bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical features and outcomes of combined hepatocellular carcinoma and cholangiocarcinoma versus hepatocellular carcinoma versus cholangiocarcinoma after surgical resection: A propensity score matching analysis
Authors: Lin Chih-Wen , Lin Hung-Yu , Hung Chao-Ming , Hsieh Pei-Min , Wu Tsung-Chin , Yeh Jen-Hao , Hsiao Pojen , Huang Ya-Ling , Li Yu-Chan , Wang Ya-Chih , Shu Chih-Wen , Chen Yaw-Sen
Published: June 2020

Background: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is an infrequent type of primary liver cancer that comprises hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). This study investigated the clinicopathological features and prognosis among cHCC-CC, HCC, and CC groups.Methods: We prospectively collected the data of 608 patients who underwent surgical resection for liver cancer between 2011 and 2018 at E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. Overall, 505 patients with cHCC-CC, HCC, and CC were included, and their clinicopathological features, overall survival (OS), and recurrence were recorded. OS and recurrence rates were analyzed using the Kaplan–Meier analysis.Results: In the entire cohort, the median age was 61 years and 80% were men. Thirty-five (7.0%) had cHCC-CC, 419 (82.9%) had HCC, and 51 (10.1%) had CC. The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. OS was significantly lower in the cHCC-CC group than in the HCC group but was not significantly higher in the cHCC-CC group than in the CC group. The median OS of cHCC-CC, HCC, and CC groups was 50.1 months [95% confidence interval (CI): 38.7–61.2], 62.3 months (CI: 42.1–72.9), and 36.2 months (CI: 15.4–56.5), respectively. Cumulative OS rates at 1, 3, and 5 years in cHCC-CC, HCC, and CC groups were 88.5%, 62.2%, and 44.0%; 91.2%, 76.1%, and 68.0%; and 72.0%, 48.1%, and 34.5%, respectively. After propensity score matching (PSM), OS in the cHCC-CC group was not significantly different from that in the HCC or CC group. However, OS was significantly higher in the HCC group than in the CC group before and after PSM. Furthermore, the disease-free survival was not significantly different among cHCC-CC, HCC, and CC groups before and after PSM.Conclusion: The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. The OS rate was significantly lower in the cHCC-CC group than the HCC group. However, after PSM, OS and disease-free survival in the cHCC-CC group were not significantly different from those in the HCC or CC group.
Recruitment And Retention Of Participants From Socioeconomically Deprived Communities: Lessons From The Awareness And Beliefs About Cancer (ABACus3) Randomised Controlled Trial
Authors: Kolovou Vasiliki , Moriarty Yvonne , Gilbert Stephanie , Quinn-Scoggins Harriet , Townson Julia , Padgett Louise , Owen Sioned , Buckle Peter , Edwards Adrian , Hepburn Julie , Lau Mandy , Matthews Maura , Mitchell Caroline , Neal Richard , Playle Rebecca , Robling Michael , Smits Stephanie , Trubey Robert , Wood Fiona , Brain Kate
Published: June 2020

Background
Recruitment of research participants poses challenges in socioeconomically deprived areas. The Awareness and Beliefs About Cancer (ABACus) phase 3 Randomised Control Trial recruited adult participants from socioeconomically deprived areas using a combined healthcare/community engagement model. We report the strategies used to successfully recruit and retain our trial participant sample.
Methods
Community and healthcare settings in areas of high socioeconomic deprivation were identified by lay advisors who recruited participants opportunistically or by appointment. Follow-up was done by telephone or post at 2-weeks and 6-months after recruitment, and all participants were offered financial incentives. Qualitative interviews were conducted with lay advisors regarding their experience and reflections.
Results
The lay advisors identified and contacted 107 potential recruitment venues across South and West Yorkshire and South East Wales of which 41.1% (n = 42) were opened for recruitment. A total of 234 participants were recruited, with 91% (n = 212) retention at 2-weeks and 85% (n = 199) at 6-months. Community settings yielded 75% (n = 176) of participants. Participants had a mean age of 61.3 years and 63.3% (n = 148) were female, with 66% (n = 154) resident in the most deprived geographical areas. Lay advisors described recruitment as intensive, although engaging participants was easier in community settings.
Conclusions
The ABACus3 trial achieved recruitment and high retention with a population that is often “hard to reach” or entirely missed in health research. Strategies were specifically tailored to engage the venues and adult residents of highly deprived areas. Future studies recruiting adults living in the most deprived areas might benefit from community recruitment and from collaborating with local gatekeepers who are key to engagement.
Associations between Age, Oral Health-Related Quality of Life, and Oral and Swallowing Function among Psychiatric Inpatients in Japan : a cross-sectional study
Authors: Haresaku Satoru , Nakashima Fuyuko , Hara Yayoi , Kuroki Madoka , Aoki Hisae , kubota Keiko , Naito Toru
Published: June 2020

【Background】Along with the ageing society, hospitalized psychiatric patients are also ageing in Japan. The purpose of this study was to investigate the associations between age, oral health-related quality of life (OHRQoL), and oral health, including oral and swallowing function, among psychiatric inpatients. 【Methods】The subjects included 165 psychiatric inpatients in two psychiatric hospitals in Japan. The General Oral Health Assessment Index (GOHAI) and the Eating Assessment Tool (EAT-10) were included in the questionnaire survey for the measurement of OHRQoL and swallowing function. A score ≥3 on the EAT-10 was defined as suspected dysphagia. Oral examinations and oral diadochokinesis (ODK) measurements for the tongue-lip motor function evaluation were conducted. A chi-squared test, the Mann-Whitney U test, and linear regression analysis were used for the analysis. 【Results】A total of 100 (64.5%) psychiatric inpatients (49 males and 51 females) participated in this study. Their mean±SD age was 67.3±14.5. The higher DMFT index, the lower tongue-lip function, and suspected dysphagia was significantly associated with the higher age group. Tooth loss and suspected dysphagia were significantly associated with low GOHAI scores. The EAT-10 score was significantly correlated with the GOHAI score only after adjusting for age and sex (β=-0.725, 95% CI:-0.97, -0.64). 【Conclusions】In hospitalized psychiatric patients, impaired oral health in the older subjects was more pronounced compared with that among general adults. Tooth loss and swallowing function were associated with OHRQoL. Therefore, oral care for the recovery of occlusal and swallowing functions may be needed to improve OHRQoL among psychiatric patients.
Acute Superior Mesenteric Artery Embolism treated with Percutaneous Mechanical Thrombectomy: Preliminary application and Experience
Authors: Xu Qiyang , Wang Yi , Wang Di , Xu Bin , Yang Leibo , Hu Songjie , Yan Jinlin , Lang Dehai
Published: June 2020

Background:Acute superior mesenteric artery embolism is a life-threatening disease and the prognosis is very poor. Few reports have described the application of Percutaneous Mechanical Thrombectomy in Acute superior mesenteric artery embolism. In the article, we show a series of cases treated with Percutaneous Mechanical Thrombectomy and share our experience.Methods:Review and analyze seven patients with acute superior mesenteric artery embolism treated by Angiojet Ultra thrombectomy system in our institution. Based on the literature, we summarize the diagnosis, treatment and surgical experience of acute superior mesenteric artery embolism. Results:Percutaneous Mechanical Thrombectomy were achieved successfully in all the patients without surgical complication occurred. Five patients’ symptoms relieved significantly and smoothly discharged from the hospital. Two patients still complained of abdominal pain after operation. One patient underwent surgical laparotomy and intestinal resection and the other one abandoned surgical treatment. During the first six months of follow-up, six patients were free of any clinical symptoms or signs and one patient who refused laparotomy died two days later with septic shock.Conclusion:Percutaneous Mechanical Thrombectomy by Angiojet Ultra thrombectomy system is a safe, effective and minimally invasive method in the initial stage of acute superior mesenteric artery embolism. We believe Percutaneous Mechanical Thrombectomy could be a promising alternative in selected cases. Furthermore, large sample data and long term follow-up are needed to verify its effect.
Exploring the Mechanisms of Lian Hua Qing Wen Capsule against COVID-19 by Network Pharmacology and Molecular Docking Approach
Authors: Chen Li , Qu Hua , Tan Yu , Wu Tao Han , Shi Zhuo Da
Published: June 2020

Background The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) disease has led to a wide-spread global pandemic. There is no specific antiviral drug proven effective for the treatment of patients with COVID-19 at present. Combination of western and traditional Chinese medicine (TCM) is recommended, and Lian Hua Qing Wen (LHQW) capsule is a basic prescription and widely used to treat COVID-19 in China. However, the mechanisms of LHQW capsule treating COVID-19 are not clear. The aim of the study is to explore the mechanisms of LHQW capsule treating COVID-19 based on network pharmacy and molecular docking approach. Methods The active compounds and targets of LHQW capsule were obtained from traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP). COVID-19 related target genes were obtained from GeneCards database and OMIM database. Protein–protein interaction (PPI) networks of LHQW capsule targets and COVID-19-related genes were visualized and merged to identify the candidate targets for LHQW capsule treating COVID-19. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were also performed. The hub genes involved in the gene-related pathways were screened and their corresponding compounds were used for in vitro validation of molecular docking predictions.Results A total of 185 active compounds of LHQW capsule were screened out, and 263 targets were predicted. Third hundred and fifty-two COVID-19 related target genes were obtained from GeneCards database and OMIM database. GO functional enrichment analysis showed that the biological processes of LHQW capsule treating COVID-19 were closely linked with the regulation of inflammation, immunity, cytokines production, vascular permeability, oxidative stress and apoptosis. KEGG enrichment analysis revealed that the pathways of LHQW capsule treating COVID-19 were significantly enriched in AGE−RAGE signaling pathway in diabetic complications, Kaposi sarcoma−associated herpesvirus infection, TNF, IL−17, and Toll−like receptor (TLR) signaling pathway. The hub targets genes in the gene-related pathways analysis of LHQW capsule treating COVID-19 included MAPK1, MAPK3, RELA, IL-6 and CASP8, which closely associated with inflammation, cytokines storm and apoptosis. Finally, molecular docking showed that top 5 compounds of LHQW capsule also had good binding activities to the important targets in COVID-19.Conclusions The mechanisms of LHQW capsule treating COVID-19 may involve in inhibiting inflammatory response, cytokine storm and virus infection, and regulating immune reactions, apoptosis and endothelial barrier.
A Novel Immunochromatographic Test Strip Versus A Commercial Rapid Diagnostic Test for the Detection of Imported Plasmodium Species in Guangxi Province, China: A Comparative Evaluation
Authors: kangming lin , Wang Duo-Quan , Kokouvi Kassegne , Wang Jun-Yun , Shi Feng , Qian Ying-Jun , Qin Jian , Chen Jian-Feng , Ma An-Xiang , Li Jun , Yang Yi-Chao , Abilahi Faraji , Mihayo Michael , Lu Shen-Ning , Yang Fan , Zhou Xiao-Nong , Li Shi Zhu
Published: June 2020

Background: China has made significant progress towards malaria elimination by achieving zero reports of indigenous malaria cases over two consecutive years. The diagnosis of malaria, which is based on microscopic examination, still remains a challenge, due to a lack of sensitivity for detecting low-level parasitaemia. This study aimed to evaluate the diagnostic value of a novel immunochromatographic test strip for imported malaria. Methods: After obtaining informed consent, blood samples were collected from migrants returning home from Africa to Shanglin County in Guangxi, PR China, in 2018-2019, and were tested with the novel test strips. The test results were compared with those of microscopic examination, commercial malaria rapid diagnostic test (RDT), and polymerase chain reaction (PCR) assay. Results: A total of 535 samples were tested. Both microscopy and PCR test results showed a total of 162 (30.28%) malaria-positive samples, of which 99 were positive for Plasmodium falciparum (P. falciparum), three for P. vivax, five for P. malariae, and 50 for P. ovale, whereas five had mixed infections. The sensitivity, specificity, and efficiency of the novel RDT were 74.1%, 93.0%, and 87.3%, respectively, whereas its sensitivity of detecting P. falciparum, P. vivax, P. malariae, and P. ovale was 91.9%, 100%, 20.0%, and 44.0%, respectively. Furthermore, the sensitivity, specificity, and efficiency of the commercial RDT were 86.0%, 89.3%, and 88.2%, respectively, whereas its sensitivity of detecting P. falciparum, P. vivax, P. malariae, and P. ovale was 96.0%, 100%, 40.0%, and 70.0% respectively. The differential detection of Plasmodium species using the new RDT was significantly better compared to that of the commercial RDT (c2 = 14.73; P = 0.0001), which can detect only P. falciparum. This was consistent with Kappa analysis (Kappa = 0.881). A significant difference (c2 = 24.50; P < 0.0001) in the detection rate of other Plasmodium species was observed with an average consistency using Kappa analysis (Kappa = 0.716). Conclusion: The novel malaria RDT test strip had high sensitivity and specificity in detecting P. falciparum and P. vivax. Improvement in P. ovale and P. malariae detection efficiency may lead to the scale-up of this RDT in the future.
Hygiene along the continuum of care in the early post-natal period: an observational study in Nigeria
Authors: Nalule Yolisa , Buxton Helen , Flynn Erin , Oluyinka Olutunde , Sara Stephen , Cumming Oliver , Dreibelbis Robert
Published: June 2020

Background
Newborns delivered in healthcare facilities in low- and middle-income countries are at an increased risk of healthcare associated infections. Facility–based studies have focused primarily on healthcare worker behaviour during labour & delivery with limited attention to hygiene practices in post-natal care areas and largely ignore the wide variety of actors involved in maternal and neonatal care.
Methods
This exploratory mixed-methods study took place in six healthcare facilities in Nigeria where 31 structured observations were completed during post-natal care, discharge, and the first six hours after return to the home. Frequency of hand hygiene opportunities and hand hygiene actions were assessed for types of patient care (maternal and newborn care) and the role individuals played in caregiving (healthcare workers, cleaners, non-maternal caregivers). Qualitative interviews with mothers were completed approximately 1 week after facility discharge.
Results
Maternal and newborn care were performed by a range of actors including healthcare workers, mothers, cleaners and non-maternal caregivers. Of 291 hand hygiene opportunities observed at health facilities, and 459 observed in home environments, adequate hand hygiene actions were observed during only 1% of all hand hygiene opportunities. Adequate hand hygiene prior to cord contact was observed in only 6% (1/17) of cord contact related hand hygiene opportunities at healthcare facilities and 7% (2/29) in households. Discharge advice was infrequent and not standardised and could not be remembered by the mother after a week. Mothers reported discomfort around telling non-maternal caregivers to practice adequate hand hygiene for their newborn.
Conclusions
In this setting, hand hygiene practices during post-natal care and the first six hours in the home environment were consistently inadequate. Effective strategies are needed to promote safe hand hygiene practices within the post-natal care ward and home in low resource, high-burden settings. Such strategies need to target not just mothers and healthcare workers but also other caregivers.
Regional Robust Secure Precise Wireless Transmission Design for Multi-user UAV Broadcasting System
Authors: Shen Tong , Liu Tingting , Lin Yan , Wu Yongpeng , Shu Feng , Han Zhu
Published: June 2020

In this paper, two regional robust secure precise wireless transmission (SPWT) schemes for multi-user unmanned aerial vehicle (UAV): 1)regional signal-to-leakage-and-noise ratio (SLNR) and artificial-noise-to-leakage-and-noise ratio (ANLNR) (R-SLNR-ANLNR) maximization and 2) point SLNR and ANLNR (P-SLNR-ANLNR) maximization, are proposed to tackle with the estimation errors of the target users’ location. In the SPWT system, the estimation error for SPWT cannot be ignored. However the conventional robust methods in secure wireless communications optimize the beamforming vector in the desired positions only in statistical means and cannot guarantee the security for each symbol. The proposed regional robust schemes are designed for optimizing the secrecy performance in the whole error region around the estimated location. Specifically, with the known maximal estimation error, we define the target region and wiretap region. Then design an optimal beamforming vector and an artificial noise projection matrix, which achieve the confidential signal in the target area having the maximal power while only few signal power is conserved in the potential wiretap region. Instead of considering the statistical distributions of the estimated errors into optimization, we optimize the SLNR and ANLNR of the whole target area, which significantly decreases the complexity. Moreover, the proposed schemes can ensure that the desired users are located in the optimized region, which are more practical than the conventional methods. Simulation results show that our proposed regional robust SPWT design is capable of substantially improving the secrecy rate compared to the conventional non-robust method. The P-SLNR-ANLNR maximization-based method has the comparable secrecy performance with lower complexity than that of the R-SLNR-ANLNR maximization-based method.
Successful Chiropractic and Rehabilitation Prevents Spinal Fusion Surgery for Chronic Low Back Pain: A Case Report
Authors: Roloff Joel
Published: June 2020

A 37-year-old female presented with low back and right leg pain that increased over a year despite interventions from a Chiropractor, Physical Therapist, Orthopedist, Pain Specialist, and Neurosurgeon. The patient failed medical management, local steroid injections, physical therapy, and had a very brief period of relief following surgical discectomy. She was considering spinal fusion surgery when she sought a second opinion. She described radiating pain that extended beyond the knee into the calf and ankle area latera and anterior as “sharp” and “twisted”. Treatment began with Chiropractic adjustments and soft tissue work using post-isometric relaxation (PIR) due to the amount of pain the patient was in and progressed from twice a week to weekly intervals using both passive therapy and active rehabilitation exercises. Using the Oswestry disability index (Fairbank JC, 2000), the patient progressed from a 62% disability “(crippled)” to 36% “(moderate disability)” during five weeks of in-office treatment, to 16% “(minimal disability)” during a 5 ½ week hiatus from in office care during which she continued at home active rehabilitation exercises. The goal of this report is to detail the importance of proper assessment and incorporating both passive and active care into a treatment plan. This report shows the effectiveness of a comprehensive history that leads to patient informed goal determination, in conjunction with examination, functional assessment, with the addition of active exercise to a passive treatment plan.
LncRNA-SNHG6 promotes the progression of hepatocellular carcinoma by targeting miR-6509-5p and FKBP1A
Authors: Zhao Zhongwei , Song Jingjing , Zhang Dengke , Wu Fazong , Tu Jianfei , Xu Min , Ji Jiansong
Published: June 2020

Accumulating evidences has been reported that long noncoding RNAs play crucial roles in the progression of hepatocellular carcinoma (HCC). snoRNA host gene 6 (SNHG6) is believed to be involved in several human cancers, but the specific molecular mechanism of SNHG6 in HCC is not well studied. Here, we found SNHG6 was highly expressed in HCC tissues. Next, using Hep3B and Huh7 cells, we confirmed knockdown of SNHG6 could reduce the proliferation, migration and invasion abilities in vitro. Also, by bioinformatics analysis, further molecular and cellular experiments, we found miR-6509-5p bound to SNHG6 directly, and the expression level of FKBP1A was regulated through SNHG6/ miR-6509-5p axis. Finally, we found that down-regulation of SNHG6 could dramatically reduce the tumor growth ability of Huh7 cells in vivo. Taking together, we concluded that SNHG6/miR-6509-5p/FKBP1A axis functioned in the progression of hepatocellular carcinoma, and could be the promising therapeutic targets in hepatocellular carcinoma.
Development and validation of an immune-related gene pairs signature in lower-grade glioma
Authors: Zhang Xu , Ping Shuai , Zhang Rui , Li Can , Gao Caibin , Ma Hui , Sun Tao , Wang Feng
Published: June 2020

Background

Lower-grade gliomas (LGG) are the prevalent primary intracerebral malignancy tumor. Increasing evidence indicated an association between immune signature and LGG prognosis. Thus, we aim to develop an immune-related gene pairs (IRGPs) signature that can predict prognosis for LGG.
Method:

Gene expression levels and clinical information of LGG patients (LGGs) were collected from The Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA) databases. The two databases were divided into training cohort (n = 515) and an independent validation cohort (n = 604). IGRPs significantly associated with prognosis were selected by Cox regression. Gene set enrichment analysis and filtration were performed on IGRPs.
Results

Within 1991 immune genes, an 8 IRGPs signature including 15 unique genes was constructed, which had a significant association with survival. In the validation dataset, the IRGPs signature significantly stratified LGGs into low- and high-risk groups (P < 0.001), and it remained an independent prognostic factor in univariate and multivariate analyses (P < 0.001). Additionally, 26 functional pathways were filtrated through the intersection of Gene set enrichment analysis (GSEA) and gene ontology (GO) enrichment analysis.
Conclusion

The IGRPs signature demonstrated good prognostic value in lower-grade glioma, which may provide new insights into individual treatment for glioma patients. And the IGRPs might take effect through these filtrated 26 functional pathways.
Immune gene prognostic signature for disease free survival of gastric cancer Translational research of an artificial intelligence survival predictive system
Authors: zhang zhiqiao , He Tingshan , Huang Liwen , Li Jing , Wang Peng
Published: June 2020

Background
The progress of artificial intelligence algorithms and massive data provide new ideas and choices for individual mortality risk prediction for cancer patients. The current research focused on depict immune gene related regulatory network and develop an artificial intelligence survival predictive system for disease free survival of gastric cancer.
Methods
Multi-task logistic regression algorithm, Cox survival regression algorithm, and Random survival forest algorithm were used to develop the artificial intelligence survival predictive system.
Results
Nineteen transcription factors and seventy immune genes were identified to construct a transcription factor regulatory network of immune genes. Multivariate Cox regression identified fourteen immune genes as prognostic markers. These immune genes were used to construct a prognostic signature for gastric cancer. Concordance indexes were 0.800, 0.809, and 0.856 for 1-, 3- and 5- year survival. An interesting artificial intelligence survival predictive system was developed based on three artificial intelligence algorithms for gastric cancer. Gastric cancer patients with high risk score have poor survival than patients with low risk score.
Conclusions
The current study constructed a transcription factor regulatory network and developed two artificial intelligence survival prediction tools for disease free survival of gastric cancer patients. These artificial intelligence survival prediction tools are helpful for individualized treatment decision.
Interleukin-8 is not a predictive biomarker for the development of the acute promyelocytic leukemia differentiation syndrome
Authors: de Almeida Luciana Yamamoto , Pereira-Martins Diego Antonio , Lima Ana Sílvia Gouvêa , Baggio Márcia Sueli , Koury Luisa Corrêa de Araujo , Lange Ana Paula , Bassi Sarah Cristina , Scheucher Priscila Santos , Rego Eduardo
Published: June 2020

Background
Differentiation syndrome (DS) is the main life-threatening adverse event that occurs in acute promyelocytic leukemia (APL) patients treated with all-trans retinoic acid (ATRA). Cytokine imbalances have been reported to play role during the developing of APL-DS. However, the relationship between the plasma cytokine levels and their prognostic value for the prediction of DS developing in APL patients during the treatment with ATRA and anthracyclines has not been previously reported.
Methods
In this study, we followed an APL cohort (n = 17) over seven days of ATRA therapy in DS (n = 6) and non-DS groups (n = 11). Interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70 and TNF-α were measured in the peripheral blood plasma from 17 APL patients and 11 healthy adult controls by using the cytometric bead array method.
Results
In non-DS patients, IL-8 plasma levels were significantly reduced in the seventh day of ATRA treatment whereas their levels did not discriminate between DS and non-DS development. No significant differences were found in IL-6 levels between groups. Other cytokines tested were all undetectable in APL patients or healthy controls.
Conclusions
We demonstrated that the modulation of IL-8 following ATRA treatment may occur regardless of the development of DS and, therefore, does not appear to be a predictive biomarker to monitor the APL-DS.
Adolescent fertility in Zambia- a critical discourse analysis of adolescent fertility control from a postcolonial perspective
Authors: Munakampe Margarate Nzala , Michelo Charles , Zulu Joseph Mumba
Published: June 2020

Background Despite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries. This study aimed to explore the competing discourses that shape adolescent fertility control in Zambia. Methods A qualitative case study design was adopted, involving 33 individual interviews and 9 focus group discussions with adolescents and other key-informants such as parents, teachers and policymakers. Thematic analysis was used to analyze the data critically. Results Adolescents’ age significantly reduced their access to SRH services. Also, adolescent fertility discussions were influenced by marital norms and Christian-religious beliefs, as well as health and rights values. While early marriage or child-bearing was discouraged, married adolescents and adolescents who had given birth before faced fewer challenges when accessing SRH information and services compared to their unmarried or nulliparous counterparts. Besides, the major influencers such as parents, teachers and health workers were also conflicted about how to package SRH information to young people, due to their varying roles in the community. Conclusion The pluralistic view of adolescent fertility is fueled by “multiple consciousnesses”. This is evidenced by the divergent discourses that shape adolescent fertility control in Zambia, compounded by the disempowered position of adolescents in their communities. We assert that the competing moral worlds, correct in their own right, viewed within the historical and social context unearth significant barriers to the success of interventions targeted towards adolescents’ fertility control in Zambia, thereby propagating the growing problem of high adolescent fertility. This suggests proactive consideration of these discourses when designing and implementing adolescent fertility interventions.
Impaired wound healing after neoadjuvant radiotherapy and resection of soft tissue sarcomas
Authors: Bakhshai Yasmin , Klein Alexander , Lindner Lars , Rauch Josefine , Birkenmaier Christof , Jansson Volkmar , Weber Patrick , Dürr Hans Roland
Published: June 2020

Background

In soft tissue sarcomas (STS) radiotherapy (RTx) may be applied pre- or postoperatively with advantages and disadvantages on either side. We examined the effect of preoperative radiation on wound healing in patients with STS of the extremities and the pelvis.
Methods

Between August 2008 and March 2011, 32 patients with an average of 54 years (SD 18.7) and with STS (all Grade 2 or 3) were treated with a planned wide resection after neoadjuvant RTx leaving a rim of uninvolved soft tissue around the tumor. Preoperative RTx was given at an average dose of 51,5 Gy (SD 4.6) and mean follow up was 12.2 months (SD 9.8). The results were compared to a consecutive series of 60 patients treated later on without neoadjuvant RTx.
Results

R0 resection were performed in 31 of 32 patients. Impaired wound healing (IWH) occurred in 19 patients (59%), revision surgery had to be performed in 17 patients (53% of total). Four patients had to undergo 2 or more revisions. One patient had to be amputated and one patient died due to septic complications after revision surgery. IWH was seen more frequently in the lower (18 / 28) than in the upper extremities (1 / 4), yet this was not statistically significant in our series (p = 0.223, Fisher’s exact test). Comorbidities were not found to be of influence. In the control group, revision surgery was necessary in 18% of the patients (p = 0.0006).
Conclusions

Radiotherapy is effective in local tumour control, but causes a high rate of impaired wound healing (59%), if applied prior to surgery. This frequently resulted in one or more revision surgeries delaying the schedule of further therapies. The authors recommend RTx to be applied only in selected cases in a neoadjuvant setting.
Impact of relative dose intensity of oxaliplatin in adjuvant therapy among stage III colon cancer patients on early recurrence: a retrospective cohort study
Authors: Żok Jolanta , Bieńkowski Michał , Radecka Barbara , Korniluk Jan , Adamowicz Krzysztof , Duchnowska Renata
Published: June 2020

Background
The oxaliplatin-based therapy with FOLFOX-4 or CAPOX administrated over 6 months remains the standard adjuvant treatment for stage III colon cancer (CC) patients. However, many patients experience dose reduction or early termination of chemotherapy due to oxaliplatin toxicity, which may increase the risk of early recurrence. The objective of this study was to analyze the relationship between the relative dose intensity of oxaliplatin (RDI-O) and early recurrence among stage III CC patients.
Methods
The study included 365 patients treated at five oncology centers in Poland, between 2000–2014. Survival analysis was performed using the Kaplan-Meier method. Univariate analysis was performed using the Cox’ proportional hazard model; multivariate analysis was performed with the stepwise forward approach. For all analyses the α level of 0.05 was employed.
Results
The median follow-up was 51.8 months (range 8.2-115.1). The early recurrence < 36 months after surgery occurred in 130 patients (37.8%). In this group 51 (39.2%) and 87 (66.9%) at low and high-risk, respectively. Receipt < 60% RDI-O was associated with early recurrence within 18 months after surgery (OR = 2.05; 95%CI: 1.18–3.51; p = 0.010), especially in low-risk group (HR = 1.56 (95%CI: 0.96–2.53), p = 0.07). In the multivariate analysis early recurrence were correlated with grade (OR = 2.47; 95% CI: 1.25–4.8; p = 0.008), pN (OR = 2.63; 95% CI: 1.55–4.54; p < 0.001), the number of lymph nodes harvested (OR = 0.51; 95% CI: 0.29–0.86; p = 0.013) and RDI-O (OR = 1.91; 95%CI: 1.06–3.39; p = 0.028). The early vs. late recurrence negatively correlated with OS regardless of the RDI-O (HR = 22.9 (95%CI: 13.9–37.6; p < 0.001).
Conclusions
RDI-O < 60% in adjuvant therapy among stage III CC (especially in low-risk group) increase the risk of early recurrence within 18 months after surgery. Patients with early recurrence showed worse overall survival regardless of the RDI-O.
Novel Promising Technique for Traumatic Pancreatic Injury Management.
Authors: Takrouney Mohammed Hamada , Bothara Vipul Prakash , Jahhav Bhushan , Osman Mohamed Abdelkader , Ibrahim Ibrahim Ali , Eltayeb Almoutaz Ahmed , Mostafa Mahmoud Mohamed , Sandlas Gursev
Published: June 2020

Introduction: Pancreatic injuries in children are relatively uncommon. The precise location of the injury, the status of the main pancreatic duct, and the time between diagnosis and intervention are a potentially useful guide for management decisions. We report a successful endoscopic simple primary repair with the pancreatic preservation even with transected main pancreatic duct without duct stenting.Patients and Methods: Between May 2017and December 2019, 3 patients with pancreatic trauma and duct transection underwent endoscopic (laparoscopic and robotic) repair. Demographics, Operative data, Postoperative complications, and clinical outcomes were documented and analyzed.Results: Three patients with pancreatic fractures, 2 patients with grade IV, and one patient grade III injury. The median age was 11 years, the median time of hospital admission after the trauma was 72 hours. The median time of surgical intervention was 24 hours. Average operative time was160 minute and the average hospital stay was 9 days with no recorded postoperative or follow up complications till now.Conclusion: Primary simple pancreatic repair is a promising and plausible technique for the management of pancreatic trauma, especially with duct transaction it maybe instead of all other modalities of pancreatic trauma treatment. We implore all pediatric surgery centers to espouse this technique.
Correlations between left ventricular and left atrial function assessed by speckle tracking echocardiography in patients with treated well-controlled arterial hypertension
Authors: Uziebło-Życzkowska Beata , Krzesiński Paweł
Published: June 2020

BackgroundEven in patients with well-controlled arterial hypertension (AH) and without significant comorbidities left ventricular (LV) and left atrial (LA) strain abnormalities may sometimes be found in speckle-tracking echocardiography. Therefore, the aim of this study was to investigate the correlation between LA strain and LV diastolic and systolic function in a group of patients with treated, well-controlled AH.Methods LA contractile, conduit, and reservoir function, together with echocardiographic signs of LV diastolic function and LV global longitudinal strain (LV GLS), were assessed in 101 patients with treated, well-controlled AH who met the standard criteria of normal LV ejection fraction (LVEF) and normal LV diastolic function.ResultA relevant percentage of study participants presented lower than reference LV and LA strain values. Moreover, there were statistically significant differences in LA longitudinal strain (LAS) values (LAS during reservoir phase—LASr (p<0.001) and LAS during conduit phase—LAScd (p = 0.008)) between patients with high and lower LV GLS, confirmed by significant correlations between LASr, LAScd, and GLS. In the correlations analysis between LAS values and LV diastolic function parameters, statistical significance was obtained for the following: LASct (contraction) vs. e’avg, LASct vs. E/A, LASct vs. A, LAScd vs. e’avg, LAScd vs. E/A, and LAScd vs. A. Conclusions LV and LA strain abnormalities occurred within a significant percentage of patients with treated, well-controlledAH. Impaired LA strain is associated with lower LV strain and reduced LV diastolic function parameters, reflecting both the passive and active properties of the LA.
A Novel USH2A Variant in a Patient with Hearing Loss and Prenatal Diagnosis of a Familial Fetus: a Case Report and Literature Review
Authors: Zhou Cong , Xiao Yuanyuan , Xie Hanbing , Liu Shanling , Wang Jing
Published: June 2020

Background: Usher syndrome (USH) is the most common cause of inherited deaf-blindness. This study aimed to identify pathogenic mutations in a Chinese patient with hearing loss and reviewed the relevant literature.Methods: Genomic DNA obtained from a five-year-old girl with hearing loss was analyzed via the disease-targeted gene panel. Results: We identified the compound heterozygous mutations c.8559-2A>G and c.4749delT in Usher syndrome type 2A (USH2A) gene as the underlying cause of the familial hearing loss; the former variation has been reported in the literature, but not the latter. The parents of the girl were heterozygous carriers. The two variants were pathogenic. Based on these findings, amniotic fluid samples were used for prenatal diagnosis of the couple's fetus, which was found to carry c.4749delT but not c.8559-2A>G variation. During the follow-up period of more than 9 months after the birth of the fetus, it was confirmed that the infant was healthy.Conclusions: We performed genetic diagnosis of Usher syndrome by disease-targeted gene panel and have proven that this method can serve as a rapid, high-throughput, and efficient screening strategy. The novel mutation expands the spectrum of USH2A variants in USH.
Positive Correlation between General Public Knowledge and Attitudes Regarding COVID-19 Outbreak One Month after First Cases Reported in Indonesia
Authors: Sari Dina Keumala , Amelia Rina , Dharmajaya Ridha , Sari Liza Meutia , Fitri Nadya Keumala
Published: June 2020

Background: The increasing number cases of coronavirus disease (COVID-19) infections in the general population in Indonesia raises questions concerning the public’s knowledge and attitudes regarding this pandemic. Objective: To determine the correlation between the general public’s knowledge and attitudes regarding the COVID-19 outbreak one month after the first cases were reported in Indonesia. Methods: This cross-sectional study was conducted between early March and the end of April 2020 in the general population of Indonesia, beginning with the North Sumatra region, where the spread of COVID-19 in Indonesia began. Questionnaires were randomly distributed online in the red zone in Indonesia. Data were collected by collecting people’s responses to the questionnaire, which were distributed via WhatsApp (WA) application and were competed independently by the participants. A descriptive analysis was conducted to describe the demographic characteristics, knowledge, and attitudes of the general population. Results: A total of 201 people had good knowledge (98%) and a positive attitude (96%) regarding the COVID-19 pandemic. The respondents had a negative attitude in relation to two aspects of the COVID-19 outbreak: having to always maintain a distance of 1.5 m when in crowds, and not being able to regularly exercise or eat nutritious food (78.6% and 79.1%, respectively). Conclusions: Most people in Indonesia have good knowledge and a positive attitude regarding the COVID-19 pandemic. However, negative attitudes were still found in this study, and as a result, transmission prevention measures cannot reach their maximum effectiveness by simply publicizing the increase in day-to-day cases to the general public.
Incidental Lowering of Otitis-media Complaints in Otitis-prone Children During COVID-19 Pandemic: Not All Evil Comes to Hurt
Authors: Torretta Sara , Capaccio Pasquale , Coro Ilaria , Bosis Samantha , Pace Elisabetta , Tosi Pietro , Pignataro Lorenzo , Marchisio Paola
Published: June 2020

Given COVID-19 pandemic periodic outpatient assessment of otitis-prone children regularly followed at our tertiary outpatient clinic of upper respiratory tract infections was discontinued since March 9th. In order to avoid leaving the patients to themselves just during the winter months which are the most critical ones for these children, we kept in touch with the families of 102 children (mean age 41.4±14.0 months) who had had a follow-up visit scheduled during the lockdown, and compensated with telemedicine assessment. This incidentally lead to the unexpected but not at all negative finding that a consistent clinical improvement had been occurred in most (82.3%) of children. A statistically significant reduction in the mean number of documented acute otitis media episodes, otorrhea episodes, and systemic antibiotic treatments during the February-April 2020 period compared to February-April 2019 was attested. Clinical evaluation performed in 27.4% cases revealed normal middle ear findings in all but three (89.3%) children.Conclusion: Our data document a global improvement of otitis-prone children in Milan during the Italian lockdown, as a fortuitous and incidental positive effect of the national lockdown.
Coronavirus disease 2019 outbreak: does confinement have any impact on weight variation and weight change perception?
Authors: Haddad Chadia , Zakhour Maha , Siddik Ghina , Haddad Rima , Sacre Hala , Salameh Pascale
Published: June 2020

Background: In the time of confinement, a reduction of physical activities, unhealthy diet, sedentary behavior, and an increase in sitting time will contribute to weight change. During these stressful times, individuals might have a greater concern about their body image and weight. Therefore, the first objective of the current study is to evaluate the impact of confinement during the COVID-19 outbreak on weight variation. The second objective is to evaluate factors associated with weight perception among a sample of the Lebanese population.Method: A cross-sectional web-based online survey, carried out between 3 and 18 April, 2020, enrolled 407 participants. Due to the confinement situation, the height and weight of the participants were estimated by them themselves. The variation of declared BMI was calculated by taking away the weight estimated during the confinement from the weight estimated before the confinement. The perception of weight change was assessed using one dichotomized question (positive/negative). Results: No significant variation was found for the BMI before and during the confinement (p=0.40). A perceived weight change was found in 212 (52.1%) participants. Multivariable analysis showed that longer duration of confinement (Beta=-0.01), higher restraint (Beta=-0.21), higher physical activity (Beta=-0.006) and low income (Beta=-0.59) were significantly associated with a lower BMI variation. When taking perceived weight change as the dependent variable, the results showed that a higher fear of COVID-19 score (ORa=0.96) was significantly associated with lower positive weight change perception. However, higher confinement duration (ORa=1.07), higher anxiety (ORa=1.05) and higher eating concern (ORa=1.81) were significantly associated with greater weight change perception.Conclusion: Our main results indicate that no significant change in weight was detected before and during confinement. The fear of COVID -19 was not related to weight change; however, a negative association was found with weight perception. Also, longer duration of confinement were associated with a lower declared BMI variation and greater weight change perception. These results are a step forward to understand the long-term effects of confinement on physical and psychological health.
Determinants of diet and physical activity in adolescents in Mysore, India: a qualitative study
Authors: Joseph Shama , Krishnaveni G. V. , Kumaran K. , Weller Susie , Ramya M. C. , Krishna Divyashree , Kehoe Sarah H. , Fall Caroline , Hardy-Johnson Polly , Barker Mary
Published: June 2020

Background

Adolescence is an important transitional period in which major physical, psychological and cognitive changes occur. Lifestyle habits during this time, particularly related to dietary behaviour and physical activity, strongly influence overall health and non-communicable disease risk in adulthood. There are gaps in knowledge about the determinants of food choices and physical activity habits of adolescents in low and middle income countries.

Objectives

To identify factors which influence the food choices and physical activity habits of adolescents in the South Indian city of Mysore, India.

Methods

Six focus group discussions were conducted in selected urban neighbourhoods of Mysore. Thirty volunteers were recruited by purposive sampling method to include younger (10-12 years old, n=12) and older (15-17 years old, n=12) adolescents, and caregivers of adolescents (n=6). The focus group discussions were conducted by investigators who were native to the region

Results

Despite revealing a propensity for consuming fast foods, adolescents ate home cooked meals regularly, and both young people and their parents were satisfied with the quality of the adolescents’ diets. Also, all participant groups reported that adolescents regularly played and enjoyed games and sports, and did household chores as part of their physical activity. However, the pressure of schoolwork and the increasing amounts of time spent on digital devices including mobile phones were major constraints to being active.

Conclusions

Adolescents and caregivers perceive that Mysore adolescents’ dietary habits remain satisfactory. Academic study was found to be the priority in adolescents’ lives. This is recognized and accepted both socially and culturally as the right choice by parents and young people alike. Therefore, not much time or effort is spent on being active. A contradiction is that although time is considered to be a scarce commodity that necessitates careful partitioning, any surplus time is preferentially spent in playing digital games and interacting on social media. Interventions are needed to increase the amount of physical activity undertaken by Mysore adolescents.