bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factor analysis and severity assessment of wound hematoma after anterior cervical spine surgery: A retrospective study
Authors: Zhou Kai , Quan Zhengxue , He Zhongyuan , Tang Ke
Published: December 2020

Background

We aim to explore the risk factors independently associated with postoperative wound hematoma in patients who have undergone anterior cervical spine surgery.
Methods

The clinical data of patients with cervical spondylosis or cervical disc herniation who underwent anterior cervical spine surgery by the senior author from January 2011 to December 2017 were evaluated. Multivariate logistic regression was conducted to compare the hematoma group and the no-hematoma group to determine which factors were independently associated with hematoma formation in patients who need evacuation. The Mann-Whitney U test was conducted to compare the Neck Disability Index score in the two groups.
Results

A total of 678 patients met the criteria and underwent anterior cervical spine surgery. Thirteen patients undergone hematoma evacuation. Multivariate logistic regression analysis identified that history of hypertension (p = 0.039 OR = 4.42 95% CI 1.08–18.07) and therapeutic heparin use (p = 0.020 OR = 4.58 95% CI 1.27–16.59) were independent risk factors for hematoma formation. The t-test showed no significant differences between the hematoma group and the no-hematoma group in terms of APTT or PT levels (p > 0.05). The Mann-Whitney U test indicated that there was no difference in NDI scores between the two groups(p > 0.05).
Conclusion

History of hypertension and therapeutic heparin use are risk factors for hematoma formation. Meticulous hemostasis, moderate muscle subtraction, and perioperative airway management are critical for avoiding hematoma development. The Neck Hematoma Scores can quickly determine the severity of a hematoma in the absence of radiographic image evidence.
Alleviation of Cholesterol Gallstones by Lactobacillus Targeting the Gut Microbiota Depends on Global Farnesoid X Receptor-Mediated Bile Acid Metabolism
Authors: Wan Xinjian , Ye Xin , Zhuang Qian , Dong Zhixia , Wang Xiaoxin , Shen Shuang , Wu Shan , Ning Min , Xia Jie , Wang Jingjing
Published: December 2020

Background

Cholesterol gallstone (CGS) disease is characterized by an imbalance in bile acid (BA) metabolism and is closely associated with gut microbiota disorders. However, the role and mechanism by which probiotics targeting the gut microbiota attenuate CGS are still unknown. In this study, Lactobacillus reuteri CGMCC 17942 (LR) and L. plantarum CGMCC 14407 (LP) were individually administered to lithogenic diet (LD)-fed mice at a dosage of 109 CFU/day for 8 weeks.
Results

Both Lactobacillus strains significantly reduced LD-induced gallstones, hepatic steatosis, and hyperlipidemia. These strains modulated serum BA profiles, with significantly decreased conjugated primary BA taurine-β-muricholic acid (T-β-MCA), an FXR antagonist. At the molecular level, LR and LP increased Farnesoid X Receptor (FXR) expression in the liver but not in the ileum, increased the levels of ileum and liver fibroblast growth factor 15 (FGF15) and liver FGFR4, small heterodimer partner (SHP), and subsequently reduced cholesterol 7α-hydroxylase (CYP7A1) and cytochrome P450 family 7 subfamily B polypeptide 1 (CYP7B1) to inhibit BA synthesis in the liver. At the same time, the two strains enhanced BA transport by increasing the levels of multidrug-resistance-associated protein homologs (MRP) 3/4, multidrug-resistance-associated protein homologs (MRP) 3/4, hepatic multidrug resistance protein (MDR2) and bile salt export pump (BSEP) mRNA in the liver. In addition, both LR and LP reduced LD-associated gut microbiota dysbiosis. LR increased the relative abundance of Muribaculaceae, while LP increased that of Akkermansia. The changed gut microbiota was significantly negatively correlated with the grade and incidence of gallstones, hyperlipidemia, the level of T-β-MCA in serum, or the gene expression levels of Fxr in liver. Furthermore, the protective effects of the two strains were abolished by a global but not intestinal-specific FXR antagonist.
Conclusions

Taken together, our results suggested that Lactobacillus might relieve gallstones through FXR-dependent regulation of BA synthesis and transport.
Development of a complex intervention to improve mobility and participation of older people with vertigo, dizziness and balance disorders in primary care: a mixed methods study
Authors: Regauer Verena , Seckler Eva , Grill Eva , Ippisch Richard , Jahn Klaus , Bauer Petra , Müller Martin
Published: December 2020

Background: Vertigo, dizziness and balance disorders (VDB) are common in older individuals and cause restrictions in mobility and participation. Due to a multifactorial aetiology, health care is often overutilitised, but many patients are also treated insufficiently in primary care. The purpose of this study was to develop a care pathway as a complex intervention to improve mobility and participation in older people with VDB in primary care.Methods: The development followed the UK Medical Research Council guidance using a mixed-methods design with individual and group interviews carried out with patients, physical therapists (PTs), general practitioners (GPs), nurses working in community care and a multi-professional expert panel to create a first draft of a care pathway (CPW) and an implementation strategy using the Consolidated Framework of Implementation Research and the Expert recommendations for Implementing Change. Subsequently, small expert groups modelling of specific components of CPW was carried out, with GPs, medical specialists and PTs. The Behaviour Change Wheel was applied to design the intervention´s behaviour change. To explicate theoretical assumptions, we adopted Kellogg´s Logic Model to consolidate the hypothesized chain of causes leading to patient-relevant outcomes.Results: Individual interviews with patients showed that VDB symptoms need to be taken more seriously by GPs. Patients demanded age-specific treatment offers, group sessions or a continuous mentoring by a PT. GPs required a specific guideline for diagnostics and treatment options adding psycho-social interventions. Specific assignment to and a standardized approach during physical therapy was desired by PTs. Nurses favoured a multi-professional documentation system. The structured three-day expert workshop resulted in a first draft of CPW and potential implementation strategies. Subsequent modelling resulted in a CPW with components and appropriate training materials for involved health professionals. A specific implementation strategy is now available.Conclusion: Mixed-methods design proved to be a suitable approach to develop a complex intervention and its implementation. We will subsequently test the intervention for its acceptability and feasibility in a feasibility study accompanied by a comprehensive process evaluation to inform a subsequent effectiveness trial.Trial Registration: The research project is registered in “Projektdatenbank Versorgungsforschung Deutschland” (Project-ID: VfD_MobilE-PHY_17_003910; date of registration: 30.11.2017).
Progress towards the 2020 Fast Track HIV/AIDS reduction targets across ages in Ethiopia as compared to neighboring countries using Global Burden of Diseases 2017 data
Authors: Mirkuzie Alemnesh H. , Ali Solomon , Abate Ebba , Worku Asnake , Misganaw Awoke
Published: December 2020

Background: Sustainable Development Goal (SDG) 3.3, targets to eliminate HIV from being a public health threat by 2030. For better tracking of this target interim Fast Track milestones for 2020 and composite complementary measures have been indicated. This study measured the Fast Track progress in the epidemiology of HIV/AIDS in Ethiopia across ages compared to neighboring countries.Methods: The National Data Management Center for health's research team at the Ethiopian Public Health Institute has analyzed the Global Burden of Disease (GBD) 2017 secondary data for the year 2010 to 2017 for Ethiopia and its neighbors. GBD 2017 data sources were census, demographic and a health survey, prevention of mother-to-child HIV transmission, antiretroviral treatment programs, sentinel surveillance, and UNAIDS reports. Age-standardized and age-specific HIV/AIDS incidence, prevalence, mortality, Disability-Adjusted Life Years (DALYs), incidence:mortality ratio and incidence:prevalence ratio were calculated with corresponding 95% confidence intervals.Results: Ethiopia and neighboring countries recorded slow progress in reducing new HIV infection since 2010. Only Uganda would achieve the 75% target by 2020. Ethiopia, Tanzania, and Uganda already achieved the 75% mortality reduction target set for 2020. The incidence: prevalence ratio for Ethiopia, Rwanda, and Uganda were < 0.03, indicating the countries were on track to end HIV by 2030. Ethiopia had an incidence: mortality ratio <1 due to high mortality; while Kenya, Rwanda, Tanzania and Uganda had a ratio of >1 due to high incidence. The HIV incidence rate in Ethiopia was dropped by 76% among under 5 children in 2017 compared to 2010 and the country would likely to attain the 2020 national target, but far behind achieving the target among the 15-49 age group.Conclusions: Ethiopia and neighboring countries have made remarkable progress towards achieving the 75% HIV/AIDS mortality reduction target by 2020, although they progressed poorly in reducing HIV incidence. By recording an incidence:prevalence ratio benchmark of less than 0.03, Ethiopia, Rwanda, and Uganda are well heading towards epidemic control. Nonetheless, the high HIV/AIDS mortality rate in Ethiopia for its incidence requires innovative strategies to reach out undiagnosed cases and to build institutional capacity for generating strong evidence to ensure sustainable epidemic control.
Averting expenditure on malaria: effects on labour productivity of maize farmers in Bunkpurugu-Nakpanduri District of Ghana
Authors: Mabe Franklin Nantui , Dafurika Thomas
Published: December 2020

Background Malaria has been one of the commonest diseases during farming season, which affects farmers’ health resulting in a reduction in the number of days spent on the farm. As a result, farmers are regularly trying to avert malaria infection through preventive measures. Motivated by this argument, this study sought to determine the effects of malaria averting expenditure on labour productivity of maize farmers in Bunkpurugu-Nakpanduri District in the Northern Region of Ghana. Methods A cross-sectional primary data was collected from 194 maize farmers. Both descriptive and quantitative data analysis approaches were employed. Conditional Mixed Process was used to estimate the effects of malaria prevention expenditure on maize farmers’ labour productivity. Results The study revealed that maize farmers incurred an average expenditure of GHc284.6 to prevent malaria annually. The result shows that factors that affect maize farmers’ malaria prevention expenditure include off-farm income, household size, presence of bushes around houses, presence of pregnant women and number of household members in school. Meanwhile, quantity of fertilizer, seed, weedicides, farming experience, age, ownership of motorbike and averting expenditure are significant determinants of maize labour productivity. The study revealed that farmers who spend more money to avert malaria attack are more labour productive. Conclusions Therefore, this study recommends that Ministry of Health and Ministry of Food and Agriculture should collaborate and integrate health extension service on malaria in agricultural extension to educate farmers on the need to avert malaria. Farmers should be educated on malaria preventive strategies, such as clearing of bushes around houses, draining of stagnant water, sleeping in treated mosquito nets among others. Lastly, aside distribution of free mosquito nets to pregnant women, they should be subsidized and made available to all farmers for malaria prevention.
Drug resistance markers within an evolving efficacy of anti-malarial drugs in Cameroon: a systematic review and meta-analysis protocol
Authors: Niba Peter Thelma Ngwa , Nji Akindeh M. , Evehe Marie-Solange , Ali Innocent M. , Netongo Palmer Masumbe , Ngwafor Randolph , Moyeh Marcel N. , Ngum Lesley Ngum , Ndum Oliva Ebie , Acho Fon Abongwa , Mbu'u Cyrille Mbanwi , Fosah Dorothy A. , Atogho-Tiedeu Barbara , Achonduh-Atijegbe Olivia , Djokam-Dadjeu Rosine , Chedjou Jean Paul Kengne , Bigoga Jude D. , Moukoko Carole Else Eboumbou , Ajua Anthony , Achidi Eric , Tallah Esther , Leke Rose G. F. , Tourgordi Alexis , Ringwald Pascal , Alifrangis Michael , Mbacham Wilfred F.
Published: December 2020

Background: Cameroon remains a country faced with high malaria burden despite enormous efforts made in the control of the disease. The rapid development and dispersal of mutations associated with anti-malarial drug resistance influenced policy changes from the use of chloroquine, amodiaquine and sulphadoxine-pyrimethamine to the adoption of artemisinin-based combination therapies (ACTs) for the treatment of uncomplicated falciparum malaria. However, the impact of drug policy changes on the evolution of molecular markers of Plasmodium falciparum resistance in Cameroon has not been completely understood. Hence, this systematic review and meta-analysis aims to determine the prevalence and distribution of P. falciparum drug resistance markers within an evolving efficacy of anti-malarial drugs in Cameroon from 1998 to present.Methods: The PRISMA, PRISMA-P and STREGA statements will be adopted in the quality assessments of studies to be included in this review. The electronic databases of Medline via Pubmed, EMBASE, Google Scholar and Science Direct will be searched by two independent researchers using different MeSH terms and Boolean operators (AND, OR). More so, unpublished data that will be sourced from academic libraries will also be extracted. Quantitative syntheses will be done using the “metaphor” and “meta” commands in the R statistical software package version 3.5.2. Heterogeneity will be assessed using the Cochran’s Q and I2 statistics. The random effects model will be used as standard in the determination of heterogeneity between studies. Discussion: The primary outcome of this review is to identify and describe molecular markers conferring drug resistance in Plasmodium falciparum parasites that have been circulating for a period of over 20 years in Cameroon. This review will be able to pool data from previously published and unpublished studies on anti-malarial drug resistance gene mutations. This will provide evidence to support the continuous use of ACTs in the treatment of uncomplicated P. falciparum malaria. Furthermore, data generated from the study will be used as baseline information for the design and adoption of a robust anti-malarial drug resistance surveillance system nationwide which is inexistent. Systematic review registration: PROSPERO CRD42020162620
Adaptive Immune Responses Mediated Age-related Plasmodium yoelii 17XL and 17XNL Infections in 4 and 8-week-old BALB/c Mice
Authors: Wang Qiu-bo , Du Yun-ting , Liu Fei , Sun Xiao-dan , Sun Xun , Chen Guang , Pang Wei , Cao Yaming
Published: December 2020

Backgroud: It is important to expound the opposite clinical outcomes between children and adulthood for eradicate malaria. There remains unknown about the correlation between adaptive immune response and age-related in malaria.. Methods: 4 and 8-week-old mice were used to mimic children and adulthood, respectively. Parasitemia and the survival rate were monitored. The proportion and function of Th1 and Th2 cells were detected by FACS. The levels of IFN-γ, IL-4, total IgG, IgG1, IgG2a and Plasmodium yoelii MSP-1-specific IgG were measured by ELISA. Results: The adult group showed greater resistance to P. yoelii 17XL infection, with lower parasitemia. Compared with 4-week-old mice, the percentage of CD4+T-bet+IFN-γ+ Th1 cells as well as IFN-γ production were significantly increased on day 5 p.i. in the 8-week-old mice after P. yoelii 17XNL infection. The percentage of CD4+GATA3+IL-4+ Th2 cells and CD4+CXCR5+ Tfh cells, and IL-4 production in the 8-week-old mice significantly increased on day 5 and day 10 after P. yoelii 17XNL infection. Notably, the levels of total IgG, IgG1, IgG2a and P. yoelii MSP-1-specific IgG were also significantly increased in the 8-week-old mice. PD-1, a marker of exhaustion, was up-regulated on CD4+ or activated CD4+ T cells in the 8-week-old mice as compared to the 4-week-old group. Conclusions: Thus, we consider that enhanced cellular and humoral adaptive immunity might contribute to rapid clearance of malaria among adults, likely in a PD-1-dependent manner due to induction of CD4+ T cells exhaustion in P. yoelii 17XNL infected 8-week-old mice.
Impact of Doxycycline on COVID-19 Patients with Risk Factors: DYNAMIC, a Multi-Centre, Randomised, Placebo-Controlled, Double-Blind Trial
Authors: Poinas Alexandra , Boutoille David , Vrignaud Florence , Nguyen Jean-Michel , Bonnet Fabrice , Rat Cédric , Garcia Gilles , Dompmartin Anne , Leccia Marie-Thérèse , Piroth Lionel , Maubec Eve , Gandon Pierre , Jobert Alexandra , Boinet Soizic , Cassecuel Julie , Flet Laurent , Khammari Amir , Dréno Brigitte
Published: December 2020

Background: The DYNAMIC study is based on three properties of tetracyclines. (1) Tetracyclines are known to chelate zinc from matrix metalloproteinases. It is possible their chelating activity may help inhibit COVID-19 infection by limiting its ability to replicate in the host. (2) As seen with dengue virus, tetracyclines may also be able to inhibit the replication of positive polarity single-stranded RNA viruses, such as COVID-19. (3) Tetracyclines are also modulators of innate immunity (anti-inflammatory activity), a property that has been used to treat inflammatory skin diseases for many years. They could therefore participate in limiting the cytokine storm induced by COVID-19. Moreover, the lipophilic nature of tetracyclines and their strong pulmonary penetration could allow them to inhibit viral replication at this level. Among the tetracyclines, doxycycline has three advantages: its long safety history (side effects are uncommon with no notable risks), its short treatment duration and its low cost.Methods: The trial will involve 330 patients who are positive for SARS-CoV-2 infection and have one or more risk factors for worsening the disease. These patients will be included in six hospitals covering the whole of France. For 14 days they will be given either 200mg of doxycycline a day or a placebo. Our hypothesis is a considerable reduction in the number of patients hospitalised due to COVID-19 thanks to the treatment of doxycycline.Discussion: This study could have an impact on general practitioners’ management of COVID-19 patients with risk factors prior to hospital admission. If kept at home under experimental treatment, these patients would help reduce the risk of spreading SARS-CoV-2 among the population. This treatment would therefore contribute to supporting the deconfinement strategy by blocking the viral infection early and reducing the infectious period.Trial Registration: On ClinicalTrials.gov, registration number NCT04371952, first published on 30 April 2020.
Climate change causes changes in biochemical markers of renal disease
Authors: Ephraim Richard Kobina Dadzie , Asamoah Christopher Amey , ABAKA-YAWSON ALBERT , Kwadzokpui Precious Kwablah , Adusei Samuel
Published: December 2020

Background: Climate change is a significant threat to the health of the Ghanaian people. Evidence abounds in Ghana that temperatures in all the ecological zones are rising, whereas rainfall levels have been generally reducing and patterns are increasingly becoming erratic. The study estimated the impact of climate variation between seasons on biochemical markers of renal disease.Methods: This study conveniently recruited 50 apparently healthy peasant farmers and hawkers at Wa in the Upper West Region of Ghana. A pre-study screening for hepatitis A and C, Diabetes mellitus, hypertension was done. Serum creatinine and urea levels were analyzed to rule out kidney preexisting renal disease . Baseline data was collected by estimating urea, creatinine, sodium, potassium, eGFR (estimated glomerular filtration rate) as well as for hemoglobin (Hb) and hematocrit (Hct) concentrations. Anthropometric data such as height, weight and blood pressure were measured by trained personnel. The study participants were closely followed and alerted deep in the dry season for the second sampling (urea, creatinine, hemoglobin, hematocrit, blood pressure, anthropometry)Results: This study recruited more males (58.82%) than females (41.15%), majority (52.92%) of which were aged 25-29 years with the youngest being 22 years and the eldest being 35 years. The study found body mass index (p<0.001), systolic blood pressure (p=0.019), creatinine (p<0.001), urea (p=0.013) and eGFR (p<0.001) to be significantly influenced by climate change. Stage 1 hypertension was predominant among the study participants during the dry season, 8 (15.69%) than was observed during the rainy season, 4 (7.84%) nonetheless the number of participants with normal BMI rose from 49.02% in the rainy season to 62.75% during the dry reason. Additionally, the study observed that the impact of climate change on systolic blood pressure and urea varied based on age and sex. Conclusion: This study revealed that climatic changes cause variations in various biochemical parameters used to assess renal function. Public health education on climatic changes and its implication including precautionary measures should be done among inhabitants of Wa and its environs to reduce its effect. Additionally, appropriate dietary patterns should also be advised to avoid the development of non-communicable diseases such as hypertension and obesity that are known principal causes of Chronic Kidney Disease (CKD).
Low post-arthroplasty Infection rate is possible in developing countries Long-term Experience of local Vancomycin use from a high-volume tertiary Knee center in Iran
Authors: Tahmasebi Mohammad Naghi , Vaziri Arash Sharafat , Vosoughi Fardis , Tahami Mohamad , Khalilizad Majid , Rabie Hamid
Published: December 2020

Background: Utilizing intrawound vancomycin powder in TKA surgery has yielded rather contrasting results in the current literature. Furthermore, CDC criteria, although effective in general, are not specifically designed for post-TKA infections. Here, we present a 7-year experience of vancomycin use in primary TKA in a high-volume tertiary knee center in Iran. Also, new criteria are proposed to detect suspected superficial post-TKA infections. Methods: This is a retrospective analysis of primary total knee arthroplasties performed in a tertiary knee center, from March 2007 to December 2018, by a single senior knee surgeon. All patients with follow-up periods of less than one year were excluded from the study. Since March 2011, all patient received vancomycin (powder, 1gr) before water-tight closure of the joint capsule. Comparison was made between this group and historical control subjects (operated from March 2007 to March 2011). Results: Altogether, 2024 patients were included in the study. The vancomycin and the control group included 1710 and 314 cases respectively. Patients were mostly women (male to female ratio: 1 to 4), with a mean age of 65.20 (SD=10.83) years. In the vancomycin group, the rate of suspected SII (1.87%) and PJI (0.41%) was significantly lower than the control group (P= 0.002). Conclusions: Our experience shows that by utilizing intrawound vancomycin as a routine practice along with other measures, we were able to reach relatively low rates of deep post-TKA infections. Howbeit, randomized controlled trials are required to clarify the effect of intrawound vancomycin on post-TKA infection rate.
Infectious endocarditis: Improving diagnostic performance in native and prosthetic valve infection with 18F-FDG PET/CT
Authors: Marinho Ana Vera , Almeida José Paulo , Soeiro Paula , Silva Rodolfo , Gonçalves Francisco , Costa Gracinda , Gonçalves Lino , Ferreira Maria João
Published: December 2020

Background: ﻿The diagnosis of infective endocarditis (IE) remains a clinical challenge. Diagnostic accuracy of the modified Duke criteria is suboptimal for native valve endocarditis (NVE) and even worse in the presence of prosthetic material-related infection (PVE). We aim to evaluate the diagnostic performance of 18F-FDG PET in patients with suspected IE referred to perform PET/CT.Methods: Consecutive patients with suspected IE, referred to perform PET/CT between May 2016 and June 2019 were included. Diagnostic performance of modified Duke criteria (mDC) and PET/ CT for IE for NVE and PVE was determined.Results: In total, 82 patients (mean age of 61 ± 19 years, 62% of male gender) were enrolled. There were 67 18F-FDG PET/CT concordant results with final diagnosis, corresponding to a 96% of agreement, k=0.91(p=0.04). A SUV max cutoff value of ≥3.1 identified positive cases with 88.9% sensitivity and 70.0% specificity. In patients with NVE, the addition of PET/CT to the mDC resulted in a reduction of the number of possible IE cases (from 58% to 4.3%). In patients with PVE/intracardiac devices, PET/CT allowed reclassification of 67.4% of possible cases to 4.2%. An alternative diagnosis was provided in 55.6% of the negative IE cases.Conclusions: 18F-FDG PET/CT proved to be a useful diagnostic tool in patients with both suspected NVE and PVE with good sensitivity and specificity, resulting in a significant decrease of the number of possible endocarditis. Furthermore, it allowed the identification of the cause of clinical scenario in more than 50% of patients in which the diagnosis was excluded.
The burden of the current curative expenditure of injury in Dalian, China:based on “System of Health Accounts 2011”
Authors: Sun Shu , Yang Liuna , Hu Xinzhu , Zhu Yalan , Liu Boxi , Yang Yunbin , Wang Xin
Published: December 2020

Background: Injury is one of the major public health problems and causes more than 5 million deaths in the world annually. Cases of specific types of injury are life-threatening and heavily-burdened to individuals and society. This study was aimed to assess the financial burden of injury on patients. Methods: A total of 565 medical institutions were selected with multistage stratified cluster random sampling, containing 152553 valid samples. Subsequently, the distribution of injury current curative expenditure (CCE) in different dimensions (including age and site of injury) was analyzed under the framework of System of Health Accounts 2011 (SHA 2011) using the established database. Results: In China, both urban and rural injury mortality rates showed an upward trend of more than 5 percentage points from 2006 to 2016. In Dalian, the CCE of injury reached 1572.73 million RMB, accounting for 7.45% of the total CCE. Those aged 15-24 reported larger proportion of CCE than the other age groups. As for the injuries in body parts, injuries occurred to the spine, lower limb, head and foreign body cost most.Conclusions: Dalian has a relatively serious burden of injury costs. The essential and primary goal is to reduce the cost. Young people should pay attention to protect their head and limbs from injury, and related government sectors should implement preventive and educative measures.
Psychosocial beliefs related to intention to use HIV testing and counselling services among Suspected Tuberculosis patients in Kassala State, Sudan
Authors: Idris Almutaz Mohamed , Crutzen Rik , Borne H.W. Van den
Published: December 2020

Background: There is limited information about the psychosocial sub-determinants regarding the use of HIV Testing and Counselling (HTC) services among suspected Tuberculosis (TB) patients in Sudan. This study aimed to assess the association between psychosocial beliefs and the intention to use HTC services and to establish the relevance of these beliefs for developing behaviour change interventions among suspected TB patients Methods:Suspected TB patients (N= 383) from four separate TB facilities completed a cross-sectional questionnaire which was based on the Reasoned Action Approach theory. Eligibility criteria included attending Tuberculosis Management Units in Kassala State as suspected TB patients and aged 18-64 years. A Confidence Interval Based Estimation of Relevance (CIBER) analysis approach was employed to investigate the association of the beliefs with the intention to use HTC services and to establish their relevance to be targeted in behaviour change interventions.Results: The CIBER results showed the beliefs included in the study accounted for 59% to 70% of the variance in intention to use HTC services. The belief "My friends think I have to use HTC services" was positively associated with the intent to use HTC, and it is highly relevant for intervention development. The belief “I would fear to be stigmatized if I get a HIV positive result" was negatively related to the intention to use HTC services and was considered a highly relevant belief. The belief “If I use HTC services, health care providers will keep my HIV test result confidential" was strongly associated with the intention to use HTC services. However, the relevance of this belief as a target for future interventions development was relatively low. Past experience with HTC services was weakly associated with the intention to use HTC services.Conclusion: The intention to use HTC was a function of psychosocial beliefs. The beliefs investigated varied in their relevance for interventions designed to encourage the use of HTC services. Interventions to promote intention to use HIV testing and counselling services should address the most relevant beliefs (sub-determinants). Further study is needed to establish the relevance of sub-determinants of the intention to use HTC services for interventions development.
Efficacy of dulaglutide on vascular health indexes in subjects with type 2 diabetes: A randomized trial.
Authors: Tuttolomondo Antonino , Cirrincione Anna , Casuccio Alessandra , Cuore Alessandro Del , Daidone Mario , Chiara Tiziana Di , Raimondo Domenico Di , Corte Vittoriano Della , Maida Carlo , Simonetta Irene , Scaglione Stefania , Pinto Antonio
Published: December 2020

Background: Recent cardiovascular outcome trials have shown significant reductions in major cardiovascular (CV) events with glucagon-like peptide (GLP)-1 receptor agonists. Additionally, adjunctive surrogates for cardiovascular risk validated by some studies include arterial stiffness and endothelial function indexes. To date, no randomized trial has addressed the possible effects of antidiabetic interventional drugs such as GLP1 agonists on endothelial and arterial stiffness indexes as surrogate markers of vascular damage. Aims: We aimed to evaluate metabolic efficacy and surrogate vascular efficacy endpoints of once-weekly dulaglutide (1.5 mg) plus traditiona antidiabetic treatment compared with traditional antidiabetic treatment alone in subjects with type 2 diabetes. Methods: Men and women (aged ≥50 years) with established or newly detected type 2 diabetes whose HbA1c level was 9.5% or less on stable doses of up to two oral glucose­lowering drugs with or without basal insulin therapy were eligible for randomization. Subcutaneous dulaglutide was initiated at the full dose (1.5 mg/day weekly). Arterial stiffness (PWV: pulse wave velocity and augmentation index) and endothelial function (RHI: reactive hyperaemia index) were evaluated at baseline and at three-month and nine-month examination visits. At each visit (at 3 and 9 months), the subjects were also evaluated for glycaemic variables such as fasting plasma glucose (FPG) and HbA1c and lipid variables such as total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride levels. Results: At the three-month follow-up, the subjects treated with dulaglutide showed significantly lower serum levels of FPG and HbA1c than control subjects treated with conventional therapy. At the 9-month follow-up, subjects treated with dulaglutide showed significant lower values of the mean diastolic blood pressure, BMI, total serum cholesterol, LDL cholesterol, FPG, HbA1c and PWV and higher mean RHI values than control subjects treated with conventional therapy . Conclusions: Our randomized trial showed that subjects with type 2 diabetes treated with conventional therapy plus 1.5 mg/day of subcutaneous dulaglutide compared with subjects treated with conventional therapy alone showed favourable metabolic effects associated with positive effects on vascular health markers such as arterial stiffness and endothelial function markers. These findings are consistent with previous study findings indicating the strict relationship between cardiovascular risk factors such as systolic blood pressure, total serum cholesterol and LDL levels and cardiovascular events and vascular health surrogate markers.
Exosomes derived from miR-301a-3p-overexpressed adipose-derived mesenchymal stem cells reverse hypoxia-induced erectile dysfunction in rat models
Authors: Liang Li , Zheng Dachao , Lu Chao , Xi Qinghong , Bao Hua , Li Wengfeng , Gu Yufei , Mao Yuanshen , Xu Bin , Gu Xin
Published: December 2020

Background: Erectile dysfunction (ED) has often been observed in patients with obstructive sleep apnea (OSA). Research on adipose-derived mesenchymal stem cells (ADSCs)-derived exosomes has shown that they have significant therapeutic effects in many diseases including ED. Methods: In this study, ED was induced in Sprague Dawley (SD) rats using chronic intermittent hypoxia (CIH) exposure. CIH-mediated influences were then measured in the corpus cavernous smooth muscle cells (CCSMCs). Results: Our data showed that miR-301a-3p-enriched exosomes treatment significantly recovered erectile function in rats and CCSMCs by promoting autophagy and inhibiting apoptosis. The treatment also significantly recovered the level of alpha Smooth Muscle Actin (α-SMA) in rats and CCSMCs. Bioinformatics predicted that Phosphatase and tensin homolog (PTEN) and Toll-like receptor 4 (TLR4) might be targets of miR-301a-3p. Conclusions: Our results indicate that PTEN-overexpression vectors or TLR4-overexpression vectors reverse the therapeutic effects achieved by miR-301a-3p in CCSMCs indicating that PTEN/HIF-1α and TLR4 signaling pathways play key roles in the progression of ED. The findings in this study suggest that miR-301a-3p should be considered as a new therapeutic target for treating ED associated with OSA.
Surgical outcomes of the thoracic ossification of ligamentum flavum: A retrospective analysis of 61 cases
Authors: Yamada Tsuyoshi , Shindo Shigeo , Yoshii Toshitaka , Ushio Shuta , Kusano Kazuo , Miyake Norihiko , Arai Yoshiyasu , Otani Kazuyuki , Okawa Atsushi , Nakai Osamu
Published: December 2020

Background: Thoracic ossification of ligamentum flavum (T-OLF), as one of the causes of thoracic myelopathy, is often combined with other spinal disorders. Concurrent lumbar spinal canal stenosis (LCS) is often obscured by symptoms due to T-OLF, leading to difficulty in identifying the origin of these neurological findings. It is common to be misdiagnosed or delayed diagnosis due to the complicated nature. We evaluated the prevalence, distribution, and clinical characteristics of OLF, especially in patients with LCS.Methods: The authors performed a retrospective analysis of the outcomes of 61 patients who underwent thoracic surgeries performed for symptomatic T-OLF. In all the patients, whole spine lesions were evaluated preoperatively. We examined the factors related to poor outcomes (the recovery rate of the Japanese Orthopedic Association score for thoracic myelopathy is less than 40%) following OLF surgeries. We compared the clinical outcomes according to whether there was concurrent LCS, and determined the optimal surgical approach.Results: The occurrence of T-OLF increased with age. Forty-six cases (75.4%) were considered to be tandem T-OLF and LCS (LCS group). An advanced age, and concurrent LCS were associated with a poor outcome after the surgery. The LCS group significantly included a greater number of elderly, and more light-weighted patients with Modic change in thoracic spine and a greater sagittal vertical axis, resulting in the lower neurological recovery. Additional lumbar surgery (13cases) effectively improved both the T-JOA and L-JOA scores (from 6.5 ± 2.0 points to 8.0 ± 1.8 points, p=0.0406, and from 14.5 ± 4.7 points to 20.7 ± 2.6 points, p=0.001, respectively) in OLF patients with LCS.Conclusions: T-OLF was highly associated with other spinal disorders. Poor outcomes in T-OLF surgery could be associated with age and concurrent LCS, and an additional surgery for another lumbar lesion significantly improved neurological findings in T-OLF patients.
Factors influencing Adolescent Girls and Young Women's participation in a Combination HIV Prevention Intervention in South Africa
Authors: Appollis Tracy McClinton , Duby Zoe , Jonas Kim , Dietrich Janan , Maruping Kealeboga , Abdullah Fareed , Slingers Nevilene , Mathews Catherine
Published: December 2020

Background: For interventions to reach those they are intended for, an understanding of the factors that influence their participation, as well as the facilitators and barriers of participation are needed. This study explores factors associated with participation in a combination HIV prevention intervention targeting adolescent girls and young women (AGYW) aged 15-24-years-old, as well as the experiences of AGYW, intervention implementers, and facilitators in this intervention. Methods: This study used mixed-methods approach with quantitative household survey data from 4399 AGYW aged 15-24-years-old in six of the ten districts in which the intervention was implemented. In addition, qualitative methods included semi-structured in-depth interviews and focus group discussions in five of the ten intervention districts with 185 AGYW who participated in one or more of the key components of the intervention, and 13 intervention implementers and 13 facilitators. Results: Findings reveal that almost half of AGYW (48.4%) living in the districts where the intervention took place, participated in at least one of the components of the intervention. For both 15-19-year-olds and 20-24-year-olds, factors associated with increased participation in the intervention included being HIV negative, in school, never been pregnant, and having had a boyfriend. Experiencing intimate partner violence (IPV) and/or sexual violence in the past 12 months was associated with increased levels of participation in the intervention for 20-24-year-olds only. In our analysis of the qualitative data, facilitators to participation included motivating participants to join the interventions through explaining the benefits of the programme. Barriers included misguided expectations about financial rewards or job opportunities; competing responsibilities, interests or activities; family responsibilities including childcare; inappropriate incentives; inability to disrupt the school curriculum and difficulties with conducting interventions after school hours due to safety concerns; miscommunication about meetings; as well as struggles to reach out-of-school AGYW. Conclusion: Designers of combination HIV prevention interventions need to address the structural barriers to participation so that AGYW can attend without risking their safety and compromising their family, childcare and schooling responsibilities. Strategies to create demand need to include clear communication about the nature and potential benefits of such interventions, and the inclusion of valued incentives.
Sleep and Its Relation to Health-Related Quality of Life in 3–10-year-old Children
Authors: Sundell Anna Lena , Angelhoff Charlotte
Published: December 2020

Background: Considering the reports of increasing sleep problems in children, affecting health and well-being in young children and their families, we found it important to gain more knowledge about sleep and its correlation to health-related quality of life (HRQoL) in young, healthy children. The aims with this study were to describe sleep quality, sleep duration, and HRQoL in healthy 3–10-year-old children and to test associations between children’s sleep and HRQoL. Methods: Parents of 160 children (average age: 6.9 years, SD ±2.2) participated in the study. Sleep onset problems (SOP), sleep maintenance problems (SMP), and sleep duration were measured by the Pediatric Insomnia Severity Index (PISI). KIDSCREEN-27 was used to measure HRQoL in five dimensions: physical well-being, psychological well-being, autonomy and parent relation, social support and peers, and school environment. Results: The average score was 2.2 for SOP (SD +/-2.2) and 1.3 for SMP (SD +/-1.6). Few children (2%) were reported to sleep less than eight hours per night. Younger children had statistically significant higher SOP and SMP than older children. Correlations were found between SOP and poor psychological well-being (p < 0.05, ρ = - 0.16), and between SMP and poor physical wellbeing (p < 0.05, ρ = -0.16), psychological well-being (p < 0.05, ρ = - 0.21), poor school environment (p < 0.01, ρ = - 0.29), autonomy and parent relation (p < 0.05, ρ = - 0.16), and poor social support and peers (p < 0.05, ρ = - 0.19).Conclusion: Children’s sleep associates with health-related quality of life and needs to be acknowledged in child health care settings and schools.
Photoelectronic Properties of End-bonded InAsSb Nanowire Array Detector under Weak Light
Authors: Yao Xiaomei , Zhang Xutao , Kang Tingting , Song Zhiyong , Sun Qiang , Wei Dongdong , Zou Jin , Chen Pingping
Published: December 2020

A simple fabrication of end-bonded contacts InAsSb NW (nanowire) array detector to weak light is demonstrated in this study. The detector is fabricated using InAsSb NW array grown by molecular beam epitaxy on GaAs substrate. The MIGS (metal-induced gap states) is induced by the end-bonded contact which suppresses the dark current at various temperatures. The existence of the interface dipole due to the interfacial gap states enhances the light excitation around the local field, thus upgrade the photo responsivity and photo detectivity to the weak light. The light intensity of the infrared light source in this report is 14 nW/cm2 which is about 3 to 4 orders of magnitude less than the laser source. The responsivity of the detector has reached 28.57 A/W at room temperature with the light (945 nm) radiation, while the detectivity is 4.81×1011 cm·Hz1/2 W−1. Anomalous temperature-dependent performance emerges at the variable temperature experiments, and we discussed the detailed mechanism behind the non-linear relationship between the photoresponse of the device and temperatures. Besides, the optoelectronic characteristics of the detector clarified that the light trapping effect and photogating effect of the NWs can enhance the photoresponse to the weak light across ultraviolet to near-infrared. These results highlight the feasibility of the InAsSb NW array detector to the infrared weak light without a cooling system.
Opportunities of ultrasound diagnostics of lung injury in SARS-CoV-2 infection (COVID-19): a clinical case
Authors: Neklyudova G. V. , Chernyak А. V. , Tsareva N. А. , Аvdeev S. N.
Published: December 2020

The article describes a clinical case demonstrating the results of the lungs ultrasound examination in the COVID-19 patient during the acute period of the disease and early recovery period.
Correlation between bronchopulmonary diseases and vitamin D level
Authors: Velikaya O. V. , Vasilieva L. V. , Nedomolkina S. А. , Nedomolkin S. V.
Published: December 2020

The review presents data from 56 publications about functions of vitamin D in the human body, the mechanisms of its action and the relationship between lung diseases and the level of vitamin D in the blood. Low serum vitamin D levels are associated with impaired lung function and an increase in inflammatory, infectious, or neoplastic diseases. The results of numerous studies allow considering vitamin D not only a marker of different courses of bronchopulmonary diseases but also as a therapeutic target in the treatment of patients with chronic obstructive pulmonary disease while maintaining the immune system and anti-infectious protection.
Examining Influence of Religiosity on Ethical Attitude Towards Business: Evidence from India and China
Authors: Goel Puneeta , Misra Rupali , Dhanalakshmi A.
Published: December 2020

The primary purpose of the paper is to examine how religiosity influences ethical attitude towards business and to compare and contrast this relationship for two populous Asian countries: India and China. The socio-cultural setting of both the countries resonates strongly weaved religious values and traditional ideology, though with a disparate political system. Using Attitude towards Business Ethics Questionnaire (ATBEQ) and 10-item Religious Commitment Inventory (RCI-10), data from 231, i.e., n(India)=122 and n(China)=109, respondents is collected, and research variables are compared based on gender and country of origin. Men demonstrate a higher ethical attitude towards business, higher religiosity, and higher score on ethical business philosophies than their women counterparts. Additionally, Indians score significantly higher than the Chinese on the three constructs. The results of regression analysis demonstrate that religiosity influences ethical attitude towards business for men, women, and Indians only. The relationship is not supported for China. The study further deconstructs religiosity into two subscales: intra (inner interpretive understanding) and inter (outer demonstrative action) religiosity to examine their influence on ethical attitude towards business. Individuals with higher intrareligiosity have a higher ethical attitude while no such relationship is evidenced for interreligiosity. Even further, items of ATBEQ are mapped to represent four ethical business philosophies and their differences compared on the basis of sub-constructs of religiosity. Variations in ethical business philosophies are shown by intra-religiosity only. Essentially, it is not about preaching religion, it is about practicing a religion that really matters. Freedom to practice religion, religion-based teaching, and ethical values embedded into business practices could help shape new virtue ethics as an inspiring point of reference and guidance for business leaders.
Linking Cooperative Psychological Climate, Harmonious Passion, and Servicing Empowerment with Innovative Work Behaviour
Authors: Jan Ghulam , Zainal Siti Rohaida Mohamed
Published: December 2020

Innovative work behaviour (IWB) forms an essential basis for obtaining competitive advantage and long-term success for the hospitality firms. Nonetheless, empirical research on this potential behaviour has received limited attention in hospitality research. Drawing from self-determination theory (SDT), this study tests a conceptual model that examines the mediating role of harmonious passion between cooperative psychological climate and IWB within the hospitality industry. This study also recognises the importance of servicing empowerment as the boundary condition between harmonious passion and IWB. We further developed a moderated mediation model to test the above said relationships. A total of 257 employees who worked in the four- and five-star hotels in Pakistan participated in the study. Partial least structural equation modelling (PLS-SEM) was used to analyse the data. Results reported significant mediating effect of harmonious passion between cooperative psychological climate and IWB. The relationship between harmonious passion and IWB was strengthened to the extent that servicing empowerment in the hotel firms was high. Furthermore, the indirect effect of cooperative psychological climate on IWB (via harmonious passion) was stronger when the servicing empowerment was high. Practitioners looking to enhance harmonious passion and IWB can do so by creating a cooperative climate in their hotel firms. This study carries value as research on harmonious passion in the organisational context is still unexplored and this study extends the scope of cooperative psychological climate research that this factor has the potential to foster employees’ harmonious passion leading them display IWB.