bluuebunny/crossref_metadata_2025 huggingface dataset:
Phenobarbital is Associated with Cholestasis in Preterm Infants with Hemo-dynamically Significant Patent Ductus Arteriosus
Authors: Shen Xintian , Huang Yie , Peng Haibo , Zhou Ping
Published: May 2022

Objectives: This retrospective study aimed to assess whether phenobarbital was associated with cholestasis in preterm infants with hemo-dynamically significant patent ductus arteriosus (hsPDA).Methods: This study included 151 preterm infants (24~34 weeks, birth weight<2000 g) diagnosed with hsPDA, admitted to a level III neonatal intensive care unit (NICU) from September 2016 to September 2019. Of the 151 infants, twenty-seven infants were diagnosed with cholestasis. To assess the independent association of phenobarbital with cholestasis, binary logistic regression was done, adjusting for major confounders (birth weight, gestational age, critical risk index for babies and etc).Result: To explore whether the risk of cholestasis was independently increased by duration of phenobarbital, binary logistic regression analysis was done adjusting for significant confounders (p<0.05). After adjustment with confounders “critical risk index for babies”, “invasive mechanical ventilation”, “any sepsis onset in 28 days” and “duration of cimetidine”, cholestasis was still associated with “duration of phenobarbital” (OR: 1.350; 95% CI: 1.064, 1.714; P = 0.014) and “CMV infection” (OR: 10.818; 95% CI: 0.915, 127.914; P = 0.059). Furthermore, “duration of phenobarbital” might independently delay the time to reach full enteral feeding (OR: 1.479; 95% CI: 1.088, 2.011; P = 0.013), causing parenteral nutrition associated cholestasis.Conclusion: This study found that duration of phenobarbital was associated with neonatal cholestasis in premature infants with hsPDA. Phenobarbital should be used cautiously in preterm infants with hsPDA or cholestasis.
The mediating effect of social support on the association between socioeconomic status and oral health among the migrant elderly following children in Weifang, China: a cross-sectional study
Authors: Pang Mingli , Wang Jieru , Tian Tingting , Zhao Jinfeng , Jiang Xiaoxu , Li Hexian , Kong Fanlei
Published: May 2022

Background
As an important part of the elderly population, the migrant elderly following children (MEFC) have received more and more attention in the background of active aging. The purpose of this study is to clarify the mediating effect of social support on the relationship between socioeconomic status (SES) and oral health among the MEFC in Weifang, China.
Methods
Multistage cluster random sampling was used to select the participants and finally 613 MEFC were included in the survey. The Social Support Rating Scale (SSRS) and the Chinese version of the Geriatric Oral Health Assessment Index (GOHAI) scale were used for data collection. Descriptive analysis, chi-square test, t-test and structural equation modeling (SEM) were conducted in this study.
Results
Mean score of GOHAI of the MEFC was 54.95 ± 6.47. The SES of MEFC exerted positive direct effect both on social support (standardized coefficient = 0.15) and oral health (standardized coefficient = 0.22); social support exerted positive direct effect on oral health (standardized coefficient = 0.17). Social support partially mediated the association between SES and oral health [95% confidence interval (CI): 0.003–0.064, P < 0.05], and the mediating effect of social support accounted for 12.0% of the total effect.
Conclusions
Higher GOHAI score of MEFC indicated their good oral health status. MEFCs’ SES could exert positive effect both on social support and oral health, while the moderating effect of social support between SES and oral health of MEFC was established. Targeted implication for the government, community and family members were proposed to improve the oral health of MEFC.
The FLURESP European Commission project: Cost-Effectiveness assessment of eight public health measures against influenza in Italy: is there an interest in COVID-19 pandemic?
Authors: Beresniak Ariel , Napoli Christian , Oxford John , Daruich Alejandra , MA Laurent Niddam , Duru Gérard , Tozzi Alberto E , Atti Marta Ciofi , Dupont Danielle , Bremond-Gignac Dominique , Rizzo Caterina
Published: May 2022

Background: The FLURESP project is a public health research funded by the European Commission, with the objective to design a methodological framework to assess and compare the cost-effectiveness of existing public health measures against human influenza pandemics in four target countries: France, Italy, Poland and Romania. This article presents the results relevant to the Italian health system using a dataset specifically collected for this purpose. As most of interventions against human influenza are relavant against other respiratory diseases pandemics, potential interests in COVID-19 are discussed.Methods: Eight public health measures against human influenza pandemics pandemic were selected to be also relevant to other respiratory virus pandemics such as COVID 19: 1) individual (hand washing, using masks), 2) border control (quarantine, fever screening, border closure), 3) community infection (school closure, class dismissal, social distancing, limitation of public transport), 4) reduction of secondary infections (implementation of antibiotic therapy guidelines), 5) pneumococcal vaccination for at-risk people, 6) development of Intensive Care Unit (ICU) capacity, 7) implementation of life support equipments in ICU and 8) screening interventions (virus testing).The outcome "achieving a mortality reduction of higher or equal to 40%” has been selected as a meaningful effectiveness criteria from the public health perspective. Cost distributions have been taken into account according to the Italian health system using a uniform distribution. Results: In the frame of the major pandemic event observed in Italy in 2020, the most cost-effective strategies are “reduction of secondary infections” and “implementation of life support equipment in ICU”. The least cost-effective option during a major pandemic event is screening interventions.Conclusions: A number of intervention strategies against human influenza pandemics appears relevant against respiratory virus pandemics in general such as the COVID-19 pandemic. These pandemics are imposing a substantial economic burden in Italy, confirming the interest of considering the cost-effectiveness of public health measures to enlighten decision making.
The impact of fetal programming in ewe nutrition with chromium propionate or calcium salts of palm oil on the meat quality and bone of the progeny
Authors: Brochine Luciano , Santos Fernanda Ferreira , Moreira Flávia Mallaco , Leme Paulo Roberto , Tedeschi Luis Orlindo , Gallo Sarita Bonagurio
Published: May 2022

This study aimed to evaluate the inclusion of chromium propionate or calcium salts of palm oil in ewes' diet in the final third of gestation and lactation on the effects of progeny performance, carcass characteristics, non-carcass components, and bone density. Forty-three ewe, Santa Inês and Dorper breeds, 3 ± 1 years old and weighing 57 ± 10 kg were used. The ewes were distributed in causal blocks in three treatments, CTL treatment (n = 15) with starch from corn; CR (n = 15) diet CTL plus chromium propionate; PF (n = 13) diet CTL plus calcium salts of palm oil. After weaning, 23 male lambs from these ewes were confined in individual stalls, with the same diet for 60 days, slaughtered. The data were analyzed using PROC GLM and means evaluated using the Tukey at 5%. Maternal diet did not alter the DMI, FE, and ADWG. Therefore, weaning and slaughter weights were higher for Cr and PF groups than CTL (P < 0.05). Carcass yield was also higher for these treatments (P < 0.05), but loin eye area and fat thickness were not influenced (P > 0.05) by diet regimen. The spleen and the respiratory tract were smaller for PF and larger for CTL (P < 0.05). The leg weight was about half of the carcass weight for the CR. The perimeter and depth of the shank for the CR and PF lambs were higher, indicating an effect of maternal nutrition in this commercial cut. The CR group had a smaller epiphysis measurement and femur length than the CTL group. We concluded that the fetal programming effect in ewes fed with Cr propionate and Ca salts of palm oil benefited the progeny by increasing their body weight, better carcass yield, and a higher proportion of prime cuts.
Transtendon technique versus repair after completion of the tear for articular-sided partial rotator cuff tear - a meta-analysis
Authors: Yang Yimeng , Hu Dan , Chen Shiyi , Guan Shibing , Shang Xiliang
Published: May 2022

Background
Partial-thickness rotator cuff tears (PT-RCTs) are a common cause of shoulder pain and disability. Arthroscopic repair is an effective treatment for articular-sided PT-RCTs, and transtendon repair and repair after completion of the tear have been widely used to treat such lesions. However, controversy continues with the best management. The present study was designed to compare the clinical outcomes and tendon integrity following arthroscopic repair of articular PT-RCTs using transtendon repair or repair after completion of the tear.
Methods
We performed a systematic electronic database search on Cochrane Central Register of Controlled Trials, PubMed and Embase to identify articles equating articular-sided PT-RCTs repair. The randomised controlled clinical trials that met our criteria were evaluated for quality of methodology. The results obtained were further analysed and correlated to present the benefits and drawbacks comparing the two surgical procedures.
Result
According to our inclusion and exclusion criteria, six articles were included in the present study. A total of 501 patients were analyzed as part of this study. The results indicated that both the surgical treatments provided excellent functional improvements and tendon integrity. However, no significant differences for the visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, constant score, range of motion, postoperative adhesive capsulitis, tendon integrity and patient satisfaction were found between the two cohorts (p > 0.05).
Conclusions
The study demonstrated technical characteristics of both repair techniques, contributing to make a decision under different clinical circumstance. Compared to transtendon technique, repair after completion of the tear has the advantage of simple operation and the removal of possible bursal degeneration tissue, and could be a convenient choice to degenerated articular-sided PT-RCTs.
Plasma metabolomic profiles reveal sex- and maturation-dependent metabolic strategies in sea lamprey (Petromyzon marinus)
Authors: Tamrakar Sonam , Huerta Belinda , Chung-Davidson Yu-Wen , Li Weiming
Published: May 2022

Introduction Adult sea lamprey (Petromyzon marinus) cease feeding and migrate to spawning streams where males build nests, undergo final sexual maturation, and subsequently produce and release large quantities of bile acid pheromones that attract mature females. These animals are predicted to rearrange their metabolic pathways drastically to support their reproductive strategies, presenting advantageous opportunities to examine how sex and the maturation processes affect metabolism.Objectives The objective is to investigate the metabolic differences between sexes and maturation states in sea lamprey that support changes in physiological functions.Methods We compared plasma metabolomes of spawning and prespawning sea lamprey in both sexes using both non-targeted and targeted metabolomics approaches using UPLC/MS-MS with electrospray ionization in both positive and negative modes. The data were processed using Progenesis QI, Compound Discoverer and XCMS softwares for alignment, peak picking, and deconvolution of the peaks. Principle component analyses (PCA) and partial least squares discriminant analyses (PLS-DA) were performed using SIMCA and Metaboanalyst softwares to identify discriminating features, followed by fragmentation matching with extensive database search and pathway mapping. Results The pheromonal bile acid biosynthesis was upregulated significantly in males compared to females. Spermiating males further upregulated bile acid biosynthesis by altering amino acid metabolisms, upregulating cofactors and nucleotide metabolisms, but downregulating carbohydrate and energy metabolisms. Conclusion Plasma metabolomes are sex- and maturation-dependent and reflect the special metabolic demands at each life stage and reproductive strategy.
The clinical outcomes and complications of combined fixation with cannulated screws and the modified Pyrford technique for the treatment of transverse patellar fractures: a case series study
Authors: Li Yihan , Tian Qingxian , Leng Kunpeng , Guo Meng
Published: May 2022

Background: Transverse patellar fractures can be fixed using various techniques. The purpose of the current study was to assess the clinical outcomes and complications rate of a combined fixation technique using cannulated screws and the modified Pyrford technique with non-absorbable polyester sutures. Methods and Patients: Between January 2015 and February 2021, 26 transverse patellar fractures were fixed with this combined technique. Pre-operative data were collected from patients with transverse patellar fractures and the patients were followed up for at least 12 months. At each follow-up visit, plain radiographs were taken. At the 12-month post-operative follow-up, range of motion of the affected knee joint and clinical outcomes, as evaluated by the Bostman scoring system, were recorded.Results: The average Bostman score at the 12-month post-operative follow-up was 28.3±1.5. Further, the average extension and flexion of the knee joint were 1.2±2.1 and 125.6±6.7 degrees, respectively. One patient experienced delayed bone union and one experienced superficial wound infection. There were no other post-operative complications. One patient required removal of the device for social-psychological reasons. Conclusions: The combined fixation technique with cannulated screws and the modified Pyrford technique with suture materials produced excellent clinical outcomes and a low rate of complications in the treatment of transverse patellar fractures.
Predictors of referral to specialised palliative care at a University Hospital: Towards purposeful commitment of a limited resource
Authors: Adamidis F. , Baumgartner N. , Kitta A. , Kum L. , Unseld M. , Marosi C. , kreye G. , Fischer C. , Zeilinger E.L , Masel E.K
Published: May 2022

Purpose
Palliative Care (PC) can be divided into general PC (GPC) as an integrated part of patient care in all fields of medicine and specialised PC (SPC), which is usually provided within palliative care units (PCUs) by specialised PC physicians. To date, the criteria on which patients are selected for SPC or GPC are not standardized. Such information would be vital for increasing the efficiency of the limited resource of SPC. The present study aims at identifying criteria associated with the referral to SPC in a large University hospital.
Methods
This retrospective single-centre study evaluated the total of 704 PC consultation requests between March 2016 and August 2020 to examine characteristics of patients who were referred to SPC at a PCU compared to those receiving GPC. To analyse criteria correlated with referral to PCU, binary logistic regression was conducted. Significant variables were then incorporated into a multivariate logistic regression model.
Results
The total of 704 PC consultation requests included 374 requests for a referral to SPC and 330 requests for a PC consultation, only. Of the 374 patients for whom the treating physician requested a referral to SPC, 145 (38.8%) patients were actually referred. Statistically significant factors associated with referral to SPC were the need for pain management (OR = 2.3) and nutritional advice (OR = 4.4).
Conclusion
Indicated triggers requiring SPC included complex symptom burdens, particularly pain and nutrition problems. Further education regarding these findings could help to ameliorate targeted use of the limited resource SPC.
Evaluation of a scale-up WHO SCC and mentoring based program for improving quality of intrapartum care in public sector in Rajasthan, India: repeated mixed-methods surveys
Authors: Singh Samiksha , Kannuri Nanda Kishore , Mishra Aparajita , Gaikwad Leena , Shukla Rajan , Tyagi Mukta , Chamarty Swecha
Published: May 2022

Background: Dakshata program in India aims to improve resources, providers’ competence and accountability in labour wards of public sector secondary care hospitals. It is based on the WHO Safe Childbirth Checklist coupled with mentoring. In Rajasthan state, an external technical partner trained, mentored and periodically assessed performance; identified local problems and supported solutions; supported state in monitoring. We (a third party) evaluated the effectiveness and factors contributing to success and sustainability.Methods: We conducted three repeat mixed-method surveys across 24 hospitals which were at different stage of program implementation when evaluation initiated: Group 1-trainings started and Group 2-one round of mentoring completed. We followed them over 18 months. Data was collected by directly observing obstetric assessments and childbirth, extracting information from casesheets and registers, and interviewing postnatal women. Theory-driven qualitative assessment included in-depth interviews with administrators, mentors, obstetric staff, and officers/mentors from external partner.Results: Average adherence to practices increased, saw a dip and then again improved. Significant improvement noted in several practices in the two groups—more in pause points 1, 2 and 3 but less in 4. Overall average adherence improved: Group 1, 55% to 72%; and Group 2, 69% to 79% (p<0.001). Stillbirth rate reduced: Group 1, 1.5/1,000 to 0.2; and Group 2, 2.5 to 1.1 (p<0.001). The mentoring with periodic assessments were highly acceptable, efficient means of capacity building, and ensured continuity in skills upgradation. Nurses felt empowered while involvement of doctors was low. The state health administration was highly committed and involved in program management; hospital administration supported. The competence, consistency and support from the technical partner were highly appreciated. Conclusion: Dakshata program was successful in improving resources and competencies. The program is sustainable and scalable. The states with low capacities will require intensive external support for a head start.
Mucosal associated Lymphoid Tissue Lymphoma of the uvea: an analysis of 3 cases
Authors: Wang Zhenyu , Liu Yueming , Mo Jing , Cao Xusheng , Xu Xiaolin , Shen Lin , Wang Hong , Wei Wenbin
Published: May 2022

Background: Ocular MALT lymphoma involving orbit and conjunctiva usually has an indolent clinical course with “salmon patch” mass as typical presentation. This study is to report a series of rare cases and investigate the clinical and pathological features of ocular MALT lymphoma that involved uveal tissue primarily and presented as posterior scleritis.Methods: From 2018 to 2020 in Beijing Tongren Eye Cener, 3 cases of 3 eyes (2 female patients and 1 male patient) with ocular MALT lymphoma that involved uveal tissue primarily and presented as posterior scleritis were included in the study. All patients had complaints of blurred vision and hyperemia in their involved eyes. The average age was 56.33 ± 2.08 years old and the average time from initial diagnosis to pathological diagnosis was 3.00 ± 1.73 months. Ophthalmic examinations including BCVA, IOP, slit lamp microscope examinations, fundus photography, B-scan ultrasonography, UBM, OCT, FFA and ICGA were conducted. Systemic workups including orbital MRI, PET-CT and blood autoimmune antibody tests were also conducted. Pathological tissue from patients were obtained through surgeries. Biopsy examinations were performed to accurately determine pathological diagnosis. All the information of clinical, imaging and pathological changes were collected and analyzed.Results: At the initial diagnosis, the BCVA of involved eyes decreased seriously while the IOP were normal. All involved eyeball showed extensive hyperemia and local thickening in the wall of eyeballs. B-scan ultrasonography showed mass with abundant blood and irregular cysts inside the eyeball wall and in the retrobulbar orbit, surrounding the ocular wall and optic nerve. UBM showed solid lesions with low and medium echo under the conjunctiva and inside the ciliary body of 2 cases. OCT showed posterior polar wavy rise of RPE and local neuroepithelial detachment in all cases. FFA and ICGA showed vascular abnormalities (patch-like strong fluorescence and fluorescence leakage) and local thickening in retina and choroid (Rectangle-like weak fluorescence below the macula). The posterior wall of the eyeball was thickened and enhanced in MRI. PET-CT also showed thickening of posterior wall of eyeballs and increased metabolic activity but there was no sign of autoimmune disease. All patients were diagnosed as MALT lymphoma through pathologic examinations of biopsy tissue.Conclusions: The onset of primary ocular MALT lymphoma in uvea is hidden. The early clinical manifestations are lack of specificity and misleading. B-scan ultrasonography has characteristic manifestations and is valuable in diagnosis. However, pathological diagnosis through tissue biopsy is irreplaceable.
Does fixation of both clavicle and scapula is better than clavicle alone in surgical treatment of floating shoulder injury? A retrospective study
Authors: Shao Yijie , Zhu Xu , Liu Bo , Ji Chenchen , Chen Guangdong
Published: May 2022

Background: Little research was available to explore which surgical fixation was better between fixation of both clavicle and scapula and clavicle alone in management of floating shoulder injury.Methods: Total 69 patients with floating shoulder injury receiving surgery from February 2005 to July 2020 participated in the study. 49 patients underwent fixation of the clavicle alone (Group C) while 20 patients underwent fixation of both clavicle and scapula (Group C+S). They were further divided into subgroups according to age: Group C1, Group C+S1 (age≤55 years old) and Group C2, Group C+S2 (age＞55 years old). The radiological parameter (glenopolar angle (GPA)) and clinical outcomes (Herscovici score, Constant-Murley shoulder outcome score (CSS score), and Visual Analogue Scale score (VAS score)) were collected and compared between these groups. The correlation between age and radiological parameter and clinical outcomes were calculated by the Spearman correlation analysis. Results: All people were followed up for at least 1 year. The degree of change in GPA before and after surgery in Group C+S is significantly better than that in Group C. The Herscovici and CSS score in Group C+S2 were significantly higher than those in Group C2 at 1 month, 3 months and 1 year after surgery. However, no significant difference in Herscovici and CSS score was found at final follow-up (1 year after surgery) between Group C+S1 and Group C1. The VAS score in Group C+S2 at final follow-up was significantly lower than that in Group C2. No significant difference in VAS score at final follow-up was found between Group C+S1 and Group C1. In addition, the VAS score was negatively correlated with Herscovici and CSS score. No correlation was found between VAS score and GPA.Conclusions: Both types of surgical fixation are effective in management of floating shoulder injury. For young people with floating shoulder injury, both types of surgical fixation are equally effective. However, for older people with floating shoulder injury, fixation of both clavicle and scapula is better in prognosis than fixation of clavicle alone.
Does pathological T factor affect the long-term prognosis of locally advanced colorectal cancer treated with Laparoscopic multi-visceral resection?
Authors: Ishiyama Yasuhiro , Hirano Yasumitu , Yonezawa Hiroki , Sasaki Megumi , Fujii Takatugu , Okazaki Naoto , Ishii Toshimasa , Deguchi Katuya
Published: May 2022

Purpose: Local advanced colorectal cancer (LACC) has poor long-term outcomes. Our hypothesis was that the depth of pathological findings would affect postoperative outcomes in patients who underwent multivisceral resection (MVR) resulting in clear margins (R0). The aim of this study was to analyze short- and long-term outcomes in patients who underwent MVR for LACC between T3 and T4 stages.Methods: This was a propensity score-matched (PSM) retrospective study. All 8,764 consecutive patients who underwent surgery for colorectal cancer between April-2007 and January- 2021 at the Saitama Medical University International Medical Center were screened. 572 underwent MVR for LACC. We compared the T3 and T4 groups to evaluate outcomes.Results: The 5-year disease-free survival (DFS) rates did not significantly differ between the two groups (HR 1.344 95% CI (0.638–-2.907), P=0.33). The 5-year overall survival (OS) rates were significantly worse for the T4 group than for the T3 group (HR 3.162 95% CI (1.077–-11.44), P=0.037).To determine the association between American Society of Anesthesiologists (ASA) score, transfusion, pathological T and OS, we performed univariate and multivariate analyses. ASA, transfusion, and pathological T were associated with worse OS in univariate analysis (T3 vs. T4, respectively).Conclusion: Our study showed that the postoperative complications and DFS of the T4 group were similar to those of the T3 group. However, OS was worse in the T4 group compared with T3 group. Multivariate risk factors were ASA>2, transfusion, and, T4.
Incidence, Mortality, and Epidemiology of Leukemia in South Asia: An Ecological Study
Authors: Rifat Rakibul Hasan , Poran Md. Shah , Islam Saiful , Sumaya Anika Tabassum , Alam Md. Mozahidul , Rahman Md Rashedur
Published: May 2022

Nowadays cancer is a buzzword in every corner of the world. Among all other Cancer, leukemia is not as familiar as breast cancer or lung cancer. Treat or curing Cancer is challenging, there is still no worthy hope to fight against it. Back a few decades, Cancer was not that much known to the people of South Asia let alone known of Leukemia. Information on the incidence and mortality of Leukemia is paramount to planning health measures and improving the treatment and management of leukemia for general people. Many countries in the South Asian region are designated as developing countries. Hence, the deficiency of diagnosis system, treatment, management, and lack of knowledge about leukemia in this region are major problems. Therefore, the incidence rate, mortality rate, and several deaths are increasing day by day. This study is aimed to investigate the incidence and mortality of leukemia in South Asian Countries for the year 2020 by acquiring data from the global cancer project (GLOBOCAN2020). India has the highest number of leukemia cases followed by Pakistan and Bangladesh in 2020. Not only the number of cases but also the mortality rates of leukemia are highest in those countries. In contrast, Sri Lanka and Pakistan have the incidence rate instead. Children aged from 0-14 years old and adults aged from 60-85 years old have the highest rate of incidence. This indicates the chances of having leukemia are more in this age ranges than in any other age range.
Association between Dietary Zinc and Self-Reported Eye Affliction/Retinopathy in Individuals with Diabetes: National Health and Nutrition Examination Survey, 2007–2018
Authors: Xu Han , Dong Xinxin , Wang Jin , Chai Ruiyu , Wang Yingshuang , Yao Yan , Jin Lina
Published: May 2022

Background
Emerging evidence supported that dietary zinc is beneficial for diabetes. However, few studies were available concerning the association between dietary zinc and diabetic retinopathy (DR). The present study aimed to describe the association between dietary zinc intake and the risk of DR in US adults.
Methods
A total of 3749 diabetic patients with self-reported eye affliction/retinopathy from the National Health and Nutrition Examination Survey (NHANES) 2007–2018 were involved. Stratified analysis by gender was performed, and logistic regression and restricted cubic spline (RCS) models were applied to assess the association between dietary zinc and DR. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of zinc intake for predicting DR.
Results
Dietary zinc was inversely associated with diabetic retinoapthy in men (OR: 0.981, 95%CI:0.965–0.997), while this trend was not significant in women. Higher quartile of dietary zinc was associated with lower occurrence of diabetic retinopathy (OR: 0.531, 95%CI: 0.334–0.846). Furthermore, increased amounts of dietary zinc was significantly associated with reduced occurrence of diabetic retinopathy (OR: 0.622, 95%CI: 0.411–0.941). ROC analysis identified a daily dietary zinc intake of 7.53 mg as the optimal cut-off value for predicting DR.
Conclusion
Higher levels of dietary zinc are suggested to reduce the risk of diabetic retinopathy and have been observed to have a dose-response effect in men. Assessment of dietary zinc levels may be part of the treatment of patients with diabetic complications.
Time trends in the incidence of cardiovascular disease, hypertension, and diabetes by socioeconomic status in Catalonia, Spain
Authors: Bennett Matthew , Pistillo Andrea , Recalde Martina , Reyes Carlen , Freisling Heinz , Salles Talita Duarte
Published: May 2022

Background: It is unclear how cardiovascular disease, hypertension, and type 2 diabetes mellitus incidence trends have evolved in different population subgroups by age, sex, and socioeconomic status. Our study aims to estimate the trends in cardiovascular disease, hypertension, and type 2 diabetes mellitus incidence in Catalonia, Spain from 2009-2018, considering age, sex, and socioeconomic deprivation.Methods: Our study is a population-based cohort study using prospectively collected data from electronic health records from primary care and hospital settings in Catalonia, Spain, from 2009-2018. Our final study population included 3,247,244 adults (≥40 years). We calculated the annual incidence (per 1000 persons-year) and incidence rate ratios (IRR) between three time periods of cardiovascular disease, hypertension, and type 2 diabetes mellitus to measure trends and changes in incidence during the study period.Results: In 2016-2018 compared to 2009-2012, cardiovascular disease incidence increased in the 40-54 (e.g., IRR=1.61, 95%CI: 1.52-1.69 in women) and 55-69 (1.35, 1.31-1.40 in women) age groups. There was no change in cardiovascular disease incidence in women aged 70+ years, and a slight decrease in men aged 70+ years (0.93, 0.90-0.95). Hypertension incidence decreased in all age groups for both sexes. Type 2 diabetes mellitus incidence decreased in all age groups for both sexes (e.g., 0.72, 0.70-0.73 in women aged 55-69 years), except for the 40-54 year age group (e.g., 1.09, 1.06-1.13 in women). Incidence trends by deprivation for all three conditions mirrored overall trends, although there were higher incidence levels in the most deprived areas, especially in the 40-54 and 55-69 year groups. These differences have remained constant or narrowed in recent years.Conclusions: Overall cardiovascular disease incidence has increased while hypertension and type 2 diabetes mellitus incidence have decreased in the last years in Catalonia, Spain. Differences in trends by age group and socioeconomic deprivation were found. Calling attention to these differences can serve to inform policies aimed at reducing the burden of these conditions and health inequities.
Factors Associated With Poor Quality of Life of Transgender People
Authors: Coswosck Kaio Henrique Cesconetto , Moreira Juliana Almeida , Navarro Joel Hirtz do Nascimento , Guandalini Valdete Regina , Marques-Rocha Jose Luiz
Published: May 2022

Background: The term transgender (TRANS) may be used for people whose gender identity differs from the one assigned at birth. A large part of this population segment faces social (lack of social support, discrimination, rejection, transphobia) and psychological (anxiety, depression) challenges. These factors, in turn, may negatively impact the quality of life (QoL) of these individuals. The aim of this study is to identify factors that influence the quality of life of transgender people when compared with cisgender people (CIS). Methods: Cross-sectional case-control study with non-probability sample, conducted with transgender and cisgender adults living in a southeastern Brazilian state. The research questionnaire was accessed electronically and comprised sociodemographic, health, and QoL information. QoL was assessed through the Short-Form 6 dimensions (SF-6D) instrument. Multivariate logistic regression was used to verify the participation of the independent variables in QoL. Odds ratio (OR) values and their respective confidence intervals (CI) were estimated. The analyses were carried out in the SPSS® software, version 22.0, with a significance level of 5%. Results: The sample included 65 transgender and 78 cisgender individuals. The cisgender group showed a predominance of people with higher education (p=0.002) and higher income (p=0.000) when compared with the transgender group. Transgender participants had worse QoL score (p=0.014) and the same was observed when QoL was assessed by dimension (p≤0.05). In addition, having an income between 1 to 3 minimum wages (MW) reduced by 94.6% (OR=0.054, CI=0.004 – 0.707, p=0.026) the chances of having better QoL, when compared with those with income higher than 3 MW. Living in the state’s capital reduced the chances of having better QoL by 96.2% (OR=0.038, CI=0.004 - 0.387, p=0.006) when compared with those living in the countryside. Conclusion: The transgender population showed worse QoL when compared with the cisgender population, with income and place of residence being the factors that influenced this indicator.
Effect of Carnitine Supplementation in Pediatric Patients with Left Ventricular Dysfunction
Authors: Ikeda Nobuyuki , Loomba Rohit , Patel Riddhi , Dorsey Vincent , Yousef Faeeq , Nelson-McMillan Kristen
Published: May 2022

Carnitine is an essential amino acid involved in transporting fatty acids across the mitochondrial membrane. Fatty acids are a primary source of energy for the myocardium. Studies in adults demonstrated decreased carnitine levels in the ischemic myocardium, but subsequent exogenous carnitine supplementation showed improvement of myocardial metabolism and left ventricular function. However, only limited data regarding carnitine is available in pediatrics. A single-center retrospective, paired data study was conducted. Patients < 18 years, left ventricular ejection fraction (LVEF) < 55% by echocardiography and had received at least 7 days of oral or intravenous carnitine supplementation between January 2018 and March 2021 are included in the study. Several endpoints and covariates were collected for each patient; before, one week after, one month after, and six months after carnitine supplementation. Univariate analysis consisted of an analysis of variance (ANOVA), followed by an analysis of covariance (ANCOVA) to model LVEF while adjusting for other variables. 44 patients included in the final analyses. LVEF significantly improved from 50.5–56.6% (p < 0.01). When LVEF was adjusted for other interventions (mechanical ventilation, afterload reduction, diuretic therapy, spironolactone), the estimated means demonstrated a significant increase from 45.7–58.0% (p < 0.01). Free carnitine level increased significantly (p = 0.03), and N-terminal-pro-brain-natriuretic peptide (p = 0.03), creatinine (p < 0.01), and lactate (p < 0.01) all significantly decreased over the study period. Carnitine supplementation in pediatric patients with left ventricular systolic dysfunction may be associated with an increase in LVEF and improvement in laboratory markers of myocardial stress and cardiac output.
A retrospective study on the cases with congenital cardiac disease and their risk factors applied to Pediatric Cardiology Clinic
Authors: Şanlı Cihat , Agaoglu Said , Kandur Yaşar
Published: May 2022

Many cases of congenital heart disease are multifactorial and result from a combination of genetic predisposition and an as-yet-to-be-determined environmental stimulus. The purpose of the study is to determine the patients who were diagnosed with CHD through echocardiography and to reveal the risk factors that may cause congenital heart anomalies in our center since 2010. The medical records of pediatric patients applied to our pediatric cardiology clinic between 2010–2017 were retrospectively reviewed. A total of 14,173 patients applied to our clinic between 2010–2017. One hundred and fourteen cases diagnosed with CHD by ECHO performed by a pediatric cardiologist were detected. Sixty (52.6%) of the cases were female and 54 (47.4) were male. Seventy-seven of the 114 patients included in the study were acyanotic (67.5%) and 37 (32.5%) were cyanotic. Seventeen of the aycanotic patients had mixed CHD. The mean maternal gestational age was 28.2+/-5.78 years. 26 (22.8%) were born preterm. Seventeen (14,9%) patients were born with low birth weight (under 2500 g). Eight (7%) patients were LGA (large for gestational age) (birth weight over 4000 g). The average birth weight was 2,982.8+/-740,87 gr. Consanguinity was found in the parents of 28 (24.5%) patients. There was a history of CHD in the relatives of 6 (5.2%) patients, siblings of 4 (3.5%) patients, and parents of 5 (4.3%) patients. Chromosomal abnormalities were found in 9 (7.9%) patients. Our study is a valuable contribution to the existing literature in that it showed that the frequency and distribution of congenital heart diseases have not changed in recent years, and its findings are compatible with the literature findings.
Efficacy of live attenuated vaccines after two doses of intravenous immunoglobulin therapy for Kawasaki disease
Authors: Morikawa Yoshihiko , Sakakibara Hiroshi , Miura Masaru
Published: May 2022

BackgroundIt is unclear when live attenuated vaccines (LAV) should be administered to children with Kawasaki disease (KD) who have received a second dose of intravenous immunoglobulin (IVIG) after failing to respond to the initial treatment. The present study aimed to assess the efficacy of LAV after two IVIG treatments and to explore the appropriate timing of vaccination.MethodsThe present, single-arm, prospective, interventional study included KD patients who had no medical history of measles, rubella, varicella, mumps or vaccinations against these diseases and received two IVIG treatments at age 6 months or older. The subjects received vaccinations against these diseases for the first time at six or nine months after their IVIG treatment. IgG specific to each virus was measured by EIA at three months after the initial vaccination. If the results were negative, the subjects received a booster vaccination at 12 months after IVIG treatment. The primary outcome was the prevalence of positivity for antibodies after the initial and booster vaccinations.ResultsThe present study enrolled 11 children, three of whom were vaccinated at six months and eight at nine months after IVIG treatment. One and two subjects who were vaccinated at six months remained negative for measles and rubella antibodies, respectively, but all those vaccinated at nine months were positive. Booster vaccination for measles and rubella led to seroconversion in all patients. At the time of their initial vaccination, all the subjects were negative for mumps antibodies, and about 30% were positive for varicella. Booster vaccinations for mumps and varicella resulted in seroconversion in 82% of the subjects. ConclusionThese findings suggested that six months may be too short an interval after two IVIG treatment before administering measles and rubella vaccines whereas nine months may be adequate. The mumps and varicella vaccines were ineffective at either time point, but a sero-response was obtainable by administering a booster vaccination.Clinical Trial Registration: UMIN-CTR, UMIN000007174, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000008452
Southern Hemisphere Monsoonal System during Superinterglacial Stages: MIS5e, MIS11c and MIS31
Authors: Gurjão Carlos Diego , Justino Flávio , Pires Gabrielle , Senna Mônica , Lindemann Douglas , Rodrigues Jackson
Published: May 2022

Based on coupled climate experiments conducted with the coupled ICTP-CGCM model focusing on interglacial stages MIS5e (127 ka), MIS11c (409 ka) and MIS31 (1,072 ka), the Austral summer monsoonal system is investigated. The interannual variability and intensity of monsoon events are analysed from vorticity indices and air-sea interaction processes for Africa, Australia and South America monsoons. Results demonstrated with respect to present day conditions, an orbital driven decrease in precipitation in summer, but slightly shift of the onset and demise periods of monsoons. Sensitivity experiments indicate, furthermore, that the monsoons are forced not only by external factors such as the dominant effect of insolation, but also by distant climate anomalies, such as surface temperature of the equatorial Atlantic and Pacific basins. During the interglacial stages, cooling occurs in the Southern Hemisphere whereas Northern Hemisphere substantially warms, inducing remarkable changes in the position of the oceanic subtropical high pressure systems and equatorial convergence zone. Regionally, these mechanisms contribute to periods of drought, with reduced precipitation rate over sectors of the Amazon and Northeastern Brazil, northern Australia and southern Africa. Monsoonal rainfall shows different responses to precessional forcing, as well as the relationship between the monsoon and Niño 3.4 differs among the interglacial stages. Compared to current climate, correlation analyses have demonstrated weaker influence of the equatorial Pacific Ocean on the Austral summer monsoon for the MIS5e, MIS11c and MIS31. Exception is noticed for the South America monsoon, where the Niño 3.4 exerts a more prominent role in these distant intervals, in consonance with the tropical Atlantic in particular during the MIS5e.
Corneal biomechanical properties in vernal keratoconjunctivitis and its subtypes: a preliminary study
Authors: Zhang Xueling , Huang Feifei , Qiu Jini , yang Yujing , Zhang Chaoran
Published: May 2022

Purpose
To explore the corneal biomechanical properties (CBPs) of patients with vernal keratoconjunctivitis (VKC) and the discrepancies among three subtypes of VKC including palpebral, limbal, and mixed forms.
Methods
Forty eyes of 20 VKC patients and twenty eyes of 10 non-VKC patients were included in this case-control study. Patients with VKC were further divided into three subtypes (6 patients in Palpebral form, 5 patients in limbal form, and 9 patients in mixed form). The CBPs of all patients were obtained from the Corneal Visualization Scheimpflug Technology (Corvis ST).
Results
First applanation (A1) length, Ambrosio relational thickness in horizontal (ARTh), and stiffness parameter at first applanation (SP-A1) were significantly lower in the VKC group while A1 velocity was significantly higher in the VKC group (p < 0.05), compared to the non-VKC group. Furthermore, A1 velocity presented a positive correlation with disease course (p < 0.05). In addition, VKC patients of limbal form had lower central corneal thickness (CCT), SP-A1, and higher deformation amplitude ratio (DA ratio), compared to the other two subtypes (p < 0.05). Besides, patients in limbal form had higher A1 velocity, integrated radius, and corneal biomechanical index (CBI) compared with mixed form, and lower A1 length than palpebral form (p < 0.05).
Conclusions
The corneas of VKC patients were softer and more protruded compared with the control group, and the property of steepness was closely related to disease course. VKC patients in limbal form were more inclined to be keratoconus than the other two subtypes due to their CBPs` discrepancies.
Design, Analysis and Evaluation of a Lightweight Symmetric Key Stream Generator for Smart Meter and Autonomous Vehicle Security
Authors: HEDIYAL NAGARAJ , Divakar B P
Published: May 2022

The security of the smart grid and autonomous vehicles is the cause for concern as they function with the aid of heterogeneous networks formed by information & communication technologies. These technologies employ different standards and protocols to operate, resulting in security issues. The issue of security can be mitigated by applying cryptographic solutions. The basic requirements of security solutions must be lightweight in terms of hardware complexity, cost, least computation time, memory, and other resources. This paper proposes a symmetric key stream generator that satisfies the requirements of being a lightweight solution. An experimental setup developed around a popular Arduino nano-platform was used to implement the proposed symmetric key generator. Also, a statistical test suite was developed to conduct statistical tests on the output bit stream of the proposed symmetric key generator. The proposed symmetric key generator and its output bit stream were subjected to mathematical, experimental, statistical, security, and comparative analysis to validate its suitability for smart grid and autonomous vehicle security. The results have proved that the proposed symmetric-key generator is indeed suitable for smart grid and autonomous vehicle security.
Habitat suitability and distribution of endangered Ethiopian wolf (Canis simensis Ruppell 1840) and the potential effects of climate change on its habitat in the Ethiopian highlands
Authors: Ahmed Ahmed Seid , Kufa Chala Adugna , Atickem Anagaw , Yihune Mesele , Bekele Afework
Published: May 2022

An endangered Ethiopian wolf has been declining because of climate change coupled with various anthropogenic disturbances, resulted in restricted geographic distribution. Knowledge of the effects of these stressors on animal distribution is vital to promoting conservation campaigns and implementing effective management strategies. We used the MaxEnt algorithm to model habitat suitability of the Ethiopian wolf and project the potential effects of future climate changes on the predicted habitat distribution. We used to project changes in habitat distribution of a taxon under three shared socio-economic pathways (low (ssp126), intermediate (ssp245), and worst (ssp585)) future climate change scenarios. Our findings revealed the maximum temperature of the warmest month and ecoregion had the highest percent contributions, 65.4 and 16.1, respectively. The predicted potential suitable habitat under the current conditions was lower 2.45% (2779658 ha) compared to the total area of Ethiopia. The projected suitable areas of C. simensis under future climate change showed that an increase, range shifts, fragmentation, and small in availability were observed. To resolve these issues, habitat restoration, reduction of anthropogenic pressures, and climate change mitigation should be emphasized to improve the conservation of endemic species, including C. simensis. To further understand the possible implications of biotic variables on Ethiopian wolf habitat suitability and distribution, more research on the ecological niches of a taxon connected with its prey species overlap is needed.