bluuebunny/crossref_metadata_2025 huggingface dataset:
The Biomechanical Effect on the Adjacent L4/L5 Segment Under S1 Superior Facet Arthroplasty: A Finite Element Analysis
Authors: Shi Zewen , Shi Lin , Chen Xianjun , Liu Jiangtao , Wu Haihao , Wang Chenghao , Chen Zeming , Yang Fang , Yu Sheng , Pang Qingjiang
Published: January 2021

Background. The superior facet arthroplasty is important for intervertebral foramen microscopy. To our knowledge, no study about the postoperative biomechanics of adjacent L4/L5 segments after different methods of S1 superior facet arthroplasty. To evaluate the effect of S1 superior facet arthroplasty on lumbar range of motion and disc stress of adjacent segment (L4/L5) under the intervertebral foramina plasty.Methods. Eight finite element models (FEMs) of lumbosacral vertebrae (L4/S) had been established and validated. The S1 superior facet arthroplasty was simulated with different methods. Then, the models were imported into Nastran software after optimization. 500N preload was imposed on the L4 superior endplate and 10 Nm was given to simulate flexion, extension, lateral flexion and rotation. The range of motion (ROM) and intervertebral disc stress of L4-L5 spine were recorded.Results. The ROM and disc stress of L4/L5 increased with the increasing of the proportions of S1 superior facet arthroplasty. Compared with the normal model, the ROM of L4/L5 significantly increase in most directions of motion when S1 superior facet formed greater than 3/5 from ventral to dorsal or 2/5 from apex to base. The disc stress of L4/L5 significantly increase in most directions of motion when S1 superior facet formed greater than 3/5 from ventral to dorsal or 1/5 from apex to base.Conclusion. In this study, the ROM and disc stress of L4/L5 were effected by the unilateral S1 superior facet arthroplasty. It is suggested that the forming range from ventral to dorsal should be less than 3/5 of S1 upper facet joint. It is not recommended to form from apex to base.
Caffeine Consumption Among Orthopedic Residents is Higher Than the General Population
Authors: Garrett Christopher , Shaath Mohammed Kareem , Avilucea Frank
Published: January 2021

Background:Orthopaedic surgery residency can be quite demanding at times and leads many residents to consume stimulants, caffeine, to perform their work duties. Question/Purpose:The purpose of this study was to evaluate caffeine consumption among orthopedic surgery residents. We hypothesized that compared to the general population, residents will consume more caffeine.Patients/Methods:An electronic survey consisting of 13 multiple-choice questions was created to query residents on their caffeine consumption. The survey link was e-mailed to all residency program coordinators in the United States who then forwarded the survey to their residents. A subgroup analysis was performed based on respondents’ post-graduate year (PGY), to identify variations in caffeine use.Results:We received 209 surveys which represents 5.4% of orthopedic residents in the country. Of those 209 residents, 189 (90.4%) indicated regular caffeine usage. Of those who consume caffeine 59.8% indicated that they need caffeine to perform their work while 64.6% indicated that they are dependent on caffeine. Nearly one-fourth (24.3%) of respondents indicated that they consume more than 400 mg of caffeine/day. There were no significant relationships across resident PGY groups.Conclusion:We have demonstrated a large proportion of orthopedic surgery residents consume caffeine. When used in moderation, caffeine can be beneficial by improving efficiency, alertness and memory however, in high doses it may have undesirable side effects.Level of Evidence:Level IV evidence
Transcriptomics and Co-expression Network Profiling of Effects of Levamisole Hydrochloride on Bursaphelenchus Xylophilus
Authors: Chen Jie , Wang Buyong , Hao Xin , Pan Jialiang , Ma Ling
Published: January 2021

Background: Bursaphelenchus xylophilus is one of the most dangerous forest pathogens in the world, resulting in the devastating death of pine forests and causing great economic losses and forest ecological damage to the affected areas. To explore the effect of levamisole hydrochloride (LH) as an effective control agent on nematode.Results: The results indicated that 2.5 mg/mL and 3.5 mg/mL LH had the toxicological effect on B. xylophilus, and the mortality increased significantly with the increase of concentration (P<0.05). We found and studied Sodium / Chloride and other ion genes belonging nervous system were up-regulated and the ion signal transmitted to the muscle protein and cause disorders, producing body-wall muscle twitchin, paralysis, and ultimately death. In the other hand, 2 Senecionine N-oxygenase and 2 Alcohol dehydrogenase as the central genes in drug metabolism-cytochrome P450 (ko00982) and metabolism of xenobiotics by cytochrome P450 (ko00980), and 8 highly related genes including Cuticle collagen, Cystathionine beta-synthase, Endochitinase, Pyruvate dehydrogenase E1 component subunit beta, Aldehyde dehydrogenase, Lipase, Zinc metalloproteinase. Their expressions up-regulation significantly at low concentrations and were significantly related to the resistance of B. xylophilus to LH. Conclusion: This study has shown that B. xylophilus gene family expansions occurred in xenobiotic detoxification pathways through the degree of genes expression and potential horizontal correlated gene transfer with LH, and shed light on LH lethality and evolutionary mechanisms behind adaptations of B. xylophilus to the environment. These findings contribute in several ways to our understanding of B. xylophilus under LH and provide a basis for control of it.
Comparison of Machine Learning Methods for the Detection of Focal Cortical Dysplasia Lesions: Decision Tree, Support Vector Machine and Artificial Neural Network
Authors: Ganji Zohreh , Zamanpour Seyed Amir , Zare Hoda
Published: January 2021

Background: Accurate classification of focal cortical dysplasia (FCD) has been challenging due to the problematic visual detection in magnetic resonance imaging (MRI). Hence, recently, there has been a necessity for employing new techniques to solve the problem.Methods: MRI data were collected from 58 participants (30 subjects with FCD type II and 28 normal subjects). Morphological and intensity-based characteristics were calculated for each cortical level and then the performance of the three classifiers: decision tree (DT), support vector machine (SVM) and artificial neural network (ANN) was evaluated.Results: Metrics for evaluating classification methods, sensitivity, specificity and accuracy for the DT were 96.7%, 100% and 98.6%, respectively; It was 95%, 100% and 97.9% for the SVM and 96.7%, 100% and 98.6% for the ANN.Conclusion: Comparison of the performance of the three classifications used in this study showed that all three have excellent performance in specificity, but in terms of classification sensitivity and accuracy, the artificial neural network method has worked better.
Changes in Biothiol Levels are Closely Associated with Alzheimer's Disease
Authors: han hui , Wang Feng , Chen Juanjuan , Li Xingxing , Fu Gaoqing , Zhou Jiawei , Zhou Dongsheng , Wu Wei , Chen Haimin
Published: January 2021

Background：Alzheimer’s disease (AD) is a progressive, neurodegenerative disease of the brain. Serum homocysteine (Hcy) level is considered to be an important biomarker for AD, however, the status of Hcy in brain tissue and neuronal cells, and the association between brain and serum levels of Hcy in clinical AD patients currently remain unclear. Methods: The levels of Hcy and other biothiols such as cysteine (Cys) and glutathione (GSH) in clinical blood samples were evaluated using a non-cytotoxic and stable multi-signal fluorescent probe, ethyl (E)-3-(9-chloro-11-oxo-2,3,6,7-tetrahydro-1H,5H,11H-pyrano[2,3-f] pyrido[3,2,1 -ij]quinolin-10-yl)-2-cyanoacrylate (Probe 1), which were verified by ELISA. Results: Measurement by Probe 1 revealed a significant increase in Hcy level, and a decrease in Cys and GSH levels in PC12 cells treated with in Aβ1-42. The hippocampus and whole brain of APP/PS1 mice also showed a significant increase in Hcy level alongside the accumulation of age-related AD symptoms, while levels of Cys and GSH decreased simultaneously. This change was also observed in serum samples acquired from patients with AD. The upregulation of Hcy and the downregulation of Cys and GSH were reversed in the Aβ1-42-treated PC12 cells and the brain of APP/PS1 mice when supplemented with VB6, an important coenzyme in Hcy metabolism. Conclusions: Changes in Hcy, Cys and GSH levels in the brain of APP/PS1 mice and Aβ1-42-treated PC12 cells were observed in situ with a new fluorescent probe, which were consistent with the abnormal changes in Hcy, Cys and GSH levels in the serum of AD patients. VB6 supplementation was successful in ameliorating abnormal upregulation of Hcy in the brain of APP/PS1 mice and in Aβ1-42-treated PC12 cells.
Comparison of Clinical and Inflammatory Parameters in Dogs with Pyometra Before and After Ovariohysterectomy
Authors: Ahn Soomin , Han HyunJung , Park Jinho , Kim Sang-Ki , Jung Dong-In , Yu Dohyeon
Published: January 2021

Background: this study aimed to identify potential biomarkers for the screening and therapeutic monitoring of sepsis in canine pyometra and correlations with clinical parameters. Samples were collected from a total of 90 dogs with pyometra and 26 healthy female controls. The levels of inflammatory biomarkers and clinical parameters recorded in the dogs with pyometra at presentation were compared with those in the healthy subjects. In addition, consecutive samples from 22 dogs with surgically corrected pyometra and nine healthy controls, were compared before and after ovariohysterectomy. Results: significant leucocytosis, anaemia, hyperglobulinaemia, hypoalbuminaemia, and elevated activities of the alanine aminotransferase and alkaline phosphatase (ALP) enzymes, were observed in the dogs with pyometra at presentation. Moreover, the concentrations of acute inflammatory proteins of C-reactive protein (CRP) and serum amyloid A (SAA), as well as those of cell-free DNA (cfDNA), were significantly higher in the dogs with pyometra. cfDNA was the most sensitive biomarker for systemic inflammation, based on the receiver operating characteristic curve analysis (area under the curve = 0.959). After surgical removal of the inflamed uterus, leucocyte and red blood cell counts, cholesterol, albumin, globulin levels, and the ALP activity significantly decreased. The levels of inflammatory parameters such as interleukin-6 (IL-6), high-mobility group box 1 (HMGB1), and procalcitonin (PCT) also significantly decreased after surgical treatment. Conclusions: these findings indicate that cfDNA, CRP, and SAA have the potential to be used as clinical biomarkers for screening canine sepsis, whereas PCT, IL-6, and HMGB1 may be useful biomarkers for the therapeutic monitoring of canine sepsis.
The Effect of Oral Zinc Therapy in Psoriasis Patients with Serum Zinc Deficiency: A Prospective Observational Study
Authors: Mogaddam Majid Rostami , Ardabili Nastaran safavi , Maleki Nasrollah
Published: January 2021

Introduction: Some studies have reported an association between serum zinc levels and psoriasis. This study aimed to assess the serum zinc level and thyroid dysfunction between psoriasis patients and healthy controls. Also, we evaluated the effect of oral zinc therapy in psoriasis patients with serum zinc deficiency. Materials and Methods: A total of 100 psoriasis patients and 100 healthy age- and sex-matched volunteers were enrolled in this prospective cross-sectional study. Finally, 52 psoriasis patients with serum zinc deficiency were randomly divided into two groups: one in which clobetasol cream alone was treated (group A), and one in which clobetasol cream plus oral zinc sulfate was treated (group B). The treatment response was assessed with Psoriasis Area and Severity Index (PASI) score. Results: The mean serum zinc level in psoriasis patients and controls was 62.3 ± 14.3 μg/dL and 87.7 ± 35.2 μg/dL, respectively (P-value= .001). Serum zinc deficiency was found in 52% and 26% of psoriasis patients and control subjects, respectively. Thyroid dysfunction was found in 8% of patients with psoriasis compared with 7% in control subjects (P-value=.361). At the end of the 12th week of treatment, the mean value of % reduction from baseline values of PASI Score in group A was 23.8 ± 18.2%, whereas this was 21.31 ± 17.8% in group B (P-value=.486). Conclusion: Although the prevalence of serum zinc deficiency is higher in psoriasis patients compared with healthy subjects, oral zinc supplementation does not appear to have therapeutic benefits in these patients. Also, we could not find any relationship between thyroid dysfunction and psoriasis.
Does spontaneous eradication of Helicobacter pylori infection lead to functional dyspepsia? 
Authors: Habibzadeh Shahram , Aslani Mohammad Reza , Yazdanbod Abbas , Alamdari Monouchehr Iranparvar , Chakarabbaci Babak , Mohammadshahi Jafar , Maleki Narollah
Published: January 2021

Introduction: The treatment of patients with functional dyspepsia in cases of active helicobacter pylori (H. pylori) infection is not promising. Therefore, the present study was designed to determine in which of the dyspeptic patients with the normal endoscopic examination and negative stool testing for H. pylori antigen (without a history of specific treatment for H. pylori) there is evidence of a previous H. pylori infection in the serum.Materials and methods: In this cross-sectional study, patients with functional dyspepsia who were negative in terms of the H. pylori stool antigen test and rapid urease test, and had no obvious gross pathologic sign in gastroduodenoscopy were considered suitable candidates for serological study for the detection of H. pylori IgG specific antibodies.Results: A total of 200 patients were enrolled in this study, including 86 men (43%) and 114 women (57%), with an average age of 38.76 ± 12.35 years. The results showed that 109 (54.5%) were positive subjects were positive by anti-H. pylori IgG ELISA tests. It was found that positive anti-H. pylori IgG ELISA tests were a higher significant difference among rural residents (75.2%) compared with urban residents (24%) (p<0.001).Conclusion: More than half of patients with functional dyspepsia have a history of previous H.pylori infection. Despite the possibility of spontaneous H. pylori infection, the complication of old infections may be sustained by dyspepsia and early treatment of acute H. pylori infections may prevent this complication.
The influence of geomagnetic storms on magnetotelluric data analysis
Authors: Chen Hao , Mizunaga Hideki , Tanaka Toshiaki
Published: January 2021

The geomagnetic storm is a temporary disturbance of the earth's magnetosphere caused by a solar wind shock wave interacts with the earth's magnetic field. It is rarely acquired in the practical magnetotelluric (MT) survey. The rare MT researcher pays attention to the influence of geomagnetic storms on the MT data. MT data include the natural electromagnetic signals and artificial noises (instrumental, humanmade, and so on). Therefore, not all the time series contain usable information about the electrical conductivity distribution at depth, particularly when the signal-to-noise ratio is low. However, the signal-to-noise ratio will increase when there is a geomagnetic storm. In this paper, we focus on research the influences of the geomagnetic storm on MT data. Three case studies were demonstrated to show the positive effect of the geomagnetic storm on MT data. As a result, we could obtain reliable MT impedances at the noisy site using the geomagnetic storm data. It is difficult to get a reliable impedance tensor under electromagnetic environments contaminated by continuous noise. Therefore, predicting the geomagnetic storm by the space weather forecast before acquiring the MT data is effective. Utilizing the MT data during a geomagnetic storm may get a reliable result at the site contaminated by the continuous noise.
Inter-limb differences in patients following total hip arthroplasty four to five years after surgery: a cross-sectional study
Authors: John Stefanie , Weizel David , Heumann Anna Sophie , Fischer Anja , Orlowski Katja , Mrkor Kai-Uwe , Edelmann-Nusser Jürgen , Witte Kerstin
Published: January 2021

Backgroundː Total hip arthroplasty (THA) is an effective procedure for patients with end-stage hip osteoarthritis. However, whether or not pre-operatively existing functional deficits are persisting several years post-surgery in the affected limb has not been thoroughly researched. Therefore, the primary aim of the study was to investigate differences between the operated and non-operated leg in hip strength, range of motion (ROM), balance, and gait in patients four to five years after undergoing THA. The secondary aim was to compare these values from the operated leg of the patients to those of the legs of healthy subjects. Methodsː Sixteen patients (age: 65.20±5.32 years) following unilateral THA (post-operation time: 4.7±0.7 years) and ten, healthy, age-matched control subjects (age: 60.85±7.57 years) were examined for maximum isometric hip muscle strength, active ROM of the hip joint, balance and gait on both limbs. Paired t-tests were used to assess the inter-limb differences in the THA group. Analyses of covariance (ANCOVA) were performed to compare groups, using age as a covariate. Results: The analysis of inter-limb differences in patients following THA revealed significant deficits on the operated side for hip abduction strength (p=0.02), for hip flexion ROM (p<0.01) and for balance in terms of the length of center of pressure (COP) (p=0.04). Compared to values of the control subjects, the patients demonstrated significantly reduced hip strength in flexion, extension and abduction (p<0.05) on the operated leg as well as reduced ROM measures in hip flexion, extension and abduction (p<0.05). Conclusions: Inter-limb differences as well as reduced hip strength and hip ROM compared with control subjects were still present four to five years after THA. These persisting asymmetries and deficits in patients following THA may be one explanation for the decrease in health-related quality of life (HRQoL) seen in patients over the years after surgery. Postoperative training focusing on strengthening hip muscles should be continued months and years after hip replacement in order to compensate persisting deficits and asymmetries. Trial registration: DRKS, DRKS00016945. Registered 12 March 2019 – Retrospectively registered, http://www.drks.de/DRKS00016945
Repression of BET activity sensitizes oral squamous cell carcinoma to PARP inhibition via inhibiting DNA homologous recombination and immune inhibition
Authors: Tong Dongdong , Zhang Xin , Zhang Fenghe , Liu xiaojing
Published: January 2021

Objective: To investigate the therapeutic resistance mechanism of oral squamous cell carcinoma (OSCC) to the PARP inhibitor olaparib and explore the combination with the BET inhibitor JQ1 to enhance its treatment effects. Material and Methods: Cell proliferation, apoptosis and cell cycle distribution were evaluated. Levels of relevant factors were determined by quantitative real-time PCR, western blot and immunofluorescence. The effect of the combination treatment on xenograft OSCC mouse model was examined.Results: Cal27 cells were more sensitive to the PARP inhibitor olaparib than Scc25 cells. Functional assays demonstrated that olaparib induced HR repair and upregulated PD-L1 expression, which results in drug resistance of OSCC to olaparib. Variations of these factors in the two cell lines may explain different sensitivity to olaparib. Moreover, the JQ1 BET inhibitor and olaparib synergistically exhibited anti-cancer effects in OSCC in vitro and in vivo and inhibited essential HR repair factors RAD51, BRCA1, and TOPBP1 through the ATR/CHK1 pathway and immune suppression mediated by the PD-L1 pathway.Conclusions: Elevated HR and PD-L1 are involved in resistance mechanisms of OSCC to olaparib, attenuating its anti-tumor effects. Our results suggest that the strong synergistic anti-cancer effects of the combination of olaparib with the JQ1 BET inhibitor in OSCC in vitro and in vivo may be via suppression of the ATR/CHK1-mediated DNA damage response and PD-L1-related immune escape, indicating this combination strategy as a possible therapeutic approach for OSCC.
Association between short sleep duration and overweight/obesity among middle-school students: a cross-sectional study in Fuzhou, China
Authors: Li Guobo , Wei Shichao , Zheng Fuhao , Xu Xingyan , Cai Yingying , Wu Siying
Published: January 2021

Background: This study was designed to investigate the prevalence of short sleep duration and its association with overweight or obesity in adolescents from middle school in Fuzhou, China.Methods: A total of 13,063 students (male: 6,500; female: 6,553) from 18 different schools in Fuzhou city were included in this study. Questionnaires focusing on short sleep duration and overweight or obesity related factors were collected. The sleep duration was self-reported by the subjects. The body weight and height were measured by the qualified personnel. Logistic regression analysis was used to evaluate the effects of short sleep duration on overweight or obesity in school students.Results: The overall rates of overweight and obesity were 12.1% and 7.1%, respectively. The prevalence of short sleep duration among students was 82.8%. The majority of high school students (92.5%) showed a short sleep duration. Compared with male children with a sleep duration of 8-10 h per day, the odds ratios (ORs) of overweight/obesity for those with a sleep duration of less than 6 h or 6-8 h per day were 1.60 (1.22-2.09) and 1.07 (0.90-1.29) after adjusting social and demographic status, mental health and lifestyle factors. The homologous ORs of female children were 1.45 (1.04-2.04) and 1.11(0.85-1.45), respectively.Conclusions: A large number of adolescents suffered from short sleep duration. Short sleep duration is associated with a higher OR of overweight/obesity in middle-school children, especially in the male adolescences.
Design and development of a mobile app framework to facilitate breast cancer-preventive behaviors (m-BCPB) in the at-risk women: Qualitative Study
Authors: Taymoori Parvaneh , Khazaee-Pool Maryam , Pashaei Tahereh , Ponnet Koen
Published: January 2021

Background Smartphone apps are gradually becoming a universal template for offering preventive behavior interventions among women who are at risk for breast cancer, although limited methodological procedures on mixing models, documentation, and qualitative studies for their developments are presented. Thus, this study aimed to design and develop a model-based, document-driven, and user-centered mobile app framework to facilitate breast cancer-preventive behaviors targeting at-risk women.Methods This study explains how intervention progress may be enriched with a theoretical foundation, literature review, and qualitative research. A semi-structural individual interview and focus group dissection (FGD) were accomplished to combine the user’s participation in the development. Participants were employed using a purposing sampling method. All interviews were audio-recorded, transcribed verbatim, and coded. The thematic analysis method was employed for developing themes and subthemes.Results The ASSISTS model, self-regulation, and the self-control models were chosen to design the app framework. Data from the literature review presented the most influential document for the designing of the programs. Nineteen women were invited to participate in a semi-structured interview and FGDs. The following five main themes were revealed: content, interactive performance, template, extended action and output, and motivational nature. Mobile apps are a useful tool for learning self-care tips, suitable and healthy lifestyles, and stress management due to their user-friendly and easy features. The mobile app framework developed in the present study includes culture-appropriate, user-centered, and reliable content. The mobile app design should include beautiful, visualized features and interactive multimedia.Conclusions By applying a three-phase way of combining models, the literature review and qualitative study from the target group can be held as a pattern for the prospective app design.
Effect of Baduanjin Exercise Intervention on Cognitive Function and Quality of Life in Women With Breast Cancer Receiving Chemotherapy: Study Protocol of A Randomized Controlled Trial
Authors: Wei Xiaolin , Yuan Ruzhen , Jin Yongmei , Li Shu , Wang Mingyue , Jiang Jieting , Wu Caiqin , Li Kunpeng
Published: January 2021

Background: Cancer-related cognitive impairments (CRCI) are frequently reported by cancer patients before and after medical treatment. However, there are no effective interventions to or manage cognitive problem for women with breast cancer. This pilot study was designed to evaluate the protective effect of Baduanjin exercise on cognitive function and cancer-related symptoms in women with early-stage breast cancerundergoing chemotherapy. Method/design: A single-blinded, randomized controlled trial was designed. The trail will recruit 70 patients with early-stage breast cancer scheduled to receive chemotherapy from Shanghai in China. All participants will be randomized(1:1) to receive either supervised Baduanjin exercise intervention (at least 5 times/week and 30min for each time) plus usual care or usual care alone for three months. The effect of Baduanjin exercise intervention will be evaluated by outcome measures such as subjective and objective cognitive function, symptoms (fatigue, depressive symptoms, anxiety) and health-related quality of life at baseline(T0), 8 weeks(T1) and 12 weeks(T3). Primary cognitive outcomes will be reported descriptively while effect sizes and 95% confidence intervals (CIs) will be calculated for cognitive measures. The collected data will be analysed using an intention-to-treat principle. Discussion: This study is the first-known randomized clinical trial to investigate whether Baduanjin exercise plus usual care superior to usual care alone on cognitive function in women with breast cancer receiving chemotherapy. If possible, Baduanjin exercise will be a potential non-pharmacological intervention to manage cognitive function and promote survivorship care among breast cancer survivors.Trial registration: Chinese Clinical Trial Registry(ChiCTR), ID: ChiCTR 2000033152. Registered on 22 May 2020.
Topical administration of tacrolimus and corticosteroids with concentration gradients is effective in preventing immune rejection in high-risk keratoplasty: a 5-year follow-up study
Authors: Qi Xiaolin , Wang Lichao , Zhang Xiaoyu , Liu Min , Gao Hua
Published: January 2021

BACKGROUND: To evaluate the efficacy of the topical administration of immunosuppressants and corticosteroids with concentration gradients in the management of patients with high-risk keratoplasty.METHODS: One hundred and six patients treated with topical immunosuppressants (50 eyes in the FK506 group and 56 eyes in the CsA group) and corticosteroid eye drops with concentration gradients were enrolled in the study. The rates of rejection episodes, irreversible rejection, graft survival, and related influential factors were evaluated.RESULTS: The mean follow-up period was 48.1±7.9 months (range, 36-60 months). The rates of rejection episodes (P=0.043) and irreversible rejection (P=0.062) were 14.0% and 6.00% in the FK506 group and 37.5% and 7.1% in the CsA group, respectively.Kaplan-Meier survival analysis demonstrated a significantly higher graft survival rate in the FK506 group (81.6%±5.3%, 71.1%±6.3%) compared with that in the CsA group (71.1%±6.3%, 57.5%±7.5%) at 3 and 5 years after surgery (P=0.006). Multivariate logistic regression revealed that poor medication compliance with a preoperative risk score ≥ 3 (P=0.016) and endothelial immune rejection (P=0.033) were risk factors associated with graft survival.CONCLUSIONS: Topical administration of tacrolimus and corticosteroids with concentration gradients is effective in decreasing the incidence of immune rejection in high-risk keratoplasty. Careful instruction of patients on the reasonable use of topical tacrolimus is critical to avoid immune rejection induced by sudden discontinuation of medication.
Knowledge, attitudes, practices, and the effects of COVID-19 among the youth in Kenya
Authors: Karijo Evalin , Wamugi Sylvia , Lemanyishoe Samuel , Njuki Jenny , Boit Faith , Kibui Vania , Karanja Sarah , Abuya Timothy
Published: January 2021

Background: Cases of the Corona Virus Disease of 2019 (COVID-19) in Kenya have continued to increase rapidly, since the first case in the country was confirmed in March 2020. In the wake of the pandemic, the health and socio-economic challenges experienced by the youth in Kenya are likely to be elevated. We assessed knowledge, practices, perceived risk, adoption of recommended behaviour and the effects of COVID-19 among the youth in Kenya.Methods: A cross sectional descriptive study was conducted between April 30th to May 7th, 2020 through a combined online survey and phone interviews. A total of 2,156 youth across all 47 counties in Kenya completed the responses to the study questions. All survey responses analyzed using STATA v15 were tabulated by gender, age, and education level to generate basic descriptive tables and tested for differences by category using chi-square tests. Where applicable, linear and logistic regression analysis model was conducted using covariates such as employment status, gender, and education level. Results: Knowledge on symptoms of COVID-19 was generally high. Female respondents were more likely to identify more symptoms correctly compared to men; p<0.001. However, youth reported very low levels of anyone being at risk of infection (7%). Most youth have adopted behavior necessary to slow down the infection. There were generally very low reported levels of inability to access health services related to sexual and reproductive health. About 50% of respondents reported significant decline in income during the pandemic period, nearly a third reported living in fear while 27% reported feeling stressed. Conclusion: There was high knowledge of COVID-19 symptoms, preventive strategies, and high adoption of preventive practices. Strategies to sustain behaviors positively adopted among young people will be critical to reduce the spread of COVID-19. Despite low reported rates of inability to access sexual and reproductive health, response measures should include strategies that facilitate continuity of services among young people. The reported social effects of the pandemic show the need for interventions to meet the health and socioeconomic needs of the youth and minimize the long-term consequences of the pandemic.
Rosiglitazone Protects Blood-Brain Barrier Integrity Following Ischemic Stroke by Reducing MMP-9 Expression Through a Caveolin-1-Dependent Pathway.
Authors: Huang Qianyi , Zhong Wei , Yi Xia , Qin Zhen , Tang Xiangqi
Published: January 2021

Background: Rosiglitazone (RSG) is a widely used antidiabetic drug which activates peroxisome proliferator-activated receptor-γ. Recent work have shown that RSG can up-regulate caveolin-1 levels and ameliorate both chronic and acute brain injury. However, whether rosiglitazone can ameliorate ischemic injury in the brain via a caveolin-1-dependent pathway remains unknown. Methods: Adult male sprague-dawley rats were randomly divided into sham operation group, model group, rosiglitazone group and rosiglitazone+daidzein group. The rat models of middle cerebral artery occlusion (MCAO) was established using the suture method, with ischemia for 2 hours and reperfusion for 22 hours. Neurological deficits were evaluated by the methods of Longa’s standard scoring. Cerebral infarction volume was observed by staining with 2, 3, 5-triphenyltetrazolium chloride. Evans blue content reflects BBB permeability. The expressions of caveolin-1, matrix metalloproteinase-9(MMP-9) and occludin were detected by immunofluorescent staining and western blot. Results: In this study, we found that the expression of caveolin-1 was increased in a rat model of stroke, and treatment with RSG significantly increased the levels of caveolin-1, reduced the release of MMP-9, and increased the expression of occludin. On the other hand, a caveolin-1 inhibitor daidzein canceled the protective roles of RSG in the MCAO model.Conclusions: These data unveil that RSG might protect blood-brain barrier integrity by down-regulating the levels of MMP-9 via a caveolin-1-dependent pathway.
The relationship between different types of caries and periodontal disease severity in middle-aged and elderly people: findings from the 4th National Oral Health Survey of China
Authors: Yu Lixia , WANG Xing , FENG Xi Ping , TAI Bao Jun , HU De Yu , WANG Bo , WANG Chun Xiao , ZHENG Shu Guo , LIU Xue Nan , RONG Wen Sheng , WANG Wei Jian , SI Yan , Lin Huan Cai
Published: January 2021

Background: The relationship between dental caries and periodontal disease is still controversial. The objective of this study is to explore the relationship between different types of caries and periodontal disease severity in middle-aged and elderly people in China.Methods: The study population consisted of 4,387 middle-aged and 3,225 elderly subjects. Caries were divided into the following three types: type A, crown caries; type B, lesions involving both the crown and root, representing a mixed type; and type C, root caries. These three types together represent the overall caries situation, which we call type ABC. Caries were quantitated by decayed and filled teeth (DFT index). Periodontitis was evaluated by clinical attachment loss.Results: Middle-aged people with periodontitis had a significant association with DFT of type ABC (OR: 1.09, 95% CI: 1.06‐1.11), type A (OR: 1.05, 95% CI: 1.02‐1.08), type B (OR: 1.20, 95% CI: 1.16-1.28) and type C (OR: 1.36, 95% CI: 1.15-1.60). Elderly people with periodontitis had a significant association with DFT of type ABC (OR: 1.05, 95% CI: 1.03-1.07), type B (OR: 1.07, 95% CI: 1.05-1.10) and type C (OR: 1.30, 95% CI: 1.19-1.42) but not type A.Conclusions: Different types of caries in middle-aged people and overall caries and caries types involving the root surface in elderly people were significantly associated with periodontal disease severity.
Assessment and management capacities for the child health screening and intervention initiative in Visakhapatnam, India
Authors: PAGOLU KOTESWARA RAO , RAO T. RAGHAVA
Published: January 2021

Background: Early detection and early intervention of diseases can significantly improve child quality of life. The most often a diagnosis of Developmental Delay (DDs) made by a doctor based on strict guidelines. The aim of present survey is to decide the commonness of the conditions screened and institutional facilities through the RBSK activity among the children going to the DEIC focus at Visakhapatnam, India. Methods: This observational study was conducted in Visakhapatnam, District Early Intervention Centre (DEIC) one of the north coastal district of India for one year period and 6572 children aged 2 months-18 years were taken in the study. Norms were developed by the Ministry of Health and Family Welfare, India to DEIC, according to the norms the pediatrician will examine the children who came to the center. Existing manpower analysis in the center was also done. Present study was done the multivariate logistic regression analysis were done to identify the predictors for DDs.Results: The examination of the 30 conditions screened under 4D's methodology, defects during childbirth were there in 255(3.88%), followed by deficiencies in 239 (3.63%) children, diseases during childhood were seen in 1277 (19.43%) children and disabilities and DDs were seen in 4801 (73.05%) children. From the diseases, dental caries were found in most elevated number of youngsters with 1219 (18.54%) cases. The mostly occurring DDs are language delay 941(14.31%) children had imperfections of these were observed. On analysis of deficiencies, most extreme number of 236 (3.59%) children was found with serious intense unhealthiness of severe acute malnutrition. Among the defects at birth, congenital deafness was the most frequently screened stipulation found in 84 (1.27%) children. The post of medical officer, Psychologist and DEIC manager stayed empty all through the examination time frame. Conclusion: In the present study we have undiagnosed that many curable diseases in children are not identified at all in a timely manner. Early intervention services on children's health are very useful and in future these services are extent for every individual child.
The Brain in Motion II Study: Study Protocol for a Randomized Controlled Trial of an Aerobic Exercise Intervention for Older Adults at Increased Risk of Dementia
Authors: Krüger Renata L. , Clark Cameron M. , Dyck Adrienna M. , Anderson Todd J. , Clement Fiona , Hanly Patrick J. , Hanson Heather M. , Hill Michael D. , Hogan David B. , Holroyd-Leduc Jayna , Longman R. Stewart , McDonough Meghan , Pike G. Bruce , Rawling Jean M. , Sajobi Tolulope , Poulin Marc J
Published: January 2021

Background: There remains no effective intervention capable of reversing most cases of dementia. Current research is focused on prevention, by addressing risk factors that are shared between cardiovascular disease and dementia (e.g., hypertension) before the cognitive, functional, and behavioural symptoms of dementia manifest. A promising preventive treatment is exercise. This study describes the methods of a randomized controlled trial (RCT) that assesses the effects of aerobic exercise and behavioural support interventions in older adults at increased risk of dementia due to genetic and/or cardiovascular risk factors. The specific aims are to determine the effect of aerobic exercise on cognitive performance, explore the biological mechanisms that influence cognitive performance after exercise training, and determine if changes in cerebrovascular physiology and function persist one year after a 6-month aerobic exercise intervention followed by a 1-year behavioural support program (at 18 months).Methods: We will recruit 264 participants (aged 50-80 years) at elevated risk of dementia. Participants will be randomly allocated into one of four treatment arms: (1) aerobic exercise and health behaviour support, (2) aerobic exercise and no health behaviour support, (3) stretching-toning and health behaviour support, and (4) stretching-toning and no health behaviour support. The aerobic exercise intervention will consist of three supervised walking/jogging sessions per week for 6 months whereas the stretching-toning control intervention will consist of three supervised stretching-toning sessions per week also for 6 months. Following the exercise interventions, participants will receive either one year of ongoing telephone behavioural support or no telephone support. The primary outcome is cognition assessed through neuropsychological tests. Secondary outcomes include variety of cerebrovascular/physiological, neuroimaging, sleep, cognitive, other psychological variables and healthcare utilization. The outcome assessments will be conducted at baseline, after the 6-month intervention, and 1 year after the completion of the exercise intervention (at 18 months).Discussion: This study will address knowledge gaps regarding the underlying mechanisms of the pro-cognitive effects of exercise by examining potential mediating factors, including cerebrovascular/physiological, neuroimaging, sleep, and genetic factors that will provide novel biologic evidence on how aerobic exercise can prevent declines in cognition with aging.Trial Registration: ClinicalTrials.gov (NCT03035851, 30 January 2017).
User tag weight assessment based on fuzzy theory in mobile social networks
Authors: Gao Min , Xu Li , Wang Xiaoding , Zhang Xinxin
Published: January 2021

Mobile social network supports mobile communication and asynchronous social networking. For enterprises, how to provide better services and create greater business value through the data and information provided by users is crucial. For example, enterprises need to build user profiles to achieve personalized recommendation and precision marketing. In view of the data modeling stage of user profile, we propose a method to evaluate user tag weight, which includes two steps. Specifically, we introduce fuzzy theory to get the initial weight interval. Then, genetic algorithm with single point crossover is used to optimize user tag weight. Experiment results show that the proposed method has better performance than other three methods applied to recommendation system.
Measuring cost and affordability of current vs. healthy diets in Argentina: an application of linear programming and the INFORMAS protocol.
Authors: Giacobone Gabriel , Tiscornia Maria Victoria , Guarnieri Leila , Castronuovo Luciana , Mackay Sally , Allemandi Lorena
Published: January 2021

Background Food cost and affordability is one of the main barriers to improve the nutritional quality of diets of the population. However, in Argentina, where over 60% of adults and 40% of children and adolescents are overweight or obese, little is known about the difference in cost and affordability of healthier diets compared to ordinary, less healthy ones. Methods We implemented the "optimal approach" proposed by the International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support (INFORMAS). We modelled the current diet and two types of healthy diets, one equal in energy with the current diet and one 6.3% lower in energy by linear programming. Cost estimations were performed by collecting food product prices and running a Monte Carlo simulation (10,000 iterations) to obtain a range of costs for each model diet. Affordability was measured as the percentage contribution of diet cost vs. average household income in average, poor and extremely poor households and by income deciles. Results On average, households must spend 32% more money on food to ensure equal energy intake from a healthy diet than from a current model diet. When the energy intake target was reduced by 6.3%, the difference in cost was 22%. There are no reasonably likely situations in which any of these healthy diets could cost less or the same than the current unhealthier one. Over 50% of households would be unable to afford the modelled healthy diets, while 40% could not afford the current diet.Conclusions Differential cost and affordability of healthy vs. unhealthy diets are germane to the design of effective public policies to reduce obesity and NCDs in Argentina. It is necessary to implement urgent measures to transform the obesogenic environment, making healthier products more affordable, available and desirable, and discouraging consumption of nutrient-poor, energy-rich foods.
User Knowledge Factors that Hinder the Design of New Home Healthcare Devices: Investigating Thirty-Eight Devices and Their Manufacturers
Authors: Yang Fan , Mahmud Abdullah Al
Published: January 2021

Background: The demand for home healthcare devices arises; however many home healthcare devices on the market are not designed to reflect the needs and features of the end-users. This study explored the user knowledge factors that hindered the design of new home healthcare devices, along with the interrelationships between the factors. Methods: The abovementioned factors were identified from analysing the project documents of thirty-eight carefully selected home healthcare devices produced by five manufacturers; followed by interviewing the thirty stakeholders playing key roles in the development of the devices. Results: The design of the home healthcare devices was influenced by (i) the user insights utilised in formulating project strategies; (ii) the sources of user information; (iii) the execution of user research; and (iv) the formulation of the manufacturers’ principal innovation processes.Conclusions: The users’ characteristics and needs were not sufficiently reflected within the processes of developing new home healthcare devices. One root cause was that the end-users were not perceived by the manufacturers as a key success factor in most of the cases, given that most of the devices were initiated following the public sector’s requests. Actual or potential applications of this study include the facilitation of the appropriate application of human factors methods in the development of new home healthcare devices, and the improvement of the user performance of the end-devices.
Resilience, Occupational Burnout, and Parenting Stress in Nurses Caring for COVID-2019 Patients
Authors: Bashirian Saeid , Bijani Mostafa , Borzou Seyed Reza , Oshvandi Khodayar , Khazaei Salman , Mohammadi Fateme
Published: January 2021

Background: Caring of patients with corona virus infection disease may have had an impact on the occupational burnout, resilience, and parenting of the nurses. Purpose: Evaluation occupational burnout, resilience, and parenting stress in nurses caring for COVID 2019 patients.Methods: This cross-sectional study is based on strengthening the reporting of observational studies in epidemiology statement. A total of 630 nurses caring for COVID 2019 patients in 5 hospitals were selected via convenience sampling. Participants completed the scales online. Data were analyzed in SPSS v. 22.Results: A total of 420 nurses completed and returned the questionnaires. Occupational burnout has a negative correlation with resilience and a positive correlation with parenting stress and can predict 61.32% of changes in the occupational burnout variance of nurses. Conclusion: Resilience, parenting stress, marital status, number of children, employment status, and gender predicated high percentage of the nurses’ occupational burnout variance. The nurse managers should use these findings to provide appropriate environments for nurses, to develop more comprehensive plans in support of nurses for the current and future crises.
What is the added value of CT-angiography in patients with transient ischemic attack?
Authors: Herpertz Gerrit U. , Maier Ilko L , Bähr Mathias , Psychiogios Marios-Nikos , Liman Jan
Published: January 2021

Background Transient ischemic attack (TIA) is an important predictor for a pending stroke. Guidelines recommend similar workup for TIA-patients as for stroke patients to directly assess the extra- and intracranial arteries via Computed tomography angiography (CTA) regarding vascular pathologies with direct therapeutic implications. Aim of our study was a systematic analysis of CTA-findings in TIA-patients and evaluate possible predictive TIA scores for ipsilateral vascular pathology. Methods We analysed data from TIA patients, admitted to our University Medical Centre, between September 2015 and March 2018, to identify predictors for high-risk vascular pathologies, like high-grade stenosis, dissection, thrombi or occlusion and the for need for an intervention. Following subgroups were identified: 1) no- or low-grade-stenosis (<50%) 2) ipsilateral high-risk vascular pathology and 3) high risk findings needing surgical or interventional treatment. As predictive tools for ipsilateral vascular findings we used the ABCD2-, the ABCD3- and the SPI-II score.Results Of 833 patients, 549 (65.9%) underwent initial CTA in the emergency department. In 126 (23.0%) patients, ipsilateral vascular findings were identified from which 40 (7.3%) needed treatment. The ABCD2-, ABCD3- and SPI-II-scores were not predictive for ipsilateral vascular pathologies. We identified coronary heart disease (OR 2.13, 1.35-3.39 95% CI; p=0.001) and short duration of symptoms (OR 0.7, 0.55-0,89 95% CI; p=0.004) as predictors for ipsilateral vascular pathologies. Conclusion More than every fifth TIA-patient had relevant vascular findings revealed by acute CTA. TIA-scores were not predictive for these findings. Patients with a history of coronary heart disease and short duration of symptoms most likely might benefit from acute CTA to streamline further diagnostics and therapy.