bluuebunny/crossref_metadata_2025 huggingface dataset:
Malaria in children and women of childbearing age: infection prevalence, knowledge and use of malaria prevention tools in the province of Nyanga, Gabon
Authors: IMBOUMY-LIMOUKOU Roméo Karl , MAGHENDJI-NZONDO Sydney , SIR-ONDO-ENGUIER Pater Noster , DE CARVALHO Julie NIEMCZURA , TEGOMO Nathalie Pernelle TSAFACK , Buekens Julie , OKOUGA Alain Prince , ONDEME Augustin MOUINGA , NOLNA Sylvie KWEDY , LEKANA-DOUKI Jean Bernard
Published: July 2020

Background: There is little information on the social perception of malaria and the use of preventative measures in Gabon, especially in rural areas. Adequate knowledge of malaria prevention and control can help in reducing the burden of malaria among vulnerable groups, particularly pregnant women and children under five year old living in malaria endemic settings. This study was designed to assess the prevalence of malaria and the knowledge and attitude towards this disease in households in the Nyanga Province. Methods: A cross-sectional study was conducted to assess malaria knowledge, prevention practices and prevalence of the malaria infection in five departments of the Nyanga Province. Plasmodial infection was diagnosed in children ≤ 5 years of age and women aged 15-49 years using rapid diagnostic tests. A questionnaire was administered randomly to women aged 15-49 years and to the parents or guardians of children aged ≤ 5 years in 535 households during a two weeks period in March 2018. Overall, the respondents’ socio-demographic characteristics, knowledge on malaria, malaria prevention practices and malaria prevalence were evaluated and compared across the five departments.Results: Data from a total of 1,307 participants were included in this study, including 631 women of childbearing age (including 61 pregnant women) and 676 children. Practically the entire (97.7%) interviewed population had already heard about malaria and attributed the cause of malaria to a mosquito bite (95.7%). This survey revealed that the reported rate of reported bednet use was 73.3%. The study observed an average malaria parasite prevalence of 13.9%. All departmental capitals of the Nyanga province had a significant level of malaria infection except for the Mayumba where no plasmodial infection was foundConclusion: High malaria prevalence is found in the departmental capital cities of the Nyanga province. This study reveals that respondents have a high knowledge of the malaria symptoms, its mode of transmission and preventive measures. Despite this high level of knowledge of the disease and its preventive measures, the incidence of malaria remains relatively high in this rural community highlighting the need for other types of interventions.
Activity of leaf and spike carbohydrate-metabolic and antioxidant enzymes linked with yield performance in three spring wheat genotypes grown under well-watered and drought conditions
Authors: Shokat sajid , Großkinsky Dominik K. , Roitsch Thomas , Liu Fulai
Published: July 2020

Background: To improve our understanding about the physiological mechanism of grain yield reduction at anthesis, three spring wheat genotypes [L1 (advanced line), L2 (Vorobey) and L3 (Punjab-11)] having contrasting yield potential under drought in field were investigated under controlled greenhouse conditions., drought stress was imposed at anthesis stage by withholding irrigation until all plant available water was depleted, while well-watered control plants were kept at 95% pot water holding capacity. Results: Compared to genotype L1 and L2, pronounced decrease in grain number (NGS), grain yield (GY) and harvest index (HI) were found in genotype L3, mainly due to its greater kernel abortion (KA) under drought. A significant positive correlation of leaf monodehydroascorbate reductase (MDHAR) with both NGS and HI was observed. In contrast, significant negative correlations of glutathione S-transferase (GST) and vacuolar invertase (vacInv) both within source and sink with NGS and HI were found. Likewise, a significant negative correlation of leaf abscisic acid (ABA) with NGS was noticed. Moreover, leaf aldolase and cell wall peroxidase (cwPOX) activities were significantly and positively associated with thousand kernel weight (TKW). Conclusion: Distinct physiological markers correlating with yield traits and higher activity of leaf aldolase and cwPOX may be chosen as predictive biomarkers for higher TKW. Also, higher activity of MDHAR within the leaf can be selected as a predictive biomarker for higher NGS in wheat under drought. Whereas, lower activity of vacInv and GST both within leaf and spike can be selected as biomarkers for higher NGS and HI. The results highlighted the role of antioxidant and carbohydrate-metabolic enzymes in the modulation of source-sink balance in wheat crops, which could be used as bio-signatures for breeding and selection of drought-resilient wheat genotypes for a future drier climate.
Respiratory, birth and health economic measures for use with Indigenous Australian infants in a research trial: A modified Delphi with an Indigenous panel
Authors: Perkes Sarah Jane , Bonevski Billie , Mattes Joerg , Hall Kerry , Gould Gillian
Published: July 2020

Background: There is significant disparity between the respiratory health of Indigenous and non-Indigenous Australian infants. There is no culturally accepted measure to collect respiratory health outcomes in Indigenous infants. The aim of this study was to gain end user and expert consensus on the most relevant and acceptable respiratory and birth measures for Indigenous infants at birth, between birth and 6 months, and at 6 months of age follow-up for use in a research trial. Methods: A three round modified Delphi process was conducted from February 2018 to April 2019. Eight Indigenous panel members, and 18 Indigenous women participated. Items reached consensus if 7/8 (≥80 %) panel members indicated the item was ‘very essential’. Qualitative responses by Indigenous women and the panel were used to modify the 6 months of age surveys. Results: In total, 15 items for birth, 48 items from 1 to 6 months, and five potential questionnaires for use at 6 months of age were considered. Of those, 15 measures for birth were accepted, i.e., gestational age, birth weight, Neonatal Intensive Care Unit (NICU) admissions, length, head circumference, sex, Apgar score, substance use, cord blood gas values, labour, birth type, health of the mother, number people living in the home, education of mother and place of residence. Seventeen measures from 1-to 6 months of age were accepted, i.e., acute respiratory symptoms (7), general health items (2), health care utilisation (6), exposure to tobacco smoke (1), and breastfeeding status (1). Three questionnaires for use at 6 months of age were accepted, i.e., a shortened 33-item respiratory questionnaire, a clinical history survey and a developmental questionnaire. Conclusions: In a modified Delphi process with an Indigenous panel, measures and items were proposed for use to assess respiratory, birth and health economic outcomes in Indigenous Australian infants between birth and 6 months of age. This initial step can be used to develop a set of relevant and acceptable measures to report respiratory illness and birth outcomes in community based Indigenous infants.
Newborn hearing screening coverage and detection rates of hearing impairment across China from 2008-2016
Authors: Yuan Xuelian , Deng Kui , Zhu Jun , Xiang Liangcheng , Yao Yongna , Li Qi , Li Xiaohong , Liu Hanmin
Published: July 2020

Background: Newborn hearing screening (NHS) can reduce the economic and social burden of hearing impairment. To track the progress of the goal set by the National Program of Action for Child Development (NPACD) and to estimate the detection rates of hearing impairment, the present study examined NHS coverage in 2008-2010 and 2016 and the detection of hearing impairment across China in 2016. Methods: Licensed medical institutions across China were surveyed in 2012 and 2018 by the National Center for Birth Defects Monitoring of China to collect data for the 2008-2010 period and for 2016 on live births, initial screening rates (total and referral), secondary screening rates (total and referral), and rates of hearing impairment diagnosis among infants who were referred in the secondary screening. To calculate universal newborn hearing screening (UNHS) coverage, the number of newborns who received NHS within four weeks after birth was divided by the number of live births. The detection rate of hearing impairment was calculated by combining referral rates on primary and secondary screening with the rate of diagnosis. Results: National UNHS coverage increased from 29.9% in 2008 to 86.5% in 2016, with different regions showing different increases. During this period, the number of provinces with UNHS coverage over 90.0% increased from 2 to 17, with UNHS coverage in 2016 being substantially higher in eastern provinces (93.1%) than in western provinces (79.4%). In 2016, the detection rate of hearing impairment across the country was 0.23% (95% CI 0.15-0.25%), and it varied from 0.17% in western provinces to 0.22% in central provinces and 0.28% in eastern provinces. The lowest rate was 0.02% in Heilongjiang Province and the highest rate was 0.63% in Hainan Province. Conclusions: National UNHS coverage increased substantially from 2008 to 2016, although provinces and regions still showed differences. The detection rate of infant hearing impairment in China is comparable to that in other countries. A national individual-level information system is urgently needed in China to facilitate the integration of screening, diagnosis and treatment of infant hearing impairment, which may also lead to a more accurate estimate of the detection rate.
The association between pelvic asymmetry and non-specific chronic low back pain as assessed by the Global Postural System.
Authors: Yu Qiuhua , Huang Huanjie , Zhang Zhou , Hu Xiaoqian , Li Wenfeng , Li Le , Chen Min , Liang Zhenwen , Lo Wai Leung Ambrose , Wang Chuhuai
Published: July 2020

Background: Empirical evidence that demonstrates the relationship between pelvic asymmetry and non-specific chronic low back pain (NCLBP) is currently lacking. Objective: To establish the reliability of the Global Postural System (GPS) in assessing pelvic asymmetry and identify the association between pelvic asymmetry parameters and the occurrence of NCLBP in young adults. Design: A cross-sectional, regression study. Methods: People who aged between 18 and 30 and were diagnosed with NCLBP were recruited. Healthy individuals who were matched for age, gender, and education level were recruited as controls. Global Postural System (GPS) was employed to assess pelvic asymmetry. Prior to explore the association, the reliability of GPS was assessed by the ICC (2, k) for interrater reliability, ICC (3, k) for intra-rater reliability, standard error and minimal detectable difference. Bivariate correlation analysis and logistic regression analysis were used to determine the relationship between pelvic asymmetry and the occurrence of NCLBP. Results: Twenty-eight healthy participants and 28 people with NCLBP were recruited. Moderate to excellent ICCs were observed for the inter-rater and intra-rater reliability of most postural parameters. The bivariate correlation analysis indicated that age, body mass index and pelvic asymmetry parameters were related to the occurrence of NCLBP. Pelvic angle asymmetry (odd ratio=1.17), and asymmetry of the distance between the posterior superior iliac spine and the floor (odd ratio=1.21) were significant factors associated with NCLBP. Limitation: This study did not explore the causal relationship between pelvic asymmetry in the sagittal plane/pelvic asymmetry in the transverse plane and the occurrence of NCLBP. The interpretation of the results may not be generalized beyond the sample population. Conclusions: The GPS is a reliable method to assess pelvic asymmetry in a clinical setting. The pelvic asymmetry parameters obtained from the GPS are likely to assist in the early identification of the potential occurrence of NCLBP.
Risk factors associated with knife-crime in United Kingdom among young people aged 10-24 years: A systematic review.
Authors: Haylock Sara , Boshari Talia , Alexander Emma C , Kumar Ameeta , Manikam Logan , Pinder Richard
Published: July 2020

Background Since 2013, the number of violent crimes and offences by sharp instruments have increased continually, following a previous decrease, with majority of cases occurring among young people and in London. There is limited understanding surrounding the drivers influencing this change in trends, with mostly American-based research identifying risk factors. Methods The aim of this review is to identify and synthesise evidence from a range of literature to identify risk factors associated with weapon-related crime, for young people (aged 10-24 years) within the UK. A search strategy was generated to conduct a systematic search of published and grey literature within four databases (EMBASE, Medline, PsycINFO, and OpenGrey), identifying papers within a UK-context. Abstracts and full texts were screened by two independent reviewers to assess eligibility for inclusion, namely study focus in line with the objectives of the review. Weight of Evidence approach was utilised to assess paper quality, resulting in inclusion of 16 papers. Thematic analysis was conducted for studies to identity and categorise risk factors according to the WHO ecological model. Results No association was found between gender or ethnicity and youth violence, contrasting current understanding shown within media. Multiple research papers identified adverse childhood experiences and poor mental health as positively associated with youth and gang violence. It was suggested that community and societal risk factors, such as discrimination and economic inequality, were frequently linked to youth violence. A small number of studies were included within the review as this is a growing field of research, which may have led to a constrained number of risk factors identified. Due to heterogeneity of studies, a meta-analysis could not be conducted. As many studies displayed positive results, publication bias may be present. Conclusions Several risk factors were identified, with evidence currently heterogeneous with minimal high-quality studies. However, findings highlight key areas for future research, including the link between poor mental health and knife-crime, and the trajectory into gangs. Risk factors should help identify high-risk individuals, targeting them within mitigation strategies to prevent involvement within crime. This should contribute to efforts aimed at reducing the rising crime rates within UK. Systematic Review Registration Number: CRD42019138545Registered at PROSPSERO: 16/08/2019
LncRNAs and their regulatory networks in breast muscle tissue of Chinese Gushi chicken during postnatal late development
Authors: Li Yuanfang , Jin Wenjiao , Zhai Bin , Chen Yi , Li Guoxi , Zhang Yanhua , Guo Yujie , Sun Guirong , Han Ruili , Li Zhuanjian , Li Hong , Tian Yadong , Liu Xiaojun , Kang Xiangtao
Published: July 2020

Background: Chicken skeletal muscle is an important economic product. Late stages of chicken development are the main period that affects meat production. LncRNAs play important roles in controlling the epigenetic process of growth and development. However, studies on the role of lncRNAs in the late stages of chicken breast muscle development are still lacking. In this study, in order to study the expression characteristics of lncRNAs during chicken muscle development, 12 cDNA libraries were constructed from Gushi chicken breast muscle samples from 6-, 14-, 22-, and 30-week-old chickens.Results: Therefore, a total of 1,252 new lncRNAs and 1,376 annotated lncRNAs were identified. Furthermore, 53, 61, 50, 153, 117, and 78 DE-lncRNAs were found in the W14 vs. W6, W22 vs. W14, W22 vs. W6, W30 vs. W6, W30 vs. W14, and W30 vs. W22 comparison groups, respectively. After GO enrichment analysis of the DE-lncRNAs, several muscle development-related GO terms were found in the W22 vs. W14 comparison group. Furthermore, it was found that the MAPK signaling pathway was one of the most frequently enriched pathways in the different comparison groups. In addition, 12 common target DE-miRNAs of DE-lncRNAs were found in different comparison groups, some of which were muscle-specific miRNAs, such as gga-miR-206, gga-miR-1a-3p, and miR-133a-3p. Interestingly, the precursors of four newly identified miRNAs were found to be homologous to lncRNAs. Furthermore, we found some ceRNA networks associated with muscle development-related GO terms. For example, the ceRNA networks containing the DYNLL2 gene with 12 lncRNAs that targeted 2 miRNAs. In addition, we also constructed PPI networks, such as IGF-I-EGF and FZD6-WNT11, etc.Conclusions: This study for the first time revealed the dynamic changes of lncRNA expression in Gushi chicken breast muscle at different periods, and reveal the MAPK signaling pathway play a vital role in muscle development. Furthermore, MEF2C and its target lncRNA may be involved in muscle regulation through the MAPK signaling pathway. This research provided valuable resources for elucidating post-transcriptional regulatory mechanisms to promote the development of chicken breast muscles after hatching.
Interviews with experts in Rare Diseases for the development of Clinical Decision Support System software - a qualitative study
Authors: Schaaf Jannik , Prokosch Hans-Ulrich , Boeker Martin , Schaefer Johanna , Vasseur Jessica , Storf Holger , Sedlmayr Martin
Published: July 2020

BackgroundPatients with rare diseases (RDs) are often diagnosed too late or not at all. Clinical decision support systems (CDSSs) could support the diagnosis in RDs. The MIRACUM (Medical Informatics in Research and Medicine) consortium, which is one of four funded consortia in the German Medical Informatics Initiative, will develop a CDSS for RDs based on distributed clinical data from ten university hospitals. This qualitative study aims to investigate (1) the relevant organizational conditions for the operation of a CDSS for RDs when diagnose patients (e.g. the diagnosis workflow), (2) which data is necessary for decision support, and (3) the appropriate user group for such a CDSS.MethodsInterviews were carried out with RDs experts. Participants were recruited from staff physicians at the Rare Disease Centers (RDCs) at the MIRACUM locations, which offer diagnosis and treatment of RDs.An interview guide was developed with a category-guided deductive approach. The interviews were recorded on an audio device and then transcribed into written form. We continued data collection until all interviews were completed. Afterwards, data analysis was performed using Mayring’s qualitative content analysis approach.ResultsA total of seven experts were included in the study. The results show that medical center guides and physicians from RDC B-centers are involved in the diagnostic process. B-centers are part of an RDC, representing different medical specialties with a focus on RDs (e.g. rare lung diseases). Furthermore, interdisciplinary case discussions between physicians are conducted to assess patient cases. The experts explained that RDs exist which cannot be fully differentiated, but rather described only by their overall symptoms or findings: diagnosis is dependent on the disease or disease group. At the end of the diagnostic process, most centers prepare a summary of the patient case. Furthermore, the experts considered both physicians and experts from the B-centers to be potential users of a CDSS. The experts also have different experiences with CDSS for RDs.ConclusionsThis qualitative study is a first step towards establishing the requirements for the development of a CDSS for RDs. Further research is necessary to create solutions by also including the experts on RDs.
Fabry disease screening in high-risk populations in Japan: A nationwide study
Authors: Yoshida Shinichiro , Kido Jun , Sawada Takaaki , Momosaki Ken , Sugawara Keishin , Matsumoto Shirou , Endo Fumio , Nakamura Kimitoshi
Published: July 2020

Background: Fabry disease (FD) is a X-linked inherited disorder caused by mutations in the GLA gene, which results in the deficiency of α-galactosidase A (α-Gal A). This leads to the progressive accumulation of metabolites, which can cause multisystemic dysfunction. A recent screening study among neonates reported an increase in the incidence of FD, and numerous FD patients remain undiagnosed or even misdiagnosed . Therefore, this study aimed to identify patients with FD by performing high-risk screening in 18,135 individuals, enrolled from October 2006 to March 2019, with renal, cardiac, or neurological manifestations from all prefectures in Japan . A total of 601 hospitals participated in this study.

Results: Low α-Gal A activity was detected in 846 individuals, with 224 of them diagnosed with FD by GLA sequencing. Cases with a family history of FD (n = 64) were also subjected to sequencing, without α-Gal A assay, as per individual request, and 12 of them were diagnosed with a variant of FD. A total of 236 patients with FD (97 males and 139 females) were identified from among 18,199 participants. A total of 101 GLA variants, including 26 novel variants, were detected in the 236 patients with FD from 143 families, with 39 amenable variants (39%) and 79 of the 236 patients (33%) suitable for migalastat treatment.

Conclusions: From among 18,199 participants, 101 GLA variants, including 26 novel variants, were identified in the 236 patients with FD from 143 families. Migalastat was identified as a suitable treatment option in 33% of the patients with FD and 39% of the GLA variants were detected as amenable. Therefore, the simple screening protocol using dried blood spots that was performed in this study could be useful for early diagnosis and selection of appropriate treatments for FD in high-risk and underdiagnosed patients with various renal, cardiac, or neurological manifestations.
Targeted exome sequencing identified a novel USH2A mutation in a Chinese Usher syndrome family: a case report
Authors: Xing Dongjun , Zhou Huaiyu , Yu Rongguo , Wang Linni , Hu Liying , Li Zhiqing , Li Xiaorong
Published: July 2020

Background: Usher syndrome is a king of phenotypic and genetic heterogeneous disease. Our purpose was to identify the gene mutation in a Chinese family with Usher syndrome type 2 and describe the clinical features.Case presentation: A 23-year-old man complained of 10-year nyctalopia and a 3-year decline in visual acuity of both eyes accompanied by congenital dysaudia. To clarify the diagnosis, the clinical symptoms were observed and analysed in combination with comprehensive ophthalmologic examinations as well as genetic analysis (Targeted exome sequencing, TES). Typical clinical presentation of Usher syndrome on fundus was found including a wax yellow-like disc, bone-spicule formations and retinal vessel stenosis. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) showed the loss of ellipsoid zone and the reduction in paracaval vessel density of both eyes. Genetic analysis identified a novel homozygote of c.8483_8486del (p.Ser2828*) in USH2A. The mutation of premature translation termination causes the deletion of 19 fibronectin type 3 domains(FN3), transmembrane region (TM) and PDZ-binding motif domain, which plays an important role in protein binding. Combining the clinical manifestation and genetic result, the patient was diagnosed with Usher syndrome type 2.Conclusions: We found a novel mutation of c.8483_8486del in USH2A gene through TES techniques. The result broaden the spectrum of mutations in Usher syndrome type 2 and suggest that the combination of clinical information and TES molecular diagnosis could help USH patients obtain a better diagnosis.
Assessing the role of two populations of Aedes japonicus japonicus for Zika virus transmission under a constant and a fluctuating temperature regime.
Authors: Glavinic Uros , Varga Jasmin , Paslaru Anca Iona , Hauri Jeannine , Torgerson Paul , Schaffner Francis , Veronesi Eva
Published: July 2020

Background Since the huge epidemic of Zika virus (ZIKV) in Brazil in 2015, questions were raised to understand which mosquito species could transmit the virus. Aedes aegypti has been described as the main vector. However, other Aedes species (e.g. Ae. albopictus and Ae. japonicus) proven to be competent for other Flaviviruses (e.g.West Nile, dengue and yellow fever), have been described as potential vector for ZIKV under laboratory conditions. One of these, the Asian bush mosquito Ae. japonicus is widely distributed with high abundances in Central-Western Europe. In the present study, infection, dissemination and transmission rates of ZIKV (Dak84 strain) in two populations of Ae. japonicus from Switzerland (Zürich) and France (Steinbach, Haut-Rhin) were investigated under constant (27 °C) and fluctuating (14-27 °C, mean 23 °C) temperature regimes.Results The two populations were each able to transmit ZIKV under both temperature regimes. Infectious virus particles were detected in the saliva of females from both populations, regardless of the incubation temperature regime, from 7 days post exposure to infectious rabbit blood. The highest amount of Plaque Forming Unit (PFU) (400/ml) were recorded 14 days post oral infection in the Swiss population incubated at constant temperature. No difference in terms of infection, dissemination and transmission rate were found between mosquito populations.Temperature had no effect on infection rate but the fluctuating temperature regime resulted in higher dissemination rates compared to constant temperature, regardless of the population. Finally, transmission efficiency ranged between 7-23% and 7-10% for the constant temperature and 0-10% and 3-27% under fluctuating temperatures for the Swiss and the French populations, respectively.Conclusions This is the first work confirming vector competence for ZIKV of Ae. japonicus originating from Switzerland and France at realistic summer temperatures under laboratory conditions. Considering the continuous spread of this species in the northern part of Europe and its adaptation at cooler temperatures, preventative control measures should be adopted to prevent possible ZIKV epidemics.
Enterohaemorrhagic Escherichia coli activates nitrate respiration to benefit from the inflammatory response for initiation of microcolony-formation
Authors: Nada Risa , Ebihara Shinya , Yen Hilo , Tobe Toru
Published: July 2020

Background: For successful colonization, enterohaemorrhagic Escherichia coli (EHEC) injects virulence factors, called effectors, into target cells through the type three secretion system (T3SS), which is composed of a needle and basal body. Under anaerobic conditions, the T3SS machinery remains immature and does not have a needle structure. However, activation of nitrate respiration enhances the completion of the T3SS machinery. Because nitric oxide released by the host inflammatory response increases nitrate concentration, we sought to determine the effect of the inflammatory response on initiation of EHEC microcolony-formation. Results: The colony-forming capacity was increased in accordance with the increase of nitrate in the medium. The addition of the nitric oxide-producing agent NOR-4 also enhanced the adherence capacity, which was dependent on nitrate reductase encoded by the narGHJI genes. Culture supernatant of epithelial cells, which was stimulated by a cytokine mixture, enhanced the colony-forming capacity of wild-type EHEC but not of the narGHJI mutant. Finally, colony formation by wild-type EHEC on epithelial cells, which were preincubated with heat-killed bacteria, was higher than the narGHJI mutant, and this effect was abolished by aminoguanidine hydrochloride, which is an iNOS (inducible nitric oxide synthase) inhibitor. Conclusions: These results indicate that the inflammatory response enhances EHEC adherence by increasing nitrate concentration.
‘I’ve got to be independent’: Older peoples’ views on recovery following road injury: A qualitative study
Authors: Brown Katherine , Cameron Ian D , Keay Lisa , Nguyen Ha , Dillon Lisa , Jagnoor Jagnoor , Ivers Rebecca
Published: July 2020

Background: Mild to moderate road traffic injury (RTI) in people of working age is associated with limited recovery. Less is known about RTI recovery in older age. This study explored perspectives, and factors related to recovery and health-related quality of life following mild to moderate RTI in older age.Methods: A qualitative study using content analysis was undertaken. Participants aged 65 or more years were purposively selected from a larger inception cohort study of health outcomes following mild to moderate RTI. Semi-structured interviews were undertaken at approximately 12 or 24 months after injury. Content analysis was used to code and analyse the data, with methodological rigour obtained by double-coding and discussing findings to reach consensus. Results were reported using the consolidated criteria for reporting qualitative research (COREQ). Results: Nineteen participants were invited to participate in the study of which 12 completed interviews. Data saturation was reached at the 12th interview. Recovery experiences were diverse. Five main themes were identified: recovery is regaining independence; injury & disability in older age; the burden of non-obvious disability; the importance of support, and positive personal approaches. Key facilitators of recovery were regaining independence; support from family and friends, and positive personal approaches. Key barriers were threats to independence; passive coping behaviours; non-obvious disabilities (chronic pain, psychological impacts), and for some, a reluctance to raise ongoing issues with General Practitioners. Threats to independence, especially not driving and self-care, appeared to have a more profound effect on recovery than physical functioning.Conclusion: Older people view injury as a threat to independent functioning. This is somewhat different to what younger people report. Regaining independence is key to older peoples’ recovery and health-related quality of life following RTI, and should be a key consideration for health professionals, services and supports working with this unique cohort. Greater efforts to help older people regain independence following RTI are needed and can be facilitated by health professionals and appropriate service provision.
Comparing Psychometric Properties of the SF-36 and SF-12 in Measuring Quality of Life among Adolescents in China: A Large Sample Cross-sectional Study
Authors: Lin Yanwei , Yu Yulan , Zeng Jiayong , Zhao Xudong , Wan Chonghua
Published: July 2020

Objective: By comparing the psychometric properties of the Short Form 36 (version 1, SF-36) and the Short Form 12 (version 1, SF-12), we supply evidence for the selection of instruments measuring the quality of life (QOL) and decision-making processes of adolescents in China. Methods: Stratified cluster random sampling was adopted, and the SF-36 was administered to assess QOL. The Pearson correlation coefficient was used to show correlation. Cronbach’s alpha and construct reliability (CR) were used to evaluate the reliability of SF-36 and SF-12, while criterion validity and average variance extracted (AVE, convergence validity) were used to evaluate validity. Confirmatory factor analysis was used to calculate the load factor for each item, then to obtain the CR and AVE. The Semejima grade response model (logistic two-parameter module) in item response theory was used to estimate item discrimination, item difficulty, and item average information for each item. Results: 19,428 samples were included in the study. The mean age of respondents was 14.78 years (SD = 1.77). High correlations between the corresponding domains and components of both scales were found. Reliability of each domain of the SF-36 was better than for the corresponding domain of SF-12. The domains of PF, RP, BP, and GH in SF-36 had good construct reliability (CR > 0.6). The criterion validities of SF-36 were a little higher in some corresponding dimensions, except for PCS. The convergence validities of SF-12 were higher than SF-36 in PF, RP, BP, and PCS. The items of BP, SF, RP, and VT in SF-12 had acceptable discrimination of items that were higher than in SF-36. The items’ average amounts of information of BP, VT, SF, RE, and MH in SF-36 and SF-12 were poor. Conclusion: Two component measurements of the SF-12 (PCS and MCS) appeared to perform at least as well as the SF-36 in cross-sectional settings in adolescence, but the reliability and validity of 8 domains of the SF-36 were better than those of SF-12. Some domains, for instance SF and BP, were not suitable for adolescents or need no further study.
Analyzing the technical efficiency of health systems in Asian countries: What Myanmar can learn from Bangladesh and Sri Lanka.
Authors: Win Zin Mar , Löfgren Curt
Published: July 2020

Background: Advancements in medicine leads, among other things, to increasing life expectancy and quality of life. However, at the same time, health care costs are increasing, and this may not be sustainable in the future. Governments and health care organizations need to implement efficiency measures in order to maximize health outcomes within available resources. This study aims to compare the technical efficiency of health systems in middle-income Asian countries, and to identify “efficient peers” for each “inefficient country”: in particular for Myanmar. Methods: A data envelopment analysis (DEA) variable returns to scale output-oriented model was used to evaluate technical efficiency in middle-income Asian countries. The input variables were current health expenditure per capita, the density of doctors, and the density of nurses and midwifery personnel. The output variables were health adjusted life expectancy (HALE) and the infant mortality rate (IMR). Myanmar may learn how to improve efficiency of its health care system through studying its efficient peers from DEA results. A review of relevant English language literature was used as a basis for informing a comparative analysis of the health systems of Myanmar and its efficient peers: Bangladesh and Sri Lanka.Results: Among the twenty-eight middle-income Asian countries studied, 39.3% of countries were technically efficient. Myanmar is one of the inefficient countries, and it should look at the health systems of its efficient peers, Bangladesh and Sri Lanka, to make its health system technically more efficient.Conclusions: The results of this study suggested that countries with inefficient health systems can improve their health outcomes without increasing their health care resources. As DEA measures efficiency only, future studies should take into account equity to assess comprehensive health system performance.
OTX1 exerts an oncogenic role and is negatively regulated by miR129-5p in laryngeal squamous cell carcinoma
Authors: Tu Xiu-Ping , Li Hao , Chen Liang-Si , Luo Xiao-Ning , Lu Zhong-Ming , Zhang Si-Yi , Chen Shao-Hua
Published: July 2020

Background Orthodenticle homeobox 1 (OTX1) is a transcription factor that plays an important role in various human cancers. However, the function of OTX1 in laryngeal squamous cell carcinoma (LSCC) is largely unknown. We aimed to explore the roles of OTX1 in LSCC and its possible molecular mechanism. Methods The expression levels of OTX1 were assessed in LSCC cell lines and tissue samples. We further examined the effect of OTX1 on LSCC progression. The upstream regulator of OTX1 was identified using a computer algorithm and confirmed experimentally. Results OTX1 was highly expressed in 70.7% (70/99) of LSCC tissue samples. The OTX1 expression in LSCC was significantly correlated with lymph node metastasis. High OTX1 expression in patients with LSCC was correlated with poor prognosis. Knockdown of OTX1 inhibited proliferation, colony formation, migration and invasion in LSCC cells. Knockdown of OTX1 inhibited tumor growth in a xenograft mouse model. Mechanistically, OTX1 might act as a direct target of miR-129-5p. OTX1 enhanced tumorigenicity and tumor growth both in vitro and in vivo . Conclusions Our findings support that OTX1 is an oncogene in LSCC tumorigenesis and progression. Furthermore, OTX1 is a direct target of miR-129-5p in LSCC cells. Taken together, OTX1 is a promising diagnostic and therapeutic marker for LSCC.
A novel nomogram to predict the overall survival in esthesinoeroblastoma
Authors: Jiang Lijie , Lin Tengjiao , Zhang Yu , Gao Wenxiang , Deng Jie , Xu Zhaofeng , Luo Xin , Huang Zhaoqi , Chen Fenghong , Shi Jianbo , Lai Yinyan
Published: July 2020

Background

Increasing evidence indicates that the pathology and the modified Kadish system have some influence on the prognosis of esthesioneuroblastoma (ENB). However, an accurate system to combine pathology with a modified Kadish system has not been established.

Methods

This study aimed to set up and evaluate a model to predict overall survival (OS) accurately in ENB, including clinical characteristics, treatment and pathological variables. We screened the information of patients with ENB between January 1, 1976, and December 30, 2016 from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program as a training cohort. The validation cohort consisted of patients with ENB at Sun Yat-sen University Cancer Center and The First Affiliated Hospital of Sun Yat-sen University in the same period, and 87 patients were identified. The Pearson’s chi-squared test was used to assess significance of clinicopathological and demographic characteristics. We used the Cox proportional hazards model to examine univariate and multivariate analyses. The model coefficients were used to calculate the Hazard ratios (HR) with 95% confidence intervals (CI). Prognostic factors with a p- value < 0.05 in multivariate analysis were included in the nomogram. The concordance index (c-index) and calibration curve were used to evaluate the predictive power of the nomogram.

Results

The c-index of training cohort and validation cohort are 0.737 (95% CI, 0.709 to 0.765) and 0.791 (95% CI, 0.767 to 0.815) respectively. The calibration curves revealed a good agreement between the nomogram prediction and actual observation regarding the probability of 3-year and 5-year survival. We used a nomogram to calculate the 3-year and 5-year growth probability and stratified patients into three risk groups.

Conclusions

The nomogram provided the risk group information and identified mortality risk and can serve as a reference for designing a reasonable follow-up plan.
Novel ethanol production using biomass preprocessing to increase ethanol yield and reduce overall costs
Authors: Pascoli Danielle Uchimura , Suko Azra , Gustafson Rick , Gough Heidi , Bura Renata
Published: July 2020

Background: Ethanol biorefineries need to lower their overall production costs to become economically feasible. Two strategies to achieve this are to reduce costs by using cheaper feedstocks or to increase the ethanol production yield. Low-cost feedstocks usually have high non-structural components (NSC) content, therefore a new process is necessary to accommodate these feedstocks and overcome the negative effects of NSC. This study developed a novel ethanol biorefinery process including a biomass preprocessing step that enabled the use of lower-cost feedstocks while improving ethanol production without detoxification (overliming). Two types of poplar feedstocks were used, low-quality whole-tree chips (WTC) and high-quality clean pulp chips (CPC), to determine if the proposed process is effective while using feedstocks with different NSC contents.Results: Technical assessment showed that acidic preprocessing increased the monomeric sugar recovery of WTC from 73.2% (untreated) to 87.5% due to reduced buffering capacity of poplar, improved sugar solubilization during pretreatment, and better enzymatic hydrolysis conversion. Preprocessing alone significantly improved the fermentability of the liquid fraction from 1-2% to 49-56% for both feedstocks, while overliming improved it to 45%. Consequently, it was proposed that preprocessing can substitute for the detoxification step. The economic assessment revealed that using poplar WTC via the new process increased annual ethanol production of 10.5 million liters when compared to using CPC via overliming (base case scenario). Also, savings in total operating costs were about $10 million per year when using cheaper poplar WTC instead of CPC, and by using recycled water for preprocessing lowered its total operating costs by 45-fold.Conclusions: The novel process developed in this study was successful in increasing ethanol production while decreasing overall costs, thus facilitating the feasibility of lignocellulosic ethanol biorefineries. Key factors to achieving this outcome included substituting overliming by preprocessing, enabling the use of lower-quality feedstock, increasing monomeric sugar recovery and ethanol fermentation yield, and using recycled water for preprocessing. In addition, preprocessing enabled the implementation of an evaporator-combustor downstream design, resulting in a low-loading waste stream that can be treated in a wastewater treatment plant with a simple configuration.
Corticosteroids versus clobazam in epileptic encephalopathy with ESES: a European multicenter randomized controlled clinical trial (RESCUE ESES*)
Authors: Munckhof Bart van den , Arzimanoglou Alexis , Perucca Emilio , Teeseling Heleen C. van , Leijten Frans S.S. , Braun Kees P.J. , Jansen Floor E.
Published: July 2020

Background: Epileptic encephalopathy with electrical status epilepticus in sleep (ESES) is an epilepsy syndrome occurring almost exclusively in children, usually at an age between 4 and 12 years. It is characterized by abundant sleep-induced epileptic activity in the electroencephalogram (EEG) and by acquired cognitive and behavioural deficits. The goal of treatment is to prevent further decline or even improve cognitive functioning. Based on mostly small and retrospective studies, corticosteroids and clobazam are regarded by many clinicians as the most effective pharmacological treatments. This European multicentre randomized controlled trial is designed to compare the effects of corticosteroids and clobazam on cognitive functioning after 6 months. Secondary outcomes include cognitive functioning after 18 months, EEG abnormalities in sleep, safety and tolerability, and seizure frequency. We also aimed at investigating whether treatment response in epileptic encephalopathy with ESES can be predicted by measurement of inflammatory mediators and auto-antibodies in serum.Methods: The pragmatic study will be performed in centres with expertise in the treatment of rare paediatric epilepsy syndromes across Europe. 130 patients, 2 to 12 years of age, with epileptic encephalopathy with ESES will be enrolled and randomized in a 1:1 ratio to receive either corticosteroids (monthly intravenous methylprednisolone pulses or daily oral prednisolone) or oral clobazam for 6 months according to an open-label parallel-group design. Follow-up visits with clinical assessment, EEGs and neuropsychological testing are scheduled for up to 18 months. Blood samples for cytokine and auto-antibody testing are obtained before treatment and after 8 months of treatment.Discussion: The treatment of epileptic encephalopathy with ESES aims at improving cognitive outcome. This randomized controlled study will compare the most frequently used treatments, i.e. corticosteroids and clobazam. If the study proves superiority of one treatment over the other or identifies biomarkers of treatment response, results will guide clinicians in the early treatment of this severe epilepsy syndrome.Trial registration: ISRCTN, ISRCTN42686094, registered 24 May 2013, http://www.isrctn.com/ISRCTN42686094
Clinical patterns and the evolution of relapsing polychondritis based on organ involvement: a Chinese retrospective cohort study
Authors: Zhang Lei , Yun Shuang , Wu Tiange , He Yujie , Guo Jinyan , Han Lishuai , Lu Jiameng , Liu Xiaojun , Yang Rui , Zhang Shitao , Li Tianfang , Liu Shengyun
Published: July 2020

Background

Relapsing polychondritis(RPC) is a rare autoimmune disease and its early diagnosis pose a challenge to medical committee. Defining the clinical patterns and disease course may help early recognition of RPC.

Results

Sixty-six males and 60 females were included in this study. Their average age at onset were 47.1±13.8 years with a median follow-up of 18 months. Correlation analysis revealed a strong negative correlation between airway involvement and auricular chondritis (r=-0.75，P<0.001). Four distinct clinical patterns were identified: Ear pattern (50.8%), Airway pattern (38.9%), Overlap pattern (4.8%) and Airway-Ear negative pattern (5.6%), and patients with Ear pattern and Airway pattern were further divided into limited and systemic form of RPC (27.8%with limited form of Ear pattern and 24.6% with limited form of Airway pattern initially). During follow-up, a minority of patients with Ear pattern and Airway pattern progressed into Overlap pattern, and some Airway-Ear negative pattern patients progressed into Ear pattern. While a large majority of limited RPC patients remained limited form during follow-up, some patients did become systemic form. Patients with Ear pattern had the highest survival rate and lower inflammatory status.

Conclusions

RPC patients can be categorized as 4 different clinical patterns and 2 distinct presenting forms (limited and systemic) based on organ involvement, and clinical patterns and presenting forms can evolve during follow-up. Our findings may facilitate early recognition of this rare disease.
The Diagnostic Value of SPECT/CT in Predicting the Occurrence of Osteonecrosis following Femoral Neck Fracture : a prospective cohort study
Authors: Yoon Jae Youn , Lee Soong Joon , Yoon Kang Sup , Yoon Pil Whan
Published: July 2020

Backgrounds

One of the most significant complications after a femoral neck fracture is osteonecrosis of the femoral head (ONFH). The concomitant use of single-photon emission computed tomography (SPECT) with computed tomography (CT) increases the sensitivity for detecting the anatomic location and severity of ONFH. In this study, we evaluated the diagnostic value of SPECT/CT for the occurrence of ONFH by quantifying the perfusion status of the femoral head.

Methods

A total of 30 patients who had multiple pinnings for femur neck fractures were included in this study. We classified the perfusion status into three groups: normal perfusion, decreased perfusion, and avascular groups, and compared the occurrence of femoral head necrosis between them. For quantitative analysis, we evaluated the uptake ratio of both femur heads (head-to-head uptake ratio). If the patient’s contralateral hip was incomparable, we measured the uptake ratio from the superior dome of the ipsilateral acetabulum (head-to-acetabulum uptake ratio).

Results

Twenty-four patients out of 30 achieved bone union, whereas the others developed ONFH. When the population was divided into intact and defective perfusion groups on scintigraphy, the sensitivity, specificity, and accuracy of the test were 83.3%, 75.0%, and 76.7%, respectively. The mean head-to-head uptake ratio value with a 95% confidence interval (CI) was 1.10 (95% CI: 0.85 – 1.36). In the osteonecrosis group, the mean value of the head-to-head uptake ratio was 0.33 (95% CI: 0.28 – 0.38). In contrast, the ratio was 1.30 (95% CI: 1.03 – 1.57) in the non-osteonecrosis group, demonstrating a significant difference in the uptake ratio ( P < 0.001). When the cutoff value of the uptake ratio was set to 0.5, both the sensitivity and specificity were 100%. There was also a significant difference in the head-to-acetabulum uptake ratio between the two groups ( P < 0.001).

Conclusions

SPECT/CT was useful in evaluating the perfusion status of the femoral head, showing high accuracy in predicting the occurrence of avascular necrosis. To demonstrate the reliability and validity of SPECT/CT, further prospective studies on a larger scale are warranted.