bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between mental health and physical fitness in Norwegian adolescents
Authors: Åvitsland Andreas , Leibinger Eva , Haugen Tommy , Lerum Øystein , Solberg Runar Barstad , Kolle Elin , Dyrstad Sindre Mikal
Published: January 2020

Background: Studies indicate that cardiorespiratory fitness, muscular strength and body composition are associated with mental health. However, research is scarce concerning this relationship in young adolescents in general and non-existent in Norwegian populations specifically. The aim of the study was to examine the relationship between different health-related aspects of physical fitness and self-reported mental health in Norwegian adolescents. Methods: Participants from four regions of Norway (n = 1486; mean age = 13.9; girls = 50.6%) completed the Strengths and Difficulties Questionnaire, and were measured for cardiorespiratory fitness, muscular strength and body composition. Linear mixed effects models were conducted to assess the associations between the health-related aspects of physical fitness and the total difficulties score of the questionnaire. Results: Body composition was not associated with total difficulties score. Muscular strength independently was associated with total difficulties score, but when all independent variables were entered in the fully adjusted model, only cardiorespiratory fitness was associated with total difficulties score. School clusters were included as random effects and all models were controlled for sex, socioeconomic status and birthplace (domestic or foreign). Conclusions: A small but significant negative association between cardiorespiratory fitness and total difficulties score indicated that higher cardiorespiratory fitness predicted better mental health in Norwegian adolescents. The results suggest that muscular strength is not associated with mental health in adolescents, when controlling for cardiorespiratory fitness. Future research on how exercise affects mental health should investigate whether there is a greater effect for participants who improve their cardiorespiratory fitness.
miR-574-5p regulates milk synthesis and cell survival activities via DAG-DGKs-PA pathway in GMECs
Authors: Liu Yuhan , Zhang Meng , Guo Dan , Wang Jiangang , Cao Binyun , An Xiaopeng
Published: January 2020

miRNA-regulated gene expression is momentous for mammary development and lactation performance. Prevenient work has revealed that miR-574-5p is capable of functioning on goat mammary epithelial cells, but the potential molecular mechanism remains to be further understood. According to transcriptome sequencing results, we focused on DGKI and DGKH, which both were down-regulated differentially expressed unigenes by miR-574-5p. miR-574-5p objected seed sequences of the DGKI 3’UTR and interdicted mRNA and protein levels of DGKI and DGKH, correspondingly. It’s known that diacylglycerol kinases phosphorylate diacylglycerol to produce phosphatidic acid then regulate a range of biological processes. Detection kits showed that DGKI and DGKH induced diglycerides conversion to phosphatidic acid, and DGKI facilitated triglycerides and β-casein production while DGKH only acted as a promoter of triglycerides. DGKI inhibited cell apoptosis and induced cell proliferation, and co-expression of miR-574-5p with DGKI proved an adiaphorous impact. However, DGKH had an anti-proliferative and pro-apoptotic effects on GMECs. Additionally, DGKI motivated both AKT-mTOR and Raf-1-ERK pathways while DGKH showed negative impacts on AKT-mTOR, Raf-1-ERK and IKK-NFKB pathways in GMECs. It suggested that miR-574-5p not only inactivated PA-mTOR pathway and contributed to degressive secretion of triglycerides and β-casein via depletion of DGKI, but also arrested cell proliferation and enhanced cell apoptosis by inhibiting DGKI-PA-ERK pathway. All these established a farther regulatory mechanism of miR-574-5p in milk synthesis and mammary development.
Serious Infections in People with Scleroderma: A National U.S. Study
Authors: Singh Jasvinder , Cleveland John D.
Published: January 2020

Objective: To study incidence, time-trends and outcomes of serious infections in scleroderma.
Methods: We used the 1998-2016 U.S. National Inpatient Sample data. We examined the epidemiology, time-trends and outcomes of five serious infections (opportunistic infections (OI), skin and soft tissue infections (SSTI), urinary tract infection (UTI), pneumonia, and sepsis/bacteremia) in hospitalized people with scleroderma. We performed multivariable-adjusted logistic regression analyses to analyze independent association of factors with healthcare utilization (hospital charges, length of hospital stay, discharge to non-home setting), and in-hospital mortality.
Results: There were 49,904,955 hospitalizations with serious infections in people without scleroderma and 61,615 in those with scleroderma. During 1998-2016, the most common serious infections in scleroderma were pneumonia (45%), sepsis (32%), SSTI (19%), UTI (3%) and OI (3%). In 2013-14, sepsis surpassed pneumonia as the most common serious infection; by 2015-16, sepsis was 1.8-times more common than pneumonia. Over the study period, hospital charges increased, while length of hospital stay and in-hospital mortality decreased, overall and for each serious infection. Multivariable-adjusted analyses showed that sepsis, age ≥80 years and Deyo-Charlson score ≥2 were associated with significantly higher odds of healthcare utilization and in-hospital mortality; and Medicare or Medicaid insurance payer, Northeast location, urban teaching or non-teaching hospital, and medium or large hospital bed size with significantly higher odds of healthcare utilization.
Conclusions: Outcomes in people with scleroderma hospitalized with serious infections have improved over time, except higher hospital charges. Identification of factors associated with higher healthcare utilization and in-hospital mortality allows for developing interventions to improve outcomes.
Transplantable and functional retinal pigment epithelium derived from non-colony-type monolayer of human induced pluripotent stem cells
Authors: Guo Xiaoling , Zhu Deliang , Lian Ruiling , Zeng Qiaolang , Mathew Sanjana , Tang Shibo , Chen Jiansu
Published: January 2020

Background Retinal pigment epithelium (RPE) cells derived from human induced pluripotent stem cells (hiPSCs) exhibit great promise in treating retinal degenerative diseases. To develop transplantable and functional hiPSC-RPE cells, here, we used a novel differentiation protocol based on a non-colony-type monolayer (NCM) culture and injectable spheroids. Methods The derived hiPSC-RPE cells were identified using reverse transcription-polymerase chain reaction (RT-PCR), immunofluorescence assay, Western blotting, and flow cytometry assay. The functions of transplantable hiPSC-RPE cells in vitro and in vivo were also analyzed by fluorescein leakage test, transepithelial electrical resistance (TEER) assay, atomic force microscopy observation, POS phagocytosis assay, frozen tissue sections, live/dead assay, SA-β-Gal activity assay, and immunocytochemistry. Results The derived hiPSC-RPE cells positively expressed biomarkers of RPE cells but not iPSCs, such as CRALBP (97.4%), EMMPRIN (93.8%), Oct4 (2.1%), and Sox2 (2.0%). hiPSC-RPE cells displayed RPE-like characteristics including barrier function, phagocytic activity, and polarized membrane. hiPSC-RPE cell spheroids positively expressed Nestin and exhibited reduced SA-β-Gal staining. Injectable hiPSC-RPE cell spheroids could form monolayers on decellularized corneal matrixes (DCM). After subretinal transplantation for one month, hiPSC-RPE cell spheroids could survive and maintain segmental sheet growth in RPE-degenerated chinchilla rabbits. Conclusion This study realized that NCM dissociated hiPSCs were effectively differentiated into transplantable and functional RPE through the sequential addition of defined factors but not involving exogenous genes. This study may lay the foundation for the clinical transplantation of hiPSC-RPE cell spheroids as therapy for RPE degenerative diseases in the future.
Endogenous Endophthalmitis: Yield of the Diagnostic Evaluation
Authors: Regan Kathleen A , Radhakrishnan Nila S , Hammer Jon D , Wilson Benjamin D , Gadkowski Lara , I Siva SR
Published: January 2020

Background : Endogenous endophthalmitis is an infection of the eye secondary to sepsis, occurring in 0.04-0.5% of bacteremia or fungemia. Risk factors include intravenous drug abuse (IVDA), diabetes, indwelling catheters, and immune suppression. Many patients have known or suspected bacteremia or fungemia; however, culture yield is reported to be low (approximately 50%). Methods: Retrospective chart review of patients with endogenous endophthalmitis at the University of Florida from June 2011 to February 2018. Results: Included are 40 eyes of 35 patients. Endophthalmitis was secondary to an endogenous source in 23.5% of all endophthalmitis cases observed. Intraocular culture positivity was 28.6% overall but was 0% after initiation of systemic antibiotics. Most commonly identified organisms from the eye were coagulase-negative Staphylococcus and Candida . Blood culture positivity was 48.6%, most commonly Staphylococcus . IVDA was noted with increasing frequency as a risk factor. Diagnosis of endophthalmitis upon hospital admission was associated with a higher intraocular culture positivity (P = 0.040) and a shorter hospital stay (P = 0.035). Computed tomography (CT) and magnetic resonance imaging (MRI) were the highest yield imaging modalities; X-ray and non-ocular ultrasound were less diagnostically useful. Echocardiogram was positive by transesophageal route (TEE) in 22% and in 9% by transthoracic (TTE) testing. Following discharge from the hospital, 48.4% of patients failed to follow up with outpatient ophthalmology. Conclusions: Based on the results of this study, the interdisciplinary team should consider directed imaging, eye cultures prior to antimicrobial administration, thorough history for IVDA, and caution with premature discharge from the hospital.
The ubiquitin-proteasome activity of macrophages involved in the rupture of atherosclerotic plaque based on bioinformatics analysis
Authors: Wan Jing , Li Ya , Zhang Wei , Ma Yulin , Lin Mingying , Zhao Min
Published: January 2020

Background Macrophages have been demonstrated to promote the rupture of the atherosclerotic lesion, a primary cause of ischemic events, by modulating the formation of plaque necrosis. We aimed to search the key factors of genetic macrophages in concerns of carotid ruptured plaques.Methods The database of the gene expressed GSE41571 is retrieved from the Gene Expression Omnibus (GEO) to differentially obtain the measured expression genes (DEGs) by tendering the tool usage of GEO2R. The enriched pathways of ontology at DEGs performances with DAVID interacted the constructions of protein to protein networking by the analysis of STRING and Cytoscape software. And also the identified PPI networks in the significance of hub genes module plugged into respective Cytohubba and MCODE Cytoscape.Result A total of 1481 DEGs in macrophages from ruptured and stable carotid atherosclerotic plaques are noticed, by including 568 up-regulation genes and 913 down-regulation genes. The analyzed GO shows a DEGs are mainly involved in protein ubiquitination, endocytosis, mRNA processing, and mitotic cell cycle. KEGG pathway enrichment analysis revealed that some major protein catabolism pathways, including the ubiquitin-proteasome, autophagy, and endocytosis systems, play key roles in the progressive carotid plaque clotting. The genes of the hub in the PPI network included POLR2E , PPP2R1A , HSP90AA1 , and CBL . The modules were mainly associated with ubiquitin-mediated proteolysis, endocytosis, spliceosome, proteasome.Conclusion Our findings offer novel molecular insights into the mechanisms by which macrophages drive formation and vulnerability of plaques. The candidate DEGs and potential biological pathways might be used as diagnostic targets, and facilitate the development of novel macrophage-targeting therapies for unstable atherosclerosis.
Comparison of endotracheal intubation learning curves with tracheoscopic ventilation tube for simulated difficult intubation between expert and novice anesthesiologists.
Authors: Kim Heezoo , Lee Dong Kyu , Lee Choong Hun , Gong Myung-Hoon , Oh Jung Suk
Published: January 2020

Background: Tracheoscopic ventilation tube (TVT) is a specially designed single-lumen endotracheal tube with a camera. It was developed to facilitate endobronchial blocker insertion without bronchoscopy; its ability to explore anatomy received attention for difficult intubations. To clarify the feasibility of TVT in difficult intubation, we evaluated the learning curves of intubation between novice and expert.

Methods: 182 patients who presented as Cormack-Lehane (CL) grade IIb and III with cervical in-line stabilization, and 4 trainees (2 novices, 2 experts) at single tertiary care teaching university hospital. All trainees performed intubation with TVT during laryngoscopy. Intubation attempts were limited to two times, each within 30 seconds. For every attempt, trainees visualized an imaginary pathway from the teeth to vocal cords and then shaped the stylet. Intubation was confirmed by three successive ETCO 2 measurements > 30 mmHg. Using CUSUM analysis, the trial was continued until every trainee reached an acceptable failure rate.

Results: Patients were constituted with 94.5% CL grade IIb and 5.5% grade III. The median number of acceptable performances (10% of the acceptable failure rate) was 36. Overall failure rate was 5.5% (95%CI: 2.2-8.8%), with 6.9% (95%CI: 2.0-11.8%) for novices and 3.7% (95%CI: 0.0-7.8%, P=0.165, Cohen’s h=0.14) for experts. Intubation time was longer in novices by about 3 seconds compared to experts (mean difference=2.8, 95%CI: 1.3-4.3, P<0.001, Cohen's d=0.57).

Conclusions: Intubation with TVT in CL grades IIb and III was easy to learn and could be an alternative for difficult intubation. It required small cases to reach acceptable performance, and provided a short learning period even for novice anesthesiologists, with failure rates similar to those of experienced anesthesiologists.
Ultrasound grayscale ratio: a reliable parameter for differentiating papillary thyroid microcarcinoma from micronodular goiter
Authors: Xu Chenke , Yu Lifang , Fang Jianhua , Han Zhijiang , Luo Dingcun , Li Mingkui
Published: January 2020

Background: To evaluate the reliability and diagnostic efficacy of the ultrasound grayscale ratio (UGSR) for differentiating papillary thyroid microcarcinomas (PTMC) from micronodular goiters (diameter ≤ 1.0cm).Methods: The ultrasound data of 241 pathologically-confirmed cases of patients with 265 PTMC and 141 patients with 168 micronodular goiters were retrospectively reviewed. All patients underwent outpatient ultrasonic examination and preoperative ultrasonic positioning. The RADinfo radiograph reading system (Zhejiang RAD Information Technology Co., Ltd., China) was used to measure and calculated the UGSR of PTMC, micronodular goiters. Patients were divided into the outpatient examination, preoperative positioning, and mean value groups, and the receiver operating characteristic curves (ROC) were calculated to obtain the optimal UGSR threshold for distinguishing PTMC from micronodular goiters.Results: The UGSR values of the PTMC and micronodular goiters were 0.56±0.14 and 0.80±0.19 (t=5.84, P<0.01) in the outpatient examination group, 0.55±0.14 and 0.80±0.19 (t=18.74, P<0.01) in the preoperative positioning group, and 0.56±0.12 and 0.80±0.18 (t=16.49, P<0.01) in the mean value group. The areas under the ROC curves in the outpatient examination, preoperative positioning, and mean value groups were 0.860, 0.856, and 0.875, respectively. When the cut-off UGSR values for the outpatient examination, preoperative positioning, and mean value groups were 0.649, 0.646, and 0.657, the sensitivity and specificity for predicting PTMC were 78.9% and 86.9%, 79.2% and 83.9%, 82.6%, and 85.7%, respectively. A reliable UGSR value was obtained between the outpatient examination and preoperative positioning groups (ICC=0.79, P=0.68).Conclusion: The UGSR is an accurate and feasible tool for differentiating PTMC from micronodular goiters with better diagnostic efficacy.
MRI Characteristic of Cerebral White Matter Maturation Patterns in Normal Infants of Assisted Reproductive
Authors: Wu Xiaoming , Wang Junfeng , Zou Libo , Cui Xiaojian , Wang Youcheng , Xu Qiulian , Zhang Zhiqin
Published: January 2020

Background Assisted reproductive technology (ART) such as in-vitro fertilization (IVF) and embryo transfer (ET) has been essential in the treatment of infertility, and the number of children born after these procedures has now passed 5 million worldwide. Children born after medically assisted reproduction are at higher risk of adverse birth outcomes than are children conceived naturally. In this study, we leveraged MRI technology to investigate whether ART pregnancy methods: intracytoplasmic sperm injection (ICSI) and ET have any effect on the brain development of offspring by comparing with the NAT pregnancy method. Methods A total of 75 infants were recruited in the study from 3 conception groups: 25 children born after ICSI, 25 children born after IVF-ET and 25 children born after natural pregnancy. Magnetic resonance imaging (MRI) scans provide exceptionally detailed information on how the human brain changes throughout childhood, adolescence, and old age. The use of MRI in the evaluation of the developing brain is well established. Results The results of routine brain scans on T1WI and T2WI showed that there was no significant difference among the 5-7, 11-13, and 23-25 months of infants among ET, ICSI, and NAT groups. The MRI values fluctuate at different time points indicating that they may change with the development of the brain. However, they are on a similar level for different conception groups supporting our previous statistical analysis that MRI values of ICSI and ET groups are not significantly different from NAT. Conclusions The results showed that there was no significant difference in brain development patterns between different modes of conception, which proved that ART does not affect the development of brain myelin in fetuses and infants.
Shear wave elastography of the upper trapezius muscle in patient with chronic neck pain: is there a correlation between elastic modulus and intensity of pain?
Authors: Ge Junsheng , Zhang Jun , Zhang Zhi Jie
Published: January 2020

Background Chronic neck pain is a common discomfort and the alteration of elasticity of the upper trapezius in pathological conditions is unknown. Therefore, the aims of this investigation were (1) to determine the intra- and inter-operator reliability of evaluating the elasticity of the upper trapezius by shear wave elastography in individuals with chronic neck pain; (2) to examine the alteration for the upper trapezius during cervical flexion; and (3) to explore the correlation between elasticity of the upper trapezius and pain intensity. Methods Thirty individuals with chronic neck pain were recruited for this study. Alteration in elasticity of upper trapezius was evaluated by shear wave elastography during cervical flexion at 0°and 50°. Results The intra- and inter-operator reliability was excellent with the intraclass correlation coefficients ranging from 0.92 to 0.98. An increase of 30.80% was shown in the elasticity of the upper trapezius during cervical flexion of the painful side. In addition, there was a significant positive correlation between elasticity of the upper trapezius and intensity of pain (rho=0.647, P <0.05). Conclusion Shear wave elastography is a feasible tool for assessing changes of elasticity in muscles, and the findings in this investigation might be a good reference of evaluating upper trapezius elastic alterations in chronic neck pain.
Utility of FDG PET/CT for Assessment of Lung Nodules Identified During Low Dose Computed Tomography Screening
Authors: Hadique Sarah , Jain Pranav , Hadi Yousaf , Baig Aneeqah , Parker John E
Published: January 2020

Background: Many clinical guidelines recommend FDG PET/CT for the evaluation of pulmonary nodules ≥ 8mm detected during low dose computed tomography (LDCT) lung cancer screening. However, its added value in this setting requires confirmation. We evaluated the clinical utility of FDG PET/CT, including incidental findings, during the evaluation of lung nodules detected on LDCT screening. Methods: A retrospective cohort study was performed among 75 patients who completed FDG PET/CT between January 2010 and December 2017, after lung nodules > 8mm had been detected on LDCT lung cancer screening. We report demographic variables, characteristics of the initial nodules on LDCT and FDG PET/CT, incidental findings on FDG PET/CT, as well as further work up performed and the influence of FDG PET/CT findings on management. Results: Nodules were reported to be benign on FDG PET/CT in 38/75 (50.6%) patients. Physicians chose either radiological follow-up or no further work up in all 38. FDG PET/CT was indeterminate or suggested malignancy in 37 (49.3%) patients. Biopsy was performed in 32 (86%) of these patients. Incidental findings on FDG PET/CT were reported in 37/75 (49%) patients. Further work-up of incidental findings was performed in 21/75 (28%) of patients. Conclusions: In this study, for majority of individuals with lung nodules identified during LDCT lung cancer screening, FDG PET/CT results were able to guide physicians in choosing between routine follow up or invasive biopsies. Conversely, 28% of these patients required additional investigations to address incidental findings.
The association of dietary patterns with endocannabinoids levels in overweight and obese women
Authors: Yagin Neda Lotfi , Aliasgharzadeh Soghra , Aliasghari Fereshteh , Mahdavi Reza , Hajarzadeh Samaneh
Published: January 2020

Background: Higher levels of AEA and 2-AG the main arachidonic acid-derived endocannabinoids are frequently reported in overweight and obese individuals. A dietary approach to reduce endocannabinoid levels may be a safer. The relation between endocannabinoids and dietary patterns is poorly understood. This study was evaluated the AEA and 2-AG levels across dietary patterns quintiles in overweight and obese women. Methods: In this cross sectional study 183 overweight and obese female (19–50 years old) were recruited. The participants were interviewed, the anadamide and 2-AG levels were measured and the dietary patterns were assessed using a validated semi quantitative food frequency questionnaire. To extract the dietary patterns factor analysis was applied. The association between AEA and 2-AG levels and dietary patterns was analyzed by linear regression. Results: Three major dietary patterns including “western”, “healthy” and “traditional” were extracted. After adjusting for BMI, waist circumference and fat mass higher levels of AEA and 2-AG were observed in those who were in the highest quintile of the western pattern (P for trend <0.05). Also, in both unadjusted and adjusted model, significantly lower AEA and 2-AG levels were detected in women in the highest quintile of the healthy pattern (P for trend <0.01). Also, the association between AEA and 2- AG levels and traditional pattern became significant after controlling for confounders (P for trend <0.01). Conclusion: Regarding the lower levels of endocannabinoids in healthy dietary pattern, modification of the endocannabinoids tones by changes in diet can be a promising approach in prevention and treatment of obesity.
Development, characterization, and cross-amplification of polymorphic microsatellite markers for North American Trachymyrmex and Mycetomoellerius ants
Authors: Matthews Alix E. , Rowan Chase , Stone Colby , Kellner Katrin , Seal Jon N.
Published: January 2020

Objective The objective of this study is to develop and identify polymorphic microsatellite markers for fungus-gardening (attine) ants in the genus Trachymyrmex sensu lato . These ants are important ecosystem engineers and have been a model group for understanding complex symbiotic systems, but very little is understood about the intraspecific genetic patterns across most North American attine species. These microsatellite markers will help to better study intraspecific population genetic structure, gene flow, mating habits, and phylogeographic patterns in these species and potentially other congeners. Results Using next-generation sequencing techniques, we identified 17 and 12 polymorphic microsatellite loci from T. septentrionalis and Mycetomoellerius (formerly Trachymyrmex ) turrifex , respectively, and assessed the genetic diversity of each locus. We also analyzed the cross-amplification success of the T. septentrionalis markers in two other closely related Trachymyrmex species, and identified 10 and 12 polymorphic markers for T. arizonensis and T. pomonae , respectively.
Highly-selective μ-opioid receptor antagonism does not block L-DOPA-induced dyskinesia in a rodent model
Authors: Bartlett Mitchell J. , So Lisa Y. , Szabò Lajos , Skinner David P. , Parent Kate L. , Heien Michael L. , Vanderah Todd W. , Polt Robin , Sherman Scott J. , Falk Torsten
Published: January 2020

Objectives Dopamine-replacement utilizing L-DOPA is still the mainstay treatment for Parkinson’s disease (PD), but often leads to development of L-DOPA-induced dyskinesia (LID), which can be as debilitating as the motor deficits. There is currently no satisfactory pharmacological adjunct therapy. The endogenous opioid peptides enkephalin and dynorphin are important co-transmitters in the direct and indirect striatofugal pathways and have been implicated in genesis and expression of LID. Opioid receptor antagonists and agonists with different selectivity profiles have been investigated for anti-dyskinetic potential in preclinical models. In this study we investigated effects of the highly-selective μ-opioid receptor antagonist CTAP (>1,200-fold selectivity for μ- over δ-opioid receptors) and a novel glycopeptide congener (gCTAP5) that was glycosylated to increase stability, in the standard rat LID model. Results Intraperitoneal administration (i.p.) as low as 0.5 mg/kg CTAP and 0.1 mg/kg gCTAP5 blocked morphine’s antinociceptive effect (10 mg/kg; i.p.) in the warm water tail-flick test, showing in vivo activity in rats after systemic injection. Neither treatment with CTAP (10 mg/kg; i.p.), nor gCTAP5 (5 mg/kg; i.p.) had any effect on L-DOPA-induced limb, axial, orolingual, or locomotor abnormal involuntary movements. The data indicate that highly-selective μ-opioid receptor antagonism alone might not be sufficient to be anti-dyskinetic.
Heart Rhythm Complexity as Predictors for the Prognosis of End-Stage Renal Disease Patients Undergoing Hemodialysis
Authors: Liu Hongyun , Zhan Ping , Shi Jinlong , Hu Minlu , Wang Guojing , Wang Weidong
Published: January 2020

Objective Heart rhythm complexity, a measure of heart rate dynamics and a risk predictor in various clinical diseases, has not been systematically studied in patients with end-stage renal disease. The aim of this study is to investigate the heart rhythm complexity and its prognostic value for mortality in end-stage renal disease patients undergoing hemodialysis.Methods To assess heart rhythm complexity and conventional heart rate variability measures, 4-hour continuous electrocardiography for a retrospective cohort of 202 ostensibly healthy control subjects and 51 hemodialysis patients with end-stage renal disease were analyzed. Heart rhythm complexity was quantified by the complexity index from the measurement of the multiscale entropy profile.Results During a median follow-up of 13 months, 8 people died in the patient group. Values of either traditional heart rate variability measurements or complexity indices were found significantly lower in patients than those in healthy controls. In addition, the complexity indices (Area 1-5, Area 6-15 and Area 6-20) in the mortality group were significantly lower than those in the survival group, while there were no significant differences in traditional heart rate variability parameters between the two groups. In receiver operating characteristic curve analysis, Area 6-20 (AUC = 0.895, p<0.001) showed the strongest predictive power between mortality and survival groups.Conclusion The results suggest that heart rhythm complexity is impaired for patients with end-stage renal disease. Furthermore, the complexity index of heart rate variability quantified by multiscale entropy may be a powerful independent predictor of mortality in end-stage renal disease patients undergoing hemodialysis.
Prevalence and factors predicting anemia in sudanese hemodialysis patients
Authors: Abdelkarim Omalhassan Amir , Abdelraheem Mohammed Babikir , Abubakar Usman , Ekheir Habab Khalid
Published: January 2020

Background: Anemia is a deleterious complication of end stage renal disease (ESRD). It is highly prevalent in sub-saharan Africa. The predictors of control of hemoglobin levels in ESRD patients in Sudan are unknown. Methods: A prospective observational study was conducted to evaluate the prevalence of anemia and factors affecting the control of hemoglobin levels in ESRD patients. A standardized data collection form was used for collecting patient information. A total of 1015 hemodialysis patients were recruited from twelve centers. Results: The 534 (52.6%) patients were included in the final analysis. Those were excluded, including, 194 (19.1%) patients were transferred to other centers before completion of the study, 165 (16.3%) died, 38 (3.7%) underwent renal transplantation and 84 (8.3%) were lost to follow-up. Among the patients who included in the final analysis, 307 (57.5%) were males and the mean age was 48.7±16.1 years. All the analyzed patients were anemic (hemoglobin level<12 g/dL), 67% had a hemoglobin level <10 g/dL. In multivariate analysis the variables which had statistically significant associations with hemoglobin levels equal or higher than 10 g/dL were insured patients [OR = 1.53, 95% CI (1.04–2.25)]; and two drug combinations: "Erythropioesis simulating agent (ESA), intravenous (IV) iron, oral iron, and vitamins" [OR = 1.87, (1.27–2.76)] and "ESA, oral iron and vitamins" [OR = 6.67, (2.98–14.94)]. While, a family history of ESRD [OR = 0.57, (0.35–0.94)] and duration of hypertension for "6-9 years" [OR = 0.47, (0.25–0.87)]; Female patients were identified as being more likely to have lower hemoglobin in both univariate and multivariate analyses. Conclusion: There was suboptimal treated anemia requiring attention in this population. Patients with a family history of ESRD and duration of hypertension for "6-9 years" were predicted to have lower hemoglobin levels. More concern should be paid to uninsured patients and anemia drugs, including the ESA and iron preparations. The results of this study increase our knowledge about the prevalence of anemia and the factors that contribute to control of hemoglobin levels in Sudan. Keywords: Prevalence, Anemia in ESRD, Hemodialysis, Erythropioesis Stimulating Agents, Hemoglobin Level, Health Insurance, Hypertension, Family History of ESRD, Sudan, Khartoum.
Prevalence and related factors of internet addiction among undergraduate university students, Northeastern Ethiopia. A community university-based cross-sectional study
Authors: Zenebe Yosef , Kunno Kunuya , Mekonnen Meseret , Bewuket Ajebush , Birkie Mengesha , Necho Mogesie , Seid Muhammed , Tsegaw Million , Akele Baye
Published: January 2020

Background: Globally, more than three billion persons using the Internet daily, with the common being youths and young persons. Internet addiction among university students in Ethiopia has not been studied. The current study aims to explore the magnitude and related factors of internet addiction among Wollo University students in Ethiopia.Objectives: The main objective of this study was to assess the prevalence and related factors of internet addiction among Wollo University students, Northeast, Ethiopia, 2019.Methods: A community university-based cross-sectional study was conducted among Wollo University students from April 10 to May 10, 2019, G.C. A total of six hundred three students were participated in the study using a pretested and self-administered structured questionnaire. The Young’s Internet Addiction Test instrument was used to assess the level of internet addiction. Results: Generally, the prevalence of internet addiction (IA) among the current internet users was 85 % (n=466) with 55.7 %( n=305) mild internet addiction, 27.9% (n=153) moderate internet addiction and 1.5% (n= 8) severe internet addiction. In multivariable logistic regression analysis, using the internet greater than five hours daily, having mental distress, playing online games, current khat chewing and current alcohol use were positively related to internet addiction. Using the internet for more than twelve months and using the internet by mobile internet were negatively related to internet addiction.Conclusions: The current study documents a high prevalence of internet addiction among Wollo University students. Factors independently associated with internet addiction were using the internet greater than five hours daily, having mental distress, playing online games, current khat chewing and current alcohol use.
Predictors of metabolic syndrome among people living with HIV in the Gedeo-Zone, Southern-Ethiopia: an unmatched case-control study
Authors: Bune Girma Tenkolu , Yalew Alemayehu Worku , Kumie Abera
Published: January 2020

BackgroundMetabolic syndrome (MS) among people living with HIV (PLHIVs) is a global public health issue. However, there is no primary data about predictors of MS in the SSA and Ethiopia. Therefore, the aim of this study was to determine predictors of MS, among PLHIVs in the Gedeo-Zone,Southern-Ethiopia.MethodsUnmatched case-control study approach, among PLHIVs who served at randomly chosen two hospitals and health centers in the zone, in between (December 29th-2017 and January 22nd-2019) was done. WHO-steps tools were used to gather the data, finally handled with (Epidata-V-3.1 and SPSS-V-22) software’s. Lastly, using a multivariable conditional-LR-model, 4-models with AOR (95%CI) were computed to arrived at the final model, and then variables accepted as significant at (p-value < 0.05)level. ResultOverall, 633 PLHIVs (139 cases and 494 controls) were included in the analysis. The leading factors associated with MS were Age(>/=45years-old)(AOR=4.0,95%CI: 1.4-11.9), completed secondary school education (AOR=0.1,95% CI:0.01-0.5), un-employed(a home-maker AOR=0.1,95%CI:0.03-0.7 vs able to work AOR=0.1,95%CI:0.06-0.5)),Antiretroviral-therapy-exposed(AOR=0.1,95%CI:1.0-8.5),WHO-stage(>/=III)(AOR=4.4,95% CI:1.4-13.4), total physically activity (AOR=0.1,95% CI:0.04- 0.35), history of blood sugar measured (AOR=10.7,95%CI:3.3-34.6), elevated waist-circumference(AOR=6.9,95%CI:2.5-18.7),raised body mass index(AOR=5.4 95% CI: 1.6,18.4),fasting-glucose(AOR=29.3,95%CI:10.0-85.4),raisedtriglyceride(AOR=4.8,95%CI:2.0-11.3), and low high density lipoprotein(AOR=12.3 95% CI: 5.2,29.3). ConclusionThe finding implicated, the significance of planning intervention actions that targets the above factors in to account.
Multilevel model on longitudinal data analysis in determinants of cd4 cell count among antiretroviral therapy attendant of hiv infected adults follow up in gondar teaching referral hospital, Gonder, Ethiopia.
Authors: Kebede Kindu
Published: January 2020

Background: Human immunodeficiency virus attacked an immune cell and the CD4 cell which is responsible for the body’s immune to infectious agents. Acquired immunodeficiency syndrome is one of the major public health problems in Sub-Saharan Africa including Ethiopia. The main objective of this study to identify the determinants of CD4 cell count among antiretroviral therapy attendants of infected adults follow up in Gonder teaching referral hospital, Gonder, Ethiopia implemented by SAS version 94. Methods: A retrospective cohort study was conducted on 216 regular follow up patients whose age greater than 14 years from December 1, 2012, to December 30, 2017. A multilevel model was used to identify the factors of CD4 cell count of patients and it considered variability between and within patients. Results: The mean with a standard deviation of weight, and a hemoglobin level of patients were 55.48(10.21), and 18.25(33.028) respectively. This study concluded that the variation for CD4 cell count existed between patients was 63 % and the remaining 37 % of variation existing within patients. In this study, the random coeﬃcient time-varying covariate model was well fitted which shows weight and hemoglobin level were statistically significant predictors at a 5% level of significance for the log of CD4 cell count of patients. Conclusion: This study shows the hemoglobin level and weight of patients were statistically significant for the log of CD4 cell count of patients follow up in Gonder teaching referral hospital, Gonder, Ethiopia. Moreover, the result of the study shows that the log of CD4 count of patients increased when hemoglobin level and weight of patients increased. Hence, intervention should be given the ways to increase weight and hemoglobin levels of patients during follow up antiretroviral therapy.
Repeated social defeat promotes persistent inflammatory changes in splenic myeloid cells; decreased expression of β-arrestin-2 (ARRB2) and increased expression of interleukin-6 (IL-6)
Authors: Rajalingam Dhaksshaginy , Nymoen Ingeborg , Jacobsen Daniel Pitz , Eriksen Mina Baarnes , Dissen Erik , Nielsen Morten Birkeland , Einarsen Ståle Valvatne , Gjerstad Johannes
Published: January 2020

Background Previous studies suggest that persistent exposure to social stress in mammals may be associated with multiple physiological effects. Here, we examine the effects of social stress in rats, i.e. repeated social defeat, on behavior, hypothalamic-pituitary-adrenal (HPA)-axis and immune system. Methods A resident-intruder paradigm, where an intruder rat was exposed to social stress by a dominant resident rat for one hour each day for seven consecutive days was used. The day after the last stress exposure in the paradigm the data were analyzed. Variation in social interaction was observed manually, whereas locomotion was analyzed off-line by a purpose-made software. Gene expression in the pituitary gland, adrenal gland and myeloid cells isolated from the spleen was measured by qPCR. Results The exposure to social stress induced decreased weight gain and increased locomotion. An increased nuclear receptor subfamily group C number 1 (NR3C1) expression in the pituitary gland was also shown. In myeloid cells harvested from the spleen, we observed decreased expression of the β 2 -adrenergic receptor (ADRB2) and β-arrestin-2 (ARRB2), but increased expression of interleukin-6 (IL-6). Subsequent analyses in the same cells showed that ARRB2 was negatively correlated with IL-6 following the stress exposure. Conclusion Our results show that that the experience of social stress in the form of repeated social defeat in rats is a potent stressor that in myeloid cells in the spleen promotes persistent inflammatory changes. Future research is needed to examine whether similar inflammatory changes also can explain the impact of social stress, such as bullying and harassment, among humans.
Serum level of IL-10 and IL-10-1082G/A polymorphism are associated with the risk of ischemic stroke: A meta-analysis
Authors: Rui Xiaodong , Sha Yeqin , Wen Shuang , Sun Qingyang , Hu Jingming , Yan Fengfeng , he lianping , Xie Guanghui
Published: January 2020

BACKGROUND Stroke is one of the leading causes of disability and mortality among adults worldwide. The aim of the study was to confirm the relationship of serum interleukin-10 (IL-10) and its gene polymorphism with the risk of ischemic stroke (IS). METHODS PubMed and China Wanfang database were systematically searched up to September 2, 2019. Studies illustrating on the association between serum IL-10 or IL-10-1082G/A, IL-10-819C/T, IL-10- 592C/A polymorphisms and IS susceptibility were included in this study. Newcastle–Ottawa scale was used to assess the study quality. RevMan 5.3 was used for statistical analysis. RESULTS: Seventeen case-control studies were included in this meta-analysis which provides 3754 patients with IS and 5064 controls. Combined analysis indicated that patients with IS had lower serum level of IL-10 (Mean difference [MD]: -4.25; 95% confidence interval [CI]: -6.14 to -2.36, p<0.0001). An association was identified between IL-10-1082G/A polymorphism and the risk of IS, but no association was found between polymorphism of IL-10-819C/T or IL-10- 592C/A and the risk of IS when all ethnic groups were considered together. For IL-10-1082G/A polymorphism, individuals with AA-genotype might have an increased risk of IS among Chinese Han population while no such correlation was observed in other ethnic group. CONCLUSION This meta-analysis suggested that low serum level of IL-10 and IL-10-1082G/A polymorphism may be associated with the risk of IS. More clinical studies should be conducted to confirm the relationship between serum IL-10 level and the risk of IS in all ethnic groups.
Dissatisfaction between medical providers and patients in the Republic of Kazakhstan.
Authors: Zhumadilova Anara , Kozhakhmetova Aizhan , Kuanyshbayeva Gaukhar , Kazhen Madina , Akhmadiyeva Amina , Craig Brett J.
Published: January 2020

The continuous increase in dissatisfaction among patients toward health care providers remains high in the Republic of Kazakhstan. To confirm the researcher’s previous results and see any other possible outcomes in the present study, we decided to investigate randomly selected patients and health care providers from both private and state medical hospitals. We investigated the possible factors in miscommunication between health care providers and patients to understand and discuss this demand and to develop recommendations for further improvement. The cross-sectional study of 500 patients (response rate, 85.4%) and 500 health care providers (response rate, 86.4%) from some private and state hospitals in the city of Nur-Sultan, Kazakhstan, was carried out based on their answers from a questionnaire containing the Patient-Practitioner Orientation Scale (PPOS) and scales assessing life and job satisfaction, job effort-job reward balance, and patient evaluation of communication. Our study showed that the majority of health care providers and even patients were doctor-centered. The patient-centered orientation of health care providers was negatively correlated with age (P=0.000218) and life satisfaction (P=0.000001). In patients, contrarily, patient-centeredness was enhanced by higher life satisfaction (P=0.040), although negatively correlated with age (P=2.659E-21). This study has demonstrated that younger health care providers and those with lower life satisfaction are more patient-centered. Older respondents and those with higher life satisfaction, in contrast, reported doctor-centered attitudes. The majority of younger patients have a stronger belief in good health associated with patient-centered care whereas the older population preferred a more doctor-centered care. In all patients, the preference of patient-centered care was associated with higher satisfaction in life.
Transcutaneous Oxygen Saturation Accuracy in Critically Ill Children
Authors: Brooks Joshua Cushing , Raman Sainath , Gibbons Kristen , Williams Tara , Dunster Kimble Robert , Pegg Deborah , Harkins Maria , Nelson Alphonso , Pham Trang , Schibler Andreas
Published: January 2020

Background Pulse oximetry (SpO 2 ) is used to monitor oxygen saturation levels to avoid hypoxaemia in children. Sensor manufacturers claim high sensitivity, specificity and accuracy. Few studies have evaluated accuracy and precision of SpO 2 in children. Methods This prospective, observational study was conducted in a 36-bed mixed medical/surgical paediatric intensive care unit. All children <16 years old with an arterial line were eligible. Paired SpO 2 readings obtained with a Masimo and a Nellcor sensor were prospectively matched and validated to the arterial haemoglobin oxygen saturation (SaO 2 ). Bias between SpO 2 and SaO 2 (SpO 2 -SaO 2 ), accuracy root mean square (A rms ), sensitivity, specificity and kappa agreement were calculated for sensors. Multivariable regression analysis was conducted to determine the relationship between clinical variables and bias in paired sensor readings. Findings There were 929 participants with 16,839 readings (9,382 simultaneous Masimo and Nellcor). Nineteen percent of paired values had SaO 2 <88%. Bias increased with decreasing SaO 2 . Both sensors failed to achieve FDA’s A rms requirement in all ranges. Of the 15.5% patients with ‘true hypoxaemia’ (SaO 2 <88%), 28.6% (n=1165) were not correctly identified by pulse oximetry. Variables associated with higher odds of bias included sepsis, respiratory distress and post-cardiac arrest; increasing lactate; vasoconstrictor use; lower SaO 2 and low admission weight. Interpretation Both tested sensors, with current algorithms, are not precise enough for a PICU setting. Sensor readings in patients with respiratory disease, sepsis and cardiac arrest should be used with caution.
The prevalence and associated risk factors of musculoskeletal pain among pilgrims during the Hajj: cross-sectional results from 59 nationalities
Authors: Alshehri Mansour , Alzaidi Jamal , Alasmri Sultan , Alfaqeh Ali , Arif Mohammad , Alotaiby Sultan Falh , Alzahrani Hosam
Published: January 2020

Background: Musculoskeletal pain is a major burden on individuals, social and healthcare systems. Annually, 2–3 million pilgrims perform the Hajj in Mecca, Saudi Arabia. The Hajj involves a high level of physical demand because pilgrims generally move by foot for long distances among a series of religious sites, an effort that may exceed the typical physical activity level for most individuals. To understand the impact of musculoskeletal pain on the completion of the Hajj, it is first necessary to evaluate the extent of the problem. This study aimed to estimate the point prevalence of musculoskeletal pain and associated risk factors among pilgrims. Methods: A cross-sectional survey was conducted during the period of the Hajj. Data were collected after completion of the 2 nd day of the Hajj (21–31 August 2018), mainly by volunteers using an online application or paper form and approaching individuals at different sites around Mecca. The main inclusion criteria were as follows: adult pilgrims aged 18 or older. Participants were allowed to report more than one site of pain. Prevalence and odds ratios were calculated. Results: A total of 1,715 responses were included in the data analysis. The prevalence of musculoskeletal pain was high (82.27%). Musculoskeletal pain was most commonly reported in the ankle/foot (39.07%), leg (30.38%), lower back (28.40%), knee (23.03%) and shoulder (16.09%). The odds ratios revealed that musculoskeletal pain was more common in females; older individuals; individuals who smoked, had diabetes or hypertension; those who believed that the Hajj was physically exhausting and those who had experienced a fall during the Hajj. However, there were variations in the degrees of importance of these factors across different anatomical sites of the pain. Conclusions: Musculoskeletal pain is common among pilgrims, and it is more prevalent among pilgrims than among the general population. Unlike most populations examined in other studies, ankle/foot and leg pain were the most common in pilgrims. These data provide guidance for potential preventative programs and the allocation of resources to optimise pilgrims’ experiences and ability to complete the Hajj. Trial registration: The study was registered at https://www.researchregistry.com in August 2018 (No. 4352).