bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends and determinants of diarrhea among under-five children in Ethiopia: cross-sectional study: multivariate decomposition and multilevel analysis based on Bayesian approach evidenced by EDHS 2000–2016 data
Authors: Negesse Yilkal , Taddese Asefa Adimasu , Negesse Ayenew , Ayele Tadesse Awoke
Published: January 2021

Background

Despite significant progress in the reduction of under-five child deaths over the last decades in Ethiopia, still diarrhea remains the second cause of morbidity and mortality among under five children next to pneumonia.

Objective

To show trends and determinants of diarrhea among under five children in Ethiopia based on the four Ethiopian Demographic and health surveys data (2000–2016).

Methods

A total of 10,753 in 2000, 10,039 in 2005, 10,946 in 2011 and 10,337 in 2016 under five age children were involved in this study. Multivariate decomposition and multilevel analysis based on Bayesian approach was performed.

Results

Ninety seven percent of the change in diarrhea prevalence over time was attributable to difference in behavior. Being twin (AOR = 1.3; 95% CrI 1.1–1.5), big weight (AOR = 1.63; 95% CrI 1.62–2.02), not vaccinated for rotavirus (AOR = 1.44; 95% CrI 1.12–1.9) and for measles (AOR = 1.2; 95% CrI 1.1–1.33), poor wealth status (AOR 2.6; 95% CrI 1.7–4.06), having more than three under-five children (AOR 1.3; 95% CrI 1.1–1.61), member of health insurance (AOR 2.2; 95% CrI 1.3–3.8) and long distance from the health facility (AOR 2.7; 95% CrI 2.2–3.5) were more likely to experience diarrhea.

Conclusion

The prevalence of diarrhea was significantly declined over the last sixteen years and the decline was due to difference in behavior between the surveys. Being twin, weight of child at birth, vaccinated for measles and rotavirus, number of under-five children, wealth status, distance to health facility, health insurance and child waste disposal method were significantly associated with diarrhea among under five children in Ethiopia. Therefore Ethiopian government should focus on the strengthening and scaling up of behavioral change packages of the community regarding to keeping hygiene and sanitation of the community and their environment, vaccinating their children, accessing health care services to prevent diarrheal disease.
Development and usability of educational material about workplace particulate matter exposure
Authors: Stege T. A. M. , Bolte J. F. B. , Claassen L. , Timmermans D. R. M.
Published: January 2021

Background

Particulate matter (PM) exposure is an important health risk, both in daily life and in the workplace. It causes respiratory and cardiovascular diseases and results in 800,000 premature deaths per year worldwide. In earlier research, we assessed workers’ information needs regarding workplace PM exposure, the properties and effects of PM, and the rationale behind various means of protection. We also concluded that workers do not always receive appropriate risk communication tools with regards to PM, and that their PM knowledge appears to be fragmented and incomplete.

Methods

We considered several concepts for use as an educational material based on evaluation criteria: ease of use, costs, appropriateness for target audiences and goals, interactivity, implementation issues, novelty, and speed. We decided to develop an educational folder, which can be used to inform employees about the properties, effects and prevention methods concerning PM. Furthermore, we decided on a test setup of a more interactive way of visualisation of exposure to PM by means of exposimeters. For the development of the folder, we based the information needs on our earlier mental models-based research. We adjusted the folder based on the results of ten semi-structured interviews evaluating its usability.

Results

The semi-structured interviews yielded commentaries and suggestions for further improvement, which resulted in a number of alterations to the folder. However, in most cases the folder was deemed satisfactory.

Conclusion

Based on this study, the folder we developed is suitable for a larger-scale experiment and a practical test. Further research is needed to investigate the efficacy of the folder and the application of the exposimeter in a PM risk communication system.
The influence of the municipal human development index and maternal education on infant mortality: an investigation in a retrospective cohort study in the extreme south of Brazil
Authors: Anele Carolina Ribeiro , Hirakata Vânia Naomi , Goldani Marcelo Zubaran , da Silva Clécio Homrich
Published: January 2021

Background

Infant mortality is considered an important and sensitive health indicator in several countries, especially in underdeveloped and developing countries. Most of the factors influencing infant mortality are interrelated and are the result of social issues. Therefore, this study performed an investigation of the influence of the MHDI and maternal education on infant mortality in a capital in the extreme south of Brazil.

Methods

It is a retrospective cohort study with data on births and deaths in the first year of life for the period of 2000–2017. The association between the independent variables and the outcome was done by bivariate analysis through simple Poisson regression. The variables that can potentially be considered confounding factors were used in a multiple Poisson regression for robust variances - adjusted model.

Results

The study included 317,545 children, of whom 3107 died. The medium MHDI showed associated with infant death in the first year of life. Maternal education, individually and jointly analyzed with the MHDI, showed association with the outcome of infant death in the first year of life, particularly for children of mothers with lower maternal education (p < 0.001). In relation to other related factors, maternal age; number of Prenatal Care Consultations; gestational age, weight, gender and Apgar Index (5th minute) of the newborn showed association with IM (p < 0.001).

Conclusions

The HDI is considered a good predictor of infant mortality by some authors and the analyzes of the present study also confirm an association of the medium MHDI and its low MHDIE component with infant mortality. In addition, it was maternal education with less than 8 years of study that that demonstrated a higher risk of death, revealing itself to be a social determinant with a relevant impact on infant mortality. Thus, it is possible to conclude that maternal education is available information, and it is superior to the MHDI to assess the infant mortality outcome.
Effects of effort-reward imbalance, job satisfaction, and work engagement on self-rated health among healthcare workers
Authors: Ge Jingjing , He Jing , Liu Yan , Zhang Juying , Pan Jingping , Zhang Xueli , Liu Danping
Published: January 2021

Background

Healthcare workers, who protect and improve the health of individuals, are critical to the success of health systems and achieving national and global health goals. To respond effectively to the healthcare needs of populations, healthcare workers themselves must be in a good state of health. However, healthcare workers face various psychosocial pressures, including having to work night shifts, long working hours, demands of patient care, medical disputes, workplace violence, and emotional distress due to poor interactions with patients and colleagues, and poor promotion prospects. Constant exposure to these psychosocial hazards adversely impacts healthcare workers’ health. Consequently, this study aimed to examine the influence of effort-reward imbalance, job satisfaction, and work engagement on self-rated health of healthcare workers. The results would be conducive to providing policy guidance to improve the health of healthcare workers.

Methods

We analysed the data of 1327 participants from The Chinese Sixth National Health and Services Survey in Sichuan Province that was conducted from August 2018 to October 2018. Structural equation modelling was used to test the hypothesized relationships among the variables.

Results

Only 40.1% of healthcare workers rated their health as ‘relatively good’ or ‘good’. Effort-reward imbalance had a significant negative correlation with self-rated health (β = − 0.053, 95% CI [− 0.163, − 0.001]). The associations of effort-reward imbalance and work engagement with self-rated health were both mediated by job satisfaction (95% CI [− 0.150, − 0.050] and [0.011, 0.022]), and work engagement mediated the relationship between effort-reward imbalance and self-rated health (95% CI [− 0.064, − 0.008]).

Conclusion

In order to improve the health of healthcare workers, administrators should balance effort and reward and provide opportunities for career development and training. In addition, health managers should help healthcare workers realize the significance and value of their work and keep them actively devoted to their work through incentive mechanisms.
Perceived barriers to the practice of preventive measures for COVID-19 pandemic among health professionals in public health facilities of the Gamo zone, southern Ethiopia: a phenomenological study
Authors: Mersha Abera , Shibiru Shitaye , Girma Meseret , Ayele Gistane , Bante Agegnehu , Kassa Mekidim , Abebe Sintayehu , Shewangizaw Misgun
Published: January 2021

Background

Novel coronavirus is a global pandemic and killed many individuals, including health care professionals. It caused stress on the health care system of all countries. Presently, studies are emerging regarding the COVID-19 pandemic in different aspects. However, a few have explored barriers that affecting the practice of preventive measures for the COVID-19. As such, the study aimed to fill these research gaps in the study setting.

Methods

A semi-structured interview guide was used to conduct this phenomenological study among 16 key informants. Key informants were recruited by the purposive sampling method. To analyze that data, thematic content analysis was employed by using an inductive approach in NVivo 12 Pro software.

Results

In this study, six main themes were identified with the sub-themes. Overview of COVID-19 pandemic (with the six sub-themes), consequences (with the two sub-themes), perceived practice (with four sub-themes), perceived barriers (with four sub-themes), newfangled activities (with three sub-themes), and suggestion for improvement (with seven sub-themes) were the major themes. The participants perceived the influence of shortage of personal protective equipment and solutions for hand hygiene, negligence and ignorance, inadequate infrastructure, lack of training, and lack of attention and recognition for the staff on the practice of preventive measures.

Conclusions

This study showed a gap in preventive measure practices for the COVID-19 in the health care system. Community influences, health care provider related barriers, institutional barriers, and lack of communication and support affect the practice. Hence, attention should give to fulfill the necessary supplies in the health facilities, improve the infrastructures, and equip health professionals by providing capacity-building activities. Besides, health care workers must recognize, and attention is needed.
Temporal changes of haematological and radiological findings of the COVID-19 infection—a review of literature
Authors: Lim Albert Yick Hou , Goh Jun Leng , Chua Mae Chui Wei , Heng Bee Hoon , Abisheganaden John Arputham , George Pradeep Paul
Published: January 2021

Background

COVID-19 is a systemic viral infection which mainly targets the human respiratory system with many secondary clinical manifestations especially affecting the hematopoietic system and haemostasis. Few studies have highlighted the prognostic value of blood findings such as lymphopenia, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, LDH, CRP, cardiac troponin, low-density lipoproteins and chest radiographic abnormality. A study of progressions of blood and radiological results may help to identify patients at high risk of severe outcomes. This systematic review aimed to assess the temporal progression of blood and radiology findings of patients with COVID-19.

Methods

Comprehensive systematic literature search was conducted on Medline, Embase and Cochrane databases to identify articles published for peripheral blood investigation and radiological results of COVID-19 patients.

Results

A total of 27 studies were included in this review. The common laboratory features reported include lymphopenia, elevated levels of C-reactive proteins and lactate dehydrogenase. For radiological signs, ground-glass opacifications, consolidations, and crazy paving patterns were frequently reported. There is a correlation between lymphocyte count, neutrophil count and biomarkers such as C-reactive proteins and lactate dehydrogenase; at a later phase of the disease (more than 7 days since onset of symptoms), lymphopenia worsens while neutrophil count, C-reactive protein levels and lactate dehydrogenase levels increase. Frequencies of ground-glass opacifications and ground-glass opacifications with consolidations decrease at a later phase of the disease while that of consolidation and crazy paving pattern rises as the disease progresses. More extensive lung involvement was also seen more frequently in the later phases.

Conclusion

The correlation between temporal progression and the reported blood and radiological results may be helpful to monitor and evaluate disease progression and severity.
Reconstruction using a frozen autograft for a skull and humeral lesion of synchronous multicentric osteosarcoma after undergoing successful neoadjuvant chemotherapy: a case report and review of the literature
Authors: Araki Yoshihiro , Hayashi Katsuhiro , Yamamoto Norio , Takeuchi Akihiko , Miwa Shinji , Igarashi Kentaro , Higuchi Takashi , Abe Kensaku , Taniguchi Yuta , Yonezawa Hirotaka , Morinaga Sei , Asano Yohei , Nojima Takayuki , Tsuchiya Hiroyuki
Published: January 2021

Background

Synchronous multicentric osteosarcoma (SMOS) is a rare disease characterized by simultaneous multicentricity of intraosseous osteosarcoma without visceral involvement. SMOS, including a skull lesion, which occurs relatively rarely, and reconstruction using a frozen autograft after the excision of a lesion of SMOS has been infrequently reported previously.

Case presentation

We report an 18-year-old girl with SMOS, with lesions located in the left distal femur, right proximal humerus, and left occipital bone. Her major complaint was pain and swelling around the left knee joint. Asymptomatic lesions of the humerus and skull bone were detected on a systemic bone scan. No visceral organ metastasis was observed. A biopsy of the distal femoral lesion revealed osteosarcoma. Based on the histological findings, multiple bone lesions, and absence of visceral lesion, the clinical diagnosis of SMOS was made. After five courses of neoadjuvant chemotherapy with a regimen of doxorubicin and cisplatin, reconstruction using a tumor prosthesis following wide excision of the left distal femur was performed, and total necrosis was histologically observed in the retracted specimen. Following three cycles of adjuvant chemotherapy, tumor excision and reconstruction with a frozen autograft treated with liquid nitrogen was conducted for both lesions of the humerus and skull, rather than tumor prosthesis or synthetics, in order to retain a normal shoulder function, and to obtain a good cosmetic and functional outcome after treatment of the skull lesion. Further adjuvant chemotherapy could not be administered after the completion of the surgical treatment for all lesions because the adverse events due to chemotherapy were observed. At over 5 years after the diagnosis, she remains clinically disease-free.

Conclusions

An early correct diagnosis, the proper management of chemotherapy, and surgical treatment for all lesions are essential for achieving a good clinical outcome, even in SMOS including a skull lesion. By performing reconstruction using a frozen autograft for a proximal humeral lesion and a skull lesion after confirming the good histological efficacy of neoadjuvant chemotherapy for the primary lesion, the excellent function of the shoulder joint and a good cosmetic outcome at the site of the skull lesion was acquired without complications or recurrence.
Prognostic impact of the prognostic nutritional index in cases of resected oral squamous cell carcinoma: a retrospective study
Authors: Abe Atsushi , Hayashi Hiroki , Ishihama Takanori , Furuta Hiroshi
Published: January 2021

Background

The systemic inflammatory response and nutritional status of patients with malignant tumors are related to postoperative results. We examined the usefulness of the prognostic nutritional index (PNI) as a prognostic tool in patients with oral squamous cell carcinoma who underwent radical surgery.

Methods

From 2008 to 2019, 102 patients (73 males, 29 females; age, 65.6 ± 9.8 years) who visited our hospital and underwent surgical therapy were included in this study. The endpoint was the total survival period, and the evaluation markers included the lymphocyte count and albumin level in peripheral blood obtained 4 weeks preoperatively, age, sex, alcohol consumption, smoking history, site of the tumor, pathological stage, and surgery status. The PNI was calculated using serum albumin levels and the peripheral blood lymphocyte count. The relationship between the PNI and patient characteristics were analyzed using Fisher's exact test. The Kaplan–Meier method was used to evaluate the survival rate. The survival periods were compared using the log-rank method. We evaluated the prognostic factors for overall survival (OS) and disease-free survival (DFS) in a logistic regression model.

Results

The tumor sites included the maxilla (n = 12), buccal mucosa (n = 11), mandible (n = 17), floor of the mouth (n = 9), and tongue (n = 53). The number of patients with stage I, II, III, and IV oral cancers was 28 (27.5%), 34 (27.5%), 26 (33.3%), and 14 (13.7%), respectively. During the observation period, 21 patients died of head and neck cancer. The optimal cut-off PNI value was 42.9, according to the receiver operating characteristic analysis. The proportion of patients with a short OS was lower in those with PNI higher than 42.9, and the 5-year OS in patients with PNI higher and lower than the cut-off value was 62.3% and 86.0%, respectively (P = 0.0105).

Conclusions

The OS of patients with PNI < 42.9 was lower than that of patients with PNI ≥ 42.9. The PNI, which is a preoperative head-to-foot inflammatory marker, can help in estimating the prognosis of oral cancer.
Effect of a 980-nm diode laser on post-operative pain after endodontic treatment in teeth with apical periodontitis: a randomized clinical trial
Authors: Kaplan Tuna , Sezgin Güzide Pelin , Sönmez Kaplan Sema
Published: January 2021

Background

This study aimed to assess the effect of a 980-nm diode laser following chemomechanical root canal preparation on the severity of post-operative pain (PP) after root canal treatment (RCT).

Methods

This study included asymptomatic, single-rooted teeth with a periapical index (PAI) score of 3 or 4. All the patients received RCT, including dressing with calcium hydroxide (Ca(OH)2), during two visits. The patients were randomly divided into two groups (n:30): a control group, in which the final irrigation was performed using 5 ml of 2.5% sodium hypochlorite (NaOCI), followed by 5 ml of 17% and ethylenediaminetetraacetic acid (EDTA) and 5 ml of distilled water, and a laser group, in which the root canals were irradiated using a 980-nm diode laser after the final irrigation at both visits. The pain levels after both visits were evaluated using a visual analogue scale (VAS) after 8 h, 24 h, 48 h and 7 d. In addition, the time intervals to medication intake were recorded. The collected data were statistically analysed using the chi-square and Mann–WhitneyUtest (p < 0.05).

Results

The average pain level in the control group 24 h after the first visit was significantly higher than that in the laser group (p < 0.05). The average pain level 24 h and 48 h after the second visit was significantly higher in the control group (p < 0.05). The levels of PP 24 h after the first visit were higher than those after the second visit only in the control group (p < 0.05). After the first visit, analgesic use in the control group was significantly higher after 8 h (40%) and 24 h (23%) as compared with that in the laser group (p < 0.05).

Conclusions

Root canal irradiation with a diode laser may reduce PP after RCT in single-rooted teeth with a PAI score of 3 or 4.

Trial registration: Effect of the Diode Laser on Post-operative Pain After Endodontic Treatment in Teeth with Apical Periodontitis: NCT04486196. Registered 24 July 2020—Retrospectively registered,http://clinicaltrials.gov/ct2/show/NCT04486196
Nurses’ and midwives’ perspectives on participation in national policy development, review and reforms in Ghana: a qualitative study
Authors: Acheampong Angela Kwartemaa , Ohene Lillian Akorfa , Asante Isabella Naana Akyaa , Kyei Josephine , Dzansi Gladys , Adjei Charles Ampong , Adjorlolo Samuel , Boateng Francis , Woolley Philomena , Nyante Felix , Aziato Lydia
Published: January 2021

Background

The World Health Organization has admonished member countries to strive towards achieving universal health coverage (UHC) through actionable health policies and strategies. Nurses and midwives have instrumental roles in achieving UHC via health policy development and implementation. However, there is a paucity of empirical data on nurses and midwives’ participation in policy development in Ghana. The current study explored nurses and midwives’ participation in policy development, reviews and reforms in Ghana.

Methods

A qualitative descriptive exploratory design was adopted for this study. One-on-one individual interviews were conducted after 30 participants were purposefully selected. Data was audiotaped with permission, transcribed and analyzed inductively using the content analysis procedures.

Results

Two main themes emerged from the data: participation in policy development and perspectives on policy reviews and reforms. The findings showed that during health policy development and reviews, nurses in Ghana were overlooked and unacknowledged. Policy reforms regarding bridging the pre-service preparation gap, staff development and motivation mechanisms and influence on admission into nursing schools were raised.

Conclusion

The authors concluded that nurses and midwives are crucial members of the healthcare systems and their inputs in policy development and reviews would improve health delivery in Ghana.
Co-design and feasibility of a pharmacist-led minor ailment service
Authors: Dineen-Griffin Sarah , Benrimoj Shalom I. , Williams Kylie A. , Garcia-Cardenas Victoria
Published: January 2021

Background

Community pharmacies provide an appropriate setting to deliver minor ailment services (MASs). Many community pharmacy services have been developed previously without stakeholder involvement. As a result, implementation of services may fail to produce the expected impact. The aim of this research was to co-design and test the feasibility of an Australian MAS for minor ailment presentations.

Methods

This study used co-design methodology which included two phases: (1) a focus group with stakeholders to allow the conceptualization of the service and agreement on service elements; (2) a literature review of clinical guidelines and three working meetings with a team of editors and general practitioners for the development of treatment pathways. Following this, a study evaluating the feasibility of the co-designed service was undertaken. The qualitative part of the methodology associated with the feasibility study comprised semi-structured interviews with MAS pharmacists, observation and completion of a tool by change facilitators identifying barriers and facilitators to service delivery. Qualitative data obtained for all phases were analysed using thematic analysis.

Results

The developed service included the following components: (i) an in-pharmacy consultation between the patient and pharmacist, (ii) treatment pathways accessible to pharmacists on the internet to guide consultations, (iii) existing digital communication systems used by general practice to exchange patient information, (iv) training, and (v) change facilitation. As a result of feasibility testing, twenty-six implementation factors were identified for practice change, with the main change being the simplification of the pharmacist-patient consultation and data collection processes.

Conclusions

An Australian MAS was generated as a result of co-design, while testing revealed that the co-designed service was feasible. As a result of integrating the views of multiple stakeholders, the designed MAS has been adapted to suit healthcare practices, which may increase the acceptance and impact of MAS when implemented into practice.
A case of a complete atrioventricular canal defect in a ferret
Authors: Agudelo Carlos F , Jekl Vladimír , Hauptman Karel , Crha Michal , Kocaturk Meric
Published: January 2021

Background

Atrioventricular canal defect is a rare congenital disorder of the heart and describes the presence of an atrial septal defect, a variable presentation of ventricular septal alterations including ventricular septal defect malformations in the mitral and tricuspid valves. The defect has been described in human beings, dogs, cats, pigs, and horses.

Case presentation

This paper describes the case of a complete atrioventricular canal defect in a four-year-old intact male pet ferret (Mustela putorius furo), which was presented due to posterior weakness, ataxia, and decreased appetite. A loud systolic murmur, dyspnea, and hind limb paraparesis were detected during the clinical examination. Thoracic radiographs showed generalized cardiomegaly and lung edema. ECG showed sinus rhythm with prolonged P waves and QRS complexes. Echocardiography showed a large atrial septal defect, atrioventricular dysplasia, and a ventricular septal defect. Palliative treatment with oxygen, furosemide, spironolactone, enalapril, diltiazem, and supportive care was chosen as the therapy of choice. The ferret recovered gradually during hospitalization. A follow-up examination at three and six months showed stabilization of cardiac function.

Conclusions

To the authors knowledge, this is the first time an atrioventricular canal defect has been described in a pet ferret.
Identifying of 22q11.2 variations in Chinese patients with development delay
Authors: Zhang Yuanyuan , Liu Xiaoliang , Gao Haiming , He Rong , Zhao Yanyan
Published: January 2021

Background

22q11.2 variation is a significant genetic factor relating to development delay and/or intellectual disability. However, the prevalence, genetic characteristics and clinical phenotype in Chinese patients are unknown.

Methods

In total 6034 patients with development delay and/or intellectual disability were screened by multiplex ligation-dependent probe amplification (MLPA) P245 and G-band karyotyping. The positive patients with 22q11.2 imbalance were confirmed by MLPA P250 assay.

Results

52 (0.86%) patients were found to carry different levels of 22q11.2 variations, in which 37 cases (71.2%) had heterozygous deletions, whereas 15 (28.8%) had heterogeneous duplications. 34 cases (65.4%) carried typical imbalance from low copy repeat (LCR) 22 A to D. The other cases had atypical variations, relating to LCR22 A-B, LCR22 C-D, LCR22 B-D, LCR22 D-E, LCR22 E-F and LCR22 B-F region. The phenotypes of these 52 patients were variable, including development delay, language delay, facial anomalies, heart defects, psychiatric/behavior problems, epilepsy, periventricular leukomalacia, hearing impairment, growth delay etc.

Conclusion

These data revealed the prevalence and variability of 22q11.2 genomic imbalance in Chinese patients with development delay and/or intellectual disability. It suggested that genetic detection of 22q11.2 is necessary, especially for the patients with mental retardation and development disorders, which deserves the attention of all pediatricians in their daily work.
Potential diagnostic and prognostic value and regulatory relationship of long noncoding RNA CCAT1 and miR-130a-3p in clear cell renal cell carcinoma
Authors: Jing Jingjing , Zhao Xu , Wang Jiannan , Li Tan
Published: January 2021

Background

MicroRNAs (miRNAs) and long non-coding RNAs (lncRNAs) could interact with each other to play a vital role in the pathogenesis of cancers. We aimed to examine the expression profile, clinical significance and regulatory relationship of miR-130a-3p and its predicted interactive lncRNA in clear cell renal cell carcinoma (ccRCC).

Methods

Bioinformatics analysis was used to predict lncRNAs binding with miR-130a-3p. qRT-PCR was employed to detect the expression levels of miR-130a-3p and the miRNA-targeted lncRNA, and their clinical values in ccRCC were clarified. The lncRNA sponge potential of miR-130a-3p was assessed through dual-luciferase reporter assay and the biological effects of them were observed.

Results

Colon cancer associated transcript 1 (CCAT1) directly interacted with miR-130a-3p and negatively regulated miR-130a-3p expression. CCAT1 was upregulated and miR-130a-3p was downregulated in ccRCC cell line and tissues (all P < 0.05). High CCAT1 and low miR-130a-3p expression was correlated with larger tumor size and advanced TNM stage in ccRCC patients. High CCAT1 level suggested a poor survival prognosis. There was a negative association between CCAT1 and miR-130a-3p expression (r = − 0.373, P = 0.010). MiR-130a-3p mimic and si-CCAT1 inhibited ccRCC cell proliferation and invasion, and induced apoptosis.

Conclusions

CCAT1/miR-130a-3p axis may have potential to serve as a novel diagnostic and prognostic target of ccRCC patients.
Associations between the quality of life in sarcopenia measured with the SarQoL® and nutritional status
Authors: Kim Yongtaek , Park Ki Soo , Yoo Jun Il
Published: January 2021

Background

The purpose of this study was to evaluate the relationship between nutritional status and health-related quality of life after adjusting for essential factors of muscle mass, calf circumference, grip strength, and the timed up and go (TUG) test for diagnosis of sarcopenia.

Methods

The subjects of this study were those who visited a health care center or a senior welfare center among the aged 65 years or older living in a community in two counties (Jinju, Sacheon), and the survey was conducted from April to August 2019. Among them, those with cardiovascular disease, cognitive disorder, or malignancy were excluded. To determine the nutritional status of the elderly subjects, a questionnaire-based screening tool called DETERMINE was used. Developed as a health-related quality of life tool for sarcopenia, the Sarcopenia-specific Quality of Life (SarQoL) questionnaire was used. For screening of sarcopenia, a rapid questionnaire based on self-reported information about falls, mobility, and strength known as the SARC-F questionnaire was used. Assessment of sarcopenia included skeletal muscle mass, calf circumference, grip strength, and the TUG test.

Results

A total of 324 elderly people living in rural villages who were able to move to senior and welfare centers was surveyed. As a result of evaluating the association between SarQoL and nutritional risk in elderly subjects, the association was statistically significant in the moderate-risk group (B = − 5.542, p = 0.001) and in the high-risk group (B = − 8.136, p < 0.001) in comparison to the low-risk group. Significant correlations were found in all seven domains of SarQoL, except the fear domain.

Conclusions

This study confirms an association between quality of life dimensions surveyed by the SarQoL questionnaire and nutritional status in elderly subjects. Therefore, appropriate interventions are needed following brief evaluation of sarcopenia and nutritional deficiency among elderly people in communities.
Predictive value of live birth rate based on different intrauterine adhesion evaluation systems following TCRA
Authors: Cao Mingzhu , Pan Yingying , Zhang Qingyan , You Danming , Feng Shuying , Liu Zhi
Published: January 2021

Objective

The aim of this study was to assess the predictive value of five different intrauterine adhesion (IUA) evaluation systems for live birth rate following transcervical resection of adhesion (TCRA).

Method

This retrospective study included 128 women with IUA who desired for spontaneous conception after TCRA. All the patients were retrospectively scored by the American Fertility Society (AFS) classification, European Society of Gynecological Endoscopy (ESGE) classification, March’s classification (March), Nasr classification (Nasr) and Chinese IUA diagnosis classification criteria (Chinese). The predictive value of these evaluation systems was determined by receiver operating characteristic (ROC) curves and area under a ROC curve (AUC).

Results

The correlation coefficients of AFS, ESGE, March, Nasr and Chinese classification and the live birth rate were 0.313, 0.313, 0.288, 0.380, and 0.336, respectively. Among women with hypomenorrhea and amenorrhea, as well as women with no infertility, the severities determined by all five evaluation systems were correlated with live birth rate (P <  0.001). All five scoring systems were efficient to predict live birth rate. Among them, Nasr classification showed the highest AUC (0.748) with the best predictive value. Multivariate logistic regression analyses showed that Nasr classification had the highest OR (OR, 6.523; 95% CI, 2.612, 18.263). And, Nasr’s classification system also showed highest sensitivity (81.8%) and negative predictive value (96.7%) when divide the system into mild IUA vs. moderate and severe IUA.

Conclusion

AFS, ESGE, March, Nasr and Chinese classification were demonstrated to be capable of predicting live birth following TCRA although the predictive capacities might be limited, and Nasr classification showed the highest predictive value of live birth.
I don’t want to think about it: a qualitative study of children (6–18 years) with rheumatic diseases and parents’ experiences with regular needle injections at home
Authors: Sørensen Kari , Skirbekk Helge , Kvarstein Gunnvald , Wøien Hilde
Published: January 2021

Background

Overall outcomes of pediatric rheumatic diseases (RD) have improved due to treatment with biologic agents and methotrexate. For many children, this treatment often entails regular needle injections. Pain and fear of needle injections are common in childhood, but how children and parents handle long-term needle injections at home has not been fully explored. This study aimed to explore how regular needle injections affect children with RD and their parents in their daily living.

Methods

This explorative qualitative study used individual interviews and focus groups to ensure a comprehensive investigation of the topic. Children aged 6 to 16 years (n = 7) and their parents (n = 8) were interviewed individually 4 to 6 months after the onset of needle injection treatment. The focus groups included children aged 11 to 17 years (n = 9) and parents (n = 8) with a minimum of 6 months of experience with injection treatment. Data were analyzed using thematic analysis.

Results

The main themes; “challenges,” “motivational factors,” and “routines” captured experiences and strategies that influenced the continuation of needle injections at home. Many children feared the moment immediately before the needle stick, although they had become accustomed to the pain. Most parents felt insecure about handling needle injections and lacked follow-up from healthcare providers. The children’s experience of treatment effects and self-confidence were essential to maintain motivation for further injections. A number of coping strategies helped children focus away from injection related discomfort, often discovered by chance. Facilitating firm routines and shared responsibility within families helped children develop self-confidence during the procedure. Children and parents struggled to find suitable information on the Internet.

Conclusions

Children and parents experienced long-term needle injections challenging. They used their own limited resources and cooperated within the families to create routines and to introduce coping strategies necessary to manage and keep up with the procedure. Although the injection itself was not experienced very painful, the discomfort, worries and impact on daily life represented far more than a little needle stick, and thus needs more attention from healthcare providers.
Systemic inflammation and chronic kidney disease in a patient due to the RNASEH2B defect
Authors: He Tingyan , Xia Yu , Yang Jun
Published: January 2021

Introduction

Aicardi-Goutières (AGS) is a rare immune dysregulated disease due to mutations in TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, ADAR1, or IFIH1. Clinical features include basal ganglia calcifications, white matter abnormalities, and cerebral atrophy. Severe systemic inflammation and chronic kidney disease (CKD) are extremely rare in AGS. Herein, we report a patient presenting with systemic inflammation and CKD to broaden the clinical phenotype spectrum of the RNASEH2B defect.

Methods

All testing and molecular genetic analysis were performed after obtaining the informed consent of the parents. Demographic, clinical, and laboratory findings were abstracted from outpatient and inpatient encounters. Cerebral magnetic resonance imaging (MRI), computed tomography (CT) scans, and renal biopsy histopathology reports were reviewed and summarized. Whole exome sequencing (WES) was performed on peripheral blood cells. After exposure to cGAMP in vitro for 24 h, mRNA expression of 12 IFN-stimulated cytokine genes in PBMCs was assessed. Serum cytokine levels were detected by Milliplex.

Results

A 11-year-old girl presented with recurrent aseptic fever, arthritis, chilblains, failure to thrive, mild hearing loss, and neurological manifestations. Laboratory and immunologic findings demonstrated lymphopenia, low complement levels, positive autoantibodies, elevated levels of acute-phase reactants and inflammatory cytokines. Cerebral imaging showed cerebral atrophy, white matter abnormalities, and intracranial calcification. Renal biopsy showed glomerular sclerosis in 3 of 14 glomeruli, infiltration of lymphocytes and other mononuclear cells. WES revealed a homozygous and heterozygous mutations in RNASEH2B. Over-expression of IFN-stimulated cytokine genes was observed, including IFI44, IFI27, IFIT1, IFIT2, IFIT3, ISG15, OAS1, and SIGLEC1.

Conclusions

To date, only two cases with AGS have been reported to have renal disease. Here, we describe a patient with both homozygous and heterozygous variants in RNASEH2B, presenting with neurological manifestations, persistently systemic autoinflammation, and CKD. CKD has never been reported in patients with AGS due to the RNASEH2B defect.

Trial registration

Not applicable; this was a retrospective study.
Gender differences in externalizing and internalizing problems in Singaporean children and adolescents with attention-deficit/hyperactivity disorder
Authors: Lau Tsz Wing Ivy , Lim Choon Guan , Acharryya Sanchalika , Lim-Ashworth Nikki , Tan Yi Ren , Fung Shuen Sheng Daniel
Published: January 2021

Background

Studies on gender differences in attention-deficit/hyperactivity disorder (ADHD) comorbidities in the Asian populations have been limited and previous studies have shown inconclusive findings. Singapore is a city-state country in Southeast Asia with a population of 5.7 million. This study examined gender differences in internalizing and externalizing problems in Singaporean children and adolescents with ADHD. The plausible social factors underlying the gender differences were discussed.

Methods

A total of 773 participants (aged 6 to 18, 88% males) newly diagnosed with ADHD were recruited from the largest public child and adolescent psychiatric center in Singapore. Their internalizing and externalizing problems were assessed using the Child Behavioral Checklist and Teacher’s Report Form by parents and teachers respectively. Demographics and relevant social factors were collected using parent questionnaires.

Results

Females with ADHD were reported to have less delinquent and aggressive behavior but more depressive symptoms than their male counterparts, similar to findings in the Western literature. Gender remained a significant predictor of externalizing problem after controlling for other factors. Lower socioeconomic status and parental use of physical punishment were significant predictors of both internalizing and externalizing problems.

Conclusions

Gender differences in ADHD comorbidities do exist in the Asian clinical population. The lack of externalizing symptoms in females with ADHD has made timely referral and diagnosis challenging. More research is needed in understanding the gender differences in ADHD and the biopsychosocial mechanism underlying the differences in order to improve the detection of ADHD in females.
Mice carrying a schizophrenia-associated mutation of the Arhgap10 gene are vulnerable to the effects of methamphetamine treatment on cognitive function: association with morphological abnormalities in striatal neurons
Authors: Hada Kazuhiro , Wulaer Bolati , Nagai Taku , Itoh Norimichi , Sawahata Masahito , Sobue Akira , Mizoguchi Hiroyuki , Mori Daisuke , Kushima Itaru , Nabeshima Toshitaka , Ozaki Norio , Yamada Kiyofumi
Published: January 2021

We recently found a significant association between exonic copy-number variations in the Rho GTPase activating protein 10 (Arhgap10) gene and schizophrenia in Japanese patients. Special attention was paid to one patient carrying a missense variant (p.S490P) in exon 17, which overlapped with an exonic deletion in the other allele. Accordingly, we generated a mouse model (Arhgap10 S490P/NHEJ mice) carrying a missense variant and a coexisting frameshift mutation. We examined the spatiotemporal expression of Arhgap10 mRNA in the brain and found the highest expression levels in the cerebellum, striatum, and nucleus accumbens (NAc), followed by the frontal cortex in adolescent mice. The expression levels of phosphorylated myosin phosphatase-targeting subunit 1 and phosphorylated p21-activated kinases in the striatum and NAc were significantly increased in Arhgap10 S490P/NHEJ mice compared with wild-type littermates. Arhgap10 S490P/NHEJ mice exhibited a significant increase in neuronal complexity and spine density in the striatum and NAc. There was no difference in touchscreen-based visual discrimination learning between Arhgap10 S490P/NHEJ and wild-type mice, but a significant impairment of visual discrimination was evident in Arhgap10 S490P/NHEJ mice but not wild-type mice when they were treated with methamphetamine. The number of c-Fos-positive cells was significantly increased after methamphetamine treatment in the dorsomedial striatum and NAc core of Arhgap10 S490P/NHEJ mice. Taken together, these results suggested that schizophrenia-associated Arhgap10 gene mutations result in morphological abnormality of neurons in the striatum and NAc, which may be associated with vulnerability of cognition to methamphetamine treatment.
Molecular characterization of Cryptosporidium isolates from humans in Ontario, Canada
Authors: Guy Rebecca A. , Yanta Christine A. , Muchaal Pia K. , Rankin Marisa A. , Thivierge Karine , Lau Rachel , Boggild Andrea K.
Published: January 2021

Background

Cryptosporidiosis is a gastrointestinal disease with global distribution. It has been a reportable disease in Canada since 2000; however, routine molecular surveillance is not conducted. Therefore, sources of contamination are unknown. The aim of this project was to identify species and subtypes of Cryptosporidium in clinical cases from Ontario, the largest province in Canada, representing one third of the Canadian population, in order to understand transmission patterns.

Methods

A total of 169 frozen, banked, unpreserved stool specimens that were microscopy positive for Cryptosporidium over the period 2008–2017 were characterized using molecular tools. A subset of the 169 specimens were replicate samples from individual cases. DNA was extracted directly from the stool and nested PCR followed by Sanger sequencing was conducted targeting the small subunit ribosomal RNA (SSU) and glycoprotein 60 (gp60) genes.

Results

Molecular typing data and limited demographic data were obtained for 129 cases of cryptosporidiosis. Of these cases, 91 (70.5 %) were due to Cryptosporidium parvum and 24 (18.6%) were due to Cryptosporidium hominis. Mixed infections of C. parvum and C. hominis occurred in four (3.1%) cases. Five other species observed were Cryptosporidium ubiquitum (n = 5), Cryptosporidium felis (n = 2), Cryptosporidium meleagridis (n = 1), Cryptosporidium cuniculus (n = 1) and Cryptosporidium muris (n = 1). Subtyping the gp60 gene revealed 5 allelic families and 17 subtypes of C. hominis and 3 allelic families and 17 subtypes of C. parvum. The most frequent subtype of C. hominis was IbA10G2 (22.3%) and of C. parvum was IIaA15G2R1 (62.4%).

Conclusions

The majority of isolates in this study were C. parvum, supporting the notion that zoonotic transmission is the main route of cryptosporidiosis transmission in Ontario. Nonetheless, the observation of C. hominis in about a quarter of cases suggests that anthroponotic transmission is also an important contributor to cryptosporidiosis pathogenesis in Ontario.

Graphical Abstract
Lipoptena fortisetosa as a vector of Bartonella bacteria in Japanese sika deer (Cervus nippon)
Authors: Sato Shingo , Kabeya Hidenori , Ishiguro Sayuri , Shibasaki Yasuhiro , Maruyama Soichi
Published: January 2021

Background

Two species of deer ked (Lipoptena cerviandL. mazamae) have been identified as vectors ofBartonellabacteria in cervids in Europe and the USA. In an earlier study we showed that Japanese sika deer (Cervus nippon) harbor threeBartonellaspecies, namelyB. capreoli(lineage A) and two novelBartonellaspecies (lineages B and C); however, there is currently no information on the vector ofBartonellabacteria in sika deer. The aim of this study was to clarify potential vectors ofBartonellain Japanese sika deer.

Methods

Thirty-eight wingless deer keds (L. fortisetosa) and 36 ticks (HaemaphysalisandIxodesspecies) were collected from sika deer. The prevalence ofBartonellain the arthropods was evaluated by real-time PCR targeting the 16S−23S internal transcribed spacer (ITS) and by culture of the organisms. The total number ofBartonellabacteria were quantified using real-time PCR. The distribution ofBartonellabacteria in deer ked organs was examined by immunofluorescence analysis. The relationship ofBartonellastrains isolated from sika deer and arthropods were examined by a phylogenetic analysis based on concatenated sequences of thegltA,rpoB,ftsZ, andribCgenes, followed by a BLAST search forgltAandrpoB.

Results

Bartonellaprevalence in deer keds was 87.9% by real-time PCR and 51.5% in culture and that in the ticks was 8.3% by real-time PCR and 2.8% in culture. The mean number ofBartonellabacteria per ked was calculated to be 9.2 × 105cells.Bartonellaaggregates were localized in the midgut of the keds. The phylogenetic analysis and BLAST search showed that both the host deer and the keds harbored twoBartonellaspecies (lineages B and C), whileB. capreoli(lineage A) was not detected in the keds. Two novelBartonellaspecies (lineages D and E) were isolated from one ked.

Conclusions

Lipoptena fortisetosalikely serves as a vector of at least twoBartonellaspecies (lineages B and C), whereas ticks do not seem to play a significant role in the transmission ofBartonellabetween sika deer based on the lower detection rates ofBartonellain ticks compared to keds.Bartonellaspecies in lineages D and E appear to beL. fortisetosa-specific strains.

Graphical Abstract