bluuebunny/crossref_metadata_2025 huggingface dataset:
Extended Injection Intervals of Gonadotropins With Superficial Skin Administration In Ivf Treatment Is both Cost-Effective and Patient-Friendly
Authors: Hsu Isabel , Hsu Leonard , Hsu Chao Chin
Published: December 2020

BackgroundWomen undergoing IVF treatments have to receive daily injections of rFSH for multiple follicles growth based on the short half-life of rFSH administered subcutaneously. This study was designed to assess if longer intervals of injection, based on rFSH half-life of 102 hours under superficial subcutaneous administration, effective for women receiving IVF.MethodsOne hundred women, aged 25–45, requesting IVF treatments from January to December 2018 were recruited in this observatory study. All women received long protocol employing GnRH-agonist since day 18 of the previous cycle. An initial bolus of 900 IU rFSH was injected into superficial subcutaneous skin at day 2 of the treatment cycle followed by longer intervals with added doses at day 7 and/or day 10. The main outcomes included the dose of gonadotropin and numbers of injection, serum FSH level, and mature oocytes retrieved.ResultsA total of 70 women completed the treatments, in which 10, 30, and 30 women received one, two and three injections of rFSH, respectively. On average, 2.31 ± 0.73 numbers of Gn injection and 1662 ± 397 IU of rFSH were administered. In comparison with baseline FSH level of 5.6 ± 2.2 IU/L, the serum concentrations of FSH were 35.3 ± 7.0 to 10.7 ± 3.7 IU/L at 1 to 5 days after an initial 900 IU rFSH administration. There were 10.5 ± 6.6 mature oocytes retrieved which resulted in 7.3 ± 5.1 two pronuclei embryos, and 1.8 ± 0.6 embryos were transferred back to the uterus and the remaining embryos were cryopreserved. In total, 72%, 91%, and 31% were noted for fertilization, cleavage, and implantation rates, respectively. The cumulative live birth rate was 36%.ConclusionsBased on the serum FSH levels detected, rFSH only needs to be administered every five days instead of daily injection. This administration mode with less injections and much less expenses for gonadotropin might reach the goal of a more patient-friendly and cost-effective treatment for IVF. Regarding higher response and efficacy of the present study, this administration mode could be employed in women with poor ovarian reserve and in women of poor or suboptimal ovarian response.Trial registration: None
Galectin-9 regulates serum amyloid A-induced inflammasome activation in human neutrophils
Authors: Temmoku Jumpei , Fujita Yuya , Matsumoto Haruki , Matsuoka Naoki , Asano Tomoyuki i , Sato Shuzo , Furuya Makiko , Suzuki Eiji , Watanabe Hiroshi , Migita Kiyoshi
Published: December 2020

Objective

The Nod-like receptor (NLR) Family Pyrin Domain Containing 3 (NLRP3) inflammasome plays roles in host defense and the development of autoinflammation. Galection-9 (Gal-9), one of the β-galactoside binding lectins, plays important regulatory roles in autoimmune diseases. T cell immunoglobulin and mucin-domain containing molecule 3 (TIM-3)/Gal-9 inhibitory interaction has been proposed in innate immune system. We investigate the role of Galectin-9 (Gal-9) on serum amyloid A (SAA)-induced inflammasome activation and IL-1β processing by human neutrophils.
Results

SAA stimulation induced the release of cleavage of IL-1β (p17) from neutrophils suggesting that SAA induces the inflammasome activation and subsequent processing of pro-IL-1β. ELISA data demonstrated that SAA stimulation also induced cleaved caspase-1 (p20) secretion from human neutrophils, and this release was suppressed by Gal-9 pretreatment. Gal-9 pretreatment diminished the SAA-induced cleaved IL-1β secretion, however, did not affect SAA-induced pro-IL-1β secretion from neutrophils. Furthermore, Gal-9 pretreatment suppressed SAA-induced intracellular accumulation of cleaved IL-1β, suggesting that Gal-9 functions as a negative regulator of SAA-induced inflammasome activation and may be a potential therapeutic target for the treatment of autoinflammatory disorders.
Path analysis reveals the direct effect of PCB28 on cognitive dysfunction in older Chinese females
Authors: Pan Chen-Wei , Zhao Hui-Juan , Xu Yong , Tian Dajun , Xiao Shuo , Wang Haiyin , Wei Xiao , Ruan Yuanyuan , Tao Gonghua , Zheng Weiwei
Published: December 2020

Background

Current findings support the hypothesis that the exposure of dioxin-like polychlorinated biphenyls (dl-PCBs) has adverse cognitive effects even at levels that are generally considered to pose low or no risk. However, the effect of non-dioxin-like PCBs (ndl-PCBs) on neurobehavior of aging people is largely unknown. Therefore, this study aimed toinvestigate the association of ndl-PCBs burden with the cognition functions among elderly adults.
Methods

Using samples and data from Weitang Geriatric Diseases study (2014–2015), 6 indicator-PCBs were detected in plasma by GC-MS and cognitive dysfunction (CoD) were measured by the Abbreviated Mental Test in 266 participants (age: 61–90). Sequential logistic regression was used to analyze the effects of PCBs on cognition functions. Then the female aged less than and equal to 80 years was selected, and path analysis was used to determine the direct or indirect impacts of co-exposure PCBs on COD by Structural Equation Modeling.
Results

After sequential adjusting for potential confounder, no association of PCBs 52, 101, 138, 153, 180, LPCBs, HPCBs, and ∑PCBs with the risk of COD was observed; however, the exposure of PCB28 was significantly associated with COD ((Model 3: OR = 3.12, 95% CI = 1.19–8.11, p = 0.020). The final path model also fits that only exposure to PCB28 had a direct effect on COD (β = 0.696, SE = 1.14; p = 0.036).
Conclusions

After controlling the co-exposures and confounders, the exposure to PCB28 can directly increase the risk of cognitive impairment in older Chinese females.
Obesity Measures, Metabolic Health and Their Association with 15-Year All-Cause and Cardiovascular Mortality in the SAMINOR 1 Survey: A Population-Based Cohort Study
Authors: Michalsen Vilde Lehne , Wild Sarah H. , Kvaløy Kirsti , Svartberg Johan , Melhus Marita , Broderstad Ann Ragnhild
Published: December 2020

Background: The mortality of metabolic―obesity phenotypes has been thoroughly studied, but it is not known how the association between continuous measures of body mass index (BMI) or waist circumference differ in strata of cardiometabolic health status. Methods: We linked data on 12,815 men and women aged 36―79 years from the SAMINOR 1 Survey with mortality data from the Norwegian Cause of Death Registry. We defined metabolically healthy and unhealthy as having zero and ≥1, respectively, of the following: MetS, pre-existing diabetes or cardiovascular disease (CVD), or prescribed drugs for high blood pressure, hyperglycaemia or dyslipidaemia. We defined general and abdominal obesity as BMI ≥30 kg/m2 and waist circumference ≥88 cm (women) or 102 cm (men), respectively, and cross-classified these categories with metabolic status to create metabolically healthy non-obese and obese (MHNO and MHO) and metabolically unhealthy non-obese and obese (MUNO and MUO) phenotypes. We used Cox regression to estimate the hazard ratio (HR) for all-cause and CVD mortality for 1) the four phenotypes and 2) continuous measures of BMI and waist circumference fitted with restricted cubic splines. We adjusted for age, leisure-time physical activity, education, smoking and alcohol consumption, and tested for interactions with sex and metabolic status (only continuous measures). Results: The MHO phenotype was present in 7.8% of women and 5.8% of men. During a median follow-up of 15.3/15.2 years, 596/938 women/men had died, respectively. The MUNO and MUO group had higher mortality than the MHNO group. Sex and phenotypes interacted with respect to CVD mortality (p=0.05 for general and p=0.02 for abdominal obesity): relative to the MHNO group, the MHO group had an adjusted HR (95% confidence interval) for CVD mortality of 1.05 (0.38–2.88) in women and 2.92 (1.71–5.01) in men. We found curvilinear associations between BMI/waist circumference and all-cause mortality irrespective of metabolic status. Corresponding relationships with CVD mortality were linear and the slope differed by sex and metabolic status.Conclusion: The relationships between continuous measures of BMI/waist circumference and mortality differed by sex, metabolic status and cause of death. Poor metabolic health substantially increases mortality regardless of obesity status.
Leptin Levels in Lymph Node Aspiration Biopsy is a Predictor of Smoking Tendencies: A Pilot Study
Authors: Qeadan Fares , Ahmadian Rosstin , Alden Emily , Pascetti Erica , Gu Lily Y. , Saeed Ali I.
Published: December 2020

Background: Cytokine profiles have traditionally been explored in serum due to its ease of accessibility and the diagnostic and assessment capabilities in a clinic setting. Utilization of additional cytokine depots, such as hilar lymph nodes, has not thoroughly been explored. In this study, we examined the cytokine profile of mediastinal and hilar lymph node fine needle aspirates to identify markers capable of differentiating high-risk smokers (>30 pack-years) from low-risk smokers (<30 pack-years), independent of current cancer diagnosis. Methods: We used the cytokine profiles of 27 patients from a pro-spective convenience pilot study conducted at the University of New Mexico. Logistic regression analysis was employed.Results: A significant difference in mean cytokine values for Leptin was discovered between patients categorized as low-risk and high-risk pack year smokers (p=0.034). Additionally, mean cytokine values of Leptin did not differ between patients by cancer diagnosis (malignant vs. benign). Our analysis demonstrated Leptin as a fair marker for discriminating between high-risk smokers and low-risk smokers (AUC 0.73). Conclusions: We conclude Leptin is an optimal cytokine to discriminate between high-risk and low-risk smokers. To our knowledge, this is the first study to assess the ability of Leptin to serve as such an indicator via hilar lymph nodes.
Comparison of Cost Effectiveness between Video-Assisted Thoracoscopic Surgery (VATS) and Open Lobectomy: A Retrospective Study
Authors: Chen Wei , Yu Zhanwu , Zhang Yichen , Liu Hongxu
Published: December 2020

Background Lung cancer is highly prevalent in Chinese population. The association of operative approach with economic burden in these patients remains unknown. ObjectivesThis institution-level cohort study aimed to compare the cost-related clinical outcomes and health care costs among patients undergoing video-assisted thoracoscopic surgery (VATS) and open lobectomy, and to investigate the factors associated with the costs. MethodsThis retrospective cohort study included patients who underwent VATS or open lobectomy in a provincial referral cancer center in China in 2018. Clinical effectiveness measures included post-operative blood transfusion, lung infection, and length of stay (LOS). Hospitalization costs were extracted from hospital information system to assess economic burden. ResultsCompared to open lobectomy group, the VATS lobectomy group had a lower blood transfusion rate (1.70% vs. 4.33%, P=0.033), lower lung infection rate (23.77% vs. 40.87%, P<0.001) and shorter post-operative LOS (9.42 ± 3.72 days vs. 10.97 ± 5.81 days, P<0.001). Total hospitalization costs of VATS lobectomy group and open lobectomy were similar: RMB 84,908.72±18,914.87, RMB 81,944.70 ±16,625.20, respectively. VATS approach, lung infection, longer post-operative length of stay, male sex, lung cancer diagnosis, and heart disease were associated with higher total hospitalization costs (P<0.05). ConclusionsVATS lobectomy has a lower post-operative blood transfusion rate, lower lung infection rate, and shorter post-operative LOS than open lobectomy. Future studies are needed to investigate other aspects of clinical effectiveness and the economic burden from a societal perspective.
Lesion Segmentation in Breast Ultrasound Images using Optimized Marked Watershed Method
Authors: Shen Xiaoyan , Ma He , Liu Ruibo , Li Hong , He Jiachuan , Wu Xinran
Published: December 2020

Background: Ultrasound is the most popular tool for early detection of breast cancer because of its non radiation and low cost. However, breast ultrasound(BUS) images have low resolution and speckle noise, which make lesion segmentation become a challenge. Most of deep learning(DL) models applied on images segmentation don't have good generalization ability for BUS images. Therefore, it is time to go back to the classical method and consider combining it with DL to achieve more accurate and efficient effect in a semi-automatic way.Methods: This paper mainly proposed an effective and efficient semi-automatic BUS images segmentation method, Adaptive morphological snake and marked watershed( AMSMW). It includes two parts: preprocessing and segmentation. In the first part, we combine contrast limited adaptive histogram equalization(CLAHE) and side window filtering(SWF) methods for the first time. In the second part, We use the proposed adaptive morphological snake algorithm (AMS) to provide a mark for marked watershed(MW) method. Results: we tested on 500 BUS images, whose ratio of benign and malignant is 1:1. After quantitative and qualitative analysis, AMSMW is proven to outperform existing classical methods on the effectiveness and efficiency. Furthermore, we compared with Zhuang’s RDAU-NET on both our dataset and theirs. Experimental result showes AMSMW achieved better performance on most of indicators, including loss, accuracy, sensitivity, dice and F1-score. Conlusions: The new image preprocessing method proposed by us has obvious effect on segmentation of breast ultrasound image. In addition, the proposed adaptive morphology snake method and optimized marked watershed turn out to be more efficient and effective than some relative classical method and the advanced DL method at present. Moreover, by studying on the algorithm’s sensitivity in segmenting benign and malignant tumors, we found that AMSMW is more sensitivity to malignant tumors, and more stable to benign tumors, which is significant for further research of precision medicine.
Trends and determinants of HIV transmission among men who inject drugs in the Pokhara Valley, Nepal: Analysis of cross-sectional studies
Authors: Hogan Sam , Page Andrew , Ogbo Felix , Dixit Sameer , Rajbhandari Rajesh Man , Rawal Bir , Deuba Keshab
Published: December 2020

Background HIV is a major public health issue around the world, especially in developing countries. Although the overall prevalence of HIV in Nepal is relatively low, there are specific sub-populations where the prevalence is far higher than the national average. One of these sub-groups is male people who inject drugs (male PWIDs). In order to understand the reasons for the differences in prevalence, a series of socio-demographic, behavioural and knowledge-based risk factors were assessed. Methods The study used a series of 7 cross-sectional survey datasets from Pokhara (Nepal), collected between 2003 and 2017 (N=2,235) to investigate trends in HIV prevalence among male PWIDs by socio-demographic, behavioural, and knowledge-based risk factors. A series of logistic regression models were conducted to investigate the association between study factors and HIV. Results HIV prevalence decreased from the levels seen in 2003 (22.0%) and 2005 (21.7%), with the lowest prevalence recorded in 2015 (2.6%), however prevalence increased in the most recent period (4.9%). A lower risk of HIV was associated with younger age (<=24 years compared to >24 years, OR = 0.17, 95% CI = 0.10-0.31), being married (OR = 1.91, 95% CI = 1.25-3.02) and shorter duration of drug use (<=4 years compared to >4 years, OR = 0.16, 95% CI = 0.09-0.29). A higher risk of HIV was associated with low (compared to secondary or higher) education level (OR = 2.76, 95% CI = 1.75-4.36), a lack of addiction treatment (OR = 2.59, 95% CI = 1.64-4.08), and recent use of unsterilized injection equipment (OR = 2.22, 95% CI = 1.20-4.11). Conclusion The prevalence of HIV in male PWIDs in Pokhara has been variable, but overall has reduced in recent years to 2.6% before increasing in 2017 to 4.9%. The main determinants which increase the risk of HIV among male PWIDs in Pokhara are low education level, a lack of treatment for drug addiction and the recent use of unsterilised equipment. Each of these indicate the need to improve addiction treatment and education programs for intra-venous drug use to aid this key population in avoiding risk-taking behaviours.
Knowledge, attitude and self-efficacy program intended to improve public health professionals’ ability to identify and manage perinatal depressive symptoms: A quasi-experimental study
Authors: Phoosuwan Nitikorn , Lundberg Pranee C.
Published: December 2020

Background: During the perinatal period women lack screening and treatments for perinatal depressive symptoms, while public health professionals (PHPs) in primary care centres (PCCs) need training for identification and management of such symptoms. This quasi-experimental study was aimed at evaluating knowledge, attitudes and self-efficacy among PHPs after participating in a Knowledge, Attitude, and Self-efficacy (KAS) program for identification and management of perinatal depressive symptoms.Method: The KAS-program, carried through in Sakonnakhon in north-eastern Thailand, comprised one day of theory and a four-week period of field practice. Thirty-three PHPs from PCCs participated in the program. Twenty-three of them participated in focus group discussions (FGDs). Chi-square for trend, paired-sample T-tests and content analysis were used. Results: Knowledge, attitude and self-efficacy scores increased after the PHPs had fully participated in the KAS-program. Four categories emerged from the FGDs: increased understanding and knowledge, being aware and having a positive attitude, having confidence and ability to work, and need of regular training and feedback.Conclusion: The KAS-program may contribute to giving PHPs in PCCs the knowledge, positive attitude and self-efficacy they need to identify and manage perinatal depressive symptoms. Implementation of the KAS-program to other healthcare professionals such as nurses/midwives is great of interest.
ECG-based Characteristics of Death or Re-infarction on the 12-Lead or 15-Lead ECG among UA/NSTEMI Patients: A Protocol for a Systematic Review and Meta-Analysis
Authors: Dzikowicz Dillon J , Mulligan Darcey H. , Carey Mary G.
Published: December 2020

BackgroundThe incidence of unstable angina/ non-ST elevation MI (UA/NSTEMI) continues to rise, and despite treatment advancements the risks of death and re-infarction persist. The electrocardiogram (ECG) remains the first assessment of myocardial ischemia caused by UA/NSTEMI, and is performed within the first 10-minutes of emergency presentation. Once ischemia is identified on the ECG, interventions are delivered timely to decrease the risk of death and re-infarction. Since the ECG informs intervention decisions, it is crucial providers understand the prognostic value of individual characteristics on the ECG. However, characteristics on ECG are limited due to low sensitivity though newer research has aimed to overcome these limitations. This is the protocol for a systematic review and meta-analysis that will assess the significance of individual characteristics on the ECG for predicting death and re-infarction among UA/NSTEMI patients, and identify remaining gaps in clinical understanding of ECG.MethodsThis is the protocol for a systematic review and meta-analysis that will be conducted to assess the prognostic value of specific characteristics on the ECG in the emergency department for predicting re-infarction and death. Electronic databases and specific journals will be searched using predefined search terms to identify relevant studies. Eligible studies will include peer-reviewed research articles with empirical findings on the risk of re-infarction and death based on individual characteristics on the ECG. To be inclusive, we will assess characteristics on both the 12-lead and 15-lead ECG. Methodological quality of will be assessed with the Newcastle-Ottawa Quality Assessment Scale and GRADE criteria. A random effects meta-analysis and exploratory meta-regression will be conducted. Citations will be managed using EndNote X9. Meta-Essentials package for Microsoft Excel and STATA will be used to compute statistics.Discussion This study will systematically evaluate and quantitatively assess the evidence available on the prognostic value of individual characteristics on the ECG for the risk of death and re-infarction among UA/NSTEMI patients. By conducting this study, we will inform clinicians about the significance of characteristics on the ECG to better inform treatment decisions for UA/NSTEMI patients. Registration This systematic review and meta-analysis is registered with the International Prospective Register of Systematic Reviews (PROSPERO; ID CRD42020158491).
Prevalence And Predictors Of Diabetes Mellitus Among Persons Living With HIV: A Retrospective Cohort Study Conducted In 4 Public Healthcare Facilities In Kwazulu-Natal
Authors: Umar David Mohammed , Naidoo Panjasaram
Published: December 2020

Background: Diabetes mellitus is a chronic non-infectious medical condition which is evident by raised levels of glucose in the blood, because the body cannot produce any or enough of the hormone insulin or use insulin effectively. Diabetes, if not well managed leads to complications such as neuropathy, retinopathy, nephropathy which can be fatal. Some of the factors that predisposes to diabetes include older age, higher body mass index, heredity and hypertension. With the availability of HAART for managing HIV/AIDS infection, life span of persons living with HIV (PLWHIV) has increased significantly. With increased longevity, the aging population of PLWHIV also face chronic diseases such as diabetes in addition to HIV. The burden of both HIV and diabetes is high in South Africa, particularly in KwaZulu-Natal. Nevertheless, the prevalence of diabetes among PLWHIV in KwaZulu-Natal and its predictors is not well understood. Therefore, this study was conducted to determine the prevalence, predictors of diabetes and the outcome of managing diabetes among PLWHIV.Methods: This retrospective cohort study was conducted in four public health care facilities in KwaZulu-Natal with a total sample size of 1203 after ethical approval and informed consent were obtained. A pretested questionnaire and hospital patient charts were used to collect data. SPSS version 26 was used to analyze the data using descriptive statistics and logistic regression. Results: The prevalence of diabetes among PLWHIV was 9%. Just over 47% of those who had diabetes, had uncontrolled blood sugar, with a mean fasting blood sugar (FBS) of 11.7 mmol/L. The predictors of diabetes among PLWHIV were, male gender and older age. Male PLWHIV had 65% less chances of having diabetes and those who were between the ages of 18 and 48 years were 88% less probable to have diabetes compared to those who were older than 48 years. Conclusion: Public sector health care facilities in KwaZulu-Natal need to do much more to manage diabetes in PLWHIV in order to prevent diabetic complications and possible negative impact on the outcome of HIV management.
Interaction study of Pasteurella multocida with culturable aerobic bacteria isolated from porcine respiratory tracts using coculture in conditioned media
Authors: Hanchanachai Nonzee , Chumnanpuen Pramote , E-KOBON Teerasak
Published: December 2020

Background: The porcine respiratory tract harbours multiple microorganisms, and the interactions between these organisms could be associated with animal health status. Pasteurella multocida is a culturable facultative anaerobic bacterium isolated from healthy and diseased porcine respiratory tracts. The interaction between P. multocida and other aerobic commensal bacteria in the porcine respiratory tract is not well understood. This study aimed to determine the interactions between porcine P. multocida capsular serotype A and D strains and other culturable aerobic bacteria isolated from porcine respiratory tracts using a coculture assay in conditioned media followed by calculation of the growth rates and interaction parameters.Results: One hundred and sixteen bacterial samples were isolated from five porcine respiratory tracts, and 93 isolates were identified and phylogenetically classified into fourteen genera based on 16S rRNA sequences. Thirteen isolates from Gram-negative bacterial genera and two isolates from the Gram-positive bacterial genus were selected for coculture with P. multocida. From 17x17 (289) interaction pairs, the majority of 220 pairs had negative interactions indicating competition for nutrients and space, while 17 pairs were identified as mild cooperative or positive interactions indicating their coexistence. All conditioned media, except those of Acinetobacter, could inhibit P. multocida growth. Conversely, the conditioned media of P. multocida also inhibited the growth of nine isolates plus themselves.Conclusion: Negative interaction was the major interactions among the coculture of these 15 representative isolates and the coculture with P. multocida. The conditioned media in this study might be further analysed to identify critical molecules and examined by the in vivo experiments. The study proposed the possibility of using these molecules in conditioned media to control P. multocida growth.
Effect of real-time ultrasound imaging for biofeedback on trunk muscle contraction in healthy subjects: a preliminary study
Authors: Lin Shanshan , Zhu Bo , Zheng Yiyi , Huang Guozhi , Zeng Qing , Wang Chuhuai
Published: December 2020

Background: Real-time ultrasound imaging (RUSI) has been increasingly used as a form of biofeedback when instructing and re-training muscle contraction. However, the effectiveness of the RUSI on a single sustained contraction of the lumbar multifidus (LM) and transversus abdominis (TrA) has rarely been reported. This preliminary study aimed to determine if the use of RUSI, as visual biofeedback, could enhance the ability of activation and continuous contraction of the trunk muscles including LM and TrA.Methods: Forty healthy individuals were included and randomly assigned into the experimental group and control group. All subjects performed a preferential activation of the LM and/or TrA (maintained the constraction of LM and/or TrA for 30 seconds and then relaxed for two minutes), while those in the experimental group also received visual feedback provided by RUSI. The thickness of LM and/or TrA at rest and during contraction (Tc-max, T15s, and T30s) were extracted and recorded. The experiment was repeated three times.Results: No significant differences were found in the thickness of LM at rest (P > 0.999), Tc-max (P > 0.999), and T15s (P = 0.414) between the two groups. However, the ability to recruit LM muscle contraction differed between groups at T30s (P = 0.006), with subjects in the experimental group that received visual ultrasound biofeedback maintaining a relative maximum contraction. Besides, no significant differences were found in the TrA muscle thickness at rest (P > 0.999) and Tc-max (P > 0.999) between the two groups. However, significant differences of contraction thickness were found at T15s (P = 0.031) and T30s (P = 0.010) between the two groups during the Abdominal Drawing-in Maneuver (ADIM), with greater TrA muscle contraction thickness in the experimental group.Conclusions: RUSI can be used to provide visual biofeedback, which can promote continuous contraction, and improve the ability to activate the LM and TrA muscles in healthy subjects.
Maternal Obesity Influences Birth Weight more than Gestational Diabetes
Authors: Alfadhli Eman M
Published: December 2020

BACKGROUNDMaternal obesity and gestational diabetes (GDM) are commonly encountered during pregnancy. Both conditions are independently associated with unfavorable pregnancy consequences. The objective of this study was to compare the effects of obesity and GDM on birth weight, macrosomia, and other adverse pregnancy outcomes.METHODSThis cohort study involved 531 women with a singleton pregnancy attending the Maternity and Children’s Hospital, Medina, Saudi Arabia, between June 2014 and June 2015. Participants underwent a 75-g oral glucose tolerance test between 24 and 28 weeks. The International Association of Diabetes and Pregnancy Study Groups criteria were used for GDM diagnosis. BMI was assessed at the first antenatal visit, and obesity was defined as a BMI ≥30.0 kg/m2. All women were followed up until delivery. Women were divided into 4 groups: non-GDM nonobese (reference group), GDM nonobese, obese non-GDM, and obese GDM. Clinical characteristics and adverse pregnancy outcomes were compared.RESULTSThe mean age and BMI of the participants were 30.5 years and 29.3 kg/m2, respectively. GDM was diagnosed in 50.2% of the participants, and obesity was diagnosed in 47.8% of the participants. Obese women with GDM were the oldest and heaviest among all women. The mean birth weight increased in order among the four groups; it was highest in the infants in the obese GDM group, followed by those in the obese non-GDM, GDM nonobese and reference groups. Obesity and GDM alone or in combination were associated with higher rates of macrosomia and cesarean deliveries than the reference group. Neonatal intensive care unit (NICU) admission was higher in infants in the GDM nonobese and obese GDM groups. The frequency of low Apgar score was significantly higher in infants in the obese GDM group than in infants in the reference group.CONCLUSIONSMaternal obesity seems to influence birth weight more than GDM, while GDM is associated with a greater risk of admission to the NICU. The combination of both conditions is associated with the greatest risk of adverse pregnancy outcomes.
Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics
Authors: Mremi Irene , George Janeth , Rumisha Susan F. , Sindato Calvin , Mboera Leonard E.G. , Kimera Sharadhuli I.
Published: December 2020

Background: Public health surveillance requires valid, timely and complete health information for early detection of outbreaks. Countries in Sub-Saharan Africa (SSA) adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in response to an increased frequency of emerging and re-emerging diseases in the region. This systematic review aimed to analyse how IDSR implementation has embraced advancement in information technology, big data analytics techniques and wealth of data sources to strengthen detection and management of infectious disease epidemics in SSA. Methods: Three databases were searched for eligible articles: HINARI, PubMed, and advanced Google Scholar databases. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. A total of 1,809 articles were identified using key descriptors and screened at two stages, and 45 studies met the inclusion criteria for detailed review.Results: Of the 45 studies, 35 were country-specific, seven studies covered the region, and three studies covered 3-4 countries. A total of 24 studies assessed the IDSR core functions, while 42 studies evaluated the support functions. Twenty-three studies addressed both the core and support functions. Most of the studies involved Tanzania (9), Ghana (6) and Uganda (5). The implementation of the IDSR strategy has shown improvements, mainly in the support functions. The Health Management Information System (HMIS) has remained the main source of IDSR data. However, the HMIS system is characterised by inadequate data completeness, timeliness, quality, analysis and utilisation as well as lack of integration of data from sources other than health care facilities. Conclusion: In most SSA, HMIS is the main source of IDSR data, characterised by incompleteness, inconsistency and inaccuracy. This data is considered to be biased and reflects only the population seeking care from healthcare facilities. Community-based event-based surveillance is weak and non-existence in the majority of the countries. Data from other systems are not effectively utilised and integrated for surveillance. It is recommended that SSA countries consider and adopt multi-sectoral, multi-disease and multi-indicator platforms that integrate the existing surveillance systems with other sources of health information to provide support to effective detection and prompt response to public health threats.
Exosomes derived from miR-301a-3p-overexpressing adipose-derived mesenchymal stem cells reverse hypoxia-induced erectile dysfunction in rat models
Authors: Liang Li , Zheng Dachao , Lu Chao , Xi Qinghong , Bao Hua , Li Wengfeng , Gu Yufei , Mao Yuanshen , Xu Bin , Gu Xin
Published: December 2020

Background: Erectile dysfunction (ED) has often been observed in patients with obstructive sleep apnea (OSA). Research on adipose-derived mesenchymal stem cells (ADSCs)-derived exosomes has shown that they have significant therapeutic effects in many diseases including ED. Methods: In this study, ED was induced in Sprague Dawley (SD) rats using chronic intermittent hypoxia (CIH) exposure. CIH-mediated influences were then measured in the corpus cavernous smooth muscle cells (CCSMCs). Results: Our data showed that miR-301a-3p-enriched exosomes treatment significantly recovered erectile function in rats and CCSMCs by promoting autophagy and inhibiting apoptosis. The treatment also significantly recovered the level of alpha Smooth Muscle Actin (α-SMA) in rats and CCSMCs. Bioinformatics predicted that Phosphatase and tensin homolog (PTEN) and Toll-like receptor 4 (TLR4) might be targets of miR-301a-3p. Conclusions: Our results indicate that PTEN-overexpression vectors or TLR4-overexpression vectors reverse the therapeutic effects achieved by miR-301a-3p in CCSMCs indicating that PTEN/hypoxia inducible factor-1 alpha (HIF-1α) and TLR4 signaling pathways play key roles in the progression of ED. The findings in this study suggest that miR-301a-3p should be considered as a new therapeutic target for treating ED associated with OSA.
Evidence for Implementation of Interventions to Promote Mental Health in the Workplace: A Systematic Scoping Review Protocol
Authors: Paterson Charlotte , Leduc Caleb , Maxwell Margaret , Aust Birgit , Amann Benedikt L. , Cerga-Pashoja Arlinda , Coppens Evelien , Couwenbergh Chrisje , O’Connor Cliodhna , Arensman Ella , Greiner Birgit A.
Published: December 2020

Background: Mental health problems are common in the working population and represent a growing concern internationally, with potential impacts on workers, organisations, workplace health and compensation authorities, labour markets and social policies. Workplace interventions that create mental health-supportive workplaces, promote mental health awareness, destigmatise mental illness and support those with mental disorders are likely to improve health and economical outcomes for employees and organisations. Identifying factors associated with successful implementation of these interventions can improve their quality and evaluation and facilitate the uptake and expansion. Therefore, we aim to review research reporting on the implementation of mental health promotion interventions delivered in workplace settings, in order to increase understanding of factors influencing successful delivery. Methods and analysis: A scoping review will be conducted incorporating a stepwise methodology to identify relevant literature reviews, primary research and grey literature. This review is registered with Research Registry (reviewregistry897). One reviewer will conduct the search to identify English language studies in the following electronic databases from 2008 through to July 1, 2020: Scopus, PROSPERO, Health Technology Assessments, PubMed, Campbell Collaboration, Joanna Briggs Library, PsycINFO, Web of Science Core Collection, CINAHL, Institute of Occupational Safety and Health (IOSH). Reference searching, Google Scholar, Grey Matters, IOSH and expert contacts will be used to identify grey literature. Two reviewers will screen title and abstracts, aiming for 95% agreement, and then independently screen full texts for inclusion. Two reviewers will assess methodological quality of included studies using the Mixed Methods Appraisal Tool, and extract and synthesize data in line with the RE-AIM framework, Nielson and Randall’s model of organisational-level interventions and Moore’s sustainability criteria, if the data allows. We will recruit and consult with international experts in the field to ensure engagement, reach and relevance of the main findings. Discussion: This will be the first systematic scoping review to identify and synthesise evidence of barriers and facilitators to implementing mental health promotion interventions in workplace settings. Our results will inform future evaluation studies and randomised controlled trials and highlight gaps in the evidence base.
Establishment of an evaluation index system of competencies for graduating students in general practice medicine
Authors: Zhao Rui , Liu Feng , zhu kun
Published: December 2020

Background: The competencies of graduating students in general practice medicine have attracted attention. This study aimed to construct an evaluation index system of competencies for graduating students in general practice medicine and to promote the reform and optimization of training programs for general medicine talent in colleges.Methods: The two-round Delphi method was used to determine the evaluation index system of competencies for graduating students in general practice medicine, and the analytic hierarchy process (AHP) was used to calculate the weights of all levels of elements.Results: The evaluation index system of competencies for graduating students in general practice medicine was established with 3 primary factors, 9 secondary factors and 32 tertiary factors. The Delphi results revealed that the active coefficient of experts was 1 and the authority coefficient was 0.858. The 3 primary factors were knowledge level, job skills and professionalism with weights of 0.1532, 0.4207 and 0.4261, respectively. Among the secondary factors, the top three weight coefficients were professional ethics (0.2614), community practice (0.1526) and communication skills (0.1308). Among tertiary factors, "scientific research" exhibited the lowest value with a weight coefficient of 0.0049.Conclusion: In this study, we constructed an evaluation index system of competencies for graduating students in general practice medicine. The consensus on the content of the competencies of graduating students in general practice medicine suggests that these elements are necessary for those who will become general practitioners. This system can be used as the basis to evaluate the ability of graduating students in general practice medicine and provide guidance for the cultivation and evaluation of general medicine talent.
Gender Differences in Health Insurance Coverage in China
Authors: Zhou Mei , Zhao Shaoyang , Zhao Zhi
Published: December 2020

Background: China initiated a reform of the health insurance system in the late 1990s. The new insurance, urban Employee basic medical insurance (UEBMI), is employment-based, which makes it more difficult than it used to be for those unemployed or informal employed (most of whom are women) to be covered by health insurance. Methods: based on three large sample of micro datasets, we first use statistical methods to identify gender differences in health insurance. Next, we construct a logistic regression model to capture the differences in insurance coverage across age groups using the parameter of interaction terms for gender and age groups.Results: Based on data from a demographic survey that covers a large sample, we find that in the below 50 (in 2005) or 60 (in 2015) years age group, the coverage gap of UEBMI between men and women was relatively smaller, while a larger disparity existed in the above 50 (in 2005) or 60 (in 2015) group. Moreover, gender differences in health insurance were more significant in the low-education group, while no gender differences were found in the high-education group.Conclusions: This paper explains the gender gap in health insurance and the reason for the wider gap among older people. Our study indicates that because the UEBMI in China mainly covers people with formal jobs, a lower labor participation rate (even much lower in formal jobs) of women has led to their greater difficulty in obtaining health insurance. Since the older women’s greater difficulty in obtaining jobs or susceptibility to lay-offs during the period of the UEBMI’s implementation, the possibility of being covered was even much lower. In fact, it was because of the combined effects of the UEBMI system and the labor market condition at that time that older women had a lower proportion of being covered under the UEBMI.
Personalized single-cell networks: a framework to predict the response of any gene to any drug for any patient
Authors: HARIKUMAR HARIPRIYA , Quinn Thomas P , Rana Santu , Gupta Sunil , Venkatesh Svetha
Published: December 2020

Background: The last decade has seen a major increase in the availability of genomic data. This includes expert-curated databases that describe the biological activity of genes, as well as high-throughput assays that measure gene expression in bulk tissue and single cells. Integrating these heterogeneous data sources can generate new hypotheses about biological systems. Our primary objective is to combine population-level drug-response data with patient-level single-cell expression data to predict how any gene will respond to any drug for any patient.Methods: We take 2 approaches to benchmarking a “dual-channel” random walk with restart (RWR) for data integration. First, we evaluate how well RWR can predict known gene functions from single-cell gene co-expression networks. Second, we evaluate how well RWR can predict known drug responses from individual cell networks. We then present two exploratory applications. In the first application, we combine the Gene Ontology database with glioblastoma single cells from 5 individual patients to identify genes whose functions differ between cancers. In the second application, we combine the LINCS drug-response database with the same glioblastoma data to identify genes that may exhibit patient-specific drug responses.Conclusions: Our manuscript introduces two innovations to the integration of heterogeneous biological data. First, we use a “dual-channel” method to predict up-regulation and down-regulation separately. Second, we use individualized single-cell gene co-expression networks to make personalized predictions. These innovations let us predict gene function and drug response for individual patients. Taken together, our work shows promise that single-cell co-expression data could be combined in heterogeneous information networks to facilitate precision medicine.
Construction of a bivalent vaccine against anthrax and smallpox using the attenuated vaccinia virus KVAC103
Authors: Park Deok Bum , Ahn Bo-Eun , Son Ho Sun , Lee Young-Ran , Kim Yu-Ri , Jo Su Kyoung , Chun Jeong-Hoon , Yu Jae-Yon , Choi Myung-Min , Rhie Gi-eun
Published: December 2020

Background: Anthrax and smallpox are high-risk infectious diseases, and considered as potential agents for bioterrorism. To develop an effective countermeasure for these diseases, we constructed a bivalent vaccine against both anthrax and smallpox by integrating a gene encoding protective antigen (PA) of Bacillus anthracis to the genome of the attenuated vaccinia virus strain, KVAC103.Results: Immunization with this bivalent vaccine induced antibodies against both PA and vaccinia virus in a mouse model. We also observed that the efficacy of this vaccine can be enhanced by combined immunization with immunoadjuvant-expressing KVAC103. Mouse groups co-immunized with PA-expressing KVAC103 and either interleukin-15 (IL-15) or cholera toxin subunit A (CTA1)-expressing KVAC103 showed increased anti-PA IgG titer and survival rate against B. anthracis spore challenge compared to the group immunized with PA-expressing KVAC103 alone.Conclusions: We demonstrated that the attenuated smallpox vaccine KVAC103 is an available platform for a multivalent vaccine and co-immunization of immunoadjuvants can improve vaccine performance.
A EDUCAÇÃO COMO INSTRUMENTO EMANCIPATÓRIO NO SISTEMA PRISIONAL
Authors: Kanaan Danielle Pereira Gomes , Souza Roberto Martins de , Pelissari Lucas Barbosa
Published: December 2020

O trabalho proposto tem por objetivo analisar a educação no sistema prisional do Paraná como instrumento de emancipação dos alunos-apenados, segundo os preceitos do PEESP. Desse modo, o tema se mostra digno de estudo, uma vez que a Lei de Execução Penal, assegura ao preso a assistência educacional a fim de prevenir novos crimes e reconduzi-los ao convívio social (arts. 10 e 11, IV) aptos a exercer a cidadania e a atividade profissional. Todavia, muito embora presente na legislação penal desde 1.984, o acesso à educação no nível médio só passou a ser obrigatório nas unidades penais a partir da Lei nº 13.163, no ano de 2.015. Ainda assim, o que se verifica no cenário carcerário, jurídico e social se mostra contrário às expectativas legais. Para tanto, a elaboração deste trabalho fez uso da metodologia de pesquisa a partir de uma análise qualitativa acerca das fontes documentais, isto é, dos aparatos tecnológicos que regem o ensino no sistema penitenciário e bibliográfica, por meio da interdisciplinaridade do campo CTS e ciência jurídica. Assim, com a finalidade de contribuir não somente com o meio acadêmico e jurídico, mas também prisional e à sociedade, o artigo tramitará pelo contexto jurídico ao conceituar e fundamentar a educação como um direito fundamental aos presos, perpassando pela educação ao buscar em suas funções a medida de se efetivar a formação emancipatória do apenado como sujeito de direitos. Contudo, concluiu-se que a educação ministrada no sistema prisional paranaense, segundo seus textos normativos, ainda que sutilmente embasadas em um discurso emancipador, se mostra falaciosa ante as suas propostas de ensino profissional tecnicista lançadas nos referidos artefatos tecnológicos, das quais se tornam impossíveis efetivar uma educação plena, contribuindo tão somente para uma reprodução social de classes dentro de uma sociedade industrial avançada.