bluuebunny/crossref_metadata_2025 huggingface dataset:
Mutation of c.244G>T in NR5A1 gene causing 46, XY DSD by affecting RNA splicing
Authors: Yu Bingqing , Gao Yinjie , Mao Jiangfeng , Wang Xi , Nie Min , Wu Xueyan
Published: August 2021

Objective

To identify the pathogenic mechanism of the c.244G>T mutation in NR5A1 gene found in a Chinese patient with 46, XY disorders of sex development (DSD). Subjects and methods: Genomic DNA was extracted from a Chinese 46, XY DSD patient. Targeted next-generation and Sanger sequencing were performed to investigate and validate the gene mutation causing 46, XY DSD, respectively. In silico tools were used to predict the pathogenicity of the variant. Dual luciferase reporter gene assay and minigene splicing reporter assay were used to identify the pathogenicity of the variant.

Results

A novel heterozygous variant, c.244G>T (p.Ala82Ser), in NR5A1 gene was detected in the 46, XY DSD patient. Four of five silico tools predicting pathogenicity of missense variants indicated that the variant was pathogenic. However, in vitro functional study showed that p.Ala82Ser did not affect the transcriptional activity of NR5A1. In silico tools predicting the potential splicing loci revealed that c.244G>T led to aberrant splicing of NR5A1 RNA. Minigene splicing reporter assay confirmed that c.244G>T resulted in the deletion of exon2 or deletion of 19 nucleotides in 3′ end of exon2.

Conclusions

Mutation of c.244G>T in NR5A1 results in 46, XY DSD by inducing abnormal splicing of NR5A1 RNA instead of amino acid substitution of NR5A1.
Evaluation of post-operative complications after mastectomy performed without perioperative antimicrobial prophylaxis in dogs
Authors: Spåre Philip , Ljungvall Ingrid , Ljungvall Karl , Bergström Annika
Published: August 2021

Background

Mastectomy is the most common procedure for treatment of mammary tumours. Dogs undergoing mastectomy have a risk of developing surgical site infections (SSI) and other postoperative complications. However, potential risk factors associated with such complications have been sparsely investigated. Thus, the objective of this retrospective study was to determine the incidence of, and identify risk factors for, SSI and non-SSI postoperative complications after mastectomy performed without perioperative antimicrobial prophylaxis in privately owned otherwise clinically healthy dogs.

Results

Medical records were reviewed retrospectively for 135 client-owned female dogs, 10–35 kg in weight and three to 10 years of age, which had undergone mastectomy due to mammary tumours at three referral animal hospitals in Sweden over a 3-year period. Twelve (8.9%) dogs developed SSI, and 21 dogs (17.1%) dogs suffered a non-SSI postoperative complication. The incidence of SSI and all complications (SSI and non-SSI) were higher in dogs that had two to three (SSI: P = 0.036 and all complications: P = 0.0039) and four to five (SSI and all complications: P = 0.038) mammary glands excised, compared to dogs that had one mammary gland excised. The incidence of SSI was 1.7% (n = 1/60) in dogs that had one gland removed. The incidence of non-SSI postoperative complications was higher in dogs with a higher body weight (P = 0.02).

Conclusions

The incidence of SSI was lower than or similar to previously reported incidences of SSI in dog populations that have undergone tumour excisional surgery, despite the fact that dogs in the present study had not received perioperative antibiotics. Dogs that had two or more glands excised had an increased risk of developing SSI and non-SSI complications compared to dogs that had one gland excised. Furthermore, higher BW was associated with an increased risk of non-SSI complications. Results from the study indicate that routine use of perioperative antibiotics in tumour excisional surgery can be questioned, at least in single gland mastectomy in otherwise clinically healthy dogs.
Pre-pandemic sleep behavior and adolescents’ stress during Covid-19: a prospective longitudinal study
Authors: Gruber Reut , Gauthier-Gagne Gabrielle , Voutou Denise , Somerville Gail , Saha Sujata , Boursier Johanne
Published: August 2021

Objective

To prospectively document changes in adolescents’ sleep before versus during the COVID-19 pandemic, and to examine their impact on adolescents’ perceived stress.

Methods

Sixty-two typically developing adolescents participated in the study before (Time 1: January 15 to March 13, 2020) and during (Time 2: May 15 to June 30, 2020) the COVID-19 pandemic in Canada. At Time 1, each participant’s sleep pattern was assessed in the home environment using actigraphy and sleep logs for seven consecutive nights. Adolescents completed a battery of questionnaires in which they reported on their sleep schedule, duration, and quality, as well as their activities at bedtime, their daytime sleepiness, and their social/emotional behavior. The participants’ parents provided demographic information. At Time 2, each participant completed a sleep log, the same battery of questionnaires regarding sleep, and the Perceived Stress Scale.

Results

(1) Adolescents’ reported sleep was of longer duration and on a delayed schedule during the COVID-19 pandemic compared to pre-pandemic. (2) A larger proportion of adolescents reported meeting or exceeding the recommended amount of sleep during the COVID-19 pandemic compared to pre-pandemic sleep. (3) “Social jet lag” disappeared during the COVID-19 pandemic. (4) A shorter reported sleep duration and higher level of arousal at bedtime at Time 1 were significant predictors of adolescents’ perceived stress at Time 2—during the COVID-19 pandemic. (5) A higher levels of arousal at bedtime and lower reported sleep quality at Time 2 were concurrently associated with higher levels of perceived stress among adolescents, even when we controlled for the levels of pre-pandemic emotional or behavioral issues, sleep duration, or sleep quality.

Conclusion

Sleep duration and cognitive-emotional arousal, which are both modifiable behaviors, were associated with adolescents’ perceived stress during the COVID-19 pandemic. These behaviors could be useful targets for preventive interventions aiming to reduce adolescents’ stress in the face of stressogenic situations, such as the COVID-19 pandemic.
Circular RNAs: characteristics, biogenesis, mechanisms and functions in liver cancer
Authors: Shen Hao , Liu Boqiang , Xu Junjie , Zhang Bin , Wang Yifan , Shi Liang , Cai Xiujun
Published: August 2021

Background

Hepatocellular carcinoma (HCC) is one of the most common malignancies globally. Despite aggressive and multimodal treatment regimens, the overall survival of HCC patients remains poor.

Main

Circular RNAs (circRNAs) are noncoding RNAs (ncRNAs) with covalently closed structures and tissue- or organ-specific expression patterns in eukaryotes. They are highly stable and have important biological functions, including acting as microRNA sponges, protein scaffolds, transcription regulators, translation templates and interacting with RNA-binding protein. Recent advances have indicated that circRNAs present abnormal expression in HCC tissues and that their dysregulation contributes to HCC initiation and progression. Furthermore, researchers have revealed that some circRNAs might serve as diagnostic biomarkers or drug targets in clinical settings. In this review, we systematically evaluate the characteristics, biogenesis, mechanisms and functions of circRNAs in HCC and further discuss the current shortcomings and potential directions of prospective studies on liver cancer-related circRNAs.

Conclusion

CircRNAs are a novel class of ncRNAs that play a significant role in HCC initiation and progression, but their internal mechanisms and clinical applications need further investigation.
The interaction effect of aerobic exercise and vitamin D supplementation on inflammatory factors, anti-inflammatory proteins, and lung function in male smokers: a randomized controlled trial
Authors: Nikniaz Leila , Ghojazadeh Morteza , Nateghian Hooman , Nikniaz Zeinab , Farhangi Mahdieh Abbasalizad , Pourmanaf Hadi
Published: August 2021

Background

This study aimed to investigate the interaction effect of aerobic exercise and vitamin D supplementation on inflammation (TNF-α, IL-6, CC16, SP-D, and CC16/SP-D ratio) and lung function (FEV1, FVC, and FEV1/FVC ratio) in male smokers.

Methods

After applying inclusion criteria, a total of 40 healthy male smokers were recruited in this study. The participants were randomly divided into four groups as follows: Aerobic Exercise + vitamin D Supplementation (AE + VitD,n = 10), Aerobic Exercise (AE,n = 10), vitamin D Supplementation (VitD,n = 10), and Control (C,n = 10). The participants in the AE + VitD and AE groups performed aerobic exercise training (running) up to 50% of the maximum heart rate, three times a week for four weeks. Participants in AE + VitD and VitD groups received 6000 IU/w vitamin D3for four weeks. The participants in control group did not receive any intervention. Serum tumor necrosis factor (TNF)-α, interleukin (IL)-6, Clara cell protein (CC16), surfactant protein (SP)-D, CC16/SP-D ratio, and lung function (FEV1, FVC, and FEV1/FVC ratio) were measured before and after four weeks of intervention.

Results

Serum levels of TNF-α, IL-6, and CC16 decreased significantly in AE + VitD, VitD, and AE groups after four weeks (P < 0.05). Serum SP-D level decreased significantly only in the AE + VitD group (P = 0.011). In addition, FEV1 and FVC increased significantly (P < 0.05) in AE + VitD and AE groups after four weeks of intervention. However, the interventions did not have a significant effect on CC16/SP-D ratio and FEV1/FVC ratio (P > 0.05). Furthermore, serum levels of 1,25-dihydroxyvitamin D increased significantly in AE + VitD and VitD groups (P < 0.05) after four weeks of intervention. However, except for TNF-α, between-group comparisons showed no significant differences in levels of IL-6, CC16, SP-D, CC16/SP-D ratio, FEV1, FVC, FEV1/FVC, and 1,25-dihydroxyvitamin D (P > 0.05).

Conclusions

The results of present study were that aerobic exercise combined with vitamin D supplementation can reduce serum inflammatory factors and anti-inflammatory proteins and improve lung function after four weeks of intervention. Further trials with larger sample size and longer duration are suggested to confirm these results.

Trial registrationRetrospectively registered. IRCT20180513039637N4. Registration date: 2020/10/20. URL:https://www.irct.ir/search/result?query=IRCT20180513039637N4
Measurement of catestatin and vasostatin in wild boar Sus scrofa captured in a corral trap
Authors: Fahlman Åsa , Lindsjö Johan , Bergvall Ulrika A. , Ågren Erik O. , Norling Therese Arvén , Stridsberg Mats , Kjellander Petter , Höglund Odd
Published: August 2021

Objective

Our aim was to analyse the chromogranin A-derived peptides vasostatin and catestatin in serum from wild boar (Sus scrofa) captured in a corral trap. Acute capture-related stress quickly leads to a release of adrenalin and noradrenalin, but these hormones have a short half-life in blood and are difficult to measure. Chromogranin A (CgA), a glycoprotein which is co-released with noradrenalin and adrenalin, is relatively stable in circulation and the CgA-derived peptides catestatin and vasostatin have been measured in domestic species, but not yet in wildlife.

Results

Vasostatin and catestatin could be measured and the median (range) serum concentrations were 0.91 (0.54–2.86) and 0.65 (0.35–2.62) nmol/L, respectively. We conclude that the CgA-derived peptides vasostatin and catestatin can be measured in wild boar serum and may thus be useful as biomarkers of psychophysical stress.
Prevalence of bullying victimisation among primary school children in South Africa: a population-based study
Authors: Manuel Donnay , Adams Sabirah , Mpilo Mulalo , Savahl Shazly
Published: August 2021

Objectives

Bullying victimisation (BV) among children in South Africa has been identified as a major public health concern. While several studies report on the prevalence rates of BV, there is currently a dearth of research that reports on the prevalence of BV among a national sample of primary school children. This study determines the prevalence rates of BV among a nationally representative sample of school-going children in South Africa across provinces, age, and gender. The sample comprised 7067 children (boys = 45.6%; girls = 54.4%) between the ages of 10–12-years attending 61 primary schools across the nine provincial regions of South Africa.

Results

In terms of ‘being hit’ by other children, percentages range from 22.55% (North West) to 33.34% (Free State). Children in Gauteng (33.59%) and Limpopo (38.54%) had the highest percentage of children being ‘left out’ or excluded. Additionally, across all provinces more than 30% of children reported that they had been ‘called unkind names’. Across gender, boys are more likely to experience all three forms of BV (being hit, left out, and called unkind names). The findings further indicate that 10-year-olds reported being ‘hit’ and ‘left out’, whereas a greater percentage of 12-year-olds reported ‘being called unkind names’ (44.28%).
Sleep disturbance, psychiatric issues, and employment status of Iranian people living with HIV
Authors: Najafi Arezu , Mahboobi Marzieh , Sadeghniiat Haghighi Khosro , Aghajani Faezeh , Nakhostin-Ansari Amin , Soltani Saber , Jafarpour Ali , Afsar Kazerooni Parvin , Bazargani Matin , Ghodrati Somayeh , Akbarpour Samaneh
Published: August 2021

Objectives

There are limited studies on the psychological issues and sleep problems among the Iranian people living with HIV (HIV). In this study, we aimed to assess sleep disorders, psychiatric characteristics, and employment status among Iranian PLWH.

Results

In total, 304 PLWH with a mean age of 40.01 (SD = 9.60) years participated in the study. About 72% of the participants had a global PSQI score of more than 5, with a mean score of 7.71 (SD = 3.31). About 55.6%, 50%, and 67.4% of subjects had abnormal scores for depression, anxiety, and stress. Unemployed participants had 2.13 times more chance (95% CI 1.01–4.53) of having poor sleep quality compared to employed patients, and stress increased its likelihood by 3.18 times (95% CI 1.47–5.88).
Microarray analysis of ductal carcinoma in situ samples obtained by puncture from surgical resection specimens
Authors: Jikuzono Tomoo , Manabe Eriko , Kure Shoko , Akasu Haruki , Ishikawa Tomoko , Fujiwara Yoko , Makita Masujiro , Ishibashi Osamu
Published: August 2021

Objective

The incidence of ductal carcinoma in situ (DCIS) is increasing due to more widespread mammographic screening. DCIS, the earliest form of breast cancer, is non-invasive at the time of detection. If DCIS tissues are left undetected or untreated, it can spread to the surrounding breast tissue. Thus, surgical resection is the standard treatment. Understanding the mechanism underlying the non-invasive property of DCIS could lead to more appropriate medical treatments, including nonsurgical options.

Data description

We conducted a microarray-based genome-wide transcriptome analysis using DCIS specimens obtained by puncture from surgical specimens immediately after surgery.
Aβ misfolding in blood plasma is inversely associated with body mass index even in middle adulthood
Authors: Möllers Tobias , Stocker Hannah , Perna Laura , Nabers Andreas , Rujescu Dan , Hartmann Annette M. , Holleczek Bernd , Schöttker Ben , Gerwert Klaus , Brenner Hermann
Published: August 2021

Background

To understand the potential for early intervention and prevention measures in Alzheimer’s disease, the association between risk factors and early pathological change needs to be assessed. Hence, the aim of this study was to determine whether risk factors of Alzheimer’s clinical syndrome (clinical AD), such as body mass index (BMI), are associated with Aβ misfolding in blood, a strong risk marker for AD among older adults.

Methods

Information on risk factors and blood samples were collected at baseline in the ESTHER study, a population-based cohort study of older adults (age 50–75 years) in Germany. Aβ misfolding in blood plasma was analyzed using an immuno-infrared-sensor in a total of 872 participants in a nested case-control design among incident dementia cases and matched controls. Associations between risk factors and Aβ misfolding were assessed by multiple logistic regression. For comparison, the association between the risk factors and AD incidence during 17 years of follow-up was investigated in parallel among 5987 cohort participants.

Results

An inverse association with Aβ misfolding was seen for BMI at age 50 based on reported weight history (aOR 0.64, 95% CI 0.43–0.96, p = 0.03). Similar but not statistically significant associations were seen for BMI at baseline (i.e., mean age 68) and at age 40. No statistically significant associations with Aβ misfolding were found for other risk factors, such as diabetes, smoking, and physical activity. On the other hand, low physical activity was associated with a significantly reduced risk of developing clinical AD compared to physical inactivity.

Conclusions

Our results support that AD pathology may be detectable and associated with reduced weight even in middle adulthood, many years before clinical diagnosis of AD. Physical activity might reduce the risk of onset of AD symptoms.
Atypical idiopathic intracranial hypertension presenting as cyclic vomiting syndrome: a case report
Authors: Talukder Nafee T. , Clorfeine Amanda H. , Black Moira K. , Moody Shade B.
Published: August 2021

Background

Idiopathic intracranial hypertension is a disorder of increased intracranial pressure in the absence of cerebrospinal outflow obstruction, mass lesion, or other underlying cause. It is a rare phenomenon in prepubertal children and is most typically found in women of childbearing age. The classic presentation consists of headaches, nausea, vomiting, and visual changes; however, children present more atypically. We report a case of idiopathic intracranial hypertension in an otherwise healthy, 4-year-old child with atypical symptoms resembling those of cyclic vomiting syndrome.

Case presentation

A 4-year-old Caucasian, otherwise healthy, male child presented to our emergency department with episodic intermittent early-morning vomiting occurring once every 1–3 weeks without interepisodic symptoms, starting 10 months prior. With outpatient metabolic, autoimmune, endocrine, allergy, and gastroenterology work-up all unremarkable, he was initially diagnosed with cyclic vomiting syndrome. Discovery of mild optic nerve sheath distension on magnetic resonance imaging of the brain 10 months after symptom onset led to inpatient admission and a lumbar puncture notable for an opening pressure of 47 mmHg, with normal cell count and protein levels. He had no changes in visual acuity or optic disc edema on dilated fundoscopic examination. The patient was started on acetazolamide, with resolution of episodic emesis at his last follow-up visit 12 weeks after discharge.

Conclusions

Idiopathic intracranial hypertension presents atypically in prepubescent children, with about one-fourth presenting asymptomatically, and only 13–52% presenting with “classic” symptoms. With a prevalence of only 0.6–0.7 per 100,000, much remains unknown regarding the underlying pathophysiology in this demographic. Cyclic vomiting syndrome, however, has a much higher prevalence in this age group, with a prevalence of 0.4–1.9 per 100. It is thought to be an idiopathic, periodic disorder of childhood, often linked to neurological conditions such as abdominal migraines, epilepsy, mitochondrial disorders, and structural lesions such as chiari malformation and posterior fossa tumors. While cyclic vomiting syndrome is thought to have a benign course, untreated idiopathic intracranial hypertension can have long-term detrimental effects, such as visual loss or even blindness. We present a case of idiopathic intracranial hypertension presenting with symptoms resembling cyclic vomiting syndrome in a 4-year-old child, diagnosed 10 months after initial onset of symptoms. We aim to demonstrate the need for a high level of clinical suspicion and the need for further investigation into underlying pathophysiology in this vulnerable population.
Game-related injuries in schools: a retrospective nationwide 6-year evaluation and implications for prevention policy
Authors: Jaffe Eli , Khalemsky Anna , Khalemsky Michael
Published: August 2021

Background

Child injury is a global public health problem. Children spend 25–50% of their daytime in school and risks of school accidents are high. The purpose of this study is to perform a comprehensive analysis of game-related injuries.

Methods

A nationwide dataset of 36,002 school injury events that occurred in Israel between 2013 and 2019 and were served by the National EMS, was used. The relations between different variables were demonstrated using multidimensional frequency tables. Z-tests, chi-square tests, ANOVA tests, and J48 classification trees were used to analyze the data.

Results

The prevailing injury cause (36.8%) was “game”, 44.8% of which occur during breaks, and the most frequently injured body regions were head, hand, and leg/foot (47.2%, 26.7%, and 19.7%, respectively). Age was negatively correlated with head injuries and positively correlated with limb injuries. 33% of all injuries occur in the playground and 20.1% occur in the sports field. About 33.3% of game-related injuries in elementary schools occur during the 10:00 a.m. break and an additional 24.7% during the 12:00 p.m. lunch break.

Conclusion

Games are the prevailing cause of school injuries in Israel. Gender and age differences, and seasonal and circadian trends were observed. Understanding the patterns and the trends of school injuries can enable the development of effective prevention policies on the national, municipal, and local levels, focusing the efforts on the key factors affecting injury incidence. Efficient use of resources is necessary, taking into account resource and budget constraints. Efforts can include education of teachers and pupils in relation to school accidents, promoting a safer physical environment, safety education, staff development and family and community involvement, and coordinative training with a focus on proprioception.
Work-related interventions for preventing back pain—protocol for a systematic review and network meta-analysis
Authors: Eisele-Metzger Angelika , Schoser Daria S. , Grummich Kathrin , Schwarzer Guido , Schwingshackl Lukas , Biallas Bianca , Wilke Christiane , Meerpohl Joerg J. , Braun Cordula
Published: August 2021

Background

Back pain is a widespread health problem that accounts for substantial disability and high costs. The workplace is considered to critically affect the occurrence and persistence of back pain and therefore offers an important opportunity for preventive interventions. Various work-related intervention strategies including both single- and multicomponent interventions have been developed and evaluated so far. To determine their effectiveness, a method of analysis is needed that particularly meets the challenges of the multidimensionality and diversity of these interventions. This planned systematic review and network meta-analysis aims to compare the effects of different work-related interventions for preventing non-specific back pain in people within a formal employment-related context.

Methods

We will search the following databases: CENTRAL, MEDLINE, Web of Science, CINAHL, PsycINFO, PEDro, SPORTDiscus, and Academic Search Premier from their inception onwards, as well as additional sources. Randomized controlled trials (RCTs) and cluster-RCTs will be considered if they (1) include people within a formal employment-related context, (2) include people without back pain or mixed samples (i.e., people with and without back pain), (3) compare one or more work-related preventive intervention(s) to a control condition, and (4) assess non-specific back pain (incidence or/and pain intensity), ability to work (numbers of participants or/and numbers of days absent from work), intervention-related adverse events or/and self-reported satisfaction with the intervention. Random-effects pairwise meta-analyses and frequentist network meta-analyses will be conducted where appropriate. We will calculate summary effect sizes for each comparison of interventions and rank interventions according to their P scores. If feasible, we will conduct additional component network meta-analyses. We plan to conduct subgroup analyses for job exposure, intervention duration, baseline back pain, different localizations of back pain, and gender. Risk of bias will be assessed using RoB 2 and the certainty of the evidence will be rated using the GRADE approach.

Discussion

This systematic review aims to identify work-related intervention strategies as well as components within work-related interventions that are effective for preventing back pain. We expect the results to provide guidance for selecting the most promising interventions and foster the purposeful use of resources. Additionally, they may inform the development and implementation of work-related interventions as well as the design of future research in this field.

Trial registration

PROSPERO CRD42021232469
Multiterm boundary value problem of Caputo fractional differential equations of variable order
Authors: Bouazza Zoubida , Souid Mohammed Said , Günerhan Hatıra
Published: August 2021

In this manuscript, the existence, uniqueness, and stability of solutions to the multiterm boundary value problem of Caputo fractional differential equations of variable order are established. All results in this study are established with the help of the generalized intervals and piece-wise constant functions, we convert the Caputo fractional variable order to an equivalent standard Caputo of the fractional constant order. Further, two fixed point theorems due to Schauder and Banach are used, the Ulam–Hyers stability of the given Caputo variable order is examined, and finally, we construct an example to illustrate the validity of the observed results. In literature, the existence of solutions to the variable-order problems is rarely discussed. Therefore, investigating this interesting special research topic makes all our results novel and worthy.
Cervical cancer screening using HPV tests on self-samples: attitudes and preferences of women participating in the VALHUDES study
Authors: De Pauw Hélène , Donders Gilbert , Weyers Steven , De Sutter Philippe , Doyen Jean , Tjalma Wiebren A. A. , Vanden Broeck Davy , Peeters Eliana , Van Keer Severien , Vorsters Alex , Arbyn Marc
Published: August 2021

Background

Interventions to reach women who do not participate regularly in screening may reduce the risk of cervical cancer. Self-collection of a vaginal specimen has been shown to increase participation. The relative clinical accuracy of human papillomavirus (HPV) testing on first-void urine (with Colli-Pee) and on vaginal self-samples versus on cervical clinician-collected samples is being investigated in the VALHUDES trial. The current study assesses attitudes and experiences regarding self-sampling among women enrolled in VALHUDES.

Methods

Questionnaires from 515 women (age 25–64 years [N = 498]; < 25 [N = 10], age ≥ 65 [N = 3], enrolled between December 2017 - January 2020) referred to colposcopy because of previous cervical abnormalities and enrolled in VALHUDES (NCT03064087) were analysed.

Results

Of the 515 participants, nearly all women confirmed that self-sampling may help in reaching under-screened women (93%). Nevertheless, 44% of the participants stated before starting collection that a clinician-collected sample is more effective than a self-collected sample. After self-sampling, the large majority of women (> 95%) declared that instructions for self-collection were clear, that collection was easy, and that they were confident about having performed the procedure correctly, for both urine and vaginal collection. However, a proportion of women found self-sampling unpleasant (9.5% [49/515] for urine collection; 18.6% [96/515] and 15.5% [80/515] for vaginal sampling with cotton swabs or plastic brushes, respectively). For their next screening round, 57% would prefer self-sampling whereas 41% opted for collection by a clinician. Among women preferring self-sampling, 53% would choose for urine collection, 38% for vaginal self-collection and 9% had no preference. Age did not modify preferences.

Conclusion

We conclude that both urine and vaginal self-sampling are well accepted by women, with a preference for urine sampling. Although the large majority of women are confident in their ability to perform self-sampling, four to five over ten women preferred specimen collection by a clinician.

Trial registration

The study VALHUDES was registered in ClinicalTrials.gov (identifier: NCT03064087).
Socio-economic inequalities in the chronic diseases management among Chinese adults aged 45 years and above: a cross sectional study
Authors: Guo Jing , Li Jiasen , Huang Kehui , Huang Ning , Feng Xing Lin
Published: August 2021

Backgrounds

Non-communicable diseases (NCDs) have become a priority public health issue. The aim of this study was to examine whether socio-economic inequalities exist in chronic disease management among Chinese adults, and whether the relationship between SES and chronic disease management mediated by social capital.

Methods

We used combined data from China Health and Retirement Longitudinal Study (CHARLS). A total of 19,291 subjects, including 14,905 subjects from 2011 survey, 2036 subjects from 2013, and 2350 subjects from 2015 was included in this study.

Results

Subjects living in urban setting, with higher education attainment and economic status were more likely to have annual health checks, and to be diagnosed for those with hypertension, diabetes and dyslipidemia (all P < 0.05). Social participation could mediate the association between social economic status (SES) and annual health checks, diagnosis of hypertension and dyslipidemia, and health education of hypertension. Health checks could mediate the association between social participation and the diagnosis of hypertension, diabetes and dyslipidemia. The proportions of mediation were 17.5, 23.9 and 8.9%, respectively. There were no mediating effects observed from cognitive social capital variable-perceived helpfulness.

Conclusion

It is necessary to deeply reform our social security system and enhance the social capital construction to promote those low SES people’s physical health.
Living with singleness: needs and concerns of never-married women over 35
Authors: Shahrak Shakiba Pourasad , Brand Serge , Taghizadeh Ziba
Published: August 2021

Background

Cultural and religious norms and expectations may influence the needs and behavior of single women. This is particularly true in those countries where religion and cultural expectations are salient in everyday life. In this context, the present study investigated the needs and concerns of Iranian never-married women aged 35 and older.

Methods

This qualitative study involved a conventional content analysis. Interviews were done with 23 never-married women aged 36–64 years in Iran.

Results

A total of 773 codes, 22 subcategories, 8 categories, and 3 themes were extracted from the interviews. The 3 themes were: (1) mental-spiritual lack; categories were lack of emotional support, uncertain future, mental rumination, and sexual worries; (2) reform of culture and society; categories were an adverse effect of culture and being overlooked in society; (3) loneliness arising from disability; categories were aging and loneliness and sickness and loneliness.

Conclusions

The results of the analysis indicate that the needs and concerns of never-married women over the age of 35 years in Iran remain unmet. This suggests that policymakers and health planners should take into consideration the growing number of never-married women as a societal reality deserving of attention.
Pharmacovigilance study of anti-infective-related acute kidney injury using the Japanese adverse drug event report database
Authors: Nakao Satoshi , Hasegawa Shiori , Umetsu Ryogo , Shimada Kazuyo , Mukai Ririka , Tanaka Mizuki , Matsumoto Kiyoka , Yoshida Yu , Inoue Misaki , Satake Riko , Nishibata Yuri , Liao Jun , Nakamura Mitsuhiro
Published: August 2021

Background

Acute kidney injury (AKI) is associated with significant increases in short- and long-term morbidity and mortality. Drug-induced AKI is a major concern in the present healthcare system. Our spontaneous reporting system (SRS) analysis assessed links between AKI, along with patients’ age, as healthcare-associated risks and administered anti-infectives. We also generated anti-infective-related AKI-onset profiles.

Method

We calculated reporting odds ratios (RORs) for reports of anti-infective-related AKI (per Medical Dictionary for Regulatory Activities) in the Japanese Adverse Drug Event Report database and evaluated the effect of anti-infective combination therapy. The background factors of cases with anti-infective monotherapy and combination therapy (≥ 2 anti-infectives) were matched using propensity score. We evaluated time-to-onset data and hazard types using the Weibull parameter.

Results

Among 534,688 reports (submission period: April 2004–June 2018), there were 21,727 AKI events. The reported number of AKI associated with glycopeptide antibacterials, fluoroquinolones, third-generation cephalosporins, triazole derivatives, and carbapenems were 596, 494, 341, 315, and 313, respectively. Crude RORs of anti-infective-related AKI increased among older patients and were higher in anti-infective combination therapies [anti-infectives, ≥ 2; ROR, 1.94 (1.80–2.09)] than in monotherapies [ROR, 1.29 (1.22–1.36)]. After propensity score matching, the adjusted RORs of anti-infective monotherapy and combination therapy (≥ 2 anti-infectives) were 0.67 (0.58–0.77) and 1.49 (1.29–1.71), respectively. Moreover, 48.1% of AKI occurred within 5 days (median, 5.0 days) of anti-infective therapy initiation.

Conclusion

RORs derived from our new SRS analysis indicate potential AKI risks and number of administered anti-infectives.
Physical activity in patients with axial spondyloarthritis in a multi-ethnic south-east Asian country
Authors: Phang Jie Kie , Khor Andrew Yu Keat , Kwan Yu Heng , Ng Chin Teck , Fong Warren
Published: August 2021

Background

Patients with axial spondyloarthritis (axSpA) may experience spinal stiffness and pain, leading to reduced physical function and quality of life. Despite the benefits of physical activity (PA) and exercise, previous studies have demonstrated lower levels of PA among patients with axSpA. This study aims to examine the patterns of PA among patients with axSpA compared to the general population in a multi-ethnic Asian country.

Methods

This was a cross-sectional study conducted between May 2016 and Jan 2017. Consecutive patients with axSpA were recruited at an outpatient rheumatology clinic at Singapore General Hospital, the largest tertiary hospital in Singapore. Controls were based on a previous cross-sectional study. PA was assessed using the Global Physical Activity Questionnaire (GPAQ).

Results

Seventy-four patients with axSpA were recruited and compared with 2679 controls. Lower proportion of patients with axSpA met the WHO recommendations for PA (axSpA = 77.0%, controls = 89.7%, p <  0.001). More patients with axSpA had high level of sedentary activity compared to controls (axSpA = 56.8%, controls = 36.1%, p <  0.001). Levels of PA did not differ between patients with inactive versus active axSpA disease (p = 0.91).

Conclusions

Proportion of patients with axSpA meeting the WHO recommendations for PA differed significantly from the general population, and level of PA did not differ between patients with active and inactive axSpA disease. Higher levels of sedentary activity were seen in patient with axSpA compared to the general population, highlighting the need for interventions to promote PA among patients with axSpA.
The Metabolomic Effects of Tripeptide Gut Hormone Infusion Compared to Roux-en-Y Gastric Bypass and Caloric Restriction
Authors: Jones Ben , Sands Caroline , Alexiadou Kleopatra , Minnion James , Tharakan George , Behary Preeshila , Ahmed Ahmed R , Purkayastha Sanjay , Lewis Matthew R , Bloom Stephen , Li Jia V , Tan Tricia M
Published: August 2021

Context

The gut-derived peptide hormones glucagon-like peptide-1 (GLP-1), oxyntomodulin (OXM), and peptide YY (PYY) are regulators of energy intake and glucose homeostasis and are thought to contribute to the glucose-lowering effects of bariatric surgery.

Objective

To establish the metabolomic effects of a combined infusion of GLP-1, OXM, and PYY (tripeptide GOP) in comparison to a placebo infusion, Roux-en-Y gastric bypass (RYGB) surgery, and a very low-calorie diet (VLCD).

Design and Setting

Subanalysis of a single-blind, randomized, placebo-controlled study of GOP infusion (ClinicalTrials.gov NCT01945840), including VLCD and RYGB comparator groups.

Patients and Interventions

Twenty-five obese patients with type 2 diabetes or prediabetes were randomly allocated to receive a 4-week subcutaneous infusion of GOP (n = 14) or 0.9% saline control (n = 11). An additional 22 patients followed a VLCD, and 21 underwent RYGB surgery.

Main Outcome Measures

Plasma and urine samples collected at baseline and 4 weeks into each intervention were subjected to cross-platform metabolomic analysis, followed by unsupervised and supervised modeling approaches to identify similarities and differences between the effects of each intervention.

Results

Aside from glucose, very few metabolites were affected by GOP, contrasting with major metabolomic changes seen with VLCD and RYGB.

Conclusions

Treatment with GOP provides a powerful glucose-lowering effect but does not replicate the broader metabolomic changes seen with VLCD and RYGB. The contribution of these metabolomic changes to the clinical benefits of RYGB remains to be elucidated.
Novel Therapies for Kidney Disease in People With Diabetes
Authors: Khurana Nayana , James Steven , Coughlan Melinda T , MacIsaac Richard J , Ekinci Elif I
Published: August 2021

Context

The increasing burden of diabetic kidney disease (DKD) has led to the discovery of novel therapies.

Objective

This review aims to summarize the results of recent clinical trials that test the efficacy of potential therapies for DKD.

Methods

A systematized narrative review was performed utilizing the PubMed, Embase (Ovid), CINAHL, and Cochrane databases (January 2010 to January 2021). The included trials assessed the efficacy of specific medications using renal endpoints in adult participants with type 1 or 2 diabetes.

Results

Fifty-three trials were identified. Large, multinational, and high-powered trials investigating sodium-glucose cotransporter 2 (SGLT2) inhibitors demonstrated improved renal outcomes, even in patients with established DKD. Trials examining incretin-related therapies also showed some improvement in renal outcomes. Additionally, mineralocorticoid receptor antagonists exhibited potential with multiple improved renal outcomes in large trials, including those involving participants with established DKD. Atrasentan, baricitinib, ASP8232, PF-04634817, CCX140-B, atorvastatin, fenofibrate, probucol, doxycycline, vitamin D, omega-3 fatty acids, silymarin, turmeric, total glucosides of paeony, and tripterygium wilfordii Hook F extract were all associated with some improved renal endpoints but need further exploration. While bardoxolone methyl was associated with a decrease in albuminuria, high rates of cardiovascular adverse effects curtailed further exploration into this agent. Selonsertib, allopurinol, praliciguat, palosuran, benfotiamine, and diacerein were not associated with improved renal outcomes.

Conclusion

Trials have yielded promising results in the search for new therapies to manage DKD. SGLT2 inhibitors and incretin-related therapies have demonstrated benefit and were associated with improved cardiovascular outcomes. Mineralocorticoid receptor antagonists are another class of agents with increasing evidence of benefits.
Pericyte Insulin Receptors Modulate Retinal Vascular Remodeling and Endothelial Angiopoietin Signaling
Authors: Warmke Nele , Platt Fiona , Bruns Alexander F , Ozber Claire H , Haywood Natalie J , Abudushalamu Yilizila , Slater Charles , Palin Victoria , Sukumar Piruthivi , Wheatcroft Stephen B , Yuldasheva Nadira Y , Kearney Mark T , Griffin Kathryn J , Cubbon Richard M
Published: August 2021

Pericytes regulate vascular development, stability, and quiescence; their dysfunction contributes to diabetic retinopathy. To explore the role of insulin receptors in pericyte biology, we created pericyte insulin receptor knockout mice (PIRKO) by crossing PDGFRβ-Cre mice with insulin receptor (Insr) floxed mice. Their neonatal retinal vasculature exhibited perivenous hypervascularity with venular dilatation, plus increased angiogenic sprouting in superficial and deep layers. Pericyte coverage of capillaries was unaltered in perivenous and periarterial plexi, and no differences in vascular regression or endothelial proliferation were apparent. Isolated brain pericytes from PIRKO had decreased angiopoietin-1 mRNA, whereas retinal and lung angiopoietin-2 mRNA was increased. Endothelial phospho-Tie2 staining was diminished and FoxO1 was more frequently nuclear localized in the perivenous plexus of PIRKO, in keeping with reduced angiopoietin-Tie2 signaling. Silencing of Insr in human brain pericytes led to reduced insulin-stimulated angiopoietin-1 secretion, and conditioned media from these cells was less able to induce Tie2 phosphorylation in human endothelial cells. Hence, insulin signaling in pericytes promotes angiopoietin-1 secretion and endothelial Tie2 signaling and perturbation of this leads to excessive vascular sprouting and venous plexus abnormalities. This phenotype mimics elements of diabetic retinopathy, and future work should evaluate pericyte insulin signaling in this disease.
Population Thinking and Narrative Networks: Dickens, Joyce, andThe Wire
Authors: Alexander Sam
Published: August 2021

Recent approaches to literary character treat fictional population as a defining element of narrative form but continue to read novels at the level of individual characters. This essay uses the tools of narrative network analysis to bridge the gap between microlevel readings and the interpretation of the novel’s character-system as a population. Network analyses of three highly populous works—Charles Dickens’s Bleak House, James Joyce’s Ulysses, and David Simon’s HBO series The Wire—yield measures of social density and character centrality that show how Joyce adapted a Dickensian network plot that emerged amid the population explosion of nineteenth-century Britain to an Irish context marked by demographic decline. This adaptation of Dickens’s plot structure prepared it for a similar use in The Wire. Both Joyce and Simon use a large fictional network to periodically decenter their protagonists and undermine the typological assumptions of much realist fiction. The essay suggests that, rather than read these developments as evidence of a formal rupture between modernism and realism, we view Bleak House, Ulysses, and The Wire as playing a role in an understudied tradition of “population thinking” in the novel.
The Effects of Parental and Sibling Incarceration: Evidence from Ohio
Authors: Norris Samuel , Pecenco Matthew , Weaver Jeffrey
Published: August 2021

Every year, millions of Americans experience the incarceration of a family member. Using 30 years of administrative data from Ohio and exploiting differing incarceration propensities of randomly assigned judges, this paper provides the first quasi-experimental estimates of the effects of parental and sibling incarceration in the United States. Parental incarceration has beneficial effects on some important outcomes for children, reducing their likelihood of incarceration by 4.9 percentage points and improving their adult neighborhood quality. While estimates on academic performance and teen parenthood are imprecise, we reject large positive or negative effects. Sibling incarceration leads to similar reductions in criminal activity. (JEL H76, J13, K42)
Asymmetric Attention
Authors: Kohlhas Alexandre N. , Walther Ansgar
Published: August 2021

We document that the expectations of households, firms, and professional forecasters in standard surveys simultaneously extrapolate from recent events and underreact to new information. Existing models of expectation formation, whether behavioral or rational, cannot account for these observations. We develop a rational theory of extrapolation based on limited attention, which is consistent with this evidence. In particular, we show that limited, asymmetric attention to procyclical variables can explain the coexistence of extrapolation and underreactions. We illustrate these mechanisms in a microfounded macroeconomic model, which generates expectations consistent with the survey data, and show that asymmetric attention increases business cycle fluctuations. (JEL C53, D83, D84, E23, E27, E32)
Περιβαλλοντικός θόρυβος
Authors: Βασιλειάδης Βασίλειος
Published: August 2021

Αντικείμενο της διατριβής αποτελεί η μέτρηση και αξιολόγηση του περιβαλλοντικού θορύβου και ιδιαίτερα του οδικού κυκλοφοριακού θορύβου στη Θεσσαλονίκη, με τη σύγκριση μακροχρόνιων επιτόπιων μετρήσεων θορύβου με στοιχεία υποκειμενικής αξιολόγησης. Η διατριβή επικεντρώνεται στην ευρωπαϊκή μεθοδολογία μέτρησης και αξιολόγησης του περιβαλλοντικού θορύβου όπως αυτή περιγράφεται στις σχετικές ευρωπαϊκές οδηγίες. Η εργασία κάνει μια συνολική προσέγγιση στον οδικό κυκλοφοριακό θόρυβο αναλύοντας τις επιδράσεις στην ποιότητα της ζωής, στην υγεία αλλά και στην ίδια τη διάρκεια της ζωής. Οι στόχοι της διατριβής συνοψίζονται στη συμβολή στη διαμόρφωση μιας μεθοδολογίας αξιολόγησης του περιβαλλοντικού, και ιδιαίτερα του οδικού κυκλοφοριακού θορύβου, στη διερεύνηση των κοινωνικοοικονομικών συνεπειών της έκθεσης στον κυκλοφοριακό θόρυβο, στην πρόταση για την υιοθέτηση των παραμέτρων της Οδηγίας 2002/49/ΕΚ για την Ελλάδα και στην διαμόρφωση ενός εργαλείου αξιολόγησης των μέτρων αντιμετώπισης του θορύβου, το οποίο να είναι χρήσιμο στους ειδικούς μελετητές. Προκειμένου να επιτευχθούν με ολοκληρωμένο τρόπο οι παραπάνω στόχοι, κρίθηκε απαραίτητη η σύγκριση και αξιολόγηση μακροχρόνιων μετρήσεων οδικού κυκλοφοριακού θορύβου με τα αποτελέσματα επιτόπιας κοινωνικής έρευνας σε συγκεκριμένες υπό διερεύνηση περιοχές της Θεσσαλονίκης.