bluuebunny/crossref_metadata_2025 huggingface dataset:
Disparities in utilization of sexual and reproductive health services among high school adolescents from youth friendly service implemented and non-implemented areas of Southern Ethiopia
Authors: Haile Bayu , Shegaze Mulugeta , Feleke Tesfaye , Glagn Mustefa , Andarge Eshetu
Published: November 2020

Background: In recent years, much effort was made to improve access to sexual and reproductive health services (SRH) to adolescents and youths in Ethiopia particularly through establishment of youth friendly service (YFS) corners as part of the existing health care facilities. The existing evidences focused on investigating the utilization of SRH services at YFS established areas alone. There is a dearth of evidence which compares the SRH service use between the YFS implemented and non-implemented areas so that evidences can be drawn to suggest on the successes of the expansion of youth friendly corners. Methods: A school-based comparative cross-sectional study was conducted by employing a multistage cluster sampling method. A pre-tested self-administered questionnaire was used to collect data and the collected data were entered in to Epidata version 4.4.1 software and then exported to SPSS version 20 for analysis. χ2 test was used to see a significant difference in SRH service utilization among adolescents from YFS implemented and non-implanted areas. The association between the SRH services utilization and the independent variables were examined using binary logistic regression. Finally, variables having p-value less than or equal to 0.05 in the multivariable logistic regression model were considered as statistically significant.Results: There were a significant difference in the rate of SRH service utilization between YFS implemented (33.8%) and YFS non- implemented (9.9%) areas (χ2=37.49, p<0.001). Higher educational status of mothers (AOR=2.588, 95 % CI: 1.220, 5.491), having open discussion with family (AOR=3.175, 95%CI: 1.624, 6.206), having good knowledge (AOR= 4.511, 95% CI: 2.458, 8.278) and having positive attitude (AOR= 5.084, 95% CI: 2.764, 9.352) were factors positively associated with SRH services utilization.Conclusion: Compared with high schools from YFS implemented areas, the SRH service utilization was significantly lower among students from high schools where health facilities did not implement YFS. There is a need for enhancing efforts to establish YFS corners by the stakeholders at different hierarchies at places where the centers were not established so that SRH service uptake would be improved. In addition, it is better to promote open discussion with adolescents at the family level, and emphasis should be given for women education in the broad sense. Furthermore, wide-range awareness creation strategies should be used to address poor knowledge and negative attitude.
Relationship between oxygen radical absorbance capacity (ORAC) index, body composition and blood biochemical markers in overweight /obese compared to normal weight subjects: a cross-sectional study
Authors: Madani Zahra , Javardi Maryam Moussavi , Khalili Ghazaleh , Djazayeri Sayed Abolghassem , Movahedi Ariyo , Karandish Majid
Published: November 2020

Background: Obesity is an important preventable disease, which promotes the development of chronic disorders by altering several factors including oxidative stress. Dietary antioxidants protect the body against oxidative stress. The purpose of this study was to evaluate the potential association of oxygen radical absorbance capacity (ORAC) index with obesity and its associated features in adults.Methods: participants were divided in two groups of normal weight and overweight /obesity. General characteristics were registered and a 147-item food frequency questionnaire was completed. Thereafter, anthropometric measurements were conducted. Biochemical indices were obtained from science and Research branch of Islamic Azad University of Tehran, Iran. The amount of the dietary ORAC index was estimated using the data provided by the USDA Foods Table.Results: The results showed that there was a significant difference between the normal and overweight/obese groups in terms of body mass index (BMI) and waist-to-hip ratio (WHR) (P=0.0001). Participants with normal weight consumed more fruits and vegetables than another group. Also, the dietary ORAC index in normal individuals was higher than the case group, but there was not significant difference (P=0.352). There was also a significant inverse correlation between dietary ORAC and BMI and WHR, whereas a significant positive correlation between dietary ORAC and plasma HDL was observed (P<0.05).Conclusion: Our findings suggest that dietary antioxidants is inversely associated with BMI, fasting blood glucose, triglyceride, total Cholesterol and LDL in both groups. It seems that following a diet rich in antioxidants can counteract obesity and its associated comorbidities.
Cooperative treatment effectiveness of ATR and HSP90 inhibition in Ewing’s sarcoma cells
Authors: Marx Christian , Schaarschmidt Marc U. , Kirkpatrick Joanna , Marx-Blümel Lisa , Hoelzer Doerte , Meyer Felix B. , Geng Yibo , Schadwinkel Hauke M. , Siniuk Kanstantsin , Halilovic Melisa , Becker Sabine , Thierbach René , Beck James F. , Sonnemann Jürgen , Wang Zhao-Qi
Published: November 2020

Introduction: Ewing's sarcoma is an aggressive childhood malignancy whose outcome has not substantially improved over the last two decades. In this study, combination treatments of the HSP90 inhibitor AUY922 with either the ATR inhibitor VE821 or the ATM inhibitor KU55933 were investigated for their effectiveness in Ewing's sarcoma cells.Methods: Effects were determined in p53 wild-type and p53 null Ewing's sarcoma cell lines by flow cytometric analyses of cell death, mitochondrial depolarization and cell-cycle distribution. They were molecularly characterized by gene and protein expression profiling, and by quantitative whole proteome analysis.Results: AUY922 alone induced DNA damage, apoptosis and ER stress, while reducing the abundance of DNA repair proteins. The combination of AUY922 with VE821 led to strong apoptosis induction independent of the cellular p53 status, yet based on different molecular mechanisms. p53 wild-type cells activated pro-apoptotic gene transcription and underwent mitochondria-mediated apoptosis. p53 null cells, however, accumulated higher levels of DNA damage, ER stress and autophagy, eventually leading to apoptosis. Impaired PI3K/AKT/mTOR signaling further contributed to the antineoplastic combination effects of AUY922 and VE821 in p53 null cells. In contrast, the combination of AUY922 with KU55933 did not produce a cooperative effect.Conclusion: Our study reveals that HSP90 and ATR inhibitor combination treatment may be an effective therapeutic approach for Ewing's sarcoma irrespective of the p53 status.
Using Bundling to Visualize Multivariate Urban Mobility Structure Patterns in the Sao Paulo Metropolitan Area
Authors: Martins Tallys Gustavo , Lago Nelson , Santana Eduardo Felipe Zambom , Telea Alexandru , Kon Fabio , Souza Higor Amario de
Published: November 2020

Internet-based technologies such as IoT, GPS-based systems, and cellular networks enable the collection of geolocated mobility data of millions of people in large metropolitan areas. In addition, large, public datasets are made available on the Internet by open government programs, providing ways for citizens, NGOs, scientists, and public managers to perform a multitude of data analysis with the goal of better understanding the city dynamics to provide means for evidence-based public policymaking. However, it is challenging to visualize huge amounts of data from mobility datasets. Plotting raw trajectories on a map often causes data occlusion, impairing the visual analysis. Displaying the multiple attributes that these trajectories come with is an even larger challenge. One approach to solve this problem is trail bundling, which groups motion trails that are spatially close in a simplified representation. In this paper, we augment a recent bundling technique to support multi-attribute trail datasets for the visual analysis of urban mobility. Our case study is based on the travel survey from the Sao Paulo Metropolitan Area, which is one of the most intense traffic areas in the world. The results show that bundling helps the identification and analysis of various mobility patterns for different data attributes, such as peak hours, social strata, and transportation modes.
Decadal Variability in Land Carbon Sink Efficiency Reveals Apparent Trend Reversal After 2009
Authors: Zhu Lei , Ciais Philippe , Bastos Ana , Ballantyne Ashley P. , Chevallier Frederic , Gasser Thomas , Kondo Masayuki , Pongratz Julia , Rödenbeck Christian , Li Wei
Published: November 2020

Background: The climate mitigation target of limiting the temperature increase below 2 °C above the pre-industrial levels requires the efforts from all countries. Tracking the trajectory of the land carbon sink efficiency is thus crucial to evaluate the nationally determined contributions (NDCs). Here, we define the instantaneous land sink efficiency as the ratio of natural land carbon sinks to emissions from fossil fuel and land-use and land-cover change with a value of 1 indicating carbon neutrality to track its temporal dynamics in the past decades.Results: Land sink efficiency has been decreasing during 1957-1990 because of the increased emissions from fossil fuel. After the effect of the Pinatubo eruption diminished (after 1994), the land sink efficiency firstly increased before 2009 and then began to decrease again after 2009. This reversal around 2009 is mostly attributed to changes in land sinks in Latin America in response to climate variations.Conclusions: The decreasing trend of land sink efficiency in the recent years reveals greater challenges in climate change mitigation, and impacts of climate on land carbon sinks need to be accurately quantified to assess the implementation of climate mitigation policies.
Study on miRNAs-Mediated Seed and Stone-Hardening Regulatory Networks and the Mechanism of miRNAs’ Manipulating Gibberellin-Induced Seedless Berries in Grapevine (Vitis vinifera L.)
Authors: Wang Chen , Wang Wenran , 宿 子文 , Abdelrahman Mostafa , Jiu Songtao , Zheng Ting , Gong Peijie , Wang Xicheng , Jia Haifeng , Fang Jinggui
Published: November 2020

A significant body of evidence supports the important roles of miRNAs in grape berry developments. However, their specific molecular functions during stone-hardening stage development remain unclear. Here, a total of 161 conserved and 85 species-specific miRNAs/miRNAs*(precursor) were identified in grape stone hardening stage berries using Solexa sequencing. Out of them, 30 VvmiRNAs were tissue-specific and identified as stone-hardening related to VvmiRNAs, whereas 52 exhibited differential expression profiles during berry development, potentially participating in modulation of development, and qRT-PCR analysis verified their expression patterns. Interestingly, high SNP variations in VvmiRNA sequences might result into generation of new VvmiRNA family members like VvmiR168, VvmiR479, VvmiR3636 families and so on. Through GO and KEGG pathway analyses, we revealed that 13 VvmiRNAs involved in the regulation of embryo development, 11 in lignin and cellulose biosynthesis, and 28 in the modulation of hormone signaling, sugar and proline metabolism. Furthermore, the target genes for novel VvmiRNAs related to berry development were validated using RLM-RACE and PPM-RACE methods, and it was revealed their cleavage sites mainly happened at the 9th-11th sites from the 5’ ends of miRNAs at their binding regions. The potential roles of these VvmiRNAs in gibberellins repressing grape stone-hardening and embryo development by potentially inducing the expression of VvmiR31-3p and VvmiR8-5p to increase the cleavage product accumulation levels of corresponding target genes like lignin biosynthesis genes, CAFFEOYL COENZYME A-3-O-METHYLTRANSFERASE (VvCCoAOMT) and DDB1-CUL4 ASSOCIATED FACTOR1 (VvDCAF1), as a potential key molecular mechanism involved in GA-induced grape seedless berry development. Based on the characterization of stone-hardening stage related to VvmiRNAs, a schematic model of miRNA-mediated grape seed and stone-hardening development was proposed in this work. This is the first report about the regulatory role of VvmiRNAs in the regulation of stone-hardening stage of grape berries, which provides valuable genetic information for the breeding of seedless grape varieties.
Retinitis Pigmentosa Results in Neurodegeneration Concomitant With Neuroinflammation, Extracellular Matrix Disorganization and the Upregulation of Neuroprotective Pathways in Glial Cells and Neurons
Authors: Bielmeier Christina B. , Roth Saskia , Schmitt Sabrina I. , Boneva Stefaniya K. , Schlecht Anja , Vallon Mario , Tamm Ernst R. , Ergün Süleyman , Neueder Andreas , Braunger Barbara M.
Published: November 2020

BackgroundHereditary retinal degenerations like retinitis pigmentosa (RP) are amongst the leading causes of blindness in younger patients. To enable in vivo investigation of cellular and molecular mechanisms responsible for photoreceptor cell death and to allow testing of therapeutic strategies that could prevent retinal degeneration, animal models have been created. Here, we in-depth characterized the transgenic VPP mouse model, a genetic model for autosomal dominant RP. MethodsWe examined the degree of photoreceptor degeneration and studied the impact of the VPP transgene-induced retinal degeneration on the transcriptome level of the retina using next generation RNA sequencing (RNASeq) analyses followed by weighted correlation network analysis (WGCNA). We furthermore identified cellular subpopulations responsible for some of the observed dysregulations using in situ hybridizations, immunofluorescent staining and 3D reconstruction. ResultsOne month-old VPP mice showed a significantly higher number of apoptotic photoreceptor cells that resulted in a significantly thinner ONL in three months-old VPP mice, concomitant with an increase in reactivity of microglia and Müller cells. By RNASeq analysis we identified 9,256 dysregulated genes and six significantly associated gene modules in the subsequently performed WGCNA. Gene ontology enrichment showed, amongst others, dysregulation of TGF-β regulated extracellular matrix organization, factors of the (ocular) immune system/response and apoptosis. ConclusionThe predominant effect pointed towards induction of neuroinflammation and the upregulation of neuroprotective pathways like TGF-β, G-protein activated and VEGF signaling that were significantly associated with the VPP transgene-induced photoreceptor degeneration. Thus, modulation of these processes might represent new therapeutic options to delay the degeneration of photoreceptors in diseases like RP.
Preliminary Phytochemical and Physicochemical Analysis of Selected Mistletoes from Ethiopia
Authors: Yirgu Abraham , Mekonnen Yalemtsehay
Published: November 2020

The authors have requested that this preprint be removed from Research Square.
A Silent Public Health Threat: Emergence of Mayaro Virus and Co-infection with Dengue in Peru
Authors: Aguilar-Luis Miguel Angel , Mendoza Juana del Valle , Sandoval Isabel , Silva-Caso Wilmer , Mazulis Fernando , Carrillo-Ng Hugo , Tarazona-Castro Yordi , Martins-Luna Johanna , Aquino-Ortega Ronald , Peña-Tuesta Isaac , Cornejo-Tapia Angela , Valle Luis J. del
Published: November 2020

Objective: To describe the prevalence and clinical characteristics of MAYV infection in Piura, as well as the association of this pathogen with DENV.Results: A total of 86/496 (17.3%) cases of MAYV were detected, of which 54 were MAYV mono-infection and 32 were co-infection with DENV, accounting for 10.9% and 6.4%, respectively. When evaluating monoinfection by MAYV the main groups were 18-39 and 40 – 59 years old, with 25.9% and 20.4% respectively. Co-infections were more common in the age group 18-39 and those >60 years old, with 34.4% and 21.9%, respectively. The clinical presentation most frequent were headaches (94.4%, 51/54) followed by arthralgias (77.8%, 42/54). During the 8-month study period the most cases were identified in the months of May (29.1%) and June (50.0%).
Views of Patients With Advanced Disease and Their Relatives on Participation in Palliative Care Research
Authors: Vlckova Karolina , Polakova Kristyna , Tuckova Anna , Houska Adam , Loucka Martin
Published: November 2020

Background: Patients with advanced disease may not be invited to participate in research based on the assumption that participation would be too burdensome for them. The aim of this study was to explore how patients with advanced disease and their relatives evaluate their experience with research participation.Methods: This study used data from two parts of a larger project. The first dataset was a cross-sectional questionnaire study focused on priorities at the end of life. The second dataset used longitudinal design with structured interviews on prognostic awareness. In both studies, participants evaluated their experience on a 5-point Likert scale and specified their motivation in an open-ended question.Setting/participants: Data were collected in 6 hospitals in the Czech Republic with patients with advanced disease and life expectancy less than 1 year and their relatives. Data were analysed using non-parametric tests and thematic analysis. Results: First dataset consisted of 167 patients and 102 relatives, and second dataset consisted of 135 patients and 92 relatives (in total 496 respondents). Results were similar in both datasets with half of the sample (53 %, 48 %) scoring neutral and over 30 % of sample identified their experience as interesting. The most significant factors associated with the evaluation were religiosity (p= 0.001) and the type of diagnosis (p= 0.04). Motivation for participation was to improve care, support research, express own opinion, opportunity to talk and trusting relationship. Conclusion: Patients with advanced disease and relatives do not mind participating in palliative care research and it can be even a positive experience for them.
Compositional and Isotopic Characteristics for The Longmaxi Shale Gas in The Northern Guizhou Area, South China
Authors: Jiang Wenting , Xia Peng , Li Qingguang , Fu Yong , Mou Yuliang
Published: November 2020

The organic-rich marine shale of the Lower Silurian Longmaxi formation in the northern Guizhou area (NGA), China, is characterized by its high thermal maturity (Ro values range in 2.18%~3.12%), high TOC values (0.92%~4.87%), high gas contents (0.47~2.69 m3/t) and type II1 organic matter, and has recently been a precursor for shale gas exploration and development. Compositional and isotopic parameters of 7 gas samples from Longmaxi shale from DY-1 well were analyzed in this study. Dry coefficient of the gases is up to 30~200 making the northern Guizhou Longmaxi shale gas among the driest gaseous hydrocarbons in the world. The δ13CCH4 values range from -38.6‰ to -18.6‰ and the δ13CC2H6 values vary in -36.2‰~-30.8‰. These results indicate that the Longmaxi shale gas is of thermogenic origin and oil derived. This Longmaxi shale gas has high proportion of non-hydrocarbon gases especially including nitrogen in response to complicate tectonic movements and strong hydrodynamic flushing. Tectonic movement and hydrodynamic flushing not only destroy hydrocarbon gases reservoirs but also change the isotope distribution of gaseous hydrocarbons. Isotopic reversal is frequent in closed system, and under relatively bad preserving condition, the isotope distribution will back to normal even at overmature evolution stage.
Severe Acute Myopathy Following SARS-CoV-2 Infection: A Case Report and Review of Recent Literature
Authors: Islam Badrul , Ahmed Mohiuddin , Islam Zhahirul , Begum SM
Published: November 2020

Background: SARS-CoV2 virus could be potentially myopathic. Serum creatinine phosphokinase (CPK) is frequently found elevated in severe SARS-CoV2 infection, which indicates skeletal muscle damage precipitating limb weakness or even ventilatory failure. Case presentation: We addressed such a patient in his forties presented with features of severe SARS-CoV2 pneumonia and high serum CPK. He developed severe sepsis and acute respiratory distress syndrome (ARDS) and received intravenous high dose corticosteroid and Tocilizumab to counter SARS-CoV2 associated cytokine surge. After 10 days of mechanical ventilation (MV) weaning was unsuccessful albeit apparently clear lung fields, having additionally severe and symmetric limb muscle weakness. Ancilliary investigations in addition with serum CPK, including electromyogram, muscle biopsy and muscle magnetic resonance imaging (MRI) suggested acute myopathy possibly due to skeletal myositis. Conclusion: We wish to stress that myopathogenic medication in SARS-CoV2 pneumonia should be used with caution. Additionally serum CPK could be a potential marker to predict respiratory failure in SARS-CoV2 pneumonia as skeletal myopathy affecting chest muscles may contribute ventilatory failure on top of oxygenetion failure due to SARS-CoV2 pneumonia.
How gender influence the health state? A cross sectional study in an endocrine setting
Authors: Bianchini Marta , Puliani Giulia , Chiefari Alfonsina , Lauretta Rosa , Mormando Marilda , Barnabei Agnese , Terrenato Irene , Appetecchia Marialuisa
Published: November 2020

Background: Gender medicine focuses on how gender differences affect health status and diseases development and how they influence health services access and attitude to screening programmes. Endocrine diseases are influenced by many gender-related issues, some of which have not been sufficiently investigated. The aim of this study was to evaluate gender difference in determinants of health (as lifestyle, level of education, area of origin, distance from hospital) and how these elements could influence diseases prevalence in an endocrine outpatients setting, with a special focus on oncological disease. Methods: We performed a cross-sectional study enrolling patients referring for the first time to our Oncological Endocrinology Unit, between January 2019 to December 2019. Results: We enrolled 1107 consecutive patients. Mean age was 56.8 ± 15.0 years (77% females). The main reasons for referral were thyroid and bone diseases. We found a gender difference in some disease prevalences: malignant endocrine diseases and iatrogenic thyroid diseases were more frequent in males, while other thyroid disorders, adrenal and metabolic diseases and cancer treatment induced bone loss were higher in females. The frequency of oncological comorbidities was higher in females. No difference was found in the propensity to travel long distances to reach the hospital. In our population, women had a higher socio-cultural level and followed healthier lifestyle. In fact, alcohol and tobacco consumption was lower in females and women had lower BMI. The percentage of smokers or ex-smokers was higher in patients with any malignancy compared to patients with benign endocrine diseases. Conclusions: the study showed the importance of considering gender as a determinant of health, able to influence also lifestyle and habits, and as an element to keep in consideration to promote a healthier lifestyle and a targeted endocrine screening especially in oncological setting.
Severe Oxalosis Secondary to Acute Kidney Disease Contributes to Delayed Early Recovery of Renal Function
Authors: Zhou Jing , Yu Xiaojuan , Su Tao , Wang Suxia , Yang Li
Published: November 2020

Backgrounds: This study aimed to summarize and analyze the clinicopathological features of acute kidney disease patients with renal oxalosis, to improve understanding of the disease characteristics. Methods: Data for patients with acute kidney disease (AKD) diagnosed from January 2011 to October 2018 and confirmed by renal biopsy showing oxalate crystal deposition were collected. The underlying diseases, dietary habits before disease onset, pathological characteristics of newly emerging kidney disease, renal oxalosis, and causes of AKD were analyzed. Urine volume, serum creatinine, uric acid, and electrolyte clearance were recorded. The long-term renal prognosis was observed. Results: A total of 23 patients with AKD and renal oxalosis were included. The patients comprised 18 men (78.3%) and 5 women (21.7%) with a mean age of 51.6 ± 15.9 years. The peak serum creatinine was 669.9 ± 299.8 μmol/L, and 95.7% of patients had stage 3 acute kidney injury. Drug-induced AKD was the most common cause (65.2%), followed by severe nephrotic syndrome (17.4%). Other causes included severe glomerulonephritis, and infection. All patients had pathological changes indicating tubulointerstitial disease (TIN), and 11 patients were complicated with newly emerging glomerular disease (GD). Oxalate deposits caused by increased enterogenous oxalate absorption accounted for 26.1%, and most of the causes came from new kidney diseases. Oxalate crystals were located in the renal tubule. The majority (75%) of moderate to severe oxalate crystal deposition occurred in patients without GD. There were no significant differences in the total score for acute tubulointerstitial injury, score for tubular injury (T-IS), and score for interstitial inflammation in patients with different severities of renal oxalosis. Rate of serum creatinine decrease (ΔScr%) was negatively correlated with severity of oxalosis (R = −0.542, P = 0.037), score for acute tubular injury (R = −0.553, P = 0.033), and age (R = −0.736, P = 0.002). ΔScr% at week 4 was correlated with T-IS (R = −0.433, P = 0.050), but was not correlated with severity of oxalosis. Conclusions: The present findings revealed that 95.7% of AKD cases with renal oxalosis occurred in critically ill patients, secondary to kidney injury with tubular injury, and that drug-induced AKD was the most common cause. Severe oxalosis contributed to delayed early recovery of renal function.
Enhancing Disease Awareness for Tuberous Sclerosis Complex in Patients with Radiologic Diagnosis of Renal Angiomyolipoma: An Observational Study
Authors: Bausch Kathrin , Wetterauer Christian , Diethelm Julian , Ebbing Jan , Boll Daniel T. , Dill Patricia , Rentsch Cyrill A. , Seifert Hans H.
Published: November 2020

BackgroundTuberous Sclerosis Complex (TSC) is a genetic disorder, with renal manifestations like angiomyolipoma (AML) occurring in 70-80% of patients. AML usually cause more complications in TCS patients than in non-TSC patients. However, AML patients are not routinely investigated for TSC. Our aim was to retrospectively assess the correlation between radiologically diagnosed AML and TSC.MethodsAll patients were stratified into AML related vs. unrelated to TSC. Correlations were calculated to determine the association between age, AML, and TSC. ResultsComplete data were available for 521 patients with renal AML, in 7 of which the concurrent diagnosis of TSC was found. Younger age significantly positively correlated with the prevalence of TSC in AML patients (p<0.01). 37 (7%) of the 521 patients were within the age-range of 18-40 years, in which TSC occurred in 6 cases, 4 (66.7%) of which presented with multiple, bilateral renal AML (p<0.05), and 2 (33.3%) of which with a single, unilateral AML (p<0.05). In patients with AML but without TSC, unilateral AML was found in 83.9% and bilateral AML in 16.1% (p<0.05). Simple binary logistic regression analysis revealed bilateral AML (OR 33.0; 95% CI 3.2–344.0; p=0.003) (but not unilateral AML (OR 0.09; 95% CI 0.01–0.88; p=0.04)) to be a risk factor for TSC. ConclusionsThe presence of bilateral AML in patients within the age-range of 18-40 years should raise suspicion for TSC as the underlying cause. Therefore, our advice is to refer patients with multiple bilateral renal AML for further investigations regarding TSC.
Progression to Chronic Kidney Disease According to Albuminuria in Diabetic Nephropathy Patients With Preserved Renal Function
Authors: Kim Hae Ri , Na Ki Ryang , Lee Jong In , Lee Eu Jin , Ham Young Rok , Choi Dae Eun , Lee Kang Wook , Jeon Jae Wan
Published: November 2020

Background: Albuminuria predicts progression of diabetic nephropathy (DN) but lacks specificity and sensitivity for the diagnosis of chronic kidney disease (CKD) and progressive decline in estimated glomerular filtration rate (eGFR). We evaluated the decline in renal function in patients with DN and analyzed the prognosis of renal function according to the level of albuminuria and the incidence of cardiovascular disease (CVD), cerebrovascular diseases, and peripheral artery disease (PAD) according to the level of albuminuria. Methods: This retrospective study included 331 patients with eGFR > 60 mL/min/1.73 m2 and urinary albumin/creatinine (Cr) ratio (ACR) > 30 mg/g Cr who were treated at the Chungnam National University Hospital between January 2012 and December 2018. Patients were divided into mildly increased albuminuria, moderately increased albuminuria, and severely increased albuminuria groups according to their urine ACRs of 30–300, 300–900, and >900 mg/g Cr, respectively. Renal outcomes and incidence of CVD, cerebrovascular disease, and PAD were compared among the three groups.Results: The rate of reduction in eGFR per year was 1.47 ± 6.61 mL/min/1.73 m2 in the mildly increased albuminuria, 4.10 ± 8.98 mL/min/1.73 m2 in the moderately increased albuminuria, and 9.19 ± 10.39 mL/min/1.73 m2 in the severely increased albuminuria (p < 0.001). More severe albuminuria was associated with higher rates of progression to CKD (p < 0.001) and >50% reduction in eGFR from baseline (p < 0.001). There was a statistically significant difference in the rate of PCI with angina or myocardial infarction (p = 0.030). However, cerebrovascular disease and PAD did not significantly differ among the three groups.Conclusion: Among patients with DN who maintained a relatively preserved renal function with an eGFR > 60 mL/min/1.73 m2, the rates of renal deterioration and progression to CKD were significantly more frequent in those with more severe albuminuria.
Comparative assessment of insecticide resistance phenotypes in two major malaria vectors, Anopheles funestus and Anopheles arabiensis in south-eastern Tanzania
Authors: Pinda Polius Gerazi , Eichenberger Claudia , Ngowo Halfan S , Msaky Dickson S , Abbasi Said , Kihonda Japhet , Bwanaly Hamis , Okumu Fredros O
Published: November 2020

BackgroundLong-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS) have greatly reduced malaria transmission in sub-Saharan Africa, but are threatened by insecticide resistance. In south-eastern Tanzania, pyrethroid-resistant Anopheles funestus are now implicated in > 80% of malaria infections, even in villages where the species occurs at lower densities than the other vector, Anopheles arabiensis. This study compared the insecticide resistance phenotypes between the two malaria vectors in an area where pyrethroid-LLINs are widely used.MethodsThe study used the World Health Organization (WHO) assays with 1×, 5× and 10× insecticide doses to assess levels of resistance, followed by synergist bioassays to understand possible mechanisms of the observed resistance phenotypes. The tests involved adult mosquitoes collected from three villages across two districts in south-eastern Tanzania and included four insecticide classes.FindingsAt baseline doses (1×), both species were resistant to the two candidate pyrethroids (permethrin and deltamethrin), but susceptible to the organophosphate (pirimiphos-methyl). Anopheles funestus, but not An. arabiensis was also resistant to the carbamate (bendiocarb). Both species were resistant to DDT in all villages except in one village where An. arabiensis was susceptible. Anopheles funestus showed strong resistance to pyrethroids, surviving the 5× and 10× doses, while An. arabiensis reverted to susceptibility at the 5× dose. Pre-exposure to the synergist, piperonyl butoxide (PBO), enhanced the potency of the pyrethroids against both species and resulted in full susceptibility of An. arabiensis (>98% mortality). However, for An. funestus from two villages, permethrin-associated mortalities after pre-exposure to PBO only exceeded 90% but not 98%.ConclusionsIn south-eastern Tanzania, where An. funestus dominates malaria transmission, the species also has much stronger resistance to pyrethroids than its counterpart, An. arabiensis, and can survive more classes of insecticides. The pyrethroid resistance in both species appears to be mostly metabolic and may be partially addressed using synergists, e.g. PBO. These findings may explain the continued persistence and dominance of An. funestus despite widespread use of pyrethroid-treated LLINs, and inform new intervention choices for such settings. In short and medium-term, these may include PBO-based LLINs or improved IRS with compounds to which the vectors are still susceptible.
Validation of the Arabic version of the Perinatal Anxiety Screening Scale (PASS) among antenatal and postnatal women
Authors: Jr Hoda , Alfarhan Thikrayat , Alsuraimi Anas
Published: November 2020

Background Anxiety among women in the perinatal period is common. Assessing the severity of perinatal anxiety will help monitor the progress of the patient through the stages of anxiety and facilitated the treatment. This study assesses the validity and reliability of the “Perinatal Anxiety Screening Scale” (PASS) in the Arabic language. Methods The PASS was translated into Arabic. 217 women in the antenatal and postnatal phase participated (92 antenatal and 125 postnatal) answered to PASS, GHQ12, EPDS-10, and DASS-21. Content validity, factor analysis, internal consistency, and test retest reliability were assessed. Results Content Validity Index (CVI) and Content Validity Ratio (CVR) were .88 and 0.79; respectively. The scale loaded on four components: acute anxiety, social anxiety, and dissociation; specific fears and trauma; general anxiety and adjustment; and perfectionism and control. Cronbach’s Alpha value for the scale was 0.78 and test retest correlation coefficient was 0.94. PASS significantly correlated with EPDS-10 (rho=0.46), GHQ-12(rho=0.58), the three components of DASS-21 (0.47, 0.50, and 0.43; respectively), and experiencing adverse life events. Conclusion The Arabic translated version of the PASS showed reasonably adequate validity and reliability and can be used to screen for anxiety disorder among women in the perinatal phase.
Clinical teaching of university-degree nursing students: Are the nurses in practice in Uganda ready?
Authors: Drasiku Amos , Gross Janet L. , Jones Casey , Nyoni Champion N.
Published: November 2020

Background: Nurses with degree qualifications offer better nursing care compared to nurses prepared at lower levels. University based nursing degrees have been sanctioned as entry into professional nursing and several low-resource states have introduced university based nursing degrees. The clinical teaching of students enrolled in such degrees is challenged, as most nurses in practice do not have university degrees and are incompetent in moulding the clinical reasoning processes which is inherent within degree education. A university in Uganda established a bachelor’s degree in Nursing program and was expecting to use nurses in practice at a teaching hospital for the clinical teaching of university-degree nursing students. This study reports on the perceptions of the nurses in practice regarding their readiness for the clinical teaching of undergraduate nursing students.Methods: A qualitative descriptive research study was conducted among 33 conveniently sampled nurses from ARRH who had been supervising Diploma and/or Certificate in Nursing students. Five focus group discussions and three informant interviews were used to generate the data. Data were transcribed verbatim and analysed using an inductive approach through thematic analysis.Results: The nurses in practice perceived themselves as ready for clinical teaching of undergraduate nursing students. Three themes emerged namely; “Willingness to teach undergraduate students” “Perceived attributes of undergraduate students”, and “The clinical practice environment”.Conclusion: The nurses in practice need support in the execution of the clinical teaching role of undergraduate nursing students. The nature of supports would include, continuing professional development specific to clinical teaching, engaging the educators in the clinical environment, positively engaging power gradients and address insecurities among the nurses and the students. Students in these programmes should be exposed to the clinical environment earlier within the programme, and be exposed to interprofessional and trans-professional education.
Expression and Prognostic Significance of the Nicotinic Receptor Cluster on 15q25 about CHRNA5 and PSMA4 mRNA in Lung Adenocarcinoma Utilizing TCGA Datasets
Authors: Wang Yuxiu , Wang Xiaolin , Wang Liping , Gu Jianjun , Gong Daohui , Jiang Jixin , Xu Xingxiang , Hu Suwei , Shu Yusheng , Min Lingfeng
Published: November 2020

Background: Genome-wide association studies of lung cancer have shown a common variation at 15q24-25.1 as a determinant of risk, but the role of specific genes has not been proven. This study aims to explore the expression of mutations and the prognostic significance of 15q25 (CHRNA5 and PSMA4) mRNA in lung adenocarcinoma (LAC) based on immunohistochemistry, TCGA and bioinformatics. Methods: The expression of mutations on chromosome 15q25 of 576 primary LAC patients was selected and survival and gene expression data were extracted from TCGA. The relationship between expression of genes on 15q25 and clinical and prognostic Significance of LAC. An experiment with Beas-2b, A549 and H1299 cell lines was performed to further prove the difference in CHRNA5 and PSMA4 expression between lung cancer and normal cells. Immunohistochemistry data of CHRNA5 and PSMA4 were detected in LAC and normal tissues from 122 patients. Finally, Gene enrichment analysis (GSEA) was conducted to predict the regulatory genes of CHRNA5 and PSMA4. Results: CHRNA5 and PSMA4 are frequently mutated in TCGA (CHRNA5, 1.7%; PSMA4, 1.3%). Besides, the expression of CHRNA5 and PSMA4 was obviously higher in A549 and H1299 cells. And the immunohistochemical staining revealed that the levels of CHRNA5 and PSMA4 were considerably higher in the LAC group than in the normal group. Meanwhile, there was a significant association between high CHRNA5 expression and smoking history (P=0.011), smoking history pack year value (P=0.010). Furthermore, there was a significant correlation between CHRNA5 and PSMA4 expression levels and prognosis (P=0.003; P=0.008), and between higher expression and worse prognosis. GSEA results suggested that between samples with high CHRNA5 and PSMA4 expression were respectively enriched to cell cycle, base excision repair, oxidative phosphorylation, protein export, and aminoacyl tRNA biosynthesis, among others. Conclusions: CHRNA5 and PSMA4 mRNA expression has a significant impact on the clinical and survival of LAC, and they may be a potential target for treating patients with lung adenocarcinoma.
Impact of career choice motivation on academic burnout in senior dental students: A cross-sectional study
Authors: Mohebbi Simin Z. , Gholami Mahdia , Chegini Mostafa , Ghoreyshi Younes , Gorter Ronald C. , Bahramian Hoda
Published: November 2020

Background: Motivation triggers all human activities including learning and lack of career motivation can lead to decreased efficiency. This study assessed the association between academic burnout and career choice motivation in senior dental students.Methods: This cross-sectional study was performed on senior dental students of all four dental schools in Tehran in 2017. Dental students voluntarily filled out a 33-item questionnaire that comprised three sections. The first section included the Burnout Clinical Subtype Questionnaire (BCSQ-SS) with 12 questions addressing academic burnout. The second section consisted of 8 questions about career choice motivation, and the third section concentrated on 13 questions dealing with demographics. The individual scores of each section and the total scores were reported. The factor analysis of 8 questions about dental career choice motivation yielded 3 factors of social status and security, altruism, and others’ advice motivations. The data were analyzed using regression test. Results: Totally, 131 students filled out the questionnaire (response rate = 86%). The total score of academic burnout was 38.89% ± 1.13%. The highest and the lowest burnout scores belonged to the domains of “overload” (46.69%± 1.46%) and “neglect” (31.98%± 1.32%), respectively. The most and the least frequently mentioned source of motivation for choosing dentistry were high income and failing to enter other fields, respectively. The burnout score was higher in students with altruism motivations (P=0.007) and lower in students with others’ advice motivations (P=0.004). The burnout score was higher in students with inadequate or moderate financial support from the family and lower in students whose mothers’ educational level was high-school diploma or lower. Conclusion: Senior dental students in Tehran encountered different levels of academic burnout. In the present study, low financial support and altruism as career choice motivations were associated with higher level of academic burnout.
Understanding the effects of beetroot juice intake on CrossFit performance by assessing hormonal, metabolic and mechanical response: a randomized, double-blind, crossover design
Authors: Garnacho-Castaño Manuel V. , Palau-Salvà Guillem , Serra-Payá Noemí , Ruiz-Hermosel Mario , Berbell Marina , Viñals Xavier , Bataller Manuel Gomis , Carbonell Teresa , Vilches-Saez Sergio , Cobo Eulogio Pleguezuelos , Molina-Raya Lorena
Published: November 2020

Background: Acute beetroot juice (BJ) intake has shown to enhance aerobic and anaerobic performance. However, no studies have evaluated the effects of BJ intake on CrossFit (CF) performance by linking hormonal, metabolic, and mechanical responses. The purpose of this study was to determine the causal physiological association between hormonal, metabolic and mechanical responses, and CF workouts performance after acute BJ intake. Methods: Twelve well-trained male practitioners undertook a CF workout ﻿after drinking 140 mL of BJ (~ 12.8 mmol NO3−) or placebo. The two experimental conditions (BJ or placebo) were administered using a randomized, double-blind, crossover design. The CF workout consisted of repeating the same exercise routine twice: Wall ball (WB) shots plus full back squat (FBS) with 3-min rest (1st routine) or without rest (2nd routine) between the two exercises. A 3-min rest was established between the two exercise routines. Results: An interaction effect was observed in the number of repetitions performed (p = 0.04). The Bonferroni test determined a higher number of repetitions after BJ than placebo intake when a 3-min rest between WB and FBS (1st routine) was established (p = 0.007). An interaction effect was detected in cortisol response (p = 0.04). Cortisol showed a higher increase after BJ compared to placebo intake (76% vs. 36%, respectively). No interaction effect was observed in the testosterone and testosterone/cortisol ratio (p > 0.05). A significant interaction effect was found in oxygen saturation (p = 0.01). A greater oxygen saturation drop was observed in BJ compared to placebo (p < 0.05). An interaction effect was verified in muscular fatigue (p = 0.03) with a higher muscular fatigue being observed with BJ than placebo (p = 0.02). Conclusions: BJ intake improved anaerobic performance only after the recovery time between exercises. This increase in performance in the first routine probably generated greater hypoxia in the muscle mass involved, possibly conditioning post-exercise performance. This was observed with a fall in oxygen saturation and in muscle fatigue measured at the end of the CF workout. The greatest perceived changes in cortisol levels after BJ intake could be attributed to the nitrate-nitrite-nitric oxide pathway
Digital Consultations in Swedish Primary Health Care: A Qualitative Study of Physicians’ Job control, Demand and Support
Authors: Fernemark Hanna , Skagerstrom Janna , Seing Ida , Ericsson Carin , Nilsen Per
Published: November 2020

Background: Digital consultation with primary care physicians via mobile telephone apps has been spreading rapidly in Sweden since 2014. Digital consultation allows remote working because physicians can work from home, outside their traditional primary care environment. Despite the spread of digital consultation in primary care, there is a lack of knowledge concerning how the new service affects physicians’ psychosocial work environment. Previous research has focused primarily on the patients’ point of view and the cost-effectiveness of digital consultation. Hence, there is a paucity of studies from the perspective of physicians, focusing on their psychosocial work environment. The aim of this study was to investigate primary care physicians’ perceived work demands, control over working processes, and social support when providing digital consultation to primary care patients.Methods: The study has a qualitative design, using semi-structured interviews conducted in Sweden in 2019. We used a purposeful sampling strategy to achieve a heterogeneous sample of physicians who represented a broad spectrum of experiences and perceptions. The interviews were conducted by video meeting, telephone, or a personal meeting, depending on what suited the participant best. The interview questions were informed by the Job Demand-Control-Support (JDCS) model, which was also used as the framework to analyze the data by categorizing the physicians’ perceptions and experiences into the three categories of the model (Demand, Control, Support), in the deductive analysis of the data.Results: Analysis of the data yielded 9 subcategories, which were mapped onto the 3 categories of the JDCS model. Overall, the participants saw numerous benefits with digital consultations, not only with regard to their own job situation but also for patients and the health care system in general even though they identified some shortcomings and risks with digital care.Conclusions: This study has demonstrated that physicians perceive working with digital consultation as flexible with a high grade of autonomy and reasonable to low demands. According to the participants, digital consultation is not something you can work with full time if medical skills and abilities are to be maintained and developed.