bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of a village-based intervention for depression in community-dwelling older adults: a randomised feasibility study
Authors: Oh In Mok , Cho Maeng Je , Hahm Bong-Jin , Kim Byung-Soo , Sohn Jee Hoon , Suk Hye Won , Jung Bu Young , Kim Hye Jung , Kim Hyeon A , Choi Ki Bok , You Da Hye , Lim Ah Reum , Park In Ok , Ahn Jeung Hyuck , Lee Hee , Kim Yeon Hee , Kim Mi Ra , Park Jee Eun
Published: January 2020

Background: Although a focus on late-life depression may help preventing suicide in older adults, many older people, especially those living in rural areas, have relatively low accessibility to treatment. This study examined the feasibility and effectiveness of a village-based intervention for depression targeting older adults living in rural areas. Methods: A community-based randomised pilot trial was performed in two small rural villages in South Korea. Two villages were randomly selected and assigned to the intervention or active control group; all older adults living in the two villages (n = 451) were included in the intervention program or received standard Community Mental Health Service (CMHS) care, and the effectiveness of the program was examined using representative samples from both groups (n = 160). The 12-week intervention included case management according to individual risk level and group-based activities. Healthy residents living in the intervention village who played major roles in monitoring at-risk older individuals were supervised by CMHS staff. The score on the Korean version of the Geriatric Depression Scale-Short Form (SGDS-K) was the primary outcome, while social network, functional status, and global cognitive function were secondary outcomes. Linear mixed models including the factors of intervention group, time, and their interaction were used to examine group differences in changes in primary and secondary outcomes from baseline to follow up. Results: Overall, there was no significant group × time interaction with respect to the SGDS-K score, but older individuals with more depressive symptoms at baseline (SGDS-K ≥ 6) tended to have a lower likelihood of progressing to severe depression at post-intervention. The social network was strengthened in the intervention group, and there was a significant group × time interaction (F[df1, df2], 5.29 [1, 153], p = 0.023).Conclusion: This study examined a 12-week village-based intervention for late-life depression in which the CMHS helped village-dwellers deal with late-life depression in their communities. Although the intervention improved social interactions among older adults, it did not reduce depressive symptoms. Further studies including more rural villages and long-term follow up are needed to confirm the effectiveness of this prevention program. Trial registration: NCT04013165 (date: 9 July 2019, retrospectively registered)
Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care
Authors: Haukland Ellinor Christin , von Plessen Christian , Nieder Carsten , Vonen Barthold
Published: January 2020

Background: Anticancer treatment exposes patients to negative consequences such as increased toxicity and decreased quality of life, and there are clear guidelines recommending limiting use of aggressive anticancer treatments for patients near end of life. The aim of this study is to investigate the association between anticancer treatment given during the last 30 days of life and adverse events contributing to death and elucidate how adverse events can be used as a measure of quality and safety in end-of-life cancer care Methods: Retrospective cohort study of 247 deceased hospitalised cancer patients at three hospitals in Norway. The Global Trigger Tool method were used to identify adverse events. We used Poisson regression and binary logistic regression to compare adverse events and association with use of anticancer treatment given during the last 30 days of life. Results: 30 % of deceased hospitalised cancer patients received some kind of anticancer treatment during the last 30 days of life, mainly systemic anticancer treatment. These patients had 62 % more adverse events compared to patients not being treated last 30 days, 39 vs. 24 adverse events per 1 000 patient days (p<0.001, OR 1.62 (1.23 – 2.15). They also had twice the odds of an adverse event contributing to death compared to patients without such treatment, 33 vs. 18 % (p=0.045, OR 1.85 (1.01 – 3.36)). Receiving follow up by specialist palliative care reduced the rate of AEs per 1 000 patient days in both groups by 29 % (p= 0.02, IRR 0.71, CI 95% 0.53 – 0.96). Conclusions: Anticancer treatment given during the last 30 days of life is associated with a significantly increased rate of adverse events and related mortality. Patients receiving specialist palliative care had significantly fewer adverse events, supporting recommendations of early integration of palliative care in a patient safety perspective.
The impact of the duration of the palliative care period on cancer patients with regard to the use of hospital services and the place of death: a retrospective cohort study
Authors: Hirvonen Outi Maaria , Leskelä Riikka-Leena , Grönholm Lotta , Haltia Olli , Voltti Samuli , Tyynelä-Korhonen Kristiina , Rahko Eeva K. , Lehto Juho T. , Saarto Tiina
Published: January 2020

Background In order to avoid unnecessary use of hospital services at the end-of-life, palliative care should be initiated early enough in order to have time to initiate and carry out advance care planning (ACP). This single center study assesses the impact of the PC decision and its timing on the use of hospital services at EOL and the place of death. Methods A randomly chosen cohort of 992 cancer patients treated in a tertiary hospital between Jan 2013 –Dec 2014, who were deceased by the end of 2014, were selected from the total number of 2737 identified from the hospital database. The PC decision (the decision to terminate life-prolonging anticancer treatments and focus on symptom centered palliative care) and use of PC unit services were studied in relation to emergency department (ED) visits, hospital inpatient days and place of death. Results The PC decision was defined for 82% of the patients and 37% visited a PC unit. The earlier the PC decision was made, the more often patients had an appointment at the PC unit (>180 days prior to death 72% and <14 days 10%). The number of ED visits and inpatient days were highest for patients with no PC decision and lowest for patients with both a PC decision and an PC unit appointment (60 days before death ED visits 1.3 vs 0.8 and inpatient days 9.9 vs 2.9 respectively, p<0.01). Patients with no PC decision died more often in secondary/tertiary hospitals (28% vs. 19% with a PC decision, and 6% with a decision and an appointment to a PC unit). Conclusions The PC decision to initiate a palliative goal for the treatment had a distinct impact on the use of hospital services at the EOL. Contact with a PC unit further increased the likelihood of EOL care at primary care.
Commercial 4-Dimensional Echocardiography for Murine Heart Volumetric Evaluation after Myocardial Infarction
Authors: Rutledge Cody A , Cater George , McMahon Brenda , Guo Lanping , Wu Yijen , Villanueva Flordeliza , Kaufman Brett A
Published: January 2020

Background Traditional preclinical echocardiography (ECHO) modalities, including 1-dimensional motion-mode (M-Mode) and 2-dimensional long axis (2D-US), rely on geometric and temporal assumptions about the heart for volumetric measurements. Surgical animal models, such as the mouse coronary artery ligation (CAL) model of myocardial infarction, result in morphologic changes that do not fit these geometric assumptions. New ECHO technology, including 4-dimensional ultrasound (4D-US), improves on these traditional models. This paper aims to compare commercially available 4D-US to M-mode and 2D-US in a mouse model of CAL. Methods 37 mice underwent CAL surgery, of which 32 survived to a 4 week post-operative time point. ECHO was completed at baseline, 1 week, and 4 weeks after CAL. M-mode, 2D-US, and 4D-US were taken at each time point and evaluated by two separate echocardiographers. At 4 weeks, a subset (n=12) of mice underwent cardiac magnetic resonance (CMR) imaging to serve as a reference standard. End systolic volume (ESV), end diastolic volume (EDV), and ejection fraction (EF) were compared among imaging modalities. Hearts were also collected for histologic evaluation of scar size (n=16) and compared to ECHO-derived wall motion severity index (WMSI) and global longitudinal strain as well as gadolinium-enhanced CMR to compare scar assessment modalities. Results 4D-US provides close agreement of ESV (Bias: -2.55%, LOA: -61.55 to 66.66) and EF (US Bias: 11.23%, LOA -43.10 to 102.8) 4 weeks after CAL when compared to CMR, outperforming 2D-US and M-mode estimations. 4D-US has lower inter-user variability as measured by intraclass correlation (ICC) in the evaluation of EDV (0.91) and ESV (0.93) when compared to other modalities. 4D-US also allows for rapid assessment of WMSI, which correlates strongly with infarct size by histology (r=0.77). Conclusion 4D-US outperforms M-Mode and 2D-US for volumetric analysis 4 weeks after CAL and has higher inter-user reliability. 4D-US allows for rapid calculation of WMSI, which correlates well with histologic scar size.
R-spondin 2 mediates neutrophil egress into the alveolar space through increased lung permeability.
Authors: Jackson Sergio Randell , Costa Maria Fernanda De Mello , Pastore Christopher Frances , Zhao Gan , Weiner Aaron I. , Adams Stephanie , Palashikar Gargi , Quansah Kwaku , Hankenson Kurt , Herbert De'Broski , Vaughan Andrew
Published: January 2020

Objective R-spondin 2 (RSPO2) is required for lung morphogenesis, activates Wnt signaling, and is upregulated in idiopathic lung fibrosis. Our objective was to investigate whether RSPO2 is similarly important in homeostasis of the adult lung. While investigating the characteristics of bronchoalveolar lavage in RSPO2-deficient (RSPO2-/-) mice, we observed unexpected changes in neutrophil homeostasis and vascular permeability when compared to control (RSPO2+/+) mice at baseline. Here we quantify these observations to explore how tonic RSPO2 expression impacts lung homeostasis. Results Quantitative PCR (qPCR) analysis demonstrated significantly elevated myeloperoxidase (MPO) expression in bronchoalveolar lavage fluid (BALF) cells from RSPO2-/- mice. Likewise, immunocytochemical (ICC) analysis demonstrated significantly more MPO+ cells in BALF from RSPO2-/- mice compared to controls, confirming the increase of infiltrated neutrophils. We then assessed lung permeability/barrier disruption via Fluorescein Isothiocyanate (FITC)-dextran instillation and found a significantly higher dextran concentration in the plasma of RSPO2-/- mice compared to identically treated RSPO2+/+ mice. These data demonstrate that RSPO2 may be crucial for blood-gas barrier integrity and can limit neutrophil migration from circulation into alveolar spaces associated with increased lung permeability and/or barrier disruption. This study indicates that additional research is needed to evaluate RSPO2 in scenarios characterized by pulmonary edema or neutrophilia.
Hyponatremia As A Predictor Of Adverse Outcome In Children With Severe Lower Respiratory Tract Infection In Tribhuvan University Teaching Hospital (Tuth), Nepal
Authors: Lamichhane Machhindra , Shrestha Laxman , Bajracharya Luna , Bagale Archana
Published: January 2020

Background Lower respiratory tract infection (LRTI) is one of the major causes of mortality in children with estimated 1 million deaths every year. Hyponatremia is the most common electrolyte abnormality seen in LRTI. Objective To find association of hyponatremia (serum sodium<135meq/l) with severe LRTI. Design Prospective cross sectional study Settings Pediatric Emergency, Ward and Pediatric Intensive Care Unit of Tribhuvan University Teaching Hospital(TUTH) Subjects Children between 2 months to 16 years presenting with cough for less than 3 weeks, fast breathing and chest indrawing. Methods Children between 2 month to 16 years of age having cough, fast breathing and chest indrawing admitted in emergency, ward or PICU of TUTH were screened and among them, children having pediatric respiratory severity score of 4-5 were enrolled in the study. Serum sodium was sent during admission and collected within 2 hours. Daily follow up was done to find need of respiratory support, duration to resolve hypoxia, total duration in hospital and final outcome of patient. Statistical test applied were Chi-square test and Fisher exact test. Results 47.5% of study population had hyponatremia, of whom 65.79% had mild hyponatremia 26.31% had moderate and 7.89%had severe hyponatremia. Association of hyponatremia with need of non rebreathing face mask (p=0.001), ventilatio r (p=0.009), duration of hospital stay (p=0.047) were significant. The study also found the association of severity of hyponatremia with need of non rebreathing facemask (p=0.001),ventilator (p=0.01), outcome (p=0.001), duration of stay (0.002). Mean time to resolve hypoxia in children with hyponatremia (4.5 days) was longer compared to normal sodium (2.58 days). Four patients died during the study period and all of them had hyponatremia.
Family and peer effect on young and adolescent smoking in Bangladesh
Authors: Ahmed Moin Uddin , Hashmi Rubayyat , Pulok Mohammad Habibullah , Tannous Kathy , Alam Khorshed
Published: January 2020

The authors have withdrawn this preprint from Research Square.
lncRNA-Associated ceRNA Networks in Spleen of Nocth1-correlated T-ALL Leukemia Mice
Authors: Shi Min , Wang Shaohua , Li Xiaofei , Li Yongjun
Published: January 2020

Background Acute T-lymphocytic leukemia (T-ALL) is a highly aggressive malignant tumor in leukemia. Nocth1 is considered as an major oncogene in the development of T-ALL. Increasing evidences have revealed that the occurrence and progression of T-ALL referred to abnormal gene expression, pathway activation and the regulation between these genes. However, the potential lncRNA-associated competing endogenous RNA (ceRNA) network involved in spleen of Nocth1-correlated T-ALL leukemia mice remains unclear. Methods Overexpression of Notch intracellular domain (ICN) of Notch1 by retroviral infection was used to set up mouse T-ALL model. Deep RNA-sequencing analysis was performed the expression of lncRNAs and mRNA in spleen of T-ALL mice and C57BL/6 mice. Results The deep RNA-sequencing analysis shown that 1833 lncRNAs and 4626 mRNAs were deregulated according to the P-value (p<0.05) and fold change (>2-fold) in spleen of T-ALL leukemia mice compared with that of C57BL/6 mice. Gene Ontology(GO) and KEGG pathway analysis were performed to reveal the potential roles of differentiated expressed lncRNAs. Co-expression Network was performed to reveal the regulation relationship between the differentiated expressed lncRNAs and mRNAs. CeRNA prediction constructed the lncRNA-miRNA-mRNA model to find the core ceRNA based on regression model analysis and seed sequence matching methods. Conclusion This study provided a systematic overview of the altered lncRNAs and mRNA expression, pathway and ceRNA regulation network in the pathogenesis of Nocth1-correlated T-ALL.
One-year Serial Measurements of High-sensitivity Troponin T in Hemodialysis Patients A Randomized Placebo-controlled Sub-study Investigating Angiotensin-II-Blockade, Variation Over Time and Associations with Clinical Outcome
Authors: Peters Christian Daugaard , Kjaergaard Krista D. , Christensen Kent L. , Bibby Bo Martin , Jespersen Bente , Jensen Jens Dam
Published: January 2020

Background Troponin T (TnT) is a well-known risk factor for negative outcome in hemodialysis (HD) patients, but little is known about variation over time, and the impact of clinical and dialysis specific factors. This study investigated the effect of angiotensin II receptor blockade (ARB), short and long-term variation in TnT and associations with clinical parameters.Methods In this analysis based on the SAFIR-cohort (Clinical Trials ID: NCT00791830) 81 HD patients were randomized double-blind for placebo (n=40) or angiotensin II receptor blocker (ARB) treatment (n=41) with irbesartan (150-300 mg) and followed for 12 months with six serial measurements of TnT using a high-sensitivity assay. Results Fifty-four patients (67%) completed follow-up. Baseline TnT-medians (min-max) were (placebo/ARB): 45(14-295)/46(10-343)ng/L. ARB-treatment did not significantly affect mean TnT-levels over the 12-month study period. Median week-to-week and one-year TnT-variation (5th-95th-percentile range) using all samples regardless of intervention were: 0(-14-10)ng/L (week-to-week) and 3(-40-71)ng/L (12 months). Median TnT-amplitude, capturing the change from the lowest to the highest TnT-value observed during the one-year study period was 38% or 20.5 ng/L. Median ratios with 95% limits of agreement were: 1.00(0.73-1.37); P=0.92 (1 week/baseline; n=77) and 1.07(0.52-2.25); P=0.19 (12 months/baseline; n=54). Baseline TnT was positively correlated with diabetes, ultrafiltration volume, arterial stiffness, change in intradialytic total peripheral resistance and N-terminal pro b-type natriuretic peptide (NT-proBNP) and negatively correlated with hematocrit, residual renal function and change in intradialytic cardiac output. High baseline TnT was associated with a higher risk of admission and cardiovascular (CV) events during follow-up. Increase in TnT over time (ΔTnT=12-months-baseline) was significantly associated with increase in left ventricular (LV) mass and NT-proBNP and decrease in LV ejection fraction and late intradialytic stroke volume. ΔTnT was not significantly associated with admissions, CV or intradialytic hypotensive events during follow-up. Admissions were significantly more likely with a high (TnT-amplitude>20.5 ng/L) than a low TnT-amplitude. Peaks in TnT were less frequent in aspirin-treated patients. Conclusion ARB-treatment had no significant effect on TnT-levels. Week-to-week variation was generally low, yet over 12 months individual patients had considerable TnT fluctuations. Rise in TnT over time was significantly correlated with markers of cardiac deterioration.
Immune dysfunction in ankylosing spondylitis (AS) and the potential of tumor necrosis factor-α (TNF-α) inhibitor Anbainuo as an effective treatment
Authors: Yang Mingcan , Lv Qing , Wei Qiujing , Jiang Yutong , Qi Jun , Xiao Min , Fang Linkai , Xie Ya , Cao Shuangyan , Lin Zhiming , Zhang Yanli , Tu Liudan , Zhao Minjing , Pan Yunfeng , Jin Ou , Gu Jieruo
Published: January 2020

Background Studies into ankylosing spondylitis (AS) and its relationship with immune function are controversial, and the correlation between the efficacy of TNF-α inhibitor and changes in immune function is unclear. Methods A total of 40 immune cells were tested with flow cytometry, and the results of 105 HC (healthy control) subjects, 177 active-stage AS patients, and 23 AS cases before and after 12 weeks of Anbainuo therapy were analyzed. Results Compared with the HC group, the proportion of immune cells, such as naïve and central memory CD4+T cells, in AS increased (p<0.0001), but effector memory and terminally differentiated CD4+T cells were decreased (p<0.01 and 0.0001, respectively). Naïve, central memory, and effector memory CD8+T cells were increased (p<0.0001, 0.001, and 0.01, respectively), but terminally differentiated CD8+T cells were decreased (p<0.0001). Th1 cells (helper T cells-1), Tfh1 cells (follicular helper T cells-1), Tc1 cells (cytotoxic T cells-1), and Tregs (regulatory T cells) were lower (p<0.01, 0.05, 0.0001, and 0.001, respectively), but Th17 cells, Tfh17 cells, and Tc cells were higher (p<0.001, 0.0001 and 0.001, respectively). The proportions of total B cells and class-switched B cells were increased (p<0.05), but non-switched B cells, plasma cells, memory B cells, and immature Bregs (regulatory B cells) were lower (p<0.01, 0.0001, 0.0001, and 0.0001, respectively). After Anbainuo therapy, the percentage of Tregs and B10 cells (IL-10-producing regulatory B cells) had increased (p<0.01and 0.05, respectively), and the increase in Tregs was positively correlated with the decrease in CRP (C-reactive protein) (r= 0.489, p=0.018). Conclusions We found that, in terms of both innate and acquired immunity, active-stage AS patients have an immunity imbalance involving multiple types of immune cells, including CD4+T cells, CD8+T cells, Th cells, Tfh cells, Tc cells, Tregs, Bregs, and B cells. Anbainuo can not only help to inhibit disease activity and partial immune function imbalance in AS but can also increase the number of negative regulatory cells in inflammation.
Physical Activity Reduces Anxiety And Regulates Brain Fatty Acid Synthesis
Authors: Liśkiewicz Arkadiusz Damian , Przybyła Marta , Wojakowska Anna , Marczak Łukasz , Bogus Katarzyna , Nowacka-Chmielewska Marta , Liśkiewicz Daniela , Małecki Andrzej , Barski Jarosław , Lewin-Kowalik Joanna , Toborek Michal
Published: January 2020

Physical activity impacts brain functions, but the direct mechanisms of this effect are not fully recognized or understood. Among multidimensional changes induced by physical activity, brain fatty acids (FA) appear to play an important role; however, the knowledge in this area is particularly scarce. Here we performed global metabolomics profiling of the hippocampus and the frontal cortex (FC) in a model of voluntary running in mice. Examined brain structures responded differentially to physical activity. Specifically, the markers of the tricarboxylic acid (TCA) cycle were downregulated in the FC, whereas glycolysis was enhanced in the hippocampus. Physical activity stimulated production of myristic, palmitic and stearic FA; i.e., the primary end products of de novo lipogenesis in the brain, which was accompanied by increased expression of hippocampal fatty acid synthase (FAS), suggesting stimulation of lipid synthesis. The changes in the brain fatty acid profile were associated with reduced anxiety level in the running mice. Overall, the study examines exercise-related metabolic changes in the brain and links them to behavioral outcomes.
Myelination- and immune mediated MR-based brain network correlates
Authors: Cerina Manuela , Muthuraman Muthuraman , Gallus Martin , Koirala Nabin , Dik Andre , Wachsmuth Lydia , Hundehege Petra , Schiffler Patrick , Tenberge Jan-Gerd , Fleischer Vinzenz , Gonzalez-Escamilla Gabriel , Narayanan Venu , Krämer Julia , Faber Cornelius , Budde Thomas , Groppa Sergiu , Meuth Sven G
Published: January 2020

Background:
Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS), characterized by inflammatory and neurodegenerative processes. Despite demyelination being a hallmark of the disease, how it relates to neurodegeneration has still not been completely unraveled, and research is still ongoing into how these processes can be tracked non-invasively. Magnetic resonance imaging (MRI) derived brain network characteristics, which closely mirror disease processes and relate to functional impairment, recently became important variables for characterizing immune-mediated neurodegeneration, however their histopathological basis remains unclear.
Methods:
In order to determine the MRI-derived correlates of myelin dynamics and to test if brain network characteristics derived from diffusion tensor imaging reflect microstructural tissue reorganization, we took advantage of the cuprizone model of general demyelination in mice and performed longitudinal histological and imaging analyses with behavioral tests. By introducing cuprizone into the diet, we induced targeted and consistent demyelination of oligodendrocytes, over a period of 5 weeks. Subsequent myelin synthesis was enabled by reintroduction of normal food.
Results:
Using specific immune-histological markers, we demonstrated that two weeks of cuprizone diet induced a 52% reduction of myelin content in the corpus callosum (CC) and a 35% reduction in the neocortex. An extended cuprizone diet increased myelin loss in the CC, while remyelination commenced in the neocortex. These histologically determined dynamics were reflected by MRI measurements from diffusion tensor imaging. Demyelination was associated with decreased fractional anisotropy (FA) values and increased modularity and clustering at the network level. MRI-derived modularization of the brain network and FA reduction in key anatomical regions, including the hippocampus, thalamus and analyzed cortical areas, were closely related to impaired memory function and anxiety-like behavior.
Conclusion:
Network specific remyelination, shown by histology and MRI metrics, determined amelioration of functional performance and neuropsychiatric symptoms. Taken together, we illustrate the histological basis for the MRI-driven network responses to demyelination, where increased modularity leads to evolving damage and abnormal behavior in MS. Quantitative information about in vivo myelination processes is mirrored by diffusion based imaging of microstructural integrity and network characteristics.
Catch-up Growth in Intrauterine Growth-restricted Piglets Associated with the Return of Pancreatic and Intestinal Functions via Porcine Glucagon-like peptide-2 Microspheres
Authors: Qi Ke-ke , Wu Jie , Zhou Wen-Jun , Deng Bo , Men Xiao-ming , Xu Zi wei
Published: January 2020

Background Intrauterine growth restriction (IUGR) results in abnormal morphology and gastrointestinal function. As a gastrointestinal growth factor, the manner by which the porcine glucagon-like peptide-2 (pGLP-2) microsphere administration catches up with the growth of IUGR piglets was investigated. Methods Fourteen newborn IUGR piglets were assigned into the IUGR and pGLP-2 microsphere groups. The piglets in the pGLP-2 microsphere group were intraperitoneally administered with 100 mg of pGLP-2 microspheres on day 1 of birth. Results From days 15 to 26 of trial, the body weight of the IUGR piglets treated with pGLP-2 microspheres was significantly higher than that in the control group. Importantly, the weaning weight in the pGLP-2 group catches up with the body weight of normal birth weight piglets. IUGR piglets treated with pGLP-2 microspheres significantly showed increased pancreas weight, serum insulin content, and activities of digestive enzymes (lipase, trypsin, chymotrypsin, and amylase). Injection of pGLP-2 microspheres returned the intestinal absorptive capacity by significantly increasing the mRNA expression of sodium-glucose cotransporter 1 in the jejunum, glucose transporter type 2 in the duodenum and jejunum, H + -coupled transporter, and peptide transporter 1 in the jejunum and ileum. It also returned the redox balance by increasing the catalase mRNA expression and decreasing the heat shock protein 70 mRNA expression. In addition, this improvement was associated with the significant increase in gut diameter, length, and weight induced by pGLP-2. Conclusions Injection of pGLP-2 microspheres was a suitable therapeutic strategy for compensatory growth in low birth weight IUGR piglet.
Coexistence of endometriosis in women with mature cystic ovarian teratoma may not be rare.
Authors: Chae Heesuk
Published: January 2020

Background We investigated the incidence of endometriosis in women with mature cystic ovarian teratoma and analyzed the clinicopathologic features of this occurrence. Methods From January 2017 through December 2018, we retrospectively studied 71 women who had undergone cystectomy for mature cystic ovarian teratoma (n = 55, teratoma group) and coexistence of endometriosis and mature cystic ovarian teratoma (n = 16, complex group). Serum anti-Müllerian hormone (AMH) levels were measured preoperatively and one month after surgery. Results Sixteen (22.54%) patients had coexistence of endometriosis and mature cystic ovarian teratoma (complex group); 55 patients had mature cystic teratoma alone (teratoma group). Early-stage endometriosis (stage I) was present in eight patients and advanced-stage endometriosis (stage III or IV) was present in eight. In five cases (31.25%), the coexistence of endometrioma and mature cystic teratoma in the same ovary was observed. The mean operation time was significantly shorter in the teratoma group than in the complex group (61.02 ± 22.74 vs. 86.31 ± 35.35 min, p = 0.007). The complex group had more dysmenorrhea (43.8% vs. 7.3%, p = 0.002) and a significantly higher rate of decrease in serum anti-Müllerian hormone (AMH) levels (33.06 ± 24.92 vs. 16.31 ± 28.17%, p = 0.048). Conclusion(s) The prevalence of coexisting endometriosis and mature cystic ovarian teratoma may be underestimated. Patients with this rare concurrence may present with worsening dysmenorrhea and damage to ovarian reserve after surgery may be greater in patients with coexisting endometriosis than in patients with mature cystic teratoma alone.
Can SSTR2 expression in previously resected SI-NETs predict overall survival after PRRT treatment of remaining lesions?
Authors: Elf Anna-Karin , Johanson Viktor , Marin Ida , Bergström Anders , Nilsson Ola , Svensson Johanna , Wängberg Bo , Bernhardt Peter , Elias Erik
Published: January 2020

Purpose Small intestinal neuroendocrine tumours (SI-NET) often present with distant metastases at diagnosis. Peptide receptor radiotherapy (PRRT) with radiolabelled somatostatin analogues is a systemic treatment that increases overall survival (OS) in patients with SI-NET. However, PRRT treatment response is variable and predictive factors have not been established. PRRT predominantly targets somatostatin receptor 2 (SSTR2). This study evaluates if SSTR2 expression in SI-NET tumours predicts OS after PRRT treatment.Methods Using a previously constructed Tissue Micro Array (TMA) consisting of 412 SI-NET patients we identified a subgroup consisting of 44 patients (95 tissue samples) that had received PRRT treatment during 2006-2016 at Sahlgrenska University hospital. IHC expression of SSTR2, Ki-67 and neuroendocrine markers were assessed. A retrospective estimation of 177 Lu-DOTATATE uptake in 33 patients was performed. An additional subgroup of 34 patients with paired samples from 3 tumour sites was identified. SSTR2 expression was assessed in corresponding tissue samples (n=102). Data regarding OS and non-surgical treatment were collected for both groups.Results SSTR2 expression did not vary between tumour sites but correlated among the patients’ lesions. Patients were grouped into Low SSTR2 or High SSTR2 depending on levels of SSTR2 expression. OS based on SSTR2 expression was not significantly different. However, PRRT treated patients with low SSTR2 expression received less additional treatment compared to patients with high SSTR2 expression and had a tendency towards higher 177 Lu-DOTATATE uptake.Conclusion The results from the present study suggest that low SSTR2 expression should not exclude patients from PRRT.
Clinical Correlates of Insomnia in Patients with Persistent Post-Traumatic Headache Compared with Migraine
Authors: Kim Soo-Kyoung , Chong Catherine D , Dumkrieger Gina , Ross Katherine , Berisha Visar , Schwedt Todd J.
Published: January 2020

Background: Close associations between insomnia with other clinical factors have been identified in migraine, but there have been few studies investigating associations between insomnia and clinical factors in patients with persistent post-traumatic headache (PPTH). The study objective was to contrast the severity of insomnia symptoms in PPTH, migraine, and healthy controls, and to identify factors associated with insomnia in patients with PPTH vs. migraine.
Methods: In this cross-sectional cohort study, 57 individuals with PPTH attributed to mild traumatic brain injury, 39 with migraine, and 39 healthy controls were included. Participants completed a detailed headache characteristics questionnaire, the Migraine Disability Assessment Scale (MIDAS), Insomnia Severity Index (ISI), Hyperacusis Questionnaire (HQ), Allodynia Symptom Checklist, Photosensitivity Assessment Questionnaire, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Post-Traumatic Stress Disorder (PTSD) checklist, Ray Auditory Verbal Learning Test, and the Trail Making Test A and B to assess headache characteristics, disability, insomnia symptoms, sensory hypersensitivities, and neuropsychological factors. Fisher’s test and one-way ANOVA were used to assess group differences of categorical and continuous data. Stepwise logistic regression analyses were conducted to identify clinical variables associated with insomnia symptoms.
Results: Those with PPTH had significantly higher ISI scores (16.72 ± 6.58) compared to migraine patients (11.28 ± 6.42) and healthy controls (4.05 ± 4.80) (p < 0.001). For those with PPTH, insomnia severity was most strongly correlated with the BDI (Spearman's rho (ρ) = 0.634, p < 0.01), followed by Trait Anxiety (ρ = 0.522, p < 0.01), PTSD (ρ = 0.505, p < 0.01), HQ (ρ = 0.469, p < 0.01), State Anxiety (ρ = 0.437, p < 0.01), and MIDAS scores (ρ = 0.364, p < 0.01). According to linear regression models, BDI, headache intensity, and hyperacusis scores were significantly positively associated with insomnia severity in those with PPTH, while only delayed memory recall was negatively associated with insomnia severity in those with migraine.
Conclusions: Insomnia symptoms were more severe in those with PPTH compared to migraine and healthy control cohorts. Depression, headache intensity, and hyperacusis were associated with insomnia in individuals with PPTH. Future studies should determine the bidirectional impact of treating insomnia and its associated symptoms.
A Systematic Approach for Introduction of Novel Treatments to a Chronic Patient Group: sacubitril-valsartan as a case study
Authors: Norberg Helena , Bergdahl Ellinor , Ängerud Karin Hellström , Lindmark Krister
Published: January 2020

Background When novel treatments prove to be better than conventional therapy there is a need for effective introduction, both for cost-effectiveness and to minimize patient suffering. Effective implementation is a challenge in patients with chronic diseases who may be treated both in primary care and/or specialist clinics. Studies have shown that introduction is often unnecessary delayed. Our aims were to develop a model for systematic introduction and to test the feasibility of this model on a new treatment of a chronic disease. We also investigated how such an approach would be received by the patients. Methods The systematic introduction approach is a seven step procedure; Step 1 - define a few main criteria for the specific therapy, Step 2 – primary scan patients with the one or two main criteria using computerised medical records, databases or clinical registries, Step 3 – identify patients applying the other predefined criteria, Step 4 - evaluate if any examinations or laboratory test updates are required, Step 5 - summon identified patients to the clinic with an information letter, Step 6 – discuss treatment with the patient and prescribe to appropriate patients, Step 7 – follow-up on initiated therapy and evaluate the applied process. The model was tested in a case study during introduction of the new drug sacubitril-valsartan in a heart failure population. Patient experiences with the approach were investigated in an interview study with general inductive approach using qualitative content analysis. Results By applying the systematic introduction approach in the case study, 76 out of 1924 patients were identified to be eligible for sacubitril-valsartan and summoned to the clinic to discuss treatment. The content analysis resulted in three final categories of how the model was received by the patients; A good approach , Role of the information letter , and Trust in care . Conclusions The systematic introduction approach ensures that strict criteria are used in the selection process and that a treatment can be implemented in eligible patients within a specified population with limited resources and time. The model was effective in our case study and maintained the patient’s confidence in health care.
Modeling tuberculosis transmission flow in China
Authors: Wang Li , Xu Chengdong , Hu Maogui , Chen Wei , Wang Jinfeng , Qiao Jiajun , Cheng Shiming
Published: January 2020

Background: China has the largest population and third largest number of tuberculosis cases in the world. Tuberculosis still remains a major public health concern in China. The increasing floating population has become an important part of China’s socioeconomic process and brought the potential risk for infectious disease transmission in the huge population. Both the flow of tuberculosis population in the country and the role of massive floating population in tuberculosis transmission are yet unclear.Methods: 14,027 tuberculosis flow data were derived from the new smear-positive pulmonary tuberculosis cases in China in 2012, provided by the nationwide Infectious Disease Reporting System. Spatial interaction model was used to model the tuberculosis flow and the regional socioeconomic factors.Results: The Pearl River Delta in southern China and the Yangtze River Delta along China’s east coast presented as the largest destination and concentration areas of tuberculosis inflows. Socioeconomic factors were determinants of tuberculosis flow. A 10% increase in per capita GDP was associated with 2.1% decrease in tuberculosis outflows from the provinces of origin, and 0.5% increase in tuberculosis inflows to the destinations and 18.9% increase in intraprovincial flow. Per capita net income of rural households and per capita disposable income of urban households were positively associated with tuberculosis flows. A 10% increase in per capita net income corresponded to 3.6% increase in outflows from the origin, 12.8% increase in inflows to the destinations and 47.9% increase in intraprovincial flows. Tuberculosis incidence had positive impacts on tuberculosis flows. A 10% increase in the number of tuberculosis cases corresponded to 1.1% increase in tuberculosis inflows to the destinations, 2.0% increase in outflows from the origins, and 2.2% increase in intraprovincial flows. A 10% increase in the tuberculosis incidence rate was associated with 9.9% increase in tuberculosis intraprovincial flows. In addition, the tuberculosis flow had a significant spatial dependence and positively affected tuberculosis flows in the neighboring regions.Conclusions: Tuberculosis flows had clear spatial stratified heterogeneity and spatial autocorrelation; regional socio-economic characteristics had different and statistically significant effects on tuberculosis flows in the origin and destination, and income factor played an important role among the determinants.
Molecular detection and identification of piroplasms (Babesia spp. and Theileria spp.) and Anaplasma phagocytophilum in questing ticks from northwest Spain
Authors: Remesar Susana , Diaz Pablo , Prieto Alberto , García-Dios David , Panadero Rosario , Fernández Gonzalo , Brianti Emmanuele , Díez-Baños Pablo , Morrondo Patrocinio , López Ceferino Manuel
Published: January 2020

Background: Ticks can transmit a wide range of pathogens; some of them are regarded as emerging or re-emerging pathogens causing a significant impact on human and animal health. Methods: In order to determine prevalence and zoonotic potential of Anaplasma spp., Candidatus Neoehrlichia mikurensis and piroplasms in questing ticks from north-western Spain, 1,056 Ixodes ricinus, nineteen Dermacentor marginatus, seventeen Dermacentor reticulatus, twelve Ixodes frontalis and a single Ixodes acuminatus were molecularly analysed. Also, 23 pools of I. ricinus larvae were investigated for the presence of piroplasms. Anaplasma and piroplasm DNA was firstly detected using two commercial qPCR assays. Samples positive to Anaplasma spp. were confirmed and identified at species level by sequence analysis of the groESL, 16S rRNA and msp2 genes. Those samples negative to Anaplasma spp. groESL were pooled and processed to detect a fragment of the groESL gene of Ca. N. mikurensis. qPCR piroplasm positive samples were molecularly identified at the species level by partial sequencing of the 18S rRNA and ITS1 genes.Results: Four pathogen species were detected in individual I. ricinus, namely Babesia venatorum (1.5%), A. phagocytophilum (0.7%), Babesia microti (0.3%) and Theileria sp. OT3 (0.2%). Babesia venatorum was also identified in a single I. ricinus larvae pool (maximum likelihood estimation 0.6%) whereas no I. ricinus pools were positive to Ca. N. mikurensis. In addition, one I. frontalis (8.3%) tested positive to A. phagocytophilum. Conclusions: Our results revealed that a low percentage of I. ricinus from northwest Spain were infected with A. phagocytophilum and piroplasms. Since a potentially pathogenic variant of A. phagocytophilum and two zoonotic Babesia species were detected, these results may have public health concern. Since the vector of Theileria sp. OT3 remains unknown, its identification in I. ricinus is especially interesting; nevertheless, further investigations are needed to unravel the role of I. ricinus in the transmission of this Theileria species.
Patient Willingness to Accept Hepatitis C-Infected Kidneys for Transplantation.
Authors: Edwards Gretchen C. , Shipe Maren E , Smith Lindsay , Gamble Christianna , Shaffer David , Concepcion Beatrice P. , Forbes Rachel C
Published: January 2020

Background As organs infected with Hepatitis C virus (HCV) provide an opportunity to expand the donor pool, the primary aim of this study is to gauge patient willingness to accept a kidney from HCV-infected donors compared to other high-risk donors.Methods An anonymous, electronic survey was sent to all active kidney transplant waitlist patients at a single large volume transplant center. Patients were asked to respond to three hypothetical organ offers from the following: 1) HCV-infected donor 2) Donor with active intravenous drug use and 3) Donor with longstanding diabetes and hypertension.Results The survey was sent to 435 patients of which 125 responded (29% response rate). While 86 out of 125 patients (69%) were willing to accept an HCV-infected kidney, only a minority of respondents were willing to accept a kidney from other high-risk donors. In contrast to other studies, by multivariable logistic regression, age and race were not associated with willingness to accept an HCV-infected kidney.Conclusions From a patient perspective, utilization of kidneys from HCV-infected donors to expand the donor pool appears to be an acceptable option.
Tolerability And Safety Of Urotainer® Polihexanide 0.02% In Long-Term Catheterized Patients: A Prospective Cohort Study
Authors: Pannek Jürgen , Everaert Karel , Möhr Sandra , Vance Will , Aa Frank Van der , Kesselring Jürg
Published: January 2020

Background: In patients with long-term indwelling bladder catheters, bacterial colonization is inevitable, leading to urinary tract infections or encrustations with subsequent catheter blockage. Currently, bladder irrigations are the most frequently used prophylactic means, but the best solution remains yet to be determined. In vitro studies demonstrate that polihexanide is a promising option for catheter irrigation, but no data about safety and tolerability exist. Methods: In a prospective observational study in patients with long-term (> 2 weeks) indwelling bladder catheter, a 0.02% polihexanide solution was used to rinse the catheter on five consecutive days. Adverse events, tolerability and vital signs were assessed before, during, after and at the end of the treatment period. Results: There was no serious adverse event in the study. A total of 28 adverse events (AEs) in 15 (46.88%) participants were experienced. Absolute changes in pain scores were not clinically relevant. No incidences of either flushing or sweating were found during instillation. Bladder spasms during instillation were reported in two cases during a single instillation. Mean pulse rates did not change by more than 3 beats per minute. Mean changes in body temperature did not exceed 0.12 °C. Clinically relevant changes in blood pressure were recorded for 3 patients. Conclusions: This is the first study to demonstrate that a 0.02% polihexanide solution can safely be used for catheter Irrigation.
Mix Of Destinations And Sedentary Behavior Among Brazilian Adults
Authors: Florindo Alex Antonio , Turrel Gavin , Garcia Leandro Martin Totaro , Barbosa Joao João Paulo dos Anjos Souza , Cruz Michele Santos , Failla Marcelo Antunes , Aguiar Breno Souza , Barrozo Ligia Vizeu , Goldbaum Moises
Published: January 2020

Background: Sedentary behavior is influenced by contextual, social and individual factors, including the built environment. However, the associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil. Methods: This study uses data from the Sao Paulo Health Survey (n=3,145). Sedentary behavior was assessed by questionnaire using two questions: total sitting time in minutes on a usual weekday; and on a usual weekend day. Mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500m of each participant’s residence. Linear and categorical (<4, ≥4 hours/day) measures of sitting time were derived and analyzed using linear and logistic multilevel regression. Models accounted for clustering within census-tracts and households, were stratified by gender, and adjusted for environmental, sociodemographic, and health-related factors. Results: Average minutes of sitting, and the likelihood of sitting for more than four hours, were significantly higher among males, younger people, the more educated, single persons, smokers, those who engaged in low levels of physical activity, the obese and those with chronic disease, and those who owned a private motor vehicle. Among females, mix of destinations was inversely related with minutes of sitting time on a weekday (β= -11 minutes; p=0.001) and weekend day (β= -8 minutes; p=0.012). Females who had a higher mix of destinations within their residential catchment had a significantly lower likelihood of sitting for four hours or more on weekdays (OR=0.66 IC95%0.47-0.94). No significant associations were found for males. Conclusion: This is the first-known study to examine the relationship between mix of destinations and sedentary behavior among adults in Sao Paulo City, Brazil. Our results suggest that health promotion and policy should focus on reducing sedentary behavior in the whole population, and especially those groups who engage in higher-levels of sitting time.