bluuebunny/crossref_metadata_2025 huggingface dataset:
KAWASAKI DISEASE IN INFANTS LESS THAN ONE YEAR OF AGE: AN ITALIAN COHORT FROM A SINGLE CENTER
Authors: Mastrangelo Greta , Cimaz Rolando , Calabri Giovan Battista , Simonini Gabriele , Lasagni Donatella , Resti Massimo , Trapani Sandra
Published: August 2019

Background and aims

Few data are currently available for Kawasaki disease (KD) below 12 months especially in Caucasians. This study aims to analyze clinical and laboratory features of KD among an Italian cohort of infants.

Methods

A retrospective chart review of KD children aged less than one year at time of disease onset between January 2008-December 2017 was performed. Clinical data, laboratory parameters, instrumental findings, treatment and outcome were collected in a customized database.

Results

Among 113 KD patients, 32 (28.3%) were younger than 1 year. Nineteen patients aged below 6 months, and three below 3 months. The median age was 5.7 ±2.7 months. The mean time to diagnosis was 7±3 days and was longer in the incomplete forms (8 ± 4 vs 6 ± 1 days). Conjunctival injection was present in 26 patients (81.2%); rash in 25 (78.1%); extremity changes in 18 (56.2%); mucosal changes in 13 (40.6%,) and lymphadenopathy only in 7 (21.8%). Mucosal changes were the least common features in incomplete forms (18.2%). Twenty-two patients (68.7%) had incomplete KD. Nineteen (59.4%) had cardiac involvement, of whom 13 (59.0%) had incomplete form. ESR, PCR and platelet values were higher in complete KD; especially, ESR resulted significantly higher in complete forms (80 ± 25.7 mm/h vs 50 ± 28.6 mm/h; p = 0.01). Conversely, AST level was statistically significant higher in patients with incomplete forms (95.4 ± 132.7 UI/L vs 29.8 ± 13.2 UI/L; p = 0.03). All patients received IVIG. Response was reported in 26/32 patients; 6 cases needed a second dose of IVIG and one required a dose of anakinra.

Conclusion

In our cohort, incomplete disease was commonly found, resulting in delayed diagnoses and poor cardiac prognosis. Infants with incomplete KD seem to have a more severe disease and a greater predilection for coronary involvement than those with complete KD. AST was significantly higher in incomplete forms, thus AST levels might be a new finding in incomplete forms’ diagnosis. Eventually, we highlight a higher resistance to IVIG treatment. To our knowledge this is the first study involving an Italian cohort of patients with KD below 12 months.
Sporting programs aimed at inactive population groups in the Netherlands: factors influencing their long-term sustainability in the organized sports setting
Authors: Ooms Linda , Kruijsbergen Mette van , Collard Dorine , Leemrijse Chantal , Veenhof Cindy
Published: August 2019

Background: The organized sports sector has received increased interest as a setting to stimulate physical activity among inactive target groups. To include many inactive people and to obtain population health benefits, it is important that effective sporting programs are sustained (i.e. continuation of program activities) over a long period of time. This study identified the factors influencing the long-term sustainability of these kind of sporting programs located within local sports clubs in the Netherlands.
Methods: Fourteen Dutch sporting programs aimed at increasing physical activity levels of inactive population groups and funded within the National Action Plan for Sport and Exercise (NAPSE) were the focus of this study. The programs were developed by ten Dutch National Sports Federations (NSFs) and implemented by different sports clubs in the Netherlands within a three-year funded implementation period (2008-2011). This research consisted of semi-structured face-to-face interviews with the program coordinators of the NSFs (n=14) and semi-structured telephone interviews with representatives of sports clubs that provided the programs (n=17 continued the program, n=11 discontinued the program) six and a half years after the funding period ended (November 2017-March 2018). A sustainability framework with five pre-specified main themes (i.e. program design, implementation, trainer/coach, organizational setting, broader community environment) guided data collection and (deductive) thematic analysis.
Results: Ten of the fourteen NAPSE funded sporting programs were sustained at the level of the NSFs. Most factors facilitating (+) and impeding (-) the long-term sustainability of the programs were common to both NSFs and sports clubs, like program adaptation (+) and a lack of program financing (-). Program evaluation (+) and high program costs (-) were specific factors mentioned by NSFs, while factors related to human resources (e.g. lack of volunteers (-)) or the sports club nature (e.g. social aspect in program design (+)) applied to sports clubs. The factors were summarized in the form of a checklist.
Conclusions: Key factors influencing the long-term sustainability of the sporting programs were identified. The results can be used to develop strategies to promote long-term sustainability of these kind of programs and inform funding guidelines in countries with a similar organized sports infrastructure.
Combining transcriptomics and metabolomics to characterize ergosterol biosynthesis in Flammulina velutipes during the fruiting process
Authors: Wang Ruihong , Ma Pengda , Li Chen , Xiao Lingang , Liang Zongsuo , Dong Juane
Published: August 2019

Background:
Flammulina velutipes (F. velutipes) is one of the most important mushrooms in Japan and China because of its potential medicinal and nutritional value. Ergosterol is an important precursor of vitamin D2, progesterone, hydrocortisone, brassinolide, and novel anticancer and anti-HIV drugs. One of the main methods for obtaining ergosterol is extraction of its natural products from fungi. However, because of the low production of ergosterol due to its inefficient biosynthesis, its approach cannot meet human needs. Therefore, increasing the ergosterol level in fungi is an important goal to be pursued. Although genes encoding key enzymes in the biosynthesis pathway of ergosterol have been identified in Saccharomyces cerevisiae, the mechanism and regulation of ergosterol biosynthesis in F. velutipes remain unclear, and are the focus of this study.
Results:
In this work, nine cDNA libraries produced from the three stages of F. velutipes were sequenced by using the Illumina HiSeqTM 4000 platform, resulting in at least 6.63 Gb of clean reads from each library. De novo sequence assemblers were used to generate 220,523 transcripts and 28,330 unigenes, which were annotated according to seven protein databases. Here, we combined transcriptomics and metabolomics approaches to investigate the biosynthesis of bioactive ergosterol from F. velutipes. The contents of 16 intermediates or metabolites from different stages (young fruiting body stage and mycelium stage) were found to be significantly different. Then, transcriptional profiling of the genes involved in ergosterol biosynthesis was carried out, and the transcripts of key genes involved in the metabolism were analysed. A total of 51 key unigenes (12 upregulated unigenes and 39 downregulated unigenes) were identified as differentially expressed. Furthermore, four genes (i.e., ERG10s, ERG1s, ERG11s and ERG26s) were identified as the most important genes that played roles in the regulation of the pathway flux towards ergosterol synthesis in F. velutipes. Combining transcriptomics and metabolomics, we explored the regulatory relationship between ergosterol biosynthesis genes and metabolites in F. velutipes.
Conclusions:
The data obtained in this work provide useful information for understanding the biosynthesis, metabolism and regulation of sterols in F. velutipes and for channelling the metabolic flux towards ergosterol at different growth stages.
Disaster preparedness among Thai elderly emergency department patients: A survey of patients’ perspective
Authors: Sri Jiraporn , Vanichkulbodee Alissara , Sinsuwan Natchapon , Rojsaengroeng Rapeeporn , Kamsom Anucha , Liu Shan Woo
Published: August 2019

Background: In disaster situations, the elderly are considered to be a particularly vulnerable population. Preparedness is the key to reduce post-disaster damage. There is limited research in middle-income countries on how well elderly emergency department (ED) patients are prepared for disaster situations. The objective of this study was to determine the attitudes and behavior of elderly ED patients toward disaster preparedness.
Methods: This study was a cross-sectional face-to-face survey at one urban teaching hospital in Bangkok, Thailand between August 1st and September 30th, 2016. Patients aged 60 and older who presented to the ED were included to this study. We excluded patients who had severe dementia [defined as Short Portable Mental State Questionnaires (SPMSQ) > 8], were unable to speak Thai, had severe trauma and/or needed immediate resuscitation. The survey instruction was adapted from previous disaster surveys. This study was approved by the Vajira Institutional Review Board (IRB).
Results: A total of 243 patients were enrolled. Most of them were female [154 patients (63.4%)]. The median age was 72 [Interquartile range (IQR) 66-81] years and the most common underlying diseases were hypertension [148 patients (60.9%)] and diabetes [108 patients (44.4%)]. The majority of patients [172 patients (72.4%)] reported that they had had some teaching about disaster knowledge from a healthcare provider and had experienced a disaster [138 patients (56.8%)]. While 175/197 (81.8%) patients who had underlying diseases reported that they had a medication supply for disaster situations, only 61 (25.1%) patients had an emergency toolbox for disasters. Most patients (159, 65.4%) did not know the emergency telephone number, and 133 (54.7%) patients reported transportation limitations.
Conclusions: While most Thai elderly ED patients reported having a medication supply for disaster situations, many lacked comprehensive plans for a disaster situation. Work needs to be done to improve the quality of preparedness in disaster situations among elderly patients. Future research should focus on preparedness knowledge regarding evacuation, and shelter/residence for older patients.
Influence of Preoperative Serum Creatinine Level and Intraoperative Volume of Contrast Medium on the Risk of Acute Kidney Injury After Transfemoral Transcatheter Aortic Valve Implantation: a retrospective observational study
Authors: Miura Daisuke , Yamada Yasutaka , Kusaba Shinichiro , Nogami Eijiro , Yunoki Junji , Sakamoto Yoshiko , Hikichi Yutaka , Node Koichi , Sakaguchi Yoshiro
Published: August 2019

Objective:
This study aimed to determine if contrast medium volume (CMV) is a risk factor for acute kidney injury (AKI) during transcatheter aortic valve implantation (TAVI) via a transfemoral approach performed without major complications. All TAVI procedures performed at our institution between March 2014 and March 2018 were retrospectively reviewed. AKI was diagnosed using the Acute Kidney Injury Network classification based on the Valve Academic Research Consortium-2 definition. Procedures performed via a transapical approach and those in which circulatory dynamics failed intraoperatively were excluded.
Results:
Eighty-one (96.4%) of 100 patients scheduled for TAVI were enrolled; seven (8.6%) developed AKI and 74 (91.4%) did not. The serum creatinine (SCr) level was significantly higher (p<0.05) and the estimated glomerular filtration rate was significantly lower in the AKI group (p<0.05). The CMV was significantly higher in the AKI group (103ml vs 84ml, p<0.05), as was the CMV × SCr/BW value (3.34 vs 1.49, p<0.01). The area under the curve for CMV × SCr/BW was 0.9228 and the cutoff value was 2.99. The CMV, SCr, and estimated glomerular filtration rate affect the likelihood of AKI after transfemoral TAVI and a CMV × SCr/BW value > 2.99 accurately predicts AKI.
Knowledge and practice of immediate new-born care among midwives in central zone public health Facilities, Tigray, Ethiopia: cross sectional study.
Authors: Gebru Tesfay Tsegay , Murugan Rajalakshmi , Abrha Alem Gebremariam , Goyteom Mekonnen Haftom
Published: August 2019

Objective

The objective of this study was to assess knowledge and practice of immediate newborn care among midwives in governmental health facilities of central zone of Tigray regional state, 2016.

Results

The mean age of the study participants was 34.1 years. Majority of the participants (83%) were diploma midwives. The score of knowledge of participants on immediate newborn care was 17.7% good and 25.2% poor. More than half (52.4%) of midwives practiced immediate newborn care. Midwives working in health center have 82% lower odds of newborn care compared to those working in hospital (p=0.000, OR=0.18 (0.07, 0.43).
Association among cytokine profiles of innate and adaptive immune responses and clinical-virological features in untreated patients with chronic hepatitis B
Authors: Gu Yurong , Lian Yifan , Zheng Qiaolan , Huang Zexuan , Gu Lin , Bi Yanhua , Li Jing , Huang Yanlin , Wu Yuankai , Huang Yuehua
Published: August 2019

Background

Complete clearance of intracellular viruses depends on effector cells of innate and adaptive immune system. This study aimed to identify the relationship between antiviral cytokines produced by natural killer (NK) and T cells and clinical-virological characteristics in untreated chronic hepatitis B (CHB) patients.

Methods

We measured antiviral cytokines interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), and interleukin-2 (IL-2) produced by T, NK and natural killer T (NKT) cells in a cohort of chronic hepatitis B virus (HBV) infection (CHB). We also correlated these cytokines with clinical-virological characteristics using a linear regression model.

Results

IFN-γ+ and TNF-α+ by CD4+ and CD8+ T cells were significantly higher in immune active (IA) than other phases. Immune tolerant (IT) patients showed the least expression of IFN-γ+ by NK and NKT cells, and TNF-α+ by NK cells. IFN-γ+, TNF-α+ and IL-2+ by CD4+ and CD8+ T cells were comparable between IA and gray zones (GZ) phases. Principal component analysis based on cytokines confirmed that most IT patients significantly differ from inactive carriers (IC) and IA patients, while GZ patients were widely scattered. Multivariate analysis showed both T and NK cells producing IFN-γ+ and TNF-α+, but not IL-2+, had significant association with serum alanine aminotransferase (ALT). Moreover, IFN-γ+ by NKT cells was associated with HBV DNA, while IFN-γ+ by CD4+ and CD8+ T cells had correlation with age.

Conclusion

HBV clinical phases are characterized by distinct cytokines signatures, which showed little relationship to viral features at a single time point in these untreated CHB patients.
Pattern of nucleotide variants of TP53 and their correlation with the expression of p53 and its downstream proteins in a Sri Lankan cohort of breast and colorectal cancer patients
Authors: Manoharan Vahinipriya , Karunanayake Eric Hamilton , Tennekoon Kamani Hemamala , De Silva Sumadee , Imthikab Ahamed Ilyas Ahamed , De Silva Kanishka , Angunawela Preethika , Lunec John
Published: August 2019

Background
Breast cancer (BC) is known to be the most common malignancy in females whereas colorectal cancer (CRC) incidence also higher in both genders in Sri Lanka. TP53 is an important tumour suppressor gene and its somatic mutations are reported in approximately 27% of BC and 43% of CRC cases. Analysis of TP53 gene variants not only provides clues for the aetiology of the tumour formation, but also has an impact on treatment efficacy. The current study was conducted to investigate the pattern of TP53 variants in patients with BC and CRC from Sri Lanka.

Methods
30 patients with BC, 21 patients with CRC and an equal number of healthy controls were screened for mutational status of TP53 by polymerase chain reaction (PCR) followed by direct sequencing. In addition, a subset of these samples were analysed for the protein expression of p53 and comparison made with the mutational status of TP53. We also analysed the protein expression of p21 and MDM2 as potential indicators of p53 functional status and compared it with the protein expression of p53. Additionally, hotspot codons of the KRAS, BRAF and PIK3CA genes were also analysed in a subset of CRC patients.
Results
Twenty seven sequence variants, including several novel variants in the TP53 gene were found. Nine BC and seven CRC tumour samples carried pathogenic TP53 variants. Pathogenic point missense variants were associated with strong and diffuse positive staining for p53 by immunohistochemistry (IHC), whereas, wild type TP53 showed complete absence of positive IHC staining or rare positive cells, regardless of the type of cancer. There was no direct correlation between p21 or MDM2 expression and p53 expression in either BCs or CRCs. Four of the CRC patients had pathogenic hotspot variants in KRAS; three of them were on codon 12 and one was on codon 61.
Conclusion
The prevalence of pathogenic somatic TP53 variants was 31% and 33.33% in the studied BC and CRC cohorts respectively. All of them were located in exons 5 – 8 and the pathogenic missense variants were associated with strong immuno-positive staining for p53.
IL-17 affects progression, metastasis, and recurrence of laryngeal cancer via the inhibition of apoptosis through activation of the PI3K/AKT/FAS/FASL pathways
Authors: Song Yang , Yang Ming , Zhang Jianhong , Sun Yan , Tao Ye , Li Huihui , Zhang Jing , Li Yuncheng , Yang Jianming
Published: August 2019

Background. Cytokines play important roles in development and prognosis of laryngeal cancer (LC). Interleukin-17 (IL-17) from a distinct subset of CD4 + T-cells may significantly induce cancer-elicited inflammation to prevent cancer cells from immune surveillance. Methods. The expression levels of IL-17 were examined among 60 patients with LC. Immunofluorescence co-localization experiments were performed to verify the localization of IL-17 and FAS/FASL in Hep-2 and Tu212 cells. IL-17 was silenced for expression in LC cell lines by siRNA techniques for determination of the role of IL-17 in LC. Results. In our LC patients, cytokines were dysregulated in LC tissues compared with normal tissues. We found that IL-17 was overexpressed in a cohort of 60 LC tumors paired with non-tumor tissues. Moreover, high IL-17 expression was significantly associated with advanced T category, late clinical stage, differentiation, lymph node metastasis, and disease recurrence. In addition, the time-course expression of FAS and FASL was observed after stimulation and treatment with IL-17 stimulator. Finally, in vitro experiments demonstrated that IL-17 functioned as an oncogene by inhibiting the apoptosis of LC cells via the PI3K/AKT/FAS/FASL pathways. Conclusions. Taken together, our findings for the first time demonstrate the role of IL-17 as a tumor promoter and a pro-metastatic factor in LC, indicating that IL-17 may have an oncogenic role and serve as a potential prognostic biomarker and therapeutic target in LC.
Prevalence of diabetes among homeless and slum dwellers in Accra, Ghana: A survey study
Authors: BAWAH AHMED TIJANI , Yawson Albert Abaka , Seini Mohammed Mustapha , Yeboah Francis Agyemang , Ngala Robert Amadu
Published: August 2019

Objective: This study aimed at determining diabetes status of homeless people in Nima and Agbogbloshie, Accra, Ghana and to evaluate the association between socio-demographic characteristics and diabetes prevalence.
Results: A total of 130 homeless and slum dwellers took part in the study out of which 7 (5.4%) participants were diagnosed with diabetes while 13 (10 %) were considered as having prediabetes. This is slightly lower than what had been reported two decades ago but similar to overall estimates of diabetes prevalence in Africa (5.7%). Diagnosis of normoglycemia, prediabetes and diabetes was based on individual’s hemoglobin A1c (HbA1c) level: ≤5.9%, 6.4–6.0%, and ≥6.5%, respectively. There was no significant association between prevalence of diabetes or prediabetes and the socio-demographic characteristics of the participants. The slightly lower diabetes prevalence among the homeless and slum dwellers compared to the general population may be due to constant movement of these people in the streets, a practice that could serve as a form of exercise for them. Intensive social support aimed at preventing and managing diabetes is crucial if we are to further reduce the incidence of diabetes in homeless people.
Keywords: Homeless, Diabetes mellitus, Hemoglobin A1c, Head porters
Glutathione imparts stress tolerance against Alternaria brassicicola infection via miRNA mediated gene regulation
Authors: Datta Riddhi , Boro Priyanka , Mandal Kajal , Sultana Asma , Chattopadhyay Sharmila
Published: August 2019

Objective: Glutathione (GSH) is well-known to play a crucial role in imparting resistance against various pathogen invasions. Nevertheless, the role of GSH in regulating miRNA mediated defence response is yet to be explored. Results: To decipher the GSH mediated regulation of miRNA expression during necrotrophic infected Arabidopsis thaliana, wild-type Col-0 and AtECS1, the transgenic line exhibiting enhanced GSH content, was infected with necrotrophic pathogen Alternaria brassicicola. AtECS1 plants exhibited enhanced resistance as compared to wild-type. MiRNA next generation sequencing (NGS) was performed to compare the miRNA expression in Col-0 and AtECS1 leaves. Under control condition, differentially expressed 96 known miRNAs and 17 novel miRNAs viz. ath-miR8167f, ath-miR1886.3, ath-miR3932b-5p, etc were identified. Whereas, under infected condition, 73 known and 43 novel differentially expressed miRNAs viz. ath-miR5652, ath-miR160b, ath-miR865-5p, etc. were identified. Functional annotation and enrichment analysis revealed that several miRNAs that target defence-related genes like leucine rich repeat protein kinase, MYB transcription factors, TCP8, etc. were down regulated in the AtECS1 line which, in turn, relieves the repression of their target gene expression leading to resistance against infection.Together, the present investigation suggests that GSH plays a decisive role in modulating the miRNA mediated regulation of defence related genes during pathogen invasion.
Shu-mu point Catgut embedding therapy for abdominal obesity: study protocol for a randomized controlled trial
Authors: Feng Jialei , Ren Yulan , Jin Yuhao , Meng Jiangqiong , Yang Qiming , Zhong Yuan , Xing Chonghui , Guo Taipin
Published: August 2019

Background Obesity has become a multifactorial epidemic, affecting individuals, families, societies and countries. Abdominal obesity (AO) is the most harmful kind in obesity. Acupoint catgut embedding (ACE), one of an acupuncture therapy, has been widely used in China although it’s efficiency has not been tested by randomized controlled trial (RCT). The aim of this study is to evaluate the efficacy and safety of the ACE on AO. Methods This is a blinding, RCT. A total of ninety-two patients who met the inclusion criteria for this trial will be enrolled from two independent hospitals and randomly assigned to shu-mu point group and non-acupoint group. ACE will be conducted once every two weeks, three times for one course. There will be a total of two courses in the whole treatment, and a follow-up will be performed in the fourth week after the end of treatment. The primary outcomes are weight and waist circumference (WC). The secondary outcomes are body mass index (BMI), hip circumference (HC), Quality of Life Scale (SF-36), Zung Self-Rating Anxiety Scale (SAS) and Zung Self-Rating Depression Scale (SDS). Discussion The results of this study will be obtained by RCT, and the outcomes will be analyzed to prove that ACE is effective and safe for AO. The results of this study will be derived from RCT. We expect that this experiment will evaluate the effectiveness and safety of ACE for AO, and will also observe the changes in the physical conditions of patients before and after the treatment from the two groups.
WITHDRAWN: Alkalizing properties of new calcium-silicate endodontic biomaterials
Authors: Kot Katarzyna , Kucharski Łukasz , Marek Ewa , Safranow Krzysztof , Lipski Mariusz
Published: August 2019

Background: Calcium silicate-based cements (CSC), are self-setting hydraulic biomaterials widely used for reparative procedures in dentistry and endodontics. These materials possess bio-properties like biocompatibility, biointeractivity (release calcium (Ca2+ ) and hydroxyl (OH-) ions), and bioactivity (apatite-forming ability in contact with body fluids). Methods: Six calcium silicate-based materials were selected for this study: TheraCal LC (Bisco Inc. Schamburg, IL, USA), MTA Plus (Prevest Denpro, Jammu, India Avalon Biomed Inc, Bradenton, FL, USA), Biodentine (Septodont, Saint-Maur-des-Fossés, France), RetroMTA (BioMTA, Seoul, Korea), MTA Flow (Ultradent Products, Inc., South Jordan UT, USA), and OrthoMTA (BioMTA, Seoul, Korea). The pH was analysed immediately after immersion (baseline) and after 1 hour, 3 hours, 1 day, 2 days, 3 days, 1 week, 2 weeks, 3 weeks and 1 year with a pH meter, previously calibrated with solutions of known pH. To analyze the change in pH levels of the materials at each time point, 1- and 2-way analysis of variance, ANOVA followed by Tukey's multiple comparison test. The level of significance was set at p < 0.05. Results: Analysis of the tested materials showed statistically significant differences in terms of pH changes as a function of time showed a gradual rise in the pH of all materials. Conclusion: All tested materials exhibited continuous hydroxyl ion release resulting in a rise in pH until the end of time of experience. Because of the highly alkaline pH values of these materials, they possess biointeractivity properties.
Measles Outbreak Investigation in Artuma Fursi Woreda, Oromia Zone, Amhara Region, Ethiopia, 2018: A case control study
Authors: Tariku Mengistie Kassahun , Misikir Sewnet Wongiel
Published: August 2019

Abstract
Objective: To confirm the existence of Outbreak, describe cases in person, place and time, and identify determinants of the outbreak. Unmatched case control study in the ratio of 1:4 (38 cases and 152 controls) was conducted in Artuma fursi woreda from July 13- August 1 /2018. Data were collected with standard questionnaires. Collected data were entered into Epi Info version 7 and exported to Statistical package for social science (SPSS) version 23 for analysis.
Results: A total of 38 cases and 1 death with attack rate and case fatality rate 11.8/100,000 and 2.6% respectively. All study participants had not vaccination history. Females and age group 5-15 were more affected. Being 5-15 years old [adjusted odd ratio (AOR) =3.53; 95% CI; 1.52-8.45)], contact with cases AOR=2.78; 95% CI; 1.23-8.67] and travel history 7-18 days prior onset of illness [AOR= 2.53; 95% CI; 1.31-7.24] were significantly associated with contracting measles.Routine and supplement immunization should be strengthened to reduce future occurrence of outbreak.
Keywords: Measles, outbreak, Artuma fursi woreda
Transcription factors involved in stem cell maintenance are downstream of Slug/Snail2 and repressed by TGF-β in bronchial epithelial progenitors from Chronic Obstructive Pulmonary Disease
Authors: Grange Pierre de la , Jolly Ariane , Courageux Charlotte , Brahim Chamseddine Ben , LEROY Pascale
Published: August 2019

Objectives: Patients with Chronic Obstructive Pulmonary Disease (COPD) have a bronchial epithelium with many anomalies and basal/progenitor cells showing a decrease of self-renewal and differentiation potential. The objective of this study was to identify deregulations in the genetic program of COPD bronchial progenitors that could account for their exhaustion. The transcription factor Slug/Snail2 is highly expressed in bronchial progenitors and we aimed at identifying genes downstream of Slug whose expression is deregulated in COPD progenitors. Results: We knocked down Slug in primary basal cells from COPD subjects and, since COPD subjects have higher levels of Transforming Growth Factor (TGF)-β Slug is regulated by TGF-β, we selected genes downstream of Slug involved in differentiation that respond to TGF-β. We identified transcription factors involved in stem cell maintenance downstream of Slug and repressed by TGF-β in COPD but not normal progenitors. We found that the effect of TGF-β on the expression of these genes is correlated to Slug knockdown effect. We also found a correlation between the mRNA levels of Slug and these genes only in presence of TGF-β. These results reveal that stem cell maintenance genes are deregulated in COPD bronchial progenitors, Slug and TGF-β being involved in that deregulation.
Radial Endobronchial Ultrasonography with a Guide Sheath for the Diagnosis of Diffuse Parenchymal Lung Diseases
Authors: Inomata Minoru , Kuse Naoyuki , Awano Nobuyasu , Tone Mari , Yoshimura Hanako , Jo Tatsunori , Moriya Atsuko , Bae Yuan , Kumasaka Toshio , Takemura Tamiko , Izumo Takehiro
Published: August 2019

Background
Radial-endobronchial ultrasonography (R-EBUS) is a useful bronchoscopic tool for the diagnosis of solitary pulmonary peripheral lesions. However, the utility of R-EBUS for the diagnosis of diffuse parenchymal lung disease (DPLD) remains unclear. This study aimed to examine the characteristics of R-EBUS patterns in association with computed tomography (CT) findings in diagnosing DPLD.

Methods
Transbronchial lung biopsy (TBLB) was performed using R-EBUS and a guide sheath (GS) in consecutive 35 patients with suspected DPLD on chest CT between March–November 2017. Consolidation, ground glass opacity (GGO), reticular, and nodular patterns were diagnosed, and the mean CT Hounsfield units in the sampled area were measured in patients with consolidation. R-EBUS characteristics and their association with CT findings and pathological diagnostic yield were evaluated.

Results
R-EBUS showed a dense pattern only in patients with consolidation, and a blizzard pattern in patients with consolidation, GGO, reticular, and nodular patterns on CT. The biopsied area’s mean CT value was significantly higher in patients with dense than with blizzard patterns (p < 0.0001), and pathological findings were also dense in patients with R-EBUS dense pattern. The pathological diagnostic yield was significantly higher in patients with overt R-EBUS patterns than in patients without R-EBUS patterns by obtaining better lung tissue samples with the GS (p < 0.0001).

Conclusions
Dense and blizzard R-EBUS patterns were novel findings in diagnosing DPLD, and TBLB with R-EBUS-GS may be a valuable tool in diagnosing DPLD
Exposure to environmental tobacco smoke and respiratory morbidity among adolescents in a Middle-Eastern country
Authors: Booalayan Hussain , Abdulrasool Mosa , Al-Shanfari Saad , Boujarwa Abdulwahab , Al-Mukaimi Abdullah , Alkandery Omar , Akhtar Saeed
Published: August 2019

Background: There is increasing evidence linking exposure to environmental tobacco smoke (ETS) at homes to the development of respiratory morbidity including asthma among adolescents. Few studies have addressed this issue in the Middle-Eastern countries including Kuwait. Therefore, this study cross-sectional assessed the prevalence of ETS exposure at home, prevalence of asthma and other respiratory morbid conditions and examined the ETS exposure and personal smoking status as risk factors for asthma among high-school students in Kuwait.
Methods: During October 2015, a cross-sectional study design was implemented using a self-administered, modified version of the ISAAC (International study of asthma and allergies in childhood) questionnaire among students enrolled in nine high-schools of Hawally Governorate of Kuwait. Prevalence of ETS exposure, and eczema were computed. Multivariable log-binomial regression models were used to evaluate association between exposures of interest and asthma status.
Results: Of 800 invited students, 746 (92.2%) participated, of whom 74.8% were Kuwaiti and 50.1% were female with a mean (SD) age of 16.8 (0.68) years. ETS exposure prevalence at home was 54% and personal current smoking was 12.4%. Asthma prevalence was 20.5%. Furthermore, the prevalence of physician-diagnosed asthma, wheezing during the last 12 months and wheezing ‘ever’ was 16.4%, 20.1% and 26.2%, respectively. Final multivariable log-binomial regression model showed that compared to the adolescents without asthma, adolescents with asthma tended to be current smokers (adjusted prevalence ratio (adjusted PR) = 1.86; 95% CI: 1.37 – 2.53; p < 0.001) or significantly more likely to have had ETS exposure at home (adjusted PR = 1.64; 95% CI: 1.21 – 2.23; p = 0.002).
Conclusions: We recorded high prevalence of ETS exposure at home, high prevalence of asthma and identified ETS exposure at home and being a current smoker as strong risk factors for asthma among adolescents. Voluntary household smoking bans may substantially minimize the ETS exposure among adolescents. Additionally, such restriction may inculcate an antismoking attitude and prevent smoking initiation among adolescents. Such efforts are likely to pay dividends in terms of reduction in ETS exposure and associated asthma risk and other smoking-related morbidities in this and other similar settings.
Preschool environment and preschool teacher’s physical activity and their association with children’s activity levels at preschool
Authors: Chen Chu , Ahlqvist Viktor H. , Henriksson Pontus , Magnusson Cecilia , Berglind Daniel
Published: August 2019

Background

The preschool environment presents an ideal opportunity to promote early development of healthy physical activity (PA) and sedentary time (ST) habits in young children. However, less is known about how environmental and structural characteristics of preschools are associated with preschool children’s objectively assessed levels of PA and ST during preschool hours. The aim of the current study was to investigate to what extent preschool playground size, formalized PA policies, time spent outdoors and preschool teacher’s levels of PA were associated with children’s objectively assessed levels of PA and ST during preschool hours.

Methods

In total, 369 children and 84 preschool teachers from 27 preschools in Södermalm municipally, Stockholm Sweden wore an Actigraph GT3X+ accelerometer during 7 consecutive days. Preschool environmental and structural characteristics were measured via the Environment and Policy Evaluation Self-Report (EPAO-SR). Instrument and time in- and outdoors was recorded by preschool teachers on all days during the PA measurements. Weight and height of participating children were measured via validated scales and parents filled out a questionnaire on demographical and descriptive variables. Analyses were adjusted for age of the child, sex and BMI.

Results

The mean child age was 4.7 years (SD 0.8) and 45% were girls. We found that children were more active in preschools with a formalized PA policy, compared to schools without such a policy, but not less sedentary. The association between policy and activity seemed to be more pronounced when accounting for other environmental factors. Preschool teachers light PA (LPA) (ß=0.25, P=0.004) and steps (ß=0.52, P<0.001) were associated with children’s LPA and steps while the preschool playground size showed no association with PA in children.

Conclusion

The current study showed that preschool structural characteristics such as formalized PA policies and more time spent outdoors were positively associated with children’s PA. These findings suggest that formalized PA policies and time outdoors may be of importance for promoting children’s PA during preschool hours.
Tobacco use and associated risk factors in Burkina Faso: Results from a nationwide population-based cross-sectional survey.
Authors: Bonnechère Bruno , Kadari Cissé , Tiéba Millogo , Gautier Ouédraogo H. , Franck Garanet , Mariam Ouedraogo A. , Gabriela Boyle , Sékou Samadoulougou , Seni Kouanda , Fati Kirakoya
Published: August 2019

Background

Tobacco is a leading preventable cause of non-communicable diseases (NCDs). Studies that characterize prevalence of tobacco use in low-income countries are lacking. This study describes the prevalence of tobacco use in Burkina Faso and its associated factors.

Methods

Data were analyzed from the 2013 Burkina Faso WHO Stepwise approach to Surveillance (STEPS) survey that NCDs risk factors. Prevalence of any tobacco product use, cigarette smoking and other tobacco use were calculated. Logistic regression analyses identified factors associated with tobacco use.

Results

The prevalence of any tobacco use was 19.8% (95% CI: 18.4 – 21.2). Tobacco use was higher for men (29.2% [27.0 – 31.5]) than women (11.8% [10,3 – 13.4]). The prevalence of smoked tobacco was 11.3% (10.3 – 12.4), with significantly higher prevalence among men (24.5% [22.1-27.0]) than women (0.1% [0.01-0.3]). The overall prevalence of other tobacco use was 8.9% (7.4-10.7) with lower values for men (5.6% [4.2-7.4]) compared to women(11.7% [9.5-14.3]. Tobacco smoking among men was significantly associated with increased age and alcohol consumption. Analysis of risk factors for other tobacco use stratified by gender show that age, education, residence and alcohol consumption were significantly associated with consumption for women.

Conclusion

Tobacco use is common in Burkina Faso. To effectively reduce tobacco use in Burkina Faso, a comprehensive tobacco control program should consider associated factors, such as gender, age and alcohol consumption.
Understanding factors influencing care seeking for sick children in Ebonyi and Kogi states, Nigeria
Authors: Dougherty Leanne , Gilroy Kate , Olayemi Abimbola , Ogesanmola Omitayo , Ogaga Felix , Nweze Chinwe , Banerjee Joya , Oduenyi Chioma , Pacqué Michel
Published: August 2019

Background

Nigeria has one of the highest child mortality rates in the world, with an estimated 750,000 deaths annually among children under age five. The majority of these deaths are due to pneumonia, malaria, or diarrhea. Many parents do not seek sick-child care from trained, biomedical providers, contributing to this high rate of mortality.

Methods

This qualitative study explores factors enabling or preventing parents from seeking care for sick under-five children in Nigeria’s Kogi and Ebonyi states, including gender-related roles and social norms. Interviews were conducted with parents of sick under-five children and service providers, and focus group discussions were held with community leaders to assess how care-seeking behavior was influenced by four modes from the Colvin et al conceptual framework for household decision-making and pathways to care. These include (1) caregivers’ recognition and response to illness, (2) seeking advice and negotiating access within the family, (3) making use of community-based treatment options, and (4) accessing biomedical services.

Results

Parents were found to have a general understanding of illness symptoms but did not always attribute illness to biomedical causes. Intra-household decision-making processes were shaped by gender dynamics between men and women, and were found to have great effects on decisions to seek care. Use of traditional medicine and self-treatment were found to be common first steps in treatment before turning to the biomedical care system. Once the decision to seek biomedical care was taken, the route of seeking care varied between seeking care at chemists and then continuing to health facilities or starting with a health facility and then accessing prescriptions from a chemist.

Conclusion

We conclude that care-seeking decisions do not follow a linear process; that intra-household decision-making processes particularly among parents should not be underestimated in addressing sick-child care seeking; and that, given the role of mothers as primary caregivers, their knowledge in illness recognition and agency in care-seeking decision-making, and seeking biomedical care, is deserving of future study.
Inequalities, harm reduction and non-combustible nicotine products: a meta-ethnography of qualitative evidence
Authors: Lucherini Mark , Hill Sarah , Smith Katherine
Published: August 2019

As a new ‘disruptive’ technology, electronic cigarettes have the potential to interact with socioeconomic differences in smoking attitudes and practices in ways that are distinct from more traditional cessation aids. We sought to review qualitative evidence on how smokers of low socioeconomic status engage with non-combustible nicotine products, including electronic cigarettes and nicotine replacement therapies, in order to provide insight into how these products might impact on smoking inequalities. The review found very few studies exploring the attitudes of disadvantaged smokers towards non-combustible nicotine products for harm reduction or cessation purposes. Using a lines-of-argument meta-ethnographic approach, our analysis suggests that, while nicotine replacement therapies and e-cigarettes are often used in harm reduction or cessation attempts, socio-economic disadvantage makes continued use difficult. This may be exacerbated by a lack of a perceived advantage of alternative products over smoking. Overall, our review highlights the importance of considering the social, cultural and economic circumstances that influence the experience and significance of smoking and the use of alternative products, particularly for smokers of low socio-economic status.
Change in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder: a repeat cross sectional community survey in Nepal
Authors: Luitel Nagendra Prasad , Garman Emily C , Jord Mark JD , Lund Crick
Published: August 2019

Background

Despite the availability of evidence-based treatment, there is a substantial gap between the number of individuals in need of mental health care and those who receive treatment. The aim of this study was to assess changes in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder (AUD) before and after implementation of a district mental health care plan (MHCP) in Nepal.

Methods

The repeat population-based cross-sectional community survey was conducted with randomly selected adults in the baseline (N=1983) and the follow-up (N=1499) surveys, 3 years and 6 months apart. The Patient Health Questionnaire (PHQ-9) and Alcohol Use Disorder Identification Test (AUDIT) were used to screen people with probable depression and AUD. Barriers to seeking mental health care were assessed by using a standardized tool, the Barriers to Care Evaluation Scale (BACE).

Results

The proportion of the participants receiving treatment for depression increased by 3.7 points (from 8.1% in the baseline to 11.8% in the follow-up) and for AUD by 5.2 points (from 5.1% in the baseline to 10.3% in the follow-up study), however, these changes were not statistically significant. Significant reductions were found in the overall BACE score (p=0.004) and the specific BACE domains scores pertaining to financial barriers (p<0.001); stigma (p=0.004) and lack of support (p<0.001) among participants with depression. There was also a significant reduction between the baseline and follow-up in the overall BACE score (p=0.011) and the specific BACE domains scores pertaining to financial barriers (p<0.001) and lack of support (p<0.001) in the AUD group.

Conclusion

The study found a non-significant trend for improvements in treatment coverage but significant reductions in barriers to mental health care following implementation of the district mental health care plan. The possible areas for improvement in the current strategy to improve treatment coverage could include establishing a confidential place for consultation in each health facility, and targeted community awareness programs to sensitize community members about mental health problems and the availability of evidence-based treatment in primary and community health care systems.
The Influence of Family Structure Differences on Physical Activity of Children and Adolescents in China —— Taking Social Capital and Health Behavior as Mediating Factors
Authors: Wu Jingtao , Zhang Defa , LYU BEI , Yang Yanchao , Chen Hui
Published: August 2019

Background: This paper is based on the relationship between family structure and family health.
Methods: This paper applies the method of empirical research to explore the impact of social capital investment and health behavior acquisition on the degree of completion of recommended amount of physical activity for children and adolescents under different family structures.
Results: This paper finds that the 30-minute MVPA and 60-minute MVPA of children and adolescents in joint families and stem families are larger than those in other families, and the overall 60-minute MVPA participation is obviously insufficient. As for the influence of family structure and social capital on the recommended amount of physical activity for children and adolescents, compared with other families, greater expenditure on sports is related with better family-friend interaction, stronger sense of school belongingness, better campus friendship, better social trust, greater likelihood that the recommended physical activity is completed, and more social support for the physical activity of children and adolescents.
Conclusions: Social capital and health behavior served as a way to improve the achievement rate of recommended physical activity for children and adolescents. But the effect of health behavior is not prominent.
A Longitudinal Analysis of Mental and General Health Status of Informal Carers in Australia
Authors: Mohanty Itismita , Niyonsenga Theo
Published: August 2019

Background

The study investigates the self-assessed mental and general health status of informal carers in Australia. It evaluates the influence of carer’s health behaviours, namely: physical activity, smoking and drinking status; along with their social connectedness and workforce engagement on their health status.

Methods

The study uses a retrospective longitudinal design using data from the Household Income and Labour Dynamics of Australia survey, waves 5-15 (2005-2015). It includes individuals aged 15 years and older from Australian households surveyed over a period of 11 years. The sample consists of 23,251 individuals. The outcome measures include: Mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life. Using fixed effects regression, the analysis takes care of the issue of individuals self-selecting themselves as carers due to some predisposing factors such as age, poor health, socioeconomic status and sedentary behaviour.

Results

Informal carers suffer from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. Increasing age has a modifying impact on carers’ mental and general health outcomes. The older carers are coping better with their caregiving status than the younger ones. Moreover, physical activities have a positive influence on both mental and general health for non-cares, with more activities generating better health outcomes. Also, physical activities have a modifying impact on carers’ mental health compared to non-carers. Furthermore, the study finds that moderate levels of social drinking have beneficial modifying impact on carers’ mental and general health.

Conclusion

Findings suggest that some targeted support programs for young carers and, in general, carer focused community physical activities programs, could help to improve the poor health profiles of carers. Moreover, improved informal carer’s health would help to reduce the institutional demand for carers and could bridge the gap in carers’ demand and supply. Finally, the study identified a link between moderate levels of social drinking and carer health that needs to be further explored with more targeted future research.