bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender-specific typologies of older adults’ sedentary behaviors and their associations with health-related and socio-demographic factors: a latent profile analysis
Authors: Compernolle Sofie , De Bourdeaudhuij Ilse , Cardon Greet , Dyck Delfien Van
Published: November 2020

Background. Some types of sedentary behaviors tend to cluster in individuals or groups of older adults. Insight into how these different types of sedentary behavior cluster is needed, as recent research suggests that not all types of sedentary behavior may have the same negative effects on physical and mental health. Therefore, the aim of this study was to identify gender-specific typologies of older adults’ sedentary behavior, and to examine their associations with health-related and socio-demographic factors. Methods. Cross-sectional data were collected as part of the BEPAS Seniors, and the Busschaert study among 696 Flemish older adults (60+). Typologies of self-reported sedentary behavior were identified using latent profile analysis, and associations with health-related and sociodemographic factors were examined using analyses of variances. Results. Five distinct typologies were identified from seven sedentary behaviors (television time, computer time, transport-related sitting time, sitting for reading, sitting for hobbies, sitting for socializing and sitting for meals) in men, and three typologies were identified from six sedentary behaviors (television time, transport-related sitting time, sitting for reading, sitting for hobbies, sitting for socializing and sitting for meals) in women. Typologies that are characterized by high television time seem to be related to more negative health outcomes, like a higher BMI, less grip strength, and a lower physical and mental health-related quality-of-life. Typologies that are represented by high computer time and motorized transport seem to be related to more positive health outcomes, such as a lower body mass index, more grip strength and a higher physical and mental health-related quality-of-life.Conclusions. Although causal direction between identified typologies and health outcomes remains uncertain, our results suggests that future interventions should better focus on specific types of sedentary behavior (e.g. television time), or patterns of sedentary behavior, rather than on total sedentary behavior.
Reduced translation efficiency due to novel splicing variants in 5′ untranslated region and identification of novel cis-regulatory elements in canine and human BRCA2
Authors: Yoshikawa Yasunaga , Kozuma Hajime , Morimatsu Masami , Sugawara Kaori , Orino Koichi
Published: November 2020

Background: Breast cancer 2, early onset (BRCA2) is a tumor suppressor gene. The protein encoded by this gene plays an important role in homologous recombination (HR)-mediated DNA repair. Deleterious mutations in BRCA2 and downregulation of its expression have been associated with tumorigenesis in dogs and humans. Thus, regulation of BRCA2 expression level is important for maintaining homeostasis in homologous recombination.Results: In this study, the mechanisms that regulate the expression of BRCA2 were proposed. Novel splicing variants were identified in the 5′ untranslated region (UTR) of canine and human BRCA2 in canine testis, canine ovary, and canine and human cultured cell lines. In cultured cells, the ratio of BRCA2 splicing variants at the 5′ UTR was altered by serum starvation. These novel splicing variants, excluding one of the canine splicing variants, were found to reduce the translational efficiency. Additionally, the DNA sequence in human BRCA2 intron 1 harbored novel cis-regulatory elements. Three silencer and two enhancer cis-regulatory elements were identified in human BRCA2 intron 1.Conclusions: This study demonstrates that BRCA2 expression level is regulated via 5′ UTR splicing variants and that the BRCA2 intron 1 region harbors cis-regulatory elements.
COVID-19 in Northeast Bosnia and Herzegovina and Patient’s Length of Hospitalization
Authors: Trnacevic Alma , Mujkanovic Amer , Al-Salloum Noura , Sakusic Amra , Trnacevic Emir , Jusufovic Emir , Hukic Fatima , Jahic Rahima , Stratton Richard
Published: November 2020

Background Since the outbreak of COVID-19 pandemic, clinical data from various parts of the world have been reported. Until now, there has been no clinical data with regards to COVID-19 from Bosnia and Herzegovina (B&H). The aim was to report on the first cohort of patients from B&H and to analyze clinical factors of COVID-19 patients that have influenced the length of hospitalization (LOH) of COVID-19 infected patients.Methods This retrospective cohort study was conducted at Tuzla University Clinical Center (UKC). It included 25 COVID-19 positive patients that were hospitalized between March 28th and April 27th 2020. The LOH was measured from the time of admission to discharge. Factors analyzed induced age, BMI, presence of known comorbidities, serum creatinine and O2 saturation upon admission.Results The mean age was 52.92±19.15 years and BMI 28.80±4.22. LOH for patients with BMI <25 was 9± SE2.646 days (CI 95% 3.814-14.816) vs 14.182 ±SE .937 (CI 95% 12.346-16.018 p<0.05; HR 5.148 CI95% 1.217 to 21.772 p=0.026) for ≥25 BMI. The mean LOH of patients with normal levels of O2 ≥95% was 11.667 ±SE1.202 (CI95% 8.261 to 13.739; p=0.046), while LOH for patients with <95% was 14.625 ±SE 1.231 CI95% 12.184 to 16.757 p=0.042; HR 3.732 CI95%1.137-12.251 p=0.03). Patients without known comorbidities had a mean LOH of 11.700± SE1.075 (CI 95% 9.592-13.808), while those with comorbidities had a mean of 14.8±1.303 (CI 95% 12.247-17.353; p=0.029) with HR2.552Conclusion LOH varied among COVID-19 patients and was prolonged when clinical characteristics such as BMI, known comorbidities, elevated creatinine, and O2 saturation <95% were present. Furthermore, risk factors for COVID-19 patients in B&H do not deviate from those reported in other countries.
Predicting EQ-5D-5L crosswalk from the PROMIS-29 profile for the United Kingdom, France, and Germany
Authors: Klapproth Christoph Paul , Bebber Jan van , Sidey-Gibbons Christopher J. , Valderas Jose M , Leplege Alain , Rose Matthias , Fischer Felix
Published: November 2020

Background: EQ-5D health state utilities (HSU) are commonly used in health economics to compute quality-adjusted life years (QALYs). The EQ-5D, which is country-specific, can be derived directly or by mapping from self-reported health-related quality of life (HRQoL) scales such as the PROMIS-29 profile. The PROMIS-29 from the Patient Reported Outcome Measures Information System is a comprehensive assessment of self-reported health with excellent psychometric properties. We sought to find optimal models predicting the EQ-5D-5L crosswalk from the PROMIS-29 in the United Kingdom, France, and Germany and compared the prediction performances with that of a US model.Methods: We collected EQ-5D-5L and PROMIS-29 profiles and three samples representative of the general populations in the UK (n=1,509), France (n=1,501), and Germany (n=1,502). We used stepwise regression with backward selection to find the best models to predict the EQ-5D-5L crosswalk from all seven PROMIS-29 domains. We investigated the agreement between the observed and predicted EQ-5D-5L crosswalk in all three countries using various indices for the prediction performance, including Bland-Altman plots to examine the performance along the HSU continuum.Results: The EQ-5D-5L crosswalk was best predicted in France (nRMSEFRA = 0.075, nMAEFRA = 0.052), followed by the UK (nRMSEUK = 0.076, nMAEUK = 0.053) and Germany (nRMSEGER = 0.079, nMAEGER = 0.051). The Bland-Altman plots show that the inclusion of higher-order effects reduced the overprediction of low HSU scores.Conclusions: Our models provide a valid method to predict the EQ-5D-5L crosswalk from the PROMIS-29 for the UK, France, and Germany.
An Assessment of Heatwave Impact in Enugu Metropolis of Enugu State
Authors: Agu Christian Chijioke , Amarachi Ikwuka , Tukur Kamila , Omede Hassan , Nwadike Blessing Kakushia
Published: November 2020

Background: The context of this research the impact of heatwave within Enugu city center, with the aim to analyze the impact in the city metropolis of Enugu state which comprises of three local government areas namely Enugu East Enugu North and Enugu South.Result: From the result, our findings showed the increase in lst over the period of years and over 50% inhabitants feel discomfort, while the vegetation index reduced in year 2020.Conclusion: The summary of the research looked at the change detection, NDVI, LST, and thermal comfortablity index, the potential implication of the result shows that heatwave impact is more felt in the study area and, the city will become more hotter in the near future thereby making it unfavourable and un comfortable for people to live or habit.
The Impact of COVID-19 Pandemic on Dental Practice in Iran: A questionnaire-based report
Authors: Ahmadi Hanie , Ebrahimi Alireza , Ghorbani Farhad
Published: November 2020

Background: The highly contagious nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), besides the fact that dental procedures commonly generate blood and saliva droplets that could lead to the contagion have resulted in the closure of many dental clinics. In the present study, we aimed to evaluate the impact of coronavirus disease 2019 (COVID-19) pandemic on dental practice by conducting an online questionnaire among the Iranian dental practitioners and finding their perspectives on the subject.Methods: This report is based on a questionnaire that was conducted among Iranian dentists. The survey included questions that evaluate the dentists’ perceptions and attitudes toward the COVID-19 pandemic and its effect on their personal life, financial status, and the quality of dental services for patients.Results: Overall, 240 dentists contributed to this study (214 general dentists and 26 specialists). The majority of the participants (n=170, 70%) did not perform non-emergency procedures during the pandemic. The dental practitioners have suggested several strategies to decrease the risk of contagion, such as reducing treatment sessions (n=90, 37%), strict triage of patients (n=156, 64%), and using personal protective equipment (n=108, 45%). However, most of the dentists (n=210, 87%) had problems, providing personal protective equipment during the pandemic. Moreover, 97% (n=234) of the participants reported that they encountered a decrease in their financial income since the eruption of the pandemic.Conclusion: Dental health care workers are at the highest risk of contracting COVID-19. Thus, dental practitioners ought to execute the standard protocols more cautiously during the pandemic. They could also lower their work hours and limit dental procedures to emergency treatments to reduce the risk of COVID-19 transmission. Besides, the public organizations should provide proper equipment for the dental practitioners to decrease the risk of contagion.
Data quality of the routine health management information system at the primary healthcare facility and district levels in Tanzania
Authors: RUMISHA SUSAN F. , LYIMO EMANUEL P. , MREMI IRENE R. , TUNGU PATRICK K. , MWINGIRA VICTOR S. , MBATA DORIS , MALEKIA SIA E. , JOACHIM CATHERINE , Mboera Leonard
Published: November 2020

Background: Effective planning for disease prevention and control requires accurate, adequately-analysed, interpreted and communicated data. In recent years, efforts have been put in strengthening health management information systems (HMIS) in Sub-Saharan Africa to improve data accessibility to decision-makers. This study assessed the quality of routine HMIS data at primary healthcare facility (HF) and district levels in Tanzania. Methods: This cross-sectional study involved reviews of documents, systems and databases, and collection of primary data from facility registers, tally sheets and monthly summary reports. Thirty-four indicators from Outpatient, Inpatient, Antenatal care, Family Planning, Post-natal care, Labour and Delivery, and Provider-Initiated Testing and Counselling service areas were assessed. Indicator records were tracked and compared across the process of data collection, compilation and submission to the district office. Monthly report forms submitted by facilities to the district were also reviewed. The availability and utilization of HMIS tools were assessed, while completeness and data accuracy levels were quantified for each phase of the reporting system. Results: A total of 115 HFs (including hospitals, health centres, dispensaries) in 11 districts were involved. Registers (availability rate=91.1%; interquartile range (IQR):66.7%-100%) and report forms (86.9%; IQR:62.2%-100%) were the most utilized tools. There was a limited use of tally-sheets (77.8%; IQR:35.6%-100%). Tools availability at the dispensary was 91.1%, health centre 82.2% and hospital 77.8%. The availability rate at the district level was 65% (IQR:48%-75%). Wrongly filled or empty cells in registers and poor adherence to the coding procedures were observed. Reports were highly over-represented in comparison to registers’ records, with large differences observed at the HF phase of the reporting system. The OPD and IPD areas indicated the highest levels of mismatch between data source and district office. Indicators with large number of clients, multiple variables, disease categorization, or those linked with dispensing medicine performed poorly. Conclusion: There are high variations in the tool utilisation and data accuracy at facility and district levels. The routine HMIS is weak and data at district level inaccurately reflects what is available at the source. These results highlight the need to design tailored and inter-service strategies for improving data quality.
Analysis of Anxiety-Related Factors amongst Frontline Dental Staff during the COVID-19 Pandemic in Yichang, China
Authors: Zhao Suli , Cao Jing , Sun Rongcan , Zhang Lin , Liu Beibei
Published: November 2020

Background: Dental staff were characterized with the tolerance of enduring stress and they are at a high risk to respiratory infectious disease. This study compared the anxiety level of the frontline dental staff (FDS) to the general public in Yichang during the coronavirus disease of 2019 (COVID-19) pandemic and examined potential explanatory factors to the differences.Methods: Two online questionnaires were used separately to collect data from FDS and the general public. The Chinese version of Beck Anxiety Inventory (BAI) was included for the assessment of anxiety. Firstly, a Chi-square test was conducted to compare the anxiety state between these two groups. Then, a bivariate analysis using Cramer’s V and Eta squared was conducted to find the potential factors. Lastly, a binary logistic regression was performed to examine the association between potential factors and the anxiety state of FDS.Results: In general, FDS were 4.342 (95% CI: 2.427-7.768) times more likely to suffer from anxiety disorders than the general public. The bivariate analysis showed that age, Level Three Protective Measures (PM-3), conflicts with patients and/or colleagues were moderately associated with the anxiety state of FDS. But the knowledge of COVID-19, the treatment to suspected or confirmed cases both had a weak association with the anxiety among FDS. Conversely, workload, the exposure to potential infectious substance and conducting aerosol generated performance were not significantly related to the anxiety of FDS. As the model indicated, an elder age and PM-3 protective measures could lower the anxiety state of FDS, whereas the conflict with patients or/and colleagues would worsen it.Conclusions: During the COVID-19 pandemic, FDS were more likely to suffer from anxiety disorders than the general public. An elder age, sufficient personal protective measures and good relationships with colleagues and patients would help them to maintain good mental health.
Wear of feldspathic-ceramic-veneered zirconia posterior FPDs after 10 years
Authors: Matta Ragai Edward , Motel Constantin , Kirchner Elena , Stelzer Simon , Adler Werner , Wichmann Manfred , Berger Lara
Published: November 2020

Background: The abrasion behavior of various ceramics is rarely investigated, though it is relevant for the clinical success of such restorations. The aim of this in vivo study was to evaluate the wear of feldspathic-ceramic-veneered zirconium oxide frameworks over a period of at least 10 years.Methods: The abrasion behavior of 15 bridge constructions from 15 different participants was examined after a period of 3, 5, and 10 years using plaster models, which were then subjected to a scanning process on the Atos II industrial scanner and digitized for three-dimensional evaluation of the abrasion by the corresponding software (ATOS Professional 7.6). The individual post-examination models were compared to the baseline model and deviations calculated in the sense of the largest, punctual loss of material in millimeters ("minimal distance"), the average abrasion in millimeters ("mean distance"), and the volume decrease in cubic millimeters ("integrated distance"). Statistical analyses were performed using the Wilcoxon sign rank test or mixed regression models. Multiple testing was considered by Benjamini-Hochberg correction. The significance level was set at 0.05.Results: We found steadily increasing wear of the ceramic. The average volume decrease was significant (P < 0.001) at 3 years and 10 years (-3.25 mm3 and -8.11 mm3, respectively).Conclusions: The results of this study indicate that the rate of volume loss in feldspathic-ceramic-veneered zirconia frameworks in the posterior region increases significantly over time. An increasing frequency of parameters was observed, particularly in the second half of the study period. However, the use of this class of materials can be considered clinically acceptable.This study is registered in DRKS - German Clinical Trials Register with the register number 00021743.
Choroidal Alterations of Sturge-Weber Syndrome Secondary Glaucoma and Non-glaucoma Port-wine Stain Patients Distinguished by Enhanced Depth Imaging Optical Coherence Tomography
Authors: Wu Yue , Huang Lulu , Liu Yixin , Xu Li , Guo Wenyi
Published: November 2020

Background: To evaluate the choroidal changes in Sturge-Weber syndrome (SWS) secondary glaucoma and non-glaucoma port-wine stain (PWS) patients by enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: SWS and PWS patients who were over 3 years old and treated or screened at our ophthalmology department were included in the study. Baseline demographics, EDI-OCT and fundus photography data were collected from all patients. Results: Forty-six non-glaucoma PWS (NGPWS) patients and 35 SWS secondary glaucoma(SG)patients were included, with mean ages of 16.52±13.63 and 13.94±8.27 years, respectively (p>0.05). Among these patients, 2 exhibit bilateral PWS and unilateral glaucoma. Thus the two eyes of each person were divided into NGPWS group and SG group respectively. Twenty-one eyes had choroidal hemangiomas and 7 eyes had excessive thickening of the choroid without choroidal hemangiomas. Choroidal hemangiomas were only observed in ipsilateral eyes of SG patients. The choroidal thicknesses of the ipsilateral and contralateral eyes of NGPWS patients were 358.10±117.40 μm (45 eyes) and 288.20±79.04 μm (41 eyes), respectively (p<0.05). The choroidal thicknesses of the ipsilateral and contralateral eyes of SG patients were 511.40±242.10 μm (15 eyes) and 283.90±92.27 μm (29 eyes), respectively (p<0.05). Significant differences were found between the ipsilateral eyes of SWS and PWS patients (p<0.05). Six of 13 eyes (46%) with choroidal hemangiomas exhibited post-operative posterior segment complications. Conclusions: Non-glaucoma PWS and SWS secondary glaucoma patients had a thicker choroid in the ipsilateral eye. The trend was even more pronounced in SWS secondary glaucoma patients. Choroidal hemangiomas were only found in the ipsilateral eyes of SG. In addition, choroidal hemangioma was a risk factor for post-operative posterior segment complications in SWS patients.
Relationship between insulin sensitivity and gene expression in human skeletal muscle
Authors: Parikh Hemang , Elgzyri Targ , Alibegovic Amra , Hiscock Natalie , Ekström Ola , Eriksson Karl-Fredrik , Vaag Allan , Groop Leif , Ström Kristoffer , Hansson Ola
Published: November 2020

Background: Insulin resistance in skeletal muscle is a key feature of the pre-diabetic state, hypertension, dyslipidemia, cardiovascular diseases and also predicts type 2 diabetes. However, the underlying molecular mechanisms are still poorly understood. Methods: To explore these mechanisms, we related global skeletal muscle gene expression profiling of 38 non-diabetic men to a surrogate measure of insulin sensitivity, i.e. homeostatic model assessment of insulin resistance (HOMA-IR). Results: We identified 70 genes positively and 110 genes inversely correlated with insulin sensitivity in human skeletal muscle, identifying autophagy-related genes as positively correlated with insulin sensitivity. Replication in an independent study of 9 non-diabetic men resulted in 10 overlapping genes that strongly correlated with insulin sensitivity, including SIRT2, involved in lipid metabolism, and FBXW5 that regulates mammalian target-of-rapamycin (mTOR) and autophagy. The expressions of SIRT2 and FBXW5 were also positively correlated with the expression of key genes promoting the phenotype of an insulin sensitive myocyte e.g. PPARGC1A. Conclusions: These data suggest that activation of genes involved in lipid metabolism, e.g. SIRT2, and genes regulating autophagy and mTOR signaling, e.g. FBXW5, are associated with increased insulin sensitivity in human skeletal muscle, reflecting a highly flexible nutrient sensing.
Adherence to personal protective equipment use among healthcare workers caring for confirmed COVID-19 and alleged non-COVID-19 patients
Authors: Neuwirth Meike Maria , Mattner Frauke , Otchwemah Robin
Published: November 2020

Adherence observations of health care workers (HCW) revealed deficiencies in the use of recommended personal protective equipment (PPE) among HCW caring in COVID-19 and non-COVID-19 wards during the first period of the SARS-CoV-2 pandemic in a university hospital in Germany. The adherence to wearing surgical face or FFP2-masks and disinfecting hands prior to donning and after doffing the PPE was significantly higher in COVID-19 wards However, there was no total adherence of 100 per cent in COVID-19 wards.
Age-related changes in postural control in older women: transitional tasks in step initiation
Authors: Michalska Justyna , Kamieniarz Anna , Sobota Grzegorz , Stania Magdalena , Juras Grzegorz , Słomka Kajetan J
Published: November 2020

Background: Aging, being a natural process, involves many functional and structural changes within the body. Identifying the age-related postural changes will provide insight into the role of aging on postural control during locomotion. The aim of this study was to identify age-related postural changes during a transitional task under different conditions.Methods: Sixty healthy females divided into three age groups: A (50-60 y/o), B (60-70 y/o), and C (70-80 y/o). The transitional task was measured by two force platforms. The procedure consisted of three phases: quiet standing, transfer onto a second platform, and quiet standing on the second platform. Four different conditions were applied: unperturbed transfer, obstacle crossing, step-up, and step-down. Double-support time, transit time, and stability time before and after the step task were analyzed.Results: The transit time was longer by 30% for subjects over 70 y/o. The double-support time was longer by 11% among adults 60-70 y/o, while in people over 70 y/o it was longer by almost 50% compared to the 50-60 y/o subjects. The stability time before the transitional task was longer by 17% among adults over 60 y/o compared to middle-age subjects. The stability times before and after the transitional task were longer for adults in the 50-60 y/o category. Conclusion: The proposed procedure is adequate for assessing age-related changes in postural control while undergoing a transitional task. An analysis of the double-support time and stability time before and after the step task enabled the detection of early signs of balance changes in middle-age adults. Independent of age, the transitional task parameters changed with the increasing difficulty of the tasks.
Rice farming care as a novel method of green care farm in East Asian context: an implementation research
Authors: Ura Chiaki , Okamura Tsuyoshi , Yamazaki Sachiko , Shimmei Masaya , Torishima Keisuke , Eboshida Akira , Kawamuro Yu
Published: November 2020

BackgroundGreen care farms, which offer care for people with dementia in a farm setting, have been emerging in the Netherlands. The aim of this study was to 1) implement green care farms which use rice farming in Japan, 2) explore the positive experiences of rice farming care, and 3) compare the effect of rice farming care to that of usual care on well-being and cognitive ability. MethodsWe developed a new method of green care farm in Japan which uses rice farming, a farming that is practiced all over East Asia. The participants were 15 people with dementia (mean age = 75.6±9.8 years) who participated in a one-hour rice farming care program once a week for 25 weeks. We also collected qualitative data on the positive experiences of study participants after the program. As a reference data, we also collected the corresponding data of the usual care group which included 14 people with dementia (mean age = 79.9±5.8 years) who were attending the near-by day-care.ResultsThe mean participation rate on the rice farming care group was 72.1%. After the intervention, participants reported experiencing enjoyment and connection during the program. It also changed the staff’s view on dementia. The green care farm group showed a significant improvement in well-being but no significant difference in cognitive function compared to the usual care group. ConclusionsGreen care farms by using rice farming is promising care method which is evidence-based, empowerment-oriented, strengths-based, community-based dementia service, which also delivers meaningful experience for the people with dementia in East Asia.
‘I decided to go back to work so I can afford to buy her formula’: a longitudinal mixed-methods study to explore how women in informal work balance the competing demands of infant feeding and working to provide for their family. ﻿
Authors: Luthuli Silondile , Haskins Lyn , Mapumulo Sphindile , Rollins Nigel , Horwood Christiane
Published: November 2020

Background: In South Africa almost 2 million women work informally. Informal work is characterised by poor job security, low earnings, and unsafe working conditions, with high rates of poverty and food insecurity. The peripartum period is a vulnerable time for many working women. This study explored how mothers navigate the tension between the need to work and needing to take care of a newborn baby, and how this affects their feeding plans and practices. Methods: A mixed methods longitudinal cohort method was employed. Informal workers were recruited in the last trimester of pregnancy during an antenatal visit at two clinics in Durban, South Africa. Data were collected using in-depth interviews and quantitative questionnaires at three time points: pre-delivery, post-delivery and after returning to work. Framework analysis was used to analyse qualitative data in NVIVO v12.4. Quantitative analysis used SPSSv26. Results: Twenty-four participants were enrolled and followed-up for a period of up to one year. Informal occupations included domestic work, home-based work, informal trading, and hairdressing, and most women earned <R3000 (US$175) per month. Participants had good knowledge of the importance of breastfeeding for child health. Most women planned to take time off work after the birth of their babies, supporting themselves during this time with the child support grant (CSG) received for older children, their savings, and support from the baby’s father and other family members. However, financial pressures forced many mothers to return to work earlier than planned, resulting in changes to infant feeding practices. Several mothers tried expressing breastmilk, but only one was able to sustain this while away from the baby. Most participants introduced formula, other foods and fluids to their babies when they returned to work or stopped breastfeeding entirely, but some were able to change their work or adapt their working hours to accommodate breastfeeding. Conclusions: Interventions are needed within the social and work environment to support mothers with breastfeeding while they continue earning an income in the informal economy. The extension of the CSG to the antenatal period could assist mothers to stay at home longer post-delivery to breastfeed their babies.
Altered gut microbiota correlate with different immune response to HAART in HIV-infected individuals
Authors: Xie Yirui , Sun Jia , Wei Li , Jiang Haiyin , Hu Caiqin , Yang Jiezuan , Huang Ying , Ruan Bing , Zhu Biao
Published: November 2020

Background: Although gut microbiota dysbiosis has been reported in HIV infected individuals recently, the relationship between the gut microbiota and immune activation in patients with different immune responses to highly active antiretroviral therapy (HAART) is still not well understood. Gut microbiota and immune activation were studied in 36 non-HIV-infected subjects (healthy controls) and 58 HIV-infected individuals, including 28 immunological responders (IR) and 30 immunological non-responders (INR) (≥500 and <200 CD4+ T-cell counts/µl after 2 years of HIV-1 viral suppression respectively) without comorbidities. Results: Metagenome sequencing revealed that HIV-infected immunological responders and immunological non-responders could not recover completely from the gut microbiota dysbiosis. At a 97% similarity level, the relative abundances of Fusobacterium, Ruminococcus gnavus and Megamonas were greater, whereas Faecalibacterium, Alistipes, Bifidobacterium, Eubacterium rectale and Roseburia were more depleted in the IR and INR groups than those in the healthy controls. Ruminococcaceae and Alistipes were positively correlated with nadir and current CD4+ T-cell counts, but negatively correlated with CD8+CD57+ T-cell counts . Inflammation markers and translocation biomarkers (LPS) levels were positively correlated with the abundances of genus Ruminococcus and Fusobacterium but were negatively correlated with the genus Faecalibacterium . The relative abundances of Escherichia-Shigella and Blautia were significantly higher in the IR than those in the INR group. Escherichia-Shigella were negatively correlated with the CD4/CD8 ratio but positively correlated with the amount of C D8+CD57+ T-cells. Roseburia and Blautia were negatively associated with nadir CD4+ T-cell and positively associated with CD8+CD57+ T-cell counts. Conclusions: Gut microbiota dysbiosis may be one of the factors contributing to different immune responses and treatment outcomes to HAART.
Potential hemo-biological identification markers to the left displaced abomasum in dairy cows
Authors: Song Yuxiang , Loor Juan J , Zhao Chenchen , Huang Dan , Du Xiliang , Li Xiaobing , Wang Zhe , Liu Guowen , Li Xinwei
Published: November 2020

Background: Left displaced abomasum (LDA) occurs at high frequency in the early postpartum period and can affect production performance of dairy cows. Clinical diagnosis of LDA is usually done by abdominal auscultation and percussion. The purpose of this study was to explore the potential applicability of blood biomarkers for early warning and diagnosis of LDA in dairy cows.Results: Twenty early postpartum healthy cows and thirty early postpartum LDA cows of similar parity were used. A receiver operating characteristic curve (ROC) method was used to analyze the sensitivity of hematological biomarkers to LDA including energy balance metabolic biomarkers, liver/kidney function biomarkers, and minerals. A cut-off point was defined for each of the selected hematological biomarkers deemed sensitive markers of LDA. Compared with healthy cows, body condition score (BCS), dry matter intake (DMI) and milk production were lower in LDA cows. Among energy metabolism markers, serum non-esterified fatty acid (NEFA), β-hydroxybutyric acid (BHBA), insulin (INS), and revised quantitative insulin sensitivity check index (RQUICKI) levels were lower while serum glucagon (GC) was greater in LDA cows. Among the liver/kidney function biomarkers, activities of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), the ratio of AST/ALT and levels of total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), albumin (ALB), blood urea nitrogen (BUN), creatinine, and total protein (TP) were greater in LDA cows. Among minerals analyzed, serum Cl, Ca, and K were lower in LDA cows. After ROC analysis, it was determined that serum Ca, INS, RQUICKI, ALT, GGT, and creatinine are potential indicators for early warning and diagnosis of LDA for early postpartum dairy cows.Conclusions: Dairy cows with LDA were under severe negative energy balance (NEB), had signs of liver damage and potentially lower insulin sensitivity. A combination of multi-hematological biomarkers including Ca, INS, RQUICKI, ALT, GGT and creatinine has the potential to help identify cows at risk of LDA in the early postpartum period.
Clinical warning of hemophagocytic syndrome caused by Epstein-Barr virus
Authors: Shi Jinjin , Chu Chu , Yu Min , Zhang Dandan , Li Yuqin , Fan Yujie , Yu Yixue , Luo Yali , Zhou Wei-fang
Published: November 2020

Objectives: This study aimed to compare the clinical features and laboratory tests of infectious mononucleosis (IM) and hemophagocytic syndrome (HLH) caused by Epstein-Barr virus (EBV) in 1-3-year-old children and to explore the risk factor of HLH caused by EBV (EBV-HLH). Methods: The clinical data of 92 children with EBV infection admitted in our hospital from 2011 to 2019 were collected; 61 cases were diagnosed as EBV-IM, and 31 cases were diagnosed as EBV-HLH. The subjects’ clinical manifestations and laboratory tests were analyzed retrospectively. Results: Compared with EBV-IM patients, EBV-HLH patients had longer durations of fever, both before hospitalization and overall, and a higher probability of hepatomegaly. The levels of ALT, AST, LDH, TG, SF, D-Dimer and the plasma EBV DNA load of EBV-HLH patients were significantly higher than those of EBV-IM patients. The absolute values of CD3 + , CD4 + , CD8 + , NK, and CD3-CD19 + cells and IgA and IgM levels of EBV-HLH patients were significantly lower than those of EBV-IM patients. The plasma EBV DNA load was positively correlated with the PT, TT, α-HBDH, AST, LDH, CK, Scr, BUN, UA, TG, and CRP levels in EBV-HLH patients, and the plasma EBV DNA load was positively correlated with the D-Dimer level in the EBV-IM patients. Among the 10 different potential markers, at the cut-off point of 1721.500 µg/L, the sensitivity and specificity of D-Dimer was 88.90% and 90.20%, respectively. Conclusion: The D-Dimer level may be a good prognostic indicator of EBV-HLH caused by EBV.
Geospatial Analysis, Web-Based Mapping and Determinants of Prostate Cancer Incidence in Georgia Counties: Evidence from the 2012-2016 SEER Data.
Authors: Aheto Justice Moses Kwaku , Utuama Ovie A. , Dagne Getachew A.
Published: November 2020

Background: Prostate cancer (CaP) cases are high in the United States. According to the American Cancer Society, there are an estimated number of 174,650 CaP new cases in 2019. The estimated number of deaths from CaP in 2019 is 31,620, making CaP the second leading cause of cancer deaths among American men with lung cancer been the first. Our goal is to estimate and map prostate cancer relative risk, with the ultimate goal of identifying counties at higher risk where interventions and further research can be targeted. Methods: The 2012-2016 Surveillance, Epidemiology, and End Results (SEER) Program data was used in this study. Analyses were conducted on 159 Georgia counties. The outcome variable is incident prostate cancer. We employed a Bayesian geospatial model to investigate both measured and unmeasured spatial risk factors for prostate cancer. We visualised the risk of prostate cancer by mapping the predicted relative risk and exceedance probabilities. We finally developed interactive web-based maps to guide optimal policy formulation and intervention strategies. Results: Number of persons above age 65 years and below poverty, higher median family income, number of foreign born and unemployed were risk factors independently associated with prostate cancer risk in the non-spatial model. Except for the number of foreign born, all these risk factors were also significant in the spatial model with the same direction of effects. Substantial geographical variations in prostate cancer incidence were found in the study. The predicted mean relative risk was 1.20 with a range of 0.53 to 2.92. Individuals residing in Towns, Clay, Union, Putnam, Quitman, and Greene counties were at increased risk of prostate cancer incidence while those residing in Chattahoochee were at the lowest risk of prostate cancer incidence.Conclusion: Our results can be used as an effective tool in the identification of counties that require targeted interventions and further research by program managers and policy makers as part of an overall strategy in reducing the prostate cancer burden in Georgia State and the United States as a whole.
Morphological study of the vastus medialis oblique in recurrent patellar dislocation based on magnetic resonance images
Authors: Shu Lei , Yang Xu , He Hangyuan , Chen Biao , Chen Liaobin , Ni Qubo
Published: November 2020

Background: To investigate the morphological parameters of the vastus medialis obliquus (VMO) muscle and delineate its importance in the maintenance of patellofemoral joint stability.Methods: The magnetic resonance imaging (MRI) data of seventy-five knees (fifty-four patients) with recurrent lateral patella dislocation (LPD) and seventy-five knees (seventy patients) without recurrent LPD were retrospectively analysed. Five morphological parameters related to the VMO (elevation in the sagittal plane and coronal plane, craniocaudal extent, muscle-fibre angulation, cross-sectional area ratio) and two patella tilt parameters (patella tilt angle, bisect offset ratio) were measured in MR images. The independent-samples t test or chi-square test was used for statistical comparisons.Results: The mean ages of the patients in the recurrent LPD group and control group were 22.1 ± 9.9 years and 24.0 ± 6.5 years, respectively. Eighteen out of seventy-five (24%) patients MRI showed VMO injuries. Compared with the control group, the patients with recurrent LPD showed significantly higher sagittal VMO elevation (10.4 ± 2.3 mm vs 4.1 ± 1.9 mm), coronal VMO elevation (15.9 ± 5.7 mm vs 3.9 ± 3.7 mm), muscle-fibre angulation (35.4 ± 8.0° vs 27.9 ± 6.3°), patella tilt angle (25.9 ± 10.7° vs 9.1 ± 5.2°), and bisect offset ratio values (0.9 ± 0.3 vs 0.5 ± 0.1) and significantly lower craniocaudal extent (13.7 ± 5.3 mm vs 16.7 ± 5.1 mm) and cross-sectional area ratio values (0.05 ± 0.02 vs 0.07 ± 0.02).Conclusions: The results showed that abnormalities in the VMO and patella tilt were clearly present in recurrent LPD patients compared with normal people.
Safety and family satisfaction of a home-delivered chemotherapy program for children with cancer
Authors: De Zen Lucia , Rizzo Irene Del , Ronfani Luca , Barbieri Francesca , Rabusin Marco , Dall’Amico Roberto , Barbi Egidio , Robazza Margherita
Published: November 2020

Background: Home chemotherapy programs for children with cancer are safe and feasible, and their impact on the quality of life has been reported in different countries. A home chemotherapy program was implemented between 2011 and 2019 in an Italian region. This pilot study investigates its safety and, feasibility, along with parental satisfaction. Methods: Patients between 0 and 18 years diagnosed with malignancy were included. Deceased patients and patients whose families moved abroad or interrupted contact with the service were excluded. Adverse events comprised immediate deterioration of the patient’s condition, equipment failure, errors in drug storage, dose or patient identification and personnel safety issues. Parental satisfaction was explored through an email survey of 32 Likert-type and short open questions. Results: Thirty-five patients received 419 doses of intravenous chemotherapy at home (cytarabine, vincristine, vinblastine). No adverse events were reported. Twenty-three families out of 25 eligible completed the survey. Most reported being “very satisfied” with the possibility of maintaining a work/domestic routine and reducing time and financial burden of hospital access. Most were “very satisfied” with the opportunity for their child of being less troubled by the treatment. Besides, most reported being “very satisfied” with the chance for healthy siblings of maintaining their routine and coping with their brother/sister’s disease. Most perceived the program as safe. All families recommended extending the program to all children in the region. Conclusions: This first Italian study supports home chemotherapy as safe and effective, positively influencing the quality of life for children and families.
The Sequence of Disease Modifying Anti-Rheumatic Drugs: Pathways to and Predictors of Tocilizumab Monotherapy
Authors: Solomon Daniel , Xu Chang , Collins Jamie , Kim Seoyoung C. , Losina Elena , Yau Vincent , Johansson Fredrik D.
Published: November 2020

Background: There are numerous non-biologic and biologic disease modifying anti-rheumatic drugs (bDMARDs) for rheumatoid arthritis (RA). Typical sequences of bDMARDs are not clear. Future treatment policies and trials should be informed by quantitative estimates of current treatment practice. Methods: We used data from Corrona, a large real-world RA registry, to develop a method for quantifying sequential patterns in treatment with bDMARDs. As a proof of concept, we study patients who eventually use tocilizumab monotherapy (TCZm), an IL-6 antagonist with similar benefits used as monotherapy or in combination. Patients starting a bDMARD were included and were followed using a discrete-state Markov model, observing changes in treatments every six-months and determining whether they used TCZm. A supervised machine learning algorithm was then employed to determine longitudinal patient factors associated with TCZm use. Results: 7,300 patients starting a bDMARD were followed for up to 5 years. Their median age was 58 years, 78% were female, median disease duration was 5 years, and 57% were seropositive. During follow-up, 287 (3.9%) reported use of TCZm with median time until use of 25.6 (11.5, 56.0) months. 82% of TCZm use began within three years of starting any bDMARD. 93% of TCZm users switched from TCZ combination, a TNF inhibitor, or another bDMARD. Very few patients are given TCZm as their first DMARD (0.6%). Variables associated with use of TCZm included: prior use of TCZ combination therapy, older age, longer disease duration, seronegative, higher disease activity, and no prior use of a TNF inhibitor. Conclusions: Improved understanding of treatment sequences in RA may help personalize care. These methods may help optimize treatment decisions using large-scale real-world data.
Beyond standardized mortality ratios; some uses of smoothed age-specific mortality rates on small areas studies.
Authors: Perez-Panades Jordi , Botella-Rocamora Paloma , Martinez-Beneito Miguel Angel
Published: November 2020

Background: Most epidemiological risk indicators strongly depend on the age composition of populations, which makes the direct comparison of raw (unstandardized) indicators misleading because of the different age structures of the spatial units of study. Age-standardized rates (ASR) are a common solution for overcoming this confusing effect. The main drawback of ASRs is that they depend on age-specific rates which, when working with small areas, are often based on very few, or no, observed cases for most age groups. A similar effect occurs with life expectancy at birth and many more epidemiological indicators, which makes standardized mortality ratios (SMR)the omnipresent risk indicator for small areas epidemiologic studies.Methods:To deal with this issue, a multivariate smoothing model, the M-model, is proposed in order to fit the age-specific probabilities of death (PoDs) for each spatial unit, which assumes dependence between closer age groups and spatial units. This age-space dependence structure enables information to be transferred between neighboring consecutive age groups and neighboring areas, at the same time, providing more reliable age-specific PoDs estimates.Results: Three case studies are presented to illustrate the wide range of applications that smoothed age specific PoDs have in practice . The first case study shows the application of the model to a geographical study of lung cancer mortality in women. This study illustrates the convenience of consideringage-space interactions in geographical studies and to explore the different spatial risk patterns shown by the different age groups. Second, the model is also applied to the study of ischaemic heart disease mortality in women in two cities at the census tract level. Smoothed age-standardized rates are derived and compared for the census tracts of both cities, illustrating some advantages of this mortality indicator over traditional SMRs. In the latest case study, the model is applied to estimate smoothed life expectancy (LE), which is the most widely used synthetic indicator for characterizing overall mortality differences when (not so small) spatial units are considered.Conclusion: Our age-space model is an appropriate and flexible proposal that provides more reliable estimates of the probabilities of death, which allow the calculation of enhanced epidemiological indicators (smoothed ASR, smoothed LE), thus providing alternatives to traditional SMR-based studies of small areas