bluuebunny/crossref_metadata_2025 huggingface dataset:
Better muscle strength can decrease the risk of arthralgia and back & joint stiffness in Kurdish men; a cross-sectional study using data from RaNCD cohort study
Authors: Pasdar Yahya , Hamzeh Behrooz , Moradi Shima , Najafi Farid , Moradinazar Mehdi , Shamsi Mohammadbagher , Shakiba Ebrahim
Published: August 2020

Background

Musculoskeletal disorders can reduce the quality of life and work capacity. In this study, we found that better muscle strength could prevent musculoskeletal pain, including arthralgia and back & joint stiffness. The study assessed handgrip strength (HGS) in relation to low back pain and arthralgia in Kurdish men.

Methods

This cross-sectional study was conducted using data from Ravansar non-communicable diseases (RaNCD) cohort study on 2164 men aged 35-65 years. HGS was measured using a hand-held hydraulic hand grip dynamometer. Low back pain, arthralgia, and joint stiffness were evaluated by the RaNCD cohort study physician using a standard questionnaire.

Results

The results showed that 21.39% and 24.58% of studied participants had low back pain and arthralgia, respectively. Among the participants with low back pain, 14.5% had back stiffness, and among those with arthralgia, 12.8% had joint stiffness. The mean of HGS in participants with arthralgia and back & joint stiffness was significantly less than those without these disorders (P<0.001, P=0.05, and P= 0.005, respectively). Multiple-adjusted OR and 95% confidence intervals (CI) for arthralgia and back and joint stiffness across muscle strength showed the HGS increase to be associated with a lower risk of arthralgia and back &joint stiffness, but not low back pain.

Conclusions

Our results highlighted that higher HGS was associated with a lower risk of arthralgia and back & joint stiffness. However, there was no association between HGS and low back pain. Exercise and adherence to proper nutrition are suggested to enhance muscle strength in order to reduce musculoskeletal pain.
Root-associated endophytic bacterial community composition and structure of three medicinal licorices and their changes with the growing year
Authors: Dang Hanli , Zhang Tao , Li Guifang , Mu Yudi , Lv Xinhua , Wang Zhongke , Zhuang Li
Published: August 2020

Background The dried roots and rhizomes of medicinal licorices are widely used worldwide as a traditional medicinal herb, which are mainly attributed to a variety of bioactive compounds that can be extracted from licorice root. Endophytes and plants form a symbiotic relationship, which is an important source of host secondary metabolites. Results In this study, we used high-throughput sequencing technology and high-performance liquid chromatography to explore the composition and structure of the endophytic bacterial community and the content of bioactive compounds (glycyrrhizic acid, liquiritin and total flavonoids) in different species of medicinal licorices (Glycyrrhiza uralensis, Glycyrrhiza glabra, and Glycyrrhiza inflata) and in different planting years (1–3 years). Our results showed that the contents of the bioactive compounds in the roots of medicinal licorices were not affected by the species, but were significantly affected by the main effect growing year (1–3) (P < 0.05), and with a trend of stable increase in the contents observed with each growing year. In 27 samples, a total of 1,979,531 effective sequences were obtained after quality control, and 2,432 effective operational taxonomic units (OTUs) were obtained at 97% identity. The phylum Proteobacteria, Actinobacteria, Bacteroidetes and Firmicutes, and the genera unified-Rhizobiaceae, Pseudomonas, Novosphingobium, and Pantoea were significantly dominant in the 27 samples. Distance-based redundancy analysis (db-RDA) showed that the content of total flavonoids explained the differences in composition and distribution of endophytic bacterial communities in roots of cultivated medicinal liquorices to the greatest extent. Total soil salt was the most important factor that significantly affected the endophytic bacterial community in soil factors, followed by ammonium nitrogen and nitrate nitrogen. Among the leaf nutrition factors, leaf water content had the most significant effect on the endophytic bacterial community, followed by total phosphorus and total potassium. Conclusions This study not only provides information on the composition and distribution of endophytic bacteria in the roots of medicinal licorices, but also reveals the influence of abiotic factors on the community of endophytic bacteria and bioactive compounds, which provides a reference for improving the quality of licorice.
Evaluation of an exercise-enabling control interface for powered wheelchair users: a feasibility study with Duchenne muscular dystrophy
Authors: Lobo-Prat Joan , Enkaoua Aure , Rodríguez-Fernández Antonio , Sharifrazi Nariman , Medina-Cantillo Julita , Font-Llagunes Josep M. , Torras Carme , Reinkensmeyer David J.
Published: August 2020

BackgroundPowered wheelchairs are an essential technology to support mobility, yet their use is associated with a high level of sedentarism that can have negative health effects for their users. People with Duchenne muscular dystrophy (DMD) start using a powered wheelchair in their early teens due to the loss of strength in their legs and arms. There is evidence that low-intensity exercise can help preserve the functional abilities of people with DMD, but options for exercise when sitting in a powered wheelchair are limited.MethodsIn this paper, we present the design and the feasibility study of a new version of the MOVit device that allows powered-wheelchair users to exercise while driving the chair. Instead of using a joystick to drive the wheelchair, users move their arms through a cyclical motion using two powered, mobile arm supports that provide controller inputs to the chair. The feasibility study was carried out with a group of five individuals with DMD and five unimpaired individuals. Participants performed a series of driving tasks in a wheelchair simulator and on a real driving course with a standard joystick and with the MOVit 2.0 device.ResultsWe found that driving speed and accuracy were significantly lowered for both groups when driving with MOVit compared to the joystick, but the decreases were small (speed was 0.26 m/s less and maximum path error was 0.1 m greater). Driving with MOVit produced a significant increase in heart rate (7.5 bpm) compared to the joystick condition. Individuals with DMD reported a high level of satisfaction with their performance and comfort in using MOVit.ConclusionsThese results show for the first time that individuals with DMD can easily transition to driving a powered wheelchair using cyclical arm motions, achieving a reasonable driving performance with a short period of training. Driving in this way elicits cardiopulmonary exercise at an intensity found previously to produce health-related benefits in DMD.
Central Sensitization Inventory scores correlate with pain at rest in patients with hip osteoarthritis: A retrospective study
Authors: Ohashi Yoshihisa , Fukushima Kensuke , Inoue Gen , Uchida Kentaro , Koyama Tomohisa , Tsuchiya Maho , Uchiyama Katsufumi , Takahira Naonobu , Takaso Masashi
Published: August 2020

Background: Patients with persistent pain due to osteoarthritis (OA) complain of multiple symptoms that cannot be explained solely by structural changes. A poor correlation exists between structural and inflammatory changes in OA and pain levels. Central sensitization (CS) has been identified as a factor that induces chronic pain in patients with OA. Although it is important to identify osteoarthritis patients with CS components, the prevalence and characteristics of CS, especially those in patients with hip OA, are not well understood. Thus, we aimed to determine the prevalence and characteristics of CS in patients with hip OA, in this study. Methods: The CS Inventory (CSI), used as a non-invasive routine clinical tool to evaluate the presence of CS 1 month before surgery in 100 patients with hip OA, was measured at our outpatient clinic, and the data were retrospectively reviewed. We determined the number of patients with a CSI score of 40 points or higher and assessed the relationships between the CSI score and clinical factors (including age, duration of hip pain, degree pain at rest and on activity, by using the visual analogue scale [VAS] and the Harris Hip Score) using the Spearman’s correlation coefficient. Results: The mean age of participants was 63.9±11.6 years, and there were 15 men and 85 women. All patients had hip OA, categorised as advanced and terminal stage (Tönnis grade 2–3) on preoperative plain radiography. The mean duration of hip pain was 4.2±4.4 years. The mean CSI score was 19.5±11.3 and 5 (5.0%) of the patients had a score of 40 or more points. CSI scores correlated significantly only with VAS pain at rest (r=0.348, P<0.001). Conclusion: In this study, 1 out of every 20 hip OA patients had CS components. CSI scores were significantly correlated with pain at rest in hip OA patients. CS approaches to hip OA may be one of the treatment options for pain at rest.
Cardiac radiation dose predicts survival in esophageal squamous cell carcinoma treated by definitive concurrent chemotherapy and intensity modulated radiotherapy
Authors: Pao Tzu-Hui , Chang Wei-Lun , Chiang Nai-Jung , Chang Jeffrey Shu-Ming , Lin Chia-Ying , Lai Wu-Wei , Tseng Yau‐Lin , Yen Yi‐Ting , Chung Ta-Jung , Lin Forn-Chia
Published: August 2020

Background: The prognostic significance of cardiac radiation dose in esophageal cancer after definitive concurrent chemoradiotherapy (CCRT) remains largely unknown. We aimed to investigate the association between cardiac dose-volume parameters and overall survival (OS) in esophageal squamous cell carcinoma (ESCC) after definitive CCRT. Methods: One hundred and twenty-one ESCC patients undergoing definitive CCRT with intensity modulated radiotherapy technique between 2008 and 2018 were reviewed. Cardiac dose-volume parameters were calculated. Survival of patients and cumulative incidence of adverse events were estimated by the Kaplan–Meier method and compared between groups by the log-rank test. The prognostic significance of cardiac dose-volume parameters was determined with multivariate Cox proportional hazards regression analysis. Results: Median follow-up was 16.2 months (range, 4.3-109.3). Median OS was 18.4 months. Heart V5, V10, and V20 were independent prognostic factors of OS. Median OS was longer for patients with heart V5 ≤ 94.3% (24.7 vs. 16.3 months, p = 0.0025), heart V10 ≤ 86.4% (24.8 vs. 16.9 months, p = 0.0041), and heart V20 ≤ 76.9% (20.0 vs. 17.2 months, p = 0.047). Lower cumulative incidence of symptomatic cardiac adverse events was observed among patients with heart V5 ≤ 94.3% (p = 0.017), heart V10 ≤ 86.4% (p = 0.02), and heart V20 ≤ 76.9% (p = 0.0057). Patients without symptomatic cardiac adverse events had a higher 3-year OS rate (33.8% vs. 0%, p = 0.03). Conclusions: Cardiac radiation dose inversely correlated with survival in ESCC after definitive CCRT. Radiation dose to the heart should be minimized.
Evaluation of OAR sparing and plan robustness of beam-specific PTV in lung cancer IMRT treatment
Authors: Chang Yu , Xiao Feng , Quan Hong , Yang Zhiyong
Published: August 2020

Purpose: Margins are employed in radiotherapy treatment planning to mitigate the dosimetric effects of geometric uncertainties for the clinical target volume (CTV). We propose a margin concept that takes the beam direction into consideration, generating a beam-specific PTV (BSPTV) on a beam entrance view. The total merged BSPTV was considered as target using for optimization. We investigated the impact of this novel approach when applied to lung IMRT treatments, and compared the treatment plans generated using BSPTV with conventional PTV. Methods and Materials: We generated the BSPTV by expanding the CTV perpendicularly to the incident beam direction using the 2D version of van Herk’s margin concept. The BSPTV and conventional PTV margin were first analyzed in digital phantom simulation. Then, fifteen lung cancer patients were used in this planning study. First, all patient targets were performed with the CTV projection area analysis to select the suitable beam angles. Then, BSPTV were generated according to the selected beam angles. IMRT plans were optimizted with the conventional PTV and BSPTV as the target volumes, respectively. The dosimetry metrics were calculated and evaluated between these two plans. The plan robustness of both plans for setup uncertainties was evaluated with worst-case analysis. Results: Both conventional PTV and BSPTV plans satisfied the CTV coverage. The BSPTV plans improved the sparing of high doses to target-surrounding lung tissues much better than the conventional PTV plans. Both D mean of Ring PTV and Ring BSPTV were significantly lower in BSPTV plans (38.89Gy and 39.43Gy) than that in the conventional PTV plans (40.27Gy and 40.68Gy). The V20, V5 and mean lung dose of the affected lung were significant lower in BSPTV plans (16.20%, 28.75% and 8.93Gy) than that in the conventional PTV plans (16.69%, 29.22% and 9.18Gy). About 80% of target coverage in all uncertainty scenarios could be achieved for both conventional PTV and BSPTV plans. Conclusions: The results suggested that the plan robustness can be guaranteed in both the BSPTV and conventional PTV plans. However, the BSPTV plans can spare the normal tissues such as lungs significant better than the conventional PTV plans.
Distribution and Prognostic Value of Left Ventricular Global Longitudinal Strain in Elderly Patients with Symptomatic Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement
Authors: Povlsen Jonas Agerlund , Rasmussen Vibeke Guldbrand , Vase Henrik , Jensen Kaare Troels , Terkelsen Christian Juhl , Christiansen Evald Høj , Tang Mariann , Pedersen Anders Lehmann Dahl , Poulsen Steen Hvitfeldt
Published: August 2020

AimsThe aim of present study was to examine the preoperative prevalence and distribution of impaired left ventricular global longitudinal strain (LVGLS) in elderly patients with symptomatic aortic stenosis (AS) undergoing transcutaneous aortic valve replacement (TAVR) and to determine the predictive value of LVGLS on survival.MethodsWe included 411 patients with symptomatic severe AS treated with TAVR during a 5-year period, where a baseline echocardiography including LVGLS assessment was available.ResultsMean age was 80.1±7.1 years and aortic valve area (AVA) index 0.4±0.1 cm2. 78 patients died during a median follow-up of 762 days. Mean left ventricular ejection fraction (LVEF) was 50±13% and mean LVGLS was -14.0%. LVEF was preserved in 60% of patients, while impaired LVGLS >-18% was seen in 75% of the patients. Previous myocardial infarction, LVEF < 50%, LVGLS >-14%, low gradient AS (< 4.0 m/s), tricuspid regurgitant gradient >30 mmHg were identified as significant univariate predictors of all-cause mortality. On multivariate analysis LVGLS >-14% (HR 1.79 [1.02-3.14], p=0.04) was identified as the only independent variable associated with all-cause mortality. Reduced survival was observed with an impaired LVGLS >-14% in the total population (p<0.002) but also in patients with high AS gradient with preserved LVEF. LVGLS provided incremental prognostic value with respect to clinical characteristics, AVA and LVEF (χ2 19.9, p=0.006).ConclusionsIn patients with symptomatic AS undergoing TAVR, impaired LVGLS was highly prevalent despite preserved LVEF. LVGLS >-14% was an independent predictor of all-cause mortality, and survival was reduced if LVGLS >-14 %.
A Multilevel Study of Patient-Centered Care Perceptions In Mental Health Teams
Authors: Durand Francois , Fleury Marie-Josée
Published: August 2020

Background: The combination of interprofessional collaboration in teams and patient-centered care is a necessary amalgamation when it comes to delivering complex mental healthy care and services. Yet collaboration is challenging and patient-centered care is intricate to manage. This study examines the impact of predictors of patient-centered care such as team adaptivity and proactivity, collaboration, belief in interprofessional collaboration, informal role self-efficacy in multidisciplinary mental health teams.Method: Cross-sectional multilevel design using self-administered bilingual validated questionnaires.Results: This study showed that belief in interprofessional collaboration’s impact on patient-centered perceptions is increased in teams with high collaboration. We also showed that collaboration is a mediator; that is, a process by which team adaptive and proactive behaviors are transformed into positive patient-centered perceptions.Conclusions: In terms of research our results are in line with recent theorising on team processes and specifically established collaboration as key in a multilevel examination of predictors of patient-centered care perceptions. In terms of practice, we showed that multidisciplinary teams should know that working hard on collaboration as an answer to the complexity of patient-centered care impacts the teams’ ability to respond to its challenges but also impacts individuals’ beliefs central to the delivery of interprofessional care.
Invasion-induced root-fungal disruptions alter plant water and nitrogen economies
Authors: Bialic-Murphy Lalasia , Smith Nicholas , Voothuluru Priya , McElderry Robert , Roche Morgan , Steven Cassidy , Kivlin Stephanie , Kalisz Susan
Published: August 2020

Despite widespread evidence that biological invasion influences the biotic and abiotic soil environments, the extent to which each of these pathways underpins the effects of invasion on native plant traits and performance is unknown. Leveraging a long-term (14-yr) manipulative field experiment, we show that an allelochemical-producing invader, Alliaria petiolata, affects native plants through biotic mechanisms, altering the soil fungal community composition, with no apparent shifts in soil nutrient availability. These changes in belowground soil fungal communities resulted in a high cost of resource uptake for native forest perennial herbs and a shift in functional traits linked to their carbon and nutrient economies. Furthermore, we illustrate that some species in the invaded community compensate for high nutrient costs by reducing nutrient uptake and maintaining photosynthesis by expending more water. This demonstrates a trade-off in trait investment that increases nutrient use efficiency as nutrient costs increase. Our results show that invasion-induced disruptions in the soil fungal community belowground can cascade to affect aboveground plant communities via shifts in physiological traits needed to maintain plant water and nutrient economies. These complex above-belowground linkages suggest that plant invasions should be evaluated at the system-level to fully understand and predict their impact on native plants and communities.
Prevalence of High Risk Obstructive Sleep Apnoea by Berlin Questionnaire in Patients with Hypertension: Study from a Tertiary Care Hospital
Authors: Kareem Ozaifa , Tanvir Masood , Bader Ghulam Nabi
Published: August 2020

Background: Obstructive Sleep Apnoea (OSA), a condition characterized by a complete or partial cessation of airflow during sleep, can cause various cardiovascular disorders including hypertension. The aim of the study was to determine the prevalence of OSA in patients with hypertension. Methods: A cross-sectional prospective cohort study of 504 patients with hypertension was undertaken at a tertiary care hospital of India for a period of six months. OSA was evaluated using the Berlin questionnaire while the daytime sleepiness was determined using Epworth Sleepiness Scale. Data analysis was done using SPSS v. 20. Results: High risk of OSA was identified in 120 (23.8%) patients and the prevalence of sleepiness (Epworth Sleepiness score ˃16) was found to be 32.5% (95% CI, p˂0.001) in these patients. The mean neck circumference, waist circumference and waist-to-hip ratio for high-risk OSA group were 37.41 ± 3.396 cm, 105.90 ± 11.28 cm and 1.01 ± 0.065 respectively while for the low-risk group, these parameters were 35.45 ± 2.652 cm, 98.75 ± 10.87 cm and 0.99 ± 0.080 respectively (95% CI, p˂0.001). The mean blood pressure (BP) ≥133.52/84.37 mm Hg was recorded in patients with a high risk of OSA (95% CI, P<0.05), and resistant hypertension (3.3%) was significantly associated with the risk of OSA (95% CI, P<0.05).Conclusion: In the tertiary health care setting, the prevalence of high-risk of OSA in patients with hypertension is high. Screening for OSA should be a part of the hypertensive medical investigation and patients may benefit from a proper evaluation of OSA.
Carbon ion radiotherapy for prostate cancer with bladder invasion
Authors: Miyasaka Yuhei , Kawamura Hidemasa , Sato Hiro , Kubo Nobuteru , Mizukami Tatsuji , Matsui Hiroshi , Miyazawa Yoshiyuki , Ito Kazuto , Nakano Takashi , Suzuki Kazuhiro , Ohno Tatsuya
Published: August 2020

BackgroundThe optimal management of clinical T4 (cT4) prostate cancer (PC) is still uncertain. At our institution, carbon ion radiotherapy (CIRT) for nonmetastatic PC, including tumors invading the bladder, has been performed since 2010. Since carbon ion beams provide a sharp dose distribution with minimal penumbra and have biological advantages over photon radiotherapy, CIRT may provide a therapeutic benefit for PC with bladder invasion. Hence, we evaluated CIRT for PC with bladder invasion in terms of the safety and efficacy.MethodsBetween March 2010 and December 2016, a total of 1,337 patients with nonmetastatic PC received CIRT at a total dose of 57.6 Gy (RBE) in 16 fractions over 4 weeks. Among them, 7 patients who had locally advanced PC with bladder invasion were identified. Long-term androgen-deprivation therapy (ADT) was also administered to these patients. Adverse events were graded according to the Common Terminology Criteria for Adverse Event (CTCAE) version 5.0.ResultsAt the conclusion of our study, all the patients with cT4 PC were alive with a median follow-up period of 78 months. Grade 2 acute urinary disorders were observed in only 1 patient. Regarding late toxicities, only 1 patient developed grade 2 hematuria and urinary urgency. There was no grade 3 or worse toxicity. Gastrointestinal toxicity was not observed. Six (85.7%) patients had no recurrence or metastasis. One patient had biochemical and local failures 42 and 45 months after CIRT, respectively. However, the recurrent disease has been well controlled by salvage ADT.ConclusionsSeven patients with locally advanced PC invading the bladder treated with CIRT were evaluated. Our findings seem to suggest positive safety and efficacy profiles for CIRT.
Thyroid function and non-alcoholic fatty liver disease in hyperthyroidism patients
Authors: Wang Bairong , Yang Yumei , Wang Baomin , Xu Jing , Hong Mengyang , Xia Mingfeng , Li Xiaomu , Gao Xin
Published: August 2020

Background: Although thyroid function has been demonstrated to be associated with non-alcoholic fatty liver disease (NAFLD) in different population, the prevalence and features of NAFLD in hyperthyroidism have not been reported. The present study aims to investigate the prevalence of NAFLD and association of thyroid function and NAFLD in hyperthyroidism patients.Methods: This cross-sectional study was performed in Zhongshan Hospital, Fudan University, China. A total 117 patients with hyperthyroidism were consecutively recruited from 2014-2015. Thyroid function and other clinical features were measured, liver fat content was measured by color Doppler ultrasonically, NFALD was defined in patients with liver fat content more than 9.15% . Statistical analyses were performed with SPSS software package version 13.0.Results: The prevalence of NAFLD was 11.97% in hyperthyroidism. Patient with NAFLD had lower fT3 and fT4 levels than patients without NAFLD (P < 0.05). After adjusting for age, gender, metabolic parameters and inflammation factors, higher fT3 were associated with lower liver fat content (β=－0.072, P=0.009) and decreased odds ratio of NAFLD (OR=0.267, 95%CI 0.087-0.817, P=0.021). Conclusions: The prevalence of NAFLD was 11.97% in hyperthyroidism patients, and FT3 level was negatively associated with the liver fat content in this population.
Effect of a Benign Prostatic Hyperplasia (BPH) Xenobiotic - Croton membranaceus Müll.Arg. Root Extract on CYP1A2, CYP3A4, CYP2D6, and GSTM1 Drug Metabolizing Enzymes in Rat Model
Authors: Asare George A. , Ongong'a Royronald Ochieng , Anang Yvonne , Asmah Richard H. , Rahman Habibur
Published: August 2020

Background

Croton membranaceus Müll.Arg., root extract has been scientifically and clinically proven to be efficacious in the management of BPH. However, its effect on liver drug-metabolizing enzymes has not been established. This study aimed to determine the effect of the plant extract on phase I and phase II drug-metabolizing enzymes.
Materials and methods

Fifteen (15) castrated testosterone-induce BPH male Albino Wister rats weighing between 120–150 grams were randomly divided into 3 groups of 5 rats each (Groups II-IV). Five (5) uncastrated rats in Group I was used as a negative control, receiving only distilled water. Group II was administered 30 mg/kg b. wt extracts of C. membranaceus. Group III was the BPH-model group (administered distilled water) while Group IV was administered 0.5 mg/kg b. wt finasteride and was used as the positive control. BPH was induced in groups II-IV by administering testosterone propionate, 3 mg/kg b. wt for 28 days after a 7-day post castration rest period. Rats were euthanized and individual livers harvested for microsome preparation. The liver microsomes were assayed for, Phase I Drug Metabolizing Enzymes (DME); CYP1A2, CYP3A4, CYP2D6, and phase II; GST-M1 using Enzyme-Linked Immuno-Sorbent Assay (ELISA) techniques.
Results

Significant induction in phase I enzymes CYP1A2 was observed (p = 0.02), while CYP3A4 and CYP2D6 were inhibited (0.00, 0.01, respectively). Phase II enzymes, GSTM1, showed a significant induced (p = 0.01). C.membranaceus induced CYP1A2 strongly, GSTM1 modestly, and had an inhibitory effect on CYP3A4/CYP2D6.
Conclusion

Croton membranaceus induces and inhibits some phase I metabolizing enzymes while moderately inducing phase II metabolizing enzymes. Care should be taken in the use of phytotherapy in conjunction with other drugs.
Spatial Distribution and Determinant Factors of Anaemia Among Adults Aged 15-59 in Ethiopia; Using Mixed-Effects Ordinal Logistic Regression Model
Authors: Tusa Biruk Shalmeno , kebede Sewnet Adem , Weldesenbet Adisu Birhanu Birhanu
Published: August 2020

Background: Anaemia is a global public health problem particularly in developing countries. Assessing the geographical distributions and determinant factors is a key and crucial step in designing targeted prevention and intervention programmes to address anaemia. Thus, the current study aimed to assess the spatial distribution and determinant factors of anaemia among adults aged 15-59 in Ethiopia.Methods: A secondary data analysis was done based on 2016 Ethiopian Demographic and Health Surveys (EDHS). Total weighted samples of 29,140 adults were included. Data processing and analysis were performed using STATA 14; ArcGIS 10.1 and SaTScan 9.6 software. Spatial autocorrelation was checked using Global Moran’s index (Moran’s I). Hotspot analysis was made using Gettis-OrdGi*statistics. Additionally, spatial scan statistics were applied to identify significant primary and secondary cluster of anaemia. Mixed effect ordinal logistics were fitted to determine factors associated with the level of anaemia.Result: The spatial distribution of anaemia among adults age 15-59 was found to be clustered in Ethiopia (Global Moran’s I = 0.81, p value < 0.0001). In the multivariable mixed-effect ordinal regression analysis; being females [AOR = 1.53; 95% CI: 1.42, 1.66], never married [AOR = 0.86; 95% CI: 0.77, 0.96], higher educated [AOR = 0.71; 95% CI: 0.60, 0.84], rural residents [AOR = 1.53; 95% CI: 1.23, 1.81], rich wealth status [AOR = 0.77; 95% CI: 0.69, 0.86] and underweight [AOR = 1.15; 1.06, 1.24] were significant predictors of anaemia among adults.Conclusions: A significant clustering of anaemia among adults aged 15-59 were found in Ethiopia and the significant hotspot areas with high clusters of anaemia were identified in Somalia, Afar, Gambella, Dire Dewa and Harari regions. Besides, gender, marital status, educational level, place of residence, region, wealth index and body mass index (BMI) were significant predictors of anaemia. Therefore, effective public health intervention and nutritional education should be designed in the identified hotspot areas and risk groups to decrease the incidence of anaemia.
GDF15 Mediates the Metabolic Effects of PPARβ/δ by Activating AMPK
Authors: Aguilar-Recarte David , Barroso Emma , Pizarro-Delgado Javier , Peña Lucía , Ruart Maria , Palomer Xavier , Wahli Walter , Vázquez-Carrera Manuel
Published: August 2020

Peroxisome proliferator-activated receptor β/δ(PPARβ/δ) activates AMP-activated protein kinase (AMPK) and plays a crucial role in glucose and lipid metabolism. Here, we examined whether the beneficial effects of PPARβ/δ activation depended on growth differentiation factor 15 (GDF15), a stress response cytokine that regulates energy metabolism. Pharmacological PPARβ/δ activation increased GDF15 levels and ameliorated glucose intolerance, fatty acid oxidation, endoplasmic reticulum stress, inflammation and activated AMPK in HFD-fed mice, whereas these effects were abrogated by the injection of a GDF15 neutralizing antibody and in Gdf15-/- mice. The AMPK-p53 pathway was involved in the PPARβ/δ-mediated increase in GDF15, which in turn activated again AMPK. Finally, Gdf15-/- mice showed reduced AMPK activation in skeletal muscle, whereas GDF15 administration resulted in AMPK activation in this organ. Collectively, these data reveal a novel mechanism by which PPARβ/δ activation increases the levels of GDF15 via AMPK and p53, which in turn mediates the metabolic effects of PPARβ/δ by sustaining AMPK activation.
Genetic Diversity Analysis of Brown Marmorated Stink Bug, Halyomorpha Halys Based on Mitochondrial COI and COII Haplotypes
Authors: Yan Juncong , Pal Chandan , Anderson Diane , Vétek Gábor , Farkas Péter , Burne Allan , Fan Qing-Hai , Zhang Jinping , Gunawardana Disna N. , Balan Rebijith Kayattukandy , George Sherly , Li Dongmei
Published: August 2020

Background:In the past decade, the brown marmorated stink bug (BMSB), Halyomorpha halys (Hemiptera: Pentatomidae) has caused extensive damage to global agriculture. As a high-risk pest for many countries, including New Zealand, it is important to explore its genetic diversity to enhance our knowledge on and devise management strategies for BMSB populations. In this study, two mitochondrial genes, Cytochrome c oxidase I (COI) and Cytochrome c oxidase II (COII) were used to explore the genetic diversity among 463 BMSB individuals collected from 12 countries.Result:In total, 51 COI and 29 COII haplotypes of BMSB were found, which formed 59 combined haplotypes (5 reported and 54 novel). Of these, H1h1 was the predominant haplotype. The haplotype diversity (Hd) and nucleotide diversity (π) were high while the neutrality (Fu's Fs) values were negative for the BMSB populations in the native countries, China, and Japan. For the BMSB populations from the invaded countries, the Fu's Fs values were negative for populations from Chile, Georgia, Hungary, Italy, Romania, Turkey, and USA, indicating that those populations are under demographic expansion. In comparison, the Fu's Fs values were positive for the populations from Austria, Serbia, and Slovenia, revealing a potential population bottleneck. Analysis of molecular variance (AMOVA) suggested that significant genetic difference exist between groups of populations: China, Japan, and the invasive populations.Conclusion:This study revealed that the haplotype diversity of the BMSB populations was high in those two studied countries where BMSB is native to (China and Japan) but low in those countries which have been invaded by the species. The analysis indicated that multiple invasions of BMSB occurred and a new stable genetic cluster has established in Europe and USA. The study also revealed that three ancestral lines and most of the novel haplotypes were evolved from them. Moreover, we observed two genetic clusters in the invasive populations that are formed during different invasion events. Our study provided a comprehensive overview on the global haplotypes distribution thus expanding the existing knowledge on BMSB genetic diversity that potentially could play an important role in formulating feasible pest management strategies, especially biocontrol.
Psychometric Evaluation of the Arabic Version of the Higher Education Inventory Scale for nursing students
Authors: Masha’al Dina , Hayajneh Audai , Tawalbeh Loai Issa
Published: August 2020

BackgroundStudies in the literature have relied on a single instrument to assess stress levels and sources among nursing students in Jordan and in other Arab countries. Thus, there is a need for adopting Arabic versions of psychometrically validated instruments for evaluating a wider range of aspects related to stress and stressors. The Higher Education Stress Inventory (HESI) is an instrument used to assess various features of stress and stressors related to higher education in different educational settings and among different student populations. To date, no exploratory or confirmatory factor analyses (EFA) (CFA) have been conducted to study the factor structure of the Arabic version of the HESI. The current study aimed to evaluate the psychometric properties of the Arabic version of the HESI (Arabic-HESI) among nursing students in Jordan. MethodsThe structure of the instrument was tested using EFACFA and using maximum likelihood estimation among a sample of 355 nursing students at five Jordanian universities.ResultsThe Arabic-HESI proved to have excellent content validity (CVI = 0.92The instrument showed good internal consistency reliability (Cronbach’s α was0.75), as well as for the two emerged factors “challenges” and “dissatisfaction” (Cronbach’s α were 0.75, 0.72 respectively). The results support the two-factor model for the Arabic-HESI because it has robust structure and acceptable goodness-of-fit indices. ConclusionThe Arabic-HESI is a reliable and valid instrument for assessing stress levels and stressors among nursing students in Jordan. Using the reduced version of the HESI to assess stress among nursing students is recommended. Identifying new features of stress and stressors among nursing students in Jordan will enable universities and nursing faculties to better support their students.
Incidence of Post-Traumatic Stress Disorder after Coronavirus Disease
Authors: Chang Min Cheol , Park Donghwi
Published: August 2020

Background

There was an outbreak of coronavirus disease (COVID-19) in Daegu, the Republic of Korea, in 2020. We investigated the prevalence of post-traumatic stress disorder (PTSD) among patients with COVID-19 who were treated and discharged at a university hospital in Daegu, Korea.
Methods

A total of 64 patients who were diagnosed with COVID-19 and hospitalized, treated, and discharged from a university hospital between February and April 2020 participated to our study. We conducted a phone interview and evaluated the presence of PTSD using the PTSD checklist (PCL-5) from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; score range: 0 to 80). If a score ≥ 33 was obtained, then a diagnosis of PTSD was rendered.
Results
Thirteen patients scored \(\ge\)33 on the PCL-5, which indicated that 20.3% (13/64) of the patients had PTSD. No statistically significant differences in the demographic data, including sex, age, hospitalization time, and duration after discharge, were observed between the patients with PTSD and those without PTSD.
Conclusions

We found that 20% of patients with COVID-19 who were hospitalized, treated, and discharged had PTSD. Accordingly, clinicians should be aware of the high possibility of PTSD among COVID-19 patients and mental health support among the infected patients should be provided.
Association between Postoperative Changes in the Gut Microbiota and Pseudopsia After Cardiac Surgery: Prospective observational study
Authors: Maekawa Masaki , Yoshitani Kenji , Yahagi Musashi , Asahara Takashi , Shishido Yoshiyuki , Fukushima Satsuki , Tadokoro Naoki , Fujita Tomoyuki , Ohnishi Yoshihiko
Published: August 2020

Background
Delirium after cardiac surgery affects mortality, but the mechanism remains unclear. Previous studies have reported gut microbiota are associated with brain activity. Systemic inflammation and antibiotics can damage the gut microbiota after cardiac surgery. We aimed to investigate changes in the gut microbiota and the association between the gut microbiota and delirium after cardiac surgery.
Methods
Twenty-one patients who underwent cardiac surgery were enrolled. Microbiota counts and fecal organic acid concentrations were measured in fecal samples harvested before surgery, just after surgery, and before discharge. To quantify the microbiota, we extracted total RNA fractions and examined gut microbiota composition using 16S and 23S rRNA-targeted quantitative-reverse Transcription-PCR. Postoperative delirium, insomnia, and pseudopsia were assessed for 1 week. Postoperative total bacterial counts changed significantly from 10.2 ± 0.2 log10 cells/g of feces to 9.8 ± 0.5 in the first postoperative samples (p = 0.003) and 10.0 ± 0.4 in the samples before discharge (p = 0.039). Fecal pH was 6.9 ± 0.6 before surgery and 7.4 ± 0.7 in the first postoperative samples (p = 0.001). Postoperative Staphylococcus and Pseudomonas counts were significantly higher in patients with postoperative pseudopsia than in patients without pseudopsia (3.2 ± 1.3 vs. 5.4 ± 0.9; p = 0.012 and 1.7 ± 0.8 vs. 4.6 ± 2.7; p = 0.001).
Conclusions
Total bacterial counts were significantly lower after surgery and until discharge. Fecal pH was significantly higher than preoperative levels. Staphylococcus and Pseudomonas counts were significantly higher in patients with postoperative pseudopsia.
Development and Evaluation of Two-Parameter Linear Free Energy Models for the Prediction of Human Skin Permeability Coefficient of Neutral Organic Chemicals
Authors: Naseem Sana , Zushi Yasuyuki , Nabi Deedar
Published: August 2020

The experimental values of skin permeability coefficients, required for dermal exposure assessment, are not readily available for many chemicals. The existing estimation approaches are either less accurate or require many parameters that are not readily available. Furthermore, current estimation methods are not easy to apply to complex environmental mixtures. We present two models to estimate the skin permeability coefficients of neutral organic chemicals. The first model, referred to here as the 2-parameter partitioning model (PPM), exploits a linear free energy relationship (LFER) of skin permeability coefficient with a linear combination of partition coefficients for octanol-water and air-water systems. The second model is based on the retention time information of nonpolar analytes on comprehensive two-dimensional gas chromatography (GC × GC). The PPM successfully explained variability in the skin permeability data (n = 175) with R2 = 0.82 and root mean square error (RMSE) = 0.47 log unit. In comparison, the US-EPA’s model DERMWIN exhibited an RMSE of 0.78 log unit. The Zhang model \(-\) a 5-parameter LFER equation based on experimental Abraham solute descriptors (ASDs) \(-\) performed slightly better with an RMSE value of 0.44 log unit. However, the Zhang model is limited by the scarcity of experimental ASDs. The GC × GC model successfully explained the variance in skin permeability data of nonpolar chemicals (n = 79) with R2 = 0.90 and RMSE = 0.23 log unit. The PPM can easily be implemented in US-EPA’s Estimation Program Interface Suite (EPI Suite™). The GC × GC model can be applied to the complex mixtures of nonpolar chemicals.
Impact of COVID-19 on Health-related Quality of Life in Patients With Cardiovascular Disease: A Multi-ethnic Asian Study
Authors: Lim Shir Lynn , Woo Kai Lee , Lim Eleanor , Ng Faclin , Chan Mark YY , Gandhi Mihir
Published: August 2020

BackgroundLittle is known about the impact of the global coronavirus disease-2019 (COVID-19) pandemic on patients with cardiovascular disease (CVD), the biggest global killer and major risk factor for severe COVID-19 infections. We aim to explore the indirect consequences of COVID-19 on health-related quality of life (HRQoL) of patients with CVD. MethodsEighty-one adult outpatients with CVD were assessed using the EQ-5D, a generic health status instrument with five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), before and during the pandemic. Changes in the EQ-5D dimensional responses were compared categorically as well as using the dimension-specific sum-score (range 1 to 3, with a higher score indicates worse health). The responses and sum-score were compared using the exact test of symmetry and the paired t-test, respectively. ResultsThese patients [mean age (SD) 59.8 (10.5); 92.6% males; 56% New York Heart Association (NYHA) functional class I] had coronary artery disease (69%), heart failure (28%), or arrhythmias (15%). None experienced change in NYHA class between assessments. About 30% and 38% of patients reported problems with at least one of the EQ-5D dimensions pre- and during the pandemic, respectively. The highest increase in health problems was reported for anxiety/depression (12.5% pre-pandemic vs 23.5% during pandemic; p = 0.035) with mean domain-specific score from 1.12 (SD 0.33) to 1.25 (SD 0.46) (p = 0.012). There was no meaningful change in other dimensions as well as overall HRQoL. Conclusion The COVID-19 pandemic is associated with a significant worsening of the mental health of patients with CVD.
Dynamic feldspar alteration governed by single self-evolved fluid system
Authors: Duan Gan , Brugger Joel , Ram Rahul , Xing Yan , Etschmann Barbara
Published: August 2020

The evolution of hydrothermal fluids during metasomatic and/or hydrothermal processes is responsible for the formation of ore deposits and associated alteration. In systems with well-developed breccia and fractures, mineral reactions are largely driven by decompression boiling, fluid cooling or external fluid mixing, but in less permeable rocks, elements exchanges occur at fluid-mineral interfaces, resulting in a self-evolved fluid-mineral reaction system. However, the dynamic fluid evolution leading to large-scale (km) alteration remains poorly understood. We observed experimentally that the sequential sodic and potassic alterations associated with mineralization in large ore deposits, in particular Iron Oxide Copper Gold (IOCG) deposits, can occur via a single self-evolved, originally Na-only, hydrothermal fluid, driven by a positive feedback between equilibrium and kinetic factors. Albite formed first upon reaction of sanidine ((K,Na)AlSi3O8) with a NaCl fluid at 600˚C, 2 kbar. However, with increasing reaction time, some of the initially formed albite was in-turn replaced by K-feldspar (KAlSi3O8). Fluorine accelerated the process, resulting in nearly complete back-replacement of albite within 1 day. These experiments demonstrate that potassic alteration can be induced by Na-rich fluids, and pervasive sequential sodic and potassic alterations do not necessarily reflect near-equilibrium, externally-driven changes in fluid alkali contents.
Further evidence that CP-AMPARs are critically involved in synaptic tag and capture at hippocampal CA1 synapses
Authors: Park Pojeong , Kang Heather , Georgiou John , Zhuo Min , Kaang Bong-Kiun , Collingridge Graham L
Published: August 2020

The synaptic tag and capture (STC) hypothesis provides an important theoretical basis for understanding the synaptic basis of associative learning. We recently provided pharmacological evidence that calcium-permeable AMPA receptors (CP-AMPARs) are a crucial component of this process. Here we have investigated two predictions that arise on the basis of CP-AMPARs serving as a trigger of the STC effect. Firstly, we compared the effects of the order in which we delivered a strong theta burst stimulation (TBS) protocol (75 pulses) and a weak TBS protocol (15 pulses) to two independent inputs. We only observed a significant STC effect when the strong preceded the weak TBS. Second, we found that pausing stimulation following either the sTBS or the wTBS for ~20 min largely eliminates the STC effect. These observations are exactly as predicted for a process that is triggered by the synaptic insertion of CP-AMPARs and provide a framework for establishing the underlying molecular mechanism.
Association of depression symptom severity with short-term risk of an initial hospital encounter in adults with major depressive disorder
Authors: Voelker Jennifer , Wang Kun , Tang Wenze , He Jinghua , Daly Ella , Pericone Christopher D , Sheehan John J
Published: August 2020

BackgroundDespite the availability of pharmacologic and nonpharmacologic treatment options, depression continues to be one of the leading causes of disability worldwide. The impact of depression symptom severity on short-term risk of hospitalization is not well established in the literature. This study evaluates the degree to which depression symptom severity in patients diagnosed with MDD is associated with risk of an initial hospital encounter (ER visit or hospitalization) in the short-term following an outpatient PHQ-9 assessment. MethodsAdult patients (≥18 years of age) with ≥1 PHQ-9 assessment in an outpatient setting (index date) and ≥1 MDD diagnosis within 6 months prior were included from the de-identified Optum Electronic Health Record database (April 2016-June 2019). Patients were categorized based on PHQ-9 scores obtained by natural language processing. Crude rates and adjusted absolute risks of all-cause, MDD-related, and suicidal ideation (SI)/suicide attempt (SA)-related hospital encounters within 30 days of patients’ PHQ-9 assessments were evaluated.ResultsThe study population consisted of 280 145 patients with MDD and ≥1 PHQ-9 assessment in an outpatient setting. Based on PHQ-9 scores, 26.9% of patients were categorized as having none/minimal depression symptom severity, 16.4% as mild, 24.7% as moderate, 19.6% as moderately severe, and 12.5% as severe. Among patients with none/minimal, mild, moderate, moderately severe, and severe depression, the adjusted absolute short-term risks of an initial all-cause hospital encounter were 3.9%, 4.3%, 4.9%, 5.7%, and 6.7%, respectively; of a MDD-related hospital encounter they were 0.8%, 1.0%, 1.3%, 1.6%, and 2.2%, respectively; of a SI/SA-related hospital encounter they were 0.1%, 0.1%, 0.1%, 0.3%, and 0.8%, respectively ConclusionsThese study findings indicate that depression symptom severity is a key driver of short-term risk of hospital encounters, emphasizing the need of timely interventions that can ameliorate depression symptom severity.