bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiology and Pathology of Oral Squamous Cell Carcinoma in a Multi-ethnic Population: Analysis of 154 cases over 12 years in Qatar
Authors: Elaiwy Orwa , Ansari Walid El , Al-Khalil Moustafa , Ammar Adham
Published: August 2020

Background: Oral cancer (OC) is a neoplastic process of the oral cavity that has high mortality and significant effects on patients’ aesthetics. Majority of OC is oral squamous cell carcinoma (OSCC) and resection remains the most frequent therapy. Recurrence is the main cause of tumor-related mortality.Material and methods: A retrospective review of patients’ charts in Hamad Medical Corporation studied of 154 adults who were diagnosed as OSCC in between 2006- 2018 . The data extracted was demographic, pathologic and clinical. All patients with oral cavity tumors other than squamous cell carcinoma were excluded.Results: Males comprised the majority of the sample, mean age was 46.93 years. Tongue was the most common location. Majority of the patients were diagnosed at early stages and a small subset of patients had histologically-proven local recurrence.Conclusion: Demographics of OSCC patients in Qatar revealed an unprecedented male predominance with a significant younger portion. Most patients were non-nationals, mainly from South Asia. No significant association was found between age groups and local recurrence against multiple parameters. Improving of follow-up system is suggested.Conclusion: The young male predominance of OSCC patients in Qatar is unprecedented worldwide. Most patients were non-Qataris, mainly from South Asia. Loss of follow-up was a challenge in assessing the long term outcomes of OSCC. Our findings suggest the need for a more vigilant surveillance approach to oral lesions particularly in male South-Asian patients, as well as improving the follow-up strategies.
Determinants of Female Genital Mutilation/Cutting in Khartoum State - Sudan, 2020: A Cross-Sectional Study
Authors: Elnimeiri Mustafa Khidir Mustafa , Abdelbasit Reem Mahmoud Mohamed , Ibrahim Mohanad Kamaleldin Mahmoud , Mingaryous Dimetry Adel Dimetry , Abdelrahim Taqwa Mohieldeen Hamid , Satti Shahenaz Seifaldeen Mustafa
Published: August 2020

Background: Female genital cutting/mutilation (FGC/M) is deeply rooted and widely practiced in Sudan. Although the trend is slowly decreasing, the magnitude is still very high as the procedure has no known benefit but has many consequences. The aim of this study was to identify the causes and the risk factors associated with FGC/M among reproductive-age women in the country.Methods: A community based cross-sectional survey was conducted among 902 women in the reproductive age (15-49) years in Khartoum State-Sudan, sampled proportionate to size using multistage clustering and participants were drawn using systematic probability sampling technique. Data were collected using a standardized administered questionnaire. Statistical analysis was done using bivariate and multivariate logistic regression. Results: Among 902 women who participated in the study, 89% of were married and 48% of them got married for the first time at age less than 20 years. The commonest age for such practice was 6-7 years as stated by about 48% of them. There is a significant association between educational level of participants and practicing FGC/M among their daughters (P value=.0001) with a tendency of the participants who attained a higher educational levels to less subject their daughters to any form of FGC/M. There is a significant association between the type of FGC/M of participants and the type of FGC/M of their daughters (P value=.001) with a tendency of the participants’ daughters to be subjected to clitorectomy rather than pharaonic. 39% of the participants stated that they themselves influenced the decision to subject their daughters to FGC/M while 32% of them stated that the grandmothers influence such a decision. The study revealed 45% of the participants believed in customs and traditions as the main reason for the conduct of FGC/M.Conclusion: The FGC/M was widely practiced by the participants’ families indicating the deeply rooted practice as a social norm. Parental education is inversely associated with practicing FGC/M to their daughters. The socio-cultural reason was the main cause of practicing FGC/M among participants. Therefore, a significant change in factors such as education, and social development might cause a gradual decline in FGC/M.
Estimation of the degree of gastric mucosal atrophy based on serum pepsinogen levels after eradication of Helicobacter pylori
Authors: Suzuki Takahiro , Higuchi Tomohiro , Kagami Takuma , Yamade Mihoko , Tani Shinya , Hamaya Yasushi , Iwaizumi Moriya , Osawa Satoshi , Sugimoto Ken , Miyajima Hiroaki , Furuta Takahisa
Published: August 2020

Background

Serum pepsinogen (PG) levels correlate with the degree of gastric mucosal inflammation and atrophy, which correlate with gastric cancer risk, in patients infected with Helicobacter pylori (H. pylori). Serum PG levels change after eradication of H. pylori, but it is not known if there are corresponding changes in the gastric mucosa. We examined whether the degree of gastric atrophy correlated with PG levels measured after eradication of H. pylori.
Methods

We retrospectively examined the relationship between gastric atrophy and serum levels of PG I, PG II and PG I/II ratios measured after eradication of H. pylori. The degree of gastric mucosal atrophy before H. pylori eradication was scored (0, 1, 2) according to the Kyoto classification of gastritis.
Results

A total of 430 treated patients were enrolled. Serum levels of PG I (ρ = − 0.362 and P < 0.001), PG II (ρ = − 0.158 and P = 0.001) and PG I/II ratio (ρ = − 0.337 and P < 0.001) all correlated negatively with atrophy scores. When PG I/II was less than 3.4, 5.4 or 6.7, the probability of the open type of gastric atrophy was estimated to be 75%, 50%, or 25%, respectively.
Conclusion

Our results suggest that serum PG levels measured after H. pylori eradication can be used to estimate the degree of gastric mucosal atrophy and are useful for selecting individuals with a high risk of gastric cancer after H. pylori eradication.
Patterns and risk factors of cognitive decline among community-dwelling Korean older adults: The Korean Longitudinal Study of Aging (2006–2016)
Authors: Shin Jinhee , Cho Eunhee
Published: August 2020

Background

Dementia prevalence is increasing worldwide, and thus, the global impact of cognitive impairment and dementia has become a priority public health issue. This study aimed to assess the patterns of and risk factors for cognitive decline over time in community-dwelling Korean adults aged ≥ 65 years.
Methods

Older adults with normal cognitive function at baseline in 2006 were evaluated, and changes in their cognitive function were followed over time. The data were obtained from the 2006–2016 Korean Longitudinal Study of Aging. Cognitive function in 2016 was classified based on the Korean-Mini-Mental State Examination score as normal, mild dementia, and moderate and severe dementia. The t-test, ANOVA, and linear mixed models were used to analyse the patterns and risk factors f cognitive decline over time.
Results

Of the 1,262 participants examined, 752 maintained normal cognitive function, 267 older adults showed a change from normal cognitive function to mild dementia, and 243 older adults showed a decline from normal cognitive function to moderate and severe dementia between 2006 and 2016. There were significant differences in cognitive function over time among the three groups, and these were influenced by age, gender, education level, religion, activities of daily living, instrumental activities of daily living, regular exercise, number of meetings with friends, and depression. The differences have gradually increased over 10 years.
Conclusions

This study identified the patterns of cognitive decline over time and important factors related to cognitive decline. Individualised interventions such as improving physical function through regular exercise, increasing social activity, and managing depression by early detection and treatment may contribute to maintain cognitive function.
Learning to Predict in-hospital mortality risk in intensive care unit with attention-based Temporal convolution network
Authors: Chen Yu-wen , Li Yu-jie , Yang Zhi-yong , Zhong Kun-hua , Zhang Li-ge , Chen Yang , Zhi Hong-yu , Deng Peng , Wang Dan-dan , Gu Jian-teng , Ning Jiao-lin , Lu Kai-zhi , Zhang Ju , Xia Zheng-yuan , Yi Bin
Published: August 2020

Background: Dynamic prediction of patients’ mortality risk in ICU with time series data is limited due to the high dimensionality, uncertainty with sampling intervals, and other issues. New deep learning method, temporal convolution network (TCN), makes it possible to deal with complex clinical time series data in ICU. We aimed to develop and validate it to predict mortality risk using time series data from MIMIC III dataset. Methods: 21139 records of ICU stays were analyzed and in total 17 physiological variables from the MIMIC III dataset were used to predict mortality risk. Then we compared the model performances of attention-based TCN with traditional artificial intelligence (AI) method. Results: Area Under Receiver Operating Characteristic (AUCROC) and Area Under Precision-Recall curve (AUC-PR) of attention-based TCN for predicting the mortality risk 48h after ICU admission were 0.837(0.824 -0.850) and 0.454. The sensitivity and specificity of attention-based TCN were 67.1% and 82.6%, compared to the traditional AI method yield low sensitivity (<50%). Conclusions: Attention-based TCN model achieved better performance in prediction of mortality risk with time series data than traditional AI methods and conventional score-based models. Attention-based TCN mortality risk model has the potential for helping decision-making in critical patients.
Neutrophil-Lymphocyte Count Ratio Better Predict Prognosis than Conventional Markers in Critical Patients? A Multiple-Centered Retrospective Cohort Study
Authors: Zhou Tao , Zheng Nan , Li Xiang , Zhu Dongmei , HAN YI
Published: August 2020

Background: Neutrophil-lymphocyte count ratio (NLCR) has been reported as better indicator of bacteremia than procalcitonin (PCT), and better predictor of mortality than C-reactive protein (CRP) in various medical conditions. However, large controversy remains upon this topic. We compared the efficiency of NLCR with conventional inflammatory markers in predicting the prognosis of critical illness. Methods: We performed a multiple-centered retrospective cohort study consisting of 536 ICU patients with outcomes of survival, 28- and 7-day mortality. NLCR was compared with conventional inflammatory markers such as PCT, C-reactive protein (CRP), serum lactate (LAC), white blood cell, neutrophil and severity score APACHE II (Acute Physiology and Chronic Health Evaluation II) to evaluate the predictive value on outcomes of critical illness. Then receiver operating characteristics (ROC) curves were constructed to assess and compare each marker’s sensitivity and specificity respectively. Results: NLCR values were not differential among survival and mortality groups. Meanwhile remarkable differences were observed upon APACHE II score, CRP, PCT and LAC levels among survival and death groups. ROC analysis revealed that NLCR was not competent to predict prognosis of critical illness. The AUROCs of conventional markers such as CRP, PCT, LAC and APACHE II score were more significant in predicting 28- and 7-day mortality. Conclusions: NLCR is not competent and less reliable than conventional markers CRP, PCT, LAC and APACHE II score in assessing severity and in predicting outcomes of critical illness.
Association Between Meteorological Factors and Coronary Heart Disease in Northeast China
Authors: Huang Jinling , Zheng Liqiang , Zhu Jinghai
Published: August 2020

Background: To investigate the effect of daily meteorological factors in northeast China on coronary heart disease and explore in depth the impact of the environment on health. Methods: The population data primarily included daily coronary heart disease hospitalizations between January 1, 2015 and December 31, 2019, comprising a total of 25,461 patients. The meteorological data included daily temperature, barometric pressure, relative humidity, precipitation, and wind speed between January 1, 2015 and December 31, 2019. A multiple linear regression model was constructed for analyzing the relationship between meteorological factors and coronary heart disease.Results: After controlling for confounding factors, the mean monthly temperature negatively correlated with the monthly number of coronary heart disease hospitalizations, particularly in the warm season (Apr–Sep; β = –12.468, p < 0.05).Conclusions: In the warm season and during a mild weather, high temperature might be a protective factor against coronary heart disease.
Can the sedentary behavior of young male basketball and volleyball players impact the bone mass and bone geometry?
Authors: Etchebehere Mauricio , Bergamo Raiany Rosa , Carvalho Humberto Moreira , Moraes Anderson Marques de , Guerra-Junior Gil
Published: August 2020

Background: Sedentary behavior is considered a health risk independent of physical activity. We evaluated the relationship between sedentary behavior, bone mass, and bone geometry among young male basketball and volleyball players.Methods: Fifty-five athletes (basketball n=21; volleyball n=34) aged 14 to 17 years old were included. Body composition and bone mass were measured by dual-energy X-ray absorptiometry, comprising bone mineral density, bone mineral content at the lumbar spine (L1-L4), and femoral neck. Bone quality was evaluated by bone geometry considering the femur strength index, section modulus, cross-sectional moment of inertia, and cross-sectional area. Information on all foods and beverages were obtained by a nutritionist through a 24-hour food recall and a semi-quantitative food frequency questionnaire. The sedentary behavior was assessed using the Adolescent Sedentary Activity Questionnaire. A series of multilevel linear regression models were fitted to explore whether there was variation for players' body composition, bone parameters, diary nutrient intake and sedentary behavior by sport. All models were fitted using Bayesian methods.Results: Body composition and bone mass values were high for both basketball and volleyball players. However, there was no substantial variation between players by sport for body composition. Adjusting for age, there was no association of sedentary behavior on both bone mass and geometry among the athletes. Except for femoral strength index, age had a substantial moderate to large association with all bone mass and geometry indicators. Lastly, there was no substantial influence of sport (level-2 unit) on the estimates of the association between sedentary behavior and age with bone mass and geometry, as uncertainty estimates for group-level effects were high. Conclusions: In conclusion, there is no association between sedentary behaviour and bone mass and bone geometry, showing that accumulated training loads (15+ h/week) among young basketball and volleyball players are critical; they produce a positive stimulus on bone mass and bone geometry development.
Prevalence of sarcopenia and associations of sarcopenia components with physical function and health-related quality of life in Australian older adults performing exercise training
Authors: Akehurst Ewelina , Scott David , Rodriguez Juan Peña , Gonzalez Carol Alonso , Murphy Jasmaine , Dorgo Sandor , Hayes Alan
Published: August 2020

Background

Sarcopenia can be prevented and treated with exercise, particularly resistance training. Our aim was to explore the prevalence of sarcopenia and associations of its components with self-reported function and health-related quality of life (HRQoL) in older adults training at conventional or Helsinki University Research [HUR] gyms owned and operated by an aged care provider, Uniting AgeWell in Melbourne.
Methods

Eighty community-dwelling older adults (mean ± SD 76.5\(\pm\)6.5 years) already undergoing resistance training were assessed for muscle strength (hand grip strength and chair stands), appendicular lean mass, and physical performance (gait speed [GS], short physical performance battery [SPPB], timed up and go [TUG] and 400-metre walk [400mW]). Pearson correlations examined associations of sarcopenia components with self-reported function (via SARC-F) and HRQoL (via AQoL-4D) in which higher scores mean worse function and better quality, respectively.
Results

Sarcopenia prevalence ranged from 1.3–10.3% depending on the definition applied, with no significant differences between gym types. In the HUR group, GS (r=-0.593) and SPPB (r=-0.626) were negatively associated (p < 0.001) with function, while TUG (r = 0.683; p < 0.01) was positively associated with function. Similar associations were observed with the HRQoL independent living component. Equivalent associations for conventional gym participants were observed for SPPB and TUG (function) and GS and TUG (HRQoL). Additionally, 400 mW time (r = 0.537) and appendicular lean mass (r = 0.586) were positively associated with function in the conventional gym users (p < 0.01). Similar, but negative, associations of 400 mW (r=-0.553; p < 0.01) were also observed with HRQoL, suggesting better function was linked to independent living and better mental health. Hand grip strength was not associated with function or HRQoL in either group.
Conclusion

Sarcopenia prevalence in community-dwelling older adults participating in supervised exercise programs was low and did not differ based on gym type. Mobility-related measures, fitness and lean mass measures in conventional gym users only were associated with function and HRQoL. However, muscle strength was not associated with these outcomes.
Zinc Monotherapy for Young Patients with Presymptomatic Wilson Disease: A Single Center, Retrospective Study
Authors: Hou Haiman , Chen Dingbang , Liu Junxiu , Feng Li , Zhang Jiwei , Liang Xiuling , Xu Yuming , Li Xunhua
Published: August 2020

Background

Few studies have focused on the treatment failure of zinc monotherapy for presymptomatic Wilson disease (WD) patients. Therefore, we aimed to evaluate the long-term efficacy of zinc monotherapy in presymptomatic patients and to analyze the possible factors that may influence the outcome of this treatment.
Methods

We retrospectively reviewed the medical records of presymptomatic WD patients who received zinc monotherapy from the time of diagnosis. Then, the characteristics of patients who were treated with zinc monotherapy successfully and those who experienced treatment failure were investigated.
Results

Forty presymptomatic WD patients were identified that have received zinc monotherapy as initial treatment, with a median age of 3.83 years at the time of diagnosis. 36 (90%) patients had abnormal alanine transaminase/aspartate transaminase levels at baseline. None of the patients became symptomatic during zinc monotherapy. 28 (70%, Group 1) patients were treated with zinc monotherapy successfully for a median period of 2.8 years. In Group 1, serum aminotransferase levels significantly decreased 6 and 12 months after zinc therapy compared to the baseline levels (P < 0.05). 12 (30%, Group 2) patients experienced treatment failure with zinc monotherapy due to uncontrolled serum liver enzyme levels, and D-penicillamine was combined. The baseline 24-hour urine copper levels before treatment were significantly higher in Group 2 compared to that in Group 1 (P = 0.018). Comparing the age at onset; ceruloplasmin, serum copper, ALT, and AST levels; and proportions of abdominal ultrasonography abnormality at baseline between Groups 1 and 2 revealed no statistically significant differences.
Conclusions

We found that high initial 24-hour urinary copper levels may lead to treatment failure of zinc monotherapy in presymptomatic WD patients. It might be reasonable to follow up liver function tests more closely during zinc monotherapy and to begin combination treatment with chelators early in patients with high level of 24-hour urinary copper.
WITHDRAWN: Discovery of New Metallic and Superconducting Phase in GaTa4Se8 Under High Pressure
Authors: Deng Hongshan , Zhang Jianbo , Jeong Min Yong , Sereika Raimundas , Wang Dong , Nakagawa Takeshi , Chen Bijuan , Yin Xia , Ren Ji-Chang , Han Myung Joon , Chang Jun , Weng Hongming , Ding Yang , Mao Ho-Kwang
Published: August 2020

Pressure is a unique thermodynamic variable to explore the phase competitions and novel phases inaccessible at ambient conditions. The resistive switching material GaTa4Se8 displays several quantum phases under pressure, such as Jeff = 3/2 Mott insulator, correlated quantum magnetic metal, and d-wave topological superconductivity, which has recently drawn mounting interest. Using high-pressure Raman, X-ray diffraction, extended X-ray absorption, and transport measurements, together with theoretical calculations, we reveal a remarkably rich phase diagram of this molecular magnetic Mott insulator at pressures up to ~ 68 GPa. In this previously unreached pressure regime, we find, GaTa4Se8 exhibits a new metallic phase whose structural and magnetic properties are clearly distinctive from the lower pressure one. Further, we identify a new superconducting phase in this high-pressure regime below Tc ~ 5.5K. Our discoveries highlight GaTa4Se8 as a unique playground in which novel quantum phases and orders coexist and compete with each other; ranges from Mott insulator to Fermi liquid and exhibits multiple metallic and superconducting states.
Risk Factors for Problematic Alcohol Use Among Male Waste Pickers and Caddies in Johannesburg, South Africa: A Cross-Sectional Study
Authors: Mdlel Simbulele Onesimo , Wilson Kerry , Ntlebi Vusi , Made Felix , Kootbodien Tahira , Tlotleng Nonhlanhla , Makhubele Matimba , Naicker Nisha
Published: August 2020

BackgroundInformal workers may be prone to problematic substance use due to many factors, including adverse working conditions and low income. Therefore, research must be conducted to improve the lifestyle of this vulnerable group of workers. This research aimed to assess problematic alcohol use and risk factors among male informal workers in Johannesburg.MethodsTwo groups of informal workers, waste pickers, and golf caddies were included. Alcohol use was measured using the World Health Organization (WHO) Alcohol Use Disorder Identification Test (AUDIT) tool. The WHO self-reporting questionnaire (SRQ) for common mental health disorders (CMD) was used to assess mental health. Data analysis included demographic analysis of the participants, assessment of substance use, and the ascertainment of drinking problem risk factors.ResultsThe study consisted of 514 participants, of which 48.4% were golf caddies and 51.6%, waste pickers. Most participants were younger than 40 years (50.9%). Over half of the participants (54.7%) were alcohol consumers and 74.1% were smokers. Over 60% of the participants who were alcohol consumers had a probable drinking problem. The prevalence of mental distress in the study group was 27% mental distress. Unstratified regression results showed that informal workers positive for mental distress were more likely to have a probable drinking problem (aOR=1.06; 95%CI: 1.01 – 1.11). Informal workers aged 30 – 40 years (aOR=2.06; 95%CI: 1.13 – 3.75), and those who were smokers (aOR=2.25; 95%CI: 1.33 – 3.80) were also more likely to have a probable drinking problem.ConclusionProblematic drinking amongst informal workers in this study was common along with smoking. Problematic alcohol use was associated with the type of informal work, mental distress, age, and smoking. Measures such as providing counselling services to informal workers and improvement of working conditions are needed to change the behaviours of this vulnerable group.
Sarcopenia in elderly major trauma; A single centre retrospective analysis of psoas and masseter muscle groups
Authors: Varma Surabhi , Wilson Michael SJ , Naik Mitesh , Sandhu Amandeep , Ota Helen Chidera Uchenna , Aylwin Christopher , Fertleman Michael , Peck George
Published: August 2020

Background

There is an emerging role for the radiological evaluation of the psoas muscle as a marker of sarcopenia, and as a prognostic discriminant in elderly patients with traumatic injuries. Older trauma patients are more likely to undergo cranial than abdomino-pelvic imaging. Identifying sarcopenia using masseter cross sectional area (M-CSA) has shown correlation with mortality. We sought to determine the correlation between psoas: lumbar vertebral index (PLVI) and the M-CSA, and their association with health outcomes.
Methods

Patients aged 65 or above, who presented as a trauma call over a 1 year period were included if they underwent cranial or abdominal CT imaging. Images were retrospectively analyzed to obtain PLVI and mean M-CSA measurements. Electronic records were abstracted for demographics and outcomes. Logistic regression methods, log scale analyses, Cox regression model and Kaplan-Meier plots were used to determine association of sarcopenia with outcomes.
Results

There were 155 eligible patients in the M-CSA group and 204 patients in the PLVI group. Sarcopenia was defined as the lowest quartile in each group. Both PLVI and M-CSA measurements were available in 142 patients. Pearson’s correlation indicated a weakly positive linear relationship (r = 0.35, p < 0.001) between these. There was no statistical association between M-CSA sarcopenia status and any measured outcomes. Those with PLVI sarcopenia were more likely to die in hospital (adjusted OR 3.38, 95% CI 1.47–9.73, p = 0.006) and at 2-years (adjusted HR 1.90, 95% CI 1.11–3.25, p = 0.02). Only 29% patients with PLVI sarcopenia were discharged home, compared with 58% without sarcopenia (p = 0.001).
Conclusion

Sarcopenia, defined by PLVI, is predictive of increased in-patient and 2- year mortality. Our study did not support prognostic relevance of M-CSA. Further research should be directed at improving the validity of masseter measurements or identifying alternative radiological determinants of sarcopenia on cranial imaging.
Cardiovascular Risk Factors and their Relationship with Endothelial Dysfunction in Rural and Urban South African Children
Authors: Matjuda Edna N. , Engwa Godwill Azeh , Anye Samuel Nkeh Chungag , Chungag Benedicta N. Nkeh , Goswami Nandu
Published: August 2020

Background: Endothelial dysfunction is known to be an initiator to the development and progression of atherosclerotic cardiovascular disease (CVD). However, there is paucity o knowledge on its relationship with cardiovascular risk factors in children. More so, some of these cardiovascular risk factors are known to be influenced by feeding habits and life style changes which often vary between rural and urban settings. This study was aimed to investigate the relationship between cardiovascular risk factors and endothelial function in rural and urban children. Methods: A cross-sectional study on 6-9 years old children in randomly selected rural and urban schools of the Eastern Cape Province of South Arica was conducted. General anthropometric indices were measured followed by blood pressure (BP) measurements. The pulse wave velocity (PWV) was measured using a Vicorder. Urine sample was collected for the determination of albumin, creatinine, asymmetric dimethylarginine (ADMA), 8-hydroxy-2deoxyguanosine (8-OHdG) and thiobarbituric acid reactive substance (TBARS). Albumin to creatinine ratio (ACR) was calculated.Results: Children from urban settings (10.8%) had a higher prevalence of overweight/obesity than their rural counterparts (8.5%) while the prevalence of elevated/high blood pressure was higher in rural children (23.2%) than in urban children (19.0%). Diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) significantly (p<0.005) increased with increasing quartiles of PWV. ADMA positively associated with HR in rural girls and showed a weak risk for elevated SBP and MAP. Body mass index (BMI) increased with increasing PWV and predicted endothelial dysfunction. 8-OHdG significantly (p<0.005) increased with increasing quartiles of ADMA and positively correlated with ADMA. Creatinine, albumin and ACR significantly (p<0.005) increased with increasing ADMA and ADMA associated positively with creatinine. Conclusion: Endothelial dysfunction was associated with obesity, high blood pressure, oxidative stress and microalbuminuria in children, and this relationship varied between rural and urban children.
Preoperative anaemia screening and treatment: Barrier identification and implementation strategy mapping
Authors: Delaforce Alana , Duff Jed , Munday Judy , Hardy Janet
Published: August 2020

Background: Patients undergoing major surgery are at risk of significant blood loss and subsequent transfusion, which increases substantially if the patient has pre-existing anaemia. Preoperative anaemia screening and treatment pathways (PAST-P) outline recommended blood tests and treatment to ensure patient optimisation before surgery. Although documented success in using PAST-P to reduce transfusions and improve patient outcomes exists, the reporting quality of such studies is suboptimal, and it remains unclear what implementation strategies best support the implementation of PAST-P. This study uses qualitative methods to identify local barriers and maps them to recommended implementation strategies.Method: Maximum variation, purposive sampling was used to recruit a total of 15 participants, including a range of health professionals and patients. Qualitative data was collected using semi-structured interviews. Data analysis utilised a deductive approach informed by the Consolidated Framework for Implementation Research (CFIR) for barrier identification and the Expert Recommendations for Implementing Change (ERIC) for reporting recommended implementation strategies. The Action, Actor, Context, Target and Time (AACTT) framework assisted with conceptualisation and targeted strategy selection.Results: The analysis revealed ten barriers: external policy and incentives, patient needs and resources, structural characteristics, networks and communications, relative priority, available resources, access to knowledge and information, knowledge and beliefs about the intervention, self-efficacy and executing. ERIC strategies recommended to mitigate barriers are: conduct educational meetings, develop educational materials, distribute educational materials, access new funding, promote network weaving, organise clinician implementation team meetings, obtain and use patients/consumers/family feedback, involve patients/consumers/family members and conduct a local needs assessment.Conclusion: Five of ten identified barriers had strong recommendations, and nine implementation strategies were identified as being suitable to address them. Mapping the barriers and strategies using the ERIC framework on the basis of individual actor categories proved to be useful in identifying a pragmatic number of implementation strategies that may help in supporting the utilisation of the PAST-P, once it is launched at the study hospital.
The Role of Socio-Economic Inequality in Physical Immobility Among Older Adults: Did the Scenario Changed from 2004-05 to 2017-18?
Authors: Srivast Shobhit , Patel Ratna , Chauhan Shekhar , Kumar Pradeep , Dhillon Preeti
Published: August 2020

Background: Despite declining overall growth rate of the population across the world, the number of older adults is rising. To understand the needs and problems faced by older adults, it is imperative to understand the demographic and socio-economic conditions of the individuals. On these lines, physical immobility among older adults is attributed to various risk factors. The living arrangement is found to be one of the critical risk factors along with economic dependency in explaining physical immobility among older adults in India. Therefore, this study is an attempt to explore the role of socio-economic inequality in physical immobility among older adults in India. Methods: This study utilized 60th and 75th rounds of data from the National Sample Survey conducted in 2004-05 and 2017-18, with a sample size of 34,831 and 42,762 older adults aged 60 and above, respectively. Further, the study decomposes the concentration index using regression-based decomposition technique to understand the relative contribution of various socio-economic factors to the physical immobility of older adults.Results: Result found a decline of 0.6 points in the prevalence of physical immobility from 2004-05 to 2017-18. The sharpest increase was observed in Puducherry (9.9%) followed by Chandigarh (7.6%), and decline was witnessed in Nagaland (9.2%) followed by Lakshadweep (6.4%) and Delhi (5.3%). Physical immobility was more concentrated among well-off older adults in 2017-18 as compared to in 2004-05. Living alone, chronic diseases, and rich wealth status contributed significantly to explaining the observed socio-economic inequality in physical immobility.Conclusions: Based on the observations made on the socio-economic inequality in physical immobility among older adults in India, some health interventions are required to cater to the needs of older adults.
Association Between MMP-9 -1562 C/T Polymorphism and the Risk of Sepsis in a Chinese Population: A Case-control Study
Authors: Zheng Cuijuan , Wang Jiayu , Xie Shouxiang
Published: August 2020

Background: Matrix metalloproteinase-9 (MMP-9) plays an important role in the development of sepsis. In order to explore the relationship between MMP-9 -1562 C/T polymorphism and sepsis risk in Chinese Han population, we conducted a case-control study with a sample size of 312 sepsis patients and 413 controls.Methods: The ABI PRISM SNaPshot method (Applied Biosystems, Carlsbad, CA, USA) was performed to genotype the MMP-9 -1562 C/T polymorphism.Results: Our data indicated that MMP-9 -1562 C/T polymorphism was associated with an increased risk of sepsis (CT vs. CC: P = 0.032, OR=1.45, 95%CI =1.03-2.05; TT + CT vs. CC: P = 0.019, OR =1.49, 95%CI = 1.07-2.07). Stratified analyses demonstrated that this increased risk was more evident in smokers, drinkers, females, and overweight individuals (BMI ≥ 25). In addition, cross-over analyses suggested that the combination of smoking and CT genotype of MMP-9 -1562 C/T polymorphism contributed to a higher risk for sepsis.Conclusion: In conclusion, MMP-9 -1562 C/T polymorphism is associated with an increased risk of sepsis in Chinese Han population. MMP-9 -1562 C/T polymorphism may serve as a diagnostic marker for sepsis patients.
Integrative Bioinformatics Study Reveals Tangeretin Targets and Molecular Mechanisms Against Metastatic Breast Cancer
Authors: Hermawan Adam , Putri Herwandhani , Hanif Naufa , Ikawati Muthi
Published: August 2020

Background: Agents that target metastasis are important to improve treatment efficacy in patients with breast cancer. Tangeretin, a citrus flavonoid, exhibits antimetastatic effects on breast cancer cells, but its molecular mechanism remains unclear.Results: Tangeretin targets were retrieved from PubChem, whereas metastatic breast cancer regulatory genes were downloaded from PubMed. In total, 58 genes were identified as potential therapeutic target genes of tangeretin (PTs). Gene ontology analysis with Webgestalt showed that the PTs participate in the biological process of stimulus response, are the cellular components of the nucleus and the membrane, and play molecular roles in enzyme regulation. Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis revealed that the PTs regulate the PI3K/Akt pathway. Genetic alterations for each target gene were MTOR (3%), NOTCH1 (4%), TP53 (42%), MMP9 (4%), NFKB1 (3%), PIK3CA (32%), PTGS2 (15%), and RELA (5%). The Kaplan–Meier plot displayed that patients with low mRNA expression levels of MTOR, TP53, MMP9, NFKB1, PTGS2, and RELA and high expression of PIK3CA had a significantly better prognosis than their counterparts. Further validation of gene expression by using GEPIA revealed that the mRNA expression of MMP9 was significantly lower in breast cancer tissues than in normal tissues, whereas the mRNA expression of PTGS2 showed the opposite. Analysis with ONCOMINE demonstrated that the mRNA expression levels of MMP9 and NFKB1 were significantly higher in metastatic breast cancer cells than in normal tissues. The results of molecular docking analyses revealed the advantage of tangeretin as an inhibitor of PIK3CA, MMP9, PTGS2, and IKK.Conclusion: Tangeretin inhibits metastasis in breast cancer cells by targeting TP53, PTGS2, MMP9, and PIK3CA and regulating the PI3K/Akt signaling pathway. Further investigation is needed to validate the results of this study.
Optimized duration of antituberculosis treatment for managing female genital tuberculosis: real-world experience from a high prevalence region in Eastern China
Authors: Yang Jianghua , Sun Jian , Wang Wenjie , Ding Jing , Cheng Yusheng , Zhou Yunfeng
Published: August 2020

Background

Duration of antituberculosis therapy (ATT) for managing female genital tuberculosis (FGTB) is controversial with the intermittent regimen no more advocated. We therefore conducted a prospective, real-world research to compare 6 months and 9 months of ATT.
Methods

Between 2012 and 2018, 109 drug-susceptible patients newly diagnosed with FGTB and/or tuberculous peritonitis (genital, 13; peritoneal, 34; mixed, 62) received naïve treatment for 9–12 months and further 18-month follow-up. Data on disease features at baseline and long-term outcome (intent-to-treat) were compared between group A (aged 15–35 years) and group B (aged ≥ 36 years). Efficacy and side effects of treatment were compared within each group 6 months and 9 months from ATT initiation (per-protocol), respectively.
Results

In contrast to group B at baseline, group A had more clinical evidence predicting active tuberculosis (P < 0.05), severer performance of genital lesions and pelvic adhensions (P < 0.05), more signs of active pulmonary tuberculosis (P < 0.01), and less performance of only TBP (P < 0.01). Intent-to-treat analysis showed higher incidence of overall single side effects and poor compliance in group B (P < 0.05), and similar recurrence rate between 2 groups. Per-protocol analysis showed increased complete response rate (P < 0.01) and similar incidence of side effects (P > 0.05) in group A, similar complete response rate (P > 0.05) and increased incidence of overall single side effects (P < 0.05) in group B at 9-mo duration.
Conclusions

Younger females with FGTB had a greater risk of systemic infection of TB compared to older ones. Nine-month ATT using daily therapy proved to be beneficial for younger patients at reproductive age. Six-month option was suitable for older patients for improving the side effects and poor compliance in the duration of treatment.
Trend Analysis of Major Sexually Transmitted Infections in China, 1999-2018
Authors: Chunxia Han , Zisheng Ai
Published: August 2020

Background

Sexually transmitted infections (STIs) are mainly transmitted by sexual contact or similar sexual contact, which can cause diseases of genitourinary organs ,accessory lymphatic system and major organs of the whole body. STIs include clinically symptomatic diseases and asymptomatic infections. The World Health Organization (WHO) reports that More than 1 million sexually transmitted infections (STIs) are acquired every day worldwide.By analyzing the temporal trend of the sexually transmitted infections incidence in China in the past 20 years, we can provide a scientific basis for the further development of prevention and control measures related to sexually transmitted infections.
Methods

Joinpoint regression model is used to fit the incidence data of three sexually transmitted diseases in China from 1999 to 2018. Annual percentage change (APC) and Average annual percentage Change (AAPC) are calculated to evaluate the temporal trend changes of the incidence of three major sexually transmitted diseases.
Results

The overall incidence of AIDS/HIV has been on the rise for 20 years, rising by an average of 33.7% per year (P < 0.05). The most obvious increase is in 2002–2005, an average annual increase of 102.5%. The overall incidence of gonorrhea is on a downward trend, decreasing by 4.9% per year on average (P < 0.05).However, its incidence shows a slow rising trend from 2012 to 2018, with an average annual increase of 6.0%. The overall incidence of syphilis is also on the rise, increasing by an average of 9.1% per year (P < 0.05). Except 1999–2003, the incidence of syphilis shows a downward trend, and the other time stages shows a significant upward trend.
Conclusions

In the past 20 years, the corresponding measures have been taken in China for sexually transmitted infections and achieved remarkable results, but the three major sexually transmitted infections are still in the forefront of the reported notifiable infectious diseases incidence in China. At the same time, all sexually transmitted infections are beginning to shift from high-risk population to the general population, especially adolescents and the floating population.Therefore, China should still pay more attention to the prevention and control of STIs to hold back their further spread or epidemic.
Plant Bioestimulants: Compost Tea and Bioslurry Characterization
Authors: Funes-Pinter M. Iván , Pisi Gabriel , Aroca Matías , Martínez Laura Elizabeth , Fernández Marcela , Uliarte Ernesto Martín
Published: August 2020

In the present study, the quality of aerated and non-aerated compost teas and bioslurry as bio-fertilizers and its application on two plant species in different substrates were tested. Compost tea brewed from a mixture residues compost presented higher nutrient content than that brewed from grape marc composted. Aeration, with shorter extraction time, resulted in higher pH, but in general with lower nutrient concentration, while bioslurry, presented higher nitrogen content. No pathogen and toxic effects were detected in the bio-products. Finally, Bio-products were evaluated in ornamental plant species: Petunia hibrida and Impatiens walleriana , where compost teas and bioslurry presented highly variable properties and effects on plant growth, depending on the substrate and species used. While in sand no significant effect on plant biomass and pigments were observed, in compost and commercial substrate bioslurry presented values similar to the traditional fertilizer. Compost tea presented variable results with no differences between aerated and non-aerated, both increasing carotenoids in I. walleriana in sand. We conclude that aeration showed no differences in compost tea quality, whilst bioslurry demonstrated to increase plant biomass at similar values to traditional fertilizer. Our results demonstrated that alternative products are an efficient, safe, ecological, and economical alternative to traditional products.
Interleukin 17A Promotes Cell Migration, Enhances anoikis resistance, and Favors Microenvironment for Triple Negative Breast Cancer Tumor Metastasis
Authors: Tsai Yi-Fang , Huang Chi-Cheng , Lin Yen-Shu , Hsu Chih-Yi , Huang Ching-Po , Liu Chun-Yu , Chiu Jen-Hwey , Tseng Ling-Ming
Published: August 2020

Background: Our previous study demonstrated that overexpression of multiple epidermal growth factor-like domains 11 was involved the recurrence mechanism of triple negative breast cancer (TNBC) via up-regulation of cytokines and chemokines, including IL-17A signaling pathway. However, information concerning the role of IL-17A in tumor behavior or cancer microenvironment remains lacking. The aim of this study was to investigate the role of IL-17A on TNBC recurrent mechanisms, including tumor behavior, circulating tumor cells (CTCs), and cancer microenvironment. Methods: Using human TNBC MDA-MB-231 and MDA-MB-468 lines, the role of IL17-A was elucidated by knocked down IL-17A (DIL-17A) or administration of different dose of IL-17A in the culture medium. Cell proliferation, migration assay, Western blot analysis and Real-time PCR for IL-17A related signaling were evaluated. Three groups of implanted 4T1 cells in BALB/c mice were designed, namely, wild type (WT), DIL-17A, and WT + neutralizing IL-17 antibody (WT+Ab). Tumor weight, necrosis area, and the number of CTCs were measured. Immunohistochemistry or Western blot for CD34, CD8, and TGF-b1 were evaluated. Anoikis resistance was analyzed by live/dead stain and flow cytometry. Finally, clinic-pathological correlation between IL-17A expression and patients’ outcome such as disease free survival (DFS) and overall survival (OS) was performed by Kaplan-Meier’s method.Results: Our results demonstrated that IL-17A stimulated migratory activity, but not growth rate, of MDA-MB-231/468 cells via increased Src, Rho, and COX2 expression. In vivo, there was an increased necrosis area, a decreased tumor CD34 expression and CTCs in DIL-17A group; while there was a decreased tumor CD34 expression, CD8(+) cells, and CTCs, but an increased TGF-b1 expression in WT+Ab group, compared to the WT group. Knocked down-IL-17A also decreased anoikis resistance in human TNBC and murine 4T1 cell lines. Kaplan-Meier’s analysis disclosed a negative correlation between tumor IL-17A expression and OS in TNBC patients. Conclusion: We conclude that IL-17A promotes migratory and angiogenic activity in the tumors, enhances anoikis resistance, and modulates the immune landscape of tumor microenvironment favoring subsequent cancer metastasis. The blockade of IL-17A might provide a co-treatment target to prevent tumor metastasis or recurrence in TNBC patients.
Correlation between Sagittal Morphology of Lower Lumbar Endplate and Degenerative Changes in Patients with Lumbar Disc Herniation
Authors: Xu Chongqing , Yin Mengchen , Mo Wen
Published: August 2020

Background: As an important anatomic factor in the process of Lumbar disc herniation (LDH), the correlation between endplate sagittal morphology and intervertebral disc degeneration (IDD) is unclear. and research on imaging data of lumbar endplate in patients with LDH is still insufficient. Our study aimed to observe the morphological change of the lower lumbar endplate (L3-S1) in patients with LDH on magnetic resonance imaging (MRI), and analyze its correlation with the degree of IDD.Methods/Design: All 116 patients were included. Based on their MRI, we divided endplates into three types (concave, flat and irregular), assigned intervertebral discs with Grade I-V given 1-5 points successively according to Pfirrmann system, and determined whether there was Modic change of each endplate. The correlation between the morphology of endplate and the degree of IDD was analyzed.Results: There were excellent inter-observer agreement for each item we analyzed (ICC > 0.75). Concave endplate appeared most frequently (187, 53.7%) and mainly distributed in L3/4 and L4/5, while irregular endplate was the least common type (54, 15.5%) and mainly concentrated in L5/S1. The IDD degree of corresponding disc increased gradually from concave (3.27 ± 0.81) to irregular endplates (4.25 ± 0.79) (P < 0.05). Irregular endplates were more likely to have Modic changes than concave and flat endplates (P < 0.05). Conclusion: The sagittal morphology of lower lumbar endplate is related to Modic changes and degree of IDD (based on Pfirrmann grading system) in patients with LDH, and the concave endplate mostly reflects a lower degree of lumbar disc degeneration, which has substantial clinical significance.