bluuebunny/crossref_metadata_2025 huggingface dataset:
Real-time monitoring of bacterial biofilms metabolic activity by a redox-reactive nanosensors array
Authors: Yeor-Davidi Ella , Zverzhinetsky Marina , Krivitsky Vadim , Patolsky Fernando
Published: May 2020

Background

Bacterial biofilms are communities of surface-associated microorganisms living in cellular clusters or micro-colonies, encapsulated in a complex matrix composed of an extracellular polymeric substance, separated by open water channels that act as a circulatory system that enable better diffusion of nutrients and easier removal of metabolic waste products. The monitoring of biofilms can provide important information on fundamental biofilm-related processes. That information can shed light on the bacterial processes and enable scientists to find ways of preventing future bacterial infections. Various approaches in use for biofilm analysis are based on microscopic, spectrochemical, electrochemical, and piezoelectrical methods. All these methods provide significant progress in understanding the bio-process related to biofilm formation and eradication, nevertheless, the development of novel approaches for the real-time monitoring of biochemical, in particular metabolic activity, of bacterial species during the formation, life and eradication of biofilms is of great potential importance.

Results

Here, detection and monitoring of the metabolic activity of bacterial biofilms in high-ionic-strength solutions were enabled as a result of novel surface modification by an active redox system, composed of 9,10-dihydroxyanthracene/9,10-anthraquinone, on the oxide layer of the SiNW, yielding a chemically-gated FET array. With the use of enzymatic reactions of oxidases, metabolites can be converted to H2O2 and monitored by the nanosensors. Here, the successful detection of glucose metabolites in high-ionic-strength solutions, such as bacterial media, without pre-processing of small volume samples under different conditions and treatments, has been demonstrated. The biofilms were treated with antibiotics differing in their mechanisms of action and were compared to untreated biofilms. Further examination of biofilms under antibiotic treatment with SiNW-FET devices could shed light on the bioprocess that occurs within the biofilm. Moreover, finding proper treatment that eliminates the biofilm could be examined by the novel nanosensor as a monitoring tool.

Conclusions

To summarize, the combination of redox-reactive SiNW-FET devices with micro-fluidic techniques enables the performance of rapid, automated, and real-time metabolite detection with the use of minimal sample size, noninvasively and label-free. This novel platform can be used as an extremely sensitive tool for detection and establishing medical solutions for bacterial-biofilm eradication and for finding a proper treatment to eliminate biofilm contaminations. Moreover, the sensing system can be used as a research tool for further understanding of the metabolic processes that occur within the bacterial biofilm population.
Prisoners should not be left behind in HCV research and policies
Authors: Moazen Babak , Stöver Heino , Dolan Kate , Jahn Albrecht , Neuhann Florian
Published: May 2020

With a worldwide prevalence of 15.4%, hepatitis C virus (HCV) has been estimated to be the most prevalent major infectious disease in prisons. The exceptionally high prevalence of HCV in prisons is attributable to common risk behaviors including sharing contaminated tattooing equipment and drug paraphernalia, as well as lack of HCV control interventions including needle and syringe programs. Despite the importance of attention to prisoners as a highly at-risk population to acquire and transmit HCV, the number of HCV research and policy documents ignoring prisoners is increasing. Highlighting this issue, the present manuscript discusses how excluding prisoners from HCV-related research and policies will jeopardize the global HCV elimination goals set forth by the global community.
Interaction of sleep quality and anxiety on quality of life in individuals with type 2 diabetes mellitus
Authors: Dong Dong , Lou Peian , Wang Jian , Zhang Pan , Sun Jianquan , Chang Guiqiu , Xu Chunrong
Published: May 2020

Purpose

Sleep disturbances and anxious symptoms are very common in people with type 2 diabetes mellitus(T2DM). This study aimed to assess the interactive effects of poor sleep quality and anxious symptoms on the quality of life of people with T2DM.

Methods

Nine hundred and forty-four participants with T2DM were enrolled in a cross-sectional study. Demographic and physiological characteristics were recorded. Each participant completed a Chinese version of the Pittsburgh Sleep Quality Index, the Patient Health Questionnaire-9 and General Anxiety Disorder questionnaire, and the Diabetes Specificity Quality of Life scale. The products of poor sleep quality and anxiety were added to a logistic regression model to evaluate the multiplicative interactions, expressed as the relative excess risk of interaction, the attributable proportion of interaction, and the synergy index.

Results

Poor sleep quality and anxiety symptoms were associated with reduced quality of life. There was a significant interaction between poor sleep quality and anxiety symptoms; this combined effect significantly reduced quality of life scores by 6.09-fold. The relative excess risk of interactions was 1.36.

Conclusions

The combined effect of poor sleep quality and anxiety symptoms reduces quality of life in people with T2DM.

Trial registration

ChiCTR-IOP-16008045. Registered 3 March 2016.

A clinical study to investigate gum infection in patients undergoing kidney dialysis.
How does the EQ-5D-Y Proxy version 1 perform in 3, 4 and 5-year-old children?
Authors: Verstraete Janine , Lloyd Andrew , Scott Des , Jelsma Jennifer
Published: May 2020

Background

The EQ-5D-Y Proxy is currently recommended for Health Related Quality of Life (HRQoL) measurement in children aged 4–8 years of age. However, it has only been validated in children over six years of age. The aim of this study was to investigate the performance of the EQ-5D-Y proxy version 1 in children between the ages of 3–6 years.

Methods

A sample of 328 children between 3 and 6 years of age were recruited which included children who were either acutely-ill (AI), chronically-ill (CI) or from the general school going population (GP). The EQ-5D-Y Proxy Version 1 and the PedsQL questionnaires were administered at baseline. The EQ-5D-Y Proxy was administered telephonically 24 h later to children with chronic illnesses to establish test-retest reliability. The distribution of dimensions and summary scores, Cohen’s kappa, the intraclass correlation coefficient, Pearson’s correlation and Analysis of variance were used to explore the reliability, and validity of the EQ-5D-Y for each age group. A single index score was estimated using Latent scores and Adult EQ-5D-3 L values (Dolan).

Results

The groups included 3-year olds (n = 105), 4-year olds (n = 98) and 5-years olds (n = 118). The dimension Looking after Myself had the greatest variability between age groups and had the highest rate of problems reported. Worried, Sad or Unhappy and Pain or Discomfort were not stable across time in test-retest analysis. The Visual Analogue Scale (VAS), and single index scores estimated using the latent values and Dolan tariff had good test retest (except for the latent value scores in a small number of 4-year olds). EQ-5D-Y scores for all ages had small to moderate correlations with PedsQL total score. The EQ-5D-Y discriminated well between children with a health condition and the general population for all age groups. Caregivers reported difficulty completing the Looking after Myself dimension due to age-related difficulties with washing and dressing.

Conclusion

The dimension of Looking after Myself is problematic for these young children but most notably so in the 3 year old group. If one considers the summary scores of the EQ-5D-Y Proxy version 1 it appears to work well. Known group validity was demonstrated. Concurrent validity was demonstrated on a composite level but not for individual dimensions of Usual Activities or Worried, Sad or Unhappy.. The observable dimensions demonstrated stability over time, with the inferred dimensions (Pain or Discomfort and Worried, Sad or Unhappy) less so, which is to be expected. Further work is needed in exploring either the adaptation of the dimensions in the younger age groups.
Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre
Authors: Faqah Anadil , Sheikh Hassan , Bakar Muhammad Abu , Tayyaab Fatima , Khawaja Sahrish
Published: May 2020

Background

Venous Thromboembolism (VTE) in cancer patients is associated with increased mortality and morbidity. While newer data on use of direct oral anticoagulants (DOACs) in treating cancer associated thrombosis (CAT) is promising; its data is still few and inconsistent across literature. We designed the study to assess if rivaroxaban would be an appealing alternate choice to treat CAT.

Methods

We conducted a retrospective study to evaluate the efficacy and safety profile of rivaroxaban versus enoxaparin in cancer patients after developing a symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE). Baseline patient characteristics and laboratory values were assessed in each arm. Primary efficacy outcome was measured by radiographically confirmed VTE recurrence at different intervals. Primary safety outcome was measured by presence of major and minor bleeding using the ISTH scale.

Results

Our study recruited 150 cancer patients with radiologically confirmed DVT and PE; 80 patients were evaluated in enoxaparin arm and 70 patients in rivaroxaban arm. Our results showed that there was no statistically significant difference between the incidence of VTE recurrence at 6 months between the enoxaparin and rivaroxaban arm (10% vs 14.2%, p = 0.42). Historically significant risk factors for VTE in cancer patients such as high platelet count, high leukocyte count, low hemoglobin level, high risk gastrointestinal, genitourinary and lung cancers were not found to be significantly associated with the risk of VTE recurrence. Primary safety outcome analysis also showed no statistically significant difference in major (11.2% vs 11.4%) and minor (15% vs 10%) bleeding between enoxaparin versus rivaroxaban arm respectively (p = 0.65).

Conclusion

We conclude that there was no significant difference seen between the efficacy and safety profile of enoxaparin and rivaroxaban in our cancer patient population.
Redressing the gender imbalance: a qualitative analysis of recruitment and retention in Mozambique’s community health workforce
Authors: Steege Rosalind , Taegtmeyer Miriam , Ndima Sozinho , Give Celso , Sidat Mohsin , Ferrão Clara , Theobald Sally
Published: May 2020

Background

Mozambique’s community health programme has a disproportionate number of male community health workers (known as Agentes Polivalentes Elementares (APEs)). The Government of Mozambique is aiming to increase the proportion of females to constitute 60% to improve maternal and child health outcomes. To understand the imbalance, this study explored the current recruitment processes for APEs and how these are shaped by gender norms, roles and relations, as well as how they influence the experience and retention of APEs in Maputo Province, Mozambique.

Methods

We employed qualitative methods with APEs, APE supervisors, community leaders and a government official in two districts within Maputo Province. Interviews were recorded, transcribed and translated. A coding framework was developed in accordance with thematic analysis to synthesise the findings.

Findings

In-depth interviews (n = 30), key informant interviews (n = 1) and focus group discussions (n = 3) captured experiences and perceptions of employment processes. Intra-household decision-making structures mean women may experience additional barriers to join the APE programme, often requiring their husband’s consent. Training programmes outside of the community were viewed positively as an opportunity to build a cohort. However, women reported difficulty leaving family responsibilities behind, and men reported challenges in providing for their families during training as other income-generating opportunities were not available to them. These dynamics were particularly acute in the case of single mothers, serving both a provider and primary carer role. Differences in attrition by gender were reported: women are likely to leave the programme when they marry, whereas men tend to leave when offered another job with a higher salary. Age and geographic location were also important intersecting factors: younger male and female APEs seek employment opportunities in neighbouring South Africa, whereas older APEs are more content to remain.

Conclusion

Gender norms, roles and power dynamics intersect with other axes of inequity such as marital status, age and geographic location to impact recruitment and retention of APEs in Maputo Province, Mozambique. Responsive policies to support gender equity within APE recruitment processes are required to support and retain a gender-equitable APE cadre.
Heat shock response regulates stimulus-specificity and sensitivity of the pro-inflammatory NF-κB signalling
Authors: Paszek Anna , Kardyńska Małgorzata , Bagnall James , Śmieja Jarosław , Spiller David G. , Widłak Piotr , Kimmel Marek , Widlak Wieslawa , Paszek Pawel
Published: May 2020

Background

Ability to adapt to temperature changes trough the Heat Shock Response (HSR) pathways is one of the most fundamental and clinically relevant cellular response systems. Heat Shock (HS) affects the signalling and gene expression responses of the Nuclear Factor κB (NF-κB) transcription factor, a critical regulator of proliferation and inflammation, however, our quantitative understanding of how cells sense and adapt to temperature changes is limited.

Methods

We used live-cell time-lapse microscopy and mathematical modelling to understand the signalling of the NF-κB system in the human MCF7 breast adenocarcinoma cells in response to pro-inflammatory Interleukin 1β (IL1β) and Tumour Necrosis Factor α (TNFα) cytokines, following exposure to a 37–43 °C range of physiological and clinical temperatures.

Results

We show that exposure to 43 °C 1 h HS inhibits the immediate NF-κB signalling response to TNFα and IL1β stimulation although uptake of cytokines is not impaired. Within 4 h after HS treatment IL1β-induced NF-κB responses return to normal levels, but the recovery of the TNFα-induced responses is still affected. Using siRNA knock-down of Heat Shock Factor 1 (HSF1) we show that this stimulus-specificity is conferred via the Inhibitory κB kinase (IKK) signalosome where HSF1-dependent feedback regulates TNFα, but not IL1β-mediated IKK recovery post HS. Furthermore, we demonstrate that through the temperature-dependent denaturation and recovery of IKK, TNFα and IL1β-mediated signalling exhibit different temperature sensitivity and adaptation to repeated HS when exposed to a 37–43 °C temperature range. Specifically, IL1β-mediated NF-κB responses are more robust to temperature changes in comparison to those induced by TNFα treatment.

Conclusions

We demonstrate that the kinetics of the NF-κB system following temperature stress is cytokine specific and exhibit differential adaptation to temperature changes. We propose that this differential temperature sensitivity is mediated via the IKK signalosome, which acts as a bona fide temperature sensor trough the HSR cross-talk. This novel quantitative understanding of NF-κB and HSR interactions is fundamentally important for the potential optimization of therapeutic hyperthermia protocols.
Impact of dopamine-related genetic variants on physical activity in old age – a cohort study
Authors: Dohrn Ing-Mari , Papenberg Goran , Winkler Elisabeth , Welmer Anna-Karin
Published: May 2020

Objectives

The beneficial effects of a physically active lifestyle in aging are well documented. Understanding the factors of importance for physical activity in older adults are therefore essential. Informed by animal and human data linking the dopamine system to motivation and reward processes, we investigated the associations between variations in dopamine genes and objectively measured physical activity and sedentary behaviour. Further, we aimed to verify whether higher age may exacerbate the impact of dopamine genes on physical activity.

Methods

We analyzed data from 504 older adults, 66–87 years, from the population-based Swedish National study on Aging and Care in Kungsholmen (SNAC-K). Physical activity was measured with activPAL accelerometers and DNA was extracted from blood samples for genotyping. We assessed the effects of three dopamine relevant genetic variations (DRD1, DRD2, and DRD3) on daily time in sedentary behavior, light-intensity physical activity and moderate-to-vigorous physical activity using analyses of covariance, adjusting for sex, age and physical function.

Results

Higher dopamine receptor efficacy was related to moderate-to-vigorous physical activity, but not to light-intensity physical activity or sedentary time. DRD1 explained 2.7% of variance in moderate-to-vigorous physical activity, with more pronounced effect in people aged ≥80 years, about 10% of explained variance.

Conclusion

Stronger genetic effects in older adults are in line with the well-established nonlinear effects of dopamine signaling on performance, expected to be exacerbated with aging. Individuals over 80 years, genetically predisposed to lower dopamine receptor efficacy, engaged on average 100 min/week in moderate-to-high physical activity, below the recommended levels beneficial for healthy aging. Our findings highlight that some individuals might need extra support to maintain a physically active lifestyle.
microRNA-1271 impedes the development of prostate cancer by downregulating PES1 and upregulating ERβ
Authors: Jiang Zhenming , Zhang Yuxi , Chen Xi , Wang Yan , Wu Pingeng , Wu Chengzhang , Chen Dong
Published: May 2020

Background

As a nucleolar protein associated with ribosome biogenesis, pescadillo homolog 1 (PES1) has been reported to participate in the development of many cancers. However, its role in prostate cancer is not clearly defined. Therefore, the aim of this study is to explore the effects and the specific mechanism of PES1 in prostate cancer.

Methods

A microarray-based analysis was performed to analyze differentially expressed genes (DEGs) between prostate cancer and normal samples. Next, the interaction between PES1 and microRNA-1271 (miR-1271) was investigated using bioinformatics analysis in combination with dual-luciferase reporter gene assay. The expression of miR-1271 in prostate cancer cells and tissues was determined using RT-qPCR. Its effects on downstream estrogen receptor β (ERβ) signaling pathway were further examined. Moreover, we analyzed whether miR-1271 affects proliferation, apoptosis, migration and invasion of prostate cancer cells by EdU assay, flow cytometry, and Transwell assay. Lastly, a prostate cancer mouse model was conducted to measure their roles in the tumor growth.

Results

PES1 was identified as a prostate cancer-related DEG and found to be upregulated in prostate cancer. miR-1271, which was poorly expressed in both cells and tissues of prostate cancer, can specifically bind to PES1. Additionally, overexpression of miR-1271 activated the ERβ signaling pathway. Overexpression of miR-1271 or depletion of PES1 inhibited prostate cancer cell proliferation, migration and invasion, promoted apoptosis in vitro and suppressed tumor growth in vivo.

Conclusions

Taken together, overexpression of miR-1271 downregulates PES1 to activate the ERβ signaling pathway, leading to the delayed prostate cancer development. Our data highlights the potential of miR-1271 as a novel biomarker for the treatment of prostate cancer.
High methylation of lysine acetyltransferase 6B is associated with the Cobb angle in patients with congenital scoliosis
Authors: Wu Yuantao , Zhang Hongqi , Tang Mingxing , Guo Chaofeng , Deng Ang , Li Jiong , Wang Yunjia , Xiao Lige , Yang Guanteng
Published: May 2020

Background

The etiology of congenital scoliosis (CS) is complex and uncertain. Abnormal DNA methylation affects the growth and development of spinal development. In this study, we investigated the role of DNA methylation in CS.

Methods

The target region DNA methylation level in the peripheral blood of patients with CS was analyzed. Through in-depth analysis, genes closely related to the growth and development of the vertebra were identified. EdU staining was performed to verify the role of differentially expressed genes in chondrocyte proliferation.

Results

The hypermethylated KAT6B gene was observed in patients with CS, and was positively correlated with the Cobb angle. KAT6B was primarily expressed on chondrocytes. The promoter of KAT6B in CS patients was hypermethylated, and its expression was significantly reduced. Further mechanistic studies revealed that EZH2 mediated trimethylation of lysine 27 on histone H3 of the KAT6B promoter. Overexpression of KAT6B in CS-derived primary chondrocytes can significantly promote chondrocyte proliferation, which may be related to activation of the RUNX2/Wnt/β-catenin signaling pathway.

Conclusion

Epigenetic modification of KAT6B may be a cause of CS. If similar epigenetic modification abnormalities can be detected through maternal liquid biopsy screening, they may provide useful biomarkers for early screening and diagnosis of CS.
Nephrological disorders and neurological involvement in pediatric primary Sjogren syndrome:a case report and review of literature
Authors: Zhao Jingya , Chen Qin , Zhu Yunyun , Zhao Meng , Liu Jun , Zhang Zhenzhong , Gong Xiaoting
Published: May 2020

Background

Sjögren syndrome (SS) is a rare disease in pediatrics, and little attention has been paid to the clinical feature in these patients. To date, there are few cases concern about neurological and nephrological disorders in childhood Sjögren syndrome. We describe a case of Sjögren syndrome in a 12-year-old girl who developed neurological disorders and interstitial nephritis and review the literature currently available on this topic.

Case presentation

A 12-year-old girl was admitted to our hospital for arthritis and glucosuria. She was required to do labial gland and renal biopsy, because the positive for anti-nuclear antibody and anti-Sjögren syndrome B (anti-SSB) antibody. Then the biopsy was performed revealing the lymphocytic infiltrate in the small area and renal tubular interstitial damage,thus the diagnosis of Sjögren syndrome with tubular interstitial damage was made. Three months later, she presented again with headache, fever, nausea, vomiting and was recovered without drug therapy. Based on the patient’s medical history, laboratory and imaging examination, and treatment, we speculate that the disorders of the nervous system were caused by the Sjögren syndrome. The girl has stable renal function and no residual nervous system damage in the next 1.5 years, but she underwent low dose prednisone therapy because of persistent renal glucosuria.

Conclusions

Nephrological disorders and neurological involvement are rare manifestations of Sjögren syndrome in children, and rarely presented as the initial symptoms. It should be suspected in children presenting with unexplained renal diseases, neurological abnormalities, or unexplained fever. Although there is no guidelines on the diagnosis and treatment of children Sjögren syndrome are currently available, early recognition and the appropriate treatment of renal damage and neurologic involvement would improve prognosis and prevent complications.
Recurrent Henoch-Schönlein Purpura with bullous rash and pulmonary nodules
Authors: Zheng Christopher , Childers Julie , Rabinovich Egla , Nazareth-Pidgeon Kristina
Published: May 2020

Background

Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood. It has a characteristic rash described as palpable purpura that most frequently affects the distal lower extremities and buttocks. HSP rarely presents with bullous rash nor pulmonary nodules.

Case presentation

We present a novel case of a 12-years-old female with recurrent pediatric HSP with a combination of the rare manifestations of bullous rash and pulmonary nodules. She initially presented with the bullous rash, chest pain, cough, and abdominal pain. Patient was successfully treated with intravenous pulse corticosteroids followed by a high dose oral corticosteroid taper, with resolution of the bullous rash and pulmonary nodules.

Conclusion

The rare manifestations of scarring bullous rash and pulmonary nodules can be presenting features of pediatric HSP, the combination of which has not been previously reported. The treatment of intravenous corticosteroid resolved patient’s abdominal symptoms, rash and pulmonary nodules.
Religious, socio-cultural norms and gender stereotypes influence uptake and utilization of maternal health services among the Digo community in Kwale, Kenya: a qualitative study
Authors: Mochache Vernon , Wanje George , Nyagah Lucy , Lakhani Amyn , El-Busaidy Hajara , Temmerman Marleen , Gichangi Peter
Published: May 2020

Background

Maternal health outcomes in resource-limited settings are typically influenced by supply-side factors affecting the provision of quality health services. The extent to which demand-side factors contribute to this influence is unclear. We aimed to explore how individual and community-wide factors influenced uptake and utilization of maternal health services among the Digo community residing in Kwale County of coastal Kenya.

Methods

Between March and December 2015, we conducted 5 focus group discussions (FGDs) and 15 in-depth interviews (IDIs) with members of the Digo community predominant in Kwale county, Kenya. Respondents were sampled purposively and included female (pregnant and postpartum) as well as male adult community members. A thematic content analytic approach was used.

Results

There were a total of 47 FGD respondents, including 15 (32%) females with a median (interquartile, IQR) age of 38 (27–55) years and 6 (3–8) children. Majority (40%) reported attaining secondary-level education. All IDI respondents were female with a median (IQR) age of 27 (24–35) years and 4 (2–5) children. Majority (80%) had attained primary-level education. We found that religious and socio-cultural norms as well as gender stereotypes were important influences on the uptake and utilization of maternal health services, including facility-based delivery and contraception. Key amongst this was the unspoken deference to the counsel of a prominent matriarchal figure in the decision-making process.

Conclusions

Among the Digo community of coastal Kenya, a unique social-cultural context comprising of a religious and gendered value belief system influences women’s reproductive health and rights. These findings highlight the important role of demand-side factors in influencing maternal health outcomes. In addition to addressing supply-side factors, programs in such settings should aim to address factors that leverage inherent social capital to drive demand for maternal health services ensuring that they are not only effective, but also responsive to the local context.
Determinants of modern contraceptive use among married Somali women living in Kampala; a cross sectional survey
Authors: Abdulahi Maryan , Kakaire Othman , Namusoke Fatuma
Published: May 2020

Background

Low contraceptive uptake exposes women to unintended pregnancies and often the resultant obstetric complications. The immigrant communities especially from countries with low contraceptive use present a unique challenge. The main objective of the study was to describe modern contraceptive use and associated factors among married Somali women living in Kampala.

Methods

A community based cross sectional survey was conducted among Somali women living in Kampala from August to November 2016. Using consecutive sampling, 341 respondents were recruited after informed consent. Data was collected using interviewer administered questionnaires on contraceptives use and factors associated. Data was entered in Epidata 3.1 and analyzed using STATA 11.0. Logistic regression analysis was used to determine the factors associated with use of modern contraceptives.

Results

Majority of the participants were refugees 317/341(94%), with a mean age of 30.4 (±6.7) years and 136/341 (40%) had no formal education. More than 325/341 (95%) of respondents desired to have five or more children (Average 9 + 3) and 164/341 (45%) had five or more living children. Only 29% of women were using modern contraceptives, of which 51% used oral pills, 15% condoms and 15% injectables. Having tertiary education, one who had ever used modern contraceptives and desire for spacing of more than two years were independently associated with current of use modern contraceptives.

Conclusions

The Contraceptive prevalence rate among married Somali women in Kampala was (29%). A majority of the respondents were using short acting contraceptive methods. Attaining tertiary education, ever use of modern contraceptives, those whose source of contraceptive information was health worker and desire to space for more than two years were associated with current use of modern contraceptives. There is a need for improvement of girl child education, contraceptive awareness and male involvement to increase contraceptive uptake in this community. Research looking at attitude of this community towards use of long term contraception is recommended.
Beyond health system contact: measuring and validating quality of childbirth care indicators in primary level facilities of northern Ethiopia
Authors: Weldearegay Haftom Gebrehiwot , Medhanyie Araya Abrha , Godefay Hagos , Kahsay Alemayehu Bayray
Published: May 2020

Background

Measurement of quality of health care has been largely overlooked and continues to be a major health system bottleneck in monitoring performance and quality to evaluate progress against defined targets for better decision making. Hence, metrics of maternity care are needed to advance from health service contact alone to content of care. We assessed the accuracy of indicators that describe the quality of basic care for childbirth functions both at the individual level as well as at the population level in Northern Ethiopia.

Methods

A validation study was conducted by comparing women’s self-reported coverage of maternal and newborn health interventions during intra-partum and immediate postpartum care received in primary level care facilities of Northern Ethiopia against a gold standard of direct observation by a trained third party (n = 478). Sensitivity, specificity and individual-level reporting accuracy via the area under the receiver operating curve (AUC) and inflation factor (IF) to estimate population-level accuracy for each indicator was applied for validity analysis.

Findings

455(97.5%) of women completed the survey describing health interventions. Thirty-two (43.2%) of the 93-basic quality child birth care indicators that were assessed could be accurately measure at the facility and population level (AUC > 0.60 and 0.75 < IF< 1.25). Few of the valid indicators were: whether women and their companion were greeted respectfully, whether an HIV test was offered, and whether severe bleeding (hemorrhage) was experienced by the woman. An additional 21(28.4%) indicators accurately measure at the facility or individual level, but the indicators under or over estimate at population level. Thirteen other indicators could accurately measure at population level. Eight (8.6%) indicators didn’t meet either of the validity criteria.

Conclusion

Women were able to accurately report on several indicators of quality for basic child birth care. For those few indicators that required a technical understanding tended to have higher don’t know response from the women. Therefore, valid indicators should be included as a potential measurement of quality for the childbirth care process to ensure that essential interventions are delivered.
Development and psychometric evaluation of the female infertility stigma instrument (ISI-F): protocol for a mixed method study
Authors: Taebi Mahboubeh , Kariman Nourossadat , Montazeri Ali , Majd Hamid Alavi
Published: May 2020

Background

Infertility stigma is one of the greatest challenges in most societies for reproduction and sexual health of infertile women. Since no specific tool exists for assessing the infertility stigma in women, this study would be conducted to develop and evaluate the psychometric properties of Female Infertility Stigma Instrument (ISI-F).

Methods

This is a mixed method study with sequential exploratory design (qualitative and quantitative phase). In the first qualitative phase, semi-structured interviews would be performed with infertile female who had experienced infertility whithout any psychological disorder. Women who are eligible for participating in the study will be selected using purposeful sampling method with maximum variation in terms of age, education, occupation and infertility duration. Data would be analyzed using conventional content analysis and in this phase the primary item pool will be developed for the Female Infertility Stigma Instrument (ISI-F). In the quantitative phase, the psychometric properties of the Instrument would be evaluated, including the content, face and construct validity as well as reliability via the internal consistency and stability. The psychometric properties described in the COSMIN checklist will be utilized for designing the instrument.

Discussion

Developing a valid and reliable scale for Female Infertility Stigma Instrument (ISI-F) would be helpful for future studies to assess the status of this situation. It also helps planning interventional studies for improvement of the reproductive health of infertile women.
Drug use and antiretroviral therapy (ART) interactions: a qualitative study to explore the knowledge, beliefs, adherence, and quality of life of people living with HIV taking ART and illicit drugs
Authors: Fuster-RuizdeApodaca María José , Castro-Granell Vanessa , Laguía Ana , Jaén Ángeles , Cenoz Santiago , Galindo María José
Published: May 2020

Background

To explore the use of illicit drugs by people living with HIV (PLHIV) taking antiretroviral therapy (ART) and their relationship with variables relevant to the management of HIV infection, such as knowledge and beliefs about drug–drug interactions (DDIs), ART adherence, quality of life (QoL), and use of health-care resources.

Methods

21 PLHIV in Spain who concomitantly took illicit drugs and ART participated in this qualitative study. Eight experts collaborated in the design of the semi-structured interview guide which explored the following topics: illicit drug use, knowledge and beliefs about DDIs and their impact on ART adherence, the effects of using illicit drugs on health, QoL, and use of health-care resources. Four of those experts, who were PLHIV and members of the executive boards of non-government organizations (NGOs) from four Spanish regions, recruited the participants through their NGOs and carried out the face-to-face interviews. Content analysis of the qualitative data was conducted with the support of the MAXQDA 12 program.

Results

Participants were mainly men (85.7%) and only 14.3% of them were heterosexual. Content analysis showed that the most frequently consumed illicit drugs were poppers, cocaine, and cannabis. Participants were polydrug users and this was, in many cases, prior to HIV diagnosis. Most participants presented theoretical potential moderate DDIs that would require monitoring. More than three quarters of them were not aware of these DDIs. Participants reported interactive toxicity beliefs that lead to intentional nonadherence behaviors. In most cases (n = 17), the participant’s doctor knew about their drug use, however only six of them had had an open dialogue with their physician about it. Illicit drug use led to some health-related problems, mainly sexually transmitted infections. A positive QoL’s self-perception was found among several participants that used recreational illicit drugs.

Conclusions

Adequate information about DDIs and clues about how to manage ART when PLHIV are using illicit drugs could reduce the negative effects of such interactions and improve ART adherence and QoL.
Prediabetes among HIV-infected individuals receiving antiretroviral therapy: prevalence, diagnostic tests, and associated factors
Authors: Phuphuakrat Angsana , Nimitphong Hataikarn , Reutrakul Sirimon , Sungkanuparph Somnuek
Published: May 2020

Background

Metabolic complications in human immunodeficiency virus (HIV)-infected individuals are common. Prediabetes represents a high risk for future diabetes development. This study aimed to determine the prevalence, diagnostic methods, and associated factors of prediabetes among HIV-infected individuals receiving antiretroviral therapy (ART).

Methods

A cross-sectional study was conducted among HIV-infected adults without a history of diabetes who were receiving ART. Fasting plasma glucose (FPG), 2-hour plasma glucose (2-h PG) after a 75-g oral glucose tolerance test, and hemoglobin A1c (HbA1c) were assessed.

Results

A total of 397 patients with a mean age of 47.0 ± 9.8 years and 55.7% male, were studied. All received ART with undetectable plasma viral load. The mean duration of ART was 9.6 ± 5.2 years, and the mean CD4 cell count was 554 ± 235 cells/mm3. Among the patients, 28 (7.1%) had first-diagnosed diabetes, and 133 (33.5%) patients had prediabetes. Glycemia estimation by FPG, 2-h PG, and HbA1c showed a prediabetes prevalence of 17.4%, 14.7%, and 12.5%, respectively. The kappa statistics for the agreement of FPG and 2-h PG, HbA1c and 2-h PG, and HbA1c and FPG were 0.317, 0.429, and 0.396, respectively. In multivariate analysis, hypertension [odds ratio (OR) 3.38; 95% confidence interval (CI), 1.16-9.91; p = 0.026), and triglycerides > 150 mg/dL (OR 2.11; 95% CI, 1.01-4.44; p = 0.047) were factors significantly associated with prediabetes.

Conclusions

Prediabetes among HIV-infected individuals receiving ART is common. The agreements of glycemia estimation methods are minimal to weak. HbA1c may underestimate prediabetes prevalence. Using FPG together with HbA1c increases the detection rate to approximately three-quarters of prediabetes patients. HIV-infected individuals who had hypertension and hypertriglyceridemia should be regularly assessed for prediabetes.

Trial registration ClinicalTrial.gov, NCT03545217. Registered 1 June 2018—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03545217
Fifteen new nucleotide substitutions in variants of human papillomavirus 18 in Korea
Authors: Kim Namhee , Park Jeong Su , Kim Ji Eun , Park Jae Hyeon , Park Hyunwoong , Roh Eun Youn , Yoon Jong Hyun , Shin Sue
Published: May 2020

High-risk human papillomavirus (HPV) infection is an essential factor for the development of cervical cancer. HPV18 is the second most common carcinogenic HPV type following HPV16, but the lineages of HPV18 have been less well studied than those of HPV 16. The purpose of this study was to analyze the nucleotide variants in the E6, E7, and L1 genes of HPV18, to assess the prevalence of HPV18 variants in Korea and to explore the relationship between HPV18 genetic variants and the risk for cervical cancer.

A total of 170 DNA samples from HPV18-positive cervical specimens were collected from women admitted to a secondary referral hospital located in Seoul. Among them, the lineages of the 97 samples could be successfully determined by historical nomenclature.

All the studied HPV 18 variants were lineage A. Sublineages A1 and A4 comprised 91.7% (89/97) and 1.0% (1/97), respectively. Sublineages other than A1 or A4 comprised 7.2% (7/97). We identified 15 new nucleotide substitutions among 44 nucleotide substitutions: C158T, T317G, T443G, A560G, A5467G, A5560C, A5678C, A6155G, G6462A, T6650G, G6701A, T6809C, A6823G, T6941C and T6953C. Among them, 6 substitutions at positions 317, 443, 5467, 5560, 6462, and 6823 resulted in amino acid changes (E6: F71L and N113K; L1: H13R, H44P, A345T, and N465S, respectively). The pathologic results were classified as normal in 25.8% (25/97) of the women, atypical squamous cells of undermined significance (ASCUS) in 7.2% (7/97), cervical intraepithelial neoplasia (CIN) 1 in 36.1% (35/97), CIN2/3 in 19.6% (18/97), and carcinoma in 12.4% (12/97). There was no significant association between the HPV18 sublineages and the severity of pathologic lesion or the disease progression.

This study is the first to analyze the distribution of HPV18 variants in Korean and to associate the results with pathologic findings. Although the HPV18 variants had no significant effect on the degree and progression of the disease, the newly discovered nonsynonymous mutation in L1 might serve as a database to determine vaccine efficacy in Korean women.
The influence of progressive-chronic and acute sodium bicarbonate supplementation on anaerobic power and specific performance in team sports: a randomized, double-blind, placebo-controlled crossover study
Authors: Durkalec-Michalski Krzysztof , Nowaczyk Paulina M. , Adrian Jacek , Kamińska Joanna , Podgórski Tomasz
Published: May 2020

Background

The aims of this study were to verify the effect of progressive-chronic and acute sodium bicarbonate (SB) supplementation on the anaerobic capacity, blood acid-base balance, and discipline-specific performance in team sports disciplines.

Methods

Twenty-four trained male field hockey players completed a randomized, placebo-controlled, crossover trial of either progressive-chronic (increments from 0.05 up to 0.2 g/kg) or an acute one-off dose (0.2 g/kg) supplementation protocol. Before and after treatments, athletes completed an exercise protocol that comprised of a discipline-specific field performance test conducted between two separate Wingate anaerobic tests (WAnTs).

Results

Progressive-chronic SB supplementation improved anaerobic capacity in the first bout of WAnTs, as observed based on an increase in mean power (MP: 575 ± 71 vs. 602 ± 67 W, p = 0.005, ~ + 4.7%), peak power (PP: 749 ± 94 vs. 777 ± 96 W, p = 0.002, ~ + 3.7%), power carry threshold (PCT) at 97%PP (727 ± 91 vs. 753 ± 93 W, p = 0.002, ~ + 3.6%) and average power over PCT (739 ± 94 vs. 765 ± 95 W, p = 0.001, ~ + 3.5%). Acute SB supplementation had no effect on anaerobic capacity. However, an improvement in time during discipline-specific field performance test was observed after progressive-chronic (919 ± 42 vs. 912 ± 27 s, p = 0.05; ~ − 0.8%) and acute (939 ± 26 vs. 914 ± 22 s, p = 0.006, ~ 2.7%) SB supplementation. Acute SB supplementation also improved post-exercise parameters of acid-base balance (based on blood pH, bicarbonate concentration and base excess) compared to no supplementation or placebo.

Conclusions

Our study indicates that both chronic and acute SB supplementation positively supports discipline-specific performance among field hockey athletes. Moreover, the chronic protocol supported anaerobic power indices before the inset of exercise-induced fatigue but had no significant impact afterwards. However, only the acute protocol significantly affected the buffering capacity, which can be used to determine athlete’s performance during high-intensity sporting events. This study design therefore highlighted that future studies focusing on sodium bicarbonate supplementation in team sports should concentrate on the efficiency of chronic and acute supplementation in varying time frames.
Circulating metabolites from the choline pathway and acute coronary syndromes in a Chinese case-control study
Authors: Dai Yuxiang , Tian Qianqian , Si Jing , Sun Zhonghan , Shali Shalaimaiti , Xu Lili , Ren Daoyuan , Chang Shufu , Dong Xin , Zhao Hongxia , Mei Zhendong , Zheng Yan , Ge Junbo
Published: May 2020

Background

Accumulating evidence shows that circulating levels of trimethylamine N-oxide, which is generated from the metabolism of dietary choline, may predict cardiovascular disease among Caucasians. Acute coronary syndrome (ACS), one common presentation of cardiovascular disease, is a spectrum of signs and symptoms due to acute decreased blood flow in the coronary arteries. The relationship between the metabolites from choline pathway and ACS remains unclear. We aimed to assess the associations of circulating metabolites from the choline pathway with ACS among a Chinese population, who consume a different dietary pattern than their Western counterparts.

Methods

We recruited 501 participants who were admitted to the Department of Cardiology, Zhongshan Hospital,Shanghai China between March 2017 and June 2018, including 254 ACS cases and 247 controls. Liquid chromatography-tandem mass spectrometry was used to measure circulating concentrations of metabolites in the choline pathway, including betaine, choline, trimethylamine, and trimethylamine N-oxide. A composite metabolite score using a weighted sum of these four metabolites, and the betaine/choline ratio were calculated. Multivariable logistic regressions were applied to estimate the association of metabolites with ACS, with adjustment of age, sex, body mass index, smoking index, history of diseases, and kidney function.

Results

After adjusting for traditional risk factors, per 1-standard deviation (SD) increment in choline was positively associated with the odds of ACS [odds ratio (OR), 95% confidence interval (CI), 1.77(1.44–2.18)], and the other metabolites were not associated with ACS at a statistical significance level. Compared with participants in the lowest quartile of the metabolite score, those in the highest quartile had higher odds of ACS [OR (95% CI), 3.18(1.85–5.54), p < 0.001 for trend]. Per 1-SD increment in metabolite score was positively associated with higher odds of ACS [OR (95% CI), 1.80 (1.37–2.40)], and per 1-SD increment in the betaine/choline ratio was inversely associated with the odds of ACS [OR (95% CI), 0.49 (0.39–0.60)].

Conclusions

Among our Chinese participants, trimethylamine N-oxide was not associated with ACS, while a composite metabolite score of metabolites from the choline pathway was associated with increased odds of ACS. The choline pathway metabolites may be related to the pathophysiology of ACS among Chinese.