bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa
Authors: Abrahams Nina , Gilson Lucy , Levitt Naomi S. , Dave Joel A.
Published: December 2019

Background

The burden of non-communicable diseases is growing rapidly in low- and middle-income countries. Research suggests that health interventions that aim to improve patient self-management and empower patients to care actively for their disease will improve health outcomes over the long-term. There is, however, a gap in the literature about the potential role of the inpatient setting in supporting chronic care. This is particularly important in low-and-middle income countries where hospitals may be a rare prolonged point of contact between patient and health provider. The aim of this small scale, exploratory study was to understand what factors within the inpatient setting may affect patients’ feelings of empowerment in relation to their chronic disease care and provides recommendations for future inpatient-based interventions to support self-management of disease.

Methods

This study was based in a public, academic hospital in South Africa. Eighteen qualitative, semi-structured interviews were conducted with multiple participants with experience of diabetes care: inpatients and health professionals such as nurses, endocrinologists, and dieticians. Findings were analysed using a broad, exploratory, thematic approach, guided by self-management and chronic care literature.

Results

Interviews with both patients and providers suggest that patients living in low socio-economic contexts are likely to struggle to access appropriate healthcare information and services, and may often have financial and emotional priorities that take precedence over their chronic illness. Younger people may also be more dependent on their family and community, giving them less ability to take control of their disease care and lifestyle. In addition, hospital care remains bound by an acute care model; and the inpatient setting of focus is characterised by perceived staff shortages and ineffective communication that undermine the implementation of patient empowerment-focused interventions.

Conclusions

Patient and provider contexts are likely to make supporting patient engagement in long-term chronic care difficult in lower income settings. However, knowledge of these factors can be harnessed to improve chronic care interventions in South Africa and other similar countries.
Astragaloside IV protects against diabetic nephropathy via activating eNOS in streptozotocin diabetes-induced rats
Authors: Fan Yuyan , Fan Hongyu , Zhu Bin , Zhou Yilun , Liu Qingshan , Li Ping
Published: December 2019

Background

Astragaloside IV (AS-IV) was reported to play a role in improving diabetic nephropathy (DN), however, the underlying mechanisms still remain unclear. The aim of the present study is to investigate whether AS-IV ameliorates DN via the regulation of endothelial nitric oxide synthase (eNOS).

Methods

DN model was induced in Sprague-Dawley (SD) male rats by intraperitoneal injection of 65 mg/kg streptozotocin (STZ). Rats in the AS-IV treatment group were orally gavaged with 5 mg/kg/day or 10 mg/kg/day AS-IV for eight consecutive weeks. Body weight, blood glucose, blood urea nitrogen (BUN), Serum creatinine (Scr), proteinuria and Glycosylated hemoglobin (HbA1c) levels were measured. Hematoxylin-Eosin (HE) and Periodic Acid-Schiff (PAS) staining were used to detect the renal pathology. The apoptosis status of glomerular cells was measured by TUNEL assay. The phosphorylation and acetylation of eNOS were detected by western blot. The effects of AS-IV on high-glucose (HG)-induced apoptosis and eNOS activity were also investigated in human renal glomerular endothelial cells (HRGECs) in vitro.

Results

Treatment with AS-IV apparently reduced DN symptoms in diabetic rats, as evidenced by reduced BUN, Scr, proteinuria, HbA1c levels and expanding mesangial matrix. AS-IV treatment also promoted the synthesis of nitric oxide (NO) in serum and renal tissues and ameliorated the phosphorylation of eNOS at Ser 1177 with decreased eNOS acetylation. Moreover, HG-induced dysfunction of HRGECs including increased cell permeability and apoptosis, impaired eNOS phosphorylation at Ser 1177, and decreased NO production, were all reversed by AS-IV treatment.

Conclusions

These novel findings suggest that AS-IV ameliorates functional abnormalities of DN through inhibiting acetylation of eNOS and activating its phosphorylation at Ser 1177. AS-IV could be served as a potential therapeutic drug for DN.
ACE inhibitory peptides in standard and fermented deer velvet: an in silico and in vitro investigation
Authors: Haines Stephen R. , McCann Mark J. , Grosvenor Anita J. , Thomas Ancy , Noble Alasdair , Clerens Stefan
Published: December 2019

Background

The use of deer velvet antler (DVA) as a potent traditional medicine ingredient goes back for over 2000 years in Asia. Increasingly, though, DVA is being included as a high protein functional food ingredient in convenient, ready to consume products in Korea and China. As such, it is a potential source of endogenous bioactive peptides and of ‘cryptides’, i.e. bioactive peptides enzymatically released by endogenous proteases, by processing and/or by gastrointestinal digestion. Fermentation is an example of a processing step known to release bioactive peptides from food proteins. In this study, we aimed to identify in silico bioactive peptides and cryptides in DVA, before and after fermentation, and subsequently to validate the major predicted bioactivity by in vitro analysis.

Methods

Peptides that were either free or located within proteins were identified in the DVA samples by liquid chromatography-tandem mass spectrometry (LC-MS/MS) followed by database searching. Bioactive peptides and cryptides were identified in silico by sequence matching against a database of known bioactive peptides. Angiotensin-converting enzyme (ACE) inhibitory activity was measured by a colorimetric method.

Results

Three free bioactive peptides (LVVYPW, LVVYPWTQ and VVYPWTQ) were solely found in fermented DVA, the latter two of which are known ACE inhibitors. However matches to multiple ACE inhibitor cryptides were obtained within protein and peptide sequences of both unfermented and fermented DVA. In vitro analysis showed that the ACE inhibitory activity of DVA was more pronounced in the fermented sample, but both unfermented and fermented DVA had similar activity following release of cryptides by simulated gastrointestinal digestion.

Conclusions

DVA contains multiple ACE inhibitory peptide sequences that may be released by fermentation or following oral consumption, and which may provide a health benefit through positive effects on the cardiovascular system. The study illustrates the power of in silico combined with in vitro methods for analysis of the effects of processing on bioactive peptides in complex functional ingredients like DVA.
Experience of oncology residents with death: a qualitative study in Mexico
Authors: Álvarez-del-Río Asunción , Ortega-García Edwin , Oñate-Ocaña Luis , Vargas-Huicochea Ingrid
Published: December 2019

Background

Physicians play a fundamental role in the care of patients at the end of life that includes knowing how to accompany patients, alleviate their suffering and inform them about their situation. However, in reality, doctors are part of this society that is reticent to face death and lack the proper education to manage it in their clinical practice. The objective of this study was to explore the residents’ concepts of death and related aspects, their reactions and actions in situations pertaining to death in their practice, and their perceptions about existing and necessary training conditions.

Methods

A qualitative approach was used to examine these points in depth based on interviews conducted with seven oncology residents.

Results

Participants do not have a clear concept of death and, although it is seen as a common phenomenon, they consider it an enemy to beat. The situations to which respondents react more frequently with frustration and sadness after the death of patients were when they felt emotionally involved, if they identify with the patient, in cases of pediatric patients and with patients who refuse treatment. To deal with death, participants raise barriers and attempt to become insensitive. Although residents in this study recognize the importance of training to learn how to better deal with death, it seems they are not fully invested in reaching more of it.

Conclusions

Participants face death in a daily basis without the necessary training, which appears to impact them more than they are willing to accept. They do not achieve their goals managing situations regarding death as well as they assume they do. Despite recognizing the need of more training and support for better coping with death, they prefer to continue to learn from their experience.

Trial registration

Not applicable.
Improving rare disease classification using imperfect knowledge graph
Authors: Li Xuedong , Wang Yue , Wang Dongwu , Yuan Walter , Peng Dezhong , Mei Qiaozhu
Published: December 2019

Background

Accurately recognizing rare diseases based on symptom description is an important task in patient triage, early risk stratification, and target therapies. However, due to the very nature of rare diseases, the lack of historical data poses a great challenge to machine learning-based approaches. On the other hand, medical knowledge in automatically constructed knowledge graphs (KGs) has the potential to compensate the lack of labeled training examples. This work aims to develop a rare disease classification algorithm that makes effective use of a knowledge graph, even when the graph is imperfect.

Method

We develop a text classification algorithm that represents a document as a combination of a “bag of words” and a “bag of knowledge terms,” where a “knowledge term” is a term shared between the document and the subgraph of KG relevant to the disease classification task. We use two Chinese disease diagnosis corpora to evaluate the algorithm. The first one, HaoDaiFu, contains 51,374 chief complaints categorized into 805 diseases. The second data set, ChinaRe, contains 86,663 patient descriptions categorized into 44 disease categories.

Results

On the two evaluation data sets, the proposed algorithm delivers robust performance and outperforms a wide range of baselines, including resampling, deep learning, and feature selection approaches. Both classification-based metric (macro-averaged F1 score) and ranking-based metric (mean reciprocal rank) are used in evaluation.

Conclusion

Medical knowledge in large-scale knowledge graphs can be effectively leveraged to improve rare diseases classification models, even when the knowledge graph is incomplete.
Plasma omentin levels are inversely associated with atherosclerosis in type 2 diabetes patients with increased plasma adiponectin levels: a cross-sectional study
Authors: Nishimura Masami , Morioka Tomoaki , Hayashi Mariko , Kakutani Yoshinori , Yamazaki Yuko , Kurajoh Masafumi , Mori Katsuhito , Fukumoto Shinya , Shioi Atsushi , Shoji Tetsuo , Inaba Masaaki , Emoto Masanori
Published: December 2019

Background

Omentin and adiponectin are among the anti-inflammatory and anti-atherogenic adipokines that have potentially beneficial effects on cardiovascular disorders. Recent studies indicate a paradoxical relationship between adiponectin and cardiovascular mortality across many clinical settings including type 2 diabetes. In this study, we characterized the clinical features of type 2 diabetes patients with increased adiponectin levels and examined the association between omentin and atherosclerosis in those patients.

Methods

The subjects were 413 patients with type 2 diabetes. Fasting plasma omentin and total adiponectin levels were measured by enzyme-linked immunosorbent assay. The intima-media thickness (IMT) of the common carotid artery was measured by ultrasonography. The subjects were stratified according to the median value of plasma adiponectin.

Results

In high-adiponectin group, omentin levels were higher, while IMT tended to be greater than those in low-adiponectin group. The high-adiponectin group also exhibited older age, higher systolic blood pressure, lower kidney function, body mass index, and insulin resistance index compared to the low-adiponectin group. Multivariate analysis revealed that omentin levels were independently and negatively associated with IMT in high-adiponectin group, but not in low-adiponectin group, after adjusting for adiponectin levels and traditional cardiovascular risk factors. On the other hand, adiponectin levels were not significantly associated with IMT in either group.

Conclusions

Plasma omentin levels are inversely associated with IMT in type 2 diabetes patients with increased adiponectin levels and multiple cardiovascular risk factors. This study suggests a protective role of omentin against atherosclerosis in type 2 diabetes patients, which is potentially influenced by adiponectin level and cardiovascular risk status.
Mesenchymal stromal cells induce inhibitory effects on hepatocellular carcinoma through various signaling pathways
Authors: Ai Jafar , Ketabchi Neda , Verdi Javad , Gheibi Nematollah , Khadem Haghighian Hossein , Kavianpour Maria
Published: December 2019

Hepatocellular carcinoma (HCC) is the most prevalent type of malignant liver disease worldwide. Molecular changes in HCC collectively contribute to Wnt/β-catenin, as a tumor proliferative signaling pathway, toll-like receptors (TLRs), nuclear factor-kappa B (NF-κB), as well as the c-Jun NH2-terminal kinase (JNK), predominant signaling pathways linked to the release of tumor-promoting cytokines. It should also be noted that the Hippo signaling pathway plays an important role in organ size control, particularly in promoting tumorigenesis and HCC development. Nowadays, mesenchymal stromal cells (MSCs)-based therapies have been the subject of in vitro, in vivo, and clinical studies for liver such as cirrhosis, liver failure, and HCC. At present, despite the importance of basic molecular pathways of malignancies, limited information has been obtained on this background. Therefore, it can be difficult to determine the true concept of interactions between MSCs and tumor cells. What is known, these cells could migrate toward tumor sites so apply effects via paracrine interaction on HCC cells. For example, one of the inhibitory effects of MSCs is the overexpression of dickkopf-related protein 1 (DKK-1) as an important antagonist of the Wnt signaling pathway. A growing body of research challenging the therapeutic roles of MSCs through the secretion of various trophic factors in HCC. This review illustrates the complex behavior of MSCs and precisely how their inhibitory signals interface with HCC tumor cells.
Usefulness of combined screening methods for rapid detection of falsified and/or substandard medicines in the absence of a confirmatory method
Authors: Opuni Kwabena Frimpong-Manso , Nettey Henry , Larbi Marvin Adjei , Amartey Salome Naa Amerley , Nti Gifty , Dzidonu Abraham , Owusu-Danso Patrick , Owusu Nicholas Amoah , Nyarko Alexander Kwadwo
Published: December 2019

Background

The influx of substandard and falsified medicines is a global public health challenge and its rapid detection is a key solution to the menace. This study used three screening methods and one confirmatory method for the quality assessment of 25 batches of artemether/lumefantrine dosage forms from the Ghanaian market to test that combined screening methods only can rapidly detect substandard and/or falsified medicines in areas where confirmatory methods may not be available.

Methods

The quality of artemether/lumefantrine tablet products obtained from pharmacies and licensed chemical seller shops within the Accra metropolis in Ghana were analysed using three screening methods (GPHF Minilab, Colorimetry and Counterfeit Drug Indicator) and one confirmatory method (high-performance liquid chromatography).

Results

The results showed that 18/25 batches of the artemether/lumefantrine samples passed using the combined screening and confirmatory methods and 5/25 batches of the artemether/lumefantrine samples failed using the combined screening and confirmatory methods. However, 1/25 batch of the artemether/lumefantrine samples failed using the combined screening methods but passed using the confirmatory method. Also, 1/25 batch of the artemether/lumefantrine samples passed using the combined screening methods but failed using the confirmatory method. This notwithstanding, the combined screening methods and the confirmatory method provided equivalent quality assessment profiles for 23/25 (92%) batches of the artemether/lumefantrine tablet products. Out of the 6 samples that failed the confirmatory test, 1/6, 2/6, and 3/6 failed on the high (> 110%), low (< 90%), and no active ingredient (0%), respectively. The sensitivity of Minilab, colorimetric, CoDI, and the combined screening methods at 95% confidence level were 0.5 ± 0.57, 0.83 ± 0.33, 0.75 ± 0.49, and 0.83 ± 0.33, respectively. Also, the specificity of Minilab, colorimetric, CoDI, and the combined screening methods at 95% confidence level were 1.00, 0.95 ± 0.10, 1.00, and 0.95 ± 0.10, respectively.

Conclusion

The combined screening methods may be used for rapid detection of falsified and/or substandard medicines without using a confirmatory method. However, additional research on the best combinations of screening devices/methods to rapidly detect the quality of medicines is recommended.
A current-mode system to self-measure temperature on implantable optoelectronics
Authors: Dehkhoda Fahimeh , Soltan Ahmed , Ponon Nikhil , O’Neill Anthony , Jackson Andrew , Degenaar Patrick
Published: December 2019

Background

One of the major concerns in implantable optoelectronics is the heat generated by emitters such as light emitting diodes (LEDs). Such devices typically produce more heat than light, whereas medical regulations state that the surface temperature change of medical implants must stay below + 2 °C. The LED’s reverse current can be employed as a temperature-sensitive parameter to measure the temperature change at the implant’s surface, and thus, monitor temperature rises. The main challenge in this approach is to bias the LED with a robust voltage since the reverse current is strongly and nonlinearly sensitive to the bias voltage.

Methods

To overcome this challenge, we have developed an area-efficient LED-based temperature sensor using the LED as its own sensor and a CMOS electronic circuit interface to ensure stable bias and current measurement. The circuit utilizes a second-generation current conveyor (CCII) configuration to achieve this and has been implemented in 0.35 μm CMOS technology.

Results

The developed circuits have been experimentally characterized, and the temperature-sensing functionality has been tested by interfacing different mini-LEDs in saline models of tissue prior to in vivo operation. The experimental results show the functionality of the CMOS electronics and the efficiency of the CCII-based technique with an operational frequency up to 130 kHz in achieving a resolution of 0.2 °C for the surface temperature up to + 45 °C.

Conclusions

We developed a robust CMOS current-mode sensor interface which has a reliable CCII to accurately convey the LED’s reverse current. It is low power and robust against power supply ripple and transistor mismatch which makes it reliable for sensor interface. The achieved results from the circuit characterization and in vivo experiments show the feasibility of the whole sensor interface in monitoring the tissue surface temperature in optogenetics.
Harnessing tumor-associated macrophages as aids for cancer immunotherapy
Authors: Li Xiaolei , Liu Rui , Su Xiao , Pan Yongsha , Han Xiaofeng , Shao Changshun , Shi Yufang
Published: December 2019

Cancer immunotherapies that engage immune cells to fight against tumors are proving to be powerful weapons in combating cancer and are becoming increasingly utilized in the clinics. However, for the majority of patients with solid tumors, little or no progress has been seen, presumably due to lack of adequate approaches that can reprogram the local immunosuppressive tumor milieu and thus reinvigorate antitumor immunity. Tumor-associated macrophages (TAMs), which abundantly infiltrate most solid tumors, could contribute to tumor progression by stimulating proliferation, angiogenesis, metastasis, and by providing a barrier against antitumor immunity. Initial TAMs-targeting strategies have shown efficacy across therapeutic modalities and tumor types in both preclinical and clinical studies. TAMs-targeted therapeutic approaches can be roughly divided into those that deplete TAMs and those that modulate TAMs activities. We here reviewed the mechanisms by which macrophages become immunosuppressive and compromise antitumor immunity. TAMs-focused therapeutic strategies are also summarized.
Gambling as social practice: a complementary approach for reducing harm?
Authors: Gordon Ross , Reith Gerda
Published: December 2019

Background

Gambling is now a well-recognised public health issue and forms the focus of extensive harm reduction initiatives. Recent developments in policy, practice and technology, such relaxation of regulations, the increasing influence of global gambling corporations, and the development of devices such as mobile phone apps and fixed odds betting terminals (FOBTs) mean that the landscape is a complex, dynamic, and fast moving one. Gambling is now practiced using new technologies, in various spaces and places, and features in a range of social surroundings. Therefore, research is needed to inform appropriate gambling harm reduction strategies that can respond to this complex domain. Yet, research and policy approaches to the reduction of gambling harm are predominantly framed through psychological and economic models of individual behaviour, addiction, and ‘rational’ action. This is beginning to change, with a growing corpus of socio-cultural approaches to gambling research now emerging.

Method

In this article, we argue the case of recognising gambling as a social practice, the performance of which draws upon multiple elements such as technology and materials, spaces and places, language and discourse, and structures and agency. We call for a practice theory approach to gambling research that joins efforts to move beyond individual gamblers and their behaviour, to also acknowledge the interaction of multiple elements shaping gambling practices. To achieve this, we suggest that research methods such as visual ethnography can be helpful.

Conclusion

We set out how a social practice perspective to gambling research can generate different insights and help inform more nuanced and appropriate gambling harm reduction initiatives.
Improving access to antiretrovirals in China: economic analyses of dolutegravir in HIV-1 patients
Authors: Punekar Yogesh Suresh , Guo Na , Tremblay Gabriel , Piercy James , Holbrook Tim , Young Benjamin
Published: December 2019

Background

The World Health Organisation recommended dolutegravir (DTG)-based antiretroviral therapy (ART) regimens are available but not reimbursed through the public reimbursement system in China. The objective of this analysis was to evaluate the cost-effectiveness of DTG (DTG + TDF/3TC) compared to efavirenz (EFV + TDF/3TC) in treatment-naive and ritonavir-boosted lopinavir (LPV/r + TDF/3TC) in first-line ART failure HIV-1-infected patients in China.

Methods

A dynamic Markov model comprising of 5 response states and 6 CD4+ count-based health states was used. Efficacy, estimated as probability of virologic suppression (HIV RNA < 50 copies/mL) at 48 weeks, was obtained from a published network meta-analysis for ART-naive patients and from the DAWNING study for patients failing first-line ART. Baseline cohort characteristics were informed using DTG phase 3 studies and the DAWNING study data, respectively. Health state utilities were derived from DTG phase 3 studies. A 5-year cost-effectiveness analyses was conducted using the societal perspective. Outcomes were quality-adjusted-life-years (QALYs), life-years (LYs), incremental cost per QALYs (ICER).

Results

The viral suppression rates for DTG + TDF/3TC were higher than EFV + TDF/3TC (75.3% vs 64.0%) in treatment-naive and LPV/r + TDF/3TC (74.8% vs 58.4%) in first-line ART failure patients. This resulted in higher QALYs for DTG + TDF/3TC in treatment-naive (4.232 vs 4.227) and first-line failure settings (4.224 vs 4.221). Total discounted cost for DTG + TDF/3TC patients (RMB 219.259 in treatment-naive and RMB 238,746 in first-line failures) were lower than comparators (EFV + TDF/3TC:RMB 221,605; LPV/r + TDF/3TC:RMB 244,364), thereby DTG dominated in both settings. Probabilistic sensitivity analyses indicated the probability of DTG + TDF/3TC being cost effective was 98.2% in treatment-naive setting and 100% in first-line failure setting at a willingness to pay threshold of RMB 100,000/QALY.

Conclusions

With lower costs, higher response rates and higher QALYs, DTG + TDF/3TC can be considered as a cost-effective alternative for treatment naive and first-line failure patients in China.
Prevalence, determinants and association of unawareness of diabetes, hypertension and hypercholesterolemia with poor disease control in a multi-ethnic Asian population without cardiovascular disease
Authors: Man Ryan E. K. , Gan Alvin Hong Wei , Fenwick Eva K. , Gan Alfred Tau Liang , Gupta Preeti , Sabanayagam Charumathi , Tan Nicholas , Wong Kah Hie , Wong Tien Yin , Cheng Ching-Yu , Lamoureux Ecosse L.
Published: December 2019

Background

To explore the prevalence and determinants of unawareness of diabetes, hypertension and hypercholesterolemia and its association with poor disease control in a multi-ethnic Asian population without cardiovascular disease (CVD).

Methods

We included 6904 Chinese, Malay and Indian individuals (mean age [SD] 58.2 [10.2] years; 52.6% female) with diabetes, hypertension and/or hypercholesterolemia from the cross-sectional population-based Singapore Epidemiology of Eye Diseases study (2004–2011). Diabetes was defined as random blood glucose ≥ 11.1 mmol/L or HbA1c > 6.5% or self-reported use of diabetes medication; hypertension as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or self-reported use of anti-hypertensive treatment; and hypercholesterolemia as total cholesterol ≥ 6.2 mmol/L or self-reported use of lipid-lowering medications. Unawareness was based on participants’ answers to the questions: “Did your medical practitioner ever tell you that you have diabetes/hypertension/high cholesterol?” The determinants of unawareness, and its association with poor disease control, were assessed using multivariable binary logistic regression models adjusted for known potential confounders.

Results

Of the 2380 (34.5%), 5386 (78.0%) and 3607 (52.2%) with diabetes, hypertension and hypercholesterolemia, respectively, unawareness rates were 30.7%, 43.1% and 40.9%, respectively. Having a higher BMI, particularly if obese, and Malay ethnicity were associated with greater unawareness of diabetes; Malay and Indian ethnicities and current smoking with greater unawareness of hypertension; and education ≤6 years, current smoking, and blue collar jobs or unemployment with greater unawareness of hypercholesterolemia (allP< 0.05). Lack of awareness of each condition was independently associated with poorer disease control in the case of hypertension and hypercholesterolemia, while the converse was true for diabetes (allP< 0.05).

Conclusions

Unawareness of diabetes, hypertension, or hypercholesterolemia is high in Singapore, with risk factors varying across all three diseases, although Malay ethnicity is a consistent one. Unawareness was also associated with poor management for hypertension and hypercholesterolemia. Public health education and screening programs should target at-risk individuals, especially Malays, to reduce the likelihood of incident CVD.
A comparative analysis of disability measures in Cameroonian surveys
Authors: Simo Fotso Arlette , Duthé Géraldine , Odimegwu Clifford
Published: December 2019

Background

Although identifying vulnerable groups is an important step in shaping appropriate and efficient policies for targeting populations of disabled people, it remains a challenge. This study aims to evaluate for the first time the comparability of the different disability measurements used in Cameroon. This is done by comparing them with the international standards proposed by the Washington Group (WG). It also evaluates the consistency of the association between the disability as measured by these surveys and the sociodemographic characteristics.

Method

We used data from the third Cameroonian Population and Housing Census (3RGPH) of 2005, the third Cameroonian Household survey (ECAM3) of 2007, the Demographic Health and Multiple Indicator Cluster Survey (DHS-MICS) of 2011 and a survey conducted on adults in Yaoundé (HandiVIH) in 2015 with the WG tool. The proportion and their confidence intervals, chi-square tests and multivariate logistic regressions are used for analyses.

Results

In the city of Yaoundé and for the 15–49 age group, disability prevalence was estimated at 3.6% (CI = [2.5, 5.1]), 2.7% CI = [2.1, 3.5]), 2.6% (CI = [2.4, 2.7]) and 1.0% (CI = [1.0, 1.10]), according to DHS-MICS, ECAM3, HandiVIH and 3RGPH, respectively. The prevalence of severe motor and mental disabilities in DHS-MICS (0.4% CI = [0.2, 0.8], 1.1% CI = [0.7, 1.8] and 0.5% CI = [0.2, 1.1], respectively) are not significantly different from the findings of HandiVIH (0.3% CI = [0.2, 0.3], 0.8% CI = [0.7, 0.9] and 0.5% CI = [0.5, 0.6], respectively). Only motor disability prevalence in ECAM3 (0.8%, CI = [0.5, 1.2]) is not different from that of HandiVIH. When the WG screening tool is used in HandiVIH, disability is positively associated with age, negatively associated with educational level, being in a union and socioeconomic status (SES) and it is not associated with sex. Severe disability, for its part, is not associated with SES and is positively associated with being a male. A different association trend is observed with 3RGPH, ECAM3 and DHS-MICS.

Conclusion

None of the instruments used in the nationally representative Cameroonian surveys produced both disability prevalence and association trends that are exactly similar to those obtained when using the WG disability screening tool, thus highlighting the necessity to include the WG questions in nationally representative surveys.
Inulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose–response meta-analysis of 33 randomized controlled trials
Authors: Wang Long , Yang Hong , Huang Hao , Zhang Chao , Zuo Hong-Xia , Xu Pan , Niu Yu-Ming , Wu Shi-Shi
Published: December 2019

Background

Currently, many clinical trials have shown that inulin-type fructans (ITF) supplementation is associated with glycemic control; nevertheless, the results are inconclusive. The aim of this meta-analysis of randomized controlled trials was to assess the effects of ITF supplementation on glycemic control.

Methods

PubMed, EMBASE and the Cochrane Library were searched for eligible articles up to March 6, 2019. A random-effects model was used to analyze the pooled results, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was applied to assess the quality of evidence. The dose–response model was used to recommend the daily dose and duration for ITF supplementation.

Results

Thirty-three trials involving 1346 participants were included. Overall, ITF supplementation could significantly reduce concentrations of fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS) and homeostasis model assessment-insulin resistance (HOMA-IR). In the prediabetes and type 2 diabetes (T2DM) population, a more significant reduction in FBG [weighted mean difference (WMD): − 0.60 mmol/l; 95% CI − 0.71, − 0.48 mmol/l; high rate], HbA1c (WMD: − 0.58%; 95% CI − 0.83, − 0.32%; high rate), FINS (WMD: − 1.75 µU/ml; 95% CI − 2.87, − 0.63 µU/ml; low rate), and HOMA-IR (WMD: − 0.69; 95% CI − 1.10, − 0.28; low rate) were observed, and ITF supplementation with a daily dose of 10 g for a duration of 6 weeks and longer was recommended. Moreover, subgroup analyses suggested that the effects of glycemic control were significantly influenced by the sex of the subjects and the type and the method of intake of ITF.

Conclusions

Our analyses confirmed that these four main glycemic indicators were significantly reduced by ITF supplementation, particularly in the prediabetes and T2DM population. Evidence supports that reasonable administration of ITF supplementation may have potential clinical value as an adjuvant therapy for prediabetes and T2DM management.

Trial registration The trial was registered at PROSPERO as CRD42018115875 on November 23, 2018.
Jigless knotless internal brace technique for acute Achilles tendon rupture: a case series study
Authors: Ko Po-Yen , Huang Ming-Tung , Li Chia-Lung , Su Wei-Ren , Jou I-Ming , Wu Po-Ting
Published: December 2019

Purpose

To mitigate the risk of poor wound healing and of infection associated with the open repair of Achilles tendon midsubstance ruptures, minimally invasive techniques have been developed. We report our preliminary results after reviewing our “jigless knotless internal brace technique.”

Methods

Patients were placed in prone position and a transverse 3-cm incision was made proximal to the palpable ruptured end. The proximal ruptured end was pulled out, gently debrided, and sutured using Krackow locking loops. Percutaneous sutures were crisscrossed through the distal tendon stump and looped around the Krackow sutures over the proximal stump. The ipsilateral Krackow sutures and the contralateral crisscrossed sutures were subcutaneously passed through two mini-incisions over the posterior calcaneus tuberosity and seated at the tuberosity with two 4.5-mm knotless suture anchors. All patients underwent the same post-operative rehabilitation protocol and regular follow-ups for at least 1 year.

Results

We recruited 10 patients (mean age, 37.3 years) who scored 100 points on the American Orthopaedic Foot and Ankle Society (AOFAS) scale, and who returned to their preoperative exercise levels 1-year post-operatively with no complications.

Conclusion

Our method is simple, effective, and requires no special tools. It might be a reliable option for Achilles tendon repair.

Level of evidence

III
Early and short-segment anterior spinal fusion for cervical spinal cord injury without fracture and dislocation can achieve more significant neurological recovery: a retrospective study based on the current medical system in southern China
Authors: Mu Xiaoping , Li Zhuhai , Ou Yufu , Wei Jianxun
Published: December 2019

Objective

The purpose of this study was to investigate the effects of the number of fused segments, the timing of surgery and their interaction on the prognosis of patients with cervical spinal cord injury without fracture and dislocation (CSCIWFD), and to determine the appropriate time restrictions for early surgery in CSCIWFD patients based on the current diagnosis and treatment system in southern China.

Methods

CSCIWFD patients who underwent anterior cervical decompression and internal fusion (ACDF) from January 2012 to June 2017 were selected. The patients were grouped according to the timing of surgery and the number of fused segments and evaluated based on their American Spinal Injury Association (ASIA) score, ASIA impairment scale, and Japanese Orthopaedic Association (JOA) score before and after surgery. SPSS22.0 software was used for the statistical analysis.

Results

The ASIA score, JOA score, and ASIA impairment scale in all follow-ups were significantly higher than before surgery (p < 0.05). The ASIA and JOA scores at 6, 12, and 24 months after surgery of the patients who underwent ACDF within 72 h were significantly better than those of the patients who underwent ACDF after 72 h (p < 0.05). There were significant differences in postoperative ASIA and JOA scores at 12 and 24 months between the short-segment and three-segment fusion groups (p < 0.05). The results of the interaction between the surgical timing and the number of the fused segments showed that the postoperative ASIA and JOA scores at 6, 12, and 24 months were significantly higher in the patients who underwent early short-segment fusion than in those who underwent delayed short-segment fusion (p < 0.05). However, no statistically significant difference was found between early and delayed surgery in the patients who underwent three-segment fusion (p > 0.05).

Conclusion

ACDF is safe and effective for the treatment of CSCIWFD. For patients with single- or double-segment injury, early (within 72 h) ACDF is associated with a more satisfactory prognosis. Due to the limitation of the small sample size, we cautiously recommend that 72 h can be used as a time limit for early surgery for CSCIWFD patients in regions where earlier surgery cannot be provided by the current diagnosis and treatment system.
Indirect quantification of IgG using a digital refractometer, and factors associated with colostrum quality in Norwegian Red Cattle
Authors: Johnsen Julie Føske , Sørby Johanne , Mejdell Cecilie Marie , Sogstad Åse Margrethe , Nødtvedt Ane , Holmøy Ingrid Hunter
Published: December 2019

Background

There is an increased interest in using digital refractometers to indirectly assess colostrum quality of dairy cattle, but knowledge on diagnostic accuracy for Norwegian Red dairy cows is lacking. Recent research has indicated a profound variability in the colostrum quality among dairy cows and herds in Norway. The aim of this study was to evaluate the diagnostic test sensitivity and specificity of a digital refractometer (Brix refractometer) at different cut-offs in Brix% for detection of colostrum of high quality (> 50 g/L) defined by the gold standard single radial immunodiffusion (IgG g/L). Furthermore, we aimed to identify possible associations between selected herd and cow-level management factors and colostrum IgG-levels in Norwegian Red dairy cows.

Results

Median colostrum IgG level across 167 cows from 19 herds was 35.0 g/L, ranging from 5 to 129 g/L. Mean Brix% (± SD) was 19.7 ± 4.12%, ranging from 10.1 to 30.5. Most samples (72.5%) had inferior quality as compared to the international standard of 50 g/L. Brix% and IgG in colostrum were strongly correlated (r = 0.71, P < 0.001). A Brix cut-off of 22%, which is currently recommended, yielded a sensitivity of (95% CI) 69.4% (54.6–81.7) and a specificity of 83.1% (75.0–89.3) for identifying colostrum with high quality (> 50 g/L). The only factor found to be associated with low colostrum quality was parity. Specifically, cows in the second parity were found to produce colostrum with low quality compared to cows in parities four and later.

Conclusions

The agreement between colostrum IgG and Brix% is good. However, the diagnostic test evaluation indicates suboptimal performance in identifying high vs. low colostrum quality in this population, possibly related to a high proportion of the samples with < 50 g/L IgG. The only factor found to be associated with low colostrum quality was parity. Specifically, cows in the second parity were found to produce colostrum with lower quality. Future research should investigate colostrum and serum IgG levels which best prevent calf illness under Norwegian conditions.
Inbreeding and inbreeding depression of Paeonia decomposita (Paeoniaceae), a threatened endemic plant to China
Authors: Wang Shi-Quan
Published: December 2019

Background

Small populations are predominantly vulnerable to inbreeding and inbreeding depression (ID). Owing to increased levels of inbreeding on individuals in small populations, ID could decrease the population growth rate, as well as its effective size, and exacerbate the extinction risk. Inbreeding depression remains a crucial area of research in conservation biology, ecology, and evolutionary biology. This study aims to elucidate the reproductive biology, inbreeding, and ID ofPaeonia decompositaand to conserve, manage, and improve them better in the future.

Results

Paeonia decompositabelongs to a xenogamous category and is partially self-compatible; moreover, it requires pollinators for seed production. Lately, the occurrence of pollination and pollinator limitations has affected the seed set. Low seed set primarily correlated with an abnormality of meiosis in the pollen mother cell, moderate to low genetic diversity, drought and extreme weather, pollinator limitation, or carpel space limit. One of the primary reasons for endangered mechanism inP. decompositais the low seed set under natural conditions. The cumulative value of ID was positive, and outcrossed progeny outperformed selfed progeny.

Conclusions

Paeonia decompositarequires pollinators to ensure seed production either through autogamy, geitonogamy, or allogamy. It is both allogamous and partially self-compatible, as well as a successful outcrosser. Inbreeding occurs frequently and results in ID, which imposes a potential threat to the survival of populations. Besides, it needs conservation via in situ andnatural returnmethods.
Alkamides: a new class of plant growth regulators linked to humic acid bioactivity
Authors: Zandonadi Daniel Basílio , Matos Carlos Roberto Ribeiro , Castro Rosane Nora , Spaccini Riccardo , Olivares Fábio Lopes , Canellas Luciano Pasqualoto
Published: December 2019

Background

The use of humic substances as plant biostimulants has been increasingly attracting farmers and stunning researchers. The ability of these substances to enhance root growth by changing root architecture is often linked to their hormonal activities, such as auxin effects and nitric oxide production. Humeomics accesses the molecular constituents of humic substances, revealing the importance of alkyl components because of their conformations and chemical activities. Here, we describe the alkamides present in humic acids and compare their bioactivities using plasma membrane H+-ATPase activity level as a biochemical marker.

Methods

Humic acids isolated from vermicompost were analyzed using13C and15N nuclear magnetic resonance spectroscopy. The unbound fraction was extracted with ethyl acetate and submitted to gas chromatography coupled to mass spectrometry to detect the presence ofN-isopropyldecanamide. We synthesizedN-isopropyldecanamide and treated maize seedlings for 7 and 15 days with different concentrations. The root growth and plasma membrane H+-ATPase activity were monitored. Nitric oxide accumulation in the lateral roots was imaged using 4,5-diaminofluorescein diacetate. The results were compared with those obtained for seedlings treated with humic acids isolated from vermicompost.

Results

The amide functional group produced the only nitrogen signal in the15N humic acid resonance spectrum and similar alkamide moieties were found in the unbound humic extract through comparisons using gas chromatography coupled to mass spectrometry. The synthesis ofN-isopropyldecanamide had few steps and produced a high yield (86%). The effects ofN-isopropyldecanamide on root growth were concentration dependent. High concentrations (10−4 M) enhanced root growth after 15 day of diminishing shoot biomass. However, low concentrations (10−8 M and 10−6 M) promoted root growth at 7 and 15 days, similar to the humic acid-induced plasma membrane H+-ATPase activity. BothN-isopropyldecanamide and humic acids enhanced nitric oxide accumulation during lateral root emergence.

Conclusion

We described for the first time the effects ofN-isopropyldecanamide on the plasma membrane H+-ATPase activity in maize seedling roots and compared its effects with those caused by humic acids.N-Isopropyldecanamide was detected in the unbound fraction of the humic supramolecular assembly, indicating that the putative hormone-like effects of these substances result also from the presence of this new class of plant regulators, in addition to other molecules.
An evaluation of the suitability of fluorescent fabrics and retroreflective materials for road traffic warning clothing in compliance with international standards
Authors: Park Soonja
Published: December 2019

The purpose of this study is to compare and analyze physical properties of different fluorescent fabrics and retroreflective materials to determine their compliance to international standard for high-visibility warning clothing. Four fluorescent fabrics were selected for the study: a PET 71%/Cotton 23%/PU 6% fabric used in public road cleaner uniforms in Korea (S1), an ISO-compliant Japan-made PET 65%/Cotton 35% + conductive fabric (S2), and a randomly selected Korean-made PET 100% fabric for adults (S3) and children (S4). Selected samples were evaluated on their seven criteria in ISO 20471. Subsequently, luminance and retroreflective properties of four retroreflective materials were compared: a 3M (USA) plain sample (R1), a rectangular-patterned sample made by ‘R’ company (Korea) (R2), a plain sample also by ‘R’ (R3), and a random plain sample from a marketplace in Korea (R4). As a result, S1 was the most similar to ISO-compliant S2 and moisture regain could be improved by adjusting the cotton ratio or surface finishing. However, S3 and S4 seemed less suitable. Second, two bead type (R1, R4) and two prism type (R2, R3) retroreflective materials showed luminance in the order of R4 > R2 ≥ R1 > R3. General retroreflective properties and post-5-condition retroreflective properties of all four samples were ISO-compliant, and the retroreflective property at observation angle of 12′ and incidence angle of 5° of R2, R3, and R4 against R1 ranged between 81.4% and 158.4%. Despite the variance, all four samples were ISO-compliant and suggest that R2, R3, and R4 are possible materials for export.
Bone healing at non-submerged implants installed with different insertion torques: a split-mouth histomorphometric randomized controlled trial
Authors: Amari Yoshiyuki , Piattelli Adriano , Apaza Alccayhuaman Karol Alí , Mesa Natalia Fortich , Ferri Mauro , Iezzi Giovanna , Botticelli Daniele
Published: December 2019

Objectives

To evaluate histomorphometrically the healing at implants installed with standard or very low insertion torque values

Material and methods

Twelve volunteer patients were recruited, and two screw-shaped titanium devices were installed in the distal segments of the mandible using insertion torque values of either < 10 Ncm or ~ 30 Ncm. The implants were left to heal in a non-submerged fashion. After 8 weeks, biopsies were retrieved, and ground sections were prepared for histological evaluation.

Results

Histological slides from 11 patients were available for (n= 11). The new bone in contact with the implant surface was 39.3 ± 18.5% and 49.4 ± 9.4% at the < 10 and ~ 30 Ncm sites, respectively. Considering the pre-existing old bone, the total mineralized bone was 46.8 ± 22.1% at the < 10 Ncm sites and 57.0 ± 14.1% at the ~ 30 Ncm. No statistically significant differences were found.

New bone density and total mineralized bone density were 36.6 ± 8.1% and 53.0 ± 13.5% at the < 10 Ncm sites and 35.9 ± 10.0% and 52.2 ± 16.0% at the ~ 30 Ncm sites, respectively. No statistically significant differences were disclosed.

Conclusion

From the data of the present study, it can be concluded that a trend of higher osseointegration was observed at the ~ 30 Ncm compared to the < 10 Ncm torque group. Nevertheless, it can be concluded that an implant installed with a very low torque may achieve a good integration.

Trial registration

ClinicalTrials.gov NCT04017156; trial retrospectively registered on 12 July 2019.