bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic value of Glypican family genes in early-stage pancreatic ductal adenocarcinoma after pancreaticoduodenectomy and possible mechanisms
Authors: Liu Jun-Qi , Liao Xi-Wen , Wang Xiang-Kun , Yang Cheng-Kun , Zhou Xin , Liu Zheng-Qian , Han Quan-Fa , Fu Tian-Hao , Zhu Guang-Zhi , Han Chuang-Ye , Su Hao , Huang Jian-Lu , Ruan Guo-Tian , Yan Ling , Ye Xin-Ping , Peng Tao
Published: December 2020

Background

This study explored the prognostic significance of Glypican (GPC) family genes in patients with pancreatic ductal adenocarcinoma (PDAC) after pancreaticoduodenectomy using data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO).

Methods

A total of 112 PDAC patients from TCGA and 48 patients from GEO were included in the analysis. The relationship between overall survival and the expression of GPC family genes as well as basic clinical characteristics was analyzed using the Kaplan-Meier method with the log-rank test. Joint effects survival analysis was performed to further examine the relationship between GPC genes and prognosis. A prognosis nomogram was established based on clinical characteristics and prognosis-related genes. Prognosis-related genes were investigated by genome-wide co-expression analysis and gene set enrichment analysis (GSEA) was carried out to identify potential mechanisms of these genes affecting prognosis.

Results

In TCGA database, high expression of GPC2, GPC3, and GPC5 was significantly associated with favorable survival (log-rank P = 0.031, 0.021, and 0.028, respectively; adjusted P value = 0.005, 0.022, and 0.020, respectively), and joint effects analysis of these genes was effective for prognosis prediction. The prognosis nomogram was applied to predict the survival probability using the total scores calculated. Genome-wide co-expression and GSEA analysis suggested that the GPC2 may affect prognosis through sequence-specific DNA binding, protein transport, cell differentiation and oncogenic signatures (KRAS, RAF, STK33, and VEGFA). GPC3 may be related to cell adhesion, angiogenesis, inflammatory response, signaling pathways like Ras, Rap1, PI3K-Akt, chemokine, GPCR, and signatures like cyclin D1, p53, PTEN. GPC5 may be involved in transcription factor complex, TFRC1, oncogenic signatures (HOXA9 and BMI1), gene methylation, phospholipid metabolic process, glycerophospholipid metabolism, cell cycle, and EGFR pathway.

Conclusion

GPC2, GPC3, and GPC5 expression may serve as prognostic indicators in PDAC, and combination of these genes showed a higher efficiency for prognosis prediction.
A polymeric diet rich in transforming growth factor beta 2 does not reduce inflammation in chronic 2,4,6-trinitrobenzene sulfonic acid colitis in pre-pubertal rats
Authors: Dupont-Lucas Claire , Marion-Letellier Rachel , Pala Mathilde , Guerin Charlène , Amamou Asma , Jarbeau Marine , Bôle-Feysot Christine , Nicol Lionel , David Amelyne , Aziz Moutaz , Colasse Elodie , Savoye-Collet Céline , Savoye Guillaume
Published: December 2020

Background

Pediatric Crohn’s disease is characterized by a higher incidence of complicated phenotypes. Murine models help to better understand the dynamic process of intestinal fibrosis and test therapeutic interventions. Pre-pubertal models are lacking. We aimed to adapt a model of chronic colitis to pre-pubertal rats and test if a polymeric diet rich in TGF-β2 could reduce TNBS-induced intestinal inflammation and fibrosis.

Methods

Colitis was induced in 20 five-week-old Sprague–Dawley male rats by weekly rectal injections of increasing doses of TNBS (90 mg/kg, 140 mg/kg and 180 mg/kg) for 3 weeks, while 10 controls received phosphate-buffered saline. Rats were anesthetized using ketamine and chlorpromazine. After first administration of TNBS, 10 rats were fed exclusively MODULEN IBD® powder, while remaining rats were fed breeding chow. Colitis was assessed one week after last dose of TNBS by histopathology and magnetic resonance colonography (MRC).

Results

Histological inflammation and fibrosis scores were higher in TNBS group than controls (p < 0.05 for both). MRC showed increased colon wall thickness in TNBS group compared to controls (p < 0.01), and increased prevalence of strictures and target sign (p < 0.05). Colon expression of COL1A1, CTGF, α-SMA and COX-2 did not differ between TNBS rats and controls. TNBS colitis was not associated with growth failure. Treatment with MODULEN IBD® was associated with growth failure, increased colon weight/length ratio (p < 0.01), but did not affect histological scores or MRI characteristics. Colon expression of α-SMA was significantly lower in the MODULEN group versus controls (p = 0.005).

Conclusion

Features of chronic colitis were confirmed in this model, based on MRC and histopathology. Treatment with MODULEN did not reverse inflammation or fibrosis.
Exercise and Nutrition for Healthy AgeiNg (ENHANce) project – effects and mechanisms of action of combined anabolic interventions to improve physical functioning in sarcopenic older adults: study protocol of a triple blinded, randomized controlled trial
Authors: Dedeyne Lenore , Dupont Jolan , Koppo Katrien , Verschueren Sabine , Tournoy Jos , Gielen Evelien
Published: December 2020

Background

The Exercise and Nutrition for Healthy AgeiNg (ENHANce) project aims to assess the combined effects of exercise and nutritional interventions to prevent loss of skeletal muscle mass and function with ageing, and to determine the underlying mechanisms of action.

Methods

One hundred eightycommunity-dwelling sarcopenic individuals (≥ 65 years) are allocated in a randomized controlled trial (RCT) in a 1:1 ratio into five groups for a 12-week intervention period, followed by a 12-week follow-up period: 1) exercise intervention +protein placebo +omega-3 fatty acids placebo; 2) protein +omega-3 fatty acids placebo; 3) exercise intervention +protein +omega-3 fatty acids placebo; 4) exercise intervention +protein +omega-3 fatty acids; 5) protein placebo +omega-3 fatty acids placebo. All interventions are in line with recommendations of expert groups such as the American College of Sports Medicine and the PROT-AGE study group and individualized to the physical capabilities and nutritional intake of each participant. Sarcopenia is diagnosed by the assessment of gait speed, handgrip strength (Jamar handheld dynamometer), chair stand test and muscle mass (DXA) according to the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Participants, researchers and statisticians are blinded to omega-3 fatty acids and protein treatment. Compliance to the exercise program, protein and omega-3 fatty acids interventions is objectively measured, by monitoring movement by an activity monitor, determining nitrogen content in urine and analyzing the fatty acid composition of the red blood cell membrane. The primary outcome of the RCT is the change in Short Physical Performance Battery (SPPB) score. Secondary endpoints are, among others, changes in muscle mass, strength and function, objective compliance to interventions, changes in muscle and blood biomarkers related to sarcopenia, cognition, quality of life and falls.

Discussion

This RCT in well-defined sarcopenic older adults assesses the effects of combined anabolic interventions, including the additive effects of omega-3 fatty acids supplements, compared to single or placebo interventions. Compliance with the exercise intervention and with the intake of nutritional supplements is measured objectively. Also, blood and muscle samples will be used to explore the underlying determinants that contribute to the mechanism of action of anabolic interventions.

Trial registration

Clinicaltrials.gov:NCT03649698, retrospectively registered at 28 August 2018, first participant was randomized 16 February 2018.
Bathing and toileting difficulties of older adults in rural China: the role of environment
Authors: Liu Changxi , Fong Joelle H. , Hoh Jasmon W. T. , Wu Hailin , Dong Yunsheng , Gu Danan , Feng Qiushi
Published: December 2020

Background

For older adults, difficulties in bathing and toileting are often the most prevalent in the index of Activities of daily living (ADL). This study aims to examine how environmental factors are associated with difficulty of bathing and toileting among older adults in rural China.

Method

The data are from the 2014 Thousand-Village Survey (TVS), a national survey of Chinese rural residents of old age. The sample consists of 10,689 subjects, 55 years or older, from 536 villages across all provinces of China. Logistic regressions were applied to examine how difficulty of bathing and toileting was related to environmental factors such as geographic location, neighbourhood amenity, and related facilities of bathing and toileting.

Results

Older adults living in the Southern regions of China had lesser difficulty in bathing and toileting than those living in Northern China, controlling for other confounders. Better neighbourhood conditions also reduced the likelihood of having such disabilities. Persons who bathed indoors without showering facilities, in public facilities, and outdoors were significantly more likely to have bathing disability than those who showered indoors with facility. Rural older adults who used pedestal pans and indoor buckets for toileting were more likely to have toileting disability than those who used indoor squatting facilities.

Conclusion

Environmental barriers were associated with functional disability among older adults in rural China, but the disabled individuals may change their environments to adapt to their functional capabilities. Our findings suggest that it is imperative to promote the use of showering facilities and pedestal pans for toileting in rural China.
Whole blood as an alternative to peripheral blood mononuclear cell for detection of total HIV-1 DNA
Authors: Lin Ling , Yue Yong-Song , Wang Ni-Dan , Wei Lei-Yan , Han Yang , Song Xiao-Jing , Qiu Zhi-Feng , Cao Wei , Li Tai-Sheng
Published: December 2020

Background

A more time saving, convenient, reproducible, and scalable method is needed to assess total HIV-1 DNA levels.

Methods

Frozen whole blood and peripheral blood mononuclear cell (PBMC) samples both 200 μl at the same point were used to detect total HIV-1 DNA. Automatic extraction of total HIV-1 DNA was used to ensure the consistency of sample extraction efficiency. The detection reagent was HIV-1 DNA quantitative detection kit and real-time quantitative PCR was utilized.

Results

Of the 44 included patients, 42 were male and 2 were female, with a median age of 33 years. Thirty-three cases were collected after receiving antiviral treatment, with a median duration of treatment of 3 months, and the other 11 cases were collected before antiviral treatment. The median viral load was 1.83 log10 copies/mL, the median CD4 and CD8 count were 94 and 680 cells/μL, and the median CD4/CD8 ratio was 0.18. The results of the two samples were 3.02 ± 0.39 log10 copies/106 PBMCs in PBMC samples and 3.05 ± 0.40 log10 copies/106 PBMCs in whole blood samples. The detection results of the two methods were highly correlated and consistent by using paired t test (P = 0.370), pearson correlation (r = 0.887, P < 0.0001) and intra-group correlation coefficient (ICC = 0.887, P < 0.0001) and bland-altman [4.55% points were outside the 95% limits of agreement (− 0.340 ~ 0.390)].

Conclusions

The results of the whole blood sample test for total HIV-1 DNA are consistent with those of PBMC samples. In a clinical setting it is recommended to use whole blood samples directly for the evaluation of the HIV reservoir.
Influence of body mass index and weight lifting on bicep brachii muscle and distal bicep tendon stiffness evaluated using ultrasound elastography
Authors: Al-Qahtani Mahdi , Altuwaijri Omar , Altaf Meteb , Al-Enezi Majed , Abulmeaty Mahmoud , Javed Ravish
Published: December 2020

Background

This study aimed to investigate the relationship between stiffness of the bicep brachii muscle (BBM) and distal bicep tendon (DBT) and effects of weight lifting (pre- to post-workout changes) among groups with different body mass indexes (BMI).

Methods

Participants were divided into four groups according to BMI: A, underweight (< 18.5 kg/m2); B, normal (18.5–24.9 kg/m2); C, overweight (25.0–29.9 kg/m2); and D, obese (> 30.0 kg/m2). All participants were males who were untrained and had sedentary lifestyle without involvement in sports activities for the past 12 months. Ultrasonographic measurements to determine muscle and tendon stiffness was performed on the dominant side (i.e., right side) of the upper extremities in all participants.

Results

Twenty-one healthy and untrained males volunteered to participate in this study; 14 were nonsmokers and 7 were smokers. The mean age and BMI were 22.5 ± 1.5 years and 23.8 ± 6.3 kg/m2, respectively. Groups A, B, C, and D had four, ten, four, and three participants, respectively. The BBM thickness did not increase with increase in BMI and was not significantly different (P > .05) between groups. The BBM stiffness was significantly different (all P < .05) from pre- to post-workout values in all groups, whereas DBT stiffness did not follow the same trend.

Conclusions

Our study revealed that the BBM thickness is independent of BMI. After weight lifting, BBM stiffness in groups A and B increased for BBM compared to those in groups C and D. A similar trend was also recorded for DBT. Weight lifting in concentric and eccentric motions affects the stiffness of the BBM and DBT, thus weight lifting plays a role in adjusting the stiffness of the BBM and DBT.

Trial registration The study was approved by ethics committee of the College of Applied Medical Sciences (CAMS 080-3839; March 14, 2018).
Illness perceptions predict mortality in patients with predialysis chronic kidney disease: a prospective observational study
Authors: Muscat Priscilla , Weinman John , Farrugia Emanuel , Camilleri Liberato , Chilcot Joseph
Published: December 2020

Background

Illness perceptions have been shown to predict a range of psychosocial and clinical outcomes in kidney disease; including quality of life, distress, treatment adherence and even survival in end-stage renal disease patients on dialysis. The aim of this study was to evaluate whether illness perceptions impact mortality in incident predialysis Chronic Kidney Disease (CKD) patients.

Methods

Over the study period between September 2015 and June 2019, a total of 200 participants with predialysis CKD were recruited from the Nephrology Outpatient’s clinics at Mater Dei Hospital, Malta. The participants were followed up until June 2019, and the mortality information was collected. Cox proportional hazards models were used to examine the association between illness perceptions, and mortality risk, after adjustment for covariates including distress, kidney function, co-morbidity and psychological distress.

Results

Of the 200 cases available for analysis, there were 43 deaths. The mean survival time was 718.55 days (min. 3 days, max. 1297 days). The cumulative survival 1-year post the assessment of the Revised Illness Perceptions Questionnaire (IPQ–R) was 93%. Stronger identity beliefs (HR = 1.199, 95% CI: 1.060–1.357, p = 0.004), perceptions of a chronic timeline (HR = 1.065, 95% CI: 1.003–1.132, p = 0.041), personal control beliefs (HR = 0.845, 95% CI: 0.748–0.955, p = 0.007) and perceptions of control over the treatment (HR = 0.812, 95% CI: 0.725–0.909, p = 0.000) demonstrated a significant association with mortality after controlling covariates.

In a subsequent saturated model, perceived identity, chronic timeline and treatment control perceptions remained significant predictors of mortality, together with serum albumin, comorbidities and urea.

Conclusions

CKD patients’ perceptions of treatment control, perceptions of a chronic timeline and perceived illness identity predict survival independently of clinical prognostic factors, including kidney function and co-morbidity. Illness perceptions are important and potentially modifiable risk factors in CKD. Further studies are required to test whether the assessment and the implementation of psychological interventions aimed to modify maladaptive illness perceptions influence clinical outcomes in CKD.
Post-operative optical coherence tomography angiography features of chorioretinal folds resulting from pleomorphic adenoma of the lacrimal gland (PALG) of orbit- a case report
Authors: Chen Nan-Ni , Lai Chien-Hsiung , Yueh-Ju Tsai , Chen Chau -Yin
Published: December 2020

Background

Chorioretinal fold (CFs) is a rare condition resulting from undulations in the choriocapillaris, Bruch's membrane, retinal pigment epithelium and occasionally neurosensory retina. It can be idiopathic or due to different etiologies. The use of spectral-domain optical coherence tomography (SD-OCT) has increased the diagnosis of CFs and helped in differentiation from other etiologies. Recently, optical coherence tomography angiography (OCT-A) emerged as a non-invasive imaging technique allowing visualization of the individual layers of microvasculature of the retina and the choroid by comparing consecutive B-scans. We described a rare case of pleomorphic adenoma of the lacrimal gland (PALG) causing hyperopic shift and CFs with the new OCT-A technology, getting deeper insight into vascular changes of this disease.

Case presentation

A 40-year-old Asian man experienced progressive blurred vision in his right eye over 6 months. The patient’s initial axial lengths were 25.55 mm in the right eye and 28.13 mm in the left eye. Fundus examination in the right eye revealed oblique CFs as well as the SD-OCT displayed. Magnetic resonance imaging showed intraconal mass extended from superior temporal side of the right orbit. The patient then received tumor removal surgery through lateral orbitotomy and histopathology confirmed a pleomorphic adenoma of the orbit.

The patient had regular follow-up for 1 year. His best corrected visual acuity markedly improved from 20/50 to 20/20 with nearly stationary AXL. We performed OCT-A at one year after the surgery, which showed early visualization of deep choroidal vessels. The scleral remodeling due to mass effect of retrobulbar tumor also caused displacement of the deep large choroidal vessels over the superior macular area even after tumor removal.

Conclusions

We reported a rare case of PALG with hyperopic shift and CFs as initial presentation. Surgical removal of the tumor partially resolved the CFs and contributes to impressive visual acuity recovery. The use of OCT-A provided a deeper insight to vascular architecture changes resulting from scleral remodeling after long-term tumor compression.
The working disadvantaged: the role of age, job tenure and disability in precarious work
Authors: Jetha Arif , Martin Ginis Kathleen A. , Ibrahim Selahadin , Gignac Monique A. M.
Published: December 2020

Background

Precarious work is an increasingly common characteristic of industrialized labor markets that can widen health inequities, especially among disadvantaged workforce segments. Study objectives are to compare precarious employment in workers with and without disabilities, and to examine the modifying effect of disability in the relationships between age, job tenure and precarious work.

Methods

Employed Canadians with (n = 901) and without disabilities (n = 901) were surveyed on exposure to precarious working conditions. Information on age and job tenure were collected from respondents along with sociodemographic, health and work context details. Multivariable logistic models examined the association between disability and precarious work. Also, multigroup probit models examined precarious work for young (18-35 yrs), middle-aged (36-50 yrs) and older adults (> 50 yrs) and job tenure and was stratified by participants with and without disabilities.

Results

Almost equal proportions of young, middle-aged and older participants were recruited. Mean job tenure of participants was 9.5 years (SD = 9.0). Close to one-third of participants reported working precariously. At the multivariable level, a disability was not associated with working precariously. However, multigroup modelling indicated that disability was a significant effect-modifier. Older adults with a disability had a 1.88 times greater odds of reporting precarious work when compared to young adults (OR = 1.88, 95%CI 1.19, 2.98). When reporting a disability, longer job tenure was related to a 0.95 times lower odds of precarious work (OR = 0.95 95%CI 0.93, 0.98). The relationship between age and job tenure was not significant for those not reporting a disability.

Discussion

Precarious work has the potential to affect workers with and without disabilities. For those with a disability, being an older adult and/or a new worker can contribute to a greater likelihood of being employed precariously. Policies and programs can be recommended to address precarious working conditions and related health inequities for people with disabilities based on life and career phase.
Stigma and HIV service access among transfeminine and gender diverse women in South Africa – a narrative analysis of longitudinal qualitative data from the HPTN 071 (PopART) trial
Authors:   on behalf of the HPTN 071 (PopART) study team, de Villiers Laing , Thomas Angelique , Jivan Dionne , Hoddinott Graeme , Hargreaves James R. , Bond Virginia , Stangl Anne , Bock Peter , Reynolds Lindsey
Published: December 2020

Background

Transgender women have a disproportionately high HIV prevalence compared to cisgender women and men who have sex with men, which puts them at risk of HIV-related stigma (Baral SD et al., Lancet Infect Dis, 13;3, 2013). People whose gender identities are in tension with dominant social norms (including transgender women) often also experience gender identity-related stigma. There has been increasing attention to transgender people in HIV research and interventions. However, very little research has been done in sub-Saharan African countries.

Methods

We conducted a qualitative cohort study which included eight transfeminine and/or gender diverse women (four living with HIV) in Western Cape, South Africa, for a follow-up period of 12–18 months. Using a narrative analysis approach, we set out to understand how transfeminine and gender diverse participants in the cohort anticipated, experienced and internalised HIV stigma and gender identity stigma, and how these stigmas affected HIV service access.

Result

We found that participants reported anticipated, experienced, and internalised stigma relating both to their gender identity and to living with HIV. Participants reported inconsistent uptake of antiretroviral therapy (ART) services (including ART initiation and adherence) that they linked to stigma. We also found that gender diverse women and transfeminine women are challenged with other stigmatising social identities, like being a sex worker, drug user and/or a man (or assigned male sex at birth) who have sex with men (MSM). We use the terms ‘transfeminine’ and ‘gender diverse’ as terms that are inclusive of gender variant people who were all assigned male sex at birth and identify as women in some or all aspects of their lives. The persons in our study also showed gender identifications that were fluid and sometimes varied in different contexts and situations, therefore gender identity and sexual identity were often conflated for these individuals. Participants managed high levels of reported stigma by drawing on social support networks like families, friends and peers.

Conclusion

Our study provides exploratory work on how stigma may affect HIV services uptake amongst gender diverse women and transfeminine women in South Africa. We recommend future studies to further explore the unique HIV risks of gender diverse individuals.

Trial registration

DOH-27-0513-4253.
A longitudinal study investigating change in BMI z-score in primary school-aged children and the association of child BMI z-score with parent BMI
Authors: Mears R. , Salway R. , Sharp D. , Shield J. P. H. , Jago R.
Published: December 2020

Background

This paper aims to explore change in BMI z-score through childhood and the association between parent BMI and child BMI z-score. This is important to understand for the development of effective obesity interventions.

Methods

Data from the longitudinal B-ProAct1v study (1837 participants) were analysed. A paired sample t-test examined changes in child BMI z-score between Year 1 and 4. Multivariable linear regression models examined the cross-sectional associations between child BMI z-score and parent BMI in Year 1 and 4. The influence of change in parental BMI between Year 1 and Year 4 on child BMI z-score in Year 4 was explored through regression analyses, adjusted for baseline BMI z-score.

Results

There was a strong association between child BMI z-score at Year 1 and 4. Child mean BMI z-score score increased from 0.198 to 0.330 (p = < 0.005) between these timepoints. For every unit increase in parent BMI, there was an increase in child BMI z-score of 0.047 in Year 1 (p = < 0.005) and of 0.059 in Year 4 (p = < 0.005). Parental BMI change was not significantly associated with Year 4 child BMI z-score.

Conclusion

The key indicator of higher child BMI at Year 4 is high BMI at Year 1. Further studies are needed to explore the impact of parental weight change on child BMI z-score and whether interventions targeted at overweight or obese parents, can improve their child’s BMI z-score.
Parecoxib alleviates the inflammatory effect of leukocyte-rich platelet-rich plasma in normal rabbit tendons
Authors: Zhou Ming , Wang Ning , Wang Gang , Jia Zishan , Qi Xiaolei
Published: December 2020

Background

Platelet-rich plasma (PRP) is widely used to treat tendon injuries. Its therapeutic effect varies depending on the different cell components, and white blood cells (WBCs) may play an important role in this phenomenon. The purpose of this study was to evaluate how PRP with different concentrations of WBCs affect normal rabbit tendon and assess whether non-steroidal anti-inflammatory drugs (NSAIDs) can suppress the catabolic effects of WBCs.

Methods

Sixteen adult New Zealand White rabbits were used. Blood samples were collected from each rabbit, and PRP was extracted following two different protocols to obtain leukocyte-poor PRP (LP-PRP) and leukocyte-rich PRP (LR-PRP). LP-PRP or LR-PRP was injected into the patellar tendon of each rabbit, while normal saline (NS) was injected as control. In LR-PRP + NSAID group, Parecoxib was administered after LR-PRP injection. For each group, 2 rabbits were euthanatized at day 5 and 14. The patellar tendons were collected and stained with hematoxylin and eosin. A semi-quantitative approach was used to assess the inflammatory response and tendon destruction based on the evaluation of the WBCs, vascularization, fiber structure, and fibrosis.

Results

The LR-PRP group exhibited a higher total tendon score than the LP-PRP group at day 5 after PRP injection, but there was no significant difference between the two groups at day 14. For the NSAID group, the tendon score was lower than that of the LR-PRP group both at day 5 and 14.

Conclusion

LR-PRP can promote a higher inflammatory response than LP-PRP in the normal rabbit patellar tendon, and this effect can be suppressed by NSAIDs.
Arthroscopic-assisted reduction, bone grafting and screw fixation across the scapholunate joint for proximal pole scaphoid nonunion
Authors: Wang Jung-Pan , Huang Hui-Kuang , Shih Jui-Tien
Published: December 2020

Background

There are some difficulties in treating proximal scaphoid nonunion, mainly including poor vascularity of the proximal scaphoid fragment and limited space for a stable fixation in the proximal scaphoid fragment. This study reports the outcomes of treating proximal scaphoid nonunion with arthroscopic assist for reduction, bone grafting and screw fixation across the scapholunate (SL) joint.

Methods

Between 2008 and 2017, 21 patients were enrolled. Fracture healing and change in the lateral SL angle and SL gap were evaluated. Functional outcomes were evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH) score, wrist range of motion, grip strength, and the Visual Analog Scale (VAS) for pain.

Results

Nineteen patients achieved fracture healing and their mean follow-up duration was 31.3 months (24–120 months). The average fracture healing time was 16.3 weeks (10 to 28 weeks). From the preoperative to the postoperative final evaluation, there was some significant improvement in wrist function, including wrist flexion from 54.5oto 67.4o, wrist extension from 62.3oto 71.7o, DASH scores from 52.4 to 21.4, VAS during activity from 4.6 to 2.1, and grip strength from 9.6 kg to 24.7 kg. The lateral SL angle also improved significantly, from 82oto 66o. Seventeen patients requested screw removal after fracture healing because of their cultural belief in not leaving hardware in the body. No significant SL gap widening was noted after screw removal in the sequential follow-ups.

Conclusions

Using arthroscopic-assisted reduction, bone grafting and screw fixation across the SL joint in proximal scaphoid nonunion treatment, satisfactory functional and radiographic outcomes can be achieved.
Quality of life of patients living with psoriasis: a qualitative study
Authors: Meneguin Silmara , de Godoy Natália Aparecida , Pollo Camila Fernandes , Miot Hélio Amante , de Oliveira Cesar
Published: December 2020

Background

Psoriasis is a multifactorial inflammatory disease prevalent in dermatology. We aimed to understand the perceptions of patients living with psoriasis in relation to their quality of life and to identify aspects to improve it.

Methods

This is qualitative research carried out in a dermatology outpatient clinic of the São Paulo State University (UNESP) medical school, Botucatu, Brazil, with 81 psoriasis patients. The interviews were transcribed and analysed using the Discourse of the Collective Subject method (DCS).

Results

Quality of life was linked to well-being, happiness, leisure, good food and financial stability. However, disease symptoms, social and clothing restrictions, impairment of professional activities and the absence of a cure, negatively influenced their perceptions. Suggestions for improvements included an increase of public awareness, stress reduction, disease acceptance and multidisciplinary care.

Conclusion

The meanings of quality of life revealed by the participants are subjective, multidimensional, linked to moments experienced by them and to the health-disease process. Public health policies promoting reduction in social stigma and stress as well as multidisciplinary approaches towards care can contribute to improvements of QoL in psoriasis.
No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study
Authors:   the FRESH AIR collaborators, Kjærgaard Jesper , Nissen Thomas Nørrelykke , Isaeva Elvira , Quynh Nguyen Nhat , Reventlow Susanne , Lund Stine , Sooronbaev Talant , Le An Pham , Østergaard Marianne Stubbe , Stout Jim , Poulsen Anja
Published: December 2020

Background

Training is a common and cost-effective way of trying to improve quality of care in low- and middle-income countries but studies of contextual factors for the successful translation of increased knowledge into clinical change are lacking, especially in primary care.

The purpose of this study was to assess the impact of contextual factors on the effect of training rural healthcare workers in Kyrgyzstan and Vietnam on their knowledge and clinical performance in managing pediatric patients with respiratory symptoms.

Methods

Primary care health workers in Kyrgyzstan and Vietnam underwent a one-day training session on asthma in children under five. The effect of training was measured on knowledge and clinical performance using a validated questionnaire, and by direct clinical observations.

Results

Eighty-one healthcare workers participated in the training. Their knowledge increased by 1.1 Cohen’s d (CI: 0.7 to 1.4) in Kyrgyzstan where baseline performance was lower and 1.5 Cohen’s d (CI: 0.5 to 2.5) in Vietnam. Consultations were performed by different types of health care workers in Kyrgyzstan and there was a 79.1% (CI 73.9 to 84.3%) increase in consultations where at least one core symptom of respiratory illness was asked. Only medical doctors participated in Vietnam, where the increase was 25.0% (CI 15.1 to 34.9%). Clinical examination improved significantly after training in Kyrgyzstan. In Vietnam, the number of actions performed generally declined. The most pronounced difference in contextual factors was consultation time, which was median 15 min in Kyrgyzstan and 2 min in Vietnam.

Discussion and conclusion

The effects on knowledge of training primary care health workers in lower middle-income countries in diagnosis and management of asthma in children under five only translated into changes in clinical performance where consultation time allowed for changes to clinical practice, emphasizing the importance of considering contextual factors in order to succeed in behavioral change after training.
Airway immunometabolites fuel Pseudomonas aeruginosa infection
Authors: Riquelme Sebastián A. , Prince Alice
Published: December 2020

Pulmonary infections are associated with a brisk inflammatory reaction to bacterial surface components. Lipopolysaccharides (LPS) trigger macrophage activation and release of mitochondrial metabolites that control the intensity of the immune response. Whereas succinate induces oxidative stress (ROS), HIF1α stabilization, glycolysis and IL-1β release, itaconate suppresses inflammation by inhibiting succinate oxidation, glycolytic flux and promoting anti-oxidant Nrf2-HO-1 functions. P. aeruginosa is a major pathogen associated with acute and chronic lung infection. Although both secreted toxins, LPS and proteases are key factors to establish acute P. aeruginosa pneumonia, lack of these components in chronic P. aeruginosa isolates suggest these organisms exploit other mechanisms to adapt and persist in the lung. Upon inhalation, P. aeruginosa strains trigger airway macrophage reprograming and bacterial variants obtained from acutely and chronically infected subjects exhibit metabolic adaptation consistent with succinate and itaconate assimilation; namely, high expression of extracellular polysaccharides (EPS), reduced lptD-LPS function, increased glyoxylate shunt (GS) activity and substantial biofilm production. In this review we discuss recent findings illustrating how P. aeruginosa induces and adapts to macrophage metabolites in the human lung, and that catabolism of succinate and itaconate contribute to their formidable abilities to tolerate oxidative stress, phagocytosis and immune clearance.
Visit-to-visit variability of glycated albumin was associated with incidence or progression of lower extremity atherosclerotic disease
Authors: Shen Yun , Dai Dongjun , Lu Jingyi , Wang Yufei , Zhu Wei , Bao Yuqian , Hu Gang , Zhou Jian
Published: December 2020

Background

The aim of this study was to investigate the association of visit-to-visit variability of hemoglobin A1c (HbA1c) and glycated albumin (GA) with the risk of lower extremity atherosclerotic disease (LEAD).

Method

We performed a prospective cohort study of 436 patients with type 2 diabetes (258 men and 178 women) with at least 3 measurements of HbA1c and GA prior to baseline investigation from the Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital. Different HbA1c and GA variability markers were calculated. Multivariable Cox proportional hazard regression models were used to demonstrate the association between visit-to-visit HbA1c and GA variability and the risk of incident or progressive LEAD.

Results

During a mean follow-up period of 3.77 years, 112 participants developed LEAD. Multivariate-adjusted hazard ratios (HRs) of LEAD across tertiles of GA-CV values were 1.00, 1.06 (95% confidence interval [CI] 0.65–1.75), and 1.71 (95% CI 1.07–2.73) (P for trend = 0.042), respectively. When we used GA-VIM and GA-ARV values as exposures, similar positive associations with the risk of LEAD primary were found. Multivariate-adjusted HRs of LEAD for each 1 unit increase in GA-CV, GA-VIM and GA-ARV were 1.03 (95% CI 1.01–1.06), 1.32 (95% CI 1.03–1.69), and 1.07 (95%CI 1.01–1.15), respectively. However, there was no significant association between visit-to-visit variability of HbA1c and the risk of LEAD.

Conclusions

Visit-to-visit variability of GA may be an optimal biomarker in relation to LEAD risk among patients with type 2 diabetes.
Expressing a cytosolic pyruvate dehydrogenase complex to increase free fatty acid production in Saccharomyces cerevisiae
Authors: Zhang Yiming , Su Mo , Qin Ning , Nielsen Jens , Liu Zihe
Published: December 2020

Background

Saccharomyces cerevisiae is being exploited as a cell factory to produce fatty acids and their derivatives as biofuels. Previous studies found that both precursor supply and fatty acid metabolism deregulation are essential for enhanced fatty acid synthesis. A bacterial pyruvate dehydrogenase (PDH) complex expressed in the yeast cytosol was reported to enable production of cytosolic acetyl-CoA with lower energy cost and no toxic intermediate.

Results

Overexpression of the PDH complex significantly increased cell growth, ethanol consumption and reduced glycerol accumulation. Furthermore, to optimize the redox imbalance in production of fatty acids from glucose, two endogenous NAD+-dependent glycerol-3-phosphate dehydrogenases were deleted, and a heterologous NADP+-dependent glyceraldehyde-3-phosphate dehydrogenase was introduced. The best fatty acid producing strain PDH7 with engineering of precursor and co-factor metabolism could produce 840.5 mg/L free fatty acids (FFAs) in shake flask, which was 83.2% higher than the control strain YJZ08. Profile analysis of free fatty acid suggested the cytosolic PDH complex mainly resulted in the increases of unsaturated fatty acids (C16:1 and C18:1).

Conclusions

We demonstrated that cytosolic PDH pathway enabled more efficient acetyl-CoA provision with the lower ATP cost, and improved FFA production. Together with engineering of the redox factor rebalance, the cytosolic PDH pathway could achieve high level of FFA production at similar levels of other best acetyl-CoA producing pathways.
Strengthening social accountability in ways that build inclusion, institutionalization and scale: reflections on FHS experience
Authors: Bennett Sara , Ekirapa-Kiracho Eizabeth , Mahmood Shehrin Shaila , Paina Ligia , Peters David H.
Published: December 2020

This editorial provides an introduction to the special issue on “Lessons about intervening in accountability ecosystems: implementation of community scorecards in Bangladesh and Uganda”. We start by describing the rationale for this work in the two study countries. While our project, the Future Health Systems (FHS) project, had been working over the course of more than a decade to strengthen health services, particularly for low income households in rural areas, our teams increasingly recognized how difficult it would be to sustain service improvements without fundamental changes to local accountabilities. Accordingly, in the final phase of the project 2016–2018, we designed, implemented and assessed community scorecard initiatives, in both Bangladesh and Uganda, with the aim of informing the design of a scalable social accountability initiative that could fundamentally shift the dynamics of health system accountability in favor of the poor and marginalized.

We describe the particular characteristics of our approach to this task. Specifically we (i) conducted a mapping of accountabilities in each of the contexts so as to understand how our actions may interact with existing accountability mechanisms (ii) developed detailed theories of change that unpacked the mechanisms through which we anticipated the community scorecards would have effect, as well as how they would be institutionalized; and (iii) monitored closely the extent of inclusion and the equity effects of the scorecards. In summarizing this approach, we articulate the contributions made by different papers in this volume.
Ease and equity of access to free DR-TB services in Nigeria- a qualitative analysis of policies, structures and processes
Authors: Oga-Omenka Charity , Bada Florence , Agbaje Aderonke , Dakum Patrick , Menzies Dick , Zarowsky Christina
Published: December 2020

Introduction

Persistent low rates of case notification and treatment coverage reflect that accessing diagnosis and treatment for drug-resistant tuberculosis (DR-TB) in Nigeria remains a challenge, even though it is provided free of charge to patients. Equity in health access requires availability of comparable, appropriate services to all, based on needs, and irrespective of socio-demographic characteristics. Our study aimed to identify the reasons for Nigeria’s low rates of case-finding and treatment for DR-TB. To achieve this, we analyzed elements that facilitate or hinder equitable access for different groups of patients within the current health system to support DR-TB management in Nigeria.

Methods

We conducted documentary review of guidelines and workers manuals, as well as 57 qualitative interviews, including 10 focus group discussions, with a total of 127 participants, in Nigeria. Between August and November 2017, we interviewed patients who were on treatment, their treatment supporter, and providers in Ogun and Plateau States, as well as program managers in Benue and Abuja. We adapted and used Levesque’s patient-centered access to care framework to analyze DR-TB policy documents and interview data.

Results

Thematic analysis revealed inequitable access to DR-TB care for some patient socio-demographic groups. While patients were mostly treated equally at the facility level, some patients experienced more difficulty accessing care based on their gender, age, occupation, educational level and religion. Health system factors including positive provider attitudes and financial support provided to the patients facilitated equity and ease of access. However, limited coverage and the absence of patients’ access rights protection and considerations in the treatment guidelines and workers manuals likely hampered access.

Conclusion

In the context of Nigeria’s low case-finding and treatment coverage, applying an equity of access framework was necessary to highlight gaps in care. Differing social contexts of patients adversely affected their access to DR-TB care. We identified several strengths in DR-TB care delivery, including the current financial support that should be sustained. Our findings highlight the need for government’s commitment and continued interventions.
Quality of life 10 years after cardiac surgery in adults: a long-term follow-up study
Authors: Vincelj Josip , Bitar Lela
Published: December 2020

We have read the article titled „Quality of life 10 years after cardiac surgery in adults: a long-term follow-up study “ by Perrotti A. et al. published in your distinguished journal with great interest. Unfortunately, we found few errors in this article.
Gray matter volume alterations associated with suicidal ideation and suicide attempts in patients with mood disorders
Authors: Wang Pengshuo , Zhang Ran , Jiang Xiaowei , Wei Shengnan , Wang Fei , Tang Yanqing
Published: December 2020

Background

Mood disorders are severe mental disorders related to increased suicidal behavior. Finding neural features for suicidal behavior, including suicide attempts (SAs) and suicidal ideation (SI), in mood disorders may be helpful in preventing suicidal behavior.

Methods

Subjects consisted of 70 patients with mood disorders and suicidal behavior, 128 patients with mood disorders without suicidal behavior (mood disorders control, MC), and 145 health control (HC) individuals. All participants underwent structural magnetic resonance imaging (MRI). We used voxel-based morphometry (VBM) techniques to examine gray matter volumes (GMVs).

Results

Significant differences were found in GMVs of the left and right middle frontal gyrus among the patients with mood disorders and suicidal behavior, MC, and HC. Post hoc comparisons showed significant differences in the GMVs of the above regions across all three groups (P < 0.01): HC > MC > mood disorders with suicidal behavior. However, there were no significant differences in the GMVs of the left and right middle frontal gyrus between the mood disorders with SI and mood disorders with SAs groups.

Conclusions

These findings provide evidence that abnormal regional GMV in the middle frontal gyrus is associated with suicidal behavior in mood disorders. Further investigation is warranted to determine whether the GMV alterations in mood disorders with SI are different from these in mood disorders with SAs.
Bio-sorption for effective removal of chromium(VI) from wastewater using Moringa stenopetala seed powder (MSSP) and banana peel powder (BPP)
Authors: Badessa Tolera Seda , Wakuma Esayas , Yimer Ali Mohammed
Published: December 2020

Chromium is an extremely toxic metal in the form of Cr(VI) that causes severe environmental and health problems. Therefore, the aim of this study was to remove chromium ions from wastewater by using cost effective and environmentally friendly bio-sorbents; Moringa stenopetala seed powder (MSSP), and banana peel powder (BPP) and to evaluate its adsorption capacities as bio-sorbents. FT-IR characterization of the adsorbents showed that there was a change in the functional groups of the structure of both adsorbents before and after the adsorption that might be due to the adsorption processes taken place on the surface of adsorbent. Adsorption experiments were carried out as batch studies with different contact times, pH, adsorbent dose, initial metal ion concentration, and temperature. Results showed maximum removal efficiency for Cr(VI) at 120 min contact time, adsorbent dose of 20 g/L and pH 2 by MSSP and pH 4 by BPP. The percentage removal of Cr(VI) increased with increasing adsorbent dose (from 5 to 20 g/L) and contact time (from 60 to 120 min). Freundlich isotherm model showed a better fit to the equilibrium data than the Langmuir model. The kinetics of adsorption for chromium was well represented by pseudo-second order kinetic model and the calculated equilibrium sorption capacity of the model showed good agreement with the sorption capacity obtained from experimental results.