bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of life and associated factors among women with obstetric fistula in Ethiopia
Authors: Matiwos Biruktawit , Tesfaw Getachew , Belete Asmare , Abebaw Dessie , shumet shegaye
Published: August 2020

BackgroundThe physical, emotional and social suffering associated with continuous leakage of urine has a profound impact on women quality of life. The aim of this study was to assess quality of life and associated factors among obstetric fistula patients in Ethiopia, has a significant role for further intervention.ObjectiveTo assess quality of life and associated factors among obstetric fistula patients in Ethiopia, 2017.MethodsIn this cross-sectional study, 289 women with obstetric fistula were recruited for interviews, using the systematic random sampling technique. The World Health Organization Quality of Life – Brief (WHOQOL-BREF) Version was used to assess quality of life. The Jacob perceived stigma scale and the Oslo-3 social support instruments were used to assess the factors. We computed simple and multiple linear regression analysis to assess factors associated with quality of life. P-value < 0.05 was declared statistically significant.ResultOf 289 women studied, only 12.1% felt satisfied with their general state of health and quality of life. In the physical health domain, the mean quality of life score was 40.78 ± .78. In the psychological domain, the mean quality of life score was 39.96 ± .82. In the social and environmental domain, the mean quality of life score was 32.9 ± .95, 36.45 ± .8 respectively. Duration of incontinence (unstandard β=-3.8,95% CI(-6.95,-.62), patients coming for surgical procedure (β=-4.4, 95% CI(-7.64,-1.2), poor social support(β= -6.14, 95%CI (-8.8,-3.4), Co-morbid anxiety(β= -4, 95% CI (-7,-1.1) and depression(β=-9.2, 95% CI (-12,-6.4) were negatively associated with physical domain of quality of life. Co-morbid anxiety (β= -11,95% CI (-14.8,-7.3), employment(β = 9.1,95%CI(.5, 17.6), number of children(β = 2.1,95%CI(.8, 3.4), and depression(β= -6.3,95%CI(-9.7,-2.9) were associated with a psychological domain. Duration of incontinence (β=-8.1,95%CI(-12.82,-3.4), poor social support(β= -7.8(-12,-3.6), patients coming for surgical procedure (β= -12,95%CI(-17.4,-6.4) and co-morbid anxiety(β= -9.2,95%CI(-13.8, 4.5) were negatively associated with social domain of quality of life. Number of children present (β = 2.4,95%CI(.82, 3.6), and poor social support(β= -5.5,95%CI(-9.5,-1.5) were significantly associated with an environmental domain of quality of life.Conclusion and recommendationCo-morbid depression and anxiety, poor social support, duration of urine incontinence, employment, number of children, and duration of hospital stay were factors significantly associated with domains of QOL. Treating co-morbid depression and anxiety, strong social support and controlling urine incontinence is necessary to increase women’s domain of quality of life.
Association Between The Polymorphism of MMP-1 Gene with Knee Osteoarthritis Risk: A Meta-Analysis
Authors: Lu Feifan , Sun Xiaowei , Wang Weiguo , Zhang Qidong , Guo Wanshou
Published: August 2020

Background: The existing studies on the association between polymorphisms of Matrix metalloproteinase-1 (MMP-1) (-1607 1G/2G) (rs1799750) polymorphism and the risk of knee osteoarthritis (OA, a complex multifactorial disease and a major degenerative form of arthritis) in different populations have yielded conflicting findings. Method: Literature search was performed in PubMed, Cochrane Library, Web of science, Google Scholar (From January 1990 to June 2019), and assessing this association by calculating odds ratios with 95% confidence intervals. Subgroup analyses stratified by ethnicity were also conducted. Statistical heterogeneity was quantitatively evaluated by X2 test with the significance set P<0.10 or I2>50%.Result: Five case-control based studies (924 cases and 928 controls) were included. The results suggested that the MMP-1 (-1607 1G/2G) (rs1799750) gene polymorphisms were not associated with knee OA risk in all genetic models (Allele model OR =1.22, 95% CI: 0.72-1.76, p=0.615, Recessive model OR = 1.12, 95% CI: 0.70-2.15, p=0.486, and Dominant model OR = 1.14, 95%CI: 0.64-2.04, p=0.659, Figure 3-5)Conclusions: There is no association between the polymorphism of MMP-1 (-1607 1G/2G) (rs1799750) polymorphism with the risk of knee osteoarthritis, a large number of studies may be necessary to verify this association in different populations and environmental factors.
Modulation of the Gut Microbiota of type 2 Diabetic Mice by Sodium Butyrate Attenuates Ischemic Stroke Injury
Authors: Wang Huidi , Song Wei , Gao Xuxuan , Zhu Jiajia , Li Jie , Wu Qiheng , Tan Chuhong , Zhou Hongwei , He Yan , Yin Jia
Published: August 2020

Background: Type 2 diabetes (T2D) is a major comorbidity in patients with ischemic stroke that exacerbates brain injury. Recent studies have revealed that stroke injury can be influenced by the composition of the gut microbiota. However, the role of the gut microbiota of T2D patients in stroke injury and the potential benefits of manipulating the dysbiotic gut microbiota in T2D are unknown.Methods: To modulate the gut microbiota profile, male diabetic (Db) mice and wild-type (Wt) mice were randomized to receive either sodium butyrate (SB) or sodium chloride (NaCl, Con) in drinking water. After 4 weeks, fecal samples were collected for microbiota analysis by 16S rRNA gene sequencing. We then performed fecal microbiota transplantation (FMT) and established middle cerebral artery occlusion (MCAO) model of stroke to investigate the causative relationship between the gut microbiota and stroke injury.Results: We found that SB supplementation reduced food/water intake, fasting blood glucose levels and serum triglyceride (TG) levels in Db mice. Moreover, SB-treated Db mice displayed a different gut microbiota composition and higher levels of fecal butyrate than NaCl-treated Db mice. Twenty-four hours after cerebral ischemia/reperfusion, stroke mice that underwent FMT from SB-treated Db mice exhibited improvements in neurologic deficit scores and a smaller cerebral infarct volume than mice that underwent FMT from NaCl-treated Db mice. These improvements were accompanied by reductions in neuronal loss, apoptotic cell death, and microglial activation, increased levels of tight junction-related proteins and preservation of the endothelial glycocalyx in the ischemic brain.Conclusions: This study suggests that the gut microbiota of T2D can be modified by SB to afford neuroprotection against ischemic stroke injury.
Enhancing Early Engagement (E3) in Mental Health Services Training for Children's Advocacy Center's Victim Advocates: Protocol for a Randomized Clinical Trial
Authors: Taylor Erin K , Dopp Alex R , Lounsbury Kaitlin , Thompson Yutian , Miller Michelle , Jorgensen Ashley G. , Silovsky Jane F
Published: August 2020

Background: Child maltreatment is a major public issue in the United States, yet most children affected by abuse or neglect never engage in evidence-based practices (EBP) for child mental health. Children’s Advocacy Centers (CACs’) are uniquely situated to serve as Family Navigators who connect children impacted by maltreatment to appropriate EBPs. In fact, the CAC position of Victim Advocate mirrors the Mental Health Family Navigator national initiative.Methods: We will develop, implement, and evaluate web-based and consultative training for Victim Advocates to enhance early engagement in services (E3 training). The interactive web-based training will embed key targets of knowledge and skills related to family engagement, trauma, and EBP services. Participating CACs will be randomized to E3 webinar-based training, E3 webinar plus consultation, or delayed training. The project will test the E3 training’s impact on key mechanisms of change (e.g., knowledge, skills) to improve rates of screening, referral, and access to EBP services. The feasibility of implementing the training program, and differential impact and costs by level of training will be examined.Discussion: The overarching goal of this project is to test a training that is readily implemented through CACs and examine the mechanisms for improving early engagement and, ultimately, child and adolescent mental health outcomes. Results and cost findings will be used to plan a large-scale comprehensive, mixed-methods Hybrid Type II effectiveness-implementation and cost-effectiveness trial of Family Navigator E3 training. If outcomes are positive, considerable infrastructure exists to support the scale-up and sustainability of E3 training nationwide, by embedding the training in national CAC training protocols.Trial registration: NCT04221633
Individual Differences in Job Crafting and Its Relationship with Burnout in Nursing
Authors: Pérez-Fuentes Maria del Carmen , Jurado María del Mar Molero , Martínez África Martos , Márquez María del Mar Simón , Linares José Jesús Gázquez
Published: August 2020

Background: The heavy work load and pressure to which nursing professionals are subjected leads to an increase in stress-related problems, such as burnout. Personal resources, such as job crafting, proactive personality, self-efficacy and regulatory focus are fundamental in palliating negative effects in the work environment.Objective: To analyze individual differences, with attention to proactive personality, regulatory approach and general self-efficacy in job crafting, and to determine the predictive power of these variables for burnout in nursing professionals. Methods: The sample was made up of 643 nurses. After correlation and descriptive analyses, multiple linear regression models were computed to find out the possible predictor role of the individual variables on burnout. Main Outcome Measures were: Proactive personality, Regulatory focus, Self-efficacy (participant beliefs concerning their ability to handle different daily situations adequately), Job Crafting behavior and Burnout.Results: The results showed that job crafting, proactive personality, general self-efficacy and the promotion regulatory focus were associated with a decrease in burnout in healthcare workers. Similarly, the predictive models for each of the factors in burnout in all cases included the increase in structural resources dimension of job crafting as the variable with the most weight. Furthermore, the increase in the social resources of Job Crafting for the social climate of the Burnout acted as mediator of this relationship.Conclusion: Job Crafting has been shown to be a variable promoting positive changes in the work environment that acts as a predictor of employee Burnout levels.
Low Expression of FOXP2 is Associated with Better Prognosis in Glioblastoma.
Authors: Plata-Bello Julio , Fariña-Jerónimo Helga , Betancor Isabel , Salido Eduardo
Published: August 2020

FOXP2 expression has been associated with the prognosis of some tumors, but the role of FOXP2 in glioblastoma has not been studied in-depth until now. The aim of the present work is to study the role of FOXP2 as a prognostic biomarker in glioblastoma.This is a retrospective observational case series study in which the expression of FOXP2 has been analyzed both at the protein level (immunohistochemistry) and at the mRNA level (RNAseq, in a cohort of glioblastoma patients from The Cancer Genome Atlas [TCGA] database). Other molecular and clinical data have also been included in the study, with special focus on miRNA expression data.Survival analysis using Log-Rank test and COX-regression have been used. Non-parametric statistical tests were also used to study differences between low and high FOXP2 expression groups.Patients with a high expression of FOXP2 protein showed a worse prognosis than those patients with low expression in both, progression free survival (PFS) (HR=1.711; p=0.034) and overall survival (OS) (HR=1.809;p=0.014). These associations were still statistically significant in multivariate analysis.No prognostic association was found with FOXP2 RNA expression. Interestingly, two miRNAs that target FOXP2 (hsa-miR-181a-2-3p and hsa-miR-20a-3p) showed an interaction effect on OS with FOXP2 expression. A low level of these miRNAs expression was associated with a significantly worse prognosis in patients with high FOXP2 RNA expression.Higher expression of FOXP2 at the protein level is associated with a worse prognosis. This protein expression may be regulated by the expression of specific miRNAs that target FOXP2 mRNA: hsa-miR-181a-2-3p and hsa-miR-20a-3p.
Neonatal programming of piglet gut health and postnatal effects by maternal transfer of phytogenic compounds supplemented in gestating and lactating hyperprolific sows
Authors: Reyes-Camacho David , Pérez José Francisco , Vinyeta Ester , Aumiller Tobias , Criado-Mesas Lourdes , Palade L.M. , Taranu Ionelia , Folch Josep Maria , Klis Jan Dirk Van der , Solà-Oriol David
Published: August 2020

Background The improvement of sow prolificacy by breeding has increased the number of piglets produced per sow per year. However, intrauterine crowding and/or intrauterine growth restriction typically observed in hyperprolific sows impairs foetal growth which has decreased the average individual birthweight, with a larger proportion of low birthweight (LBW) pigs born per litter with poor gut development and compromised postnatal growth performance. Phytogenic compounds (PC) are plant-derived natural bioactive substances that can be used in livestock production as feed additives to promote animal health and production efficiency. This research aims to study if a specific blend of PC (BPC) supplemented in gestating and lactating hyperprolific sow diets may promote pre- and postnatal maternal effects on performance and oxidative status of sows and their offspring, colostrum-milk features, and piglet gut health-related gene expression and morphology. Forty DanBred hybrid line Landrace x Yorkhire gilts and sows (parities 0–7) were randomly allocated by parity number and body weight into two dietary treatments including unsupplemented Control (n = 20) or Control diets supplemented with 1 g/kg feed of BPC (n = 20) throughout gestation and lactation.Results Several dietary PC from the supplemented BPC were transferred to the placental fluid and milk. The BPC supplementation during gestation enhanced the litter size, antioxidant status, and colostrum protein content of sows. Jejunal histomorphology of neonate piglets, and intestinal-function gene expression related to nutrient transport, antioxidant, innate immune response, and digestion were improved in the BPC group. For both, sows and piglets, plasma antioxidant activity of CAT and SOD enzymes were enhanced. For suckling piglets, jejunal expression of genes related to gut barrier function was improved and piglet weight gain from birth to weaning was enhanced in the BPC group.Conclusions Dietary supplementation of BPC in gestating and lactating diets for hyperprolific sows improves sow’s reproductive performance and colostrum composition, with a significant strength of the antioxidant status of sows and their offspring. The prenatal and postnatal maternal transfer (placental fluid and milk) of BPC to the offspring would influence on the neonatal programming and postnatal of piglet’s gut health, with advantageous effects on piglet’s growth performance.
A U-Shaped Association between LDL-C/HDL-C Ratio and all-Cause Mortality in Elderly Hypertensive Patients: A Prospective Cohort Study
Authors: Yu Yu , Li Minghui , Huang Xiao , Zhou Wei , Wang Tao , Zhu Lingjuan , Ding Congcong , Tao Yu , Bao Huihui , Cheng Xiaoshu
Published: August 2020

Background: Low-density lipoprotein cholesterol/high-density lipoprotein- cholesterol (LDL-C/HDL-C) ratio is an excellent predictor of cardiovascular disease (CVD). However, previous studies linking LDL-C/HDL-C ratio to mortality have been inconsistent and limited by short follow-up. Therefore, the aim of the present study was to determine whether LDL-C/HDL-C ratio could be an effective predictor of all-cause mortality in elderly hypertensive patients.Methods: We selected 6,941 hypertensive patients aged 65 years or older and untreated with lipid-lowering drugs from the Chinese Hypertension Registry for analysis. The endpoint of the study was all-cause mortality. The relationship between LDL-C/HDL-C ratio and all-cause mortality by using multivariate cox proportional hazards regression, smoothing curve fitting (penalized spline method), subgroup analysis and Kaplan–Meier survival curve to address.Results: During a median follow-up of 1.72 years, 157 all-cause deaths occurred. A U-shaped association was found between LDL-C/HDL-C ratio and all-cause mortality. The LDL-C/HDL-C ratio was divided into five groups according to quintiles. Compared to the reference group (Q3: 1.67-2.10), both lower (Q1 and Q2) and higher (Q4 and Q5) LDL-C/HDL-C ratios were associated with higher all-cause mortality (<1.67: HR 1.81, 95% CI: 1.08-3.03; ≥2.10: HR 2.00, 95% CI: 1.18-3.39). Compare with lower and higher LDL-C/HDL-C ratio groups, patients with LDL-C/HDL-C ratio of 1.67-2.10 had a significant higher survival probability (log-rank P = 0.038).Conclusion: Our results suggested that there was a U-shaped association between LDL-C/HDL-C ratio and all-cause mortality. Both lower and higher LDL-C/HDL-C ratios were associated with increased all-cause mortality in elderly hypertensive patients.
Covid-19-associated coagulopathy (CoAC): thrombin burst and insufficient fibrinolysis leading to bad outcome.
Authors: Ranucci Marco , Sitzia Clementina , Baryshnikova Ekaterina , Dedda Umberto Di , Cardani Rosanna , Martelli Fabio , Romanelli Massimiliano Corsi
Published: August 2020

Background: COVID-19 associated coagulopathy is characterized by a pro-thrombotic state. However, the nature of this pattern has not been comprehensively studied. We investigated the coagulation pattern of patients with COVID-19 acute respiratory distress syndrome (ARDS) comparing survivors to not survivors. Methods: Prospective cohort study conducted in the Intensive Care Unit (ICU) of a University Hospital . Twenty COVID-19 ARDS patients received measurements of markers of thrombin generation (prothrombin fragment 1+2, PF 1+2); fibrinolysis activation (tissue plasminogen activator, tPA) and inhibition (plasminogen activator inhibitor-2, PAI-2); fibrin synthesis (fibrinopeptide A) and fibrinolysis magnitude (plasmin-antiplasmin complex, PAP, and D-dimers). Measurements were done at the ICU admission and after 10-14 days. Results: The general pattern showed an increased thrombin generation, modest or null release of t-PA, and increased levels of PAI-2, Fibrinopeptide A, PAP and D-dimers. At baseline, non survivors had a significantly (P=0.014) higher PAI-2/PAP ratio than survivors (109, interquartile range [IQR] 18.1-216, vs. 8.7, IQR 2.9-12.6). At follow-up, thrombin generation was significantly (P=0.025) reduced in survivors (PF 1+2 from 396 pg/mL, IQR 185-585 to 237 pg/mL, IQR 120-393), whereas it increased in non-survivors. Fibrinolysis inhibition at follow-up remained stable in survivors, and increased in non-survivors, leading to a significant (P=0.026) difference in PAI-2 levels (161 pg/mL, IQR 50-334, vs. 1,088 pg/mL, IQR 177-1,565). Conclusions: Severe patterns of COVID-19 infection (ARDS) are characterized by a thrombin burst, triggered by the release of IL-6 and other cytokines, and the consequent release of Tissue Factor. Mechanisms of fibrinolysis regulation appear unbalanced toward fibrinolysis inhibition. In survivors, this pattern ameliorates, whereas in non-survivors it worsens, leading to the environment for clinically relevant thrombi generation, that was found in 58% of non-surviving patients. Trial registration: clinicaltrials.gov (NCT04441502).
Fecal microbiota transplantation reconstructs the gut microbiota of septic mice and protects the intestinal mucosal barrier
Authors: Gai Xiaowei , Wang Huawei , Li Yaqing , Zhao Haotian , He Cong , Wang Zihui , Zhao Heling
Published: August 2020

Background This study aimed to confirm the existence of gut microbiota (GM) imbalance in the early stage of sepsis, observe the effect of fecal microbiota transplantation (FMT) on sepsis, and explore whether FMT can reconstruct the GM of septic mice and restore its protective function on the intestinal mucosal barrier. Methods The study included acute experiments and 7-day mortality observation experiments with clean-grade C57BL/6, and they were randomly divided randomly into three groups, namely, the sham group, the sepsis model group and the fecal microbiota transplantation group. Fresh feces from 10 mice were kept every day to make fecal liquid. The Sham group and the CLP group were given intragastric administration once a day with phosphate-buffered saline, and the FMT group mice were given fecal microbiota transplantation once a day. The animals were euthanized at 12, 24, and 48 h after modeling, and blood, colon, and stool from each mouse were collected at the same time.Results Colonic pathological scores, pro-inflammatory cytokines, TLR4/MyD88/NF-κB protein levels, and gene expression levels, were lower in the FMT group, while anti-inflammatory factors, mucus layer thickness, MUC2, occludin, and ZO-1 proteins were higher in the FMT group than the CLP group. Bacterial flora analysis showed gut flora was reconstructed after FMT. The species composition of the differential pathways revealed that the Lachnospiraceae group contributed the most by the L-lysine pathway of fermentation to acetate and butanoate.Conclusion GM imbalance exists early in sepsis. FMT can improve morbidity and effectively reduce mortality in septic mice. After the fecal bacteria were transplanted, the abundance and diversity of the gut flora were restored, and the microbial characteristics of the donors changed. FMT can effectively reduce epithelial cell apoptosis, improve the composition of the mucus layer, upregulate the expression of tight junction proteins, and reduce intestinal permeability and the inflammatory response, thus protecting the intestinal barrier function. After FMT, Lachnospiraceae contributes the most to intestinal protection through enhancement of the L-lysine fermentation pathway, resulting in the production of acetate and butanoate, and may be the key bacteria for short-chain fatty acid metabolism and FMT success.
The Role of Awake Extracorporeal Membrane Oxygenation as Bridging Therapy for Lung Transplantation: A Retrospective Cohort Study
Authors: KIM NAM EUN , Kim Song Yee , Leem Ah Young , Park Youngmok , Kwak Se Hyun , Yong Seung Hyun , Chung Kyungsoo , Park Moo Suk , Kim Young Sam , Lee Jin Gu , Paik Hyo Chae , Lee Su Hwan
Published: August 2020

Background

As lung transplantation (LTx) becomes a standard treatment for end-stage lung disease, bridging to LTx with extracorporeal membrane oxygenation (ECMO) is increasing during waiting time, for either rescue treatment or improving ability to rehabilitation before transplant. This study investigated post-operative outcomes in patients bridging to lung transplantation with ECMO, especially those receiving awake ECMO.

Methods

In this single-center study, we retrospectively reviewed 241 consecutive LTx patients between October 2012 and March 2019. Among them, 65 patients received ECMO support while waiting for LTx; these patients were analyzed according to their awakeness. Multivaribale logistic regression and Cox proportional hazard models were used to analyze variables associated awake strategy and mortality.

Results

Thirty-three patients (50.7%) were awake during bridging ECMO, and 32 patients (49.2%) were in sedative status. The median age of awake ECMO patients was 59.0 (IQR 54.0-63.0) years, and 63.1% of population was male. There were no significant differences between awake and non-awake ECMO patients with respect to age, comorbidities, APACHE II score, ECMO duration and ECMO blood flow. Awake group have better post-operative outcome in terms of statically shorter post-operative intensive care unit (ICU) length of stay (LOS) (awake vs. non-awake, 6 [4-9.5] vs. 16 [6-22], p = 0.004) and longer ventilator free days (VFDs) (awake vs. non-awake, 24 [11.0-25.0] vs. 0 [0.0-14.5], p = 0.001). Furthermore, the awake ECMO group had a significantly lower six-month mortality rate compared to the non-awake group (18.2% vs. 40.6%, p = 0.045). It was independent predictive factor for ability to gait after LTx ([OR] 4.128, 95% CI 1.094-15.572, p = 0.036).

Conclusions

Awake ECMO therapy could be useful for high-risk patients waiting for LTx, and might help shorten ICU LOS and improve survival benefit after LTx. Furthermore, awake ECMO was independent predictive factor for postoperative gaiting.
Base-excess chloride; the best approach to evaluating the effect of chloride on the acid- base status: a retrospective study
Authors: Gucyetmez Bulent , Tuzuner Filiz , Atalan Hakan Korkut , Sezerman Ugur , Gucyetmez Kaan , Telci Lutfi
Published: August 2020

Background: To determine the effect of chloride on the acid-base status, four approaches are currently used: 1) accepted ranges of serum chloride values; 2) chloride corrections, such as chloride deficiency/excess and chloride modification; 3) the Cl/Na ratio; and 4) the sodium- chloride difference, such as base-excess chloride. However, these approaches are governed by different concepts, and they can evaluate the effects of chloride on the acid-base status differently. Our aim is to investigate which approach to the evaluation of the effect of chloride is the best.Methods: In this retrospective cohort study, 2529 critically ill patients who were admitted to the tertiary care unit were evaluated between 2011 and 2018. Patient characteristics and blood gas parameters at the ICU admission and outcomes were recorded. The effects of chloride on the acid-base status according to each evaluative approach were validated by the standard base excess and apparent strong ion difference. To compare approaches, kappa and Bland-Altman tests and a linear regression model were used. Results: In the linear regression model for all patients, only base-excess chloride in all the chloride evaluation approaches was significantly related to the standard base excess. In the subgroup, the correlation and limits of agreement between base-excess chloride and the standard base excess were the strongest (r2=0.92 p<0.001 bias: 0.5mmol/L). Conclusions: For the evaluation of the effect of chloride on the acid-base status, base-excess chloride is a better approach than accepted ranges of serum chloride values, chloride corrections and the Cl/Na ratio.
Serum and Sputum Iron Trends Distinguigh Responders and Non-Responders to Treatment of Cystic Fibrosis Pulmonary Exacerbation
Authors: Gifford Alex H , Polineni Deepika , He Jianghua , D'Amico Jessica L , Dorman Dana B , Williams Molly A , Nymon Amanda B , Balwan Akshu , Budden Theodore , Zuckerman Jonathan B
Published: August 2020

Background: The cystic fibrosis (CF) community seeks to explain the heterogeneity of pulmonary exacerbation (PEX) treatment outcomes. Studies suggest that certain substances in serum and sputum offer objective evidence of PEX onset in people with CF (PwCF) and identify those at risk for inadequate treatment responses. However, it is clinically impractical to measure most of these substances, and a lack of correlative clinical information limits their utility as drivers of medical decision-making. Here, we questioned whether routinely available indices of iron homeostasis and systemic inflammation could identify PwCF with and without sustained symptom and lung function responses to PEX treatment. Methods: We prospectively evaluated health-related quality-of-life (HRQoL) and lung function and measured biochemical indices associated with iron homeostasis in serum and sputum in twenty adults during a PEX cycle. We classified subjects as sustained symptom-responders (SRs) or non-sustained symptom-responders (NSRs) based on the absence or presence, respectively, of worsened symptom scores following initial improvement during PEX treatment. We used linear mixed models (LMMs) to explore whether treatment-related trends in lung function and hematologic and sputum parameters of interest differed between SRs and NSRs.Results: We identified ten SRs and ten NSRs. Subjects were adults with baseline lung function and symptom burden similar to other CF cohorts in the literature. SRs and NSRs were treated for similar durations. SRs had higher model-predicted trends in lung function than NSRs during treatment. Serum interleukin-6 (IL-6) and serum hepcidin-25 fell during treatment in SRs and NSRs. Trends in serum and sputum iron levels differed significantly between SRs and NSRs. Conclusions: In adults with CF treated for PEX, symptomatic non-response may be associated with lack of lung function improvement, initial increase but terminal decline in serum iron concentration, and initial decline but terminal increase in sputum iron concentration. Future work is needed to confirm the findings and understand possible mechanisms for these alterations in iron homeostasis during CF PEX.
Summary of clinical characteristics of common primary adrenal malignancies in adults
Authors: zhang zongzong , wang lina , li xiunan , song xishuang , wang xuejian , zhu xinqing , fan weiwei , wang jianbo , yang deyong
Published: August 2020

Background

To summary the clinical characteristics of common primary adrenal malignancies in adults, the survival time of the patients, and the prognostic factors associated with these rare malignancies.
Methods

The Surveillance, Epidemiology, and End Results database (1975–2016) was queried for all patients who were diagnosed with primary adrenal malignancies, including adrenocortical carcinoma(ACC), pheochromocytoma and paraganglioma (PPGL), lymphoma, and sarcoma (SA). The clinical characteristics, overall survival (OS) and cancer-specific survival (CSS) were analyzed, in which propensity score methodology, logistic regression modeling and Kaplan-Meier survival curves were used. The Multivariate Cox proportional hazard model was used to identify factors affecting the prognosis of patients with ACC.
Results

3204 patients with primary adrenal malignancies were identified, including 2180 with ACC, 593 with PPGL, 307 with lymphoma, and 124 with SA. Generally, PPGL had a better prognosis than others. For ACC and PPGL, the non-metastatic group had better OS and CSS than the metastatic group; for SA, the non-metastatic group had better OS, however, there was no significant difference in CSS between the two groups. Furthermore, For ACC, the single metastasis group had a better OS than the multiple metastasis group. After tumors metastasis, the surgery group, surgery of primary adrenal lesions, had better OS and CSS than the non-surgery group for ACC and PPGL. For lymphoma, the chemotherapy group had better OS and CSS; for ACC and PPGL, the chemotherapy group had better CSS and worse OS; for SA, the survival showed no significant difference between the two groups. Radiotherapy had the same effect on patients' survival as chemotherapy, except for the lymphoma and the ACC. As for lymphoma, the radiotherapy group had better CSS, whereas the survival showed no significant difference in OS between the two groups. For ACC, the non- radiotherapy group had better CSS and OS. More importantly, for lymphoma, under the condition that both cohorts were the same basically, the surgical group had a better prognosis. The prognosis of ACC was related to sex, age, seer historic stage, surgery, chemotherapy.
Conclusion

Understanding the clinical characteristics of these tumors and factors affecting prognosis can facilitate the selection of more appropriate clinical treatment options.
Utility of Self-rated Adherence and Assessment of Participant Feedback of the Healthy Diet and Lifestyle Study Pilot.
Authors: O’Reilly Holly , Panizza Chloe , Lim Unhee , Yonemori Kim M , Wilkens Lynne R , Shvetsov Yurii B , Harvie Michelle N , Shepherd John , Zhu Fengqing Maggie , Marchand Loïc Le , Boushey Carol J , Cassel Kevin D
Published: August 2020

Background: Self-rated adherence and qualitative feedback may be useful in monitoring and understanding participants’ compliance during lifestyle interventions. We examined self-rated adherence and qualitative feedback in the Healthy Diet and Lifestyle Study (HDLS). HDLS is a randomized pilot intervention comparing the effect of intermittent energy restriction combined with a Mediterranean diet (IER+MED) to a euenergetic Dietary Approaches to Stop Hypertension (DASH) diet, with matching physical activity regimens, for reducing visceral adipose tissue area (VAT) and weight.Methods: We analyzed the 59 (98%) participants who completed at least one week of HDLS. Self-rated adherence scores to dietary and physical activity prescriptions were collected 8 times across the 12-week intervention, using a 0-10 scale (0=Not at all, 4=Somewhat, and 10=Following the plan very well). Adherence scores for each participant were averaged and assigned to high and low adherence categories using the group median (7.3 for diet, 7.1 for physical activity). Mean changes in VAT and weight from baseline to 12 weeks are reported by adherence level, overall and by randomization arm. Participants qualitative feedback at completion of HDLS and 6 months post intervention were examined.Results: Overall, compared to participants with low self-rated adherence to dietary prescriptions, those with high adherence lost significantly more VAT (22.9 ± 3.7 cm2 vs. 11.7 ± 3.9 cm2; p=0.044) and weight at Week 12 (5.4 ± 0.8 kg vs. 3.5 ± 0.6 kg; p=0.045). For physical activity, compared to participants with low adherence, those with high adherence lost significantly more VAT (22.3 ± 3.7 cm2 vs. 11.6 ± 3.6 cm2; p=0.035). Participants’ qualitative feedback of HDLS was positive and the most common response, on how to improve the study, was to provide cooking education classes.Conclusions: Our results support the use of self-rated adherence to dietary and physical activity prescriptions as an effective method to monitor compliance and facilitate participant goal setting during a behavioral modification intervention. Study strategies were found to be effective with promoting compliance to dietary and physical activity prescriptions. The incorporation of cooking classes and demonstrations into future larger trials may further complement dietary adherence.Trial registration: ClinicalTrials.gov Identifier: NCT03639350. Registered 21st August 2018- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03639350
Causes and challenges of males’ rhinoplasty in Iranian population: Qualitative study
Authors: Ghafari Zeinab , Jalali Amir , Abasi Parvin , Yousefi-Labani Javad
Published: August 2020

Background: Rhinoplasty is a cosmetic surgery for which the society and the individual incur heavy costs. The present study is an attempt to elaborate on the causes and challenges of males’ rhinoplasty in Iranian population.Methods: The study was carried out as a qualitative study using content analysis method. Totally, 20 participants (16 clients, one family member, and three care-givers) were selected purposefully and participated in semi-structured and in-depth interviews. With 20 interviews, data saturation was achieved. Data analysis process was conducted manually along with the interviews following Lundman and Graneheim method.Results: Data analysis revealed 614 primary codes and the continuous examination and removal or repetitious codes left 417 codes, nine sub-themes, and two themes namely the reasons for rhinoplasty (lack of confidence, hope for a better face, seeking attention, keeping up with the Joneses, and persuasion by others) and challenges (family challenge, social atmosphere, financial problems, and unwanted consequence).Conclusion: The lack of confidence and the hope of having a more beautiful face were the motivators. Family challenges, financial problem and the negative side effects of the surgery were challenges in the way of men for having rhinoplasty.
Effects of Moderate Aerobic Training on Cognitive Performance and Dyslipidemia in Sedentary Older Adults
Authors: Alghadir Ahmad H. , Gabr Sami
Published: August 2020

Background: The present study was designed to evaluate the effects of 24 weeks of moderate aerobic exercise on the levels of lipids and lipoprotein; Lipo(a) markers and its association with cognitive performance in healthy older adults. Methods: A total of 150 healthy subjects (100 males, 50 females; age range; 65-95Yrs) were recruited for this study. Based up on LOTCA test score, subjects were classified randomly into two groups control group (n= 50) and cognitive impairment group (n=100).Cognitive functioning, Leisure-time physical activity (LTPA), lipid profile; total cholesterol, TG, HDL-c, LDL-C, and Lipo(a) were assessed at baseline and post- 24 week aerobic exercise interventions using LOTCA battery, pre validated PA questionnaire, colorimetric and immunoassay techniques respectively. Results. Significant improvements in the cognitive function and modulation in lipid profile and lipoprotein (a) markers were reported in all older subjects following 24 week of moderate exercise. LOTCA-7-sets scores showed a significant correlation with physical activity status and the regulation of lipids and lipo(a) markers. Physically active persons showed a higher cognitive performance along with reduction in the levels of T-Cholest., TG, LDL-C, Lipo(a) , and increase in the levels of HDL-C and aerobic fitness VO2max compared with sedentary participants. Cognitive performance correlated positively with the increase in aerobic fitness, HDL-C, and negatively with T-Cholest.,TG, LDL-C, Lipo(a) respectively. However, a significant increase, in the improvement of motor praxis, vasomotor organization, thinking operations, attention and concentration was reported among older adults. Conclusions: The data concluded that supervised moderate aerobic training for 24 weeks plays a positive significant effect in improving cognitive functions via modulating lipid profile and lipoprotein (a) of older adults.
Clinical Features of Systemic Lupus Erythematosus-related Interstitial Lung Disease-a Clinical Retrospective Study
Authors: Niu Qian , Tao Xiaonan
Published: August 2020

Background: There is no conclusion about the correlation between autoantibodies in SLE patients and ILD. In order to help early diagnosis of SLE-ILD, here we will compare the differences in clinical data of SLE-ILD and SLE-NILD patients and explore the clinical features of SLE-ILD and the value of indicators related to the diagnosis of SLE-ILD and independent risk factors. Methods: A clinical retrospective study. Select 89 SLE-ILD patients and 187 SLE-NILD patients, collect all patients' age of onset, smoking history, sex, and autoantibodies, and compare the differences between the two. Additionally collect respiratory manifestations, pulmonary auscultation signs, pulmonary computer tomography and pulmonary function of SLE-ILD patients. Rely on the above clinical data to carry out relevant summary and statistical analysis, and explore the correlation between pulmonary function and autoantibodies in SLE-ILD patients, the value of autoantibodies in the diagnosis of SLE-ILD and the independent risk factors of SLE-ILD. Results：SLE-ILD patients have a higher ANA positive rate than SLE-NILD patients. There is no correlation found between pulmonary function indexes and autoantibodies in SLE-ILD patients. The diagnostic sensitivity of ANA for SLE-ILD is 97.8%, specificity only 3.2%. The diagnostic sensitivity and specificity of Ro-52 are 61.8% and 52.9%. Age, ANA, SM, and Ro-52 are independent risk factors for the onset of SLE-ILD.Conclusions: Age, ANA, SM, and Ro-52 are meaningful and notable indicators for SLE patients when in doubt whether they are accompanied by ILD.
Comparison of Percutaneous Endoscopic Lumbar Discectomy and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Revision Surgery for the Recurrent Lumbar Disc Herniation After Percutaneous Endoscopic Lumbar Discectomy
Authors: Wang Anqi , Yu Zhengrong
Published: August 2020

Background: Percutaneous endoscopic lumbar discectomy (PELD) has become a feasible alternative to the conventional open surgery for the treatment of lumbar disc herniation (LDH), but PELD is associated with a certain rate of recurrence. Therefore, a good choice of surgical approach for recurrent lumbar disc herniation (rLDH) is important. The purpose of this study was to compare the outcomes between PELD and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for revision surgery for the rLDH after primary PELD surgery.Methods: This study retrospectively assessed 46 patients who suffered from rLDH after PELD surgery in Peking University First Hospital from January 2015 to June 2019, and patients were divided into two groups, PELD group (n=24) and MIS-TLIF group (n=22), according to different revision surgical methods. Preoperative data, perioperative conditions, complications, recurrence condition, and clinical outcomes were compared between these two groups.Results: Compared with the MIS-TLIF group, the PELD group was associated with shorter operative time, less intraoperative hemorrhage, and shorter post-operative hospitalization, but higher recurrence rate. Complication rates were comparable between two groups. Both the two groups could provide patients with satisfactory clinical outcomes at the 12-month follow-up after revision surgery. Compared with MIS-TLIF, PELD was associated with visual Analog Scale (VAS) scores of back pain, and Oswestry disability index (ODI) at the 1-month follow-up, whereas this effect was equalized after 6 months postoperatively.Conclusions: Either PELD or MIS-TLIF surgery could provide satisfactory clinical outcomes for revision surgery for the rLDH after primary PELD. PELD brought advantages in shorter operative time, less intraoperative hemorrhage, and shorter post-operative hospitalization over MIS-TLIF, however, higher postoperative recurrence rate of PELD couldn’t be ignored. Surgeons must weigh advantages against disadvantages of these surgical methods and fully informed patients preoperatively.
Treatment of patient with cirrhosis-ascites by the mineral pulse light stimuli on LV acupoints-a case report
Authors: Cha YongChol , Choe Hyok , Oh SongJin
Published: August 2020

Background: Decompensated cirrhosis is an illness that causes tremendous suffering. The incidence of cirrhosis is increasing and rates of liver transplant, the only cure, remain stagnant. Objectives: The purpose of this study is to perform the clinical trial on cirrhosis-ascites patient by the mineral pulse light stimuli on LV acupoints without any drugs use.Methods: Hepatic cirrhosis patient was stimulated by mineral pulse light stimulator (MPLS). Stimulus acupoints; LV3. LV14. SP6. The selected acupoints were stimulated by MPLS for 50~60 minutes once a day. The same method was performed on the patient for 40days without any drugs use (diuretics, Albumin, etc.).Results: After treatment, all the laboratory indicators and patient conditions were become normal.Conclusions: Cirrhosis-ascites patient was recovered by mineral pulse light stimulus on LV acupoints without any drugs use.
The Extent of Participation in Urban Agriculture and Its Effect on Food Security in Africa and Asia: Evidence from Ghana and India
Authors: Bannor Richard Kwasi , Sharma Mohit , Oppong-Kyeremeh Helena
Published: August 2020

This study examined the factors that influence the extent of urban agriculture participation and its effect on food security in Ghana and India. A total of six hundred and fifty urban agriculture farmers were interviewed for this study in Ghana and India. Food security status of urban households was assessed by the use of the Household Food Insecurity Access Scale whereas the determinants of the extent of urban agriculture and its effect on food security were analysed by the use of the heteroskedastic linear regression and the Seemingly Unrelated Regression models, respectively. From the study on average, households in Ghana were mildly food insecure, but that of India was moderately food insecure. The results further revealed that, various demographic, economic, institutional and health and nutrition factors differently influenced urban food security and urban agriculture. Also, the extent of urban agriculture participation positively influenced food security. It is recommended that, Governments and NGOs interested in the reduction of urban food insecurity should aggressively advocate for urban agriculture in urban households through extension education. Interests could be stimulated by gleaning on health benefits of urban agriculture such as producing safe and nutritious food, the opportunity to consume chemical-free food and pursue urban agriculture as a business. The implication for research is that similar studies can be conducted in other emerging urban cities in Africa and Asia for the advocacy for specific urban food security policies and programmes.
Psychological Violence and Associated Factors Among Housemaid’s in Northwest Ethiopia.
Authors: Azanaw Kefyalew , Gelagay Abebaw Addis , Lakew Ayenew Molla
Published: August 2020

Background: psychological violence often called emotional violence is a form of violence that may result in psychological trauma. Psychological violence can destroy intimate relationships, friendships and even our relationship with us. The majority of human beings may have been a victim of some form of psychological violence at some point of their life. Therefore this study expected to assess the magnitude of Psychological violence and its associated factors among housemaids.Methods: A community based cross-sectional study was conducted from April 1-30/ 2018. About 688 study participants were selected using cluster sampling. Data were entered into Epi info version 7.2.2.6 and analyzed with SPSS version 20 then, mainly analyzed using descriptive statistic and Binary logistic regression.Result: A community based cross-sectional study was conducted from April 1-30/ 2018 among 688 randomly selected housemaids. From 688 participated in the study, about 387(56.3%) (95%CI: 52.6 - 60.2) housemaids had experienced at least one form of psychological violence in their life time. From those who had experienced violence, 175(25.4%) (95%CI: 22.1%-28.6%) had experienced in the last 12 months. No formal education (AOR=3.13, 95%CI: 1.76, 5.57), primary education (AOR=2.09, 95%CI: 1.12, 3.90), being rural (AOR=2.04, 95%CI: 1.13, 3.71), and family live situation and alcohol consumption of employers had significant association with housemaid psychological violence. Conclusion: n this study,high prevalence of housemaid psychological violence has been reported. To resolve the problem, it is important to expand information education communication and behavioral change to empower housemaid.