bluuebunny/crossref_metadata_2025 huggingface dataset:
Influencing factors on the tendency of general practitioners to join in Urban Family Physician Program in Iran
Authors: Bayati Mohsen , Rashidian Arash , Delavari Sajad , Yazdi-Feyzabadi Vahid
Published: February 2020

Background Urban family physician program (UFPP) is initiated as pilot by policy makers as a main reform in future of primary health care in Iran. Despite an ongoing pilot implementation of this program from 2012, it remains a main question about providing sufficient number of general practitioners (GPs). This study aimed to investigate the factors which affect GPs' decision to join in the UFPP.Methods In this national cross-sectional study, data were gathered by a self-report questionnaire from 601 GPs. The multivariate logistic regression was applied to explore the demographic, practice and views determinants of the tendency of GPs to join in the UFPP.Results More than half of GPs (58.6%) participated in the study had a positive tendency to join in the UFPP. Older GPs (adjusted OR=3.72; 95%CI: 1.05-13.09), working in public sector (adjusted OR=2.26; 95%CI: 1.43-3.58), lower income level (adjusted OR=6.69; 95%CI:2.95-15.16), higher economic expectations (adjusted OR=2.08; 95%CI: 1.19-3.63), and higher satisfaction from medicine profession (adjusted OR=2.00; 95%CI: 1.14-3.51) were the main factors which increased the GPs tendency to join UFPP.Conclusions decision for joining in the program is mainly affected by GPs' economic status. This clarifies that if the program can make them closer to their target income, they would be more likely to decide for joining in the program.
Clinical Features Of Ocular Myasthenia Gravis In Adult Patients: Diplopia and Ophthalmoplegia
Authors: Tang Junjie , Chen Fangyuan , Liu Xiaoyong , Chen Jian , Zhou Qing
Published: February 2020

Background: The diagnosis of ocular myasthenia gravis (OMG) in adult patients remained challenged and the characteristics of diplopia and ophthalmoplegia in OMG is unclear. Methods: Retrospective case series study of medical records of 40 adult patients diagnosed with OMG at The First Affiliated Hospital of Jinan University from June, 2016 to December, 2019, was performed to analyze the clinical features, diagnostic tests and preferential affected extraocular muscles of OMG. Results: 40 adult patients with OMG were involved and men represented 20 (50%) of cases. Mean age (±SD) among men was 49 ± 21 years (range: 19-81 years) and 40 ± 15 years (range: 21-65 years) among women. 18 patients (45.0%) were 18 to 39 years old, 12 patients (30.0%) were 40 to 59 years old, 9 patients (22.5%) were 60 to 79 years old, 1 patients (2.5%) over 80 years old. The median course of the disease among all the patients was 6 months (ranged: 1 month to 10 years). Neostigmine test was positive in 32 of 40 patients (80.0%), acetycholine receptors antibodies assay was positive in 4 of 40 patients (10.0%), Thymus CT showed abnormal findings in 5 of 40 patients (12.5%). At the first visit, 27 patients (67.5%) showed diplopia only, 9 patients (22.5%) showed ptosis only, 4 patients (10.0%) showed diplopia with ptosis. The most paralytic EOM, determined through light reflection, cover-uncover test and red glass test for patients presented with diplopia only (n=27) and diplopia with ptosis (n=9), was lateral rectus (51.6%), superior rectus (19.4%), medial rectus (12.9%), inferior rectus (9.8%), superior oblique (3.2%), inferior oblique (3.2%) in order. Conclusions: OMG mainly affected adults at the working ages. Diplopia serves as initial symptom in most adult patients with OMG and lateral rectus is most susceptible.
Birth Month And Prevalence Of Atopic Dermatitis In Children Under 3 Years In Antananarivo, Madagascar
Authors: Sendrasoa Fandresena Arilala , Ratovonjanahary Volatantely , Rakotoarisaona Mendrika Fifaliana , Andrianarison Malalaniaina , Raharolahy Onivola , Ranaivo Irina Mamisoa , Mbotinirina Viviane Estelle , Sata Moril , Razanakoto Naina Harinjara , Ramarozatovo Lala Soavina , Rabenja Fahafahantsoa Rapelanoro
Published: February 2020

BACKGROUND: Several studies have been done to evaluate the relationship between month of birth and atopic diseases but the results are contradictory. So, we aim to evaluate the correlation between the month of birth and the prevalence of AD in Malagasy children less than 3 years.METHODS: A case-control study was conducted based on patients’ data of the department of Dermatology in the University Hospital Joseph Raseta Befelatanana (UH/JRB) Antananarivo. It included 354 children less than 3 years seen in this department between January 2010 and December 2018. For each AD patient, two age and sex-matched controls without a history of AD were selected from the same period.RESULTS: This study included 118 AD cases and 236 non-AD controls. Our case-control study found that there are no statistically significant correlation between birth month and risk of AD in Malagasy children < 3 years. However, the fewest children with AD were born in February (17.86%, OR: 0.40, CI 95%: 0.11-1.14), and the most were born in August (45.16%, OR: 1,73; CI 95%: 0,75-3,88). Asthma, allergic rhinitis and allergic conjunctivitis were significantly correlated with AD in our patients.CONCLUSION: Our case-control study found that there are no statistically significant correlation between birth month and risk of AD in children < 3 years. However, the high frequency of AD in children born in August (dry season) compared to non-AD controls was not negligible (p-value =0,05 and X 2 3,27).
Neoadjuvant chemoradiotherapy followed by laparoscopic distal gastrectomy with D2 lymph node dissection for a locally advanced distal gastric cancer
Authors: Li Ziyu , Liu Zining , Wang Yinkui , Shan Fei , Li Shuangxi , Ji Jiafu
Published: February 2020

Laparoscopic technique has been widely applied for early gastric cancer, with the advantages of minimal invasion and quick recovery. However, there is no report about the safety and short-term outcome of laparoscopic gastrectomy with D2 lymph node dissection for patients after neoadjuvant chemoradiotherapy. We presented the first case treated in this way. The patient was a 60-year-old man who was diagnosed with advanced distal gastric cancer. The neoadjuvant chemoradiotherapy was performed based on the regimen of GTV 50Gy/25f and CTV 45Gy/25f, as well as concurrent S-1 60mg Bid. Radiological examination determined that a partial response (PR) had been achieved by the initial therapy. Adverse events included only a myelosuppression limited to grade 2. Then laparoscopic distal gastrectomy with D2 lymph node dissection was undertook successfully for him. The patient recovered smoothly with no postoperative complications. The postoperative pathological stage was ypT3N0M0, with necrosis rate >90%. He was still in good condition after five years follow-up.
Single-Port Sutureless Partial Nephrectomy for Small Renal Cancer
Authors: Li Ching-Chia , Chien Tsu-Ming , Yeh Hsin-Chih , Lee Hsiang-Ying , Ke Hung-Lung , Wen Sheng-Chen , Chang Wei-Che , Juan Yung-Shun , Chou Yii-Her , Wu Wen-Jeng
Published: February 2020

Background: Laparoscopic single-port (LESS) sutureless partial nephrectomy (PN) is a technically demanding procedure. Here we shared our experience to reduce the warm ischemia time and shorten the learning curve in performing LESS sutureless PN.Materials and methods: Between 2015 and 2018, custom made LESS sutureless PN was performed in 33 patients with small renal cancer. Preoperative, intra-operative and postoperative variables were recorded. Renal function was evaluated by estimated glomerular filtration rate (eGFR) pre- and postoperatively.Results: The average warm ischemia time and the operation time were 11.8 ± 3.9 min and 167.9 ± 37.5 min, respectively. Only 2 patients suffered from massive urinary leakage (>200 mL/day) from the Jackson Pratt drainage tube, but the leakage spontaneously decreased within 7 days after the surgery. eGFR and serum hemoglobin were not found to be significantly different pre- and postoperatively. All tumors were removed without positive surgical margin. All patients were alive without recurrent tumors at mean postoperative follow-up of 16.5 ± 6.4 months.Conclusions: LESS sutureless PN is a feasible surgical method for most patients with small renal cancer with excellent cosmetic results, shorter learning curve without affecting oncological results.
Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): A randomised controlled feasibility study for low mood in acquired brain injury
Authors: Kusec Andrea , Murphy Fionnuala C. , Peers Polly V. , Lawrence Cara , Cameron Emma , Morton Claire , Bateman Andrew , Watson Peter , Manly Tom
Published: February 2020

Background: Acquired brain injury (ABI) affects approximately 79.3 million individuals annually and is linked with elevated rates of depression and low mood. Existing methods for treating depression in ABI have shown mixed efficacy. Behavioural Activation (BA) is a potentially promising intervention. Its premise is that individuals with low mood avoid planning and engaging in activities due to low expectations of a positive outcome. Consequently, their exposure to positive reinforcement is reduced, exacerbating low mood. BA aims to break this cycle by encouraging activity planning and engagement. It is unknown whether cognitive demands of traditional BA may undermine efficacy in ABI. Here we assess the feasibility and acceptability of two groups designed to increase activity engagement. In the Activity Planning Group (traditional BA) the importance of meaningful and positive activity will be discussed and participants encouraged to plan/engage in activities in everyday life. The Activity Engagement Group (experiential BA) instead focuses on engagement in positive experiences (crafts, games, discussion) within the group. The primary aims are to evaluate the feasibility and acceptability of the two groups in ABI. A secondary aim is to explore relative efficacy of the groups compared to an equivalent period of waitlist controls. Method: This study outlines a parallel-arm feasibility pilot trial for individuals with low mood and ABI that compares a traditional vs experiential BA group vs. waitlist controls. Adults (>18 years) will be recruited from local ABI services and randomised to condition. Feasibility and acceptability will be assessed via recruitment, retention, attendance, and participant feedback. Groups will be compared (pre- and post-intervention and 1 month follow-up) by assessing self-reported activity engagement. Secondary outcomes include self-report measures of depression, anxiety, post-traumatic distress related to the ABI, motivation, participation, and sense of control over one’s life.Ethics and Dissemination: The trial has been approved by the Health Research Authority of the NHS in the UK (East of England – Cambridge Central, REF: 18/EE/0305). Results will inform future research on interventions for mood in ABI and be disseminated broadly via peer-reviewed journals, conference presentations, and social media.
Prognosis of nontuberculous mycobacterial pulmonary disease according to the method of microbiologic diagnosis
Authors: Sin Sooim , Han Seungchul , Lee Yeon Joo , Cho Young-jae , Park Jong Sun , Yoon Ho Il , Lee Choon Taek , Lee Jae Ho
Published: February 2020

Background Current microbiologic criteria for nontuberculous pulmonary disease (NTM-PD) require cultures with two separate sputum specimens or one non-sputum specimen. However, data on NTM-PD prognosis following non-sputum culture-based diagnosis are limited. We compared the prognosis of NTM-PD diagnosed using non-sputum and sputum cultures. Methods We analyzed 1020 patients in whom NTM was isolated; they were divided into the sputum NTM isolation (n=170), sputum NTM-PD (n=688), and non-sputum NTM-PD groups (n=162). Initiation of therapy and radiographic aggravation was compared between groups. Results Overall median observation time was 44.3 months (interquartile range, 28.0–70.2). Fewer non-sputum NTM-PD patients initiated treatment than sputum NTM-PD patients (p<0.001). Moreover, fewer non-sputum NTM-PD patients exhibited radiographic aggravation than sputum NTM-PD patients (p=0.001). Both time to radiographic aggravation and initiation of therapy were significantly shorter in the sputum NTM-PD group (log-rank test; p=0.011 and p<0.001, respectively). Sputum NTM-PD patients showed higher initiation of therapy (aHR, 1.38; 95% CI, 1.02–1.87) and risk of radiographic aggravation (aHR, 1.47; 95% CI, 1.02–2.10) than non-sputum NTM-PD patients. Conclusion Prognosis of NTM-PD patients diagnosed with a non-sputum culture was better than that of NTM-PD patients diagnosed with a sputum culture. The disease course may differ depending on the diagnostic method.
Good Syndrome with Cytomegalovirus Hepatitis: Successful Resection of Thymoma: A case report
Authors: Isobe Sho , Sano Atsushi , Otsuka Hajime , Azuma Yoko , Koezuka Satoshi , Makino Takashi , Sakai Takashi , Ito Takafumi , Maeda Tadashi , Homma Sakae , Iyoda Akira
Published: February 2020

Background Good syndrome is a rare condition, manifesting as immunodeficiency due to hypogammaglobulinemia associated with thymoma. Herein, we present a patient with Good syndrome whose thymoma was resected after treatment of cytomegalovirus hepatitis. Case presentation The patient was a 45-year-old woman presenting with fever, cough, and nasal discharge, and was diagnosed with thymoma and hypogammaglobulinemia. She subsequently developed cytomegalovirus hepatitis that was treated by immunoglobulin. After resolution of the hepatitis, she underwent thymectomy through a left anterior thoracotomy. Her postoperative course was uneventful, and while receiving ongoing immunoglobulin therapy, she has been doing well without signs of infection. Conclusions Management of infections is important for patients with Good syndrome. To minimize the risk of perioperative infection, we should take care while planning the surgical approach and procedure.
Could remnant lipoprotein cholesterol become a risk factor in diabetic menopausal women with coronary artery disease? A cross-sectional study of single academic center in China
Authors: Feng Xunxun , Guo Qianyun , Zhou Shu , Sun Tienan , Liu Yuyang , Zhou Zhiming , Zhou Yujie
Published: February 2020

Background and aimsIt had been confirmed that remnant lipoprotein cholesterol (RLP-C) mediates the progression of coronary artery disease (CAD). Currently there was limited information on RLP-C in menopausal women. With the special status of diabetes mellitus (DM) combined with the special body changes of the menopausal women, the RLP-C was particularly important when studying the changes that occurred in response to CAD and its associated risk factors. This study discussed whether RLP-C could be an independent risk factor for menopausal women with CAD and DM.MethodsThe cohort consisted of 4753 menopausal women who had undergone coronary angiography. Subjects were separated into CAD and non-CAD groups, and univariate and multivariate logistic regression analysis of CAD risk factors were performed. All patients with a history of DM were divided into DM subgroups. Then, the univariate and multivariate logistic regression analysis of the risk factors of CAD and the comparison among age groups in the DM subgroup were performed. After age stratification of the DM group, the Kruskal-Wallis test was used to analyze the differences of various lipid indexes among age groups. Results The univariate and multivariate logistic regression showed that RLP-C was an independent risk factor for CAD in menopausal women (OR 1.274, 95%CI 1.107-1.467, P=0.001). In the DM subgroup, it was also found that RLP-C was an independent risk factor for CAD (OR 1.243, 95%CI 1.078-1.433, P=0.003). Kruskal-Wallis test analysis found that RLP-C had no significant difference among three groups (P>0.05).ConclusionsRLP-C was proved to be an independent risk factor for menopausal women with CAD and DM.
Association of Dyslipidemia With Sudden Sensorineural Hearing Loss: A Retrospective Study
Authors: Li Dafei , Xu Piao , Yang Jingya , Lin Qiongping , Zhao Haiyan , Chen Jiawei , Tian Guangyong
Published: February 2020

Background: Blood lipid levels have been widely studied in patients with sudden sensorineural hearing loss (SSNHL), but it has been unclear whether dyslipidemia associates with SSNHL. Whether there is a simple and feasible blood lipid index to predict the onset of SSNHL remains to be found.Methods: This study reviewed 100 SSNHL patients and 100 healthy subjects who received relevant clinical examination in our hospital from June 1, 2015 to June 1, 2019. The demographic, clinical characteristics, lipid levels and lipid metabolism indexes of the two groups were compared.Results: In this study, 100 patients (64 men [64%]; 36 women [36%]; mean [SD] age, 38.47 [14.36] years) were included in the SSNHL group, and 100 healthy people(60 men [60%]; 40 women [40%]; mean [SD] age, 36.52 [9.86] years) served as the control group. No significant differences between the SSNHL group and the control group in age, sex, BMI, smoking habits and alcohol drinking patterns were observed. Meanwhile, it can be seen the mean (SD) concentrations of total cholesterol (TC) (194.59 [38.22] vs 176.83 [23.55] mg/dL; MD, 17.76 mg/dL; 95% CI, 26.64-46.72 mg/dL), the mean (SD) concentrations of low density lipoprotein cholesterol (LDL-C) (116.99 [33.59] vs 96.91 [22.01] mg/dL; MD, 20.08 mg/dL; 95% CI, 32.43-48.26 mg/dL) and apolipoprotein (apo) B (89.82 [21.38] vs 81.16 [16.17] mg/dL; MD, 8.66 mg/dL; 95% CI, 12.03-23.21 mg/dL) were significantly higher than the control group. In addition, it was also observed that the median [IQR] concentrations of high density lipoprotein cholesterol (HDL-C) (1.51 [1.33-1.76] vs 1.56 [1.40-1.84] mg/dL) and the median [IQR] concentrations of apolipoprotein (apo) AI (118.50 [103.00-141.25] vs 133.00 [115.25-1.52.75] mg/dL) were lower than those in the control group. In terms of lipid metabolism indexes, the median [IQR] value of TC/HDL-C (3.31 [2.68-3.85] vs 2.72 [2.42-3.37]), the mean (SD) value of apo B/apo AI (0.76 [0.26] vs 0.63 [0.18]; MD, 0.13; 95% CI, 0.20-0.32) and the median [IQR] value of atherogenic index (ATH index) (1.61 [0.97-2.50] vs 1.01 [0.73-1.75]) were significantly higher than the control group, while the mean (SD) value of atherogenic index of plasma (AIP) (-0.24 [0.28] vs -0.25 [0.21]; MD, 0.01; 95% CI, -0.06-0.08) showed no difference between the two groups.Conclusions: There were significant differences in blood lipid levels and lipid metabolism between the SSNHL group and the control group. LDL-C, apo AI and apo B were important independent predictors of SSNHL.
Exploring the Consequences of decentralization: Has privatization of health services been the perceived effect of decentralization in Khartoum Locality, Sudan?
Authors: Noory Bandar , Hasssanein Sara A , Elsony Asma , Bjune Gunnar
Published: February 2020

Background: The health system of Sudan has experienced several forms of decentralization, as well as, a radical reform. Authority and governance of secondary and tertiary health facilities have been shifted from federal to state levels. Moreover, the provision of health care services have been moved from large federal tertiary level hospitals such as Khartoum Teaching Hospital (KTH) and Jafaar Ibnaouf Hospital (JIH), located in the center of Khartoum, to smaller district secondary hospitals like Ibrahim Malik (IBMH), which is located in the southern part of Khartoum. Exploring stakeholders’ perceptions on this decentralisation implementation and the relevant consequences is vital in building an empirical benchmark for the improvement of health systems. Methods: This study utilizes a qualitative design which is comprised of an in-depth interviews and qualitative content analysis with an inductive approach. The study was conducted between July and December 2015, and aimed at understanding the personal experiences and perceptions of stakeholders towards decentralization enforcement and the implications on public health services, with a particular focus on the Khartoum locality. It involves community members residing in the Khartoum Locality, specifically in catchments area where hospital decentralization was implemented, as well as, affiliated health workers and policymakers. Results: The major finding suggests that the privatization of health services occurs after decentralization. The study participants also highlighted that scrutiny and reduction of budgets allocated to health services led to an instantaneous enforcement of cost recovery user fee. Devolving KTH Khartoum Teaching and Jafaar Ibnaouf Hospitals into peripherals with less capacity is considered to be a plan to outsource services to the private sector. Another theme that was highlighted in hospitals included the profit-making aspect of the governmental sector in the form of drug supplying and profit-making retail. Conclusions: A change in health services after the enforcement of decentralization was illustrated. Moreover, the empowerment of the privatization concept was the prevailing perception among stakeholders. Having in-depth studies and policy analysis in line with the global liberalization and adjustment programs is crucial for any health sector reform in Sudan. Keywords: decentralization, privatization, stakeholders, global liberalization, profit-making.
Assessing the Youth-friendliness of Youth Clinics in Northern Sweden: A Survey Analyzing the Perspective of the Youth
Authors: Waenerlund Anna-Karin , Sebastian Miguel San , Hurtig Anna-Karin , Wiklund Maria , Christianson Monica , Goicolea Isabel
Published: February 2020

Background: Sweden has nearly 300 youth clinics that have been offering services since the 1970s. However, no evaluation has been done to assess their youth-friendliness. This study aims to assess: i) to what extent youth clinics are perceived as youth-friendly by the young people using them; and ii) if the level of youth friendliness is equally perceived across different sociodemographic groups of users. Methods: The four northernmost counties of Sweden were included in the study. Of the total identified 22 youth clinics, 20 participated by giving out questionnaires to the youth after their visits to the respective youth clinics. In total 1,110 youth participated in the study and answered questions according to the World Health Organization’s criteria of accessibility, equity, respect, privacy and confidentiality, no judgement, and quality. Means and frequencies were calculated, and t-test and ANOVA were used to compare means by sociodemographic variables.Results: Participants perceived the youth clinics as very youth friendly across the measured domains, with scores as high as 4.8 and 4.9 (of a maximum of 5) in the studied domains. Youth clinics were perceived in a similar way regardless of gender, but other sociodemographic factors influenced some of the domains, especially ethnic background. Conclusions: The perception of youth friendliness in youth clinics was very high. Nonetheless, younger users; users who did not categorize themselves as either heterosexual, homosexual, or bisexual; users with trans-experiences; and users with migrant backgrounds gave youth clinics lower scores for certain domains.
MSF experiences of providing multidisciplinary primary level NCD care for Syrian refugees and the host population in Jordan: an implementation study guided by the RE-AIM framework
Authors: Ansbro Éimhín , Homan Tobias , Quasim Jamil , Bil Karla , Tarawneh Mohammed Rasoul , Roberts Bayard , Perel Pablo , Jobanputra Kiran
Published: February 2020

Background: Humanitarian actors have rapidly scaled-up NCD services in crisis-affected low-and-middle income countries, in response to the rising global NCD burden. Using the RE-AIM implementation framework, we evaluated a multidisciplinary, primary-level model of NCD care for Syrian refugees and vulnerable Jordanians in Irbid, Jordan. We examined the Reach, Effectiveness, Adoption and acceptance of the programme; the fidelity, adaptation and costs of Implementation; and its Maintenance over time.Methods: This mixed methods, retrospective evaluation, undertaken in 2017, comprised secondary analysis of pre-existing cross-sectional household survey data; analysis of routine cohort data from January 2015 - December 2017; provider-perspective, descriptive costing analysis of total annual, per-patient and per-consultation costs for 2015-2017; clinical audit; medication adherence survey of 300 patients; and qualitative research. The latter involved thematic analysis of individual interviews with patients, staff and stakeholders and two focus group discussions with patients.Results: The programme reached 5.9% of Syrian adults with NCDs in Irbid governorate. The cohort mean age was 54.7 years; 71% had multi-morbidity and 9.9% self-reported a disability. The programme was highly acceptable to patients, staff and stakeholders. Blood pressure and glycaemic control improved as the programme matured and within six months of patient enrolment (with a drop of 7mmHg and 26.8 mg/dL from baseline, respectively). Total costs increased in parallel with increased service complexity from INT$ 4,206,481 in 2015 to 6,739,438 in 2017. Clinical guidelines were reportedly usable and self-reported medication adherence was high. Individual and organisational challenges to programme implementation and maintenance included the impacts of war and the refugee experience on Syrian refugees’ engagement; inadequate low-cost referral options; and operating in a regulated, middle-income country. Essential programme adaptations included refinement of health education and introduction of: mental health and psychosocial services, essential referral pathways, home visit services and a social worker role.Conclusion: RE-AIM proved a valuable tool in evaluating a complex intervention in a protracted humanitarian crisis setting. This programme provided high quality, reliable, free, holistic NCD care and was highly acceptable to patients, providers and stakeholders. We propose that model simplification, cost reduction and use of technology could improve effectiveness and efficiency without reducing acceptability.
Prevalence and Correlates of Mycoplasma genitalium Infections among Patients Attending a Sexually Transmitted Infection Clinic in Guangdong, China a Cross-sectional Study
Authors: Zhang Xiaohui , Zhao PZ , Ke WJ , Wang LY , Tso Lai Sze , Chen ZY , Liao YY , Liang CM , Chen HR , Ren XQ , Huang JM , Ong JJ , Yang F , Yang Ligang
Published: February 2020

Background Mycoplasma genitalium (MG) is known to cause urogenital tract infections and is associated with reproductive morbidity. Although MG has been reported across many regions and population groups, it is not yet routinely tested for in China. Our study contributes to current research by reporting the prevalence and correlates of MG for patients attending a sexually transmitted infection (STI) clinic in Guangdong from Jan 2017-May 2018.Methods Urethral (489 men) and endo-cervical (189 women) samples, blood samples, and patient histories (via questionnaires) were collected. Doctors clinically diagnosed anogenital warts (GW) during the examination (n=678). Presence of MG was tested using an in-house polymerase chain reaction. We also tested all participants for herpes simplex virus-2 (HSV-2), Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), syphilis and HIV. Univariate and multivariable logistic regressions were used to evaluate factors associated with MG.Results MG was detected among 7.2% (n=49) of patients (7.4% men, 6.9% women). Of 629 heterosexual patients, the MG was detected in 7.5% (47/629), and of 49 MSM, MG was detected in 4.1% (2/49). Among MG-infected patients, 10.2% were co-infected with CT, 6.1% with NG, 8.2% with HSV-2, 4.1% with syphilis and 22.4% with GW. Among 152 symptomatic patients, the prevalence of MG was 12.5% (n=19, of whom 17 were men). Being symptomatic was statistically significant for MG infection [OR=2.2(1.3~3.8)].Conclusion MG is a relatively common infection among individuals attending an STI clinic in Guangdong province. To make MG testing available and routinely screen symptomatic patients with urinary and /or cervical discharge in STI clinics in China is essential.
Performance of age-adjusted D-dimer values for predicting DVT before the knee and hip arthroplasty
Authors: Wu Jian Xiang , Qing Jiang Hui , Yao Yao , Chen Dong Yang , Jiang Qing
Published: February 2020

Purpose: To compare the specificity and sensitivity of preoperative D-dimer and age-adjusted D-dimer value for predicting the incidence of the DVT preoperatively in total joint arthroplasty (TJA) patients. Methods: We enrolled 406 patients finally above 50 years old. Everyone had done ultrasonography bedside, and D-dimer concentrations were collected before surgery. The D-dimer and age-adjusted D-dimer cut-off was calculated by multiple logistic regression and receiver operating curve (ROC) analyses.Results: A total of 39 patients had found asymptomatic deep vein thrombosis (DVT) by ultrasonography. The age (odds ratio [OR]: 1.067; p=0.003) and D-dimer (OR:1.331; p=0.025) were related to the existence of DVT. For conventional D-dimer and age-adjusted D-dimer value, the area under the curves (AUCs) were 0.685 (0.499-0.696) and 0.795 (0.611-0.881), respectively.Conclusion: Compared to traditional D-dimer, age-adjusted D-dimer showed better performance in screening DVT, which was useful clinically.
Factors Associated with Healthy Ageing among Chinese Rural Empty Elderly Nesters and Future Focus of Health Services
Authors: Fu Liping , Wang Yuhui , He Lanping
Published: February 2020

Background Like most countries in the world, China is stepping into an aging society and Healthy aging (HA) faces great challenges. Chinese rural empty elderly nesters (CREEN) as the vulnerable groups of ageing populations, providing health services for CREEN needs more attention and guidance. Methods Using the method of logistic regression, four dimensions of HA among 618 respondents were separately analyzed based on the fifth public panel data of the China Health and Retirement Longitudinal Study (CHARLS). Results 41.42% respondents met the recommended good physical health (PA), ‘being literate’, ‘expectation of receiving long-term care in the future from family’, and ‘good physical health of grown children’ were significant protective factors for PA. 83.17% respondents had good daily activity level, ‘aged under 60 years’ and ‘grown children being literate’ were significant protective factors while ‘CREEN once lived with grown children’ was a significant risk factor. 59.39% respondents had good psychological health, ‘Male sex’, ‘Expectations of receiving long-term care in the future’, and ‘Physical health of grown children’ were significant protective factors. 36.73% respondents met the corresponding criteria of good social participation, ‘aged under 60 years’ was a significant protective factor while ‘CREEN once lived with grown children’ was also a significant risk factor. Conclusions For the CREEN, social participation, physical health and psychological health should be the focus and direction of providing health services. One factor could have different influence on different aspects of HA among CREEN. When health services are provided for CREEN, the second focus should assess comprehensive impact and do the long-term observation. Providing health services for CREEN should not only focus on ‘What they have’ and ‘What they don’t have’, but also focus on ‘What they have and then lose’, especially factors associated with their grown children. Those points should be the future focus of health services for CREEN.
lncRNA HOTAIR overexpression promotes hybrid epithelial/mesenchymal phenotype through suppression of c-Met Receptor Tyrosine Kinase Signaling in Hepatocellular Carcinoma Cells
Authors: Topel Hande , Bagirsakci Ezgi , Comez Dehan , Bagci Gulsun , Cakan-Akdogan Gulcin , Atabey Nese
Published: February 2020

Background: Epithelial-to-mesenchymal transition (EMT) and mesenchymal-to-epithelial transition (MET) are both reversible processes, and regulation of phenotypical transition is very important for progression of several cancers including hepatocellular carcinoma (HCC). Recently, it is defined that cancer cells can attain a hybrid epithelial/mesenchymal (hybrid E/M) phenotype. Cells with hybrid E/M phenotype comprise mixed epithelial and mesenchymal properties, they can be more resistant to therapeutics and also more capable of initiating metastatic lesions. However, the mechanisms regulating hybrid E/M in HCC are not well described yet. In this study, we investigated the role of the potential crosstalk between lncRNA HOTAIR and c-Met receptor tyrosine kinase, which are two essential regulators of EMT and MET, in acquiring of hybrid E/M phenotype in HCC.Methods: Expression of c-Met and HOTAIR were defined in HCC cell lines and patient tissues through HCC progression. lncRNA HOTAIR was overexpressed in SNU-449 cells and its effects on c-Met signaling were analyzed. c-Met was overexpressed in SNU-398 cells and its effect on HOTAIR expression was analyzed. Biological significance of HOTAIR/c-Met interplay was defined in means of adhesion, proliferation, motility behavior, invasion, spheroid formation and metastatic ability. Effect of ectopic HOTAIR expression on phenotype was defined with investigation of molecular epithelial and mesenchymal traits.Results: In vitro and in vivo experiments verified the pivotal role of lncRNA HOTAIR in acquisition of hybrid E/M phenotype through modulating c-Met and its membrane co-localizing partner Caveolin-1 expression, activation and membrane organization to cope with the rate limiting steps of metastasis such as survival in adhesion independent microenvironment, escaping from anoikis and resisting to fluidic shear stress (FSS) in HCC.Conclusions: Our work provides the first evidence suggesting a role for lncRNA HOTAIR in the modulation of c-Met to promote hybrid E/M phenotype. The balance between lncRNA HOTAIR and c-Met might be critical for cell fate decision and metastatic potential of HCC cells.
Oral health status and oral health-related quality of life among patients with type 2 diabetes mellitus in the United Arab Emirates: A matched case-control study
Authors: Khalifa Nadia , Rahman Betul , Gaintantzopoulou Marianna D , Amad Suhail Al , Awad Manal M.
Published: February 2020

Background: Nearly a quarter of the population in the UAE has type 2 diabetes mellitus (T2DM), and this medical condition is associated with poorer oral health. The effects on oral health-related quality of life (OHRQoL), however, have not been examined in this population. Therefore, the objective of this study was to assess the impact of oral health problems, such as caries and periodontitis, on OHRQoL among Arab patients with and without T2DM.Methods: This matched case-control study included 88 diabetic and 88 non-diabetic participants recruited from University Dental Hospital Sharjah and University Hospital Sharjah, UAE. Participants completed a sociodemographic questionnaire, as well as the Oral Health Impact Profile short form (OHIP-14) which measures OHRQoL. Clinical examinations were conducted to assess participants’ dental caries status, using the Decayed Missing Filled Teeth (DMFT) Index, and periodontal condition, via clinical attachment loss (CAL) dichotomized to CAL < 3mm and CAL ≥ 3mm. Linear regression models were used to identify the association between OHIP domains, clinical attachment loss, DMFT scores, and diabetes status.Results: The mean age of the participants was 43.0 years. A significantly (p = 0.01) higher proportion of diabetic patients (23%) had a CAL ≥ 3mm compared to non-diabetic patients (10%). No significant differences in OHIP scores were observed between patients with and without diabetes. The results of the linear regression suggested that, irrespective of diabetic status, DMFT scores were significantly associated with physical disability, physical pain, psychological discomfort, and psychological disability, as well as total OHIP scores. CAL was significantly associated with the handicap domain. Among non-diabetics, OHIP scores were significantly associated with DMFT scores in five OHIP domains (functional limitation, physical disability, physical pain, psychological discomfort, psychological disability), as well as total OHIP scores. Among diabetics, CAL was significantly associated with both the social disability and handicap domains, while only the handicap domain reached statistical significance among non-diabetics. Conclusions: Participants who had decayed teeth, irrespective of their diabetic status, reported substantial physical and psychological impacts on OHRQoL. CAL also had a significant impact on OHRQoL, being primarily associated with the OHIP handicap domain in both groups.
Health-related quality of life and associated factors in patients with myocardial infarction after returning to work: a cross-sectional study
Authors: Chen Changying , Du Ruofei , Wang Panpan , Wang Tao , Ma Lixia , Larcher Leon
Published: February 2020

Background Return to work following myocardial infarction (MI) represents an important indicator of recovery. However, MI can cause patients to feel pressure, loneliness and inferiority during work and even detachment from employment after returning to work, which may affect their quality of life. The aims of this study were to assess the health-related quality of life (HRQoL) of patients with MI after returning to work and to examine the potential influences on HRQoL. Method This was a cross-sectional study. All participants were recruited from tertiary hospitals in China from October 2017 to March 2018. Multiple linear regression analyses were performed to explore factors related to HRQoL in patients with MI after returning to work. Results The sample consisted of 326 patients. The mean total score of quality of life was 28.03±2.554. According to the multiple linear regression analysis, next factors were associated with HRQoL, i.e. age (P=0.039), income (P=0.000), co-morbidity (P=0.000), the time taken to return to work (P=0.003), number of stent installed (P=0.003), participation in cardiac rehabilitation (CR) (P=0.000), complete CR (P=0.000), health responsibility (P=0.000), nutrition (P=0.000), exercise (P=0.000), self-realization (P=0.000), stress response (P=0.000), objective support (P=0.000), subjective support (P=0.000), utilization of social support (P=0.028), coping (P=0.000) and yield (P=0.000). Conclusions HRQoL of MI patients after returning to work is not satisfactory. Health behavior, coping strategies, social support are factors which can affect HRQoL. A comprehensive and targeted guide may be a means to improve HRQoL and to facilitate patients return to society.
Modeling the Cost-effectiveness of Esophageal Cancer Screening in China
Authors: LI Yuanyuan , Du Lingbin , Wang Youqing , Gu Yuxuan , Zhen Xuemei , Hu Xiaoqian , Sun Xueshan , Dong Hengjin
Published: February 2020

Background

This study aimed to examine the cost-effectiveness of the standard endoscopic screening with Lugol’s iodine staining in EC screening in China.

Methods

The Markov decision analysis model with eleven states was built. Separate cohorts were conducted consisting of those aged 40 to 69 years, classified as six age groups with five years interval. Three different strategies assumed for each cohort:(1) no screening; (2) endoscopic screening with Lugol’s iodine staining with annual follow-up for Low-grade intraepithelial neoplasia; (3) endoscopic screening with Lugol’s iodine staining without follow-up. Quality-adjusted life-years (QALYs) served as effectiveness. The incremental cost-effectiveness ratio (ICER) was identified as the evaluating indicators. Sensitivity analysis was introduced to assess the robustness of the model.

Results

For aged 40-49 years, the non-screening strategies were absolutely dominated with both more costs and less QALY, while for aged 50-69 years, the screening scenarios were absolutely dominated. Screening with follow-up was the preferred strategy. Compared to non-screening, screening with follow-up saved USD 10942.57 and USD 611.73 per QALY gained for aged 40-44 and 45-49 years separately. One-way sensitivity analysis addressed that the risk ratio of the EC incidence in population after screening compared to people without screening and the utility of precancerous lesion could affect the cost-effectiveness of the screening strategy. However, the probabilistic sensitivity analysis supported the results of the base case analysis.

Conclusions

EC screening with follow-up targeting aged 40-49 years was the most cost-effective strategy.
Clinical characterization, genetic profile, and epigenetic regulation of TOX in diffuse gliomas
Authors: Hao Zhang , Fan Fan , Yuanqiang Yu , Zeyu Wang , Fangkun Liu , Ziyu Dai , Liyang Zhang , Zhixiong Liu , cheng quan
Published: February 2020

Background Multiple studies focusing on immune therapy towards glioblastoma (GBM) have attained great successes. TOX has been found to be closely related to immune environment surrounding tumors, while the expression of TOX has not been fully understood in gliomas. Methods Mining data from The Cancer Genome Atlas (TCGA) and the Chinese Glioma Genome Atlas (CGGA), we analyzed 1691 WHO grade I-IV human glioma samples with transcriptome data. R language was used for most statistical analysis. Somatic mutations and somatic copy number variation (CNV) were analyzed using GISTIC 2.0.Results TOX was down-regulated in malignant gliomas, especially in the proneural and isocitrate dehydrogenase (IDH) mutant subtypes of GBM. TOX low tumours are related to loss of PTEN and amplification of EGFR, while TOX high tumours harbor mutations in IDH1 (91%). TOX was highly expressed in cellular tumour, leading edge regions. TOX was enriched in multiple immune related processes including lymphocytes migration in GBM in gene ontology and pathway analysis. Finally, TOX had negative association with the infiltration of several immune cell types in tumour microenvironment in cell lineage analysis. Conclusion TOX has the potential to be a new target for immune-therapy or a prognostic marker for GBM.
Reconstruction of lncRNA-miRNA-mRNA network based on competitive endogenous RNA reveals functional lncRNAs in melanoma
Authors: Zhu Junyou , Deng Jin , Zhang Lijun , Zhao Jingling , Zhou Fei , Liu Ning , Cai Ruizhao , Wu Jun , Shu Bin , Qi Shaohai
Published: February 2020

Background: Melanoma is the most dangerous skin tumor, and its pathogenesis is not fully understood. Methods: To identify the key lncRNAs in melanoma, we reconstructed a global triple network based on the ceRNA theory. GO and KEGG pathway analysis were performed using DAVID. And, we verified our findings through q(RT)-PCR assay. Results: According to ceRNA theory, 898 DEMs,53 DELs and 16 DEMis were selected to reconstruct the ceRNA network. MALAT1, LINC00943, and LINC00261 were selected as hub gene in the network. Conclusions: In this study, we found that MALAT1, LINC00943 and LINC00261 were closely associated with tumorigenesis and development of melanoma, and therefore, could be used as potential diagnostic biomarkers and therapeutic targets.
Control Group Design in a Complex Intervention Study: Challenges, Dilemmas and Possible Solutions
Authors: Mangset Margrete , Kitzmüller Gabriele , Evju Anne , Angel Sanne , Aadal Lena , Martinsen Randi , Bronken Berit Arnesveen , Kvigne Kari , Bragstad Line K. , Hjelle Ellen Gabrielsen , Sveen Unni , Kirkevold Marit
Published: February 2020

Background The use of a control group is one of the most critical components of an RCT. The control conditions may change over time and include assessment interviews and standard stroke treatment. Therefore, the control group should be monitored and described in as much detail as the intervention group. It is important to find ways to reduce the risk of study-induced influence on the members of the control group. The aim of this study was to explore the possible influence of the assessment interviews on the adjustment of the members of a control group in an RCT exploring psychosocial well-being following stroke. Methods Fifteen participants in the control group of the RCT, six women and nine men, aged 29-88 years, were interviewed in narrative semi-structured interviews. Ricoeur’s interpretation theory guided the analysis. Results The perceived influence of the assessment interviews on the control group varied considerably. Two different themes with subthemes were identified, describing the influence of the assessment interviews in the control group. Theme one described how participants emphasized the perceived influence of the assessment interviews that served as a safety net, enhanced their awareness and understanding, facilitated their adjustment after stroke, encouraged them to seek support, and allowed them to vent their disappointment of having been allocated to the control group. Theme two described participants’ experiences of handling their adjustment process on their own without describing any influence of the assessment interviews on their condition. These participants highlighted mild strokes, spontaneous recovery, setting own goals, support from family and friends and supporting research. Conclusions In view of the design challenges in RCTs, it seems important to explore in depth how to design assessment interviews with control group members without introducing risk of bias, and to uphold rigor and stringency in the trials.
Assessing the efficacy of CRISPR/Cas9 genome editing in the wheat pathogen Parastagonspora nodorum
Authors: Khan Haseena , McDonald Megan C , Willams Simon J , Solomon Peter
Published: February 2020

Background: The genome-editing tool CRISPR/Cas9 has revolutionized gene manipulation by providing an efficient method to generate targeted mutations. This technique deploys the Cas9 endonuclease and a guide RNA (gRNA) which interact to form a Cas9-gRNA complex that initiates gene editing through the introduction of double stranded DNA breaks. We tested the efficacy of the CRISPR/Cas9 approach as a means of facilitating a variety of reverse genetic approaches in the wheat pathogenic fungus Parastagonospora nodorum .

Results: Parastagonospora nodorum protoplasts were transformed with the Cas9 protein and gRNA in the form of a preassembled ribonuclear protein (RNP) complex targeting the Tox3 effector gene. Subsequent screening of the P. nodorum transformants revealed 100% editing of those mutants screened. We further tested the efficacy of RNP complex when co-transformed with a Tox3 -Homology Directed Repair cassette harbouring 1 kb of homologous flanking DNA. Subsequent screening of resulting transformants demonstrated homologous recombination efficiencies exceeding 70%. A further transformation with a Tox3 -Homology Directed Repair cassette harbouring a selectable marker with 50 bp micro-homology flanks was also achieved 25% homologous recombination efficiency. The success of these homology directed repair approaches demonstrate that CRISPR/Cas9 is amenable to other in vivo DNA manipulation approaches such as the insertion of DNA and generating point mutations.

Conclusion: These data highlight the significant potential that CRISPR/Cas9 has in expediting gene transgene-free knockouts in Parastagonospora nodorum and also in facilitating other gene manipulation approaches. Access to these tools will significantly decrease the time required to assess the requirement of gene for disease and to undertake functional studies to determine its role.
DEVELOPMENT OF THE INDUSTRY ECONOMY IN CONDITIONS OF BUSINESS DIGITIZATION
Authors: Panfilova Elena Evgenevna
Published: February 2020

The key trends of industrial production organization in the context of business digitalization are considered. Attention is paid to the use of public-private partnership tools in the development of regions. The directions of development of enterprises in the real sector of the economy that provide a competitive advantage in the unstable external environment are specified.