bluuebunny/crossref_metadata_2025 huggingface dataset:
Infrequent tooth brushing and teeth lost may increase the risk of oral and pharyngeal cancers: A nationwide population-based cohort study in Korea.
Authors: Woo Ho Geol , Lee Kijeong , Lee Ji Sung , Kim Jinkwon , Chang Younkyung , Kim Jin-Woo , Song Tae Jin
Published: June 2020

Background: Oral and pharyngeal cancers are emerging and troublesome diseases worldwide. Although poor oral hygiene behaviors and parameters affecting oral health have been considered as potential risk factors of oral and pharyngeal cancers including smoking and alcohol consumption for decades, study results have been inconsistent. Longitudinal studies regarding the association between poor oral hygiene behaviors and parameters of oral health and the occurrence of oral and pharyngeal cancers have been lacking. We aimed to investigate this relationship in a nationwide general population-based cohort.Methods: We included data on demographics, past history, and laboratory findings for 150,774 subjects without teeth lost from the Korean National Health Insurance System-Health Screening Cohort. The presence of periodontal disease and parameters of oral health, including frequency of tooth brushings, dental visits for any reason, professional teeth scaling, and number of teeth lost, were investigated. Oral and pharyngeal cancers were defined by the International Statistical Classification of Diseases, 10th Revision, codes of C00-C14.Results: During a median 11.1 years of follow-up, 1,155 (0.77%) oral and pharyngeal cancers occurred. Based on multivariable analysis, after adjusting for demographics, alcohol consumption, smoking status, regular exercise, body mass index, systolic blood pressure, blood and urinary laboratory findings, and parameters of oral health including frequent tooth brushing (three or more times per day) were related to a lower risk of oral and pharyngeal cancers (hazard ratio [HR]: 0.78, 95% confidence interval [CI]: 0.66–0.93, p=0.005). An increased number of teeth lost (≥15) was positively associated with occurrence of oral and pharyngeal cancers (HR: 1.71, 95% CI: 1.26–2.31, p=0.001 in model 1; HR: 1.68, 95% CI: 1.24–2.28, p<0.001 in model 2; HR: 1.66, 95% CI: 1.22–2.25, p=0.001 in model 3; p-value for trend test for HR <0.001).Conclusions: The occurrence of oral and pharyngeal cancers decreased with more frequent tooth brushing (three or more times per day) and increased with the number of teeth lost. With regards to the prevention of oral and pharyngeal cancers, improving oral hygiene may have a significant contribution.
Supporting Australian Clinical Learners in a Collaborative Clusters Education Model: A Mixed Methods Study
Authors: de Mortel Thea van , Armit Lyn , Shanahan Brenton , Needham Judith , Brown Candy , Grafton Eileen , Havell Michelle , Henderson Amanda , Grealish Laurie
Published: June 2020

Background: Nursing student numbers have risen in response to projected registered nurse shortfalls, increasing numbers of new graduates requiring transitional support and pressure on clinical placements. A Collaborative Clusters Education Model, in which Entry to Practice facilitators coach ward-based registered nurses to support students’ and new graduates’ learning, may address placement capacity. The research aim was to evaluate the acceptability of the Collaborative Clusters Education Model to stakeholders by examining their perceptions of the facilitators and barriers to the model in its implementation. Methods: A convergent mixed methods evaluation approach was adopted. The study took place in a large Australian health service in south-east Queensland. Participants included Bachelor of Nursing students, Entry to Practice facilitators, ward-based registered nurses, academics and new graduates. A mixed methods design was used. Elements included an online survey of nursing students, and interviews with new graduates, Entry to Practice facilitators, ward-based registered nurses, and academics. Descriptive statistics were calculated on quantitative data. Thematic analysis was conducted on qualitative data. Results: Participants included 134 (of 990) nursing students (response rate 13.5%), five new graduates, seven Entry to Practice facilitators, four registered nurses, and three nurse academics. Students rated facilitators’ effectiveness highly (4.43/5±0.75), although this finding is tempered by a low response rate (13.5%). For learners, the model provided access to learning experiences, although preferences for sources of support differed between students and new graduates, and further clarification of responsibilities was required. For other stakeholders, three themes emerged: students’ and new graduates’ integration into the workplace can promote learning; tensions arise in new ways to approach performance assessment; and aligning expectations requires high levels of communication. Conclusions: This evaluation found that acceptability was good but at risk from limited clarity around roles and responsibilities. Further research into this model is recommended.
Motivation factors affecting the job attitude of medical doctors and the organizational performance of public hospitals in Warsaw, Poland
Authors: Chmielewska Malgorzata , Stokwiszewski Jakub , Filip Justyna , Hermanowski Tomasz
Published: June 2020

Background This paper explores the relationship between selected motivation factors that affect the attitude to work among medical doctors at public hospitals and the organizational performance of hospitals and selected motivation factors that affect the attitude to work among medical doctors at public hospitals. Methods This study was based on World Health Organization questionnaires designed to estimate motivation factors according to Herzberg’s motivation theory and to measure the levels of organizational performance of hospitals using the McKinsey model in the social aspect. A survey was conducted among physicians (n=249) with either surgical or nonsurgical specialty in 22 departments/units of general public hospitals in Warsaw, Poland. The relationship between the examined factors of job motivation and organizational effectiveness was determined using Spearman’s rank correlation. Furthermore, 95% confidence intervals were computed. The independent samples t-test was used to confirm any statistically significant differences between the independent groups. Normality was tested by the Kolmogorov–Smirnov test. Results The survey revealed that motivation factors related to “quality and style of supervision” have the greatest effect on the hospital’s organizational performance (Spearman’s rank correlation coefficient = 0.490; p<0.001), whereas “performance feedback” was rated as the lowest to affect organizational performance among the surveyed healthcare professionals (54% of physicians). Conclusion The principles of Individual Performance Review should be incorporated into strategies designed to improve the organizational performance of hospitals (with NHS serving as a possible role model) in order to establish specific rules on how to share performance feedback with among individual physicians. The present study contributes to literature on human resource management in the healthcare sector, highlighting the importance of social nonfinancial aspects in improving organizational performance in a hospital setting.
The effects of seaward distance on above and below ground carbon stocks in estuarine mangrove ecosystems
Authors: Cleyndert Georgia de Jong , Cuni-Sanchez Aida , Seki Hamidu A , Shirima Deo D , Munishi Pantaleo K.T. , Burgess Neil , Marchant Robert
Published: June 2020

Background: Mangrove forests have gained recognition for their potential role in climate change mitigation due to the carbon sequestration of the productive ecosystems and storage in the sediments that are trapped by the mangrove tree roots and pneumatophores. Africa hosts about 19% of the world’s mangroves, yet there are relatively few studies that have examined the carbon stocks of African mangroves, and the studies available report great differences among sites and amongst the different pools of carbon stocks, particularly between the above ground carbon stored in trees (AGC) and organic carbon stored within the sediment - ‘soil organic carbon (SOC)’ and none considered the effects of seaward distance. We investigate if AGC and SOC carbon stocks differ with increasing seaward distance for estuarine mangroves in Tanzania and, how our results compare to those reported elsewhere across Africa.Results: AGC ranged between 10.9-54.9 Mg C ha-1 , but was not significantly affected by seaward distance. SOC for 0-1m depth ranged from 153.7-483.6, with a mean of 301.7 Mg C ha-1. SOC was significantly negatively correlated with seaward distance, which is different from studies in Micronesia and the Indo-Pacific. Mangrove type (estuarine/oceanic), soil erosion and soil depth may explain these differences We note important methodological differences in previous studies on carbon stocks in mangroves in Africa. Conclusion:This study indicates that seaward distance has an important effect on SOC stocks in the Lindi region of Tanzania. There is the need to standardise methodological approaches for mangroves in Africa, to report seaward distance and to describe the type of mangrove stand to make results easily comparable across sites and to assess the true value of Blue Carbon in Africa. We recommend focusing on trees >10cm diameter for AGC, and sampling soils to greater than 1m depth for SOC, which would provide a more complete assessment of the potentially considerable mangrove carbon store.
COVID-19 Pandemic- Knowledge, Perception, Anxiety and Depression Among Frontline Doctors of Pakistan
Authors: Amin Faridah , Sharif Salman , Saeed Rabeeya , Durrani Noureen , Jilani Daniyal
Published: June 2020

BackgroundCOVID-19 is a global pandemic and has become a major public health burden worldwide. With already fragile healthcare systems it can have long lasting effects in developing countries. Outbreaks especially a pandemic situation evokes fear related behaviors among healthcare professionals and there is always an increased risk of mental health disorders. Therefore, this study aims to determine knowledge and perception about this pandemic, prevalence and factors associated with depression/ anxiety among frontline physicians of Pakistan.MethodsData were collected through an online survey released in the last week of March-2020. 389 frontline physicians from all four provinces and 65 cities of Pakistan participated. Survey questionnaire consisted of 4 parts including informed consent section, demographic section, knowledge and perception about COVID-19 pandemic and assessment of depression through World Health Organization Self-reporting questionnaire (SRQ-20). A score of 8 or above on SRQ-20 was used as cut-off to label the participant as depressed. Data was analyzed using SPSS version22.ResultsA 43% prevalence of depression/anxiety among frontline physicians of Pakistan was reported. Almost all the doctors had moderate to high knowledge score. Majority of participants marked N-95 mask as essential while aerosol generating procedures, assessing patients with respiratory symptoms, in COVID patient care area, ER triage and direct care of COVID-19 patient. Only 12% of the doctors were fully satisfied with the provision of PPEs and almost 94% felt unprotected.In multivariable model, the odds of depression was high in physicians who were assessing more than five COVID suspects/patients per day (aOR=2.73, 95% CI: 1.65 – 4.52), who were working 20 hours/week or less (aOR=2.11, 1.27 – 3.49), had children among household members (aOR= 1.58, 95% CI: 1.00 – 2.50) and had moderate to low knowledge of the infection (aOR=2.69, 95% CI: 1.68 – 4.31).ConclusionDepression/anxiety among more than a third of frontline doctors of Pakistan warrants the need to address mental health of doctors caring for patients during this pandemic; control modifiable factors associated with it and explore the effectiveness of interventions to promote psychological well-being of physicians.
Antibacterial mechanism of rhodomyrtone involves the disruption of nucleoid segregation checkpoint in Streptococcus suis
Authors: Traithan Apichaya , Tongtawe Pongsri , Thanongsaksrikul Jeeraphong , Voravuthikunchai Supayang , Sriman Potjanee
Published: June 2020

Rhodomyrtone has been recently demonstrated to possess a novel antibiotic mechanism of action against Gram-positive bacteria which involved the multiple targets, resulting in the interference of several bacterial biological processes including the cell division. The present study aims to closely look at the downstream effect of rhodomyrtone treatment on nucleoid segregation in Streptococcus suis, an important zoonotic pathogen. The minimum inhibition concentration (MIC) and the minimum bactericidal concentration (MBC) values of rhodomyrtone against the recombinant S. suis ParB-GFP, a nucleoid segregation reporter strain, were 0.5 and 1 µg/ml, respectively, which were equivalent to the potency of vancomycin. Using the fluorescence live-cell imaging, we demonstrated that rhodomyrtone at 2 × MIC caused incomplete nucleoid segregation and septum misplacement, leading to the generation of anucleated cells. FtsZ immune-staining of rhodomyrtone-treated S. suis for 30 min revealed that the large amount of FtsZ was trapped in the region of high fluidity membrane and appeared to be able to polymerize to form a complete Z-ring. However, the Z-ring was shifted away from the midcell. Transmission electron microscopy further confirmed the disruption of nucleoid segregation and septum misplacement at 120 min following the rhodomyrtone treatment. Asymmetric septum formation resulted in either generation of minicells without nucleoid, septum formed over incomplete segregated nucleoid (guillotine effect), or formation of multi-constriction of Z-ring within a single cell. This finding spotlights on antibacterial mechanism of rhodomyrtone involves the early stage in bacterial cell division process.
Unhealthy lifestyle is an important risk factor for BPPV recurrence
Authors: Fu Chang-yong , Zhang Zhen-zhong , Chen Jin , Jaiswal Sandip Kumar , Yan Fu-ling
Published: June 2020

Background: Benign paroxysmal positional vertigo (BPPV) is self-limiting and recurrent but the cost is considerable. The recurrence of BPPV increased significantly under the quarantine policy in Hangzhou. The unhealthy lifestyle risk factors of the recurrence of BPPV have not yet been investigated. So, the objective is to analyze the unhealthy lifestyle risk factors of recurrent BPPV.Methods: A retrospective observational study was conducted in the Department of Neurology in Tongde Hospital of Zhejiang Province from December 2018 to March 2020. The study included 186 patients aged 23–86 years. All patients received the definitive diagnosis and canalith repositioning maneuvers (CRM) treatment and finally accomplished follow-up for one year. Demographic variables, potential recurrence risk factors, neurological examination, cranial computed tomography and lifestyle were assessed.Data Analyses: The t-test or chi-squared test was first performed for group comparison, then logistic regression analysis was performed to investigate the recurrence risk factors in all of the patients.Results: The 1-year recurrence rates of BPPV patients after reposition maneuvers were 36.02%, is significantly higher than other study especially in the first quarter of 2020 (38.8% of patients with BPPV recurrence). Logistic regression analysis shows that BPPV patients who was poor physical activities and prolonged recumbent position time have more recurrence risks. Poor physical activities (odds ratio =5.690, 95% confidence interval: 1.650-19.618, p <0.006), prolonged recumbent position time (odds ratio = 1.651, 95% confidence interval: 1.370-2.003, p = 0.000), were risk factors for the recurrence of BPPV in patients.Conclusion: We conclude that poor physical activities and prolonged recumbent position time may be independent risk factors for the recurrence of BPPV patients, but aging, Ménière’s disease, sudden deafness migraine, hypertension, hyperlipemia, diabetes, CHD, POCI, mental factors, and mental labor do not increase the recurrence risk.
Clinical Characteristics, Treatment and Outcome of Adnexal Torsion in Pregnant Women: A Retrospective Study
Authors: Deng Shan , Wang Yong-xue
Published: June 2020

Background Adnexal torsion during pregnancy is a gynecological emergency. Delayed diagnosis and treatment can cause ovarian necrosis and fetal loss. This study assessed the clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women.Methods A retrospective study was conducted at a tertiary center between January 2008 and January 2018. Eighty-two pregnant women with surgically confirmed adnexal torsion were included. The clinical characteristics, ultrasound data, surgical interventions and pregnancy outcomes were analyzed.Results The median age of the patients was 28 (range, 18–38) years. The median gestational age was 11 (range, 6–31) weeks: 53 (64.6%) were in the first trimester, 21 (25.6%) were in the second trimester, and 8 (9.8%) were in the third trimester. The most common symptoms and signs were sudden pelvic pain (100%) and adnexal or pelvic masses (97.6%), followed by nausea and vomiting (61%). The Doppler blood flow signal disappeared in 62.5% of the patients. Sixty-three (76.8%) patients underwent laparoscopy, and 29 (24.2%) underwent laparotomy. The median gestational age in patients undergoing laparotomy was higher than that in those undergoing laparoscopy (26 weeks vs 10 weeks, p < 0.001). Fifty-three (64.6%) patients underwent conservative surgery, with 48 detorsions and cystectomies, 2 detorsions and cyst fenestrations, 1 detorsion only and 2 salpingectomies only. Twenty-nine (25.4%) patients underwent unilateral salpingo-oophorectomy. There were no cases of postoperative thrombosis, spontaneous abortion or recurrence. Seven patients underwent simultaneous artificial abortion. One patient experienced intrauterine fetal death, and 74 patients had live births.Conclusion Surgical intervention was required as soon as possible. Laparoscopic conservative surgery is safe and may be appropriate to preserve ovarian function. Cystectomy could reduce the risk of recurrence.
The Relationship Between Lipid Profile and Outcomes of Pregnant Women with Gestational Diabetes Mellitus and Hypertensive Disorders: A Retrospective Study
Authors: Li Yuan , Chen Wenqing , Wang Xiaoqian , Jiang Fengjuan , Chen Xiaotian
Published: June 2020

Background Dyslipidemia during pregnancy in women with gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) has been extensively studied in western countries. However, similar researches have rarely been conducted in Asia. The present study aimed to evaluate maternal lipid profile changes in relation to pregnancy complications and clinical outcomes.Methods The medical records of 668 pregnant women were retrospectively analyzed. Maternal fasting serum lipids were assayed for total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), apolipoprotein A1 (Apo A1) and Apo B concentrations during the second trimesters. The atherogenic index of plasma (AIP) was calculated. The pregnancy complications included GDM and HDP. The clinical outcomes were collected by evaluating delivery mode, postpartum hemorrhage, macrosomia, birth weight, body length and neonatal Apgar score.Results Levels of TG and AIP were elevated while decreased TC and HDL-C was observed in women with GDM compared with that of the control group (p < 0.05). TG and AIP in HDP group were higher than in control group (p < 0.05). Significant differences were observed in postpartum hemorrhage, birth weight and body length between control group and women with GDM or HDP (p < 0.05). Compared with women with serum TG ≥ 2.5 mmol/L or TC ≥ 6.2 mmol/L, the incidence of GDM, cesarean section and macrosomia was lower in normal lipid group (p < 0.05). Spearman correlation analysis showed that the incidence of GDM was positively correlated with levels of TG (r = 0.226, p < 0.01) and AIP (r = 0.250, p < 0.01), while negative correlated with TC (r = -0.106, p < 0.01) and HDL-C (r = -0.190, p < 0.01). AIP was correlated positively with the incidence of HDP (r = 0.115, p = 0.043). According to the logistic regression analysis, each unit elevation in AIP increased the risk of GDM by 6.943 times (OR = 6.943, 95% CI: 1.761–27.374).Conclusions Lipid control, especially for women with GDM and HDP, might be a potential strategy for improving the pregnancy outcomes.
The effect of illegal mining activities on vegetation: A case study of Bontefufuo Area in the Amansie West District of Ghana
Authors: Kuffour Richard Amankwah , Tiimub Benjamin Benjamin M. , Manu Isaac , Owusu Wellington
Published: June 2020

Background:
The destruction of vegetation cover is among the main factors contributing to climate variation. The study investigated the distribution of trees, shrubs and herbs in the mined and unmined communities of Bontefufuo namely: Esaase, Manhyia, Aboabo and Mpatuam. The research was intended to determine the relationship between the spatial distribution of vegetation, composition and examine the effects of vegetation loss in the area. A total of forty 40 plots (10 m x 10 m) were studied. In each community, five (5) plots were studied each for mined and unmined areas.
Results:
The mean numbers of plant population were determined and analyzed using ANOVA. There were significant differences among the tree, shrub and herb populations at P < 0.05. The number of shrubs and trees population was reduced in the mined areas in relation to the areas that are not mined. Herbs were overwhelming within the mined regions and were found to be much higher than within the unmined regions. Photographic images showed that the practices of illicit small-scale mining contributed to land destruction by compacting the topsoil and accumulation of laterites.
Conclusion:
Climate change issues still remain a global concern and vegetation cover which plays an imperative role in regulating the carbon dioxide concentration of the atmosphere should be restored.
Mapping of Microvascular Architecture in the Brain of an Alzheimer’s Disease Mouse Model using MRI
Authors: Chang Suk-Ki , Kim JeongYeong , Lee DongKyu , Yoo Chang Hyun , Jin Seokha , Rhee Hak Young , Ryu Chang-Woo , Lee Jong Kil , Cho HyungJoon , Jahng Geon-Ho
Published: June 2020

Purpose Growing evidence suggests that alterations of the cerebral microvasculature play a critical role in the pathogenesis of Alzheimer’s disease (AD). The objective of this study was to characterize and evaluate the cerebral microvascular architecture in the AD transgenic (Tg) mice model compared with non-Tg mice using brain microvascular indices obtained by MRI.Methods Seven non-Tg mice and ten 5xFAD Tg mice were scanned using a 7-T animal MRI system to measure the transverse relaxation rates of R2 and R2* before and after injection of the monocrystalline iron oxide nanoparticle contrast agent. After calculation of the relaxation rate difference of ΔR2* and ΔR2, the microvascular indices of the vessel size index (VSI), mean vessel diameter (mVD), mean vessel density (Q), mean vessel-weighted image (MvWI), and blood volume fraction (BVf) were mapped. The voxel-based analyses and regions-of-interest (ROIs)-based analyses were performed to compare the indices between the non-Tg and Tg groups.Results The BVf, mVD, VSI, and MvWI were greater in the Tg group than in the non-Tg group based on voxel comparisons. Additionally, the ROIs-based analysis showed that ΔR2*, BVf, mVD, MvWI, and VSI were increased in the Tg group compared to the non-Tg group in several brain regions. Most ROIs defined by the mouse brain atlas were not significantly different between the two groups.Conclusion We found increased microvascular indices of VSI and mVD in the Tg mice, reflecting microvascular disruption in the brain, which may be related to damages of the neurovascular unit in AD caused by cerebral amyloid angiopathy.Clinical Relevance / Application: To date, few studies have investigated the microvascular injuries of the AD brain using MRI. We suggest that investigation of cerebral microvasculature using a high-field MRI in AD would be worthwhile to elucidate the pathophysiology of cerebral amyloid angiopathy in this disease. Indeed, microvascular MRI can be a promising imaging tool for investigating early diagnosis and monitoring treatment in AD.
Patient experiences with obstructive and nonobstructive hypertrophic cardiomyopathy: a conceptual model of symptoms and impacts on quality of life
Authors: Zaiser Erica , Sehnert Amy J. , Duenas Ashley , Saberi Sara , Brookes Ella , Reaney Matthew
Published: June 2020

Background

Hypertrophic cardiomyopathy (HCM) is a primary myocardial disorder defined by left ventricular hypertrophy that cannot be explained by another cardiac or systemic disease. There is a general lack of knowledge about patients’ perspectives on the symptoms and day-to-day limitations they experience as a result of HCM. We therefore sought an in-depth understanding of patients’ experiences of obstructive (oHCM) and nonobstructive (nHCM) forms of the disease, including symptoms and their quality of life impacts, and to develop a conceptual model to capture them.
Methods

Development of the HCM conceptual model involved a web-based survey to capture patients’ insights, a targeted literature review (which included relevant guidelines and patient advocacy websites), one-to-one interviews with clinical experts, and one-to-one qualitative concept elicitation interviews with patients. Key symptoms and their impacts most important to patients’ experiences were identified and used to develop a conceptual model of the patient experience with HCM.
Results

The HCM symptoms reported by patient interviewees (n = 27) were largely consistent with findings from the patient web survey (n = 444), literature review, and interviews with three expert clinicians. The symptoms most commonly reported in patient interviews included tiredness (89%), shortness of breath (89%), shortness of breath with physical activity (89%), and dizziness/light-headedness (89%). Other symptoms commonly reported included chest pain (angina) (70%), chest pain (angina) with physical exertion (70%), and palpitations (fluttering or rapid heartbeat) (81%). The most commonly reported impacts of HCM symptoms on patients’ lives included limitations to physical activities (78%), emotional impacts, including feeling anxious or depressed (78%), and impacts on work (63%). Symptoms and impacts were similar for both oHCM and nHCM.
Conclusions

A conceptual model was developed, which identifies the core symptoms that patients with oHCM and nHCM reported as most frequent and most important: shortness of breath, palpitations, fatigue/tiredness, dizziness/light-headedness, and chest pain, as well as the impacts those symptoms have on patients’ lives. This HCM conceptual model reflecting patients’ experiences and perspectives was used in the development of a patient-reported outcomes instrument for use in clinical trials and it may also help inform the clinical management of HCM.
Investigating the role of opiorphin genes in prostate cancer and the possible genetic mechanisms by which they modulate tumor growth and androgen-sensitivity.
Authors: Mukherjee Amarnath , Park Augene , Wang Li , Davies Kelvin Paul
Published: June 2020

Background The opiorphin family of genes (represented in humans by ProL1, hSMR3A and hSMR3B) encode peptides which act as potent neutral endopeptidase (NEP) inhibitors. Because modulated NEP activity is associated with cancer development it has been suggested that dysregulated opiorphin expression may be involved in oncogenesis and recent reports have associated upregulated opiorphin gene expression with breast and oropharyngeal cancer. These observations prompted the present studies to determine if opiorphin genes play a role in prostate cancer (PrCa). Methods Publicly available data bases were screened for evidence associating opiorphin gene expression with PrCa and the findings confirmed using PrCa tissue arrays. Androgen-insensitive (PC3) and -sensitive (LNCaP) PrCa cells were engineered to overexpress ProL1 , referred to as LNCaP-ProL1+ and PC3-ProL1+, respectively. Xenografted tumor growth of ProL1-overexpressing and parental cell-lines were compared in male, castrated-male and female nude mice. Changes in global gene expression resulting from overexpression of ProL1 in these cell-lines was determined by RNA-Seq. Results Publicly available datasets supported an association between overexpression of opiorphin genes and PrCa, which was confirmed using tissue arrays. Xenografted tumors derived from PC3-ProL1+ had an initial growth advantage over parent cell-lines in male mice, although at later time points there was no difference. Xenografted tumors derived from LNCaP-ProL1+ were able to grow in castrated male mice (in contrast to the parent cell-lines), and had impaired growth in female mice. Global gene expression analysis demonstrated that overexpression of ProL1 causes modulated expression of genes involved in signaling, angiogenesis and steroid response pathways. Conclusions This is the first report associating upregulated opiorphin gene expression and PrCa. Xengrafted tumors derived from the androgen-sensitive LNCaP cell-line engineered to overexpress ProL1 exhibit a more androgen-insensitive phenotype. Previous reports demonstrate opiorphins act as master regulators of the hypoxic response in smooth muscle cells. RNAseq data not only supports a similar role for ProL1 in PrCa (regulating genes involved in angiogenesis), but in addition, regulating genes involved in steroid response. Therefore, opiorphins may play a role in PrCa development by activating pathways that overcome the hypoxic environment of the developing tumor and promote the development of androgen-insensitivity.
Risk Factors of Composite Attachment Loss During Orthodontic Clear Aligner Therapy
Authors: Chen Yaosen , AM Mohamed , Jinbo WANG , Ziwei ZHENG , Al-balaa Maher , Yan YANG
Published: June 2020

Background The composite attachment loss during orthodontic clear aligner therapy is an adverse event that commonly happens in our daily practice. However, there is a lack of related statistical analysis, and studies analyzing the related risk factors. Therefore, the aim of this study is to assess the incidence of attachment loss during orthodontic clear aligner therapy and to identify rick factors that may predict such event.Methods The demographics and clinical variables of 94 patients undergoing clear aligner therapy (27 males and 67 females; average age: 27.60± 0.86 years) were recorded. Both patient-related and tooth-related attachment loss was recorded. The chi-square test and logistic regressive analysis were applied to identify the potential risk factors. SPSS for Mac (version 23.0, IBM, USA) was used for statistical analyses. P＜0.05 was considered statistically significant. Results Our study suggested that the risk factors for attachment loss include: frequent aligner removal (>= 5 times a day) (losing rate=60.0%, P=0.005); aligner wear time less than 18 hours a day (losing rate=50.8%, P=0.014); eating without aligners inserted (losing rate=47.9%, P=0.034); utilizing aligner tray seaters (losing rate=48.2%, P=0.006) and unilateral mastication (losing rate=52.1%, P=0.002). The multivariable logistic regression analysis indicates that aligner wear time less than 18 hours a day (P=0.020, B=0.925), using aligner tray seaters (P=0.007, B=1.168) and unilateral mastication (P=0.034, B=-0.458) were considered independent factors that can predict the composite attachment loss in orthodontic clear aligner therapy.Conclusion Wearing aligner less than 18 hours a day, using aligner tray seaters and unilateral mastication may contribute to increased incidence of composite attachment loss during orthodontic clear aligner therapy.
Public sphere attitudes toward rumor sources on COVID-19 epidemics: Evidence from community perceptions in Iran
Authors: Banakar Morteza , Sadati Ahmad Kalateh , Zarei Leila , Shahabi Saeed , Heydari Seyed Taghi , Lankarani Kamran B
Published: June 2020

Background
Advancements in technology had raised a variety of information circulation methods. In the case of the COVID-19 outbreak, misinformation seems to travel far faster than the outbreak itself. Misleading rumors are double-edged swords arousing fear and panic on the one side and a reduction in commitment to sanitary measures and induction of wrongdoing on the other side, leading to the disruption of the mitigation measures to tackle with the pandemic. This study aimed to evaluate the factors affecting individuals’ attitudes toward rumor-producing media in Iran.
Methods
An online survey was conducted in Iran in March 2020 on the source of trusted information and misinformation along with individuals’ perception of the cause of misinformation propagation during the COVID-19 pandemic.
Results
The results showed that social media were considered as the primary rumor source from the perspective of a majority of the participants (59.3%). Lack of a reliable and formal news source was also introduced as the most common cause of a rumor formation by the participants (63.6%). To identify which media is the main source of rumors, the male participants who had high levels of education and were employed by the government proposed foreign media (P < 0.01); however, the male participants aged 30–50 years with middle income level believed that social media (P < 0.01) were producing rumors. In this regard, the high educated participants (P < 0.001), government employees, and middle-income individuals (P < 0.008) believed that national media produced rumors. In addition, the high-educated individuals (P = 0.002) and government employees (P = 0.009) mentioned that national media produced rumors.
Conclusion
Although these findings were obtained during the first encounter with the Corona epidemic, the authorities immediately introduced the national media as a source of reliable news, which allowed the media and its journalists to reduce the gap between themselves and public sphere. It is suggested that social networks and foreign media be more accountable in epidemics.
Application of WASP Model to Simulate Water Pollution Control of Duriangkang Dam
Authors: Wimordi Calvin , Yudianto Doddi , Guan Yiqing
Published: June 2020

Located in Batam City, Duriangkang Dam plays an important role in the area's clean water provision regarding the fact that it is the first and largest estuary dam in Indonesia. However, with its total effective volume of 107,000,000 m 3 , Duriangkang Dam is now heavily polluted due to the enormous wastewater, both domestic and industrial, that are directly discharged into the dam. Moreover, the practice of fish farming has also contributed in making it worse. From the water sampling taken from 2016 to 2018, the water condition in Duriangkang Dam is no longer classified as the 2 nd class of raw water standard in Indonesia. This study employs the WASP model to evaluate and simulate the possible solution to control the water pollution rate in Duriangkang Dam. The water quality indicators, namely dissolved Oxygen (DO), total phosphorus (TP), and biochemical oxygen demand (BOD) will be modeled in this study. The calibration and verification results indicate the model shows excellent fitting for DO and TP but slightly less for BOD. Under several scenarios, it is identified that the best way to control the pollution rate within the dam is by implementing scenario 8 that totally eliminates the fish farm and domestic wastewater load.
Complex Interactions of Lovastatin with 10 Chemotherapeutic Drugs: A Rigorous Evaluation of Synergism and Antagonism
Authors: Gilman Kaitlyn K. , Han Seungmin , Won Young-Wook , Putnam Charles W.
Published: June 2020

Background
Evidence bearing on the role of statins in the prevention and treatment of cancer is confounded by the diversity of statins, chemotherapeutic agents and cancer types included in the numerous published studies; consequently, the adjunctive value of statins with chemotherapy remains uncertain.
Methods
We assayed lovastatin in combination with each of ten commonly prescribed chemotherapy drugs in highly reproducible in vitro assays, using an indifferent cellular substrate, Saccharomyces cerevisiae. Cell density (OD600) data were analyzed for synergism and antagonism using the Loewe additivity model implemented with the Combenefit software.
Results
Four of the ten chemotherapy drugs – tamoxifen, doxorubicin, methotrexate and rapamycin – exhibited net synergism with lovastatin. The remaining six agents (5-fluorouracil, gemcitabine, epothilone, cisplatin, cyclophosphamide and etoposide) compiled neutral or antagonistic scores. Distinctive patterns of synergism and antagonism, often coexisting within the same concentration space, were documented with the various combinations, including those with net synergism scores.
Conclusions
The interactions of tamoxifen, doxorubicin, methotrexate and rapamycin with lovastatin suggest clinical utility and merit further exploration in cell lines and animal models. No less importantly, strong antagonistic interactions between certain agents and lovastatin argue for a cautious, data-driven approach before adding a statin to chemotherapeutic regimens. We also urge awareness of adventitious statin usage by patients entering cancer treatment protocols.
A Comparison of Eating Disorder Symptomatology, Psychological Distress and Psychosocial Function Between Early and Later Onset Anorexia Nervosa
Authors: Jenkins Zoe , Chait Lior M , Cistullo Leonardo , Castle David J
Published: June 2020

Objective: Epidemiological studies suggest that the incidence of anorexia nervosa (AN) is increasing in younger populations, with some evidence that clinical differences occur between early onset (EO) and later onset (LO) AN, which may impact prognostic outcomes. The current study sought to compare eating disorder (ED) symptomatology, psychological distress and psychosocial function between EO- and LO-AN in a large sample of treatment-seeking patients with a diagnosis of AN.Methods: Participants included 249 individuals with a diagnosis of AN who were assessed at an outpatient ED service. The sample was divided into two groups based on age of onset (AOO) using a median split (median AOO=16); those with an AOO ≤16 years (N=128) were termed ‘EO-AN’ and those with an AOO of > 16 years (N=121) were termed ‘LO-AN’. Comparisons were made between AOO groups on assessments of ED symptomatology, psychological distress and psychosocial function. Results: EO-AN patients reporteda significantly longer illness duration (p<.001), significantly higher ED symptomatology (p=0.005), dysmorphic concern (p=0.02), stress (p=0.011), anxiety (p=0.023), and cognitive inflexibility (p=0.042), compared to the LO-AN group.Discussion: These findings suggest that clinical differences do occur according to AOO in AN wherebyEO-AN may represent a more severe form of illness. Treatment strategies which specifically address patients with EO-AN may improve long term health outcomes and recovery.
Bottlenecks in integrating TB and HIV services in the Philippines: a qualitative implementation research
Authors: Sy Tyrone Reden Longasa , Padmawati Retna Siwi , General Jojana Christine Poloyapoy , Imperial Reynaldo , Ahmad Riris Andono
Published: June 2020

Background

The Philippines is subdivided into 17 regions, with a devolved health system. It has a high burden of tuberculosis (TB) (554 per 100,000 population), and more than 25% increase in human immunodeficiency virus (HIV) incidence. However, years after the World Health Organization’s (WHO) recommendations on TB/HIV collaborative activities, only 24% of Filipinos with TB know their HIV status. The present study aims to describe implementation bottlenecks that hamper integration of TB and HIV services in the Philippines.
Methods

Ten focus group discussions with program managers, non-government organizations (NGO), patient organizations, and primary healthcare centers from different levels of the Philippine health system were conducted. Thematic analysis was used to analyze qualitative data.
Results

Implementation bottlenecks can be categorized into four areas: policy, operational, human resources, and patient-related factors. Mechanisms to cascade TB/HIV knowledge and policies from the national to the municipality level have been identified as barriers to integrated TB/HIV services. Double stigmatization among TB patients was also linked to poor uptake of HIV testing.
Conclusion

National policies and health promotion efforts need to be revisited to operationalize how information about TB/HIV policies is cascaded to the grassroots. Interventions to address double stigmatization should also be explored.
Health-Related Quality of Life Among Rural Chinese Patients With Upper Gastrointestinal Diseases at Different Pathological Stages: A Cross-Sectional Study
Authors: Qin Tingting , Shao Yuchen , Zhang Nan , Wang Jialin , Yao Nengliang , Zhao Deli , Liu Weidong , Anderson Roger , Sun Xiaojie
Published: June 2020

Objective: The aim of this study was to compare the health-related quality of life (HR-QoL) among rural Chinese patients with upper gastrointestinal (GI) diseases at different pathological stages and to determine the factors influencing HR-QoL in this population.Methods: A cross-sectional survey was conducted in two counties in Shandong province in China from July to September 2018. Demographic and clinical characteristics were collected, and HR-QoL of patients was assessed using a set of questionnaires, including the EORTC QLQ-C30 (V3.0), the QLQ-OES18 and the QLQ-STO22. Multivariate analysis of variance (MANOVA) and Kruskal–Wallis test were used to compare the HR-QoL of patients of different pathological stage subgroups, and multivariate regression analyses were used to determine influencing factors.Results: A total of 406 patients were included in this study. The mean scores for patients with upper GI diseases were 74.88 (SD=19.15), 8.04 (SD=16.17) and 8.64 (SD=16.96) for the global QoL scale of EORTC QLQ-C30, QLQ-OES18 and QLQ-STO22, respectively. There was no significant difference in most of the scales between the precancerous and early stage groups, but a significant difference in HR-QoL between the precancerous and advanced groups as well as between early and advanced groups. Residence area, age, education level and pathological stage were the significant factors influencing HR-QoL scores, controlling for other variables.Conclusions: The overall HR-QoL of patients with advanced upper GI cancer needs to be managed as a component of cancer care. Measures should be taken to routinely identify patient symptoms so that follow-up care can alleviate patient symptom burden. Tailored treatment and care for patients with upper GI diseases of different age, educational level and pathological stage may be needed to help improve HR-QoL.
Identification of Key Genes for Controlling Cancer Stem Cell Characteristics in Gastric Cancer
Authors: Huang Chao , Zhao Jiefeng , Ning Zhikun , Huang Jun , Zhu Zhengming
Published: June 2020

Background

Self-renewal of gastric cancer stem cells (GCSCs) is considered to be the underlying cause of the metastasis, drug resistance and recurrence of gastric cancer (GC). The purpose of this study was to characterize the expression of stem cell-related genes in GC.
Methods

The RNA sequencing results and clinical data for gastric adenoma and adenocarcinoma samples were obtained from the Cancer Genome Atlas (TCGA) database, and the results of the GC mRNA expression-based stemness index (mRNAsi) were analyzed. Weighted gene coexpression network analysis (WGCNA) was then used to find modules of interest and their key genes. Survival analysis of key genes was performed using the online tool Kaplan-Meier Plotter, and the online database Oncomine was used to assess the expression of key genes in GC.
Results

mRNAsi was significantly upregulated in GC tissues compared to normal gastric tissues (p < 0.0001). A total of 16 modules were obtained from the gene coexpression network; the brown module was most positively correlated with mRNAsi. Sixteen key genes (BUB1, BUB1B, NCAPH, KIF14, RACGAP1, RAD54L, TPX2, KIF15, KIF18B, CENPF, TTK, KIF4A, SGOL2, PLK4, XRCC2 and C1orf112) were identified in the brown module. Survival analysis and Oncomine analysis revealed that the prognosis of patients with GC and the expression of three genes (RAD54L, TPX2 and XRCC2) were consistently related.
Conclusion

Sixteen key genes play an important role in the maintenance of GCSCs. RAD54L, TPX2 and XRCC2 are the most likely therapeutic targets for inhibiting the stemness characteristics of GC cells.
Factors related to Juvenile Idiopathic Arthritis Complicated with Hyperuricemia
Authors: wu ling , Di Yazhen , Chen Yuanling , Li Yunyan , Wang Jiapei
Published: June 2020

Background

Clinical findings reported that some cases of Juvenile Idiopathic Arthritis(JIA) gradually suffer from hyperuricemia(HUA) during the course of follow-up, followed by the detection of high urate crystal, gout, renal impairment, and other manifestations. And thoes patients would influence the prognosis.
Methods

This was a retrospective study of 60 patients diagnosed with JIA between October 2016 and March 2019 and followed up for > 1 year. Single-factor analyses of the clinical data, laboratory data, and the special drug used for JIA complicated with hyperuricemia (Group A, n = 18) and JIA without hyperuricemia (Group B, n = 42) were conducted.
Results

Comparison between Groups A and B revealed differences in sex; disease course; high disease activity; diastolic pressure; the levels of serum albumin (ALB), alanine aminotransferase (ALT), aspartate transaminase (AST), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), glucose (GLU), and urea nitrogen (BUN); NSAIDS application, systemic glucocorticoid application, MTX application, and tumor necrosis factor-alpha (TNF-α) inhibitors application were not statistically significant (P > 0.05). However, the differences in age, active sacroiliitis, body mass index (BMI), systolic pressure, serum creatinine (Scr) level, and salicylazosulfapyridine (SASP) application showed a statistical significance (P < 0.05).
Conclusions

JIA patients were obese ,with high systolic pressure, and after SASP treatment will be more likely to be complicated with hyperuricemia.