bluuebunny/crossref_metadata_2025 huggingface dataset:
How and to What Extent Can Pensions Facilitate Increased Use of Health Services by Older People: Evidence From Social Pension Expansion in Rural China
Authors: chen shanquan , Chen Xi , Law Stephen , Lucas Henry , Tang Shenlan , Long Qian , Xue Lei , Wang Zheng
Published: June 2020

Background: The proportion of people aged 60 years or over is growing faster than other age groups. Traditionally, retirement has been considered as both a loss to the labour market and an additional economic burden on the nation. More recently, it is widely accepted that retired people can still contribute to society in many ways, though the extent of their contributions will depend heavily on their state of health. In this background, a significant practice issue is how to promote older people utilizing health service they need in via of pension. This study aims to evaluate the effects of pensions on older adults’ health service utilization, and estimate the level of pension required to influence such utilization.Methods: Using a nationally representative sample survey, China Health and Retirement Longitudinal Study, we conducted fuzzy regression discontinuity and segmented regression.Results: It was found that a pension did facilitate low-income people in utilizing outpatient income (OR = 1.219, 95% 1.018-1.460) and inpatient services income (OR = 1.269, 95% 1.020-1.579); but also encouraged both low- and high-income people to choose self-treatment, specifically over-the-counter (OR = 1.208, 95% 1.037-1.407; OR = 1.206, 95% 1.024-1.419; respectively) and traditional Chinese medicines (OR = 1.452, 95% 1.094-1.932; OR = 1.456, 95% 1.079-1.955; respectively). However, receiving a pension had no effect on the frequency of outpatient and inpatient service use. Breakpoints for a pension to promote recipients’ health service utilization were mainly located in the range 55-95 CNY.Conclusions: The pension has mixed effects on recipients' health service utilization from different income groups. Our study enriches related evidence on the impact of pension on healthcare-seeking behaviour and can be helpful in policy design. The information our study presents can also allow economists to formulate models relating to pensions and healthcare utilisation with greater precision.
Reasons and patterns for tooth extraction among patients presenting at a hospital of stomatology in Guangzhou, China: A cross-sectional study
Authors: Li Hongyu , Liu Zhiguo , Yu Dongsheng , Tang Haikuo
Published: June 2020

Background

Few related surveys about reasons for tooth extraction was shown in mainland China. Our aim was to investigate the primary reasons and main pattern for extractions among patients presenting at a hospital of stomatology in Guangzhou, China.
Methods

This descriptive cross-sectional study was conducted over a period of 3 months, 2000 patients who underwent tooth extraction were recorded and analyzed by age, gender, the tooth type and the extraction reasons. Chi-square test was used to examine the differences in the extraction reasons between different genders, age groups and tooth types.
Results

A total of 3106 teeth were removed from 2000 patients, with an age ranging from 6 to 91. This study revealed details of extraction reasons and suggested that dental caries (25.42%) was the main reasons for tooth extraction and pointed out preventive extraction of third molar (19.89%) had displaced periodontal diseases (12.89%) as the dominant reason for extractions. Overall, third molar was the most frequently extracted tooth (1567). Significant statistical differences were found among different age groups, genders and tooth types for tooth extraction reasons (p༜0.05). For example, caries was the main reason for tooth extraction in 30–59 years old patients, while 20–29 years old patients asked for preventive extraction of third molar teeth mostly. Posterior teeth were mostly removed because of caries and periodontal disease was the leading cause for anterior teeth extraction.
Conclusions

We found the primary reasons and the new patterns for tooth extraction among patients in Guangzhou. It was proposed for the first time that the dominant reason for extractions was preventive extraction of third molar. Our finding could help to put forward some predictors and adjust the preventive strategies in oral disorders.
Evaluating True Barriers to Dental Care for Patients with Periodontal Disease
Authors: Treloar Tina , Bishop Susan S , Dodd Virginia , Shaddox Luciana Macchion
Published: June 2020

Background: The cost of care is often reported as a primary reason why patients fail to seek dental treatment; however, this may not the only component.Aims/Objectives: To examine an underserved population’s perspective on the importance of dental care and barriers they face to seek treatment. The effectiveness of compliance incentives, such as gift cards, were also examined.Methods: We conducted a survey study to gain insight of an underserved population’s perspective of barriers to care and correlated the reported barriers with the true reasons of missed appointments in our study cohort. Appointment compliance was also examined before and after implementation of gift card incentives. Results: Most patients felt dental care was important/very important to them. However, no correlations were found between survey responses and true reasons for missing appointments. Eighty-seven percent of patients report having some form of financial difficulty and compliance statistically improved after implementation of financial compensation in this population (69% completed appointments before gift card implementation versus 75% after gift card implementation, p=0.01), but not after the implementation of additional appointment reminders and contact staff.Discussion: Although the majority of patients reported dental care was important to them, there was an average of 31% missed appointments for patients who completed the survey and no correlations were found between the information patients reported and true reasons for non-compliance. Interestingly, even though care was free of charge, most patients reported to be in some form of financial difficulty and compliance was slightly improved through the implementation of financial compensation. Conclusion: A survey is a resource to identify reasons why patients abstain from seeking care but maybe not the best one as reasons reported do not correlate with true reasons of appointment failure. Financial compensation was shown to improve compliance with appointments. Further information gathering is necessary to gain insight into true barriers to dental care within an underserved population.Trial registration number: NCT01330719. Support. NIH/NIDCR. R01DE019456
Effect of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: Results from a large, two-institution series.
Authors: Wang Jia-bin , Xue Zhen , Lu Jun , He Qing-liang , Zheng Zhi-fang , Xu Bin-bin , Xie Jian-wei , Li Ping , Xu Yu , Lin Jian-xian , Chen Qi-yue , Cao Long-long , Lin Mi , Tu Ru-hong , Huang Ze-ning , Lin Ju-li , Huang Chang-ming , Zheng Chao-Hui
Published: June 2020

Background
The relationship between sarcopenia and prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy.
Methods
This study retrospectively collected data of 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression were used to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS).
Results
In this study, there were 59 patients (42.8%) with sarcopenia. Among the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9% and 30.4%, of serious postoperative complications 0% and 3.7%, of postoperative surgical complications 13.6% and 15.2%, of postoperative systemic complications 20.3% and 15.2% (all p > 0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS:42.37% vs 65.82%, p = 0.004; RFS:52.54% vs 68.35%, p = 0.036). Multivariate analysis showed that sarcopenia was related to long-term prognoses of g-NENs patients. A stratified analysis based on pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p = 0.007; RFS: 51.43% vs 74.36%, p = 0.026); furthermore, multivariate analysis showed that sarcopenia was an independent risk factor for gMANEC patients (p < 0.05).
Conclusion
Sarcopenia is not related to short-term prognoses of g-NENs patients. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.
Enset-Based Land Use Land Cover Change Detection and Its Impact on Soil Erosion in Meki River Watershed for Sustainability of Lake Ziway, Western Lake Ziway Sub-Basin, Central Rift Valley of Ethiopia
Authors: Woldesenbet Alemu Beyene , Wudmatas Sebsebe Demisew , Denboba Mekuria Argaw , Gebremariam Azage Gebreyohannes
Published: June 2020

Background Water erosion, upland degradation and deforestation are the key environmental problems in Meki river watershed where this study was conducted. This study assessed the land use land cover change (LULCC) over the last 30 years, examined the contribution of Enset-Based land use system (EBLUS) to manage soil erosion problem for sustainability of Lake Ziway and suggested appropriate management interventions for the watershed ERDAS imagine 2014, Geo-statistical interpolation and RUSLE model was devised for LULCC detection and analysis, for different spatial inputs and soil loss modeling respectively. Result Meki river watershed covers 2110.39056 km² of area which is dominantly covered by cultivated land use system (41.5%), Enset-Based land use system (EBLUS)(10.65%), Bush and Chat land use system (25.6%), Forest and plantations land use system (14.14%), built up (7.4%) and water bodies (0.75%). Severity class of High to severe range (18-125tha-1yr-1) recorded in the sub-watersheds irrespective of the land use systems and facing sever degradation problem that increase in soil loss in all land use systems from 1987 to 2017. The average soil loss of 30.5tha-1yr-1 and 31.905tha-1yr-1 recorded from Enset growing zones and non-Enset growing zones of the watershed respectively.Conclusion Enset-Based land use system (EBLUS) saves significant amount of soil despite the steepness of the slopes of the Enset growing zones of the watershed. Hence, expansion of EBLUS can contribute in sustaining Lake Ziway by reducing soil loss rate and sedimentation problem for ecological sustainability of the watershed. Therefore, separate land use policy and awareness creation are mandatory for such EBLUS expansion, integrated watershed management and conservation of the natural environment.
Characterization of the Content and Distribution of Collagen and Proteoglycan in the Decellularized Book-Shaped Enthesis Scaffolds by SR-FTIR
Authors: Lu Hongbin , shi qiang , Chen Can , Li Muzhi , Chen Yang , Xu Yan , Hu Jianzhong
Published: June 2020

Background: Bone-tendon interface (enthesis) plays a pivotal role in relaxing load transfer between otherwise structurally and functionally distinct tissue types. Currently, decellularized extracellular matrix (DEM) from enthesis provide a natural three-dimensional scaffold with tissue-specific orientations of extracellular matrix molecules for enthesis regeneration, however, the content and distribution of collagen and proteoglycan in the decellularized book-shaped enthesis scaffolds from rabbit rotator cuff by SR-FTIR have not been reported.Methods: Native enthesis tissues (NET) harvested from rabbit rotator cuff were sectioned into cuboid (about 30 mm × 1.2 mm × 10 mm) for decalcified. The decellularized book-shaped enthesis scaffolds were conducted and intrinsic ultrastructure was evaluated by histological staining and scanning electron microscopy (SEM), respectively. The content and distribution of collagen and proteoglycan in the decellularized book-shaped enthesis scaffolds from rabbit rotator cuff were also measured innovatively by SR-FTIR.Results: The decellularized book-shaped enthesis scaffolds from rabbit rotator cuff were successfully obtained. Histomorphology and SEM evaluated the decellularized effect and the structure of extracellular matrix during decellularization. After mechanical test, we found the failure load in the NET group was higher than that in the DEM group (P < 0.05), reached 1.32 times as much as that in the DEM group. Meanwhile, the stiffness of the DEM group was significantly lower than the NET group. Furthermore, the distributions of collagen and PGs content in the decellularized book-shaped enthesis scaffolds were decreased obviously after decellularization by SR-FTIR quantitative analysis.Conclusion: SR-FTIR was applied innovatively to characterize the histological morphology of native enthesis tissues from rabbit rotator cuff. Moreover, it can be used for quantitative mapping of the content and distribution of collagen and PGs content in the decellularized book-shaped enthesis scaffolds.
Comparison of the Efficacy of Five Standard Topical Hemostats: A Study in Porcine Liver and Spleen Models of Surgical Bleeding
Authors: Paternò Valerio Antonio , Bisin Alessandro , Addis Alessandro
Published: June 2020

Background: Several topical hemostats are available to help control surgical bleeding. Cutanplast is a highly absorbent and porous gelatin product that is available in Fast sponge and powder forms. This study investigated the hemostatic efficacy of Cutanplast Standard and Fast gelatin sponge and powder and Emosist oxidized regenerated cellulose (ORC) gauze in porcine liver and spleen surgical bleeding models.Methods: Cutanplast Standard and Fast gelatin sponge and Emosist ORC gauze were tested in liver abrasion/incision, liver puncture and spleen incision/puncture injuries, and Cutanplast Standard and Fast gelatin powder products were tested in liver abrasion/incision injuries. There were 13 liver injury (five abrasion, five incision and three puncture) and six spleen injury (three puncture and three incision sites) sites per animal.Results: Rapid hemostasis (≤ 2–5 min) was achieved in the liver abrasion and incision models with all Cutanplast gelatin sponge and powder products and Emosist ORC gauze, although in the liver incision model, time to hemostasis was > 5 min with Cutanplast Standard gelatin powder and Emosist ORC gauze. Rapid hemostasis occurred with Cutanplast Fast gelatin sponge and Emosist ORC gauze in the liver puncture and spleen puncture and incision models. In the spleen incision model, Cutanplast Standard gelatin sponge had a time to hemostasis approaching 10 min.Conclusion: Cutanplast gelatin sponge and powder products and Emosist ORC gauze may be suitable for surgical applications involving parenchymal organ bleeding, but certain products may perform better than others, including Cutanplast gelatin powder in diffuse mild bleeding (such as liver abrasion), and Cutanplast Fast gelatin sponge and Emosist ORC gauze for splenic bleeding.
Knowledge, attitude and practice of Sari Birth Cohort members during early weeks of COVID-19 outbreak in Iran
Authors: Shahbaznejad Leila , Navaifar Mohammad Reza , Arabi Mohsen , Movahedi Faeze Sadat , Hosseinzadeh Fatemeh , Fahimzad Seyed Alireza , Shirazi Zahra Serati , Rezai Mohammad Sadegh
Published: June 2020

Background

It has been determined that the coronavirus disease 2019 (COVID-19) pandemic needs social distancing and proper measures to prevent its spreading. This study aimed to determine COVID-19 knowledge, attitude, and practice among Sari Birth Cohort (SBC) members.
Methods

In this cross-sectional study linked to the SBC in north of Iran, mothers living in Sari and its suburbs from March 28 to April 8, 2020 were evaluated. The measurement tool was an online researcher-made, self-reported knowledge, attitude, and practice questionnaire related to COVID-19.
Results

In total, 1449 mothers with a mean age of 31.51 ± 5.73 years participated. Of them, 82.4% had good knowledge (98.6% in healthcare workers and 79.2% in housewives, p = 0.000). Most of them were worried about spread of the disease in the country (97.4%) and agreed that COVID-19 will finally be successfully controlled around the world (72.2%). Sleep disturbance was reported in 42.7% of mothers. Eighty-eight percent of cases wore masks and gloves when leaving the house, 99.4% washed their hands frequently while 12.9% went to any crowded places. People with better knowledge followed safer practices (p = 0.000) and were more worried about the spread of the disease in the country and infection (among themselves and their first-degree relatives) (p = 0.000).
Conclusions

Most of the SBC members had a good level of knowledge about COVID-19 but were worried about a long-term pandemic period. They also had good practices regarding the prevention of the disease.
Prohibitin Protects Against Cigarette Smoke Extract-Induced Cell Apoptosis in Cultured Human Pulmonary Microvascular Endothelial Cells
Authors: Peng Yating , Zhou Zijing , Zhou Aiyuan , Duan JiaXi , Peng Hong , Ouyang Ruoyun , Chen Yan , Chen Ping
Published: June 2020

Prohibitin is an evolutionarily conserved and ubiquitously expressed protein in eukaryocyte. It mediate many important roles in cell survival, apoptosis, autophagy and senescence. In the present study, we aimed to explore the role of prohibitin in cigarette smoke extract (CSE)-induced apoptosis of human pulmonary microvascular endothelial cells (HPMECs). For this purpose, HPMECs were trasfected with prohibitin and challenged with CSE. Our results showed that CSE exposure inhibited prohibitin expression in a dose-dependent manner in HPMECs. Overexpression of prohibitin could protect cell from CSE-induced injury by inhibiting CSE-induced cell apoptosis, inhibiting reactive oxygen species (ROS) production, increase mitochondrial membrane potential, increase the content of mitochondrial transcription factor A (mtTFA), IKKα/β phosphorylation and IκB-α degradation. CSE decreases prohibitin expression in endothelial cells and restoration of prohibitin expression in these cells can protect against the deleterious effects of CSE on mitochondrial and cells. We identified prohibitin is a novel regulator of endothelial cell apoptosis and survival in the context of cigarette smoke exposure.
Azole-acridine hybrids as potential enzymatic inhibitors of coronavirus-2 main protease and RNA polymerase by molecular modeling strategy
Authors: Rono Charles K. , Makhubela Banothile C.E.
Published: June 2020

SARS-CoV-2 has been identified as the cause of the current outbreak of coronavirus disease (COVID-19). As part of the efforts to develop potential drugs with promise for clinical use, a molecular docking study on azole (triazole and pyrazole) based molecules on the main protease Mpro and RNA polymerase was conducted, as possible inhibitors that could be elected for further experimental bioassays. Autodock has been employed to identify azole derivatives 1-6 preferred conformations in the active site of the enzyme and to estimate their binding affinities to the protease and RNA polymerase targets. From the molecular docking strategy, these new azole compounds though nonpeptides in nature display possible inhibition of Mpro activity with comparable affinities (-4.7 kcal/mol to -6.5 kcal/mol) to the recently reported peptide-like inhibitors such as α-ketoamide inhibitor 13b (-5.0 k/cal/mol). They also exhibit improved binding affinities to RNA polymerase (-6.3 to -7.1 kcal/mol) comparable to remdesivir (-6.6 kcal/mol). Based on the observed binding energies, these compounds may possess anti-coronavirus bioactivity through inhibition of the virus main protease as well as RNA polymerase activities in living cells.
The biometric parameters of aniso-astigmatism and its risk factor in Chinese preschool children: the Nanjing Eye Study
Authors: Tong Haohai , Hao Qingfeng , Wang Zijin , Wang Yue , Li Rui , Zhao Xiaoyan , Sun Qigang , Zhang Xiaohan , Chen Xuejuan , Zhu Hui , Huang Dan , Liu Hu
Published: June 2020

BackgroundsTo determine the biometric components of aniso-astigmatism and associated maternal risk factors in Chinese preschool children.MethodsIn the population-based, cohort Nanjing Eye Study, children were measured for noncycloplegic refractive error using an autorefractor and for biometric parameters using an optical low-coherent reflectometry. The difference of total astigmatism (TA) between both eyes was calculated using cylinder power (non-vectorial aniso-TA was defined as ≥ 1.00 Dioptre Cylinder [DC] between both eyes) and by vector analysis (vectorial aniso-TA was defined as a difference of ≥ 0.5 in J0 or J45 between both eyes which is equivalent to 1.00 DC). The prevalence of aniso-TA was presented. Interocular biometric parameters were compared between with vs. without aniso-astigmatism group. In addition, risk factors were determined using multivariate logistic regression model.ResultsOf 1131 children (66.90 ± 3.38 months, 53.31% male), the prevalence of non-vectorial aniso-TA was 1.95% (95% Confidence Interval (CI) = 1.14%-2.75%), while the prevalence of vectorial aniso-TA was twice as common as non-vectorial aniso-TA, neither varying with sex or age. With aniso-TA eyes were more asymmetric in axial length and corneal curvature radius than without aniso-TA eyes. In multivariate logistic regression model, 5-min apgar score less than 7 was significantly associated with higher risk of aniso-TA (vectorial aniso-TA: Odds Ratio (OR) = 6.42, 95%CI = 2.63–15.69, P < 0.001; non-vectorial aniso-TA: OR = 4.92, 95%CI = 1.41–17.68, P = 0.01). Being twin or triple was significantly associated with higher risk of vectorial aniso-CA (OR = 2.43, 95%CI = 1.05–5.60, P = 0.38). Pre-term delivery (OR = 2.60, 95%CI = 1.09–6.15, P = 0.03) and post-term delivery (OR = 3.61, 95%CI = 1.31–9.96, P = 0.01) were significantly associated with higher risk of vectorial aniso-CA.ConclusionsBoth corneal curvature radius and axial length asymmetry were correlated with aniso-TA. Children with 5-min apgar score < 7 were more likely to have aniso-TA, while twin or triple, pre-term or post-term delivery were risk factors for vectorial aniso-CA.
“OK, So you Think It’s All About Work Engagement?” Exploring Precursors and Outcomes of Work Engagement Among Healthcare Professionals
Authors: Slåtten Terje , Lien Gudbrand
Published: June 2020

Background: Health services organizations need to understand how they best can achieve important organizational goals such as lowering healthcare professionals’ turnover intentions, increase their job satisfaction and level of service quality provided to patients. This study aims to test whether work engagement of healthcare professionals is a core factor in the achievement of these preferred organizational goals. The study also aims to explore whether work engagement is manageable through the direct impact of organizational culture and climate and indirectly for the accomplishment of organizational goals.Methods: The proposed conceptual model was tested in a quantitative study where healthcare professionals, in this study represented by the group of hospital nurses, participated. The data were analyzed using confirmatory factor analysis and structural equation modeling in Stata.Results: The results can be divided into three sub-results. First, work engagement of health professionals was found to be positively related to service quality of care (b = 0.551) and job satisfaction (b = 0.883). Job satisfaction fully mediates the relationship between work engagement and turnover intention and in itself explains almost 60% (R2 = 0.59) of turnover intentions. Second, health professionals’ perception of organizational culture (b = 0.278) and collaboration climate (b = 0.331) were both directly related to their work engagement. Third, work engagement fully mediates the relationship between organizational culture, organizational climate and service quality of care and job satisfaction. Moreover, work engagement particularly mediates the relationship between collaborative climate and job satisfaction.Conclusions: This study contributes to extending and deepening previous research on work engagement in health services research. Specifically, it reveals the essential role that work engagement of healthcare professionals plays for the achievement of organizational goals. Consequently, leaders and managers of healthcare organizations should have a serious focus on health professionals’ work engagement and put it on their meeting agenda regularly because it is clearly a core driver to enabling multiple desirable outcomes for healthcare organizations.
Export Diversification and Economic Growth in the United Arab Emirates: An Empirical Investigation
Authors: SHADAB SAIMA
Published: June 2020

Using the Vector Error Correction Model and Toda-Yamamoto Causality approach, this paper investigates the short-run and long-run relationship between export diversification, physical and human capital, imports, and economic growth in the UAE. The study period in consideration is 1975-2017. The findings obtained from the VECM test confirm the existence of a significant long-run relationship between export diversification, imports, and economic growth in the UAE. Besides, the Toda Yamamoto Granger Causality test results reveal that imports Granger-cause UAE’s economic growth which proves the validity of the Import-Led Growth hypothesis for the UAE economy in the long-run. The results also confirm that a unidirectional causal relationship exists from export diversification to economic growth for the UAE. This finding indicates the success of the UAE economy in attaining economic diversification and reduction from oil-dependency.
Association Between CYP2C19 Polymorphisms and Esophageal Squamous Cell Carcinoma Risk in Asian Populations: A Systematic Review and Meta-analysis
Authors: Gao Xuehan , Wang Guige , Liu Lei , Zhang Jiaqi , Zhao Ke , Wang Yanqing , Li Shanqing
Published: June 2020

Background: This meta-analysis was performed to evaluate the association between CYP2C19 gene polymorphisms and ESCC risk in Asian populations.Methods: A literature search was performed in main medical publication databases for the association between CYP2C19 gene polymorphisms and ESCC risk, up to May 2020. A random/fixed-effects model was used to calculate the pooled odds ratios (OR) and 95% confidence intervals (CI) to evaluate the associations, considering multiple genetic models. And people were classified into three groups according to metabolizer phenotypes: (i) extensive metabolizers (EMs: *1/*1, *1/*2, *1/*3); (ii) intermediate metabolizers (IMs: *1/*2, *1/*3) and (iii) poor metabolizers (PMs: *2/*2, *2/*3, *3/*3).Results: Eight studies with 1955 cases and 2754 controls were ultimately included that showed that individuals carrying the “A” allele of CYP2C19*2 G681A and AA genotype of CYP2C19*3 G636A were significantly associated with an increased ESCC risk (CYP2C19*2 A vs. G: OR = 1.823, 95% CI = 1.616-2.056; CYP2C19*3 AA vs. AG + GG: OR = 2.992, 95% CI = 1.122-7.981). In the analysis of metabolizer phenotypes, PMs and IMs groups were associated with ESCC risk compared to EMs (IMs vs. EMs: OR = 1.673, 95% CI = 1.281-2.186; PMs vs. EMs: OR = 2.605, 95% CI = 1.945-3.489). And PMs showed a stronger correlation (PMs vs. IMs + EMs: OR = 2.220, 95% CI = 1.705-2.891).Results: Eight studies with 1955 cases and 2754 controls were ultimately included that showed that individuals carrying the “A” allele of CYP2C19*2 G861A and AA genotype of CYP2C19*3 G636A were significantly associated with an increased ESCC risk (CYP2C19*2 A vs. G: OR = 1.823, 95% CI = 1.616-2.056; CYP2C19*3 AA vs. AG + GG: OR = 2.992, 95% CI = 1.122-7.981). In the analysis of metabolizer phenotypes, PMs and IMs groups were associated with ESCC risk compared to EMs (IMs vs. EMs: OR = 1.673, 95% CI = 1.281-2.186; PMs vs. EMs: OR = 2.605, 95% CI = 1.945-3.489). And PMs showed a stronger correlation (PMs vs. IMs + EMs: OR = 2.220, 95% CI = 1.705-2.891).Conclusions: Our meta-analysis revealed that “A” allele (AA+AG) ofCYP2C19*2 and AA genotype of CYP2C19*3 polymorphism are significantly associated with ESCC risk. In metabolizer phenotypes, PMs and IMs are associated with an increased risk of ESCC in Asian populations.
High Dose Atorvastatin Raises Threshold of Contrast Induced Nephropathy in Diabetic Patients Undergoing Elective Coronary Intervention.
Authors: Abdel-Galeel Ahmed , Elmaghraby Khaled , Ghaleb Ramadan , Hanafy Amr , Elsharef M Abdelfatah , Ibrahim Ayman
Published: June 2020

Background Contrast induced nephropathy (CIN) is a significant complication of angiographic procedures resulting from injection of iodinated contrast media (CM). Patients with diabetes mellitus (DM) are at the highest risk of CIN. Statins have recently been proposed for protection against CIN due to their antioxidant and anti-inflammatory propertiesAim of work To investigate the potential benefit of acute pretreatment with high dose atorvastatin (80 mg) in reduction of the incidence of CIN in diabetic patients indicated for elective coronary intervention.Patients and Methods 200 diabetic patients with indication for coronary intervention were enrolled in the study. 100 patients will be randomly assigned to receive atorvastatin (80 mg) just before coronary intervention (statin group) and 100 patients received placebo (control group). CIN was defined as a rise of serum creatinine of more than 25% or ≥0.5 mg/dl (44 μmol/l) from baseline within 48 hours of the angiography. After the procedure, TIMI flow of the culprit vessel was reported, as well as the volume of used contrast media and time of X-ray exposure.Results Our study reported a CIN incidence of 12, 18 and 6% among the whole study, placebo and statin groups respectively, p value 0.001. Among placebo group, CIN is likely to develop after 13.5 minutes X ray exposure time with specificity 73.2% and sensitivity 77.8%, AUC 0.879 (CI: 0.798-0.960), P value 0.001. While in statin group, CIN is likely to develop after 14.5 minutes X ray exposure time with specificity 74.5% and sensitivity 83.3%, AUC 0.818 (CI: 0.727-0.910), P value 0.009. In placebo group, CIN is likely to develop after injection of 145 ml with specificity 75.6% and sensitivity 77.8%, AUC 0.855 (CI: 0.757-0.952), P value 0.001. While in statin group, CIN is likely to develop after injection of 165 ml with specificity 84% and sensitivity 83.3%, AUC 0.878 (CI: 0.811-0.944), P value 0.002Conclusions Acute pre-treatment with high dose atorvastatin can effectively protect against CIN and was associated with a marked decrease in the prevalence of CIN in diabetic patients undergoing coronary interventions. Moreover, pre-treatment with high-dose atorvastatin raises the threshold of X-ray exposure time and amount of contrast media beyond which CIN is likely to develop.
Achilles Tendon Enthesitis Evaluated by MRI Assessments in Patients with Axial Spondyloarthritis and Psoriatic Arthritis: A Report of the Methodology of the ACHILLES Trial
Authors: Baraliakos Xenofon , Sewerin Philipp , de Miguel Eugenio , Pournara Effie , Kleinmond Christine , Wiedon Annette , Behrens Frank
Published: June 2020

Background: The currently available scoring methods for enthesitis are often measures of pain but not of inflammation at entheseal sites. The Outcome Measures in Rheumatology Clinical Trials (OMERACT) psoriatic arthritis (PsA) magnetic resonance imaging (MRI) scoring system (PsAMRIS) assesses inflammation and damage in PsA and was particularly developed for the hands. The ACHILLES trial used clinical measures for heel enthesitis in combination with MRI scoring based on PsAMRIS.Methods: Patients (age ≥ 18 years) with spondyloarthritis (SpA) and PsA were included in the trial if they presented with clinical and MRI-positive heel enthesitis. MRI of the affected heel was performed at three time points: screening, Week 24 and Week 52. Inflammatory MRI findings (tendinitis, bursitis and bone marrow oedema [BME]) in the area of the Achilles tendon and/or plantar aponeurosis, periarticular inflammation of the ankle joint and heel erosion were assessed qualitatively (absent/present). In addition, BME and bone erosion were quantitatively assessed based on PsAMRIS, where their proportion was compared to the volume of the affected bone. Mean scores of BME and bone erosion quantification were calculated, and the mean composite score (based on PsAMRIS) was calculated based on the individual score of each subject for periarticular inflammation, BME and bone erosion and further extended for bursitis and tendinitis. Modifications to PsAMRIS were introduced by categorising oedema length as ≤/> 0.5 cm and locating bone erosion.Conclusions: In ACHILLES, MRI was used to assess and evaluate heel enthesitis. Due to the lack of a validated scoring system for heel enthesitis at the time of ACHILLES initiation, this trial applied quantitative scoring based on PsAMRIS, with specific adaptations for the heel.Trial registration: National Clinical Trial Registry, NCT02771210. Registered 13 May 2016. https://clinicaltrials.gov/ct2/show/NCT02771210?term=NCT02771210&draw=2&rank=1
Food related taboos and misconceptions during pregnancy among rural communities of Illu Aba Bor Zone, Southwest Ethiopia
Authors: Tsegaye Dereje , Tamiru Dessalegn , Belachew Tefera
Published: June 2020

Background: Poor maternal nutrition adversely affects pregnancy and birth outcomes. In many societies, pregnant women have food taboos and misconceptions which consequently results in the depletion of vital nutrients. These cultural malpractices and beliefs can influence dietary intake of pregnant women which subsequently affects the birth outcome. This study aimed at exploring the extent of food taboos and misconceptions during pregnancy in rural communities of Illu Aba Bor Zone, Southwest Ethiopia.Methods: A qualitative study was conducted using in-depth interviews of key informants and focus group discussions among purposefully selected pregnant women and their husbands, elderly people, health workers and health extension workers. Data were transcribed verbatim, thematized; color coded and analyzed manually using the thematic framework method.Result: Thorough reading and review of the transcripts generated three major themes. The first theme was belief and practice of taboos related to the intake of certain food items during pregnancy. Pregnant women, their husbands and mothers- in- law believed that certain foods should be avoided during pregnancy. The second theme was foods that were held as taboo and the reason attached to the food taboos. The most common food items held as taboo were related to the consumption of vegetables like cabbage, pumpkin, milk and milk products, sugar cane, fruit like banana and avocado and egg and the main reasons to avoid these foods were a belief that it can be plastered on the fetal head, making fatty baby which is difficult for delivery. The third theme was the reasons underlying adherence to food taboos which is deeply embedded in the personal believes and attitudes of the pregnant women, who were nested within the influence of the social environment surrounding them and the traditional beliefs and values of the society in general.Conclusions: The results showed a widespread practice of food taboo during pregnancy in the study area. The finding suggested that there is a need for strengthening the nutrition counseling components of antenatal care follow-up and planning comprehensive nutrition education through involving important others to dispel such traditional beliefs and prevent food taboo practices in the study community.
Postprandial Negatively Charged Very-Low-Density Lipoprotein ­Is a Novel Biomarker for Atrial Remodeling in Metabolic Syndrome
Authors: Lee Hsiang-Chun , Shin Shyi-Jang , Huang Jih-Kai , Lin Yu-Hsun , Ke Liang-Yin , Jiang He-Jiun , Tsai Wei-Chung , Chao Min-Fang , Lin Yi-Hsiung
Published: June 2020

Background: Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and left atrial dilatation. Methods: We evaluated 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 hours after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrial diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchical linear model was conducted to test the independencies of each variable’s correlation with LAD. Results: The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P< 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P<0.05) after adjustment for age and sex. We observed significant interactions between VLDL-χ and blood pressure, waist circumference, and hip circumference. When adjusted for obesity- and blood pressure-related variables, 2-hour postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.62 cm. Conclusion: Postprandial VLDL-χ is associated with atrial remodeling. VLDL-χ is a novel biomarker for atrial cardiomyopathy in MetS patients and may be a therapeutic target. Trial registration: ISRCTN 69295295. Registered 9 June 2020.
15q26 Deletion in a Patient with Congenital Heart Defect, Growth Restriction and Intellectual Disability: Case Report and Literature Review
Authors: BENBOUCHTA Yahya , de Leeuw Nicole , Amasdl Saadia , Sbiti Aziza , Smeets Dominique , Sadki Khalid , Sefiani Abdelaziz
Published: June 2020

Background 15q26 deletion is a relatively rare chromosomal disorder described in only few cases. Patients with this aberration display numerous symptoms particularly pre- and postnatal growth restriction, microcephaly, intellectual disability, dysmorphic gestalt, and various congenital malformations. Case presentation We report on a girl, four years old, of consanguineous parents, with a de novo 15q26 deletion. Clinical manifestations included failure to thrive, microcephaly, dysmorphic facies with broad forehead, hypertelorism, narrowed eyelid slits, protruding columella. The patient also showed skeletal abnormalities, especially clinodactyly of the 5th finger, right foot varus equine, and left club foot. Additionally, she had teething delay and divergent strabismus. Further clinical investigations showed right-to-left atrial shunting, and enlarged right heart. Routine cytogenetic analysis revealed a derivative 15 chromosome with an abnormally short long (q) arm. Subsequent array analysis disclosed a terminal 9.15 Mb deletion detected in band 15q26.1q26.3. Five candidate genes causing the phenotype were within the deleted region, i.e. IGF1R, NR2F2, MEF2A, MCTP2, and CHD2. Conclusion 15q26 monosomy should be considered when growth retardation is associated with ear anomaly, clinodactyly and/or abnormal toe, heart defect mainly atrioventricular septal defects (AVSDs) and/or aortic arch anomaly (AAA).
Autoimmune encephalitis with antibodies against Leucinie-rich Glioma Inactivated 1 and γ-aminobutyric acid-beta-receptor: case report and literature review
Authors: Xie Yi , Wen Jia , Zhao Zhihua , Liu Hongbo , Xie Nanchang
Published: June 2020

A 60-year-old man presented with slow response and psychosis. Apart from hyponatremia, serum test also showed positive anti-Leucinie-rich Glioma Inactivated 1 (anti-LGI1) and anti-γ-aminobutyric acid-beta-receptor (anti-GABABR), and electroencephalogram exhibited moderate diffusion abnormality. The patient responded well to steroid treatment. Here we report the first autoimmune encephalitis(AE) characterized by positive anti-LGI1 and anti-GABABR, as well as summarizing AE with multiple auto-antibodies reported so far, hopefully to provide experience for clinical practice.
The Optimal Duration of Anti-Tuberculous Therapy Before Pericardiectomy in Constrictive Tuberculous Pericarditis
Authors: Fang Likui , Yu Guocan , Zhong Fangming , Chen Gang , Ye Bo
Published: June 2020

Background: It is unclear about the duration of anti-tuberculous therapy before pericardiectomy (DATT) in the patients with constrictive tuberculous pericarditis. This study aims to explore the optimal DATT and its impacts in these patients.Methods: We retrospectively enrolled 93 patients with constrictive tuberculous pericarditis undergoing pericardiectomy and divided them into two groups according to the optimal cutoff value of DATT which was determined by the receiver operating characteristic (ROC) curve and Youden Index. Postoperative and survival outcomes were compared between the two groups.Results: The optimal cutoff value of DATT was 1.05 (months). The enrolled patients were divided into the DATT≤1.05 group and the DATT>1.05 group, with 24 (25.8%) and 69 (74.2%) cases, respectively. Comparing with the DATT≤1.05 group, the DATT>1.05 group had shorter postoperative ICU stay (P=0.023), duration of chest drainage (P=0.002), postoperative hospital stay (P=0.001) and lower incidence of postoperative complications (P<0.001). There was no statistical difference between the two groups in recurrence and survival outcomes.Conclusions: It would be of great benefit to enhanced recovery after pericardiectomy in the patients with constrictive tuberculous pericarditis if DATT lasted for at least one month.
Higher Number of Steps and Breaks During Sedentary Behaviour are Associated with Better Lipid Profiles
Authors: Aho Sonja , Vuoristo Meri-Sisko , Raitanen Jani , Mansikkamäki Kirsi , Alanko Johanna , Vähä-Ypyä Henri , Luoto Riitta , Kellokumpu-Lehtinen Pirkko-Liisa , Vasankari Tommi
Published: June 2020

Background: Physical activity (PA) is known to be associated with lipid profiles and the risk of both cardiovascular diseases and cancer. The aim of this study was to evaluate the association of objectively measured PA, sedentary behaviour (SB), amount of breaks during SB and number of daily steps with serum lipids in a healthy, Finnish, middle-aged, female population.Methods: The participants (571) were recruited at mammography screening, target group was women aged 50-60 years. A measurement of PA was done with accelerometer, blood lipid profile was assessed, and questionnaires of participants characteristics were sent to participants.Results: The participants with the highest number of daily breaks during SB (≥ 41) had the highest mean concentration of HDL-cholesterol (high density lipoprotein cholesterol, HDL-c) (1.9 mmol/l, standard deviation (SD) 0.4) and the lowest mean concentration of triglycerides (1.0 mmol/l, SD 0.5). HDL-c level was 0.16 mmol/l higher (p < 0.001) in the group with 28-40.9 breaks/day and 0.25 mmol/l higher (p < 0.001) among participants with ≥ 41 breaks/day than in the group with the fewest breaks during SB (< 28).Those with the most daily steps (≥ 9100) had the highest mean HDL-c level (1.9 mmol/l). HDL-c level was 0.16 mmol/l higher (p < 0.001) among the participants with 5600-9099 steps/day and 0.26 mmol/l higher (p < 0.001) among participants with ≥ 9100 steps/day than those with the fewest steps (< 5600). The number of daily steps was inversely associated with the triglyceride concentration.From wake-time, participants spent 60% in SB, 18% standing, 14% in light PA, and 9% in moderate-to-vigorous PA (MVPA). PA was associated with serum total cholesterol (TC), HDL-c and triglyceride levels. The mean HDL-c level was the highest in the lowest quartile of SB and in the highest quartile of MVPA.Conclusions: This is the first study showing a high number of objectively measured breaks during SB is associated with a favourable effect on the level of serum lipids, which may later translate into cardiovascular health.Trial registration: This study was registered and approved by the Regional Ethics Committee of Tampere University Hospital in Finland (approval code R15137).
Rising Government Expenditures and Standard of Living in Nigeria: An Ardl Bound Test Approach
Authors: Bowale Kayode Ebenezer , Ezinwa Azuh Dominic , Ilesanmi Olagoke Alfred
Published: June 2020

This study investigated the nexus between standard of living proxy by per capital income (PCI) and the rising four components of capital and recurrent expenditure namely: Administration (ADM), Economic Services (ECS), Social and Community Services (SCS), and Transfer Payments (TRP). The study used data from the Central Bank of Nigeria Statistical Bulletin, 2018 and World Development Indicator, 2018 for the period 1981–2018, using Autoregressive Distributed Lagged (ARDL) Bound Test Approach. The study found that rising government expenditures on these four components of both capital and recurrent spending were negatively and insignificantly related to PCI, those that were positively related were also insignificant, indicating low standard of living of Nigerians during the period of study. We concluded that government expenditure did not improve the standard of living of Nigerians significantly. The study recommended that political officers should always ensure integrity and accountability in handling public funds.JEL CLASSIFICATION: F31, C01, C13, C32, C51
Atmospheric Pollution Reduction in São Paulo City and the Social Isolation Effect
Authors: Rosse Vinicius Possato , Pereira Jaqueline Natiele , Boari Arthur , Costa Gabriel Vinicius , Ribeiro João Pedro Colombo , Vieira-Filho Marcelo
Published: June 2020

Since January 2020, some studies have been reporting a reduction in air pollution in several countries due to social isolation measures, which have been adopted in order to contain the coronavirus outbreak progress (Covid-19). This study aims to evaluate the change in the atmospheric pollution levels by NO and NO2 in São Paulo city in the social isolation period. The NO and NO2 hourly concentrations were obtained through air quality monitoring stations from CETESB, from January 14 to April 12, 2020. Mann-Kendall and the Pettitt tests were performed in the air pollutants time series. We observed an overall negative trend in all stations, indicating a decreasing temporal pattern in concentrations. Regarding NO, the highest decrease rates were observed in Congonhas (-6.39 µg.m-3month-1) and Marginal Tietê (-6.19 µg.m-3month-1) stations; regarding NO2, the highest rates were observed in Marginal Tietê (-4.45 µg.m-3month-1) and Cerqueira César (-4.34 µg.m-3month-1) stations. In addition, we identified a turning point in the NO and NO2 series trends that occurred close to the start date of the social isolation period (March 20, 2020). Moreover, from statistical analysis, it was found that NO2 is a suitable surrogate for monitoring economic activities during social isolation period. Thus, we concluded that social isolation measures implemented in March 20, 2020 caused significant changes in the air pollutants concentrations in São Paulo city (as high as -200% in NO2 levels).