bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-chain acyl-CoA synthetase 2 is involved in seed oil production in Brassica napus
Authors: Ding Li-Na , Gu Shou-Lai , Zhu Fu-Ge , Ma Zhong-Yan , Li Juan , Li Ming , Wang Zheng , Tan Xiao-Li
Published: February 2020

Background

Triacylglycerols (TAGs) are the main composition of plant seed oil. Long-chain acyl-coenzyme A synthetases (LACSs) catalyze the synthesis of long-chain acyl-coenzyme A, which is one of the primary substrates for TAG synthesis. InArabidopsis, the LACS gene family contains nine members, among whichLACS1andLACS9have overlapping functions in TAG biosynthesis. However, functional characterization of LACS proteins in rapeseed have been rarely reported.

Results

An orthologue of theArabidopsis LACS2gene (BnLACS2) that is highly expressed in developing seeds was identified in rapeseed (Brassica napus). TheBnLACS2-GFP fusion protein was mainly localized to the endoplasmic reticulum, where TAG biosynthesis occurs. Interestingly, overexpression of theBnLACS2gene resulted in significantly higher oil contents in transgenic rapeseed plants compared to wild type, whileBnLACS2-RNAi transgenic rapeseed plants had decreased oil contents. Furthermore, quantitative real-time PCR expression data revealed that the expression of several genes involved in glycolysis, as well as fatty acid (FA) and lipid biosynthesis, was also affected in transgenic plants.

Conclusions

A long chain acyl-CoA synthetase,BnLACS2,located in the endoplasmic reticulum was identified inB. napus. Overexpression ofBnLACS2in yeast and rapeseed could increase oil content, whileBnLACS2-RNAi transgenic rapeseed plants exhibited decreased oil content. Furthermore,BnLACS2transcription increased the expression of genes involved in glycolysis, and FA and lipid synthesis in developing seeds. These results suggested thatBnLACS2is an important factor for seed oil production inB. napus.
Characteristics and outcomes in patients with atrial fibrillation receiving direct oral anticoagulants in off-label doses
Authors: Briasoulis Alexandros , Gao Yubo , Inampudi Chakradhari , Alvarez Paulino , Asleh Rabea , Chrischilles Elizabeth , Leira Enrique C. , Vaughan-Sarrazin Mary
Published: February 2020

Background

We evaluated adherence to dosing criteria for patients with atrial fibrillation (AF) taking dabigatran or rivaroxaban and the impact of off-label dosing on thromboembolic and bleeding risk.

Methods

We used data for a retrospective cohort from a large U.S. health plan for Medicare beneficiaries age > =65 years with AF who initiated dabigatran or rivaroxaban during 2010–2016. Stroke and major bleeding were quantified in patients who were eligible for low dose but received standard dose, and in patients who were eligible for standard dose but received low dose.

Results

We identified 8035 and 19,712 patients who initiated dabigatran or rivaroxaban, respectively. Overall, 1401 (17.4%) and 7820 (39.7%) patients who received dabigatran and rivaroxaban met criteria for low dose, respectively. Of those, 959 (68.5%) and 3904 (49.9%) received standard dose. In contrast, 1013 (15.3%) and 2551 (21.5%) of patients eligible for standard dose dabigatran and rivaroxaban received low dose. Mean follow-up for patients eligible for low and standard dose dabigatran and rivaroxaban were 13.9, 15.1, 10.1, and 12.3 months, respectively. In unadjusted analyses, patients eligible for low or standard dose dabigatran and rivaroxaban but receiving off-label dose, had no differences in the rates of ischemic stroke. Among patients who met criteria for standard dose direct oral anticoagulants (DOAC), use of low dose was associated with significantly higher risk of any major bleeding (Dabigatran: HR = 1.44; 95% CI 1.14–1.8, P = 0.002, Rivaroxaban HR 1.34, 95% CI 1.11–1.6, P = 0.002) and gastrointestinal bleeding (Dabigatran: HR = 1.48; 95% CI 1.08–2, P = 0.016). In patients who met criteria for low dose DOACs, there was lower risk of major bleeding (Dabigatran: HR = 0.59; 95% CI 0.43–0.8, P < 0.001), gastrointestinal (Rivaroxaban: HR 0.79; 95% CI 0.64–0.98, P = 0.03) and intracranial bleeding (Dabigatran: HR = 0.33; 95% CI 0.12–0.9, P = 0.001) with standard dosing. After propensity matching, use of off-label doses was not associated with stroke, major, gastrointestinal or intracranial bleeding for either dabigatran or rivaroxaban.

Conclusions

While a significant number of patients receive higher or lower dose of dabigatran and rivaroxaban than recommended, we found no evidence of significant impact on thromboembolic or hemorrhagic outcomes.
Intake of dairy protein during pregnancy in IBD and risk of SGA in a Norwegian population-based mother and child cohort
Authors: Bengtson May-Bente , Haugen Margaretha , Brantsæter Anne Lise , Aamodt Geir , Vatn Morten H.
Published: February 2020

Background

Patients with inflammatory bowel disease (IBD) tend to avoid dairy products to minimize abdominal pain and diarrhea. The aim of this study was to estimate the proportion of protein from dairy sources (PPDS) in mothers with and without IBD, and to explore the impact of PPDS on inadequate gestational weight gain (GWG) or small for gestational age (SGA) in IBD compared to non-IBD in the population-based Norwegian Mother, Father and Child Cohort Study (MoBa).

Methods

MoBa includes about 95,000 pregnant women recruited throughout Norway from 1999 to 2008. IBD phenotype and complications during pregnancy and delivery were ascertained. This study included 148 mothers with Crohn disease (CD) and 194 with ulcerative colitis and 68,858 non-IBD mothers. In mid-pregnancy participants answered a comprehensive semi-quantitative food frequency questionnaire assessing diet since the start of pregnancy. PPDS was ranked in quartiles. The two lowest quartiles were merged and considered to represent the lowest of three PPDS groups. We used logistic regression analyses to model multivariate associations, adjusting for potential confounders.

Results

The risk of belonging to the lowest PPDS group was twice as high in IBD mothers compared to non-IBD mothers (aOR = 2.02, 95% CI: 1.53, 2.67). Low compared to high PPDS strongly predicted inadequate GWG in CD (aOR = 4.22, 95% CI: 1.28, 13.92). Surprisingly, and in opposition to the non-IBD mothers, PPDS was positively associated with the risk of SGA in IBD mothers. IBD mother with low PPDS was associated with significantly lower risk of SGA than non-IBD mothers and IBD mothers with high PPDS (aOR = 0.19, 95% CI: 0.07, 0.50). The interaction term IBD/PPDS was the factor that linked SGA to IBD compared to non-IBD, and increased the association between IBD and SGA with a factor of three.

Conclusion

This study shows that intake of dairy products is lower in IBD mothers than in non-IBD mothers, and further, that low intake of dairy products in IBD mothers is associated with reduced risk of SGA compared to non-IBD and IBD mothers with high PPDS.
Mobile device use and the cognitive function and depressive symptoms of older adults living in residential care homes
Authors: Lin Lu , Jing Xiu-Chen , Lv Shu-Jiao , Liang Jing-Hong , Tian Li , Li Hui-Ling , Puts Martine , Xu Yong
Published: February 2020

Background

With the fast-paced aging and increasing digitalization of society, there has been a growing interest in the effect of mobile device use on cognitive function and depression in older adults. However, research examining this issue among older adults in residential care homes (RCHs) is scant. Therefore, this study aimed to examine the impact of mobile device use on the cognitive function and depressive symptoms of older adults living in RCHs.

Methods

A cross-sectional survey was conducted using a sociodemographic questionnaire, the Montreal Cognitive Assessment (MoCA) and the 15-item Geriatric Depression Scale (GDS-15).

Results

A total of 235 senior residents (aged 82.58 ± 5.54) in four RCHs were surveyed. Users of mobile devices had a significantly higher total MoCA score (25.02 ± 4.14) and a significantly lower GDS-15 score (3.28 ± 2.74) than non-users (MoCA: 19.34 ± 5.21, GDS-15: 4.69 ± 2.90). Multivariate linear regression indicate that mobile device use is significantly associated with total MoCA score, six of the seven sub-scores (visuospatial abilities and execution functions, attention, language, abstraction, delayed recall, and orientation)(P < 0.05). Logistic regression showed that mobile device use was significantly associated with the level of depressive symptoms (OR = 0.458, 95%CI = 0.249–0.845).

Conclusions

Use of mobile devices has a significant association with the cognitive function and depressive symptoms of older adults living in RCHs, and thus should be encouraged as a measure to maintain and improve cognition and prevent depression.
Comparative utility of frailty to a general prognostic score in identifying patients at risk for poor outcomes after aortic valve replacement
Authors: Shi Sandra , Festa Natalia , Afilalo Jonathan , Popma Jeffrey J. , Khabbaz Kamal R. , Laham Roger J. , Guibone Kimberly , Kim Dae Hyun
Published: February 2020

Background

Current guidelines recommend considering life expectancy before aortic valve replacement (AVR). We compared the performance of a general mortality index, the Lee index, to a frailty index.

Methods

We conducted a prospective cohort study of 246 older adults undergoing surgical (SAVR) or transcatheter aortic valve replacement (TAVR) at a single academic medical center. We compared performance of the Lee index to a deficit accumulation frailty index (FI). Logistic regression was used to assess the association of Lee index or FI with poor outcome, defined as death or functional decline with severe symptoms at 12 months. Discrimination was assessed using C-statistics.

Results

In the overall cohort, 44 experienced poor outcome (31 deaths, 13 functional decline with severe symptoms). The risk of poor outcome by Lee index quartiles was 6.8% (reference), 17.9% (odds ratio [OR], 3.0; 95% confidence interval, [0.9–10.2]), 20.0% (OR 3.4; [1.0–11.4]), and 34.0% (OR 7.1; [2.2–22.6]) (p-for-trend = 0.001). Risk of poor outcome by FI quartiles was 3.6% (reference), 10.3% (OR 3.1; [0.6–15.8]), 25.0% (OR 8.8; [1.9–41.0]), and 37.3% (OR 15.8; [3.5–71.1]) (p-for-trend< 0.001). The Lee index predicted the risk of poor outcome in the SAVR cohort Lee index (quartiles 1–4: 2.1, 4.0, 15.4, and 20.0%; p-for-trend = 0.04), but not in the TAVR cohort (quartiles 1–4: 27.3, 29.0, 21.3, 35.4%; p-for-trend = 0.42). In contrast, the FI did not predict the risk of poor outcome well in the SAVR cohort (quartiles 1–4: 2.3, 4.4, 15.8, and 0%; p-for-trend = 0.24), however in the TAVR cohort (quartiles 1–4: 9.1, 14.3, 29.7, and 40.7%; p-for-trend = 0.004). Compared to the Lee index, an FI demonstrated higher C-statistics in the overall (Lee index versus FI: 0.680 versus 0.735; p = 0.03) and TAVR (0.560 versus 0.644; p = 0.03) cohorts, but not SAVR cohort (0.724 versus 0.766; p = 0.09).

Conclusions

While a general mortality index Lee index predicted death or functional decline with severe symptoms at 12 months well among SAVR patients, the FI derived from a multi-domain geriatric assessment better informs risk-stratification for high-risk TAVR patients.
The prevalence of severe depression in Iranian older adult: a meta-analysis and meta-regression
Authors: Salari Nader , Mohammadi Masoud , Vaisi-Raygani Aliakbar , Abdi Alireza , Shohaimi Shamarina , Khaledipaveh Behnam , Daneshkhah Alireza , Jalali Rostam
Published: February 2020

Background

Depression is one of the most common psychiatric disorders in the older adult and one of the most common risk factors for suicide in the older adult. Studies show different and inconsistent prevalence rates in Iran. This study aims to determine the prevalence of severe depression in Iranian older adult through a meta-analysis approach.

Methods

The present meta-analysis was conducted between January 2000–August 2019. Articles related to the subject matter were obtained by searching Scopus, Sciencedirect, SID, magiran, Barakat Knowledge Network System, Medline (PubMed), and Google Scholar databases. The heterogeneity of the studies was evaluated using I2 index and the data were analyzed in Comprehensive Meta-Analysis software.

Results

In a study of 3948 individuals aged 50–90 years, the overall prevalence of severe depression in Iranian older adult was 8.2% (95% CI, 4.14–6.3%) based on meta-analysis. Also, in order to investigate the effects of potential factors (sample size and year of study) on the heterogeneity of severe depression in Iranian older adult, meta-regression was used. It was reported that the prevalence of severe depression in Iranian older adult decreased with increasing sample size and increasing years of the study, which is significantly different (P < 0.05).

Conclusion

Considering the high prevalence of severe depression in Iranian older adult, it is necessary for health policy makers to take effective control measures and periodic care for the older adult.
Incidence of and risk factors for postoperative delirium in older adult patients undergoing noncardiac surgery: a prospective study
Authors: Iamaroon Arissara , Wongviriyawong Titima , Sura-arunsumrit Patumporn , Wiwatnodom Nattikan , Rewuri Nichakarn , Chaiwat Onuma
Published: February 2020

Background

To identify the incidence of, risk factors for, and outcomes associated with postoperative delirium (POD) in older adult patients who underwent noncardiac surgery.

Methods

This prospective study recruited patients aged ≥ 60 years who were scheduled to undergo noncardiac surgery at Siriraj Hospital (Bangkok, Thailand). Functional and cognitive statuses were assessed preoperatively using Barthel Index (BI) and the modified Informant Questionnaire on Cognitive Decline in the Elderly, respectively. POD was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition criteria. Incidence of POD was reported. Univariate and multivariate analyses were used to identify risk factors for POD.

Results

Of the 249 included patients, 29 (11.6%) developed POD. Most patients (61.3%) developed delirium on postoperative day 1. Univariate analysis showed age ≥ 75 years, BI score ≤ 70, pre-existing dementia, preoperative use of opioid or benzodiazepine, preoperative infection, and hematocrit < 30% to be significantly associated with POD. Multivariate logistic analysis revealed pre-existing dementia (adjusted risk ratio [RR]: 3.95, 95% confidence interval [CI]: 1.91–8.17; p < 0.001) and age ≥ 75 years (adjusted RR: 2.54, 95% CI: 1.11–5.80; p = 0.027) to be independent risk factors for POD. Median length of hospital stay was 10 (range: 3–36) days for patients with POD versus 6 (range: 2–76) days for those without delirium (p < 0.001).

Conclusions

POD remains a common surgical complication, with an incidence of 11.6%. Patients with pre-existing dementia and age ≥ 75 years are the most vulnerable high-risk group. A multidisciplinary team consisting of anesthesiologists and geriatricians should implement perioperative care to prevent and manage POD.
Birth preparedness, complication readiness and associated factors among pregnant women in Agnuak zone, Southwest Ethiopia: a community based comparative cross-sectional study
Authors: Letose Fikru , Admassu Bitiya , Tura Gurmesa
Published: February 2020

Background

Birth Preparedness and Complication Readiness interventions have a significant role in the reduction of maternal and neonatal mortality risk. Inadequacy of birth and emergency preparedness were depicted as one of the major reasons for high maternal deaths in sub-Saharan Africa. The main objective of this study was to assess birth preparedness, complication readiness and associated factors among pregnant women.

Methods

A community based comparative cross-sectional study design was conducted among 411 urban and 209 rural respondents who were selected using multi-stage stratified random sampling technique. Quantitative data were collected by interviewer administered questionnaire while qualitative data were collected from purposely selected 54 members of the community by using guiding checklist and analyzed by thematic areas. Birth preparedness and complication readiness was measured using five birth preparedness and complication readiness items then women who scored at least three were considered as well prepared. Bivariate and multivariable logistic regressions were used to examine the association between independent variables and birth preparedness and complication readiness. The result were presented as Odds Ratio at 95% CI. P < 0.05 ware used to dictate statistical significance.

Results

A total response rate of the study was 97.3%. The prevalence of birth preparedness and complication readiness was significantly higher among urban respondents (P = 25.8%; p < 0.05). Factors such as history of obstetric complication, knowledge of key danger signs, having favourable attitude towards birth preparedness and complication readiness, starting antenatal care visit within 3 months age of pregnancy, completing at least four antenatal care visits, urban residence, having occupation of government employee or merchant and being in the higher wealth quintile were variables positively associated with birth preparedness and complication readiness.

Conclusions

Prevalence of birth preparedness and complication readiness was low in this study, though significantly higher in urban area. Three-fourth of women planned to attend 4+ antenatal care visits indicating opportunity to counsel them on birth preparedness and complication readiness which increases its prevalence. Health workers should counsel every woman on birth preparedness and complication readiness components during her first antenatal care visit and subsequent visits.
Comparing three induction chemotherapy regimens for patients with locoregionally advanced nasopharyngeal carcinoma based on TNM stage and plasma Epstein–Barr virus DNA level
Authors: Liu Sai-Lan , Sun Xue-Song , Xie Hao-Jun , Chen Qiu-Yan , Lin Huan-Xin , Liang Hu , Liang Yu-Jing , Li Xiao-Yun , Yan Jin-Jie , Lin Chao , Yang Zhen-Chong , Guo Shan-Shan , Liu Li-Ting , Tang Qing-Nan , Du Yu-Yun , Tang Lin-Quan , Guo Ling , Mai Hai-Qiang
Published: February 2020

Background

We compared the efficacy and toxicity of three IC regimens (TPF: taxanes, cisplatin, and 5-fluorouracil; TP: taxanes and cisplatin; and PF: cisplatin and 5-fluorouracil) followed by CCRT in locoregionally advanced NPC.

Methods

The retrospective study involved 1354 patients with newly diagnosed stage III-IVA NPC treated with IC and CCRT. The median follow-up time in our cohort was 50 months. Based on EBV DNA level, all the patients with stage IV were divided into low- (pre-EBV DNA < 1500 copies) and high-risk group (pre-EBV DNA ≥ 1500 copies). Progression free survival (PFS), overall survival (OS), locoregional relapse free survival (LRFS), distant metastasis free survival (DMFS) and grade 3–4 toxicities were compared among different IC regimens. The survival rates were compared using log-rank test and a Cox proportional hazards model was used to perform multivariate analyses.

Results

A multivariate analysis revealed TPF to be more effective than TP. Among stage III patients, no significant difference in clinical outcome between the different IC regimens was showed, while TPF was associated with significantly better survival conditions in the stage IV patients. A further subgroup analysis revealed that only patients with pre-EBV DNA ≥ 1500 copies could benefit from the application of TPF among stage IV NPC. In terms of acute toxicities, PF was associated with fewer grade 3/4 acute toxicities.

Conclusions

In low-risk NPC patients, PF-based IC showed similar efficacy as TPF and TP but was associated with fewer grade 3/4 acute toxicities. In high-risk patients, however, the TPF regimen was superior to PF and TP, although grade 3/4 toxicities were more common with the TPF regimen.
Peripheral retinal neovascularization secondary to highly myopic superficial Retinoschisis: a case report
Authors: Luo Mingyue , Du Hong , Ding Hua , Dai Rongping
Published: February 2020

Background

Peripheral Retinal neovascularization is well-described as a complication of X-linked retinoschisis, but less often observed in myopic and primary retinoschisis. We present a case of a myopic female who developed retinal microvascular abnormalities due to retinoschisis and subsequent vitreous hemorrhage which would cause severe visual damage without timely and proper treatment.

Case presentation

A 38-year-old highly myopic Chinese female complained of blurred vision in her right eye. Her best corrected visual acuitiy was 20/20 OU, and her refraction was − 9.00S OU. Dilated fundus examination revealed mild vitreous hemorrhage and abnormal vascular network nasal to the optic disc in her right eye. Optical Coherence Tomography (OCT)- angiography (OCTA) B-Scan showed superficial retinoschisis and well-depicted abnormal retinal microvascular network in inner retinal layer. Sectoral scatter laser photocoagulation was administered. Regression of most abnormal vessels was achieved in 1 month, but the patient experienced an unexpected episode of vitreous hemorrhage 3 months after the initial treatment, which was absorbed spontaneously in 2 weeks. Supplemental laser photocoagulation was applied and regular follow-up visit was suggested.

Conclusion

Superficial retinoschisis in pathological myopia can be a driver of retinal microvascular abnormalities, possibly neovascularization, an extremely rare but severe complication which can be vision-threatening without timely and proper intervention.
Chronic pain diagnoses and opioid dispensings among insured individuals with serious mental illness
Authors: Owen-Smith Ashli , Stewart Christine , Sesay Musu M. , Strasser Sheryl M. , Yarborough Bobbi Jo , Ahmedani Brian , Miller-Matero Lisa R. , Waring Stephen C. , Haller Irina V. , Waitzfelder Beth E. , Sterling Stacy A. , Campbell Cynthia I. , Hechter Rulin C. , Zeber John E. , Copeland Laurel A. , Scherrer Jeffrey F. , Rossom Rebecca , Simon Greg
Published: February 2020

Background

Individuals with major depressive disorder (MDD) and bipolar disorder (BD) have particularly high rates of chronic non-cancer pain (CNCP) and are also more likely to receive prescription opioids for their pain. However, there have been no known studies published to date that have examined opioid treatment patterns among individuals with schizophrenia.

Methods

Using electronic medical record data across 13 Mental Health Research Network sites, individuals with diagnoses of MDD (N = 65,750), BD (N = 38,117) or schizophrenia or schizoaffective disorder (N = 12,916) were identified and matched on age, sex and Medicare status to controls with no documented mental illness. CNCP diagnoses and prescription opioid medication dispensings were extracted for the matched samples. Multivariate analyses were conducted to evaluate (1) the odds of receiving a pain-related diagnosis and (2) the odds of receiving opioids, by separate mental illness diagnosis category compared with matched controls, controlling for age, sex, Medicare status, race/ethnicity, income, medical comorbidities, healthcare utilization and chronic pain diagnoses.

Results

Multivariable models indicated that having a MDD (OR = 1.90; 95% CI = 1.85–1.95) or BD (OR = 1.71; 95% CI = 1.66–1.77) diagnosis was associated with increased odds of a CNCP diagnosis after controlling for age, sex, race, income, medical comorbidities and healthcare utilization. By contrast, having a schizophrenia diagnosis was associated with decreased odds of receiving a chronic pain diagnosis (OR = 0.86; 95% CI = 0.82–0.90). Having a MDD (OR = 2.59; 95% CI = 2.44–2.75) or BD (OR = 2.12; 95% CI = 1.97–2.28) diagnosis was associated with increased odds of receiving chronic opioid medications, even after controlling for age, sex, race, income, medical comorbidities, healthcare utilization and chronic pain diagnosis; having a schizophrenia diagnosis was not associated with receiving chronic opioid medications.

Conclusions

Individuals with serious mental illness, who are most at risk for developing opioid-related problems, continue to be prescribed opioids more often than their peers without mental illness. Mental health clinicians may be particularly well-suited to lead pain assessment and management efforts for these patients. Future research is needed to evaluate the effectiveness of involving mental health clinicians in these efforts.
Hygiene programming during outbreaks: a qualitative case study of the humanitarian response during the Ebola outbreak in Liberia
Authors: Czerniewska Alexandra , White Sian
Published: February 2020

Background

Hygiene promotion is a cornerstone of humanitarian response during infectious disease outbreaks. Despite this, we know little about how humanitarian organisations design, deliver or monitor hygiene programmes, or about what works to change hygiene behaviours in outbreak settings. This study describes humanitarian perspectives on changing behaviours in crises, through a case study of hygiene promotion during the 2014–2016 Liberian Ebola outbreak. Our aim was to aid better understanding of decision making in high-stress situations where there is little precedent or evidence, and to prompt reflection within the sector around how to improve and support this.

Methods

We conducted in-depth, semi-structured interviews with fourteen purposively-sampled individuals (key informants) from international organisations involved in hygiene behaviour change during the outbreak. Through thematic analysis we identified the decisions that were made and processes that were followed to design, deliver and monitor interventions. We compared our findings with theory-driven processes used to design behaviour change interventions in non-outbreak situations.

Results

Humanitarians predominantly focussed on providing hygiene products (e.g. buckets, soap, gloves) and delivering messages through posters, radio and community meetings. They faced challenges in defining which hygiene behaviours to promote. Assessments focused on understanding infrastructural needs, but omitted systematic assessments of hygiene behaviours or their determinants. Humanitarians assumed that fear and disease awareness would be the most powerful motivators for behaviour change. They thought that behaviour change techniques used in non-emergency settings were too ‘experimental’, and were beyond the skillset of most humanitarian actors. Monitoring focussed on inputs and outputs rather than behavioural impact.

Conclusions

The experiences of humanitarians allowed us to identify areas that could be strengthened when designing hygiene programmes in future outbreaks. Specifically, we identified a need for rapid research methods to explore behavioural determinants; increased skills training for frontline staff, and increased operational research to explore behaviour change strategies that are suited to outbreak situations.
Current and former smokers among adolescents aged 12–17 years in Iran: a systematic review and meta-analysis
Authors: Ehsani-Chimeh Elham , Sajadi Haniye Sadat , Behzadifar Meysam , Aghaei Maryam , Badrizadeh Afsaneh , Behzadifar Masoud , Bragazzi Nicola Luigi
Published: February 2020

Background

Smoking, especially among adolescents, is considered a serious public health concern worldwide being associated with increased mortality. The present study was designed as the first systematic review and meta-analysis of the prevalence of current and former smoking behavior among adolescents in Iran.

Methods

Seven international scholarly databases, namely Scopus, Embase, Pubmed/Medline, ISI/Web of Science (WOS), the Cochrane Library, Psyc Info and Cinahl, were extensively searched from January 2000 to September 18, 2019. Google Scholar was also mined. Iranian databases were searched as well (namely, MagIran, Scientific Information Database (SID), and Barakatkns). The DerSimonian-Laird’s approach, via the Freeman-Tukey double arcsine method, was used to synthesize the prevalence estimates.

Results

The prevalence of current smokers among Iranian adolescents was estimated to be 9% (95% CI: 7 to 10). Stratifying based on gender, the prevalence was 12% among boys (95% CI: 10 to 14) and 6% among girls (95% CI: 5 to 8). The prevalence of former smokers among Iranian adolescents using the random-effect model was computed to be 24% (95% CI: 21 to 27).

Conclusion

The findings of this study showed that the prevalence of current and former smoking behavior among Iranian adolescents is a relevant public health concern. The country’s young population should be given more attention by health policy- and decision-makers and implementation of ad hoc prevention and control policies should be on their agenda.
The prevalence and correlates of burnout among Chinese preschool teachers
Authors: Li Shen , Li Yibo , Lv Hao , Jiang Rui , Zhao Peng , Zheng Xin , Wang Lili , Li Jie , Mao Fuqiang
Published: February 2020

Background

A series of studies have suggested that teachers are likely to experience professional burnout in various regions around the world. To date, no known research has been conducted to investigate the prevalence and correlates of burnout among preschool teachers in China. This study examined the level of self-reported burnout and correlates of burnout among Chinese preschool teachers.

Methods

A cross-sectional study was conducted among1795 preschool teachers in Tianjin, China, during August 2018–October 2018. The validated Chinese version of the 15-item Maslach Burnout Inventory was used to assess burnout. A self-administered questionnaire collected the sociodemographic factors. The psychological factors were collected by the Chinese version of the 20-item Center for Epidemiologic Studies Depression Scale (CES-D) and the Perceived Stress Scale-14.

Results

The prevalence of burnout in Chinese preschool teachers was 53.2% (95% CI:51%─56%). Burnout rate was significantly decreased in overweight (P = 0.001, OR = 0.58, 95% CI: 0.42–0.79) and obesity (P = 0.048, OR = 0.75, 95% CI: 0.56–1.00) teachers compared with teachers with normal weight. The type of school (P = 0.007, OR = 1.45, 95% CI: 1.11–1.91), income satisfaction (P = 0.001, OR = 0.67, 95% CI: 0.53–0.86), depression (P < 0.001, OR = 3.08, 95% CI: 2.34–4.05) and perceived stress (P < 0.001, OR = 1.15, 95%CI: 1.13–1.18) were significantly associated with burnout.

Conclusions

The prevalence of burnout among preschool teachers in Tianjin, China, is high. Burnout was significantly associated with BMI, the type of school, income satisfaction, depression and perceived stress among Chinese preschool teachers.
Seasonal movements and habitat use of African buffalo in Ruaha National Park, Tanzania
Authors: Roug Annette , Muse Epaphras A. , Clifford Deana L. , Larsen Randy , Paul Goodluck , Mathayo Daniel , Mpanduji Donald , Mazet Jonna A. K. , Kazwala Rudovick , Kiwango Halima , Smith Woutrina
Published: February 2020

Background

Assessing wildlife movements and habitat use is important for species conservation and management and can be informative for understanding population dynamics. The African buffalo (Syncerus caffer) population of Ruaha National Park, Tanzania has been declining, and little was known about the movement, habitat selection, and space use of the population, which is important for understanding possible reasons behind the decline. A total of 12 African buffalo cows from four different herds were collared with satellite transmitters. Movements were assessed over 2 years from 11 animals.

Results

The space use of the individual collared buffaloes as an approximation of the 95% home range size estimated using Brownian bridge models, ranged from 73 to 601 km2. The estimated home ranges were larger in the wet season than in the dry season. With the exception of one buffalo all collared animals completed a wet season migration of varying distances. A consistent pattern of seasonal movement was observed with one herd, whereas the other herds did not behave the same way in the two wet seasons that they were tracked. Herd splitting and herd switching occurred on multiple occasions. Buffaloes strongly associated with habitats near the Great Ruaha River in the dry season and had little association to permanent water sources in the wet season. Daily movements averaged 4.6 km (standard deviation, SD = 2.6 km), with the longest distances traveled during November (mean 6.9 km, SD = 3.6 km) at the end of the dry season and beginning of the wet season. The shortest daily distances traveled occurred in the wet season in April–June (mean 3.6 km, SD = 1.6–1.8 km).

Conclusion

The Great Ruaha River has experienced significant drying in the last decades due to water diversions upstream, which likely has reduced the suitable range for buffaloes. The loss of dry season habitat due to water scarcity has likely contributed to the population decline of the Ruaha buffaloes.
Comparison of dental plaque reduction after use of electric toothbrushes with and without QLF-D-applied plaque visualization: a 1-week randomized controlled trial
Authors: Akifusa Sumio , Isobe Ayaka , Kibata Kanako , Oyama Akinori , Oyama Hiroko , Ariyoshi Wataru , Nishihara Tatsuji
Published: February 2020

Background

To evaluate the efficacy of a newly developed electric toothbrush in reducing dental plaque via a quantitative light-induced fluorescence-digital (QLF-D)-applied visualisation system in the brush head.

Methods

Participants included 20 adults aged 19 to 28 years. Participants were randomly assigned either (i) an electric toothbrush with a monitor to visualise red-fluorescent dental plaque via a camera built into the brush head (monitor usage group, n = 10) or (ii) an electric toothbrush without a monitor (monitor-non-use group, n = 10). The amount of dental plaque was assessed by personal hygiene performance (PHP) at baseline and 1 week later.

Results

In the monitor-usage group, PHP score was significantly lower at the 1-week follow-up than at baseline (6 vs 16; range, 0–12 vs 13–21; P = 0.029). This change was not observed in the monitor-non-use group (14 vs 13; range, 6–21 vs 2–26; P = 0.778). After 1 week, the change in PHP scores in the monitor usage group was significantly greater than that in the monitor non-use group (− 10 vs 0; range, − 21 to 9 vs − 8 to 16; P = 0.021).

Conclusions

Our results clearly demonstrate that brushing teeth while looking at a monitor that depicts red-autofluorescent dental plaque via application of QLF-D improved the efficacy of dental-plaque removal relative to brushing teeth without a monitor.

Trial registration

Trial registration number: UMIN000033699.

Name of registry: Study on effect of new devise for oral care on dental plaque clearance.

Date of registration: 8th September 2018.

Status of registration: Completed.
Spectrophotometric analysis evaluating apical microleakage in retrograde filling using GIC, MTA and biodentine: an in-vitro study
Authors: Nepal Manisha , Shubham Snigdha , Tripathi Rupam , Khadka Jwolan , Kunwar Deepa , Gautam Vanita , Gautam Narayan
Published: February 2020

Background

The present study compares the apical microleakage of three different root-end filling materials in which the retrograde cavity is prepared by two different burs.

Methods

Eighty extracted single rooted maxillary and mandibular premolars were taken. Root canal treatment was completed. Apical 3 mm of all the teeth were resected with diamond disk. The tooth were divided into four groups with two subgroups for each group containing 10 tooth (N = 10) as: Group IA (Negative Control and IB (Positive Control); Group IIA and IIB: Prepared with round carbide bur and round diamond bur respectively, filled with GIC; Group IIIA and IIIB: Prepared with round carbide bur and round diamond bur respectively, filled with MTA; Group IVA and IVB: Prepared with round carbide bur and round diamond bur, filled with Biodentine. After applying two coats of nail varnish leaving apical 3 mm (except for negative control group) all teeth were immersed in 2% methylene blue for 3 days and again in 65% nitric acid for next 3 days for extraction of dye. The obtained solution was then transferred to eppendorf tube and centrifuged in microcentrifuges at 14,000 revolution per minutes (RPM) for 5 min. Optical density or absorbance of the supernatant solution was measured with UV spectrophotometer at 550 nm.

Results

The absorbance of the supernatant solution after dye extraction is decreasing in the order of positive control> GIC > MTA > Biodentine> negative control group. The significant difference was observed between GIC and MTA (p = 0.0001) and GIC and Biodentine (p = 0.0001) with two different burs but statistically non-significant difference was observed between MTA and Biodentine with Carbide bur (p = 0.127) and Diamond bur (p = 0.496) respectively.

Conclusions

Within the limitations of the present study, it can be concluded that Biodentine and MTA showed less microleakage as compared to GIC. There is no significant difference between mean microleakage of MTA and Biodentine. However, the mean OD of the Biodentine was least of all evaluated materials. Preparation of the root-end using round carbide bur as well as round diamond burs showed comparable microleakage for all three filling materials.
A full Brazilian or all natural: understanding the influences on young women’s decision to remove their pubic hair
Authors: Obst Patricia , White Katherine , Matthews Ebony
Published: February 2020

Background

Research indicates that young women are being exposed to increasing pressures to remove pubic hair from their bodies, which has the potential for both negative physical and psychological consequences. Women’s personal choice and reasoning for partaking in pubic hair removal is influenced by broader social influences; however, there is little theory-based research drawing from established decision-making models investigating the underlying processes that lead young women to engage in pubic hair removal practices. Based on the Theory of Planned Behaviour, it was hypothesised that 1) attitude, subjective norm, and perceived behavioural control would predict intention to remove pubic hair; 2) additional variables (prototype similarity and favourability) from the Prototype Willingness Model would significantly predict intention to remove pubic hair; 3) feminist values would significantly predict decreased intention to remove pubic hair; and 4) intention and perceived behavioural control would predict future self-reported removal of pubic hair.

Method

The current study included a sample of 270 young women (17–25 years old), who completed an online survey and a follow up survey 4 weeks later (N = 96).

Results

Attitudes, perceived behavioural control, and similarity to prototypical pubic hair removers were significant predictors of intention to remove pubic hair. Intention was significantly positively associated and feminist values were significantly negatively associated with actual pubic hair removal.

Conclusions

These findings align with Theory of Planned Behaviour propositions. Furthermore, the expansion of the model highlights how broader social images impact on young women when deciding whether to engage in a behaviour that is intimately associated with their body image.
Evaluation of peptide-rich root extracts of Calliandria portoriscensis (Jacq.) Benth (Mimosaceae) for in vitro antimicrobial activity and brine shrimp lethality
Authors: Ogbole Omonike O. , Ndabai Nkiruka C. , Akinleye Toluwanimi E. , Attah Alfred F.
Published: February 2020

Background

Several Host defence peptides (HDPs) are low molecular weight (< 50 amino acids residues) peptides detected in several ethnomedicinal plants and have particularly gained research interest in recent times. Due to their wide range of bioactivity, occurrence, abundance and ability to induce very little resistance, they hold promising potentials in drug development. This study investigated the presence of bioactive peptides in the roots ofCalliandra portoricensis(CPr) (Mimosaceae) and evaluated its antimicrobial activity against gram-negative and gram-positive bacteria.

Methods

The crude peptide extract was obtained and pre-purified on pre-loaded tube of RP-C18solid phase cartridges (strata giga tube C18-E; 5 g, 20 mL, Phenomenex, Germany). Peptide enriched fraction was chemically analysed for arginine-rich/aromatic amino acid-rich peptides using a modified G-250 analytical stain and ninhydrin on thin layer chromatography (TLC) for a preliminary screening. Furthermore, MALDI TOF/TOF peptidomics was used to detect the presence and masses of the peptides. Extracts from CPr were used to test the ability to inhibit microbial growth using p-INT (Para-iodonitrotetrazolium violet) dye, with 0.1% gentamycin as positive control. The concentration that inhibits the growth of microorganisms by 50% (IC50) were determined. Toxicity of the two extracts was accessed using freshly hatched nauplii ofArtemia salina.Data analysis were evaluated using Microsoft excel and GraphPad Prism5.

Results

Low molecular weight (LMW) peptides were detected in CPr using TLC and MALDI-TOF MS. Generally, the extracts exhibited good inhibition (70–95%) against the gram-negative and gram-positive bacteria, except MRSA6 typed strain. Enhanced activity was observed in the pre-purified peptide fraction than in the methanol crude, except on MRSA6. The greatest antimicrobial inhibition by pre-purified peptide fraction was against MRSA22 (IC50 = 0.69 ± 0.33 μg/mL). The crude methanol extract (LC50 = 5.13 μg/mL) was slightly more toxic than the peptide extract (LC50 = 6.12 μg/mL).

Conclusions

This is the first report on detection of bioactive LMW peptides in Mimosaceae family. These peptides appear to be rich in arginine and aromatic amino acids. The peptide extract, in its pre-purified form showed a lower Brine shrimp cytotoxicity and an enhanced antimicrobial activity against the tested gram-negative and gram-positive bacteria.
Data Access Committees
Authors: Cheah Phaik Yeong , Piasecki Jan
Published: February 2020

Background

Sharing de-identified individual-level health research data is widely promoted and has many potential benefits. However there are also some potential harms, such as misuse of data and breach of participant confidentiality. One way to promote the benefits of sharing while ameliorating its potential harms is through the adoption of a managed access approach where data requests are channeled through a Data Access Committee (DAC), rather than making data openly available without restrictions. A DAC, whether a formal or informal group of individuals, has the responsibility of reviewing and assessing data access requests. Many individual groups, consortiums, institutional and independent DACs have been established but there is currently no widely accepted framework for their organization and function.

Main text

We propose that DACs, should have the role of both promotion of data sharing and protection of data subjects, their communities, data producers, their institutions and the scientific enterprise. We suggest that data access should be granted by DACs as long as the data reuse has potential social value and provided there is low risk of foreseeable harms. To promote data sharing and to motivate data producers, DACs should encourage secondary uses that are consistent with the interests of data producers and their own institutions. Given the suggested roles of DACs, there should be transparent, simple and clear application procedures for data access. The approach to review of applications should be proportionate to the potential risks involved. DACs should be established within institutional and legal frameworks with clear lines of accountability, terms of reference and membership. We suggest that DACs should not be modelled after research ethics committees (RECs) because their functions and goals of review are different from those of RECs. DAC reviews should be guided by the principles of public health ethics instead of research ethics.

Conclusions

In this paper we have suggested a framework under which DACs should operate, how they should be organised, and how to constitute them.
Reasons for allowing and refusing generic substitution and factors determining the choice of an interchangeable prescription medicine: a survey among pharmacy customers in Finland
Authors: Nokelainen Henriikka , Lämsä Elina , Ahonen Riitta , Timonen Johanna
Published: February 2020

Background

Generic substitution (GS) was introduced in Finland in 2003 and supplemented with a reference price system (RPS) in 2009. Patients play a vital role in the acceptance of GS and the use of less expensive generic medicines. The objective of this study was to explore Finnish pharmacy customers’ experience with allowing and refusing GS. Specific aims were to investigate the reasons for (1) allowing and (2) refusing GS and (3) to determine the prescription medicine-related factors influencing the customer’s choice of an interchangeable prescription medicine.

Methods

A questionnaire survey was conducted in February 2018. Questionnaires were handed out from 18 community pharmacies across Finland to customers ≥18 years who purchased for themselves a prescription medicine included in the RPS. A descriptive approach was used in the analysis using frequencies, the Chi-square test and Fisher’s exact test.

Results

The final study material consisted of 1043 questionnaires (response rate 40.0%). Of the customers, 47.9% had both allowed and refused GS, 41.2% had only allowed GS and 6.0% had only refused GS. Customers had allowed GS because they wanted to lower their medicine expenses (75.5%), or because the prescribed medicine (30.8%) or medicine they had used before (27.4%) was unavailable at the pharmacy. The main reasons for refusing GS were an insignificant price difference between interchangeable medicines (63.3%) and satisfaction with the medicine used before (60.2%). The main factors influencing customers’ choice of an interchangeable prescription medicine were price (81.1%), familiarity (38.4%) and availability (32.8%). Customers who had allowed GS chose the medicine based on price. Customers who had only refused GS appreciated familiarity more than the price of the medicine.

Conclusions

GS is a common practice in Finnish community pharmacies. The price of the medicine was the most important factor affecting customers’ decision to allow or refuse GS and the choice of an interchangeable prescription medicine. Thus, customers should receive information about medicine prices at the pharmacy in order to help them make their decision. However, individual needs should also be taken into account in counselling because customers regard several factors as important in their choice of an interchangeable medicine.