bluuebunny/crossref_metadata_2025 huggingface dataset:
Top 100 Cited Systematic Reviews and Meta-Analyses in The Major Journals of Oral and Maxillofacial Surgery: A Bibliometric Analysis
Authors: Al-Moraissi Essam , Galvão Endi Lanza , Christidis Nikolaos , Falci Saulo Gabriel
Published: December 2020

Background : The aim of this bibliometric research was to identify and analyze the top 100 cited systematic reviews in the field of oral and maxillofacial surgery. Methods : Using the Web of Science-database without restrictions on publication year or language, a bibliometric analysis was performed for the five major journals of oral and maxillofacial surgery: International Journal of Oral and Maxillofacial Surgery, Journal of Oral and Maxillofacial Surgery, Journal of Cranio-maxillofacial Surgery, British Journal of Oral & Maxillofacial Surgery and Oral Surgery Oral medicine Oral pathology Oral radiology. Discussion : The most top-cited systematic review was published in 2015 with a total of 200 citations on survival and success rates of dental implants, consistent with the finding that “pre- and peri-implant surgery and dental implantology”, and “craniomaxillofacial deformities and cosmetic surgery” were the most frequently-cited topics (22% each). The International Journal of Oral and Maxillofacial Surgery displayed both most citations in total and in average per publication. The outcome of this article can be used as a source of information not just for researchers but also for clinicians and students, and of which areas have a large impact on the field of oral and maxillofacial surgery but cannot reflect the quality of the included systematic reviews.Systematic review registration: not applicable
miR-378a-5p inhibits the proliferation of colorectal cancer cells by downregulating CDK1
Authors: Li Kai , zhang Jieling , Zhang Mingkang , Wu Yaohua , Lu xinyu , zhu Yiping
Published: December 2020

Background
MicroRNAs (miRNAs) exerts a vital part in tumor occurrence.The role of miR-378a-5p and CDK1 in colorectal cancer (CRC) was investigated in this study.
Methods
The investigation of TCGA database and the detection of miR-378a-5p expression in colorectal cancer pathological tissues and colorectal cancer cell lines were performed by using qRT-PCR. We conducted cell function experiments (CCK-8, EDU, Colony formation assay, Wound healing assay, Transwell assay, Cell apoptosis detection, Cell cycle detection) and nude mouse tumor formation experiments to evaluate the effects of miR-378a-5p on proliferation, metastasis, The impact of invasion to explore the role of miR-378a-5p in vivo and in vitro. Then, through the TCGA database, immunohistochemistry of pathological tissues, and cell function experiments, the role of the target gene CDK1 of miR-378a-5p verified by database prediction and dual luciferase reporter gene experiments in colorectal cancer was explored. Finally, whether up-regulation of CDK1 restores the inhibitory effect of overexpression of miR-378a-5p on the proliferation of CRC cells is studied by overexpression of CDK1.
Results
Bioinformatics analysis showed significant downregulation of miR-378a-5p level within colorectal cancer (CRC). Cell function experiments and tumor xenograft mouse models confirmed the low expression of miR-378a-5p within CRC tissues, which indicated the tumor suppression role of miR-378a-5p within CRC. For better exploring the regulation of miR-378a-5p in CRC, we predicted and validated cell cycle-dependent protein kinase 1 (CDK1) to be the miR-378a-5p target geneand found that miR-378a-5p suppressed CRC cell proliferation by targeting CDK1.
Conclusion
To sum up, results in this work discover the mechanism of miR-378a-5p in retarding CRC cell proliferation through suppressing CDK1 expression, and it may become a possible therapeutic target to treat CRC.
Patient Reported Physical and Mental Health Changes Associated with a Comprehensive Cardiovascular Risk Reduction Program for Women with Breast Cancer Receiving Potentially Cardiotoxic Chemotherapy
Authors: Fradley Michael , Alomar Mohammed , Kilpatrick Marcus W. , Shields Bernadette , Tran Nhi , Best Amey , Bianco Erika , Armanious Merna , Vautier R. Ashton , Kip Kevin , Beckie Theresa , Ismail-Khan Roohi
Published: December 2020

Objective: Women with breast cancer (BCA) and cardiovascular disease (CVD) risk factors are at increased risk of developing cardiovascular complications when exposed to potentially cardiotoxic cancer therapy. The benefit of aggressive CVD risk factor modification to reduce adverse treatment-related psychologic and biologic effects is not well established.Methods: Using a single group pre-test, post-test design, 33 women with BCA receiving anthracycline and/or trastuzumab therapy participated in a 6-month comprehensive CVD risk reduction program involving formal cardio-oncology evaluation along with regular motivational counseling for improved nutrition and physical activity. Study parameters were assessed at baseline and 6 months with paired t-tests used to evaluate changes after the intervention.Results: The mental component summary score assessed by SF-36V2 improved significantly after program completion (45.0 to 48.8, effect size 0.37, p=0.017), however the physical component summary score declined (46.2 to 40.9, effect size -0.53, p=0.004). Despite this decline in perceived physical health, markers of health-related fitness and nutritional status were maintained or improved. Systolic and diastolic blood pressure also improved after the intervention (136.7 to 124.1 mm Hg, p=0.001 and 84.0 to 78.7 mm Hg, p=0.031, respectively). No significant change in resting heart rate, body mass index, lipids, hemoglobin A1C, or left ventricular ejection fraction was observed. Conclusions: Patient-reported mental health improved significantly in women with BCA enrolled in a comprehensive CVD risk reduction program despite exposure to potentially cardiotoxic therapies. This study provides preliminary data for future randomized controlled trials evaluating the effects CVD risk reduction program in high-risk breast cancer cohorts.
Diagnostic Biomarkers in Cerebrospinal Fluid in Primary Central Nervous System Lymphoma: A Protocol for Systematic Review and Meta-Analysis
Authors: Zhou Lili , Yi Hai , Chen Dan , Zhang Qian , Fan Fangyi , Qiu Ling , Zhang Nan , Su Yi
Published: December 2020

BackgroundPrimary central nervous system lymphoma (PCNSL) is a highly aggressive non-hodgkin’s lymphoma with unfavorable prognosis. Currently, the diagnosis of PCNSL relies on brain excisional biopsy, which is an invasive procedure, carries the risk of complications such as intracranial hemorrhage and functional impairment. Finding effective biomarkers will help us to diagnose PCNSL faster and safer.MethodsThis systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) 2015 guideline.We will search databases including PubMed, Cochrane Library, Medline, Web of Science, EMBASE and CNKI. The studies that demonstrated the diagnostic value of certain biomarkers in CSF for PCNSL will be included. For quantitative value, the standardized mean diffenence (SMD) and their 95% confidence intervals (CI) will be calculated. The outcomes are the mean difference of biomarker levels in CSF between PCNSL patients and controls.DiscussionIn this systematic review we will analyze the studies of the biomarkers in cerebrospinal fluid for diagnosis of PCNSL. This research can help us to identify the biomarkers with diagnostic value for PCNSL, making diagnosis of PCNSL easier, faster and safer.Systematic review registrationPROSPERO CRD42020218143.
The Effectiveness of a Modified Gui Zhi Fu Ling Wan Formulation (Gynoclear™) for The Treatment of Endometriosis: A Study Protocol for a Placebo Controlled, Double Blind, Randomised Controlled Trial.
Authors: Armour Mike , Al-Dabbas Mahmoud , Ee Carolyn , Smith Caroline , Ussher Jane , Arentz Susan , Lawson Kenny , Abbott Jason
Published: December 2020

Background: Endometriosis is the presence of tissue similar to that of the endometrium outside the uterine cavity and is the most common cause of chronic pelvic pain. Current non-surgical treatments such as non-steroidal anti-inflammatories, oral contraceptive pills, and hormonal treatments have limited effectiveness and the side effect profile is bothersome. This study will evaluate the efficacy of Gynoclear™ by change in endometriosis related pain based on the Endometriosis Pain Daily Diary (EPPD) scores.Methods: This randomised, double-blind, placebo-controlled trial will recruit a minimum of 90 adult participants across Australia who have a laparoscopic visualisation/confirmation of endometriosis in the last five years and have current moderate or greater pelvic pain. Participants will be randomly allocated in a 1:1 ratio to receive either Gynoclear™ (active) or placebo. Gyncolear’s active ingredients are Carthamus tinctorius (Safflower), Cinnamomum cassia (Chinese cinnamon), Poria cocos (Hoelen), Paeonia suffriticosa (Tree peony), Paeonia lactiflora (Peony) and Salvia miltiorrhiza (Red sage). Participants are asked to complete a total of five months’ worth of pain diary entries via the EPDD v3, including one-month screening, three-months treatment period and one-month post-treatment follow up. The primary outcome variable is change in endometriosis related pain based on the EPDD v3 scores. Secondary outcomes include change in health-related quality of life via the Endometriosis Health Profile (EHP-30), SF-12 and EQ5D scores as well as changes in rescue analgesic usage, dyspareunia and fatigue via the EPDD.Discussion: This study will determine the safety and efficacy of Gynoclear™ to reduce the severity and duration of non-cyclical pelvic pain, dysmenorrhea, dyspareunia and other symptoms of endometriosis. Study outcomes will be of interest to health professionals, and members of the public who suffer from endometriosis.Trial registration: Australia and New Zealand Clinical Trials Registry, ACTRN12619000807156 (https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377571). Registered on 03-Jun-2019.
Comparison of Bone Single-Photon Emission Computed Tomography (SPECT)/CT and Bone Scintigraphy in Assessing Knee Joints
Authors: An Young-Sil , Park Do Young , Min Byoung-Hyun , Yoon Joon-Kee
Published: December 2020

Background: This study attempted to compare the radiopharmaceutical uptake findings of planar bone scintigraphy (BS) and single photon emission computed tomography (SPECT)/computed tomography (CT) performed on knee joints.Methods: We retrospectively included 104 patients who underwent bone SPECT/CT and BS 4 hours after the intravenous administration of technetium-99m-hydroxymethylene diphosphonate (99mTc-HDP) for pain in the knee joint. The uptake degree of each of the knee regions (medial femoral, lateral femoral, medial tibial, lateral tibial, and patellar area) in planar images and SPECT/CT were evaluated by visual (grades 0 to 2) and quantitative analyses (uptake counts for planar image and standardized uptake values [SUVs] for SPECT/CT). Results: The uptake grades assessed visually on the planar images differed significantly from the uptake grades on SPECT/CT images in all areas of the knee (all p < 0.001), and SPECT/CT imaging revealed a larger number of uptake lesions than those noted in planar imaging for each patient (3.3 ± 2.0 versus 2.4 ± 2.3, p < 0.0001). In all regions of the knee, all of the quantitative values, including uptake counts obtained from the planar image as well as the maximum SUV (SUVmax) and mean SUV (SUVmean) obtained from SPECT/CT, showed statistically higher values as their visual grades increased (all p <0.001). However, when analyzed for each area, only the SUVmax showed a significant difference by grade in all knee regions. Quantitative uptake values obtained from planar images were moderately correlated with SUVs of SPECT/CT images (r = 0.58 for SUVmean and r = 0.53 for SUVmax, all p <0.001) in the total knee regions. Looking at each area, there was a significant but low correlation between the uptake counts of the planar images and the SUVs on SPECT/CT in the right lateral tibial region (r = 0.45 for SUVmean, r = 0.31 for SUVmax, all p <0.001).Conclusions: In assessing knee joints, the findings of planar images and SPECT/CT images differ both visually and quantitatively, and more lesions can be found in SPECT/CT than in the planar images.
Goal Attainment and Outcomes of Physiotherapy Participants Funded by an Individualised Government Package’
Authors: Bravo katherine Melissa Alava , McCredie Laura , Scrivener Katharine
Published: December 2020

Purpose: To determine goal attainment and change in physical outcomes of individuals participating in a community Physiotherapy program funded by a new government funding package, the National Disability Insurance Scheme (NDIS). Additionally, to describe the alignment of NDIS goals with Physiotherapy goals and the impact of the NDIS on access to Physiotherapy.Methods: A consecutive case series was conducted involving 12 participants attending NDIS-funded Physiotherapy at a private clinic in Sydney, Australia. Outcome measures were recorded upon entry to the study and again after 6 months or at discharge, whichever occurred first. The primary outcome was goal attainment measured by the Goal Attainment Scale. Secondary outcomes included the 5-metre walk test, Motor Assessment Scale, World Health Organisation Quality of Life questionnaire and Exercise Self Efficacy Scale.Results: Forty-one percent of goals were fully attained and for 53% performance was equal to baseline, however, this was not reflected in concurrently measured outcomes where small changes occurred. Physiotherapy goals focused on mobility whilst NDIS goals varied. Changes in outcome measures differed between individuals. NDIS funding provided all participants access to more frequent or otherwise inaccessible Physiotherapy.Conclusion: Physiotherapy participants funded by an individualised government package had improved access to Physiotherapy where participants attained individualised goals.
Testing a Breast Cancer Prevention and a Multiple Disease Prevention Weight Loss Programme Among Women Within The UK NHS Breast Screening Programme - A Randomised Feasibility Study
Authors: Harvie Michelle , French David P , Pegington Mary , Cooper Grace , Howell Anthony , McDiarmid Sarah , Lombardelli Cheryl , Donnelly Louise , Ruane Helen , Sellers Katharine , Barrett Emma , Armitage Christopher J. , Evans D Gareth
Published: December 2020

Excess weight and unhealthy behaviours (sedentariness, high alcohol and suboptimal diet) are common among women attending breast screening. These factors increase the risk of breast cancer and other diseases. We tested the feasibility and acceptability of a weight loss/ behaviour change programme framed to reduce breast cancer risk (breast cancer prevention programme, BCPP) compared to one framed to reduce risk of breast cancer, cardiovascular disease (CVD) and diabetes (T2D) (multiple disease prevention programme, MDPP). Methods Women aged 47-73 years with overweight or obesity (n=1356) in the NHS Breast Screening Programme (NHSBSP) were randomized (1:2) to be invited to join a BCPP or a MDPP. The BCPP included personalised information on individual level of breast cancer risk and a web and phone weight loss/behaviour change intervention. The MDPP also included an NHS Health Check (lipids, blood pressure, HbA1c and personalised feedback for risk of CVD [QRISK2] and T2D [QDiabetes and HbA1c]). Uptake, retention, change in weight, and potential harms (anxiety and self-rated health) were assessed, along with the numbers in the MDPP with previously unknown CVD and T2D risk.ResultsThe BCPP and MDPP had comparable rates of uptake; 45/508 (9%) vs. 81/848 (10%) 12-month retention; 33/45 (73%) vs. 53/81 (65%) and numbers (%) losing ≥5% body weight at 12 months; 26/45 (58%) vs. 46/81 (57%) with baseline observation carried forward imputation. Both groups experienced reductions in state anxiety score; BCPP (n=37) -0.7 (-4.6 to 3.2), MDPP (n=60) -3.5 (-6.7 to -0.4) and an increase in the EQ-5D-5L score; BCPP (n=40) 4.1 (0.6 to 7.6), MDPP (n=60) 7.3 (3.6 to 11.1). The MDPP identified 15% of women with a previously unknown 10 year CVD QRISK2 of ≥10% and 56% with 10-year Qdiabetes risk of ≥10%.ConclusionsThe MDPP identified previously unknown CVD and T2D risk factors but does not appear to increase engagement with behaviour change beyond a standard BCPP amongst women attending breast screening. The results suggest a definitive effectiveness trial of the BCPP intervention is warranted, with acceptable uptake and retention, and a clear weight loss signal.Trial Registration ISRCTN91372184, https://doi.org/10.1186/ISRCTN91372184, registered 28 September 2014.
BRD4 PROTAC Degrader ARV-825 Inhibits T-Cell Acute Lymphoblastic Leukemia by Targeting 'Undruggable' Myc-pathway Genes
Authors: Wu Shuiyan , Jiang You , Hong Yi , Chu Xinran , Zhang Zimu , Tao Yanfang , Fan Ziwei , Bai Zhenjiang , Li Xiaolu , Chen Yan-Ling , Li Zhiheng , Ding Xin , Lv Haitao , Du Xiaoli , Lim Su Lin , Zhang Yongping , Huang Saihu , Lu Jun , Pan Jian , Hu Shaoyan
Published: December 2020

BackgroundT-cell acute lymphoblastic leukemia (T-ALL) is an aggressive disease with a high risk of induction failure and poor outcomes, with relapse due to drug resistance. Targeting bromodomains and extra-terminal (BET) protein inhibitors are promising anti-cancer agents, and ARV-825, comprising a BET inhibitor conjugated with cereblon, was recently shown to attenuate the growth of multiple tumors in vitro and in vivo. However, the functional and molecular mechanisms of ARV-825 in T-ALL remain unclear. This study aimed to investigate the therapeutic efficacy and potential mechanism of ARV825 in T-ALL.MethodsExpression levels of the BET protein BRD4 were determined in pediatric T-ALL samples and differential gene expression after ARV-825 treatment was explored by RNA-seq and quantitative reverse transcription-polymerase chain reaction. T-ALL cell viability was measured by CCK8 assay after ARV-825 administration. Cell cycle was analyzed by propidium iodide (PI) staining and apoptosis was assessed by Annexin V/PI staining. The functional and molecular pathways involved in ARV-825 treatment of T-ALL were verified by western blot and chromatin immunoprecipitation (ChIP).ResultsBRD4 expression was higher in pediatric T-ALL samples compared with T-cells from healthy donors. High BRD4 expression indicated a poor outcome. ARV-825 suppressed cell proliferation in vitro by arresting the cell cycle and inducing apoptosis, with elevated poly-ADP ribose polymerase and cleaved caspase 3. BRD4, BRD3, and BRD2 were degraded in line with reduced cereblon expression in T-ALL cells. ARV-825 had a lower IC50 in T-ALL cells compared with the BET inhibitors JQ1 and dBET1. ARV-825 perturbed the H3K27Ac-Myc pathway and reduced c-Myc protein levels in T-ALL cells according to RNA-seq and ChIP. Moreover, ARV-825 inhibited cell proliferation by depleting BET and c-Myc proteins in T cell lines and in pediatric T-ALL patients. ConclusionsBRD4 indicates a poor prognosis in T-ALL. The BRD4 degrader ARV-825 can effectively suppress the proliferation and promote apoptosis of T-ALL cells via BET protein depletion and c-Myc inhibition, thus providing a new strategy for the treatment of T-ALL.
Prone Position Ventilation for Pediatric Acute Respiratory Distress Syndrome with Extracorporeal Membrane Oxygenation: A Propensity Score-Matched Retrospective Multicenter Cohort Study
Authors: Zhao Zhe , Lu Guoping , Li Shuanglei , Yang Baowang , Zhang Huiling , Cheng Ye , Zhou Yiping , Cui Yun , Cheng Wenzhe , Wang Jie , Cheng Yibing , Chen Yingfu , Liu Chengjun , Cheng Dongliang , Shi Changsong , Guo Yuxiong , Hu Yan , Hui Yi , Qu Dong , Kong Chengxiang , Jin Ping , Yu Bin , Lu Xiulan , Jin Youpeng , Yan Huiying , Hong Xiaoyang , Zhang Yucai , Feng Zhi-Chun
Published: December 2020

Background: Extracorporeal membrane oxygen (ECMO) has used for rescuing severe pediatric acute respiratory distress syndrome (PARDS) for half a century. Prone position ventilation (PPV) has been suggested according to the surviving sepsis campaign (SSC) guideline in children in 2020. We aimed to compare the outcomes and effect of PARDS patients with ECMO+PPV and ECMO only.Design: Retrospective Multicenter pair-matched StudySetting: In the present study, propensity score matching was conducted and the outcomes of severe PARDS patients were analyzed. The effect of PPV was compared as well. The efficiency of PPV included PaO2, Oxygen Index (OI), PaO2/FiO2, compliance of respiratory system and resistance of airway. The primary outcome was hospital mortality. Secondary outcomes included ECMO running time, PICU time, hospital days and mechanical ventilation time of survivors. Patients: 137 PARDS patients with criteria of ECMO from 11 hospitals in 5 years.Interventions: No interventions.Measurements and Main Results: Among 137 patients, 93 patients received ECMO+PPV at the same time and 44 patients didn’t. After matching, we got 34 pairs. For the survivors receiving ECMO+PPV, the PaO2, OI and PaO2/FiO2 increased significantly during the PPV period (P<0.01) and sustained for 4 hours at least. However, the hospital mortality of both groups showed no significant difference (50.0 vs. 55.9%, P=0.808). Conclusions: By far, there has been no ECMO+PPV efficiency study in PARDS patients. This study found that PPV was associated with improved oxygen state during ECMO. However, PPV was not associated with survival rate with PARDS patients on ECMO. Clinical Trial Registration: This study was registered at http://www.chictr.org.cn/index.aspx (chiCTR.gov; Identifier: ChiCTR1800019555). Registered 18 November 2018. Name of the registry: Extracorporeal membrane oxygenation in critical ill children with severe acute respiratory distress syndrome - A multicenter study.Take Home Message:1. Our study investigated prone position ventilation (PPV) could improve the oxygen state during ECMO for patients with severe PARDS.2. The results indicated PPV had no influence on the mortality of PARDS with ECMO.
Downregulation of Metallothionein-2 Contributes to Oxaliplatin-induced Neuropathic Pain
Authors: Huang Xuelin , Deng Jie , Xu Ting , Xin Wenjun , Zhang Yuehong , Ruan Xiangcai
Published: December 2020

Background
We previously reported a correlation between small doses of oxaliplatin penetrating onto the spinal cord and acute pain after chemotherapy. Here we propose that MT2 within the spinal dorsal horns participates the development of oxaliplatin-induced neuropathic pain and may be a pharmacological target for the prevention and treatment of chemotherapy-induced peripheral neuropathy (CIPN).
Methods
The rat model of CIPN was established by a 5 consecutive injection of oxaliplatin (0.4 mg/ 100 g/ day). Genetic restoration or inhibition of neuron-specific metallothionein-2 was implemented 21 days before oxaliplatin treatment. Mechanical allodynia and locomotor activity were assayed. Cell-specific expression of metallothionein-2, the mRNA levels of pro-inflammatory cytokines, nuclear translocation of NF-κB, the protein levels of expression of IκB-α, and interaction between IκB-α and P65 were evaluated in the spinal dorsal horns. Also, in vitro interaction of sequentially deleted IκB-α promoter with metallothionein-2 was used to assess the signal transduction mechanism.
Results
We found that oxaliplatin induced downregulation of metallothionein-2 in rat spinal cord neurons. By contrast, genetic restoration of metallothionein-2 in the spinal dorsal horn neuron blocked and reversed neuropathic pain in oxaliplatin-treated rats of both sexes, whereas genetic inhibition of metallothionein-2 triggered neuropathic pain in normal rats. No locomotor impairment was observed after the genetic alterations of metallothionein-2. At the molecular level, metallothionein-2 modulated oxaliplatin-induced neuroinflammation, activation of NF-κB, and transcriptional expression of IκB-α promoter, and these processes could be blocked by genetic restoration of metallothionein-2 in the spinal dorsal horn neurons.
Conclusions
Metallothionein-2 is a potential target for the prevention and treatment of CIPN. A reduction of NF-κB activation and inflammatory responses by enhancing the transcription of IκB-α promoter is proposed in the mechanism.
Developing an interprofessional transition course to improve team-based HIV care for Sub-Saharan Africa
Authors: Kiguli-Malwadde Elsie , Budak Jehan Z , Chilemba Evelyn , Semitala Fred , Von Zinkernagel Deborah , Mosepele Mosepele , Conradie Hoffie , Khanyola J , Haruruvizhe Clara , Martin Shayanne , Kazembe Abigail , De Villiers M , Reid Michael J A
Published: December 2020

BackgroundWith funding from the United States Health Resources Service Administration (HRSA), a consortium of health professional training institutions from Africa developed HIV-specific, interprofessional, team-based educational resources to better support trainees during the transition period between pre-service training and professional practice.MethodsTen faculty members representing nine medical and nursing schools in sub-Saharan Africa (SSA) developed a training package of modules focused on core clinical, public health, interprofessional education (IPE), and quality improvement (QI) domains related to HIV service delivery. Curriculum development was informed by a rapid needs assessment of existing tools and future needs for HIV education across 27 SSA health professions training institutions. A total of 17 modules were developed, targeted at newly qualified health care professionals to be taught in a series of two-day workshops meant to complement existing institution specific HIV-curricula. ResultsBetween April and July 2019, a comprehensive case-based HIV training package was developed to support trainees in transition from pre-service training to independent professional practice. Each module, addressing different elements of interprofessional practice, was intended to be delivered in an interprofessional format. Thus far, 70 health professions training institutions in 14 countries have implemented the program; 547 educators facilitated STRIPE workshops, with a total of 5,027 learners trained between September 2019 and September 2020.ConclusionsTo our knowledge this is the first IPE HIV-specific curriculum explicitly focused on enhancing the quality of training provided to graduating health care professionals working in SSA. The collaborative, cross-institutional, interprofessional approach to curriculum development provides a benchmark for how best-practice approaches to education can be disseminated in SSA.
Social gradient in health-related quality of life among urban middle-age residents in Limassol, Cyprus: Research article
Authors: Ellina Panagiota , Middleton Nicos , Lambrinou Ekaterini , Kouta Christiana
Published: December 2020

Background: Social inequalities in health threaten social cohesion and their investigation is an important research field. Monitoring the health of the population is necessary to identify health needs, design programs focused in people’s needs and to evaluate the effectiveness of health policies.Methods: A cross-sectional survey using primary data was applied. The study investigated the size and the extent of social inequalities in quality of life and health behaviours in Limassol, Cyprus. Data collection was done door-to-door in the form of survey interviews. The sample consisted of 450 residents aged 45-64 across 45 randomly selected neighbourhoods, that met the selection criteria. The tools used were: Demographic questionnaire, SF 36 Questionnaire, IPAQ- International Physical Activity Questionnaire short form.Results: The social gradient appears in all social indicators. Physical dimension of health has a strong relationship between health-related quality of life with the education index. Specifically, the range is 12 points for males and 14 points for females (p for interaction= 0.16). Profession systematically appears to have a stronger relationship with men than with women, and is present in both physical and mental dimensions. The range is 13 points for men and 10 points for women (p for interaction= 0.31).Conclusions: It seems that young highly educated males, employed full time, earning high income and engaging in mild physical activity, have significantly higher level of health-related life quality, compared to other middle age adult groups, living in Limassol. This finding is in agreement with other studies that show correlations between gender and the patterns of risk factors.
Metabolic acclimation supports higher aluminium-induced secretion of citrate and malate in an aluminium-tolerant hybrid clone of Eucalyptus
Authors: Li Wannian , Finnegan Patrick M. , Dai Qin , Guo Dongqiang , Yang Mei
Published: December 2020

Background: Eucalyptus is the main plantation wood species, mostly grown in aluminized acid soils. To understand the response of Eucalyptus clones to aluminum (Al) toxicity, the Al-tolerant Eucalyptus grandis × E. urophylla clone GL-9 (designated “G9”) and the Al-sensitive E. urophylla clone GL-4 (designated “W4”) were employed to investigate the production and secretion of citrate and malate by roots.Results: Eucalyptus seedlings in hydroponics were exposed to the presence or absence of 4.4 mM Al at pH 4.0 for 24 hours. The protein synthesis inhibitor cycloheximide (CHM) and anion channel blocker phenylglyoxal (PG) were applied to explore possible pathways involved in organic acid secretion. The secretion of malate and citrate was earlier and greater in G9 than in W4, corresponding to less Al accumulation in G9. The concentration of Al in G9 roots peaked after 1h and decreased afterwards, corresponding with a rapid induction of malate secretion. A time-lag of about 6h in citrate efflux in G9 was followed by robust secretion to support continuous Al-detoxification. Malate secretion alone may alleviate Al toxicity because the peaks of Al accumulation and malate secretion were simultaneous in W4, which did not secrete appreciable citrate. Enhanced activities of citrate synthase (CS) and phosphoenolpyruvate carboxylase (PEPC), and reduced activities of isocitrate dehydrogenase (IDH), aconitase (ACO) and malic enzyme (ME) were closely associated with the greater secretion of citrate in G9. PG effectively inhibited citrate and malate secretion in both Eucalyptus clones. CHM also inhibited malate and citrate secretion in G9, and citrate secretion in W4, but notably did not affect malate secretion in W4. Conclusions: G9 immediately secrete malate from roots, which had an initial effect on Al-detoxification, followed by time-delayed citrate secretion. Pre-existing anion channel protein first contributed to malate secretion, while synthesis of carrier protein appeared to be needed for citrate excretion. The changes of organic acid concentrations in response to Al can be achieved by enhanced CS and PEPC activities, but was supported by changes in the activities of other enzymes involved in organic acid metabolism. The above information may help to further explore genes related to Al-tolerance in Eucalyptus.
Predictors of young people’s use of sexual and reproductive health services in Nigeria: a mixed-method approach
Authors: Odo Amelia Ngozi , OFUEBE Justina Ifeoma , ANIKE Anthony Ifeanyi , Samuel Efiong S
Published: December 2020

Background Sexual and Reproductive health Services (SRHS) are essential for the prevention and control of SRH problems among young people and the achievement of sustainable development goal 3. These services may be available but certain factors interfere with their access and utilization by the young people. This study sought to determine factors that predict the utilization of SRHS among young people in Enugu State, Nigeria. Methods The study adopted mixed-method research employing a cross-sectional research design. The population of the study comprised young people between the ages of 12 and 22 years. A multi-stage sampling procedure was used to select 1,447 young people used for the study. A questionnaire, in-depth interview, and focus group discussion were used for data collection. Percentages, Chi-square, and logistic regression were used to analyse quantitative data, while qualitative data were thematically analysed using NVivo software.ResultsSocio-demographic factors of gender, age, education, income, and living status (p = < .05) were significant predictors of utilization of SRHS. Psycho-cultural and health system factors (p = < .05) were also significant predictors of utilization of SRHS.Conclusion The study concluded that some socio-demographic factors (of gender, age, level of education, income, and living status), psycho-cultural, and health system factors can be used to predict young people’s utilization of SRHS. These predictors could be addressed through home sex education, regular training of health care providers on youth-friendly services delivery, and policy reforms.
Differentiation in the genetic basis of stem trichome development between cultivated tetraploid cotton species
Authors: Yuan Rong , Cao Yuefen , Li Tengyu , Yang Feng , Yu Li , Qin Yuan , Du Xiongming , Liu Fang , Ding Mingquan , Jiang Yurong , Zhang Hua , Paterson Andrew H. , Rong Junkang
Published: December 2020

Background: Cotton stem trichomes and seed fibers are each single celled structures formed by protrusions of epidermal cells, and were found sharing the overlapping molecular mechanism . Compared with fibers, cotton stem trichomes are more easily observed, but the molecular mechanisms underlying their development are still poorly understood. Results: In this study, Gossypium hirsutum (Gh ) and G . barbadense ( Gb ) were found to differ greatly in percentages of varieties/accessions with glabrous stems and in trichome density, length, and number per trichopore. Gh varieties normally had long singular and clustered trichomes, while Gb varieties had short clustered trichomes. Genetic mapping using five F2 populations from crosses between glabrous varieties and those with different types of stem trichomes revealed that much variation among stem trichome phenotypes could be accounted for by different combinations of genes/alleles on Chr.06 and Chr.24. The twenty six F1 generations from crosses between varieties with different types of trichomes had varied phenotypes, further suggesting that the trichomes of tetraploid cotton were controlled by different genes/alleles. Compared to modern varieties, a greater proportion of Gh wild accessions were glabrous or had shorter and denser trichomes; whereas a smaller proportion of Gb primitive accessions had glabrous stems. A close correlation between fuzz fiber number and stem trichome density was observed in both Gh and Gb primitive accessions and modern varieties. Conclusion: Based on these findings, we hypothesize that stem trichomes evolved in parallel with seed fibers during the domestication of cultivated tetraploid cotton. In addition, the current results illustrated that stem trichome can be used as a morphological index of fiber quality in cotton conventional breeding.
Understanding forgotten exposures towards achieving Sustainable Development Goal 3: the case of herbal medicine use in Tanzania
Authors: Kessy Anna Tengia , Msalale George Chombe
Published: December 2020

Background: In most sub-Sahara African countries, herbal medicines are widely used during pregnancy or delivery for various motives despite their unclear pharmacology and potential toxicity. All risky exposures, including use of herbs during pregnancy or delivery should be restricted in order to facilitate achieving Sustainable Development Goal (SDG) 3, which states: “ensure healthy lives and promote wellbeing for all including reduction of morbidity and mortality among mothers and newborns”. Thus, this study assessed use of herbal medicines during pregnancy or delivery and determined factors associated with the practice in Tabora, Tanzania.Methods: This cross-sectional quantitative study gathered information from 340 women who delivered a live-born baby in the preceding two years. Using a two-stage-sampling technique, we selected and interviewed women attending reproductive, maternal and child health clinics in public health facilities in Tabora, central Tanzania. We compared proportions using chi-square test and performed Poisson regression analysis to determine independent correlates of herbal use.Results: Of 340 recruited women, 208 [61.2 %; 95% confidence interval (CI): 55.4, 66.3%] used herbal medicines during pregnancy or delivery. Major reasons for use included shortening of labour duration, 81 (38.9%) and reducing labour pain, 58 (27.9%). The independent predictors of herbal use were number of antenatal visits and the stance of maternity health care providers on the use of herbs. Women who made less than four visits had 24% higher prevalence ratio of using herbal medicines as compared to those who made at least four visits [adjusted Prevalence Ratio (aPR):1.24; 95%CI: 1.02, 1.50, p=0.03]. Furthermore, the adjusted prevalence ratio of using herbs was 35% higher among women who were not discouraged by health care providers against using herbs versus those who were discouraged (aPR: 1.35; 95%CI: 1.13, 1.60, p=0.01). Conclusions: Use of herbal medicines during pregnancy or delivery among women in Tanzania is high. This calls for comprehensive investigations on the effects of using herbs during pregnancy or delivery as a step towards understanding some of the challenges in achieving SDG 3. Additionally, maternity health care providers ought to strengthen provision of health education messages during antenatal visits on the undesirable effects of using herbs.
Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study
Authors: Rajbanshi Sushma , Noor Norhayati Mohd , Hussain Nik Hazlina Nik
Published: December 2020

Background: Unlike the infant mortality rate, the rate of neonatal mortality has not declined and remains a major health challenge in the low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than the neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods: A hospital-based cross-sectional study was conducted at Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and number of gestational weeks were enrolled. The key inclusion criterion was the pragmatic and management markers of NNM, and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression analysis was performed using SPSS® version 24.0.Results: One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (AOR): 4.51, 95% confidence interval (CI): 2.07–9.84), maternal secondary (AOR: 0.46, 95% CI: 0.24–0.88) and tertiary education (AOR: 0.18, 95% CI: 0.05–0.56), multiparity (AOR: 0.52, 95% CI: 0.39–0.86), and caesarean section (AOR: 0.48, 95% CI: 0.19–0.99) were associated with NNM. Conclusions: The prevalence of NNM in Nepal was 7.9%. Mothers’ obstetric factors, maternal complications and education were associated with NNM. Referral hospitals should have safer access to caesarean section and be prepared to offer NICU intervention to save mothers and their newborns.
Genetic characterization of G12P[6] and G12P[8] rotavirus strains collected in six African countries between 2010 and 2014
Authors: Rakau Kebareng G. , Nyaga Martin M. , Gededzha Maemu P. , Mwenda Jason M. , Mphahlele M. Jeffrey , Seheri L. Mapaseka , Steele Duncan
Published: December 2020

Background: G12 rotaviruses were first observed in sub-Saharan Africa in 2004 and since then have continued to emerge and spread across the continent and are reported as a significant human rotavirus genotype in several African countries, both prior to and after rotavirus vaccine introduction. This study investigated the genetic variability of 15 G12 rotavirus strains associated with either P[6] or P[8] identified between 2010 and 2014 from Ethiopia, Kenya, Rwanda, Tanzania, Togo and Zambia. Methods: The investigation was carried out by comparing partial VP7 and partial VP4 sequences of the African G12P[6] and G12P[8] strains with the available GenBank sequences and exploring the recognized neutralization epitopes of these strains. Additionally, Bayesian evolutionary analysis was carried out using Markov Chain Monte Carlo (MCMC) implemented in BEAST to estimate the time to the most recent ancestor and evolutionary rate for these G12 rotavirus strains.Results: The findings suggested that the VP7 and VP4 nucleotide and amino acid sequences of the G12 strains circulating in African countries are closely related , irrespective of country of origin and year of detection, with the exception of the Ethiopian strains that clustered distinctly. Neutralization epitope analysis revealed that rotavirus VP4 P[8] genes associated with G12 had amino acid sequences similar to those reported globally including the vaccine strains in RotaTeq and Rotarix. The estimated evolutionary rate of the G12 strains was 1.016 x10−3 substitutions/site/year and was comparable to what has been previously reported. Three sub-clusters formed within the current circulating lineage III shows the diversification of G12 from three independent ancestries within a similar time frame in the late 1990s.Conclusions: At present it appears to be unlikely that widespread vaccine use has driven the molecular evolution and sustainability of G12 strains in Africa. Continuous monitoring of rotavirus genotypes is recommended to assess the long-term impact of rotavirus vaccination on the dynamic nature of rotavirus evolution on the continent.
Parallel analysis of global garlic gene expression and alliin content following leaf wounding
Authors: Yang Xuqin , SU Yiren , wu jiaying , wan wen , chen Huijian , cao Xiaoying , Wang Junjuan , zhang Zhong , wang Youzhi , Ma Deliang , Gloake Gary , Jiang JiHong
Published: December 2020

Background: Allium sativum (garlic) is an economically important food source and medicinal plant rich in sulfides and other protective substances such as alliin, the precursor of allicin biosynthesis. Cysteine, serine and sulfur is the precursor of alliin biosynthesis. However, little is known about the alliin content under abiotic stress or the mechanism by which its synthesized. Results: The findings revealed that the content of alliin was lowest in the garlic roots, and highest in the buds. Furthermore, alliin levels decreased in mature leaves following wounding. Transcriptome data generated over time after wounding further revealed significant up-regulation of genes integral to the biosynthetic pathways of cysteine and serine in mature garlic leaves. Conclusions: The findings suggest that differential expression of cysteine, serine and sulfide-related genes underlies the accumulation of alliin and its precursors in garlic, providing a basis for further analyses of alliin biosynthesis.
The potential of contralateral non-sentinel groin node metastasis in women with early primary vulvar cancer following unilateral sentinel node metastasis: a single center evaluation in University Hospital of Düsseldorf
Authors: Winarno Andreas Suhartoyo , Mondal Anne , Martignoni Franca Christina , Fehm Tanja Natascha , Hampl Monika
Published: December 2020

Background: Since the introduction of sentinel node biopsy (SLNB) in unifocal vulvar cancer (diameter of < 4cm) and unsuspicious groin lymph nodes, the morbidity rate of patients has significantly decreased globally. In contrast to SLNB, bilateral inguinofemoral lymphadenectomy (IFL) has been associated with increased risk of common morbidities. Current guidelines (NCCN, ESGO, RCOG, and German) recommend that in cases of unilaterally positive sentinel lymph node (SLN), bilateral IFL should be performed. However, two recent publications by Woelber et al. and Nica et al. contradict the current guideline, since a significant rate of positive non sentinel lymph nodes in IFL contralaterally was not observed (Woelber et al. 0% (p=0/28) and Nica et al. 5.3% (p=1/19)). Methods: A retrospective single-center analysis conducted in the University Hospital of Dusseldorf, evaluating vulvar cancer patients treated with SLNB from 2002 to 2018. Results, discussion and conclusion: Current guideline for bilateral IFL should remain as the standard management as 22.2% of women (n=4/18) were found to have contralateral IFL groin metastasis after an initial diagnosis of unilateral SLN metastasis. The depth of tumor infiltrating cells correlated significantly and positively with the rate of incidence of groin metastasis (p=0.0038). Therefore, this depth may be taken into account as an indication for bilateral IFL.
Explaining Factors Affecting Help-Seeking Behaviors in Women with Urinary Incontinence: A Qualitative Study
Authors: Fakari Fahimeh Rashidi , Hajian Sepideh , Darvish Soodabeh , Majd Hamid Alavi
Published: December 2020

Background: Urinary incontinence is widely accepted to be among the most important issues in the global health system. However, only a limited number of women refer for treatment as different factors make help-seeking behaviors more complicated than they initially seem to be. The aim of this study was to explain the factors affecting help-seeking behaviors in women suffering from urinary incontinence.Methods: The present study used a qualitative method, the conventional content analysis approach. The study was conducted between December 2018 and August 2019 in Tehran, Iran. The participants of the study included 34 women with urinary incontinence selected using purposive sampling method. The content analysis approach was based on the Graneheim and Lundman method, and qualitative data management software was used to analyze data. Results: Data analysis illustrates two themes; "nature of facilitator " and " nature of inhibitor "; the categories "not perceiving disease", "shame", " negative support of important others", and "non-optimal health care system" were among the deterrents and the categories "weakening the quality of life" and " positive support of important others" were found to be facilitators.Conclusions: The findings of the present study highlight the need for understanding the underlying facilitators and obstacles to help-seeking behaviors in women with urinary incontinence and suggest that healthcare providers consider an open dialogue with patients taking into account their subjective beliefs and life context during routine visits as to facilitate early diagnosis of the disease and ultimately lead to an improvement in the woman's quality of life.