bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P204: Tobacco Use And The AHA 2030 Impact Goals: A Simulation
Authors: Levy Douglas , Goldberg Sydney L , Hyle Emily P , Reddy Krishna P
Published: May 2021

Background:
The AHA’s 2030 Impact Goals seek to increase population health-adjusted life expectancy (LE) by 2y. Tobacco is a top contributor to all-cause mortality and cardiovascular disease (CVD). We estimated the potential contribution of improved tobacco control to achieve the 2030 Impact Goals in the US.

Methods:
We used the validated STOP microsimulation model with NHIS estimates of age- and sex-stratified mortality and CVD incidence to project changes in LE, as well as 10y, 20y, and lifetime CVD cumulative incidence, if cigarette smoking declined among the current US population. We assessed the impact of preventing initiation (current v never smokers) or increasing cessation (current v former smokers) at different ages. To examine the maximum impact of population-wide cessation, we projected changes in population LE and CVD incidence if smoking prevalence among those ≥20yo went immediately to 0%.

Results:
Preventing smoking initiation increases LE by 10.2y (men [M]) and 9.1y (women [W]) and reduces lifetime CVD incidence by 16.8% (M) and 26.2% (W) compared to lifetime smoking. Even cessation at age 60 extends LE by 3.7y (M) and 2.5y (W) and reduces 10y CVD incidence by 39.1% (M) and 59.4% (W) (Table). Total elimination of cigarette smoking in the 2020 US population aged ≥20y (e.g. by outlawing cigarettes) would increase the cohort LE by 0.4 (M) and 0.2 (W) years and reduce 20y CVD incidence by 6.0% (M) and 7.0% (W).

Conclusion:
Preventing smoking initiation offers the greatest benefit, but cessation at any age substantially improves LE and reduces CVD risk. The modest potential contribution of tobacco elimination to achieving the 2030 Impact Goals is due to already low smoking prevalence: <14% (projected) in 2020.
Abstract P210: The Social Distribution Of Ideal Cardiovascular Health: A Global Systematic Review
Authors: Qureshi Farah , Bousquet-Santos Kelb , Shiba Sakurako , Delaney Scott , Guimond Anne-Josee , Boehm Julia K , Kubzansky Laura D
Published: May 2021

Introduction:
Numerous studies have examined the social determinants of ideal cardiovascular health (ICVH) around the world, but no work has summarized evidence to date. This study aimed to systematically review findings on the social distribution of ICVH globally, and to compare trends in high-income countries (HICs) vs. low/middle-income countries (LMICs).

Methods:
In November 2019, we systematically searched PubMed, Embase, and LILACS for observational studies published after the American Heart Association (AHA) defined ICVH as a combination of health factors and behaviors in 2010. Search terms included ICVH/Life’s Simple 7 and a pre-defined set of social determinants of health (i.e., education, income/wealth, socioeconomic status (SES), employment, occupation, and race/ethnicity). Each abstract was reviewed by two independent researchers. Studies were included if associations between a composite measure of ICVH and a social determinant of health was quantified using statistical methods. We evaluated risk of bias using an adapted version of the Newcastle-Ottawa Quality Assessment Scale. Overall findings and comparisons between HICs and LMICs (defined by World Bank guidelines) were summarized narratively.

Results:
A total of 33 studies met inclusion criteria. Only 8 studies were from LMICs (n=4 from China), while 25 were from HICs (n=19 from the US). The most commonly assessed social determinants were education (n=18) and income/wealth (n=17). In both HICs and LMICs, few studies examined occupation or area-level measures, like rurality/urbanicity. Most studies were cross-sectional (n=27). Two thirds of studies and had a moderate (n=14, 43%) or high (n=8, 24%) risk of bias, but no systematic differences were noted by country setting. Nearly half of studies used composite ICVH measures that were of moderate or poor quality (i.e., based on only self-reported data and/or unvalidated instruments), and only 15% of studies (n=5) assessed each ICVH component using the exact criteria defined by the AHA. Despite substantial heterogeneity in how ICVH measures were derived and analyzed (e.g., as a binary, categorical, or count variable), fairly consistent associations were observed between higher levels of ICVH and higher social status (higher education, income/wealth, racial/ethnic majority status) across both HICs and LMICs. Studies of occupation (n=6, all from HICs) and area-level measures (n=4, 3 from LMICs) were less conclusive.

Conclusion:
Associations between higher social status and ICVH were noted in both HICs and LMICs, but most evidence was based on correlational data from cross-sectional studies in the US, primarily in relation to education and income. Important gaps in the literature include studies from LMICs, longitudinal designs to improve causal inference, and investigations of occupation, rurality/urbanicity, and race/ethnicity in non-US settings.
Abstract P212: Comparison Of Vascular Risk Factors And Serum Fatty Acids At Admission Between Intracerebral Hemorrhage And Acute Ischemic Stroke
Authors: Mori Takahisa , Yoshioka Kazuhiro , Miyazaki Yuichi
Published: May 2021

Introduction:
Dietary triglycerides influence fatty acid (FA) serum concentrations and weight percentages (wt%), which may be associated with the onset of intracerebral hemorrhage (ICH) or acute ischemic stroke (AIS).

Hypothesis:
There are significant differences between FAs at the admission of ICH and AIS.

Methods:
We included patients admitted between 2016 and 2019 within 24 h of ICH or AIS onset and calculated correlation coefficients between their ages, serum FA concentrations, and FA wt% values. We evaluated differences in age, average blood pressure (ABP), glucose, A1c, serum lipids, and FAs between two groups. Excluding variables with multicollinearity, we performed multiple logistic regression (MLR) analysis to identify independent variables distinguishing ICH from AIS. We estimated the threshold values of independent variables using the area under the curve values derived from the receiver operating characteristic (ROC) curves.

Results:
Our inclusion criteria were met by 141 of ICH patients and 525 of AIS patients. In the ICH group, age, A1c, and eicosapentaenoic acid (EPA) levels were smaller than those in the AIS group. ABP, high-density lipoprotein cholesterol (HDL-C), myristic acid (MyA), linoleic acid (LiA) concentrations, and MyA wt% were higher than those in the AIS group. MLR analysis between two groups indicated that age, ABP, A1c, HDL-C were independent variables. Serum FA levels were not independent. ROC curves showed that the threshold values of age, ABP, A1c, and HDL-C for ICH onset were ≤ 69 years, ≥ 126.6 mmHg, ≤ 6.0%, and ≥ 1.62 mmol/L, respectively. In 27 patients with age ≤ 69 , ABP ≥ 126.6, A1c ≤ 6.0%, and HDL-C ≥ 1.62 and 87 patients with age > 69 , ABP< 126.6, A1c > 6.0, and HDL-C < 1.62, there were 19 (70.4%) and 9 (10.3%) patients with ICH, the MyA concentrations were 108 and 73 μmol/L (p < 0.001), the LiA concentration were 2,900 and 2,410μmol/L (p < 0.001), and the EPA wt% were 1.4 and 2.0% (p=0.059), respectively.

Conclusions:
Younger patients with higher ABP, lower A1c, and higher HDL-C suffered from not AIS but ICH, and their MyA and LiA concentrations were higher than older patients without them.
Abstract P225: Health Care Access And Health Indicators In Puerto Rico Pre- And Post- Hurricane Maria: Analysis Of Data From 2015-2018 Behavioral Risk Factor Surveillance System
Authors: Cortes Yamnia I , Pagan Lassalle Patricia , Perreira Krista
Published: May 2021

Background:
In September 2017, Hurricane Maria devastated Puerto Rico (PR), in what is now regarded as one of the worst natural disasters in United States (US) history. Natural disasters can impact health directly as well as indirectly through their impacts on health behavior, health utilization, and migration. Population-based estimates of the health of PR residents before and after Hurricane Maria have not been assessed.

Objective:
The overall goal of this project is to compare key health indicators, particularly cardiovascular disease risk factors, among PR residents pre- and post-Hurricane Maria.

Methods:
This study used data from the Behavioral Risk Factor Surveillance System (BRFSS) in PR. We included data from four survey years: 2015 (N=4556), 2016 (N=5765), 2017 (N=4462), and 2018 (N=4814). The sample consisted of non-institutionalized adults age ≥18 years with access to a landline or a cellular telephone. Since BRFSS data collection in PR were completed in the Spring, and Hurricane Maria struck in Fall 2017, we analyzed three yearsof pre-hurricane data (2015, 2016, 2017) and one year post-hurricane (2018). We will soon be including a second year of data post-hurricane (2019). We used logistic regression analyses to compare health care utilization (health insurance coverage, routine checkup within past year), health behaviors (alcohol use, smoking), and health outcomes (obesity, diabetes, depression) pre- and post-Hurricane Maria. Survey year 2017 was the referent in all models. Final models were adjusted for age, sex, race, education, employment, income, and marital status.

Results:
Compared to survey year 2017, in 2018 (post-hurricane) participants were more likely to have a college degree or higher, be currently employed, and not married/partnered. Post-hurricane, participants were less likely to have health insurance coverage (AOR, 95% CI: 0.75, 0.58-0.97) and had lower rates of diabetes (AOR: 0.82, 0.70-0.96). The odds of being overweight/obese were lower in 2015 (pre-hurricane) compared to 2017 (AOR, 95% CI: 0.88, 0.79-0.97). There was no significant difference in health behaviors across survey years.

Conclusions:
Participants who completed the BRFSS in PR post-Hurricane Maria had a higher socioeconomic status and lower rates of diabetes. Our results may suggest that PR residents with a lower socioeconomic status and/or chronic illness were more likely to emigrate, resulting in a compositional change in the population post-hurricane. This analysis highlights the need for long-term follow-up of PR residents to better determine the impact of Hurricane Maria, and adequately design public health programs to address healthcare needs, access, and outcomes.
Female Judges in Saudi Arabia, Hope Versus Reality
Authors: al-Agha Samah
Published: May 2021

The purpose of this research is to identify and explore the factors that have contributed to the prevention of women from working in the Saudi Arabian judiciary from the viewpoints of male Saudi judges. The study applies the qualitative research method and uses interviews to obtain the required data. It uses primary and secondary resources to support the arguments. The data analysis reveals three main themes under which these factors fall: the legal constraints, the religious constraints, and the cultural constraints. Finally, the study concludes with some findings and recommendations with regard to employing women in the judiciary.
The genus Callitriche (Plantaginaceae: Callitricheae) in South America

Authors: LANSDOWN RICHARD V. , HASSEMER GUSTAVO
Published: May 2021

Callitriche is a sub-cosmopolitan plant genus occurring throughout temperate regions of both hemispheres, including the peri-Antarctic islands, with 78 species worldwide. Records of Callitriche include frequent and extensive misidentification due to a combination of factors including a lack of taxonomic and nomenclatural clarification before the mid-20th century. This work aims to contribute to the taxonomic knowledge of the genus Callitriche in South America by presenting taxonomic novelties and a revision of some critical species. More specifically, seven new species are described: C. ciliata, C. concinna, C. dacryoidea, C. ecarinata, C. hegelmaieriana, C. praetermissa and C. schotsmaniana. In addition, C. marginata var. berteroana is here raised to species rank, C. mandonis, C. oblongicarpa and C. turfosa are re-established, and the names C. antarctica, C. deflexa, C. deflexa var. brauniana, C. deflexa var. glaziovii, C. deflexa var. phaeocarpa, C. heterophylla, C. heteropoda, C. terrestris and C. turfosa are typified.
Sorting out the muddle: taxonomy and nomenclature of Thymus ×porcii (Lamiaceae) and related nothotaxa, with comments on parent species delimitation

Authors: NACHYCHKO VIKTOR O. , SOSNOVSKY YEVHEN V.
Published: May 2021

Thymus ×porcii is a natural hybrid between T. pannonicus and T. pulegioides, occurring within the co-occurrence range of its parental species in the forest and forest-steppe zones of Europe. Taxonomy and nomenclature of this hybrid present a longstanding puzzle due to the lack of critical evaluations of the original material as well as conflicting taxonomic interpretations of the parent taxa both at specific and intraspecific levels. The present paper attempts to clarify these issues, arguing against the synonymic treatment and/or consolidation of T. pannonicus and T. pulegioides, which is accepted in modern taxonomies apparently as a result of nomenclatural confusion related to T. pannonicus typification. Based on morphology and reported molecular data, it is proposed to treat T. pannonicus and T. pulegioides as separate species, each containing two varieties being well-distinguished by the presence or absence of leaf indumentum: T. pannonicus var. latifolius (glabrous leaves) and T. pannonicus var. pannonicus (pubescent leaves), and T. pulegioides var. pulegioides (glabrous leaves) and T. pulegioides var. vestitus (pubescent leaves). In view of such treatment, T. ×porcii is divided into three nothovarieties, representing natural crosses between different varieties of the parent species. Namely, in addition to the typical T. ×porcii nothovar. porcii [T. pannonicus var. latifolius × T. pulegioides var. pulegioides] (with T. ×pilisiensis and T. ×goginae as the taxonomic synonyms), we describe a new nothovariety T. ×porcii nothovar. calvariensis [T. pannonicus var. pannonicus × T. pulegioides var. pulegioides], and propose a new nomenclatural combination T. ×porcii nothovar. opizii [T. pannonicus × T. pulegioides var. vestitus] based on the previously published name T. ×opizii. On the basis of original material examination, two collections from BP are designated here as the lectotypes of T. ×porcii (≡ T. ×porcii nothovar. porcii) and T. ×pilisiensis respectively, and one specimen from PR is designated as the lectotype of T. ×opizii (≡ T. ×porcii nothovar. opizii). Main diagnostic traits of T. ×porcii nothovarieties and their parental taxa are compared and discussed.
First description of the female of Coeliccia furcata Hämäläinen, 1986, with descriptive notes on males from Yunnan, China (Odonata: Zygoptera: Platycnemididae)
Authors: DOW RORY A. , ZHANG HAO-MIAO
Published: May 2021

Coeliccia furcata Hämäläinen, 1986, an atypical species of Coeliccia Kirby, 1890 with bifurcated male cerci, had been known solely from the holotype male collected in Myanmar in 1938. In recent years the species has been rediscovered in Yunnan, China. The first description of the female is given, along with descriptive notes on the male and illustrations of both sexes, including fresh images of the holotype. Another of the unusual features of C. furcata is the extremely simple form of its penile organ, this is discussed and compared with other species from mainland Asia and Japan currently placed in Coeliccia and with a simple penile organ.
Personality change and sustainability attitudes and behaviors
Authors: Hopwood Christopher J , Schwaba Ted , Milfont Taciano L , Sibley Chris G , Bleidorn Wiebke
Published: May 2021

Withstanding the climate crisis will depend in part on individuals behaving in a more environmentally sustainable manner. However, relatively little is known about the individual factors that promote sustainable attitudes and behaviors (SABs). Although there are established cross-sectional associations between personality traits and SABs, it is unclear whether changes in personality are related to increases in SABs over time, and how personality is differentially related to specific SABs. Using data from 61,479 participants in New Zealand, we tested preregistered hypotheses about how personality codevelops with valuing the environment, believing in climate change, concern about climate change, personal environmental efficacy, personal environmental sacrifice, and support for the Green Party. We found that SABs generally increased from 2009 to 2017, although there was variation across age cohorts, SAB variables, and samples. We replicated concurrent correlations between broad personality traits—particularly Agreeableness, Openness, and Honesty/Humility—and SABs and present novel evidence that increases in SAB are related to changes in traits, particularly Agreeableness. These findings have implications for both understanding the factors associated with changes in SABs over time and understanding the factors that drive personality change.
Grounded Theory: A Guide for Exploratory Studies in Management Research
Authors: Makri Chara , Neely Andy
Published: May 2021

Grounded theory was first introduced more than 50 years ago, but researchers are often still uncertain about how to implement it. This is not surprising, considering that even the two pioneers of this qualitative design, Glaser and Strauss, have different views about its approach, and these are just two of multiple variations found in the literature. While studies using grounded theory in management research are becoming more popular, these are often mixed with the case study approach, or they provide contradictory guidelines on how to use it. The aim of this paper is to provide a clear guide for researchers who wish to use grounded theory in exploratory studies in management research. To support this goal, the methodology’s different terms and variations, as found in the literature, are also discussed. This study can support researchers using this methodology, but it is also useful for reviewers and examiners who wish to understand more about it and the different ways in which researchers have implemented it.
The Mediating Effects of Organizational Commitment on Leadership Styles and Employee Performance in SOEs in Ghana: A Structural Equation Modeling Analysis
Authors: Donkor Francis , Dongmei Zhou , Sekyere Isaac
Published: May 2021

The primary purpose of this study is to investigate the mediating effects of organizational commitment on leadership styles (transformational, transactional and laissez-faire) and subordinate performance in state-owned enterprises in Ghana. The study adopted the partial least squares structural equation model (PLS-SEM) to test the hypotheses model. The model has been tested with 330 respondents. The data have been validated by the use of measurement modeling to determine internal consistency reliability (CR) and convergent validity (CV) with SmartPLS 3.0. The results indicate that organizational commitment mediates transformational and laissez-faire leadership. It has also been found that transformational and laissez-faire leadership have a statistically positive and significant relationship with job performance at p < .05 while transactional leadership proved insignificant. The implication is that leaders should know any action to improve subordinate commitment and job performance should take into account appropriate leadership behavior. Also, human development training should be instituted to shape the present and future leadership needs of the enterprise. In furtherance to this, the study provides discussions on the findings, limitations and went on to propose directions for future research.
‘I have more control over my life’: A qualitative exploration of challenges, opportunities, and support needs among autistic university students
Authors: Scott Matthew , Sedgewick Felicity
Published: May 2021

Background

Autistic people are known to experience more mental health issues than non-autistic people, and the same is true among university students. These difficulties can have long-term consequences, such as dropping out of university and unemployment. Understanding the challenges autistic students face can help institutions to better support this group, while allowing celebration of the opportunities higher education offers.

Methods

12 autistic university students took part in semi-structured interviews about their mental health, the impact of university on their mental health, and their experiences of support while in higher education. Interviews were subject to thematic analysis.

Results

Three key themes were identified from autistic student accounts: Relationships, Independence, and Support. While each of these encompassed positive and negative elements, Relationships were described as tying everything together – when these were supportive, things went well, but when they were characterized by stigmatizing attitudes, students experienced much greater difficulties at university.

Conclusions

Autistic students can and do thrive at university, as shown by many of our participants. However, all faced significant challenges with their mental health at times, and experienced varying levels of support. Improving autism knowledge among staff, with emphasis on enabling better relationships, would make a significant difference to the autistic student experience.
Worenine reverses the Warburg effect and inhibits colon cancer cell growth by negatively regulating HIF-1α
Authors: Ji Lijiang , Shen Weixing , Zhang Feng , Qian Jie , Jiang Jie , Weng Liping , Tan Jiani , Li Liu , Chen Yugen , Cheng Haibo , Sun Dongdong
Published: May 2021

Background

Some natural compounds inhibit cancer cell growth in various cancer cell lines with fewer side effects than traditional chemotherapy. Here, we explore the pharmacological effects and mechanisms of worenine (isolated fromCoptis chinensis) against colorectal cancer.

Methods

The effects of worenine on colorectal cancer cell proliferation, colony formation and cell cycle distribution were measured. Glycolysis was investigated by examining glucose uptake and consumption, lactate production, and the activities and expressions of glycolysis enzymes (PFK-L, HK2 and PKM2). HIF-1α was knocked down and stimulated in vitro to investigate the underlying mechanisms.

Results

Worenine somewhat altered the glucose metabolism and glycolysis (Warburg effect) of cancer cells. Its anti-cancer effects and capability to reverse the Warburg effect were similar to those of HIF-1α siRNA and weakened by deferoxamine (an HIF-1α agonist).

Conclusion

It is suggested that worenine targets HIF-1α to inhibit colorectal cancer cell growth, proliferation, cell cycle progression and the Warburg effect.
Acute appendicitis coexisting with acute pyelonephritis causing diagnostic dilemma: a case report
Authors: Ozkan Burak , Ustun Cemal , Coskuner Enis Rauf
Published: May 2021

Background

Acute appendicitis and acute pyelonephritis are the most common diseases admitted to emergency departments. Both conditions have common symptoms such as flank pain, abdominal pain, and fever. Patients’ history, physical examination, laboratory evaluation, and imaging methods are used to differentiate these two conditions. Diverticulitis, colitis, gynecological pathologies, and ureteral stones that mimic acute appendicitis should be kept in mind as differential diagnoses. Cases of pyelonephritis mimicking acute appendicitis have been reported in the literature, but there has not been a reported case in which acute appendicitis occurs during management of acute pyelonephritis. In this article, a case report which can cause such a diagnostic dilemma has been presented.

Case presentation

A 42-year-old female patient presented with clinical features suggestive of acute appendicitis that developed after a diagnosis of acute pyelonephritis. She underwent laparoscopic appendectomy on account of acute appendicitis during medical treatment for acute pyelonephritis. Physical examination showed only right costovertebral tenderness without any rebound tenderness at McBurney’s point at the first admission, but during treatment rebound tenderness at McBurney’s point was also detected. The Alvarado score of the patient was 5 at the first admission and 7 when acute appendicitis was diagnosed. The patient fully recovered and was discharged after both diseases were completely treated.

Conclusions

As seen in this case, it should be remembered that both diseases can be seen together which causes a diagnostic dilemma. If clinical or biochemical progression is detected in a patient under treatment, imaging methods should be repeated and additional ones with higher resolutions should be used.
Recent demographic histories of temperate deciduous trees inferred from microsatellite markers
Authors: Cao Yu , Zhang Da-Yong , Zeng Yan-Fei , Bai Wei-Ning
Published: May 2021

Background

Accurate inference of demographic histories for temperate tree species can aid our understanding of current climate change as a driver of evolution. Microsatellites are more suitable for inferring recent historical events due to their high mutation rates. However, most programs analyzing microsatellite data assume a strict stepwise mutation model (SMM), which could cause false detection of population shrinkage when microsatellite mutation does not follow SMM.

Results

This study aims to reconstruct the recent demographic histories of five cool-temperate tree species in Eastern Asia, Quercus mongolica, Q. liaotungensis, Juglans cathayensis, J. mandshurica and J. ailantifolia, by using 19 microsatellite markers with two methods considering generalized stepwise mutation model (GSM) (MIGRAINE and VarEff). Both programs revealed that all the five species experienced expansions after the Last Glacial Maximum (LGM). Within butternuts, J. cathayensis experienced a more serious bottleneck than the other species, and within oaks, Q. mongolica showed a moderate increase in population size and remained stable after the expansion. In addition, the point estimates of the multistep mutation proportion in the GSM model (pGSM) for all five species were between 0.50 and 0.65, indicating that when inferring population demographic history of the cool-temperate forest species using microsatellite markers, it is better to assume a GSM rather than a SMM.

Conclusions

This study provides the first direct evidence that five cool-temperate tree species in East Asia have experienced expansions after the LGM with microsatellite data. Considering the mutation model of microsatellite has a vital influence on demographic inference, combining multiple programs such as MIGRAINE and VarEff can effectively reduce errors caused by inappropriate model selection and prior setting.
A comparative genomic approach using mouse and fruit fly data to discover genes involved in testis function in hymenopterans with a focus on Nasonia vitripennis
Authors: Lécureuil Charlotte , Fouchécourt Sophie , Eliautout Rémi , Guérin Vanessa , Hidalgo Kevin , Neutre Dorian , Roux Géraldine , Monget Philippe
Published: May 2021

Background

Spermatogenesis appears to be a relatively well-conserved process even among distantly related animal taxa such as invertebrates and vertebrates. Although Hymenopterans share many characteristics with other organisms, their complex haplodiploid reproduction system is still relatively unknown. However, they serve as a complementary insect model to Drosophila for studying functional male fertility. In this study, we used a comparative method combining taxonomic, phenotypic data and gene expression to identify candidate genes that could play a significant role in spermatogenesis in hymenopterans.

Results

Of the 546 mouse genes predominantly or exclusively expressed in the mouse testes, 36% had at least one ortholog in the fruit fly. Of these genes, 68% had at least one ortholog in one of the six hymenopteran species we examined. Based on their gene expression profiles in fruit fly testes, 71 of these genes were hypothesized to play a marked role in testis function. Forty-three of these 71 genes had an ortholog in at least one of the six hymenopteran species examined, and their enriched GO terms were related to the G2/M transition or to cilium organization, assembly, or movement. Second, of the 379 genes putatively involved in male fertility in Drosophila, 224 had at least one ortholog in each of the six Hymenoptera species. Finally, we showed that 199 of these genes were expressed in early pupal testis in Nasonia vitripennis; 86 exhibited a high level of expression, and 54 displayed modulated expression during meiosis.

Conclusions

In this study combining phylogenetic and experimental approaches, we highlighted genes that may have a major role in gametogenesis in hymenopterans; an essential prerequisite for further research on functional importance of these genes.
Dexmedetomidine reduces the incidence of postoperative delirium after cardiac surgery: a meta-analysis of randomized controlled trials
Authors: Li Peng , Li Lu-xi , Zhao Zhen-zhen , Xie Jian , Zhu Cheng-long , Deng Xiao-ming , Wang Jia-feng
Published: May 2021

Background

The role of dexmedetomidine in preventing postoperative delirium (POD) after cardiac surgery remains controversial because of several recent trials with negative results. We aimed to perform an updated meta-analysis of randomized controlled trials (RCTs) to clarify this controversy.

Methods

RCTs investigating the perioperative administration of dexmedetomidine in cardiac surgery were retrieved from PubMed, Web of Science, and the Cochrane library until August,27,2020. Two researchers independently screened the literature, collected the data and evaluated the bias risk of the included studies. The meta-analysis was performed with the RevMan 5.3.

Results

A total of 15 studies including 2813 patients were included in the study. A pooled result showed that dexmedetomidine could reduce the risk of POD in adult population underwent cardiac surgery (OR 0.56, 95%CI 0.36–0.89, P = 0.0004, I2 = 64%). The subgroup analysis demonstrated that the protective effect of dexmedetomidine was only present in the patients injected with dexmedetomidine after surgery but not from the start of surgery, in the adult patients without specific age limitation but not in the elderly, and in the studies in comparison with other sedatives but not with placebo. There were no statistical differences when analyzing the secondary outcomes including hypotension (OR 1.13; 95% CI 0.54–2.37, P < 0.00001, I2 = 85%), bradycardia (OR 1.72; 95% CI 0.84–3.53, P = 0.04, I2 = 58%) and atrial fibrillation (OR 0.87; 95% CI 0.70–1.08, P = 0.43, I2 = 0).

Conclusions

Dexmedetomidine can reduce the incidence of POD compared to other sedatives and opioids after cardiac surgery in adult patients. The proper population and timing for perioperative use of dexmedetomidine after cardiac surgery remain to be further investigated.
Species diversity and spatial distribution of CL/VL vectors: assessing bioclimatic effect on expression plasticity of genes possessing vaccine properties isolated from wild-collected sand flies in endemic areas of Iran
Authors: Bordbar Ali , Parvizi Parviz
Published: May 2021

Background

Leishmaniasis is one of the ten most important neglected tropical diseases worldwide. Understanding the distribution of vectors of visceral and cutaneous leishmaniasis (VL/CL) is one of the significant strategic frameworks to control leishmaniasis. In this study, the extent of the bioclimatic variability was investigated to recognize a rigorous cartographic of the spatial distribution of VL/CL vectors as risk-maps using ArcGIS modeling system. Moreover, the effect of bioclimatic diversity on the fold change expression of genes possessing vaccine traits (SP15 and LeIF) was evaluated in each bioclimatic region using real-time PCR analysis.

Methods

The Inverse Distance Weighting interpolation method was used to obtain accurate geography map in closely-related distances. Bioclimatic indices were computed and vectors spatial distribution was analyzed in ArcGIS10.3.1 system. Species biodiversity was calculated based on Shannon diversity index using Rv.3.5.3. Expression fold change of SP15 and LeIF genes was evaluated using cDNA synthesis and RT-qPCR analysis.

Results

Frequency ofPhlebotomus papatasiwas predominant in plains areas of Mountainous bioclimate covering the CL hot spots. Mediterranean region was recognized as an important bioclimate harboring prevalent patterns of VL vectors. Semi-arid bioclimate was identified as a major contributing factor to up-regulate salivary-SP15 gene expression (P = 0.0050,P < 0.05). Also, Mediterranean bioclimate had considerable effect on up-regulation ofLeishmania-LeIF gene in gravid and semi-gravidP. papatasipopulation (P = 0.0109,P < 0.05).

Conclusions

The diversity and spatial distribution of CL/VL vectors associated with bioclimatic regionalization obtained in our research provide epidemiological risk maps and establish more effectively control measures against leishmaniasis. Oscillations in gene expression indicate that each gene has its own features, which are profoundly affected by bioclimatic characteristics and physiological status of sand flies. Given the efficacy of species-specific antigens for vaccine production, it is essential to consider bioclimatic factors that have a fundamental role in affecting the regulatory regions of environmentally responsive loci for genes used in vaccine design.
Fibroblast growth factor 21 (FGF21) is a sensitive marker of osteoporosis in haemodialysis patients: a cross-sectional observational study
Authors: Zhu Lili , Li Min , Zha Qianqian , Yang Min , Yu Jirong , Pan Mingming , Yin Qing , Jiang Liqiong , Xia Meixia , Liu Bi-Cheng , Wang Bin
Published: May 2021

Introduction

Osteoporosis is one of the important bone abnormalities in chronic kidney disease-mineral and bone disorder (CKD-MBD) and still lacks a sensitive biomarker to diagnose. Fibroblast growth factor 21 (FGF21) can stimulate bone loss in patients with diabetes and increase in CKD patients. In this study, we investigated whether FGF21 could serve as a biomarker to predict osteoporosis in a haemodialysis cohort.

Methods

We recorded demographic information, biochemical data, and serum FGF21 and FGF23 levels and measured the CT attenuation values of 339 haemodialysis patients from two large medical centres. We assessed the correlation of CT attenuation values with serum FGF21 and FGF23 levels and tested whether they were independent factors for osteoporosis. ROC curves were constructed to compare the prognostic value of FGF21 and FGF23 for osteoporosis.

Results

Based on the CT attenuation value, serum FGF21 levels were higher in our osteoporosis group (median 640.86 pg/ml vs. 245.46 pg/ml, P ˂ 0.01). Meanwhile, FGF21 (r = -0.136, P < 0.05) and FGF23 (r = -0.151, P < 0.05) were both negatively associated with osteoporosis. Moreover, FGF21 (β = -0.067, P < 0.05) was an independent factor for osteoporosis. Furthermore, FGF21 combined with age yielded a marked specificity (90.5 %) and sensitivity (61.8 %) in predicting osteoporosis of haemodialysis patients with less residual renal function.

Conclusions

FGF21 has a positive relationship with the incidence of osteoporosis in patients on haemodialysis. FGF21 combined with age is a good predictive biomarker for osteoporosis in patients on haemodialysis, especially those with less residual renal function.
Effectiveness and cost effectiveness of interpersonal community psychiatric treatment (ICPT) for people with long-term severe non-psychotic mental disorders: a multi-Centre randomized controlled trial
Authors: van Veen Mark , Koekkoek Bauke , Teerenstra Steven , Adang Eddy , Mulder Cornelis L.
Published: May 2021

Background

Long-term community mental health treatment for non-psychotic disorder patients with severe mental illness (SMI) who are perceived as difficult by clinicians, is poorly developed and lacks a structured, goal-centred approach. This study compares (cost-)effectiveness of Interpersonal Community Psychiatric Treatment (ICPT) with Care As Usual (CAU) on quality of life and clinician perceived difficulty in the care for non-psychotic disorder SMI-patients. A multi-centre cluster-randomized clinical tria was conducted in which Community Mental Health Nurses (Clinicians) in three large community mental health services in the Netherlands were randomly allocated to providing either ICPT or CAU to included patients. A total of 56 clinicians were randomized, who treated a total of 93 patients (59 in ICPT-group and 34 in CAU-group).

Methods

Primary outcome measure is patient-perceived quality of life as measured by the Manchester Short Assessment of Quality of Life (MANSA). Secondary outcome measures include clinician-perceived difficulty, general mental health, treatment outcomes, illness management and recovery, therapeutic relationship, care needs and social network. Patients were assessed at baseline, during treatment (6 months), after treatment (12 months) and at 6 months follow-up (18 months). Linear mixed-effects models for repeated measurements were used to compare mean changes in primary and secondary outcomes between intervention and control group of patients over time on an intention to treat basis. Potential efficiency was investigated from a societal perspective. Economic evaluation was based on general principles of a cost-effectiveness analysis. Outcome measures for health economic evaluation, were costs, and Quality Adjusted Life Years (QALYs).

Results

Half of the intended number of patients were recruited. There was no statistically significant treatment effect found in the MANSA (0.17, 95%-CI [− 0.058,0.431], p = 0.191). Treatment effects showed significant improvement in the Different Doctor-Patient Relationship Questionnaire-scores and a significant increase in the Illness Management and Recovery–scale Client-version scores). No effects of ICPT on societal and medical costs nor QALYs were found.

Conclusions

This is the first RCT to investigate the (cost)-effectiveness of ICPT. Compared with CAU, ICPT did not improve quality of life, but significantly reduced clinician-perceived difficulty, and increased subjective illness management and recovery. No effects on costs or QALY’s were found.

Trial registration

NTR 3988, registered 13 May 2013.
Sex differences in health status, healthcare utilization, and costs among individuals with elevated blood pressure: the LARK study from Western Kenya
Authors: Sikka Neha , DeLong Allison , Kamano Jemima , Kimaiyo Sylvester , Orango Vitalis , Andesia Josephine , Fuster Valentin , Hogan Joseph , Vedanthan Rajesh
Published: May 2021

Background

Elevated blood pressure is the leading risk factor for global mortality. While it is known that there exist differences between men and women with respect to socioeconomic status, self-reported health, and healthcare utilization, there are few published studies from Africa. This study therefore aims to characterize differences in self-reported health status, healthcare utilization, and costs between men and women with elevated blood pressure in Kenya.

Methods

Data from 1447 participants enrolled in the LARK Hypertension study in western Kenya were analyzed. Latent class analysis based on five dependent variables was performed to describe patterns of healthcare utilization and costs in the study population. Regression analysis was then performed to describe the relationship between different demographics and each outcome.

Results

Women in our study had higher rates of unemployment (28% vs 12%), were more likely to report lower monthly earnings (72% vs 51%), and had more outpatient visits (39% vs 28%) and pharmacy prescriptions (42% vs 30%). Women were also more likely to report lower quality-of-life and functional health status, including pain, mobility, self-care, and ability to perform usual activities. Three patterns of healthcare utilization were described: (1) individuals with low healthcare utilization, (2) individuals who utilized care and paid high out-of-pocket costs, and (3) individuals who utilized care but had lower out-of-pocket costs. Women and those with health insurance were more likely to be in the high-cost utilizer group.

Conclusions

Men and women with elevated blood pressure in Kenya have different health care utilization behaviors, cost and economic burdens, and self-perceived health status. Awareness of these sex differences can help inform targeted interventions in these populations.
Osimertinib versus afatinib in patients with T790M-positive, non-small-cell lung cancer and multiple central nervous system metastases after failure of initial EGFR-TKI treatment
Authors: Yang Yang , Liu Qilong , Cao Lei , Sun Wei , Gu Xiaowei , Liu Bin , Xiao Na , Teng Fei , Li Xiaoli , Chen Meiji , Yu Weiguang , Lin Huanyi , Xu Guixing
Published: May 2021

Background

The purpose of this study was to compare the efficacy of osimertinib (OSI) versus afatinib (AFA) in patients with T790M-positive, non-small-cell lung cancer (NSCLC) and multiple central nervous system (CNS) metastases after failure of initial epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment.

Methods

Consecutive patients with T790M-positive NSCLC and multiple CNS metastases after failure of initial EGFR-TKI treatment were retrospectively identified from our medical institution during 2016–2018 and underwent either oral 80 daily OSI or oral 40 daily AFA every 3 weeks for up to 6 cycles, until disease progression, intolerable adverse events (AEs), or death. The co-primary endpoints were overall survival (OS) and progression-free survival (PFS).

Results

The cohort consisted of 124 patients (OSI: n = 60, mean age = 64.24 years [SD: 12.33]; AFA: n = 64, mean age = 64.13 years [SD: 13.72]). After a median follow-up of 24 months (range, 3 to 28), a significant improvement in OS was detected (hazard ratio [HR] 0.59, 95% confidence interval [CI], 0.39–0.91; p = 0.0160; median, 13.7 months [95% CI, 11.1–14.8] for OSI vs 9.6 months [95% CI, 8.4–10.2] for AFA). The median duration of PFS was significantly longer with OSI than with AFA (HR 0.62; 95% CI, 0.41–0.91; p = 0.014; median, 4.5 months [95% CI, 3.5–5.7] vs 3.9 months [95% CI, 3.1–4.8]). The proportion of grade 3 or higher adverse events (AEs) was lower with OSI (22.4%) than with AFA (39.4%).

Conclusions

In patients with T790M-positive NSCLC and multiple CNS metastases after failure of initial EGFR-TKI treatment, OSI may be associated with significantly improved survival benefit compared with AFA, with a controllable tolerability profile.
Cryoneurolysis’ outcome on pain experience (COPE) in patients with low-back pain: study protocol for a single-blinded randomized controlled trial
Authors: Truong K. , Meier K. , Nikolajsen L. , van Tulder M. W. , Sørensen J. C.H , Rasmussen M. M
Published: May 2021

Background

Low-back pain, including facet joint pain, accounts for up to 20 % of all sick leaves in DenmarkA proposed treatment option is cryoneurolysis. This study aims to investigate the effect of cryoneurolysis in lumbar facet joint pain syndrome.

Methods

A single-center randomized controlled trial (RCT) is performed including 120 participants with chronic facet joint pain syndrome, referred to the Department of Neurosurgery, Aarhus University Hospital. Eligible patients receive a diagnostic anesthetic block, where a reduction of pain intensity ≥ 50 % on a numerical rating scale (NRS) is required to be enrolled. Participants are randomized into three groups to undergo either one treatment of cryoneurolysis, radiofrequency ablation or placebo. Fluoroscopy and sensory stimulation is used to identify the intended target nerve prior to administrating the above-mentioned treatments. All groups receive physiotherapy for 6 weeks, starting 4 weeks after treatment. The primary outcome is the patients’ impression of change in pain after intervention (Patient Global Impression of Change (PGIC)) at 4 weeks follow-up, prior to physiotherapy. Secondary outcomes are a reduction in low-back pain intensity (numeric rating scale) and quality of life (EQ-5D, SF-36) and level of function (Oswestry Disability Index), psychological perception of pain (Pain Catastrophizing Scale) and depression status (Major Depression Inventory).

Data will be assessed at baseline (T0), randomization (T1), day one (T2), 4 weeks (T3), 3 (T4), 6 (T5) and 12 months (T6).

Discussion

This study will provide information on the effectiveness of cryoneurolysis vs. the effectiveness of radiofrequency ablation or placebo for patients with facet joint pain, and help to establish whether cryoneurolysis should be implemented in clinical practice for this patient population.

Trial registration

The trial is approved by the ethical committee of Central Jutland Denmark with registration number 1-10-72-27-19 and the Danish Data Protection Agency with registration number 666,852. The study is registered at Clinicaltrial.gov with the ID number NCT04786145.
Strategies for managing the destruction of calcar femorale
Authors: Mei Jin , Pang Lili , Jiang Zhongchao
Published: May 2021

Background

The calcar femorale was identified long ago. However, our current understanding of the calcar is insufficient, and its related concepts are sometimes confused. The calcar femoral is an important anatomical structure of the proximal femur, and its function can be overlooked. In trauma, tumors, or other diseases, the calcar femorale can be destroyed or changed pathologically. As a result, the mechanical structure of the proximal femur becomes destroyed, causing pathological fractures. How to address the destruction of the calcar femorale or the damage to the calcar femorale is discussed in this article.

Main text

Destruction of the calcar femorale is accompanied by many conditions, including trauma, tumors, and other diseases. The types of hip fractures caused by trauma include femoral neck fractures and intertrochanteric fractures. Dynamic hip screws, proximal femoral nail anti-rotation, and multiple parallel cannulate pins can be used in different conditions. When metastatic and primary bone tumors involve the calcar femorale, endoprostheses are widely used. Other diseases, such as fibrous dysplasia and aneurysmal bone cyst are treated differently.

Conclusions

The calcar femorale can redistribute stresses and the destruction of the calcar femorale can lead to an increase in posterior medial stress. Many factors need to be considered when deciding whether to reconstruct the calcar femorale. Effective treatment strategies for managing the destruction of calcar femorale will need first establishing the precise mechanism of the destruction of the calcar and then designing therapies towards these mechanisms. Further investigation to the calcar needs to be carried out.