bluuebunny/crossref_metadata_2025 huggingface dataset:
SELECTION OF COLLECTIONS (FICTION) IN AN EFFORT FOR THE DEVELOPMENT OF THE COLLECTION IN THE LIBRARY OF AL IZZAH LPMIINTERNATIONAL ISLAMIC BOARDING SCHOOL BATU CITY OF EAST JAVA
Authors: Prayuda Handiawan Angling
Published: November 2019

The purpose of this study was to describe the selection of the collections in the library Al Izzah LPMI Batu, East Java. With the benefit of providing research solutions to do the selection collection in the library Al Izzah LPMI Batu City in East Java in overcoming obstacles faced about the selection of the collection. The type of research used in this study is a qualitative research technique of observation and interviews.Based on observations and interviews direct to the Library Manager Al Izzah LPMI stone town, East Java can be summed up as follows. First, the selection process for the collection activities (fiction) does not do any procurement of collection. This selection process was conducted using three tools of seletion i.e. using Catalog for publishers, Indonesia’s national bibliography, and reviews books. Second, the obstacles faced in the activity of a selection of fiction in the library Al Izzah LPMI batu City, East Java, is the lack of human resources, the difficulty of finding fiction collection shades of Islam, and is still limited to the choice of the equipment used
PENGADAAN KOLEKSI DI PERPUSTAKAAN TUNAS AULIA SD MASJID SYUHADA YOGYAKARTA DALAM MEMENUHI KEBUTUHAN INFORMASI SISWA
Authors: Ghaissani Faradhilla Ayu
Published: November 2019

This paper aims to describe about the process of acquisition at Tunas Aulia Library, Primary School of Syuhada Mosque. Methods of data collection through interviews and observations with the type of research that is qualitative descriptive. This paper identifies and describes some of the implications of the acqusition in Tunas Aulia Library are purchases, donations, deposits, making or printing in the form of bulletins, and prizes. Collections held to support students’ information needs include textbooks, fiction books, non-fiction, encyclopedias, and various dictionaries. Acquisition of collections is only a collection of printed books, not digital collections.
Modified Lemaire Lateral Extra-Articular Tenodesis Augmentation of Anterior Cruciate Ligament Reconstruction
Authors: Jesani Satyen , Getgood Alan
Published: November 2019

Background:

A modified Lemaire lateral extra-articular tenodesis (LET) is a procedure that is designed to address anterolateral complex (ALC) deficiency. The procedure is performed as an augmentation to anterior cruciate ligament reconstruction (ACLR) to reduce anterolateral rotatory laxity. Studies have demonstrated improved rotational control and reduced failure rates of ACLR when LET is added. This is particularly helpful in young patients with high-grade rotatory laxity returning to contact pivoting sport, and in the revision ACLR scenario.

Description:

A 6-cm skin incision is placed just posterior to the lateral epicondyle. The subcutaneous tissue is dissected down to the iliotibial band (ITB). A 1-cm-wide by 8-cm-long strip of the posterior half of the ITB is fashioned, leaving the distal attachment at Gerdy’s tubercle intact. The free end is whipstitched with number-1 Vicryl suture, tunneled deep to the fibular collateral ligament (FCL), and attached to the metaphyseal flare of the lateral femoral condyle at the insertion of the distal Kaplan fibers of the ITB. Fixation is performed with a staple, with the graft tensioned to no more than 20 N (by simply holding it taut and not “tensioned”), with the knee held at 60° of flexion and neutral rotation of the tibia.

Alternatives:

A number of procedures to address ALC deficiency have been described. The most common methods currently are variations of the ITB LET (Lemaire [ITB graft detached proximally, passed under the FCL, and attached to the femur] or Ellison [ITB graft detached distally, passed deep to the FCL, and reattached at Gerdy’s tubercle]) or anterolateral ligament reconstructions. No clinical studies have been performed that demonstrate that one technique is superior to another.

Rationale:

Current ACLR procedures focus on intra-articular graft placement to replace the ACL. Unfortunately, high rates of graft failure and persistent rotatory laxity (pivot shift) have been observed, particularly in young, high-demand individuals returning to contact pivoting sport. ALC deficiency has been shown to be a major cause of high-grade anterolateral rotatory laxity. The LET procedure is therefore designed to augment ACLR and reduce anterolateral rotation. The aim of adding LET to ACLR is to reduce the strain on the ACLR graft, reduce the prevalence of the pivot shift, and thereby potentially reduce the rate of ACLR graft failure.
The medium of instruction in Ethiopian Higher Education Institutions: Kotebe Metropolitan University Case study.
Authors: Taye Bekau Atnafu
Published: November 2019

The aim of this article is to examine the medium of instruction in Ethiopian higher education institutions and the perceived consequences of the failure to learn a lingua franca. The study was qualitative and it used interviews and focus group discussions (FGDs). Five teachers and five students took part in the interviews and six teachers and six students participated in the FGDs. The findings of the study showed that the role of Amharic as a working language has not been given recognition despite the fact that Amharic was constitutionally granted to be a working language. Due to language barriers, students who are speakers of Oromipha and other languages from the Eastern and Western parts of Ethiopia suffer passivity in the classroom because they do not speak Amharic although Amharic has been taught as a subject in all regional states of the country. Increased identity politics seems to have generated a negative attitude towards Amharic, Ethiopia's former official lingua franca. Non-Amharic native speakers appeared to lose interest in learning Amharic while they were in primary and secondary schools. The absence of an official, common language which could be used for wider communication in higher education has resulted in having challenges among the student population.
Prevalence of Psychoactive Substance Use Among Undergraduate Students at Chirunga College, Malawi.
Authors: Kuyokwa John , Chiziwa Symon Ernest , Semphere Nertha
Published: November 2019

The purpose of this study was to determine the prevalence of use of psychoactive substances among undergraduate students at Chirunga College in Malawi.  The study was guided by Ajzen’s Theory of Planned Behaviour. Mixed research methodologies were used, in which both quantitative and qualitative research methodologies were employed in data generation and analysis. SPSSv20 and Excel were used in quantitative data analysis and qualitative data was analyzed thematically. The study involved 147 participants and the findings revealed that (34%) of students used psychoactive substances. It recommends that undergraduate students who use psychoactive substances like any other user of these substances, require help. Accordingly, as an institution of higher learning, Chirunga College has to take the necessary steps to address this problem; including introducing counselling and psychotherapy services at the institution
Professionalism, Urban Settings, and Teachers’ Self-Efficacy in Developing Countries: A Ghanaian Perspective.
Authors: Gumah Bernard , Kulbo Nora Bakabbey , Addo Prince Clement
Published: November 2019

In achieving the goals of education, it is imperative for teachers to have high self-efficacy which has a direct positive effect on their delivery and for the overall benefit of their pupils. This study was in three-fold. First was to access the influence of teachers’ demographics on their self-efficacy. Second, how work environment influences teachers’ self-efficacy and finally, how their self-efficacy impact students’ performances in the Bolgatanga municipality of Ghana. The efficacy dimensions studied are classroom management practices, classroom instructional practices, and student engagement. It was noted that whiles gender has no significant impact on teachers’ self-efficacy, older, more educated and highly experienced teachers had higher self-efficacy. Also, teachers in the urban area tend to have higher self-efficacy than those in rural areas. Not overlooking other factors, students’ poor performance in some rural areas can largely be attributed to the lower self-efficacy of their teachers as compared to their urban counterparts. Governments should intensify their extrinsic motivation packages to make life more comfortable for teachers working in rural areas and by bridging the rural-urban developmental gap. It is also imperative to intensify self-efficacy in teacher trainees to increase their self-confidence where ever they find themselves.
Adequacy and Utilization of ICT Resources for Teaching Business Subjects in Senior Secondary Schools in Osun State, Nigeria
Authors: Ademiluyi Lawrence Femi
Published: November 2019

This study sought to determine the adequacy and utilization of ICT facilities for teaching and learning business subjects in public senior secondary schools in Osun State of Nigeria. Mixed method research design involving the distribution of questionnaires and the conduct of follow-up interviews was used for the study. The population consisted of business educators teaching in public secondary schools. No sample was drawn; the entire population was studied. The results show that ICT facilities are barely available, grossly inadequate and largely unutilized in teaching business subjects in Osun State public secondary schools in spite of the much-heralded introduction of ”Opon Imo” computer tablets supposedly made available to all senior secondary school students in the state. The study opined that government and other education stakeholders should provide functional ICT facilities and personnel in public secondary schools.
Munsaka, E., & Kalinde, B. (2017) Laying the foundation for optimal outcomes in Early Childhood, University of Zambia Press, Lusaka, 172 pp. (A5), $12.00 (paperback), ISBN 978-9982-02-099-1
Authors: Walubita Gabriel
Published: November 2019

Although the provision of quality early childhood education has been acknowledged as important both in the local and international development literature, there are few books that have been written on early childhood education in Zambia. The current review of a 161 paged A5 paperback bound book entitled “laying the foundation for optimal outcomes in early childhood education” co-authored by Ecloss Munsaka and  Bibian Kalinde is one of the first attempts to scrutinise latest resources on early childhood education challenges and prospects in Zambia. The review is timely as it responds to the recent integration of early childhood education in the mainstream Zambian education system. The review has critically examined chapters’ one up to six. The implications of the book in early childhood education practice in Zambia have been discussed.
Study protocol of a randomised controlled feasibility study of food related computerised attention training versus mindfulness-training and waiting list control for adults with overweight or obesity
Authors: Beivide Daniela Mercado , Werthmann Jessica , Campbell Iain C , Schmidt Ulrike
Published: November 2019

Background: Obesity is a highly prevalent condition with multiple adverse health consequences. Widely available first-line treatments for obesity, such as dietary and other lifestyle interventions, typically have only short-term effects. Thus, new treatment approaches are needed. Novel interventions such as Attention Bias Modification Training (ABMT) and Mindfulness Based Interventions focus on modifying different maladaptive cognitive patterns typically present in people with obesity (e.g. attention bias to food cues), however, their mechanisms of action remain largely unknown. We describe the theoretical basis and the rationale for a study protocol of a feasibility randomised controlled trial (RCT) comparing two attention trainings (ABMT vs Mindfulness Training [MT]) in people with overweight or obesity. The aim of this study is to inform the development of a large scale RCT in relation to acceptability and attendance rates and to identify preliminary evidence for the interventions’ clinical efficacy and potential underlying mechanisms.
Design: Forty-five adults who are either overweight or obese (minimum body mass index of 25 kg/m2) will be randomly allocated to receive eight sessions over eight weeks of either computerised ABMT or MT or be on a waiting list. Clinical and cognitive outcomes will be assessed at baseline, post-treatment (8 weeks) and follow-up (12 weeks post-randomisation). These include mood, body composition and attention biases. Credibility and acceptability of the trainings will be assessed using questionnaires, and recruitment and retention rates will be recorded.
Discussion: Findings will inform the feasibility of developing a large scale RCT that takes into consideration effect sizes for primary outcome measures and the acceptability of the design. The study will also provide preliminary evidence on the clinical efficacy of two different attention trainings for people with obesity and their underlying mechanisms.
Trial registration: ISRCTN15745838. Date of registration: 22nd May 2018
Keywords: Obesity, Attention Trainings, Mindfulness, Attention Bias, Trial
Comparative metabolome analysis of serum changes in sheep under overgrazing or light grazing conditions
Authors: Zhang Jize , Gao Yang , Guo Huiqin , Ding Yong , Ren Weibo
Published: November 2019

Background

Overgrazing is a primary contributor to severe reduction in forage quality and production in Inner Mongolia, leading to extensive ecosystem degradation, sheep health impairment and growth performance reduction. However, no clear information about the effect of overgrazing on sheep health and nutritional metabolism is available because no objective serum biomarkers are currently evident. We hereby hypothesize that reduced sheep growth performance under overgrazing conditions would be associated with metabolic and immune response alterations. This study used an untargeted metabolomics analysis by conducting ultra-high-performance liquid chromatography combined with quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF/MS) of sheep serum under overgrazing and light grazing conditions to identify metabolic disruptions in response to overgrazing.Results

The sheep body weight gains as well as serum biochemical variables associated with immune responses and nutritional metabolism (immunoglobulin G, albumin, glucose, and nonesterified fatty acids) were significantly decreased with overgrazing than under the light grazing condition. In contrast, other serum parameters such as alanine and aspartate aminotransferase, alkaline phosphatase, total bilirubin, blood urea nitrogen, and interleukin-8 were markedly higher in the overgrazing group. Principal component analysis discriminated the metabolomes of the light grazing from the overgrazing group. Multivariate and univariate analyses revealed alternations in the serum concentrations of 15 metabolites (9 metabolites exhibited a marked increase, whereas 6 metabolites showed a significant decrease) in the overgrazing group. Major alterations of fatty acid oxidation, bile acid biosynthesis, and purine and protein metabolism were observed.Conclusions

These findings offer metabolic evidence for putative biomarkers for overgrazing-induced changes in serum metabolism. Target-identification of these particular metabolites may potentially increase our knowledge of the molecular mechanisms of altered immune responses, nutritional metabolism, and reduced sheep growth performance under overgrazing conditions.
Predicting peripartum blood transfusion: focusing on pre-pregnancy characteristics
Authors: Ouh Yung-Taek , Lee Kyu-Min , Ahn Ki Hoon , Hong Soon-Cheol , Oh Min-Jeong , Kim Hai-Joong , Han Sung Won , Cho Geum Joon
Published: November 2019

Background: Obstetric hemorrhage is one of the most common causes of obstetrical morbidity and mortality, and transfusion is the most important management for hemorrhage. The aim of our study was to investigate the pre-pregnancy and pregnancy risk factors for peripartum transfusion.
Methods: Women who delivered a baby from 2010 to 2014 in Korea and participated in the Korean National Health Screening Program for Infants and Children were included. To analyze pre-pregnant risk factors for peripartum transfusion, an additional analysis was done for women who underwent a National Health Screening Examination within one year before pregnancy, including maternal waist circumference, body mass index, blood pressure, laboratory tests and history of smoking. Multivariable logistic regression analysis was used to estimate the risk factors for peripartum transfusion.
Results: Of the total 1,980,126 women who met the inclusion criteria, 36,868 (1.86%) were transfused at peripartum. In a multivariable regression model, the pregnancy risk factors for peripartum transfusion included maternal age above 35 years [odds ratio (OR): 1.41; 95% confidence interval (CI): 1.32–1.50], preterm birth (OR: 2.39; 95% CI: 2.15–2.65), and maternal hypertension (OR: 2.49; 95% CI: 2.24–2.77). Pre-pregnancy risk factors including fasting glucose level of more than 126 mg/dL (OR: 1.11; 95% CI: 1.02–1.20), current-smoker status (OR: 1.20; 95% CI: 1.06–1.37), and waist-circumference less than 80 cm (OR: 1.18; 95% CI: 1.06–1.30) were independently associated with peripartum blood transfusion.
Conclusions: Several pre-pregnancy and pregnancy risk factors were associated with peripartum blood transfusion. Some identified factors are modifiable before conception, and our study validated peripartum blood transfusion as a form of triage.
Keywords: Peripartum, Blood transfusion, Postpartum hemorrhage
A systematic review of brief screeners for suicidal behaviour in primary care
Authors: Lukaschek Karoline , Frank Milena , Halfter Kathrin , Schneider Antonius , Gensichen Jochen
Published: November 2019

The authors have requested that this preprint be removed from Research Square.
Combination of isoflurane and propofol, a means for general anesthesia in the orthopedic surgery of perioperative cerebral hypoperfusion rats to avoid cognitive impairment Anesthesia of perioperative cerebral hypoperfusion
Authors: Bu Xinyue , Li Tang , Wang Haiyun , Xia Zhengyuan , Guo Di , Wang Jinxin , Sun Yi , Yang Chenyi , Liu Guoqiang , Ma Ji , Yang Zhuo , Wang Guolin
Published: November 2019

Background: Perioperative cerebral hypoperfusion often occurs. However, the underlying mechanism of cognitive impairment resulting when perioperative cerebral hypoperfusion occurs remain mostly to be determined. Anesthetic isoflurane induces neuronal injury via endoplasmic reticulum (ER) stress, whereas sub-anesthetic dose of propofol improves postoperative cognitive function. However, the effects of the combination of isoflurane plus propofol, which is a common combination of anesthesia for patient, on ER stress and the associated cognitive function remain unknown.
Methods: We therefore set out to determine the effects of isoflurane plus propofol on the ER stress and cognitive function in the rats insulted by cerebral hypoperfusion. In order to get closer to the actual situation in the clinic, high incidence of fracture forces aging people to undergo surgeries needs general anesthesia, we introduce a surgery of tibial fracture with internal fixation to aging rats. The rats received isoflurane alone (1.9%), propofol alone (40 mg·kg-1·h-1) or a combination of isoflurane and propofol (1% and 20 mg·kg-1·h-1 or 1.4% and 10 mg·kg-1·h-1). Behavior studies (Fear Conditioning test), histological analyses (Nissl staining) and biochemical analyses (western blotting for the harvested rat brain tissues) were employed in the studies.
Results: We found that the combination of 1% isoflurane plus 20 mg·kg-1·h-1 propofol attenuated the cerebral hypoperfusion-induced cognitive impairment and the ER stress.
Conclusions: These data suggest that ER stress contributes to the underlying mechanism of cognitive impairment and the combination of isoflurane and propofol was able to preserve cognitive function in the rats after cerebral hypoperfusion via prevention of ER stress. These findings have established a system to study the strategy in preventing and treating perioperative cerebral hypoperfusion, leading to promotion of the future larger scale studies.
Comparative Efficacy of Glucocorticoid Receptor Agonists on Th2 Cell Function and Attenuation by Progesterone
Authors: Luchak Alexander , Author) Lauren A Solomon(Former Corresponding , Kanagalingam Tharsan , Vijeyakumaran Meerah , Rowe Brian H , Author) Lisa Cameron(New Corresponding
Published: November 2019

Background: Corticosteroids (CS) suppress cytokine production and induce apoptosis of inflammatory cells. Prednisone and dexamethasone are oral CS prescribed for treating asthma exacerbations. While prednisone is more commonly prescribed, dexamethasone is long acting and a more potent glucocorticoid receptor (GR) agonist. It can be administered as a one or two dose regime, unlike the five to seven days required for prednisone, a feature that increases compliance. We compared the relative ability of these two oral CS to suppress type 2 inflammation. Since progesterone has affinity for the GR and women are more likely to relapse following an asthma exacerbation, we assessed its influence on CS action. Results: Dexamethasone suppressed the level of IL-5 and IL-13 mRNA within Th2 cells with 10-fold less than prednisolone (the active form of prednisone). Dexamethasone induced a higher proportion of apoptotic and dying cells than prednisolone, at all concentrations examined. Addition of progesterone reduced their capacity to drive cell death, though dexamethasone maintained significantly more killing activity. Progesterone blunted dexamethasone-induction of FKBP5 mRNA, indicating the mechanism of action was by interference of the GC:GR complex. Conclusions: Dexamethasone is both more potent and effective than prednisolone in suppressing type 2 cytokine levels and mediating apoptosis. Progesterone attenuated these anti-inflammatory effects, indicating its potential influence on corticosteroid responses in vivo . Collectively, our data suggest that when oral corticosteroid is required, dexamethasone may be better able to control type 2 inflammation, eliminate Th2 cells and ultimately lead to improved long-term outcomes. Further research in asthmatics is needed
Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation
Authors: An Likun , Zhang Tongtong , Sun Xiangyao , Zhang Xinuo , Sun Siyuan , Hai Yong , Lu Shibao
Published: November 2019

Background: The thresholds of risk factors of kyphosis recurrence in thoracolumbar burst fracture patients were still controversial. The aim of this multi-center study was to identify these thresholds.
Methods: 169 patients were included in this study. Upper intervertebral angle (UIVA), lower intervertebral angle (LIVA), Cobb angle (CA), anterior vertebral height ratio (AVH%), regional angle (RA), posterior vertebral height ratio (PVH%), vertebral wedge angle (VWA), anteroposterior ratio (A/P%), Clinical assessment included Load Sharing Classification (LSC) score, Thoracolumbar Injury Classification and Severity (TLICS) score, Visual Analogue Scale (VAS), and Body mass index (BMI) were perioperatively evaluated. Patients were divided into KR group and none KR (NKR) group according to whether the loss of CA correction was less than 5˚ or not. The risk factors of KR before or after implant removal were analyzed, respectively.
Results: There were significant improvements in postoperative parameters compared with preoperative parameters, such as AVH%, A/P%, VAS, CA, VWA, PVH% (P < 0.001, respectively), and UIVA (P = 0.02). Age (AUC = 0.828) and BMI (AUC = 0.846) were good predictors of KR before implant removal. BMI (AUC = 0.871) was a good predictor of KR after implant removal.
Conclusions: There were significant differences in risk factors of KR at different postoperative follow-up stages: age > 49 years, BMI > 24 were risk factors of KR before implant removal; BMI > 25.17 was a risk factor of KR after implant removal.
Immediate implant placement in anterior teeth with grafting material of autogenous tooth bone vs xenogenic bone
Authors: Wu Dong , Zhou Lin , Lin Jichao , Chen Jiang , huang wenxiu , Chen Yonghui
Published: November 2019

Background: The aim of the study was to compare the efficacy of the autogenous tooth bone and xenogenic bone grafted in immediate implant placement with bone defect. Methods: Thirty patients whose compromised anterior teeth need immediate implant placement were enrolled. Autogenous tooth bone made from the extracted teeth by chair-side or the xenogenic bone were used to repaired bone defect. Clinical examination, radiographic assessment about the horizontal bone change in the level of 0mm, 3mm and 6mm below the implant neck and the marginal bone loss were made immediately, 6 and 12 months after implant placement. Questionnaire of the feelings about the surgery were made at the time of removing the sutures. Results: All implants achieved the success criteria without any complications at the follow-up period. The percent of the horizontal bone change and the marginal bone loss at 6 and 12 months were almost the same between two groups (P>.05). The horizontal bone loss at the first or the latter 6 months was almost the same (P>.05). But the horizontal bone loss at the 6 mm level was less than the 0 mm and 3 mm levels at 6 and 12 months (P<.05). Meanwhile patients seem more satisfied with the autogenous tooth bone derived from the questionnaire. Conclusion: The bone volume change in the facial part of the implant after immediate placement is almost the same between two groups. Providing clinical evidence that the autogenous tooth bone made from compromised tooth can be an acceptable bone graft material.
Percutaneous Mastoid Electrical Stimulator improves poststroke depression and cognitive function in patients with ischemic stroke
Authors: Lu Taoli , he lanying , Zhang Bei , Wang Jian , Zhang Lili , Dong WeiWei , Yang Hao
Published: November 2019

Backgrond Poststroke depression could lead to functional dependence, cognitive impairment and reduced quality of life. The aim of this study was to evaluate the effects of percutaneous mastoid electrical stimulator (PMES) plus antidepressant on poststroke depression and cognitive function.Methods 258 clinically depressed ischemic stroke patients within 14 d of index stroke were randomly assigned to PMES plus antidepressant (PMES group) and sham plus antidepressant (sham group). All patients underwent Montreal Cognitive Assessment (MoCA) and Hamilton Rating Scale for Depression (HRSD) test at 2 weeks (baseline), and 6 months after the stroke. The clinical outcome was defined as treatment response (≥50% reduction in HRSD) and depression remission (HRSD≤9) at 6 months.Results Compared with the sham group, PEMS group significantly improved MoCA and HRSD scoreat the end of the 6-month treatment period (P<0.001). The mean value of MoCA score change (3.50±2.55 vs 2.72±2.52; P=0.005), and HRSD score change (-11.93 ±5.32 vs -10.48 ± 6.10, P = 0.041) was significantly greater in the PMES group compared to sham group at 6 months. In fully adjusted models, PMES plus antidepressant was associated with increased treatment response rate [adjusted odds ratio (OR), 2.04; 95% confidence interval (CI), 1.15-3.63; P=0.015], and depression remission rate [adjusted OR, 1.83; 95% CI, 1.05-3.18; P=0.032]. In fully adjust models, PMES plus antidepressant was associated with decreased risk of 6-month MoCA score <26 (adjusted OR, 0.25; 95%CI, 0.09–0.70; P=0.008).Conclusion These findings demonstrate that PMES adjunctive to antidepressant therapy is highly effective in reducing depression, achieving remission in the short term, and improving cognition.
Evaluating differences in disease occurrence between two groups to determine the effect size of an observed factor based on a multi-variate model
Authors: Liu Hui
Published: November 2019

Background To describe a method to determine the effect size of an observed factor for a disease by evaluating the difference in the frequency of disease occurrence between exposed and unexposed groups.Methods A model of multiple pathogenic factors was established by analyzing the number and distribution of observed factors in a study population. The difference in the incidence between two groups (exposed and unexposed) was calculated according to the model.Results The distribution of observed factors in the population did not influence the difference in disease incidence between the two groups. However, the difference in incidence between the two groups was able to correctly reflect the number of factors combined in the models, and therefore, indicates that group differences in incidence is a reasonable indicator of effect size. Difference scores <0.25 indicate that one of four or more factors plays a role in a disease; scores >0.50 indicate one of two factors plays a role in disease and implies a high intensity level of the factor.Conclusions A difference in incidence between two groups over 0.25 is suggested as an indicator of a substantial effect size.
Nonlinear Trajectory of Estimated GFR Progression in HIV-Positive Patients with Normal Renal Function on Tenofovir - based Therapy in China: a retrospective observational cohort study
Authors: Liu Fang , Xu Aifang , Zhao Huaqing , Yang Zongxing , Chen Chen , Ranieri Brona , Bao Jianfeng , Zheng Guoxiang , Wang Miaochan , Wang Ying , Xun Yunhao
Published: November 2019

Background Estimated glomerular filtration rate (eGFR) trajectory in HIV-1-infected patients on tenofovir disoproxil fumarate (TDF) – based therapy has been widely assessed using linear models, but this linearity assumption is disputable and the nonlinearity of eGFR change remains unknown in patients with initially normal renal function. Methods This is a retrospective, observational cohort study in treatment-naïve HIV-1-infected patients in Hangzhou, China. Estimated GFR (calculated by MDRD equation) trajectories were compared by one-linear and piecewise-linear mixed effects models, before and after propensity matching, respectively. Whether the incidence of renal dysfunction (reduced renal function [RRF], eGFR < 90 mL/min/1.73 m² and rapid kidney function decline [RKFD], eGFR > -3 mL/min/1.73 m² /year) follows nonlinearity was assessed by logistic regression. Results We examined 823 (299 of TDF users and 524 of non-TDF users) treatment-naïve HIV-1-infected participants (age≥17 years) with initial eGFR greater than 90 mL/min/1.73m² . The median follow-up time was 10 (interquartile range, 2-20) months, during which 178 (21.6%) experienced RRF, and 451 (54.8%) experienced RKFD. In nonlinear adjusted model, the eGFR of TDF users decreased over time before 1.40 years (-5.31 mL/min/1.73 m² /year; 95% CI: -6.57, -4.06), and after 2.30 years (-3.71 mL/min/1.73 m² /year; 95% CI: -5.97, -1.45). However, the eGFR significantly improved from years 1.40 to 2.30 (4.83 mL/min/1.73 m² /year; 95% CI: 1.38, 8.28). Within this particular time frame, each year of TDF exposure was associated with a 78% decreased risk of RKFD (95% CI: -91%, -49%). In comparison, eGFR increased slightly at the initiation of antiviral therapy, declined after 2.15 years (-4.96 mL/min/1.73 m² /year; 95% CI: -5.76, -4.17) among non-TDF users. Such a progression nonlinear trajectory was missed on the assumption of one-linearity, whether in TDF or non-TDF users. Conclusion For HIV-1-infected Chinese initiated antiviral therapy with normal renal function, the nonlinear trajectory of renal function do exist, as revealed by the piecewise mixed effects model with advantage of speaking to the true nature of the exposure outcome relationships. Routine screen based on this nonlinear progression of eGFR, could be helpful for patient management.
Sex-specific patterns of senescence in artificial insect populations varying in sex-ratio to manipulate reproductive effort
Authors: Jehan Charly , Chogne Manon , Rigaud Thierry , Moret Yannick
Published: November 2019

Background The disposable soma theory of ageing assumes that organisms optimally trade-off limited resources between reproduction and longevity to maximize fitness. Early reproduction should especially trade-off against late reproduction and longevity because of reduced investment into somatic protection, including immunity. Moreover, as optimal reproductive strategies of males and females differ, sexually dimorphic patterns of senescence may evolve. In particular, as males gain fitness through mating success, sexual competition should be a major factor accelerating male senescence. In a single experiment, we examined these possibilities by establishing artificial populations of the mealworm beetle, Tenebrio molitor , in which we manipulated the sex-ratio to generate variable levels of investment into reproductive effort and sexual competition in males and females.Results As predicted, variation in sex-ratio affected male and female reproductive efforts, with contrasted sex-specific trade-offs between lifetime reproduction, survival and immunity. High effort of reproduction accelerated mortality in females, without affecting immunity, but high early reproductive success was observed only in balanced sex-ratio condition. Male reproduction was costly on longevity and immunity, mainly because of their investment into copulations rather than in sexual competition.Conclusions Our results suggest that T. molitor males, like females, maximize fitness through enhanced longevity, partly explaining their comparable longevity.
Pre-Hospital Low ALT Activity, a Marker of Sarcopenia and Frailty, is Associated with Increased Long-Term Mortality after COPD Exacerbations. Historic Prospective Cohort Study.
Authors: Lasman Nir , Shalom Matan , Turpashvili Natia , Goldhaber Gal , Lifshitz Yulia , Leibowitz Eyal , Berger Gideon , Zalzman-Shenhav Gilat , Brom Adi , Cohen Dor , Avaki Chen , Segal Gad
Published: November 2019

Background COPD exacerbations have negative impact on patients' survival. Several risk factors for grave outcomes of such exacerbations have been descried. Muscle dysfunction and mass loss were shown to impact negatively on prognosis and survival. Low activity of the enzyme ALT (Alanine amino-transferase) in the blood is a known indicator for sarcopenia and frailty, however, no previous studies addressed the association of low ALT amongst patients hospitalized due to COPD exacerbation and long-term survival. Methods. This is a historic prospective cohort study of patients hospitalized due to acute COPD exacerbation. Results. Included were 232 consecutive COPD exacerbation patients. The median time of follow-up was 34.9 months (IQR 23.13 – 41.73 months). During this period 104 (44.8%) patients died. All patients were grouped to quartiles according to blood ALT levels (after exclusion of cases considered to have hepatitis (ALT > 40 IU)). The risk of long-term mortality increased, in a statistically significant manner, amongst patients with low ALT values: the median survival of patients with ALT < 11 IU was 18.5 months only while the median survival for the rest of the study group was not reached. For ALT < 11IU; 12-16IU; 17-20IU and >21IU the mortality rates were 69%; 40.9%; 36.3% and 25% respectively (p < 0.001 for comparison of lower quartile with upper three quartiles). The crude hazard ratio for mortality amongst patients with ALT levels lower than 11IU was 2.37 (95% CI; 1.6 – 3.5). This increased risk of mortality remained significant after adjustment for age, weight, creatinine, albumin concentration and cardiovascular diseases (HR = 1.83; 95% CI 1.08 – 3.1, p < 0.05). Conclusions. Low ALT values, a biomarker of sarcopenia and frailty, are associated with poor long-term survival amongst patients hospitalized due to COPD exacerbation.
Clinical Characteristics and Organ System Involvement of the University of Minnesota Sarcoidosis Cohort
Authors: Sreng Hok , Perlman David M , Shenoy Chetan , Steinberger Daniel J , Cogswell Rebecca J , Roukoz Henri , Peterson Erik J , Zhang Lin , Allen Tadashi L , Bhargava Maneesh
Published: November 2019

Background: Sarcoidosis is a systemic granulomatous disease of unknown etiology. Clinical cohort studies of different populations are important to understand the high variability in clinical presentation and disease course of sarcoidosis. The aim of the study is to evaluate clinical characteristics, including organ involvement, pulmonary function tests, and laboratory parameters, in a sarcoidosis cohort at the University of Minnesota. Methods: We conducted a retrospective data collection and analysis of 187 subjects with biopsy-proven sarcoidosis seen at a tertiary center. Chi-square test or Fischer’s exact test was conducted for categorical variables, while Student’s t-test or analysis of variance was conducted for continuous variables, with p < 0.05 considered statistically significant. Results: Mean subject age at diagnosis was 45.8 ± 12.4, with a higher proportion of males (55.1%), and a higher proportion of blacks (17.1%) compared to the racial distribution of Minnesota residents (5.95%). The majority (71.1%) of subjects required anti-inflammatory therapy for at least 1 month. Compared to the A Case Control Etiologic Study of Sarcoidosis cohort, there was a higher frequency of extra-thoracic lymph node (34.2% vs. 15.2%), eye (20.9% vs. 11.8%), liver (17.6% vs. 11.5%), spleen (20.9% vs. 6.7%), musculoskeletal (9.6% vs. 0.5%), and cardiac (10.7% vs. 2.3%) involvement in our cohort. A multisystem disease with at least five different organs involved was identified in 13.4% of subjects. A restrictive physiological pattern was observed in 21.6% of subjects, followed by an obstructive pattern in 17.3% and mixed pattern in 2.2%. Almost half (49.2%) were Scadding stages II/III. Commonly employed disease activity markers, including soluble interleukin-2 receptor, angiotensin-converting enzymes, and C-reactive protein, did not differ between treated and untreated groups. Conclusions: This cohort features a relatively high frequency of high-risk sarcoidosis phenotypes including cardiac and multiorgan disease. Commonly-utilized serum biomarkers do not identify subpopulations that require or do better with treatment. Findings from this study present further the high-variability nature of sarcoidosis and the need for a more reliable biomarker to predict and measure disease severity and outcomes for better clinical management for sarcoidosis patients.
Pulmonary mucoepidermoid carcinoma: Clinicopathological characteristics of 20 cases and a literature review
Authors: Zhang Jing , Chen Yan Xiao , Qian Jun Zi , Yue Ping , Wang Jialei , Xiang Yi
Published: November 2019

Background: Pulmonary mucoepidermoid carcinoma is a rare tumor of the lung. The clinicopathological characteristics of pulmonary mucoepidermoid carcinoma are not well defined due to the low incidence. This study was performed to provide more supplementary clues for the identification and understanding of pulmonary mucoepidermoid carcinoma. Methods: We reviewed the medical records since January 1, 2000 to December 31, 2018. The patients’ medical records，including age at the time of diagnosis , gender, smoking history, preoperative evaluations, operative procedures, tumor location, tumor size, tumor stage, lymph node metastasis, pathological markers, prognosis and survival information were extracted and reviewed. Categorical variables were presented as parameters and percentages. A comparison was performed between patients with high and low grade of pulmonary mucoepidermoid carcinoma. Results: 20 patients were identified and the age span is from 18 to 67 year-old with the average age is 45. Mucoepidermoid carcinomas were commonly found in men（60%）. 80% patients had clinical presentations and the positive rate of tumor markers was 78%, although no specific tumor markers were found. TTF-1 were negative in all cases. ALK rearrangement was identified in a non-smoking woman with high grade pulmonary mucoepidermoid carcinoma. Surgery is the main procedure. 3-year survival rate is 72% and 80% patients achieved disease-free alive. High-grade patients tend to harbor older age (p=0.035), larger tumor volume (p=0.026) and higher index of ki-67(p=0.0005). Conclusions: Pulmonary mucoepidermoid carcinoma could occur in a wide age span. Early diagnosis and complete surgical resection may promise a good prognosis. Grading is a key factor to predict the overall survival time. Combined TTF-1 and MAML2 will benefit the identification of pulmonary mucoepidermoid carcinoma from other lung tumors. Future prospective randomized controlled trials and larger, multi-centric series are needed.
The Roles of Alcohol Drinking and Dietary Factors in the U-shaped Relationship Between Cigarette Smoking and Body Mass Index in Middle-aged and Elderly Chinese Rural Adults: Cross-sectional Study
Authors: Pan Da , Su Ming , Wei Jie , Wang Kai , Luo Pengfei , Smith James D. , Ma Gege , Wang Shaokang , Sun Guiju
Published: November 2019

Background To investigate the relationship between smoking behaviour and BMI, from the perspective of the roles of alcohol drinking and dietary factors in a middle-aged and elderly Chinese rural population. Methods The authors analysed cross-sectional data from 10,837 middle-aged and elderly Chinese rural adults aged from 35 to 75 years who in 2011-2017 completed a questionnaire that included questions on demographic characteristics, dietary intake, and detailed smoking and drinking status. Results Current smokers tended to have a lower BMI and consume foods less frequently (except coriander, onion, garlic, hawthorn and fermented bean curd) than non-smokers. The relationship between smoking amount and the risk of being overweight or obese was U-shaped, and the trends were also similar by stratum of baseline age groups (all p for interaction ˂ 0.001). Heavy smokers tended to have drinking habits, whereas drinking was found to be associated with increased risk of being overweight or obese (all p for trend ˂ 0.001). In addition, despite the lower risk of being overweight or obese for current smokers, the normal weight individuals were found to have the minimum smoking amount. Conclusions This study suggests that cigarette smoking may cause suppression of appetite but smokers tend to have other unhealthy habits relating to increased body weight, and highlights that dietary factors and alcohol use play important roles in the U-shaped relationship between smoking behaviours and BMI in the middle-aged and elderly Chinese rural population. Additionally, people rarely or never smoke may be more likely to be within a normal BMI range than heavy smokers.
Individual and community level factors associated with unmet need for contraception among married reproductive age women in Ethiopia. A multilevel analysis using 2016 Ethiopian Demographic and Health Survey
Authors: Anagaw Melaku Yalew , Desta Bezawit Adane , Abitew Bereket Kefale , Sinishaw Yitayish Damtie
Published: November 2019

Background: There is limited evidence on unmet need to contraceptive among married reproductive age women especially in developing countries like Ethiopia. Thus, this study aimed to assess individual and community level factors associated with unmet need for contraception among married women of reproductive age in Ethiopia, EDHS 2016 dataset, 2019. Method: A secondary analysis was done on Ethiopian Demographic and Health Survey (2016) dataset by using cross sectional study design. A total of 9125 women who were married, fecund and/or sexually active were included in the analysis. Multilevel mixed-effect logistic regression analysis was done by STATA version 14.0 to identify individual and community level factors. Adjusted odds ratio with 95% confidence interval was used to show the strength and direction of association and statistical significance was declared at P value less than 0.05. Result: Factors significantly associated with unmet need were; ages between 15-19 years [AOR=2.25, 95% CI: (1.34, 3.79)], greater than or equal to three living children [AOR=1.87, 95 % CI: (1.40, 2.49)], belong to richer household [AOR=0.73, 95% CI: (0.54, 0.97)], Muslim followers [AOR=1.37, 95% CI: (1.02, 1.83)], married more than once [AOR=1.31, 95 % CI: (1.06, 1.62)]. From community level variables, belong to Somali region [AOR=0.34, 95% CI: (0.19, 0.61)] were significantly associated with unmet need. Conclusion: Both individual and community-level factors were significant determinants of unmet need. From individual level factors; ages of women, number of living children, religion, married more than once and wealth of house hold and from community level variables; region was significantly associated with unmet need for contraception. The findings suggested that health care providers should mainly focus on women nearly on menopauses, who live in the poorest household and who had many number of living children and married more than once to decrease unmet need to contraceptive.
Low hENT1 expression indicates poor prognosis in gemcitabine-treated pancreatic cancer patients
Authors: Xiao Jianchun , Zhao Fangyu , Yang Gang , Luo Wenhao , Wang Yicheng , Qiu Jiangdong , Liu Yueze , You Lei , Zheng Lianfang , Zhang Taiping , Zhao Yupei
Published: November 2019

Background: Pancreatic cancer (PC) is still a lethal disease and has a poor prognosis, gemcitabine-based chemotherapy is now the standard regimen in the treatment of pancreatic cancer. Gemcitabine resistance is an important obstacle for effective treatment of patients and improvement in patients’ overall survival (OS) and disease free survival (DFS).
Results: Current research shows that human equilibrative nucleoside transporter 1 (hENT1) is related to gemcitabine chemoresistance for it mediates drug entry into cancer cells, and has an aberrant expression level in tumor tissues. But now discrepancies still exist between different research groups and studies about the expression level and prognostic value of hENT1 in PC patients, and the exactly underlying mechanism through which hENT1 transfer GEM into tumor cells remains unclear.
Conclusion: hENT1 was low expressed in tumor tissues and this decreased expression level indicated a worse outcome (including shortened OS and DFS) in patients who received gemcitabine treatment postoperatively.