bluuebunny/crossref_metadata_2025 huggingface dataset:
Cancer patterns and association with mortality and renal outcomes in non-dialysis dependent chronic kidney disease: a matched cohort study
Authors: Chinnadurai Rajkumar , Flanagan Emma , Jayson Gordon C. , Kalra Philip A.
Published: October 2019

Background

Cancer in patients with chronic kidney disease (CKD) is an added burden to their overall morbidity and mortality. Cancer can be a cause or an effect of CKD. In CKD patients, a better understanding of cancer distribution and associations can aid in the proper planning of renal replacement therapy (RRT) and in the choice of chemotherapeutic agents, many of which are precluded in more advanced CKD. This study aims to investigate the distribution and the association of cancer with mortality, renal progression and RRT assignment in a non-dialysis dependent CKD cohort, few studies have investigated this in the past.

Methods

The study was carried out on 2952 patients registered in the Salford Kidney Study (SKS) between October 2002 and December 2016. A comparative analysis was performed between 339 patients with a history of cancer (previous and current) and 2613 patients without cancer at recruitment. A propensity score matched cohort of 337 patients was derived from each group and used for analysis. Cox-regression models and Kaplan-Meier estimates were used to compare the association of cancer with mortality and end-stage renal disease (ESRD) outcomes. Linear regression analysis was applied to generate the annual rate of decline in estimated glomerular filtration rate (delta eGFR).

Results

Of our cohort, 13.3% had a history of cancer at recruitment and the annual rate of de novo cancers in the non-cancer patients was 1.6%. Urogenital cancers including kidney and bladder, and prostate and testicle in males, ovary and uterus in females, were the most prevalent cancers (46%), as expected from the anatomical or physiological roles of these organs and relationship to nephrology. Over a median follow-up of 48 months, 1084 (36.7%) of patients died. All-cause mortality was higher in the previous and current cancer group (49.6% vs 35%,p < 0.001), primarily because of cancer-specific mortality. Multivariate Cox regression analysis showed a strong association of cancer with all-cause mortality (HR:1.41; 95%CI: 1.12–1.78;p = 0.004). There was no difference between the groups regarding reaching end-stage renal disease (26% in both groups) or the rate of decline in eGFR (− 0.97 for cancer vs − 0.93 mL/min/year for non-cancer,p = 0.93). RRT uptake was similar between the groups (17.2% vs 19.3%,p = 0.49).

Conclusions

Cancer status proved to be an added burden and an independent risk factor for all-cause mortality but not for renal progression. CKD patients with a previous or current history of cancer should be assessed on a case by case basis in planning for renal replacement therapy options, and the presence of cancer should not be a limitation for RRT provision including transplantation.
Preliminary experience of stent-assisted coiling of wide-necked intracranial aneurysms with a single microcatheter
Authors: Park Keun Young , Jang Chang Ki , Lee Jae Whan , Kim Dong Joon , Kim Byung Moon , Chung Joonho
Published: October 2019

Background

The purpose of this study was to report our preliminary experience of stent-assisted coiling (SAC) of wide-necked intracranial aneurysms with a single microcatheter in patients with parent arteries that were small-caliber, with stenosis, or a very tortuous course.

Methods

Between March 2018 and December 2018, we treated 394 aneurysms in 359 patients with endovascular treatment. Among 197 aneurysms treated by SAC, there were 16 cases (all wide-necked unruptured aneurysms) treated by SAC with a single microcatheter and a Neuroform Atlas stent. Follow-up angiography was performed at 6 to 12 months after SAC, and clinical follow-up was performed from 6 to 12 months in all patients.

Results

The reasons for SAC with a single 0.0165-in. microcatheter were small-caliber (n = 4), stenosis (n = 2), and very tortuous course (n = 10) of the parent arteries. There was no complication related to delivering or deploying the Neuroform Atlas stent as well as no failure of selecting aneurysm by cell-through technique. All patients had a modified Rankin score of 0 at discharge and at follow-up. Initial angiographic results showed six cases (37.5%) of complete occlusion. In follow-up angiographies, 12 cases (75.0%) achieved compete occlusion.

Conclusion

When performing SAC of wide-necked intracranial aneurysms in parent arteries with small-caliber, stenosis, or a very tortuous course, cell-through SAC using a single microcatheter and a Neuroform Atlas stent within a 5 Fr- (or smaller) guiding or intermediate catheter might be a useful option.
A sleep modulated Channelopathy: a novel CACNA1A pathogenic variant identified in episodic Ataxia type 2 and a potential link to sleep alleviated migraine
Authors: Ahuja Abhimanyu S. , Rozen Todd D. , Atwal Paldeep S.
Published: October 2019

Background

To describe a patient with sleep alleviated episodic ataxia type 2 with a novel CACNA1A pathogenic variant and provide a possible link to sleep responsive migraine.

Case presentation

A 26-year-old woman with recurrent attacks of dizziness, nausea, vomiting, ataxia and dysarthria presented for a possible diagnosis of vestibular migraine. Unique to her attacks was if she could fall asleep for as little as 15 min the spells would subside. If however she remained awake the attacks would continue unabated. A presumed diagnosis of episodic ataxia type 2 was made and she became attack free on acetazolamide without recurrence. Genetic testing demonstrated a novel pathogenic variant in CACNA1A on chromosome 19. This pathogenic variant has not been previously reported in the literature and is suggested to truncate the CACNA1A polypeptide by introducing a premature stop codon.

Conclusion

A case of episodic ataxia type 2 with a novel pathogenic variant in CACNA1A is described. Interestingly, the patient’s symptoms would completely alleviate with sleep which suggests a sleep modulated channelopathy. The mechanisms by which sleep could potentially alter this pathogenic variant are hypothesized. A potential link to sleep alleviated migraine is suggested. Further study of this novel pathogenic variant may help us understand not only how sleep can modulate episodic ataxia type 2, but also migraine.
Awareness and practice of birth preparedness and complication readiness among pregnant women in the Bamenda Health District, Cameroon
Authors: Ijang Yunga Patience , Cumber Samuel Nambile Nambile , Nkfusai Claude Ngwayu , Venyuy Mbinkar Adeline , Bede Fala , Tebeu Pierre Marie
Published: October 2019

Background

Birth preparedness and complication readiness has as goal to reduce maternal and neonatal mortality. This concept developed by the organizations of the United Nations permits pregnant women and their families seek health care without delay in case of obstetric complications and delivery. Though its benefits have been proven in several countries, little is known of this in Cameroon and specifically in the North West Region. Therefore, the intention of the study was to assess the awareness and practice of birth preparedness and complication readiness in this health district.

Methods

This was a facility-based cross sectional study carried out in the Bamenda health district of the North West Region, Cameroon. Three hundred forty-five pregnant women of ≥32 weeks gestational age seen at the antenatal consultation units were recruited. The dependent variable was birth preparedness and complication readiness while the independent variables were the socio-demographic and reproductive health characteristics. Data collected was analyzed with SPSS and Microsoft excel. Frequency distributions were used to determine the awareness and practice of birth preparedness and complication readiness.

Results

Of the 345 pregnant women included in this study, 159(46.1%) were aware of birth preparedness and complication readiness. The practice of birth preparedness and complication readiness was unsatisfactory as only 65(18.8%) were considered prepared.

Conclusion

Education and counselling on birth preparedness and complication readiness is not made available to the pregnant women resulting in poor knowledge. Thus, reflected in the low practice of preparation for birth and its complication observed.
BC200 overexpression contributes to luminal and triple negative breast cancer pathogenesis
Authors: Barton Maria , Santucci-Pereira Julia , Vaccaro Olivia G. , Nguyen Theresa , Su Yanrong , Russo Jose
Published: October 2019

Background

Long non coding RNAs (lncRNAs) are RNA molecules longer than 200 nucleotides that are not translated into proteins, but regulate the transcription of genes involved in different cellular processes, including cancer. Epidemiological analyses have demonstrated that parous women have a decreased risk of developing breast cancer in postmenopausal years if they went through a full term pregnancy in their early twenties. We here provide evidence of the role of BC200 in breast cancer and, potentially, in pregnancy’s preventive effect in reducing the lifetime risk of developing breast cancer.

Methods

Transcriptome analysis of normal breast of parous and nulliparous postmenopausal women revealed that several lncRNAs are differentially expressed in the parous breast. RNA sequencing of healthy postmenopausal breast tissue biopsies from eight parous and eight nulliparous women showed that there are 42 novel lncRNAs differentially expressed between these two groups. Screening of several of these 42 lncRNAs by RT-qPCR in different breast cancer cell lines, provided evidence that one in particular, lncEPCAM (more commonly known as BC200), was a strong candidate involved in cancer progression. Proliferation, migration, invasion and xerograph studies confirmed this hypothesis.

Results

The poorly studied oncogenic BC200 was selected to be tested in vitro and in vivo to determine its relevance in breast cancer and also to provide us with an understanding of its role in the increased susceptibility of the nulliparous women to cancer. Our results show that BC200 is upregulated in nulliparous women, and breast cancer cells and tissue. The role of BC200 is not completely understood in any of the breast cancer subtypes. We here provide evidence that BC200 has a role in luminal breast cancer as well as in the triple negative breast cancer subtype.

Conclusion

When overexpressed in luminal and triple negative breast cancer cell lines, BC200 shows increased proliferation, migration, and invasion in vitro. In vivo, overexpression of BC200 increased tumor size. Although treatment for cancer using lncRNAs as targets is in its infancy, the advancement in knowledge and technology to study their relevance in disease could lead to the development of novel treatment and preventive strategies for breast cancer.
Simultaneous primary cancer occurrence of melanoma and pulmonary adenocarcinoma in leptomeningeal metastases: a case report
Authors: Stoppek Ann-Kathrin , Kebir Sied , Junker Andreas , Keyvani Kathy , Zülow Stefan , Lazaridis Lazaros , Schmidt Teresa , Pierscianek Daniela , Stuschke Martin , Sure Ulrich , Kleinschnitz Christoph , Scheffler Björn , Zimmer Lisa , Glas Martin
Published: October 2019

Background

Leptomeningeal metastasis (LM) is a predominantly late stage, devastating complication of a variety of malignant solid tumors. Diagnosis relies predominantly on neurological, radiographic, and cerebrospinal fluid (CSF) assessments. Recently, liquid biopsy tests derived from CSF has shown to be a feasible, noninvasive promising approach to tumor molecular profiling for proper brain cancer diagnostic treatment, thereby providing an opportunity for CSF-based personalized medicine. However, LM is typically misleadingly assumed to originate from only one primary tumor type.

Case presentation

In this case report, we provide first evidence of the co-occurrence of LM originating from more than one primary tumor types.

Discussion and conclusions

Based on this patient case profile, the co-occurrence of LM from two or more primary tumor types should be accounted for when deriving diagnostic conclusions from liquid biopsy tests.
Local dissemination of osteosarcoma observed after massage therapy: a case report
Authors: Miwa Shinji , Kamei Michi , Yoshida Satoru , Yamada Satoshi , Aiba Hisaki , Tsuchiya Hiroyuki , Otsuka Takanobu
Published: October 2019

Background

Limited evidence is available regarding the dissemination of tumor tissues due to compression during massage therapy, a routine procedure in patients with various symptoms in Asian countries.

Case presentation

A 12-year-old male presented at a massage clinic with pain and swelling of his left knee, which worsened the same night. Consistent with conventional osteosarcoma, radiography revealed cortical bone destruction, osteoblastic changes, and periosteal reactions. Magnetic resonance imaging revealed a tumor in the distal femur, an extraskeletal mass, and an infiltrative lesion in the intramuscular and neurovascular areas surrounding the distal femur; this was considered as hemorrhage and dissemination of the tumor tissue.18Fluorine-labelled fluorodeoxyglucose-positron emission tomography and computed tomography revealed multiple metastases in the spine, liver, and lung. Consistent with osteosarcoma, histopathological examination revealed tumor cell proliferation with extensive pleomorphism and mitoses. Despite undergoing chemotherapy, radiation therapy, and hip disarticulation, the patient died due to multiple metastases 13 months after the initial diagnosis.

Conclusions

The present case suggests association of massage therapy with the local dissemination of tumor tissues, although influence of massage therapy on metastatic lesions remains unclear. Massage therapists should be aware of the possibility for dissemination of hidden malignancies due to the procedure.
A state-level study of opioid use disorder treatment access and neonatal abstinence syndrome
Authors: Wolf Elizabeth R. , Tong Sebastian T. , Sabo Roy T. , Woolf Steven H. , Abbinanti Kassie , Pecsok James , Krist Alex H.
Published: October 2019

Background

Adult opioid use and neonatal abstinence syndrome (NAS) are growing public health problems in the United States (U.S.). Our objective was to determine how opioid use disorder treatment access impacts the relationship between adult opioid use and NAS.

Methods

We conducted a cross-sectional state-level ecologic study using 36 states with available Healthcare Cost and Utilization Project State Inpatient Databases in 2014. Opioid use disorder treatment access was determined by the: 1) proportion of people needing but not receiving substance use treatment, 2) density of buprenorphine-waivered physicians, and 3) proportion of individuals in outpatient treatment programs (OTPs). The incidence of NAS was defined as ICD-9 code 779.5 (drug withdrawal syndrome in newborn) from any discharge diagnosis field per 1000 live births in that state.

Results

Unmet need for substance use disorder treatment correlated with NAS (r = 0.54, 95% CI: 0.26–0.73). The correlation between adult illicit drug use/dependence and NAS was higher in states with a lower density of buprenorphine-waivered physicians and individuals in OTPs.

Conclusions

Measures of opioid use disorder treatment access dampened the correlation between illicit drug use/dependence and NAS. Future studies using community- or individual-level data may be better poised to answer the question of whether or not opioid use disorder treatment access improves NAS relative to adult opioid use.
Identifying medication errors in neonatal intensive care units: a two-center study
Authors: Eslami Kaveh , Aletayeb Fateme , Aletayeb Seyyed Mohammad Hassan , Kouti Leila , Hardani Amir Kamal
Published: October 2019

Background

This study aimed to assess the types and frequency of medication errors in our NICUs (neonatal intensive care units).

Methods

This descriptive cross-sectional study was conducted on two neonatal intensive care units of two hospitals over 3 months. Demographic information, drug information and total number of prescriptions for each neonate were extracted from medical records and assessed.

Results

A total of 688 prescriptions for 44 types of drugs were checked for the assessment of medical records of 155 neonates. There were 509 medication errors, averaging (SD) 3.38 (+/− 5.49) errors per patient. Collectively, 116 neonates (74.8%) experienced at least one medication error. Term neonates and preterm neonates experienced 125 and 384 medication errors, respectively. The most frequent medication errors were wrong dosage by physicians in prescription phase [WU1] (142 errors; 28%) and not administering medication by nurse in administration phase (146 errors; 29%). Of total 688 prescriptions, 127 errors were recorded. In this regard, lack of time and/or date of order were the most common errors.

Conclusions

The most frequent medication errors were wrong dosage and not administering the medication to patient, and on the quality of prescribing, lack of time and/or date of order was the most frequent one. Medication errors happened more frequently in preterm neonates (P < 0.001). We think that using computerized physician order entry (CPOE) system and increasing the nurse-to-patient ratio can reduce the possibility of medication errors.
Successful treatment in a child with enthesitis-related arthritis involving the sternoclavicular joint: a case report
Authors: Huang Po-Yu , Chang Ling-Sai , Guo Mindy Ming-Huey , Kuo Ho-Chang
Published: October 2019

Background

Although the sternoclavicular joint (SCJ) may be involved in ankylosing spondylitis, rheumatic arthritis, and Behçet’s disease and participates in the systemic inflammatory process of arthritis, it is often neglected during routine rheumatologic clinical examinations. To the best of our knowledge, this is the first study to report etanercept treatment in juvenile idiopathic arthritis (JIA) with SCJ involvement.

Case presentation

In this study, we describe an unusual case of a child with juvenile idiopathic arthritis with an initial presentation of sternoclavicular mass. The patient (age, 14 years 10 months) presented with an insidious onset atraumatic swelling of the left SCJ and complained of right hip and bilateral ankle tenderness without an apparent cause. Initial ultrasonography indicated a heterogeneous mass in the left SCJ, while computed tomography identified mild swelling of the left SCJ with a thickened synovial lining, mild bone erosion, and some turbid fluid. The patient ultimately underwent left SCJ arthrotomy, during which tapping of the SCJ revealed 2 cc of yellowish fluid, inflammation and necrosis of tissues within the SCJ. A clear yellow joint fluid was aspirated, and testing revealed a negative culture result. The patient was diagnosed with JIA. The joint tenderness improved and erythrocyte sedimentation rate decreased after administering anti-tumor necrosis factor etanercept. An additional ultrasonography demonstrated that the initial imaging findings have been resolved. At the end of a 2-year follow-up period, the patient was completely symptom-free.

Conclusions

JIA with SCJ involvement is an uncommon presentation in adolescents. Etanercept may be a beneficial treatment for SCJ involvement in patients with JIA. The upper limbs showed no signs of limited range of motion during the follow-up period. Further studies are warranted to elucidate the efficacy of etanercept in JIA with sternoclavicular joint involvement.
The ReThink study: a 3-arm parallel randomized trial of cognitive bias modification, with and without adherence promotion, for adolescent anxiety disorder: trial design and protocol
Authors: Reetz Shelley , Clarke Gregory , Weersing Robin , Amir Nader , Dickerson John , Lynch Frances L. , Leo Michael C. , Rawlings Andreea M. , Lee Mi H. , Gille Sara
Published: October 2019

Background

Anxiety disorders are the most common mental health problem among youth, contribute to reduced quality of daily life, and are associated with high rates of comorbidity. However, treatment rates for anxiety are very low, causing a sizeable treatment gap. There is an immediate need to identify treatment interventions that are effective, affordable, and can be delivered easily to the youth population. Cognitive Bias Modification (CBM) is one potentially effective intervention that could reach youth on a large scale, especially when self-administered at home. Thus, we aim to assess the benefit of CBM to treat youth anxiety. Further, we aim to test whether adding an adherence promotion (AP) component to the CBM intervention can improve outcomes, and whether CBM delivered both with and without the AP component is cost effective.

Methods

This is a 12-month randomized controlled trial (RCT) conducted within an existing healthcare system. Potentially eligible youth (ages 12 to 17) will be identified by reviewing the electronic health record (EHR) for clinical anxiety diagnoses, which are then confirmed via research interview. We aim to enroll 498 participants and randomize them 1:1:1 to one of three arms: Arm 1 is a Low-Ratio version of the CBM program (nearly identical to the other CBM versions, but minimally effective); Arm 2 is a High-Ratio “active” CBM program; and Arm 3 is the High-Ratio CBM program with an added AP component. Participants will complete assessments at baseline, 1-, 3-, 6- and 12-months post-baseline. Youth in all three arms will self-administer the CBM program at home and will be asked to complete twelve intervention sessions over a four-week period. Arm 3 participants (High-Ratio CBM + AP) will also receive up to four telephone calls from phone coaches during the intervention period to provide technical assistance, encouragement, and motivational enhancement to increase adherence. The primary clinical outcome will be anxiety remission at 6-month follow-up.

Discussion

This study protocol describes the method and design for an RCT to test whether self-administered CBM both with and without adherence promotion can be an effective at-home treatment for anxious youth.

Trial registration

ClinicalTrials.gov: NCT02156531, First Posted June 5, 2014.
Key features of an innovative sub-acute residential service for young people experiencing mental ill health
Authors: Green Rachael , Mitchell Penelope Fay , Lee Kira , Svensson Ella , Toh Jia-Wern , Barentsen Carolyn , Copeland Michala , Newton J. Richard , Hawke Kari Christine , Brophy Lisa
Published: October 2019

Background

Numerous studies across international settings have highlighted a need to improve the appropriateness and continuity of services for young people experiencing mental ill health. This paper examines key features of a sub-acute youth mental health residential service model, Youth Prevention and Recovery Care (Y-PARC) service. Y-PARC provides up to 4 weeks care to 16 to 25 year-olds at risk of hospitalisation and to those transitioning out of hospital inpatient units. The research was conducted at one of three Y-PARCs located in Victoria, Australia.

Methods

This paper presents findings from analysis of two data sources collected during evaluation of a Y-PARC service in 2015–17. Routinely collected administrative data of Y-PARC residents (n = 288) were analysed and semi-structured interviews were conducted with 38 participants: a) former residents (n = 14); b) family members of group a) (n = 5); key stakeholders (n = 9); and, Y-PARC staff (n = 10 respondents in 3 group interviews). Analysis of the qualitative data was thematic and structured by the interview guide, which covered the key service aims.

Results

Consistent with the aims of the service, respondents described practice at Y-PARC that aligns with recovery-oriented care. Key features emphasised were: a safe and welcoming environment for residents and families; provision of person-centred care; promotion of autonomy and self-help; informal interactions with staff allowing for formation of naturalistic relationships; time spent with other young people with similar experiences; and, assurance upon exit that the ‘door is always open.’

High levels of satisfaction were reported. Outcomes described included: improved resilience; better understanding of mental health; the importance of seeking help; and, stronger connections to therapeutic services. Longer and multiple stays were associated with progressive and sustained change. Family members and stakeholders widely reported that the service fills a gap between community services and acute inpatient mental health hospital wards.

Some challenging areas of practice identified included: integration of evidence-based psychosocial interventions; provision of care within a model that blends clinical and psychosocial support services; and, negotiation of family-inclusive practice.

Conclusions

The Y-PARC service model shows promise with young people experiencing mental ill health, particularly in improving the range and availability of options across a spectrum of need.
Outcomes of a tertiary-based innovative approach to engage primary care providers in provision of hepatitis C treatment in community settings
Authors: Pourmarzi Davoud , Thompson Hayley , Thomas James A. , Hall Lisa , Smirnov Andrew , FitzGerald Gerard , Rahman Tony
Published: October 2019

Background

Australia is committed to eliminating the hepatitis C virus (HCV) by 2030. Despite regulations in Australia that enable the prescription of subsidised direct acting antiviral (DAA) by primary health care providers, the number of providers who treat patients for HCV remains low and this limits the prospect of HCV elimination. The Prince Charles Hospital, Brisbane, Australia, implemented an innovative program called Cure-It aimed at engaging primary care providers in community-based HCV treatment. This paper aims to describe initial experiences and short-term patient outcomes of this program.

Methods

A formative evaluation was conducted using program data for the period March 2016 to April 2018. Descriptive statistics were used to report the number of engaged primary care providers, patients’ baseline characteristics, treatment plans, and treatment outcomes.

Results

Thirty primary care providers from different settings were engaged in HCV treatment. Among 331 patients eligible for community-based treatment, 315 (95.2%) commenced treatment, the completion rate was 92.4 and 66.5% achieved sustained virological response at 12 weeks (SVR12). The SVR12 had not been documented for 26.8% of patients. Among patients whose SVR12 was documented, 98.2% achieved SVR12. Only 1.3% of patients experienced treatment failure.

Conclusion

A flexible tertiary-led model can improve primary care providers and patients’ engagement with provision of HCV treatment. Tertiary centres need to play their role to improve the accessibility of HCV treatment through providing training and on-going support for primary care providers while enabling those providers to become more confident in providing treatment independently.
Protective practices against tick bites in Denmark, Norway and Sweden: a questionnaire-based study
Authors: Jepsen Martin Tugwell , Jokelainen Pikka , Jore Solveig , Boman Anders , Slunge Daniel , Krogfelt Karen Angeliki
Published: October 2019

Background

Tick-borne infections are of emerging and increasing concern in the Scandinavian countries Denmark, Norway and Sweden. Only few studies have investigated protective practices against tick bites in the general population. The aim of this multi-country study was to assess the use of protective practices and the perception of the efficacy of them.

Methods

We surveyed the extent of using protective practices against tick bites, using the same questionnaire in three local languages. In addition, we surveyed perceptions of how good a protection the different practices provide. Altogether 783 individuals from Denmark, 789 from Norway and 1096 from Sweden participated in the study by completing an extensive online questionnaire in October 2016.

Results

Altogether 1011 respondents (37.9%) reported using at least three different protective practices either often or always when in areas where there are ticks, while 522 (19.6%) reported using none. Female gender was among the factors identified as positively associated with using several of the specific practices often or always when in areas where there are ticks. The gender-difference in extent of using protective practices against tick bites was particularly pronounced in Sweden. Based on a multivariable logistic regression model, being female, being from Sweden, and having experienced one or more tick bites were positively associated with using at least three different protective practices against tick bites either often or always when in areas where there are ticks (odds ratios 1.90, 1.87 and 1.88, respectively).

Conclusions

The results of our study, especially the observed differences by country and by gender, can be useful in targeting future information to the public. In particular, our results suggest that men across all ages should be considered a specific target group for this information.
The effect of mild sleep deprivation on diet and eating behaviour in children: protocol for the Daily Rest, Eating, and Activity Monitoring (DREAM) randomized cross-over trial
Authors: Ward Aimee L. , Galland Barbara C. , Haszard Jillian J. , Meredith-Jones Kim , Morrison Silke , McIntosh Deborah R. , Jackson Rosie , Beebe Dean W. , Fangupo Louise , Richards Rosalina , Te Morenga Lisa , Smith Claire , Elder Dawn E. , Taylor Rachael W.
Published: October 2019

Background

Although insufficient sleep has emerged as a strong, independent risk factor for obesity in children, the mechanisms by which insufficient sleep leads to weight gain are uncertain. Observational research suggests that being tired influences what children eat more than how active they are, but only experimental research can determine causality. Few experimental studies have been undertaken to determine how reductions in sleep duration might affect indices of energy balance in children including food choice, appetite regulation, and sedentary time. The primary aim of this study is to objectively determine whether mild sleep deprivation increases energy intake in the absence of hunger.

Methods

The Daily, Rest, Eating, and Activity Monitoring (DREAM) study is a randomized controlled trial investigating how mild sleep deprivation influences eating behaviour and activity patterns in children using a counterbalanced, cross-over design. One hundred and ten children aged 8–12 years, with normal reported sleep duration of 8–11 h per night will undergo 2 weeks of sleep manipulation; seven nights of sleep restriction by going to bed 1 hr later than usual, and seven nights of sleep extension going to bed 1 hr earlier than usual, separated by a washout week. During each experimental week, 24-h movement behaviours (sleep, physical activity, sedentary behaviour) will be measured via actigraphy; dietary intake and context of eating by multiple 24-h recalls and wearable camera images; and eating behaviours via objective and subjective methods. At the end of each experimental week a feeding experiment will determine energy intake from eating in the absence of hunger. Differences between sleep conditions will be determined to estimate the effects of reducing sleep duration by 1–2 h per night.

Discussion

Determining how insufficient sleep predisposes children to weight gain should provide much-needed information for improving interventions for the effective prevention of obesity, thereby decreasing long-term morbidity and healthcare burden.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12618001671257. Registered 10 October 2018.
Geographical variations of the associations between health interventions and all-cause under-five mortality in Uganda
Authors: Nambuusi Betty B. , Ssempiira Julius , Makumbi Fredrick E. , Utzinger Jürg , Kasasa Simon , Vounatsou Penelope
Published: October 2019

Background

To reduce the under-five mortality (U5M), fine-gained spatial assessment of the effects of health interventions is critical because national averages can obscure important sub-national disparities. In turn, sub-national estimates can guide control programmes for spatial targeting. The purpose of our study is to quantify associations of interventions with U5M rate at national and sub-national scales in Uganda and to identify interventions associated with the largest reductions in U5M rate at the sub-national scale.

Methods

Spatially explicit data on U5M, interventions and sociodemographic indicators were obtained from the 2011 Uganda Demographic and Health Survey (DHS). Climatic data were extracted from remote sensing sources. Bayesian geostatistical Weibull proportional hazards models with spatially varying effects at sub-national scales were utilized to quantify associations between all-cause U5M and interventions at national and regional levels. Bayesian variable selection was employed to select the most important determinants of U5M.

Results

At the national level, interventions associated with the highest reduction in U5M were artemisinin-based combination therapy (hazard rate ratio (HRR) = 0.60; 95% Bayesian credible interval (BCI): 0.11, 0.79), initiation of breastfeeding within 1 h of birth (HR = 0.70; 95% BCI: 0.51, 0.86), intermittent preventive treatment (IPTp) (HRR = 0.74; 95% BCI: 0.67, 0.97) and access to insecticide-treated nets (ITN) (HRR = 0.75; 95% BCI: 0.63, 0.84). In Central 2, Mid-Western and South-West, largest reduction in U5M was associated with access to ITNs. In Mid-North and West-Nile, improved source of drinking water explained most of the U5M reduction. In North-East, improved sanitation facilities were associated with the highest decline in U5M. In Kampala and Mid-Eastern, IPTp had the largest associated with U5M. In Central1 and East-Central, oral rehydration solution and postnatal care were associated with highest decreases in U5M respectively.

Conclusion

Sub-national estimates of the associations between U5M and interventions can guide control programmes for spatial targeting and accelerate progress towards mortality-related Sustainable Development Goals.
Change in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder: a repeat cross sectional community survey in Nepal
Authors: Luitel Nagendra P. , Garman Emily C. , Jordans Mark J. D. , Lund Crick
Published: October 2019

Background

Despite the availability of evidence-based treatment, there is a substantial gap between the number of individuals in need of mental health care and those who receive treatment. The aim of this study was to assess changes in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder (AUD) before and after implementation of a district mental health care plan (MHCP) in Nepal.

Methods

The repeat population-based cross-sectional community survey was conducted with randomly selected adults in the baseline (N = 1983) and the follow-up (N = 1499) surveys, 3 years and 6 months apart. The Patient Health Questionnaire and Alcohol Use Disorder Identification Test were used to screen people with probable depression and AUD. Barriers to seeking mental health care were assessed by using a standardized tool, the Barriers to Care Evaluation Scale (BACE).

Results

The proportion of the participants receiving treatment for depression increased by 3.7 points (from 8.1% in the baseline to 11.8% in the follow-up) and for AUD by 5.2 points (from 5.1% in the baseline to 10.3% in the follow-up study), however, these changes were not statistically significant. There was no significant reduction in the overall BACE score in both unadjusted and adjusted models for both depression and AUD. The possible reasons for non-significant changes in treatment coverage and barriers to care could be that (i) the method of repeat population level surveys with a random sample was too distal to the intervention to be able to register a change and (ii) the study was underpowered to detect such changes.

Conclusion

The study found non-significant trends for improvements in treatment coverage and barriers to mental health care following implementation of the district mental health care plan. The key areas for improvement in the current strategy to improve treatment coverage and barriers to mental health care included change in the content of the existing community sensitization program, particularly for changing attitude and intention of people with mental illness for seeking care.
Association of lifestyle factors with blood lipids and inflammation in adults aged 40 years and above: a population-based cross-sectional study in Taiwan
Authors: Muga Miriam Adoyo , Owili Patrick Opiyo , Hsu Chien-Yeh , Chao Jane C.-J.
Published: October 2019

Background

Lifestyle factors were associated with an increased risk of cardiovascular disease (CVD) occurrence. We explored the associations between lifestyle factors and CVD risk factors, and assessed the interactive effects of lifestyle factors on CVD risk factors.

Methods

A cross-sectional data of 114,082 (57,680 men and 56,402 women) middle-aged adults and elderly in Taiwan were collected from 2001 to 2010. Logistic regression analysis was used to assess the associations between lifestyle factors and CVD risk factors. The relative excess risk due to interaction (RERI) and the attributable proportion due to interaction were used to explore the interactive effect of lifestyle factors on CVD risk factors.

Results

The interaction between alcohol consumption and smoking exhibited an excess risk of high triglycerides (RERI = 0.21; 95% CI: 0.14–0.29), and that of alcohol consumption and physical activity had an excess risk of high LDL-cholesterol (RERI = 0.11; 95% CI: 0.06–0.16) and high blood glucose (RERI = 0.05; 95% CI: 0.01–0.11). Alcohol consumption and vegetable-rich diet (intake of high vegetables with no or low meat) had an excess risk of high LDL-cholesterol and low HDL-cholesterol, but a reduced risk of high triglycerides (RERI = − 0.10; 95% CI: − 0.17 – -0.04). Smoking and physical activity had an increased risk of high blood glucose and a reduced risk of low HDL-cholesterol. Smoking and vegetable-rich diet reduced the risk of high triglycerides (RERI = − 0.11; 95% CI: − 0.18 – − 0.04), high blood glucose (RERI = − 0.14; 95% CI: − 0.21 – − 0.07) and low HDL-cholesterol (RERI = − 0.10; 95% CI: − 0.19 – -0.01).

Conclusions

The interaction between smoking, alcohol consumption, physical activity and diet were associated with lipid profile and blood glucose, hence there was an interaction between these lifestyle factors in an additive scale. Public health promotion should therefore consider multifaceted promotional activities that are likely to make a positive impact on the health status of the Taiwanese population.
Spontaneous and repeat spontaneous abortion risk in relation to occupational characteristics among working Korean women: a cross-sectional analysis of nationally representative data from Korea
Authors: Lee Wanhyung , Jung Sung Won , Lim Young-Mee , Lee Kyung-Jae , Lee June-Hee
Published: October 2019

Background

The association between spontaneous abortion (SA) and occupational characteristics among working women is not well-studied. This study aimed to assess the risk of SA and occupational factors such as occupational classification, working hours, and work schedules among working Korean women aged > 19 years.

Methods

In this cross-sectional study, 4078 working women were identified from among 25,534 workers in the Korea National Health and Nutrition Examination Surveys V (2010–2012) database, to obtain data on SA history and the number of SAs. Odds ratios (ORs) and 95% confidence intervals (CIs) for SA were calculated using multiple logistic regression models after adjusting for age, education, household income, cigarette smoking, alcohol consumption, and obesity status. The weighted prevalence for the number of SAs was calculated according to occupational characteristics to demonstrate the SA status among working Korean women.

Results

SA occurrence was reported in 5.7% of the study participants. The ORs (95% CIs) for SA were significantly higher in pink-, green-, and blue-collared workers than in white-collared workers. Regarding weekly working hours, compared with ≤50 h spent working, the ORs (95% CIs) for 51–60, 61–70, and > 70 h per week were 1.26 (0.87–1.84), 1.63 (1.04–2.56), and 1.73 (1.10–2.70), respectively. A significantly higher weighted prevalence of repeat SAs was observed in pink- and green-collared workers and in those who worked long hours.

Conclusion

We found a significant association between SA, repeat SA, and occupational characteristics among working Korean women.
Thermal damage width and hemostatic effect of bipolar electrocoagulation, LigaSure, and Ultracision techniques on goat mesenteric vessels and optimal power for bipolar electrocoagulation
Authors: Liang Jun , Xing Huimin , Chang Yali
Published: October 2019

Background

We aimed to determine the optimal bipolar electrocoagulation power for laparoscopic surgery and to investigate which method, bipolar electrocoagulation, advanced bipolar, or ultrasonic technique was more reliable.

Methods

Goat mesenteric vessels (210 in vivo samples) with diameters of 3.03–5.44 mm were selected. Bipolar electrocoagulation with 80 W, 75 W, 70 W, 65 W, 60 W, 55 W, and 50 W, and advanced bipolar and ultrasonic techniques were performed on mesenteric vessels. The thermal damage width, hemostatic effect, and burst pressure of these tissues were recorded. SPSS version 13.0 was used for all data analysis.

Results

The results showed that 60 W was the optimal for bipolar electrocoagulation based on the thermal damage width, hemostatic effect, and burst pressure. In contrast, the thermal damage width of advanced bipolar and ultrasonic techniques was smaller than that of bipolar electrocoagulation, and advanced bipolartechnique had the highest successful rate for hemostasis and highest burst pressure.

Conclusions

Bipolar electrocoagulation was optimally performed with 60 W of power. Compared with ultrasonic and bipolar electrocoagulation techniques, advanced bipolar use was more reliable for mesenteric vessels in laparoscopic surgery; however, bipolar electrocoagulation with optimal power can be used for its simplicity of operation and low cost.
Knowledge, attitudes, and practices related to breast cancer screening among female health care professionals: a cross sectional study
Authors: Heena Humariya , Durrani Sajid , Riaz Muhammad , AlFayyad Isamme , Tabasim Rabeena , Parvez Gazi , Abu-Shaheen Amani
Published: October 2019

Background

Incidence of breast cancer in the Kingdom of Saudi Arabia (KSA) has increased in recent years. Screening helps in early detection of cancer and early diagnosis and timely treatment of breast cancer lead to a better prognosis. Women in the healthcare profession can have a positive impact on the attitudes, beliefs, and practices of general public. Therefore, it is important that the healthcare workers themselves have adequate knowledge and positive attitudes. We conducted a study to assess the knowledge, attitudes, and practices related to breast cancer screening among female healthcare professionals.

Methods

A cross-sectional study was conducted on female health professional of KFMC (King Fahad Medical City). Data was collected using a pre-designed, tested, self-administered questionnaire. The questionnaire included specific sections to test the participants’ knowledge, attitude, and practices related to cervical cancer and its screening. Data analysis was done using descriptive statistics.

Results

A total of 395 health care workers participated in this study. The mean age of the participants was 34.7 years. Participants included physicians (n = 63, 16.0%), nurses (n = 261, 66.1%), and allied health workers (n = 71, 18.0%). Only 6 (1.5%) participants had a good level of knowledge of breast cancer and 104 (26.8%) participants demonstrated a fair level of knowledge. Overall, 370 (93.7%), 339 (85.8%), and 368 (93.2%) participants had heard of breast self-examination, clinical breast examination, and mammography, respectively. A total of 295 (74.7%) participants reported practicing breast self-examination, 95 (24.1%) had undergone clinical breast examination, and 74 (18.7%) had ever undergone mammography.

Conclusion

The knowledge, attitudes, and practices related to breast cancer screening were found to be lower than expected. Active steps are required to develop educational programs for the health care staff, which might empower them to spread the knowledge and positively influence the attitudes of female patients in the hospital.
Changes in ESCRT-III filament geometry drive membrane remodelling and fission in silico
Authors: Harker-Kirschneck Lena , Baum Buzz , Šarić And̄ela
Published: October 2019

Background

ESCRT-III is a membrane remodelling filament with the unique ability to cut membranes from the inside of the membrane neck. It is essential for the final stage of cell division, the formation of vesicles, the release of viruses, and membrane repair. Distinct from other cytoskeletal filaments, ESCRT-III filaments do not consume energy themselves, but work in conjunction with another ATP-consuming complex. Despite rapid progress in describing the cell biology of ESCRT-III, we lack an understanding of the physical mechanisms behind its force production and membrane remodelling.

Results

Here we present a minimal coarse-grained model that captures all the experimentally reported cases of ESCRT-III driven membrane sculpting, including the formation of downward and upward cones and tubules. This model suggests that a change in the geometry of membrane bound ESCRT-III filaments—from a flat spiral to a 3D helix—drives membrane deformation. We then show that such repetitive filament geometry transitions can induce the fission of cargo-containing vesicles.

Conclusions

Our model provides a general physical mechanism that explains the full range of ESCRT-III-dependent membrane remodelling and scission events observed in cells. This mechanism for filament force production is distinct from the mechanisms described for other cytoskeletal elements discovered so far. The mechanistic principles revealed here suggest new ways of manipulating ESCRT-III-driven processes in cells and could be used to guide the engineering of synthetic membrane-sculpting systems.