bluuebunny/crossref_metadata_2025 huggingface dataset:
Breaking barriers: using the Behavior Change Wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time
Authors: Ojo Samson O , Bailey Daniel P. , Brierley Marsha L. , Hewson David J. , Chater Angel M.
Published: September 2019

Background: The workplace is a prominent domain for excessive sitting. The consequences of increased sitting time include adverse health outcomes such as cardiovascular disease and poor mental wellbeing. There is evidence that breaking up sitting could improve health, however, any such intervention in the workplace would need to be informed by a theoretical evidence-based framework. The aim of this study was to use the Behaviour Change Wheel (BCW) to develop a tailored intervention to break up and reduce workplace sitting in desk-based workers. Methods: The BCW guide was followed for this qualitative, pre-intervention development study. Semi-structured interviews were conducted with 25 office workers (26-59 years, mean age 40.9 [SD=10.8] years; 68% female) who were purposively recruited from local council offices and a university in the East of England region. The interview questions were developed using the Theoretical Domains Framework (TDF). Transcripts were deductively analysed using the COM-B (Capability, Opportunity, Motivation – Behaviour) model of behaviour. The Behaviour Change Technique Taxonomy Version 1 (BCTv1) was thereafter used to identify possible strategies that could be used to facilitate change in sitting behaviour of office workers in a future intervention. Results: Qualitative analysis using COM-B identified that participants felt that they had the physical Capability to break up their sitting time, however, some lacked the psychological Capability in relation to the knowledge of both guidelines for sitting time and the consequences of excess sitting. Social and physical Opportunity was identified as important, such as a supportive organisational culture (social) and the need for environmental resources (physical). Reflective and automatic Motivation was highlighted as a core target for intervention. Seven intervention functions and three policy categories from the BCW were identified as relevant. Finally, 39 behaviour change techniques (BCTs) were identified as potential active components for an intervention to break up sitting time in the workplace. Conclusions: The TDF, COM-B model and BCW can be successfully applied through a systematic process to understand the drivers of behaviour of office workers to develop a co-created intervention that can be used to break up and decrease prolonged sitting in the workplace.
Four collateral circulation pathways were observed after common carotid artery occlusion
Authors: Wang Jianan , Zheng Chengrong , Hou Bei , Huang Aihua , Zhang Xiongwei , Du Bin
Published: September 2019

Background: Common carotid artery (CCA) occlusion (CCAO) is a rare condition. Owing to collateral circulation, ipsilateral internal carotid artery (ICA) and external carotid artery (ECA) are often patent. Methods: This study included 16 patients with unilateral CCAO and patent ipsilateral ICA and ECA. The pathways which supplied ICA were investigated by digital subtraction angiography (DSA), transcranial Doppler (TCD), magnetic resonance angiography (MRA) and computed tomography angiography (CTA). Results: In all 16 patients, TCD found antegrade blood flow in ipsilateral ICA in all 16 patients, which was supplied by retrograde blood flow in ipsilateral ECA through carotid bifurcation. We call this phenomenon “ICA steal”. DSA and CTA discovered four pathways of ICA steal, including 1) ipsilateral vertebral artery – occipital artery – ECA – ICA, 2) ipsilateral thyrocervical trunk or costocervical trunk – ascending cervical artery or deep cervical artery – occipital artery – ECA – ICA, 3) contralateral ECA – contralateral superior thyroid artery – ipsilateral superior thyroid artery – ipsilateral ECA – ICA, and 4) ipsilateral thyrocervical trunk – inferior thyroid artery – superior thyroid artery – ECA – ICA. Conclusions: ICA is possible to be patent and supplied by several collateral circulation pathways after CCAO.
Maternal Complication Related To Instrumental Delivery At Felege Hiwot Specialized Hospital, Northwest Ethiopia. A Retrospective Cross-Sectional Study
Authors: zewudie shimeles biru , sewyew Dagne Addisu , limenh Simachew kassa , bante Simachew animen
Published: September 2019

ABSTRACT
Objective: The study aimed to determine proportion and risk factors for maternal complication related to forceps and vacuum delivery among mother who gave birth at Felege Hiwot Comprehensive Specialized Hospital (FHCSH).
Results: Records of 406 mothers managed with instrumental vaginal delivery were reviewed and 97% of the reviewed card had complete documentation. The proportion of maternal complications related to instrumental delivery was 12.1%. A major complication of forceps assisted delivery was 2nd-degree perineal tear (7.4%), 3rd-degree perineal tear (1.5%), cervical tear (1.5%) and episiotomy extension (1%). However, the complication of vacuum-assisted vaginal delivery was only cervical tear (0.5%) and episiotomy extension (0.5%). Episiotomy during instrumental delivery reduce maternal complication by 86% [AOR=0.14, 95%CI=0.07-0.3]. Forceps assisted vaginal delivery had 3.4 times more risk for maternal complication compared to vacuum-assisted vaginal delivery [AOR=3.4, 95%CI=1.08-10.67] and the same is true for primiparity that primipara women who gave birth by the help of instrument had 3.5 times more risk for maternal complication compared to a multipara women [AOR=3.5, 95%CI=1.26-9.98].
Keywords: maternal complication, instrumental delivery, northwest, Ethiopia
A nationwide survey of the opinions of paediatricians regarding the management of neonates born to women with group B Streptococcus in Japanese maternity homes
Authors: yamaguchi kotomi , Ohashi Kazutomo
Published: September 2019

Objective: The Japanese Midwifery Association (JMA) guidelines allow midwives to manage group B Streptococcus (GBS)-positive women during pregnancy and labour at maternity homes. However, no guidelines exist to manage neonates born to GBS-positive women in Japan. We aimed to investigate the opinions of paediatricians regarding optimal management strategies for neonates born to GBS-positive women in maternity homes. A questionnaire was sent to paediatricians at 396 Japanese perinatal medical centres. We examined opinions regarding examinations and routine clinical tests for neonates born to GBS-positive women in maternity homes.
Results: Of 235 paediatricians, only 11.2% considered that paediatric examinations were unnecessary for neonates born to GBS-positive women in maternity homes. Moreover, 20.5%, 13.2%, and 11.1% of paediatricians considered culture test of the nasal cavity, serum C-reactive protein level analysis, and blood cell count analysis, respectively, necessary for neonates born to GBS-positive pregnant women with intrapartum antibiotic prophylaxis (IAP), whereas 36.3%, 56.2%, and 40.6% of paediatricians considered these tests necessary in cases without IAP. The JMA guidelines had low penetration rates among paediatricians in Japan. To manage neonates born to GBS-positive women in maternity homes, midwives should engage with commissioned paediatricians in more detail and develop appropriate strategies to increase awareness and cooperation.
Changes in Body Weight and Blood Pressure among Women Using Depo-Provera injection in Northwest Ethiopia
Authors: Zerihun Muluken Fekadie , Malik Tabarak , Ferede Yohannes Mulu , Bekele Tesfahun , Yeshaw Yigizie
Published: September 2019

Objectives: Depo-Provera is an injectable contraceptive method containing medroxyprogesterone acetate. It has some adverse effects like changes in menstrual pattern, loss in bone mineral density and risk of weight gain. Therefore, this study is aimed at to investigate the effects of Depo-Provera on body weight and blood pressure among Ethiopian women. Institution based cross-sectional study design was conducted from January 2017 to April 2017. Data were analyzed using SPSS version 21 software. Paired t-test, independent t-test and ANOVA were used to evaluate the presence of mean difference and relationship between changes in variables and duration of use of Depo-Provera. P-value ≤ 0.05 were considered as statistically significant.
Results: The mean weight and body mass index (BMI) of Depo-Provera users were increased significantly (p=0.02 for mean body weight and p=0.019, for body mass index). There was no significant difference in mean arterial blood pressure (MAP) of Depo-Provera users compared to controls or their respective pretreatment value (p-value=0.85 for Depo-Provera users and 0.67 for non-users). The finding of this study revealed that there is an increased weight gain and BMI among Depo-Provera users compared to non-users, which really requires attention of health professionals and other stake holders.
The Long-term Survival of Patients with III-IVb Stage Nasopharyngeal Carcinoma Treated with IMRT with or without Nimotuzumab: A Propensity Score-matched Analysis
Authors: Zhi-Qiang Wang , Qi Mei , Ji-Bin Li , Rui You , You-Ping Liu , Rui Sun , Guang-Yuan Hu , Ming-Yuan Chen , Hua Yijun
Published: September 2019

Background:
To assess the efficacy of Nimotuzumab in combination with first-line chemoradiotherapy treatment in Chinese patients with primary III-IVb stage nasopharyngeal carcinoma.
Methods:
Patients with primary locoregionally advanced nasopharyngeal carcinoma who were treated with intensity-modulated radiotherapy (IMRT) and concurrent cisplatin-based chemotherapy between January 2008 and December 2013 at a single institution were retrospectively reviewed. Group A received at least 6 doses of Nimotuzumab, while Group B did not receive Nimotuzumab. A propensity score matching method was used to match patients from each group in a 1:3 ratio.
Results:
In total, 730 eligible patients were propensity matched, with 184 patients in Group A and 546 patients in Group B. Significant differences were not observed in the patient and tumor characteristics between Group A and Group B. At a median follow-up of 74.78 months (range 3.53–117.83 months), locoregional recurrence, distant failure and death were observed in 10.68%, 11.10% and 16.03% of all patients, respectively. The estimated 5-year locoregional relapse–free survival, distant metastasis–free survival, progression-free survival and overall survival in the Group A versus Group B were 85.34% versus 89.79% (P=0.156), 93.09% versus 85.61% (P = 0.012), 79.96% versus 77.99% (P = 0.117) and 88.91% versus 78.30% (P=0.006), respectively.
Conclusions:
This nimotuzumab-containing regimen resulted in improved long-term survival of III-IVb stage NPC patients and warrants further prospective evaluation.
A Comparison of Ocular Trauma Scores in a Pediatric Population
Authors: Awidi Abdelhalim , Kraus Courtney L
Published: September 2019

Objective: Pediatric ocular trauma represents a major concern for ophthalmologists. Delays in presentation, incomplete exams, inaccurate visual acuity (VA) results, and amblyopia can limit accurately predicting final visual outcomes in pediatric eye trauma. We performed a retrospective clinical study to describe the demographics and causes of eye trauma. We also compared 2 ocular trauma scoring systems, one specifically designed for pediatric trauma, to classify injuries and determine which better predicted VA outcomes. A retrospective chart review of 3 years of pediatric globe trauma was performed. Analysis was focused on mechanisms of injury and VA outcomes. Complex factors that may worsen outcomes were recorded. Ocular Trauma Score (OTS) and Pediatric Ocular Trauma Score (POTS) were used to assign Groups 1-5 to each case. Group 1 was poorest prognosis, Group 5 best. Association between Group and final VA was examined. Accuracy of the two systems was compared. Results: 23 children met eligibility criteria (13 male). Initial VA averaged 20/200 (range no light perception (NLP) – 20/20). Final VA was 20/150 (range NLP - 20/20). Objects of injury were sharp metallic household objects (7), miscellaneous (4), toys (3), BB pellets (2), stick/wood (2), pencil/pen (1).
Does socioeconomic status have any influence on success at the national ranking exam?, a prospective survey
Authors: Bouchghoul Hanane , Teboul Jean-Louis , Senat Marie-Victoire , Vigoureux Solene
Published: September 2019

Background: The weight of social inequalities during education is a reality. Students of lower socioeconomic status may have less chance of success in higher education, particularly in medical studies. However, the role of students' socioeconomic factors, such as their parents' profession, in their success in the national ranking exam (NRE) has not been studied Our aim was to investigate the association between socioeconomic factors and success in the national ranking exam among sixth year medical students at the Paris-Sud Faculty of Medicine. Methods: This was a prospective survey of all sixth-year medical students at the Paris-Sud Faculty of Medicine, using a questionnaire on socioeconomic factors, which were compared according to NRE results.Results : Of 172 sixth year medical students, 110 completed the questionnaire. Their ranking ranged from 20 to 7695, with a median of 2815 (interquartile range: 1029-4581). The factors associated with ranking in the top 1500 were a high school diploma ( baccalauréat ) A or B grade, success at the first attempt in the first-year medical examination, and enrollment in the NRE preparatory lectures during the sixth year of medical training. The educational status and socio-professional category of the parents were not associated with ranking among the top 1500 medical students.Conclusion : At the Paris-Sud Faculty of Medicine, there was no association between parental socioeconomic status and sixth year students' success in the NRE.
Genomic and evolutionary features of two AHPND positive Vibrio parahaemolyticus strains isolated from shrimp (Penaeus monodon) of south-west Bangladesh
Authors: Ahmmed Shawon , Khan Md. Abdullah-Al-Kamran , Eshik Md. Mostavi Enan , Punom Nusrat Jahan , Islam Abul B.M.M.K. , Rahman Mohammad Shamsur
Published: September 2019

Background Due to its rapid lethal effect in the early stage of shrimp, acute hepatopancreatic necrosis disease (AHPND) causing great economic losses, since it first outbreak in southeast China in 2009. Vibrio parahaemolyticus , carrying the pir A and pir B toxin genes is known to cause AHPND in shrimp. The overall objective of this study was to sequence whole genome of AHPND positive V. parahaemolyticus strains isolated from shrimp ( Peneaus monodon ) of south-west region of Bangladesh in 2016 and 2017 and characterize the genomic features and emergence pattern of this marine pathogen. Results Two targeted AHPND positive V. parahaemolyticus strains were confirmed using PCR with 16S rRNA, ldh , AP3 and AP4 primers. The assembled genomes of strain MSR16 and MSR17 were comprised of total 5,393,740 bp and 5,241,592 bp, respectively. From annotation, several virulence genes involved in chemotaxis and motility, EPS type II secretion system, Type three secretion system-1 (TTSS-1) and its secreted effectors, thermolabile hemolysin were found in both strains. Importantly, the ~69 kb plasmid was identified in both MSR16 and MSR17 strains containing the two toxin genes pir A and pir B. Antibiotic resistance genes were predicted against β-lactam, fluoroquinolone, tetracycline, macrolide and cephalosporin groups in both MSR16 and MSR17 strains. Conclusions The findings of this research may facilitate the tracking of pathogenic and/or antibiotic resistance V. parahaemolyticus isolates between production sites, and the identification of candidate strains for production of vaccines as an aid to control of this devastating disease. Also, the emergence pattern of this pathogen can be highlighted to determine the characteristic differences of other strains found all over the world.
Risk score to predict time-to sputum smear and culture conversions in patients treated with shorter MDR-tuberculosis regime in Guinea (Conakry): A retrospective cohort study.
Authors: Diallo Alhassane , Diallo Boubacar Djelo , Camara Lansana Mady , Fotso Gladys Djuiga , Camara Souleymane , Bah Boubacar , Sidiki Magassouba Aboubacar , Barry Alpha Oumar , Diallo Thierno Hassane , Aboubacar Camara , Bah Néné Ramata , N’Zabintawali Fulgence , Haroune Souleymane Hassane , Lotshutshu Miguel , Diallo Mamadou Hassimiou , Sow Oumou Younoussa
Published: September 2019

Background Sputum smear and culture examination were used as bacteriological marker to monitor multidrug-resistant tuberculosis (MDR-TB) treatment. We aimed to identify the strongest contributing factors that affect time-to sputum bacteriological conversion, and to develop a practical risk scoreMethods Patients treated with shorter MDR-TB treatment regime between June 07, 2016 and June 22, 2018 from three major drug-resistance TB centres in Guinea, who had a positive smear or culture at baseline, and who had rifampicin resistance were analysed. Sputum bacteriological conversion was defined as two consecutive negative smear or culture taken at least 30 days apart. Cox regression model was used to analyse time-to initial sputum conversion, and to identify influencing factors. A simple risk score was constructed using the regression coefficients from each final model. Time-dependent AUC was used to determine the optimal time points of bacteriological conversion.Results 75% (173/232) of patients with a positive smear and culture at baseline were analyzed. A total, 90.2% (156/173) and 89% (154/173) of the patients had smear and culture conversions in a median of 59 days (inter-quartile range: 59 – 61) respectively. Lower colony count (< 3 +) of initial culture (aHR = 1.52, 1.09 – 2.14) and previously history of TB treatment (aHR = 2.10, 1.26 – 3.51) were more likely to have culture conversion, while only the higher BMI (aHR = 1.10, 1.03 – 1.18) was associated with rapid smear conversion. The predicted risk score from independent predictors showed good discrimination (0.855 ± 0.023 and 0.883 ± 0.02 respectively for smear and culture conversions). Time-to initial culture conversion provided a better discriminative capacity (AUC) to detect patients with higher chance to being treatment success during the first three months.Conclusion The identified predictors can be considered to improve the management of MDR-TB patients. The optimal time points for culture conversion was three months in shorter regime. Keywords: Conversion, Multidrug-resistant, Tuberculosis, Guinea.
Biomechanical Changes of Degenerated Adjacent Segement and Intact lumbar Spine after lumbosacral Topping-off surgery: A Three-dimensional Finite Element Analysis
Authors: Cao Liangliang , Liu Yumei , Mei Wei , Xu Jian-guang , Zhan Shi
Published: September 2019

Background: Previous studies have revealed positive effect of Topping-off technique on upper adjacent segment after fusion surgery, while for the cases with fusion surgery on L5-S1 segment, owning maximal range of motion, and pre-exsiting degenerated upper adjacent disc, it is necessary to clarify the superiority of Topping-ff technique and the effect exerted on the lumbar spine. Methods: A young healthy male volunteer was selected for thin-slice CT scanning. Then the image information was imported into the computer to establish the whole lumbar spine model as the health model. The medium degeneration model of intervertebral disc was established by changing the material properties of L4-S1 disc on the basis of the health model, and the fusion model and Topping-off model were respectively established on the basis of the degenerated model. The variation trend of ROM of L2-L5 and the stress changes of L4-L5 intervertebral disc, nucleus pulposus and facet joints were calculated respectively. Results: The L4-L5 ROM of fusion model increased significantly but the ROM of L2-L3 and L3-L4 segments did not change significantly. Compared with the degenerated model, L4-L5 activity of the Topping-off model decreased, and ROM of the L2-L3 and L3-L4 increased to some extent in the flexion and extension positions. the stress on the disc, nucleus pulposus and facet joint of the fusion model L4-L5 increased in four positions of flexion, extension, rotation and bending compared with the degenerated model, while the fiber stress on the Topping-off model decreased significantly in all four positions. Conclusion: Topping-off technology can decrease the stress and ROM of the adjacent upper degenerated segment, and increase the ROM of other upper segments, thereby delaying the degeneration of upper adjacent segments and compensating the lumbar spine mobility.
Prediction of perioperative outcome after hepatic resection for pediatric patients
Authors: Zhang Yunfei , Liu Jianxia , Zhu Hai , Qiu Lin , guo chunbao
Published: September 2019

Background Hepatic resection is associated with significant risk of morbidity and mortality. Optimising the surgical techniques and perioperative management may improve in operative morbidity and mortality. However, perioperative variables involved in the improvement for postoperative outcomes in pediatric hepatectomy have not been defined.Methods We retrospectively reviewed 156 consecutive pediatric patients who underwent hepatectomy at our center (an academic tertiary care hospital) between 2006 and 2016. Baseline demographic variables, intraoperative variables, complications, and hospital stay were explored. The patients were further investigated using univariate and multivariate analysis for the factors involved in the postoperative outcomes.Results Of the conditions requiring resections, malignant and benign liver diseases accounted for 47.4% (74/156) and 52.6% (82/156), respectively. The overall hospital mortality was 1.9% (3/156) and the overall postoperative complication rate was 44.2% (69/156). Anatomical resections were performed in 128 patients (82.1%), including 14(9.0%) extended hepatectomies. Eighty percent of patients had three or more segments resected. The median operative time was 167.7 (65-600) minutes and median estimated blood loss was 320.1(10-1600) mL. On multivariate analysis, the estimated blood loss (EBL) (mL) (OR, 2.19; 95CI, 1.18-3.13; p=0.016), extent of hepatectomy (OR, 1.81; 95CI, 1.06-2.69; p=0.001) and pringle maneuver (OR, 1.38; 95CI, 1.02-1.88; p=0.038) were the independent predictors of postoperative complications.Conclusions Extent of hepatectomy and estimated blood loss are largely responsible for the perioperative complications. with the surgical devices and management amelioration, like pringle maneuver, the treatment planning may be optimize in pediatric liver resection.
Disruption of a primary health care domestic violence and abuse service in two London boroughs: interrupted time series evaluation
Authors: Panovska-Griffiths Jasmina , Sohal Alex Hardip , Martin Peter , Capelas Estela Barbosa , Johnson Medina , Howell Annie , Lewis Natalia , Feder Gene , Griffiths Chris , Eldridge Sandra
Published: September 2019

Background Domestic violence and abuse (DVA) remains a major health concern affecting an estimated 15%-71% of women worldwide. IRIS ( Identification and Referral to Improve Safety of women affected by DVA) is a complex, system-level, training and support programme, designed to improve the primary healthcare response to DVA. Following a successful trial, since 2011 IRIS has been implemented in eleven London boroughs. In two boroughs the service was disrupted for a period of time and this work evaluates the impact of this service disruption. Methods We used anonymised data on daily referrals received by DVA service providers from general practices in two IRIS implementation boroughs that had service disruption for a period of time (six and three months). In line with previous work we refer to these as boroughs B and C. The primary outcome was the number of daily referrals received by the DVA service provider across each borough over 48 months (March 2013-April 2017) in borough B and 42 months (October 2013-April 2017) in borough C. The data were analysed using interrupted-time series, non-linear regression analysis with sensitivity studies exploring different regression models. Incidence Rate Ratios (IRRs) and 95% confidence intervals and p-values associated with the disruption were reported for each borough. Results Mixed-effects negative binomial regression was the best fit model to the data. In borough B, the disruption, that occurred towards the end of the implementation period and lasted for about 6 months, significantly (p=0.006) reduced the referral rate by about 70% (95%CI=(23%,87%)). In borough C, the three-month service disruption that occurred towards the middle of the implementation period, also significantly (p=0.005) reduced the referral rate by about 49% (95% CI=(18%,68%)). Conclusions Disrupting the IRIS service has substantially reduced the rate of referrals to DVA service providers. Our findings are evidence in favour of continuous funding of IRIS as a system level programme. Funding National Institute for Health Research (NIHR), Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames. Keywords domestic violence and abuse, interrupted time-series, non-linear regression
How does ageism influence frailty? A pilot study using a structural equation model
Authors: Ye Bo , Gao Junling , Fu Hua , Chen Hao , Dong Wenjing , Gu Ming
Published: September 2019

Objectives: Based on the Stereotype Embodyment Theory (SET), this study aims to examine the mechanism of ageism on frailty through the proposed framework of "Experiences of Ageism (EA) → Age Stereotypes (AS) → Attitudes to ageing (AA) → Frailty" using a structural equation model (SEM).
Methods: A community-based study involving 630 participants aged 60 years and older was conducted in Shanghai. EA, AS, AA and frailty status were assessed by validated scales. In particular, EA included three parts in this study, as the first part was the experiences of explicit prejudice or discrimination because of age, another two parts were the experiences of witnessed and encountered implicit negative age-based stereotypes. A SEM was performed to examine whether the proposed paths from EA to frailty were supported.
Results: EA had a direct effect (β=.168, p=.026) on frailty, but also had a significant indirect effect (.052) on frailty through the path of "EA → AS → AA → Frailty" after controlling for covariates. AA had a direct effect (β=-.337, p<.001) on frailty, AS fully mediated the association between EA and AA (indirect effect=-.153), and AA fully mediated the association between AS and frailty (indirect effect=.123).
Conclusions: These findings demonstrated a mechanism from ageism to frailty, and highlighted the potential threat of negative AS on health. Ageism and frailty are both great challenges for the process of healthy ageing.
Cross-sectional study of associations between normal body weight with central obesity and hyperuricemia in Japan
Authors: Shirasawa Takako , Ochiai Hirotaka , Yoshimoto Takahiko , Nagahama Satsue , Watanabe Akihiro , Yoshida Reika , Kokaze Akatsuki
Published: September 2019

Background

Several studies have shown that normal weight with central obesity (NWCO) is associated with cardiovascular disease risk factors such as hypertension, dyslipidemia and diabetes. However, the relationship between NWCO and hyperuricemia has not been studied in detail.

Methods

We investigated the association between NWCO and hyperuricemia among Japanese adults aged 40-64 years who had undergone periodic health examinations between April 2013 and March 2014. Obesity was defined as a body mass index (BMI) ≥25 kg/m 2 　and central obesity was determined as a waist-to-height ratio (WHtR) ≥0.5. We classified the participants into the following groups based according to having obesity and central obesity: normal weight (BMI 18.5-24.9 kg/m 2 ) without (NW; WHtR <0.5) and with (NWCO) central obesity, and obesity without (OB) and with (OBCO) central obesity. Hyperuricemia was defined as serum uric acid >7.0 and ≥6.0 mg/dL in men and women, respectively, or under medical treatment for hyperuricemia. Alcohol intake was classified as yes (daily and occasional consumption) and none (no alcohol consumption). Odds ratios (OR) and 95% confidence intervals (CI) for hyperuricemia were calculated using a logistic regression model.

Results

We analyzed data derived from 96,863 participants (69,241 men and 27,622 women). The prevalences of hyperuricemia in men and women were respectively, 21.4% and 11.0%, and of participants with NWCO respectively 15.6% and 30.0%. The adjusted OR for hyperuricemia was significantly increased in OBCO compared with NW, regardless of sex (men: OR, 2.12; 95%CI; 2.03-2.21; women: OR, 3.54; 95%CI, 3.21-3.90) and were statistically significant in NWCO compared with NW (men: OR, 1.44; 95%CI, 1.36-1.52; women: OR, 1.41; 95%CI, 1.27-1.57). The results were similar regardless of alcohol consumption.

Conclusions

We found that NWCO and OBCO were associated with hyperuricemia in middle-aged Japanese men and women. Middle-aged Japanese adults with normal weight but having central obesity should be screened using a combination of BMI and WHtR and educated about how to prevent hyperuricemia.
Utility Of Finnish Diabetes Risk Score In A Young Adult Population In An Urban Setting In Africa
Authors: MALINDISA EVANGELISTA KENAN , Balandya Emmanuel , Mashili Fredirick , Njelekela Marina
Published: September 2019

Background The prevalence of type 2 diabetes mellitus (T2D) and other NCDs is on the rise globally, low-income countries like Tanzania are not spared. Affordable and effective screening tools are needed to combat these epidemics. This study aimed to evaluate the utility and applicability of the Finnish Diabetes Risk Score (FINDRISC) as one of the screening tools for T2D and its potential risk factors in population of young adults from an urban setting in Tanzania. Methods A community based cross-sectional study was conducted in urban setting Mwanza-Tanzania. Data was collected using FINDRISC questionnaire (assessing Age, BMI, waist circumference, physical activity participation, vegetable consumption, and history of high blood pressure, history of high blood sugar and family history of diabetes) and physical assessment of, blood pressure, waist circumference and hip circumference. Laboratory measurements for fasting blood glucose, oral glucose tolerance and lipid profile. Data was analyzed using STATA 13. Pearson’s correlation was used to assess the associations between FINDRISC with clinical and biochemical parameters. Linear regression was used to assess the extent at which FINDRISC predicted various clinical and biochemical parameters. P-value was considered significant at p≤0.05. Results Of the 259 participants enrolled, 32.8% were in the FINDRISC categories of “at least slightly elevated risk” to “high risk” of developing T2D in 10 years’ time. FINDRISC correlated with FBG (r=0.12, p=0.05), diastolic blood pressure (r=0.19, p=0.02), mean arterial blood pressure (r=0.13, p=0.036), low density lipoprotein cholesterol (r=0.19, p =0.005), and waist to hip ratio - WHR (r=0.34, p = 0.001). Furthermore, FINDRISC explained 11% of the variation in WHR (Adjusted r2 = 0.11, p=0.001), 3% of diastolic blood pressure (adjusted r2= 0.03, p = 0.02), 3% of low density lipoprotein cholesterol (adjusted r2=0.03, p=0.005), 1% of mean arterial pressure (adjusted r2=0.01, p=0.036) and 1% of FBG (r2=0.01, p=0.05). Conclusion This study provides novel insights on the potential utility of FINDRISC as a simple and non-invasive screening tool for metabolic syndrome-related ailments among young adults in Africa. Longitudinal studies, with context-specific modifications of FINDRISC, are suggested to ascertain its predictive value for future T2D in this population.
miR-874 ameliorates retinopathy in diabetic rats by NF-κB signaling pathway
Authors: Li Rui , Yuan Huimin , Zhao Tao , Yan Yimin , Liu Zhaochen , Cai Jiayu , Qiu Chunli , Li Chuanjing
Published: September 2019

Background: This study aimed to explore the improvement effect of miR-874 on retinopathy in diabetic rats by NF-κB signaling pathway. Methods: Ten healthy Sprague-Dawley rats were taken as the control group. Sixty streptozotocin (60 mg/kg)-induced diabetes model rats were randomly divided into model group (without any treatment), negative control (NC) agomir group (injection of overexpressed NC vector), miR-874 agomir group (injection of miR-874 mimic), miR-874 anti-agomir group (injection of miR-874 inhibitor), EVP4593 group (injection of NF-κB signaling pathway antagonist EVP4593), and miR-874 anti-agomir + EVP4593 group (injection of miR-874 inhibitor and EVP4593). All injection was via caudal vein. Results: miR-874 could target the degradation of p65. Compared with control group, there were significantly reduced miR-874 expression, increased VEGF and Ang2 protein expressions, lowered end-diastolic velocity and peak systolic velocity of central retinal artery (CRA), and blood velocity of central retinal vein and CRA, heightened plasma viscosity, blood viscosity and erythrocyte sedimentation rate at all shear rates, decreased capillary pericytes, increased vascular endothelial cells, and ascended p65 expression in the retina of rats in model group (all P < 0.05). It showed that pathological changes were happened on the retina of diabetes rats. These indexes showed the same results after miR-874 was inhibited (all P < 0.05). However, these indexes showed the opposite results in miR-874 agomir group and EVP4593 group compared with model group (all P < 0.05). EVP4593 could alleviate the aggravation of retinopathy caused by the inhibition of miR-874 in diabetes rats. Conclusions: miR-874 mediates NF-κB signaling pathway by targeting the degradation of p65 to further improve the retina of diabetes rats, showing the improvement effect of miR-874 on diabetic retinopathy in rats.
MicroRNA-183-5p acts as a potential diagnostic biomarker for atherosclerosis and regulates the growth of vascular smooth muscle cell
Authors: Sun Bin , Shan Zhengkun , Sun Guoyu , Wang Xiaolong
Published: September 2019

Background: Atherosclerosis (AS) is a multifactorial chronic disease, and vascular smooth muscle cells (VSMCs) plays an important role in the pathology of AS. MicroRNAs regulate multiple cellular biological processes. This study aimed to investigate the clinical value of miR-183-5p in AS patients, and further explored the effects of miR-183-5p on the proliferation and migration of VSMCs.Methods: qRT-PCR was used to test the level of miR-183-5p. The diagnostic value of miR-183-5p for AS patients was assessed by a receiver operating characteristic (ROC) analysis. Cell proliferation and migration were determined via CCK-8 and Transwell assay.Results: MiR-183-5p was highly expressed in AS patients compared with the healthy group. Serum miR-183-5p expression was positively associated with CIMT and CRP in AS patients. The ROC analysis suggested that miR-183-5p had quality to be used as a biomarker with high specificity and sensitivity for AS detection. Overexpression of miR-183-5p promoted the proliferation and migration of VSMCs.Conclusion: MiR-183-5p is highly expressed in AS patients, and overexpression of miR-183-5p promots the cell proliferation and migration of VSMCs. MiR-183-5p may be a key molecular for the diagnosis and treatment of AS in the future.
Diagnostic and Predictive Value of Speckle Tracking Echocardiography in Cardiac Sarcoidosis
Authors: Stefano Cristina Di , Bruno Giulia , Calle Maria Arciniegas , Acharya Gayatri A. , Fussner Lynn M. , Ungprasert Patompong , Cooper Leslie T. , Blauwet Lori A. , Ryu Jay H. , Pellikka Patricia A. , Porquera Eva Carmona , Villarraga Hector R.
Published: September 2019

Background: Sarcoidosis is a systemic granulomatous disease that may affect the myocardium. This study evaluated the diagnostic and prognostic value of 2-dimensional speckle tracking echocardiography in cardiac sarcoidosis (CS). Methods: Eighty-three patients with extracardiac, biopsy-proven sarcoidosis and definite/probable diagnosis of cardiac involvement diagnosed from January 2005 through December 2016 were included. In order to analyze the alteration of strain parameters in early stages of CS, a subgroup of 23 CS patients with left ventricular ejection fraction (LVEF) within normal limits (LVEF>52% for men: >54% for women, mean value: 57.3%±3.8%) and no wall motion abnormalities was compared with 97 controls (1:4) without cardiac disease. LV and right ventricular (RV) global longitudinal (GLS), circumferential (GCS), and radial (GRS) strain and strain rate (SR) analyses were performed with TomTec software and correlated with cardiac outcomes (including heart failure and arrhythmias). This study was approved by the Mayo Clinic Institutional Review Board, and all patients gave informed written consent to participate. Results: Mean age of CS patients was 53.6±10.8 years, and 34.9% were women. Mean LVEF was 43.2%±12.4%; LV GLS, -12.4%±3.7%; LV GCS, -17.1%±6.5%; LV GRS, 29.3%±12.8%; and RV wall GLS, 14.6%±6.3%. In the 23 patients with early stage CS with normal LVEF and RV systolic function, strain parameters were significantly reduced when compared with controls (respectively: LV GLS, -15.9%±2.5% vs -18.2%±2.7% [ P =.001]; RV GLS, -16.9%±4.5% vs -24.1%±4.0% [ P <.001]). A LV GLS value of -16.3% provided 82.2% sensitivity and 81.2% specificity for the diagnosis of CS (AUC 0.91), while a RV value of -19.9% provided 88.1% sensitivity and 86.7% specificity (AUC 0.93). Hospital admission and heart failure significantly correlated to impaired LV GLS (> -14%). Conclusion: Reduced strain values in the LV GLS and RV GLS can be used in the diagnostic algorithm in patients with suspicion of cardiac sarcoidosis. These values also correlate with adverse cardiovascular events.
Association of CYP2A6 gene deletion with cancers in Japanese elderly: an autopsy study
Authors: Abudushataer Maidina , Sato Noriko , Mieno Makiko , Sawabe Motoji , Muramatsu Masaaki , Arai Tomio
Published: September 2019

Background CYP2A6 is an enzyme involved in oxidation of a number of environmental chemicals, including nicotine, pro-carcinogenic nitrosamines and polycyclic aromatic hydrocarbons (PAHs). The whole gene deletion of CYP2A6 (CYP2A6*4) is prevalent in East Asian population. Whether or not CYP2A6*4 associates with cancer is still controversial.Methods We undertook an association study to determine whether deletion of CYP2A6 gene associates with total cancer and major cancer types employing data of consecutive autopsy cases registered in the Japanese single-nucleotide polymorphisms for geriatric research (JG-SNP) database. The presence of cancer were inspected at the time of autopsy and pathologically confirmed. Genotyping for CYP2A6 wild type (W) and deletion (D) was done by allele specific RT-PCR method.Results Among 1373 subjects, the genotype frequency for WW, WD and DD were 65.0%, 30.6% and 4.4%, respectively, which obeyed the Hardy-Weinberg equilibrium. Association for total cancer presence, as well as major cancers including gastric, lung, colorectal, and blood cancers did not show any positive association. When male and female were separately analyzed, CYP2A6 deletion associated with decreased gastric cancer risk in female (OR=0.49, 95%CI: 0.25-0.95, p=0.021, after adjustment for age, smoking and drinking). When smoker and non-smoker were separately analyzed, CYP2A6 deletion associated with decreased total cancer in female nonsmokers (OR=0.67, 95%CI: 0.45-0.99, p=0.041 after adjustment). On the other hand, CYP2A6 deletion associated increase blood cancers in smokers (OR=2.05, 95%CI: 1.19-3.53, p=0.01 after adjustment).Conclusion The CYP2A6 deletion may not grossly affect total cancer. It may associate with individual cancers in sex and smoking dependent manner. Further studies with larger sample size are warranted to confirm our results.
Knowledge-based genetic association study of hepatitis B virus related hepatocellular carcinoma
Authors: Jiang Deke , Deng Jiaen , Dong Changzheng , Ma Xiaopin , Xiao Qianyi , Zhou Bin , Yang Chou , Wei Lin , Conran Carly , Zheng S. Lilly , Ng Irene Oi-lin , Yu Long , Xu Jianfeng , Sham Pak C. , Qi Xiaolong , Hou Jinlin , Ji Yuan , Cao Guangwen , Li Miaoxin
Published: September 2019

Background : Recent genome-wide association studies (GWASs) have suggested several susceptibility loci of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) by statistical analysis at individual single-nucleotide polymorphisms (SNPs). However, these loci only explain a small fraction of HBV-related HCC heritability. In the present study, we aimed to identify additional susceptibility loci of HBV-related HCC using advanced gene- and gene-set-based association tests.Methods: We performed a meta-analysis of two existing GWASs of HBV-related HCC, based on which a series of association analyses at genes and multiple gene sets curated according to current knowledge were carried out for prioritizing potential risk genes. A series of prioritized SNPs were selected to replicate genetic associations in an independent sample of 965 cases and 923 controls.Results: The gene-based association analysis suggested that five genes are significantly associated with HBV-related HCC risk: RNY4, GOLGA8M, LINC01207, WHAMMP2 and SLC39A8. Through gene-set-based association analysis, we found that the genes in systemic lupus erythematosus pathway may be relevant to development of HBV-related HCC. Three previously reported genes, NAT2, GSTA1 and GSTA2, were also highlighted to be susceptibility genes of HBV-related HCC when genes were stratified in a liver-specific expression set. However, probably due to small sample size, none of the genes prioritized by knowledge-based association analyses are successfully replicated in an independent sample.Conclusions: This comprehensive knowledge-based association mining study suggested several promising genes significantly associated with HBV-related HCC risk. More experiments or larger samples are needed to validate their contribution to the pathogenic mechanism of HCC.
The impact of combining dental interventions with dietary and exercise advice on waist circumference in patients with the metabolic syndrome: Protocol for a randomized controlled trial
Authors: Suzuki Hiroyuki , Komagamine Yuriko , Kanazawa Manabu , Iwaki Maiko , Doke Midori , Mizuno Tetsuya , Sema Manabu , Okayasu Kaori , Miyazaki Yasunari , Minakuchi Shunsuke
Published: September 2019

Background

Metabolic Syndrome (MetS) associated with cardiovascular diseases have been focused on by researchers. Although various studies have investigated its relationship with the oral environment, the effects of dental interventions for MetS remain unclear. The aim of this trial is to investigate whether prosthetic or periodontal treatment combined with dietary and exercise advice can improve waist circumference, a surrogate measure of the syndrome. The null hypothesis is that there will be no difference in waist circumference between participants who receive prosthetic or periodontal treatment combined with dietary and exercise advice and those who receive only dietary and exercise advice.

Methods

This is a single-center, single-blinded, parallel, randomized controlled trial. Participants are randomly allocated to an intervention group (dietary and exercise advice plus prosthetic or periodontal treatment) or a control group (dietary and exercise advice only). Outcome measures include waist circumference; blood pressure; serum triglyceride, serum HDL/LDL cholesterol, fasting blood glucose, and HbA1c assessment using blood tests; Anthropometric measurements using bioelectrical impedance; health-related quality of life assessment using MOS 36-Item Short-Form Health Survey; oral-health-related quality of life assessment using Oral Health Impact Profile-14 and Geriatric Oral Health Assessment Index; food and nutrient intake assessment using brief-type self-administered diet history questionnaire; periodontal assessment using probing pocket depth and bleeding on probing. Objective masticatory function assessment using a color-changeable chewing gum and a gummy jelly was conducted for the participants who received prosthetic treatment. Outcome measures are to be implemented at three time points: at baseline and at 1 and 3 months after intervention. Differences between two groups in each assessment is compared using the Student’s t-test. Within group, the change between each assessment time is compared using the Tukey’s test.

Discussion

This trial could help to establish a new preventive method for the MetS that can be delivered by dental practitioners. Moreover, the findings are expected to reinforce the contribution of dentistry to extending healthy life expectancy.
Changing face of Candida colonization pattern in pediatric patients with hematological malignancy during repeated hospitalizations, results of a prospective observational study (2016-2017) in Shiraz, Iran
Authors: Hamzavi Sedigheh , Amanati Ali , Badiee Parisa , Kadivar Mohammad Rahim , Jafarian Hadis , Ghasemi Fatemeh , Haghpanah Sezaneh , Dehghani Mansooreh , Baghani Abbas Norouzian
Published: September 2019

Background: Surveillance of current changes in the epidemiology of Invasive Fungal Diseases (IFDs) as an important component of the antifungal stewardship programs (ASP), requires careful regular monitoring, especially in high-risk settings such as oncology centers. This study aimed to examine Candida colonization status and corresponding current changes in children with malignancy during repeated admissions and also investigate the possible epidemiological shifts after the implementation of ASP. Methods: In this prospective observational study, all eligible patients younger than 18 years were recruited during 2016-2017 at Amir Medical Oncology Center (AMOC) in Shiraz, Iran. Totally, 136 patients were enrolled and 482 samples were collected from different sites (oral/nasal discharges, urine and stool). Weekly regular sampling was carried out during hospitalization. Candida colonization status and epidemiological changes were monitored during repeated admissions. Samples were cultivated on Sabouraud Dextrose agar medium and identified by Polymerase Chain Reaction -Restriction Fragment Length Polymorphism (PCR-RFLP). Results: Estimated Candida colonization incidence was 59.9% (82/136) in our patients. Candida colonization was found to be higher in oral cavity and rectum than that in nasal cavity. Among those long-term follow ups and repetitive hospitalizations, a significant number of patients exhibited changes in their colonization patterns (37.7%). Candida colonization did not reveal any significant relationship with age, sex, oncologic diseases and degree of neutropenia. C. albicans (72.0%) was found as the most common Candida species in colonized patients, followed by C. krusei, C. kefyr, C. glabrata and C. parapsilosis. Conclusion: Given the high incidence of Candida infections in children with cancers, close monitoring of epidemiologic changes is essential for judicious management, based on local surveillance data and improvement of overall quality of care in high risk patients. Key Words: Candida Albicans, Fungal Colonization, Pediatric Leukemia