bluuebunny/crossref_metadata_2025 huggingface dataset:
Anxiety Amongst Physicians During COVID-19: Cross-Sectional Study in Pakistan
Authors: Mahmood Qaisar Khalid , Jafree Sara Rizvi , Jalil Aisha , Fischer Florian , Nadir Syed Mujtaba Hasnain
Published: August 2020

Background: Ensuring safety and wellbeing of healthcare providers is crucial, particularly during times of a pandemic. In this study, we aim to identify the determinants of anxiety in physicians on duty in coronavirus wards or quarantine centers. Methods: We conducted a cross-sectional quantitative survey with an additional qualitative item. Overall, 103 physicians completed the questionnaire. T-test results revealed significant associations between gender and anxiety. Results: Structural equation modeling identified that high workload contributed to greater exhaustion (β=0.41, R2=0.17, p<0.001) and greater family strain (β=0.47, R2=0.22, p<0.001). Exhaustion (β=0.17, p<0.005), family strain (β=0.34, p<0.001), and feelings of protection (β=-0.30, p<0.001) significantly explained anxiety (R2=0.28). Qualitative findings further identified specific needs of physicians with regard to protective equipment, compensation, quarantine management, resource allocation, security and public support, governance improvement, and health sector development. Conclusions: It is imperative to improve governmental and social support for healthcare providers during the corona pandemic. Immediate attention is needed to reduce anxiety, workload, and family strain in frontline practitioners treating coronavirus patients, and to improve their (perceptions of) protection. This is a precondition for patient safety.
An approach to determine the coronal plane deformity of the distal tibia intraoperatively in the treatment of tibial fracture with intramedullary nail fixation
Authors: Lu Yao , Yang Jie , Xu Yibo , Ma Teng , Li Ming , Ren Cheng , Wang Qian , Li Zhong , Zhang Kun
Published: August 2020

Background To develop a new approach to determine the existence of coronal plane deformity (valgus and varus) intraoperatively in the treatment of tibial fracture with closed reduction and intramedullary nail fixation. Methods A retrospective analysis was conducted by enrolling 33 consecutive patients with tibial fracture who underwent closed reduction and intramedullary nail fixation from January 2018 to January 2019 in our trauma center. There were 23 males and 10 females aged from 22 to 69 years old with an average of 41.3. The standard anteroposterior and lateral preoperative radiographs were performed routinely. After insertion of the tibial intramedullary nail through the standard entry point intraoperatively, the parallel relationship between the distal horizontal interlocking screw and the tibiotalar joint surface on the anteroposterior fluoroscopy was used to determine the occurrence of valgus or varus deformity of the distal tibial fragment. Results 33 patients were postoperatively followed up for 13 to 25 months (mean 18.7 months). The fractures achieved bone union in 4.3 months by average (ranging from 3 to 6 months). The lateral distal tibial angle (LDTA) of the unaffected side which is measured postoperatively was 87.3°-89.6 ° (average 88.7 °± 0.8°), and the LDTA of the affected side was 87.5°-90.4°(average 88.9°± 1.1°). There was no statistically significant difference between the unaffected side and the affected side (t=-1.865, p=0.068). The intraoperative measurement indicated 6 cases of valgus angulation and 3 cases of varus angulation deformities, and all the deformities were corrected accordingly during the surgery. According to the Olerud-Molander Ankle Score, the clinical outcomes demonstrated 22 excellent cases, 8 good cases, 2 fair cases, and 1 poor case of all the fractures at 12 months after surgery. Conclusion During closed reduction and intramedullary nail fixation for tibial fractures, the parallel relationship between the distal horizontal interlocking screw and the tibiotalar joint surface on the intraoperative anteroposterior films showed the better discriminative ability to determine the onset of valgus or varus deformity of the distal tibial fragment after the tibial intramedullary nail inserted through the standard entry point.Level of Evidence: Level IV, case series study.
A comparison of clinical outcomes and cartilage repair between opening wedge and closed wedge high tibial osteotomy procedures in patients with medial osteoarthritis of the knee
Authors: Akamatsu Tomotaka , Kumagai Ken , Yamada Shunsuke , Nejima Shuntaro , Sotozawa Masaichi , Ogino Takahiro , Inaba Yutaka
Published: August 2020

Background: The aim of the present study was to assess differences in clinical outcomes and postoperative cartilage repair between opening wedge high tibial osteotomy (OWHTO) and closed wedge HTO (CWHTO) for medial osteoarthritis (OA) of the knee.Methods: A total of 90 knees of 76 patients who underwent HTO were investigated. OWHTO was performed in 45 knees of 40 patients with a correction angle of 15° or less, and CWHTO was performed in 45 knees of 36 patients with a correction angle of greater than 15°. Initial arthroscopy was performed at the time of HTO, and a second-look arthroscopy was performed at the time of plate removal. Cartilage repair was classified into the following stages: Stage 1 (no reparative change); Stage 2 (partial coverage with white cartilaginous tissue); and Stage 3 (full coverage with white cartilaginous tissue). Clinical outcomes were assessed using Knee Society scores, and radiographic assessment was carried out by measuring the femorotibial angle (FTA).Results: Regarding preoperative OA grade, varus alignment, and function score, CWHTO patients showed more advanced OA status than OWHTO patients. Knee scores and function scores were significantly improved after surgery with both HTO procedures (P<0.05), with no significant difference between the two procedures. Cartilage repair of stage 2 or 3 was found in more than 80% of the subjects in the medial femoral condyle and more than 60% in the medial tibial condyle. However, there were no significant differences between the two HTO procedures. There was no relationship between clinical outcomes and postoperative cartilage status in both HTO procedures. Multivariate logistic regression analysis showed that preoperative International Cartilage Repair Society (ICRS) grade was the only factor affecting cartilage repair.Conclusions: CWHTO improved clinical outcomes and cartilage status as much as OWHTO. Although the effects of cartilage repair on clinical outcomes are unknown, HTO is an effective treatment option even for severe medial OA of the knee.
Identification of Key Genes and Pathways Associated with Differences of Subchondral Bone in Osteoarthritis
Authors: Zhang Yiyuan , Yu Rongguo , Zhang Jiayu , Feng Eryou , Wang Haiyang , Li Zhanglai , Wang Wulian , Zhuo Youguang , Lin Liqiong , Huang Yuting , Wu Chunlin
Published: August 2020

BackgroundOsteoarthritis (OA) is a common chronic disease worldwide. Subchondral bone is an important pathological change in OA and responds more rapidly to adverse loading and events compared to cartilage. However, the pathogenic genes and pathways of subchondral bone are largely unclear.ObjectiveThis study aimed to identify signature differences in genes involved in knee lateral tibial (LT) and medial tibial (MT) plateaus of subchondral bone tissue while exploring their potential molecular mechanisms via bioinformatics analysis.MethodsFirst, the gene expression data of GSE51588 was downloaded from the GEO database. Differentially expressed genes (DEGs) between knee LT and MT were identified, and functional enrichment analyses were performed. Then, a protein-protein interactive network was constructed in order to acquire the hub genes, and modules analysis was conducted using STRING and Cytoscape for further analysis. The enriched hub genes were queried in DGIdb database to find suitable drug candidates in OA.ResultsA total of 202 DEGs (112 upregulated genes and 84 downregulated genes) were determined. In the PPI network, ten hub genes were identified. Five significant modules were identified using the MCODE plugin unit. Functional enrichment analysis revealed the most important signaling pathways. Six of the ten hub genes were targetable by a total of 35 drugs, suggesting their possible therapeutic use for OA .ConclusionsThe identified hub genes and functional enrichment pathways were implicated in the development and progression of subchondral bone in OA, thus improving our understanding of OA and offering molecular targets for future therapeutic modalities.
Causes and Challenges of Males’ Rhinoplasty in Iranian Population: Qualitative Study
Authors: Ghafari Zeinab , Jalali Amir , Abbasi Parvin , Yousefi-Labani Javad
Published: August 2020

Background: Rhinoplasty is a cosmetic surgery for which the society and the individual incur heavy costs. The present study is an attempt to elaborate on the causes and challenges of males’ rhinoplasty in Iranian population. Methods: The study was carried out as a qualitative study using content analysis method. Totally, 20 participants (16 clients, one family member, and three care-givers) were selected purposefully and participated in semi-structured and in-depth interviews. With 20 interviews, data saturation was achieved. Data analysis process was conducted manually along with the interviews following Lundman and Graneheim method.Results and conclusion: Data analysis revealed 614 primary codes and the continuous examination and removal or repetitious codes left 417 codes, nine sub-themes, and two themes namely the reasons for rhinoplasty (lack of confidence, hope for a better face, seeking attention, keeping up with the Joneses, and persuasion by others) and challenges (family challenge, social atmosphere, financial problems, and unwanted consequence). The lack of confidence and the hope of having a more beautiful face were the motivators. Family challenges, financial problem and the negative side effects of the surgery were challenges in the way of men for having rhinoplasty.
Identification and validation of a two‐gene metabolic signature for survival prediction in patients with kidney renal clear cell carcinoma
Authors: Guo Xudong , Sun Zhuolun , Jiang Shaobo , Jin Xunbo , Wang Hanbo
Published: August 2020

Background: Kidney renal clear cell carcinoma (KIRC) is one of the most common malignant tumors worldwide. Deregulated tumor cell metabolism is emerging as a common feature of tumorigenesis. The expression pattern and clinical significance of metabolism-related genes (MRGs) in KIRC remains unclear.Methods: We downloaded the RNA sequencing data and corresponding clinical information for KIRC from the Cancer Genome Atlas (TCGA) database and identified the differently expressed MRGs between tumors and normal tissues. According to the Cox regression analysis and least absolute shrinkage and selection operator (LASSO), we identified target genes for prognostic signature construction. We also analyzed the correlations of the signature risk score with clinicopathological features. The robustness of the signature was further examined by stratified survival analysis. A predictive nomogram was built for the optimal strategy to predict the survival possibility of KIRC patients. The expression levels of target genes were validated in multiple datasets. Gene set enrichment analyses (GSEA) were performed to unveil several significantly enriched pathways.Results: A total of 123 differentially expressed MRGs were identified, including 60 up-regulated genes and 63 down-regulated genes. Next, RRM2 and ALDH6A1 were identified as prognosis-related genes and used to construct a prognostic signature. The signature was proved to be an independent prognostic factor for KIRC survival by multivariable Cox regression analysis. Subgroup analysis indicated that this signature could serve as a classifier for the evaluation of low- and high-risk groups. Up regulation of RRM2 and down regulation of ALDH6A1 were associated with unfavorable prognosis in patients suffering from KIRC. Nomogram including the signature suggested some clinical net benefit for overall survival prediction. In addition, the calibration curves indicated the nomogram performed well in predicting 3‐ and 5-year OS compared with the ideal model. The expression level of RRM2 was significantly up-expressed, while ALDH6A1 were significantly down-expressed in KIRC samples compared with the normal samples in multiple datasets. Furthermore, RRM2 and ALDH6A1were significantly enriched in different pathways.Conclusion: Our study identified a two‐gene metabolic signature that had important clinical implications in KIRC prognosis prediction, which might provide potential biomarkers and targets of metabolic therapeutic relevance.
Prelabour Uterine Rupture In Two Patients With A Previous Caesarean Section For Placenta Previa
Authors: Dellino Miriam , Crupano Francesco Maria , He Xuemin , Vimercati Antonella
Published: August 2020

Background Spontaneous uterine rupture is a severe pregnancy complication. Several risk factors have been described, especially for women with a previous caesarean section.Method We reported two cases of uterine rupture (UR) occurred outside of labour in patients with a history of caesarean section for placenta previa were reports. Results The current study evaluates how a higher hysterotomy, combined with some risk factors, can increase the prevalence of UR in the next pregnancy. Conclusion These cases presentation provide a supplement to over-all knowledge about UR showing that a careful evaluation of risk factors could promote the early UR management and consequently, improve the maternal-fetal outcome.
Time for more evidence: a scoping review of the effects of sanctions on Iranian health
Authors: Majdzadeh Reza , Yahyaei Faeze , Sajadi Haniye Sadat , Danaei Goodarz
Published: August 2020

Background

Islamic Republic of Iran has been the target of massive sanctions since 1979, which got intensified in 2005, 2012, and also in 2015 following JCPOA cancellation. Long-term economic sanctions have impacted Iran’s health system. The aim of this study is to examine the impact of sanctions on health system in Iran, and Iranian people’s health.
Methods

A scoping review was performed. PubMed/Medline, Embase, Web of Science, Scopus, and Scientific Information Database were searched from 2012 using the sanction, health and Iran keywords to find the studies that examined the impacts of sanctions on health in Iran. After screening, only original studies, namely studies which collected data through experiments, surveys, observation, interviews, or review of the literature were included, and letters to the editors and secondary reports were excluded. Final listings of articles were supplemented with hand searches of reference listings to ensure completeness. Data on study characteristics and the impacts of sanctions on health were extracted and summarized.
Result

The preliminary search has identified 273 documents among which 11 articles had the eligibility criteria to be included. They showed remarkable effects of sanctions on access to medicines for the treatment of cancers, non-communicable diseases, asthma, epilepsy, addiction, and hemophilia.
Conclusion

While there is a scarcity of evidence in quantifying the sanction’s impact and also the potential impact on different dimensions of people’s health, it seems that innocent people suffered from the economic downturn caused by sanction. The exact impact of sanctions on different health related areas could be the subject of further studies. Furthermore, more vigorous monitoring and evaluation systems are needed to investigate the effects of sanctions on health outcomes and system to be sure that they do not violate people’s fundamental human right to health.
CT Radiomics and Morphologic Characteristics for Predicting PD-L1 Expression on Tumour Cells and Tumour Infiltrating Lymphocytes in Gastric Cancer
Authors: Qiao Xiangmei , Li Lin , Li Zhengliang , Ji Changfeng , Li Hui , Shi Tingting , Gu Qing , Liu Song , Zhou Kefeng , Zhou Zhengyang
Published: August 2020

Background

To explore CT radiomics and morphologic characteristics for predicting programmed cell death ligand 1 on tumour cells (PD-L1) and tumour infiltrating lymphocytes (PD-L1-TILs) status in gastric cancer (GC).
Methods

From March 2019 to October 2019, 101 patients identified with GCs who underwent surgery at our hospital were enrolled in this study retrospectively. Radiomic features were extracted from regions of interest manually drawn on venous CT images. Besides, 13 morphologic characteristics were evaluated. The signatures based on radiomics and morphologic characteristics were built using multiple classifiers (Support Vector Machine [SVM], Naive Bayes [NB], Decision Trees [DT], and Random Forest [RF]). Receiver operating characteristic (ROC) curve was performed to assess diagnostic efficiency.
Results

The adjacent adipose tissue (P = 0.009) and numerous radiomic features (all P < 0.05) differed significantly between GCs with different PD-L1 status. Six radiomic features showed significant differences between different PD-L1-TILs status (all P < 0.05). The highest areas under the ROC curves (AUCs) of signatures generated by classifiers were 0.807 (SVM) and 0.729 (NB) for the prediction of PD-L1 and PD-L1-TILs status, respectively.
Conclusions

It was promising to predict PD-L1 status in GCs noninvasively using CT radiomics combined with morphologic characteristics. It might help to improve clinical decision making with regard to immunotherapy. However, the prediction for PD-L1-TILs needs to be explored further.
WITHDRAWN: Management of canine insulinomas with toceranib phosphate: 30 cases (2009-2019)
Authors: Sheppard-Olivares Sabina , Bello Nora , Johannes Chad M , Hocker Samuel , Billler Barbara , McKee Talon , McMillan Mattison , Husbands Brian , Wood Elizabeth , Wouda Raelene M
Published: August 2020

BACKGROUNDInsulinomas are the most common tumour of the endocrine pancreas in dogs. These are malignant tumours with a high metastatic rate and limited efficacious chemotherapeutic options available. Recent literature supports the use of the multi-receptor tyrosine kinase inhibitor sunitinib malate for treatment of metastatic insulinoma in people. Toceranib phosphate is a veterinary targeted therapy that may provide benefit in treatment of canine insulinomas. The primary objectives of this retrospective study were to describe the control of clinical signs, response to toceranib in the case of measurable disease, and outcomes of toceranib therapy for canine insulinoma. A secondary objective was to describe the adverse effects of toceranib in dogs with insulinoma.RESULTSA medical record search identified 30 dogs diagnosed with insulinoma and treated with toceranib at five university hospitals and eight veterinary specialty referral hospitals. A majority (66.7%) of dogs with measurable disease experienced either complete response (CR), partial response (PR), or stable disease (SD) for a minimum of 10 weeks with toceranib therapy. The overall median progression free interval (PFI) was 561 days (95% confidence interval: [246, 727 days]). The overall medial survival time (OST) was 656 days [310, 1045 days]. Larger dogs were at increased risk for disease progression (P = 0.0310) and death (P = 0.0064), with every 1 kg increase in body weight resulting in hazard ratios (HRs) of 1.045 [1.003, 1.084] and 1.05 [1.012, 1.090], respectively. In addition, time to disease progression was associated with use of therapies prior to toceranib (P = 0.0050) and type of veterinary practice (P = 0.0025). The most common adverse events with toceranib therapy were grade 1 or 2 gastrointestinal toxicities.CONCLUSIONSClinical benefit was reported in the majority of dogs diagnosed with insulinoma treated with toceranib, but randomized, prospective studies are needed to assess and quantify the effect of this therapy. The most commonly observed adverse events (AEs) were grade 1 or 2 gastrointestinal AEs.
IgG seroprevalence against SARS-CoV-2 in a cohort of 449 non-hospitalized, high-risk exposure individuals.
Authors: Martínez Patricia Torres , García Paula Diaque , Salas María Rubio , Sánchez Raquel Rodríguez , García Felipe , Llamas Miguel Ángel , Saz-Leal Paula , Fresno CArlos del
Published: August 2020

COVID-19 pandemic caused by SARS-CoV-2 led the Spanish government to impose a national lockdown in an attempt to control the spread of the infection. Mobility restrictions but also the requirement of a medical prescription to gain access to serological testing for COVID-19 were included among the measures. Under this scenario, between April 15th to June 15th, 2020, we performed a seroprevalence observational study including 449 individuals that fulfill prescription requirements: manifesting COVID-19 compatible symptoms, being in contact with a COVID-19 confirmed case or belonging to essential occupations including healthcare workers, firefighters or public safety personnel such as police. Importantly, none of the participants was hospitalized. Altogether, we studied this specific, non-commonly addressed cohort for SARS-CoV-2 seroprevalence, uncovering intrinsic features of great demographic interest. The overall rate of IgG seropositivity was 33.69% (95% CI: 29.27 – 38.21). This seroprevalence was comparable between different occupations performed by the participants. However, contacts with confirmed cases associated positively with IgG+ results, with stronger correlation if being a household member. The number of symptoms also correlated positively with IgG+ prevalence. Ageusia/anosmia, pneumonia and cutaneous manifestations were the top-three symptoms that most strongly associated with IgG+ seroprevalence. However, while pneumonia and cutaneous manifestations were barely present in our cohort, fever, ageusia/anosmia and asthenia were the most frequently symptoms described within IgG+ subjects. Therefore, our data illustrate how specific cohorts display heterogeneous characteristics that should be taken into account when identifying population seroprevalence against SARS-CoV-2 and key defining symptoms for COVID-19.
The Influence of Parental Feeding Knowledge and Practices on Chinese Children and Adolescents’ Weight Status
Authors: Zhang Li , Zhang Yaorong , Qiu Liya , Yang Guangxing
Published: August 2020

Background: Child and adolescent overweight is becoming more prevalent in recent decades. It is imperative to investigate the determinants of children and adolescents’ weight outcomes. Methods: Through analyzing the 2004, 2006, 2009 and 2011 waves of survey data released by China Health and Nutrition Survey (CHNS), this paper investigated the gender and rural-urban differences in terms of the ways in which parental feeding knowledge and practices affected the weight status of Chinese children and adolescents aged 6 to 17. Data were collected through random sampling strategy and logistic regression models were built to conduct analyses.Results: The results showed that feeding knowledge and practices varied by parental residence and were different among mothers and fathers. In addition, parental feeding knowledge, parental eating habits and styles, mother’s intervention on children’s food intakes and physical exercise, and the number of meals parents sharing with children showed significant effects on children and adolescents' weight status. Conclusions: As compared to fathers, mothers’ feeding practices showed more significant effects on children and adolescents’ weight status. The manner in which parental feeding practices influenced children and adolescents’ weight status also differed in rural and urban settings. These findings suggested that mothers were still “gatekeepers” of children and adolescents’ food choices and selection; their feeding practices played a more decisive role on Chinese youth’s weight status. The urban-rural differentials highlighted in this research also reminded us that the “one-fits-all” solutions to prevent youth’s obesity should be avoided.
The relationship between hormone receptor status, tumor size and clinical stage and the efficacy of neoadjuvant chemotherapy for locally advanced breast cancer, predictors of survival, and the establishment of Cox-Based risk prediction model and nomogram
Authors: Fengjiao Gan , Mengxi Xu , Xiaomei Li , Lian Wang , Mingyue Zhang , Lin Xu , Qiaoyuan Wu , Ni Jiang , Kang Hu , Yi Li , Suhong Sun , Qing Luo
Published: August 2020

Background: Neoadjuvant chemotherapy is currently mainly used for locally advanced breast cancer. However, there is currently no effective way to predict the prognosis of neoadjuvant chemotherapy patients. Methods: All relevant data before and after chemotherapy were collected and evaluate the efficacy of chemotherapy through RECIST1.1 and pathology. Survival curves were generated by the Kaplan-Meier method and compared using the log-rank test. A nomogram was developed using a binary logisti regression model with a cross validation. Results: A total of 158 patients were included in our study. The ORR was 64.6% (cCR, 3.8%; cPR, 60.8%). The pCR rates wer 12.0% for breast tumor and axillary nodes. The pCR rates were 17.1% for breast tumor and 30.4% for axillary nodes. Our study found that only differences in HER-2 status could predict different clinical efficacy, and clinical remission (CR+PR) was more likely to be achieved if HER-2 positive than negative (16.7% vs 7.5%, p=0.05). There was no significant difference in the clinical efficacy of neoadjuvant chemotherapy in age, clinical stage, and molecular classification of patients. In a single factor COX proportional hazard model study, it was found that ER positive relative to HR negative(HR 0.479,CI 95% 0.272-0.844, p=0.011), PR positive relative to PR negative (HR 0.423,CI 95% 0.235-0.763, p=0.004), HER-2 positive relative to HER-2 negative (HR 2.011, CI 95% 1.000-4.042, p=0.050), TNBC (HR 2.229, CI 95% 1.189-4.178, p=0.012), and HER-2 (HR 2.808, CI 95% 1.301-6.062, p=0.009) type are more effective than patients with Luminal type breast cancer 0btain a longer survival time, which is considered a protective factor. A nomogram was developed based on the clinical and statistically significant predictors. ROC curve for 3-year survial with area under the curve = 0.731 (95% confidence interval, 0.663-0.828); ROC curve for 5-year survial with area under the curve = 0.743 (95% confidence interval, 0.652-0.834); ROC curve for 10-year survial with area under the curve = 0.726 (95% confidence interval, 0.639-0.812). Conclusion: In conclusion, the hormone receptor status before chemotherapy can predict the prognosis of patients in advance, and we successfully constructed nomogram, which can help us predict the OS of patients with NAC.
A Cross-sectional Study Exploring Sex Differences in the Relationship Between Sex Partner Attitudes and Current Quit Attempt Among a Sample of Smokers in Baltimore, MD, USA.
Authors: A. Davey-Rothwell Melissa , Crossnohere Norah , Hammond Paige , Tseng Tuo-Yen , Whittington Marlesha , Tobin Karin , Latkin Carl , Knowlton Amy
Published: August 2020

Background: Limited research has explored sex differences in the relationship between partner behavior and attitudes and smoking cessation. Methods: The study examined sex partner attitudes about smoking among men and women who are currently trying to quit smoking cigarettes. Data were collected as part of the Tobacco Use in Drug Environment (TIDE) study, a cross-sectional study conducted in Baltimore, MD, USA from September 2013-May 2015. Interviews were administered with current smokers. The sample size for the current analysis was 134 men and 86 women. Results: Approximately thirty-three percent of male participants (n=45) reported currently trying to quit smoking cigarettes. Twenty-nine percent of women were currently trying to quit. Having a sex partner who did not mind the participant’s smoking was associated with decreased odds of trying to quit among men (AOR=0.35, p=0.03, 95% CI: 0.13, 0.91). Having a sex partner who expressed concern about the participant’s smoking (AOR=12.9, p<0.01, 95% CI: 3.49, 47.0) and having a sex partner who encouraged the participant to quit smoking was significantly associated current quit attempt. Conclusions: The relationship between partner support for cessation and current quit attempt was stronger for women than men in this population. Understanding sex-partner attitudes regarding smoking and their relationship to smoking cessation activities may provide insights for future tailored cessation interventions.
Relationship Between Physical Activity and the Availability of Exercise Facilities in an Urban Elderly Population: Cross-sectional Results from China
Authors: Wang Houlei , Wang Zhu ying , Kang Douye , Zhang xuhui , WU Zhi-jian
Published: August 2020

BACKGROUND: Sports facilities have great potential in promoting physical activity. Few studies have explored this relationship in the elderly. Therefore, this study explored the relationship between the community availability of sports facilities and physical activity levels in the elderly. METHODS: Overall, 569 elderly individuals (56.9% female) were randomly selected from 32 communities in Nanjing City. Participants were given accelerometers to wear for 4 consecutive days. A global positioning system and ActiGraph GT3+ device ware used to track, measure duration, and determine spatial details of outdoor activities. It was used to measure the availability of sports facilities within a 500-m buffer zone around the residence of the elderly. Sociodemographic variables and community types were included as covariates. RESULTS: Elderly individuals having 6–7 sports facilities in their buffer zone spent 9.19 minutes (95% confidence interval: 0.05–18.33) longer exercising than did individuals without facilities. Sex, age, and community type significantly influenced the duration of physical activity. After controlling for confounding factors, the physical activity standard reaching rate of the elderly with access to 6–7 sports facilities was 118% higher than that of elderly individuals without access. Further, the compliance rate of the elderly aged 60–65 years and the marginal community was relatively higher. The availability of sports facilities was associated with the probability of achieving the recommended amount of physical activity and moderate to high outdoor physical activity levels of the elderly. CONCLUSIONS: We show that the promotion of physical activity and the improvement of health status are based on facility availability, which in turn affects the physical activity levels of the elderly.
Role of Temporal Discounting in a Conditional Cash Transfer (CCT) Intervention to Improve Engagement in the Prevention of Mother-to-child Transmission (PMTCT) Cheaascade
Authors: Saleska Jessica Londeree , Turner Abigail Norris , Gallo Maria F. , Shoben Abigail , Kawende Bienvenu , Ravelomanana Noro Lantoniaina Rosa , Thirumurthy Harsha , Yotebieng Marcel
Published: August 2020

Background: Temporal discounting (TD), the tendency of individuals to discount future costs and benefits relative to the present, is often associated with greater engagement in risky behaviors. Incentives such as conditional cash transfers (CCTs) have the potential to counter the effects of TD on health behaviors. We hypothesized that CCTs work by mitigating the effects of high TD, measured using a delay-discounting task. Methods: We conducted an interaction analysis using data from a randomized trial of a CCT intervention among 434 HIV-positive pregnant women in the Democratic Republic of Congo. The analysis focused on two outcomes: 1) retention in HIV care, and 2) uptake of prevention of mother-to-child transmission (PMTCT) services. Results: The effect of TD on retention was small, and we did not observe evidence of interaction between TD and CCT on retention. However, our findings suggest that CCT may mitigate the negative effect of high TD on uptake of PMTCT services (interaction contrast (IC): 0.18, 95% CI: -0.09, 0.44). Conclusions: Our findings support the continued use of small, frequent incentives, to motivate improved uptake of PMTCT services, especially among women exhibiting high TD.
Assessment of Serum Vitamin D3 Level in One Year Old Children Using D3 Supplement
Authors: Alebouyeh Danial , Khalessi Nasrin , Saboute Maryam , Chamkhaleh Maryam Alizadeh , Kashaki Mandana
Published: August 2020

Introduction. Vitamin D status is a key determinant of bone health and growth during childhood and adolescence. Therefore, we design a study to find out the association between the levels of serum vitamin D and need to consumption of vitamin D supplement.Method and materials. In this cross sectional study infants under 20 months referred to Ali Asghar Children's Hospital were included. Infants with maternal diseases and congenital malformations were excluded. All infants used vitamin D3 supplementation 400 IU per day from day fifth of birth. The level of 25-hydroxy vitamin D at the age of 1 years (month 12) were measured. Level of 25-hydroxy vitamin D in mothers were checked, too. Furthermore, we defined sufficient level of 25-hydroxy vitamin D ≥30ng/ml.Results. In this study, 68 infants under 20 months were examined. Half of them were boy. Mean age of infants was 16±3 months and mothers was 33±3 years old. In addition, the mean level of serum 25-hydroxy vitamin D in the infants were 40.99±13.86 ng/ml and in mothers were 31.39±13.14 ng/ml. 62.1% of mothers were in sufficient group and also 83% of infants had sufficient vitamin D level (25-hydroxy vitamin D ≥ 30ng/ml). There was not any significant correlation between vitamin D level in infants and mothers (P value=0.965). The mean level of serum vitamin D3 in boys was 39.55±3.79 ng/ml (12-51) and girls was 35.32±3.67 ng/ml (13.4-50). Similarly, significant relationship was not shown between gender and vitamin D of infants (P value = 0.437). Level of vitamin D in second children was significantly higher than first children (P value=0.011). The correlation between gestational age and vitamin D3 deficiency was also insignificant (P value=0.087). Head circumference (r= -0.404, P value=0.014) and age of mothers (r= 0.344, P value=0.04) correlated with vitamin D.Conclusion. In summary, we demonstrated most of the infants had sufficient vitamin D level at the age of 1 year. So it is recommended to continue vitamin D3 supplementation consumption.
Effects of Task-Specific Virtual Reality Training Using a Leap Motion Controller on Hemiparetic Upper Extremity in Patients with Stroke
Authors: Fong Kenneth N. K. , TANG Y. M. , SIE Karen , YU Andy K. H. , LO Cherry C. W. , MA Yuko W. T.
Published: August 2020

Background: Task-specific training has been proven to be effective in promoting recovery of the hemiparetic upper extremities after a stroke. This study was to develop a new and innovative task-specific VR (TS-VR) program using a Leap Motion Controller VR device and the Unity3D program for distal hand function training, and to investigate whether a two-week program of TS-VR training would promote recovery of the hemiparetic upper extremity in patients with chronic stroke.Methods: We designed the TS-VR program based on seven general hand function tasks used in the activities of daily living that require upper limb movement, such as pushing open a door and pouring water. Then, we examined the content validity of the TS-VR according to the views of an expert panel and through field testing on patients with stroke. The final version of the TS-VR was tested on 20 patients suffering from chronic stroke with upper extremity hemiparesis over 2 weeks, 5 sessions per week, 30 minutes per session. Outcomes were assessed using the Fugl-Meyer Assessment-Upper Extremity score (FMA-UE), the Wolf Motor Function Test (WMFT), and the Motor Activity Log (MAL). Data were collected at the first session (week 0), last session (week 2), and follow-up session (week 5). Patients’ arm impairments were stratified into lower- and higher-functioning groups according to the Functional Test for the Hemiplegic Upper Extremity (FTHUE).Results: Significant improvements in upper extremity functions were found after TS-VR training in FMA-UE Total score (χ2=34.219, p=0.000), FMA-UL subscore (χ2=31.2, p=0.000), FMA-Hand subscore (χ2=22.6, p=0.000), and WFMT score (χ2=27.8, p=0.000) among the three time occasions, but no significant effect on grip strength was found. Moreover, the higher-functioning group (levels 5-7 in FTHUE) benefited more from the TS-VR, as indicated in outcome measures of FMA-UL, FMA-Hand, FMA-UE Total, and WMFT respectively, as well as amount of use score in MAL, but this was not the case for those in the lower-functioning group (levels 1-4 in FTHUE).Conclusions: Our findings suggest that our new TS-VR training system was useful for upper extremity recovery in patients with chronic stroke. It has potential to be applied in clinical settings in future.
Technology-Based Interventions for Nursing Home Residents: Implications for Nursing Home Practice Amid and Beyond the Influence of COVID-19: A Systematic Review Protocol
Authors: Su Zhaohui , Meyer Kylie , Li Yue , McDonnell Dean , Joseph Nitha Mathew , Li Xiaoshan , Du Yan , Advani Shailesh , Cheshmehzangi Ali , Ahmad Junaid , Veiga Claudimar Pereira da , Chung Roger Yat-Nork , Wang Jing
Published: August 2020

Background: A growing number of technology-based interventions are used to support the health and quality of life of nursing home residents. The onset of COVID-19 and recommended social distancing policies that followed led to an increased interest in technology-based solutions to provide healthcare and promote health. Yet, there are no comprehensive resources on technology-based healthcare solutions that describe their efficacy for nursing home residents. This systematic review will identify technology-based interventions designed for nursing home residents and describe the characteristics and effects of these interventions concerning the distinctive traits of nursing home residents and nursing facilities. Additionally, this paper will present practical insights into the varying intervention approaches that can assist in the delivery of broad digital health solutions for nursing home residents amid and beyond the impact of COVID-19.Methods: Databases including PubMed, PsycINFO, CINAHL, and Scopus will be used to identify articles related to technology-based interventions for nursing home residents published between January 1st, 2020 to July 7th, 2020. Titles, abstracts, and full-texts papers will be reviewed against the eligibility criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process, and implications for existing interventions and research evaluated by a multidisciplinary research team.Results: NA—protocol studyConclusions: Our study will fill critical gaps in the literature by providing a review of technology-based interventions tested in the nursing home setting. As the older adult population grows, there is an urgent need to identify effective technology-based interventions that can address the distinctive characteristics and preferences of nursing home residents. Clear and comprehensive understanding of how available technology-based health solutions facilitate healthcare for nursing home residents will shed light on the approaches open to residents to fend off the negative health consequences amid and beyond the influence of COVID-19.Systematic Review Registrations: PROSPERO CRD 42020191880
Construction of a protein-based model for prognosis prediction of kidney renal clear cell carcinoma: an investigation based on functional proteomics data
Authors: Jiang Huiming , Chen Haibin , Wan Pei , Chen NanHui
Published: August 2020

Background

Several studies have shown prognostic value of gene-based models at mRNA level in kidney renal clear cell carcinoma (KIRC). However, protein-based models for prognosis prediction of KIRC are rarely reported, then we conduct this study.
Methods

Proteomics and clinical data of KIRC were acquired from The Cancer Proteome Atlas (TCPA) and The Cancer Genome Atlas (TCGA), respectively. Prognosis-associated proteins were screened by univariate Cox regression analysis and log-rank test. Patients were grouped into training set and testing set. The protein-based prognostic model was constructed by lasso Cox regression analysis in training set and validated in test set and whole set.
Results

A five-protein model (ACC1, IGFBP2, MIG6, PEA15 and RAD51) was constructed for KIRC prognosis prediction. It could well classify KIRC patients into high-risk and low-risk group with significantly different survival. The results was validated in the testing set and whole set. Age, AJCC stage and risk score based on the five-protein model were identified as independent prognostic parameters and they were used to construct a nomogram. The calibration plot showed the nomogram had good agreement between predicted and actual outcomes. Time-dependent ROC curves revealed the nomogram performed best in predicting the 1-year, 3-year and 5-year overall survival (OS) compared with other independent prognostic parameters. DCA demonstrated the nomogram had obviously clinical net benefit. Furthermore, several cancer-related biological signaling pathways were enriched in the functional enrichment analysis.
Conclusion

Our study developed an effective protein-based model to predict the OS of KIRC, which may help clinicians to offer individual treatment.
Salvia miltiorrhiza alleviates hypoxia-induced nerve injury associated with Ngb/Akt intracellular signaling pathway
Authors: Zhang Xianxie , Qiu Haiying , Kong Jian , Wu Yan , Yuan Hailong
Published: August 2020

Background: Salvia miltiorrhiza (Danshen), a traditional Chinese herbal medicine, can effectively improve the high-altitude adverse reactions of high-altitude patients. While, the mechanism of how they exert neuroprotective effect to intervene the hypoxic at high altitudes is still not well understood.Methods: The study established high altitude hypoxia mouse model and CoCl2 -induced PC12 cell hypoxia model , the protective effects of S. miltiorrhiza radix extract (SE), Tanshinone IIA (Tan IIA) and salvianic acid A sodium (SAS) on hypoxia model were studied in vitro and in vivo.Results: The results showed that SE, TanⅡA, and SAS are able to improve biochemical level in high altitude hypoxia mouse model, increase in Ca2+ concentration, and decrease in MMP, inhibit apoptosis in CoCl2 -induced PC12 cell hypoxia model by activating Akt signaling pathway, protecting neurons, thus improving the oxygen carrying capacity of brain tissue.Conclusion: This study confirms the efficacy of SE, Tan Ⅱ A, and SAS with respect to therapeutic treatment of hypoxia, shown that S. miltiorrhiza and its active monomers can protect neurons by activating Ngb/Akt intracellular signaling pathway, and attenuate cerebral anoxia and neuronal damage, subsequently nerve injury caused by hypoxia at high altitude. Providing important information for the clinical treatment of nerve injury caused by hypoxia at high altitude.
A Mini-fluid Challenge of 200 mL Predicts fluid Responsiveness Using Pulmonary Artery Catheter in Septic Shock Patients an Observational Study
Authors: Yang Ting , Weng Li , Jiang Wei , Wang Chunyao , Peng Jingmin , Hu Xiaoyun , Li Shan , Du Bin
Published: August 2020

Background: Mini-fluid challenge may predict fluid responsiveness and limit fluid overload. This study was designed to explore the minimal infusion volume in effectively predicting fluid responsiveness in septic shock patients.Methods: ICU septic shock patients with indwelling pulmonary artery catheter received five sequential intravenous boluses of 100 mL 4% gelatin. Cardiac output was measured with thermodilution before fluid challenge (baseline) and three minutes after each bolus. Fluid responsiveness (FR) was defined as an increase in CO greater than 10% after 500 mL fluid infusion. The smallest volume which can perform an effective fluid challenge was analyzed. Results: Forty-seven patients were included in this prospective study. After 500 mL volume expansion, thirty-six patients presented with FR (77%) and 11 patients were fluid nonresponders. A mini fluid of 100 mL colloid had a poor predictive value (AUC = 0.67, p > 0.05). The minimal volume required to predict FR in a mini fluid challenge was 200 mL. An increase in CO greater than 5.2% after 200 mL colloid infusion was able to predict FR with a sensitivity of 83.3% and specificity of 90.9%. The AUC under the ROC curve was 0.93 (95% CI: 0.84 – 1, p < 0.05). Conclusion: In septic shock patients, a minimal volume of 200 mL 4% gelatin could reliably detect fluid responders and nonresponders.Trial registration: ClinicalTrial.gov (NCT01941472). Registered on 13 September 2013.
Maternal and Fetal Outcomes of Patients with Liver Cirrhosis:A Case-Control Study
Authors: Gao Xiang , Zhu Yunxia , Liu Haixia , Yu Hongwei , Wang Ming
Published: August 2020

Objective:We aimed to describe the characteristics and outcomes in pregnant women with liver cirrhosis, and identify the predictors of negative outcome of the mother and fetus.Methods: Retrospectively collect the mothers with liver cirrhosis in our center from 6/2010 to 6/2019. Women without liver cirrhosis were selected as a control in a 1:2 ratio. The primary assessment was the frequency of negative maternal and fetal outcomes. The secondary assessment was the negative outcomes between patients continuing the pregnancy or not and the factors to predict the severe negative outcomes.Results:Of 126 pregnancies enrolled, 29 pregnancies were discontinued for worrying the disease progression and 97 pregnancies were continued. 194 pregnancies without liver cirrhosis were selected as control. At baseline, patients with liver cirrhosis have a lower level of platelet, hemoglobin, Prothrombin activity, and a higher level of ALT, Total Bilirubin, Creatinine. Compared to control, patients with liver cirrhosis have a higher frequency of negative outcomes, including bleeding gums(7.2 %vs. 1.0%), TBA elevation (18.6 %vs.3.1%), infection (10.3 %vs.0.5%), cesarean section (73.6 %vs.49.5%), postpartum hemorrhage(13.8% vs 2.1%), blood transfusion (28.9% vs 2.1%), new ascites or aggravating ascites(6.2% vs.0%), MODS(7.2% vs.0.5%) and intensive care unit admissions(24.1% vs 1.1%). The incidence of severe maternal negative outcomes was also higher (32.0% vs 1.5%). Women who chose to discontinue the pregnancy had less severe negative outcomes (3.4% vs.32.0%).A higher frequency of fetal/infants complication were observed in liver cirrhosis population than control, including newborn asphyxia(10.2% vs1.1%), Low birth weight infant(13.6% vs. 2.6%) .In those patients who progressed into the third trimester, multivariable regression demonstrated that severe negative outcomes were associated with a higher CTP scores (OR 2.128, 95% CI[ 1.002, 4.521] ,p=0.049). Wilson’s disease related liver cirrhosis has a better prognosis (OR= 0.009, 95% CI[0, 0.763], p=0.038).Conclusions:The incidence of the negative outcomes was significantly increased in pregnancies complicated by cirrhosis. The predictor of severe negative outcomes is higher CTP score and Wilson’s disease induced liver cirrhosis have a better prognosis. Timely terminate the pregnancy during the first trimester may avoid the incidence of severe negative outcomes.
The carbon dioxide signal from the COVID-19 lock-down
Authors: Reid John
Published: August 2020

Two unintended experiments provide insight into the role of anthropogenic emissions in the global carbon cycle. One was the temporary reduction in emissions during the COVID-19 lock-down. The other was the emission of a radioactive isotope of carbon during the testing of nuclear weapons in the 1950s and the abrupt cessation of these tests in 1963. Together they imply the existence of two distinct reservoirs which exchange carbon with the atmosphere, viz.: the mixed layer and the deep ocean. Exchanges with the former are noisy because they are influenced by sea surface temperature which, in turn, depends on local weather conditions. They completely mask any variations caused by the COVID-19 lock-down. Exchanges with the latter are steady, long-term and uninfluenced by the weather. They result in half the carbon content of the atmosphere and mixed layer being replaced every eleven years.