bluuebunny/crossref_metadata_2025 huggingface dataset:
Immune checkpoint inhibitor-induced inflammatory arthritis: a qualitative study identifying unmet patient needs and care gaps
Authors: Cappelli Laura , Grieb Suzanne M. , Shah Ami A. , Bingham Clifton O. , Orbai Ana-Maria
Published: April 2020

Background: Patients treated for cancer with immune checkpoint inhibitors (ICI) may develop autoimmune adverse events, including ICI-induced inflammatory arthritis (IA). ICI-induced IA treatment requires balancing immune activation to fight cancer and immune modulation to control autoimmunity. Our objective was to learn how patients experience ICI-induced IA and potentially conflicting treatment decisions. Methods: Semi-structured interviews were conducted with participants with rheumatologist-diagnosed ICI-induced IA recruited from a longitudinal cohort. The interview guide probed the experience of diagnosis and treatment, symptoms and impact of ICI-induced IA, coping mechanisms, and treatment decision-making. Two researchers used an iterative coding process to identify themes through inductive thematic analysis and consensus. An overarching conceptual framework was derived from the qualitative analysis to identify care gaps perceived by patients, and inform future research.Results: Fourteen patients with ICI-induced IA participated in semi-structured interviews. Five overarching themes were identified: an awareness gap leading to delay in diagnosis of IA, descriptors of ICI-induced IA and relationship to other adverse events, emotional and quality-of-life impact of IA, fear and decision-making, and contextual factors including social support. Conclusions: As reported by patients, ICI-induced IA had a significant functional and emotional impact, even as compared to cancer and other ICI-induced side effects. Increasing awareness and integrated care of ICI-induced IA, and increasing social support are key targets for improving patient care. Additionally, more data on cancer outcomes in patients requiring immunomodulation for ICI-induced IA would help address fear and uncertainty for patients, and better support them through therapeutic decisions.
Health workers' views on factors affecting caregiver engagement with bubble CPAP
Authors: Salimu Sangwani , Kinshella Maggie Woo , Vidler Marianne , Banda Mwai , Newberry Laura , Dube Queen , Molyneux Elizabeth M , Goldfarb David , Kawaza Kondwani , Nyondo-Mipando Alinane Linda
Published: April 2020

Background Severe respiratory distress is a leading cause of mortality among neonates in Malawi. Despite evidence on the safety, cost effectiveness and efficacy of bubble continuous positive airway pressure (CPAP) in managing the condition, its use in Malawian health facilities is limited and little is known about caregivers' engagement with perspectives of bubble CPAP. The purpose of this study was to explore caregiver perspectives for bubble CPAP at both central and district hospitals and key factors that enable effective caregiver engagement in Malawi. Methods This was a descriptive qualitative study employing secondary analysis of 46 health care worker in-depth interviews. We interviewed the health workers about their thoughts on caregiver perspectives regarding use of bubble CPAP. We implemented the study at a tertiary facility and three district hospitals in southern Malawi. This was a part of a larger study to understand barriers and facilitators to implementing neonatal innovations in resource-constrained hospitals. Interviews were thematically analysed in NVivo 12 software (QSR International, Melbourne, Australia). Health workers were purposively selected to include nurses, clinicians and district health management involved in the use of bubble CPAP.Results Emerging issues included caregiver fears around bubble CPAP equipment as potentially harmful to their new-borns and how inadequate information provided to caregivers exacerbated knowledge gaps and was associated with refusal of care. However, good communication between health care providers and caregivers was associated with acceptance of care. Caregivers’ decision-making was influenced by relatives and peer advocates were helpful in supporting caregivers and alleviating fears or misconceptions about bubble CPAP.Conclusions Since caregivers turn to relatives and peers for support, there is need to ensure that both relatives and peers are counselled on bubble CPAP for improved understanding and uptake. Health workers need to provide simplified, accurate, up-to-date information on the intervention as per caregivers’ level of understanding. Notably, contextualised comprehensible information will help alleviate caregivers’ fear and anxieties about bubble CPAP.
High-temperature requirement factor A1 rs11200638 polymorphism and age-related macular degenerative from a comprehensive analysis about 15316 subjects
Authors: Liu Ying , Jin Huipeng , Wei Dong , Li Wenxiu
Published: April 2020

Background: The high-temperature requirement factor A1 (HTRA1) gene at the 10q26 locus has been associated with age-related macular degenerative (AMD) risk, with the significantly associated polymorphism being (rs11200638, -625G/A), however, above association is not consistent. We investigated an updated meta-analysis to evaluate the association between rs11200638 polymorphism and AMD risk thoroughly addressing this issue. Methods: An identification was covered with the Pubmed and Chinese Wanfang databases through 27th Jan, 2020. Odds ratios (OR) and 95% confidence intervals (CI) were used to assess the strength of associations. After a thorough and meticulous search, 35 different articles (33 case-control studies with HWE, 22 case-control studies about wet/dry AMD) were retrieved. Results: Individuals carrying A-allele or AA genotype may have an increased risk to be AMD disease. For example, there has a significantly increased relationship between rs11200638 polymorphism and AMD both for Asians (OR: 2.51, 95%CI: 2.22-2.83 for A-allele vs. G-allele) and Caucasians (OR: 2.63, 95%CI: 2.29-3.02 for A-allele vs. G-allele). Moreover, a similar trend in the source of control subgroup was detected. To classify the type of AMD, increased association was also observed in both wet (OR: 3.40, 95%CI: 2.90-3.99 for dominant model) and dry (OR: 2.08, 95%CI: 1.24-3.48 for dominant model) AMD. Finally, based on the different genotyping methods, increased relationships were identified by sequencing, TaqMan, PCR-RFLP and RT-PCR. Conclusions: Our present meta-analysis suggests that the HTRA1 rs11200638 polymorphism are potentially associated with the risk of AMD development, especially about individuals carrying A-allele or AA genotype, who may be as identified targets to detect and intervene in advance. Further studies using larger sample sizes and including information about gene-environment interactions should be conducted to elucidate.
Lessons learned through piloting a community-based SMS referral system for common mental health disorders used by female community health volunteers in rural Nepal
Authors: Bhardwaj Anvita , Subba Prasansa , Rai Sauharda , Bhat Chaya , Ghimire Renasha , Jordans Mark , Green Eric , Vasudevan Lavanya , Kohrt Brandon
Published: April 2020

Objective: The Community Informant Detection Tool (CIDT) is a paper-based proactive case detection strategy with evidence for improving help-seeking behavior for mental healthcare. Key implementation barriers for the paper-based CIDT include delayed reporting of cases and lack of active follow up. We used mobile phones and the structured text messages to improve timeliness of case reporting, encouraging follow up, and case record keeping. 36 female community health volunteers piloted this mobile phone CIDT (mCIDT) for three months in 2017 in rural Nepal. Results: Only 8 cases were identified by health volunteers using mCIDT, and only two of these cases engaged with health services post-referral. Accuracy with the mCIDT was considerably lower than paper-based CIDT, especially among older health volunteers, those with lower education, and those unfamiliar with sending text messages. Qualitative findings revealed implementation challenges including cases not following through on referrals due to perceived lack of staff at health facilities, assumptions among health volunteers that all earthquake-related mental health needs had been met, and lack of financial incentives for use of mCIDT. Based on study findings, we provide 5 recommendations—in particular attitudinal and system preparedness changes—to effectively introduce new mental healthcare technology in low resource health systems.
Comparative Analysis of Enoxaparin versus Rivaroxaban in the Treatment of Cancer Associated Venous Thromboembolism: Experience from a Tertiary Care Cancer Centre
Authors: Faqah Anadil , Sheikh Hassan , Bakar Muhammad Abu , Tayyaab Fatima , Khawaja Sahrish
Published: April 2020

BACKGROUND Venous Thromboembolism (VTE) in cancer patients is associated with increased mortality and morbidity. While newer data on use of direct oral anticoagulants (DOACs) in treating cancer associated thrombosis (CAT) is promising; its data is still few and inconsistent across literature. We designed the study to assess if rivaroxaban would be an appealing alternate choice to treat CAT.METHODS We conducted a retrospective study to evaluate the efficacy and safety profile of rivaroxaban versus enoxaparin in cancer patients after developing a symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE). Baseline patient characteristics and laboratory values were assessed in each arm. Primary efficacy outcome was measured by radiographically confirmed VTE recurrence at different intervals. Primary safety outcome was measured by presence of major and minor bleeding using the ISTH scale. RESULTS Our study recruited 150 cancer patients with radiologically confirmed DVT and PE; 80 patients were evaluated in enoxaparin arm and 70 patients in rivaroxaban arm. Our results showed that there was no statistically significant difference between the incidence of VTE recurrence at 6 months between the enoxaparin and rivaroxaban arm (10% vs 14.2%, p=0.42). Historically significant risk factors for VTE in cancer patients such as high platelet count, high leukocyte count, low hemoglobin level, high risk gastrointestinal, genitourinary and lung cancers were not found to be independently significantly associated with the risk of VTE recurrence. Primary safety outcome analysis also showed no statistically significant difference in major (11.2% vs 11.4%) and minor (15% vs 10%) bleeding between enoxaparin versus rivaroxaban arm respectively (p=0.65). CONCLUSION We conclude that there was no significant difference seen between the efficacy and safety profile of enoxaparin and rivaroxaban in our cancer patient population.
Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification
Authors: Ogawa Tomoya , Kawai Nobuyuki , Miyake Keisuke , Shinomiya Aya , Yamamoto Yuka , Nishiyama Yoshihiro , Tamiya Takashi
Published: April 2020

Background :The molecular features of isocitrate dehydrogenase (IDH) mutation and chromosome 1p and 19q (1p/19q) codeletion status have pivotal role for differentiating gliomas and have been integrated in the World Health Organization (WHO) classification in 2016. Positron emission tomography (PET) with 3’-Deoxy-3’-[18F]fluorothymidine (FLT) has been used to evaluate tumour grade and proliferative activity and compared with L-[methyl-11C]-methionine (MET) in glioma patients. Herein, we evaluated tracer uptakes of MET-PET/CT and FLT-PET/CT for differentiating glioma based on the 2016 WHO classification especially in relation to IDH1 mutation status.Methods : In total, 81 patients with newly diagnosed supratentorial glioma were enrolled in this study. They underwent PET/CT studies with MET and FLT before surgery. The molecular features and histopathological diagnosis based on the 2016 WHO classification were determined using surgical specimens. The ratios of the maximum standardized uptake value (SUV) of the tumours to the mean SUV of the contralateral cortex (T/N ratios) were calculated on MET-PET/CT and FLT-PET/CT images. Results : The mean T/N ratios of MET-PET/CT and FLT-PET/CT in IDH1-wildtype tumours were significantly higher than those in IDH1-mutant tumours (P<0.001 and P<0.001, respectively). Receiver operating characteristic analysis for differentiating IDH1 mutation status showed that the area under the curve of the FLT T/N ratio was significantly larger than that of the MET T/N ratio (P<0.01). The mean T/N ratio of FLT-PET/CT in IDH1-wildtype tumours was significantly higher than that in IDH1-mutant tumours among grade Ⅱ and Ⅲ gliomas (P=0.005), but this was not the case for MET-PET/CT. Both MET-PET/CT and FLT-PET/CT were able to distinguish between grade Ⅱ and Ⅲ gliomas in IDH1-mutant tumours (P=0.002 and P<0.001, respectively), but only FLT-PET/CT was able to distinguish between grade Ⅲ and Ⅳ gliomas in IDH1-wildtype tumours (P=0.029).Conclusion :This study showed that FLT-PET/CT can be used to determine the IDH1 mutation status and evaluate glioma grade more accurately than MET-PET/CT. FLT-PET/CT can improve glioma differentiation based on the 2016 WHO classification, but caution must be paid for tumours without contrast enhancement and further studies should be conducted with more cases.
Use, awareness and willingness to self-test for HIV: An analysis of cross-sectional population-based surveys in Malawi and Zimbabwe
Authors: Johnson Cheryl Case , Neuman Melissa , MacPherson Peter , Choko Augustine , Quinn Caitlin , Wong Vincent J , Hatzold Karin , Nyirenda Rose , Ncube Getrude , Baggaley Rachel , Terris-Prestholt Fern , Corbett Elizabeth
Published: April 2020

Background Many southern African countries are nearing the global goal to diagnose 90% of people with HIV by 2020. In 2016, 84% and 86% of people with HIV knew their status in Malawi and Zimbabwe respectively. Despite this progress, gaps remain, particularly among men (≥25 years). We investigated awareness, use and willingness to HIV self-test (HIVST) prior to large scale implementation and explored sociodemographic associations. Methods We pooled responses from two of the first cross-sectional Demographic Health Surveys to include HIVST questions: Malawi and Zimbabwe in 2015-16. Sociodemographic factors and sexual risk behaviours associated with previously testing for HIV, and awareness, past use and future willingness to self-test were investigated using univariable and multivariable logistic regression, adjusting for the sample design and limiting analysis to participants with completed questionnaire and a valid HIV result. Analysis of willingness to self-test was restricted to Zimbabwean men, as Malawians and women were not asked this question. Results Of 31 385 individuals, the proportion never-tested was higher for men (31.2%) than women (16.5%), p<0.001. For men, having ever tested increased with age. Past use and awareness of HIVST was very low, 1.2% and 12.6% respectively. Awareness was lower among women than men (9.1% vs 15.3%, adjusted odds ratio (aOR)=1.55; 95% confidence interval [CI]: 1.37-1.75), and at younger ages, and lower education and literacy levels. Willingness to self-test among Zimbabwean men was high (84.5%), with having previously tested for HIV, high sexual risk, and being ≥25 years associated with greater willingness. Wealthier men had greater awareness of HIVST than poorer men (p<0.001). Men at higher HIV-related sexual risk, compared to men at lower HIV-related sexual risk, had the greatest willingness to self-test (aOR=3.74; 95%CI: 1.39-10.03, p<0.009).Conclusions In 2015-16 many Malawian and Zimbabwean men had never tested for HIV. Despite low awareness and minimal HIVST experience at that time, willingness to self-test was high among Zimbabwean men, especially in older men with moderate to high HIV-related sexual risk. These data provide a valuable baseline against which to investigate population-level uptake of HIVST as programmes scale-up. Programmes introducing, or planning to introduce HIVST, should consider including questions in population-based surveys.
Is oral lichen planus a risk factor for peri-implant diseases? A systematic review and meta-analysis
Authors: Xiong Xiaoqin , Xu Tiantian , Wang Xinhong , Qin Wenguang , Yu Ting , Gang Luo
Published: April 2020

Background: To evaluate whether oral lichen planus (OLP) is a risk factor for peri-implant diseases (PIDs) with a systematic review and meta-analysis.Methods: Five electronic databases including Medline, Embase, Web of Science, the Cochrane Library and Scopus were searched. The included studies are observational human studies written in English. The population of interest included those with/without OLP who received dental implant treatment. The follow-up time after implantation was from one month to 20 years. The quality of the included articles regarding risk of bias and methodology were assessed with the Newcastle-Ottawa Scale or the Agency for Healthcare Research and Quality. The data involving exposure (OLP), primary outcomes (implants having PIDs) and secondary outcomes (probing depth/PD, bleeding on probing/BOP and bone loss/BL) and potential confounders were extracted. Heterogeneity was assessed by I² test. Dichotomous data are expressed as the risk ratio (RR) and 95% confidence interval (CI) which were calculated with a fixed effect model.Results: Of the 66 articles, two studies were enrolled and evaluated as high quality, which totally contained 68 participants receiving 222 (OLP vs. non-OLP, 112 vs. 110) implants with 12 to 120-month follow-up time. Proportions of implants with PIDs between OLP and non-OLP groups were as follows: 19.6% (22/112) vs. 22.7% (25/110) for PIM and 17.0% (19/112) vs. 10.9% (12/110) for PI. The meta-analysis revealed no recognizable difference in number of implants with PIDs (PI: RR = 1.49, 95% CI 0.77-2.90, P = 0.24; PIM:RR = 0.88, 95% CI 0.53 -1.46, P = 0.61; PIDs: RR = 1.08, 95% CI 0.75 -1.55, P = 0.68) or BOP (RR = 0.90, 95% CI: 0.70-1.15, P = 0.40) between OLP and non-OLP groups.Conclusions: Available articles regarding the effects of OLP on PIDs remains very limited. Existing evidence does not support OLP as a suspected risk factor for PIDs. Large-scale prospective trials are required to validate the findings.
Feasibility and impact of laparoscopic sleeve gastrectomy after renal transplantation on comorbidities, graft function and quality of life.
Authors: Alenazi Naif , Ahmad Khaled S , Elsamahy Ilham A , Essa Mohamed S
Published: April 2020

Background: The aim of this study is to clarify the feasibility and effect of laparoscopic sleeve gastrectomy (LSG) on comorbidities, graft function and quality of life in patients who underwent renal transplantation (RT) Methods: This is a retrospective review of 5 patients who underwent LSG after RT. Demographic data, anthropometric parameters, the effect on comorbidities, postoperative course, immunosuppressive medications, causes of RT, renal function, the survival of graft, and quality of life after SG in obese patients with a history of RT were assessed using BAROS–Moorhead–Ardelt survey Results From September 2015 to September 2019, 5 renal transplant patients underwent LSG; 60% were female, and 40 were male. Median body mass index (BMI) decreased from 42.17 kg/m2 (range 36–55) before surgery to 28.16 kg/m2 (range 25–42) after surgery. Improvement in blood pressure, triglyceride, and cholesterol levels was observed, and all cases were able to decrease their medications. Insulin was stopped and replaced with linagliptin in all diabetic patients. Graft function improved, and proteinuria level decreased in all cases (100%). All patients reported to have an excellent quality of life.Conclusion: LSG showed excellent outcomes in this high-risk group of patients regarding comorbidities, graft function and quality of life
Risk factors for one-year all-cause mortality in elderly multimorbid medical in-patients.
Authors: Wang-Hansen Marte Sofie , Kersten Hege , Wyller Torgeir Bruun
Published: April 2020

Background: Due to expansion of longevity, the proportion of elderly people with multimorbidity is increasing. Our aim was to identify risk factors for all-cause mortality in elderly multimorbid medical in-patients one year after acute hospitalization. Information regarding risk factors is important to support targeted care plans after discharge. Methods: Prospective cohort study of patients acutely admitted to a medical department in a Norwegian regional hospital. Eligible patients were community-dwelling, received home care services before hospitalization, were aged 75+, and suffered from two or more chronic conditions. Inclusion period was 1. April – 31. October 2012. Candidate variables were number of daily prescribed drugs, Cumulative Illness Rating Scale for Geriatrics score, delirium, body mass index (BMI), handgrip strength, Barthel Activities of Daily Living Index score, and the laboratory analyses haemoglobin (Hgb), sodium (Na) and estimated glomerular filtration rate (eGFR). Results: We included 227 patients; mean age 86 years, 59% women, 71% lived alone. During the year after hospitalization, 39% died. In the adjusted cox proportional hazards regression analysis, significant and independent risk factors were BMI (hazard ratio (HR) 0.93, 95% confidence interval (CI) 0.88-0.98 per kg/m2), Hgb (HR 0.87, 95% CI 0.76-0.98 per g/100 mL), Na (HR 0.94, 95% CI 0.90-0.99 per mmol/L) and eGFR < 60 mL/min/1.73 m2 (HR 1.82, 95% CI 1.07-3.08).Conclusions: In this cohort of multimorbid elderly internal medicine patients, low body mass, hyponatremia, impaired renal function and anaemia were identified as independent and significant risk factors for one-year mortality.
Changes in Prenatal Depression and Anxiety Levels in Low Risk Pregnancy Among Iranian Women: A Prospective Study
Authors: Kazemi Ashraf , Dadkhah Aazam
Published: April 2020

Background There is limited information on the changes in uncomplicated pregnancies. Therefore, in the present study, the changes of depression and anxiety changes in uncomplicated pregnancies during the prenatal period was evaluated.Method This longitudinal study was performed on 256 pregnant women at the beginning of the first trimester of pregnancy. Inclusion criteria included the absence of pre-pregnancy depression and anxiety and poor pregnancy history. Exclusion criteria were the incidence of pregnancy complications. The level of their depression and anxiety at the time of entering the study were completed by self-report using the DASS questionnaire at 9–10, 11–12, 24–25, and 33–35 weeks of pregnancy.Results The results of the study indicated the effect of time on the level of perinatal depression and anxiety (p < 0.001). These findings showed that the level of depression increased significantly from 9 to 24 weeks of pregnancy and decreased in the 32–34 weeks, but did not reach the level of depression at 9 weeks of pregnancy. Also, the anxiety level increased significantly from the onset of pregnancy to the 24 weeks gestation but did not change during the second and third trimesters. The findings of the study showed that depression and anxiety levels in each of the pregnancy termites were related to its level in the previous trimesters.Conclusion The results of the study showed that the level of depression and anxiety of women in uncomplicated pregnancies also increases. Therefore, psychological health screenings in the second trimester of pregnancy should be performed in these women.
The role of the Oncostatin M/ OSM receptor β axis in activating dermal microvascular endothelial cells in Systemic Sclerosis
Authors: Marden Grace , Wan Qianqian , Wilks James , Nevin Katherine , Feeney Maria , Wisniacki Nicolas , Trojanowski Marcin , Bujor Andreea , Stawski Lukasz , Trojanowska Maria
Published: April 2020

Background
Scleroderma (SSc) is a rare autoimmune disease characterized by vascular impairment and progressive fibrosis of the skin and other organs. Oncostatin M, a member of the IL-6 family, is elevated in SSc serum and was recognized as a significant player in various stages of fibrosis. The goal of this study was to assess the contribution of the OSM/OSMRβ pathway to endothelial cell (EC) injury and activation in SSc.
Methods
IHC and IF were used to assess the distribution of OSM and OSMRβ in SSc (n = 14) and healthy control (n = 7) skin biopsies. Cell culture experiments were performed in human dermal microvascular endothelial cells (HDMECs) and included mRNA and protein analysis, and cell migration and proliferation assays. Ex vivo skin organoid culture was used to evaluate the effect of OSM on perivascular fibrosis.
Results
OSMRβ protein was elevated in dermal ECs and in fibroblasts of SSc patients. Treatments of HDMECs with OSM or IL-6 + sIL-6R have demonstrated that both cytokines similarly stimulated proinflammatory genes and genes related to endothelial-to mesenchymal transition ((EndMT). OSM was more effective than IL-6 + sIL-6R in inducing cell migration, while both treatments similarly induced cell proliferation. The effects of OSM were mediated via OSMRβ and STAT3, while the LIFR did not contribute to these responses. Both, OSM and IL-6 + sIL-6R induced profibrotic gene expression in HDMECs, as well as expansion of the perivascular PDGFRβ+ cells in the ex vivo human skin culture system. Additional studies in HDMECs showed that siRNA-mediated downregulation of FLI1 and its close homolog ERG resulted in increased expression of OSMRβ in HDMECs.
Conclusions
This work provides new insights into the role of the OSM/OSMRβ axis in activation/injury of dermal ECs and supports the involvement of this pathway in SSc vascular disease.
Guidelines for physical activity and screen-time in the outside school hours childcare setting: a scoping review.
Authors: Virgara Rosa , Lewis Lucy K , Phillips Anna , Richardson Mandy , Maher Carol A
Published: April 2020

Background:
Globally millions of children attend outside school hours care. Children’s activity in this setting is critical to meeting daily physical activity recommendations. Guidelines are evidence-based statements intended to optimise practice. This study aimed to identify guidelines for physical activity and screen time for use in outside school hours care.
Methods:
Guidelines were identified by systematically searching Medline, Emcare, Embase, Scopus, ERIC, Sportsdiscus, TROVE, ProQuest, UpToDate, NICE, SIGN and Google in accordance with PRISMA-ScR guidelines. Results were screened independently by two reviewers and data synthesized narratively.
Results:
Nine guideline documents were identified from grey literature only (n = 8 USA, n = 1 Canada). The guidelines focused predominantly on the after school care period (n = 9 vs n = 1 for the before-school period). All had recommendations for physical activity, whilst 7 also had screen time recommendations. The guidelines varied considerably in their physical activity and screen time recommendations, though taken together, they recommended > 30–60 minutes of MVPA and < 60 minutes of recreational screen time per session. All guidelines were developed by expert/stakeholder panels, but none followed rigorous guideline development methods.
Conclusions:
Limited published guidelines for physical activity and screen-time in outside school care exist. Guidelines designed with rigorous tools and for other world regions are warranted.
Human pegivirus (HPgV, GBV-C) RNA prevalence, genome characterization and association with HIV coinfection among volunteer blood donors from a public hemotherapy service in Northern Brazil.
Authors: Silva Aniel , Silva Clayton , Barata Rafael , Silva Pedro , Monteiro Patrícia , Lamarão Letícia , Burbano Rommel , Nunes Márcio , Lima Patrícia
Published: April 2020

BackgroundHuman pegivirus (HPgV) - formerly known as GBV-C - is a member of the Flaviviridae family and belongs to the species Pegivirus C. It is a non-pathogenic virus and is transmitted among humans mainly through the exposure to contaminated blood and is often associated with human immunodeficiency virus (HIV) infection. This study aimed to determine the prevalence of HPgV viremia, its association with HIV and clinical epidemiological factors, as well as the full-length sequencing and genome characterization of HPgV recovered from blood donors of the HEMOPA Foundation in Belém-PA-BrazilMethodsPlasma samples were obtained from 459 donors, tested for the presence of HPgV RNA by the RT-qPCR. From these, a total of 26 RT-qPCR positive samples were submitted to the NGS sequencing approach in order to obtain the full genome+. Genome characterization and phylogenetic analysis were conducted.ResultsThe prevalence of HPgV was 12.42%. We observed the highest prevalences among donors aged between 18 to 30 years old (16.5%), with brown skin color (13.2%) and men (15.8%). The newly diagnosed HIV-1 prevalence was 26.67%. The genotype 2 (2A and 2B) was identified. No data on viral load value was found to corroborate the protective effect of HPgV on HIV evolution.ConclusionsThis study provided information regarding the HPgV infection among blood donors from HEMOPA Foundation. Furthermore, we genetically characterized the HPgV circulating strains and described by the first time the genotype 2 genomes in the Brazilian Amazon region.
Association between atherosclerotic cardiovascular diseases risk and renal outcome in patients with type 2 diabetes mellitus
Authors: Ren Honghong , Zhao Lijun , Zou Yutong , Wang Yiting , Zhang Junlin , Wu Yucheng , Zhang Rui , Wang Tingli , Wang Jiali , Zhu Yitao , Guo Ruikun , Xu Huan , Li Lin , Cooper Mark E. , Liu Fang
Published: April 2020

Background
Chronic kidney disease (CKD) and diabetes mellitus increase atherosclerotic cardiovascular diseases (ASCVD) risk. However, the association between renal outcome of diabetic kidney disease (DKD) and ASCVD risk is unclear.
Methods
This retrospective study enrolled 218 adult patients with type 2 diabetes mellitus and biopsy-proven DKD, and without known cardiovascular diseases. These patients were followed up at least 1 year. Baseline characteristics were obtained and the 10-year ASCVD risk score was calculated using the Pooled Cohort Equation (PCE). Renal outcome was defined as progression to end-stage renal disease (ESRD). The association between ASCVD risk and renal function and outcome was further analyzed with logistic regression and Cox proportional hazard analysis.
Results
Among all patients, the median 10-year ASCVD risk score was 14.1%. The median of ASCVD risk score in CKD stage 1, 2, 3, and 4 was 10.9%, 12.3%, 16.5%, and 14.8%, respectively (P = 0.268). Compared with patients with lower ASCVD risk(༜14.1%), those with higher ASCVD risk had lower eGFR, higher systolic blood pressure, and more severe renal interstitial inflammation. High ASCVD risk(> 14.1%) was an independent indicator of renal dysfunction in multivariable-adjusted logistic analysis(odds ratio [OR], 3.997; 95% confidence interval [CI], 1.385–11.530;P = 0.010). However, univariate and multivariate COX proportional hazard analysis showed the 10-year ASCVD risk score failed to be an independent risk factor for ESRD in patients with type 2 diabetes mellitus.
Conclusions
PCE can estimate ASCVD risk in patients with DKD, and DKD patients even in CKD stage 1 had comparable ASCVD risk score to patients in CKD stage 2, 3, and 4. Higher ASCVD risk indicated severe renal insufficiency, while no prognostic value of ASVCD risk for renal outcome was observed, which implied macroangiopathy and microangiopathy in patients with DKD were related, but relatively independent.
A novel risk stratification for predicting prognosis of colorectal cancer patients with bone metastasis
Authors: Ma Chenxi , Guan Xu , Quan Jichuan , Zhao Zhixun , Chen Haipeng , Huang Haiyang , Wei Ran , Liu Zheng , Jiang Zheng , Wang Xishan
Published: April 2020

Backgroud: Our understanding in prognosis of bone metastasis (BM) from colorectal cancer (CRC) is limited. We aimed to establish a clinical risk stratification for individually predicting the survival of CRC patients with BM.Methods: A total of 200 CRC patients with BM were included in this study. Survival time from BM diagnosis was estimated using the Kaplan-Meier method. The multivariable COX regression model identified the risk factors on cancer specific survival (CSS). Based on weighted scoring system, the stratification model was constructed to classify patients with BM according to prognostic risk. Discrimination power and calibration ability of risk stratification were measured.Results: The median CSS time was 11 months after BM diagnosis. Lymph node metastasis, CA199 levels, bone involvement, KPS scores, primary tumor resection, bisphosphonates therapy and radiotherapy were identified as predictors of CSS. Four risk groups were stratified according to weighted scoring system, including low risk, medium risk, medium-high risk and high risk group, with 35, 16, 9 and 5 months of median CSS, respectively (P = 0.000). The risk stratification displayed good accuracy in predicting CSS, with acceptable discrimination and calibration.Conclusion: This novel risk stratification predicts CSS in CRC patient with BM using easily accessible clinicopathologic factors, which is recommended for use in individualized clinical decision making in patient with BM.
Integrative analysis of exosomal microRNA-149-5p in lung adenocarcinoma
Authors: Tian Wen , Yang He , Zhou Baosen
Published: April 2020

Background Exosomes play an important role in the regulation of various processes in the tumor microenvironment. In this study, we explored the mechanisms of exosomal miR-149-5p in the pathogenesis of lung adenocarcinoma. Methods Raw GEO data were downloaded and normalized using the R package. Exosomal miRNAs that were found to be significantly expressed were subjected to WGCNA co-expression network analysis. The proliferation, migration and apoptotic abilities of tumor cells were assessed by the MTS, Transwell and apoptosis assays. Univariate and multivariate analyses were performed to identify the independent factors of target genes. Results Results showed that exosomal miR-149-5p was enriched in peripheral serum and tumor cells. The upregulation of exosomal miR-149-5p promoted the growth and migration of tumor cells, and inhibited apoptosis of tumor cells. Notably, target genes of exosomal miR-149-5p, AMOTL2 and MSRB3, were significantly downregulated in lung adenocarcinoma and thus may be considered as independent risk factors of poor survival. In TCGA-LUAD cohort, miR-149-5p was found to be a negative regulator of AMOTL2 and MSRB3 genes.Conclusion Collectively, these results provide novel insights for further mechanistic studies on lung adenocarcinoma.
Nurse Practitioners’ Job Satisfaction and Associated Factors among Nurses working at the University of Gondar Specialized Hospital: A Cross-sectional Survey study
Authors: Azagew Abere Woretaw , Mekonnen Chilot
Published: April 2020

Background Job satisfaction is an important measure of cognitive as well as a behavioral component of employees’ feelings of comfort in their particular work. It is also the outlook and spirit of certain professionals towards their work. Nurses’ job satisfaction is a significant predictor of staff retention. Therefore, this study aimed to assess Nurse Practitioners’ Job Satisfaction and Associated Factors among Nurses Working at the University of Gondar Specialized Hospital Northwest Ethiopia.Methods A cross-sectional study design was employed from May 15–20/2019. A total of 416 nurses participated in the study. A simple random sampling technique was used to select each study participant. A pretested structured questionnaire was used to collect the data. A Minnesota satisfaction measurement tool was used to measure nurse practitioners’ job satisfaction. A binary logistic regression analysis was used. Variables having p-value < 0.05 in a multivariable analysis model were considered as statistically significant and independently associated with the outcome variable.Result A total of 416 study participants were used in the study with a response rate of 97.6%. In this study, 204(50.2%) of nurse practitioners were dissatisfied with their job. Motivational factors such as professional advancement (AOR = 2.737, 95% CI; 1.109, 6.751), work itself (AOR = 4.250, 95%CI; 1.645, 10.983), recognition at work (AOR = 11.869, 95% CI; 4.238, 33.241), growth at work (AOR = 6.272, 95% CI; 2.278,17.264), and hygienic factors; organizational policy (AOR = 5.623, 95% CI; 2.131, 14.836), relationship with friends (AOR = 6.112,95% CI; 2.393, 15.612), work-security (AOR = 6.562, 95% CI; 95% CI; 2.374,18.136), relationship with supervisor(AOR = 5.127, 95% CI; 1.796, 14.641), payment (AOR = 5.889, 95% CI; 1.989, 17.438), and working conditions AOR = 3.806, 95% CI; 1.195, 12.123) were the factors associated with nurses’ job dissatisfactionConclusions In this study, one of every two nurses experienced job dissatisfaction. Motivational factors such as professional advancement, work itself, recognition at work, growth at work, organizational policy, relationship with friends, work security, relationship with supervisor, payment, and working conditions were the factors associated with nurses’ job dissatisfaction.
Therapeutic abortion in Iran: an epidemiologic study of legal abortion in 2 years
Authors: Mahdavi Seyed Amirhosein , Jafari Asieh , Azimi Khadijeh , Dehghanizadeh Nikoo , Bazegar Abdolrazagh
Published: April 2020

Objectives
Unsafe abortion is one of the most important causes of death and disability among mothers in countries where abortion is illegal. These conditions have changed since then. The present study has investigated the cases who were referred to the legal medicine organization to receive abortion permission. This country level cross sectional retrospective study, investigated all the cases who were referred to the legal medicine centers of Iran for abortion permission during 2015 to 2017. The results were analyzed using SPSS software version 21.
Results
From 21477 applicants, 15617 (72.71%) received permission including 14367 (91.99%) for fetal abnormalities and 1250 (8.01%) for maternal diseases. The most common fetal abnormalities/disorders were nervous system malformations (26.4%), chromosomal abnormalities (18.4%) and of maternal diseases were circulatory system diseases (43.9%), neoplasms (13.4%) and genitourinary system diseases (9.9%). The most common reasons for not permission were lack of supplementary documents to prove (38.8%), not competency with the criteria (33.9%), and gestational age of more than 19 weeks (25.8%).
Lifetime Co-Occurring Psychiatric Disorders in Newly Diagnosed Adults with Attention Deficit Hyperactivity Disorder (ADHD) or/and Autism Spectrum Disorder (ASD)
Authors: Pehlivanidis Artemios , Papanikolaou Katerina , Mantas Vasilios , Kalantzi Eva , Korobili Kalliopi , Xenaki Lida- Alkistis , Vassiliou Georgia , Papageorgiou Charalambos
Published: April 2020

Background Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose.Methods The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n = 151), the ASD (n = 58), the ADHD + ASD (n = 28) and the nonADHD/nonASD (NN) (n = 88) group.Results At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD + ASD group and in 76.1% of the NN group (p = 0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD, the ASD and NN groups was found for substance use disorder (SUD) (p = 0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p = 0.025).Conclusions Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.
Magnitude of Nurses’ Intention to Leave Their Jobs and Its Associated Factors of Nurses Working in Tigray Regional State, North Ethiopia: Cross sectional study
Authors: Negarandeh Reza , Kahsay Woldegebriel Gebregziabher , Pashaeypoor Shahzad , Navab Elham
Published: April 2020

Introduction A significant number of nurses is leaving the health care sector. High rates of turnovers contribute to labor shortages of nursing and adversely affect patient outputs and nursing costs.Objectives To determine the magnitude of nurses’ intention to leave a job and its associated factors.Methods A cross-sectional, analytical descriptive study design among 634 nurses working in Tigray Regional State general hospitals from March 2018 to 30 June 2019 was conducted. Clustered random sample nurses completed self-administered three-item Michigan Organizational Assessment Questionnaire during data collection. Descriptive and multiple logistic regression analyses were done using SPSS version 20, 95% confidence interval and p-value < 0.05 was considered.Findings Response rate was 95.9%. Nurses were with a mean of 33.60 ± 9.71, 10.07 ± 9.54, and 2.10 ± 1.455 in years for age, work experience, and service in hospital respectively. About 56.4% were females, 95.4% Orthodox, and 56.7% were Bachelors of Science in Nursing. The magnitude of nurses’ intention to leave their jobs was 43.9%. The male nurses were 1.5 times more likely (AOR = 1.565, 95% CI = 1.095–2.237) had the intention to leave. Those nurses working in medical ward were also 2 times more likely (AOR = 1.886, 95% CI = 1.113–3.193) than working in the Out-Patient Department of the hospitals had the intention to leave.Conclusions Nurses in hospitals intend to leave their jobs. Gender and working in medical ward are the predictors for their intentions. Health care policymakers are recommended to develop nurses’ retention strategies and establish continuing education to socialize male nurses and set economic incentive strategies to encourage male nurses to stay in hospitals fulfilling their families’ income to earn. Managers are recommended to make regular rotation of nurses within hospitals to minimize a possible burden in medical wards. For the quality nursing care, nursing managers should create a favorable environment in medical wards. Educators are recommended to increase the intake of the nursing students. This study did not show the cause and effect of variables. Therefore, other researchers are recommended to conducting longitudinal studies.
Clinicopathological and Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) in Gastric Cancer: An Updated Meta-Analysis
Authors: Zhang Xunlei , Zhao Wenjing , Yu Yang , Qi Xue , Song Li , Zhang Chenfei , Li Guoxing , Yang Lei
Published: April 2020

Background
Systemic inflammatory parameters, such as the elevator PLR (platelet-lymphocyte ratio), have been found to be associated with the prognosis in gastric cancer (GC); however, the results remain controversial. So we aimed to evaluate the prognostic role of the PLR in gastric cancer by conducting this meta-analysis.
Methods
We performed a systematic literature search in PubMed, Embase and the Cochrane Library. The hazard ratio (HR) /Odds Ratio (OR) and its 95% confidence (CI) of survival outcomes and clinicopathological parameters were calculated.
Results
A total of 49 studies (51 cohorts) with 28,929 GC patients were included in the final meta-analysis. The pooled results showed that elevated PLR was significantly associated with poor overall survival (OS) (HR: 1.37, 95% CI: 1.26–1.49, p < 0.001; I2 = 79.90%, Ph < 0.001) and disease-free survival (DFS) (HR 1.52, 95%CI 1.22–1.90, P < 0.001, I2 = 88.6%, Ph< 0.001) of GC patients. Furthermore, patients with elevated PLR had a higher risk of lymph node metastasis (OR = 1.17, 95% CI: 1.02–1.33, p = 0.023), serosal invasion (T3 + T4) (OR = 1.34, 95% CI: 1.10–1.64, p = 0.003) and increased advanced stage (III + IV) (OR = 1.20, 95% CI: 1.06–1.37, p = 0.004).
Conclusions
This meta-analysis demonstrated that elevated PLR was a prognostic factor for poor OS and DFS, and associated with clinicopathological parameters in patients with GC.
ILC2-derived IL-9 inhibit s colorectal cancer progression by activating CD8+ T cells
Authors: Wan Jie , Huang Lan , Wu Yinqiu , Ji Xiaoyun , Yao Shun , Abdelaziz Mohamed Hamed , Cai Wei , Wang Huixuan , Cheng Jianjun , kumar Kesavan Dinesh , Aparna Vasudevan , Sun Caixia , Su Zhaoliang , Wang Shengjun , xu huaxi
Published: April 2020

Background
Type 2 innate lymphoid cells (ILC2s), characterized by secreting type 2 cytokines, regulate multiple immune responses. ILC2s are found in different tumor tissues and ILC2-derived interleukin (IL)-4, IL-5, and IL-13 act on the cells in tumor microenvironment to participate in tumor progression. ILC2s are abundant in colorectal cancer (CRC) tissue, but the role of ILC2s in CRC remains unclear.
Methods
ILC2s were sorted from the spleen using microbeads combined with flow cytometry and tumor infiltrating CD8+ T cells were isolated from tumor tissue by microbeads. Flow cytometry and immunofluorescence were used to detect the percentage of ILC2s and CD8+ T cells in the spleen and CRC tissue. Effects of IL-9 and IL-9-stimulated CD8+ T cells on CT26 cells were measured by proliferation, apoptosis, and migration assays in vitro. GEPIA was used to detect the ILC2s chemokines in CRC tissue and adjacent normal tissue.
Results
We found that ILC2s were increased in CRC tissue compared with the adjacent normal tissue. In vitro experiments showed that IL-9 could activate CD8+ T cells to promote the death of CT26 cells. ILC2s were the main IL-9-secreting cells in CRC tissue as shown by flow cytometry analysis. In vivo experiments showed that neutralizing ILC2s promoted the tumor growth, while tumor inhibition occurred by intravenous injection of IL-9.
Conclusions
Our results demonstrated that ILC2-derived IL-9 activated CD8+ T cells to promote anti-tumor effects in CRC.
Geospatial Approach For Assessment Of Vulnerability To Flood In Local Self Governments
Authors: S Deepak , Rajan Gopika , G Jairaj P
Published: April 2020

Recent years have shown a significant increase in the occurrence of flood globally, with impact on habitation and different sectors of the economy. This, in turn, necessitates the use of different flood mitigation strategies, wherein flood vulnerability assessment plays a significant role. The proposed work presents a methodology which combines vulnerability under physiographic and socio-economic domains to assess the overall flood vulnerability at the local self-government level. The methodology was illustrated to the case of Aluva municipality, located on the banks of River Periyar, in Kerala state, India. The spatial variation of hazard inducing factors and population statistics were analysed using GIS tools. The machine learning algorithm, Random Forest, which uses hazard inducing factors as input was implemented for the evaluation of physiographic vulnerability. The social vulnerability of the region was analysed using GIS Multi-criteria decision analysis approach, with criteria weights to incorporate the interests of different stakeholders. The critical combinations of the two domains of vulnerability in the assessment of the vulnerability to flood, to have efficient flood management in local self-government was demonstrated in this study and can be made use of for any flood event.