bluuebunny/crossref_metadata_2025 huggingface dataset:
Traffic police officers’ use of first aid skills at work: a qualitative content analysis of focus group discussions in Dar es Salaam, Tanzania
Authors: Ndile Menti Lastone , Saveman Britt-Inger , Lukumay Gift G. , Mkoka Dickson A. , Outwater Anne H. , Backteman-Erlanson Susann
Published: August 2020

Background: The World Health Organisation (WHO) recommends involving lay people in prehospital care. Several training programmes have been implemented to build lay responder first aid skills. Findings show that most programmes significantly improved participants’ first aid skills. However, there is a gap in knowledge of what factors influence the use of these skills in real situations. The current study aimed to describe police officers’ views on and experiences of factors that facilitate or hinder their use of trained first aid skills at work. Methods Thirty-four police officers participated in five focus group discussions. A structured interview guide was used to collect data. Interviews were audio-recorded and transcribed verbatim. Data were analysed using qualitative content analysis. Results: We identified five categories of facilitators or hindrances. Training exposure was considered a facilitator; work situation and hospital atmosphere were considered hindrances; and the physical and social environments and the resources available for providing first aid could be either facilitators or hindrances. Conclusion: Practical exposure during training is perceived to improve police officers’ confidence in applying their first aid skills at work. However, contextual factors related to the working environment need to be addressed to promote this transfer of skills.
How do private practitioners in Pakistan manage children suspected having tuberculosis?
Authors: Yaqoob Aashifa , Hinderaker Sven , Fatima Razia , Najmi Hina , Haq Anwar
Published: August 2020

Background:Private providers provide a large portion of health care in Pakistan, including tuberculosis (TB). All TB patients are supposed to be reported to the National Tuberculosis Program (NTP), which provides drugs free of charge in addition to monitoring, supervision and support. Diagnosis of TB in children is difficult. We aimed to assess the private health care providers’ investigation practices and management of childhood TB. Methods:This cross-sectional study was based on a national survey that measured under-reporting of children with TB in 12 selected districts in Pakistan from Apr-Jun, 2016. We explored the practices of private health care providers, like general practitioners, pediatricians, pulmonologists and chest specialists, involved in the diagnosis of TB in children under 15 years for investigating and managing children suspected having TB.Results:Among 6519 presumptive child TB cases, a total of 5193(79.7%) children under 15 years were diagnosed as TB by private health care providers during second quarter, 2016. Only 187(2.9%) were notified to NTP. The majority of presumptive child TB cases reported cough, fever, and failure to thrive; few had TB contacts with pulmonary TB patients. Failure to thrive, loss of body weight and absence of BCG scar was more common in female children. Private providers relied on chest X-ray in 46.1%, but tuberculin skin test and Gene-Xpert MTB/RIF testing was little utilized. Bacteriological confirmation was present in 7.6%, and clinical assessment was the only basis for diagnosis in 39.3%. Of children with presumptive TB, only 955(14.6%) children were treated by private provider, while 3121(47.9%) cases were referred for diagnosis and 2443(37.5%) were referred after diagnosis for treatment; among all the referred, 3812(68.5%) were sent for investigations to District TB Centre (NTP).Conclusion:This study showed that many private providers referred children suspected having TB to laboratories for further diagnosis, but cases identified in investigations were often not notified to the NTP. This problem needs to be resolved by strengthening the referral linkages between private health providers, NTP laboratories and treatment centres through capacity building and training of their staff.
Cardiometabolic risk factors among patients with tuberculosis attending tuberculosis treatment centers in Nepal
Authors: Poudyal Indra Prasad , Khanal Pratik , Mishra Shiva Raj , Malla Milan , Poudel Prakash , Jha Raj Kumar , Phuyal Anil , Barakoti Abiral , Adhikari Bipin
Published: August 2020

Background The co-morbidity of cardiometabolic diseases in patients with Tuberculosis adds a significant burden in current health systems in developing countries including Nepal. The main objective of this study was to explore cardiometabolic risk factors among patients with Tuberculosis. Methods This was a cross-sectional study conducted among patients with tuberculosis in 12 tuberculosis treatment centers from eight districts of Nepal between May and July 2017. Interviews with participants were conducted using a structured questionnaire and were supplemented by anthropometric measurements and on-site blood glucose tests. Data were analyzed using descriptive and inferential statistics. Results Among 221 study participants, 138 (62.4%) had new smear-positive pulmonary tuberculosis, 24 (10.9%) had new smear-negative pulmonary tuberculosis and 34 (15.4%) had new extra- pulmonary tuberculosis. Overall, 43.1% of the patients with tuberculosis had at least one cardiometabolic risk factor. The prevalence of at least one cardiometabolic risk factor was more in male than female (47.8% versus 33.8%). Prevalence of tobacco (18.9% versus 4.8%), and alcohol (12.6% versus 6.5%) use was proportionately higher in male compared to female. The prevalence of hypertension (17% vs. 21%) and obesity (11.9% vs. 12.9%) was lower in male compared to females. Female (AOR=0.47; CI: 0.23-0.94), those from Gandaki Province (AOR=0.32; CI: 0.13-0.79) and literate (AOR=0.49; CI: 0.25-0.96) had reduced risk of cardiometabolic disease risk factors. Conclusions This study highlights the role of gender and socio-demographic characteristics associated with the risk of cardiometabolic diseases in patients with Tuberculosis. The findings from this study can guide medical practitioners and policy makers to consider clinical suspicion, diagnosis and treatment. National treatment guideline can benefit by integrating the management of non-communicable diseases in Tuberculosis treatment centers.
The psychometric properties of the Bergen–Yale Sex Addiction Scale for the Iranian population
Authors: Youseflu Samaneh , Kraus Shane W. , Razavinia Fatemeh , Afrashteh Majid Yousefi , niroomand soudabeh
Published: August 2020

Introduction

Background: The assessment of sex addiction among different populations requires a valid and reliable tool. Since the Bergen–Yale Sex Addiction Scale (BYSAS) was not available in Iran, this study aimed to evaluate the validity and reliability of the Persian version of the BYSAS.
Method: After translation/back-translation procedure, a total of 756 Iranian men and women completed the BYSAS. The structural validity of this tool was evaluated by exploratory and confirmatory factor analyses. An expert panel review also examined content validity of the items. Psychometric properties of the scale including validity, reliability (internal consistency [Cronbach’s alpha]) and test-retest) and factor structure were assessed.
Results: Content Validity Index (CVI) and Content Validity Ratio (CVR) scores for the BYSAS were 0.75 and 0.62, respectively. In the measure's structural validity, the results of exploratory and confirmatory factor analysis supported the One-factor structure. Data analysis demonstrated satisfactory internal consistency (Cronbach’s alpha ranging from 0.88 to 0.89).
Discussion: Study findings suggest that the BYSAS is a valid and reliable instrument for assessing sex addiction among Persian speaking adults. Replication of research findings is needed to expand the BYSAS for clinical and non-clinical Iranian populations.
Association of Adipocytokines with Lipid and Glycemic Profiles in Women with Normal Weight Obesity
Authors: Taheri Ehsaneh , Hosseini Saeed , Qorbani Mostafa , Mirmiran Parvin
Published: August 2020

Background: Individuals with normal weight obesity (NWO) are prone to cardiometabolic disorders. The aim of this study is to investigate the circulating levels of vaspin and leptin and their association with glycemic and lipid profiles in women with NWO.Methods: Forty women with body mass index (BMI)=18.5-24.9 kg/m2 and fat mass (FM) ≥ 30% were assigned in the NWO group and thirty age-matched women with identical BMI range and FM<30% (normal weight non-obese; NWNO) as control group were invited. Anthropometric measurement, fasting blood sugar (FBS), insulin, glycated hemoglobin (HbA1c), lipid profiles and also, leptin and vaspin were measured.Results: The mean ± standard deviation (SD) age was 28.76 ± 4.76 years in the NWO group and 29.23 ± 4.50 years in the control condition. The NWO group had higher mean serum levels of insulin (9.02 ± 4.75 vs. 6.24 ± 2.51, P = 0.009), leptin (17.31 ± 8.10 vs. 9.94 ± 4.30, P < 0.001) and homeostatic model assessment of insulin resistance (HOMA-IR) (33.77 ± 20.71 vs. 23.48 ± 10.03, P = 0.009) compared to the NWNO group. Serum level of vaspin was higher in the NWO group compared to the control group (34.82 pg/ml vs. 27.72 pg/ml, respectively, P = 0.12). In NWO group, serum levels of leptin correlated positively with FBS (r = 0.45, P = 0.02), insulin (r = 0.51, P = 0.008), and HOMA-IR (r = 0.46, P = 0.02) and vaspin concentration was positively associated with insulin (r = 0.36, P = 0.02) and HOMA-IR (r = 0.30, P = 0.06). Conclusion: It is concluded that concentration of insulin and HOMA-IR index were significantly higher in women with NWO compared to NWNO. Higher levels of leptin and vaspin in the NWO group were associated with glycemic profiles.
Cost-benefit analysis of the monitoring measures for the malaria elimination stage in Fujian, China
Authors: Huang Chun-yan , Zhang Shan-ying , Chen Zhu-yun , Xie Han-guo , Yang Rong Ou
Published: August 2020

Background Malaria is an insect-borne infectious disease that spreads through bites from infected Anopheles mosquitos. The disease seriously endangers human health and economic development. Against the background of eliminating malaria in Fujian Province, in order to understand the cost and benefit of malaria monitoring measures, the health economics of the monitoring measures should be examined..Methods The malaria epidemic data during the malaria elimination stage (2005–2019) in Fujian Province were collected and sorted. The basic economic data were obtained from the Fujian Statistical Yearbook. A cost-benefit analysis was conducted for this study, based on the fundamental theories in health economics. Moreover, the Cost (C) of monitoring measure during the malaria elimination stage was calculated, and the Benefit of malaria elimination stage (B) was analyzed.Results The total cost of monitoring measures in the malaria elimination stage was about 607,878,783.36 yuan ( USD $ 87,534,544.80). The proportions of the costs were as follows: case detection and treatment was 66.62%, health education was 13.31%, epidemic monitoring was 10.05%, supervision and assessment was 5.15%, and training and meeting was 4.87%. The total benefit of the malaria elimination stage was about 116,123,417,911.81 yuan (USD$ 16,721,772,179.30), the economic benefit was 22.61%, and the social benefit was 77.39%. The cost-benefit analysis of the malaria elimination stage showed that the NB of monitoring measures was about 115,515,539,128.45 yuan (USD$ 16,634,237,634.50) and the BCR was 191.03. The monitoring cost for residents was 1.08 yuan (USD$ 0.16) per capita, and the benefit for residents was 206.12 yuan (USD$ 29.68) per capita. Conclusion In the past 15 years, malaria control work has achieved excellent economic and social benefits in Fujian, China. The work should continue in strengthening the monitoring and control of imported malaria cases, increasing health education in high-risk locations (such as those frequented by entry-exit personnel), and enhancing residents’ awareness about prevention and personal protection. The work should continue to be consolidated for the elimination of malaria. The framework and results of this study conform to the principles of health economics and have a certain reference value for current malaria monitoring practices.
Dandelion Extract Relaxes Mouse Airway Smooth Muscle by Blocking VDLCC and NSCC Channels
Authors: ping zhao , Liu Jia , Ming Qian , Tian Di , He Jingwen , Yang Ziwei , Shen Jinhua , Liu Qinghua , Yang Xinzhou
Published: August 2020

Background: Asthma is one of the main intractable diseases recognized by the international medical community. The current widely used bronchodilators for asthma—β2-adrenal receptor agonists—have limited therapeutic effects, necessitating the development of novel antiasthma drugs with increased efficacy and fewer adverse effects. In this study, we investigated the relaxant effects and underlying mechanism of an ethyl acetate extract from dandelion (EAED) on mouse airway smooth muscle. Methods: The effects of EAED on agonist-induced precontraction in mouse airway smooth muscle were evaluated with force measurement. Mouse lung slices were used to study the effects of EAED on bronchial smooth muscle. The intracellular Ca2+ concentration was measured using a calcium imaging system. L-type voltage-dependent calcium channel (VDLCC) and non-selective cationic channel (NSCC) currents were measured by patch-clamp. The lung functions of healthy and asthmatic mouse groups were assessed via the forced oscillation technique. Results: EAED inhibits acetylcholine-induced sustained contractions of whole airway smooth muscle by inhibiting VDLCCs, NSCCs, and some unknown channels, reduces the agonist-induced increase in the cytosolic free Ca2+ concentration in airway smooth muscle cells, blocks VDLCC and NSCC currents, and relieves the respiratory resistance of healthy and asthmatic mice. Conclusions: EAED may have potential beneficial effects on mitigating asthma attacks.
Outcomes of Cardiac Resynchronization Therapy in Patients with Hypothyroidism and Heart Failure
Authors: YANG MEI , Li Xuping , III John C. Morris , Liang Jinjun , Deshmukh Abhishek J. , Hodge David , Li Yi-Gang , Cha Yong-Mei
Published: August 2020

Background Hypothyroidism is known to be associated with adverse clinical outcomes in heart failure. The association between hypothyroidism and cardiac resynchronization therapy outcomes in patients with severe heart failure is not clear.Methods The study included 1,316 patients who received cardiac resynchronization therapy between 2002 and 2015. Baseline demographics and cardiac resynchronization therapy outcomes, including left ventricular ejection fraction, New York Heart Association class, appropriate implantable cardioverter-defibrillator therapy, and all-cause mortality, were collected from the electronic health record. Results Of the study cohort, 350 patients (26.6%) were classified as the hypothyroidism group. The median duration of follow-up was 3.6 years (interquartile range, 1.7-6.2). Hypothyroidism was not associated with a higher risk of all-cause mortality in patients receiving CRT for heart failure. The risk of appropriate implantable cardioverter-defibrillator therapy significantly increased in association with increased baseline thyroid-stimulating hormone level in the entire cohort (hazard ratio, 1.23 per 5mIU/L increase; 95% CI, 1.01-1.5; P=0.04) as well as in the hypothyroid group (hazard ratio, 1.44 per 5mIU/L increase; 95% CI, 1.13-1.84; P=0.004). Conclusions CRT improves cardiac function in hypothyroid patients. The ventricular arrhythmic events requiring ICD therapies are associated with baseline TSH level, which might be considered as an important biomarker to stratify the risk of sudden death for patients with heart failure and hypothyroidism.
NGS based expanded carrier screening for genetic disorders in North Indian population reveals unexpected results – a pilot study.
Authors: Singh Kanika , Bijarnia-Mahay Sunita , Ramprasad Vedam Lakshmi , Puri Ratna Dua , Nair Sandhya , Sharda Sheetal , Saxena Renu , Kohli Sudha , Gujral Kanwal , Ganguli Indrani , Verma Ishwar Chander
Published: August 2020

Background: To determine the carrier frequency and pathogenic variants of common genetic disorders in the north Indian population by using next generation sequencing (NGS).Methods: After pre-test counselling, 200 unrelated individuals (including 88 couples) were screened for pathogenic variants in 88 genes by NGS technology. The variants were classified as per American College of Medical Genetics criteria. Pathogenic and likely pathogenic variants were subjected to thorough literature-based curation in addition to the regular filters. Variants of unknown significance were not reported. Individuals were counselled explaining the implications of the results, and cascade screening was advised when necessary.Results: Of the 200 participants, 52 (26 %) were found to be carrier of one or more disorders. Twelve individuals were identified to be carriers for congenital deafness, giving a carrier frequency of one in 17 for one of the four genes tested (SLC26A4, GJB2, TMPRSS3 and TMC1 in decreasing order). Nine individuals were observed to be carriers for cystic fibrosis, with a frequency of one in 22. Three individuals were detected to be carriers for Pompe disease (frequency one in 67). None of the 88 couples screened were found to be carriers for the same disorder. The pathogenic variants observed in many disorders (such as deafness, cystic fibrosis, Pompe disease, Canavan disease, primary hyperoxaluria, junctional epidermolysis bullosa, galactosemia, medium chain acyl CoA deficiency etc.) were different from those commonly observed in the West. Conclusion: A higher carrier frequency for genetic deafness, cystic fibrosis and Pompe disease was unexpected, and contrary to the generally held view about their prevalence in Asian Indians. In spite of the small sample size, this study would suggest that population-based carrier screening panels for India would differ from those in the West, and need to be selected with due care. Testing should comprise the study of all the coding exons with its boundaries in the genes through NGS, as all the variants are not well characterized. Only study of entire coding regions in the genes will detect carriers with adequate efficiency, in order to reduce the burden of genetic disorders in India and other resource poor countries.
Portable neuromodulation induces neuroplasticity to re-activate motor function recovery from brain injury: A high-density MEG case study
Authors: D'Arcy Ryan C.N. , Greene Trevor , Greene Debbie , Frehlick Zack , Fickling Shaun D. , Campbell Natasha KJ , Etheridge Tori , Smith Christopher , Bollinger Fabio , Danilov Yuri , Livingstone Ashley , Tannouri Pamela , Martin Pauline , Lakhani Bimal
Published: August 2020

Background: In a recent high-profile case study, we used functional magnetic resonance imaging (fMRI) to monitor improvements in motor function related to neuroplasticity following rehabilitation for severe traumatic brain injury (TBI). The findings demonstrated that motor function improvements can occur years beyond current established limits. The current study extends the functional imaging investigation to characterize neuromodulation effects on neuroplasticity to further push the limits.Methods: Canadian Soldier Captain (retired) Trevor Greene (TG) survived a severe open-TBI when attacked with an axe during a 2006 combat tour in Afghanistan. TG has since continued intensive daily rehabilitation to recover motor function, experiencing an extended plateau using conventional physical therapy. To overcome this plateau, we paired translingual neurostimulation (TLNS) with the continuing rehabilitation program. Results: Combining TLNS with rehabilitation resulted in demonstrable clinical improvements along with corresponding changes in movement evoked electro-encephalography (EEG) activity. High-density magneto-encephalography (MEG) characterized cortical activation changes in corresponding beta frequency range (27Hz). MEG activation changes corresponded with reduced interhemispheric inhibition in the post-central gyri regions together with increased right superior/middle frontal activation suggesting large scale network level changes. Conclusions: The findings provide valuable insight into the potential importance of non-invasive neuromodulation to enhance neuroplasticity mechanisms for recovery beyond the perceived limits of rehabilitation.
Mothers’ knowledge and attitudes regarding child feeding recommendations, complementary feeding practices and determinants of adequate diet
Authors: Appiah Kingsley B , Cheyuo Ernest K , Alhassan Abdul-Mumin , Ayanore Martin A , Kubuga Clement K , MOGRE VICTOR
Published: August 2020

Background: Complementary feeding is critical for optimal nutrition in infant and young children as it ensures their growth, health and development to attain their full potential. However, evidence shows children from developing countries do not meet the core indicators for appropriate complementary feeding. We evaluated mothers’ knowledge and attitudes regarding child feeding recommendations and the determinants of adequate diet among children aged 6-23 months.

Methods: This cross-sectional study included 200 children aged 6-23 months and their mothers/care givers recruited during the child welfare clinics of two health facilities in Ghana. Data was collected using a structured questionnaire. Multivariate logistic regression was used to assess determinants of adequate diet.

Results: Sixty-eight percent of the mothers knew the recommended duration of continued breastfeeding, 56.5% how to ensure dietary diversity and enrich their children’s diets and 94% (n=188) had positive attitude towards recommended infant and young child feeding practices. Majority of the mothers (92%, n=183) practiced continued breastfeeding, 10.5% of the children met minimum diet diversity score, 39.5% minimum meal frequency and 8.5% received minimum adequate diet. Determinants of receipt of minimum adequate diet were: having high knowledge in child feeding recommendations (100% vs. 0.0; p<0.001) and child’s father reportedly earning adequate income to cater for the family (AOR = 12.1 (1.32 – 109.72; p = 0.027).

Conclusion: Motherss knowledge levels regarding infant and young child feeding recommendations had notable deficiencies although they generally had a positive attitude towards child feeding recommendations. Knowledge regarding infant and young child feeding recommendations as well as the child’s father having adequate income were important determinants of adequate diet. Nutrition education should emphasize on improving mothers’ nutrition knowledge regarding infant and young child feeding recommendations and supporting mothers to overcome barriers to feed their children with adequate diets.
High prevalence of cardiovascular risk factors in adults living in Greece: The EMENO National Health Examination Survey
Authors: Touloumi Giota , Karakosta Argiro , Kalpourtzi Natasa , Gavana Magda , Vantarakis Apostolos , Kantzanou Maria , Hajichristodoulou Christos , Chlouverakis Grigoris , Trypsianis Grigoris , Voulgari Paraskevi V. , Alamanos Yannis , Makrilakis Konstantinos , Liatis Stavros , Chatzipanagiotou Stylianos , Stergiou George
Published: August 2020

Background: Nationwide data on cardiovascular risk factors prevalence is lacking in Greece. This work presents the findings of the national health examination survey EMENO regarding the prevalence of hypertension, hypercholesterolemia, diabetes, obesity and smoking.
Methods: A random sample of adults (≥18 years) was drawn by multistage stratified random sampling based on 2011 Census. All EMENO participants with ≥1 measurement of interest [blood pressure (BP), fasting glucose, HbA1c, total cholesterol (TC), Body Mass Index (BMI)] were included. Hypertension was defined as BP≥140/90mmHg and/or antihypertensive treatment; diabetes as fasting glucose≥126mg/dL and/or HbA1c≥6.5% or self-reported diabetes; hypercholesterolemia as TC≥190mg/dL. Sampling weights were applied to adjust for study design and post-stratification weights to match sample age and sex distribution to population one. Non-response was adjusted by inverse probability weighting.
Results: Of 6,006 EMENO participants, 4,822 were included (51.5% females, median age:47.9 years). The prevalence of hypertension was 39.2%, higher in men (42.4%) than in women (36.1%); of hypercholesterolemia 60.2%, similar in men (59.5%) and women (60.9%); of diabetes 11.6%, similar men (12.4%) and women (10.9%); of obesity 32.1%, higher in women (33.5% vs 30.2%), although in subjects aged 18-40 year it was higher in men; of current smoking 38.2%, higher in men (44.0%) than in women (32.7%). The prevalence of all risk factors increased substantially with age, except smoking, which followed an inverse U shape.
Conclusions: The burden of cardiovascular risk factors among Greek adults is alarming. There is considerable preventive potential and actions at health care and societal level are urgently needed.
Impact on place of death in cancer patients: a causal exploration in southern Switzerland
Authors: Kern Heidi , Corani Giorgio , Huber David , Vermes Nicola , Zaffalon Marco , Varini Marco , Wenzel Claudia , Fringer André
Published: August 2020

Background Most terminally ill cancer patients prefer to die at home, but a majority die in institutional settings. Research questions about this discrepancy have not been fully answered. This study applies artificial intelligence and machine learning techniques to explore the complex network of factors and the cause-effect relationships affecting the place of death, with the ultimate aim of developing policies favouring home-based end-of-life care.Methods A data mining algorithm (a classifier) and a causal probabilistic model (a credal network) for data analysis were developed with information derived from expert knowledge that was merged with data from 116 deceased cancer patients in southern Switzerland. This data set was obtained via a retrospective clinical chart review.Results Dependencies of disease and treatment-related decisions demonstrate an influence on the place of death of 13%. Anticancer treatment in advanced disease prevents or delays communication about the end of life between oncologists, patients and families. Unknown preferences for the place of death represent a great barrier to a home death. A further barrier is the limited availability of family caregivers for terminal home care. The family’s preference for the last place of care has a high impact on the place of death of 51%, while the influence of the patient’s preference is low, at 14%. Approximately one-third of family systems can be empowered by health care professionals to provide home care through open end-of-life communication and good symptom management. Such intervention has an influence on the place of death of 17%. If families express a convincing preference for home care, the involvement of a specialist palliative home care service can increase the probability of home deaths by 24%.Conclusion Concerning death at home, open communication about death and dying is essential. Furthermore, for the patient preference for home care to be respected, the family’s decision for the last place of care seems to be key. The early initiation of family-centred palliative care and the provision of specialist palliative home care for patients who wish to die at home are suggested.
The uses of fig (Ficus) by five ethnic minority communities in Southern Shan State, Myanmar
Authors: Mon Aye Mya , Shi Yinxian , Yang Xuefei , Hein Pyae Phyo , Oo Thaung Naing , Whitney Cory W. , Yang Yongping
Published: August 2020

Background: Most regions of Myanmar fall within the Indo-Burma Biodiversity Hotspot and are threatened of biodiversity loss. Development of a comprehensive framework for sustainable development is crucial. Figs are ecological keystone species within these regions and are also important for their traditional spiritual, food and health uses, which often have accompanying conservation practices. These may offer clues to help guide the development of national policies for sustainable development. In this study we showcase the rich ethnobotanical knowledge as well as the variety of collection and conservation practices of figs among five ethnic groups in Southern Shan State.Methods: We performed both key informant and semi-structured interviews with 114 informants from five ethnic groups. Their uses for figs were categorized according to local practices and recipes. Informants were asked about trends in conservation status over the past 10 years and any conservation related customs and practices. Data were analyzed quantitatively with common quantitative ethnobotany indices, the use report (UR) and use value (UV). Results: Informants reported the uses of eight fig species (Ficus auricularta，F. concinna, F. geniculata，F. hispida, F. racemosa, F. religiosa，F. semicordata, and F. virens). F. geniculata and F. virens were most useful (UR = 228) and were used by all five ethnic groups, corresponding to a high use value (UV = 2). Treatments for 16 diseases were reported from seven species. Household consumption, economic, and sacred uses were accompanied by sustainable practices of harvest and protection. Traditional taboos, in situ and ex situ conservation were practiced especially for highly demanded species (F. geniculata and F. virens), and the sacred fig F. religiosa.Conclusion: Findings suggest that figs are useful for food (all informants) and medicine (13.16% of the informants) in the study area. Traditional taboos, in situ and ex situ conservation practices help to maintain sustainable utilization of locally important figs. This is an early contribution to the traditional knowledge of edible figs. Although similar uses have been reported in neighboring countries for seven of the fig species, the ethnobotanical use of F. concinna is novel.
miR-431-5p regulates cell proliferation and apoptosis in fibroblast-like synoviocytes in rheumatoid arthritis by targeting XIAP
Authors: Wang Yuejiao , Zhang Kailin , Yuan Xiaowei , Xu Neili , Zhao Shuai , Hou Linxin , Yang Lili , Zhang Ning
Published: August 2020

Background miR-431-5p is dysregulated in various cancers and plays an important function in the development of cancer. However, its role in fibroblast-like synoviocytes (FLSs) in patients with rheumatoid arthritis (RA) remains to be understood.Methods Quantitative real-time polymerase chain reaction was used to detect the relative expression of miR-431-5p in synovial tissues and FLSs. Cell proliferation assays helped examine RA FLS proliferation. Flow cytometry was performed to determine apoptosis and cell cycle progression in RA FLSs. We used dual-luciferase assays to determine the correlation between miR-431-5p and its putative target, X-linked inhibitor of apoptosis (XIAP). Quantitative real-time PCR and western blotting were used to measure XIAP levels in synovial tissues and transfected RA FLSs.Results miR-431-5p was downregulated in synovial tissues and FLSs of patients with RA. Upregulation of miR-431-5p prohibited cell proliferation and the G0/G1-to-S phase transition, but promoted apoptosis in RA FLSs; while miR-431-5p inhibition showed the opposite results. miR-431-5p directly targeted XIAP in RA FLSs, and reversely correlated with XIAP levels in synovial tissues. Notably, XIAP silencing partially restored the effects of miR-431-5p inhibition in RA FLSs.Conclusion miR-431-5p regulates cell proliferation, apoptosis，and cell cycle of RA FLSs by targeting XIAP, suggesting its potential in the treatment of RA.
Assessment of the simultaneous effect of hypothyroidism and thyroid autoimmunity with gestational diabetes on the incidence of type 2 diabetes
Authors: zahedi Maryam , Kazemian Elham , Tehrani Fahimeh Ramezani , tohidi Maryam , azizi Fereidoun , Khalili Davood , Rahmati maryam , Amouzegar Atieh
Published: August 2020

Introduction: Despite the evidence available on the adverse impact of gestational diabetes (GDM) and thyroid disorders on developing type 2 diabetes (T2DM), the concurrent influence of these disorders on the incidence of T2DM has not been reported yet.
Methods: In this prospective study, 1894 non-diabetic women aged 20 to 60 years, with a history of at least one term delivery, without diagnosed hyperthyroidism were selected at the initiation of the Tehran Thyroid Study (TTS). Pooled logistic regression analyses were used to investigate the association of GDM, thyroid disorders i.e., hypothyroidism and/or thyroid peroxidase antibody (TPOAb) positivity and interaction between GDM and thyroid disorders with the risk of incident T2DM.
Results: Of the 1894 participants of the present study, 346 (18.3%) had a history of GDM, and 832 (43.9%) had thyroid disorders. The total cumulative incidence rate of T2DM at the median follow-up time of ~ 12 years was overall 12/1000 person-years (95% confidence interval (CI): 10/1000–13/1000), with an incidence rate of 16/1000 (95%CI: 13/1000–20/1000) in women with GDM; and 11/100,000 (95%CI: 9/100,000–12/1000) among those without GDM. After adjustment for age, the risk of incident T2DM increased among individuals with previous GDM compared to women without a history of GDM (odds ratio (OR): 1.54, 95%CI: 1.06, 2.25). No significant associations were found between either thyroid disorders or the interaction between GDM and thyroid disorders with the development of T2DM; (OR: 1.14, 95%CI: 0.82, 1.58) and (OR: 1.27, 95%CI: 0.66, 2.43), respectively.
Conclusion: GDM and thyroid disorders have no concurrent impacts on the incidence of T2DM.
Evaluation of the Content Validity Index of the Australian/Canadian Osteoarthritis Hand Index, the Patient-Rated Wrist/Hand Evaluation and the Thumb Disability Exam in People with Hand Arthritis
Authors: Bobos Pavlos , MacDermid Joy C , Boutsikari Eleni C. , Lalone Emily A. , Ferreira Louis , Grewal Ruby
Published: August 2020

Background The Australian/Canadian Osteoarthritis Hand Index (AUSCAN), the Patient-Rated Wrist/Hand Evaluation (PRWHE) and the Thumb Disability Exam (TDX) are patient-reported outcome measures (PROM) designed to assess pain and hand function in patients with hand arthritis, hand pain and disability, or thumb pathology respectively. This study evaluated the content validity of AUSCAN, PRWHE and TDX in people with hand arthritis. Methods This study enrolled participants with hand arthritis to rate the items of all 3 PROM in terms of relevance and clarity. The Content Validity Index (CVI) was computed for each item in each scale (I-CVI) as well as for the overall scale (S-CVI). Kappa was used to determine the inter-rater agreement among the raters. Results Overall, 64 individuals with hand arthritis (27% with OA, 67% with rheumatoid arthritis and 6% with psoriatic arthritis) participated in the study. The I-CVI for all items and all scales were very high (I-CVI > 0.76) and the modified Kappa agreement among the raters demonstrated excellent agreement (k>0.76).The S-CVI for all PROMs was very high for relevance (AUSCAN = 0.92, 95% CI 0.90 to 0.94; PRWHE = 0.85, 95% CI 0.82 to 0.88 and TDX = 0.87, 95% CI 0.85 to 0.89) and for clarity (AUSCAN = 0.99, 95% CI 0.98 to 1.00; PRWHE = 0.95, 95% CI 0.93 to 0.97 and TDX = 0.91, 95% CI 0.89 to 0.94), respectively. Conclusions This study demonstrated very high content validity indices for the AUSCAN, PRWHE and TDX; with strong consensus across raters. This augments prior studies demonstrating appropriate statistical measurement properties, to provide confidence that all three measures assess important patient concepts of pain and disability.
Survival and diagnostic age of 175 Taiwanese patients with mucopolysaccharidoses (1985-2019)
Authors: Lin Hsiang-Yu , Lee Chung-Lin , Chang Chia-Ying , Chiu Pao Chin , Chien Yin-Hsiu , Niu Dau-Ming , Tsai Fuu-Jen , Hwu Wuh-Liang , Lin Shio Jean , Lin Ju-Li , Chao Mei-Chyn , Chang Tung-Ming , Tsai Wen-Hui , Wang Tzu-Jou , Chuang Chih-Kuang , Lin Shuan-Pei
Published: August 2020

Background Mucopolysaccharidoses (MPSs) are a group of inherited metabolic diseases, which are characterized by the accumulation of glycosaminoglycans, and eventually lead to the progressive damage of various tissues and organs.Methods An epidemiological study of MPS in Taiwan was performed using multiple sources. The survival and diagnostic age for different types of MPS between 1985 and 2019 were evaluated.Results Between 1985 and 2019, there were 175 patients diagnosed with MPS disorders in the Taiwanese population, with a median diagnostic age of 3.9 years. There were 21 (12%), 78 (45%), 33 (19%), 32 (18%) and 11 (6%) patients diagnosed with MPS I, II, III, IV and VI, respectively, with median diagnostic ages of 1.5, 3.8, 4.7, 4.5 and 3.7 years, respectively. Diagnosis of MPS patients was significantly earlier in recent decades (p<0.01). Pilot newborn screening programs for MPS I, II, VI, IVA, and IIIB were progressively introduced in Taiwan from 2016, and 48% (16/33) of MPS patients diagnosed between 2016 and 2019 were diagnosed by one of these screening programs, with a median diagnostic age at 0.2 years. For patients born between 2016 and 2019, up to 94% (16/17) were diagnosed with MPS via the newborn screening programs. At the time of this study, 81 patients had passed away with a median age at death of 15.6 years. Age at diagnosis was positively correlated with life expectancy (p<0.01). Life expectancy also significantly increased between 1985 and 2019, however this increase was gradual (p<0.01).Conclusions The life expectancy of Taiwanese patients with MPS has improved in recent decades and patients are being diagnosed earlier. Because of the progressive nature of the disease, early diagnosis by newborn screening programs and timely implementation of early therapeutic interventions may lead to better clinical outcomes.
Bridging different realities - a qualitative study on patients experiences of preoperative care for benign hysterectomy and opportunistic salpingectomy in Sweden
Authors: Collins Elin , Lindqvist Maria , Mogren Ingrid , Idahl Annika
Published: August 2020

Background Hysterectomy is a common procedure worldwide and removing healthy fallopian tubes at the time of hysterectomy (opportunistic salpingectomy) to possibly prevent ovarian cancer is increasing in frequency, but still controversial. The experiences and perceptions of women, eligible for the procedure, have not been previously investigated.This study aims to, among women waiting to undergo hysterectomy, explore i) experiences and perceptions of self and healthcare in relation to their elective surgery, ii) perceptions of risks and benefits of hysterectomy, including opportunistic salpingectomy.Methods A qualitative study, with focus group discussions including women < 55 years, planned for hysterectomy with ovarian preservation, was performed. Participants were recruited through purposive sampling from six gynecological departments in different parts of Sweden, including both country and university hospitals. Focus group discussions were conducted using a semi-structured interview guide, digitally recorded, transcribed verbatim and analysed by qualitative manifest and latent content analysis. Results Twenty-one Swedish-speaking women participated. They were 40-53 years of age, reported varying educational levels, countries of birth and indications for hysterectomy. Analysis rendered a theme “Bridging different realities” over four categories: “Being a woman today”, “Experiencing and managing body failure”, “Navigating the healthcare system” and “Processing continuously until surgery”, including 17 subcategories. The participants displayed varying attitudes towards the significance of their uterus in being a woman. A vague understanding of their body was described, leading to fear related to the reasons for surgery as well as surgery itself. Participants described difficulties understanding and recalling information but also stated that insufficient information was provided. Perceptions of the risks and benefits of opportunistic salpingectomy varied. Involvement in decisions regarding the hysterectomy and potential opportunistic salpingectomy was perceived to be dependent on the counselling gynecologist. Conclusions The theme Bridging different realities captures the complexity of women deciding on removal of their uterus, and possibly fallopian tubes. It also describes the women’s interactions with healthcare and perceived difference between the health professionals and the women’s perception of the situation, as viewed by the women. Bridging the different realities faced by patients is required to enable shared decision-making, through sufficient support from healthcare.
Metastasis to lateral lymph nodes with no mesenteric lymph node involvement in low rectal cancer: a retrospective case series
Authors: Li Peng , Zhang Zhichun , Zhou Yuanda , Zeng Qingsheng , Zhang Xipeng , Sun Yi
Published: August 2020

ABSTRACT
Purpose The aim of this study is to examine the pattern of lymph node metastasis (lateral vs. mesenteric lymph nodes) in low rectal cancer.
Methods This retrospective analysis included all patients undergoing laparoscopic total mesorectal excision plus lateral lymph node dissection for advanced low rectal cancer (up to 8 cm from the anal verge) during a period from July 1, 2017 to August 31, 2019 at the Department of Colorectal Surgery, Tianjin Union Medical Center. The decision to conduct lateral lymph node dissection was based on positive findings in preoperative imaging assessments.
Results A total of 42 patients were included in data analysis. Surgery was successfully completed as planned, without conversion to open surgery in any case. A minimal of 10 mesenteric lymph nodes and 1 lateral lymph node on each side were dissected in all patients. Pathologic examination of resected specimens showed no metastasis to either mesenteric or lateral lymph nodes in 7 (16.7%) case, metastasis to both mesenteric and lateral lymph nodes in 26 (61.9%) cases, metastasis to mesenteric but not lateral lymph nodes in 4 (9.5%) cases, and metastasis to lateral but not mesenteric lymph nodes in 5 (11.9%) cases (n=2 in the obturator region; n=3 in the iliac artery region).
Conclusion A clinically significant proportion of low rectal cancer patients have metastasis to lateral lymph nodes without involvement of mesenteric lymph nodes. More carefully planned prospective studies are needed to verify this preliminary finding.
Plasma calprotectin was associated with platelet activation and no-reflow phenomenon in acute coronary syndrome
Authors: Song Nian-Peng , Zhen Xiao-Wen , Li Liu-dong , Zhong Lin , Wang Hua , AN YI
Published: August 2020

Background No-reflow occurs in 3–4% of all percutaneous coronary interventions (PCIs) and has a strong negative impact on clinical outcomes of acute coronary syndrome. (ACS). Therefore, the discovery of a biomarker that can early predict the occurrence of no-reflow has great clinical significance. Multiple factors including platelet activation are relevant to no-reflow. Calprotectin is found to be a biomarker of plaque instability and is identified to be a novel diagnostic and prognostic biomarker of cardiovascular diseases. But theThe association of plasma calprotectin with platelet activation and no-reflow phenomenon in acute coronary syndromeACS is not clear. Methods In this prospective study performed at Yantai Yuhuangding Hospital from 2017 to 2018, a total of 176 Chinese patients with acute coronary syndromeACS who had undergone percutaneous coronary interventionsPCIs were recruited consecutively, aged from 30 to 88 years. The coronary angiography and percutaneous coronary intervention procedures were performed and angiographicAngiographic no-reﬂow was defined as a thrombolysis in myocardial infarction scores grade less than 3. Blood samples were collected immediately at admission for the detection of plasma calprotectin and platelet–monocyte aggregates formation. Statistical analysis was performed for the variable’s comparisons between groups and for the prediction value of plasma calprotectin for no-reflow.Results In this study, we have demonstrated that acute coronary syndromeThe mean age of the 176 included ACS patients were 64(±11) years and acute ST-segment elevation myocardial infarction (STEMI) was present in 41.5 percent of patients. 22 patients had no-reflow during the PCI procedures and the prevalence was 12.5%. Patients with higher plasma calprotectin had an elevateda higher level of platelet activation–monocyte aggregates (PMA) and a higher incidenceprevalence of no-reflow. Plasma (p<0.001). The multivariate regression showed that plasma calprotectin level wasand admission hs-cTnI were independently associated with platelet activation and no-reflow in patients with acute coronary syndrome. Despite that platelet activation biomarker platelet–monocyte aggregate was associated with no-flow, onlyPMA, while plasma calprotectin and serum low density lipoprotein cholesterol acted asLDL-c were independent predictors of no-reflow in patients with acute coronary syndrome.(p<0.001 and p=0.017). AUC of calprotectin for predicting no-reflow were 0.898. The cut-off value of plasma calprotectin for no-reflow was 4748.77 ng/mL with a sensitivity of 0.95 and a specificity of 0.77. Conclusion Plasma calprotectin was associated with platelet activation and may act as an early predictionpredictive biomarker of no-reflow in patients with acute coronary syndrome.
An Open Source Chemical Structure Curation Pipeline using RDKit
Authors: Bento A Patrícia , Hersey Anne , Felix Eloy , Landrum Greg , Gaulton Anna , Atkinson Francis , Bellis Louisa J , De Veij Marleen , Leach Andrew R
Published: August 2020

Background
The ChEMBL database is one of a number of public databases that contain bioactivity data on small molecule compounds curated from diverse sources. Incoming compounds are typically not standardised according to consistent rules. In order to maintain the quality of the final database and to easily compare and integrate data on the same compound from different sources it is necessary for the chemical structures in the database to be appropriately standardised.
Results
A chemical curation pipeline has been developed using the open source toolkit RDKit. It comprises three components: a Checker to test the validity of chemical structures and flag any serious errors; a Standardizer which formats compounds according to defined rules and conventions and a GetParent component that removes any salts and solvents from the compound to create its parent. This pipeline has been applied to the latest version of the ChEMBL database as well as uncurated datasets from other sources to test the robustness of the process and to identify common issues in database molecular structures.
Conclusion
All the components of the structure pipeline have been made freely available for other researchers to use and adapt for their own use. The code is available in a GitHub repository and it can also be accessed via the ChEMBL Beaker webservices. It has been used successfully to standardise the nearly 2 million compounds in the ChEMBL database and the compound validity checker has been used to identify compounds with the most serious issues so that they can be prioritised for manual curation.