bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of hookah/waterpipe smoking on general health and the cardiovascular system
Authors: Qasim Hanan , Alarabi Ahmed B. , Alzoubi Karem H. , Karim Zubair A. , Alshbool Fatima Z. , Khasawneh Fadi T.
Published: September 2019

Hookah or waterpipe smoking or use is an emerging trend in the US population, especially among the youth. The misperception of hookah being less harmful than cigarettes and the availability of different but “appealing” flavors are considered among the main reasons for this trend. Hookah users however are exposed to many of the same toxic compounds/by-products as cigarette users, but at dramatically higher levels, which might lead to more severe negative health effects. In fact, hookah users are at risks of infections, cancers, lung disease, and other medical conditions. Moreover, because of the overlapping toxicant/chemical profile to conventional cigarettes, hookah smoke effects on the cardiovascular system are thought to be comparable to those of conventional cigarettes. A major source of tobacco addiction is nicotine, whose levels in hookah are extremely variable as they depend on the type of tobacco used. Taken together, in this review of literature, we will provide insights on the negative health effects of hookah in general, with a focus on what is known regarding its impact on the cardiovascular system.
A multiscale mathematical model of cell dynamics during neurogenesis in the mouse cerebral cortex
Authors: Postel Marie , Karam Alice , Pézeron Guillaume , Schneider-Maunoury Sylvie , Clément Frédérique
Published: September 2019

Background

Neurogenesis in the murine cerebral cortex involves the coordinated divisions of two main types of progenitor cells, whose numbers, division modes and cell cycle durations set up the final neuronal output. To understand the respective roles of these factors in the neurogenesis process, we combine experimental in vivo studies with mathematical modeling and numerical simulations of the dynamics of neural progenitor cells. A special focus is put on the population of intermediate progenitors (IPs), a transit amplifying progenitor type critically involved in the size of the final neuron pool.

Results

A multiscale formalism describing IP dynamics allows one to track the progression of cells along the subsequent phases of the cell cycle, as well as the temporal evolution of the different cell numbers. Our model takes into account the dividing apical progenitors (AP) engaged into neurogenesis, both neurogenic and proliferative IPs, and the newborn neurons. The transfer rates from one population to another are subject to the mode of division (proliferative, or neurogenic) and may be time-varying. The model outputs are successfully fitted to experimental cell numbers from mouse embryos at different stages of cortical development, taking into account IPs and neurons, in order to adjust the numerical parameters. We provide additional information on cell kinetics, such as the mitotic and S phase indexes, and neurogenic fraction.

Conclusions

Applying the model to a mouse mutant for Ftm/Rpgrip1l, a gene involved in human ciliopathies with severe brain abnormalities, reveals a shortening of the neurogenic period associated with an increased influx of newborn IPs from apical progenitors at mid-neurogenesis. Our model can be used to study other mouse mutants with cortical neurogenesis defects and can be adapted to study the importance of progenitor dynamics in cortical evolution and human diseases.
Ploidy level and nucleotide variations in inflorescence dichotomous cultivars of plantain (Musa spp. AAB genome)
Authors: Brisibe Ebiamadon Andi , Ekanem Norah Godwin
Published: September 2019

Background

Inflorescence dichotomy inMusaspecies is a rare developmental event which leads to the production of multiple bunches on a single pseudostem at fruiting. In spite of its fascinating attraction and seductive appeal, little is known about the cytogenetic basis and molecular mechanisms that could be ascribed to this phenomenon. To bridge this gap in information, an integrative approach using cytological fingerprinting and DNA ploidy level profiling (based on chromosome counting and flow cytometry) were assayed on five inflorescence dichotomous plantain varieties and a single-bunching cultivar that served as control. This was done to assess the number and behaviour of chromosomes on the one hand and single nucleotide polymorphisms identified during analysis of nucleotide variations on the other.

Results

Chromosomes stained with aceto-orcein were very tiny, compact, metacentric and acrocentric, and differed both in number and ploidy level between the inflorescence dichotomous and single-bunching cultivars. The dichotomous plantains were mainly diploid (2n = 2x = 22) while the single-bunching ‘Agbagba’ cultivar was consistently a triploid (2n = 3x = 33), as revealed by histological chromosome counting and flow cytometry, implying that there was a high incidence of genomic divergence on account of ploidy variations among the differentMusacultivars. Molecular genotyping using single nucleotide polymorphisms detected on theGTPase-protein bindinggene of the leaf tissue gene complex provided further evidence indicating that differences in the number of bunches among the inflorescence dichotomous cultivars could be ascribed to nucleotide diversity that was elicited by changes in amino acid sequences in the genome of the crops. Non-synonymous nucleotide substitutions resulted mainly from transversion (from purine to pyramidine and vice versa), tacitly implying that these changes were crucial and promoted a cascade of reactions in the genome that were, probably, responsible for the non-persistence of the dichotomization event(s) or the reversals in the bunch phenotype detected among the inflorescence dichotomous cultivars.

Conclusions

This is the first report of cytogenetic fingerprints and nucleotide diversity detection among single- and multiple-bunchingMusacultivars. A clear distinction between the two groups was found that is indicative of variations both in ploidy level and nucleotide sequences. The pattern of single nucleotide polymorphisms provided profound clues suggesting that there was a high incidence of genomic divergence, due to random and unstable genetic events that were triggered by frequent spontaneous somatic mutations.
Sub-hypnotic dose of propofol as antiemetic prophylaxis attenuates intrathecal morphine-induced postoperative nausea and vomiting, and pruritus in parturient undergoing cesarean section — a randomized control trial
Authors: Kampo Sylvanus , Afful Alfred Parker , Mohammed Shiraj , Ntim Michael , Buunaaim Alexis D. B. , Anabah Thomas Winsum
Published: September 2019

Background

Postoperative Nausea and Vomiting (PONV) is a dreadful and uncomfortable experience that significantly detracts patients’ quality of life after surgery. This study aimed to examine the antiemetic effect of a single sub-hypnotic dose of propofol as prophylaxis for PONV.

Method

In this prospective, double-blind, randomized control trial, 345 parturients presented for elective cesarean section at the Obstetric unit of Tamale Teaching Hospital were recruited. Each recruited parturient was randomly assigned to one of three groups; Propofol group (n = 115) represented those who received propofol 0.5 mg/kg, Metoclopramide group (n = 115) represented those who received metoclopramide 10 mg and, Control group (n = 115) represented those who received 0.9% saline. Spinal anesthesia with 0.5% hyperbaric bupivacaine 7.5–10 mg, and intrathecal morphine 0.2 mg was employed for the anesthesia.

Results

The data indicate that 108 (93.9%) parturients from the control group, 10 (8.7%) from the propofol group and 8 (7.0%) from the metoclopramide group experienced some incidence of PONV. There was no significant difference in the incidence of PONV (nausea, vomiting, and none) between the propofol and the metoclopramide groups (P = 0.99; 0.31; and 0.35 respectively). Parturients who received antiemetic agents were 105 (97.2%), 1 (10.0%) and 3 (37.5%) from the control, propofol and metoclopramide groups respectively. The data indicated that 98 (85.2%) parturients from the control, 3 (2.6%) from propofol group, and 100 (87.0%) from the metoclopramide group experienced some levels of pruritus. There was a significant difference in the incidence of pruritus (mild, moderate, and no pruritus) between the metoclopramide and propofol groups (P <  0.01;P <  0.01; andP <  0.01 respectively).

Conclusion

A sub-hypnotic dose of propofol is effective as metoclopramide in the prevention of PONV in parturient undergoing cesarean section under spinal anesthesia with intrathecal morphine. Sub-hypnotic dose of propofol significantly reduces the incidence of postoperative pruritus following intrathecal morphine use.

Trial registration

Current control trial, registered at ISRCTN trial registry:ISRCTN15475205. Date registered: 03/04/2019. Retrospectively registered.
Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study
Authors: Fernandez-Lazaro Cesar I. , García-González Juan M. , Adams David P. , Fernandez-Lazaro Diego , Mielgo-Ayuso Juan , Caballero-Garcia Alberto , Moreno Racionero Francisca , Córdova Alfredo , Miron-Canelo Jose A.
Published: September 2019

Background

Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The aim of this study is to assess adherence to treatment and related-factors among patients with chronic conditions in primary care settings.

Methods

A cross-sectional study was conducted among 299 adult patients with ≥1 chronic condition(s) and prescribed medication in primary healthcare centers of Spain. The Morisky-Green-Levine questionnaire was used to assess medication adherence via face-to-face interviews. Crude and adjusted multivariable logistic regression models were used to analyze factors associated with adherence using the Multidimensional Model proposed by the World Health Organization — social and economic, healthcare team and system-related, condition-related, therapy-related, and patient-related factors.

Results

The proportion of adherent patients to treatment was 55.5%. Older age (adjusted odds ratio 1.31 per 10-year increment, 95% CI 1.01–1.70), lower number of pharmacies used for medication refills (0.65, 95% CI 0.47–0.90), having received complete treatment information (3.89, 95% CI 2.09–7.21), having adequate knowledge about medication regimen (4.17, 95% CI 2.23–7.80), and self-perception of a good quality of life (2.17, 95% CI 1.18–4.02) were independent factors associated with adherence.

Conclusions

Adherence to treatment for chronic conditions remained low in primary care. Optimal achievement of appropriate levels of adherence through tailored multifaceted interventions will require attention to the multidimensional factors found in this study, particularly those related to patients’ education and their information needs.
An educational study to investigate the efficacy of three training methods for infiltration techniques on self-efficacy and skills of trainees in general practice
Authors: Michels Nele R. , Vanhomwegen Els
Published: September 2019

Background

Research shows that few general practitioners perform intra- and periarticular infiltrations. Lack of good training strategies to teach these skills would be an important reason for this observation. In this study, we investigated and compared three different training strategies for infiltrations of the glenohumeral joint, subacromial space, lateral epicondyle, carpal tunnel and knee joint.

Methods

Trainees in general practice were randomized into three teaching groups: a theoretical lecture (n = 18), or a theoretical lecture with training on anatomical models (n = 19) or with a training on cadavers (n = 11). The study period was 3 months. Before and after the training, the self-efficacy (questionnaire) and skills (Objective Structured Clinical Examination or OSCE, test on anatomical models) were evaluated. The self-efficacy was assessed again 3 months later. A Kruskal-Wallis test was used to compare the results before versus after training and between groups (p < 0.05).

Results

All three training strategies had a significantly positive effect on the self-efficacy concerning knowledge and skills. This benefit remained 3 months after training. However, some participants still felt uncomfortable to perform infiltrations. Best scores for self-efficacy concerning skills and best scores on the OSCE were observed after training on cadavers, followed by training on anatomical models.

Conclusions

Based on this study we suggest the combination of a theoretical lecture with a training on cadavers to teach infiltration techniques. To achieve an optimal long-term effect, additional refresher trainings may be necessary.
Characterization of the hepatitis C virus epidemic in Pakistan
Authors: Mahmud Sarwat , Al Kanaani Zaina , Abu-Raddad Laith J.
Published: September 2019

Background

With one in every 20 Pakistanis already infected, Pakistan has the second largest number of hepatitis C virus (HCV) infections globally. The aim of this study was to present a quantitative and analytical characterization of the HCV epidemic in Pakistan.

Methods

A standardized database of HCV antibody incidence and prevalence and HCV genotypes in all subpopulations was systematically assembled. Random-effects meta-analyses and random-effects meta-regressions were performed. Shannon Diversity Index was calculated to determine genotype diversity.

Results

The database included two incidence, 309 prevalence, and 48 genotype measures. Pooled mean HCV prevalence ranged between 7.0% (95% confidence interval (CI): 5.8–8.3%) in Sindh and 0.9% (95% CI: 0.1–2.4%) in Federally Administered Tribal Areas (F.A.T.A). Estimated number of chronically-infected persons ranged between 4.2 million in Punjab and 0.03 million in F.A.T.A. HCV prevalence was stable over time [adjusted odds ratio (AOR) of 1.0 (95% CI: 1.0–1.0)]. Population classification was the strongest predictor of HCV prevalence, explaining 51.8% of prevalence variation. Relative to the general population, HCV prevalence was higher in people who inject drugs [AOR of 23.8 (95% CI: 13.0–43.6)], populations with liver-related conditions [AOR of 22.3 (95% CI: 15.7–31.6)], and high-risk clinical populations [AOR of 7.8 (95% CI: 4.8–12.7)]. Low genotype diversity was observed (Shannon diversity index of 0.67 out of 1.95; 34.5%). There were only minor differences in genotype diversity by province, with genotype 3 being most common in all provinces.

Conclusion

Pakistan’s HCV epidemic shows homogeneity across the provinces, and over time. HCV prevalence is strikingly persistent at high level, with no evidence for a decline over the last three decades. Scale up of HCV treatment and prevention is urgently needed.
Vaccination uptake among Australian early childhood education staff: assessing perceptions, behaviours and workplace practices
Authors: Seale Holly , Dwyer Stephanie , Kabir Alamgir , Kaur Rajneesh
Published: September 2019

Background

Early Childhood Education Centre (ECEC) staff are strongly recommended to receive several immunizations including influenza and pertussis. However, evidence regarding the uptake is either old or lacking across all Australian States/Territories. This study aimed to explore the attitudes and barriers around ECEC staff vaccination and the immunisation policy/practices employed at their workplaces.

Methods

An online cross-sectional survey was undertaken of staff members (administrators and childcare center staff) in early 2017. We compared the individual’s knowledge, attitude and practices as well as the centre’s policy and practice variables between the vaccinated and unvaccinated respondents. A logistic model was used to identify the factors associated with uptake of the different vaccines.

Results

A total of 575 ECEC staff completed the survey. Sixty percent reported being aware of the recommendations about staff immunisation. While participants did acknowledge that they could spread diseases if unvaccinated (86%), 30% could not recall receiving a dTpa in the last 10 years. Private centres were less likely to provide free or onsite vaccination compared to other categories of centres. Less than half reported receiving any encouragement to get the influenza vaccine and only 33% reported that their centre provides onsite influenza vaccination. Regarding the introduction of mandatory policies, 69% stated that they would support a policy.

Conclusion

Employers should consider supporting methods to maximize vaccination of their employees including providing free onsite vaccination. Participants were open to idea of mandatory vaccination; however, this needs to be explored further to determine how vaccine costs and access issues could be resolved.
What happens after HIV self-testing? Results from a longitudinal cohort of Chinese men who have sex with men
Authors: Tang Weiming , Huang Wenting , Lu Haidong , Cao Bolin , Wu Dan , Ong Jason , Fu Hongyun , Zhang Ye , Yang Bin , Wang Cheng , Ma Wei , Wei Chongyi , Tucker Joseph D.
Published: September 2019

Background

HIV self-testing (HIVST) is a promising approach to expand HIV testing. HIVST is a process in which a person performs an HIV test and interprets the result. Negative HIVST results may encourage men who have sex with men (MSM) to use HIV prevention services. The objective of this study was to examine behaviors (e.g., facility-based HIV testing, condom use) after a negative HIVST test result among Chinese MSM.

Methods

We collected data from MSM in eight Chinese cities over a 12-month period. This is a secondary analysis of longitudinal cohort data collected as part of an intervention trial to increase HIV testing. Men completed a survey that described sociodemographic information, sexual behaviors, HIV self-testing, and facility-based HIV testing. Men who completed at least one follow-up survey were included in this analysis. Generalized linear mixed models were used to evaluate whether HIVST increased subsequent facility-based HIV testing and consistent condom use.

Results

We included 1219 men. Most men (78.7%) were under 30 years old and had never been married (87.0%). 755 (61.9%) men tested for HIV and 593 (49.3%) men self-tested during the study period. At baseline, among men who had never been tested for HIV, 44.9% (314/699) initiated HIVST during the study period. HIVST was associated with subsequent facility-based testing (aOR of 1.87, 95% CI: 1.47–2.37). HIVST was also associated with subsequent consistent condom use (aOR = 1.53, 95% CI: 1.13–2.06).

Conclusion

HIVST was associated with subsequent facility-based HIV testing and consistent condom use. HIVST may enhance uptake of related HIV prevention services at facilities, suggesting the need for more implementation research.
In search of potential predictors of erythropoiesis-stimulating agents (ESAs) hyporesponsiveness: a population-based study
Authors: Ingrasciotta Ylenia , Lacava Viviana , Marcianò Ilaria , Giorgianni Francesco , Tripepi Giovanni , D’ Arrigo Graziella , Chinellato Alessandro , Ugo Tari Daniele , Santoro Domenico , Trifirò Gianluca
Published: September 2019

Background

Evidences show that around 20% of biosimilar or originator erythropoiesis-stimulating agents (ESAs) users are hyporesponsive. Controversial post-marketing data exist on the predictors of ESA hyporesponsiveness. The aim of this study was to identify predictors of ESA hyporesponsiveness in patients with chronic kidney disease (CKD) or cancer in clinical practice.

Methods

During the years 2009–2015, a multi-center, population-based, cohort study was conducted using claims databases of Treviso and Caserta Local Health Units (LHUs). All incident ESA users were characterized at baseline and the differences between the baseline hemoglobin (Hb) value, that is the Hb registered within 30 days prior to the first ESA dispensing (index date, ID) and each outcome Hb value (registered between 30 and 180 days after ID) were calculated and defined as delta Hb (ΔHb). Incident ESA users were defined as hyporesponsive if, during follow-up, they registered at least one ΔHb < 0 g/dL. Including all potential predictors of ESA hyporesponsiveness and stratifying by indication for use, univariate and multivariate binary logistic regression models and Receiver Operating Characteristic (ROC) curves were carried out.

Results

`In general, 1080 incident ESA users (CKD: 57.0%; cancer: 43.0%) were identified. In CKD, predictors of ESA hyporesponsiveness were C-reactive protein (OR = 1.2, 95% CI: 1.0–1.5; P-value = 0.060) and high levels of baseline Hb (OR = 1.7, 95% CI: 1.2–2.2; P-value< 0,001), the latter being also predictor of ESA hyporesponsiveness in cancer (OR = 1.7, 95% CI: 1.1–2.4; P-value = 0.007). Both in CKD and in cancer, the type of ESA, biosimilar or originator, was not a predictor of ESA hyporesponsiveness. In CKD, concomitant use of iron preparations (OR = 0.3, 95% CI: 0.2–0.7; P-value = 0.002) and of high dosage of angiotensin-converting enzyme inhibitors/angiotensin II-receptor blockers (OR = 0.5, 95% CI: 0.3–0.9; P-value = 0.022) were protective factors against ESA hyporesponsiveness.

Conclusions

The study confirmed traditional potential predictors of hyporesponsiveness to ESA. The use of biosimilar or originator ESA was not a predictor of hyporesponsiveness in an outpatient setting from two large Italian areas. A better knowledge of the predictors of ESA response would allow a better anemia management to improve patients’ quality of life.
Gingival metastasis from primary hepatocellular carcinoma: a case report and literature review of 30 cases
Authors: Hou Yating , Deng Weiping , Deng Gang , Hu Linhui , Liu Chao , Xu Lishu
Published: September 2019

Background

Gingival metastasis from primary hepatocellular cancer (HCC) is rare, highly malignant, and generally has no distinct symptoms. Not performing a biopsy can lead to misdiagnosis. This article reports an 87-year-old male with gingival metastasis from HCC. To gain a better insight into this disease, we also conducted a literature review of 30 cases and discussed the clinical and pathological characteristics, diagnosis, treatment and prognosis of this unusual form of liver cancer.

Case presentation

An 87-year-old man was hospitalized with a chief complaint of chronic constipation and diffuse lower extremity edema. His past medical history included a three-year hepatitis B infection and a cerebral infarction 17 years prior. Imaging examination detected a massive hepatocellular carcinoma in the right liver lobe and multiple metastases in the lungs. Oral examinations revealed a reddish, cherry-sized exophytic mass on the right upper gum. The mass was tentatively diagnosed as a primary gingival tumor and was ultimately confirmed by biopsy as a metastatic carcinoma originating in the liver. The patient decided, with his guardians, to receive palliative care and not to remove the mass. Unfortunately, the patient accidentally bit the mass open; profuse bleeding ensued and local pressure exerted a poor hemostatic effect. The patient’s condition worsened, and he eventually died of multiple organ failure. We also performed a literature review and discussed 30 cases of gingival metastases from HCC. The findings indicated that these lesions affected males more than females, with a ratio of 6:1, and infiltrated the upper gingivae (63.1%) more than the lower gingivae (36.7%). Survival analysis indicated that the overall survival for patients with upper gingival metastasis was worse than for those with lower gingival metastasis, and patients receiving treatments for primary liver cancer or metastatic gingival tumors had better overall or truncated survival times.

Conclusion

Gingival metastasis from primary hepatocellular carcinoma is rare, and its diagnosis has presented challenges to clinicians. To avoid a potential misdiagnosis, a biopsy is mandatory regardless of whether a primary cancer is located. Early diagnosis and treatment for primary liver cancer or metastatic gingival lesions may improve survival expectations.
Preoperative chemotherapy and carbon ions therapy for treatment of resectable and borderline resectable pancreatic adenocarcinoma: a prospective, phase II, multicentre, single-arm study
Authors: Vitolo Viviana , Cobianchi Lorenzo , Brugnatelli Silvia , Barcellini Amelia , Peloso Andrea , Facoetti Angelica , Vanoli Alessandro , Delfanti Sara , Preda Lorenzo , Molinelli Silvia , Klersy Catherine , Fossati Piero , Orecchia Roberto , Valvo Francesca
Published: September 2019

Background

Pancreatic adenocarcinoma is a high-mortality neoplasm with a documented 5-years-overall survival around 5%. In the last decades, a real breakthrough in the treatment of the disease has not been achieved. Here we propose a prospective, phase II, multicentre, single-arm study aiming to assess the efficacy and the feasibility of a therapeutic protocol combining chemotherapy, carbon ion therapy and surgery for resectable and borderline resectable pancreatic adenocarcinoma.

Method

The purpose of this trial (PIOPPO Protocol) is to assess the efficacy and the feasibility of 3 cycles of FOLFIRINOX neoadjuvant chemotherapy followed by a short-course of carbon ion radiotherapy (CIRT) for resectable or borderline resectable pancreatic adenocarcinoma patients. Primary outcome of this study is the assessment of local progression free survival (L-PFS). The calculation of sample size is based on the analysis of the primary endpoint “progression free survival” according to Fleming’s Procedure.

Discussion

Very preliminary results provide initial evidence of the feasibility of the combined chemotherapy and CIRT in the neoadjuvant setting for resectable or borderline resectable pancreatic cancer. Completion of the accrual and long term results are awaited to see if this combination of treatment is advisable and will provide the expected benefits.

Trial registration

ClinicalTrials.gov Identifier: NCT03822936 registered on January 2019.
Characterization and risk association of polymorphisms in Aurora kinases A, B and C with genetic susceptibility to gastric cancer development
Authors: Mesic Aner , Rogar Marija , Hudler Petra , Bilalovic Nurija , Eminovic Izet , Komel Radovan
Published: September 2019

Background

Single nucleotide polymorphisms (SNPs) in genes encoding mitotic kinases could influence development and progression of gastric cancer (GC).

Methods

Case-control study of nine SNPs in mitotic genes was conducted using qPCR. The study included 116 GC patients and 203 controls. In silico analysis was performed to evaluate the effects of polymorphisms on transcription factors binding sites.

Results

The AURKA rs1047972 genotypes (CT vs. CC: OR, 1.96; 95% CI, 1.05–3.65; p = 0.033; CC + TT vs. CT: OR, 1.94; 95% CI, 1.04–3.60; p = 0.036) and rs911160 (CC vs. GG: OR, 5.56; 95% CI, 1.24–24.81; p = 0.025; GG + CG vs. CC: OR, 5.26; 95% CI, 1.19–23.22; p = 0.028), were associated with increased GC risk, whereas certain rs8173 genotypes (CG vs. CC: OR, 0.60; 95% CI, 0.36–0.99; p = 0.049; GG vs. CC: OR, 0.38; 95% CI, 0.18–0.79; p = 0.010; CC + CG vs. GG: OR, 0.49; 95% CI, 0.25–0.98; p = 0.043) were protective. Association with increased GC risk was demonstrated for AURKB rs2241909 (GG + AG vs. AA: OR, 1.61; 95% CI, 1.01–2.56; p = 0.041) and rs2289590 (AC vs. AA: OR, 2.41; 95% CI, 1.47–3.98; p = 0.001; CC vs. AA: OR, 6.77; 95% CI, 2.24–20.47; p = 0.001; AA+AC vs. CC: OR, 4.23; 95% CI, 1.44–12.40; p = 0.009). Furthermore, AURKC rs11084490 (GG + CG vs. CC: OR, 1.71; 95% CI, 1.04–2.81; p = 0.033) was associated with increased GC risk. A combined analysis of five SNPs, associated with an increased GC risk, detected polymorphism profiles where all the combinations contribute to the higher GC risk, with an OR increased 1.51-fold for the rs1047972(CT)/rs11084490(CG + GG) to 2.29-fold for the rs1047972(CT)/rs911160(CC) combinations. In silico analysis for rs911160 and rs2289590 demonstrated that different transcription factors preferentially bind to polymorphic sites, indicating that AURKA and AURKB could be regulated differently depending on the presence of particular allele.

Conclusions

Our results revealed that AURKA (rs1047972 and rs911160), AURKB (rs2241909 and rs2289590) and AURKC (rs11084490) are associated with a higher risk of GC susceptibility. Our findings also showed that the combined effect of these SNPs may influence GC risk, thus indicating the significance of assessing multiple polymorphisms, jointly. The study was conducted on a less numerous but ethnically homogeneous Bosnian population, therefore further investigations in larger and multiethnic groups and the assessment of functional impact of the results are needed to strengthen the findings.
Clinical characteristics of enteroviral meningitis without pleocytosis in children: a retrospective single center observational study in the Republic of Korea
Authors: Ko Yura , Jeon Woochan , Chae Minjung Kathy , Yang Heewon , Lee Jisook
Published: September 2019

Background

We aimed to study the prevalence of enterovirus (EV) meningitis without the presence of cerebrospinal fluid (CSF) pleocytosis and identify patient factors and clinical features associated with it.

Methods

This was a retrospective analysis of patients aged < 18 years old who were diagnosed with EV meningitis by CSF reverse-transcriptase polymerase chain reaction (RT-PCR) testing between January 2015 and December 2016. Clinical variables were compared with regard to the presence of CSF pleocytosis.

Results

A total of 305 patients were enrolled in study; 169 (55.4%) had no pleocytosis. Patients without pleocytosis were younger (median age 2 months vs. 67.0 months, p < 0.01) and had lower white blood cell (WBC) count (median, 8600/mm3 vs. 10,300/mm3, p < 0.01). Also absolute neutrophil (ANC) count were lower than pleocytosis group (median, 4674/mm3 vs. 7600/mm3, p < 0.01). Comparing three age groups, CSF apleocytosis was present in 106 of 128 patients (82.8%) aged ≤3 months, 7 of 13 patients (53.8%) aged 3 months–3 years and 56 of 164 patients (34.1%) aged > 3 years. Younger age groups had higher prevalence of CSF apleocytosis (p < 0.01). In patients aged ≤3 months, 94.5% underwent lumbar puncture within 24 h of symptom onset. The frequency of not having pleocytosis was higher than the frequency of having pleocytosis during peak EV infection prevalent months (summer and fall) (p < 0.01).

Conclusion

This study shows that EV meningitis in young infants, with early lumbar puncture, or occurring during peak EV meningitis prevalent seasons cannot be solely excluded by pleocytosis. Also, a confirmation test for EV meningitis should be performed using RT-PCR.
Relationship between the changes over time of bone mass and muscle health in children and adults: a systematic review and meta-analysis
Authors: Locquet Médéa , Beaudart Charlotte , Durieux Nancy , Reginster Jean-Yves , Bruyère Olivier
Published: September 2019

Background

Various cross-sectional studies provide an abundance of evidence that shows a relationship between bone quantity and muscle health. However, one question remains, less-often studied: is their development - or decline – associated? The aim of the research was to conduct a systematic review and meta-analysis to summarize the studies exploring the association between changes in bone mineral density (BMD) and changes in muscle parameters (registration CRD42018093813).

Methods

We searched for prospective studies, both in children and adults, by consulting electronic databases (Ovid-MEDLINE, Ovid-AMED, Scopus). Each review steps were performed by two independent reviewers. For outcomes reported by less of 3 studies, we synthetized the results narratively. In other cases, a meta-analysis was performed, giving an overall r coefficient and its 95% confidence interval (CI).

Results

Fifteen papers were included. In connection with the change of BMD, 10 studies concerned the parallel change of lean mass, 4 were about grip strength, and 1 was about physical performance. Children were the population of interest for 5 studies, while the aging population was the focus of the other studies. The correlation between hip BMD and lean mass was significant, with an overall coefficient r = 0.37 (95% CI 0.23–0.49). High heterogeneity was observed between studies but the length of follow-up, sex and study quality did not seem to significantly influence results. The systematic review allowed some other highlights: a significant link between changes in BMD and changes in muscle strength was observed (p-value < 0.05 in the 4 studies), in addition to changes in performance (1 study, r = 0.21, p-value = 0.004).

Conclusion

Despite the heterogeneity between studies, we highlighted a significant association between the change of BMD and the change of various muscle parameters. Future studies should investigate preventive and therapeutic strategies that are based on a single entity: the ‘muscle-bone unit’.
Hip-related groin pain, patient characteristics and patient-reported outcomes in patients referred to tertiary care due to longstanding hip and groin pain: a cross-sectional study
Authors: Pålsson Anders , Kostogiannis Ioannis , Lindvall Håkan , Ageberg Eva
Published: September 2019

Background

Due to advances in hip arthroscopy, the number of surgical procedures has increased dramatically. The diagnostic challenge in patients with longstanding hip and groin pain, as well as the increasing number of hip arthroscopies, may lead to a higher number of patients referred to tertiary care for consideration for surgery. Therefore, the aims were: 1) to describe the prevalence of hip-related groin pain in patients referred to tertiary care due to longstanding hip and groin pain; and 2) to compare patient characteristics and patient-reported outcomes for patients categorized as having hip-related groin pain and those with non-hip-related groin pain.

Methods

Eighty-one patients referred to the Department of Orthopedics at Skåne University Hospital for longstanding hip and groin pain were consecutively included and categorized into hip-related groin pain or non-hip-related groin pain using diagnostic criteria based on current best evidence (clinical examination, radiological examination and intra-articular block injection). Patient characteristics (gender (%), age (years), BMI (kg/m2)), results from the Hip Sports Activity Scale (HSAS), the SF-36, the Copenhagen Hip and Groin Outcome Score (HAGOS), and pain distribution (pain manikin) were collected. Parametric and non-parametric statistics were used as appropriate for between-group analysis.

Results

Thirty-three (47%) patients, (30% women, 70% men, p < 0.01), were categorized as having hip-related groin pain. The hip-related groin pain group had a higher activity level during adolescence (p = 0.013), and a higher pre-injury activity level (p = 0.034), compared to the non-hip-related groin pain group. No differences (mean difference (95% CI)) between hip-related groin pain and non-hip-related groin pain were observed for age (0 (− 4; 4)), BMI (− 1.75 (− 3.61; 0.12)), any HAGOS subscales (p ≥ 0.318), any SF-36 subscales (p ≥ 0.142) or pain distribution (p ≥ 0.201).

Conclusions

Only half of the patients referred to tertiary care for long-standing hip and groin pain, who were predominantly men with a high activity level, had hip-related groin pain. Self-reported pain localization and distribution did not differ between patients with hip-related groin pain and those with non-hip-related groin pain, and both patient groups had poor perceived general health, and hip-related symptoms and function.
Association between sagittal balance and adjacent segment degeneration in anterior cervical surgery: a systematic review and meta-analysis
Authors: Zhang Yijian , Shao Yijie , Liu Hao , Zhang Junxin , He Fan , Chen Angela , Yang Huilin , Pi Bin
Published: September 2019

Background

ASD is a relatively common degenerative alteration after cervical surgery which occurs above or below the fused segment. In addition, some patients may need reoperation to treat severe ASD after the primary surgery. It was considered that sagittal balance is correlated with postoperative clinical outcomes; however, few studies have reported the influence of sagittal balance on ASD. The present study is designed to investigate whether sagittal balance impacts the pathology of adjacent segment disease (ASD) in patients who undergo anterior cervical surgery for degenerative cervical disease.

Methods

Databases including Pubmed, Embase, Cochrane library, and Web of Science were used to search for literature published before June 2018. Review Manager 5.3 was used to perform the statistical analysis. Sagittal balance parameters before and after surgery were compared between patients with and without ASD. Weighted mean difference (WMD) was summarized for continuous data and P < 0.05 was set for the level of significance.

Results

A total of 221 patients with ASD and 680 patients without ASD from seven articles were studied in this meta-analysis. There were no significant differences in most sagittal balance parameters between the two groups, except for postoperative cervical lordosis (CL) (WMD -3.30, CI -5.91, − 0.69, P = 0.01).

Conclusions

Some sagittal balance parameters may be associated with the development of ASD after anterior cervical surgery. Sufficient restoration of CL may decrease the incidence of ASD. The results in present study needed to be expanded carefully and further high-quality studies are warranted to investigate the impact of sagittal balance on ASD.
Effect of a short message service (SMS) intervention on adherence to a physiotherapist-prescribed home exercise program for people with knee osteoarthritis and obesity: protocol for the ADHERE randomised controlled trial
Authors: Nelligan Rachel K. , Hinman Rana S. , Kasza Jessica , Schwartz Sarah , Kimp Alexander , Atkins Lou , Bennell Kim L.
Published: September 2019

Background

Knee osteoarthritis (OA) is a highly prevalent condition. People with knee OA often have other co-morbidities such as obesity. Exercise is advocated in all clinical guidelines for the management of knee OA. It is often undertaken as a home-based program, initially prescribed by a physiotherapist or other qualified health care provider. However, adherence to home-based exercise is often poor, limiting its ability to meaningfully change clinical symptoms of pain and/or physical function. While the efficacy of short message services (SMS) to promote adherence to a range of health behaviours has been demonstrated, its ability to promote home exercise adherence in people with knee OA has not been specifically evaluated. Hence, this trial is investigating whether the addition of an SMS intervention to support adherence to prescribed home-based exercise is more effective than no SMS on self-reported measures of exercise adherence.

Methods

We are conducting a two-arm parallel-design, assessor-and participant-blinded randomised controlled trial (ADHERE) in people with knee OA and obesity. The trial is enrolling participants exiting from another randomised controlled trial, the TARGET trial, where participants are prescribed a 12-week home-based exercise program (either weight bearing functional exercise or non-weight bearing quadriceps strengthening exercise) for their knee by a physiotherapist and seen five times over the 12 weeks for monitoring and supervision. Following completion of outcome measures for the TARGET trial, participants are immediately enrolled into the ADHERE trial. Participants are asked to continue their prescribed home exercise program unsupervised three times a week for 24-weeks and are randomly allocated to receive a behaviour change theory-informed SMS intervention to support home exercise adherence or to have no SMS intervention. Outcomes are measured at baseline and 24-weeks. Primary outcomes are self-reported adherence measures. Secondary outcomes include self-reported measures of knee pain, physical function, quality-of-life, physical activity, self-efficacy, kinesiophobia, pain catastrophising, participant-perceived global change and an additional adherence measure.

Discussion

Findings will provide new information into the potential of SMS to improve longer-term exercise adherence and ultimately enhance exercise outcomes in knee OA.

Trial registration

Prospectively registered with the Australian New Zealand Clinical Trials Registry. Reference: ACTRN12617001243303

Date/version:August 2019/two
Abbreviated quantitative UTE imaging in anterior cruciate ligament reconstruction
Authors: Fukuda Takeshi , Wengler Kenneth , Tank Dharmesh , Korbin Seth , Paci James M. , Komatsu David E. , Paulus Megan , Huang Mingqian , Gould Elaine , Schweitzer Mark E. , He Xiang
Published: September 2019

Background

Existing ultrashort echo time magnetic resonance imaging (UTE MRI) methods require prohibitively long acquisition times (~ 20–40 min) to quantitatively assess the clinically relevant fast decay T2* component in ligaments and tendons. The purpose of this study was to evaluate the feasibility and clinical translatability of a novel abbreviated quantitative UTE MRI paradigm for monitoring graft remodeling after anterior cruciate ligament (ACL) reconstruction.

Methods

Eight patients who had Graftlink™ hamstring autograft reconstruction were recruited for this prospective study. A 3D double-echo UTE sequence at 3.0 Tesla was performed at 3- and 6-months post-surgery. An abbreviated UTE MRI paradigm was established based on numerical simulations and in vivo validation from healthy knees. This proposed approach was used to assess the T2* for fast decay component ($$ {T}_{2s}^{\ast } $$

T

2
s

∗

) and bound water signal fraction (fbw) of ACL graft in regions of interest drawn by a radiologist.

Results

Compared to the conventional bi-exponential model, the abbreviated UTE MRI paradigm achieved low relative estimation bias for $$ {T}_{2s}^{\ast } $$

T

2
s

∗

and fbw over a range of clinically relevant values for ACL grafts. A decrease in $$ {T}_{2s}^{\ast } $$

T

2
s

∗

of the intra-articular graft was observed in 7 of the 8 ACL reconstruction patients from 3- to 6-months (− 0.11 ± 0.16 ms, P = 0.10). Increases in $$ {T}_{2s}^{\ast } $$

T

2
s

∗

and fbw from 3- to 6-months were observed in the tibial intra-bone graft ($$ {\varDelta T}_{2s}^{\ast } $$

ΔT

2
s

∗

: 0.19 ± 0.18 ms, P < 0.05; Δfbw: 4% ± 4%, P < 0.05). Lower $$ {T}_{2s}^{\ast } $$

T

2
s

∗

(− 0.09 ± 0.11 ms, P < 0.05) was observed at 3-months when comparing the intra-bone graft to the graft/bone interface in the femoral tunnel. The same comparisons at the 6-months also yielded relatively lower $$ {T}_{2s}^{\ast } $$

T

2
s

∗

(− 0.09 ± 0.12 ms, P < 0.05).

Conclusion

The proposed abbreviated 3D UTE MRI paradigm is capable of assessing the ACL graft remodeling process in a clinically translatable acquisition time. Longitudinal changes in $$ {T}_{2s}^{\ast } $$

T

2
s

∗

and fbw of the ACL graft were observed.
Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review
Authors: Zhou Suying , Xiao Yundan , Liu Xin , Zhong Yi , Yang Haitao
Published: September 2019

Background

Gout in spine is rare and commonly mimics some infectious or tumoral lesions, the differentiation of spinal gout from other diseases is not always easy. We report a case of gout involved cervical disc and adjacent vertebral endplates whose etiology was initially not determined. Compared with the previous published 10 similar cases, this case displayed a complete and continuous image data with higher image quality and resolution than before. So we give a brief literature review for concerning cervical gout, with the emphasis on the discussion of radiological findings.

Case presentation

A 50-year-old male with a 5-year history of neck and shoulder pain had muscle atrophy and weakness in both arms. Physical examination revealed multiple tophi were seen in left wrist, both feet and knee; bilateral superficial sensory declined below level of mastoid portion and the muscle strengths of limbs decreased. Laboratory findings showed hyperuricemia and the C-reactive protein level was very high. Imaging studies including Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed abnormality of the C5–6 intervertebral disc and irregular osteolytic destruction of both adjacent C5–6 endplates, narrowing of C5–6 disc space and swelling of prevertebral soft tissue. Under the circumstance of the lesions being not determined and nerve root symptoms, surgical treatment was performed and pathological examination of the specimen revealed deposited uric acid crystals surrounded by granulomatous inflammation. After surgery combined with pharmaceutical and rehabilitation treatment, the muscle strengths of limbs, the pain of neck and shoulder and the level of serum uric acid were all improved.

Conclusions

Cervical spinal gout involving the disc and adjacent vertebral endplates is uncommon and may misunderstand infectious spondylodiscitis. Physician and radiologist should take the gouty spondylitis into account with a combination with previous history and clinical manifestations when encountering with such this condition.
Implementation of a regional quality improvement collaborative to improve care of people living with opioid use disorder in a Canadian setting
Authors: Beamish Laura , Sagorin Zach , Stanley Cole , English Krista , Garelnabi Rana , Cousineau Danielle , Barrios Rolando , Klimas Jan
Published: September 2019

Background

Although opioid agonist therapy is effective in treating opioid use disorders (OUD), retention in opioid agonist therapy is suboptimal, in part, due to quality of care issues. Therefore, we sought to describe the planning and implementation of a quality improvement initiative aimed at closing gaps in care for people living with OUD through changes to workflow and care processes in Vancouver, Canada.

Methods

The Best-practice in Oral Opioid agoniSt Therapy (BOOST) Collaborative followed the Institute for Healthcare Improvement’s Breakthrough Series Collaborative methodology over 18-months. Teams participated in a series of activities and events to support implementing, measuring, and sharing best practices in OAT and OUD care. Teams were assigned monthly implementation scores to monitor their progress on meeting Collaborative aims and implementing changes.

Results

Seventeen health care teams from a range of health care practices caring for a total of 4301 patients with a documented diagnosis of OUD, or suspected OUD based on electronic medical record chart data participated in the Collaborative. Teams followed the Breakthrough Series Collaborative methodology closely and reported monthly on a series of standardized process and outcome indicators. The majority of (59%) teams showed some improvement throughout the Collaborative as indicated by implementation scores.

Conclusions

Descriptive data from the evaluation of this initiative illustrates its success. It provides further evidence to support the implementation of quality improvement interventions to close gaps in OUD care processes and treatment outcomes for people living with OUD. This system-level approach has been spread across British Columbia and could be used by other jurisdictions facing similar overdose crises.