bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnitude and Clinical characteristics of Sigmoid Volvulus
Authors: Awedew Atalel Fentahun , Amsalu Bedemariam Tadesse , Belay woldemariam Beka , Yalewu Dawit Zerihun
Published: July 2020

Background: Sigmoid volvulus is a major cause of mechanical large bowel obstruction in volvulus belt countries. The objective of this study to explore the magnitude and clinical characteristics of Sigmoid Volvulus Methods: Hospital-based retrospective cross-sectional study employed in Debre Tabor general hospital Northcentral Ethiopia. A medical review conducted on the medical chart from Jan1, 2016 to Dec31, 2019. The collected data checked manually for completeness and consistency. The final data coded and entered to SPSS version 23 for data processing and analysis. Binary logistic regression used to measure the association of each covariate with the outcome variable. In addition, factors that have p=0.25 with the outcome variables were taken into a multivariable logistic regression analysis to control the potential confounders. The result of the final model expressed in terms of adjusted Odd Ratios (AOR) and 95% CI and statistical significance declared if the P-value is less than 0.05. Result: There were 124 patients with sigmoid volvulus admitted within four years of the study. During the study period, 408 patients with bowel obstructions were admitted, among Mechanical large bowel obstruction (MLBO) 135 (33.1%), Mechanical small bowel obstruction (MSBO) 251(61.5%), and Ileosigmoid knotting 22(5.4%). Our study showed that sigmoid volvulus accounted for 91.9% and 30.4% of Mechanical Large bowel obstruction and Bowel obstruction respectively. Most of the patients were male 97.6 %( N=121) and rural residents 91.1 %( N=113). The peak age was 56-65 years accounted for 29 % and 65.3 %( N=81) of patients were above age 50years. The age ranged from 19-88 years. The mean and median ages were 56.52± (SD=14.4) and 58.5± (IQR=17.75) respectively. The mean of hospital stay for elective admission was 10.98(SD±4.33) days and the median was 11 (IQR±5) days. The mean of hospital stay for emergency admission excluding death and leave against medical advice was 8.4(SD±4.1) days and median was 8 (IQR±2) days Conclusion: Primary resection and anastomosis was the common procedure for management of sigmoid volvulus. Mortality rate was 6.45% and higher in gangrenous sigmoid volvulus (14.6 % vs. 2.4%)
Knockdown of lincRNA PADNA promotes bupivacaine-induced neurotoxicity by miR-194/FBXW7 axis
Authors: Yuning Fan , Liang Chen , Tenghuan Wang , Zhenhua Nan , Gong Shengkai
Published: July 2020

Background: The aim of the study was to explore the function and mechanism of lincRNA PADNA in bupivacaine-induced neurotoxicity. Methods: Mouse DRG neurons were cultured in vitro and treated with bupivacaine to establish a neurotoxicity model. Caspase3 activity, cell viability, and TUNEL assays were analyzed to assess the role of lincRNA PADNA. A dual-luciferase reporter assay was used to determine the binding target of lincRNA PANDA. Results: The expression of lincRNA PADNA was significantly increased with increasing concentrations of bupivacaine. Functional analysis revealed that knockdown of lincRNA PADNA increased caspase3 activity and inhibited cell viability. Western blot analysis showed that knockdown of lincRNA PADNA promoted cleaved caspase3 levels. We also revealed that lincRNA PADNA may bind with miR-194. Knockdown of miR-194 rescued the function of lincRNA PADNA, suggesting that lincRNA PADNA may sponge miR-194. In addition, we provided new evidence that the lincRNA PADNA/miR-194/FBXW7 axis plays an important role in the neurotoxicity process. Conclusion: We performed comprehensive experiments to verify the function and mechanism of lincRNA PADNA in bupivacaine-induced neurotoxicity. Our study provides new evidence and clues for the prevention of neurotoxicity.
DeepGraphMolGen, a multi-objective, computational strategy for generating molecules with desirable properties: a graph convolution and reinforcement learning approach
Authors: Khemchandani Yash , O'Hagan Steve , Samanta Soumitra , Swainston Neil , Roberts Timothy J , Bollegala Danushka , Kell Douglas
Published: July 2020

We address the problem of generating novel molecules with desired interaction properties as a multi-objective optimization problem. Interaction binding models are learned from binding data using graph convolution networks (GCNs). Since the experimentally obtained property scores are recognised as having potentially gross errors, we adopted a robust loss for the model. Combinations of these terms, including drug likeness and synthetic accessibility, are then optimized using reinforcement learning based on a graph convolution policy approach. Some of the molecules generated, while legitimate chemically, can have excellent drug-likeness scores but appear unusual. We provide an example based on the binding potency of small molecules to dopamine transporters. We extend our method successfully to use a multi-objective reward function, in this case for generating novel molecules that bind with dopamine transporters but not with those for norepinephrine. Our method should be generally applicable to the generation in silico of molecules with desirable properties.
A Canadian-Wide Perspective on the Essential Conditions for Taking a Comprehensive School Health Approach
Authors: Neely Kacey C , Montemurro Genevieve R. , Storey Kate E.
Published: July 2020

Background: The primary purpose of this research was to confirm whether the essential conditions for taking a Comprehensive School Health (CSH) approach held true in other contexts across Canada. The secondary purpose was to determine if the development of an evaluative tool or resource is needed to assess the implementation of the essential conditions. Methods: Data were generated through individual semi-structured interviews (n = 38) and small focus groups (n = 3) with 45 participants across Canada involved in implementing policies or programs which take a CSH approach. Interviews were subjected to content analysis. Results: There was positive support for the essential conditions and results indicated the essential conditions are relevant across Canada. Findings revealed the necessity for a new essential condition that reflected support and leadership from the school district and/or provincial/territorial governing bodies. Modifications to the description of each of the essential conditions were also suggested to provide clarity. Results also indicated that an evaluative tool that was concise, meaningful, and provided immediate feedback would be useful to school communities to establish readiness, assess, and improve ongoing implementation of CSH approaches. Conclusions: This research contributes to the evidence-base of CSH by providing school communities across Canada with a set of refined and understandable essential conditions that support successful implementation. Further, the development of an evaluation tool will support school health champions, researchers, and policymakers in the optimization and implementation of policies or programs which take a CSH approach, ultimately supporting healthier school communities across the country.
Population migration, spread of COVID-19, and epidemic prevention and control: empirical evidence from China
Authors: Hu Zhen , Wu Yuanyang , Yang Hualei , Lin Xie , Zhang Anqi , Lin Xueyu , Nie Yafeng
Published: July 2020

Background: This study applied the SEIR model to analyze and simulate the transmission mechanisms of the coronavirus disease 2019 (COVID-19) in China. Methods: The population migration was embedded in the SEIR model to simulate and analyze the effects of the amount of population inflow on the number of confirmed cases. Based on numerical simulations, this study used statistical data for the empirical validation of its theoretical deductions and discussed how to improve the effectiveness of epidemic prevention and control considering population migration variables. Statistics regarding the numbers of infected people in various provinces were obtained from the epidemic-related data reported by China’s National Health Commission.Results: This study explored how the epidemic should be prevented and controlled from the perspective of population migration variables. It found that a combination of a susceptible population, an infected population, and transmission media was an important route affecting the number of infections and that the migration of a Hubei-related infected population played a key role in promoting epidemic spread. Epidemic prevention and control should focus on regions with better economic conditions than the epidemic region. Prevention and control efforts should focus on the more populated neighboring provinces having convenient transportation links with the epidemic region. To prevent and control epidemic spread, priority should be given to elucidating the destinations and directions of population migration from the domestic origin of infections, and then stemming population migration or human-to-human contact after such migration. Conclusions: This study enriched and expanded on simulations of the effects of population migration on the COVID-19 epidemic and China-based empirical studies while offering an epidemic evaluation and warning mechanism to prevent and control similar public health emergencies in the future.
Magnetic Resonance Imaging and Dynamic X-ray's correlations with Dynamic Electrophysiological Findings in Cervical Spondylotic Myelopathy: a retrospective cohort study.
Authors: Yu Zhengran , Lin Kaiyuan , Chen Jiacheng , Chen Kuan-Hung , Chen Yuguang , Guo Wei , Dai Yuhu , Zou Xuenong , Peng Xinsheng
Published: July 2020

Background: Dynamic somatosensory evoked potentials (DSSEP) can be used to disclose abnormalities of ascending sensory pathways at dynamic positions and diagnose cervical spondylotic myelopathy (CSM). However, radiographic tests including magnetic resonance imaging (MRI) and dynamic X-ray are used much more widely in the management of CSM. Our study aims to clarify the correlations between several radiographic parameters and the DSSEP results, and further determine their reliability with clinical data.Methods: We retrospectively enrolled 38 CSM patients with surgical intervention. DSSEP tests were performed before surgery. Amplitude ratios of DSSEP N13 and N20 waves at extension and flexion were calculated and recorded as N13_E, N20_E, N13_F, N20_F respectively. Baseline severity was evaluated with the modified Japanese Orthopedic Association (mJOA) score and the Nurick grades. Prognosis was evaluated based on the 2-year recovery rate. Sagittal diameter and transverse areas of the cord and canal were measured and the Spinal cord/Canal Area Ratio were calculated. The compressive ratios at the compressed site (Compression_Ratio), central (Central_Ratio) and 1/4-lateral points (1/4-Lateral_Compression_Ratio), and intramedullary T2 hyperintensity patterns (Ax-CCM types) were also collected from MRI axial images. Dynamic X-rays were used to test for segmental instability of the cervical spine. The correlations between radiologic findings, DSSEP data, and clinical assessments were investigated.Results: We found that DSSEP N13_E and N13_F correlated with the Compression_Ratio, Central_Ratio, 1/4-Lateral_Compression_Ratio (Pearson, p<0.05) and Ax-CCM types (ANOVA, p<0.05) in MRI axial images and cervical segmental instability in dynamic X-ray (t-test, p<0.05). Apart from the 1/4-Lateral_Compression_Ratio, these radiographic parameters above also correlated with the baseline clinical assessments (Spearman or ANOVA or t-test, p<0.05) and postoperative recovery rate (Pearson or ANOVA or t-test, p<0.05).Conclusions: We found that the preoperative Compression_Ratio, Central_Ratio and 1/4-Lateral_Compression_Ratio in MRI and cervical segmental instability in dynamic X-ray could reflect the dynamic neural dysfunction of the spinal cord. Different Ax-CCM types corresponded to different DSSEP results at extension and flexion, suggesting divergent pathophysiology. These radiographic parameters could help evaluate disease severity and predict postoperative prognosis.Trial registration: The trial "动态诱发电位对脊髓型颈椎病诊断和预后评估(Dynamic Somatosensory Evoked Potentials for the diagnostic and prognostic evaluation for Cervical Spondylotic Myelopathy)" was retrospectively registered on April 30th, 2020 and the registration number is "伦审[2020]151号".
Sex differences and Psychological Stress: Responses to the COVID-19 epidemic in China
Authors: Song Kangxing , Xu Rui , Stratton Terry D. , Kavcic Voyko , Luo Dan , Hou Fengsu , Bi Fengying , Jiao Rong , Yan Shiyan , Jiang Yang
Published: July 2020

Background
About 83000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contains its spread - have altered individuals’ “normal” daily functioning. This impact on social, psychological, and emotional well-being remain relatively unexplored – in particular, the ways in which Chinese men and women experience and respond to potential behavioral-related stressors.
Objective
To investigate gender differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents.
Methods
In late February (2020), an anonymous online questionnaire was disseminated via WeChat, a popular social media platform in China. The cross-sectional study design utilized a non-probabilistic “snowball” or convenience sampling of residents from various provinces and regions of China. Basic demographic characteristics (i.e., age and gender) – along with residential living arrangements and conditions – were measured along with psychological stress and emotional responses to the COVID-19 pandemic.
Results
3088 questionnaires were received: 1749 females (56.6%) and 1339 males (43.4%). The mean level of stress, as measured by a visual analog scale, was 3.4 (SD = 2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age (≤ 45 years), employment (unsteady income, unemployed), risk infection population (exposed to COVID-19,completed medical observation), difficulties encountered (diseases, work/study, financial, mental), behaviors(higher desire for COVID-19 knowledge, more time spent on the COVID-19). “Protective” factors included frequently contact with colleagues, calmness, and psychological resilience. Males and females also differed significantly in adapting to current living/working status, coping with heating, and psychological support service needs.
Conclusion
Among Chinese, self-reported stress related to the COVID-19 epidemic were significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.
Attitude towards ageing and perceived Health Status of Community-Dwelling Older Persons in a low resource setting: A rural-urban comparison
Authors: Cadmus Eniola Olubukola , Adebusoye Lawrence Adekunle , Owoaje Eme Theodora
Published: July 2020

Background: Ageing is a personal experience peculiar to each individual and is influenced by several demographic and social factors. Individuals, however, have different ways of coping with the challenges experienced during this process which affects their quality of life and health-related outcomes. Despite the increasing number of older persons in sub-Saharan Africa, there is limited information about their experience. This study examines the experience and attitude of older persons in Nigeria regarding the ageing processMethods: A descriptive cross-sectional study was carried out among older persons aged 60 years and above in a selected rural and an urban community in Oyo State, south-western Nigeria. Using a multistage sampling technique, data were collected with the aid of an interviewer-administered, semi-structured questionnaire. The Attitude to Ageing Questionnaire (AAQ) was used to measure participants' perception of ageing in three domains of psychosocial loss, physical changes and psychological growth. Data were analysed using Stata version 14 at a level of significance p<0.05. Results: A total of 1,180 participants (588 rural vs 592 urban) were recruited for the study. The mean age was 73.2 ±9.3 years. The majority (69.7%) were females and still working (50.5%) Overall, urban-dwelling participants had a better attitude to the ageing process in all the domains compared with rural-dwelling participants (psychological growth 32.5±3.4 vs 32.4±3.3, p=0.30; physical change 27.5±5.1 vs 26.9±5.0, p=0.03; and psychosocial loss 25.3±5.7 vs 25.0±5.3, p=0.60. The predictors for having a positive attitude to ageing especially among the urban-dwelling older persons were having a formal education, being employed and good self-rated health. While among the rural-dwelling older participants good self-rated health was the only predictor of having a positive attitude to ageing in the psychosocial loss and physical change domains. Conclusion: Older persons residing in urban communities had a better attitude to ageing process compared with their rural older counterparts. The common predictor of positive attitude to ageing in both groups was good self-rated health. This information can be used for the planning of targeted interventions and informing policy formation for improved provisions for community-dwelling older persons in Nigeria and other sub-Saharan African countries
Sodium butyrate protects against oxidative stress between obesity-prone and obesity-resistant rats induced by HFD through modulating Nrf2 pathway and mitochondrial function
Authors: Lu Yipin , Sun Yongjuan , Li Yingrui , Ma Shuhua , Zhang Kai , Tang xue , Yu Renqiang
Published: July 2020

Background

Sodium butyrate (NaB) is obtained by fermenting dietary fiber via intestinal microflora and has recently been shown to improve some antioxidant enzymes in vivo.
Methods

In this study, we investigated the antioxidant effects of Sodium butyrate on obesity rats induced by high-fed diet.
Results

NaB intervention could effectively reduce the body weight of rats in the obesity-prone(OP) and obesity-resistant(OR)group, and reduce insulin resistance, plasma lipid, protect the gastrocnemius muscle and pancreas from oxidative stress induced by high fat diet, upregulate T-AOC, antioxidant enzyme activity and GSH/GSSG ratio, reduce ROS level and MDA content. NaB may increase Pi3k, Nrf2, Nqo-1, Ho-1 and inhibit Gsk-3β mRNA expression by regulating Nrf2 antioxidant pathway to enhance tissue antioxidant capacity. At the same time, NaB intervention could significantly increase the expression of Glut4 and Irs-1 mRNA in gastrocnemius muscle of OP and OR rats, suppress the expression of Bax and Caspase 3, increase the mRNA expression of Pdx1, MafA and Bcl-2, and increase insulin secretion and muscle insulin sensitivity. The regulatory effect of NaB was correlated with its significantly increased activity of mitochondrial antioxidant enzymes, mitochondrial membrane potential, NADH/NAD+ ratio, acetyl-CoA and ATP production, Tfam and Pgc-1α expression and mitochondrial DNA copy number. In addition, 6% NaB intervention in OP rats, 4%NaB intervention in OR rats were more significant, indicating that there were dose effects of NaB intervention in different obesity phenotypes.
Conclusions

NaB activates the Nrf2 antioxidant pathway, enhances the expression level of downstream antioxidant genes, improves the antioxidant capacity of obese rat tissues, and at the same time promotes muscle protein synthesis, improves insulin sensitivity, and promotes glucose metabolism.
Differences of tensile strength in knot tying technique between orthopaedic surgical instructors and trainees
Authors: Harato Kengo , Yagi Mitsuru , Kaneda Kazuya , Iwama Yu , Masuda Akihiko , Kaneko Yosuke , Oya Akihito , Matsumura Noboru , Suzuki Taku , Nakayama Robert , Kobayashi Shu
Published: July 2020

Background: Knot tying technique is an extremely important basic skill for all surgeons. Clinically, knot slippage or suture breakage will lead to wound complications. Although some previous studies described the knot-tying technique of medical students or trainees, little information had been reported on the knot-tying technique of instructors. The objective of the preset study was to assess surgeons’ manual knot tying techniques and to investigate the differences of tensile strength in knot tying technique between surgical instructors and trainees.Methods: A total of 48 orthopaedic surgeons (postgraduate year: PGY 2-18) participated. Surgeons were requested to tie surgical knots manually using same suture material. They were divided into two groups based on each career; instructors and trainees. Although 4 open conventional knots with 4 throws were chosen and done with self-selected methods, knot tying practice to have the appropriate square knots was done as education only for trainees before the actual trial. The knots were placed over a 30 cm long custom made smooth polished surface with 2 cylindrical rods. All knots were tested for tensile strength using a tensiometer. The surgical loops were loaded until the knot slipped or the suture broke. The tensile strength of each individual knot was defined as the force (N) required to result in knot failure. Simultaneously, knot failure was evaluated based on knot slippage or suture rupture. In terms of tensile strength or knot failure, statistical comparison was performed between groups using two-tailed Mann-Whitney U test or Fisher exact probability test, respectively.Results: Twenty-four instructors (PGY6- PGY18) and 24 trainees (PGY2-PGY5) were enrolled. Tensile strength was significantly greater in trainees (83.0 ± 27.7N) than in instructors (49.9 ± 34.4N, P=0.0246). The ratio of slippage was significantly larger in instructors than in trainees (P<0.001). Knot slippage (31.8 ± 17.7N) was significantly worse than suture rupture (89.9 ± 22.2N, P<0.001) in tensile strength.Conclusions: Mean tensile strength of knots done by trainees after practice was judged to be greater than that done by instructors in the present study. Clinically, knot slippage can lead to wound dehiscence, compared to suture rupture.
LHH1, a Novel Antimicrobial Peptide with Anti-Cancer Activity Identified from Lactobacillus casei HZ1
Authors: He Junfang , Jin Duxin , Luo Xuegang , Zhang Tongcun
Published: July 2020

Antimicrobial peptides have been attracting increasing attention for their multiple beneficial effects. In present study, a novel AMP with a molecular weight of 1875.25 Da, was identified from the genome of Lactobacillus casei HZ1. The peptide, which was named as LHH1 was comprised of 16 amino acid residues, and its α-helix content was 95.34% when dissolved in 30 mM SDS. LHH1 exhibited a broad range of antimicrobial activities against gram-positive bacteria and fungus. It could effectively inhibit staphylococcus aureus with a minimum inhibitory concentration of 3.5 μM and showed a low hemolytic activity. The scanning electron microscope, confocal laser scanning microscope and flow cytometry results showed that LHH1 exerted its antibacterial activity by damaging the cell membrane of staphylococcus aureus. Meanwhile, LHH1 also exhibited anti-cancer activities against several cancer cells including MGC803, HCT116 and C666-1 cells, and one major action of its anti-cancer mechanism was breaking the cell membrane.
A Case of Severe Puffer Fish Poisoning: The Best Time to Establish Artificial Airway
Authors: Zhu Siqi , Yang Ying , Fan Zhao , Zhou Qidi , Fan Xiaoran
Published: July 2020

Background Puffer fish poisoning is one of the main causes of death from food poisoning in China. Currently, there is still no effective treatment method. The establishment of artificial airway and early implementation of mechanical ventilation are crucial to the prognosis of patients, but the optimal time is still not clear. Case Presentation A 62-year-old male patient complained of ‘numbness around the mouth for 3 hours after eating puffer fish’ was admitted to the emergency department, he was performed gastric lavage in time, but did not be performed protective endotracheal intubation.His condition worsen rapidly and respiratory and cardiac arrest was quickly occurred.He received aggressive treatment in the ICU, but still did not regain spontaneous breathing. Conclusion The establishment of artificial airway and early implementation of mechanical ventilation are crucial for the prognosis of patients,and we provide possible principles for performing endotracheal intubation.
Adherence to quarterly HIV prevention services and its impact on HIV incidence in men who have sex with men in West Africa (CohMSM ANRS 12324 – Expertise France)
Authors: DAH Ter Tiero Elias , Yaya Issifou , Sagaon-Teyssier Luis , Coulibaly Alou , Kouamé Malan Jean-Baptiste , Agboyibor Mawuényégan Kouamivi , Maiga Kader , Traoré Issa , Mora Marion , Palvadeau Paméla , Rojas-Castro Daniela , Diallo Fodié , Mensah Ephrem , Anoma Camille , Keita Bintou Dembélé , Spire Bruno , Laurent Christian
Published: July 2020

BackgroundAccess to tailored HIV prevention services remains limited for West African MSM. We assessed adherence to quarterly HIV prevention services and its impact on HIV incidence in MSM followed up in four cities in Burkina Faso, Côte d’Ivoire, Mali, and Togo.MethodsWe performed a prospective cohort study between 2015 and 2018. HIV-negative MSM aged over 18 benefited from quarterly medical visits which included a clinical examination, HIV testing, screening and treatment for other sexually transmitted infections, peer-led counselling and support, and the provision of condoms and lubricants. Determinants of adherence to quarterly follow-up visits and incident HIV infections were identified using generalized estimating equation models and Cox proportional hazard models, respectively.Results618 MSM were followed up for a median time of 20.0 months (interquartile range 15.2–26.3). Overall adherence to quarterly follow-up visits was 76.5% (95% confidence interval [CI] 75.1–77.8), ranging from 66.8% in Abidjan to 87.3% in Lomé (p < 0.001). 78 incident HIV infections occurred during a total follow-up time of 780.8 person-years, giving an overall incidence of 10.0 per 100 person-years (95% CI 8.0-12.5). Adherence to quarterly follow-up visits was not associated with the risk of incident HIV infection (adjusted hazard ratio 0.92, 95% CI 0.51–1.67, p = 0.791).ConclusionsStrengthening HIV prevention services among MSM in West Africa, including the use of PrEP, will be critical for controlling the epidemic, not only in this key population but also in the general population. Quarterly follow-up of MSM, which is essential for PrEP delivery, appears feasible.ClinicalTrials.gov, number NCT02626286 (December 10, 2015)https://clinicaltrials.gov/ct2/results?term=NCT02626286
Personal Health Perceptions as Predictors to Medication Adherence in a Prospective Cohort Study Among Patients with Multiple Sclerosis
Authors: Neter Efrat , Glass-Marmor Lea , Wolkowitz Anat , Lavi Idit , Miller Ariel
Published: July 2020

Background: Though adherence to disease-modifying therapies (DMTs) among persons with multiple sclerosis (PwMS) varies and is often below 80%, only few prospective studies on adherence examined predictors beyond demographic and clinical characteristics. Objectives: Identify antecedents to adherence and persistence in a prospective design among PwMS.Methods: PwMS (n=186) were prospectively assessed at three time points: baseline, 6 and 12 months later. Clinical, demographic information and patient-reported medication beliefs, illness perceptions, medication habits, perceived health and affect were assessed. Adherence and persistence were assessed by a combination of self-reports and retrospective review of medication claims. Findings: PwMS were 69.9% (Time 1) and 71% (Time 2) adherent to their DMTs and 64.5.9% were persistent. Beliefs about Medications were consistently predictive at both time points (baseline to Time 1 and Time 1 to Time 2) of medication adherence and persistence whereas other perceptions were predictive at some analyses; clinical and demographic characteristic were mostly not predictive of adherence nor persistence. The prospective association of beliefs about medication with adherence held also in multivariate analyses.Conclusions: Adherence and persistence are predicted by medication beliefs of PwMS. As medication beliefs are modifiable, they should be assessed periodically and targeted as a focus of tailored interventions aimed to improve adherence and consequently health outcomes in PwMS.
Classification and Generation of Microscopy Images With Plasmodium Falciparum Via Artificial Neural Networks
Authors: Ramarolahy Rija Tonny Christian , Gyasi Esther Opoku , Crimi Alessandro
Published: July 2020

Background: Recent studies use machine-learning techniques to detect parasites in microscopy images automatically. However, these tools are trained and tested in specific datasets. Indeed, even if over-fitting is avoided during the improvements of computer vision applications, large differences are expected. Differences might be related to settings of camera (exposure, white balance settings, etc) and different blood film slides preparation. Moreover, generative adversial networks offer new opportunities in microscopy: data homogenization, and increase of images in case of imbalanced or small sample size. Methods: Taking into consideration all those aspects, in this paper, we describe a more complete view including both detection and generating synthetic images: i) an automated detection used to detect malaria parasites on stained blood smear images using machine learning techniques testing several datasets. ii) investigate transfer learning and further testing in different unseen datasets having different staining, microscope, resolution, etc. iii) a generative approach to create synthetic images which can deceive experts. Results: The tested architecture achieved 0.98 and 0.95 area under the ROC curve in classifying images with respectively thin and thick smear. Moreover, the generated images proved to be very similar to the original and difficult to be distinguished by an expert microscopist, which identified correcly the real data for one dataset but had 50\% misclassification for another dataset of images. Conclusion: The proposed deep-learning architecture performed well on a classification task for malaria parasites classification. The automated detection for malaria can help the technician to reduce their work and do not need any presence of experts. Moreover, generative networks can also be applied to blood smear images to generate useful images for microscopists. Opening new ways to data augmentation, translation and homogenization.
Socio-economic Variable of Parents as a Correlate Promoting Teenage Pregnancy Among Medical Students in Delta State University, Abraka
Authors: Nwogueze Bartholomew Chukwuebuka , Ovuakporaye Simon Irikefe , Daubry Tarela Elias M , Nnama Tochukwu Nnamdi , Ossai Richard Nduka , Nwogueze Jane-Francis Onyinye
Published: July 2020

Purpose: The incidence of teenage pregnancy has attracted global concern due to its impact on the teen’s maternal health, the overall wellbeing of the child and the society at large. This study examined socio-economic variable of parents as a correlate promoting teenage pregnancy among medical students in Delta State University, Abraka Delta State. Methods: The Ex-Post Facto method was chosen as the research design for the study. 294 female medical students were selected from a total of 982 students from the medical college using simple random sampling technique. The instruments used for data collection was a self-structured and well-designed questionnaire containing 25 multiple choice items based on the research questions developed in the study. 278 questionnaires were successful retrieved from the field and was used for data analysis. Frequency count, percentages, mean score and Pearson product moment correlation were employed as the statistical technique for data analysis. SPSS version 21.0 was utilized for data analysis. Results: Findings from this study revealed that parental income (p=0.003) and occupation (p=0.005) were the viable parents’ socio-economic variable promoting teenage pregnancy among medical students in Delta State University, Abraka when compared to educational background (p=0.343), religion (p=0.307) and marital status (p=0.053) variables that were not significantly related. Conclusions: It appears that significant number of adolescent female students who become pregnant has to leave school and this have a long-term implication for them as individual, their family and their community. Therefore, effective parent-daughter relationships and school-based reproductive health education programmes are strongly recommended.
Behavioral factors associated with utilization of outpatient services among elderly in Pakistan: evidence from a nationally representative survey
Authors: Naz Lubna , Ghimire Umesh , Zainab Abida
Published: July 2020

BackgroundIn Pakistan, health system is facing unprecedented challenges to deal with the healthcare demand of the growing ageing population. Using conceptual framework, this study analyzes the factors associated with outpatient services utilization by the elderly population Methods This study used a sample of 5,319 individuals aged 60 and above extracted from the Pakistan Social and Living Standards Measurement Survey 2014-15. We modified the Anderson’s Behavioral model to accommodate available information on the elderly healthcare utilization. The behavioral factors, including predisposing, enabling and need factors, associated with the use of outpatient service were analyzed using exploratory data analysis and binary logistic regressions. The utilization of outpatient service in the study refers to the visits to private and government hospitals.ResultsOut of total 5,319 participants, 72.4% of participants visited outpatient services in private hospitals for their healthcare needs. Multivariate analysis showed that older age-group (80 years and above) and participants from urban were 35% and 53% times more likely to visit outpatient services in private hospitals, respectively. The elderly persons from Khyber Pakhtunkhwa were three times (AOR: 3.29, CI 2.5-4.8) more likely to visit government hospitals than their peers in Punjab. Participants who attended school (AOR: 1.21, CI 0.82-1.31) were more likely to utilize outpatient service in private hospitals. Elders from rich (AOR: 1.04, CI 0.84-1.13) and richest (AOR: 1.29, CI 0.89-1.87) wealth quintiles were more likely to visit private hospitals. The likelihood of the utilization of outpatient service in private hospitals increased by 17% with the increase in the frequency of consultation by three times and more.ConclusionsOur findings underscore a dire need for expanding the outreach of healthcare services, particularly government hospital facilities, for the elderly population. Moreover, the knowledge generated through this research may be employed to make particular behavioral interventions in areas, such as, age, caregiving for elderly living without spouse, poor, and elderly without social security or pension, and education.
Geriatric scores as single-handed tools in the risk of 30-day mortality after hip fracture
Authors: Casa Carmen da , Pablos-Hernández Carmen , González-Ramírez Alfonso , Blanco Juan F
Published: July 2020

Background

The 30-day mortality rate after hip fracture surgery has been considered as an indirect indicator of the quality of care. This work aims to validate the Barthel Index, Katz Index, Lawton-Brody Index, and Physical Red Cross Scale analyzed in the Comprehensive Geriatric Assessment at admission as predictors of 30-day mortality after hip fracture surgery.
Methods

Prospective study including 899 hip fracture patients over 65. Bed-ridden, non- surgically treated patients, and high energy trauma or tumoral etiology fractures were excluded. Variables distribution were assessed by χ2, and we performed binary logistic regression for risk assessment. P < 0.05 was considered statistically significant.
Results

We noted a 30-day mortality rate of 5.9%. We related Barthel Index (OR = 0.986 [0.975–0.996], p = 0.010), Katz Index (OR per point = 1.254 [1.089–1.444], p = 0.002), Lawton-Brody Index (OR = 0.885 [0.788–0.992], p = 0.037), and Physical Red Cross Scale (OR = 1.483 [1.094–2.011], p = 0.011) with the 30-day mortality of patients after hip fracture surgery. We also validate the Barthel Index inflection point (0–55) (ORBI(0−55) = 2.428 [1.379–4.275], p = 0.002) and Katz Index inflection point (A-B) (ORKI(A−B) = 0.493 [0.273–0.891], p = 0.019) for the assessment of the highest risked patients.
Conclusions

The geriatric scores would be useful multifunctional tools in the assessment of hip fracture patients as singly predictors of 30-day mortality.
Optimization of Orbital Retraction During Endoscopic Transorbital Approach: Quantitative Measurement of Intraocular Pressure - SevEN 006
Authors: Kim Woo Hyun , Moon Ju Hyung , Kim Eui Hyun , Han Ji Sang , Hong Chang Ki , Hong Je Beom
Published: July 2020

Background: Increased utilization of transorbital approach (TOA) necessitates study of the risk of increased intraocular pressure (IOP) and intraorbital pressure (IORP) due to orbital compression. We aimed to investigate the changes in IOP and IORP in response to orbital retraction in TOA and establish a method for continuous measurement of intraoperative IORP.Methods: We investigated nine patients who underwent TOA surgery from January 2017 to December 2019, and five cadavers. IORP and IOP were measured using a cannula needle monitor, tonometer, cuff manometer, and micro strain gauge monitor.Results: In all nine clinical cases and five cadavers, increased physical compression of the orbit increased the IOP and IORP in curvilinear pattern. In clinical cases, when the orbit was compressed 1.5 cm from the lateral margin in the sagittal plane, mean IOP and IORP levels were measured at 25.4±5.2 mmHg and 14±9.2 mmH2O, respectively. The IORP reflected the IOP satisfactorily (Pearson correlation coefficient=0.824, p<0.001).Conclusion: We measured IOP and IORP simultaneously during orbital compression offering the basic information of the pressure change. In clinical cases, we found that the change in IOP can be monitored conveniently and noninvasively using continuous IORP measurement.
Glyburide Attenuates B(a)p and LPS-Induced Inflammation-Related Lung Tumorigenesis in Mice
Authors: Li Mengyuan , Liu Hong , Shao Hua , Zhang Peng , Gao Min , Huang Li , Shang Pingping , Zhang Qiao , Wang Wei , Wang Jing , Feng Feifei
Published: July 2020

Background: Glyburide (Gly) serves as inhibitor of NLRP3 inflammasome, which is also one of the most common medication used in the treatment of type 2 diabetes. Although accumulating evidences suggest that Gly could affect cancer risk and tumor growth, the role of chronic Gly treatment in lung tumorigenesis remains unclear. In this study, we evaluated whether Gly inhibited the occurrence of lung cancer and explored the possible mechanisms in the non-diabetes mice model of inflammation-related lung cancer induced by benzo(a)pyrene [B(a)p] plus lipopolysaccharide (LPS).Methods: The C57BL/6J mice exposed to B(a)p (1mg/mouse, once a week for 4 times) and 3 weeks later instilled intratracheally with LPS (2.5μg/mouse, once every three weeks for 5 times), and the Gly was administered by gavage (at a dose of 10μl/g body weight) one week before the mice exposed to B(a)p until the animal model finished (the week of the first time of Gly treatment named Week 0). At week 34, we analyzed the incidence, number and histopathology of lung tumors, and detected the expression of NLRP3, IL-1β and Cleaved-IL-1β protein.Results: Vehicles and tricaprylin+Gly could not induce lung tumorigenesis in the whole process. The incidence and the mean tumor count of mice in B(a)P/LPS+Gly group was decreased compared to those in B(a)p plus LPS group respectively. Histopathological examination found that Gly-treatment alleviated inflammatory changes compared with mice exposed to B(a)p plus LPS and revealed a reduction of the number of pathological tumor nest in the B(a)P/LPS+Gly group compared to the B(a)p plus LPS group. The expression of NLRP3, IL-1β and Cleaved-IL-1β protein was significantly increased in B(a)p plus LPS group compared to Vehicle control group, but decreased in B(a)P/LPS+Gly(0.96mg/kg) group compared to B(a)p plus LPS group.Conclusions: Glyburide might inhibit NLRP3 inflammasome to attenuate B(a)p plus LPS-induced inflammation-related lung tumorigenesis in non-diabetes mice.
Heteronormativity in Schools is Associated with Unhealthy Weight-Control Behaviors in Lesbian, Gay, and Bisexual Youth: A Multilevel Analysis.
Authors: Santos Carolina da Franca Bandeira Ferreira , Godoy Fabiana , Menezes Valdenice , Colares Viviane , Zarzar Patrícia , Ferreira Raquel , Kawachi Ichiro
Published: July 2020

Background: Previous studies found that a school climate of more heteronormativity is associated with adverse effects on the mental health of LGB students. Accordingly, our aim was to assess the association between low LGB visibility in schools and unhealthy weight-control behaviors among LGB youth. Methods: Cross-sectional, multilevel study based in public high schools in the city of Olinda, Northeast Brazil. A multilevel logistic regression was performed, including 2,500 adolescents enrolled in 27 schools. The contextual variable was the prevalence of LGB youth in each school (as a proxy for heteronormativity in schools) while the outcome was unhealthy weight-control behaviors (fasting, purging, and taking diet pills). We controlled for socioeconomic characteristics (age, gender, receiving a family allowance), obesity, and self-reported happiness. Results: Low LGB visibility in schools was associated with higher odds of engaging in unhealthy weight-control behaviors (OR: 1.5, 95%CI: 1.0, 2.2) among all youth, regardless of sexual orientation. Among LGB youth, there was some suggestion that the association between LGB visibility and unhealthy weight control behaviors was mediated by experiences of victimization and self-perceptions of unhappiness.Conclusion: A school environment of low LGB visibility was associated with unhealthy weight-control behaviors in youth.
HDAC6 Inhibitor WT161 Performs Antitumor Effect on Ostersarcoma and Synergistically Interacts with 5-FU
Authors: Sun Jun , Tang Xiaofeng , Zhang Feifei , Ju Cheng , Liu Renfeng , Liang Yiping , Yu Bo , Lv Bin , Guo Yuhong , Zeng Duo , Wang Min , Zhang Zhiping , Zhang Changhua , Lv Xiao-Bin
Published: July 2020

Background: WT161 as a new selective HDAC6 inhibitor has been shown to play anti-tumor effects on multiple myeloma and breast cancer. However, the role of WT161 in osteosarcoma remains unclear. The aim of this study is to explore the role of WT161 in osteosarcoma and its underlying mechanisms.Methods: The anti-proliferative effect of WT161 on osteosarcoma cells was examined using MTT assay and colony formation assay. Cell apoptosis was analyzed using flow cytometer. The synergistic effect was evaluated by isobologram analysis using CompuSyn software. The osteosarcoma xenograft models were esatablished to evaluate the anti-proliferative effect of WT161 in vivo.Results: WT161 suppressed the cell growth and induced apoptosis of osteosarcoma cells in a dose- and time-dependent manner. Mechanistically, we found that WT161 treatment obviously increased the protein expression level of PTEN and decreased the phosphorylation level of AKT. Notably, WT161 shows synergistically inhibitory effects on osteosarcoma cell combined with 5-FU. Animal experiment results show WT161 inhibits the growth of osteosarcoma tumor and further illustrates that WT161 and 5-FU have a synergistic efficiency in osteosarcoma.Conclusions: These results indicate that WT161 inhibiting the growth of osteosarcoma through PTEN and has a synergistic efficiency with 5-FU.
Algorithm for Program of the Vertical Thermo-siphon Re-boiler
Authors: Ketin Sonja , JOVICIC Aleksandar , ANDREJIC Marko
Published: July 2020

Paper will present algorithm for program and estimation of the vertical thermo-siphon re-boiler, using the FORTRAN77 programming language that is based on the method of Sarm and al. Unlike previously proposed approaches and the literature this method in the estimation of the pressure drop in pipes apparatus, takes into account the mechanism of the two-phase flow. The results of the program are analyzed in detail and discussed in the exploitation of real examples.
Role of Open Cerclage Wires Used in Patients with Comminuted Fractures of Femoral Shaft Treated with Intramedullary Nails
Authors: Wang Tzu-Hao , Chuang Hao-Chun , Kuan Fa-Chuan , Hong Chih-Kai , Yeh Ming-Long , Su Wei-Ren , Hsu Kai-Lan
Published: July 2020

IntroductionThe role of open cerclage wiring in comminuted femoral shaft fracture treatment with intramedullary nails remains unclear. Here, we analyzed the effect of open cerclage wiring and the risk factors for nonunion after interlocking nailing in comminuted femoral shaft fracture treatment. We hypothesize that open cerclage wiring is applicable to patients with severe comminuted femoral shaft fractures without affecting bone healing.Patients and MethodsThis retrospective cohort study used data of consecutive patients who underwent interlocking nail fixation of a comminuted femoral shaft fracture between January 1, 2009, and December 31, 2016. First, eligible patients were divided into wire and no wire groups according to the surgical technique used and their union rate was recorded. The patients were then divided into union and nonunion groups and their perioperative data were analyzed.ResultsIn total, 71 comminuted femoral shaft fractures treated with interlocking nail fixation were included: 38 fractures (53.5%) augmented with the open wiring technique and 33 reduced with closed or mini–open wound without wiring. The wire group demonstrated significant improvements in fracture reduction compared with the no wire group, whereas no significant difference was observed in the union rate between the wire and no wire groups (p = 0.180). Moreover, 46 (65%) of 71 fractures united smoothly, and no significant difference was observed in any perioperative data between union and nonunion groups.DiscussionAugmented open cerclage wiring is indicated for comminuted femoral shaft fractures treated with intramedullary nails, even when the fragments are large or far displaced. Thus, open cerclage wiring can be used for fracture treatment, without decreasing the union rate.