bluuebunny/crossref_metadata_2025 huggingface dataset:
Avaliação da efetividade da estação ecológica de Carijós, frente a sua urbanização adjacente
Authors: Vedana Jaísa , Paiotti do Canto Marina , Schvambach Amabilly , Costa Bruna
Published: October 2019

A degradação da zona costeira no município de Florianópolis está associada ao crescimento da população e a sua expansão urbana, que tem aumentado a pressão sobre os ecossistemas. A ESEC Carijós foi criada em 1987 com o objetivo de conservação dos manguezais na ilha catarinense. O presente artigo buscou avaliar a efetividade da ESEC, frente à urbanização da sua área de entorno. Analisando a efetividade dessa unidade de conservação, através da comparação deimagens do satélite Landsat, com o uso do Software QGIS, pode-se observar que houve expansão urbana até os limites da UC e que a zona de amortecimento, não delimitada pelo decreto de criação da unidade, nem por seu plano de manejo, oferece oportunidade para que haja ocupação em seu entorno imediato. Portanto, a criação da zona de amortecimento se faz necessária e de extrema relevância, para ao menos regular o desenvolvimento das áreas ainda não ocupadas.
Utilização de imagens de satélite para detecção do aumento da área urbanizada do município de Camboriú - SC
Authors: Claudino Carla , Cardoso de Sales Filho Pedro
Published: October 2019

O município de Camboriú está localizado no Estado de Santa Catarina, próximo à cidade de Balneário Camboriú, que por sua vez é densamente urbanizada. Uma vez que a urbanização implica no movimento de saída dos habitantes da zona rural para a zona urbana, faz-se necessário o estudo do aumento da mancha urbana, bem como a sua espacialização, de forma a poder fundamentar a tomada de decisão a respeito das políticas públicas, com o intuito de promover o desenvolvimento sustentável. Desta forma, com a utilização do sensoriamento remoto, imagens do satélite Landsat 5 e 8, referentes aos anos de 2000 a 2019, foram classificadas e analisadas em termos da evolução da mancha urbana do município de Camboriú-SC. Como resultado, foi obtido que houve o aumento da mancha urbana, de forma a espacializar o crescimento apresentado pelo censo do IBGE no período de tempo estudado.
Endovascular Treatment for Acute Basilar Artery Occlusion: A Single Center Retrospective Observational Study
Authors: sun xuan , tong xu , gao feng , lao huiting , miao zhongrong
Published: October 2019

Background and purpose: Endovascular treatment (EVT) is now considered the gold standard for select patient populations with anterior circulation stroke; however, data on the treatment of posterior circulation stroke are less clear. This study aims to determine the characteristics and treatment outcomes of patients with acute basilar artery occlusion (BAO) and to evaluate the effectiveness and safety of EVT for patients with acute BAO in a high-volume stroke center. Methods: This study included 187 consecutive patients with acute BAO who underwent EVT from January 2012 to July 2018 in Beijing Tiantan Hospital. The baseline characteristics, procedure parameters, and functional outcome were assessed. Results: Among the 187 patients, 138 (73.8%) underwent mechanical thrombectomy with a stent retriever, 33 (17.6%) underwent direct intracranial angioplasty (balloon dilation and/or stent implantation) for underlying severe intracranial atherosclerotic disease, and 91 (48.7%) underwent combined mechanical thrombectomy and angioplasty. Successful recanalization [modified Thrombolysis in Cerebral Infarction (mTICI) grade 2b-3] was achieved in 158 patients (84.5%). Overall, the rates of functional independence [modified Rankin Scale (mRS) 0-2] and favorable outcome (mRS 0-3) at 90 days were 36.4% and 49.2%, respectively, and 90- day all-cause mortality was 20.3%. Conclusion􀀌􀀁EVT was effective and safe for treating patients with acute BAO.
High fecal carriage of Extended Beta Lactamase producing Enterobacteriaceae among adult patients admitted in Referral Hospitals in Dar es salaam, Tanzania
Authors: Kibwana Upendo Ozeniel , Majigo Mtebe , Kamori Doreen , Manyahi Joel
Published: October 2019

Background Multi-drug resistance pathogens such as Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae (ESBL-PE) are of great global health concern, since they are associated with increased morbidity and mortality. Even in the absence of infections caused by these pathogens, colonization is a great threat and can lead to cross transfer among hospitalized patients. To date data on carriage of these pathogens is still limited in Tanzania. Therefore, this study aimed to determine ESBL-PE fecal carriage rate and associated factors among hospitalized patients at Referral hospitals in Dar es Salaam. Methods This was a cross sectional study conducted from May to July 2017 among patients admitted in three referral hospitals in Dar es Salaam, Tanzania. Rectal swabs were collected and screened for ESBL production using MacConkey agar supplemented with Ceftazidime 2mg/ml. Phenotypic confirmation of ESBL-PE was done by double disk diffusion method. Statistical analysis was performed using Statistical Package for Social Sciences (SPPS) software version 20. Results Of the 196 enrolled participants, 59.7% (117/196) were confirmed to carry ESBL-PE. Diarrheic patients (57/79) had statistically significant high prevalence of ESBL-PE colonization compared to those without diarrhea (60/117) ( p = 0.01). A total of 131 ESBL-PE were isolated from 117 patients, whereby, Escherichia coli accounted for 68.7%, Klebsiella pneumoniae 28.2% and Citrobacter species 0.8%. ESBL-PE carriage was significantly higher in patients with diarrhea compared to those without diarrhea (72% vs 53.1%, p=0.01). Recent antibiotic use was independently associated with carriage of ESBL-PE (aOR 14.65, 95%CI 3.07-69.88, p=0.01). Conclusions High fecal carriage of ESBL-PE was observed in patients admitted in tertiary hospitals in Dar es Salaam, Tanzania. The use of antibiotics was associated with carriage of ESBL producers among the study population.
Molecular characterization of Blastocystis subtypes in HIV-positive patients and evaluation of risk factors for colonization
Authors: Sulekova Lucia Fontanelli , Gabrielli Simona , Furzi Federica , Milardi Giovanni Luigi , Biliotti Elisa , De Angelis Maurizio , Iaiani Giancarlo , Fimiani Caterina , Maiorano Myriam , Mattiucci Simonetta , Taliani Gloria
Published: October 2019

Background
Blastocystis is one of the most common intestinal protozoa in human faecal samples with uncertain impact on public health . Studies on the prevalence of Blastocystis in HIV-positive patients are limited and dated.
Methods
A cross-sectional study was carried out involving 156 HIV- positive patients to evaluate the prevalence of Blastocystis -subtypes by molecular amplification and sequencing of the SSU rDNA gene, to identify the risk factors for its transmission, to examine the relationship between the presence of the protist and gastrointestinal disorders. Furthermore, the evaluation of the faecal calprotectin by immunoassay from a sample of subjects was performed to evaluate the gut inflammation in Blastocystis- carriers.
Results
Blastocystis- subtypes ST1, ST2, ST3, ST4 were identified in 39 HIV-positive patients (25%). No correlation was found between the presence of the protist and virological or epidemiological risk factors. Blastocystis was more frequently detected in homosexual subjects (p=0.037) infected by other enteric protozoa (p= 0.0001) and with flatulence (p=0.024). No significant differences in calprotectin level was found between Blastocystis- carriers and free ones.
Conclusions
Blastocystis is quite common in HIV-positive patients on ART showing in examined patients 25% prevalence. Homosexual behaviour may represent a risk factor for its transmission, while CD4 count and viremia didn’t correlate with the presence of the protist. The pathogenetic role of Blastocystis remains unclear and no gut inflammation status was detected in Blastocystis- carriers. The only symptom associated with Blastocystis was the flatulence, evidencing a link between the presence of the protist and the composition and stability of gut microbiota.
Factors generating ambivalent feelings in women who gave birth after receiving a negative result on non-invasive prenatal testing: A qualitative study
Authors: Yotsumoto Junko , Sekizawa Akihiko , Inoue Satomi , Suzumori Nobuhiro , Samura Osamu , Yamada Takahiro , Miura Kiyonori , Masuzaki Hideaki , Sawai Hideaki , Murotsuki Jun , Hamanoue Haruka , Kamei Yoshimasa , Endo Toshiaki , Fukushima Akimune , Katagiri Yukiko , Takeshita Naoki , Ogawa Masaki , Okamoto Yoko , Tairaku Shinya , Kaji Takashi , Maeda Kazuhisa , Nishizawa Haruki , Matsubara Keiichi , Ogawa Masanobu , Osada Hisao , Ohba Takashi , Kawano Yukie , Sasaki Aiko , Sago Haruhiko
Published: October 2019

Background: Some women with negative results on non-invasive prenatal genetic testing (NIPT) may have ambivalent feelings later. This study aimed to investigate the factors generating ambivalent feel-ings among women who gave birth after having received negative results on NIPT.

Methods: A questionnaire was sent to women who received a negative NIPT result, and a contents analysis was conducted for those 1562 women who responded to the open-ended question. The con-tents of these qualitative data were analyzed using the N-Vivo software package.

Results: Environmental factors, genetic counseling-related factors, and increased anticipatory anxiety affected the feeling of ambivalence among pregnant women. Furthermore, pregnant women desired more information regarding the detailed prognosis for individuals with Down syndrome and living with them and/or abortion, assuming the possibility that they were positive.

Conclusions: Three major interrelated factors affected the feeling of ambivalence in women. High-lighting and discussing such factors during genetic counseling may resolve some of these ambivalences, thereby enhancing the quality of decisions made by pregnant women.
Serum Erythropoietin Concentration And Its Correlation With Stage Of Diabetic Retinopathy
Authors: Davidović Sofija , Nikola Babić , Sandra Jovanović , Sava Barišić , Desanka Grković , Aleksandar Miljković
Published: October 2019

Summary: Background: Erythropoietin (Epo) is one of systemic angiogenic factors, and its role in ocular angiogenesis and in diabetic retinopathy (DR) is not yet fully understood. Latest research data reveal possible correlation of higher EPO concentrations of erythropoietin in blood and in the eye, with more severe of stages of DR. The main aim of this work was to examine the possible influence of serum concentrations of erythropoietin on the development and stages of diabetic retinopathy in patients with diabetes mellitus type 2. Methods: The research involved 90 patients examined at University Eye Clinic in Clinical Center of Vojvodina in Novi Sad, Serbia. First group comprised of 60 patients with diabetes mellitus lasting 10 years or more, with diabetic retinopathy. Second, control group, consisted of 30 healthy individuals. In the first group of 60 diabetic patients, 30 of them had non-proliferative diabetic retinopathy (NPDR), and 30 had proliferative diabetic retinopathy (PDR). Laboratory EPO serum levels were determined, and they were correlated to the stage of DR. Concentration of EPO was assessed by ELISA method at the end of the study. Results: The highest average concentration of EPO in serum (9.95 mIU/ml) was determined in group of diabetics with PDR. The lowest average concentration of EPO in serum (6.90 mIU/ml) was found in control group. The average concentration of Epo in serum in group of diabetics with NPDR was 7.00 mIU/ml. EPO concentration in serum was elevated in group of PDR, and it was directly proportional to the level of clinical stadium of PDR, being significantly higher in moderate and severe subgroup of PDR comparing to control healthy subjects, NPDR and mild PDR (h=9.858, p=0.007). Conclusions: Significantly elevated serum concentration of EPO in advanced stages of DR, and positive correlation between EPO serum concentration and clinical stadium of PDR, suggest that erythropoietin presents one of the important growth factors from blood, which plays role in retinal ischemia and angiogenesis in diabetic retinopathy, especially in the proliferative stage of this disease. Keywords: diabetic retinopathy; erythropoietin; glycated hemoglobin; non-proliferative diabetic retinopathy; proliferative diabetic retinopathy.
Surgical treatment to multiple primary lung cancer patients: A systematic review and meta-analysis
Authors: Chen Ting-Fei , Xie Chun-Ying , Rao Bing-Yu , Shan Shi-Chao , Zhang Xin , Zeng Bo , Lei Yi-Yan , Luo Hong-He
Published: October 2019

Background As there is no consensus on the optimal surgery strategy for multiple primary lung cancer (MPLC), we conducted this study to address this issue by comparing the prognosis of MPLC patients underwent different surgical strategies including sublobar resection and the standard resection through a systemic review and meta-analysis. Methods Relevant literature was obtained from three databases including PubMed, Embase and Web of Science. Inclusion and exclusion criteria were set for the screening of articles to be selected for further conduction of systemic review and meta-analysis. The HRs of OS of the sublobar group compared with standard resection group were extracted directly or calculated indirectly from included researches. Result s: Ten researches published from 2000 to 2017 were included in this study, with 468 and 445 MPLC cases for the standard resection group and sublobar resection group respectively. The result suggested that OS of MPLC patients underwent sublobar resection (segmentectomy or wedge resection for at least one lesion) was comparable with those underwent standard resection approach (lobectomy or pneumonectomy for all lesions), with HR 1.07, 95% CI 0.67 - 1.71, p = 0.784. Further analysis found no difference in subgroups of synchronous and metachronous (from second metachronous lesion), different population region and dominant sex type. Conclusions This study may reveal that sublobar resection is acceptable for patients with MPLC at an early stage, because of the equivalent prognosis to the standard resection and better pulmonary function preservation. Further research is needed to validate these findings.
CRISPR-cas system in the acquisition of virulence genes in dental-root canal and hospital-acquired isolates of Enterococcus faecalis
Authors: Gholizadeh Pourya , Aghazadeh Mohammad , Ghotaslou Reza , Rezaee Mohammad Ahangarzadeh , Pirzadeh Tahereh , Lanotte Philippe , Ganbarov Khudaverdi , Bastami Milad , Yousefi Mehdi , Kafil Hossein Samadi
Published: October 2019

Introduction

Enterococcus faecalis is one of the important causative agents of nosocomial and life-threatening infections in human. Several studies have demonstrated that the presence of CRISPR- cas is associated with antibiotic susceptibility and lack of virulence traits. In this study, we aimed to assess the phenotypic and genotypic virulence determinants in relation to CRISPR elements from the dental-root canals and hospital-acquired isolates of E. faecalis .Methods and materials

Eighty-eight hospital-acquired and 73 dental-root canal isolates of E. faecalis were assessed in this study. Phenotypic screening of the isolates included biofilm formation, and gelatinase and hemolysis activities. Genotypical screening using PCR was further used to evaluate the presence of CRISPR elements and different virulence-associated genes such as efaA , esp , cylA , hyl , gelE , ace , ebpR , and asa1 .Results

Biofilm formation, and gelatinase and hemolysis activity were detected in 93.8%, 29.2% and 19.2% of the isolates, respectively. The most prevalent virulence-associated gene was ace , which was followed by efaA , whereas cylA was the least identified. The presence of CRISPR1- cas , orphan CRISPR2 and CRISPR3- cas was determined in 13%, 55.3% and 17.4% of the isolates, respectively. CRISPR elements were significantly more prevalent in the dental-root canals isolates. An inverse significant correlation was found between CRISPR- cas loci, esp and gelE , while direct correlations were observed in the case of cylA , hyl , gelE (among CRISPR-loci 1 and 3), asa1 , ace , biofilm formation, and hemolysis activity.Conclusion

Findings, therefore, indicate that CRISPR- cas might prevent the acquisition of some respective pathogenicity factors in some isolates, though not all; so selective forces could not influence pathogenic traits.
Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism
Authors: Park Eun Sil , Yoon Ju Young
Published: October 2019

Background

Congenital hypothyroidism (CH) is one of the most common endocrine diseases in childhood. A significant proportion of CH cases are transient, but the risk factors for permanent CH (PCH) are not yet well established. The current guidelines suggest using levothyroxine until the age of 3 years, but some studies suggest the possibility of earlier discontinuation. However, few, if any, studies have followed up on the results of early discontinuation. This study aimed to identify predictive factors of transient CH among infants with CH. We also investigated the results in patients who underwent a trial of early discontinuation.

Methods

We gathered data regarding infants diagnosed with CH between July 2005 and July 2014 by retrospective chart review. Among them, early discontinuation subgroup was defined as those who discontinued levothyroxine before 30 months of age.

Results

From the 80 infants (40 males, 40 females) enrolled in this study, 51 were preterm. Nine (11.3%) were diagnosed with PCH. Compared with transient cases, those with PCH were on higher levothyroxine dose at discontinuation (4.3 vs 2.9 µg/kg, P < 0.001). There was no difference in the proportion of permanent cases between preterm and full-term groups. In preterm group,infants with PCH required higher levothyroxine dose at discontinuation than those with transient CH (3.8 vs 2.5 µg/kg, P = 0.018). Levothyroxine discontinuation at a dose of 2.86 µg/kg could suggest PCH (sensitivity, 88.9%; specificity, 71.0%). Among the 9 patients who underwent a trial of early discontinuation, 8 successfully discontinued levothyroxine.

Conclusion

The majority of CH patients discontinued levothyroxine successfully, including those who underwent a trial of early discontinuation. Higher levothyroxine dose at the time of discontinuation was found to be a predictive factor for PCH.
Assessment of seroepidemic conditions of hepatitis B virus among people under 29 years of age and evaluation of the hepatitis B vaccine after 22 years in Jiangsu Province, China
Authors: Sun xiang , Tang Fenyang , Hu Ying , Deng Xiuying , Wang Zhiguo , Liu Yuanbao , Zhou Minghao
Published: October 2019

Background This study aims to investigate the epidemiologic characteristics and variational trends following a hepatitis B vaccine (HepB) inoculation programme carried out in children over the last 22 years in Jiangsu province. It also aims to evaluate the effect of hepatitis B vaccine immunisation and to analyse the influential of HBsAg positive carriers. Finally, the study also provides reliable data and a baseline for adjusting future prevention and intervention strategies in Jiangsu province. Methods The incidence rates of hepatitis B virus (HBV) in Jiangsu province from 2004 to 2014 were obtained from the National Notifiable Disease Reporting System (NNDRS). A stratified cluster random sampling method was used to select 3,002 subjects aged 1-29 years across 13 hepatitis B virus monitoring points throughout the province, which had been classified as either urban or rural. HBV was assessed from venous blood samples using Abbott microparticle enzyme immunoassay (MEIA) kits (Abbott Laboratories, Chicago, Illinois). Results HBV incidence in the 1-29 age group showed a significant downward trend since 2004 (P<0.001). Serological assessments showed that the prevalence values of the hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) in the 1-29 age group were 1.20% and 5.33%, respectively. And 66.89% tested positive for the hepatitis B surface antibody (anti-HBs). The HBsAg positive rate among participants was significantly lower in subjects who had been vaccinated than in those who had not (0.46% vs 14.93%, p<0.0001). Among persons who had received the full three-dose vaccine regimen, 90.93% received the first dose of the HBV vaccine within 24 hours of the baby’s birth. In this same group, the prevalence rates of HBsAg and anti-HBc were 0.05% and 0.95%, respectively, and the HBV infection rate decreased significantly after 2006. Conclusions The overall rate of Hepatitis B vaccinations and vaccinations administered within 24 hours of the baby’s birth have continuously improved since the HepB vaccine was integrated into the immunisation programme in Jiangsu province. Hepatitis B prevention and control works in the target population has achieved remarkable results.
Cryptococcal antigenemia and its predictors among HIV infected patients in resource limited settings: a systematic review
Authors: Derbie Awoke , Mekonnen Daniel , Woldeamanuel Yimtubeznash , Abebe Tamrat
Published: October 2019

Background : Cryptococcosis is an opportunistic fungal infection that primarily affects people with advanced Human immunodeficiency virus (HIV) disease and is an important cause of morbidity and mortality around the globe. By far the most common presentation of the disease is cryptococcal meningitis (CM), which leads to an estimated 15-20% of all HIV related deaths worldwide, 3/4 of which are in sub-Saharan Africa. However, to the best of our knowledge there is quite limited reviewed data that on the epidemiology of cryptococcal antigenemia in a large HIV-infected population in resource limited settings. Methods : Articles published in English irrespective of the time of publication were systematically searched using comprehensive search strings from PubMed/Medline and SCOPUS. In addition, Google Scholar and Google databases were searched manually for grey literature. Two reviewers independently assessed study eligibility, extracted data, and assessed risk of bias. The magnitude of cryptococcal antigenemia and its predictors were presented with descriptive statistics and summary measures. The pooled prevalence of cryptococcal antigenemia was also determined with 95% confidence interval (CI). Result: A mong 2941 potential citations, we have included 22 studies with a total of 8,338 HIV positive individuals. The studies were reported in ten different countries during the year (2007-2018). Most of the articles reported the mean CD4 count of the participants <100 cells/µl. The pooled prevalence of cryptococcal antigenemia at different CD4 count and ART status was at 8% (95%CI: 6-10%) (ranged between 1.7% and 33%). Body mass index (BMI) <18.5kg/m 2 , CD4 count <100 cells, presenting with headache and male gender were reported by two or more articles as an important predictors of cryptococcal antigenemia. Conclusions : Implementing a targeted screening of HIV patients with low BMI, CD4 count <100 cells, having headache and males; and treatment for asymptomatic cryptococcal disease should be considered. Additional data is needed to better define the epidemiology of cryptococcal antigenemia and its predictors in resource limited settings in order to design prevention, diagnosis, and treatment strategies.
Needs, Aggravation, And Degree of Burnout In Informal Care Providers Of Patients With Chronic Cvd
Authors: Szlenk-Czyczerska Elżbieta , Guzek Marika , Prusaczyk Artur , Bielska Dorota Emilia , Ławnik Anna , Kurpas Donata
Published: October 2019

Background. A growing number of patients with chronic cardiovascular disease (CVD) creates a growing demand for homecare. Personal and professional limitations, health issues, and lack of systemic support of informal care providers are major causes of insufficient care models for chronically ill patients in home environments. This study aimed to identify the sociodemographic variables that are associated with the needs and increasing occupational burnout observed among home care providers. Methods. This study reports on 161 informal home care providers of patients with CVDs. The research was conducted in the homes of patients, using the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Maslach Burnout Inventory (MBI), and a structured interview questionnaire developed by the authors. Spearman’s rank correlation coefficient test and logistic regression were used for analyses. Results. The majority of the participants were female (70.2%; n=113). We found that younger care providers were less likely to report unmet needs ( p = 0.011), and less likely to report burnout as measured by the MBI Emotional Exhaustion ( p = 0.010) and Depersonalization ( p = 0.009) subscales. Care providers with primary education were more likely to report burnout on the MBI Depersonalization subscale ( p = 0.028). In addition, care providers who worked more often reported higher levels of met needs ( p = 0.022), and burnout as measured on the MBI Depersonalization ( p = 0.005) and Emotional Exhaustion ( p = 0.018) subscales. Subjects residing in urban areas were more likely to report unmet needs ( p = 0.007), and were also more likely to report burnout as measured on the MBI Emotional Exhaustion ( p = 0.006) subscale. Conclusion. Older care providers who are unemployed and reside in cities and unemployed should be targeted with directed programmes to determine the category of unmet needs, and for personalized support. Care providers with these demographic characteristics should be targeted for occupational burnout prevention programmes. Keywords: informal caretaker, met and unmet needs, growing burnout.
A survey of the working status of family medicine physicians in clinics and hospitals in Korea
Authors: Shin Hyun-Young
Published: October 2019

Background In the approximately 35 years since family medicine was established in South Korea, family medicine physicians have sought to expand their expertise to cover clinical fields beyond primary medicine. This study examines their working status and compares the working conditions of family medicine physicians in clinics and hospitals in Korea.Methods We conducted an online survey with 4,057 family medicine physicians in Korea in 2016. The results were analyzed using descriptive statistics.Results Of the respondents, 572 doctors were working in clinics and 441 in hospitals. In the analysis of treatment pattern by doctors, the rate of chronic disease management was 84.7% in clinics and 93.4% in hospitals ( p < 0.001), and the rate of diseases covered by national insurance was 74.8% in clinics and 76.9% in hospitals ( p = 0.005). Among physicians younger than 40 years, the rate of chronic disease management and diseases covered by national insurance were 64.6% and 68.0% in clinics and 93.6% and 78.5% in hospitals, retrospectively.Conclusions Family medicine physicians working in hospitals have higher rates of chronic disease management and diseases covered by national insurance. This discrepancy of treatment pattern became larger for doctors younger than 40 years. More in-depth studies of the treatment pattern and its tendencies between family medicine physicians in clinics and hospitals are needed in the future.
Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis
Authors: Anothaisintawee Thunyarat , Karnjanapiboonwong Auttakiat , Chaikledkaew Usa , Dejthevaporn Charungthai , Attia John , Thakkinstian Ammarin
Published: October 2019

Background This systematic review aimed to estimate the performance of clinic(CBPM) and home blood pressure measurements(HBPM) compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of white coat and masked hypertension.Methods Medline and Scopus databases were searched up to 11th June 2018. Studies having diagnostic test as CBPM or HBPM, reference standard as ABPM, and reported sensitivity and specificity of either or both tests and/or proportion of white coat or masked hypertension were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of white coat and masked hypertension.Results Forty-six studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio of CBPM were 66%(95%CI:58%-73%), 83%(95%CI:75%-89%), and 9.75(95%CI:6.45-14.74), respectively. Pooled prevalence of white coat and masked hypertension were 31%(95%CI:26%-35%) and 25%(95%CI:22%-28%). Pooled sensitivity, specificity, and diagnostic odds ratio of HBPM were 71%(95%CI:58%-80%), 84%(95%CI:73%-91%), and 12.47(95%CI:6.13-25.37), respectively. Pooled prevalence of white coat and masked hypertension were 19%(95%CI:10%-27%) and 31%(95%CI:10%-52%).Conclusions Diagnostic performances of HBPM were slightly higher than performance of CBPM. However, prevalence of masked hypertension was high in both negative CBPM and HBPM. Therefore, ABPM is still necessary for hypertension diagnosis, especially in people suspected with masked hypertension.
Depression, Anxiety and Associated Factors among Housemaids Working in Addis Ababa Ethiopia
Authors: Ejigu Alem Kebede , Seraj Zahra Reshid , Libanos Mahlet Wolday Gebre , Jelcha Tolosa Fanta , Bezabih Yodit Habtamu
Published: October 2019

Background: Housemaids are part of women’s with low socioeconomic status and most of them are migrant from rural to central part of Ethiopia, less educated, either with poor, separated, single or divorced family and/or dead parents. Housemaid may experience problems like depression and anxiety more than other groups of women. Therefore, the aim of this study was to assess the magnitude and determinants of those problems among housemaids. Objective: to assess the magnitude and determinants of depression & anxiety among housemaids in Addis Ababa; Ethiopia; 2018. Methods: community based cross-sectional study was conduct from January 2018 – August 2018 housemaid working in Addis Ababa, Ethiopia. Multistage sampling technique was applied with a total of 826 samples. Quantitative data was employed by using structured questionnaires. The collected data was coded, entered in to Epi-Info version 7 and analyzed by using SPSS version 20. Descriptive, analytical statistical procedures; bivariate and multivariate binary logistic regressions with odds ratios and 95% confidence interval was employed. The statistical significance was declared at p value < 0.05. Results: This study enrolled 862 participants with response rate 99.5%. The result showed that prevalence of depression and anxiety found 27.5% (95% CI= 24.3 – 30.40) and 32.3% (95% CI= 29.3 - 35.4) respectively. Among all participants 44.6% (95% CI= 41.0 – 47.9) have mild, 18.5% (95% CI= 15.7 – 21.2) have moderate and 6.1% (95% CI= 4.5 – 7.8) have severe form of comorbid anxiety with depression. Both depression and anxiety found more (44.9% & 41.9% respectively) prevalent among age group 16 to 20. In this study history of parental divorce, divorce, physical violence and sexual violence are positively associated. Other factors; being less educated (not educated, 1 ry & 2 ry level of education) and living with relatives; were associated negatively. Conclusion: The prevalence of Depression and Anxiety is found high among housemaid; its prevalence is more among age group 16 to 20 than other age groups. Violence, divorce, history of parental divorce and no contraceptive use have positively associated with depression and anxiety.
Dysbiosis in dementia is associated with gut barrier dysfunction and linked to malnutrition and prescription drug use
Authors: Stadlbauer Vanessa , Engertsberger Lara , Komarova Irina , Feldbacher Nicole , Leber Bettina , Pichler Gerald , Fink Nicole , Scarpatetti Monika , Schippinger Walter , Schmidt Reinhold , Horvath Angela
Published: October 2019

Background: Dementia is an increasing public health threat worldwide. The pathogenesis of dementia has not been fully elucidated yet. Inflammatory processes are hypothesized to play an important role as a driver for cognitive decline but the origin of inflammation is not clear. We hypothesize that disturbances in gut microbiome composition, gut barrier dysfunction, bacterial translocation and resulting inflammation are associated with cognitive dysfunction in dementia. Methods: To test this hypothesis, a cohort of 23 patients with dementia and 18 age and sex matched controls without cognitive impairments were studied. Gut microbiome composition, gut barrier dysfunction, bacterial translocation and inflammation were assessed from stool and serum samples. Malnutrition was assessed by Mini Nutritional Assessment Short Form (MNA-SF), detailed information on drug use was collected. Microbiome composition was assessed by 16s sequencing, QIIME 2 and Calypso 7.14 tools. Results: Dementia was associated with dysbiosis characterized by differences in beta diversity and changes in taxonomic composition. Gut permeability was increased as evidenced by increased serum diamine oxidase levels and systemic inflammation was confirmed by increased soluble cluster of differentiation 14 levels (sCD14). BMI and statin use use had the strongest impact on microbiome composition.Conclusion: Dementia is associated with changes in gut microbiome composition and increased biomarkers of gut permeability and inflammation. Lachnospiraceae NK4A136 group as a potentially butyrate producing bacterial strain was reduced in dementia. Malnutrition and drug intake were factors, that impact on microbiome composition and function. Increasing butyrate producing bacteria and targeting malnutrition may be promising therapeutic targets in dementia.Trial Registration: NCT03167983
Impact of mobile device use on the cognitive function and depressive symptoms of older adults living in residential care homes
Authors: Lin Lu , Jing Xiuchen , Lv Shujiao , Liang Jinghong , Tian Li , Li Huiling , Puts Martine , Xu Yong
Published: October 2019

Background With the fast-paced aging and increasing digitalization of society, there has been a growing interest in the effect of mobile device use on cognitive function and depression in older adults. However, research examining this issue among older adults in residential care homes (RCHs) is scant. Therefore, this study aimed to examine the impact of mobile device use on the cognitive function and depressive symptoms of older adults living in RCHs.Methods A cross-sectional survey was conducted using a sociodemographic questionnaire, the Montreal Cognitive Assessment (MoCA) and the 15-item Geriatric Depression Scale (GDS-15).Results A total of 235 senior residents (aged 82.58 ± 5.54) in four RCHs were surveyed. Users of mobile devices had a significantly higher total MoCA score (25.02 ± 4.14) and a significantly lower GDS-15 score (3.28±2.74) than non-users (MoCA: 19.34 ± 5.21, GDS-15: 4.69±2.90). Multivariate linear regression indicate that mobile device use is significantly associated with total MoCA score, six of the seven sub-scores (visuospatial abilities and execution functions, attention, language, abstraction, delayed recall, and orientation)(P<0.05). Logistic regression showed that mobile device use had a significant effect on the level of depressive symptoms (OR=0.458, 95%CI=0.249-0.845).Conclusions Use of mobile devices has a significant impact on the cognitive function and depressive symptoms of older adults living in RCHs, and thus should be encouraged as a measure to maintain and improve cognition and prevent depression.
Rural-urban disparities in unmet long-term care needs and the demand for community care services among elderly people in China
Authors: Zeng Yanbing , Wang Lixia , Zhang Liangwen , Fang Ya
Published: October 2019

Background: Estimates of unmet needs, as an indicator of future needs for long-term care (LTC) services, have become increasingly crucial policy concerns. This study aimed to examine the urban-rural differences in unmet needs and the demand for community care service among community-dwelling elderly people in China. Methods: The data come from the 2014 Chinese Longitudinal Health Longevity Survey (CLHLS). A total of 1587 community residents aged 65+ with disabilities in the activities of daily living (ADLs) were included in this study. Based on the Andersen theoretical model, binary logistic regression was used to estimate the correlates of unmet needs in LTC. A chi-square test was used to examine the differences in expected needs for community-based LTC services between urban and rural areas. Results: Over half (55.07%) of the participants reported their needs were unmet. Poor economic status and reluctant caregivers seriously affected elderly unmet needs. Among urban older adults, those who were male and lonely reported more unmet needs. Among rural ones, those with severe ADL disability and poor self-rated health reported more unmet needs. In addition, access to medication and home visit services were negatively associated with unmet needs. Living with children (69.12%) was viewed as the most desirable living arrangement among older adults, while living in a LTC facility seemed to be more accepted for rural residents with unmet needs than for other elderly respondents. Residents showed a high demand for community LTC care services, with 82.55% of them expecting to need home visits and 74.29% to healthcare education. Specifically, rural residents had greater expected needs for every community care service than their urban counterparts. However, only 4.66% to 36.42% of the respondents reported that all eight types of services were available, which was far below the demand for these services. Conclusion: The risk of having unmet LTC needs is largely determined by elderly people’s economic status and caregivers’ willingness to provide care for both rural and urban elderly residents. More attention should be paid to psychological consulting services in urban areas, as well as personal care, home visits, psychological consulting and healthcare education services in rural areas.
Thickness profiles of the corneal epithelium along the steep and flat meridians of astigmatic corneas after orthokeratology
Authors: Zhou Jiaqi , Xue Feng , Zhou Xingtao , Naidu Rajeev Krishnan , Qian Yishan
Published: October 2019

Background: To investigate the changes in the corneal epithelial thickness along the steep (ETS) and flat (ETF) meridians of astigmatic corneas after six months of overnight spherical myopic orthokeratology (OK) lens wear.Methods: A prospective study. Fifty-seven subjects (age range: 9–38 years) with up to 1.50 diopters (D) of corneal toricity wore spherical OK lenses in both eyes for 6 months. Evaluations of OK lens fit, visual acuity, refractions and corneal topography were performed at baseline and after 6 months’ of overnight OK lens wear. Fourier-domain optical coherence tomography (FD-OCT) was conducted to measure the central corneal epithelial topography along varying meridians over a diameter of 6mm. The values of epithelial thickness (ET) along the steep and flat meridians were recorded at 1mm intervals from the corneal apex to the mid-periphery along chords with a diameter of 6mm（Φ6mm）and compared between pre- and post-lens wear (change of ET at the steep meridian: △ETS; change of ET at the flat meridian: △ETF). The mean of △ET of the same diameter at individual meridians (△ETSm and △ETFm) were calculated and compared. Results: Visual acuity and refraction improved significantly after OK lens wear. The central corneal epithelium thinned and the mid-peripheral corneal epithelium thickened after OK lens wear (P < 0.05). ETFm thinned more than ETSm atΦ3mm andΦ4mm and ETSm thickened more than ETFm atΦ5mm andΦ6mm. Conclusions: The corneal epithelium thinned more along the flat meridian of the paracentral cornea and thickened more along the steep meridian of the mid-peripheral cornea after spherical OK lens wear.
Potential mechanisms underpinning aerobic exercise-induced analgesia in primary dysmenorrhea: a controlled non-randomized pilot trial
Authors: Kannan Priya , Cheung Kwok-Kuen , Chi Chan Sheung , Yan Lam King , Xi Law Yee , Ki Ng Sze , Yan Siu Hoi , Wong Sze Chuen Cesar
Published: October 2019

BackgroundAerobic exercise has been shown to alleviate the pain of primary dysmenorrhea in several studies however, no study has yet identified the physiological mechanisms underlying the beneficial effects of aerobic exercise-induced pain relief in primary dysmenorrhea. The objectives of the study are: (1) To evaluate the feasibility of the protocol for a randomized controlled trial to investigate the physiological mechanisms underlying the beneficial effects of aerobic exercise on the pain associated with primary dysmenorrhea and (2) to obtain preliminary results (effect size) to estimate the sample size for the future randomized controlled trial.MethodsTwenty women aged 18–29 years were divided into two groups (high-intensity aerobic-exercise group and no-exercise control group) in a 1:1 ratio. Women assigned to the exercise group performed high-intensity treadmill-based aerobic exercise for three days a week, at 70–85% of maximum heart rate for 30 minutes for 4 weeks. The control group did not receive trial intervention but provided blood for estimation of plasma variables. Blood plasma levels of progesterone, metabolites of prostaglandin (PG) F2-alpha (13,14-dihydro-15-keto-prostaglandin F2 alpha [KDPGF2α]) and PGE2 (13,14-dihydro-15-keto-prostaglandin E2 [KDPGE2]), and tumor necrosis factor-alpha (TNF-α) were measured at 4-weeks post-intervention.ResultsWith respect to feasibility outcomes, 90% of the required number of participants were recruited in 3-4 weeks. Adherence to the intervention was 97% and the retention rate was 90%. There was an increase in progesterone levels (d = 0.36) and decreases in KDPGF2α (d = 0.35), KDPGE2 (d = 0.47), and TNF-α (d = 0.33) from baseline to week 4 in the exercise group compared with the control group.ConclusionThe study methodology appears to be feasible for conducting a full-scale randomized controlled trial. The findings indicated a trend towards an increase in progesterone levels and decreases in inflammatory pain mediators, including KDPGF2α, KDPGE2, and TNF-α, in the exercise group compared with the control group, suggesting the possibility that aerobic exercise may be effective for primary dysmenorrhea via its influence on progesterone and inflammatory pain mediators. Trial Registration Our trial is registered in the Australian New Zealand Clinical Trials Registry (ACTRN12618000784213). The date of registration is 09 May 2018. Trial registration was completed prior to enrollment of the first participant.
Overexpression of citrus UDP-GLUCOSYL TRANSFERASE gene enhances anthocyanin and proanthocyanidins contents and confers high light tolerance
Authors: Rao Muhammad Junaid , Xu Yuantao , Huang Yue , Tang Xiaomei , Deng Xiuxin , Xu Qiang
Published: October 2019

Background Citrus fruits are consumed freshly or as juice to directly provide various dietary flavonoids to humans. Diverse metabolites at different levels are present among Citrus genera and many flavonoids biosynthetic genes were induced after abiotic stresses. To better understand the underlying mechanism, we designed experiments to overexpress a UDP-GLUCOSYL TRANSFERASE gene from Citrus sinensis (sweet orange) to evaluate its possible function in metabolism and response to stress.Results Our results demonstrated that overexpression of Cs-UGT78D3 resulted in high accumulation of proanthocyanidins in the seed coat and a dark brown color to transgenic Arabidopsis seeds. In addition, the total contents of flavonoid and anthocyanin were significantly enhanced in the leaves of overexpressed lines. Gene expression analyses indicated that many flavonoid (flavonol) and anthocyanin genes were up-regulated by 4-15 folds in transgenic Arabidopsis. Moreover, after 14 days of high light stress treatment, the transgenic Arabidopsis lines showed strong antioxidant activity and higher total contents of anthocyanins and flavonoids in leaves compared with the wild type.Conclusion Our study concluded that the citrus Cs-UGT78D3 gene is involved in proanthocyanidins accumulation in seed coats and confers tolerance to high light stress by accumulating the total anthocyanin and flavonoid contents with better antioxidant potential (due to photoprotective activity of anthocyanin) in the transgenic Arabidopsis.
A comparative gene co-expression networks analysis of two congener filmy ferns identifies specific desiccation tolerance mechanisms associated to their microhabitat preference.
Authors: Ostria-Gallardo Enrique , Larama Giovanni , Berríos Graciela , Fallard Ana , Gutierrez Ana , Ensminger Ingo , Bravo León A.
Published: October 2019

Background Filmy-ferns (Hymenophyllaceae) are poikilohydric, homoiochlorophyllous desiccation-tolerant (DT) epiphytes. They can colonize lower and upper canopy environments of humid forest. Filmy-ferns desiccate rapidly (hours), contrasting with DT angiosperms (days/weeks). We hypothesized that desiccation tolerance in filmy-ferns would be associated mainly with constitutive features rather than induced responses during dehydration. Hence, the inter-specific differences in vertical distribution would be associated with different dynamics of gene expression within the dehydration or rehydration phases. A comparative transcriptomic analysis with an artificial neural network was done on Hymenophyllum caudiculatum (restricted to lower canopy) and Hymenophyllum dentatum (reach upper canopy) during a desiccation/rehydration cycle.Results Raw reads were assembled into 69,599 transcripts for H. dentatum and 34,726 transcripts for H. caudiculatum . Few transcripts showed significant changes in differential expression (DE). H. caudiculatum had ca. twice DE genes than H. dentatum and higher proportion of increased-and-decreased abundance of genes occurs during dehydration. In contrast, the abundance of genes in H. dentatum decreased significantly when transitioning from dehydration to rehydration. According to the artificial neural network results, H. caudiculatum enhanced osmotic responses and phenylpropanoid related pathways, whilst H. dentatum enhanced its immune system responses and protection against high light stress.Conclusions Our findings provide a deeper understanding of the mechanisms underlying the desiccation tolerance responses of two filmy ferns and the relationship between the species-specific response and the microhabitats these ferns occupy in nature.