bluuebunny/crossref_metadata_2025 huggingface dataset:
Fundus Photography, Fundus Fluorescein Angiography, and Optical Coherence Tomography of Healthy Cynomolgus Monkey, New Zealand Rabbit, Sprague Dawley Rat, and BALB/c Mouse Retina
Authors: Xian Bikun , Zhao Minglei , Peng Yuting , Wang Wencong , Li Zhiquan , Zhang Henig , Li Weihua , Huang Bing
Published: May 2020

Background

A variety of experimental animal models are used in basic ophthalmological research to elucidate physiological mechanisms of vision and disease pathogenesis. The choice of animal model is based on the measurability of specific parameters or structures, the applicability of clinical measurement technologies, and the similarity to human eye function. Studies of eye pathology usually compare optical parameters between a healthy and altered state, so accurate baseline assessments are critical, but few reports have comprehensively examined the normal anatomical structures and physiological functions in these models.
Methods

Three cynomolgus monkeys, six New Zealand rabbits, ten Sprague Dawley (SD) rats, and BALB/c mice were examined by fundus photography (FP), fundus fluorescein angiography (FFA), and optical coherence tomography (OCT).
Results

Most retinal structures of cynomolgus monkey were anatomically similar to the corresponding human structures as revealed by FP, FFA, and OCT. New Zealand rabbits have large eyeballs, but they have large optic disc and myelinated retinal nerve fibers in their retina, and the growth pattern of retinal vessels were also different to the human retina. Unlike monkeys and rabbits, the retinal vessels of SD rats and BLAB/c mice were widely distributed and clear. And the OCT preformance of them were similar with human beings.
Conclusion

Monkey is a good model to study changes in retinal structure associated with fundus disease, rabbits are not suitable for studies on retinal vessel diseases and optic nerve diseases, and rats and mice are good models for retinal vascular diseases. These measures will help guide the choice of model and measurement technology and reduce the number of experimental animals required.
Diet Quality and Mental Health Amongst Acute Inpatient Psychiatric Patients
Authors: Gill Raveena , Tyndall Sean F , Vora Darshini , Hassan Rashedul , Megna James , Leontieva Luba
Published: May 2020

BackgroundPoor diet quality has been found to be prevalent in people with mental illness [71] and even contribute to mental illness [71]. The purpose of this exploratory study is to examine the relationship between diet quality, mental health problems, socioeconomic variables, physical activity level, and body mass index amongst acute psychiatric inpatients.MethodThe study sample were 100 adult inpatients. Tools administered were Eating Habit Questionnaires (Dana Farber Institute) and the KIDMed index to assess food compliance in accordance with a Mediterranean diet. The Index marks all individuals as either having an “unhealthy score” or “healthy score”. The study utilized a descriptive correlation research design.ResultsThe results showed that 75% of the patients displayed an unhealthy score as per the KIDMed index. The findings displayed an inverse relationship of BMI and the KIDMed score. There was a significant positive correlation between the level of education and the KIDMed score. There is a positive correlation towards increased consumption of sugar in schizophrenic patients. There was no statistical significance between age, gender, income and physical activity with regards to the KIDMed score.ConclusionPsychiatric inpatients display unhealthy eating habits which is likely both an effect of and a contributing factor to the various mental illnesses. Prospective interventional randomized controlled studies are necessary for clarification of cause-effect relationships.
Cross-Calibration of Bone Mineral Densities and Body Composition Between GE-Lunar Prodigy and Osteosys Primus
Authors: Ha Yong-Chan , YOO JUN-IL
Published: May 2020

Background:The aim of this study was to investigate the correlation between bone mineral density (BMD) and body composition measured by the Osteosys Primus® and the GE Lunar Prodigy® and to calculate the conversion formula between the two devices.Methods:The forty subjects were men and women in aged 20-29 years old. Study subjects with a body mass index (BMI) greater than or equal to 17 kg / m2 and less than or equal to 35 kg / m2with a negative pregnancy test at the time of screening, and participants who voluntarily participated and agreed to provide written consent were included in the study. The study exclusion criteria were patients with scoliosis, osteoarthritis, rigid vertebral osteomalacia, or other clinical vertebral deformities, adverse events after previous DXA or radiography, pregnant or lactating women, those with artificial pacemakers, or implanted cardiac pacemakers, and those with mental illnesses, such as severe depression. All participants were scanned twice on both the Osteosys Primus (OsteoSys, Seoul, Korea) and the GE-Lunar Prodigy (Madison, WI, USA) DXA systems using the manufacturers’ standard scanning and positioning protocols. Results:Compared to the GE Lunar device, the mean Osteosys fat mass was overestimated to be 12.1 % (1776.9 g) in the whole body, 5.1 % (163.9 g) in gynoid, and 6.7 % (87.2 g) in android. Compared with the GE Lunar device, the mean BMDs of the Osteosys Primus were underestimated to be 2.3 % (0.023 g/cm2) in the whole body and 3.1 % (0.035 g/cm2) in L1-4. Compared with the GE Lunar device, the mean lean mass derived by the Osteosys Primus were underestimated to 2.3 % (1045.3 g) in the total body, 3.8 % (179.4 g) in arms, and 7.7 % (1104.8 g) in legs, respectively. There were a strong correlation of BMD and body composition between both groups.Conclusion:There was a very high correlation of BMD and muscle mass between theOsteosys Primus and the GE Lunar Prodigy.
Giving women WOICE postpartum: Prevalence of maternal morbidity using the WHO-WOICE instrument
Authors: Lamus Martha Narvaez , Lozano Stephanie , MPoca Charles , Guida Jose Paulo , Parpinelli Mary Angela , Cecatti Jose Guilherme , Vidarte Maria Escobar , Say Lale , Chou Doris , Costa Maria Laura
Published: May 2020

BackgroundThere are no accurate estimates of the prevalence of non-severe maternal morbidities. Given the lack of instruments to fully assess these morbidities, the World Health Organization (WHO) developed an instrument called WOICE.ObjectiveTo evaluate the prevalence of non-severe maternal morbidities in puerperal women and analyses factors associated to impaired clinical, social and mental health conditions.Method﻿A cross-sectional study with 519 postpartum women in a single encounter 6 to 12 weeks postpartum. The WOICE questionnaire included three sections: the first with maternal and obstetric history, sociodemographic data, risk and environment factors, violence and sexual health; The second considers functionality and disability, general symptoms and mental health; and the third includes data on physical and laboratory tests. Data collection was supported by Tablets with REDCAP software. Initially, a descriptive analysis was performed, with general prevalence of all variables contained in the WOICE, including scales on anxiety and depression (GAD-7 and PHQ-9- altered if ≥ 10), functionality (WHODAS- altered when ≥ 37.4) and data on violence and substance use. Subsequently, an evaluation of cases with alterations was performed, with a logistic regression to investigate factors associated to impaired non-clinical and clinical conditions.Results517 women were included, majority (54.3%) multiparous, ages between 20 and 34 years (65.4%) and with partner (75,6%). Over a quarter had (26.2%) preterm birth, however good perinatal outcomes. Around a third (30.2%) reported health problems informed by the physician, although more than 80% considered having good or very good health. About 10% reported any substance and 5.9% suffered violence. Anxiety was identified in 19.8% of cases, depression in 36.9% and altered functioning in 4.4% of women. Logistic regression identified that poor overall health rating was associated to increased anxiety/depression and impaired functioning. Having a partner reduces the perception of women on the presence of clinical morbidities.ConclusionDuring postpartum care, women presented high frequency of anxiety and depression and relevant frequency of substance use and violence. These aspects of women´s health need further evaluation and specific interventions to improve quality of care.
Absence of False Acetabulum is a Potent Indicator for Predicting the Use of Subtrochanteric Osteotomy in Total Hip Arthroplasty for High Dislocated Hips
Authors: Sun Jing-yang , Zhang Guo-qiang , Du Yin-qiao , Shen Jun-min , Zhou Yong gang , Wang Yan
Published: May 2020

Introduction: This study aimed to evaluate the predictive values of false acetabulum for assessment of whether to use subtrochanteric osteotomy.Materials and Methods: We retrospectively included a total of 182 patients (232 hips) affected by Crowe type IV developmental dysplasia who underwent primary THA with modular cementless stem from April 2008 to May 2019 in our institution. Based on radiographs and operative notes, we found 175 hips were performed with subtrochanteric osteotomy and 57 without subtrochanteric osteotomy, which was named (subtrochanteric osteotomy) STO group and non-STO group, respectively. The predictive values of absence of false acetabulum and distalization of greater trochanter were analyzed using receiver operating characteristic (ROC) curves.Results: ROC curves showed that absence of false acetabulum and distalization of greater trochanter had the AUCs of 0.957 and 0.987, respectively. And there was no statistical significance in the difference of these two AUCs (P=0.392). The optimal threshold for the distalization of greater trochanter was 4.83 cm, which resulted in a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 92.6%, 100%, 100%, and 81.4%, respectively. For the absence of false acetabulum, the sensitivity, specificity, PPV, and NPV were 94.9%, 96.5%, 98.8%, and 85.9%, respectively.Conclusions: The absence of false acetabulum may be a potent indicator in predicting the use of subtrochanteric osteotomy in high dislocated hips.
Comparison of Sagittal Spinal Alignment on Standing Plain X-Rays and Supine MRI in Degenerative Lumbar Disease
Authors: Wang Yulu , Bai Jinwu , Pan Zhijun , Xue Deting
Published: May 2020

Background:The purpose of present study is to examine the possible correlation between standing plain X-rays and supine MRI for evaluating spinal sagittal alignment in degenerative lumbar disease.Methods: The characteristics and images of 64 patients with degenerative lumbar diseases were reviewed retrospectively. The thoracolumbar junction kyphosis (TJK), lumbar lordosis (LL), and sacral slope (SS) were measured on lateral plain X-rays and by magnetic resonance imaging (MRI). Inter- and intra-observer reliability were tested using intra-class correlation coefficients. Results: The results suggested that TJK measurements obtained from MRI tended to underestimate the radiographic measures by 2°, whereas SS measurements obtained from MRI tended to overestimate the radiographic measures by 2°. The LL measurements obtained from MRI were approximately equal to the radiographic measures. The X-ray and MRI measurements were linearly related. Conclusions:In conclusion, supine MRI can be directly translated into sagittal alignment angle measurements obtained from standing X-rays with an acceptable degree of accuracy. This can avoid the impaired view caused by the overlapping ilium, while reducing the patient’s exposure to radiation.
Evaluating drug prescription patterns in children according to World Health Organisation's indicators, Kigali, Rwanda: A cross-sectional study
Authors: HABIMANA Gaspard , Nyandwi Theogene , Kabayiza Jean Claude , Kayumba Pierre Claver
Published: May 2020

Background Irrational drug use is a worldwide problem at all levels of health care, especially in hospitals. Prescribers in community tend to omit hospital prescribing practices, thus this problem is present at all levels of health care. Use of medicines can be greatly improved and wastage reduced if simple principles of drug management are followed. To help in solving this problem, World Health Organization (WHO) has designed prescribing core indicators that were used to evaluate drug prescription patterns in Rwanda Social Security Board (RSSB) affiliated patients.Material and Methods A retrospective cross-sectional study with quantitative analysis was carried out for a period of six months. Among the 1000 prescriptions collected, 18 of them were rejected for not fulfilling the inclusion criteria, the remaining 982 prescriptions were almost distributed equally from either private and public hospital or clinics. The study analyzed prescriptions from health facilities located in Kigali City, Rwanda. The results were presented in table with comparisons with the WHO prescription indicators.Results The average number of drugs per prescription is 2.4 which is higher than 1.8 recommended by WHO. The percentages of drugs prescribed with a generic name and those from National Essential drug List are 28.5% and 61.1% respectively, which are very low compared to WHO target of 100% for both core prescribing indicators. The percentage of encounters with an antibiotic prescribed is 42.5% and the encounters who received an injections account 1.2%.Conclusion This study revealed that there is a big gap in implementing WHO core indicators of prescription and concerned stakeholders should take measures to address this issue.
Atorvastatin Promotes Bone Formation in Aged apoE–/– Mice through the Sirt1–Runx2 Axis
Authors: Hong Wei , Wei Zhanying , Qiu Zhaohui , Li Zheng , Fu Chensheng , Ye Zhibin , xu xiaoya
Published: May 2020

Background
Statins are the most widely used drugs in elderly patients, the most common clinical application of statins is in aged hyperlipemia patients. There are few studies on the effects and mechanisms of statins on bone in elderly mice with hyperlipemia. The study is to examine the effects of atorvastatin on bone phenotypes and metabolism in aged apolipoprotein E-deficient (apoE–/–) mice, and the possible mechanisms involved in these changes.
Methods
Twenty-four 60-week-old apoE–/– mice were randomly allocated to two groups. Twelve mice were orally gavaged with atorvastatin (10 mg/kg body weight/day) for 12 weeks; the others served as the control group. Bone mass and skeletal microarchitecture were determined using micro-CT. Bone metabolism was assessed by serum analyses, qRT-PCR, and Western blot. Bone marrow-derived mesenchymal stem cells (BMSCs) from apoE–/– mice were differentiated into osteoblasts and treated with atorvastatin and Sirt1 inhibitor EX-527.
Results
The results showed that long-term administration of atorvastatin increases bone mass and improves bone microarchitecture in trabecular bone but not in cortical bone. Furthermore, the serum bone formation marker osteocalcin (OCN) was ameliorated by atorvastatin, whereas the bone resorption marker tartrate-resistant acid phosphatase 5b (Trap5b) did not appear to be impacted by atorvastatin treatment. The mRNA expression of Sirt1, runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP) and OCN in bone tissue were increased after atorvastatin administration. Western blot showed same trend in Sirt1 and Runx2. The in vitro study showed that when BMSCs from apoE–/– mice were pretreated with EX527, the higher expression of Runx2, ALP and OCN activated by atorvastatin decreased significantly or showed no difference compared with the control. The protein expression of Runx2 showed same trend.
Conclusions
Accordingly, the current study validates the hypothesis that atorvastatin can increase bone mass and promote osteogenesis in aged apoE−/− mice by regulating the Sirt1–Runx2 axis.
Mirabilite with ice pack after Total Knee Arthroplasty: A Randomized Controlled Trial Study
Authors: Zhong Ying , Zheng Cheng , Du Wenxi , Zheng Jiahua , Xu Shanchun , Tong Peijian
Published: May 2020

Background
Total knee arthroplasty (TKA) is a well-established procedure for end-state arthritis of knee with complications such as swelling and pain. The aim of this study is to evaluate the effect of mirabilite with ice pack versus ice pack alone on relieving pain, reducing swelling, range of motion (ROM), and serum CRP level in patients after TKA.
Methods
Eighty patients undergoing primary unilateral TKA were randomly assigned to two groups (MIP group and WIP group). We used VAS to measure knee pain at 24 h, 48 h, and 72 h after the surgery respectively. Knee swelling degree was evaluated by measuring the girth of leg at the center of patella and 10 cm above and below it at the same frequency. The active ROM of the knee was measured by using a universal goniometer of plastic material at 72 h postoperatively. The serum CRP level was also measured at 72 h postoperatively.
Results
The MIP group showed statistically significant lower knee girth at 48 h (p༜0.05), 72 h (p < 0.05) postoperatively and VAS score at 72 h (P = 0.018) at postoperatively after TKA than WIP group. The ROM of MIP group were significantly wider than WIP group (P = 0.024). The CRP level (P = 0.036) and length of stay (LOS) (P = 0.037) of MIP group were significantly lower than WIP group.
Conclusions
Mirabilite with ice pack after TKA showed superiority in relieving pain, reducing swelling, and improving ROM than ice pack alone.
Trial registration:
Chinese Clinical Trial Registry (ChiCTR), ChiCTR-OCN-15006356. Registered 6 MAY 2015, http://www.chictr.org.cn/showproj.aspx?proj=10927
Fluctuations of Driving Pressure during Mechanical Ventilation Indicates Elevated Central Venous Pressure and Poor Outcomes
Authors: Mao Jiayu , Li Dong-kai , Ding Xin , Zhang Hong-min , Long Yun , Wang Xiao-ting , Liu Da-wei
Published: May 2020

The authors have removed this preprint from Research Square.
Application of magnesium sulphate as a " multimodal general anesthesia" protocol in patients undergoing hysteroscopy: a randomized controlled study
Authors: Gao Peng-fei , Lin Jing-yan , Wang Shun , Zhang Yun-feng , Wang Guo-qiang , Xu Qi , Guo Xiao
Published: May 2020

Background The purpose of the study was to applicate magnesium sulphate as a " multimodal general anesthesia" protocol to reduce perioperative opioids requirements in patients undergoing hysteroscopy. Methods 70 patients scheduled for hysteroscopy were randomly divided into 2 groups. Patients in the Group M received intravenous magnesium sulfate 50 mg/kg in 100 ml of isotonic saline over 15 min before propofol injection and then 15 mg/kg per hour by continuous intravenous infusion. Patients in the control group received an equal volume of normal saline as placebo. All patients were anesthetized under a BIS guided monitored anesthesia care with propofol and fentanyl. Intraoperative anesthetic agent requirements and hemodynamic variables were recorded. Postoperative pain score was assessed with verbal numerical rating scale (VNRS) 1 min, 15 min, 30 min, 1 hour and 4 hours after recovery of consciousness. Results Postoperative serum magnesium concentrations in Group C were significantly declined than preoperative levels (0.86 ± 0.06 to 0.80 ± 0.08 mmol/L, P=0.001) while there was no statistical change in Group M (0.86 ± 0.07 to 0.89 ± 0.07 mmol/L, P=0.129). The total dose of fentanyl given to patients in Group M was less than the one administered to Group C (100 (75-150) vs 145 (75-175) μg, median (range); P < 0.001). Fewer patients in Group M required additional analgesic postoperatively. In addition, patients receiving magnesium displayed less VNRS scores at 15 min, 30 min, 1 hour and 4 hours postoperatively. Conclusions Intravenous infusion of magnesium sulphate significantly reduces perioperative opioids requirements. Meanwhile, it was beneficial to reduce postoperative pain and maintain stable of serum magnesium concentration after the procedure.
Generation of Dyskeratosis Congenita-like Hematopoietic Stem Cells through the Stable Inhibition of DKC1
Authors: Carrascoso-Rubio Carlos , Zittersteijn Hidde A. , Pintado-Berninches Laura , Fernández-Varas Beatriz , Lozano M. Luz , Manguan-Garcia Cristina , Sastre Leandro , Bueren Juan A. , Perona Rosario , Guenechea Guillermo
Published: May 2020

Dyskeratosis congenita is a rare telomere biology disorder, which results in different clinical manifestations, including severe bone marrow failure. To date, the only curative treatment for bone marrow failure in dyskeratosis congenita patients is allogeneic hematopoietic stem cell transplantation. However due to the toxicity associated to allogeneic hematopoietic stem cell transplantation in dyskeratosis congenita, new non-toxic therapies are recommended to improve the life expectancy of these patients. Since bone marrow biopsies are not routinely performed during the follow-up of dyskeratosis congenita patients, the availability of dyskeratosis congenita hematopoietic stem cells constitutes a major limitation in the development of new hematopoietic therapies for dyskeratosis congenita. Here we aimed at generating dyskeratosis congenita-like human hematopoietic stem cells in which the efficacy of new therapies could be investigated. X-linked dyskeratosis congenita is one of the most frequent variants of dyskeratosis congenita and is associated with an impaired expression of the DKC1 gene. In this study we thus generated dyskeratosis congenita-like hematopoietic stem cells based on the stable knock-down of DKC1 in human CD34+ cells, using lentiviral vectors encoding for DKC1 short hairpin RNAs. At a molecular level, DKC1-interfered CD34+ cells showed a decreased expression of TERC, as well as a diminished telomerase activity and increased DNA damage. Moreover, DKC1-interfered human CD34+ cells showed defective clonogenic ability and were incapable of repopulating the hematopoiesis of immunodeficient NSG mice. The development of dyskeratosis congenita-like hematopoietic stem cells will facilitate the understanding of the molecular and cellular basis of the bone marrow failure characteristic of dyskeratosis congenita patients, and will serve as a platform for the development of new hematopoietic therapies for dyskeratosis congenita patients.
Identification of a 9-Gene Prognostic signature for breast cancer
Authors: Tian Zelin , Tang Jianing , Liao Xing , Yang Qian , Wu Yumin , Wu Gaosong
Published: May 2020

Background Breast cancer (BRCA) is the most common cancer among women worldwide and results in the second leading cause of woman cancer death.Methods This study sought to develop a prognostic gene signature to predict the prognosis of patients with BRCA. Studies were performed using the genome-wide data of BRCA patients from the Gene Expression Omnibus dataset (GSE20685, GSE42568, GSE20711, GSE88770). Univariate COX regression analysis was used to determine the association between gene expression levels and overall survival(OS) in each dataset. Taking P value < 0.05 as the inclusion criterion, the common genes in all datasets were selected as prognostic genes, and a 9-gene prognostic signature was developed.Results The Kaplan-Meier survival curve was constructed using log-rank test to assess survival differences. The overall survival of patients in the low-risk group was significantly higher than that in the high-risk group. ROC analysis showed that this 9-gene signature showed good diagnostic efficiency both in overall survival(OS) and disease free survival(DFS). The 9-gene signature was further validated using GSE16446 dataset. In addition, multiple Cox regression analysis showed that this 9-gene signature was an independent risk factor. Finally, we established a nomogram that integrates conventional clinicopathological features and 9-gene signature. The analysis of the calibration plots showed that the nomogram has good performance.Conclusions This study has developed a reliable 9-gene prognostic signature, which is of great value in predicting the prognosis of BRCA and will help to make personalized treatment decisions for patients at different risk score.
GHG displacement factors of harvested wood products: the myth of substitution
Authors: LETURCQ Philippe
Published: May 2020

Background
A commonly held idea is that substituting wood for fossil fuels and energy intensive materials is a better strategy in mitigating climate change than storing more carbon in forests. This opinion, although ratified by the forest and energy policies of many countries, especially in Europe, remains highly questionable for at least two reasons.
Results
Firstly, the carbon footprints of wood-products are underestimated as far as the “carbon neutrality” assumption is involved in their life cycle analysis, as it is most often the case. As a matter of fact, when taking into account the forest carbon dynamics consecutive to wood harvest and the limited lifetime of products, these carbon footprints are time-dependant and their presumed values under the carbon neutrality assumption are achieved only in steady-state conditions. For time horizons comparable with the climatic deadlines, the values to apply may be of the same order as the carbon mass in the harvested wood from which the products originate. Secondly, even if carbon footprints are correctly estimated, the benefit of substitutions is overestimated when all or part of the wood products are supposed to replace non-wood products whatever the market conditions. Indeed, substitutions can be considered as effective only if an increase in wood harvesting implies verifiably a global reduction in production of non-wood products.
Conclusions
Most studies that advocate energy or material substitutions lack rigour to these respects and incite the increase in wood harvesting. Such an increase impedes forest carbon storage and could be counter-productive for climate change mitigation objectives.
The meaning of postpartum sexual health for women living in Spain: A phenomenological inquiry.
Authors: Pardell-Dominguez Lidia , Palmieri Patrick Albert , Dominguez-Cancino Karen A. , Camacho-Rodriguez Doriam E. , Edwards Joan E. , Watson Jean , Leyva-Moral Juan M.
Published: May 2020

Background
Sexual health is a multidimensional phenomenon constructed by personal, social, and cultural factors but continues to be studied with a biomedical approach. During the postpartum the woman transitions to mother, as well as partner to parent and couple to family. There are new realities in life in the postpartum, including household changes and new responsibilities that can impact the quality of sexual health. This phenomenon is understudied especially in the context of Spain. The purpose of this study was to describe the lived experience of postpartum sexual health among primiparous women giving birth in Catalonia (Spain).
Methods
This was a phenomenological study with a purposive sample of women within the first postpartum year. Data was collected through semi-structured interviews until saturation was achieved. Analysis followed Colaizzi's seven-step process with an eighth translation step added to limit cross-cultural threats to validity. Also, the four dimensions of trustworthiness were established through strategies and techniques during data collection and analysis.
Results
Ten women were interviewed from which five themes emerged, including: Not feeling ready, inhibiting factors, new reality at home, socio-cultural factors, and the clinician within the health system. The process of returning to sexual health was “figured out” as women engaged in experiential learning through trial and error. Most participants reported reduced libido after childbirth, experienced altered body image, and resumed sexual activity before feeling ready. A common finding was fatigue and feeling overloaded by the demands of the newborn. Partner support was described as essential to returning to a normal relationship. Discussions about postpartum sexual health with clinicians were described as taboo, and largely absent from the care model.
Conclusion
Evidence-based practices should incorporate the best evidence from research, consider the preferences of the woman, and use clinician expertise to make decisions. As such, human caring practices should be incorporated into clinical guidelines to recognize the preferences of women regarding their sexual health. Clinicians need to be authentically present, engage in active communication, and tailor their care. More qualitative studies are needed to understand postpartum sexual health in different contexts, cultures, and countries and to identify similarities and differences through metasynthesis.
Knowledge, Attitude and Practice among dispensers of Community Pharmacy on Emergency Contraceptive Pills in Kathmandu Valley: A cross-sectional study
Authors: Shakya Sujyoti , shrestha sweta , Shrestha Rojeena Koju , Giri Usha , Shrestha Sunil
Published: May 2020

Background Unintended pregnancies, the primary cause of abortion, can consequence in severe negative effects such as infertility and maternal death. Adequate knowledge of emergency contraceptive pills (ECPs) and a positive attitude among the dispensers in community pharmacy is a prerequisite for timely access to ECP thus ultimately abating the incidence of unintended pregnancies. This study intended to explore the knowledge, attitude and practice of dispensers of community pharmacy toward ECPs in Kathmandu valley. Methods A cross-sectional study was conducted in community pharmacies located in three districts of Kathmandu valley. A convenient sampling method was employed to interview dispensers in 227 community pharmacies using a validated questionnaire. The questionnaire assessed the demographic characteristics, knowledge, attitude and dispensing practice of the dispensers. The data were subjected to descriptive and inferential analysis using SPSS 18 (SPSS Inc., Chicago, IL, USA). Results Respondents’ knowledge was statistically significant with dispensing practice and had a positive relation [AOR= 11.86, 95% CI (5.821-24.190)]. Approximately (74.9%) of respondents had a good practice and about 65.6% had a good knowledge on dispensing ECP. Majority (93.4%) had a positive attitude towards ECP yet some of the respondents (54.2%) had conservative belief about the Over the Counter (OTC) availability of ECP. ECP related knowledge was higher among the age group 40-49 years, Bphamacy degree holders with experience above 10 years and pharmacies located inside the city and in the Kathmandu district. After adjusting the possible confounder variables, age, degree and district of pharmacy were significantly associated with knowledge. Similarly, respondents’s practice towards ECP was higher among the age group 40-49 years with experience above 10 years and pharmacies located inside the city and in the Kathmandu district. Adjusted for other variables, only pharmacies located at Kathmandu district was significantly associated with practice. Conclusion The dispensers lacked specific significant information on ECP and posed a conservative perception of its’ OTC availability, despite good overall knowledge and positive attitude. Hence, training on proper counseling strategies should be afoot to refine service delivery.
Clinical Characteristics, Serological and Radiological Longitudinal Changes of Patients With COVID-19
Authors: Yang Zhiwei , Yu Mingxue , Li Ganwen , Liu Guirong , Xie Jinjun , Song Hongzhong , Li Gang , Jie Yusheng
Published: May 2020

Background

Since December 2019, an outbreak of coronavirus disease 2019 (COVID-19) that began in Wuhan and rapidly spread globally. The speed and scope of spread of COVID-19 makes urgent of the defining clinical characteristics, serological and radiological changes of the affected patients.

Method

7 patients with laboratory-confirmed COVID-19 who admitted to the Third affiliated hospital of Sun Yat-sen university Yuedong hospital from January 2020 to March 2020 were retrospectively enrolled and their clinical features, serological and radiological longitudinal changes were analyzed.

Results

Among the 7 patients, all (100%) had a clear epidemiological history. The most common symptoms were respiratory symptoms 6 (85.7%), and only 2 (28.6%) of the patients had fever at their first visit. The cohort included 4 (57.1%) common types and 3 (42.9%) severe types. Two (28.6%) common types patients developed to severe type in a short time. All of the 7 patients (100%) had abnormal liver function, normal renal function and normal procalcitonin. The detection time of specific antibody in 7 patients was 5~13d after symptoms. Before the specific antibody could be detected, the absolute value of lymphocytes decreased in 2 (28.6%) common type cases transferred to severe type cases accompanied with obvious progress in pulmonary imaging, and the phenomenon of decreased albumin and elevated globulin occurred in 6 patients (85.7%). The predominant pattern of lung lesions observed was bilateral (71.4%) and mainly near the pleura at the first diagnosis. Bilateral pulmonary involvement occurred in 6 cases (85.7%) during the course of disease. In 4 cases (57.1%) with obvious pulmonary lesions, the absolute value of lymphocytes decreased, albumin decreased and globulin increased during the course of the disease.

Conclusion

Serum specific antibodies can be detected within 2 weeks of onset. Close observation of the dynamic changes of absolute value of blood lymphocytes, serum albumin and globulin which were related to pulmonary imaging changes in patients will contribute to assessment of COVID-19.
Design preferences for global scale: A mixed-methods study of “glocalization” of an animated, video-based health communication intervention.
Authors: Adam Maya , Chase Rachel P , McMahon Shannon A , Kuhnert Kira-Leigh , Johnston Jamie , Ward Victoria , Prober Charles , Bärnighausen Till
Published: May 2020

Background
Designing health communication interventions for global scaling reinforces health literacy promotion and facilitates time-sensitive global health messaging. Limited literature explores preferences for animation prototypes and other content characteristics across participants living in different global regions. Prior research underscores an urgent need for health communication interventions that are more compelling and accessible across diverse global cultures. This study provides valuable international insights and key considerations for health communicators and educators developing video-based, animated content intended for global distribution.
Methods
We used a mixed-methods, sequential explanatory design, drawing on participation via an international group of learners enrolled in a massive open online course. Through an online quantitative survey (n = 330), we sought preferences from participants in 73 countries for animation design prototypes to be used in video-based, globally scalable, health communication interventions. To learn more about these preferences, we conducted in-depth interviews (n = 20) with participants selected using maximum variation purposive sampling.
Results
For globally scalable interventions, most respondents preferred animation design prototypes that were free of cultural identifiers, especially when these were localized through familiar-sounding voiceovers. Across global regions, participants favored narrative approaches, short videos and family structures that were inclusive across age and gender.
Conclusions
This study summarizes preferences from participants in 73 countries for a variety of design prototypes that could be used in globally scalable, animated health communication videos. We also present novel content development considerations that could inform future interventions. Our findings suggest that global learners may be willing to accept simplified visuals, designed for broad cross-cultural acceptability, especially if the content is localized in other ways, such as the use of locally resonating narratives and voiceovers.
Therapeutic potential of CKD-506, a novel selective histone deacetylase 6 inhibitor, in a murine model of rheumatoid arthritis
Authors: Park Jin Kyun , Jang Yu Jin , Oh Bo Ram , Shin Jieun , Bae Daekwon , Ha Nina , Choi Young Il , Youn Gi Soo , Park Jinseu , Lee Eun Young , Lee Eun Bong , Song Yeong-Wook
Published: May 2020

Objectives Histone deacetylase (HDAC) 6 promotes inflammation. We investigated the anti-arthritic effects of CKD-506, a novel HDAC6 inhibitor, in vitro and in a murine model of arthritis as a novel treatment option for rheumatoid arthritis (RA). Methods HDAC6 was overexpressed in mouse peritoneal macrophages and RAW 264.7 cells and the effects of a HDAC6 inhibitor CKD-506 on cytokine production and activity of NF-κB and AP-1 signaling were examined. Peripheral blood mononuclear cells (PBMCs) from RA patients and fibroblast-like synoviocytes (FLS) were activated in the presence of CKD-506. Next, regulatory T cells (Treg) were induced from RA patients and co-cultured with healthy effector T cells (Teff) and cell proliferation was analyzed by flow cytometry. Finally, the effects of the inhibitor on the severity of arthritis was assessed in a murine model of adjuvant-induced arthritis (AIA). Results Overexpression of HDAC6 induced in macrophages to produce TNF-α and IL-6. The inhibitory effect of CKD-506 was mediated via blockade of NF-κB and AP-1 activation. HDAC6 inhibition reduced TNF-α and IL-6 production by activated RA-PBMCs. Also, CKD-506 inhibited production of MMP-1, MMP-3, IL-6 and IL-8 by activated FLS. In addition, CKD-506 inhibited proliferation of Teffs directly and indirectly by improving iTreg function. In AIA rats, oral CKD-506 improved clinical arthritis in a dose-dependent manner. A combination of sub-therapeutic CKD-506 and methotrexate exerted a synergistic effect. Conclusion The novel HDAC6 inhibitor CKD-506 induces regulatory immune responses in monocytes/macrophages, improves Treg function, and ameliorates arthritis severity in a murine model of RA. Thus, CKD-506 might be a novel and effective treatment option for RA.
Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease
Authors: Rastad Hadith , Karim Hossein , Ejtahed Hanieh-Sadat , Tajbakhsh Ramin , Noorisepehr Mohammad , Babaei Mehrdad , Azimzadeh Mehdi , Soleimani Alireza , Inanloo Seyed Hasan , Hassani Neda Shafiabadi , Rasanezhad Fariba , Shahrestanaki Ehsan , Khodaparast Zeinab , Golami Hossein , Qorbani Mostafa
Published: May 2020

Background: Diabetes mellitus (DM) and cardiovascular disease (CVD) are present in a large number of patients with novel Coronavirus disease 2019 (COVID-19). We aimed to determine the risk and predictors of in-hospital mortality from COVID-19 in patients with DM and CVD.Methods: This retrospective cohort study included hospitalized patients aged ≥ 18 years with confirmed COVID-19 in Alborz province, Iran, from 20 February 2020 to 25 March 2020. Data on demographic, clinical and outcome (in-hospital mortality) data were obtained from electronic medical records. Self-reported comorbidities were classified into the following groups: “DM” (having DM with or without other comorbidities), “only DM” (having DM without other comorbidities), “CVD” (having CVD with or without other comorbidities), “only CVD” (having CVD without other comorbidities), and “having any comorbidity”. Multivariate logistic regression models were fitted to quantify the risk and predictors of in-hospital mortality from COVID-19 in patients with these comorbidities.Results: Among 2957 patients with COVID-19, 2656 were discharged as cured, and 301 died. In multivariate model, DM (OR: 1.62 (95%CI: 1.14-2.30)) and only DM (1.69 (1.05-2.74)) increased the risk of death from COVID-19; but, both CVD and only CVD showed non-significant associations (p>0.05). Moreover, “having any comorbidities” increased the risk of in-hospital mortality from COVID-19 (OR: 2.66 (95%CI: 2.09 -3.40)). Significant predictors of mortality from COVID-19 in patients with DM were lymphocyte count, creatinine and C-reactive protein (CRP) level (all P- values < 0.05).Conclusions: Our findings suggest that diabetic patients have an increased risk of in-hospital mortality following COVID-19; also, lymphocyte count, creatinine and CRP concentrations could be considered as significant predictors for the death of COVID-19 in these patients.
The Impact of Metabolic Syndrome Defined by IDF or Revised NCEP on Glycemic control in Malaysians with Type 2 Diabetes
Authors: Saif-Ali Riyadh , Kamaruddin Nor Azmi , AL-Habori Molham , Al-Dubai Sami A , Ngah Wan Zurinah Wan
Published: May 2020

BackgroundChronic complication of Type 2 diabetes mellitus such as macrovascular disease is amplified with the increase in the number of the metabolic syndrome (MeS) risk factors. Specific criteria for diagnosis of metabolic syndrome are essential to help in glycemic control and reduce cardiovascular morbidity and mortality in diabetic patients with metabolic syndrome.Methods The study involved 485 Type 2 DM patients who are receiving treatment at the University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia. Metabolic syndrome among the Type 2 DM patients was diagnosed based on IDF and NCEP-R criteria. The C-peptide and glycated hemoglobin (HbA1c) levels were determined by an automated quantitative immunoassay analyzer and high-performance liquid chromatography respectively. The metabolic syndrome factors, glucose, triglyceride and HDL cholesterol were measured by spectrophotometerResultsApplication of IDF and NCEP-R criteria respectively resulted in 73% and 85% of Type 2 DM subjects being diagnosed with metabolic syndrome. The concordance of these criteria in diagnosing metabolic syndrome among Type 2 DM was low (kappa=0.33, P<0.001). Both IDF and NCEP-R criteria indicated that Type 2 DM with five criteria of metabolic syndrome had higher insulin resistance (P=2.1×10-13, P=1.4×10-11), C-peptide (P=1.21×10-13; 4.1×10-11), blood glucose (P=0.01; 0.021) and HbA1c (P=0.039; 0.018) than those Type 2 DM without metabolic syndrome respectively.ConclusionHowever, there is a low concordance between IDF and NCEP-R criteria in the diagnosis of metabolic syndrome among Type 2 DM, both criteria showed that type 2 DM with five criteria of metabolic syndrome had higher insulin resistance, blood glucose and HbA1c.
LncRNA SNHG12 promotes proliferation and migration of vascular smooth muscle cells via targeting miR-766-5p/ EIF5A
Authors: liu wen , che jianhuan , Gu Yan , song ling , Jiao yingying , yu shui
Published: May 2020

Background Although lncRNAs have reported to serve as potential biomarkers of atherosclerosis (AS), the role of lncRNA SNHG12 in AS are still unknown. Methods In present study, we investigated the regulatory effects of SNHG12 on human vascular smooth muscle cells (hVSMCs). RT-qPCR were employed to determine the expressions of SNHG12, miR-766-5p and eukaryotic translation initiation factor 5A (EIF5A). Cell viability was estimated via the Cell Counting Kit-8 assay. Wound healing and Transwell invasion assays were used for evaluation of hVSMCs migratory capacity. To further investigate the regulatory mechanisms, binding sites between SNHG12 and miR-766-5p, EIF5A and miR-766-5p were speculated via starBase V2.0, and validated using luciferase reporter gene assay. Results It was identified that SNHG12 was up-regulated in oxidized low-density lipoprotein (ox-LDL)-insulted hVSMCs. Silencing SNHG12 inhibited ox-LDL-induced proliferation and migration of hVSMCs. Moreover, we found that SNHG12 acted as a sponge of miR-766-5p, and miR-766-5p also interacted with EIF5A. EIF5A plasmids promoted the proliferation and migratory capacities of hVSMCs, however, shRNA-SNHG12 counteracted the facilitation of EIF5A plasmids on biological behaviors of hVSMCs. Conclusions These findings of this study demonstrated that SNHG12 facilitated the migration and invasion of hVSMCs via targeting miR-766-5p/EIF5A axis.
Can posterior stand-alone expandable cages safely restore lumbar lordosis? A minimum 5-year follow-up study
Authors: Kim Seung-Kook , Elbashier Ogeil Mubarak , Lee Su-chan , Choi Woo-jin
Published: May 2020

Background Lumbar lordosis (LL) can be restored and screw-related complications may be avoided with the stand-alone expandable cage method. However, the long-term spinopelvic profile changes and safety remain unknown. We aimed to elucidate the long-term radiologic outcomes and safety of this technique. Methods Data from a total of 69 patients who underwent multi-level stand-alone expandable cage fusion and 80 patients who underwent screw-assisted fusion between February 2007 and December 2012, with at least 5 years of follow-up, were retrospectively analyzed. Segmental angle and translation, short and whole LL, pelvic incidence, pelvic tilt, sacral slope (SS), sagittal vertical balance, thoracic kyphosis, and presence of subsidence, pseudoarthrosis, retropulsion, cage breakage, proximal junctional kyphosis (PJK), and screw malposition were assessed. The relationship between local and spinopelvic effects was investigated. The implant failure rate was considered a measure of procedure effectiveness and safety. Results The stand-alone expandable cage fusion group showed shorter operative times, a lower rate of PJK, and better improvements in segmental angles than the control group, and there was a positive correlation with LL. However, the whole LL was not restored; the SS significantly increased; and subsidence, pseudoarthrosis, and retropulsion rates were significantly higher than those in the control group. Conclusions Stand-alone expandable cage fusion can restore local lordosis, however, global sagittal balance was not restored. Furthermore, implant safety still has not been proven.
Antioxidative enzyme-related gene expression levels in cumulus cells during in vitro fertilization: A comparison between normal and poor ovarian responders
Authors: Orprayoon Nalina , Thuwanut Paweena , Sereepapong Wisan , Rungsiwiwut Ruttachuk , Sirayapiwat Porntip
Published: May 2020

Background: Preeminent interfering factor caused in vitro fertilization (IVF) failure has been broadly emphasized on poor ovarian response (POR) to controlled ovarian hyperstimulation (COH). The specific etiology and precise infertility treatment in POR patients, until now, has not been established and leads to detrimental effects on physical or psychological patient life qualities. To date, one biological stress phenomena, oxidative stress, is broadly implicated in varieties of female reproductive pathological conditions including poor oocyte quantity and quality. Hence, the present study is principally aimed to investigate oxidative stress scavenging system; enzymatic antioxidant-related gene expression level (SOD1, SOD2 and GPx4), in cumulus cells retrieved from poor ovarian responders (POR) and normal ovarian responders (NOR).Methods: A cross-sectional analytic study; fifty-six infertile women, aged between 25-49 years-old who underwent IVF procedure, were enrolled into this study with 28 participants in POR group (1-4 retrieved oocytes) and 28 participants in NOR group (5-15 oocytes). The cumulus cells from first punctured follicle were processed for mRNA gene expression levels of enzymatic antioxidant-related genes (Superoxide dismutase: SOD1, SOD2 and Glutathione peroxidase: GPx4) by quantitative real-time PCR (qPCR) and their association to other reproductive biological factors.Results: The relative mRNA expression of SOD1, SOD2 and GPx4 neither differed between poor and normal responders nor correlated with other relevant reproductive biological cohorts. However, the relative SOD2 mRNA expression level in patients who received human menopausal gonadotropin (hMG) was notably higher than the recombinant follicle stimulating hormone (rFSH) group (P = 0.017).Conclusions: Our major findings indicated that the enzymatic antioxidant-related gene mRNA expression in the cumulus cells do not associate with the ovarian response and other clinical outcomes (i.e. fertilization and pregnancy rates) after IVF procedure. However, the enzymatic antioxidant-related genes positively relate with type of gonadotropin administration.