bluuebunny/crossref_metadata_2025 huggingface dataset:
Children’s physical activity level and sedentary behavior in Norwegian early childhood education and care: effects of a staff-led cluster-randomized controlled trial
Authors: Andersen Eivind , Øvreås Steinar , Jørgensen Kari Anne , Borch-Jenssen Janne , Moser Thomas
Published: September 2020

Background: A growing body of evidence suggests that children’s physical activity (PA) level in early childhood education and care (ECEC) settings is insufficient. Since most children attend ECEC settings for many hours on most days of the week and these institutions reach children across the socioeconomic spectrum, ECEC settings may serve as an ideal avenue for increasing PA level, reducing sedentary time and enhancing the overall health of young children. This paper investigates the effectiveness of the “Active Kindergarten – Active Children” study in increasing children’s PA level and reducing sedentary time within the ECEC setting. Methods: Accelerometers were used to assess PA and sedentary time. A total of 116 three- to four-year-olds took part in a randomized controlled trial in 11 ECEC settings. The participants were cluster-randomized, by ECEC setting, to either a 12-week staff-led and expert-supported intervention or a waiting-list control group. Results: The intervention group increased time spent in moderate- and vigorous-intensity PA by 10 min/day (95% CI = 3, 18; P=0.01), took 1909 more steps per day (95% CI = 1130, 2688; P˂0.01) and reduced sedentary time by 14 min/day (95% CI = -27, -1; P=0.04) compared to the control group. The intervention group was 2.4 times more likely (95% CI = 1.05, 5.7; P = 0.04) to meet the PA recommendations than the control group at follow-up. Conclusions: Our results show that a flexible staff-led and expert-supported multi-component PA intervention can increase the total PA level and moderate- and vigorous-intensity PA and reduce sedentary time in three- to four-year-old children during their stay in ECEC settings.
Risk Factors for Sub–therapeutic Serum Concentrations of Magnesium Sulfate in Severe Preeclampsia of Chinese Patients
Authors: Li Jingjing , Tang Lian , Tang Ruiheng , Peng Lan , Chai Liqiang , Zhu Liping , Yu Yanxia
Published: September 2020

Background: Magnesium sulfate (MgSO4) is the standard drug for eclampsia prophylaxis and treatment. In China, the effective therapeutic serum magnesium level is 1.8–3.0 mmol/L. There is little information on how to achieve and maintain effective therapeutic concentrations. This study aimed to investigate risk factors for sub-therapeutic serum concentrations of MgSO4 in patients with severe preeclampsia. Methods: Patients with severe preeclampsia who received MgSO4 intravenous infusion were retrospectively reviewed. The maternal demographic characteristics, regimens for the administration of MgSO4, and lab test results of patients were collected. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were conducted for the risk factors influencing the serum magnesium concentration. Results: A total of 93 patients with severe preeclampsia were included in the study. 52 (55.91%) patients did not attain therapeutic serum magnesium levels. A multivariate logistic regression analysis identified creatinine clearance (Ccr), whether the loading dose was given, and measurement time of serum magnesium concentration (referring to the time from start of MgSO4 infusion to blood draw for serum sampling) as independent risk factors for sub-therapeutic serum magnesium concentration (P < 0.05). ROC curve analysis indicated that the continuous variable Ccr had a significant predictive value for the serum magnesium concentration, which resulted in a cutoff point of 133 mL/min; while measurement time had limited predictive value, with cutoff point of 2.375 h. Conclusions: Ccr, whether the loading dose was given, and measurement time were independent risk factors for sub-therapeutic serum magnesium concentration. A loading dose of MgSO4 everytime before the maintenance dose, as well as the duration of MgSO4 maintenance dose of more than 2.375 hours are recommended for all the patients with severe PE. Routine evaluation of serum magnesium levels is a recommended practice for women with severe PE and whose Ccr is ≥ 133 mL/min.
Low Reported COVID-19 Cases in South Asian Countries: A Luck of Nature or A Ticking Time Bomb
Authors: Khan Soban Qadir , Moheet Imran Alam , Farooqi Faraz Ahmed , Alhareky Muhanad , Alonaizan Faisal
Published: September 2020

Objective

Purpose of the current study was to find the trend in progression of COVID-19 among South Asian countries as compared to more developed western countries.

Method

COVID-19 data of South Asian countries was taken for this observational study. Data was taken up to 21 st April since the outbreak of the virus. There were 4 out of 7 countries which passed through the inclusion criteria and included for analysis.

Results

Increase in average weekly reported cases after 5 th week since first case reported was exponential. Correlation between reported cases and tests performed was found strong and significant (r=0.90, p-value=0.037). However, on average 315.25 tests per million population was performed which was at least 12 times lower than the tests performed in the countries having large number of COVID-19 cases.

Conclusion

At present, number of reported cases from South Asia was found extrememly lower than western countries. However, it could be due to a smaller number of tests performed. Hence, increase in strength of performing diagnostic tests is highly recommended. Strict measures are required to be taken to make the people of these countries to follow the instructions of social distancing and comply with preventive measures.
Exosomal miR-29b found in aqueous humour mediates calcium signaling in diabetic patients with cataract
Authors: Gao Chao , Liu Xin , Fan Fan , Yang Jianing , Zhou Xiyue , Mei Hengjun , Lin Xiaolei , Luo Yi
Published: September 2020

Background: Ca2+ was supposed to play an important role in the formation of cataract. Exosomal miR-29b from aqueous humour may play an important role in the mechanism of diabetes and cataracts. The purpose of this study was to investigate the role of exosomal miR-29b and Ca2+ in regulating the function of human lens epithelial cells.Methods: Exosomes were isolated from human aqueous humour by ultracentrifugation, and visualized by nanoparticle tracking and transmission electron microscopy. Exosomal miRNA sequencing was performed to identify differentially expressed miRNAs between diabetes and cataracts group (DMC) and age-related cataracts group (ARC). TargetScan was used to predict potential target of certain miRNA. The expression of CACNA1C mRNA was determined by quantitative real-time PCR and CACNA1C protein was determined by Western blotting. Concentration of Ca2+ of human aqueous humour and cell culture supernatant was detected by the Calcium Assay Kit. Cell Counting Kit-8 was used to determine cell viability.Results: Exosomes were isolated from human aqueous humour, which had a typical cup-shaped phenotype and a particle size distribution in accordance with micro extracellular vesicles. Exosomal miRNA sequencing revealed that miR-29b was significantly downregulated in diabetes and cataracts group (DMC) compared with age-related cataracts group (ARC). Ca2+ concentration of human aqueous humour in DMC was higher than that in ARC. Cell culture supernatant transfected with miR-29b inhibitors had a higher concentration of Ca2+ than that transfected with miR-29b mimics. miR-29b reduced the viability of human lens epithelium cells (HLECs) by up-regulating CACNA1C expression.Conclusions: Exosomes isolated from human aqueous humour contained abundant miRNAs. A significantly expressed miRNA, miR-29b, could affect the concentration of Ca2+ and regulate HLEC processes by up-regulating CACNA1C.
Vancomycin-lock therapy for prevention of catheter-related bloodstream infection in very low body weight infants 
Authors: Liang Hong , Zhang Lian , Guo Xiaoping , Sun Li
Published: September 2020

Background: This study was to evaluate the effectiveness and safety of vancomycin- lock therapy for the prevention of catheter-related bloodstream infection (CRBSI) in very low body weight (VLBW) preterm infant patients.Methods: One hundred and thirty-seven cases of VLBW preterm infants who retained peripherally inserted central catheters (PICCs) were retrospectively reviewed, including 68 treating with heparin plus vancomycin (vancomycin-lock group) and 69 with heparin only (control group). The incidence of CRBSI, related pathogenic bacteria, adverse events during the treatment, complications, antibiotic exposure, PICC usage time, hospital stay, etc. were compared between the above two groups.Results: The incidence rate of CRBSI in the vancomycin-lock group (4.4%, 3/68) was significantly less than in the control group (21.7%, 15/69, p=0.004). Total antibiotic exposure time during the whole observation period was significantly shorter in the group than in the control group (11.2±10.0 vs 23.6±16.1 d; p<0.001). No hypoglycemia occurred during the locking, and the blood concentrations of vancomycin were not detectable.Conclusions: Vancomycin-lock may effectively prevent CRBSI in Chinese VLBW preterm infants and reduce the exposure time of antibiotics, without causing obvious side complications.
Longitudinal change in arterial stiffness after delivery in women with preeclampsia and normotension: a prospective cohort study
Authors: KIM Sehun , LIM Hyun Ja , KIM Jeung-Ran , OH Kyung Joon , HONG Joon-Seok , Suh Jung-Won
Published: September 2020

Background: Preeclampsia is associated with increased arterial stiffness during pregnancy. However, data on the longitudinal change in arterial stiffness after delivery in women with preeclampsia are lacking. In this pilot study, we aimed to examine the longitudinal change in arterial stiffness using the cardio-ankle vascular index after delivery in women with preeclamptic and normotensive pregnancies. Methods: We enrolled pregnant women with preeclampsia (n=37) and normotension (n=36) who gave birth at Seoul National University Bundang Hospital between March 2013 and May 2016, and followed-up at day 1, 6 months, and 12 months after delivery. The longitudinal change in the cardio-ankle vascular index and other variables (blood pressure, lipid profiles, serum creatinine, and liver enzymes) were compared between the two groups using the mixed-effects model, and interactions among the main predictors were examined. Results: The longitudinal change in the cardio-ankle vascular index did not significantly differ between the two groups (β=0.11, 95% CI: -0.31–0.54, p=0.60). Predictors of the longitudinal change in the cardio-ankle vascular index included age, time since delivery, body mass index, and diabetes mellitus. Women with preeclampsia showed significantly elevated blood pressure, lipid profiles, serum creatinine, and liver enzymes compared to women with normotension over the course of one year of follow-up. Conclusions: Preeclampsia is associated with unfavorable blood pressure and metabolic indices after delivery. However, we found no difference in the longitudinal change in arterial stiffness between women with preeclampsia and normotension over the course of one year after delivery. Trial registration: Retrospectively registered at ClinicalTrials.gov on October 29, 2019 (NCT04142268).
Uptake of routine vitamin A supplementation for children in Humbo district, Southern Ethiopia: Community-based cross-sectional study
Authors: Kassa Getnet , Mesfin Addisalem , Gebremedhin Samson
Published: September 2020

Background: In low- and middle-income countries routine vitamin A supplementation (VAS) is a key strategy for reducing vitamin A deficiency and mortality and morbidity of preschool children. However, in Ethiopia, there is paucity of evidence regarding the level and determinants of the uptake of the supplement. This study was designed to assess the coverage and predictors of VAS among preschool children in Humbo district, Southern Ethiopia.Methods: A cross-sectional study was conducted in April 2016. A total of 840 mothers/caregivers having children 6-59 months of age were selected using multistage cluster sampling technique from six rural villages implementing routine VAS program. Data were collected using interviewer administered questionnaire. Possible predictors considered in the study include distance from the nearby health facility, household socio-economic status, type of the household (model vs non-model), maternal access to health education on VAS, and knowledge on vitamin A and VAS. Multivariable logistic regression analysis was performed to identify predictors of uptake of VAS. The outputs are presented using adjusted odds ratio (AOR) with the respective 95% confidence interval (CI). Results: The coverage of VAS was 75.0% (95% CI: 72.1-77.9). Better knowledge of mothers about the importance of the supplement (AOR: 1.49, 1.02-2.17), obtaining VAS related information from frontline community health workers (AOR: 1.51, 1.34-2.72) than health professionals and being from households in the “rich” wealth tertile (AOR: 1.80, 95% CI: 1.07-3.03) were positively associated with uptake VAS. Conclusion: The VAS coverage of the area was approaching the expected national target of 80%. However, the uptake can be enhanced though awareness creation and improving socio-economic status of the community.
A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson’s disease
Authors: Barnish Maxwell S , Barran Susannah M
Published: September 2020

Background: Parkinson’s disease (PD) is a common neurodegenerative condition associated with a wide range of motor and non-motor symptoms. There has been increasing interest in the potential benefit of performing arts as a therapeutic medium in PD. While there have been previous reviews, none have considered all performing arts modalities and most have focused on dance. This systematic review examined the potential benefit of all active group-based performing arts interventions for quality of life, functional communication, speech, motor function and cognitive status. Methods: Searches were conducted in February 2020 on five scholarly databases. Supplementary searches were conducted. Included studies were quantitative in design, and assessed the potential benefit of any active group-based performing arts intervention for quality of life, functional communication, speech, motor function or cognitive status in people with PD. Full text papers were eligible for inclusion, as were conference abstracts since January 2018. Screening, data extraction, narrative synthesis and quality assessment were conducted independently by two reviewers. Quality assessment used the SURE checklists. Results: 56 studies were eligible for inclusion in this systematic review, reported in 67 publications. Published from 1989 to 2020, these studies included a total of 1531 people with PD from 12 countries, and covered four broad performing arts modalities: dance, singing, music therapy and theatre. Dance remains the most commonly studied performing arts modality for PD (38 studies), while there were 12 studies on singing interventions, four on music therapy, and only two on theatrical interventions. There was evidence for a beneficial effect of all four performing arts modalities on at least some outcome domains. Conclusions: This is the first systematic review to assess the potential benefit of all active group-based performing arts interventions in PD. The evidence suggests that performing arts may be a useful therapeutic medium in PD. However, a substantial limitation of the evidence base is that no studies compared interventions from different performing arts modalities. Moreover, not all performing arts modalities were assessed for all outcome domains. Therefore it is not currently possible to determine which performing arts modalities are most beneficial for which specific outcomes.
Two-step Seismic Noise Reduction caused by COVID-19 Induced Reduction in Social Activity in metropolitan Tokyo, Japan
Authors: Yabe Suguru , Imanishi Kazutoshi , Nishida Kiwamu
Published: September 2020

The COVID-19 pandemic that started at the end of 2019 forced populations around the world to reduce social and economic activities; it is believed that this can prevent the spread of the disease. In this paper, we report an analysis of the seismic noise during such an induced social activity reduction in the Tokyo metropolitan area, Japan. Using seismic data obtained from 18 stations in the Metropolitan Seismic Observation Network (MeSO-net), a two-step seismic noise reduction was observed during the timeline of COVID-19 in Tokyo. The first noise reduction occurred at the beginning of March 2020 in the frequency band of 20–40 Hz. This corresponded with the request by the Prime Minister of Japan for a nationwide shutdown of schools. Although social activity was not reduced significantly at this juncture, local reduction of seismic wave excitation in the high frequency band, 20–40 Hz, was recorded at some MeSO-net stations located in school properties. The second reduction of seismic noise occurred at the end of March to the beginning of April 2020 in a wider frequency band including lower frequency bands of 1–20 Hz. This timing corresponds to when the Governors of the Tokyo metropolitan area requested citizens to stay home and when the state of emergency was declared for the Tokyo metropolitan area by the government, respectively. Since then, the estimated population at train stations abruptly dropped, which suggests that social activity was severely reduced. Such large-scale changes in social activity affect the seismic noise level in low frequency bands. The seismic noise level started to increase from the middle of May correlating with increase in population at the train stations. This suggests that social activity restarted even before the state of emergency was lifted at the end of May. The two-step seismic noise reduction observed in this study has not been reported in other cities around the world. Unexpected reduction of social activity due to COVID-19 provided a rare opportunity to investigate the characteristics of seismic noise caused by human activities.
Frailty, delirium and hospital mortality of older adults admitted to intensive care: the Delirium (Deli) in ICU study.
Authors: Sanchez David , Brennan Kathleen , Safye Masar El , Shunker Sharon-Ann , Bogdanoski Tony , Hedges Sonja , Hou Yu Chin , Lynch Joan M , Hunt Leanne , Alexandrou Evan , Saxena Manoj , Abel Simon , Lakshmanan Ramanathan , Bhonagiri Deepak , Parr Michael J. , Aneman Anders , Chroinin Danielle Ni , Hillman Kenneth M. , Frost Steven Alfred
Published: September 2020

Background: As the population ages clinical frailty among older adults admitted to intensive care has been proposed as an important determinant of patient outcomes. Among this group of patients an acute episode of delirium is also common, but its relationship to frailty and increased risk of mortality has not been extensively explored. Therefore, the aim of this study was to explore the relationship between clinical frailty, delirium and hospital mortality of older adults admitted to intensive care.Methods: This study is part of a Delirium in Intensive Care (Deli) study that is being conducted across the SWSLHD between May 1st 2019 and the end of April 2020. During the initial 6-month baseline period, clinical frailty status on admission to intensive care, among adults aged 50-years or more, acute episodes of delirium, and the outcomes of intensive care and hospital stay will be described.Results: During the 6-month baseline period 997 patients, aged 50-years or more, were included in this study. The average age was 71-years (IQR, 63-79), 55% were male (n = 537). Among these patients 39.2% (95% CI 36.1 – 42.3%, n = 396) had a Clinical Frailty Score (CFS) of 5 or more, and 13.0% (n=127) had at least one acute episode of delirium. Frail patients were at greater risk of an episode of delirium (17% versus 10%, adjusted Rate Ratio (adjRR) = 1.71, 95% Confidence Interval (CI) 1.20 – 2.43, p = 0.003), had a longer hospital stay (2.6 days, 95% CI 1-7 days, p = 0.009), and higher risk of hospital mortality (19% versus 7%, adjRR = 2.54, 95% CI 1.72 – 3.75, p < 0.001), when compared to non-frail patients. Patients who were frail and experienced an acute episode of delirium in the intensive care had a 35% rate of hospital mortality, versus 10% among non-frail patients who also experienced delirium in the ICU.Conclusion: We have been able to show that among older frail admissions to intensive care, not just delirium, but hospital mortality is high. Importantly, we have found that approximately one in three frail patients who experienced an acute episode of delirium during their stay in the intensive care did not survive to hospital discharge. These results suggest the importance of recognising clinical frailty in the intensive care setting, not just to improve the prediction of outcomes from critical illness, but to identify patients at the greatest risk of adverse events such as delirium, and institute measures to reduce risk, and, importantly to discuss these issues in an open and empathetic way with the patient and their families.
Finite Element Analysis of the Size Effect of Vertebral Implant with Honeycomb Sandwich Structure
Authors: Guo Yuan , Liu Jing , Zhang Xushu , Xing zejun , Chen weiyi , Huang Di
Published: September 2020

Background: Because of osteoporosis, traffic accidents, falling from high places and other reasons, the vertebral body could be compressed injury, even collapse. Vertebral implant can be used for clinical treatment. Because of the advantages of honeycomb sandwich structure, such as low cost, less material, light weight, high strength, and good cushioning performance, honeycomb sandwich structure was used as the basic structure of vertebral implant.Methods: In this paper, we applied the orthogonal experiment method to analyze the size effect of honeycomb sandwich structure by finite element method. Based on the minimum requirements of three indexes of peak stress, axial displacement, and anterior-posterior displacement, the optimal structure size was determined. Further, through local optimization of the overall structure of the implant, we designed better honeycomb sandwich structure vertebral implant.Results: The optimal structure size combination is determined as the face sheets thickness 1mm, wall thickness 0.49mm, cell side length 1mm, height 6mm. Than through local optimization, the peak stress is further reduced, the overall stress distribution is uniform, and the deformation is reduced. The optimized peak stress decreases to 1.041MPa, the axial deformation is 0.111%, and the anterior-posterior deformation is 0.014%. The honeycomb sandwich structure vertebral implant with stable structure and good mechanical performance was designed.Conclusions: The research result provides a method for the optimal design of vertebral body implant structures, as well as provides a new idea and biomechanical basis for clinical treatment after vertebral body injury.
Inhibiting DDX3X Triggers Tumor-Intrinsic Type I Interferon Response and Enhances Anti-Tumor Immunity
Authors: Choi Hyeongjwa , Kwon Juntae , Sun Jiafang , Cho Min Soon , Sun Yifan , Casey John L , Toretsky Jeffrey , Han Cecil
Published: September 2020

Accumulating evidence has shown that cellular double-stranded RNAs (dsRNAs) induce antiviral innate immune responses in human normal and malignant cancer cells. However, it is not fully understood how endogenous ‘self’ dsRNA homeostasis is regulated in the cell. Here, we show that an RNA-binding protein, DEAD-box RNA helicase 3X (DDX3X), prevents the aberrant accumulation of cellular dsRNAs. Loss of DDX3X induces dsRNA sensor-mediated type I interferon signaling and innate immune response in breast cancer cells due to abnormal cytoplasmic accumulation of dsRNAs. Dual depletion of DDX3X and a dsRNA-editing protein, ADAR1 synergistically activates the cytosolic dsRNA pathway in the breast cancer cells. Moreover, inhibiting DDX3X enhances the antitumor activity by increasing tumor intrinsic-type I interferon response, antigen presentation, and tumor-infiltration of cytotoxic T cells as well as dendritic cells in breast tumors, which may lead to the development of breast cancer therapy by targeting DDX3X in combination with immune checkpoint blockade.
Addressing the Contribution of Indirect Potable Reuse to Inland Freshwater Salinization
Authors: Bhide Shantanu , Grant Stanley , Parker Emily , Rippy Megan , Godrej Adil , Kaushal Sujay , Prelewicz Greg , Saji Niffy , Curtis Shannon , Vikesland Peter , Maile-Moskowitz Ayella , Edwards Marc , Lopez Kathryn , Birkland Thomas , Schenk Todd
Published: September 2020

Inland freshwater salinity is on the rise in many regions across the globe—a phenomenon called the freshwater salinization syndrome (FSS). In this paper we investigate a potential conflict between managing the FSS and indirect potable reuse, the practice of augmenting water supplies through the addition of reclaimed wastewater to surface waters and groundwaters. From time-series data collected over the past 25 years, we quantify the contributions of three salinity sources—a wastewater reclamation facility and two rapidly urbanizing watersheds—to the rising concentration of sodium (a major ion associated with the FSS) in a regionally important drinking water reservoir in the Mid-Atlantic United States. Sodium mass loading to the reservoir is primarily from watershed runoff during wet weather periods and reclaimed wastewater during dry weather periods. Across all timescales evaluated, sodium concentration in the reclaimed wastewater is higher than in outflow from the two watersheds. Sodium in reclaimed wastewater originates from chemicals added during wastewater treatment, industrial and commercial discharges, human excretion, and down drain disposal of drinking water and sodium-rich household products. Thus, numerous opportunities exist to reduce the contribution of indirect potable reuse to sodium pollution at this site, and the FSS more generally. On the ground implementation will require deliberative engagement with a diverse community of watershed stakeholders and careful consideration of the local political, social, and environmental context.
Effect of mass transfer channels on flexural strength of C/SiC composites fabricated by femtosecond laser assisted CVI method with optimized laser power
Authors: Wang Jing , Cao Liyang , Zhang Yunhai , Liu Yongsheng , Fang Hui , Chen Jie
Published: September 2020

In this work, femtosecond laser assisted-chemical vapor infiltration (LA-CVI) was employed to produce C/SiC composites with 1, 3, and 5 rows of mass transfer channels. The effects of laser machining power on the quality of produced holes were investigated. The results showed that the increase in power yielded complete hole structures. The as-obtained C/SiC composites with different mass transfer channels displayed higher densification degrees with flexural strengths reaching 546±15 MPa for row mass transfer channel of 3. The strengthening mechanism of the composites was linked to the increase in densification and formation of “dense band” during LA-CVI process. Multiphysics finite element simulations of the dense band and density gradient of LA-CVI C/SiC composites revealed C/SiC composites with improved densification and lower porosity due to the formation of “dense band” during LA-CVI process. In sum, LA-CVI method looks promising for future preparation of ceramic matrix composites with high densities.
Four Year Results of a School-Based Anti-Smoking Intervention : The “PEPITES” Cluster Randomized Trial.
Authors: VIEIRA Stéphanie , LAMBERT Céline , CHERUEL Fabrice , PEREIRA Bruno , SANCHO-GARNIER Hélène
Published: September 2020

Background PEPITES is an interventional research study, using a cluster-randomized design to assess the effectiveness of interventions both in reducing the tobacco initiation rate and the regular smoking rate of secondary school pupils.Methods The regional National Education authority designated 6 state secondary schools for the PEPITES trial. The 6 schools were randomly allocated to 2 groups: 1 control group (2 clusters), 1 intervention group (4 clusters) with 2 workshops per year during a 4 year period. The interventions targeted the variables of the Theory of Planned Behaviors and the reinforcement of psycho-social competencies. The 2 principal outcomes for the PEPITES trial were: the prevalence of pupils having experimented tobacco smoking at the end of years 2, 3 and 4, and the prevalence of regular cigarette smokers at the end of years 2, 3 and 4. The process was also evaluated. To compare the evolution of smoking experimentation over time in the two randomization groups, generalized linear mixed models with logit link function were used, considering the school and student as random effects.Results Globally, over time and regardless of the method of experimentation, the increase in the rate of pupils experimenting is slower in the intervention group than in the control group. The difference between the two groups during this period becomes significant (p=0.03) at the end of 9th grade. Concerning confirmed smokers, we note a slower but not significant increase in the percentage of cigarette smokers in the intervention group. For those who are smoking every day, no increase was noted in the intervention group, whereas a 2.8% increase was noted in the control group at the end of 9th grade.Conclusions The implementation of effective tobacco prevention actions in schools is important, as part of a programmed pathway from nursery school right through to high school. The implementation of the addictions plan for 2018-2020 should contribute to this policy but should rely on programs which have already proven to be effective in the medium and long term like this study.Trial Registration ISRCTN85812512. Retrospectively registered 15 May 2018.
Eight-year Retrospective Analysis of Malaria Trends in Gedeo Zone, South Ethiopia (2012-2019)
Authors: Belete Eshetu Molla , Behaksra Sinknesh Wolde , Tadesse Fitsum G , A Sisay Dugassa , Belachew Endalamaw Gadisa , Idrees Hassen Mamo
Published: September 2020

Background: Informed decision making is underlined by all level of the tiers in the health system. Poor data record system coupled with under- (over)-reporting of malaria cases affects the country’s elimination activities. Thus, malaria data at health facilities and health offices are important particularly to monitor and evaluate malaria elimination progresses. This study was intended to assess overall reported malaria cases, spatiotemporal trends and factors associated in Gedeo zone, South Ethiopia, and compare malaria case reports by the health centers and health offices.Methods: Past eight years retrospective data stored in 17 health centers and 5 district health offices in Gedeo Zone were extracted. Malaria cases data at each health center with sociodemographic information, between 2012 and 2019, were included. Meteorological data were obtained from the national meteorology agency. The data were analyzed using Stata 13.Results: A total of 485,414 clinical suspects were examined for malaria during the previous 8 years at health centers. Of these suspects, 57,228 (11.79%) were confirmed malaria cases. We noted, an overall under reporting of malaria, 3,758 clinical suspects and 467 confirmed malaria cases were not captured at the health offices level. Based on the health centers records, Plasmodium falciparum (49.74%) was slightly higher (p = 0.795) than P. vivax (47.59%). The majority of cases were found in adults (≥15 years of age) that accounted for 11.47% of confirmed malaria cases (p < 0.0001). There was high spatiotemporal variation: highest cases record was during autumn (12.55%) (p < 0.0001) and, the highest (18,150, 13.17%)) and lowest (5,187 (10.44%)) malaria cases were reported from Dilla town and Yirgacheffe rural district, respectively (p = 0.0002). Monthly rainfall and minimum temperature exhibited strong positive associations with the number of confirmed malaria cases.Conclusion: A notable decline in malaria cases was observed over the eight-year period. Both P. falciparum and P. vivax co-exist; hence, control measures should continue targeting both species. The high malaria burden in urban (Dilla town) and suburban (Dilla zuria district) settings and autumn season need spatiotemporal consideration by the elimination program.
The Effects of Pre-Response Before COVID-19 Outbreak on Strategic Decision Making
Authors: Jung Jae Hun , Kim Daewook , Jung Il Hyo
Published: September 2020

Background: In the case of COVID-19, many countries have introduced their own policies for prevention. In Sweden, herd immunity policy was implemented and it was difficult to reduce the number of fatalities. In South Korea, the number of fatalities was not high because the public had earlier received a risk warning from the government and followed the policy well. In order to prevent the spread of infectious diseases, the government’s policy is important, but it is also important for the people to agree and follow the policy. As such, an individual’s behavior such as preventive measures and pre-responses may be linked to the prevention of the spread of COVID-19. Methods: To evaluate the effect of strategy selection between individuals and groups when pre-response action, we incorporate a comparmental epidemic model into a game theoretical framework and use this to fit the cumluative confirmed data of Sweden (Feb. 27 - Mar. 12) and South Korea (Feb. 4 - Mar. 3). Results: The transmission rate ( β ) is estimated from the fitted model, and the reproduction numbers ( R0 ) of two countries, Sweden and South Korea are estimated by 6.93 and 3.71, respectively. The probability of infection ( φ p ) of Sweden is about 12% higher than that of South Korea. As the probability of attack that an epidemic occurs ( θ ) increases, individuals equilibrium gradually increased than group optimum. Conclusions: When comparing prevention policies of Sweden and South Korea, it was confirmed that pre-response can be an appropriate preventive strategy against the transmission of infection. The selection of a strategy between individuals and groups can lead to the collapse of altruism that tends to select an action strategy for personal benefit, as the probability of the epidemic attack increases.
Paediatric Non-Infectious Uveitis in Cape Town, South Africa: A Retrospective Review of Disease Characteristics and Outcomes on Immunomodulating Treatment
Authors: Slamang Waheba , Tinley Christopher , Brice Nicola , Scott Christiaan
Published: September 2020

Background Non-infectious uveitis is a well-reported cause of blindness in more developed countries, however data from sub-Saharan Africa is lacking. Here we aim to describe the diseases associated with non-infectious uveitis and the impact of currently available treatment in this setting. Methods A retrospective observational analysis of children with non-infectious uveitis from January 2010 to December 2017, attending the tertiary paediatric rheumatology and ophthalmology referral units in Cape Town was conducted. Statistical analysis utilising STATA13 software was performed with p < 0.05 considered significant.Results Twenty-nine children were identified: median age at first visit of 74 months (IQR 49–86 months), female to male ratio of 0.9:1, predominantly of mixed race (72.4%).Juvenile idiopathic arthritis associated uveitis (JIAU) (48.3%) was the most frequent diagnosis. All children with JIAU had chronic anterior uveitis and 3 (21.4%) presented with uveitis before arthritis. There were no differences between children with uveitis and those with arthritis only, for gender (p = 0.68) and race (p = 0.58) but significantly, children with uveitis presented at an overall younger age (p = 0.008), with antinuclear antibody positive (p < 0.001) oligo-articular JIA (p = 0.01). Older age appeared to be protective (p = 0.01 OR1.0 CI 0.6-1.7).Children with idiopathic uveitis (41.4%) were predominantly male (66.6%), of mixed race (75%), with chronic anterior uveitis (41.7%) and presented with cataracts (100%). Less commonly, sarcoidosis (6.9%) and Behcet’s disease (3.5%) were diagnosed.55.2% had complications at presentation, predominantly cataracts (87.5%). 19 children (65.5%) had inactive disease at 12 months from diagnosis. Remission, as assessed at the last clinical visit was achieved in 58.6% on standard initial therapy and in 75% of those on tumour necrosis factor inhibitors. Surgery was needed in 41.4%, primarily in the idiopathic group. Visual acuity improved or was maintained on treatment. Conclusion The spectrum and characteristics of immune-mediated non-infectious uveitis are comparable to that reported in more developed countries. Current practice detects children with potentially sight-threatening disease and access to tumour necrosis factor inhibitors has improved outcomes in refractory cases.
Surgical Stabilization of Clavicle Fractures Reduces Organ Failure Rates in Multiply-injured Patients with Thoracic Trauma: An Analysis Based on the TraumaRegister DGU®.
Authors: Eberbach Helge , Lefering Rolf , Hager Sven , Schumm Klaus , Bode Lisa , Jaeger Martin , Maier Dirk , Kalbhenn Johannes , Hammer Thorsten , Schmal Hagen , Bayer Jörg
Published: September 2020

Introduction: Thoracic trauma has decisive influence on the outcome of multiply-injured patients and is often associated with clavicle fractures. The affected patients are prone to lung dysfunction and multiple organ failure. The aim of this study is to investigate the influence of surgical stabilization of clavicle fractures in patients with thoracic trauma on specific outcome parameters.Methods: A multi-center, retrospective analysis of patient records documented in the TraumaRegister DGU® between 2009 and 2015 was performed. The inclusion criteria were multiply-injured patients with thoracic trauma and associated clavicle fracture, maximum AIS severity ≥ 3 and admission to the intensive care unit. The influence of operative vs. non-operative clavicular fracture treatment and timing of surgery on lung failure, multiple organ failure, sepsis, length of ICU stay, intubation time and length of hospital stay was assessed by regression analysis.Results: A total of 3,209 patients were included in the analysis. In 1,362 patients (42%) the clavicle fracture was treated operatively after 7.1 ± 5.3 days. Surgically treated patients had a significant reduction in lung failure (p = 0.013, OR = 0.74), multiple organ failure (p = 0.001, OR = 0.64), intubation time (p = 0.004; -1.81 days) and length of hospital stay (p = 0.014; -1.51 days) compared to non-operative treatment. Moreover, surgical fixation of the clavicle within five days following hospital admission significantly reduced the rates of lung failure (p = 0.01, OR = 0.62), multiple organ failure (p = 0.01, OR = 0.59) and length of hospital stay (p = 0.01; -2.1 days).Conclusions: Based on our results, multiply-injured patients with thoracic trauma and concomitant clavicle fracture seem to benefit significantly from surgical stabilization of a clavicle fracture, especially when surgery is performed within the first five days after hospital admission.
Effects of Tree Species Diversity and Stand Structure on Carbon Stocks of Homestead Forests in Maheshkhali Island, Southern Bangladesh
Authors: Baul Tarit Kumar , Chakraborty Avinanda , Nandi Rajasree , Mohiuddin Mohammed , Kilpeläinen Antti , Sultana Taslima
Published: September 2020

BackgroundThis study aimed to estimate the carbon (C) stocks in homestead forest ecosystems (trees, litterfall, and soil) of Maheshkhali Island in Bangladesh and how tree species diversity and stand structural variation affected these C stocks. We randomly surveyed a total of 239 homestead forests proportionately allocating in hillside (67), beachside (69), and inland (103) in 2019 for measuring woody plants and sampling litterfall and C in soil at 0-30 cm depth. Tree (above- and below-ground) biomass was estimated by using pan-tropical allometric equations, and carbon of litterfall and soil were analyzed in a laboratory. ResultsWe found a total of 52 tree species, of which, 41, 42, and 48 species were in the hillside, beachside, and inland, respectively, corresponding to the individuals of 840, 540, and 1504 sampled. According to the results, species diversity, richness, stand density, basal area (BA), and tree diameter at breast height (DBH) and height were significantly (p ≤ 0.05) greater in the hillside and inland homestead forests, compared to the beachside. Most abundant species, for example, Mangifera indica, Samanea saman, and Artocarpus heterophyllus in the inland and hillside homestead forests stored most C in biomass, compared to the beachside forest. Tree biomass C stocks were 48-67% greater in the inland and hillside than on beachside forests due to significantly (p ≤ 0.05) greater stand density, BA, and DBH. The overall C stock of litterfall was 0.1% of the total biomass carbon. C stock in soil surface was greatest in the hillside homestead forests due to the greatest litterfall. The total soil C stock was also affected by tree species, stand density and species richness, and their interaction with soil properties. Total soil C stocks across the depths were greatest (51 Mg ha-1) in the inland homestead forests, with the greatest stand density and species richness. ConclusionsHomestead forest ecosystems across the area stored total 96 Mg C ha-1, which thus can contribute to climate change mitigation while generating C credit for small-scale homestead forests owners as well as conserving biodiversity in Bangladesh and countries alike.
Health-related Quality of Life in Men and Women who Experienced Cardiovascular Diseases: Tehran Lipid and Glucose Study
Authors: Jalali-Farahani Sara , Amiri Parisa , Fakhredin Hanieh , Torshizi Kiana , Cheraghi Leila , Khalili Davood , Azizi Fereidoun
Published: September 2020

Background: Cardiovascular diseases (CVDs) are among the most common causes of death worldwide, including in Iran. Considering the adverse effects of CVDs on physical and psychosocial health; this study aims to investigate the association between CVDs incidence and health-related quality of life (HRQoL) in adult participants of the Tehran Lipid and Glucose Study (TLGS). Methods: The participants of this cross-sectional study were 7009 adults (≥20 years) who participated in the TLGS during 2014-2017. Demographic information and HRQoL data was collected through validated questionnaires by trained interviewers. HRQoL was assessed by the Iranian version of the SF-12 questionnaire. Data was analyzed using SPSS software.Results: The mean age of participants was 46.8±14.6 years and 46.1% of them were men. A total of 9.0% of men and 4.4% of women had CVDs. In men, the mean physical HRQoL summary score was significantly lower in those with CVDs compared to those without CVDs (46.6±0.8 vs. 48.5±0.7, p >0.001). In women, the mean mental HRQoL summary scores was significantly lower in those with CVDs compared to those without CVDs (42.8±1.0 vs. 45.2±0.5, p =0.009). In adjusted models, men with CVDs were more likely to report poor physical HRQoL compared to men without CVDs (OR(95%CI): 1.93(1.32-2.84), p=0.001); whereas for women, the chance of reporting poor mental HRQoL was 68% higher in those with CVDs than those without CVDs (OR(95%CI): 1.68(1.11-2.54), p =0.015). Conclusion: The findings of the current study indicate poorer HRQoL in those who experienced CVDs compared to their healthy counterparts with a sex specific pattern. While for men, CVDs were associated with greater impairment in the physical dimension of HRQoL, women experienced a similar impairment in the mental dimension of HRQoL.
HMT Inhibits Prostate Cancer Progression by Targeting PAK-1.
Authors: LEE SEON-OK , Xu YINZHU , LEE YOU-KYUNG , RYU SOO-IN , LEE MIN-HO , Lee Hyo-Jeong
Published: September 2020

Background: Heamatang (HMT) is a classic medicinal formula used in traditional Chinese and Korean medicine; it contains seven distinct components, mainly of herbal origin. HMT is used as an anti-aging remedy, in the treatment of urinary disorders, and to increase energy and vitality. However, the therapeutic applications of this formula have not been evaluated with evidence-based science. Methods: Therefore, we assessed HMT through various in vitro methods, including cell viability assay, fluorescence-activated cell sorting assay (FACS), western blotting, migration assay, three-dimensional (3D) cell culture, siRNA-mediated PAK-1 knockdown, and crystal violet assays. Results: HMT decreased PAK-1 expression in PC-3 cells and inhibited cell viability, growth, and motility. The inhibition of cell motility by HMT was correlated with PAK-1-mediated inhibition of Lim domain kinase (LIMK) and cofilin. HMT induced G1 arrest and apoptosis through the transcriptional regulation of cell cycle regulatory proteins (inhibition of cyclin-dependent kinase (CDK) 4, 6, and cyclin D1) and apoptosis-related proteins (increase in cleaved caspase-3 (c-cas3) and inhibition of poly ADP-ribose polymerase (PARP) and B-cell lymphoma 2 (BCL-2)). Moreover, HMT suppressed P21-activated kinase (PAK-1) expression, leading to the inhibition of AKT activities. Finally, we showed that Decursin was the active ingredient involved in the inhibitory effect of HMT on PAK-1. Conclusion: Our findings demonstrated that HMT exerts its anticancer influence through the inhibition of PAK-1 expression. The HMT formula could be applied in various fields, including functional health food and pharmaceutical development.
Detecting Response Shift in Health-related Quality of Life Measurement among Patients with Hypertension Using Structural Equation Modeling.
Authors: Chen Hao , Zhu Lin , Zhou Rui , Liu Panpan , Lu Xiaoyang , Patrick Donald L. , Edwards Todd C. , Wang Hongmei
Published: September 2020

Background: Outcomes derived from longitudinal self-reported health-related quality of life measures can be confounded by response shift. This study was aimed to detect response shift phenomena among patients with hypertension attending a community-based disease management program. Methods: 240 consecutive consulting or followed up patients with diagnosed hypertension were recruited. The SF-36 instruments were self-administered at 12 community health service stations and four weeks after attending the program. RS was assessed by the 4-step structural equation modeling approach. Results: Data from 203 (84.6%) patients were eligible for analyses (mean age 65.9±10.8 years, 46,3% female). The results showed uniform recalibration of social functioning ( X2SBdiff(1)=22.98, P<0.001), and non-uniform recalibration of role limitations due to physical problems ( X2SBdiff(1)=8.84, P=0.003), and bodily pain ( X2SBdiff(1)=17.41, P<0.001). The effects of response shift were calculated as “small”, but the influence on the measurement results was noticeable. After accounting for the response shift effect, the general physical health of participants was improved (+0.234, P<0.001), while a deterioration of general mental health (-0.165, P=0.025) was also found. Conclusions: Recalibration existed among patients with hypertension attending the disease management program. The adaptation to chronic illness might act as a catalyst that induced the response shift. We concluded that response shift should be considered in hypertension researches with longitudinal health-related quality of life data, and linking with measurement of the appraisal process was recommended.