bluuebunny/crossref_metadata_2025 huggingface dataset:
Behavioral outcome among survivors of childhood brain tumor: a case control study
Authors: Alias Hamidah , Morthy Sasirekha Krisnan , Zakaria Syed Zulkifli Syed , Muda Zulaiha , Tamil Azmi Mohd
Published: February 2020

Background

Advances in the treatment of childhood brain tumors have significantly improved survival rates. With improved survival rates, long-term treatment-related toxicities have become important, and the resulting complications can affect patients’ emotion and behavior. This study aimed to 1) evaluate behavioral outcomes among survivors of childhood brain tumors, 2) compare behavioral outcomes among survivors of childhood brain tumors with survivors of childhood leukemia and healthy children, and 3) determine any demographic, disease, and/or treatment-related factors that could affect the behavioral outcomes of survivors of childhood brain tumors.

Methods

A comparative cross-sectional study was conducted over a period of 1 year (June 1st, 2018–May 31st, 2019) in two tertiary referral centers in Kuala Lumpur, Malaysia. Thirty-eight survivors of childhood brain tumors aged 6 to 18 years old who had been off-treatment for at least 1 year and were in remission, 38 age- and gender-matched survivors of childhood leukemia who had been off-treatment for at least 1 year and were in remission, and 38 age- and gender-matched unrelated healthy children were recruited. The Child Behaviour Checklist (CBCL) parent report and Youth Self-Report (YSR) questionnaires were used to assess behavioral outcomes.

Results

Survivors of childhood brain tumors showed statistically significantly worse behavioral outcomes than healthy children for social problems and attention problems (p < 0.05, respectively). A significantly worse outcome was found for “social problems” (p < 0.05) in survivors of childhood brain tumors compared to survivors of childhood leukemia. Significant associations were also found between physical disability, visual impairment, education level of survivors, and father’s occupation and behavioral outcomes among survivors of childhood brain tumors.

Conclusions

Survivors of childhood brain tumors in our center showed poor behavioral outcomes for social problems and attention problems. Thus, effective psychosocial support interventions tailored to individual patients as soon as treatment is completed are important to prevent potentially debilitating emotional problems.
Psychometric evaluation of two short versions of the Revised Child Anxiety and Depression Scale
Authors: Klaufus Leonie , Verlinden Eva , van der Wal Marcel , Kösters Mia , Cuijpers Pim , Chinapaw Mai
Published: February 2020

Background

Anxiety and depression are common in children and adolescents, which can be detected via self-report questionnaires in non-clinical settings like the school environment. Two short versions of the Revised Child Anxiety and Depression Scale (i.e., RCADS-25 and RCADS-20) seem to be feasible for administering at schools. The present study evaluated the psychometric properties of the RCADS-25 and RCADS-20 used as screening instruments for anxiety and depression in a general population of schoolchildren and adolescents.

Methods

The RCADS-25 was completed by 69,487 schoolchildren and adolescents aged 8 to 18. The RCADS-25 and RCADS-20 broad anxiety scales are equal (15 items), but there are two versions of the major depressive disorder (MDD) scale: the RCADS-25 MDD scale (10 items) and the RCADS-20 MDD scale (5 items). The three scales were assessed on structural validity, internal consistency, test-retest reliability, criterion validity, and hypotheses for construct validity.

Results

The RCADS-25/RCADS-20 broad anxiety scale demonstrated a sufficient structural validity (CFI = 0.98, TLI = 0.99, RMSEA = 0.03, SRMR = 0.03), internal consistency (alpha = 0.82), test-retest reliability (ICC = 0.73), criterion validity (AUC = 0.79), and all four hypotheses concerning construct validity were confirmed. The RCADS-25 MDD scale demonstrated a sufficient test-retest reliability (ICC = 0.70) and three out of four hypotheses concerning construct validity were confirmed, but its structural validity was suspect (CFI = 0.89, TLI = 0.94, RMSEA = 0.09, SRMR = 0.06). The RCADS-20 MDD scale demonstrated a sufficient structural validity (CFI = 0.97, TLI = 0.97, RMSEA = 0.08, SRMR = 0.04) and internal consistency (alpha = 0.72). Two out of four hypotheses concerning construct validity were confirmed. The test-retest reliability (ICC = 0.60) was insufficient. Since both MDD scales showed shortcomings, the shortening of the RCADS-25 MDD scale was re-examined post hoc by principal component and reliability analyses. The result was an MDD scale with seven items.

Conclusions

The RCADS-25/RCADS-20 broad anxiety scale is valid and reliable for screening schoolchildren and adolescents, but the RCADS-25 and RCADS-20 MDD scales showed shortcomings. An MDD scale of seven items showed acceptable psychometric properties.
A behavioural change intervention study for the prevention of childhood obesity in South Africa: protocol for a randomized controlled trial
Authors: Dukhi Natisha , Sartorius Benn , Taylor Myra
Published: February 2020

Background

South Africa is currently undergoing a nutrition transition, and overweight and obesity is on the increase in South African children. Urbanization and other health determinants have led to reduced physical activity and unhealthy eating that have increased the risk of adverse chronic health conditions. This study aims to provide evidence of the effectiveness of a school-based intervention study that targets diet and physical activity for the prevention of child and adolescent overweight and/or obesity.

Methods

We will employ a mixed method study design which is divided into two phases. Phase 1, namely the qualitative elicitation research phase will inform the development of the quantitative intervention phase (phase 2), consisting of a cluster-randomized trial, based on input from key stakeholders. The study will be undertaken in 16 government-funded primary schools in the iLembe district of KwaZulu-Natal, South Africa. The study will target learners in Grades 4 and 7, their parents, Life Orientation educators, school principals and members of school governing bodies. Assessment for the primary objective (BMI Z scores), and the secondary objectives (change in knowledge, attitudes and behaviours regarding diet and physical activity) in both study arms will be conducted at baseline in March 2020 and at the end of the study in October 2020.

Discussion

The study will be a novel combined mixed methods/RCT design that focuses on diet, physical activity school and family-based interventions in the context of rapidly increasing overweight and obesity prevalence in KwaZulu-Natal. To encourage behaviour change and management of malnutrition, education including diet and physical activity, is an important strategy that must be considered. Nutrition education extends beyond the dissemination of food information; it includes addressing the needs of participants, empowers and encourages decision-making and choice of foods, change in nutrition attitudes, beliefs and influences based on resources available and within cultural boundaries.

Trial registration

Pan African Clinical Trial Registry PACTR201711002699153. Protocol registered on 16 November 2017.
An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: a cross-sectional study
Authors: James Peter Bai , Wardle Jonathan , Steel Amie , Adams Jon
Published: February 2020

Background

We examined the magnitude and correlates of Ebola virus disease (EVD)-related stigma among EVD survivors in Sierra Leone since their return to their communities. In addition, we determined whether EVD-related stigma is a predictor of informal health care use among EVD survivors.

Methods

We conducted a cross-sectional study among 358 EVD survivors in five districts across all four geographic regions (Western Area, Northern Province, Eastern Province and Southern Province) of Sierra Leone. Ebola-related stigma was measured by adapting the validated HIV related stigma for people living with HIV/AIDS instrument. We also measured traditional and complementary medicine (T&CM) use (as a measure of informal healthcare use). Data were analysed using descriptive statistics and regression analysis.

Results

EVD survivors report higher levels of internalised stigma (0.92 ± 0.77) compared to total enacted stigma (0.71 ± 0.61). Social isolation (0.96 ± 0.88) was the highest reported enacted stigma subscale. Ebola survivors who identified as Christians [AOR = 2.51, 95%CI: 1.15–5.49, p = 0.021], who perceived their health to be fair/poor [AOR = 2.58, 95%CI: 1.39–4.77. p = 0.003] and who reside in the northern region of Sierra Leone [AOR = 2.80, 95%CI: 1.29–6.07, p = 0.009] were more likely to experience internalised stigma. Verbal abuse [AOR = 1.95, 95%CI: 1.09–3.49, p = 0.025] and healthcare neglect [AOR = 2.35, 95%CI: 1.37–4.02, p = 0.002] were independent predictors of T&CM use among EVD survivors.

Conclusion

Our findings suggest EVD-related stigma (internalised and enacted) is prevalent among EVD survivors since their return to their communities. Religiosity, perceived health status and region were identified as independent predictors of internalised stigma. Verbal abuse and healthcare neglect predict informal healthcare use. EVD survivor-centred and community-driven anti-stigma programs are needed to promote EVD survivors’ recovery and community re-integration.
Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fractures
Authors: Erichsen Christoph J. , Heyde Christoph-Eckhard , Josten Christoph , Gonschorek Oliver , Panzer Stephanie , von Rüden Christian , Spiegl Ulrich J.
Published: February 2020

Background

The purpose of this retrospective cohort study was to compare treatment strategies of two level-one trauma centers regarding clinical and radiological outcomes focusing on non-osteoporotic AOSpine type A3 fractures of the thoracolumbar spine at levels T11 to L2.

Methods

Eighty-seven patients between 18 and 65 years of age that were treated operatively in either of two trauma centers were included. One treatment strategy includes open posterior stabilization whereas the other uses percutaneous posterior stabilization. Both included additional anterior fusion if necessary. Demographic data, McCormack classification, duration of surgery, hospital stay and further parameters were assessed. Owestry Disability Index (ODI), Visual Analog Scale (VAS) and SF-36 were measured for functional outcome. Bisegmental kyphosis angle, reduction loss and sagittal alignment parameters were assessed for radiological outcome. Follow up was at least 24 months.

Results

There was no significant difference regarding our primary functional outcome parameter (ODI) between both groups. Regarding radiological outcome kyphosis angle at time of follow up did not show a significant difference. Reduction loss at time of follow up was moderate in both groups with a significantly lower rate in the percutaneously stabilized group. Surgery time was significantly shorter for posterior stabilization and anterior fusion in the percutaneous group. Time of hospital stay was equal for posterior stabilization but shorter for anterior fusion in the open stabilized group.

Conclusion

Both treatment strategies are safe and effective showing only minor loss of reduction. Clinical relevant differences in functional and radiographic outcome between the two surgical groups could not be demonstrated.

Trial registration

It was conducted according to ICMJE guidelines and has been retrospectively registered with the German Clinical Trials Registry (identification number:DRKS00015693, 07.11.2018).
Paraspinal muscle changes after single-level posterior lumbar fusion: volumetric analyses and literature review
Authors: Cho Sung-Min , Kim Se-Hoon , Ha Sung-Kon , Kim Sang-Dae , Lim Dong-Jun , Cha Jaehyung , Kim Bum-Joon
Published: February 2020

Background

Posterior lumbar fusion is a widely accepted surgical technique; however, it has been related to the possibility of paraspinal muscle atrophy after surgery. We investigated 1-year postoperative changes in paraspinal muscle volume using a simple formula applicable to magnetic resonance imaging (MRI) or computed tomography (CT) images.

Methods

Patients with degenerative lumbar spinal stenosis who underwent posterior interbody fusion (PLIF) at the L4/5 level in the period from May 2010 to June 2017 were enrolled in this study. Radiologic parameters were measured using MRI or CT images which were taken before surgery and at 1 year after surgery. The volume of the paraspinal muscles was calculated using a simple formula which was derived from the formula for calculating the volume of truncated elliptic cones.

Results

A total of 40 patients were included; 24 were analyzed using MRI and 16 were analyzed using CT. The mean age of the patients was 59.6 ± 12.1 years and 32 (80.5%) were female. When comparing the preoperative and 1-year-postoperative images, multifidus muscle (MF) reduction was consistently observed in the MRI and CT groups, right and left (p = 0.003, p < 0.001, p = 0.005 and p < 0.001, respectively). In the erector spinae (ES) group, decrease in muscle volume was observed in the right-sided muscles of the CT group (p < 0.001), but no significant change was observed in the MRI group. The psoas muscle showed no significant change after 1 year. Conversely, regression analysis showed a negative correlation between MF muscle volume loss and age in the MRI group (right and left, p = 0.002 and p = 0.015, respectively), that is, the younger the age, the greater loss of muscle mass.

Conclusion

After the posterior lumbar fusion, the volume of the MF muscles was markedly decreased, and the degree of decrease was apparent in the MRI. The volume of the ES muscles, which are located relatively laterally, also tended to decrease at 1 year after surgery.
Effect of herbal extract Eurycoma longifolia (Physta®) on female reproductive hormones and bone biochemical markers: an ovariectomised rat model study
Authors: M. Chinnappan Sasikala , George Annie , Ashok Godavarthi , Choudhary Yogendra Kumar
Published: February 2020

Background

Each year 1.5 million women experience menopause when menstrual cycles cease resulting from the loss of ovarian function and oestrogen deprivation, a hormone that helps prevent bone loss. This study investigated the effects ofPhysta®, a standardized herbal extract ofEurycoma longifoliaJack (PEL), on hormonal balance and parameters associated with hormonal imbalance, namely body and uterus weight and bone biochemical markers relevant in menopausal symptoms.

Methods

Forty-eight Sprague Dawley rats were randomly divided into six groups of eight rats each: (A) Sham operated; control (B) Untreated (ovariectomised (OVX) with vehicle), (C) PEL 100 (OVX + 100 mg/kg body weight (bw)), (D) PEL 300 (OVX + 300 mg/kg bw), (E) PEL 500 (OVX + 500 mg/kg bw) and (F) Positive control, testosterone undecanoate (TU) (OVX+ 10 mg/kg bw). Group A and B received daily oral administrations of the vehicle, Group C-E received daily oral administration of PEL and Group F received testosterone undecanoate intramuscularly weekly. At the end of 8 weeks, serum calcium, phosphate, bone alkaline phosphatase (BALP), osteocalcin, follicle stimulating hormone (FSH), luteinising hormone (LH), oestrogen, progesterone and testosterone were measured, then the animals were sacrificed and uterus was isolated, while weight was recorded in all experimental groups.

Results

Treatment of OVX rats with PEL at a dose of 500 mg/kg showed decreased serum FSH (P < 0.001, 4.25 ± 0.22 mIU/ml) and LH (NS, 4.07 ± 0.12 mIU/ml), while there was a significant increase in progesterone (P < 0.05, 2.48 ± 0.08 ng/ml) and oestrogen (P < 0.05, 11.02 ± 0.13 pg/ml) levels when compared to untreated group. PEL treatment at doses of 100 mg/kg, 300 mg/kg and 500 mg/kg showed a non-significant but increasing trend in serum calcium, phosphate, bone alkaline phosphate and testosterone levels. Ovariectomy resulted in a significant reduction (P < 0.001, 238.81 ± 5.39 mg) in uterus weight in the ovariectomised rats, which was alleviated in all PEL treated ovariectomised rats with an increasing trend of uterine weight.

Conclusion

The results suggest that PEL could be protective and beneficial for the management of reproductive hormone and bone markers. Therefore, it could be used to address hormonal imbalances and symptoms associated with menopause.
The effect of education around ethical principles on nurses’ perception to patient safety culture in an Iranian mental health inpatient unit: a pilot study
Authors: Razzani Behzad , Atashzadeh-Shoorideh Foroozan , Jamshidi Tayebeh , Barkhordari-Sharifabad Maasoumeh , Lotfi Zahra , Skerrett Victoria
Published: February 2020

Background & objectives

Patient safety is a crucial factor in the provision of quality healthcare and is therefore a global health concern. It is an area in which ethical concerns and high-quality clinical practice are inextricably linked. This study investigates the effect of education around ethical principles on nurses’ perception of patient safety in a psychiatric unit.

Materials & methods

This pre- and post-test descriptive study was conducted in a mental health inpatient unit in a hospital in Tehran, capital of Iran, in 2018. A total of 33 nurses, selected by census sampling, participated in the study. Data was collected using a demographics questionnaire and Hospital Survey on Patient Safety Culture (HSOPSC), and was analyzed with SPSS21.

Results

The mean score of patient safety was 116.85 ± 9.98 before the educational intervention, 143.58 ± 7.21 immediately after intervention, and 153.12 ± 9.47 1 month after intervention. The rate of error report by most participants over the past 12 months was 3–5 and 6–10 events before intervention, and 6–10 events immediately after and 1 month after intervention. Also, 42.4% of the participants assessed patient safety after intervention as very good and 36.4% assessed it as acceptable and very good 1 month after intervention whereas most of the participants (45.5%) assessed patient safety as acceptable before intervention.

Conclusion

Education on ethical principles exerts a positive effect on nurses’ perception of patient safety culture. Thus, it is recommended as an effective method of promoting nurses’ perception of this variable. In this way, healthcare quality and enhanced patient safety can be achieved.
Dissonances and disconnects: the life and times of community-based accountability in the National Rural Health Mission in Tamil Nadu, India
Authors: Gaitonde Rakhal , San Sebastian Miguel , Hurtig Anna-Karin
Published: February 2020

Background

There are increasing calls for developing robust processes of community-based accountability as key components of health system strengthening. However, implementation of these processes have shown mixed results over time and geography. The Community Action for Health (CAH) project was introduced as part of India’s National Rural Health Mission (now National Health Mission) to strengthen community-based accountability through community monitoring and planning. In this study we trace the implementation process of this project from its piloting, implementation and abrupt termination in the South Indian state of Tamil Nadu.

Methods

We framed CAH as an innovation introduced into the health system. We use the framework on integration of innovations in complex systems developed by Atun and others. We used qualitative approaches to study the implementation. We conducted interviews among a range of individuals who were directly involved in the implementation, focusing on the policy making organizational level.

Results

We uncover what we have termed “dissonances” and “disconnects” at the state level among individuals with key responsibility of implementation. By dissonances we refer to the diversity of perspective on the concept of community-based accountability and its perceived role. By disconnects we refer to the lack of spaces and processes for “sense-making” in a largely hierarchically functioning system. These constructs we believe contributes significantly to making sense of the initial uptake and the subsequent abrupt termination of the project.

Conclusions

This study contributes to the overall field of policy implementation, especially the phase between the emergence on the policy agenda and its incorporation into the day to day functioning of a system. It focuses on the implementation of contested interventions like community-based accountability, in Low- and Middle-income country settings undergoing transitions in governance. It highlights the importance of “problematization” a dimension not included in most currently popular frameworks to study the uptake and spread of innovations in the health system. It points not only to the importance of diverse perspectives present among individuals at different positions in the organization, but equally importantly the need for spaces and process of collective sense-making to ensure that a contested policy intervention is integrated into a complex system.
Understanding beneficial self-management support and the meaning of user involvement in lifestyle interventions: a qualitative study from the perspective of healthcare professionals
Authors: Salemonsen Elin , Førland Georg , Hansen Britt Sætre , Holm Anne Lise
Published: February 2020

Background

In light of the high prevalence of overweight and obesity among adults and the subsequent stigmatization and health consequences, there is a need to develop effective interventions to support lifestyle change. The literature supports the key role of healthcare professionals (HPs) in facilitating self-management through lifestyle interventions for those with chronic conditions. However, there is a lack of knowledge about how HPs practice self-management support (SMS) and user involvement for persons afflicted by overweight or obesity in lifestyle interventions in primary care Healthy Life Centres (HLC). The aim of this study was to explore how HPs provide SMS and what user involvement implies for HPs in HLCs.

Methods

An interpretative exploratory design, using qualitative thematic analysis of data from two focus group interviews with ten HPs from eight different HLCs, was conducted.

Results

The analysis resulted in one overall theme; A partnership based on ethical awareness, non-judgemental attitude, dialogue and shared responsibility, comprising four interrelated themes: 1) Supporting self-efficacy, self-worth and dignity through an attitude of respect, acknowledgement and generosity, 2) Promoting self-belief and self-perceived health, 3) Collaborating and sharing responsibility, and 4) Being flexible, adjusting and sharing time.

Conclusion

HPs in HLCs see service users as equal partners in a collaboration based on shared responsibility, acknowledgement and generosity. In order to help, their practice involves a heightened level of ethical awareness, including a non-judgemental attitude and dialogue. HPs in HLCs have something to teach us about ethical acting and helping persons who are struggling with overweight or obesity to change their lifestyle and regain dignity. They seem to see the service users’ existential needs and have learned the art of meeting the other in her/his most vulnerable situation i.e., seeking help for a “wrong lifestyle”. It may be time to highlight the need for SMS and user involvement to focus on shared responsibility in partnership rather than personal responsibility. More research is required to explore the conditions for such practice.
Surface components and metabolites of probiotics for regulation of intestinal epithelial barrier
Authors: Liu Qing , Yu Zhiming , Tian Fengwei , Zhao Jianxin , Zhang Hao , Zhai Qixiao , Chen Wei
Published: February 2020

The gut microbiota can significantly affect the function of the intestinal barrier. Some intestinal probiotics (such asLactobacillus,Bifidobacteria, a fewEscherichia colistrains, and a new generation of probiotics includingBacteroides thetaiotaomicronandAkkermansia muciniphila) can maintain intestinal epithelial homeostasis and promote health. This review first summarizes probiotics’ regulation of the intestinal epithelium via their surface compounds. Surface layer proteins, flagella, pili and capsular polysaccharides constitute microbial-associated molecular patterns and specifically bind to pattern recognition receptors, which can regulate signaling pathways to produce cytokines or inhibit apoptosis, thereby attenuating inflammation and enhancing the function of the gut epithelium. The review also explains the effects of metabolites (such as secreted proteins, organic acids, indole, extracellular vesicles and bacteriocins) of probiotics on host receptors and the mechanisms by which these metabolites regulate gut epithelial barrier function. Previous reviews summarized the role of the surface macromolecules or metabolites of gut microbes (including both probiotics and pathogens) in human health. However, these reviews were mostly focused on the interactions between these substances and the intestinal mucosal immune system. In the current review, we only focused on probiotics and discussed the molecular interaction between these bacteria and the gut epithelial barrier.
Preconditioning rats with three lipid emulsions prior to acute lung injury affects cytokine production and cell apoptosis in the lung and liver
Authors: Huang Li-Mi , Hu Qingqing , Huang Xiaoxia , Qian Yan , Lai Xin-He
Published: February 2020

Background

Critically ill patients are at higher risk having acute lung injury (ALI) and more often in need of parenteral nutrition. We sought to study whether preconditioning with representative of lipid emulsions for one week could benefit rats from ALI.

Methods

Using a lipopolysaccharide (LPS)-induced ALI rat model and techniques such as polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA), and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining.

Results

PGE2 production in the serum was highest in the LPS group, followed with Intralipid group, and the PGE2 level of these two groups was significantly (P < 0.05) higher than the rest. Intralipid conditioning caused significantly less production of LTB4 than the LPS, Clinoleic, or Omegaven group. In contrast to Intralipid, rats pretreated with Clinoleic or Omegaven significantly decreased their production of inflammatory mediators (IL-1 β, IL-6 and TNF-α), had less apoptosis in the lung tissues, and Omegaven greatly improved liver function upon lipopolysaccharide (LPS) challenge.

Conclusions

In an ALI setting, preconditioning with Omegaven or Clinoleic was better than Intralipid in decreasing the intensity of the cytokine storm and apoptosis caused by LPS challenge, and Omegaven in addition had the potential to improve liver function. The results from the present study set a basis for further investigation of the molecular mechanisms of ALI, including the up- and downstream pathways of proinflammatory factor production, in search of (small) molecules intervening with the pathogenesis of ALI in order to translate relevant research findings into clinical benefit for patients with ALI. The use of Omegaven or Clinoleic, particularly in patients with ALI, is still characterized by uncertainty due to a lack of relevant studies. Future investigations must specifically focus on the route of administration and mode of application (enteral vs. parenteral/bolus vs. continuous), determining an optimal dose of Omegaven or Clinoleic, and the defining the best timepoint(s) for administration. Critically ill patients are at higher risk having acute lung injury (ALI) and more often in need of parenteral nutrition. The effect of lipid emulsion via parenteral nutrition on liver function was first time evaluated in rats in an ALI setting. The comparison of three forms of lipid emulsion in a rat model of acute lung injury was first time studied. The fish oil-based lipid emulsion decrease in PGE 2 and increase in LTB 4 was first time reported.
Local delivery of minocycline-loaded PLGA nanoparticles from gelatin-coated neural implants attenuates acute brain tissue responses in mice
Authors: Holmkvist Alexander Dontsios , Agorelius Johan , Forni Matilde , Nilsson Ulf J. , Linsmeier Cecilia Eriksson , Schouenborg Jens
Published: February 2020

Background

Neural interfaces often elicit inflammatory responses and neuronal loss in the surrounding tissue which adversely affect the function and longevity of the implanted device. Minocycline, an anti-inflammatory pharmaceutics with neuroprotective properties, may be used for reducing the acute brain tissue responses after implantation. However, conventional administration routes require high doses which can cause adverse systemic side effects. Therefore, the aim of this study was to develop and evaluate a new drug-delivery-system for local and sustained administration of minocycline in the brain.

Methods

Stainless steel needles insulated with Parylene-C were dip-coated with non-crosslinked gelatin and minocycline-loaded PLGA nanoparticles (MC-NPs) were incorporated into the gelatin-coatings by an absorption method and subsequently trapped by drying the gelatin. Parylene-C insulated needles coated only with gelatin were used as controls. The expression of markers for activated microglia (CD68), all microglia (CX3CR1-GFP), reactive astrocytes (GFAP), neurons (NeuN) and all cell nuclei (DAPI) surrounding the implantation sites were quantified at 3 and 7 days after implantation in mice.

Results

MC-NPs were successfully incorporated into gelatin-coatings of neural implants by an absorption method suitable for thermosensitive drug-loads. Immunohistochemical analysis of the in vivo brain tissue responses, showed that MC-NPs significantly attenuate the activation of microglial cells without effecting the overall population of microglial cells around the implantation sites. A delayed but significant reduction of the astrocytic response was also found in comparison to control implants. No effect on neurons or total cell count was found which may suggest that the MC-NPs are non-toxic to the central nervous system.

Conclusions

A novel drug-nanoparticle-delivery-system was developed for neural interfaces and thermosensitive drug-loads. The local delivery of MC-NPs was shown to attenuate the acute brain tissue responses nearby an implant and therefore may be useful for improving biocompatibility of implanted neuro-electronic interfaces. The developed drug-delivery-system may potentially also be used for other pharmaceutics to provide highly localized and therefore more specific effects as compared to systemic administration.
Effects of physical activity programs on sleep outcomes in older adults: a systematic review
Authors: Vanderlinden J. , Boen F. , van Uffelen J. G. Z.
Published: February 2020

Background

One in two older adults report sleep problems, which not only cause fatigue, but also negatively affect general functioning, activities of daily living, and physical and mental health. Although it is known that physical activity is positively associated with sleep in older adults, the effects of physical activity programs on sleep in older adults has not been reviewed. The aim of this systematic review was to systematically review the effects of physical activity programs on sleep in generally healthy older adults aged 60+ years.

Methods

Searches were performed in PubMed, Embase, Web of Science, SPORTDiscus, PEDro and CINAHL. The methodological quality of the included studies was rated using the ‘Quality Assessment Tool for Quantitative Studies’. Only studies of moderate and strong quality were included. This review was registered in PROSPERO (CRD42018094007).

Results

Fourteen studies met the inclusion criteria (six randomised controlled trials and eight pretest-posttest studies). Of these studies, five were moderate and nine were strong quality studies. Mean age of study samples ranged from 64 to 76 years. Exercise programs included various activities aimed at improving mobility, endurance and strength. Intervention duration ranged from 2 weeks to 12 months. Eleven studies used subjective measures of sleep, two used objective measures and one used both. Sixteen different sleep outcomes were reported. All but one study, found at least one significant improvement on sleep outcomes. No significantly detrimental effects were reported. Effect sizes, calculated in ten studies, ranged from 0,34–1,55 and were substantial (≥0,8) in four studies.

Conclusions

This systematic review suggests that exercise programs positively affect various aspects of sleep in generally healthy older adults. More specifically, moderate intensity exercise programs, with a frequency of three times per week and a duration of 12 weeks up to 6 months, showed the highest number of significant improvements in different sleep outcomes in older adults. Furthermore, programs that offered single exercise types, such as Baduanjin, Tai chi and the silver yoga program, or a combination of exercises showed the highest proportion of significant versus reported effects on sleep outcomes.
Plasminogen activator inhibitor-2
(PAI-2) overexpression supports
bladder cancer development
in PAI-1 knockout mice in N-butyl-N-
(4-hydroxybutyl)-nitrosamine- induced bladder
cancer mouse model
Authors: Furuya Hideki , Hayashi Kazukuni , Shimizu Yoshiko , Kim Nari , Tsukikawa Yutaro , Chen Runpu , Sun Yijun , Chan Owen T. M. , Pagano Ian , Peres Rafael , Hokutan Kanani , Igari Fumie , Chan Keith S. , Rosser Charles J.
Published: February 2020

Background

Accumulating evidence suggests that plasminogen activator inhibitor-1 (PAI-1) plays an important role in bladder tumorigenesis by regulating cell cycle. However, it remains unclear whether and how inhibition of PAI-1 suppresses bladder tumorigenesis.

Methods

To elucidate the therapeutic effect of PAI-1 inhibition, we tested its tumorigenicity in PAI-1 knockout (KO) mice exposed to a known bladder carcinogen.

Results

PAI-1 deficiency did not inhibit carcinogen-induced bladder cancer in mice although carcinogen-exposed wild type mice significantly increased PAI-1 levels in bladder tissue, plasma and urine. We found that PAI-1 KO mice exposed to carcinogen tended to upregulate protein C inhibitor (PAI-3), urokinase-type plasminogen activator (uPA) and tissue-type PA (tPA), and significantly increased PAI-2, suggesting a potential compensatory function of these molecules when PAI-1 is abrogated. Subsequent studies employing gene expression microarray using mouse bladder tissues followed by post hoc bioinformatics analysis and validation experiments by qPCR and IHC demonstrated that SERPING1 is further downregulated in PAI-1 KO mice exposed to BBN, suggesting that SERPING1 as a potential missing factor that regulate PAI-2 overexpression (compensation pathway).

Conclusions

These results indicate that serpin compensation pathway, specifically PAI-2 overexpression in this model, supports bladder cancer development when oncoprotein PAI-1 is deleted. Further investigations into PAI-1 are necessary in order to identify true potential targets for bladder cancer therapy.
Paroxetine suppresses reactive microglia-mediated but not lipopolysaccharide-induced inflammatory responses in primary astrocytes
Authors: Zhang Xiong , Zhu Lan-Bing , He Jia-Hui , Zhang Hong-Qiu , Ji Shu-Ya , Zhang Chao-Nan , Hou Na-Na , Huang Chen-Ping , Zhu Jian-Hong
Published: February 2020

Background

Astrocytes are the most abundant glial cells in a brain that mediate inflammatory responses and provide trophic support for neurons. We have previously disclosed that paroxetine, a common selective serotonin reuptake inhibitor, ameliorates LPS-induced microglia activation. However, it remains elusive for the role of paroxetine in astrocytic responses.

Methods

Isolated primary astrocytes were pretreated with paroxetine and stimulated with different stimuli, lipopolysaccharide (LPS) or microglia conditioned medium pre-activated with LPS (M/Lps). Inflammatory and neurotrophic responses, underlying mechanisms and the impact on neuronal survival were assessed.

Results

Paroxetine had no impact on LPS-stimulated iNOS, TNF-α, and IL-1β expression, but inhibited M/Lps-induced TNF-α and IL-1β expression in primary astrocytes. Paroxetine suppressed M/Lps- but not LPS-induced activation of NF-κB and had no impact on the activation of MAPKs and STAT3. Incubation with the resulted astrocyte conditioned media caused no change in the viability of SH-SY5Y cells. BDNF and MANF mRNA expressions were upregulated by M/Lps and paroxetine, respectively. However, M/Lps- or LPS-induced extracellular releases of NO, TNF-α, and/or BDNF in astrocytes were in minor amount compared to those by microglia.

Conclusions

Paroxetine ameliorates the reactive microglia-mediated inflammatory responses in astrocytes partially via inhibition of the NF-κB pathway but has no impact on LPS-stimulated astrocyte activation. While the effects of paroxetine on secondary astrocytic responses are not robust compared to its effect on the innate immune responses of microglia, the results together may implicate a therapeutic potential of paroxetine against neuroinflammation-associated neurological disorders such as Parkinson’s disease.
Increased age and male sex are independently associated with higher frequency of blood–cerebrospinal fluid barrier dysfunction using the albumin quotient
Authors: Castellazzi Massimiliano , Morotti Andrea , Tamborino Carmine , Alessi Francesca , Pilotto Silvy , Baldi Eleonora , Caniatti Luisa M. , Trentini Alessandro , Casetta Ilaria , Granieri Enrico , Pugliatti Maura , Fainardi Enrico , Bellini Tiziana
Published: February 2020

Background

The cerebrospinal fluid (CSF)/serum quotient of albumin (QAlb) is the most used biomarker for the evaluation of blood–cerebrospinal fluid barrier (B-CSF-B) permeability. For years QAlb was considered only as an age-related parameter but recently it has also been associated to sex. The aim of the present study was to explore the impact of sex in the determination of B-CSF-B dysfunction.

Methods

The analysis was retrospectively conducted on subjects consecutively admitted to the neurological ward. CSF and serum albumin levels were measured by immunonephelometry and pathological QAlb thresholds were considered: 6.5 under 40 years, 8.0 in the age 40–60 and 9.0 over 60 years.

Results

1209 subjects were included in the study. 718 females and 491 males (age: 15–88 years): 24.6% of patients had a diagnosis of multiple sclerosis, 23.2% suffered from other inflammatory neurological diseases, 24.6% were affected by non-inflammatory neurological diseases, and for 27.6% of patients the final neurological diagnosis could not be traced. Dysfunctional B-CSF-B was detected more frequently (44 vs. 20.1%, p < 0.0001) and median QAlb value were higher (7.18 vs. 4.87, p < 0.0001) in males than in females in the overall study population and in all disease subgroups. QAlb and age were positively correlated both in female (p < 0.0001) and male (p < 0.0001) patients, however the slopes of the two regression lines were not significantly different (p = 0.7149), while the difference between the elevations was extremely significant (p < 0.0001) with a gap of 2.2 units between the two sexes. Finally, in a multivariable linear regression analysis increased age and male sex were independently associated with higher QAlb in the overall study population (both p < 0.001) and after stratification by age and disease group.

Conclusions

Accordingly, identification and validation of sex-targeted QAlb thresholds should be considered as a novel tool in an effort to achieve more precision in the medical approach.
An ethnobotanical study of medicinal plants in Sheka Zone of Southern Nations Nationalities and Peoples Regional State, Ethiopia
Authors: Kassa Zewdie , Asfaw Zemede , Demissew Sebsebe
Published: February 2020

Background

People’s classification, management, and use of plants represent attempt to attracting people from different academic disciplines. Many countries use traditional medicine for their primary healthcare system. Medicinal plants have been important components of healthcare systems since the time immemorial. The objective of this research was to document and analyze traditional medicinal plants used by the Sheka people and associated ethnobotanical knowledge.

Methods

Data was collected by administering pre-prepared semi-structured interview items to 414 informants. Market surveys, group discussion, and guided field walk were used. Data were analyzed using descriptive and inferential statistics; determination of informant consensus factor, fidelity level, as well as ranking and scoring.

Results

A total of 266 plant species belonging to 192 genera and 74 families were identified. About 204 (77%) of the medicinal plants were used to treat human health problems. Only ten (4%) were used to treat livestock health problems and 52 (19%) of them were used to treat both human and livestock health problems. Croton macrostachyus, Prunus africana, Peperomia retusa, Lobelia giberroa, and Celosia schweinfurthiana were found to be high ranking medicinal plants against gastrointestinal problems based on simple preference ranking.

Conclusion

Very high number of medicinal plant species recorded from the study area indicates that vegetation of Sheka is reservoir of medicinal plants. Hence, the area needs attention for medicinal plant conservation priorities. Plant parts used as medicines also play vital role in the entire medicinal plant life cycle. Therefore, it is useful to consider harvesting impacts. Except well-experienced traditional healers, people of the study area use the medicinal plants haphazardly. There may be high risk of being victims of dosage and improper usage. High ranking medicinal plants are candidates for further phytochemical profiling, drug research, and development.
Mechanical stability study of three techniques used in the fixation of transverse and oblique metaphyseal-diaphyseal junction fractures of the distal humerus in children: a finite element analysis
Authors: Liu Chuang , Kamara Allieu , Liu Tianjing , Yan Yunhui , Wang Enbo
Published: February 2020

Background

Management of distal humerus metaphyseal-diaphyseal junction (MDJ) region fractures can be very challenging mainly because of the higher location and characteristics of the fracture lines. Loss of reduction is relatively higher in MDJ fractures treated with classical supracondylar humerus fractures (SHFs) fixation techniques.

Methods

Three different fracture patterns including transverse, medial oblique and lateral oblique fractures were computationally simulated in the coronal plane in the distal MDJ region of a pediatric humerus and fixated with Kirschner Wires (K-wires), elastic stable intramedullary nails (ESIN), and lateral external fixation system (EF). Stiffness values in flexion, extension, valgus, varus, internal, and external rotations for each fixation technique were calculated.

Results

In the transverse fracture model, 3C (1-medial, 2-lateral K-wires) had the best stiffness in flexion, varus, internal, and external rotations, while 3L (3-divergent lateral K-wires) was the most stable in extension and valgus. In the medial oblique fracture model, EF had the best stiffness in flexion, extension, valgus, and varus loadings, while the best stiffness in internal and external rotations was generated by 3MC (2-medial, 1-lateral K-wires). In the lateral oblique fracture model, 3C (1-medial, 2-lateral K-wires) had the best stiffness in flexion and internal and external rotations, while ESIN had the best stiffness in extension and valgus and varus loadings.

Conclusion

The best stability against translational forces in lateral oblique, medial oblique, and transverse MDJ fractures would be provided by ESIN, EF, and K-wires, respectively. K-wires are however superior to both ESIN and EF in stabilizing all three fracture types against torsional forces, with both 2-crossed and 3-crossed K-wires having comparable stability. Depending on the fracture pattern, a 3-crossed configuration with either 2-divergent lateral and 1-medial K-wires or 2-medial and 1-lateral K-wires may offer the best stability.
Anterior quadratus lumborum block for postoperative recovery after total hip arthroplasty: a study protocol for a single-center, double-blind, randomized controlled trial
Authors: Kikuchi Masaru , Mihara Takahiro , Mizuno Yusuke , Fujimoto Hiroko , Arai Sachiko , Nomura Takeshi , Goto Takahisa
Published: February 2020

Background

Appropriate pain management is essential to improve the postoperative recovery after total hip arthroplasty (THA). Various case reports have indicated that anterior quadratus lumborum block (QLB) provides effective postoperative analgesia in lower limb surgeries. However, few randomized controlled trials have confirmed the efficacy of anterior QLB for lower limb surgeries. The aim of this single-center, double-blind, randomized controlled trial is to confirm the efficacy of anterior QLB for postoperative recovery after THA.

Methods

The participants will be randomly assigned to either the anterior QLB or placebo groups, using a set of random numbers for the allocation sequence. Only pharmacists will be aware of the allocations; other investigators will be blinded until study completion. After induction of general anesthesia, anterior QLB will be performed by using 0.25% levobupivacaine or normal saline. Fentanyl will be administered according to blood pressure change during the surgery. The primary outcome will be the quality of recovery 40 score (QoR-40). Secondary outcomes will include the visual analog scale score of pain intensity at rest and movement, intraoperative and postoperative doses of fentanyl, and incidence of postoperative nausea and vomiting. Statistical analysis will be performed by using the Student’s t test, Mann–Whitney U test, and Fisher’s exact test as appropriate. A P value of less than 0.05 will be considered statistically significant.

Discussion

The results of our study will reveal whether anterior QLB is effective for postoperative recovery after THA.

Trial registration

UMIN Clinical Trials Registry, UMIN000032255. Registered on 15 April 2018.
Metabolic phenotype in Darier disease: a cross-sectional clinical study
Authors: Ahanian Tara , Curman Philip , Leong Ivone U. S. , Brismar Kerstin , Bachar-Wikstrom Etty , Cederlöf Martin , Wikstrom Jakob D.
Published: February 2020

Background

Human data supporting a role for endoplasmic reticulum (ER) stress and calcium dyshomeostasis in diabetes is scarce. Darier disease (DD) is a hereditary skin disease caused by mutations in the ATP2A2 gene encoding the sarcoendoplasmic-reticulum ATPase 2 (SERCA2) calcium pump, which causes calcium dyshomeostasis and ER stress. We hypothesize that DD patients have a diabetes-like metabolic phenotype and the objective of this study was to examine the association between DD with impaired glucose tolerance and diabetes.

Methods

Cross-sectional clinical study on 25 DD patients and 25 matched controls. Metabolic status was assessed primarily by fasting blood glucose, oral glucose tolerance test, HOMA2-%S (insulin resistence) and HOMA2-%B (beta cell function).

Results

DD subjects showed normal oral glucose tolerance test and HOMA2-%S, while fasting blood glucose was lower and c-peptide as well as HOMA2-%B was higher.

Conclusion

Increased HOMA2-%B values are indicative of increased basal insulin secretion which is a type of beta cell dysfunction associated to diabetes development. These results supports a role of ER stress in diabetes pathophysiology and contribute to the understanding of DD as a multi-organ syndrome.