bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex-specific impact of patterns of imageable tumor growth on survival of primary glioblastoma patients
Authors: Whitmire Paula , Rickertsen Cassandra R , Hawkins-Daarud Andrea , Carrasco Eduardo , Lorence Julia , De Leon Gustavo , Curtin Lee , Bayless Spencer , Clark-Swanson Kamala , Peeri Noah , Corpuz Christina , Angeles Christine Paula Lewis-de los , Bendok Bernard , Gonzalez-Cuyar Luis , Vora Sujay , Mrugala Maciej M , Hu Leland , Wang Lei , Porter Alyx , Kumthekar Priya , Johnston Sandra , Egan Kathleen , Gatenby Robert , Canoll Peter , Rubin Joshua , Swanson Kristin
Published: October 2019

Background : Sex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences.
Methods : Combining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients (299 males and 195 females).
Results : Among males, tumor (T1Gd) radius was a predictor of overall survival (HR=1.027, p=0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR=1.011, p<0.001). Female extreme survivors had significantly smaller tumors (T1Gd) (p=0.010 t-test), but tumor size was not correlated with female overall survival (p=0.955 CPH). Both male and female extreme survivors had significantly lower tumor cell net proliferation rates than other patients (M p=0.004, F p=0.001, t-test). Additionally, extent of resection, tumor laterality, and IDH1 mutation status were also found to have sex-specific effects on overall survival.
Conclusion : Despite similar distributions of the MR imaging parameters between males and females, there was a sex-specific difference in how these parameters related to outcomes.
Development, Validation and Translation of Cardiopulmonary Resuscitation and Automated External Defibrillator Training and Placement Bilingual Questionnaire
Authors: Chew Keng Sheng , Liaw Siew Yee , Zahedi Ahmad Zulkarnain Ahmad , Wong Shirly Siew Ling , Singmamae Nariman , Kaushal Dev Nath , Chan Hiang Chuan
Published: October 2019

Objectives:
This paper describes the development and translation of a questionnaire purported to measure (1) the perception of the placement strategy of automated external defibrillator, (2) the perception on the importance of bystander cardiopulmonary resuscitation and automated external defibrillator (3) the perception on the confidence and willingness to apply these two lifesaving interventions as well as (4) the fears and concerns in applying these two interventions. For construct validation, exploratory factor analysis was performed using principal axis factoring and promax oblique rotation and confirmatory factor analysis performed using partial least square.
Results
Five factors with eigenvalue >1 were identified. Pattern matrix analysis showed that all items were loaded into the factors with factor loading >0.4. One item was subsequently removed as Cronbach’s alpha >0.9 which indicates redundancy. Confirmatory factor analysis demonstrated acceptable factor loadings except for one item which was subsequently removed. Internal consistency and discriminant validity was deemed acceptable with no significant cross-loading.
Maternal and partner’s level of satisfaction on the delivery room service in University of Gondar Referral Hospital, Northwest, Ethiopia: A comparative cross-sectional study.
Authors: Taddese Asefa Adimasu , Gashaye Kiros Terefe , Dagne Henok , Andualem Zewudu
Published: October 2019

Abstract

Background: Asking patients/clients what they perceive about the care and treatment they have received is one of the important steps towards improving the quality of health care. However, little is known about the birth experiences of partners in Ethiopia, particularly in the study area. Therefore, this study was conducted to evaluate and compare the birth satisfaction of mothers and partners and its determinant factors in the study area.

Methods: A comparative cross-sectional study was conducted from Dec 2018 to January 2019 in University of Gondar referral hospital. The birth satisfaction scale is used for the mother, and it was adapted to the partners’ perspective. Paired-samples t tests were used for comparing mothers and partners for the birth satisfaction scales global and thematic scores. A binary logistic regression model was fitted to identify predicting factors for mothers’ and partners satisfaction.

Results: The overall satisfaction of mothers in this study was 47.6 % whereas 41.2% of partners were satisfied by delivery room services. There were mean difference between mothers and partners’ birth satisfaction scale (p=0.02). Maternal satisfaction scale was affected by age [OR = 0.36, 95%CI (0.18, 0.73 )], perception [OR =0.02, 95%CI (0.00,0.09)], waiting time [OR = 0.11 , 95%CI (0.00, 0.09)],visiting mode [OR = 0.01 , 95%CI (0.00,0.08)], pregnancy status [OR = 0.04, 95%CI (0.01 ,0.33)] and fatal outcome [OR=0.00, 95%CI (0.00,0.018)] .whereas, partners satisfaction was associated with age [OR=0.16,95%CI (0.05 0.49)], occupational status [OR = 0.02, 95%CI (0.00, 0.24), amount of money to pay for service [OR = 2.87, 95%CI (1.07, 7.71), visiting mode of his wife [OR = 0.08, 95%CI (0.01, 0.35)], waiting time [OR = 0.12, 95%CI (0.04, 0.33)], privacy [OR = 10.61, 95%CI (3.00, 37.52)], mode of delivery of his wife [OR = 7.69, 95%CI (3.00, 19.69)].

Conclusion : This study indicated that overall level of satisfaction of mothers and their partners is very low compared to other similar hospitals in the country and mothers were more satisfied than partners’ by delivery room service.
Paving the way for more precise diagnosis of EcPV2-associated equine penile lesions
Authors: Ramsauer Anna Sophie , Wachoski-Dark Garrett Louis , Fraefel Cornel , Tobler Kurt , Brandt Sabine , Knight Cameron Greig , Favrot Claude , Grest Paula
Published: October 2019

Background
There is growing evidence that equine papillomavirus type 2 (EcPV2) infection is causally associated with the development of equine genital squamous cell carcinomas (SCCs). Early stages of disease present clinically as plaques or wart-like lesions which can gradually progress to tumoural lesions. Histologically these lesions are inconsistently described as benign hyperplasia, papilloma, penile intraepithelial neoplasia (PIN), carcinoma in situ (CIS) or SCC. Guidelines for histological classification of early SCC precursor lesions are not precisely defined, leading to potential misdiagnosis. The aim of this study was to identify histologic criteria and diagnostic markers allowing for a more accurate diagnosis of EcPV2-associated equine penile lesions.
Results
A total of 61 archived equine penile lesions were histologically re-assessed and classified as benign hyperplasia, papilloma, CIS or SCC. From these, 19 representative lesions and adjacent normal skin were comparatively analysed for the presence of EcPV2 DNA and transcripts using PCR and RNA in situ hybridisation (RISH). All lesional samples were positive by EcPV2 PCR and RISH, while adjacent normal skin was negative. RISH analysis yielded signal distribution patterns that allowed distinction of early (hyperplasia, papilloma) from late stage lesions (CIS, SCC). Subsequently, the 19 lesions were further assessed for expression of p53, Ki67, MCM7 and MMP1 by immunohistochemistry (IHC). All four proteins were expressed in both normal and lesional tissue. However, p53 expression was up-regulated in basal keratinocyte layers of papillomas, CIS and SCCs, as well as in upper keratinocyte layers of CIS and SCCs. MCM7 expression was only up-regulated in upper proliferating keratinocyte layers of papillomas, CIS and SCCs.
Conclusion
This study proposes combining a refined histological protocol for analysis of equine penile lesions with PCR- and/or RISH based EcPV2-screening and p53/MCM7 IHC to more accurately determine the type of lesion. This may help to guide the choice of optimum treatment strategy, especially at early stages of disease.
Body mass index and lifetime healthcare utilization
Authors: Edwards Christina Hansen , Aas Eline , Kinge Jonas Minet
Published: October 2019

Background: Overweight and obesity is a major global public health challenge, and understanding the implications for healthcare systems is essential for policy planning. Past studies have typically found positive associations between obesity and healthcare utilization, but these studies have not taken into consideration that obesity is also associated with early mortality. We examined associations between body mass index (BMI, reported as kg/m2) and healthcare utilization with and without taking BMI-specific survival into consideration. Methods: We used nationally representative data on 33 882 adults collected between 2002 and 2015. We computed BMI- and age-specific primary and secondary care utilization and multiplied the estimated values with gender-, age-, and BMI-specific probabilities of surviving to each age. Then, we summed the average BMI-specific utilization between 18 and 85 years. Results: During a survival-adjusted lifetime, males with normal weight (BMI: 18.5–24.9) had, on average, 167 primary care, and 77 secondary care contacts. In comparison, males with overweight (BMI: 25.0–29.9), category I obesity (BMI: 30.0–34.9), and category II/III obesity (BMI ≥35.0) had 11%, 41%, and 102% more primary care, and 14%, 29%, and 78% more secondary care contacts, respectively. Females with normal weight had, on average, 210 primary care contacts and 91 secondary care contacts. Females with overweight, category I obesity, and category II/III obesity had 20%, 34%, and 81% more primary care contacts, and 26%, 16%, and 16% more secondary care contacts, respectively. Conclusion: The positive association between BMI and healthcare utilization was reduced, but not offset, when BMI-specific survival was taken into consideration. Our findings underpin previous research and suggest that interventions to offset the increasing prevalence of overweight, and especially obesity, are warranted.
Whole genome analysis of Black Bengal goat from Savar Goat Farm, Bangladesh
Authors: Chowdhury Ziqrul Haq , Hussain Nazmul , Hasan Saam , Kabir Ajran , Mahmud Muket , Robbani Mahdi , Tabassum Tahmina , Afroze Tamanna , Rahman Aura , Islam Rafiqul , Hossain Maqsud
Published: October 2019

Objectives:
Single Nucleotide Polymorphisms (SNPs) play critical roles in genetic diversity and disease. Many traits and diseases are linked with exonic SNPs that are significant for gene function, regulation or translation. This study focuses on SNPs that potentially act as the genetic basis for desirable traits in the Black Bengal Goat. This variety of goat is native to South Asia, and is identified as one of the most commercially important meat producing animals in the world. The aim of this study was to sequence the genome of Black Bengal Goats and identify SNPs that might play a significant role in determining meat quality in the organism. The study focuses on exonic SNPs for their greater likelihood of affecting the final translated protein product.
Results:
Approximately 76,000 exonic variants were identified in the study. After filtration using a Wilcoxon test based score, the number came down to 49, 965 which were found to be distributed in 11,568 genes. The functional pathways affected by these variations included fatty acid metabolism and degradation, which are important processes that influence meat quality.
The effects of aerobic exercises on high sensitivity C-reactive protein and depression in patients living with HIV infection; a systematic review with meta-analysis
Authors: Anieto Ebuka Miracle , Uduonu Ekezie Mmanwanne , Ezeukwu Obinna Antoninus , Abaraogu Ukachukwu Okoroafor , Nwadilibe Ijeoma Blessing , Adu Omotoyosi Johnson , Kalu Michael Ebe
Published: October 2019

Background

HIV infection and chronic use of highly active antiretroviral therapy have been associated with increased expression of pro-inflammatory biomarkers (e.g. high-sensitivity C-reactive protein) and major affective disorders (e.g. depression). There is a growing research interest in aerobic exercise as an adjunct therapy on inflammatory outcomes and depression in people living with HIV (PLHIV) who are undergoing antiretroviral therapy. Synthesizing and appraising available evidence may be essential to guide practice and future research on exercise intervention to this population. This review evaluated the effects of aerobic exercises on serum levels of high-sensitivity C-reactive protein (hs-CRP) and depressive symptoms in PLHIV.

Methods

Cochrane Central Register of Controlled Trials, MEDLINE, PEDRO, EMBASE, AMED, CINAHL, and Web of Science were systematically searched to include clinical trials that investigated the effects of aerobic exercises on hs-CRP and/or depression in PLWH. Two reviewers independently screened all the articles for eligibility and also evaluated the risk of bias using the Cochrane Collaboration risk of bias assessment tool. Data were extracted and meta-analyses conducted using Review Manager Software.

Results

Six studies (261 participants) met the inclusion criteria and were included in the review. Four of the studies reported on depressive symptoms and two on hs-CRP outcome The meta-analysis result showed a significant (Z=3.78, p<0.0002) decrease in depression scores in PLWH; implying that aerobic exercise interventions reduce depressive symptoms among PLWH. The two studies that reported on hs-CRP outcome, found no significant effect of aerobic exercise on hs-CRP. Overall, the GRADE evidence for this review was of moderate quality.

Conclusion

There was evidence that aerobic exercises of about 24-60 minutes duration, two to five times per week can lead to a significant improvement in depression level but not hs-CRP in PLWH. However, it should not be concluded as ‘no evidence of effect’ because the included trials do not have sufficient power to detect treatment effects. Thus, further homogenous research with enough “power” is necessary for a conclusive estimate of effects.
Correlation Between Ischaemia Modified Albumin Level And Coronary Collateral Circulation
Authors: Chen Xin , Lin Yan , Tian Lihua , Wang Zhiquan
Published: October 2019

Abstract
Objective: To investigate the correlation between ischaemia modified albumin(IMA) level and coronary collateral circulation(CCC) in patients with chronic total occlusive disease(CTO).Methods: Coronary angiography was performed in the Department of Cardiology, Zhongnan Hospital of Wuhan University from 2017-08 to 2019-02 to determine 128 patients with CTO lesions in at least one major coronary artery.According to the Rentrop evaluation criteria,the degree of CCC formation was divided into CCC poor formation group (Rentrop0-1grade,n=69)and CCC formation good group(Rentrop2-3grade,n=59).The IMA level of the patients was measured using an albumin-cobalt binding assay.Record and analyze the patient's general data, blood routine,total bilirubin(TBIL),blood lipids,uric acid (UA),left ventricular ejection fraction(LVEF) and other indicators,while recording the patient's occlusion of blood vessels.Results: The proportion of platelet count and diabetes in the poor CCC group was higher than that in the good group (P<0.05).The ratio of ischemic modified albumin and total bilirubin in the poor CCC group was lower than that in the good group (P<0.05).Multivariate logistic regression analysis showed that ischemic modified albumin was positively correlated with CCC formation[OR=1.190,95%CI(1.092-1.297),P<0.001],diabetes was negatively correlated with CCC formation[OR=0.285,95%CI(0.094-0.864),P<0.05].Ischemic modified albumin predicts good formation of CCC under the ROC curve and the area under the ROC curve is 0.769(95%CI:0.686-0.851，P＜0.001);the optimal cut-off value was 63.35KU/L,the sensitivity is 71.2%,specificity is 71%.Conclusion: The IMA level is closely related to the good formation of CCC.The higher IMA level can be used as an effective predictor of the good CCC formation in CTO.
Comparative Analysis of the Effects of Propofol and Sevoflurane on Postoperative Cognitive Function in Elderly Patients with Lung Cancer
Authors: Sun Haitao , Zhang Guohua , Ai Bolun , Zhang Huimin , kong xiangyi , Lee Wan-Ting , Yan Tao , Zheng Hui , Sun Li
Published: October 2019

Background The potential risk for cognitive impairment following surgery and anesthesia is a common concern, especially in the elderly and more fragile patient. The risk for various neurocognitive effects is thus an area of importance. The independent impact of surgery and anesthesia is still not known. Likewise, the independent effect of different drugs used during anesthesia is a matter of debate as is the number and amounts of drugs used and the "depth of anesthesia". So, understanding the drug-related phenomenon and mechanisms for postoperative cognitive impairment is essential. This meta-analysis aims to compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function in elderly patients with lung cancer.
Methods This study is a meta-analysis for controlled-clinical-studies. Public-available online databases were searched to identify eligible randomized placebo-controlled trials or prospective cohort studies concerning the effects of propofol and sevoflurane on postoperative cognitive function. The primary endpoints are postoperative mini-mental state examination (MMSE) scores at various time points; the secondary endpoint is the serum S100beta concentration 24 hours after surgery. Standard mean differences (SMDs) along with 95% confidence intervals (CIs) were extracted and analyzed using random or fixed effects models. Analyses regarding heterogeneity, risk of bias assessment, and sensitivity were performed.
Results We searched 1626 eligible publications and 14 studies of 1404 patients were included in the final analysis. The majority of included studies had been undertaken in Asian populations. Results suggested that propofol has a greater adverse effect on cognitive function in the elderly patients with lung cancer than sevoflurane. There were significant differences in issues of MMSE 6h (11 studies; SMD -1.391, 95% CI -2.024, -0.757; p < 0.001), MMSE 24h (14 studies; SMD -1.106, 95% CI -1.588, -0.624; p < 0.001), MMSE 3d (11 studies; SMD -1.065, 95% CI -1.564, -0.566; p < 0.001), MMSE 7d (10 studies; SMD -0.422, 95% CI -0.549, -0.295; p < 0.001), and serum S100beta concentration at 1 day after surgery (13 studies; SMD 0.746, 95% CI 0.475, 1.017; p < 0.001).
Conclusion Propofol has a more significant adverse effect on postoperative cognitive function in elderly patients with lung cancer than sevoflurane.
Association between anemia and frailty in 13,175 community-dwelling adults aged 50 years and older in China
Authors: Ruan Ye , Guo Yanfei , Kowal Paul , Lu Ye , Liu Chazhen , Sun Shuangyuan , Huang Zhezhou , Zheng Yang , Wang Wenjing , Li Gan , Shi Yan , Wu Fan
Published: October 2019

Background: Anemia and frailty contribute to poor health outcomes in older adults; however, most current research in lower income countries has concentrated on anemia or frailty alone rather than in combination. The aim of the present study was to investigate the association between anemia and frailty in community-dwelling adults aged 50 years and older in China.
Methods: The study population was sourced from the 2007/10 SAGE China Wave 1. Anemia was defined as hemoglobin less than 13g/dL for men and less than 12g/dL for women. A frailty index (FI) was compiled to assess frailty. The association between anemia and frailty was evaluated using a 2-level hierarchical logistic model.
Results: The prevalence of anemia was 31.0% (95%CI: 28.4%, 33.8%) and frailty 14.7% (95%CI: 13.5%, 16.0%). In the univariate regression model, presence of anemia was significantly associated with frailty (OR=1.62, 95% CI: 1.39, 1.90) and the effect remained consistent after adjusting for various potential confounding factors including age, gender, residence, education, household wealth, fruit and vegetable intake, tobacco use, alcohol comsumption and physical activity (adjusted OR =1.31, 95% CI:1.09, 1.57). In the linear model, each 1 g/dL increase in hemoglobin concentration was associated with 4% decrease in the odds of frailty after adjusting for several confounding variables (adjusted OR =0.96, 95% CI: 0.93, 0.99).
Conclusion: Anemia and low hemoglobin concentrations were significantly associated with frailty. Therefore, health care professionals caring for older adults should increase screening, assessment of causes and treatment of anemia as one method of avoiding, delaying or even reversing frailty.
The impact of an orthogeriatric intervention in patients with fragility fractures: A cohort study
Authors: Abrahamsen Charlotte , Nørgaard Birgitte , Draborg Eva , Nielsen Morten Frost
Published: October 2019

Background:
While orthogeriatric care to patients with hip fractures is established, the impact of similar intervention in patients with fragility fractures in general is lacking. Therefore, we aimed to assess the impact of an orthogeriatric intervention on postoperative complications and readmissions among patients admitted due to and surgically treated for fragility fractures.
Methods:
A prospective observational cohort study with a retrospective control was designed. A new orthogeriatric unit for acute patients of sixty-five years or older with fragility fractures in terms of hip, vertebral or appendicular fractures was opened on March 1, 2014. Patients were excluded if the fracture was cancer-related or caused by high-energy trauma, if the patient was operated on at another hospital, treated conservatively with no operation, or had been readmitted within the last month due to fracture-related complications.
Results:
We included 591 patients; 170 in the historical cohort and 421 in the orthogeriatric cohort. No significant differences were found between the two cohorts with regard to the proportion of participants experiencing complications (24.5% versus 28.3%, p = 0.36) or readmission within 30 days after discharge (14.1% vs 12.1%, p = 0.5). With both cohorts collapsed and adjusting for age, gender and CCI, the odds of having postoperative complications as a hip fracture patient was 4.45, compared to patients with an appendicular fracture (p < 0.001). Furthermore, patients with complications during admission were at a higher risk of readmission within 30 days than were patients without complications (22.3% vs 9.5%; p < 0.001).
Conclusions:
In older patients admitted with fragility fractures, our model of orthogeriatric care showed no significant differences regarding postoperative complications or readmissions compared to the traditional care. However, we found significantly higher odds of having postoperative complications among patients admitted with a hip fracture compared to other fragility fractures. Additionally, our study reveals an increased risk of being readmitted within 30 days for patients with postoperative complications.
Knowledge, Attitude and Practices toward Chronic Kidney Disease among care providers in Jimma Town: Cross-sectional study
Authors: Wolide Amare Desalegn , Goro Kabaye Kumele , Dibaba Fantu Kerga , Debalke Serkadis , Seboka Meskerem , Tufa Birtukan Edilu , Fufa Fanta Gashe , Bobasa Eshetu Mulisa
Published: October 2019

Introduction: Chronic kidney disease (CKD) is a common and growing health problem that requires adequate knowledge by health care providers to reduce the progress of the diseases. Thus, this study is aimed to assess the care provider’s knowledge, attitude, and practices toward CKD.Method: Cross-sectional study was conducted among 326 care providers at Jimma University Specialized hospital and three medium to higher clinics found in Jimma Town. Collected data entered to Epi-Data version 3.1 and exported to SPSS version 21 for windows for data analysis. Descriptive statistics and generalized linear modal were used to analyze the data.Result: The mean age and service year of the participants were 29.68(±4.877) and 4.28(±4.561), respectively. The overall weighted knowledge, attitude and practice score of the study participant was 9.0971(8.77, 9.42), 2.53(2.4,2.65), 10.14(9.94,10.33) respectively. Over half of the care providers had the awareness to use eGFR to assess kidney function and patient referral to nephrologist respectively. Also, many care providers knew the five-stage of CKD and the risk factors of CKD such as diabetes, long term alcohol consumption, and anemia and cardiovascular disorders respectively. Care providers had an understanding of late detection and referral of CKD would increase kidney disease complication. Besides, 275(84.4 %) of them are worried about treatment cost related to CKD. Over half of the care providers, 238(73.0%) believed that the Ethiopian ministry of health gave less attention to the problem. Furthermore, 234(71.8%) are interested to study more on CKD management. Majority 256(78.5%), very likely or likely refer patient to senior physician and Nephrologist.Conclusion: Care provides knowledge was found to be above moderate level and many had the knowledge on the basic function of the kidney, risk factors, treatment, and management of CKD. Many are worried about treatment cost and interested to learn about CKD primary from textbook and internet. The majority had a practice of referring patients to nephrologists or a senior physician. Many care providers had a frequent discussion on the prevention strategies of CKD.
The relationship of depression and anxiety among diabetic patients with changes in the components of lipid profile
Authors: Abdelfattah Diaa , Alduraywish Abdulrahman
Published: October 2019

Introduction our study aimed to investigate the presence of depression and anxiety symptoms in diabetic patients and their association with various components of lipid profile.Methods 428 patients with diabetes mellitus joined our study. Their de- mographic and lipid profile measurements were collected. The screening questionnaire HADS was used to evaluate level of depression and anxiety. An age matched control group consisting of 50 individuals were taken and their lipid profiles and depression and anxiety levels were determined.Results it was found that 22.4% of the sample showed marked depressive symptoms and 28.5% showed marked anxiety symptoms. We found that: depression was associated strongly but not significantly (P=0.057) with lower high density lipoproteins, and associated significantly (P=0.036) with lower total cholesterol level. In addition, anxiety was associated significantly (0.000) with lower high density lipoproteins and was associated significantly (P=0.004) with higher triglycerides level. There was insignificant association between all components of lipid profile and either depression or anxiety levels in the control group.Conclusion Depressive and anxiety symptoms were common among diabetic patients. Depression was related to lower high density lipoproteins, and to lower total cholesterol level. Anxiety was strongly related to lower high density lipoproteins and to higher triglycerides level. This relationship was specific to patients with diabetes mellitus in our study .
Effects of weight- and age-related syndesmophytes on patients with ankylosing spondylitis.
Authors: Dong Chen , Wang Jing , Zhao Rui , Ji Juan , Chen Yuanyuan , Fu Ting , Gu Zhifeng
Published: October 2019

Objective: To determine contributors of syndesmophytes and evaluate their effects on various aspects of quality of life among patients with ankylosing spondylitis (AS). Methods: we conducted a cross-sectional study and 85 AS patients received the X-ray examination and completed the questionnaire including demographic variables, clinical variables, psychological variables and quality of life. Results: There were 44(51.8%) with syndesmophytes among AS patients. Age, gender, body mass index (BMI), waist hip ratio (WHR), education level, disease duration and the level of ESR were different between AS patients with or without syndesmophytes. AS patients with syndesmophytes have more problems in functional status, spinal mobility, night or global pain, disability and health related quality of life. Conclusions: Syndesmophytes had negative effects on AS patients in the field of functional status, spinal mobility, pain, disability and quality of life. In addition, aging, gender, WHR was the key predictor of syndesmophytes formation.
Large Difference between Proximal Junctional Angle and Rod Contouring Angle is a Risk Factor for Proximal Junctional Kyphosis
Authors: Wang Jie , Yang Ningning , Luo Ming , Li Ning , Fan Yonggang , Xia Lei
Published: October 2019

Background: There are several risk factors for proximal junctional kyphosis (PJK) in adolescent idiopathic scoliosis (AIS) surgery. Decreased rod contouring angle (RCA) has been proposed as a risk factor for PJK, but the role of difference between proximal junctional angle (PJA) and RCA (PJA-RCA) has not been fully investigated. The aim of this study was to assess the role of PJA-RCA for the development of postoperative PJK in AIS. Methods: We performed a retrospective analysis of 96 AIS patients who underwent posterior segmental spinal instrumentation and fusion between the years 2012 and 2018 (minimum 1.5-year and average 2-year follow-up) at a single institution. Each patient was measured on preoperative, postoperative and final follow-up long-cassette standing radiographs. The PJA-RCA was regarded as a new definition that reflects the match degree between proximal rod contouring and vertebra curvature, and radiographic parameters were compared between PJK and non-PJK group. Results : Among the 96 patients with a mean age of 14.00 years (± 0.82), the overall incidence of PJK was 22%. PJK group showed a significantly greater preoperative SVA (P = 0.032) and larger correction of SVA (P = 0.007) than non-PJK group. At the last follow-up, PJK patients had significantly greater LL (P = 0.046). Patients in the PJK group had significantly greater preoperative PJA-RCA than the non-PJK group (4.07±3.30 vs. 1.42±4.28, P = 0.024). However, RCA was not significantly different between two groups (3.88 ± 4.34 vs. 2.86 ± 3.36, P = 0.405). In addition, Pearson correlation coefficient showed a significant correlation between the change of SVA and the last follow-up PJA (r = -0.208, P = 0.042). Preoperative PJA-RCA and postoperative PJA-RCA demonstrated similar results which showed a strong correlation with the last follow-up PJA (r = 0.528 and r = 0.532 respectively, P < 0.000). Conclusions: As a new reflex of improper rod contouring, large PJA-RCA is a risk factor for PJK in AIS, and PJK might be a compensation mechanism rather than complication when spine is shifted and overcorrected. Keywords: adolescent idiopathic scoliosis, proximal junctional kyphosis, proximal junctional angle, rod contouring angle.
Impact of First Metatarsal Shortening on Forefoot Loading Pattern: A Finite Element Model Study
Authors: Xiang Geng , Jiaqi Shi , Wenming Chen , Ma Xin , Xu Wang , Chao Zhang , Li Chen
Published: October 2019

Backgrounds Shortening of the first metatarsal is common following hallux valgus correction procedure. However, it remains controversial whether post-operative complications such as transfer metatarsalgia can be simply attributed to excessive shortening of first metatarsal. This study investigated the relationship between first metatarsal shortening and forefoot loading pattern: The goal was to determine whether and to what extent the first metatarsal might be shortened effectively reducing the risks of complications.Methods A finite element model of the human foot simulating the push-off phase of the gait was established and validated by subject-specific plantar pressure data. Various levels of first metatarsal osteotomy were sequentially applied to the model, and model predictions in terms of pressure and force distributions under each foot rays are obtained.Results Results show that the plantar pressure of the first ray decreased with increasing shortening level; the pressure of the lateral rays continued to rise. However, when the shortening reaches 6 mm, the load ratio of the middle rays exceeds a critical threshold of 55%—this was considered risky. Under such circumstances, the loading ratio at the central rays could still be manipulated to normal if the distal end of the first metatarsal could be displaced in the dorsal-to-plantar direction by 3 mm.Conclusions During the first metatarsal osteotomy, a maximum of 6 mm of shortening length is considered to be within the safe range. Whenever a higher level of shortening is necessary, pushing down the distal metatarsal segment could be a compensatory procedure to maintain normal plantar force distributions.
Undiagnosed Hypertension and Associated Factors among Adult Dwellers in Hawela Tula Sub City, Hawassa, Southern Ethiopia: A Community Based Cross-sectional Study
Authors: Wachamo Demelash , Markos Endrias , Geleta Dereje
Published: October 2019

Introduction Hypertension is a common public health problem and often goes unnoticed and can lead to a stroke or heart attack. It contributes to the high burden of cardiovascular disease, premature mortality, reduced quality of life and high costs to the health care system, especially in low and middle-income countries. Therefore, this study aimed to assess the prevalence of undiagnosed hypertension and influencing factors with health-seeking behaviour.Method A community-based cross-sectional study was conducted on 390 randomly selected adults in Hawela Tulla Sub-city, Hawassa, southern Ethiopia from February to June, 2019. Data was collected by pre-tested questionnaires and physical measurements of weight, height and blood pressure were collected through standardized procedures adapted from WHO STEPS survey tools. Data entry and analyzed for descriptive and logistic regression models by SPSS v.23. The result declared as statistically significant at p < 0.05.Result The prevalence of the undiagnosed hypertension among the respondents was 12.3%. The male [AOR= 3.70, 95% CI:1.64-8.32] than female contributing. Family history of hypertension had [AOR 3.69, 95% CI: 1.31-10.34], being physical inactive [AOR 3.21, 95% CI: 1.50- 6.84], salty food consumer [AOR 3.67, 95% CI:1.26-10.64], BMI 25 Kg/m2 and above [AOR 3.06, 95% CI:1.41-6.65] and not seek health care for some early hypertensive symptoms without serious illness [AOR 4.58, 95% CI: 1.85-11.32] when compared to their counterparts, were found to be determinant factors for undiagnosed hypertension.Conclusions and Recommendation The prevalence of undiagnosed hypertension found to be prevalent and calls for intervention. Health officials need to consider integrating the prevention and control of hypertension at the community level. The clinicians need to intervene on unhealthy lifestyles, by promoting healthy practices and health-seeking behavior to prevent undiagnosed hypertension.
Is Opium Use Associated with an Increased Risk of Lung Cancer? A Case-Control Study
Authors: Tahami Ahmad Naghibzadeh , Marzban Maryam , Feyzabadi Vahid Yazdi , Dabiri Shahryar , Mohseni Shokrollah , Rayeni Reza Abbasi , Fekri Mitra Samareh , Larizadeh Mohammad Hasan , karimpoor Behnaz , Khanjani Narges
Published: October 2019

Background: In recent years, lung cancer (LC) incidence has increased in Iran. The use of opium and its derivatives (O&D) has increased as well. The aim of this study was to investigate the association between the use of O&D and LC incidence.
Methods: In this case-control study conducted in Kerman, Iran; 140 patients with lung cancer and 284 healthy controls matched by age, sex, and place of residence were included. Data including O&D use, cigarette smoking, alcohol use, and diet were collected using a structured questionnaire. The relation between the use of O&D and LC was evaluated using conditional logistic regression test.
Results: The use of opium was associated with an increased risk of LC (Adjusted Odds Ratio (AOR) = 7.95, 95% CI: 3.78 -16.73). A significant dose-response relation between the use of opium and its derivatives was observed (low use AOR = 7.47, 95% CI: 2.33-23.98 and high use AOR = 11.57, 95% CI: 2.25-59.49). Also, there was a relation between starting to use O&D at lower ages and an increased risk of LC (AOR = 5.78, 95 % CI: 2.36 - 14.14).
Conclusion: The results of this study support that opium use could be considered as a strong risk factor for LC. Thus, it is highly suggested that tailored policies to be applied in order to reduce use of opium.
Outcomes of Patients with Initially Locally Advanced Pancreatic Adenocarcinoma who did not Benefit from Resection: A Prospective Cohort Study
Authors: Garnier Jonathan , Ewald Jacques , Marchese Ugo , Gilabert Marine , Launay Simon , Moureau-Zabotto Laurence , Poizat Flora , Giovannini Marc , Delpero Jean-Robert , Turrini Olivier
Published: October 2019

Background: There is no consensus about the optimal treatment for patients with unresectable non-metastatic locally advanced pancreatic adenocarcinoma (LAPA) after induction chemotherapy. Accordingly, the current study aimed to evaluate the outcomes of patients with LAPA who did not benefit from resection considering the treatment strategy.

Methods: Between 2010 and 2017, 234 patients underwent induction chemotherapy for non-metastatic LAPA that could not be treated with surgery. After oncologic restaging, continuous chemotherapy or chemoradiation (CRT) was decided for patients without metastatic disease. The Kaplan-Meier method was used to determine overall survival (OS), and the Wilcoxon test to compare survival curves. Multivariate analysis was performed using the stepwise logistic regression method.

Results: FOLFIRINOX was the most common induction regimen (168 patients, 72%), with a median of 6 chemotherapy cycles and resulted in higher OS, compared to gemcitabine (19 vs. 16 months, P =.03); however, no difference was observed after adjusting for age (≤75 years) and performance status score (0–1). At restaging, 187 patients (80%) had non-metastatic disease: CRT was administered to 126 patients (67%) while chemotherapy was continued in 61 (33%). Patients who received CRT had comparable characteristics to those who continued with chemotherapy, with similar OS; they also had longer recurrence-free survival (median 13.3 vs. 9.6 months, P <.01) and contrastingly, more frequently metastatic disease (hazard ratio=2.9, P <.01).

Conclusions: The median survival of patients who could not undergo surgery was 19 months. Hence, CRT should not be eliminated as a treatment option and may be useful as a part of optimized sequential chemotherapy to treat both local and metastatic disease.
Nomogram Model for Predicting Cause-Specific Mortality in Patients with Stage I Small-Cell Lung Cancer: A Competing Risk Analysis
Authors: Li Jianjie , Zheng Qiwen , Zhao Xinghui , Zhao Jun , An Tongtong , Wu Meina , Wang Yuyan , Zhuo Minglei , Zhong Jia , Yang Xue , Jia Bo , Chen Hanxiao , Dong Zhi , Wang Jingjing , Zhai Xiaoyu , Chi Yujia , wang ziping
Published: October 2019

Background: The five-year cumulative incidence rate in patients diagnosed with stage I small-cell lung cancer (SCLC) who were instructed to undergo surgery was from 40% to 60%.The death competition influence the accuracy of the classical survival analyses.The aim of the study is to investigate the mortality of stage I small-cell lung cancer (SCLC) patients in the presence of competing risks according to a proportional hazards model, and to establish a competing risk nomogram to predict probabilities of both cause-specific death and death resulting from other causes. Methods: The study subjects were patients diagnosed with stage I SCLC according to ICD-O-3.First,the cumulative incidence functions (CIFs) of cause-specific death, as well as of death resulting from other causes, were calculated. Then, a proportional hazards model for the sub-distribution of competing risks and a monogram were constructed to evaluate the probability of mortality in stage I SCLC patients. Results: 1811 patients were included in this study. The five-year probabilities of death due to specific causes and other causes were 61.5% and 13.6%, respectively. Tumor size, extent of tumor, surgery, and radiotherapy were identified as the predictors of death resulting from specific causes in stage I SCLC. The results showed that surgery could effectively reduce the cancer-specific death, and the one-year cumulative incidence dropped from 34.5% to 11.2%.Like surgery, chemotherapy and radiotherapy improved the one-year survival rate. Conclusions: We constructed a predictive model for stage I SCLC using the data from the SEER database. The proportional sub-distribution models of competing risks revealed the predictors of death resulting from both specific causes and other causes. The competing risk nomogram that we built to predict the prognosis showed good reliability and could provide beneficial and individualized predictive information for stage I SCLC patients.
Plasmacytoma in patients with multiple myeloma: morphology and immunohistochemistry
Authors: Firsova Maiia , Mendeleeva Larisa , Valeri Savchenko , Kovrigina Alla , Solovev Maxim
Published: October 2019

Background. To study the histological structure and immunohistochemical (IHC) parameters of the plasmacytoma tumor substrate in patients with MM.
Methods. The study included 21 patients (10 men/11 women) aged 23 to 73 years old with a newly diagnosed MM complicated by plasmacytoma. Bone plasmacytoma was diagnosed in 14 patients, and extramedullary plasmacytoma was diagnosed in 7 patients. Plasmacytoma tissue specimens were examined using a LEICA DM4000B microscope. Anti-CD56, CD166, CXCR4, Ki-67, c-MYC antibody panels were used for the IHC study of plasmacytoma biopsy.
Results. When comparing the morphology of bone and extramedullary plasmacytoma, no significant differences were revealed, however, when the substrate of the extramedullary plasmacytoma was compared to the bone plasmacytoma substrate it was more often represented by tumor cells with immature morphology (57.1% vs. 28.6%). We founded a significant difference in the expression of CD166 in bone and extramedullary plasmacytoma. It was shown that the mean values ​​of the CD166 expression in bone plasmacytoma cells were significantly higher (p = 0.033) and amounted to 36.29 ± 7.61% versus 9.57 ± 8.46% in extramedullary plasmacytoma cells. We noticed that in the cells of the extramedullary plasmacytoma, there were higher values ​​in the Ki-67 index than observed in comparison to the cells of the bone plasmacytoma independent of the cells’morphology.
Conclusion. The mechanisms involved in the dissemination of tumor plasma cells are currently unexplored. Our study revealed significant differences in the IHC parameters of the tumor substrate from extramedullary and bone plasmacytoma. Thus, the expression of the CD166 in extramedullary plasmacytoma cells is almost 4 times lower than that in bone plasmacytoma cells, which may indicate the involvement of CD166 in the mechanisms of bone destruction. A high proliferative activity of extramedullary plasmacytoma cells was shown when compared to bone plasmacytoma cells.
Comprehensive transcriptomic analysis of Papillary Thyroid Cancer: potential biomarkers associated with tumor progression
Authors: Hosseinkhan Nazanin , Honardoost Maryam , Blighe Kevin , Moore C.B. Tara , Khamseh Mohammad Ebrahim
Published: October 2019

Background Identification of stage-specific prognostic/predictive biomarkers could lead to the more efficient clinical management in papillary thyroid carcinoma (PTC). The main objective of this study was to characterize the stage-specific deregulations in gene and miRNA expression in PTC and also to identify potential prognostic biomarkers.Methods 495 RNASeq and 499 miRNASeq PTC samples (stage I-IV) as well as, respectively, 56 and 57 normal samples were retrieved from The Cancer Genome Atlas (TCGA). DESeq2 was used to identify deregulation of genes and miRNAs between sequential stages of PTC. To identify the minority of patients who progress from stage I to higher stages, we additionally performed a clustering analysis focused on the stage I RNASeq data. Moreover a validation study was done on an independent PTC RNASeq study.Results Large amount of heterogeneity in gene expression patterns was observed in stage I PTC patients. LTF and PLA2R1 were identified as two promising biomarkers that exhibited down-regulation in a small subgroup of stage I (both in TCGA and in the validation data set) and in the majority of stage IV patients (in TCGA data set). hsa-miR-205, hsa-miR-509-2, hsa-miR-514-1 and hsa-miR-514-2 were also identified as up-regulated miRNAs in both PTC patients with stage I and stage III.Conclusion Common gene expression alterations in early and advanced stages of PTC, could be used for individualized risk stratification and personalized treatment approach.
Microbiome responses in a novel nematode defensive symbiosis
Authors: Dahan Dylan , Preston Gail M. , Sealey Jordan , King Kayla C.
Published: October 2019

Background Bacteria adapted to live within animals can protect their hosts against harmful infections. Beyond antagonism with parasites, a ‘defensive’ bacterial symbiont could engage in additional interactions with other colonizing micro-organisms. A single bacterium might thus have cascading ecological impacts on the whole microbiome that are rarely investigated. Here, we assess the role of a symbiont as a driver of host-associated microbiota composition by using an experimentally-adapted bacterium with protective properties ( Enterococcus faecalis ) inside a nematode host model ( Caenorhabditis elegans ).Results An analysis of 16S rRNA data from C. elegans exposed to E. faecalis and subsequently reared in soil, reveal that E. faecalis presence and adaptation to host environment had minimal impact on microbiota diversity. In addition, the protective effects of E. faecalis against opportunistic Staphylococcus aureus pathogens were still maintained despite multi-species interactions within the microbiota.Conclusions Our results reveal the degree to which a novel, evolving symbiont can colonise and maintain its conferred phenotype (i.e., parasite-resistance) with minimal change to the host microbiome.
Level of self-care practice and associated factors among hypertensive patients in Jimma University Specialized Hospital, south west Ethiopia
Authors: Abdulwahed anwar , Seid Anwar , Yimam Ebrahim
Published: October 2019

Background: Globally hypertension is a major public health problem and leading cause of mortality in developing countries. Self-care practice encourage hypertensive patients to have better quality of life by preventing complication and decrease health care expenditure. The aim of this study is to assess self-care practice and associated factors among hypertension patients in Jimma University Specialized Hospital, south west Ethiopia.Methods: An institution based cross-sectional study was employed on 322 adult hypertensive patients using simple random sampling procedure between March to May, 2016. Data was analyzed using SPSS version 20.0. A p-value of <0.05 was considered as statistically significant. Adjusted odds ratio at 95% CI was considered to declare the independent effect of independents variables on the outcome.Result: In this study, the overall participants with the recommended level of self-care practice were found to be 44.7%. Being employed [AOR = 2.032, 95% Confidence Interval [CI]: (1.162, 3.552), educational attainment (AOR = 3.730, 95% CI: (1.837, 7.576) and presence of comorbidity diseases (AOR = 0.502, 95% CI:0.2886, 0.8850) were factors significantly associated with self-care practice.Conclusion and recommendation: This study revealed levels of self-care practice were low among hypertensive patients. Occupation, educational status and comorbidity were factors significantly associated with self-care practice. Hypertensive patients with low socioeconomic status, no formal educational attainment and with co-morbidity needs special attention to improve their self-care practice.