bluuebunny/crossref_metadata_2025 huggingface dataset:
Adverse events reporting in stage III NSCLC trials investigating surgery and radiotherapy
Authors: Iseli Thomas , Berghmans Thierry , Glatzer Markus , Rittmeyer Achim , Massard Gilbert , Durieux Valérie , Buchsbaum Thomas , Putora Paul Martin
Published: September 2020

Background

Current treatment options for stage III non-small cell lung cancer (NSCLC) consist of different combinations of chemotherapy, surgery, radiotherapy and immunotherapy. Treatment choices are highly individual decisions, in which adverse events (AEs) are relevant for decision-making. This study aims to analyse reporting of AEs in prospective stage III NSCLC trials, focussing on trials including radiotherapy and/or surgery.

Methods

PubMed was searched for prospective studies dealing with stage III NSCLC from January 1987 to April 2019. Meta-analyses were screened as a positive control. Pearson's Chi-squared test and smooth kernel distribution were used to estimate distributions. Data was resampled using bootstrapping.

Results

Out of 1193 initially identified studies, 119 met the inclusion criteria. Of these, 31 had a surgical procedure in any study arm. Grade 3 and 4 AEs were reported in 94.12% and 92.44% of the included studies, respectively. Reporting of grade 5 AEs was provided in 87.39% of cases. Grade 1 and 2 AEs were less commonly reported at 53.78% and 63.03%, respectively. One study did not mention any AEs. Of the 31 treatment arms including any form of surgery, AEs were not reported in 10. Overall, 231 different AE items were reported, only 18 of them were included in at least 20% of the analysed studies.

Conclusion

Overall, AE reporting in stage III NSCLC was inconsistent and inhomogeneous. Studies including surgical study arms often reported only treatment-related deaths in regards of surgical AEs. Underreporting of AEs prohibits the extraction of patient-relevant information for decision-making and represents a suboptimal use of invested resources.
Mortality and morbidity in obstructive sleep apnoea–hypopnoea syndrome: results from a 30-year prospective cohort study
Authors: Dodds Sophie , Williams Linda J. , Roguski Amber , Vennelle Marjorie , Douglas Neil J. , Kotoulas Serafeim-Chrysovalantis , Riha Renata L.
Published: September 2020

Background

Obstructive sleep apnoea–hypopnoea syndrome (OSAHS) carries substantial negative health consequences. This study examines factors affecting mortality and morbidity according to continuous positive airway pressure (CPAP) use and predictors affecting CPAP adherence in a longitudinal cohort of OSAHS patients.

Materials and methods

This prospective, cohort study comprised 4502 patients who were diagnosed with OSAHS at a tertiary sleep disorders centre between 1982 and 2003. Of these, 1174 patients completed follow-up in 2012. Data collected included anthropometric, sleep and demographic characteristics, including comorbidities, ongoing medications and CPAP adherence. Patients were followed up for an average of 14.8±3.7 years.

Results

Imputation analysis showed that long-term CPAP users (>5 years) were 5.63 times more likely to be alive at study end than non-CPAP users (95% CI: 4.83–6.58, p<0.001) and 1.74-times more likely than short-term CPAP users (≤5 years) (95% CI: 1.49–2.02, p<0.001). Females had a significantly higher mortality rate during the follow-up period (26.8%versus19.6%, p<0.001). Respiratory mortality was more common in patients with OSAHS, in particular those who did not use CPAP, compared to the general population (17.2%versus12.2%, p=0.002 respectively), whereas deaths from cancer were less common compared to the general population (16.2%versus25.6%, p<0.001). Compared to CPAP users, non-CPAP-users had a significantly increased incidence of type II diabetes mellitus (DMII) (27.9%versus18.7%, p=0.003), ischaemic heart disease (IHD) (25.5%versus12.7%, p<0.001) and myocardial infarction (MI) (14.7%versus4.2%, p<0.001) at long-term follow-up.

Conclusions

Long-term CPAP use in men and women with OSAHS reduces mortality and decreases the incidence of DMII and cardiovascular disease.
Does an mHealth system reduce health service use for asthma?
Authors: To Teresa , Lougheed M. Diane , McGihon Rachel , Zhu Jingqin , Gupta Samir , Licskai Christopher
Published: September 2020

Background

Breathe is a mobile health (mHealth) application developed for the self-management of asthma in adults. There is evidence to suggest that mHealth interventions can be used for asthma control; however, their effects on the use of health services remain poorly understood. We sought to determine whether Breathe reduces health services use amongst asthma patients who used the app compared to controls who did not.

Methods

The impact of Breathe on health services use was estimated using a quasi-experimental approach. Two groups of subjects who had participated in a previous randomised clinical trial were included: an intervention group of asthma patients who used the app for 12 months, and a group of controls who did not use the app but received equivalent quality asthma care. A third, external control group of asthma patients were matched to the intervention participants. Generalised linear mixed models were used to determine relative changes in rates of asthma hospitalisations, emergency department (ED) visits, outpatient physician visits and completion of pulmonary function tests (PFTs) over time.

Results

A total of 677 individuals with asthma were included in the study: 132 in the intervention group, and 149 and 396 in the internal and external control groups, respectively. There were no statistically significant differences in the change of asthma hospitalisations, ED visits, physician office visits or completion of PFTs between the intervention group and either control group.

Conclusions

Use of the Breathe app is not associated with changes in health services use in adults with asthma.
Cigarette-related cadmium and environmental pollution exposure are reflected in airway ultrafine particle content
Authors: Fireman Einat Klein , Adir Yochai , Fireman Elizabeth , Kessel Aharon
Published: September 2020

Introduction

Particulate matter (PM) and cigarette-related cadmium exposure increases inflammation and smokers' susceptibility to developing lung diseases. The majority of inhaled metals are attached to the surface of ultrafine particles (UFPs). A low inhaled UFP content in exhaled breath condensate (EBC) reflects a high inflammatory status of airways.

Methods

EBC was collected from 58 COPD patients and 40 healthy smokers and nonsmokers. Participants underwent spirometry, diffusion capacity, EBC and blood sampling. Environmental pollution data were collected from monitoring stations. UFPs were measured in EBC and serum, and cadmium content was quantified.

Results

Subjects with low UFP concentrations in EBC (<0.18×108·mL−1) had been exposed to higher long-term PM2.5levelsversussubjects with high UFP concentrations in EBC (>0.18×108·mL−1) (21.9 µg·m−3versus17.4 µg·m−3, p≤0.001). Long-term PM2.5exposure levels correlated negatively with UFP concentrations in EBC and positively with UFP concentrations in serum (r=−0.54, p≤0.001 and r=0.23, p=0.04, respectively). Healthy smokers had higher cadmium levels in EBCversushealthy nonsmokers and COPD patients (25.2 ppmversus23.7 ppm and 23.3 ppm, p=0.02 and p=0.002, respectively). Subjects with low UFP concentrations in EBC also had low cadmium levels in EBCversussubjects with high UFP levels (22.8 ppmversus24.2 ppm, p=0.004)

Conclusions

Low UFP concentration in EBC is an indicator of high-level PM exposure. High cadmium levels in EBC among smokers and the association between cadmium and UFP content in EBC among COPD patients indicate cadmium lung toxicity.
Impaired effective functional connectivity of the sensorimotor network in interictal episodic migraineurs without aura
Authors: Wei Heng-Le , Chen Jing , Chen Yu-Chen , Yu Yu-Sheng , Guo Xi , Zhou Gang-Ping , Zhou Qing-Qing , He Zhen-Zhen , Yang Lian , Yin Xindao , Li Junrong , Zhang Hong
Published: September 2020

Background

Resting-state functional magnetic resonance imaging (Rs-fMRI) has confirmed sensorimotor network (SMN) dysfunction in migraine without aura (MwoA). However, the underlying mechanisms of SMN effective functional connectivity in MwoA remain unclear. We aimed to explore the association between clinical characteristics and effective functional connectivity in SMN, in interictal patients who have MwoA.

Methods

We used Rs-fMRI to acquire imaging data in 40 episodic patients with MwoA in the interictal phase and 34 healthy controls (HCs). Independent component analysis was used to profile the distribution of SMN and calculate the different SMN activity between the two groups. Subsequently, Granger causality analysis was used to analyze the effective functional connectivity between the SMN and other brain regions.

Results

Compared to the HCs, MwoA patients showed higher activity in the bilateral postcentral gyri (PoCG), but lower activity in the left midcingulate cortex (MCC). Moreover, MwoA patients showed decreased effective functional connectivity from the SMN to left middle temporal gyrus, right putamen, left insula and bilateral precuneus, but increased effective functional connectivity to the right paracentral lobule. There was also significant effective functional connectivity from the primary visual cortex, right cuneus and right putamen to the SMN. In the interictal period, there was positive correlation between the activity of the right PoCG and the frequency of headache. The disease duration was positively correlated with abnormal effective functional connectivity from the left PoCG to right precuneus. In addition, the headache impact scores were negatively correlated with abnormal effective functional connectivity from the left MCC to right paracentral lobule, as well as from the right precuneus to left PoCG.

Conclusions

These differential, resting-state functional activities of the SMN in episodic MwoA may contribute to the understanding of migraine-related intra- and internetwork imbalances associated with nociceptive regulation and chronification.
Haemodynamic activity characterization of resting state networks by fractal analysis and thalamocortical morphofunctional integrity in chronic migraine
Authors: Porcaro Camillo , Di Renzo Antonio , Tinelli Emanuele , Di Lorenzo Giorgio , Parisi Vincenzo , Caramia Francesca , Fiorelli Marco , Di Piero Vittorio , Pierelli Francesco , Coppola Gianluca
Published: September 2020

Background

Chronic migraine (CM) can be associated with aberrant long-range connectivity of MRI-derived resting-state networks (RSNs). Here, we investigated how the fractal dimension (FD) of blood oxygenation level dependent (BOLD) activity may be used to estimate the complexity of RSNs, reflecting flexibility and/or efficiency in information processing in CM patients respect to healthy controls (HC).

Methods

Resting-state MRI data were collected from 20 untreated CM without history of medication overuse and 20 HC. On both groups, we estimated the Higuchi’s FD. On the same subjects, fractional anisotropy (FA) and mean diffusivity (MD) values of bilateral thalami were retrieved from diffusion tensor imaging and correlated with the FD values.

Results

CM showed higher FD values within dorsal attention system (DAS) and the anterior part of default-mode network (DMN), and lower FD values within the posterior DMN compared to HC. Although FA and MD were within the range of normality, both correlated with the FD values of DAS.

Conclusions

FD of DAS and DMN may reflect disruption of cognitive control of pain in CM. Since the normal microstructure of the thalamus and its positive connectivity with the cortical networking found in our CM patients reminds similar results obtained assessing the same structures but with the methods of neurophysiology, in episodic migraine during an attack, this may be yet another evidence in supporting CM as a never-ending migraine attack.
Social and family factors as determinants of exercise habits in Japanese elementary school children: a cross-sectional study from the Super Shokuiku School Project
Authors: Sawa Satomi , Sekine Michikazu , Yamada Masaaki , Fukazawa Yugo , Hiraku Yusuke
Published: September 2020

Background

Many studies have already reported on the relationship between exercise habits and health among schoolchildren. However, few have examined social and/or family factors as determinants of exercise habits.

Methods

This study’s participants included 1721 schoolchildren aged between 6 and 13 who were involved in the Super Shokuiku School Project in January 2016. A survey was conducted to assess gender, grade level, physical activity, lifestyle, overall health, enrichment of school life, social background, and parental lifestyles. Both dislike and lack of physical activity were used to measure poor exercise habits; correlates were analyzed using logistic regression.

Results

“Lack of close friends” had the strongest links with both dislike (adjusted odds ratio [OR] 5.30; 95% confidence interval [CI], 2.78–10.1) and lack of (adjusted OR 5.40; 95% CI, 2.81–10.4) physical activity. Further, children who engaged in long periods of screen time and lacked parental communication also tended to dislike and lack physical activity. Children with mothers who were unemployed (housewives) and had unhealthy lifestyles, as well as those with poor health, were also more likely to lack physical activity.

Conclusion

Social and family factors (e.g., having close friends) may be determinants of exercise habits among schoolchildren, independent of their own lifestyle factors. Although a longitudinal study is needed to determine causality, substantial attention may thus be required to these factors when promoting physical activity in children.
Testing species hypotheses for Fridericia magna, an enchytraeid worm (Annelida: Clitellata) with great mitochondrial variation
Authors: Martinsson Svante , Klinth Mårten , Erséus Christer
Published: September 2020

Background

Deep mitochondrial divergences were observed in Scandinavian populations of the terrestrial to semi-aquatic annelidFridericia magna(Clitellata: Enchytraeidae). This raised the need for testing whether the taxon is a single species or a complex of cryptic species.

Results

A total of 62 specimens from 38 localities were included in the study, 44 of which were used for species delimitation. First, the 44 specimens were divided into clusters using ABGD (Automatic Barcode Gap Discovery) on two datasets, consisting of sequences of the mitochondrial markers COI and 16S. For each dataset, the worms were divided into six not completely congruent clusters. When they were combined, a maximum of seven clusters, or species hypotheses, were obtained, and the seven clusters were used as input in downstream analyses. We tested these hypotheses by constructing haplowebs for two nuclear markers, H3 and ITS, and in both haplowebs the specimens appeared as a single species. Multi-locus species delimitation analyses performed with the Bayesian BPP program also mainly supported a single species. Furthermore, no apparent morphological differences were found between the clusters. Two of the clusters were partially separated from each other and the other clusters, but not strongly enough to consider them as separate species. All 62 specimens were used to visualise the Scandinavian distribution, of the species, and to compare with published COI data from otherFridericiaspecies.

Conclusion

We show that the morphospeciesFridericia magnais a single species, harbouring several distinct mitochondrial clusters. There is partial genetic separation between some of them, which may be interpreted as incipient speciation. The study shows the importance of rigorous species delimitation using several independent markers when deep mitochondrial divergences might give the false impression of cryptic speciation.
The development of early pioneer neurons in the annelid Malacoceros fuliginosus
Authors: Kumar Suman , Tumu Sharat Chandra , Helm Conrad , Hausen Harald
Published: September 2020

Background

Nervous system development is an interplay of many processes: the formation of individual neurons, which depends on whole-body and local patterning processes, and the coordinated growth of neurites and synapse formation. While knowledge of neural patterning in several animal groups is increasing, data on pioneer neurons that create the early axonal scaffold are scarce. Here we studied the first steps of nervous system development in the annelid Malacoceros fuliginosus.

Results

We performed a dense expression profiling of a broad set of neural genes. We found that SoxB expression begins at 4 h postfertilization, and shortly later, the neuronal progenitors can be identified at the anterior and the posterior pole by the transient and dynamic expression of proneural genes. At 9 hpf, the first neuronal cells start differentiating, and we provide a detailed description of axonal outgrowth of the pioneer neurons that create the primary neuronal scaffold. Tracing back the clonal origin of the ventral nerve cord pioneer neuron revealed that it is a descendant of the blastomere 2d (2d221), which after 7 cleavages starts expressing Neurogenin, Acheate-Scute and NeuroD.

Conclusions

We propose that an anterior and posterior origin of the nervous system is ancestral in annelids. We suggest that closer examination of the first pioneer neurons will be valuable in better understanding of nervous system development in spirally cleaving animals, to determine the potential role of cell-intrinsic properties in neuronal specification and to resolve the evolution of nervous systems.
Overexpression of transcription factor SlWRKY28 improved the tolerance of Populus davidiana × P. bolleana to alkaline salt stress
Authors: Wang Xin , Ajab Zainab , Liu Chenxi , Hu Songmiao , Liu Jiali , Guan Qingjie
Published: September 2020

Background

WRKY transcription factors (TFs) have been suggested to play crucial roles in the response to biotic and abiotic stresses. This study is the first to report the alkaline salt regulation of the WRKY gene.

Results

In this study, we cloned a WRKY gene (SlWRKY28) from the Salix linearistipularis and then transferred to the Populus davidiana × P. bolleana for expression. Sequence analysis on the transcriptome of Salix linearistipular showed the significant up-regulation of WRKY gene expression in response to salt-alkali stress in seedlings. Our data showed that SlWRKY28 localized to the nucleus. Furthermore, the expression of the SlWRKY28 from female plants increased with saline-alkali stress according to the northern blot analysis results. The results of 3,3′-Diaminobenzidine (DAB) staining showed that hydrogen peroxide (H2O2) concentration was lower under stress, but ascorbate peroxidase (APX) enzyme activity was significantly higher in the overexpressed plants than that in non-transgenic (NT) plants.

Conclusions

We found out the SlWRKY28 induced regulation of the enzyme gene in the reactive oxygen species (ROS) scavenging pathway is a potential mechanism for transgenic lines to improve their resistance to alkaline salt. This study shows theoretical and practical significance in determining SlWRKY28 transcription factors involved in the regulation of alkaline salt tolerance.
Understanding seasonal weight loss tolerance in dairy goats: a transcriptomics approach
Authors: Parreira José Ricardo , Hernández-Castellano Lorenzo Enrique , Argüello Anastasio , Capote Juan , Castro Noemí , de Sousa Araújo Susana , de Almeida André Martinho
Published: September 2020

Background

Seasonal weight loss (SWL) is a very important limitation to the production of ruminants in the Mediterranean and Tropical regions. In these areas, long dry seasons lead to poor pastures with low nutritional value. During the dry season, ruminants, particularly those raised in extensive production systems, lose around 30% of their body weight. Seasonal weight loss has important consequences on animal productive performance and health. In this study, RNA sequencing was used to characterize feed restriction effects in dairy goat of 2 breeds with different SWL tolerance:Majorera(tolerant) andPalmera(susceptible). NineMajoreraand tenPalmeragoats were randomly distributed in a control and a restricted group:MajoreraControl (adequately fed; MC;n = 4),PalmeraControl (adequately fed; PC;n = 6),MajoreraRestricted (feed restricted; ME;n = 5) andPalmeraRestricted (feed restricted; PE; n = 4). On day 22 of the trial, mammary gland biopsies were collected for transcriptomics analysis.

Results

From these samples, 24,260 unique transcripts were identified. From those, 82 transcripts were differentially expressed between MC and ME, 99 between PC and PE, twelve between both control groups and twenty-nine between both restricted groups.

Conclusions

Feed restriction affected several biochemical pathways in both breeds such as: carbohydrate and lipid transport; intracellular trafficking, RNA processing and signal transduction.This research also highlights the importance or involvement of the genes in tolerance (ENPP1,S-LZ,MT2AandGPNB) and susceptibility (GPD1,CTPS1,ELOVL6andNR4A1) to SWL with respectively higher expression in theMajorerarestriced group and thePalmerarestricted group in comparison to the control groups. In addition, results from the study may be extrapolated to other dairy ruminant species.
CrustyBase: an interactive online database for crustacean transcriptomes
Authors: Hyde Cameron J. , Fitzgibbon Quinn P. , Elizur Abigail , Smith Gregory G. , Ventura Tomer
Published: September 2020

Transcriptome sequencing has opened the field of genomics to a wide variety of researchers, owing to its efficiency, applicability across species and ability to quantify gene expression. The resulting datasets are a rich source of information that can be mined for many years into the future, with each dataset providing a unique angle on a specific context in biology. Maintaining accessibility to this accumulation of data presents quite a challenge for researchers.

The primary focus of conventional genomics databases is the storage, navigation and interpretation of sequence data, which is typically classified down to the level of a species or individual. The addition of expression data adds a new dimension to this paradigm – the sampling context. Does gene expression describe different tissues, a temporal distribution or an experimental treatment? These data not only describe an individual, but the biological context surrounding that individual. The structure and utility of a transcriptome database must therefore reflect these attributes. We present an online database which has been designed to maximise the accessibility of crustacean transcriptome data by providing intuitive navigation within and between datasets and instant visualization of gene expression and protein structure.

The site is accessible at https://crustybase.org and currently holds 10 datasets from a range of crustacean species. It also allows for upload of novel transcriptome datasets through a simple web interface, allowing the research community to contribute their own data to a pool of shared knowledge.
Interactions between genetics and environment shape Camelina seed oil composition
Authors: Brock Jordan R. , Scott Trey , Lee Amy Yoonjin , Mosyakin Sergei L. , Olsen Kenneth M.
Published: September 2020

Background

Camelina sativa (gold-of-pleasure) is a traditional European oilseed crop and emerging biofuel source with high levels of desirable fatty acids. A twentieth century germplasm bottleneck depleted genetic diversity in the crop, leading to recent interest in using wild relatives for crop improvement. However, little is known about seed oil content and genetic diversity in wild Camelina species.

Results

We used gas chromatography, environmental niche assessment, and genotyping-by-sequencing to assess seed fatty acid composition, environmental distributions, and population structure in C. sativa and four congeners, with a primary focus on the crop’s wild progenitor, C. microcarpa. Fatty acid composition differed significantly between Camelina species, which occur in largely non-overlapping environments. The crop progenitor comprises three genetic subpopulations with discrete fatty acid compositions. Environment, subpopulation, and population-by-environment interactions were all important predictors for seed oil in these wild populations. A complementary growth chamber experiment using C. sativa confirmed that growing conditions can dramatically affect both oil quantity and fatty acid composition in Camelina.

Conclusions

Genetics, environmental conditions, and genotype-by-environment interactions all contribute to fatty acid variation in Camelina species. These insights suggest careful breeding may overcome the unfavorable FA compositions in oilseed crops that are predicted with warming climates.
Conceptualizations of clinical decision-making: a scoping review in geriatric emergency medicine
Authors: Gamborg Maria Louise , Mehlsen Mimi , Paltved Charlotte , Tramm Gitte , Musaeus Peter
Published: September 2020

Background

Clinical decision-making (CDM) is an important competency for young doctors especially under complex and uncertain conditions in geriatric emergency medicine (GEM). However, research in this field is characterized by vague conceptualizations of CDM. To evolve and evaluate evidence-based knowledge of CDM, it is important to identify different definitions and their operationalizations in studies on GEM.

Objective

A scoping review of empirical articles was conducted to provide an overview of the documented evidence of findings and conceptualizations of CDM in GEM.

Methods

A detailed search for empirical studies focusing on CDM in a GEM setting was conducted in PubMed, ProQuest, Scopus, EMBASE and Web of Science. In total, 52 publications were included in the analysis, utilizing a data extraction sheet, following the PRISMA guidelines. Reported outcomes were summarized.

Results

Four themes of operationalization of CDM emerged: CDM as dispositional decisions, CDM as cognition, CDM as a model, and CDM as clinical judgement. Study results and conclusions naturally differed according to how CDM was conceptualized. Thus, frailty-heuristics lead to biases in treatment of geriatric patients and the complexity of this patient group was seen as a challenge for young physicians engaging in CDM.

Conclusions

This scoping review summarizes how different studies in GEM use the term CDM. It provides an analysis of findings in GEM and call for more stringent definitions of CDM in future research, so that it might lead to better clinical practice.
Avoidability of drug-induced liver injury (DILI) in an elderly hospital cohort with cases assessed for causality by the updated RUCAM score
Authors: Danjuma Mohammed Ibn-Mas’ud , Almasri Hussam , Alshokri Shaikha , Khir Fadi Khazahia , Elmalik Ashraf , Battikh Naim Ghazi , Abdallah Ibtihal Mahmoud Hassan , Elshafei Mohamed , Fatima Haajra , Mohamed Mouhand Faisal Hamad , Maghoub Yahya , Hussain Tanweer , Kamal Ijaz , Anwer Zubair , Bidmos Mubarak Ariyo , Elzouki Abdel-Naser
Published: September 2020

Background

Drug-induced liver injury (DILI) represents an increasing morbidity in the general population, but more so in the elderly cohort of patients. Despite this, the concept of its prevention through prospective analysis has largely remained unexamined. We evaluated the utility of recently validated adverse drug reactions (ADR) avoidability tool in a cohort of elderly patients with DILI.

Methods

We examined 38 DILI-drug pairs from n=38 patients in a prospective cohort of patients presenting with adverse drug reactions to a Weill Cornell-affiliated tertiary hospital between February 2019 and January 2020. DILI outcomes were adjudicated by the updated Roussel Uclaf Causality Assessment Method (RUCAM). Two clinical pharmacologists and two general physicians utilized the Liverpool adverse drug reactions avoidability tool (LAAT) and the modified Hallas tools to rate the preventability of DILI-drug pairs. Inter-rater, exact agreement proportions, as well as intraclass correlation coefficients were generated and expressed as ordinal outcomes.

Results

The cases examined for the determination of DILI avoidability had probability likelihood of “probable” or “highly probable” by the updated RUCAM scale. Examination of the 38 DILI-drug pairs (n= 38 patients) resulted in a total of 152 ordinal outcome decisions. We found about 32.3% (50/152) and 34.2% (52/152) of DILI-drug pairs were rated as “avoidable” (“probable” or “definite”) by the LAAT and the modified Hallas tools respectively. The overall median Krippendorf’s kappa with the LAAT was 0.61 (SE 0.12, CI 0.36, 0.85) and for modified Hallas tool was 0.53 (SE 0.18; CI 0.16, 0.89). The inter-rater correlation coefficient (ICC) for the LAAT and modified Hallas were 0.50 [0.32, 0.65] and 0.63 [0.48, 0.76] respectively. Exact pairwise agreement was present in 30/38 (IQR 29.5, 34.5), and 28/38 (IQR 27.5-35.5) of DILI-ADR pairs using the LAAT and modified Hallas tools respectively.

Conclusion

We found a significant proportion of drug-induced liver injury adjudicated by the updated RUCAM scale in elderly hospitalized cohort of patients were avoidable with significant implication for therapeutic commissioning as well as cost effectiveness interventions in this cohort of patients.
Identifying risk factors for chronic kidney disease stage 3 in adults with acquired solitary kidney from unilateral nephrectomy: a retrospective cohort study
Authors: Zhang Wen-Jun , Wang Zi-Yi , Zhou Wei-Xing , Yang Ning-Qiang , Wang Ya , Tang Ya , Zhou Xiao-Chun , Dao Jie-Cao , Ma Yan-Ru , He Yan-Ping , Wang Xiao-Ling , Wang Wen-Ge , Yang Li
Published: September 2020

Background

We aimed to examine the risk factors for chronic kidney disease (CKD) stage 3 among adults with ASK from unilateral nephrectomy.

Methods

We retrospectively collected data from adult patients with ASK between January, 2009 and January, 2019, identified from a tertiary hospital in China. The clinical data were compared between patients who developed CKD stage 3 and those who did not develop CKD stage 3 during follow-up.

Results

In total, 172 patients with ASK (110 men; median 58.0 years) were enrolled, with a median follow-up duration of 5.0 years. During follow-up, 91 (52.9%) and 24 (14.0%) patients developed CKD stage 3 and end-stage renal disease, respectively. Multiple regression analyses showed that age (odds ratio [OR] 1.076, 95% confidence interval [CI] 1.039–1.115, p < 0.001), diabetes (OR 4.401, 95% CI 1.693–11.44, p = 0.002), hyperuricemia (OR 2.733, 95% CI 1.104–6.764, p = 0.03), a history of cardiovascular disease (CVD) (OR 5.583, 95% CI 1.884–18.068, p = 0.002), and ASK due to renal tuberculosis (OR 8.816, 95% CI 2.92–26.62, p < 0.001) were independent risk factors for developing CKD stage 3 among patients with ASK.

Conclusions

Regular follow-up of renal function is needed among adult patients with ASK. Optimal management of diabetes, hyperuricemia, and CVD may reduce their risk of CKD stage 3, especially among those that undergo unilateral nephrectomy for renal tuberculosis.
Intracranial arterial stenosis associated with Hashimoto’s disease: angiographic features and clinical outcomes
Authors: Hamano Eika , Nishimura Masaki , Mori Hisae , Satow Tetsu , Takahashi Jun C.
Published: September 2020

Background

Hashimoto’s disease has reportedly been associated with stroke; however, cerebrovascular morphology and clinical course remain poorly documented. The present study aimed to determine the angiographic features and clinical outcomes of intracranial arterial stenosis (IAS) associated with Hashimoto’s disease in a retrospective cohort.

Methods

Overall, 107 adult patients with IAS were screened for anti-thyroid antibodies; of these, 26 patients tested positive. The 42 affected hemispheres were classified into subgroups according to the steno-occlusion site and the development of abnormal collateral (moyamoya) vessels. These subgroups were dichotomized into moyamoya vessels positive (MM type) and negative (non-MM type). The initial presentation, IAS progression, and vascular events during the follow-up period were compared.

Results

The following sites of stenosis were identified: the bifurcation of the internal carotid artery in 11 (26.2%), M1 or A1 in 29 (69.0%), and more distal (M2-M4/A2-A4) in 2 (4.8%) hemispheres. Further, 17 hemispheres were categorized into the MM type and 25 were classified into the non-MM type. During the follow-up period (mean 2.5 years), IAS progression was identified in 8 (32%) hemispheres of the non-MM type and 0 (0%) hemispheres of the MM type (p = 0.041). Ischemic attacks occurred in 5 (20.0%) hemispheres of the non-MM type (4.6%/year) and 0 hemispheres of the MM type (p = 0.08). Further, 4 (23.5%) hemispheres of the MM type experienced intracerebral hemorrhage, whereas none of the non-MM type hemorrhaged (p = 0.012).

Conclusions

Hashimoto’s disease-associated IAS exhibits various angiographic morphologies, resulting in different clinical presentations. Screening for anti-thyroid antibodies and careful management based on vascular morphology appears important in adults with IAS.
Reference intervals of gestational sac, yolk sac, embryonic length, embryonic heart rate at 6–10 weeks after in vitro fertilization-embryo transfer
Authors: Ouyang Yan , Qin Jiabi , Lin Ge , Xiang Shuanglin , Li Xihong
Published: September 2020

Background

Accurately determining the normal range of early pregnancy markers can help to predict adverse pregnancy outcomes. The variance in ovulation days leads to uncertain accuracy of reference intervals for natural pregnancies. While the gestational age (GA) is accurate estimation during in vitro fertilization-embryo transfer (IVF-ET). Thus, the objective of this research is to construct reference intervals for gestational sac diameter (GSD), yolk sac diameter (YSD), embryonic length (or crown–rump length, CRL) and embryonic heart rate (HR) at 6–10 gestational weeks (GW) after IVF-ET.

Methods

From January 2010 to December 2016, 30,416 eligible singleton pregnancies were retrospectively recruited. All included participants had full records of early ultrasound measurements and phenotypically normal live neonates after 37 GW, with birth weights > the 5th percentile for gestational age. The curve-fitting method was used to screen the optimal models to predict GSD, CRL, YSD and HR based on gestational days (GD) and GW. Additionally, the percentile method was used to calculate the 5th, 50th, and 95th percentiles.

Results

There were significant associations among GSD, CRL, YSD, HR and GD and GW, the models were GSD = − 29.180 + 1.070 GD (coefficient of determination [R2] = 0.796), CRL = − 11.960 - 0.147 GD + 0.011 GD2 (R2 = 0.976), YSD = − 2.304 + 0.184 GD - 0.011 GD2 (R2 = 0.500), HR = − 350.410 + 15.398 GD - 0.112 GD2 (R2 = 0.911); and GSD = − 29.180 + 7.492 GW (R2 = 0.796), CRL = − 11.960 - 1.028 GW + 0.535 GW2 (R2 = 0.976), YSD = − 2.304 + 1.288 GW - 0.054 GW2 (R2 = 0.500), HR = − 350.410 + 107.788 GW - 5.488 GW2 (R2 = 0.911), (p < 0.001).

Conclusions

Reference intervals for GSD, YSD, HR and CRL at 6–10 gestational weeks after IVF-ET were established.
Factors associated with low birth weight at term: a population-based linkage study of the 100 million Brazilian cohort
Authors: Falcão Ila R. , Ribeiro-Silva Rita de Cássia , de Almeida Marcia F. , Fiaccone Rosemeire L. , dos S. Rocha Aline , Ortelan Naiá , Silva Natanael J. , Paixao Enny S. , Ichihara Maria Yury , Rodrigues Laura C. , Barreto Mauricio L.
Published: September 2020

Background

Factors associated with low birth weight at term (TLBW), a proxy for intrauterine growth restriction (IUGR), are not well-elucidated in socioeconomically vulnerable populations. This study aimed to identify the factors associated with TLBW in impoverished Brazilian women.

Methods

Records in the 100 Million Brazilian Cohort database were linked to those in the National System of Information on Live Births (SINASC) to obtain obstetric, maternal, birth and socioeconomic data between 2001 and 2015. Multivariate logistic regression was performed to investigate associations between variables of exposure and TLBW.

Results

Of 8,768,930 term live births analyzed, 3.7% presented TLBW. The highest odds of TLBW were associated with female newborns (OR: 1.49; 95% CI: 1.47–1.50), whose mothers were black (OR: 1.20; 95% CI: 1.18–1.22), had a low educational level (OR: 1.57; 95% CI: 1.53–1.62), were aged ≥35 years (OR: 1.44; 95% CI: 1.43–1.46), had a low number of prenatal care visits (OR: 2.48; 95% CI: 2.42–2.54) and were primiparous (OR: 1.62; 95% CI: 1.60–1.64). Lower odds of TLBW were found among infants whose mothers lived in the North, Northeast and Center-West regions of Brazil compared to those in the South.

Conclusion

Multiple aspects were associated with TLBW, highlighting the need to comprehensively examine the mechanisms underlying these factors, especially in more vulnerable Brazilian populations, in order to contribute to the elaboration of health policies and promote better conditions of life for poor and extremely poor mothers and children.
Upregulated expression of LncRNA nicotinamide nucleotide transhydrogenase antisense RNA 1 is correlated with unfavorable clinical outcomes in cancers
Authors: Zhang Chenghao , Ren Xiaolei , Liu Zhongyue , Tu Chao
Published: September 2020

Background

The nicotinamide nucleotide transhydrogenase antisense RNA 1 (NNT-AS1) is a long non-coding RNA aberrantly expressed in human malignancies. We aimed to analyze available data to evaluate the correlation between NNT-AS1 expression and cancer prognosis.

Methods

Literature retrieval was performed by systematic searching related databases from inception to April 2, 2020. Studies regarding correlation between NNT-AS1 expression, survival outcomes and clinical characteristics of cancer patients were collected and pooled to calculate the the hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (95% CIs).

Results

Ten studies comprising 699 patients were included, all of which were conducted in China according to literature selection criteria. Overexpression of NNT-AS1 had a significant association with unfavorable overall survival (OS) (HR = 2.08, 95% CI: 1.84–2.36,P < 0.001). Stratified analysis showed that tumor type, sample size, follow-up months, and survival analysis approach did not change the predictive value of NNT-AS1 on OS. Furthermore, elevated NNT-AS1 level had significant association with distant metastasis (DM) (OR = 2.45, 95% CI: 1.39–4.30), lymph node metastasis (LNM) (OR = 3.92, 95% CI: 1.35–11.41), TNM stage (OR = 4.25, 95% CI: 1.71–10.56), and vascular invasion (OR = 3.98, 95% CI: 2.06–7.71), but was not associated with age and gender. The TCGA dataset further consistently showed that the NNT-AS1 expression was associated with poor OS and disease-free survival.

Conclusions

High expression of NNT-AS1 is associated with unfavorable survival outcomes and poor clinicopathologic characteristics. However, large-cohort data and geographical studies are still needed to further validate the prognostic value of NNT-AS1 in cancers.
Impact of integrated district level mental health care on clinical and functioning outcomes of people with depression and alcohol use disorder in Nepal: a non-randomised controlled study
Authors: Jordans M. J. D. , Garman E. C. , Luitel N. P. , Kohrt B. A. , Lund C. , Patel V. , Tomlinson M.
Published: September 2020

Background

Integration of mental health services into primary healthcare is proliferating in low-resource countries. We aimed to evaluate the impact of different compositions of primary care mental health services for depression and alcohol use disorder (AUD), when compared to usual primary care services.

Methods

We conducted a non-randomized controlled study in rural Nepal. We compared treatment outcomes among patients screening positive and receiving: (a) primary care mental health services without a psychological treatment component (TG); (b) the same services including a psychological treatment (TG + P); and (c) primary care treatment as usual (TAU). Primary outcomes included change in depression and AUD symptoms, as well as disability. Disability was measured using the 12-item WHO Disability Assessment Schedule. Symptom severity was assessed using the 9-item Patient Health Questionnaire for depression, the 10-item Alcohol Use Disorders Identification Test for AUD. We used negative binomial regression models for the analysis.

Results

For depression, when combining both treatment groups (TG,n = 77 and TG + P,n = 60) compared to TAU (n = 72), there were no significant improvements. When only comparing the psychological treatment group (TG + P) with TAU, there were significant improvements for symptoms and disability (aβ = − 2.64; 95%CI − 4.55 to − 0.74,p = 0.007; aβ = − 12.20; 95%CI − 19.79 to − 4.62;p = 0.002, respectively). For AUD, when combining both treatment groups (TG,n = 92 and TG + P,n = 80) compared to TAU (n = 57), there were significant improvements in AUD symptoms and disability (aβ = − 15.13; 95%CI − 18.63 to − 11.63,p < 0.001; aβ = − 9.26; 95%CI − 16.41 to − 2.12,p = 0.011; respectively). For AUD, there were no differences between TG and TG + P. Patients’ perceptions of health workers’ skills in common psychological factors were associated with improvement in depression patient outcomes (β = − 0.36; 95%CI − 0.55 to − 0.18;p < 0.001) but not for AUD patients.

Conclusion

Primary care mental health services for depression may only be effective when psychological treatments are included. Health workers’ competencies as perceived by patients may be an important indicator for treatment effect. AUD treatment in primary care appears to be beneficial even without additional psychological services.
Knowledge, attitude and practice towards risky sexual behaviors among secondary and preparatory students of Metu town, south western Ethiopia
Authors: keto Terefe , Tilahun Ayele , Mamo Aklilu
Published: September 2020

Abstracts

Background

Sexual risk behaviors are defined as sexual activities that may make an individual liable to the risk of sexually transmitted infections including Human Immunodeficiency virus (HIV) and unplanned pregnancies. Adolescents are at high risk of developing sexual risk behavior. The rate of risky sexual behaviors and the spread of STIs continue to be increase among the adolescent population. Therefore this study aimed to assess Metu secondary and preparatory school adolescent knowledge, attitude, and practice of risky sexual behaviors.

Methods

Institution based descriptive cross sectional study was conducted among Metu secondary and preparatory school students from 04 Feb 2019–07 June 2019. The study participants were selected through systematic random sampling techniques and the data was collected through self-administered questionnaires. A Total of 361 study subjects were included in the study. Data was entered in EpiData and analyzed by using SPSS version 21.

Results

Three hundred sixty one respondents participated in this study. Of those, 75.9% of them have awareness about risky sexual behaviors and about 76.5. % of them has awareness on consequences of unsafe sex. Among the total study participants, about 22.7% of them had previously practiced in sexual activity; of these 61.7% of respondents had more than one sexual partner. From the respondents who had practiced sex, 19.8% of them had always used condom during their sexual intercourse with their partners, while 58% of them never used condom during sexual intercourse.

Conclusions

Even though the majority of the students have an awareness regarding sexual risk behaviors, a considerable number of students have practiced risky sexual behaviors that might predispose them for different sexual and reproductive health problems and peer pressure was revealed as a major factor that influences the respondents towards their first sexual intercourse. Peers have greater influence on the positive and negative behavior of their friends. Therefore the school should emphasize on promoting peer educators and peer discussion to protect adolescents and youth from risky sexual behaviors.
Association between long-term exposure to air pollutants and cardiopulmonary mortality rates in South Korea
Authors: Hwang Jeongeun , Kwon Jinhee , Yi Hahn , Bae Hyun-Jin , Jang Miso , Kim Namkug
Published: September 2020

Background

The association between long-term exposure to air pollutants, including nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), ozone (O3), and particulate matter 10 μm or less in diameter (PM10), and mortality by ischemic heart disease (IHD), cerebrovascular disease (CVD), pneumonia (PN), and chronic lower respiratory disease (CLRD) is unclear. We investigated whether living in an administrative district with heavy air pollution is associated with an increased risk of mortality by the diseases through an ecological study using South Korean administrative data over 19 years.

Methods

A total of 249 Si-Gun-Gus, unit of administrative districts in South Korea were studied. In each district, the daily concentrations of CO, SO2, NO2, O3, and PM10 were averaged over 19 years (2001–2018). Age-adjusted mortality rates by IHD, CVD, PN and CLRD for each district were averaged for the same study period. Multivariate beta-regression analysis was performed to estimate the associations between air pollutant concentrations and mortality rates, after adjusting for confounding factors including altitude, population density, higher education rate, smoking rate, obesity rate, and gross regional domestic product per capita. Associations were also estimated for two subgrouping schema: Capital and non-Capital areas (77:172 districts) and urban and rural areas (168:81 districts).

Results

For IHD, higher SO2 concentrations were significantly associated with a higher mortality rate, whereas other air pollutants had null associations. For CVD, SO2 and PM10 concentrations were significantly associated with a higher mortality rate. For PN, O3 concentrations had significant positive associations with a higher mortality rate, while SO2, NO2, and PM10 concentrations had significant negative associations. For CLRD, O3 concentrations were associated with an increased mortality rate, while CO, NO2, and PM10 concentrations had negative associations. In the subgroup analysis, positive associations between SO2 concentrations and IHD mortality were consistently observed in all subgroups, while other pollutant-disease pairs showed null, or mixed associations.

Conclusion

Long-term exposure to high SO2 concentration was significantly and consistently associated with a high mortality rate nationwide and in Capital and non-Capital areas, and in urban and rural areas. Associations between other air pollutants and disease-related mortalities need to be investigated in further studies.