bluuebunny/crossref_metadata_2025 huggingface dataset:
“You talk about problems until you feel free”: South African adolescent girls’ and young women’s narratives on the value of HIV prevention peer support clubs
Authors: Baron Deborah , Scorgie Fiona , Ramskin Lethabo , Khoza Nomhle , Schutzman Jennifer , Stangl Anne , Harvey Sheila , Delany-Moretlwe Sinead ,   for the EMPOWER study team
Published: June 2020

Background

Daily oral pre-exposure prophylaxis (PrEP) can reduce HIV infection in adolescent girls and young women if used consistently during periods of risk. The EMPOWER study evaluated peer-based clubs incorporating an empowerment curriculum offered to adolescent girls and young women (16–24 years) in South Africa and Tanzania for adherence support.

Methods

Using serial in-depth interviews (n = 33), we assessed the benefits and challenges of club attendance among 13 EMPOWER participants in the Johannesburg site who were randomised to clubs. We used a summary matrix of coded data to support a narrative, case-based analysis. Four case studies are presented.

Results

Club participants reported benefits such as increased self-esteem and self-efficacy, reduced isolation, and greater insight into gender-based violence and strategies to address it. Day-to-day PrEP adherence was not the only topic discussed in clubs; participants also appreciated the safe space for sharing problems (such as relationship conflict and PrEP stigma) and found interactive exercises helpful in improving partner communication.

Conclusions

Findings support the use of peer-based clubs using a structured empowerment approach, which may offer valuable PrEP initiation support to adolescent girls and young women in settings with high HIV and gender-based violence prevalence.

Trial registration

Pan African Clinical Trials Registry PACTR202006754762723, 5 April  2020, retrospectively registered.
Correlates of intimate partner violence among married women in Uganda: a cross-sectional survey
Authors: Gubi Derrick , Nansubuga Elizabeth , Wandera Stephen Ojiambo
Published: June 2020

Background

In Uganda, just like in many sub-Saharan countries, studies on Intimate Partner Violence (IPV) among married women are limited. The aim of this paper was to determine the correlates of emotional, sexual, physical IPV and any form of IPV among married women in Uganda.

Methods

The 2016 Uganda Demographic and Health Survey (UDHS) data was used, and a weighted sample of 6879 married women were selected from the Domestic Violence module. Frequency distributions were used to describe the characteristics of respondents. Chi-square tests were used to establish the association between IPV and the explanatory variables. Binary logistic regressions were used to establish the factors that were associated with IPV among married women in Uganda.

Results

More than half (56%) of the married women experienced some form of IPV. Sexual IPV was the least prevalent (23%) and 4 in 10 women (41 and 40%) experienced physical and emotional IPV, respectively. Factors associated with all the different forms of IPV included, age, region, witnessing parental violence, partner’s controlling behaviors, duration of the relationship, and frequency of intoxication of the male partner.

Conclusion

IPV among Ugandan married women is far too common. This calls for collective efforts to reduce IPV in Uganda by addressing excessive alcohol consumption, controlling behaviors, and lack of awareness of the issue. Interventions aimed at preventing perpetration and tolerance of violence in the home settings should be promoted.
Physical inactivity, non-participation in sports and socioeconomic status: a large population-based study among Norwegian adolescents
Authors: Heradstveit Ove , Haugland Siren , Hysing Mari , Stormark Kjell Morten , Sivertsen Børge , Bøe Tormod
Published: June 2020

Background

Physical activity in adolescence is found to promote both immediate and long-term health, as well as school- and work performance. Previous studies suggest that parental socioeconomic status (SES) may influence the level of activity, although the results are inconsistent. The objective of this study was to examine the overall level of low physical activity/sports participation and the associations with parental SES and adolescent school program in a population-based study of older adolescents.

Methods

The youth@hordalandy study, a large population-based study in Hordaland county, Norway, conducted in 2012, included 10,257 adolescents aged 16–19 years (53% girls). Physical activity was examined by self-reported overall activity, and participation in organized team- and individual sports. Predictor variables were parental SES measured by youth self-reports of family economic well-being, parental education and work affiliation and self-reported current high school program (vocational versus general studies). Age, ethnicity, and family structure were included as covariates.

Results

Girls who reported lower parental education had small, but significant higher risk for physical inactivity and non-participation in individual sports compared with their counterparts who reported higher family education (RRs ranging from 1.04 to 1.12, p < 0.01). There were some, but inconsistent, evidence of an increased risk for physical inactivity and non-participation in sports among those (and particularly boys) with lower family economic well-being. Parental work status was largely unrelated with physical inactivity/non-participation in sports. Adolescents in vocational studies had a small but significantly increased risk of physical inactivity and non-participation in sports compared with individuals in general studies (RRs ranging from 1.03 to 1.05, all p < 0.05).

Conclusions

We found some evidence of a social gradient for lower physical inactivity and non-participation in sports for adolescents. Although effect sizes were small, vocational studies was the most robust correlate for physical inactivity/non-participation in sports among the SES-variables, while the corresponding associations with parental education and family economic well-being differed by gender.
Barriers and facilitators of patient centered care for immigrant and refugee women: a scoping review
Authors: Filler Tali , Jameel Bismah , Gagliardi Anna R.
Published: June 2020

Background

Migrants experience disparities in healthcare quality, in particular women migrants. Despite international calls to improve healthcare quality for migrants, little research has addressed this problem. Patient-centred care (PCC) is a proven approach for improving patient experiences and outcomes. This study reviewed published research on PCC for migrants.

Methods

We conducted a scoping review by searching MEDLINE, CINAHL, SCOPUS, EMBASE and the Cochrane Library for English-language qualitative or quantitative studies published from 2010 to June 2019 for studies that assessed PCC for adult immigrants or refugees. We tabulated study characteristics and findings, and mapped findings to a 6-domain PCC framework.

Results

We identified 581 unique studies, excluded 538 titles/abstracts, and included 16 of 43 full-text articles reviewed. Most (87.5%) studies were qualitative involving a median of 22 participants (range 10–60). Eight (50.0%) studies involved clinicians only, 6 (37.5%) patients only, and 2 (12.5%) both patients and clinicians. Studies pertained to migrants from 19 countries of origin. No studies evaluated strategies or interventions aimed at either migrants or clinicians to improve PCC. Eleven (68.8%) studies reported barriers of PCC at the patient (i.e. language), clinician (i.e. lack of training) and organization/system level (i.e. lack of interpreters). Ten (62.5%) studies reported facilitators, largely at the clinician level (i.e. establish rapport, take extra time to communicate). Five (31.3%) studies focused on women, thus we identified few barriers (i.e. clinicians dismissed their concerns) and facilitators (i.e. women clinicians) specific to PCC for migrant women. Mapping of facilitators to the PCC framework revealed that most pertained to 2 domains: fostering a healing relationship and exchanging information. Few facilitators mapped to the remaining 4 domains: address emotions/concerns, manage uncertainty, make decisions, and enable self-management.

Conclusions

While few studies were included, they revealed numerous barriers of PCC at the patient, clinician and organization/system level for immigrants and refugees from a wide range of countries of origin. The few facilitators identified pertained largely to 2 PCC domains, thereby identifying gaps in knowledge of how to achieve PCC in 4 domains, and an overall paucity of knowledge on how to achieve PCC for migrant women.
The association between cystatin C and COPD: a meta-analysis and systematic review
Authors: Chai Limin , Feng Wei , Zhai Cui , Shi Wenhua , Wang Jian , Yan Xin , Wang Qingting , Zhang Qianqian , Li Manxiang
Published: June 2020

Background

In recent years, many studies have discovered that cystatin C (Cys C) may play an important role in respiratory diseases, especially in chronic obstructive pulmonary disease (COPD). However, the findings of these studies were inconsistent. This systematic review and meta-analysis aimed to assess the relationship between serum Cys C and COPD.

Methods

We conducted a systematic literature search in PubMed, Embase, Web of Science, Wanfang databases, and the China National Knowledge Infrastructure. The standardized mean difference (SMD), Fisher’s Z-value and 95% confidence interval (CI) were calculated to investigate the effect sizes. Subgroup analyses were performed on disease status, ethnicity, assay method, and study design. Sensitivity was performed, and publication bias was assessed.

Results

A total of 15 studies, including 4079 COPD patients and 5949 controls, were included in this meta-analysis. The results showed that serum Cys C levels in patients with COPD were significantly higher than those in controls (SMD = 0.99, 95% CI =0.62–1.37, P < 0.001), especially in AECOPD (SMD = 1.59, 95% CI =1.05–2.13, P < 0.001), and there were statistically different among AECOPD and SCOPD (SMD = 0.35, 95% CI =0.10–0.59, P = 0.005). The serum Cys C levels were negatively correlated with FEV1%pre (Z = − 0.45, 95%CI = -0.58--0.32, P = 0.011) and FEV1/FVC (Z = − 0.32, 95%CI = -0.50--0.14, P = 0.006). The serum Cys C levels were independent of ethnicity, assay method, and study design.

Conclusion

Serum Cys C levels were associated with COPD and COPD exacerbation, and they were inversely correlated with FEV1%pre and FEV1/FVC.
Evaluation of Judet view radiographs accuracy in classification of acetabular fractures compared with three-dimensional computerized tomographic scan: a retrospective study
Authors: Tazeabadi Sepideh Abdi , Noroozi Shima Ghafourian , Salehzadeh Meysam , Bahardoust Mansour , Farahini Hossein , Hajializade Mikaiel , Yeganeh Ali
Published: June 2020

Background

In the current diagnostic procedure, generally, both plain radiographs and 3D-CT scans are used for the diagnosis of acetabular fractures. There is no consensus regarding the value of a three-dimensional computerized tomographic (3D-CT) scan alone in the classification of acetabular fractures. In this study, we compared the accuracy of 3D-CT scan and plain radiography through the evaluation of their agreement with the intraoperative surgeon’s classification.

Method

In a retrospective study, patients who were referred to our center with an acetabular fracture and underwent surgical treatment were included. The classification of acetabular fractures was performed once using Judet view plain radiographs and once using a 3D-CT scan by the corresponding one Experienced musculoskeletal radiologist one independent trauma fellowship-trained orthopaedic who routinely treat acetabular fractures and based on Letournel and Judet classification (17 and 23 years of experience respectively). Cohen’s kappa value was used for the assessment agreement between the two imaging modalities, as well as between the imaging modalities and intraoperative classification.

Results

Medical files of 152 patients with acetabular fracture were retrospectively reviewed. A kappa value of 0.236 was obtained as the agreement level between radiographs and intraoperative findings (p < 0.001). A kappa value of 0.943 was obtained as the agreement level between 3D-CT and intraoperative classification (p < 0.001). An agreement level of 0.264 was found between the Judet radiographs and 3D-CT scans (p < 0.001).

Conclusions

3D-CT scans are reliable enough in the classification of acetabular fractures, and plain radiographs could be omitted to avoid radiation exposure as well as to reduce the cost for patients who sustain acetabular fractures.
Guideline-adherence in the treatment of symptomatic urolithiasis in children and adolescents in southwestern Germany
Authors: Blasl-Kling Felix , Dold Simone Katrin , Klein Jan-Thorsten , Wakileh Gamal Anton , Humke Ulrich , Ebert Anne-Karoline
Published: June 2020

Background

Approximately 1% of urolithiasis cases in Germany affect children. Interdisciplinary groups have agreed on national and international guidelines for children to recommend appropriate treatment pathways. The aim of this retrospective and preliminary study is to analyze whether adherence to current guidelines for pediatric stone disease in southwestern Germany is feasible.

Methods

During 2014 to 2017 24 children and adolescents (nine female, 15 male, median age 9.7 years), were treated for symptomatic urolithiasis in our institutions. We retrospectively collected clinical and operative courses. Clinical pathways were compared to previous guideline recommendations of the EAU 2014 and the German S2k guideline 2015.

Results

17 of the 24 patients were treated according to guideline recommendations (71%). Non-adherency was based on parental decisions in two and technical/medical considerations in five cases. In 11 children (45.8%) secondary or adjunctive treatments were necessary, in three of the seven non-adherently treated (43%) and in eight of the 17 adherently treated children (47%).

Conclusion

Our daily treatment approach seems to comply well with current pediatric stone guidelines. Nevertheless, guideline-non-adherent decision making emphasizes their strength and limitations, as specific clinical situations in children may require an individual treatment plan, as non-predictable conditions may occur.
Promoting positive perceptions of and motivation for research among undergraduate medical students to stimulate future research involvement: a grounded theory study
Authors: Ommering Belinda W. C. , Wijnen-Meijer Marjo , Dolmans Diana H. J. M. , Dekker Friedo W. , van Blankenstein Floris M.
Published: June 2020

Background

Research is of great value to make advancements within the medical field and, ultimately, offer the best possible patient care. Physician-scientists are key in contributing to the development of medicine, as they can bridge the gap between research and practice. However, medicine currently faces a physician-scientist shortage. A possible solution to cultivate physician-scientists is to engage medical students in research in early phases of medical school. Evidence-based strategies to stimulate positive perceptions of and motivation for research among students could help to enhance research engagement. Consequently, understanding of students’ perceptions of and motivation for research is needed. Therefore, this study aimed to identify conditions under which students develop positive perceptions of and motivation for research by answering the following sub-questions: 1) how do first-year medical students perceive research? and 2) which factors contribute to motivation or demotivation for conducting research?

Methods

We conducted a qualitative study with individual interviews using a grounded theory approach, involving 13 purposively sampled first-year medical students at Leiden University Medical Center.

Results

Our results suggest that first-year students are already able to identify many aspects of research. Students elaborated on the relevance of research for professional practice and personal development. Furthermore, our results suggest a relationship between perceptions of and motivation for research. Some perceptions were identical to motivating or demotivating factors to conduct research, like the relevance of research for practice and performing statistics respectively. Other motivating factors were, among others, acknowledgment, autonomy, and inspiring role models. Demotivating factors were, among others, lack of autonomy and relevance, and inadequate collaboration.

Conclusions

Our results contribute to the idea that perceptions of research are related to motivation for research, which offers possibilities for interventions to promote motivation for research by making use of student perceptions of research. Consequently, practical implications to stimulate research engagement in early phases of medical school are provided. Moreover, the results contribute to existing motivational theories like Theory of Planned Behavior and Self-Determination Theory within this specific domain.
Supporting Australian clinical learners in a collaborative clusters education model: a mixed methods study
Authors: van de Mortel Thea F. , Armit Lyn , Shanahan Brenton , Needham Judith , Brown Candy , Grafton Eileen , Havell Michelle , Henderson Amanda , Grealish Laurie
Published: June 2020

Background

Nursing student numbers have risen in response to projected registered nurse shortfalls, increasing numbers of new graduates requiring transitional support and pressure on clinical placements. A Collaborative Clusters Education Model, in which Entry to Practice facilitators coach ward-based registered nurses to support students’ and new graduates’ learning, may address placement capacity. The research aim was to evaluate the acceptability of the Collaborative Clusters Education Model to stakeholders by examining their perceptions of the facilitators and barriers to the model in its implementation.

Methods

A convergent mixed methods evaluation approach was adopted. The study took place in a large Australian health service in south-east Queensland. Participants included Bachelor of Nursing students, Entry to Practice facilitators, ward-based registered nurses, academics and new graduates. A mixed methods design was used. Elements included an online survey of nursing students, and interviews with new graduates, Entry to Practice facilitators, ward-based registered nurses, and academics. Descriptive statistics were calculated on quantitative data. Thematic analysis was conducted on qualitative data.

Results

Participants included 134 (of 990) nursing students (response rate 13.5%), five new graduates, seven Entry to Practice facilitators, four registered nurses, and three nurse academics. Students rated facilitators’ effectiveness highly (4.43/5 ± 0.75), although this finding is tempered by a low response rate (13.5%). For learners, the model provided access to learning experiences, although preferences for sources of support differed between students and new graduates, and further clarification of responsibilities was required. For other stakeholders, three themes emerged: students’ and new graduates’ integration into the workplace can promote learning; tensions arise in new ways to approach performance assessment; and aligning expectations requires high levels of communication.

Conclusions

This evaluation found that acceptability was good but at risk from limited clarity around roles and responsibilities. Further research into this model is recommended.
The Greek versions of the TeamSTEPPS teamwork perceptions questionnaire and Minnesota satisfaction questionnaire “short form”
Authors: Lakatamitou Ioanna , Lambrinou Ekaterini , Kyriakou Martha , Paikousis Lefkios , Middleton Nicos
Published: June 2020

Background

Teamwork and job satisfaction are important among the multidisciplinary team who care patients with chronic illnesses such as heart failure (HF) patients. TeamSTEPPS teamwork perceptions questionnaire (T-TPQ) and Minnesota Satisfaction Questionnaire “short form” (MSQ-short) are both self-report questionnaires which examine multiple dimensions of perceptions of teamwork and job satisfaction within healthcare settings, respectively. The aim of the study was to examine the psychometric properties of the Greek versions of the TeamSTEPPS Teamwork perceptions questionnaire (Gr-T-TPQ) and Minnesota Satisfaction Questionnaire “short form” (Gr-MSQ-short).

Methods

A methodological study was contacted in order to assess the construct validity and reliability of the Gr-T-TPQ and Gr-MSQ-short. For that reason, 292 questionnaires were administrated to Greek-Cypriot health care professionals (HCPs). Confirmatory factor analysis (CFA) was conducted for the data collected with the GrT-TPQ and Exploratory factor analysis (EFA) and CFA were also conducted for the data collected with the GrMSQ-short questionnaire. Cronbach’s a was calculated as well.

Results

CFA of the data collected with Gr-T-TPQ confirmed the initial scale structure with excellent fit indices (× 2 (df) 1124.75 (550), p < 0.0001, AGFI = 0.986, TLI = 0.994, CFI = 0.994, RMSEA = 0.06, 90%, C.I.[0.055–0.065]). Furthermore, all dimensions were found to be correlated (r = 0.65 to r = 0.88) and internal consistency was found adequate (Cronbach’s α = 0.96). Subscales also, demonstrated high internal consistency (α = 0.87–0.95). CFA for the data collected with Gr-MSQ-short, did not confirm the initial scale’s dimensions. In EFA items 1, 5, 6, 12 and 18 were eliminated from the analysis due to low communalities and multiple components loading. The oblimin rotation with two factors was explaining 58% of the variance. These two factors identified were Supervisor/Autonomy and Task Enrichment.

Conclusions

In general, the Gr-T-TPQ and Gr-MSQ-short are construct-valid instruments for measuring perceptions of teamwork and job satisfaction in Greek speaking HCPs’ population.
A genome-wide survey of copy number variations reveals an asymmetric evolution of duplicated genes in rice
Authors: Zhao Fengli , Wang Yuexing , Zheng Jianshu , Wen Yanling , Qu Minghao , Kang Shujing , Wu Shigang , Deng Xiaojuan , Hong Kai , Li Sanfeng , Qin Xing , Wu Zhichao , Wang Xiaobo , Ai Cheng , Li Alun , Zeng Longjun , Hu Jiang , Zeng Dali , Shang Lianguang , Wang Quan , Qian Qian , Ruan Jue , Xiong Guosheng
Published: June 2020

Background

Copy number variations (CNVs) are an important type of structural variations in the genome that usually affect gene expression levels by gene dosage effect. Understanding CNVs as part of genome evolution may provide insights into the genetic basis of important agricultural traits and contribute to the crop breeding in the future. While available methods to detect CNVs utilizing next-generation sequencing technology have helped shed light on prevalence and effects of CNVs, the complexity of crop genomes poses a major challenge and requires development of additional tools.

Results

Here, we generated genomic and transcriptomic data of 93 rice (Oryza sativaL.) accessions and developed a comprehensive pipeline to call CNVs in this large-scale dataset. We analyzed the correlation between CNVs and gene expression levels and found that approximately 13% of the identified genes showed a significant correlation between their expression levels and copy numbers. Further analysis showed that about 36% of duplicate pairs were involved in pseudogenetic events while only 5% of them showed functional differentiation. Moreover, the offspring copy mainly contributed to the expression levels and seemed more likely to become a pseudogene, whereas the parent copy tended to maintain the function of ancestral gene.

Conclusion

We provide a high-accuracy CNV dataset that will contribute to functional genomics studies and molecular breeding in rice. We also showed that gene dosage effect of CNVs in rice is not exponential or linear. Our work demonstrates that the evolution of duplicated genes is asymmetric in both expression levels and gene fates, shedding a new insight into the evolution of duplicated genes.
Dietary administration of β-1,3/1,6-glucan and Lactobacillus plantarum improves innate immune response and increases the number of intestine immune cells in roach (Rutilus rutilus)
Authors: Kazuń Barbara , Małaczewska Joanna , Kazuń Krzysztof , Kamiński Rafał , Adamek-Urbańska Dobrochna , Żylińska-Urban Joanna
Published: June 2020

Background

The aim of the study has been to compare the effect of dietary supplementation of β-1,3/1,6-glucan, Lactobacillus plantarum bacteria or their mixture on the growth performance, selected parameters of the immune system as well as the liver and intestinal histology of roach. Fish were fed for 14 days with four different diets, each treatment being carried out in triplicate. In control group, fish were fed dry commercial starter feed Aller Performa 2 (Aller Aqua, Denmark). The other experimental fish groups received the same commercial starter feed supplemented with: 1% β-1,3/1,6-glucan (Leiber® Beta-S) in group G; 108 cfu L. plantarum g− 1 in group L; 1% β-1,3/1,6-glucan + 108 cfu L. plantarum g− 1 in group G + L. The stimulating effect of the tested preparations was evaluated once the feeding with commercial feed exclusively was resumed and 2 weeks afterwards.

Results

No effect on the survivability and growth performance of the fish was observed in any of the groups. Supplementation of feed with β-1,3/1,6-glucan improved (P < 0.05) selected parameters of innate humoral immunity and the pinocytotic activity of phagocytes. Increased respiratory burst activity of head kidney phagocytes (RBA) was observed in groups L and G + L (P < 0.05), and the effect persisted for 2 weeks after the commercial feed regime was resumed. An analogous tendency was determined for the killing activity of phagocytes (PKA) of the head kidney with respect to Aeromonas hydrophila, although this effect appeared only during the feed supplementation period. Supplying roach with β-1,3/1,6-glucan, singly or with L. plantarum, had no effect (P > 0.05) on the proliferation of mitogen-activated lymphocytes. However, an increase in the number of CD3-positive cells and goblet cells was noticed in the digestive system of the L group fish (P < 0.05).

Conclusions

The results show that feeding fish with added L. plantarum and β-1,3/1,6-glucan stimulates the non-specific resistance mechanisms and raises the counts of intestinal immune cells. Synbiotic may help to control serious bacterial diseases and offer an alternative to antibiotics commonly used in fish farming, and its prolonged immunostimulatory effect could increase fish surviving after release to the natural environment.
SGLT2i: beyond the glucose-lowering effect
Authors: Ni Lihua , Yuan Cheng , Chen Guopeng , Zhang Changjiang , Wu Xiaoyan
Published: June 2020

Sodium/glucose cotransporter-2 inhibitors (SGLT2i) are a new type of glucose-lowering drug that can reduce blood glucose by inhibiting its reabsorption in proximal tubules and by promoting urinary glucose excretion. SGLT2i are widely used in the clinical treatment of type 2 diabetes mellitus (T2DM). In recent studies, SGLT2i were found to not only reduce blood glucose but also protect the heart and kidney, which can significantly reduce cardiovascular events, delay the progression of renal failure, greatly improve the quality of life of patients, and reduce medical expenses for families and society. As adverse cardiac and renal events are the most common and serious complications of T2DM, it is very important to understand the cardio- and renoprotective mechanisms of SGLT2i. This article reviews the historical development, pharmacological mechanism, heart and kidney protection and safety of SGLT2i. The information presented provides a theoretical basis for the clinical prevention and treatment of diabetes and its complications and for the development of new glucose-lowering drugs.
Immune-related long non-coding RNA signature identified prognosis and immunotherapeutic efficiency in bladder cancer (BLCA)
Authors: Cao Rui , Yuan Lushun , Ma Bo , Wang Gang , Tian Ye
Published: June 2020

Background

As bladder cancer was recognized to be immunogenic, dozens of studies have focused on immune biology of BLCA, but little is known about its relationship with the long non-coding RNAs (lncRNAs).

Methods

LASSO Cox regression model was used to establish immune-related lncRNAs signature (IRLS) in BLCA. The immune infiltration landscape of BLCA was conducted via ssGSEA and immunotherapy response was calculated through TIDE algorithm.

Results

A total of 82 immune-related lncRNAs were screened out according to spearman correlation analysis with the immune score (|R| > 0.4, p < 0.05). We selected 5 prognostic lncRNAs to construct immune-related lncRNAs signature (IRLS) through LASSO Cox regression analysis. Then we validated that 5 enrolled lncRNAs was downregulated in BLCA tissues and cells when compared with paracancerous tissues and normal bladder epithelium cell. The univariate and multivariate Cox regression analysis both demonstrated the IRLS was a robust independent prognostic factor in overall survival prediction with high accuracy. The GSVA and GSEA also suggested that the IRLS are involved in the immune-related biological processes and pathways which are very well known in the context of BLCA tumorigenesis. In addition, we found that IRLS is strikingly positive correlated with tumour microenvironment (TME) immune cells infiltration and expression of critical immune checkpoints, indicating that the poor prognosis might be caused partly by immunosuppressive TME. Finally, the results from the TIDE analysis revealed that IRLS could efficiently predict the clinical response of immunotherapy in BLCA.

Conclusion

We have developed a novel IRLS, which have a latent prognostic value for BLCA patients and might facilitate personalized counselling for immunotherapy.
Relation of anxiety and other psychometric measures, balance deficits, impaired quality of life, and perceived state of health to dizziness handicap inventory scores for patients with dizziness
Authors: Schmid D. A. , Allum J. H. J. , Sleptsova M. , Welge-Lüssen A. , Schaefert R. , Meinlschmidt G. , Langewitz W.
Published: June 2020

Background

An important question influencing therapy for dizziness is whether the strengths of the relationships of emotional and functional aspects of dizziness to 1) anxiety and other mental states, 2) perceived state of health (SoH) and quality of life (QoL) are different in patients with and without normal balance control. We attempted to answer this question by examining these dimensions’ regression strengths with Dizziness Handicap Inventory (DHI) scores.

Methods

We divided 40 patients receiving group cognitive behavioural therapy (CBT) and vestibular rehabilitation for dizziness, into 2 groups: dizziness only (DO) and normal balance control; dizziness and a quantified balance deficit (QBD). Group-wise, we first performed stepwise multivariate regression analysis relating total DHI scores with Brief Symptom Inventory (BSI) sub-scores obtained pre- and post-therapy. Then, regression analysis was expanded to include SoH, QoL, and balance scores. Finally, we performed regressions with DHI sub-scores.

Results

In both groups, the BSI phobic anxiety state score was selected first in the multivariate regression analysis. In the DO group, obsessiveness/compulsiveness was also selected. The correlation coefficient, R, was 0.74 and 0.55 for the DO and QBD groups, respectively. When QoL and SoH scores were included, R values increased to 0.86 and 0.74, explaining in total 74, and 55% of the DHI variance for DO and QBD groups, respectively. Correlations with balance scores were not significant (R ≤ 0.21). The psychometric scores selected showed the strongest correlations with emotional DHI sub-scores, and perceived QoL and SoH scores with functional DHI sub-scores.

Conclusions

Our findings suggest that reducing phobic anxiety and obsessiveness/compulsiveness during CBT may improve emotional aspects of dizziness and targeting perceived SoH and QoL may improve functional aspects of dizziness for those with and without normal balance control.
Impact of surgical strategies on the survival of gallbladder cancer patients: analysis of 715 cases
Authors: Chang Yigang , Li Qiang , Wu Qian , Chi Limin , Bi Xiaogang , Zeng Qingmin , Huo Huaying
Published: June 2020

Objective

The aim of the study is to evaluate the impact of application of surgical strategies at different cancer stages on the survival of gallbladder cancer (GBC) patients.

Methods

The patients with GBC were divided into 3 groups according to their received surgical strategies: simple resection (full-thickness cholecystectomy for removal of primary tumor site), radical resection (gallbladder bed removal combined with partial hepatectomy), and palliative surgery (treatment at advanced stages). The overall survival (OS) of GBC patients who were received different surgical strategies was compared.

Results

Survival analysis showed that radical resection had a best OS at clinical stage II, and simple resection had a best OS at tumor clinical stage IV. Cox hazard proportional regression analysis showed that more advanced tumor stages, tumor location of gallbladder body or neck, and CA199 ≥ 27 U/mL were the major risk factors for the OS of GBC.

Conclusions

At tumor stage II, radical resection should be the most effective surgical therapy for GBC. However, the effect of radical resection at advanced stages could be restricted. The utilization of radical resection should be increased at tumor stage II for a better long-term survival outcome.
Prevalence of perinatal depression among Japanese women: a meta-analysis
Authors: Tokumitsu Keita , Sugawara Norio , Maruo Kazushi , Suzuki Toshihito , Shimoda Kazutaka , Yasui-Furukori Norio
Published: June 2020

Background

Perinatal depression is one of the important mental illnesses among women. However, not enough reviews have been done, and a certain consensus has not been obtained about the prevalence of perinatal depression among Japanese women. The purpose of our study is to reveal the reliable estimates about the prevalence of perinatal depression among Japanese women.

Method

We searched two databases, PubMed and ICHUSHI, to identify studies published from January 1994 to December 2017 with data on the prevalence of antenatal or postnatal depression. Data were extracted from published reports.

Results

We reviewed 1317 abstracts, retrieved 301 articles and included 123 studies. The point prevalence of postpartum depression at 1 month was 14.3% incorporating 108,431 Japanese women. The period prevalence of depression at pregnancy was 14.0% in the second trimester and 16.3% in the third trimester. The period prevalence of postpartum depression was 15.1% within the first month, 11.6% in 1–3 months, 11.5% in 3–6 months and 11.5% in 6–12 months after birth. We also identified that compared with multiparas, primiparas was significantly associated with a higher prevalence of postpartum depression; the adjusted relative risk was 1.76.

Conclusions

The prevalence of postpartum depression at 1 month after childbirth was found to be 14.3% among Japanese women. During pregnancy, the prevalence of depression increases as childbirth approaches, and the prevalence of depression was found to decrease in the postpartum period over time. In addition, we found that the prevalence of postpartum depression in primiparas was higher than that in multiparas. Hence, we suggest that healthcare professionals need to pay more attention to primiparas than multiparas regarding postpartum depression.
Multimodal non-invasive assessment of intracranial hypertension: an observational study
Authors: Robba Chiara , Pozzebon Selene , Moro Bedrana , Vincent Jean-Louis , Creteur Jacques , Taccone Fabio Silvio
Published: June 2020

Background

Although placement of an intra-cerebral catheter remains the gold standard method for measuring intracranial pressure (ICP), several non-invasive techniques can provide useful estimates. The aim of this study was to compare the accuracy of four non-invasive methods to assess intracranial hypertension.

Methods

We reviewed prospectively collected data on adult intensive care unit (ICU) patients with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), or intracerebral hemorrhage (ICH) in whom invasive ICP monitoring had been initiated and estimates had been simultaneously collected from the following non-invasive indices: optic nerve sheath diameter (ONSD), pulsatility index (PI), estimated ICP (eICP) using transcranial Doppler, and the neurological pupil index (NPI) measured using automated pupillometry. Intracranial hypertension was defined as an invasively measured ICP > 20 mmHg.

Results

We studied 100 patients (TBI = 30; SAH = 47; ICH = 23) with a median age of 52 years. The median invasively measured ICP was 17 [12–25] mmHg and intracranial hypertension was present in 37 patients. Median values from the non-invasive techniques were ONSD 5.2 [4.8–5.8] mm, PI 1.1 [0.9–1.4], eICP 21 [14–29] mmHg, and NPI 4.2 [3.8–4.6]. There was a significant correlation between all the non-invasive techniques and invasive ICP (ONSD, r = 0.54; PI, r = 0.50; eICP, r = 0.61; NPI, r = − 0.41—p < 0.001 for all). The area under the curve (AUC) to estimate intracranial hypertension was 0.78 [CIs = 0.68–0.88] for ONSD, 0.85 [95% CIs 0.77–0.93] for PI, 0.86 [95% CIs 0.77–0.93] for eICP, and 0.71 [95% CIs 0.60–0.82] for NPI. When the various techniques were combined, the highest AUC (0.91 [0.84–0.97]) was obtained with the combination of ONSD with eICP.

Conclusions

Non-invasive techniques are correlated with ICP and have an acceptable accuracy to estimate intracranial hypertension. The multimodal combination of ONSD and eICP may increase the accuracy to estimate the occurrence of intracranial hypertension.
Study design of the DAS-OLT trial: a randomized controlled trial to evaluate the impact of dexmedetomidine on early allograft dysfunction following liver transplantation
Authors: Ni Chenlu , Masters Joe , Zhu Ling , Yu Weifeng , Jiao Yingfu , Yang Yuting , Cui Cui , Yin Suqing , Yang Liqun , Qi Bo , Ma Daqing
Published: June 2020

Background

Perioperative ischemia/reperfusion (I/R) injury during liver transplantation is strongly associated with early allograft dysfunction (EAD), graft loss, and mortality. Hepatic I/R injury also causes remote damage to other organs including the renal and pulmonary systems. Dexmedetomidine (DEX), a selective α2-adrenoceptor agonist which is used as an adjuvant to general anesthesia, has been shown in preclinical studies to provide organ protection by ameliorating the effects of I/R injury in a range of tissues (including the liver). However, prospective clinical evidence of any potential benefits in improving outcomes in liver transplantation is lacking. This study aimed to verify the hypothesis that the application of dexmedetomidine during the perioperative period of liver transplantation can reduce the incidence of EAD and primary graft non-function (PNF). At the same time, the effects of dexmedetomidine application on perioperative renal function and lung function were studied.

Methods

This is a prospective, single-center, randomized, parallel-group study. Two hundred participants (18–65 years) scheduled to undergo liver transplantation under general anesthesia will be included in this study. For participants in the treatment group, a loading dose of DEX will be given after induction of anesthesia (1 μg/kg over 10 min) followed by a continuous infusion (0.5 μg/kg /h) until the end of surgery. For participants in the placebo group, an equal volume loading dose of 0.9% saline will be given after the induction of anesthesia followed by an equal volume continuous infusion until the end of surgery. All other supplements, e.g., opioids, sedatives, and muscle relaxant, will be identical in both arms and administered according to routine clinical practice.

Discussion

The present trial will examine whether DEX confers organoprotective effects in the liver, in terms of reducing the incidence of EAD and PNF in orthotopic liver transplantation recipients.

Trial registration

ClinicalTrials.govNCT03770130. Registered on 10 December 2018.https://clinicaltrials.gov/ct2/show/NCT03770130
Postoperative analgesia of scalp nerve block with ropivacaine in pediatric craniotomy patients: a protocol for a prospective, randomized, placebo-controlled, double-blinded trial
Authors: Xiong Wei , Li Lu , Bao Di , Wang Yaxin , Liang Yi , Lu Pengwei , Zhang Di , Liu Gaifen , Qiao Lanxin , Zheng Na , Jin Xu
Published: June 2020

Background

Moderate-to-severe postoperative pain following craniotomy has a high incidence in pediatric patients. Such pain may cause agitation, intracranial hypertension, epileptic seizures, and postoperative hematoma, which affect morbidity and mortality. Although scalp nerve block (SNB) achieves satisfactory pain relief except for suboccipital mid-craniotomy in adults and ropivacaine is widely used as a long-acting peripheral nerve block agent in children, there are few studies of SNB with ropivacaine in pediatric patients undergoing craniotomy. In addition, the neurosurgery operation time is relatively long, but the duration of action of SNB is limited. It is generally believed that postoperative SNB is better than preoperative SNB for postoperative analgesia. However, considering the concept of preemptive analgesia, we believe that preoperative SNB may achieve a longer postoperative analgesia effect than we expected.

Methods

This trial is a single-institution, prospective, randomized, controlled, double-blind study. A total of 180 children aged between 1 and 12 years who are undergoing elective craniotomy will be randomly allocated in a 1:1:1 ratio to three groups: group B (preoperative ropivacaine block group), group A (postoperative ropivacaine block group), and group N (nonblocking control group). This randomization will be stratified by age in two strata (1–6 years and 7–12 years). The primary outcome is the total consumption of sufentanil within 24 h after surgery. The secondary outcomes include assessment of pain scores, total consumption of sufentanil and emergency-remedy medicine consumption at observation points, the occurrence of postoperative complications, and the length of hospitalization after surgery.

Discussion

This study is designed to explore the effect and feasibility of SNB with ropivacaine for postoperative analgesia in pediatric patients undergoing craniotomy. Further aims are to compare the effects of preoperative and postoperative SNB on postoperative analgesia in order to identify whether there is a preemptive analgesic effect and determine the better time to implement SNB in pediatric patients during craniotomy.

Trial registration

Chinese Clinical Trial RegistryChiCTR1800017386. Registered on 27 July 2018.
Dynamic simulation of continuous mixed sugar fermentation with increasing cell retention time for lactic acid production using Enterococcus mundtii QU 25
Authors: Wang Ying , Chan Ka-Lai , Abdel-Rahman Mohamed Ali , Sonomoto Kenji , Leu Shao-Yuan
Published: June 2020

Background

The simultaneous and effective conversion of both pentose and hexose in fermentation is a critical and challenging task toward the lignocellulosic economy. This study aims to investigate the feasibility of an innovative co-fermentation process featuring with a cell recycling unit (CF/CR) for mixed sugar utilization. A l-lactic acid-producing strain Enterococcus mundtii QU 25 was applied in the continuous fermentation process, and the mixed sugars were utilized at different productivities after the flowing conditions were changed. A mathematical model was constructed with the experiments to optimize the biological process and clarify the cell metabolism through kinetics analysis. The structured model, kinetic parameters, and achievement of the fermentation strategy shall provide new insights toward whole sugar fermentation via real-time monitoring for process control and optimization.

Results

Significant carbon catabolite repression in co-fermentation using a glucose/xylose mixture was overcome by replacing glucose with cellobiose, and the ratio of consumed pentose to consumed hexose increased significantly from 0.096 to 0.461 by mass. An outstanding product concentration of 65.2 g L−1 and productivity of 13.03 g L−1 h−1 were achieved with 50 g L−1 cellobiose and 30 g L−1 xylose at an optimized dilution rate of 0.2 h−1, and the cell retention time gradually increased. Among the total lactic acid production, xylose contributed to more than 34% of the mixed sugars, which was close to the related contents in agricultural residuals. The model successfully simulated the transition of sugar consumption, cell growth, and lactic acid production among the batch, continuous process, and CF/CR systems.

Conclusion

Cell retention time played a critical role in balancing pentose and hexose consumption, cell decay, and lactic acid production in the CF/CR process. With increasing cell concentration, consumption of mixed sugars increased with the productivity of the final product; hence, the impact of substrate inhibition was reduced. With the validated parameters, the model showed the highest accuracy simulating the CF/CR process, and significantly longer cell retention times compared to hydraulic retention time were tested.
Regulation of autoimmune arthritis by the SHP-1 tyrosine phosphatase
Authors: Markovics Adrienn , Toth Daniel M. , Glant Tibor T. , Mikecz Katalin
Published: June 2020

Background

The Src homology region 2 domain-containing phosphatase-1 (SHP-1) is known to exert negative regulatory effects on immune cell signaling. Mice with mutations in theShp1gene develop inflammatory skin disease and autoimmunity, but no arthritis.

We sought to explore the role of SHP-1 in arthritis using an autoimmune mouse model of rheumatoid arthritis. We generatedShp1transgenic (Shp1-Tg) mice to study the impact of SHP-1 overexpression on arthritis susceptibility and adaptive immune responses.

Methods

SHP-1 gene and protein expression as well as tyrosine phosphatase activity were evaluated in spleen cells of transgenic and wild type (WT) mice. WT andShp1-Tg (homozygous or heterozygous for the transgene) mice were immunized with human cartilage proteoglycan (PG) in adjuvant, and arthritis symptoms were monitored. Protein tyrosine phosphorylation level, net cytokine secretion, and serum anti-human PG antibody titers were measured in immune cells from WT andShp1-Tg mice. WT mice were treated with regorafenib orally to activate SHP-1 either before PG-induced arthritis (PGIA) symptoms developed (preventive treatment) or starting at an early stage of disease (therapeutic treatment). Data were statistically analyzed and graphs created using GraphPad Prism 8.0.2 software.

Results

SHP-1 expression and tyrosine phosphatase activity were elevated in both transgenic lines compared to WT mice. While all WT mice developed arthritis after immunization, none of the homozygousShp1-Tg mice developed the disease. Heterozygous transgenic mice, which showed intermediate PGIA incidence, were selected for further investigation. We observed differences in interleukin-4 and interleukin-10 production in vitro, but serum anti-PG antibody levels were not different between the genotypes. We also found decreased tyrosine phosphorylation of several proteins of the JAK/STAT pathway in T cells from PG-immunizedShp1-Tg mice. Regorafenib administration to WT mice prevented the development of severe PGIA or reduced disease severity when started after disease onset.

Conclusions

Resistance to arthritis in the presence of SHP-1 overexpression likely results from the impairment of tyrosine phosphorylation (deactivation) of key immune cell signaling proteins in the JAK/STAT pathway, due to the overwhelming tyrosine phosphatase activity of the enzyme inShp1-Tg mice. Our study is the first to investigate the role of SHP-1 in autoimmune arthritis using animals overexpressing this phosphatase. Pharmacological activation of SHP-1 might be considered as a new approach to the treatment of autoimmune arthritis.