity of Proportions at α = 0.05.

Results. There was no significant difference between proportions of patients with vomiting, extreme tiredness, diarrhoea, mild anaemia, stability and overall survival because p value > 0.05. However, p value < 0.05 for AC remains less toxic by 22.6%, 25.7% and 25.3% than TC in changes in taste, muscle pain and hands burning respectively, whereas TC remains less toxic by 52.9%, 26.3%, 11.3%, 32.5%, 15.5% and 1.75% in dizziness, sore throat, moderate anaemia, weight loss, blood transfusion and haemoglobin level respectively.

Discussion. TC is less toxic than AC in more aspects, whereas both combinations have same overall survival rate.

November 19, 2017
Background. Satisfaction evaluation is widely used in healthcare systems around the world to improve healthcare service quality and levels, in order to obtain better health outcomes. In the evaluation of healthcare reform, patient and medical staff satisfaction with this reform is a key criterion. The aim of this study was to measure employee work satisfaction and patient satisfaction status in the Wuhan region, China; the unsatisfactory factors as discovered through the evaluation will be used as a reference by healthcare policy makers and management so that they can adopt reasonable and effective measures to decrease the risk of dissatisfaction in the future. Methods. A cross-sectional study was conducted in 14 medical institutions in Wuhan from October to November 2016. The medical institutions included public general hospitals (tertiary and secondary) and community healthcare service centers/stations (primary). Stratified sampling of target medical staff and patients was carried out and the final valid sample comprised a total of 696 medical staff and 668 patients. Results. In the Wuhan area, it was found that the reliability levels of medical staff work satisfaction scales and patient satisfaction scales comprised Cronbach's alpha=0.973 and Cronbach's alpha=0.949, respectively. The studies in Wuhan and Guangzhou showed that the psychometric characteristics of the scales were basically the same. The overall satisfaction levels of medical staff and patients were 58.28±14.60 and 65.82±14.66, respectively. The medical staff satisfaction ranking in sequence from most to least satisfied was: work itself, work environment and atmosphere, hospital management, practicing environment, and job rewards. The patient satisfaction ranking in sequence from most to least satisfied was: physician-patient relationship and communication, service organization and facilities, continuity and collaboration of medical care, access to relevant information and support, and healthcare and related services. There were differences in the overall satisfaction levels of medical staff based on gender, age, educational level, job title, nature of the job, employment status, and whether staff were at the standardized training stage (p<.05 or .01). There was no statistically significant difference in various demographic variables in terms of overall patient satisfaction (p>.05). Discussion. The overall satisfaction evaluation of medical staff was average. In the future, healthcare policy makers and management staff of medical institutions should focus on job rewards and practicing environment in order to decrease the risk of dissatisfaction amongst medical staff. This would allow them to increase their work happiness and sense of belonging, which in turn would allow them to provide better medical services to patients. The overall patient evaluation was satisfactory, with patients satisfied at all levels of the satisfaction evaluation.
November 17, 2017
Introduction: Using spatial-temporal analyses to understand coverage and trends in elimination of mother-to-child transmission of HIV (eMTCT) efforts may be helpful in ensuring timely services are delivered to the right place. We present spatial-temporal analysis of 7-years of HIV early infant diagnosis data collected from 12 districts in western Kenya from January 2007 to November 2013, during pre-Option B+ use. Methods: We included in the analysis infants up to one year old. We performed trend analysis using extended Cochran–Mantel–Haenszel stratified test and logistic regression models to examine trends and associations of infant HIV status at first diagnosis with: early diagnosis (<8 weeks after birth), age at specimen collection, infant ever having breastfed, use of single dose nevirapine (sdNVP), and maternal antiretroviral therapy (ART) status. We examined these covariates and fitted spatial and spatial-temporal semi-parametric Poisson regression models to explain HIV-infection rates using R-Integrated Nested Laplace Approximation (INLA) package. We calculated new infections per 100,000 live births and used Quantum GIS to map fitted MTCT estimates for each district in Nyanza region. Results: Median age was 2 months, interquartile range (IQR) 1.5 to 5.8 months. Unadjusted pooled positive rate was 11.8% in the 7-years period and declined from 19.7% in 2007 to 7.0% in 2013, p<0.01. Uptake of testing ≤8 weeks after birth was under 50% in 2007 and increased to 64.1% by 2013, p<0.01. By 2013, the overall case rate was 447 infections per 100,000 live births. Based on Bayesian deviance information criterion comparisons, the spatial-temporal model with maternal and infant covariates was best in explaining geographical variation in MTCT. Discussion: Improved EID uptake and reduced MTCT rates are indicators of progress towards e-MTCT. Co-joined analysis of time and covariates in a spatial context provides a robust approach for explaining differences in programmatic impact over time. Conclusions: During this pre-Option B+ period, the PMTCT program in this region has not achieved e-MTCT target of ≤50 case rates per 100,000 live births. Geographical disparities in program achievements may signify gaps in spatial distribution of e-MTCT efforts and could indicate areas needing further resources and interventions.
November 16, 2017
Although water and sanitation are considered as a human right, about three out of ten people (2.1 billion) do not have access to safe drinking water. In 2016, 5.6 million students were enrolled in the 33.9% of Brazilian schools located in rural areas. Only 72% of them have a public water supply network. Herein, we proposed to evaluate the efficacy of environmental intervention for water treatment in rural schools of the Western Amazonia. The study is characterized by an experimental design with environmental intervention for the treatment of water for human consumption, through the installation of a simplified chlorinator, in 20 public schools in the rural area of Rio Branco municipality, Acre state. Before the intervention, the results revealed 20% (n = 4), 100% (n = 20) and 70% (n = 14) of schools having water outside the potability standards for Turbidity, Faecal coliforms, and Escherichia coli, respectively. There was no significant difference in the turbidity results after the intervention (p = 0.71). On the other hand, there was a very significant difference in the results of Faecal coliforms and Escherichia coli after the intervention (p<0.001). The actions carried out in this intervention have considerably improved the water quality of the schools, thus decreasing children’s health vulnerability due to inadequate water provided to the school community in the rural area. The activities of training, educational lectures, installation of equipment, supply of materials and supplies (65% calcium hypochlorite, and reagents) were fundamental to the obtained results.
November 14, 2017

Background. Participation rate is one of the main challenges medical researchers face. We examined how demographic background and trust in medical research affect the willingness of people to participate in medical research in Taiwan.

Methods. Data from the 2011 Taiwan Genomic Survey were used. A total of 3,159 people aged 18 to 70 years were sampled, and 1,538 of them completed the survey. Missing data were excluded. A total of 1,389 respondents were included in the final analysis.

Results. About 12 percent of the respondents answered that they would be willing to participate in medical research. Respondents who had a college degree or above and were married orlived with a significant other were less likely to participate in medical research. By contrast, respondents who were men and who or their close family members had a biomedicine-related degree were more likely to participate in medical research. After adjustment for demographic factors, respondents who expressed trust in doctors who conduct medical research, agreed that doctors would never ask them to join a medical research study that might harm them, thought that participating in a medical research study is safe, and agreed that medical researchers have no selfish reasons for doing research were more likely to participate in medical research.

Discussion. Some of our findings, such as the effect of education level and marital status on participation in medical research, are different from the findings of most previous studies conducted in other countries. This study is useful for the development of strategies for improving participant recruitment.

November 9, 2017
Anogenital warts are caused by human papillomavirus (HPV). HPV genotype 6 and 11 are most often associated with anogenital warts. The diversity of HPV genotypes found in Thai patients with genital warts is not well-characterized. The objective of this study was to investigate HPV-associated anogenital warts in the Thai population and whether genotypes found are represented in the vaccine. A total of 206 anogenital swab samples were analyzed for HPV DNA by PCR and sequencing. HPV positive was identified in 88.3% (182/206) of the samples. The majority of HPV (75.2%) were low-risk genotypes HPV6 and HPV11. Thus, HPV6 and HPV11 were most common infection in genital wart. We conclude that the quadrivalent vaccine could potentially prevent 84.5% of the genital warts found in the Thai population.
October 28, 2017
Background : Although, most of the research focus on the effect of birth methods on postpartum hemorrhage (PPH), there is, however, a lack of studies that examine whether the association between PPH and birth methods is different between nulliparous and multiparous women. We aims to compare the effects of birth methods on PPH between nulliparous and multiparous women. Methods: The data on 151,333 eligible women, who gave birth between January 2014 and May 2016, was obtained from the electronic health records in Shanxi province, China. The ordered logistic regression model was used to examine the association of birth methods and varying degrees of PPH between nulliparous and multiparous women. Results: In comparison with the odds for SVB, the odds of increased PPH for CS in multiparous women (aOR: 4.32; 95% CI: 3.03-6.14) was more than twice that in the nulliparous women (aOR: 2.04; 95% CI: 1.40-2.97). However, the PPH risk for episiotomy between multiparous (aOR: 1.24; 95% CI: 0.96-1.62) and nulliparous women (aOR: 1.55; 95% CI: 0.92-2.60) were nearly the same. The PPH risk of forceps-assisted birth was much higher in multiparous women (aOR: 9.32; 95% CI: 3.66-23.71) than in nulliparous women (aOR: 1.70; 95% CI: 0.91-3.18). Meanwhile, that for vacuum-assisted birth in multiparous women (aOR: 2.41; 95% CI: 0.36-16.29) was more than twice the PPH risk in the nulliparous women (aOR: 1.05; 95% CI: 0.40-2.73). However, the difference was insignificant. Uterine inertia was more prone to cause PPH in the multiparous women (aOR: 5.54; 95% CI: 1.76-17.50) than in the nulliparous women (aOR: 3.03; 95% CI: 1.48-6.21). In contrast to uterine inertia, vertex malposition presented a decreased effect to the development of PPH in the multiparous (aOR: 1.93; 95% CI: 1.25-3.00) and nulliparous women (aOR: 0.87; 95% CI: 0.63-1.22). Conclusion: The associations between birth methods and PPH are different between nulliparous and multiparous women. Therefore, the choice of birth methods should be tailored for nulliparous and multiparous women at labor to lower the severity of postpartum hemorrhage.


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