bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacists’ knowledge, experiences and perceptions of treatments for attention-deficit/hyperactivity disorder
Authors: Yuen Terence , Zhang Hantao , Bonin Robert P.
Published: January 2021

Background:

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins in childhood and often persists into adulthood. ADHD increases the risk of various negative impacts, and pharmacists are well positioned to address these issues in the community.

Objectives:

This survey study aims to first identify pharmacists’ ADHD knowledge gaps and experience with ADHD management and to second assess their preferences for continuing education and their experience with sleep-related issues in ADHD.

Methods:

A survey was sent to Part A Ontario pharmacists with active licenses who opted in to receive research-related emails ( n = 6022). Descriptive statistics were used to analyze survey data, while free-form answers were pooled and evaluated for common themes and trends.

Results:

A total of 238 complete responses were received. The average self-reported ADHD knowledge was 5.8 ± 1.96 on a 10-point scale. There was no correlation between the number of years of practice as a pharmacist, the number of working hours per week or the location of practice on pharmacists’ self-reported knowledge scores. There was a significant difference in self-reported knowledge of ADHD between pharmacists who were not aware of the Canadian ADHD Resource Alliance (CADDRA) guidelines (5.1 ± 2.1) and those who refer to it for standard of care (7.1 ± 1.5). Almost all pharmacists (95%) indicated they could benefit from additional ADHD education, with a strong preference for “online continuing education modules” (81%). The majority of responders considered psychostimulant ADHD medication as the major possible contributor to sleep disturbances (47%) in ADHD, highlighting a need for further education on the inconclusive link between ADHD medication effects on sleep.

Conclusion:

The study results raise the concern that pharmacists may require additional ADHD education but also show the lack of awareness of available resources, such as the CADDRA guidelines. Can Pharm J (Ott) 2021;154:xx-xx.
Will ‘we’ continue to exercise? The associations between group identification, identity leadership, and relational identification on group exercise class adherence
Authors: Rowe Laura F , Slater Matthew J
Published: January 2021

The present study sought to provide support for the roles of both the social identity approach (group identification and identity leadership) and relational identification in adherence to group exercise classes. One hundred and twenty U.K. based group exercise class attendees completed an online survey in a cross-sectional design. Group identification, perceptions of identity leadership behaviour, and relational identification were not significantly associated with length of class attendance. However, both identity leadership behaviour of the class instructor and ingroup affect (measured as an element of multi-dimensional group identification), were significantly associated with expected likelihood of continued class participation. For every 1 unit increase in the identity leadership and in-group affect measures respectively, participants were 1.9 and 2.0 times more likely to be ‘at or near 100%’ likely to continue vs not. Social identity variables were not associated with how long exercisers had been attending class, but identity leadership and ingroup affect are positive influencers of expected future adherence. Further research into the social identity approach and identity leadership behaviour regards exercise class attendance tenure vs volume is warranted and is likely to benefit from the use of multi-dimensional group identification measures.
Teaching young consumers in Europe: a multicentre qualitative needs assessment with educators on food hygiene and food safety
Authors: Eley C , Lundgren PT , Kasza G , Truninger M , Brown C , Hugues VL , Izso T , Teixeira P , Syeda R , Ferré N , Kunszabo A , Nunes C , Hayes C , Merakou K , McNulty CAM
Published: January 2021

Aim:

Foodborne illnesses have a significant global burden and can be life-threatening, with higher risk in vulnerable groups such as children. SafeConsume is an EU-funded, transdisciplinary project aiming to improve consumers’ food safety behaviour. Developing educational resources on food safety for use in schools has potential to improve teaching of our young consumers. The aim of this study was to explore school educators’ attitudes, behaviours and knowledge towards food hygiene, safety and education.

Methods:

Focus groups and interviews in England, France, Portugal and Hungary explored educator knowledge, skills, intentions and beliefs around educating young people (11–18 years) about food safety. Data were analysed using NVivo and emerging themes were applied to the Theoretical Domains Framework.

Results:

A total of 48 educators participated. Knowledge, confidence and skills to teach food safety to young people varied depending on background and training. Educators reported they had a role to teach food safety to young people, were positive about delivering education and optimistic they could improve students’ food safety behaviour. Barriers to teaching included lack of national curriculum coverage, limited time and money, and lack of facilities. Educators reported that social influences (family, celebrity chefs, public health campaigns and social media) were important opportunities to improve young peoples’ awareness of food safety and consequences of foodborne illness.

Conclusion:

Educator food safety expertise varied; training could help to optimise educator knowledge, confidence and skills. Ministries of Health and Education need encouragement to get food safety incorporated further into school curricula across Europe, so schools will be motivated to prioritise these topics.
Envisioning PR research without taking organizations as collective actors for granted: A rejoinder and extension to Hou
Authors: Buhmann Alexander , Schoeneborn Dennis
Published: January 2021

In a recent article in Public Relations Inquiry, Jenny Hou has fittingly argued for a stronger focus on agency and actorhood in PR research. We point to two crucial aspects in which we think her arguments need to be extended, namely: (a) embracing the constitutive role of communication for organizational actorhood and agency, and (b) rethinking the role of PR in the constitution of organizational actors. We argue that such extension would allow for an important and radical twist in perspective that highlights a widely neglected question in PR research: What if the collective actorhood status of organizations is not treated as a given but rather arises from communicative attributions of such actorhood status to social entities? Finally, we develop key implications from this shift in perspective for PR scholarship, education, and practice.
Replacing cheap nature? Sustainability, capitalist future-making and political ecologies of robotic pollination
Authors: Nimmo Richie
Published: January 2021

This article undertakes a critical examination of emergent technologies involving the use of robots to carry out crop pollination in the context of declining populations of bees and other insect pollinators. It grasps robotic pollination research and development as a future-making practice, which imagines and partially materialises one possible future by inscribing a specific ontology in the present which is geared to enact that future. Unpacking this, the article traces how artificial pollination reframes pollination ecology around a productivist ontology and inscribes a web of meanings around nature, technology and economy which point to a future where insect pollinators are largely absent or extinct. It argues that this effectively backgrounds alternative futures in which structural transformations of agriculture and the world food system are able to mitigate and avert pollinator decline and biodiversity loss, and also reveals the deep rationale of artificial pollination. While invoking notions of sustainability and food security, robotic pollination defines these in highly anthropocentric, economistic and self-referential terms, as a matter of enabling the reproduction of agro-industrial capital accumulation. Drawing upon the political ecology of Jason W Moore, the article situates robotic pollination as a future-making project in relation to capitalist strategies of accumulation through the appropriation of ‘Cheap Nature’, to show how the automation of pollination would enact a shift in the composition of agro-industrial capital, with systemic consequences inimical to both ecological sustainability and sustained accumulation. In this respect, robotic pollination is a case study in the propensity of capital to invest in the making of sustainable futures only insofar as sustainability equates to the reproduction of capital within the web of life.
Study on the strength of glued laminated timber beams with round holes: difference in structural performance between homogeneous-grade and heterogeneous-grade timber
Authors: Okamoto Shigefumi , Akiyama Nobuhiko , Araki Yasuhiro , Aoki Kenji , Inayama Masahiro
Published: January 2021

Various design codes and design proposals have been proposed for glued laminated timber beams with round holes, assuming that the entire beam is composed of homogeneous-grade timber. However, in Japan, glued laminated timber composed of homogeneous-grade timber is rarely used for beams. In this study, the difference in the load-bearing capacity of glued laminated beams composed of homogeneous-grade timber and heterogeneous-grade timber with round holes when fractured by cracking was investigated experimentally and analytically. The materials used in the tests were glued laminated beams composed of homogeneous-grade Scots pine timber with a strength grade of E105-F345 and heterogeneous-grade Scots pine timber with a strength grade of E105-F300. Experiments confirmed that although the glued laminated beams composed of heterogeneous-grade timber have a lower material strength in the lamina with holes, its resistance to fracturing due to cracks associated with the holes is almost the same as that of the glued laminated beams composed of homogeneous-grade timber. The stresses acting on the holes in the laminated timber with holes of less than half the beam height were lower in the glued laminated beams composed of heterogeneous-grade timber than in the glued laminated beams composed of homogeneous-grade timber. The ratio of the stresses was found to be approximately equal to the ratio of the maximum bending stress or the maximum shear stress acting on the inner layer lamina, as determined by Bernoulli–Euler theory.
Role of liver enzymes in patients with blunt abdominal trauma to diagnose liver injury
Authors: Shrestha Anup , Neupane Harish Chandra , Tamrakar Kishor Kumar , Bhattarai Abhishek , Katwal Gaurav
Published: January 2021

Background

The liver is the second most injured organ following blunt abdominal trauma (BAT) after the spleen. Although the computed tomography (CT) scan is considered as the gold standard for diagnosing liver injury in BAT, it may not readily available in all the hospitals. This study was performed to evaluate the role of aspartate transaminase (AST) and alanine transaminase (ALT) in patients with BAT and its significance in predicting the diagnosis and severity of the liver injury.

Method

The study was conducted in Chitwan Medical College Teaching Hospital (CMCTH) from February 2019 to May 2020. It was a prospective observational study. All the patients with BAT were received by on-duty surgical residents in the emergency department. Based on the imaging and operative finding, patients with liver injury and without liver injury were noted with the associated injury. For comparisons of clinical and grading characteristics between the two groups (liver injury and no liver injury), the chi-squared test was used for categorical variables as appropriate, and the Mann-Whitney U test used for quantitative variables (AST and ALT). The comparisons between more than two groups (grade of injury) were performed using the Kruskal-Wallis test. The receiver operating characteristic (ROC) was used to calculate the optimal cut-off value of AST and ALT.

Results

Among the 96 patients admitted with BAT, 38 patients had liver injury and 58 patients had no liver injury. The median length of the intensive care unit (ICU) stay of patients with liver injury was higher than without liver injury. There was a significant difference in the median level of AST and ALT (< 0.001) between patients with liver injury and no liver injury. The area under the ROC curve of AST was 0.89 (95% confidence interval 0.86–0.98) and of ALT was 0.92 (95% confidence interval 0.83–0.97). The area under the curve demonstrated that the test was a good predictor for the identification of liver injury and also the severity of liver enzymes. The cut-off values for the liver injury were 106 U/l and 80 U/l for AST and ALT, respectively. Based on these values, AST ≥ 106 U/l had a sensitivity of 71.7%, a specificity of 90%, a positive predictive value of 86.8%, and a negative predictive value of 77.6%. The corresponding values for ALT ≥ 80 U/l were 77.8%, 94.1%, 92.1%, and 82.8%, respectively.

Conclusion

In conclusion, we report the optimal cut-off value of AST and ALT for liver injury in BAT as ≥ 106 U/l and 80 U/l, respectively. The elevated level of AST and ALT might assist the emergency physicians and surgeons to timely refer the suspected patients with the liver injury to a tertiary center.
The association of age with decline in renal function after low anterior resection and loop ileostomy for rectal cancer: a retrospective cohort prognostic factor study
Authors: Rhemouga Amal , Buettner Stefan , Bechstein Wolf O. , Woeste Guido , Schreckenbach Teresa
Published: January 2021

Background

Low anterior resection (LAR) is often performed with diverting loop ileostomy (DLI) for anastomotic protection in patients with rectal cancer. We aim to analyze, if older patients are more prone to a decline in kidney function following creation and closure of DLI after LAR for rectal carcinoma versus younger patients.

Methods

A retrospective cohort study from a database including 151 patients undergoing LAR for rectal carcinoma with DLI was used. Patients were divided in two age groups (Group A: <65 years, n = 79; Group B: ≥65 years, n = 72). For 123 patients undergoing DLI reversal prognostic factors for an impairment of serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) 3 months after DLI reversal was analyzed using a multivariate linear regression analysis.

Results

SCr before LAR(T0) was significant higher in Group B (P = 0.04). Accordingly, the eGFR at T0 in group B was significantly lower (P < 0.001). No patients need to undergo hemodialysis after LAR or DLI reversal.

Age and SCr at T0were able to statistically significant predict an increase in SCr (P<0.001) and eGFR (P=0.001) three months after DLI reversal (The R² for the overall model was .82 (adjusted R² = .68).

Conclusion

DLI creation may result in a reduction of eGFR in older patients 3 months after DLI closure. Apart from this, patients do not have a higher morbidity after creation and closure of DLI resulting from LAR regardless of their age.
Tertiary lymphoid tissue in early‐stage IgG4-related tubulointerstitial nephritis incidentally detected with a tumor lesion of the ureteropelvic junction: a case report
Authors: Miyanaga Tatsuhito , Mizuguchi Keishi , Hara Satoshi , Zoshima Takeshi , Inoue Dai , Nishioka Ryo , Mizushima Ichiro , Ito Kiyoaki , Fuji Hiroshi , Yamada Kazunori , Sato Yuki , Yanagita Motoko , Kawano Mitsuhiro
Published: January 2021

Background

IgG4-related kidney disease causes renal impairment of unknown pathogenesis that may progress to kidney failure. Although ectopic germinal centers contribute to the pathogenesis of the head and neck lesions of IgG4-related disease, the presence of tertiary lymphoid tissue (TLT) containing germinal centers in IgG4-RKD has rarely been reported.

Case presentation

We report a 72-year-old Japanese man who had IgG4-related tubulointerstitial nephritis (TIN) with TLT formation incidentally detected in a resected kidney with mass lesion of IgG4-related ureteritis in the ureteropelvic junction. During follow-up for past surgical resection of a bladder tumor, renal dysfunction developed and a ureter mass was found in the right ureteropelvic junction, which was treated by nephroureterectomy after chemotherapy. Pathology revealed no malignancy but abundant IgG4-positive cell infiltration, obliterative phlebitis and storiform fibrosis, confirming the diagnosis of IgG4-related ureteritis. In the resected right kidney, lymphoplasmacytes infiltrated the interstitium with focal distribution in the renal subcapsule and around medium vessels without storiform fibrosis, suggesting the very early stage of IgG4-TIN. Lymphocyte aggregates were also detected at these sites and consisted of B, T, and follicular dendritic cells, indicating TLT formation. IgG4-positive cells infiltrated around TLTs.

Conclusions

Our case suggests that TLT formation is related with the development of IgG4-TIN and our analysis of distribution of TLT have possibility to elucidate IgG4-TIN pathophysiology.
Neurocritical care complications and interventions influence the outcome in aneurysmal subarachnoid hemorrhage
Authors: Hammer Alexander , Erbguth Frank , Hohenhaus Matthias , Hammer Christian M. , Lücking Hannes , Gesslein Markus , Killer-Oberpfalzer Monika , Steiner Hans-Herbert , Janssen Hendrik
Published: January 2021

Background

This observational study was performed to show the impact of complications and interventions during neurocritical care on the outcome after aneurysmal subarachnoid hemorrhage (SAH).

Methods

We analyzed 203 cases treated for ruptured intracranial aneurysms, which were classified regarding clinical outcome after one year according to the modified Rankin Scale (mRS). We reviewed the data with reference to the occurrence of typical complications and interventions in neurocritical care units.

Results

Decompressive craniectomy (odds ratio 21.77 / 6.17 ; p < 0.0001 / p = 0.013), sepsis (odds ratio 14.67 / 6.08 ; p = 0.037 / 0.033) and hydrocephalus (odds ratio 3.71 / 6.46 ; p = 0.010 / 0.00095) were significant predictors for poor outcome and death after one year beside “World Federation of Neurosurgical Societies” (WFNS) grade (odds ratio 3.86 / 4.67 ; p < 0.0001 / p < 0.0001) and age (odds ratio 1.06 / 1.10 ; p = 0.0030 / p < 0.0001) in our multivariate analysis (binary logistic regression model).

Conclusions

In summary, decompressive craniectomy, sepsis and hydrocephalus significantly influence the outcome and occurrence of death after aneurysmal SAH.
Clinical features associated with the efficacy of chemotherapy in patients with glioblastoma (GBM): a surveillance, epidemiology, and end results (SEER) analysis
Authors: Wen Jieqiong , Chen Wanbin , Zhu Yayun , Zhang Pengbo
Published: January 2021

Background

Glioblastoma (GBM) is a highly malignant brain tumor with poor survival and prognosis. Randomized trials have demonstrated that chemotherapy improves survival in patients with GBM. This study aims to examine the clinical characteristics that are potentially associated with the efficacy of chemotherapy and the risk factors of GBM.

Methods

A total of 25,698 patients diagnosed with GBM were identified between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER). The clinical and demographic variables between groups were examined by Student’s t-test and Pearson’s chi-square test. GBM-specific survival (GBMSS) and overall survival (OS) were evaluated using the Kaplan-Meier method with the log-rank test. Univariable and multivariable analyses were also performed using the Cox proportional hazards model to identify statistically significant prognostic factors.

Results

Patients who received chemotherapy had better overall survival (median OS 13 vs. Three months, HR = 1.9224, 95%CI 1.8571–1.9900, p < 0.0001) and better GBMSS (median GBMSS of 12 vs. Three months, HR = 1.9379, 95%CI 1.8632–2.0156, p < 0.0001), compared to patients who did not. Further subgroup analysis revealed that among patients who underwent chemotherapy, those who were younger, with a supratentorial tumor, received surgery, or radiotherapy had both improved OS and GBMSS. Age, race, tumor location, tumor size, and treatments were identified as independent prognostic factors by multivariable analyses for patients with glioblastoma.

Conclusion

Patients with GBM who were younger (< 65 years), underwent surgery, or radiotherapy can benefit more from chemotherapeutic regimens. Age, race, tumor size, tumor location, surgery, radiotherapy, and chemotherapy were factors associated with the prognosis of patients with GBM.
Analysis of cranial type characteristics in term infants: a multi-center study
Authors: Yang Wang , Hu Bin , Chen Jianping , Shen Wenzhi , Wang Chengju , Chang Qin , Li Wenzao , Qu Fuxiang , Pan Qiuming , Zhang Yuping
Published: January 2021

Background

Positional head deformity (PHD) is defined as a change in the shape of an infant’s skull due to an external force. In certain cases, it can lead to cosmetic deformities or even neurological issues due to its impact on the developing nervous system. Therefore, we conducted this study to investigate the incidence and characteristics of PHD in term infants in China and preliminarily establish a localized diagnostic reference standard.

Methods

Overall, 4456 term infants from three medical institutions in Chongqing were and divided and analyzed according to their age. Cranial vault asymmetry (CVA) and cephalic index (CI) were calculated in all infants. The current international diagnostic criteria were used to understand PHD incidence and analyze the CVA and CI distribution.

Results

According to the current international standards, the total detection rate of PHD in Chongqing’s term infants was 81.5%, with brachycephaly alone being the most frequent (39.4%), followed by brachycephaly with plagiocephaly (34.8%) and plagiocephaly alone (6.2%). The detection rates of dolichocephaly were low: alone, 0.9% and combined with plagiocephaly, 0.2%. According to age, plagiocephaly (44.5%) and brachycephaly (82.0%) were the most frequent in the 2-3-month group. The 75th/90th/97th and 3rd/10th/25th/75th/90th/97th percentiles of CVA and CIs were 0.4/0.7/1.0 and 76.4/78.8/82.3/91.1/94.6/99.2%, respectively.

Conclusions

According to the current international standards, the PHD detection rate among term infants in Chongqing was high. Therefore, a new diagnostic standard for Chinese infants was proposed where CVA ≥ 0.4 cm indicates plagiocephaly, CI ≥ 91% indicates brachycephaly, and CI ≤ 82% indicates dolichocephaly.
Prevalence, distribution and risk factors for brucellosis infection in goat farms in Ningxiang, China
Authors: Li Yin , Tan Dan , Xue Shuang , Shen Chaojian , Ning Huajie , Cai Chang , Liu Zengzai
Published: January 2021

Background

In south China, goats are the major source of Brucellosis for human infection. However, there are few studies on the prevalence of and risk factors for goat brucellosis in south China. In this study, we conducted a cross-sectional study to investigate the herd prevalence, spatial distribution and relevant risk factors for goat brucellosis in Ningxiang county, south China. Commercial goat farms (n = 457) were randomly selected, and their disease status was ascertained by testing serum samples of chosen individuals using the Rose Bengal Test (screening test) and the Serum Agglutination Test (confirmatory test) in series. A farm with at least two positive individuals was defined as a case farm. Standardized questionnaires were used to collect information on management and hygiene practices in farms. A logistic model with a binomial outcome was built to identify risk factors for being seropositive.

Results

The true herd prevalence in commercial goat farms was 4.5% (95%CI: 0.2%-12.2%) and the townships in the centre of the county had higher herd prevalence. The risk factors associated with seropositive on local goat farms include “Introduction in the past 12 months” (OR= 61, 95%CI: 16-333), “Improperly disposal of the sick or dead goats” (OR= 33, 95%CI: 5-341) and “Poor hygiene in lambing pen” (OR= 25, 95%CI: 5-192).

Conclusions

These findings will aid in the development of control strategies of Brucellosis in south China and risk factors identified in this study should be taken into consideration when designing a control strategy.
Correlation analysis of IL-11 polymorphisms and Hirschsprung disease subtype susceptibility in Southern Chinese Children
Authors: Zhang Hong , Zhao Jing-Lu , Zheng Yi , Xie Xiao-Li , Huang Li-Hua , Li Le , Zhu Yun , Lu Li-Feng , Hu Tu-Qun , Zhong Wei , He Qiu-Ming
Published: January 2021

Background

Hirschsprung disease (HSCR) is a hereditary defect, which is characterized by the absence of enteric ganglia and is frequently concurrent with Hirschsprung-associated enterocolitis (HAEC). However, the pathogenesis for HSCR is complicated and remains unclear. Recent studies have shown that pro-inflammatory cytokines such as interleukin-11 (IL-11) are involved in the enteric nervous system's progress. It was found that IL-11 SNPs (rs8104023 and rs4252546) are associated with HSCR in the Korean population waiting for replication in an independent cohort. This study evaluated the relationship between IL-11 and the susceptibility of patients to HSCR by performing subphenotype interaction examination, HAEC pre-/post-surgical patient-only association analysis, and independence testing.

Methods

In this study, a cohort consisting of children from Southern China, comprising 1470 cases and 1473 controls, was chosen to examine the relationship between two polymorphisms (rs8104023 and rs4252546 in IL-11) and susceptibility to HSCR by replication research, subphenotype association analysis, and independence testing.

Results

The results showed that IL-11 gene polymorphisms (rs8104023 and rs4252546) are not associated with the risk of HSCR in the Chinese population. The results of both short-segment and long-segment (S-HSCR and L-HSCR) surgery (3.34 ≤ OR ≤ 4.05, 0.02 ≤ P ≤ 0.04) showed that single nucleotide polymorphisms (SNP) rs8104023 is associated with susceptibility to HAEC.

Conclusions

This study explored the relationship between genetic polymorphisms and susceptibility to HAEC in HSCR subtypes for the first time. These findings should be replicated in a larger and multicentre study.
Correction to: A super-spreader of SARS-CoV-2 in incubation period among health-care workers
Authors: Wei Chaojie , Yuan Yufeng , Cheng Zhenshun
Published: January 2021

An amendment to this paper has been published and can be accessed via the original article.
Impact of a transition education program on health-related quality of life in pediatric patients with congenital heart disease: study design for a randomised controlled trial
Authors: Werner Oscar , Bredy Charlene , Lavastre Kathleen , Guillaumont Sophie , De La Villeon Gregoire , Vincenti Marie , Gerl Cristelle , Dulac Yves , Souletie Nathalie , Acar Philippe , Pages Laurence , Picot Marie-Christine , Bourrel Gerard , Oude Engberink Agnes , Million Elodie , Abassi Hamouda , Amedro Pascal
Published: January 2021

Background

Recent advances in the field of congenital heart disease (CHD) led to an improved prognosis of the patients and in consequence the growth of a new population: the grown up with congenital heart disease. Until recently, more than 50% of these patients were lost to follow up because of the lack of specialized structures. The critical moment is the transition between paediatric and adult unit. Therapeutic education is crucial to solve this issue by helping patients to become independent and responsible. The TRANSITION-CHD randomized trial aims to assess the impact of a transition education program on health-related quality of life (HRQoL) of adolescents and young adults with CHD.

Methods

Multicentre, randomised, controlled, parallel arm study in CHD patients aged from 13 to 25 years old. Patients will be randomised into 2 groups (education program vs. no intervention). The primary outcome is the change in self-reported HRQoL between baseline and 12-month follow-up. A total of 100 patients in each group is required to observe a significant increase of the overall HRQoL score of 7 ± 13.5 points (on 100) with a power of 80% and an alpha risk of 5%. The secondary outcomes are: clinical outcomes, cardiopulmonary exercise test parameters (peak VO2, VAT, VE/VCO2 slope), level of knowledge of the disease using the Leuven knowledge questionnaire for CHD, physical and psychological status.

Discussion

As the current research is opening on patient related outcomes, and as the level of proof in therapeutic education is still low, we sought to assess the efficacy of a therapeutic education program on HRQoL of CHD patients with a randomized trial.

Trial registration

This study was approved by the National Ethics Committee (South-Mediterranean IV 2016-A01681-50) and was registered on Clinicaltrials.gov (NCT03005626).
Comparison of the overall survival of proximal and distal gastric cancer after gastrectomy: a systematic review and meta-analysis
Authors: Xue Jiaming , Yang Huiliang , Huang Shanshan , Zhou Tingting , Zhang Xiangwen , Zu Guo
Published: January 2021

Background

The aim of this study was to investigate the overall survival (OS) between proximal gastric cancer (PG) and distal gastric cancer (DG) patients after gastrectomy.

Methods

Articles on the prognostic study of PG and DG patients after gastrectomy were collected from the PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases from the date of establishment until December 2020. The data were statistically analyzed by Stata software (version 11.0, StataCorp).

Results

A total of 10 articles met the inclusion criteria. Meta-analysis showed that the 1-, 3- and 5-year OS rates of PG patients were significantly lower than those of DG patients (RR = 0.898, 95% CI: 0.825 to 0.977,P= 0.013; RR = 0.802, 95% CI: 0.708 to 0.909,P= 0.001; RR = 0.736, 95% CI: 0.642 to 0.844,P= 0.000). After subgroup analysis according to different countries, the combined RR values of were as follows: 1-year OS: eastern countries: RR = 0.966, 95% CI: 0.944 to 0.988,P= 0.003, western countries: RR = 0.687, 95% CI: 0.622 to 0.759,P= 0.000; 3-year OS: eastern countries: RR = 0.846, 95% CI: 0.771 to 0.929,P= 0.000, western countries: RR = 0.742, 95% CI: 0.399 to 1.382,P= 0.348; and 5-year OS: eastern countries: RR = 0.798, 95% CI: 0.716 to 0.889,P= 0.000, western countries: RR = 0.646, 95% CI: 0.414 to 1.008,P= 0.054.

Conclusion

In terms of 1-, 3-, and 5-year OS, PG patients had lower rates than DG patients and the eastern countries/western countries subgroup, but there were no significant differences in 3- and 5-year OS for the western countries. These results merit further clinical validation in future studies.

(Registration ID: UMIN000040393; Date of registration: 2020/05/13)
Family, school and individual characteristics associated with adolescents’ physical activity at school in Hong Kong: the iHealt(H) study
Authors: Carver Alison , Akram Muhammad , Barnett Anthony , Huang Wendy Yajun , Gao Gemma Yang , Mellecker Robin R. , Cerin Ester
Published: January 2021

Background

Adolescents (11–18-year-olds) are at risk of physical inactivity. There is limited knowledge of physical activity (PA) levels among adolescents in the school setting in Hong Kong. We developed and tested a novel theoretical model of how household/family characteristics, school-level social and physical environmental factors and individual adolescent’s characteristics impact on their school-based PA during and after school hours.

Methods

Cross-sectional study participants were Hong Kong adolescents attending secondary school, paired with their parent/caregiver (n = 1299 dyads). Parents survey-reported on household/family characteristics, parental PA and rules related to PA. Adolescents survey-reported on school PA-friendly policy, PA equipment at school (combined to create PA-friendly index), social support for PA from peers, athletic ability, attitude to and enjoyment of PA. Adolescents self-reported their school-based PA during school hours (physical education; recess) and after school (sports teams/classes). Objectively-measured moderate-to-vigorous PA (MVPA) was measured using accelerometers for a sub-sample of adolescents (n = 588). Generalized additive mixed models were used to estimate how household/family-level and school-level factors, and adolescents’ individual characteristics were related to adolescents’ school-based PA in Hong Kong, and to identify potential mediators of these associations.

Results

A complex network of potential pathways of influence on adolescents’ school-based PA was identified. Overall, most of the significant effects were indirect ones. However, there were far fewer significant pathways between household/family characteristics and objectively-measured MVPA at school than there were for self-reported PA at school. In fact, there were no indirect pathways between these variables and MVPA at school. Gender disparities among pathways were identified. For example, school PA-friendly index was significantly associated with MVPA after school only among girls (eb = 1.06, 95%CI (1.02,1.12)).

Conclusions

Key points of intervention identified by our study may be in the re-design of PE classes so that adolescents spend more time being physically active during these classes, and promotion of active play during recess. Further research measuring amount, intensity and location of adolescents’ PA using accelerometer and Global Positioning Systems is required in Hong Kong, as well as observational studies of PA during PE classes and in the schoolyard during recess, to guide the design of PA interventions.
Determinants of low breastfeeding self-efficacy amongst mothers of children aged less than six months: results from the BADUTA study in East Java, Indonesia
Authors: Titaley Christiana Rialine , Dibley Michael J. , Ariawan Iwan , Mu’asyaroh Anifatun , Alam Ashraful , Damayanti Rita , Do Tran Thanh , Ferguson Elaine , Htet Kyaw , Li Mu , Sutrisna Aang , Fahmida Umi
Published: January 2021

Background

Despite the increasing rate of exclusive breastfeeding in Indonesia, there is still a need for supportive interventions. The breastfeeding self-efficacy of mothers is a key factor positively associated with optimum breastfeeding practices. Our analysis aims to assess the determinants of low breastfeeding self-efficacy amongst a sample of women with children aged under 6 months in Malang and Sidoarjo Districts, East Java, Indonesia.

Methods

We used information from 1210 mothers of children aged < 6 months recruited in the BADUTA study conducted in 2015–2016 in Malang and Sidoarjo Districts. The outcome variable in this analysis was mothers’ self-efficacy for breastfeeding using the 14 statements in the Breastfeeding Self-Efficacy-Short Form. We evaluated 17 potential predictors of breastfeeding self-efficacy, organized into six sub-groups of variables: (1) context/demographic; (2) household factors; (3) maternal characteristics; (4) child characteristics; (5) breastfeeding practices; and (6) antenatal and delivery care. Logistic regression analyses were employed to examine factors associated with mothers’ self-efficacy with breastfeeding.

Results

More than half of the women in this study had a low level of self-efficacy. One of the factors associated with low breastfeeding self-efficacy found in this study was mothers’ problems related to breastfeeding. Mothers who had problems with breastfeeding not related to illness (adjusted odds ratio [aOR] 3.27; 95% CI 2.45, 4.36) or problems related to both illness and non-illness conditions (aOR 3.57; 95% CI 1.37, 9.33) had higher odds of low breastfeeding self-efficacy than those who did not have any problems. Compared to mothers who completed university education, there was a significantly higher odds of low breastfeeding self-efficacy in mothers who completed primary school or lower (aOR 1.88; 95% CI 1.16, 3.05); completed junior high school (aOR 2.27; 95% CI 1.42, 3.63); and completed senior high school (aOR 1.94; 95% CI 1.29, 2.91). Other significant predictors of low breastfeeding self-efficacy were mothers not exposed to any breastfeeding interventions (aOR 1.87; 95% CI 1.09, 3.22); working outside the house (aOR 1.69; 95% CI 1.23, 2.32); not obtaining any advice on breastfeeding (aOR 1.40; 95% CI 1.08, 1.82); with low knowledge of breastfeeding (aOR 1.38; 95% CI 1.03, 1.84); and delivered by Caesarean section (aOR 1.34; 95% CI 1.05, 1.70).

Conclusions

Multipronged breastfeeding education programs and support are required to improve women’s self-efficacy with breastfeeding. Improved access to breastfeeding counselors, active support for mothers following cesarean delivery, and increased supporting facilities at workplaces are essential to improve self-efficacy with breastfeeding.
Difference in the early postoperative change of the joint line convergence angle between opening wedge and closed wedge high tibial osteotomies
Authors: Kumagai Ken , Fujimaki Hiroshi , Yamada Shunsuke , Nejima Shuntaro , Matsubara Joji , Inaba Yutaka
Published: January 2021

Background

The purpose of this study was to investigate the correction error associated with soft tissue balance in high tibial osteotomy (HTO) and the difference between opening wedge HTO (OWHTO) and closed wedge HTO (CWHTO).

Methods

A total of 170 knees of 130 patients (85 knees of 68 patients in OWHTO and 85 knees of 62 patients in CWHTO) were evaluated. Anteroposterior radiographs of the knee and full-length leg were taken preoperatively, immediately under general anesthesia postoperatively, 2 days, and 1 and 12 months postoperatively. The femorotibial angle (FTA), joint line convergence angle (JLCA), and medial proximal tibial angle (MPTA) were measured.

Results

The postoperative FTA was decreased from 170.5 ± 2.1° at 0 day to 168.6 ± 2.2° at 2 days in OWHTO (P < 0.05), whereas it was not changed from 168.7 ± 2.4° at 0 day to 168.1 ± 2.8° at 2 days in CWHTO. The JLCA was 4.8 ± 1.8° preoperatively, 4.2 ± 1.9° at 0 day, 2.2 ± 1.8° at 2 days (P < 0.05 vs 0 day), 2.6 ± 1.7° at 1 month, and 2.7 ± 1.6° at 12 months in OWHTO, and 7.1 ± 3.2° preoperatively, 4.1 ± 2.4° at 0 day (P < 0.05 vs preoperative), 3.4 ± 2.5° at 2 days, 3.9 ± 2.3° at 1 month, and 4.2 ± 2.6° at 12 months in CWHTO. Multiple regression analysis showed that preoperative factors affecting change of the JLCA from preoperative to postoperative 1 month were the correction angle in OWHTO (P = 0.001) and the preoperative standing JLCA in OWHTO (P < 0.001) and CWHTO (P < 0.001).

Conclusions

A significant decrease of the JLCA occurred immediately after osteotomy under anesthesia in CWHTO, whereas in OWHTO there was no decrease under anesthesia, but it decreased several days postoperatively.
RETRACTED ARTICLE: lncRNA HAND2-AS1 is downregulated in osteoarthritis and regulates IL-6 expression in chondrocytes
Authors: Si Zhenxing , Zhou Shifeng , Shen Zilong , Luan Feiyu , Yan Jinglong
Published: January 2021

Background

Osteoarthritis (OA) is a leading cause of disability. The incidence of OA is progressively rising due to the diminishing levels of physical activity and ever-expanding aging population. However, the mainstay for OA treatment only can improve symptoms without delay the progression of this severe disease. This study aimed to explore the biological role and clinical function of lncRNA HAND2-AS1 in OA.

Methods

Blood samples and synovial fluid were collected from OA patients and normal subjects. HAND2-AS1 expression was detected by qRT-PCR and IL-6 expression was detected by ELISA. The plasma levels of HAND2-AS1 were also detected in different ages, stages, and gender of OA patients and controls. Furthermore, the ROC curve was used to analyze whether HAND2-AS1 can distinguish OA patients from normal subjects. Also, Pearson correlation coefficient analysis was used to analyze the correlation between lncRNA HAND2-AS1 and IL-6. In addition, Western blot was used to detect the IL-6 level upon HAND2-AS1 over-expression in chondrocytes and qRT-PCR was used to detect the HAND2-AS1 level after endogenous IL-6 treatment.

Results

HAND2-AS1 and IL-6 were dysregulated in plasma and synovial fluid of OA patients. The expression of HAND2-AS1 in plasma of OA patients was decreased with aging and progression. Furthermore, HAND2-AS1 downregulation effectively distinguished OA patients from the healthy controls. Over-expression of HAND2-AS1 inhibited IL-6 expression in chondrocytes, while treatment with exogenous IL-6 did not affect HAND2-AS1 expression.

Conclusion

HAND2-AS1 effectively distinguished OA patients from the healthy controls and regulates IL-6 expression in human chondrocytes.

Trial registration

ChiCTR, ChiCTR2000038635. Registered 11 February 2019
Anti-platelet aggregation of Panax notoginseng triol saponins by regulating GP1BA for ischemic stroke therapy
Authors: Xu Zhi-yi , Xu Yang , Xie Xiao-fang , Tian Yin , Sui Jun-hui , Sun Yong , Lin Da-sheng , Gao Xing , Peng Cheng , Fan Yu-jiang
Published: January 2021

Background

Panax notoginseng triol saponins (PTS) has been used clinically for ischemic stroke therapy (IST) in China for more than 17 years due to its anti-platelet aggregation and neuro-protective effects, but its mechanism of action is not fully understand. In this study, anti-platelet aggregation-related protein analysis and computer simulations of drug-protein binding interactions were performed to explore the mechanism of the effects of PTS against ischemic stroke in an ischemia reperfusion model.

Methods

Three oral doses of PTS were administered in a model of middle cerebral artery occlusion (MCAO) in rats. Panax notoginseng total saponins (PNS) and a combination of PTS and aspirin were chosen for comparison. To evaluate therapeutic effects and explore possible mechanisms of anti-platelet aggregation, we measured cerebral infarct size and water content in brain tissue, histomorphological changes, expression of related factors (such as arachidonic acid metabolites) and platelet receptors in serum, as well as the binding affinity of PTS for platelet adhesion receptors.

Results

Compared with PNS, PTS showed a stronger and more potent anti-platelet aggregation effect in MCAO model rats. The combination of PTS and aspirin could reduce adverse gastrointestinal effects by regulating the TXA2/PGI2 ratio. We demonstrated for the first time that PTS was able to regulate Glycoprotein Ib-α (GP1BA) in a model animal. The binding of ginsenoside Rg1 and GP1BA could form a stable structure. Moreover, PTS could reduce von Willebrand factor (VWF)-mediated platelet adhesion to damaged vascular endothelium, and thus enhance the probability of anti-platelet aggregation and anti-thrombosis under pathological conditions.

Conclusions

Our results showed that GP1BA was closely related to the anti-platelet aggregation action of PTS, which provided new scientific and molecular evidence for its clinical application.
Fibroblasts from idiopathic Parkinson’s disease exhibit deficiency of lysosomal glucocerebrosidase activity associated with reduced levels of the trafficking receptor LIMP2
Authors: Thomas Ria , Moloney Elizabeth B. , Macbain Zachary K. , Hallett Penelope J. , Isacson Ole
Published: January 2021

Lysosomal dysfunction is a central pathway associated with Parkinson’s disease (PD) pathogenesis. Haploinsufficiency of the lysosomal hydrolase GBA (encoding glucocerebrosidase (GCase)) is one of the largest genetic risk factors for developing PD. Deficiencies in the activity of the GCase enzyme have been observed in human tissues from both genetic (harboring mutations in the GBA gene) and idiopathic forms of the disease. To understand the mechanisms behind the deficits of lysosomal GCase enzyme activity in idiopathic PD, this study utilized a large cohort of fibroblast cells from control subjects and PD patients with and without mutations in the GBA gene (N370S mutation) (control, n = 15; idiopathic PD, n = 31; PD with GBA N370S mutation, n = 6). The current data demonstrates that idiopathic PD fibroblasts devoid of any mutations in the GBA gene also exhibit reduction in lysosomal GCase activity, similar to those with the GBA N370S mutation. This reduced GCase enzyme activity in idiopathic PD cells was accompanied by decreased expression of the GBA trafficking receptor, LIMP2, and increased ER retention of the GBA protein in these cells. Importantly, in idiopathic PD fibroblasts LIMP2 protein levels correlated significantly with GCase activity, which was not the case in control subjects or in genetic PD GBA N370S cells. In conclusion, idiopathic PD fibroblasts have decreased GCase activity primarily driven by altered LIMP2-mediated transport of GBA to lysosome and the reduced GCase activity exhibited by  the genetic GBA N370S derived PD fibroblasts occurs through a different mechanism.
Vitamin C sensitizes BRAFV600E thyroid cancer to PLX4032 via inhibiting the feedback activation of MAPK/ERK signal by PLX4032
Authors: Su Xi , Li Peng , Han Bin , Jia Hao , Liang Qingzhuang , Wang Haichao , Gu Mengwei , Cai Jiaxuan , Li Shaolei , Zhou Yaqi , Yi Xin , Wei Wei
Published: January 2021

Background

BRAFV600E mutation is the most common mutation in thyroid cancer. It strongly activates MAPK/ERK pathway and indicates an invasive subtype of thyroid cancer. PLX4032 is a selective oral inhibitor of the BRAFV600 kinase although with limited effect in treating this panel of thyroid cancer, due to the feedback activation of MAPK/ERK as well as PI3K/AKT pathways. It was investigated that Vitamin C plays a positive role in inhibiting these pathways in thyroid cancer. However, whether Vitamin C could enhance the antitumor effect of PLX4032 remains largely unclear.

Methods

The antitumor efficacy of combination therapy with PLX4032 and Vitamin C on BRAFMT thyroid cancer cell was assessed by the MTT assay, EdU assay and colony formation, Chou-Talalay way was employed to analyze the synergistic effect. Flow cytometry were employed to assess cells’ apoptosis and cell cycle arrest in response to combination therapy. Xenograft models were used to test its in vivo antitumor activity. Western blot and IHC were applied to investigate the mechanism underlying synergistic effect.

Results

PLX4032 or Vitamin C monotherapy was mildly effective in treating BRAFMT thyroid cancer cell and xenografts model. The combination therapy significantly inhibited cancer cell proliferation and tumor growth in nude mice, and induced cell apoptosis and cell cycle arrest compared to either monotherapy. PLX4032 monotherapy induced feedback activation of MAPK/ERK as well as PI3K/AKT pathway; while combination therapy significantly relieved this feedback.

Conclusion

Vitamin C promotes the antitumor effect of PLX4032 in BRAFMT thyroid cancer cell and xenografts model via relieving the feedback activation of MAPK/ERK as well as PI3K/AKT pathway. PLX4032/Vitamin C combination may be a potential therapeutic approach to treat BRAFMT thyroid cancer.