bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimized breeding strategies to harness genetic resources with different performance levels
Authors: Allier Antoine , Teyssèdre Simon , Lehermeier Christina , Moreau Laurence , Charcosset Alain
Published: May 2020

Background

The narrow genetic base of elite germplasm compromises long-term genetic gain and increases the vulnerability to biotic and abiotic stresses in unpredictable environmental conditions. Therefore, an efficient strategy is required to broaden the genetic base of commercial breeding programs while not compromising short-term variety release. Optimal cross selection aims at identifying the optimal set of crosses that balances the expected genetic value and diversity. We propose to consider genomic selection and optimal cross selection to recurrently improve genetic resources (i.e. pre-breeding), to bridge the improved genetic resources with elites (i.e. bridging), and to manage introductions into the elite breeding population. Optimal cross selection is particularly adapted to jointly identify bridging, introduction and elite crosses to ensure an overall consistency of the genetic base broadening strategy.

Results

We compared simulated breeding programs introducing donors with different performance levels, directly or indirectly after bridging. We also evaluated the effect of the training set composition on the success of introductions. We observed that with recurrent introductions of improved donors, it is possible to maintain the genetic diversity and increase mid- and long-term performances with only limited penalty at short-term. Considering a bridging step yielded significantly higher mid- and long-term genetic gain when introducing low performing donors. The results also suggested to consider marker effects estimated with a broad training population including donor by elite and elite by elite progeny to identify bridging, introduction and elite crosses.

Conclusion

Results of this study provide guidelines on how to harness polygenic variation present in genetic resources to broaden elite germplasm.
Assessment of databases to determine the validity of β- and γ-carbonic anhydrase sequences from vertebrates
Authors: Zolfaghari Emameh Reza , Kuuslahti Marianne , Nosrati Hassan , Lohi Hannes , Parkkila Seppo
Published: May 2020

Background

The inaccuracy of DNA sequence data is becoming a serious problem, as the amount of molecular data is multiplying rapidly and expectations are high for big data to revolutionize life sciences and health care. In this study, we investigated the accuracy of DNA sequence data from commonly used databases using carbonic anhydrase (CA) gene sequences as generic targets. CAs are ancient metalloenzymes that are present in all unicellular and multicellular living organisms. Among the eight distinct families of CAs, including α, β, γ, δ, ζ, η, θ, and ι, only α-CAs have been reported in vertebrates.

Results

By an in silico analysis performed on the NCBI and Ensembl databases, we identified several β- and γ-CA sequences in vertebrates, including Homo sapiens, Mus musculus, Felis catus, Lipotes vexillifer, Pantholops hodgsonii, Hippocampus comes, Hucho hucho, Oncorhynchus tshawytscha, Xenopus tropicalis, and Rhinolophus sinicus. Polymerase chain reaction (PCR) analysis of genomic DNA persistently failed to amplify positive β- or γ-CA gene sequences when Mus musculus and Felis catus DNA samples were used as templates. Further BLAST homology searches of the database-derived “vertebrate” β- and γ-CA sequences revealed that the identified sequences were presumably derived from gut microbiota, environmental microbiomes, or grassland ecosystems.

Conclusions

Our results highlight the need for more accurate and fast curation systems for DNA databases. The mined data must be carefully reconciled with our best knowledge of sequences to improve the accuracy of DNA data for publication.
Effect of trait’s expression level on single-step genomic evaluation of resistance to Dothistroma needle blight
Authors: Klápště Jaroslav , Dungey Heidi S. , Graham Natalie J. , Telfer Emily J.
Published: May 2020

Background

Many conifer breeding programs are paying increasing attention to breeding for resistance to needle disease due to the increasing importance of climate change. Phenotyping of traits related to resistance has many biological and temporal constraints that can often confound the ability to achieve reliable phenotypes and consequently, reliable genetic progress. The development of next generation sequencing platforms has also enabled implementation of genomic approaches in species lacking robust reference genomes. Genomic selection is, therefore, a promising strategy to overcome the constraints of needle disease phenotyping.

Results

We found high accuracy in the prediction of genomic breeding values in the disease-related traits that were well characterized, reaching 0.975 for genotyped individuals and 0.587 for non-genotyped individuals. This compared well with pedigree-based accuracies of up to 0.746. Surprisingly, poorly phenotyped disease traits also showed very high accuracy in terms of correlation of predicted genomic breeding values with pedigree-based counterparts. However, this was likely caused by the fact that both were clustered around the population mean, while deviations from the population mean caused by genetic effects did not appear to be well described. Caution should therefore be taken with the interpretation of results in poorly phenotyped traits.

Conclusions

Implementation of genomic selection in this test population of Pinus radiata resulted in a relatively high prediction accuracy of needle loss due to Dothistroma septosporum compared with a pedigree-based approach. Using genomics to avoid biological/temporal constraints where phenotyping is reliable appears promising. Unsurprisingly, reliable phenotyping, resulting in good heritability estimates, is a fundamental requirement for the development of a reliable prediction model. Furthermore, our results are also specific to the single pathogen mating-type that is present in New Zealand, and may change with future incursion of other pathogen varieties. There is no doubt, however, that once a robust genomic prediction model is built, it will be invaluable to not only select for host tolerance, but for other economically important traits simultaneously. This tool will thus future-proof our forests by mitigating the risk of disease outbreaks induced by future changes in climate.
Anemia and perioperative mortality in non-cardiac surgery patients: a secondary analysis based on a single-center retrospective study
Authors: Luo Xueying , Li Feng , Hu Haofei , Liu Baoer , Zheng Sujing , Yang Liping , Gao Rui , Li Ya , Xi Rao , He Jinsong
Published: May 2020

Background

Evidence regarding the relationship between anemia and perioperative prognosis is controversial. The study was conducted to highlight the specific relationship between anemia and perioperative mortality in non-cardiac surgery patients over 18 years of age.

Methods

This study was a retrospective analysis of the electronic medical records of 90,784 patients at the Singapore General Hospital from January 1, 2012 to October 31, 2016. Multivariate regression, propensity score analysis, doubly robust estimation, and an inverse probability-weighting model was used to ensure the robustness of our findings.

Results

We identified 85,989 patients, of whom75, 163 had none or mild anemia (Hemoglobin>90g/L) and 10,826 had moderate or severe anemia (Hemoglobin≤90g/L). 8,857 patients in each study exposure group had similar propensity scores and were included in the analyses. In the doubly robust model, postoperative 30-day mortality rate was increased by 0.51% (n = 219) in moderate or severe anemia group (Odds Ratio, 1.510; 95% Confidence Interval (CI), 1.049 to 2.174) compared with none or mild anemia group (2.47% vs.1.22%, P<0.001). Moderate or severe anemia was also associated with increased postoperative blood transfusion rates (OR, 5.608; 95% CI, 4.026 to 7.811, P < 0.001). There was no statistical difference in Intensive Care Unit (ICU) admission rate among different anemia groups within 30 days after surgery (P=0.104).

Discussion

In patients undergoing non-cardiac surgery over 18 years old, moderate or severe preoperative anemia would increase the occurrence of postoperative blood transfusion and the risk of death, rather than ICU admission within 30 days after surgery.
Does the revised intubating laryngeal tube (ILTS-D2) perform better than the intubating laryngeal mask (Fastrach)? – a randomised simulation research study
Authors: Ott Thomas , Tschöpe Katharina , Toenges Gerrit , Buggenhagen Holger , Engelhard Kristin , Kriege Marc
Published: May 2020

Background

The intubating laryngeal tube (ILTS-D™) and the intubating laryngeal mask (Fastrach™) are devices that facilitate both extraglottic application and blind tracheal intubation. A revised model of the iLTS-D (for scientific reasons called ILTS-D2) has been designed but not yet evaluated. Therefore, we compared the ILTS-D2 with the established Fastrach under controlled conditions in a prospective randomised controlled simulation research study.

Methods

After ethical approval, we randomised 126 medical students into two groups. Each participant received either Fastrach or ILTS-D2 to perform five consecutive ventilation attempts in a manikin. The primary endpoint was the time to ventilation in the last attempt of using the devices as extraglottic devices. Secondary endpoints were the time to tracheal intubation and the success rates.

Results

There was no relevant difference between the two devices in the time to ventilation in the last of five attempts (Fastrach: median 14 s [IQR: 12–15]; ILTS-D2: median 13 s [IQR: 12–15], p = 0.592). Secondary endpoints showed a 2 s faster blind tracheal intubation using the Fastrach than using the ILTS-D2 (Fastrach: median 14 s [IQR: 13–17]; ILTS-D2: median 16 s [IQR: 15–20] p < 0.001). For both devices, the success rates were 100% in the last attempt.

Conclusions

Concerning extraglottic airway management, we could not detect a relevant difference between the revised ILTS-D2 and the Fastrach under laboratory conditions. We advocate for an evaluation of the ILTS-D2 in randomised controlled clinical trials.

Trial registration

Identifier at clinicaltrials.gov: NCT03542747. May 31, 2018
Staged open surgery for bicuspid aortic valve regurgitation and coarctation of the aorta in a Jehovah’s witness
Authors: Sumi Kohei , Yoshida Shigehiko , Okamura Yoshitaka , Nakamura Tomokazu
Published: May 2020

Background

Jehovah’s Witnesses refuse allogeneic blood transfusions, which makes cardiovascular surgery challenging. Surgeons must minimize blood and fluid loss within one procedure.

Case presentation

We herein describe a 17-year-old male Jehovah’s Witness with bicuspid aortic valve regurgitation and coarctation of the aorta. The procedures were performed in the following order: aortic valve replacement combined with Nick’s aortic root enlargement, right axillary artery–bilateral external iliac artery bypass, and distal arch–descending aorta bypass.

Conclusions

Axillary artery–bilateral external iliac artery bypass maintained distal perfusion and reduced the amount of heparin during distal arch–descending aorta bypass surgery.
Prognostic prediction tools and clinician communication: a qualitative study of the effect of the STUMBL tool on clinical practice
Authors: O’Neill Claire , Hutchings Hayley A. , Abbott Zoe , Battle Ceri
Published: May 2020

Background

In recent years, researchers and clinicians have been developing prognostic prediction tools (PPTs) as a way of identifying patients at risk of deterioration. The use of PPTs in the clinical environment not only impacts the risk of adverse outcomes for patients, but the use of these tools also effect clinical practice. Much attention has been paid to the clinical performance of PPTs. But more insight is needed on how the use of PPTs impacts clinical practice. The objective of this study was to map some of the ways in which PPTs effect clinical practice.

The STUMBL (STUdy evaluating the impact of a prognostic model for Management of BLunt chest wall trauma patients) feasibility trial evaluated the use of a new prognostic prediction tool (PPT) to guide the management blunt chest wall trauma patients in the emergency departments (ED). The trial was undertaken between October 2016 and September 2018 and conducted at four sites in England and Wales. Nested within the feasibility trial was a qualitative study aimed at understanding how ED clinicians experienced and used the PPT. The qualitative methods included a focus group and telephone interviews with 9 ED clinicians. This study focused on participant perceptions of the feasibility and use of the STUMBL tool on clinical practice in the ED.

Results

Clinical practice is reshaped as a result of the introduction of the STUMBL PPT into the clinical environment. The PPT enhanced reflexive awareness of prognostic practice; facilitated communication between patients and professionals; helps to guide patient outcomes; and provides a common ground for clinician discussion on prognostication.

Conclusions

The qualitative data collected offered useful insights into the ways in which the tool changes clinical practice. This was a small study of the effect of one kind of PPT on clinical practice. Nevertheless, this study maps areas in which clinical practice is affected by the introduction of a PPT into the clinical environment. More research is needed to better understand these effects, and to understand how these tools become embedded in clinical practice over the longer term.
A cross-sectional study of nausea in functional abdominal pain: relation to mucosal mast cells and psychological functioning
Authors: Friesen Craig , Singh Meenal , Singh Vivekanand , Schurman Jennifer V.
Published: May 2020

Background

Nausea is a common symptom in youth with chronic abdominal pain. The aims of the current study were to assess: 1) the frequency of nausea in patients with functional dyspepsia (FD) and irritable bowel syndrome (IBS), respectively, as defined by Rome IV criteria; and, 2) relationships between nausea and mucosal inflammation as defined by antral and duodenal eosinophil and mast cell densities. A secondary aim was to assess relationships between nausea and other gastrointestinal symptoms, non-gastrointestinal somatic symptoms, and psychological dysfunction.

Methods

Records from patients with pain associated functional gastrointestinal disorders were retrospectively reviewed for gastrointestinal and somatic symptoms and anxiety, depression, and somatizations scores as assessed by the Behavior Assessment System for Children (BASC-2). In addition, previous gastric and mucosal biopsies were assessed for mast cell and eosinophil densities, respectively.

Results

250 patients, ages 8 to 17 years, were assessed. Nausea was reported by 78% and was equally prevalent in those with FD alone, those with IBS alone, and those with both FD and IBS. Nausea was associated with increased mean (21.4 vs. 17.5) and peak (26.2 vs. 22.9) duodenal mast cell densities as compared those without nausea. Nausea was also associated with a wide variety of individual gastrointestinal symptoms, as well as headaches, fatigue, and dizziness. Lastly, nausea was associated with elevated self-report scores for anxiety (55.2 vs. 50.0), depression (50.2 vs. 46.1), and somatization (70.3 vs. 61.8).

Conclusions

Nausea is common in children and adolescents with pain-associated FGIDs as defined by Rome IV and is not unique to either FD or IBS. Nausea is associated with increased mucosal mast cell density, non-gastrointestinal somatic symptoms, and psychologic dysfunction.
Comparative implementation-effectiveness of three strategies to perform hearing screening among older adults in primary care clinics: study design and protocol
Authors: Bettger Janet Prvu , Dolor Rowena J. , Witsell David L. , Dubno Judy R. , Pieper Carl F. , Walker Amy R. , Silberberg Mina , Schulz Kristine A. , Majumder Pranab , Juhlin Erika , Smith Sherri L. , Francis Howard W. , Tucci Debara L.
Published: May 2020

Background

The burden of hearing loss among older adults could be mitigated with appropriate care. This study compares implementation of three hearing screening strategies in primary care, and examines the reliability and validity of patient self-assessment, primary care providers (PCP) and diagnostic audiologists in the identification of ‘red flag’ conditions (those conditions that may require medical consultation and/or intervention).

Methods

Six primary care practices will implement one of three screening strategies (2 practices per strategy) with 660 patients (220 per strategy) ages 65–75 years with no history of hearing aid use or diagnosis of hearing loss. Strategies differ on the location and use of PCP encouragement to complete a telephone-based hearing screen (tele-HS). Group 1: instructions for tele-HS to complete at home and educational materials on warning signs and consequences of hearing loss. Group 2: PCP counseling/encouragement on importance of hearing screening, instructions to take the tele-HS from home, educational materials. Group 3: PCP counseling/encouragement, in-office tele-HS, and educational materials. Patients from all groups who fail the tele-HS will be referred for diagnostic audiological testing and medical evaluation, and complete a self-assessment of red flag conditions at this follow-up appointment. Due to the expected low incidence of ear disease in the PCP cohort, we will enroll a complementary population of patients (N = 500) from selected otolaryngology head and neck surgery clinics in a national practice-based research network to increase the likelihood of occurrence of medical conditions that might contraindicate hearing aid fitting. The primary outcome is the proportion of patients who complete the tele-HS within 2 months of the PCP appointment comparing Group 3 (PCP encouragement, in-office tele-HS, education) versus Groups 2 and 1 (education and tele-HS at home, with and without PCP encouragement, respectively). The several secondary outcomes include direct and indirect costs, patient, family and provider attitudes of hearing healthcare, and accuracy of red flag condition evaluations compared with expert medical assessment by an otolaryngology provider.

Discussion

Determining the relative effectiveness of three different strategies for hearing screening in primary care and the assessment accuracy of red flag conditions can each lead to practice and policy changes that will reduce individual, family and societal burden from hearing loss among older adults.

Trial registration

Clinicaltrials.gov: NCT02928107; 10/10/2016 protocol version 1.
Podocytic infolding in Schimke immuno-osseous dysplasia with novel SMARCAL1 mutations: a case report
Authors: Xiong Shiqiu , Shuai Lanjun , Li Xiaoyan , Dang Xiqiang , Wu Xiaochuan , He Qingnan
Published: May 2020

Background

Schimke immuno-osseous dysplasia (SIOD) is a rare autosomal recessive disorder characterized by spondyloepiphyseal dysplasia, progressive renal insufficiency and defective cellular immunity. Podocytic infolding glomerulopathy (PIG) is a newly proposed disease entity characterized by microspheres or microtubular structures associated with podocytes infolding into the glomerular basement membrane (GBM) on electron microscopy (EM).

Case presentation

A 4-year-old boy was admitted to our ward due to proteinuria and edema lasting 1 month. He had a short trunk and demonstrated subtle dysmorphology, with a triangular shape, a broad nasal bridge and a bulbous nasal tip. The laboratory findings were as follows: lymphocytes, 0.5 × 109/L; urine protein, 3.67 g/d; albumin, 9.8 g/L; and cholesterol, 11.72 mmol/L. Skeletal X rays showed small iliac wings, small ossification centers of the capital femoral epiphyses, shallow dysplastic acetabular fossae and mildly flattened vertebrae. The specimen for light microscopy (LM) suggested focal segmental glomerulosclerosis (FSGS). EM revealed a focal thickness of the GBM with some cytoplasmic processes of podocyte infolding into the GBM. Gene sequencing showed novel compound heterozygous mutations in the SMARCAL1 gene (c.2141 + 5G > A; c.2528 + 1G > A) that were inherited from his parents. Finally, we established the diagnosis of SIOD and treated him with diuretics and angiotensin-converting enzyme inhibitors (ACEIs).

Conclusion

The pathogenic mechanism of PIG has not been clarified. Further studies are required to understand whether gene mutations, especially those related to podocytes, contribute to the pathogenesis of podocytic infolding.
Healing architecture and Snoezelen in delivery room design: a qualitative study of women’s birth experiences and patient-centeredness of care
Authors: Nielsen Jane Hyldgaard , Overgaard Charlotte
Published: May 2020

Background

The physical place and environment has a profound influence on experiences, health and wellbeing of birthing women. An alternatively designed delivery room, inspired by the principles of healing architecture and Snoezelen, was established in the Regional Hospital in Herning, Denmark. These principles provided knowledge of how building and interior design affects the senses, including users’ pain experience and stress levels. The aim of the study was to explore women’s experience of the environment and its ability to support the concept of patient-centeredness in the care of birthing women.

Methods

Applying a hermeneutical-phenomenological methodology, fourteen semi-structured interviews with low-risk women giving birth in an alternative delivery room at an obstetric unit in Denmark were undertaken 3–7 weeks after birth.

Results

Overall, women’s experiences of given birth in the alternative delivery room were positive. Our analysis suggests that the environment was well adapted to the women’s needs, as it offered a stress- and anxiety-reducing transition to the hospital setting, at the same time as it helped them obtain physical comfort. The environment also signaled respect for the family’s needs as it supported physical and emotional interaction between the woman and her partner and helped relieve her concern for the partner’s well-being. The psychosocial support provided by the midwives appeared inseparable from the alternative delivery room, as both affected, amplified, and occasionally restricted the women’s experience of the physical environment.

Conclusion

Our findings support the use of principles of healing architecture and Snoezelen in birth environments and add to the evidence on how the physical design of hospital environments influence on both social and physical aspects of the well-being of patients. The environment appeared to encompass several dimensions of the concept of patient-centered care.
Knowledge-based analyses reveal new candidate genes associated with risk of hepatitis B virus related hepatocellular carcinoma
Authors: Jiang Deke , Deng Jiaen , Dong Changzheng , Ma Xiaopin , Xiao Qianyi , Zhou Bin , Yang Chou , Wei Lin , Conran Carly , Zheng S. Lilly , Ng Irene Oi-lin , Yu Long , Xu Jianfeng , Sham Pak C. , Qi Xiaolong , Hou Jinlin , Ji Yuan , Cao Guangwen , Li Miaoxin
Published: May 2020

Background

Recent genome-wide association studies (GWASs) have suggested several susceptibility loci of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) by statistical analysis at individual single-nucleotide polymorphisms (SNPs). However, these loci only explain a small fraction of HBV-related HCC heritability. In the present study, we aimed to identify additional susceptibility loci of HBV-related HCC using advanced knowledge-based analysis.

Methods

We performed knowledge-based analysis (including gene- and gene-set-based association tests) on variant-level associationp-values from two existing GWASs of HBV-related HCC. Five different types of gene-sets were collected for the association analysis. A number of SNPs within the gene prioritized by the knowledge-based association tests were selected to replicate genetic associations in an independent sample of 965 cases and 923 controls.

Results

The gene-based association analysis detected four genes significantly or suggestively associated with HBV-related HCC risk:SLC39A8,GOLGA8M,SMIM31, andWHAMMP2. The gene-set-based association analysis prioritized two promising gene sets for HCC, cell cycle G1/S transition and NOTCH1 intracellular domain regulates transcription. Within the gene sets, three promising candidate genes (CDC45,NCOR1andKAT2A) were further prioritized for HCC. Among genes of liver-specific expression, multiple genes previously implicated in HCC were also highlighted. However, probably due to small sample size, none of the genes prioritized by the knowledge-based association analyses were successfully replicated by variant-level association test in the independent sample.

Conclusions

This comprehensive knowledge-based association mining study suggested several promising genes and gene-sets associated with HBV-related HCC risks, which would facilitate follow-up functional studies on the pathogenic mechanism of HCC.
Wearable cardioverter-defibrillator as bridging to ICD in pediatric hypertrophic cardiomyopathy with myocardial bridging – a case report
Authors: Kurath-Koller Stefan , Sallmon Hannes , Scherr Daniel , Bisping Egbert , Burmas Ante , Knez Igor , Koestenberger Martin
Published: May 2020

Background

There is only limited experience with wearable cardioverter-defibrillators (WCD) in pediatric patients. We report on the successful application of a WCD in an adolescent patient with hypertrophic cardiomyopathy and myocardial bridging.

Case presentation

A 15-year-old girl presented with a history of recurrent syncope, dyspnea, and vertigo with exercise. Diagnostic work-up revealed non-obstructive hypertrophic cardiomyopathy and signs of myocardial ischemia with exercise. Given this high-risk constellation, the patient was scheduled for prophylactic implantation of an implantable cardioverter-defibrillator (ICD). One month after initial presentation and days prior to the planned ICD implantation, the patient collapsed during an episode of sustained ventricular tachycardia (VT) while running. VT was terminated by WCD shock delivery. Following this event, computerized tomography scan revealed myocardial bridging of the left anterior descending coronary artery causing a 90% stenosis in systole. After coronary surgery, life threatening arrhythmias have not recurred, but due to progressive heart failure, the patient underwent successful heart transplantation after 2 years.

Conclusions

The reported case highlights the importance and applicability of WCDs and the potentially malign nature of myocardial bridging in pediatric high-risk patients.
Psychiatric disorders risk in patients with iron deficiency anemia and association with iron supplementation medications: a nationwide database analysis
Authors: Lee Herng-Sheng , Chao Hsin-Hao , Huang Wan-Ting , Chen Solomon Chih-Cheng , Yang Hsin-Yi
Published: May 2020

Background

It has been shown that iron deficiency anemia (IDA) is associated with psychosocial consequences and psychiatric morbidity. However, the association between adults with IDA and psychiatric disorders has not been clarified. The purpose of this study was to investigate the psychiatric disorder morbidity of an IDA group in comparison with a non-IDA group and to examine the risk of psychiatric disorders in IDA patients treated with iron supplementation.

Methods

All study subjects were 20 years of age or over with newly diagnosed IDA enrolled in the Taiwan National Health Insurance Database from 2000 to 2012. We matched IDA and non-IDA subjects according to age and gender in a 1:2 ratio. Our primary outcome was diagnosis of psychiatric disorders and the patients were monitored until the end of 2013. A multivariate Cox proportional hazards regression model was used to explore the risk of psychiatric disorders in patients with IDA after adjustment for confounders, including demographic characteristics and comorbidities.

Results

The adjusted hazard ratios (aHRs) of psychiatric disorders was 1.52 (95% CI = 1.45–1.59) in the IDA group compared with the non-IDA group. Among the different types of psychiatric disorders, the IDA group was associated with significantly higher incidence and risks of anxiety disorders, depression, sleep disorders, and psychotic disorders (p <  0.05). Furthermore, iron supplementation in IDA subjects was associated with a significantly lower risk of psychiatric disorders compared to non-iron supplementation in IDA patients.

Conclusions

Our study indicates that IDA subjects had an increased risk of psychiatric disorders, regardless of other confounders. In IDA patients, iron supplementation was associated with a decreased risk of psychiatric disorders. Moreover, IDA patients receiving iron supplementation also had a lower risk of sleep disorders.
The effects of suicidal ideation and constructs of theory of planned behavior on suicidal intention in women: a structural equation modeling approach
Authors: Rezapur-Shahkolai Forouzan , Khezeli Mehdi , Hazavehei Seyyed-Mohammad-Mahdi , Ariapooran Saeed , Soltanian Ali Reza , Ahmadi Alireza
Published: May 2020

Background

The Theory of Planned Behavior (TPB) is proposed to predict behavioral intention. We conducted this study aimed to investigate the effects of Suicidal Ideation (SI) and constructs of TPB on suicidal intention.

Methods

This cross-sectional study was conducted with 923 married women selected by multi-stage sampling method from Gilan-e Gharb County, the west part of Iran, in 2018. Data gathering tools were a questionnaire on demographic characteristics, the Beck Scale for Suicidal Ideation, and a four-part questionnaire based on constructs of TPB, including Attitude, Subjective Norms, Perceived Behavioral Control (PBC), and Intention. Data were analyzed by SPSS 19 and AMOS using Structural Equation Modeling (SEM).

Results

Out of 923 participants, 345 women (37.4%) had some degree of suicidal ideation. The mean score of suicidal ideation in all of participants was 5.98 ± 7.79, while in the 345 individuals with suicidal ideation was 15.53 ± 3.65. Suicidal ideation had the strongest positive total effect on suicide intent, while PBC and attitude had the negative effect on suicide intent.

Conclusions

Since suicidal ideation had the strongest direct effect on suicidal intent, it is suggested that this variable be used for risk assessment in all suicide prevention programs and counseling measures be implemented to reduce suicidal thoughts. Also, undesirable attitudes toward suicide and perceived behavioral control on suicide intention can be considered and emphasized in planning future interventions.
Nutrient patterns and cardiometabolic risk factors among Iranian adults: Tehran lipid and glucose study
Authors: Mottaghian Mohammad , Salehi Pantea , Teymoori Farshad , Mirmiran Parvin , Hosseini-Esfahani Firoozeh , Azizi Fereidoun
Published: May 2020

Background

The present study aimed to assess the relation between nutrient patterns and changes in adult anthropometric and cardiometabolic factors.

Methods

This study was conducted on 1637 adults participating in the Tehran Lipid and Glucose Study (2005–2008), who were free of cardiovascular diseases and cancer and had completed dietary data. They were followed to the next survey (2008–2011). Dietary intakes were collected and nutrient patterns were obtained. Three year changes in anthropometric and cardiometabolic factors were measured.

Results

Five nutrient patterns were extracted. The first pattern was characterized by “plant protein, thiamine, niacin, and minerals including phosphorus, zinc, copper, magnesium, manganese, and selenium”. Animal protein, lactose, vitamin D, riboflavine, pantothenic acid, vitamin B12, calcium, phosphorus, and zinc" were loaded in the second pattern. The third and fourth patterns were characterized by “vitamin K, fiber, calcium, iron, manganese, and potassium”, and “high correlation with starch, thiamine and folate, and negative correlation with mono and poly unsaturated fatty acids and vitamin E”, respectively. The fifth pattern was high in Fructose, vitamins A, C, pyridoxine, and potassium. There was no association between nutrient patterns and 3-year changes in blood pressure and fasting blood glucose; whereas, per each quartile increment of the fifth pattern adjusted for potential confounders, triglyceride change was decreased [β = − 3.66, 95% CI (− 6.57, − 0.57); P for trend = 0.014].

Conclusion

Present study indicates that nutrient patterns may have an association with cardiometabolic factors, particularly a pattern rich in fructose, vitamins A, C, pyridoxine, and potassium which decreases triglyceride level.
Interventions to increase uptake of cervical screening in sub-Saharan Africa: a scoping review using the integrated behavioral model
Authors: Lott Breanne E. , Trejo Mario J. , Baum Christina , McClelland D. Jean , Adsul Prajakta , Madhivanan Purnima , Carvajal Scott , Ernst Kacey , Ehiri John
Published: May 2020

Background

Sub-Saharan Africa (SSA) experiences disproportionate burden of cervical cancer incidence and mortality due in part to low uptake of cervical screening, a strategy for prevention and down-staging of cervical cancer. This scoping review identifies studies of interventions to increase uptake of cervical screening among women in the region and uses the Integrated Behavioral Model (IBM) to describe how interventions might work.

Methods

A systematic search of literature was conducted in PubMed, Web of Science, Embase, and CINAHL databases through May 2019. Screening and data charting were performed by two independent reviewers. Intervention studies measuring changes to uptake in screening among women in SSA were included, with no restriction to intervention type, study setting or date, or participant characteristics. Intervention type and implementation strategies were described using behavioral constructs from the IBM.

Results

Of the 3704 citations the search produced, 19 studies were selected for inclusion. Most studies were published between 2014 and 2019 (78.9%) and were set in Nigeria (47.4%) and South Africa (26.3%). Studies most often assessed screening with Pap smears (31.6%) and measured uptake as ever screened (42.1%) or screened during the study period (36.8%). Education-based interventions were most common (57.9%) and the IBM construct of knowledge/skills to perform screening was targeted most frequently (68.4%). Willingness to screen was high, before and after intervention. Screening coverage ranged from 1.7 to 99.2% post-intervention, with six studies (31.6%) reporting a significant improvement in screening that achieved ≥60% coverage.

Conclusions

Educational interventions were largely ineffective, except those that utilized peer or community health educators and mHealth implementation strategies. Two economic incentivization interventions were moderately effective, by acting on participants’ instrumental attitudes, but resulted in screening coverage less than 20%. Innovative service delivery, including community-based self-sampling, acted on environmental constraints, striving to make services more available, accessible, and appropriate to women, and were the most effective. This review demonstrates that intent to perform screening may not be the major determinant of screening behavior, suggesting other theoretical frameworks may be needed to more fully understand uptake of cervical screening in sub-Saharan Africa, particularly for health systems change interventions.
Do people living in disadvantaged circumstances receive different mental health treatments than those from less disadvantaged backgrounds?
Authors: Giebel Clarissa , Corcoran Rhiannon , Goodall Mark , Campbell Niall , Gabbay Mark , Daras Konstantinos , Barr Ben , Wilson Tim , Kullu Cecil
Published: May 2020

Background

Socio-economic status (SES) has been linked to treatment outcomes for mental health problems, whilst little to no literature has explored the effects of SES on access to both medication and psychological therapy. The aim of this study was to explore whether access to mental health treatments differed by SES.

Methods

The North West Coast Household Health Survey (HHS) collected data from residents aged 18+ from across 20 disadvantaged and 8 less disadvantaged neighbourhoods in 2015, and from 20 disadvantaged neighbourhoods in 2018. Logistic regression was used to explore the effects of SES on access to treatment (medication, psychological therapy) for people who had experienced mental health problems in the past 12 months.

Results

Of 6860 participants, 2932 reported experiencing mental health problems in the past 12 months. People from more disadvantaged backgrounds experienced greater rates of anxiety and depression. Anti-depressant and anti-psychotic medication treatment was significantly more common in residents with lower SES, as well as counselling. Regression analysis showed that residents from more disadvantaged neighbourhoods who reported mental distress were more likely to receive medication.

Conclusions

This appears to be the first study showing higher levels of treatment with medication and psychological therapy in people from disadvantaged backgrounds. Future research needs to address the underlying factors associated with increased mental health treatment uptake in people from lower socio-economic backgrounds.
Digital versus analogue chest drainage system in patients with primary spontaneous pneumothorax: a randomized controlled trial
Authors: Ruigrok Dieuwertje , Kunst Peter W. A. , Blacha Marielle M. J. , Tomlow Ben , Herbrink Jacobine W. , Japenga Eva J. , Boersma Wim , Bresser Paul , van der Lee Ivo , Mooren Kris
Published: May 2020

Background

Patients with a primary spontaneous pneumothorax (PSP) who are treated with chest tube drainage are traditionally connected to an analogue chest drainage system, containing a water seal and using a visual method of monitoring air leakage. Electronic systems with continuous digital monitoring of air leakage provide better insight into actual air leakage and changes in leakage over time, which may lead to a shorter length of hospital stay.

Methods

We performed a randomized controlled trial comparing the digital with analogue system, with the aim of demonstrating that use of a digital drainage system in PSP leads to a shorter hospital stay.

Results

In 102 patients enrolled with PSP we found no differences in total duration of chest tube drainage and hospital stay between the groups. However, in a post-hoc analysis, excluding 19 patients needing surgery due to prolonged air leakage, hospital stay was significantly shorter in the digital group (median 1 days, IQR 1–5 days) compared to the analogue group (median 3 days, IQR 2–5 days) (p 0.014). Treatment failure occurred in 3 patients in both groups; the rate of recurrence within 12 weeks was not significantly different between groups (16% in the digital group versus 8% in the analogue group, p 0.339).

Conclusion

Length of hospital stay was not shorter in patients with PSP when applying a digital drainage system compared to an analogue drainage system. However, in the large subgroup of uncomplicated PSP, a significant reduction in duration of drainage and hospital stay was demonstrated with digital drainage. These findings suggest that digital drainage may be a practical alternative to manual aspiration in the management of PSP.

Trial registration

Registered 22 September 2013 - Retrospectively registered, Trial NL4022 (NTR4195)
Plasma adiponectin, visfatin, leptin, and resistin levels and the onset of colonic polyps in patients with prediabetes
Authors: Deng Lili , Zhao Xiaotong , Chen Mingwei , Ji Hua , Zhang Qunhui , Chen Ruofei , Wang Yalei
Published: May 2020

Background

Prediabetes is associated with a high risk of colon cancer, and abdominal obesity, which can result in the secretion of several obesity-related adipocytokines, is an independent influencing factor for colonic polyps in prediabetes subjects. However, the correlation between adipocytokine levels and colonic polyps in prediabetes subjects is unclear. This research explores the relationship between plasma adiponectin, visfatin, leptin, and resistin levels and the development of colonic polyps in prediabetes subjects.

Methods

A total of 468 prediabetes subjects who underwent electronic colonoscopy examinations were enrolled in this study; there were 248 cases of colonic polyps and 220 cases without colonic mucosal lesions. Then, colonic polyps patients with prediabetes were subdivided into a single-polyp group, multiple-polyps group, low-risk polyps group, or high-risk polyps group. In addition, 108 subjects with normal glucose tolerance who were frequency matched with prediabetes subjects by sex and age were selected as the control group; 46 control subjects had polyps, and 62 control subjects were polyp-free. Plasma adiponectin, visfatin, leptin, and resistin levels were measured in all the subjects, and the related risk factors of colonic polyps in prediabetes subjects were analysed.

Results

Plasma adiponectin levels were significantly lower in the polyps group than in the polyp-free group [normal glucose tolerance (9.8 ± 4.8 vs 13.3 ± 3.9) mg/L, P = 0.013; prediabetes (5.6 ± 3.7 vs 9.2 ± 4.4) mg/L, P = 0.007]. In prediabetes subjects, plasma adiponectin levels were decreased significantly in the multiple polyps group [(4.3 ± 2.6 vs 6.7 ± 3.9) mg/L, P = 0.031] and the high-risk polyps group [(3.7 ± 2.9 vs 7.4 ± 3.5) mg/L, P < 0.001] compared to their control groups. Plasma visfatin levels were higher in the polyps group and the multiple-polyps group than those in their control groups (P = 0.041 and 0.042, respectively), and no significant difference in plasma leptin and resistin levels was observed between these three pairs of groups (all P > 0.05). The multivariate logistic regression analysis showed that lower levels of plasma adiponectin was a risk factor for colonic polyps, multiple colonic polyps, and high-risk colonic polyps in prediabetes subjects.

Conclusions

Plasma adiponectin levels are inversely associated with colonic polyps, multiple colonic polyps, and high-risk colonic polyps in prediabetes subjects. And adiponectin may be involved in the development of colon tumours in prediabetes subjects.
Dental expenditure, progressivity and horizontal inequality in Chinese adults: based on the 4th National Oral Health Epidemiology Survey
Authors: Cheng Meng Lin , Wang Chun Xiao , Wang Xing , Feng Xi Ping , Tai Bao Jun , De Hu Yu , Lin Huan Cai , Wang Bo , Zheng Shu Guo , Liu Xue Nan , Rong Wen Sheng , Wang Wei Jian , Si Yan , Xu Tao
Published: May 2020

Background

The financial burden of oral diseases is a growing concern as the medical expenses rise worldwide. The aim of this study was to investigate the dental expenditure, analyze its progressivity and horizontal inequality under the general health finance and insurance system, and identify the key social determinants of the inequality for Chinese adults.

Methods

A secondary analysis used the data of 13,464 adults from the 4th National Oral Health Epidemiological Survey (NOHES) in China was undertaken. The dental expenditure was collected and divided into out-of-pocket and health insurance payments. Horizontal inequality index and Kakwani index were used to analyze the horizontal inequality and progressivity, respectively. The decomposition model of the concentration index was set up to explore the associated socioeconomic determinants.

Results

The results showed that a mean dental expenditure per capita of Chinese adults was $20.55 (95% Confidence Interval-CI: 18.83,22.26). Among those who actually used dental service, the cost was $100.95 (95%CI: 93.22,108.68). Over 90% of dental spending was due to out-of-pocket expenses. For self-reported oral health, the horizontal inequality index was − 0.1391 and for the decayed tooth (DT), it was − 0.2252. For out-of-pocket payment, the Kakwani index was − 0.3154 and for health insurance payment it was − 0.1598. Income, residential location, educational attainment, oral hygiene practice, self-reported oral health, age difference were the main contributors to the inequality of dental expenditure.

Conclusion

Dental expenditure for Chinese adults was at a lower level due to underutilization. The ratio of payments of dental expenditure and utilization was disproportional, whether it was out-of-pocket or insurance payment. Individuals who were more in need of oral care showed less demand for service or not required service in time. For future policy making on oral health, it is worth the effort to further promote the awareness of the importance of oral health and utilization of dental service.
6-Shogaol enhances the anticancer effect of 5-fluorouracil, oxaliplatin, and irinotecan via increase of apoptosis and autophagy in colon cancer cells in hypoxic/aglycemic conditions
Authors: Woźniak Marta , Makuch Sebastian , Winograd Kinga , Wiśniewski Jerzy , Ziółkowski Piotr , Agrawal Siddarth
Published: May 2020

Background

The development and growth of colorectal cancer based on constitutive activation of numerous signaling pathways that stimulate proliferation and metastasis. Plant-derived agents excel by targeting multiple aspects of tumor progression. Previous investigations have shown that ginger derivatives- shogaols possess anti-cancer and anti-inflammatory effects. In the present study, we have examined the anti-cancer effects of 6-shogaol alongside with the most widely used chemotherapeutic agents/regimens in the tumor-like microenvironment conditions.

Methods

Cytotoxicity on two colon cancer cell lines (SW480 and SW620) was measured by MTT test. Apoptosisassay, immunocytochemical and Western blotting analysis for autophagy and apoptosis detection were performed.

Results

Here, we report that 6-shogaol by itself or in combination with chemotherapeutic agents/regimens exerted a cytotoxic effect on CRC cells. Cell death might be linked with the activation of autophagy and apoptosis-related pathways. In the tumor-like microenvironment, which is characterized by hypoxia and glucose starvation, 6-shogaol with chemotherapeutics is significantly more potent than conventional chemotherapy alone.

Conclusions

Collectively, our data suggest that the addition of 6-shogaol to established chemotherapeutic regimens could potentially be a remarkable therapeutic strategy for colorectal cancer.