bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of potential drug- drug interactions and associated factors among outpatients and inpatients in Ethiopian Hospitals: a systematic review and Meta-analysis of observational studies
Authors: Ayenew Wondim , Asmamaw Getahun , Issa Arebu
Published: August 2020

Background: Drug-drug interaction is an emerging threat to public health. Currently, there is an increase in comorbid disease, polypharmacy, and hospitalization in Ethiopia. Thus, the possibility of drug-drug interaction occurrence is high in hospitals. This study aims to summarize the prevalence of potential drug-drug interactions and associated factors in Ethiopian hospitals.Methods: A literature search was performed by accessing legitimate databases in PubMed/MEDLINE, Google Scholar, and Research Gate for English-language publications. To fetch further related topics advanced search was also applied in Science Direct and HINARI databases. The search was conducted on August 3 to 25, 2019. All published articles available online until the day of data collection were considered. Outcome measures were analyzed with Open Meta Analyst and CMA version statistical software. Der Simonian and Laird’s random effect model, I2 statistics, and Logit event rate were also performed.Results: A total of 14 studies remained eligible for inclusion in systematic review and meta-analysis. From the included studies, around 8,717 potential drug-drug interactions were found in 3,259 peoples out of 5,761 patients. The prevalence of patients with potential drug-drug interactions in Ethiopian hospitals was found to be 72.2% (95% confidence interval: 59.1%, 85.3%). Based on severity, the prevalence of major, moderate, and minor potential drug-drug interaction was 25.1%, 52.8%, 16.9%, respectively, also 1.27% for contraindications. The factors associated with potential drug-drug interactions were related to patient characteristics such as polypharmacy, age, comorbid disease, and hospital stay.Conclusions: There is a high prevalence of potential drug-drug interactions in Ethiopian hospitals. Polypharmacy, age, comorbid disease, and hospital stay were the risk factors associated with potential drug-drug interactions.
Ovarian metastasis from nongynecologic primary sites: a retrospective analysis of 177 cases and 13-year experience
Authors: Zhang Jing-Jing , Cao Dong-Yan , Yang Jia-Xin , Shen Keng
Published: August 2020

Background: Metastasis to the ovary from nongynecologic organs accounts for 9% of all ovarian malignancies. Although the most common nongynecologic primary site of ovarian metastasis is the gastrointestinal tract, metastasis from other sites to the ovary is not uncommon. Differential diagnosis of primary and metastatic ovarian tumors is important; otherwise, appropriate treatment cannot be determined. Furthermore, an optimal treatment strategy for ovarian metastasis from nongynecologic primary sites still needs to be explored.Methods: One hundred seventy-seven patients with ovarian metastasis from nongynecologic primary sites admitted to Peking Union Medical College Hospital between May 2005 and May 2018 were retrospectively evaluated.Results: The mean age was 48 years (range, 18 - 83). Approximately 60% of patients were premenopausal women. The two most common nongynecologic primary sites of ovarian metastasis were the colorectum (68 cases) and stomach (61 cases). In addition to the most common symptoms of abdominal distension (39.0%), abdominal pain (37.9%), and ascites (27.7%), 18.1% of patients presented with abnormal uterine bleeding. Half of the patients who tested serum CA-125 preoperatively had elevated CA-125 levels within the range of 35 U/ml to 200 U/ml. More than 70% of synchronous ovarian metastases were preoperatively misdiagnosed as primary ovarian cancer. Of all included cases, 56.5% achieved optimal cytoreductive surgery (the diameter of the largest residual lesion < 2 cm). The overall 5-year survival rate and median survival time were 10% and 20 months, respectively. The primary site, optimal cytoreductive surgery, tumor differentiation, and postoperative adjuvant treatment were identified as prognostic indicators.Conclusions: The colorectum and stomach are the most common nongynecologic primary sites of ovarian metastasis. Synchronous ovarian metastasis is easily misdiagnosed as primary ovarian cancer. Optimal cytoreductive surgery and postoperative adjuvant treatment can be performed to confer survival benefit in selected patients.
Uterine Transcriptome Analysis Reveals Mechanism Underlying the Ultrastructure Differences of Eggshell in Young and Aged Laying Hens
Authors: Feng Jia , Zhang Hai-jun , Wu Shu-geng , Qi Guang-hai , Wang J.
Published: August 2020

Background

Lower eggshell quality in the late laying period leads to economic loss. It is a major threat to the quality and safety of egg products. Age-related variations in ultrastructure were thought to induce this deterioration. Eggshell mineralization is a highly complex process under precise regulation of genes and biological pathways in uterus of laying hens. Herein, we evaluated the physical, mechanical and ultrastructure properties of eggshell and conducted RNA sequencing to learn the transcriptomic differences in uterus between laying hens in the peak (young hens) and late phase (aged hens) of production.

Results

The declined breaking strength and fracture toughness of eggshell were observed in aged hen group compared to those in young hen group, accompanied with ultrastructure variations including the increased thickness of mammillary layer and the decreased incidence of early fusion. During the initial stage of eggshell formation, a total of 183 differentially expressed genes (DEGs; 125 upregulated and 58 downregulated) were identified in uterus of laying hens in the late phase in relative to those at peak production. The DEGs annotated to Gene Ontology terms related to antigen processing and presentation were downregulated in aged hens compared to young hens. The contents of proinflammatory cytokine IL-1β in uterus were higher in aged hens relative to those in young hens. Besides, the genes of some matrix proteins potentially involved in eggshell mineralization, such as ovalbumin, versican and glypican 3, were also differentially expressed between two groups.

Conclusions

Altered gene expression of matrix proteins along with the compromised immune function in uterus of laying hens in the late phase of production may conduce to age-related impairments of eggshell ultrastructure and mechanical properties. The current study enhances our understanding of the age-related deteriorations in eggshell ultrastructure and provides potential targets for improvement of eggshell quality in the late laying period.
The morphological changes in bitches endometrium affected by Cystic Endometrail Hyperplasia - Pyometra complex – the value of routine histopathological examination
Authors: Woźna-Wysocka Magdalena , Rybska Marta , Błaszak Beata , Jaśkowski Bartłomiej Maria , Kulus Magdalena , Jaśkowski Jędrzej Maria
Published: August 2020

Background: The aim of the analysis was to designate the morphological symptoms that appear during the Cystic Endometrial Hyperplasia - Pyometra complex (CEH-P), diagnosed by microscopic examination. The investigation were conducted on the uteri of 120 bitches in age between 1 – 16. The microscopic examinations were based on histological stainings. The aim of examinations was to find the differences in morphology of endometrium in the specimens of the uteri wall (H&E stain). All of the uteri were divided into three pathological groups (GI – GIII), created on the basis of macroscopic examinations of analyzed diseases. Uteri without macroscopic pathological changes were classified as a control group (C).Results: Histopathological analysis that were conducted have confirmed preliminary macroscopic evaluation for control group with unchanged uteri, group GII with cystic endometrial hyperplasia of uteri (CEH), and group GIII with uteri with pyometra. The confirmation of compatibility of both macroscopic and microscopic evaluation of the uteri were observed in groups GII and GIII. In the uteri of the group GI a severe congestion of endometrium have been observed – it is typical for the inflammation – which was not confirmed during histopathological examinations. Those examinations revealed only endometrial haemorrhage.Conclusions: The results are showing that during classification of research material microscopic examinations are required. The diagnose based on the macroscopic changes in typical for CEH-P symptoms might be incorrect, if it is not supported by detailed research. More than that, in all uteri with the closed pyometra the CEH was also observed. It suggest that pyometra may occur as a consequence of cystic endometrial hyperplasia and bacterial infections ended with inflammation. The results obtained can be used to create a basis for pathologic classification of endometrial hyperplasia and indicate typical morphological changes in endometrium during development of CEH-P complex in bitches.
Role of Interprofessional Primary Care Teams in Preventing Avoidable Hospitalizations and Hospital Readmissions in Ontario, Canada: A Retrospective Cohort Study
Authors: Haj-Ali Wissam , Moineddin Rahim , Hutchison Brian , Wodchis Walter P , Glazier Richard H.
Published: August 2020

Background: Improving health system value and efficiency are considered major policy priorities internationally. Ontario has undergone a primary care reform that included introduction of interprofessional teams. The purpose of this study was to investigate the relationship between receiving care from interprofessional versus non-interprofessional primary care teams and ambulatory care sensitive condition (ACSC) hospitalizations and hospital readmissions. Methods: Population-based administrative databases were linked to form data extractions of interest between the years of 2003-2005 and 2015-2017 in Ontario, Canada. The data sources were available through ICES. The study design was a retrospective longitudinal cohort. We used a “difference-in-differences” approach for evaluating changes in ACSC hospitalizations and hospital readmissions before and after the introduction of interprofessional team-based primary care while adjusting for physician group, physician and patient characteristics. Results: As of March 31 st , 2017, there were a total of 778 physician groups, of which 465 were blended capitation Family Health Organization (FHOs); 177 FHOs (22.8%) were also interprofessional teams and 288 (37%) were more conventional group practices (“non-interprofessional teams”). In this period, there were a total of 13,480 primary care physicians in Ontario of whom 4,848 (36%) were affiliated with FHOs—2,311 (17.1%) practicing in interprofessional teams and 2,537 (18.8%) practicing in non-interprofessional teams. During that same period, there were 475,611 and 618,363 multi-morbid patients in interprofessional teams and non-interprofessional teams respectively out of a total of 2,920,990 multi-morbid adult patients in Ontario. There was no difference in change over time in ACSC admissions between interprofessional and non-interprofessional teams between the pre- and post intervention periods. There were no statistically significant changes in all cause hospital readmission s between the post- and pre-intervention periods for interprofessional and non-interprofessional teams. Conclusions: Our study findings indicate that the introduction of interprofessional team-based primary care was not associated with changes in ACSC hospitalization or hospital readmissions. The findings point for the need to couple interprofessional team-based care with other enablers of a strong primary care system to improve health services utilization efficiency.
Mid-term Outcome of Total Knee Arthroplasty with Low-restricted Posterior-stabilized Prosthesis in Patients with Severe Fixed Valgus Deformity: A Case-Control Study
Authors: Gou Jiani , Shi Xiaojun , Liu Senhao , Yang Jing , Kang Pengde
Published: August 2020

Background: The intraoperative soft tissue balance in primary total knee arthroplasty (TKA) is particularly difficult to perform in patients with severe fixed valgus deformity above 20°, which may have an adverse effect on clinical outcomes. The purpose of our study was to determine whether the TKA with low-restricted posterior-stabilized prosthesis in patients with severe fixed valgus deformity could be as successful as in those with no preoperative deformities by comparing perioperative evaluations and mid-term outcomes.Methods: 45 patients (group A) with severe valgus deformity were treated by TKA with low-restricted posterior- stabilized knee prosthesis; 90 patients (group B) without severe valgus deformity were treated with same surgery and were classified to match the cases in group A. The perioperative evaluations, clinical and radiographic outcomes were compared between the two groups. The postoperative stability was measured by the Kneelax 3 Arthrometer.Results: The mean follow-up time was 7.64 years. There was no significant difference in age, gender, BMI between the two groups. There was no revision for any reason in either group. The mean operation time and blood transfusion rate were 114 minutes and 46.7% in group A, while 81 minutes and 11.1% in group B, respectively. There were significant differences in both parameters between the two groups (p<0.001). The incidence of residual valgus in group A was 20% and the complication rate was 22.2%, while 3.3% and 4.4% in group B, respectively. The incidence of residual valgus and the complication rate was significantly higher in group A than in group B (p=0.004). However, there was no statistical difference in Hospital for Special Surgery (HSS) score, range of motion, component fixation, or knee stability at the most recent follow-up. Conclusion: Although total knee arthroplasty for severe fixed valgus deformity increases the difficulty of operation and the complication rate in perioperative period, low-restricted posterior-stabilized knee prosthesis with proper alignment and soft tissue balance can have satisfactory mid-term outcomes. Level of evidence: Case-control study, Level III.
Efficacy of non-opioid analgesics to control postoperative pain: A network meta-analysis
Authors: Carter John A , Black Libby K , Sharma Dolly , Bhagnani Tarun , Jahr Jonathan
Published: August 2020

BACKGROUND The aim of this network meta-analysis (NMA) was to evaluate the safety and efficacy of intravenous (IV) Meloxicam 30mg (MIV), an investigational non-steroidal anti-inflammatory drug (NSAID), and certain other IV non-opioid analgesics for moderate-severe acute postoperative pain. METHODS We searched PubMed and CENTRAL for Randomized Controlled Trials (RCT) (years 2000-2019, adult human subjects) of IV non-opioid analgesics (IV NSAIDs or IV Acetaminophen) used to treat acute pain after abdominal, hysterectomy, bunionectomy or orthopedic procedures. A Bayesian NMA was conducted in STATA (v15.0) to rank treatments based on the standardized mean differences in sum of pain intensity difference from baseline up to 24 hours postoperatively (Sum of pain intensity difference: SPID 24). The probability and the cumulative probability of rank for each treatment were calculated, and the surface under the cumulative ranking curve (SUCRA) was applied to distinguish each treatment by efficacy and safety where higher SUCRA values indicated better outcomes. Treatments were also compared by frequency of opioid-related adverse events (ORADEs) including gastrointestinal and respiratory and reduction in morphine milligram equivalents (MME). The study protocol was prospectively registered with by PROSPERO (CRD42019117360). RESULTS Out of 2,313 screened studies, 27 studies with 36 comparative observations were included, producing a treatment network that included the four non-opioid IV pain medications of interest (MIV, ketorolac, acetaminophen, and ibuprofen). MIV was associated with the largest SPID 24 for all procedure categories and comparators. The SUCRA ranking table indicated that MIV had the highest probability for the most effective treatment for abdominal (89.5%), bunionectomy (100%), and hysterectomy (99.8%). Significantly lower MME was associated with MIV for abdominal (vs acetaminophen, ibuprofen and ketorolac), bunionectomy (vs acetaminophen), hysterectomy (vs acetaminophen and ketorolac) and orthopedic procedures (vs acetaminophen and ibuprofen). Odds of ORADEs were significantly higher for all comparators vs MIV for orthopedic (gastrointestinal) and hysterectomy (respiratory). CONCLUSIONS MIV 30mg may provide better pain reduction with similar or better safety compared to other approved IV non-opioid analgesics. Caution is warranted in interpreting these results, as all comparisons involving MIV were indirect.
The Application of 3D Printing Technology in the Classification and Preoperative Planning of Complex Tibial Plateau Fractures
Authors: Chen Fuyang , Huang Chenyu , Ling Chen , Zhou Jinming , Wang Yufeng , Zhang Po , Jiang Xiao , Xu Xiaoming , Jian Jian , Wang Liming , Yao Qingqiang
Published: August 2020

Background: Tibial plateau fracture is one of the common intra-articular fractures in clinic. And its accurate classification and treatment is a difficult problem for orthopedic surgeons. Our research aims to investigate the application value of 3D printing in the classification and preoperative planning of complex tibial plateau fractures.Methods: 28 cases of complex tibial plateau fractures diagnosed and treated in our hospital from January, 2017 to January, 2019.01 were analyzed. Preoperative spiral CT scan was performed and then DICOM data were input into the computer. We use Mimics to process data. And 3D printing technology was applied to print the 3D model of fracture (1:1). Combined with the 3D printed model, the tibial plateau fractures were subdivided into seven types according to the geometric plane of the tibial plateau. The surgical approach was determined on the 3D printed model. And then simulated operations such as accurate reduction of fracture and selection of plate placement were performed.Results: The reconstructed 3D model of tibial plateau fracture can accurately reflect the direction of fracture displacement and the degree of plateau collapse. Also, it and can help with the preoperative surgical design of tibial plateau fracture. The intraoperative fracture details were basically the same as the 3D printed model. And the fracture surface of the tibial plateau was well improved in all 28 cases.Conclusion: 3D printing technology can be used to guide the classification and preoperative planning of complex tibial plateau fractures.
Increased Incidence of Susac Syndrome: A Case Series Study
Authors: Wilf-Yarkoni Adi , Elkayam O. , Aizenstein O. , Yahav O. , Furer V. , Zur D. , Goldstein M. , Barequet D. , Hallevi H. , Karni A. , Habot-Wilner Z , Regev K
Published: August 2020

BackgroundSusac syndrome (SuS) is a rare condition characterized by a clinical triad of sensorineural hearing loss, branch artery occlusion and encephalopathy. This study reports an increased incidence of SuS in Israel. We describe the clinical characteristics of these patients, diagnostic procedures and the use and subsequent outcomes of newly published treatment guidelines. MethodsThis is a single center retrospective study. Patients who were diagnosed with SuS between July 2017 and August 2018 were enrolled in this study. ResultsSeven patients were diagnosed with SuS according to the diagnostic criteria in a time period of 13 months. The annual incidence was recently evaluated in Austria to be 0.024/100000, therefore, our case series represent at least a 5.4- fold increase in the annual incidence of SuS expected in Israel and a 7-fold increase in the annual incidence expected in our medical center. Mean time from the onset of the symptoms to diagnosis was three weeks and follow-up time was twenty four months. Recent exposure to cytomegalovirus was serologically evident in three patients and one patient had high titer of anti-streptolysin antibody. All patients underwent brain MRI, fluorescein angiography and audiometry. All patients were treated according to the newly recommended guidelines. All patients achieved clinical and radiological stability. ConclusionsWe report of an increased incidence of SuS in Israel. Infectious serological findings may imply a post infectious mechanism. The use of the recommended diagnostic procedures reduced the time to diagnosis. Newly published treatment guidelines led to favorable clinical outcomes.
Effects of brewers’ spent grain protein hydrolysates on gas production, ruminal fermentation characteristics, microbial protein synthesis and microbial community in an artificial rumen fed a high grain diet
Authors: Ran Tao , Jin Long , Abeynayake Ranithri , Saleem Atef Moohanmed , Zhang Xiumin , Niu Dongyan , Chen Lingyun , Yang Wenzhu
Published: August 2020

Background

Brewers’ spent grain (BSG) typically contains 20 ~ 29% crude protein (CP) with high concentrations of glutamine, proline and hydrophobic and non-polar amino acid, making it an ideal material for producing value-added products like bioactive peptides which have antioxidant properties. For this study, protein was extracted from BSG, hydrolyzed with 1% alcalase and flavourzyme, with the generated protein hydrolysates (AlcH and FlaH) showing antioxidant activities. This study evaluated the effects of AlcH and FlaH on gas production, ruminal fermentation characteristics, nutrient disappearance, microbial protein synthesis and microbial community using an artificial rumen system (RUSITEC) fed a high-grain diet.

Results

As compared to the control of grain only, supplementation of FlaH decreased ( P < 0.01) disappearances of dry matter (DM), organic matter (OM), CP and starch, without affecting fibre disappearances; while AlcH had no effect on nutrient disappearance. Neither AlcH nor FlaH affected gas production or VFA profiles, however they increased ( P < 0.01) NH 3 -N and decreased ( P < 0.01) H 2 production. Supplementation of FlaH decreased ( P < 0.01) the percentage of CH 4 in total gas and dissolved-CH 4 (dCH 4 ) in dissolved gas. Addition of monensin reduced ( P < 0.01) disappearance of nutrients, improved fermentation efficiency and reduced CH 4 and H 2 emissions. Total microbial nitrogen production was decreased ( P < 0.05) but the proportion of feed particle associated (FPA) bacteria was increased with FlaH and monensin supplementation. Numbers of OTUs and Shannon diversity indices of FPA microbial community were unaffected by AlcH and FlaH; whereas both indices were reduced ( P < 0.05) by monensin. Taxonomic analysis revealed no effect of AlcH and FlaH on the relative abundance (RA) of bacteria at phylum level, whereas monensin reduced ( P < 0.05) the RA of Firmicutes and Bacteroidetes and enhanced Proteobacteria. Supplementation of FlaH enhanced ( P < 0.05) the RA of genus Prevotella , reduced Selenomonas , Shuttleworthia , Bifidobacterium and Dialister as compared to control; monensin reduced ( P < 0.05) RA of genus Prevotella but enhaced Succinivibrio .

Conclusions

The supplementation of FlaH in high-grain diets may potentially protect CP and starch from ruminal degradation, without adversely affecting fibre degradation and VFA profiles. It also showed promising effects on reducing CH 4 production by suppressing H 2 production. Protein enzymatic hydrolysates from BSG using flavourzyme showed potential application to high value-added bio-products.
The variation tendency of serum C-reactive protein is a good marker to predict postoperative complications after laparoscopic gastrectomy for adenocarcinoma of esophagogastric junction
Authors: Luo Bin , Liao Qianchao , Zheng Jiabin , Hu Weixian , Yao Xueqing , Cai Guanfu , Li Yong , Wang Junjiang
Published: August 2020

Background: Postoperative complications (PCs) after laparoscopic gastrectomy with mediastinal lymph nodes resection for adenocarcinoma of esophagogastric junction (AEG) prolonged the time of hospitalization and increased mortality rate. Early diagnosis of PCs was of great importance. This retrospective study aimed to investigate whether the variation tendency of serum C-reactive protein can be used as an early marker to predict major postoperative complications after laparoscopic gastrectomy for AEG.Methods: Data for patients underwent laparoscopic gastrectomy for AEG, from January 2015 to March 2020, were retrospectively analyzed. The area under the receiver operating characteristic (ROC) curve (AUC) was used to determine diagnostic accuracy of inflammatory markers. The optimal cutoff values were calculated by maximizing Youden’s index. Univariate and multivariate logistic regression analyses were performed to identify risk factors for PCs of grade III or more，according to the Clavien-Dindo classification. Results: A total of 114 patients were analyzed, of whom 21 (18.4%, 95% CI 11.4-25.4 %) developed major PCs, including anastomotic leakage in 13. The ratio of CRP level on postoperative day 3 to day 2 (POD3/2 CRP) provided the best diagnostic accuracy (AUC 0.903, 95% CI 0.814-0.993, p＜0.001). Proximal gastrectomy (OR 8.224, 95% CI 1.976-34.234, p=0.004) and operation time ≥360 minutes (OR 6.753, 95% CI 2.037-22.395, p=0.002) were identified as significant independent risk factors for major PCs.Conclusions: The POD3/2 CRP was the best marker to predict PCs after laparoscopic gastrectomy for AEG.
Frequency Ratio Density, Logistic Regression and Weights of Evidence Modelling for Landslide Susceptibility Assessment and Mapping in Yanase and Naka Catchments of Southeast Shikoku, Japan
Authors: Meten Matebie , Bhandary Netra Prakash
Published: August 2020

Landslide susceptibility assessment is an important tool for disaster management and development activities. Shikoku Island in the southwest Japan is one of the most landslide prone areas due to heavy typhoon rainfall, complex geology and the presence of mountainous areas and low topographic features (valleys).Yanase and Naka Catchments of Shikoku Island in Japan were chosen as a study area. The objective of this study is to apply Frequency Ratio Densisty (FRD), Logistic Regression (LR) and Weights of Evidence (WoE) models in a GIS environment to prepare the landslide susceptibility maps of this area and select the best one for future infrastructure and landuse planning. Data layers including slope, aspect, profile curvature, plan curvature, lithology, land use, distance from river, distance from fault and annual rainfall were used in this study. In FR method, two models were attempted but the FRD model was found slightly better in its performance. In case of LR method, two models, one with equal proportion and the other with unequal proportion of landslide and non-landslide points were applied and the one with equal proportions was chosen based on its highest performance. A total of five landslide susceptibility maps(LSMs) were produced using FR, LR and WoE models resulting two, two and one LSMs respectively. However, one best model was chosen from the FR and LR methods based on the highest area under the curve (AUC) of the receiver operating characteristic (ROC) curves. This reduced the total number of landslide susceptibility maps to three with the success rates of 86.7%, 86.8% and 80.7% from FRD, LR and WoE models respectively. For validation purpose, all landslides were overlaid over the three landslide susceptibility maps and the percentage of landslides in each susceptibility class was calculated. The percentages of landslides that fall in the high and very high susceptibility classes of FRD, LR and WoE models showed 82%, 84% and 78% respectively. This showed that the LR model with equal proportions of landslides and non-landslide points was slightly better than FRD and WoE models in predicting the probability of future landslide occurrence.
On Jones et al.’s Method for Assessing Limits of Agreement with the Mean for Multiple Observers
Authors: Christensen Heidi S. , Borgbjerg Jens , Børty Lars , Bøgsted Martin
Published: August 2020

Background To assess the agreement of continuous measurements between a number of observers, Jones et al. introduced limits of agreement with the mean (LOAM) for multiple observers, representing how much an individual observer can deviate from the mean measurement of all observers. Besides the graphical visualisation of LOAM, suggested by Jones et al., it is desirable to supply LOAM with confidence intervals and to extend the method to the case of multiple measurements per observer.Methods We reformulate LOAM under the assumption the measurements follow an additive two-way random effects model. Assuming this model, we provide estimates and confidence intervals for the proposed LOAM. Further, this approach is easily extended to the case of multiple measurements per observer.Results The proposed method is applied on two data sets to illustrate its use. Specifically, we consider agreement between measurements regarding tumour size and aortic diameter. For the latter study, three measurement methods are considered. Conclusions The proposed LOAM and the associated confidence intervals are useful for assessing agreement between continuous measurements.
Contralateral hemisphere as a lifeguard which is supported by melatonin for molecular and functional recovery after stroke
Authors: Kilic Ulkan , Elibol Birsen , Caglayan Ahmet Burak , Beker Mustafa Caglar , Beker Merve , Altug-Tasa Burcugul , Uysal Omer , Yilmaz Bayram , Kilic Ertugrul
Published: August 2020

Successful functional recovery from stroke is crucial in the rehabilitation of patients and mainly depends on several ischemia-induced processes, including cell survival and apoptosis. Melatonin is an interesting candidate for secondary stroke prevention due to its effect on signaling pathways. Therefore, we investigated the coordination of ipsilateral and contralateral hemispheres to evaluate delayed post-acute effect of melatonin on recovery of the cell survival and apoptosis after stroke. Melatonin was administered (4 mg/kg/day) intraperitoneally for 45 days, starting 3-day after 30-min of middle cerebral artery occlusion. The genes and proteins related to the cell survival and apoptosis were investigated by immunofluorescence, western blotting and RT-PCR techniques after behavioral experiments. Melatonin produced delayed neurological recovery by improving motor coordination, which was also reflected by enhanced neuronal survival and reduced apoptosis in the post-acute phase of stroke in both contralateral and ipsilateral hemispheres. The increase of NGF, Nrp1, c-jun; activation of AKT; and dephosphorylation of ERK and JNK at the 55th day showed that cell survival and apoptosis signaling molecules compete to contribute to the remodeling of brain. Furthermore, an increase in the CREB and Atf-1 expressions suggested the melatonin's strong reformative effect on neuronal regeneration. The contralateral hemisphere was more active at the latter stages of the molecular and functional regeneration which provides a further proof of principle about melatonin's action on the promotion of brain plasticity and recovery after stroke.
Effects of effort-reward imbalance, job satisfaction, and work engagement on self-rated health among healthcare workers
Authors: Ge Jingjing , He Jing , Liu Yan , Zhang Juying , Pan Jingping , Zhang Xueli , Liu Danping
Published: August 2020

Background
Healthcare workers, who protect and improve the health of individuals, are critical to the success of health systems and achieving national and global health goals. To respond effectively to the healthcare needs of populations, healthcare workers themselves must be in a perfect state of health. However, healthcare workers face various psychosocial pressures, including having to work night shifts, long working hours, demands of patient care, medical disputes, workplace violence, and emotional distress due to poor interactions with patients and colleagues, and poor promotion prospects. Constant exposure to these psychosocial hazards adversely impacts healthcare workers’ health. Consequently, this study aimed to examine the influence of effort-reward imbalance, job satisfaction, and work engagement on self-rated health of healthcare workers. The results would be conducive to providing policy guidance to improve the health of healthcare workers.
Methods
We analysed the data of 1327 participants from The Chinese Sixth National Health and Services Survey in Sichuan Province that was conducted from August 2018 to October 2018. Structural equation modelling was used to test the hypothesized relationships among the variables.
Results
Only 40.1% of healthcare workers rated their health as ‘relatively good’ or ‘good’. Effort-reward imbalance had a significant negative correlation with self-rated health (β = -0.053, 95% CI [-0.163, -0.001]). The associations of effort-reward imbalance and work engagement with self-rated health were both mediated by job satisfaction (95% CI [-0.150, -0.050] and [0.011, 0.022]), and work engagement mediated the relationship between effort-reward imbalance and self-rated health (95% CI [-0.064, -0.008]).
Conclusion
In order to improve the health of healthcare workers, administrators should balance effort and reward and provide opportunities for career development and training. In addition, health managers should help healthcare workers realize the significance and value of their work and keep them actively devoted to their work through incentive mechanisms.
The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review.
Authors: Carter Hayley , Littlewood Chris , Webster Kate , Smith Benjamin
Published: August 2020

Background To explore the effectiveness of preoperative rehabilitation programmes (PreHab) on postoperative physical and psychological outcomes following anterior cruciate ligament reconstruction (ACLR). Method A systematic search was conducted from inception to November 2019. Randomised controlled trials (RCTs) published in English were included. Risk of bias was assessed using Version 2 of the Cochrane risk-of-bias tool, and the Grading of Recommendations Assessment system was used to evaluate the quality of evidence. Results The search identified 739 potentially eligible studies, three met the inclusion criteria. All included RCTs scored ‘high’ risk of bias. PreHab in all three RCTs was an exercise programme, each varied in content (strength, control, balance and perturbation training), frequency (10 to 24 sessions) and length (3.1- to 6-weeks). Statistically significant differences (p<0.05) were reported for quadriceps strength (one RCT) and single leg hop scores (two RCTs) in favour of PreHab three months after ACLR. One RCT reported no statistically significant between-group difference for pain and function. No RCT evaluated post-operative psychological outcomes. Conclusion Low-quality evidence suggests that PreHab that includes muscular strength, balance and perturbation training offers a small benefit to quadriceps strength and single leg hop scores three months after ACLR. There is no consensus on the optimum PreHab programme content, frequency and length; this requires future consideration including the development of PreHab programmes that consider psychosocial factors and the measurement of relevant post-operative outcomes such as psychological readiness. PROSPERO trial registration number CRD42020162754
Unplanned hospital readmission after surgical treatment for thoracic spinal stenosis: incidence and causative factors
Authors: Wang Hui , Wang Longjie , Sun Zhuoran , Jiang Shuai , Li Weishi
Published: August 2020

Background: To assess the incidence and causative factors of unplanned hospital readmission within 90 days after surgical treatment of thoracic spinal stenosis (TSS).Methods: Hospital administrative database was queried to identify patients who underwent surgical treatment of TSS from July 2010 through December 2017. All unplanned readmissions within 90 days of discharge were reviewed for causes and the rate of unplanned readmissions was calculated. Patients of unplanned readmission were matched 1:3 to a control cohort without readmission.Results: Twenty-one patients (incidence of 1.7% in 1239 patients) presented unplanned hospital readmission within a 90-day period and enrolled as the study group, 63 non-readmission patients (a proportion of 1: 3) were randomly selected as the control group. Causes of readmission include CSF cyst (8 patients; 38%), CSF leakage combined with poor incision healing (6 patients; 29%), wound dehiscence (2 patient; 9%), surgical site infection (2 patients; 9%), spinal epidural hematoma (1 patient; 5%), inadequate original surgical decompression (2 patients; 9%). Mean duration from re-admission to the first surgery was 39.6 ± 28.2 days, most of the patients readmitted at the first 40 days (66.7%, 14/21 patients). When compared to the non-readmitted patients, diagnosis of OPLL + OFL, circumferential decompression, dural injury, long hospital stay were more to be seen in readmitted patients.Conclusions: The incidence of 90-day unplanned hospital readmission after surgical treatment of TSS is 1.7%, the peak period of readmission occurred from 10 to 40 days after surgery, CSF leakage and CSF cyst were the most common causes of unplanned hospital readmission.
WITHDRAWN: Antimicrobial activity of mouth rinses incorporating zein coated magnesium oxide nanoparticles
Authors: Naguib Ghada H , Hamed Mohamed T , Hatrom Abdulkarim A , Alnowaiser Abeer M , Bukhary Sahar MN , Hassan Ali H
Published: August 2020

Background The addition of antibacterial agents to oral prophylaxis materials showed inhibition of plaque accumulation and bacterial acid production. This study aimed to test the antimicrobial effect of distinctive oral mouth washes on an exemplary of oral bacteria after the addition of zein-coated MgO nanoparticles.Materials and Methods Three hundred and twelve groups were used in this study. MgO nanoparticles in five concentrations with zein and without zein-coating, were incorporated in three oral mouth washes: Listerine Zero, Listerine Total Control and Oral B in the mass percentages of 0.3%, 0.5%, 1%, 2%, 5% and 10%, in addition to controls with no MgO nanoparticles. The three mouthwashes with variable concentrations were studied in opposition of Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis and Candida albicans using two different tests, the Disc Diffusion Test (DDT) and Direct Contact Test (DCT). Data was analyzed with Kruskall-Wallis and Mann-Whitney U tests.Results Results showed a highly significant statistical difference of antimicrobial activity for all tested mouth washes with Zein coated MgO nanoparticles on Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, and Candida albicans in the disc diffusion test. While in the DCT, all tested mouth washes with MgO nanoparticles with and without zein coating showed antimicrobial activity on all tested microorganisms.Conclusion Zein coated MgO nanoparticles is a potent antimicrobial agent when added to oral mouth washes. It is recommended to incorporate Zein MgO nanoparticles to Oral mouth washes to improve its antibacterial property.
Investigations on Spectroscopic Properties of Manganese Ions in Sodium Lead Alumino Borate Glasses
Authors: karumuri Vijaya Babu , Vema Madhuri , Boddu Suresh
Published: August 2020

Divalent manganese ions containing 20Na2O-15PbO-(5-x)Al2O3-60B2O3:xMnO2 (x ranging from 0 to 1 mol%) NPAB glasses are prepared by using melt quenching technique and are characterized by several spectroscopic techniques. Various physical parameters are calculated from the measured density values. Structural properties of MnO2 doped NPAB glasses are investigated by Powder XRD, EPR, UV-VIS absorption and FT-IR spectroscopic techniques. The amorphous nature of prepared glass samples are confirmed by X- ray diffraction spectra. EPR spectra of these glasses exhibited a well resolved six line hyperfine structure around g = 2.00 is the characteristic nature of Mn(II) ions in distorted octahedral site symmetry. Optical absorption spectra of these glasses revealed a single broad band at  21000 cm-1 which has been assigned to the transition 6A1g(S) → 4T1g(G) of Mn(II) ions. Optical band gap energies and Urbach energies are evaluated through the fundamental Ultra Violet absorption edges of the glasses. FT-IR spectra clearly exhibited different vibrational bands and assigned to borate groups and water molecules.
Sulfoquinovose is a select nutrient of prominent bacteria and a source of hydrogen sulfide in the human gut
Authors: Hanson Buck , Kits Kerim , Löffler Jessica , Burrichter Anna , Fiedler Alexander , Denger Karin , Frommeyer Benjamin , Herbold Craig , Rattei Thomas , Karcher Nicolai , Segata Nicola , Schleheck David , Loy Alexander
Published: August 2020

Diet selectively shapes the human gut microbiota and fuels production of diverse metabolites that influence host health. Responses of the microbiota to diet are highly personalized, yet mechanistically not well understood because the metabolic capabilities of human gut microorganisms remain largely unknown. Here we show that sulfoquinovose (SQ), an omnipresent monosaccharide in green vegetables, is a selective substrate for few but ubiquitous bacteria in the human gut. In anoxic incubations of human feces and in defined co-culture, Eubacterium rectale and Bilophila wadsworthia both use previously unrecognized pathways to cooperatively catabolize SQ to hydrogen sulfide (H2S), a key intestinal metabolite with disparate effects on host health. We find SQ degradation capability encoded in almost half of E. rectale genomes but otherwise sparsely distributed among microbial species in the human intestine. Re-analysis of fecal metatranscriptome datasets of four human cohorts showed that SQ degradation (mostly from E. rectale and Faecalibacterium prausnitzii) and H2S production (mostly from B. wadsworthia) pathways were expressed abundantly across various health states, suggesting their active contribution to gut functioning. The discovery of green diet-derived SQ as an exclusive microbial nutrient and an additional source of H2S in the human gut highlights the role of individual dietary compounds and organosulfur metabolism on microbial activity and has implications for precision editing of the gut microbiota by dietary and prebiotic interventions.
Income Inequality in Obesity among US Adults 1999-2016: Does Sex Matter?
Authors: Hossein Zare , Gaskin Danielle D. , Thorpe Roland J.
Published: August 2020

Background

Obesity is a major public problem that varies by income and sex. However, there is little evidence that exists to determine the association between income and obesity may be moderated by sex and family income after controlling for potential covariates.
Objectives

To examine the association between income and obesity in adults ages 20 years and older and to test whether this relationship differs by sex.
Methods

Data for this study came from the 1999–2016 National Health and Nutrition Examination Surveys (NHANES). Obesity was defined by using Body Mass Index ≥ 30 kg/m2, and Gini Coefficient was calculated to measure income inequality by using Poverty Income Ratio (PIR). We categorized GC in five quintiles to examine the relationship between income-inequality and obesity. For the first set of analysis, Modified Poisson regression was used in a sample of 40,917 adults with almost equal number of men and women (women’s ratio was 50.6%). Models included age, racial/ethnic groups, marital status, education, health behavior (smoking and drinking status and physical activities), health insurance coverage, self-reported health, and household structure (live alone and female-headed household).
Results

Adjusting for potential confounders, higher-income men had a higher prevalence of obesity (PR: 1.11; CI: 1.00-1.25) compared to those with a lower-income, but women with upper middle income had a lower prevalence of obesity (PR:0.84; CI:0.77–0.93) compared to those with a lower income.
Conclusions

The association between income inequality and obesity was consistently significant among middle-income and higher-income men than lower-income men. The same association was not found for women, women more likely to suffer from income-inequality than men.
Increased neutrophil-to-lymphocyte ratio after thrombolysis better predicts 3-month stroke outcome
Authors: Hou Duanlu , Wang Chunjie , Ye Xiaofei , Zhong Ping , Wu Danhong
Published: August 2020

Background-Thrombolysis has become an effective therapy for acute cerebral infarction (AIS) within 4.5 hours. Thrombolysis improves prognosis by increasing perfusion of the ischemic penumbra. Inflammation as one of the mechanisms of cerebral infarction, the role of thrombolysis is the topic of our exploration. Methods-From August 1, 2017 and September 1, 2019, 493 consecutive patients with AIS were prospectively enrolled in this cohort. 170 patients received thrombolytic therapy and 323 patients did not have thrombolysis. Clinical evaluation, laboratory data before and after thrombolysis and 3-month modified Rankin scale (mRS) scores were compared. Neutrophil-to-lymphocyte ratio (NLR), which represents inflammatory response, was divided into quartiles for comparison. Multivariate regression analysis was used to determine independent factors of 3-month prognosis. The receiver operating characteristic curve was used to evaluate the predictability of NLR for good prognosis that was defined as 3-month mRS scores < 3. Results-The NLR after thrombolysis was higher than that before thrombolysis (p < 0.001) and in non-thrombolytic patients (p < 0.001). NLR after thrombolysis is an independent predictor of 3-month functional outcome (odds ratio (OR) = 1.20, 95% confidence interval (CI), 1.01–1.42, p = 0.03). Also, a cutoff value of 4.51 for NLR was detected in predicting post-thrombolysis 3-month functional outcome with a sensitivity of 65.7% and a specificity of 73.1% (area under curve [AUC], 0.85; 95% CI, 0.77–0.92). We also found a significant difference (62% vs 88%, p < 0.001) in the proportion of good 3 months prognosis between the higher and lower group. Conclusions-This study showed that NLR increase after thrombolysis better predict post-thrombolytic unfavorable functional outcome in AIS patients. Clinical Trial Registration-URL: http://www.chictr.org.cn/index.aspx, Unique identifier: ChiCTR1800018315. URL: http://www.chictr.org.cn/index.aspx, Unique identifier: ChiCTR1800019615.
Neuromyelitis optica spectrum disorders with non-opticospinal manifestations as initial symptoms: A long-term observational study
Authors: Li Rui , Lu Danli , Li Hao , Wang Yuge , Shu Yaqing , Chang Yanyu , Sun Xiaobo , Lu Zhengqi , Qiu Wei , Yang Zhi
Published: August 2020

Background
Early stage neuromyelitis optica spectrum disorders (NMOSD) with non-opticospinal manifestations as initial symptoms are easily misdiagnosed; however, data on the full symptom profile are limited. Moreover, the clinical characteristics and long-term outcomes of these patients remain unknown. We sought to analyze the clinical characteristics, imaging features, and long-term outcomes of NMOSD with non-opticospinal manifestations as initial symptoms.
Methods
We retrospectively included relevant patients from our center. Clinical, demographic, magnetic resonance imaging (MRI), treatment, and outcome data were compared according to the non-opticospinal vs. opticospinal initial symptoms.
Results
We identified 43 (9.13%) patients with non-opticospinal initial symptoms among 471 patients with NMOSD. Of these, 88.37% developed optic neuritis/myelitis during an average follow-up of 6.33 years. All non-opticospinal symptoms were brain/brainstem symptoms. Most symptoms and associated brain lesions were reversible. These patients had a younger onset age (P < 0.001), lower serum aquaporin-4 (AQP4) antibody titers (P = 0.030), and Expanded Disability Status Scale (EDSS) score was lower at onset (P < 0.001) and follow-up (P = 0.041) than NMOSD patients with opticospinal initial symptoms. In addition, EDSS scores reached 3.0 (indicating moderate disability) later than in patients with opticospinal initial symptoms (P = 0.028).
Conclusions
Patients with NMOSD with non-opticospinal initial symptoms have a younger onset age, lower serum AQP4 antibody titers, and better clinical outcomes.