bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of martial arts exercise on anthropometric and body composition parameters of overweight and obese subjects: a systematic review and meta-analysis
Authors: de Souza Fabricio , Lanzendorf Felipe Nunes , de Souza Márcia Mendonça Marcos , Schuelter-Trevisol Fabiana , Trevisol Daisson José
Published: August 2020

Background

Obesity is considered a top public health concern, and its prevalence is growing every day. Thus, interventions to address this problem should be encouraged and further studied. In this regard, the aim of this review was to summarize the evidence of martial arts interventions to evaluate their effectiveness on the anthropometric and body composition parameters of overweight and obese subjects.

Methods

A systematic literature search was conducted on January 26, 2020 using the PubMed, Medline, Lilacs, Cochrane, and Scielo databases. Reference lists of eligible articles and relevant reviews have also been examined. All randomized clinical trials on martial arts that evaluated the anthropometric and body composition parameters of overweight and obese subjects were included, and a narrative synthesis of eligible studies was conducted in accordance with PRISMA guidelines. The Downs & Black checklist was used to assess the quality of the studies. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42018086116).

Results

A total of 82 articles were identified from the initial search strategy. A further 2 articles were identified from the review of relevant bibliographies. Six studies encompassing 258 participants who were overweight or obese were included. Four studies reported Tai Chi practice, one study reported Kung Fu exercise, and another study reported martial arts exercise. The examined meta-analyses did not reveal significant benefits from martial arts practice over control groups after the experiment period for body mass index (− 1.34 kg/m2; 95% CI: − 2.72, 0.05), waist circumference (1.41 cm; 95% CI: − 0.72, 3.54) and percentage of body fat (− 0.75%; 95% CI: − 5.58, 4.08).

Conclusion

The scarcity, heterogeneity, short intervention time, small sample size, and significant methodological limitations of the available studies do not allow to conclude whether martial arts are effective in the anthropometric and body composition parameters of overweight and obese individuals. This study highlights the need for more research to assess the benefits of martial arts for overweight and obese individuals.
Changes in rural older adults’ sedentary and physically-active behaviors between a non-snowfall and a snowfall season: compositional analysis from the NEIGE study
Authors: Amagasa Shiho , Inoue Shigeru , Murayama Hiroshi , Fujiwara Takeo , Kikuchi Hiroyuki , Fukushima Noritoshi , Machida Masaki , Chastin Sebastien , Owen Neville , Shobugawa Yugo
Published: August 2020

Background

Levels of physical activity change throughout the year. However, little is known to what extent activity levels can vary, based on accelerometer determined sedentary and physically-active time. The aim of this longitudinal study was to examine older adults’ activity changes from a non-snowfall season to a subsequent snowfall season, with consideration of the co-dependence of domains of time use.

Methods

Participants were 355 older Japanese adults (53.1% women, aged 65–84 years) living in a rural area of heavy snowfall who had valid accelerometer (Active style Pro HJA-750C) data during non-snowfall and snowfall seasons. Activity was classified as sedentary behavior (SB), light-intensity PA (LPA), and moderate-to-vigorous PA (MVPA). Compositional changes from the non-snowfall to the snowfall season were analyzed using Aitchison’s perturbation method. The ratios of each component in the composition, such as [SBsnow/SBnon-snow, LPAsnow/LPAnon-snow, MVPAsnow/MVPAnon-snow] for seasonal changes, were calculated and were then divided by the sum of these ratios.

Results

In men, the percentages of time spent in each activity during the non-snowfall/snowfall seasons were 53.9/64.6 for SB; 40.8/31.6 for LPA; and 5.3/3.8 for MVPA; these corresponded to mean seasonal compositional changes (∆SB, ∆LPA, ∆MVPA) of 0.445, 0.287, and 0.268 respectively. In women, the percentages of time spent in each activity during the non-snowfall/snowfall seasons were 47.9/55.5 for SB; 47.9/41.0 for LPA; and 4.2/3.5 for MVPA; these corresponded to mean seasonal compositional changes (∆SB, ∆LPA, ∆MVPA) of 0.409, 0.302, and 0.289 respectively. The degree of seasonal change was greatest in men.

Conclusions

In older adults, activity behaviors were changed unfavorably during snowfall season, particularly so for men. The degree of seasonal change was greatest for SB. Development of strategies to keep rural older adults active during the snowfall season may be needed for maintaining a consistently-active lifestyle for their health.
Occupational health check-ups and health-promoting programs and asthma
Authors: Hakola Riina , Leino Timo , Luukkonen Ritva , Kauppi Paula
Published: August 2020

Background

The focus in occupational health check-ups is in work and health, but they offer also a possibility to assess health behavior and give guidance e.g. on weight control. We wanted to study whether having occupational health checks-up, receiving physicians’ advice to change health behavior or participation in health promotion programs had an effect on obesity in a five-year follow-up from 1998 to 2003 in asthmatic and non-asthmatic workers.

Methods

Altogether 23,220 individuals aged 20–54 years were picked up from a randomized Finnish population sample. Univariate and multivariate logistic regression analysis was used to calculate the risk for obesity in 2003. The variables used in the modelling were gender, age, smoking, asthma, depression, and physical workload.

Results

Both asthmatic and non-asthmatic workers gained weight during the follow-up. Of the asthmatics 48 and 47% of the non-asthmatics had occupational health-check-up in the last 5 years. Of the asthmatics 18 and 14% of the non-asthmatics had received physician’s advice to change their health behavior (p < 0.001). Associated factors for obesity (BMI > 30) in 2003 were gender (men OR 1.19), older age (OR 1.25), smoking (OR 1.07) or depression (OR 1.44).

Conclusions

Results show that having occupational health checks-up or receiving physicians’ advice to change health behavior or participation in health promotion programs did not stop gain of weight during a five-year follow-up. Asthmatic workers did not differ from non-asthmatics. Male gender, older age, smoking, and depression were associated with obesity but not the physical workload.
Predicting value of five anthropometric measures in metabolic syndrome among Jiangsu Province, China
Authors: Tian Ting , Zhang Jingxian , Zhu Qianrang , Xie Wei , Wang Yuanyuan , Dai Yue
Published: August 2020

Background

Metabolic syndrome (MetS), a condition of metabolic disorders, is now causing large disease burden around the world. This study aimed to update the prevalence of MetS in Jiangsu Province of China and evaluate the predicting value of five anthropometric measures including waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), a body shape index (ABSI) and body roundness index (BRI) in MetS.

Methods

8040 participants from 12 survey sites were enrolled into this cross-sectional study by multi-stage stratified cluster random sampling method from 2014 nutrition and diet investigation project in Jiangsu Province. The transformation of sex-specific z-score made the comparison meaningful when conducting the logistic analysis between anthropometric indices and MetS. The abilities of anthropometric indices to predict MetS were evaluated by the receiver operating characteristic curve (ROC).Delongtest was applied to compare area under different ROC curves.

Results

The prevalence of MetS in Jiangsu Province was 35.2% and the standardized prevalence was 34.8%. WC, BMI, WHtR, ABSI and BRI z-scores were positively related to MetS and its components. WC, WHtR and BRI z-score had stronger associations with MetS than BMI and ABSI in both male and female population. WC, WHtR and BRI had larger area under ROC curve than BMI and ABSI in male and female. WC in men had the largest area under the ROC curve, significantly higher than the other four measures of BMI, WHtR, ABSI and BRI (Z value = 9.08, 2.88, 16.73, 2.75 respectively). Among women, WC, WHtR and BRI had larger area under the ROC curve than BMI and ABSI, but the area under the WC, WHtR and BRI curve were not significantly different after the pairwise comparison by theDelongtest. The optimal cut-off values of WC, WHtR and BRI for predicting MetS was 85.25 cm, 0.52 and 3.61 in male, 80.05 cm, 0.51 and 3.83 in female.

Conclusion

MetS has become one of the major chronic diseases in Jiangsu Province. WC was better than other four indices in predicting MetS among male population in Jiangsu. WC, WHtR and BRI had superior abilities than BMI/ABSI in predicting MetS among female population.
Associations between social determinants and the presence of chronic diseases: data from the osteoarthritis Initiative
Authors: Vennu Vishal , Abdulrahman Tariq A. , Alenazi Aqeel M. , Bindawas Saad M.
Published: August 2020

Background

Some studies investigated the relationship between musculoskeletal conditions and chronic diseases. However, no study examined the association between social determinants and chronic diseases among people at high risk for knee osteoarthritis. Thus, the current study was aimed to address this gap.

Methods

A secondary data analysis was conducted on a total of 3280 men and women aged 45 to 79 who were recruited in the Osteoarthritis Initiative.

Results

Multivariable logistic regression analyses show that age ≥ 65 years was associated with 1.98, 1.96, and 1.46 times odds of the presence of diabetes, heart attack, and multi-morbidity, respectively than age ≤ 64 years. Men were associated with 1.39, 1.41, 1.76, and 2.24 times odds of the presence of arthritis, cancer, diabetes, and heart attack, respectively than women. African American/Asian/ non-Caucasian was associated with 2.71, 2.56, and 1.93 times odds of the presence of arthritis, diabetes, and heart attack, respectively than Caucasian. Primary school/less education was associated with twice or more times the odds of arthritis and chronic obstructive pulmonary disease (COPD) than ≥high school education. Unemployment was associated with 1.41-, 1.73-, 1.58-, and 1.70-time odds of the presence of arthritis, cancer, COPD, and heart attack, respectively, then employed. Unmarried/widowed/separated was associated with 1.41, 1.75, 2.77, 2.76, 1.86, and 3.34 times odds of the presence of arthritis, asthma, cancer, COPD, diabetes, and heart attack, respectively than married. Annual income < 50,000 was associated with 1.33-, 1.44-, and 1.38-time odds of the presence of arthritis, diabetes, and multi-morbidity, respectively, then annual income ≥50,000. Overweight/obese was associated with 2.28 times the odds of the presence of diabetes than healthy weight. Current/former smoker was associated with 1.57, 2.47, 2.53, 1.63, and 1.24 times odds of the presence of arthritis, cancer, COPD, heart attack, and multi-morbidity, respectively than a nonsmoker. Consuming alcohol was associated with 1.32-, 1.65-, 1.50-, and 1.24-time odds of the presence of arthritis, COPD, diabetes, and multi-morbidity, respectively, then nonalcoholic.

Conclusions

Social determinants are associated with the presence of chronic diseases. Some of the social determinants are modifiable or treatable. Thus, these findings can inform public health strategies in the United States.
Microbiological quality of kitchens sponges used in university student dormitories
Authors: Osaili Tareq M. , Obaid Reyad S. , Alowais Klaithem , Almahmood Rawan , Almansoori Moza , Alayadhi Noora , Alowais Najla , Waheed Klaithem , Dhanasekaran Dinesh Kumar , Al-Nabulsi Anas A. , Ayyash Mutamed , Forsythe Stephen J.
Published: August 2020

Background

Kitchen sponges are a major source of cross-contamination as they can transfer foodborne pathogens, infectious agents and spoilage causing microorganisms to food contact surfaces. Several studies have revealed that university students adopt poor practices regarding food safety, hygiene, and the handling of kitchen cleaning equipment.

Methods

A total of fifty kitchen sponges were collected along with a questionnaire addressing social demographics and kitchen sponge usage by students living at the University of Sharjah dormitories. The effect of storage (3 and 10 days) on the microbial population of kitchen sponges at room temperature (21 °C) was assessed. Enterobacteriaceae isolated from sponges were identified and their antibiotic resistance determined.

Results

Student responses revealed that kitchen sponges used to clean food contact surfaces were also used to clean the oven (32%), sink (26%), refrigerator (10%), and to clean spills on the floor (4%). Kitchen sponges contained high counts of mesophilic aerobic bacteria (7.9 log10/cm3), coliform (7.2 log10/cm3), Enterobacteriaceae (7.3 log10/cm3) and yeasts and molds (7.0 log10/cm3). After storage of the sponges at room temperature (21 °C) for 3 and 10 days, the number of mesophilic aerobic bacteria, coliform, Enterobacteriaceae and yeasts and molds decreased by 0.4 and 1.3 log10/cm3, 0.7 and 1.4 log10/cm3, 0.4 and 1.1 log10/cm3, and 0.6 and 1.3 log10/cm3, respectively. The most frequently isolated Enterobacteriaceae were Enterobacter cloacae (56%) and Klebsiella oxytoca (16%). All E. cloacae isolates were resistant to amoxicillin, cefalotin, cefoxitin and cefuroxime axetil.

Conclusions

This study showed that students living in dormitories lacked good hygienic practices and were at increased risk of food poisoning. Kitchen sponges were highly contaminated with potentially pathogenic bacteria which could be transferred from the general kitchen environment to food contact surfaces and consequently lead to food contamination.
Worsening pulmonary outcomes during sex reassignment therapy in a transgender female with cystic fibrosis (CF) and asthma/allergic bronchopulmonary aspergillosis: a case report
Authors: Lam G. Y. , Goodwin J. , Wilcox P. , Quon B. S.
Published: August 2020

Background

Cystic Fibrosis (CF) is a hereditary pulmonary and extra-pulmonary disease that occurs equally in men and women. However, a difference in morbidity and mortality rates between the sexes has been long documented. Similarly, a sex-disparity in disease severity has been reported in asthma as well. Studies done to date point to estrogen as a possible cause of this sex disparity in pulmonary outcomes in both conditions.

Case presentation

Here, we describe a case of a patient with CF and asthma/allergic bronchopulmonary aspergillosis (ABPA) undergoing sex reassignment therapy (male-to-female) and the negative impact it had on her lung function and frequency of pulmonary exacerbations in the context of increasing doses of exogenous estrogen.

Conclusions

This case raises the possibility of a link between estrogen and worsening pulmonary outcomes and the need for further studies into transgender individuals with CF and/or asthma/ABPA as well as those undergoing high dose estrogen therapy for other indications.
The ceramide [NP]/[NS] ratio in the stratum corneum is a potential marker for skin properties and epidermal differentiation
Authors: Yokose Urara , Ishikawa Junko , Morokuma Yuki , Naoe Ayano , Inoue Yosuke , Yasuda Yuka , Tsujimura Hisashi , Fujimura Tsutomu , Murase Takatoshi , Hatamochi Atsushi
Published: August 2020

Background

Specific species of ceramides (Cer), major constituents of lipids in the stratum corneum (SC), are decreased and are correlated with SC barrier and water-holding functions in the skin of patients with atopic dermatitis (AD) or psoriasis (Pso). However, possible correlations between Cer subclass ratios and skin properties in barrier-disrupted skin and in healthy skin remain unclear. The objective of this study was to identify a new marker to evaluate skin properties and epidermal differentiation in SC not only in barrier-disrupted skin but also in healthy skin.

Methods

The Cer subclass ratios in the SC of healthy control subjects and in patients with AD or Pso were evaluated. Correlations with candidate markers and facial skin features of healthy Japanese females (20–74 years old, n = 210) were investigated. Variations of markers during epidermal differentiation were studied in human epidermis and in cultured keratinocytes.

Results

The ratios of Cer [NP]/[NS], Cer [NH]/[NS], Cer [NP]/[AS], Cer [NH]/[NS], Cer [NDS]/[AS], Cer [AH]/[AS] and Cer [EOP]/[AS] showed significant differences between non-lesional skin of AD patients and normal skin of healthy control subjects, as well as Pso patients and their healthy control subjects. The Cer [NP]/[NS] ratio was correlated with SC functional parameters (transepidermal water loss and capacitance) and with skin appearance (texture, scaling and color) even in the cheek skin of healthy female subjects. The Cer [NP]/[NS] ratio in the SC was approximately 18-times higher than in living keratinocytes, and it increased as they differentiated.

Conclusions

The Cer [NP]/[NS] ratio in the SC is a potential marker for skin properties and epidermal differentiation in barrier-disrupted skin as well as in healthy skin.
Disruption of microbial cell morphology by Buxus macowanii
Authors: Ngobeni B. , Mashele S. S. , Malebo N. J. , van der Watt E. , Manduna I. T.
Published: August 2020

Background

Microbial infections are one of the major causes of death globally. This is attributed to the rising costs of primary healthcare and its inaccessibility especially in developing countries. Moreover, there has been an increase in microbial strains that have reduced susceptibility to antimicrobial drugs. Research on the antimicrobial properties of medicinal plants, which could address these problems, has become more important as they present fewer side effects when compared to the antibiotics currently in use. This study evaluated the antimicrobial properties of a methanolic extract fromBuxus macowaniiin order to assess its potential in the development of novel antimicrobial drugs.

Methods

Antimicrobial activity of the extract was evaluated using the broth microdilution method. The effects ofB. macowaniion the morphology ofB. cereuswere observed using Scanning and Transmission electron microscopy. Chemical profiling of the plant extract was performed using the GCMS.

Results

The extract showed antimicrobial activity against all the microbial species used. Microscopic examination of the cells ofB. cereuscells treated withBuxus macowaniishowed some changes in morphology such as damage of the cell wall, swelling of the cells and incomplete cell division that eventually resulted in cell death. Neophytadiene, an antimicrobial compound was detected in the extract using GCMS.

Conclusion

The morphological disruptions of the cell wall ofBacillus cereusexplain the antimicrobial properties ofB. macowaniiand indicate its possible application in the development of natural antimicrobial drugs.
Efficacy of smartphone-based Mobile learning versus lecture-based learning for instruction of Cephalometric landmark identification
Authors: Golshah Amin , Dehdar Fatemeh , Imani Mohammad Moslem , Nikkerdar Nafiseh
Published: August 2020

Background

Considering the increasing popularity of electronic learning, particularly smartphone-based mobile learning, and its reportedly optimal efficacy for instruction of complicated topics, this study aimed to compare the efficacy of smartphone-based mobile learning versus lecture-based learning for instruction of cephalometric landmark identification.

Methods

This quasi-experimental interventional study evaluated 53 dental students (4th year) in two groups of intervention (n = 27; smartphone instruction using an application) and control (n = 26, traditional lecture-based instruction). Two weeks after the instructions, dental students were asked to identify four landmarks namely the posterior nasal spine (PNS), orbitale (Or), articulare (Ar) and gonion (Go) on lateral cephalograms. The mean coordinates of each landmark identified by orthodontists served as the reference point, and the mean distance from each identified point to the reference point was reported as the mean consistency while the standard deviation of this mean was reported as the precision of measurement. Data were analyzed using SPSS version 18 via independent sample t-test.

Results

No significant difference was noted between the two groups in identification of PNS, Ar or Go (P > 0.05). However, the mean error rate in identification of Or was significantly lower in smartphone group compared with the traditional learning group (P = 0.020).

Conclusions

Smartphone-based mobile learning had a comparable, and even slightly superior, efficacy to lecture-based learning for instruction of cephalometric landmark identification, and may be considered, at least as an adjunct, to enhance the instruction of complicated topics.

Trial registration number

This is not a human subject research. https://ethics.research.ac.ir/ProposalCertificateEn.php?id=33714&Print=true&NoPrintHeader=true&NoPrintFooter=true&NoPrintPageBorder=true&LetterPrint=true.
A retrospective analysis of usefulness of impulse oscillometry system in the treatment of asthma
Authors: Sugawara Hiroyuki , Saito Atsushi , Yokoyama Saori , Tsunematsu Kazunori , Chiba Hirofumi , Takahashi Hiroki
Published: August 2020

Background

Bronchial asthma (BA) has different phenotypes, and it requires a clinically effective subtype classification system. The impulse oscillometry system (IOS) is an emerging technique device used in respiratory functional tests. However, its efficacy has not been validated. Therefore, this study aimed to assess the relationship between BA and the IOS parameters, and the difference in the therapeutic effects of inhaled corticosteroids (ICSs) among the subtype classifications was evaluated using the IOS.

Methods

Of the 245 patients with bronchial asthma who were screened, 108 were enrolled in this study. These patients were divided based on three subtypes according to the IOS result as follows: central predominant type (n = 34), peripheral predominant type (n = 58), and resistless type (n = 16). Then, the following ICSs were randomly prescribed in daily medical care: coarse-particle ICS (fluticasone propionate [FP]), fine-particle ICS (mometasone furoate [MF]), and moderate-particle ICS (budesonide [BUD]). The treatment effects were assessed using the Asthma Health Questionnaire (AHQ) and the Asthma Control Test (ACT) and were compared among the three subtypes.

Results

In the central predominant type, the AHQ score of the MF group was significantly higher than that of the FP group (15.4 vs. 3.6, p < 0.01) and the BUD group (15.4 vs. 8.8, p < 0.05); the ACT score of the FP group was significantly higher than that of the MF and BUD groups (24.3 vs. 21.7, 22.3, respectively, p < 0.05) at 4 weeks after treatment. In the peripheral predominant type, the AHQ score of the FP group was significantly higher than that of the MF group (14.1 vs. 3.4, p < 0.05); the ACT score of the FP group was lower than that of the MF and BUD groups (22.8 vs. 24.6, 24.4, respectively, p < 0.01) at 4 weeks after treatment.

Conclusions

An association was observed between IOS subtype classification and ICS particle size in terms of therapeutic efficacy in BA. This result indicates that the IOS could be an effective tool in the selection of ICS and the evaluation of the BA phenotype.
Using three statistical methods to analyze the association between exposure to 9 compounds and obesity in children and adolescents: NHANES 2005-2010
Authors: Wu Bangsheng , Jiang Yi , Jin Xiaoqing , He Li
Published: August 2020

Background

Various risk factors influence obesity differently, and environmental endocrine disruption may increase the occurrence of obesity. However, most of the previous studies have considered only a unitary exposure or a set of similar exposures instead of mixed exposures, which entail complicated interactions. We utilized three statistical models to evaluate the correlations between mixed chemicals to analyze the association between 9 different chemical exposures and obesity in children and adolescents.

Methods

We fitted the generalized linear regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) to analyze the association between the mixed exposures and obesity in the participants aged 6–19 in the National Health and Nutrition Examination Survey (NHANES) 2005–2010.

Results

In the multivariable logistic regression model, 2,5-dichlorophenol (2,5-DCP) (OR (95% CI): 1.25 (1.11, 1.40)), monoethyl phthalate (MEP) (OR (95% CI): 1.28 (1.04, 1.58)), and mono-isobutyl phthalate (MiBP) (OR (95% CI): 1.42 (1.07, 1.89)) were found to be positively associated with obesity, while methylparaben (MeP) (OR (95% CI): 0.80 (0.68, 0.94)) was negatively associated with obesity. In the multivariable linear regression, MEP was found to be positively associated with the body mass index (BMI) z-score (β (95% CI): 0.12 (0.02, 0.21)). In the WQS regression model, the WQS index had a significant association (OR (95% CI): 1.48 (1.16, 1.89)) with the outcome in the obesity model, in which 2,5-DCP (weighted 0.41), bisphenol A (BPA) (weighted 0.17) and MEP (weighted 0.14) all had relatively high weights. In the BKMR model, despite no statistically significant difference in the overall association between the chemical mixtures and the outcome (obesity or BMI z-score), there was nonetheless an increasing trend. 2,5-DCP and MEP were found to be positively associated with the outcome (obesity or BMI z-score), while fixing other chemicals at their median concentrations.

Conclusion

Comparing the three statistical models, we found that 2,5-DCP and MEP may play an important role in obesity. Considering the advantages and disadvantages of the three statistical models, our study confirms the necessity to combine different statistical models on obesity when dealing with mixed exposures.
Differences in responses to English and Korean versions of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD)
Authors: Sung Ki Hyuk , Kwon Soon-Sun , Cho Gyeong Hee , Chung Chin Youb , Encisa Clarissa , Menal Huroy , Narayanan Unni G. , Park Moon Seok
Published: August 2020

Background

The purpose of this study was to identify differences in caregiver responses to Korean-language and English-language versions of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD) questionnaire.

Methods

Patient data were acquired from the Cerebral Palsy Hip Outcomes Project database, which was established to run a large international multicenter prospective cohort study of the outcomes of hip interventions in cerebral palsy. Thirty-three children whose caregivers had completed the Korean version of CPCHILD were matched by propensity scoring with 33 children whose parents completed the English version. Matching was performed on the basis of 12 covariates: age, gender, gross motor function classification system level, migration percentage of right and hip, seizure status, feeding method, tracheostomy status, pelvic obliquity, spinal deformity, parental report of hip pain and contracture interfering with care.

Results

There were no significant differences in CPCHILD scores for section 4 (Communication and Social Interaction), and section 5 (Health) between two groups. Korean-language CPCHILD scores were significantly lower than English-language CPCHILD scores for section 1 (Personal Care/Activities of Daily Living), section 2 (Positioning, Transferring and Mobility), section 3 (Comfort and Emotions) and section 6 (Overall Quality of Life) as well as in terms of total score.

Conclusions

Cultural influences, and the community or social environment may impact the caregivers’ perception of the health-related quality of life of their children. Therefore, physicians should consider these differences when interpreting the study outcomes across different countries.
Role of exosomes in malignant glioma: microRNAs and proteins in pathogenesis and diagnosis
Authors: Ghaemmaghami Amir B. , Mahjoubin-Tehran Maryam , Movahedpour Ahmad , Morshedi Korosh , Sheida Amirhossein , Taghavi Seyed Pouya , Mirzaei Hamed , Hamblin Michael R.
Published: August 2020

Malignant gliomas are the most common and deadly type of central nervous system tumors. Despite some advances in treatment, the mean survival time remains only about 1.25 years. Even after surgery, radiotherapy and chemotherapy, gliomas still have a poor prognosis. Exosomes are the most common type of extracellular vesicles with a size range of 30 to 100 nm, and can act as carriers of proteins, RNAs, and other bioactive molecules. Exosomes play a key role in tumorigenesis and resistance to chemotherapy or radiation. Recent evidence has shown that exosomal microRNAs (miRNAs) can be detected in the extracellular microenvironment, and can also be transferred from cell to cell via exosome secretion and uptake. Therefore, many recent studies have focused on exosomal miRNAs as important cellular regulators in various physiological and pathological conditions. A variety of exosomal miRNAs have been implicated in the initiation and progression of gliomas, by activating and/or inhibiting different signaling pathways. Exosomal miRNAs could be used as therapeutic agents to modulate different biological processes in gliomas. Exosomal miRNAs derived from mesenchymal stem cells could also be used for glioma treatment. The present review summarizes the exosomal miRNAs that have been implicated in the pathogenesis, diagnosis and treatment of gliomas. Moreover, exosomal proteins could also be involved in glioma pathogenesis. Exosomal miRNAs and proteins could also serve as non-invasive biomarkers for prognosis and disease monitoring.
Reproductive health needs of adolescent and young adult women with pediatric rheumatic diseases
Authors: Carandang Kristine , Mruk Veronica , Ardoin Stacy P. , Huynh Brittany , Clowse Megan E. B. , Berlan Elise D. , Edens Cuoghi
Published: August 2020

Background

The purpose of this study was to identify reproductive health knowledge gaps and topics that concern adolescent and young adult (AYA) women with pediatric rheumatic diseases and their parents.

Methods

Data collection occurred in two cohorts. In the first cohort, young women (15–20 years old) with pediatric-onset rheumatic conditions and their parents were recruited from a single, academic pediatric rheumatology center. In the second cohort, young women (18–25 years old) with pediatric-onset rheumatic conditions were recruited from a national conference for families with pediatric rheumatic diseases. This resulted in 20 adolescents and young adults (18.3 ± 2.4 years old), and 7 parent focus group participants. Focus group leaders facilitated discussions centered on reproductive health topics that participants identified as important, their sources of knowledge, and preferences for patient education and ongoing follow-up. Data were summarized independently by 4 researchers to reduce potential bias and subsequently analyzed using rapid qualitative analysis.

Results

All participants, regardless of diagnosis, medication, current sexual activity, or current intention to have children, expressed concern about the effect of their rheumatic condition and medications on fertility, risks to mother and child during and after pregnancy, and obtaining safe and effective contraception. Additionally, some participants discussed the burden of disease and its potential impact on motherhood. Finally, participants raised concern around the effect of disease and medication on routine reproductive health care, such as menstrual cycles, feminine self-care, and preventive exams. Three themes emerged: 1) participants had been advised to avoid unplanned pregnancy, however reported receiving inadequate explanation to support this instruction, 2) participants conceptualized reproductive health as tied to rheumatic disease management and thus suggested ways to include family members in discussion, and 3) rheumatology practitioners were not considered a resource of reproductive health information.

Conclusions

Young women and their parents reported dissatisfaction with the availability, quantity, and quality of reproductive health information they received, particularly when related to their pediatric-onset rheumatic disease. These findings provide an initial step in understanding the patient perspective of reproductive health in rheumatology, and how to address these concerns in the care of young women with rheumatic diseases.
Suicidal behavior in problematic substance uses in South Gondar zone, Northwest Ethiopia: a cross-sectional survey
Authors: Legas Getasew , Belete Habte , Asnakew Sintayehu , Belete Amsalu , Shumet Shegaye
Published: August 2020

Background

Suicidal behavior has a significant contribution to the global burden of disease that affects individuals, families and communities at different age groups. Sadly, up to 75% of suicides in the world occur in low-and- middle income countries which have no adequate resource to prevent it. The aim of this study was to assess suicidal behavior and associated factors among community residents with problematic substance use in South Gondar zone, northwest Ethiopia.

Methods

Community based cross-sectional survey was conducted by using a suicidal behavior revised questionnaire from January 15 to March 15, 2019. A total of 4035 participants were screened for problematic substance use by using multi stage cluster sampling and 846 participants were positive for problematic substance use then asked for suicidal behavior. Multiple logistic regression analyses used to see adjusted odd rations (AOR). Multilevel binary logistic regression was used to account for the hierarchical structure of the two-level data within individual and districts level.

Results

The prevalence of suicidal behavior over the last 12 months in problematic substance uses was found to be 41.4% with 95% of confidence interval (CI) (38.2–44.9). Perceived stigma, [AOR = 1.605, 95% CI (1.16–2.23)], family history of suicide [AOR = 3.22, 95% CI (1.46–7.10)], physical illness [AOR = 2.45 95% CI (1.157–3.84)], rural resident [AOR = 1.74, 95% CI (1.16–2.62)], depression [AOR = 4.44, 95% CI (3.15–6.27)] and living alone (AOR = 1.61, 95% CI (1.16–2.24) were risks factors for suicidal behavior.

Conclusion

Suicidal behavior in problematic substance uses found to be high. Health workers should pay attention to decrease suicidal behavior and to control amendable factors.
Inhibition of the mechanistic target of rapamycin induces cell survival via MAPK in tuberous sclerosis complex
Authors: Lu Yiyang , Zhang Erik Y. , Liu Jie , Yu Jane J.
Published: August 2020

Background

Tuberous sclerosis complex (TSC) is a genetic disorder that cause tumors to form in many organs. These lesions may lead to epilepsy, autism, developmental delay, renal, and pulmonary failure. Loss of function mutations in TSC1 and TSC2 genes by aberrant activation of the mechanistic target of rapamycin (mTORC1) signaling pathway are the known causes of TSC. Therefore, targeting mTORC1 becomes a most available therapeutic strategy for TSC. Although mTORC1 inhibitor rapamycin and Rapalogs have demonstrated exciting results in the recent clinical trials, however, tumors rebound and upon the discontinuation of the mTORC1 inhibition. Thus, understanding the underlying molecular mechanisms responsible for rapamycin-induced cell survival becomes an urgent need. Identification of additional molecular targets and development more effective remission-inducing therapeutic strategies are necessary for TSC patients.

Results

We have discovered an Mitogen-activated protein kinase (MAPK)-evoked positive feedback loop that dampens the efficacy of mTORC1 inhibition. Mechanistically, mTORC1 inhibition increased MEK1-dependent activation of MAPK in TSC-deficient cells. Pharmacological inhibition of MAPK abrogated this feedback loop activation. Importantly, the combinatorial inhibition of mTORC1 and MAPK induces the death of TSC2-deficient cells.

Conclusions

Our results provide a rationale for dual targeting of mTORC1 and MAPK pathways in TSC and other mTORC1 hyperactive neoplasm.
Participation in patient support forums may put rare disease patient data at risk of re-identification
Authors: Gow James , Moffatt Colin , Blackport Jamie
Published: August 2020

Background

Rare disease patients often struggle to find both medical advice and emotional support for their diagnosis. Consequently, many rare disease patient support forums have appeared on hospital webpages, social media sites, and on rare disease foundation sites. However, we argue that engagement in these groups may pose a healthcare data privacy threat to many participants, since it makes a series of patient indirect identifiers ‘readily available’ in combination with rare disease conditions. This information produces a risk of re-identification because it may allow a motivated attacker to use the unique combination of a patient’s identifiers and disease condition to re-identify them in anonymized data.

Results

To assess this risk of re-identification, patient direct and indirect identifiers were mined from patient support forums for 80 patients across eight rare diseases. This data mining consisted of scanning patient testimonials, social media sites, and public records for the collection of identifiers linked to a rare disease patient. The number of people in the United States that may share each patient’s combination of marital status, 3-digit ZIP code, age, and sex, as well as their rare disease condition, was then estimated, as such information is commonly found in health records which have undergone de-identification by HIPAA’s ‘Safe Harbor.’ The study showed that by these estimations, nearly 75% of patients could be at high risk for re-identification in healthcare datasets in which they appear, due to their unique combination of identifiers.

Conclusions

The results of this study show that these rare disease patients, due to their choice to provide support for their community, are putting all their healthcare data at risk of re-identification. This paper demonstrates how simple adjustments to participation guidelines in such support forums, in combination with improved privacy measures at the organizational level, could mitigate this risk of re-identification. Additionally, this paper suggests the potential for future investigation into consideration of certain ‘risky’ International Classification of Diseases (ICD) codes as quasi-identifiers in de-identified datasets to further protect patients’ privacy, while maintaining the utility of such rare disease support groups.
Multi-level consistent changes of the ECM pathway identified in a typical keratoconus twin’s family by multi-omics analysis
Authors: Hao Xiao-dan , Chen Xiu-nian , Zhang Yang-yang , Chen Peng , Wei Chao , Shi Wei-yun , Gao Hua
Published: August 2020

Background

Keratoconus (KC) is a common, degenerative disorder of the cornea, and genetic factors play a key role in its development. However, the genetic etiology of KC is still unclear. This study used the family of twins as material, using, for the first time, multi-omics analysis, to systematically display the changes in KC candidate factors in patients at the DNA, RNA, and protein levels. These can evaluate candidate pathogenic factors in depth and lock onto pathogenic targets.

Results

The twins in this study presented classic phenotypes, clear diagnoses, complete case data, and clinical samples, which are excellent materials for genetically studying KC. Whole-exome sequencing was conducted on both the twins and their parents. Transcriptome sequencing was conducted on proband’s and health individual’s primary human corneal fibroblast cells. Quantitative Real-time PCR and western blot were used to validate the differential gene expressions between the proband and controls. By integrating genomics, transcriptome, and protein level data, multiple consecutive events of KC were systematically analyzed to help better understand the molecular mechanism and genetic basis of KC. The results showed that the accumulation of rare, micro-effect risk variants was the pathogenic factor in this Chinese KC family. Consistent changes in extracellular matrices (ECMs) at the DNA and RNA levels suggested that ECM related changes play a key role in KC pathogenesis. The major gene variants (WNT16,CD248,COL6A2,COL4A3andADAMTS3) may affect the expression of related collagens or ECM proteins, thus reducing the amount of ECM in corneas and resulting in KC.

Conclusions

This study, the first to explore the genetic etiology of KC via multi-omics analysis under the polygenetic model, has provided new insights into the genetic mechanisms underlying KC and an effective strategy for studying KC pathogenesis in the future.
Effect of withholding early parenteral nutrition in PICU on ketogenesis as potential mediator of its outcome benefit
Authors: De Bruyn Astrid , Gunst Jan , Goossens Chloë , Vander Perre Sarah , Guerra Gonzalo G. , Verbruggen Sascha , Joosten Koen , Langouche Lies , Van den Berghe Greet
Published: August 2020

Background

In critically ill children, omitting early use of parenteral nutrition (late-PN versus early-PN) reduced infections, accelerated weaning from mechanical ventilation, and shortened PICU stay. We hypothesized that fasting-induced ketogenesis mediates these benefits.

Methods

In a secondary analysis of the PEPaNIC RCT (N = 1440), the impact of late-PN versus early-PN on plasma 3-hydroxybutyrate (3HB), and on blood glucose, plasma insulin, and glucagon as key ketogenesis regulators, was determined for 96 matched patients staying ≥ 5 days in PICU, and the day of maximal 3HB-effect, if any, was identified. Subsequently, in the total study population, plasma 3HB and late-PN-affected ketogenesis regulators were measured on that average day of maximal 3HB effect. Multivariable Cox proportional hazard and logistic regression analyses were performed adjusting for randomization and baseline risk factors. Whether any potential mediator role for 3HB was direct or indirect was assessed by further adjusting for ketogenesis regulators.

Results

In the matched cohort (n = 96), late-PN versus early-PN increased plasma 3HB throughout PICU days 1–5 (P < 0.0001), maximally on PICU day 2. Also, blood glucose (P < 0.001) and plasma insulin (P < 0.0001), but not glucagon, were affected. In the total cohort (n = 1142 with available plasma), late-PN increased plasma 3HB on PICU day 2 (day 1 for shorter stayers) from (median [IQR]) 0.04 [0.04–0.04] mmol/L to 0.75 [0.04–2.03] mmol/L (P < 0.0001). The 3HB effect of late-PN statistically explained its impact on weaning from mechanical ventilation (P = 0.0002) and on time to live PICU discharge (P = 0.004). Further adjustment for regulators of ketogenesis did not alter these findings.

Conclusion

Withholding early-PN in critically ill children significantly increased plasma 3HB, a direct effect that statistically mediated an important part of its outcome benefit.
Cryptosporidium parvum upregulates miR-942-5p expression in HCT-8 cells via TLR2/TLR4-NF-κB signaling
Authors: Zhang Guiling , Zhang Yajun , Niu Ziwen , Wang Chenrong , Xie Fujie , Li Juanfeng , Zhang Sumei , Qi Meng , Jian Fuchun , Ning Changshen , Zhang Longxian , Wang Rongjun
Published: August 2020

Background

Micro (mi)RNAs are small noncoding RNA molecules that function in RNA silencing and post-transcriptional regulation of gene expression. This study investigated host miRNA activity in the innate immune response to Cryptosporidium parvum infection.

Methods

In vitro infection model adopts HCT-8 human ileocecal adenocarcinoma cells infected with C. parvum. The expression of miR-942-5p was estimated using quantitative real-time polymerase chain reaction (qPCR). The TLRs-NF-κB signaling was confirmed by qPCR, western blotting, TLR4- and TLR2-specific short-interfering (si)RNA, and NF-κB inhibition.

Results

HCT-8 cells express all known toll-like receptors (TLRs). Cryptosporidium parvum infection of cultured HCT-8 cells upregulated TLR2 and TLR4, and downstream TLR effectors, including NF-κB and suppressed IκBα (nuclear factor of kappa light polypeptide gene enhancer in B cells inhibitor, alpha). The expression of miR-942-5p was significantly upregulated at 4, 8, 12 and 24 h post-infection, and especially at 8 hpi. The results of TLR4- and TLR2-specific siRNA and NF-κB inhibition showed that upregulation of miR-942-5p was promoted by p65 subunit-dependent TLR2/TLR4-NF-κB pathway signaling.

Conclusions

miR-942-5p of HCT-8 cells was significantly upregulated after C. parvum infection, especially at 8 hpi, in response to a p65-dependent TLR2/TLR4-NF-κB signaling. TLR4 appeared to play a dominant role.
N6-Adenosine methylation on mRNA is recognized by YTH2 domain protein of human malaria parasite Plasmodium falciparum
Authors: Govindaraju Gayathri , Kadumuri Rajashekar Varma , Sethumadhavan Devadathan Valiyamangalath , Jabeena C. A. , Chavali Sreenivas , Rajavelu Arumugam
Published: August 2020

Background

Plasmodium falciparum exhibits high translational plasticity during its development in RBCs, yet the regulation at the post-transcriptional level is not well understood. The N6-methyl adenosine (m6A) is an important epigenetic modification primarily present on mRNA that controls the levels of transcripts and efficiency of translation in eukaryotes. Recently, the dynamics of m6A on mRNAs at all three developmental stages of P. falciparum in RBCs have been profiled; however, the proteins that regulate the m6A containing mRNAs in the parasites are unknown.

Results

Using sequence analysis, we computationally identified that the P. falciparum genome encodes two putative YTH (YT521-B Homology) domain-containing proteins, which could potentially bind to m6A containing mRNA. We developed a modified methylated RNA immunoprecipitation (MeRIP) assay using PfYTH2 and find that it binds selectively to m6A containing transcripts. The PfYTH2 has a conserved aromatic amino acid cage that forms the methyl-binding pocket. Through site-directed mutagenesis experiments and molecular dynamics simulations, we show that F98 residue is important for m6A binding on mRNA. Fluorescence depolarization assay confirmed that PfYTH2 binds to methylated RNA oligos with high affinity. Further, MeRIP sequencing data revealed that PfYTH2 has more permissive sequence specificity on target m6A containing mRNA than other known eukaryotic YTH proteins. Taken together, here we identify and characterize PfYTH2 as the major protein that could regulate m6A containing transcripts in P. falciparum.

Conclusion

Plasmodium spp. lost the canonical m6A-specific demethylases in their genomes, however, the YTH domain-containing proteins seem to be retained. This study presents a possibility that the YTH proteins are involved in post-transcriptional control in P. falciparum, and might orchestrate the translation of mRNA in various developmental stages of P. falciparum. This is perhaps the first characterization of the methyl-reading function of YTH protein in any parasites.