bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-chain fatty acid-Butyrate ameliorates hypoxia-induced pulmonary hypertension in rat
Authors: He Shixin , Zhu Tengteng , Zhu Zhaowei , Huang Yiyuan , Tai Shi , Tang Liang , Fang Zhenfei
Published: March 2020

Background: Gut Microbiome can produce numerous metabolites which may be absorbed into the circulation and play a critical role in the development of diseases. Our study wants to find out the roles of faecal microbiota and its metabolite in the development of pulmonary hypertension. Methods: SD rats were expose to either normoxia (Control, n=8) or chronic hypoxia (10% O 2 ) (n=16). Rats in chronic hypoxia were randomly received sodium butyrate (500 mg/kg) (n=8) or volume-matched saline (n=8) once a day. Rats in normoxia condition also received volume-matched saline once a day. RVSP and lung vascular features were assessed after 3 week’s treatment. Rats’ fecal samples were collected and analyzed by GCMS and 6S/18S Amplicon Sequencing. Activation of HIF-1α, HMGB2, TLR4, TNF-α, HDAC5 and PCNA was assessed using Western blot analysis. The effect of sodium butyrate on proliferation of pulmonary artery smooth muscle cell, induced by PDGF or hypoxia (1% O 2 ), was evaluated by CCK-8, EDU assay and wound healing assay. Results: Hypoxia significantly increased RVSP and induced a significant decrease in butyrate-producing bacteria, but a slight decrease of SCFAs without statistic difference. Administration of sodium butyrate remarkably attenuated the RVSP and improved lung vascular features. Decreased expression of HDAC5, PCNA, HIF-1α, HMGB2, TLR4, TNF-α and inhibited proliferation of PASMC were found in rats or cells with sodium butyrate. Conclusions: Decreased butyrate-producing bacteria may contribute to the development of PH, and sodium butyrate supplement can effectively attenuate hypoxia-induced PH in rats probably by inhibiting the proliferation and migration of PASMC.
Interpretation and content validity of the items of the numeric rating version Short-WORC to evaluate outcomes in management of rotator cuff pathology: A cognitive interview approach.
Authors: Furtado Rochelle , MacDermid Joy C , Bryant Dianne , Faber Kenneth J , Athwal George S
Published: March 2020

Background: The shortened version of the Western Ontario Rotator Cuff Index (Short-WORC) is a patient reported outcome measure that evaluates quality of life (QoL) of patients with rotator cuff pathology. However, formal content validation of the full or Short-WORC has not been reported. This study aims to understand how 1) people interpret and calibrate responses to items on the Short-WORC and 2) compensatory strategies that might enhance function and thereby affect responses.

Methods: This study uses cognitive interviewing, a qualitative methodology that focuses on the interpretation of questionnaire items. Patients with rotator cuff disorders (n=10), clinicians (n=6) and measurement researchers (n=10) were interviewed using a talk aloud structured interview that evaluated each of the 7 items of the Short-WORC. All interviews were recorded and transcribed verbatim by one researcher (R.F). Analysis was done through an open coding scheme using a previously established framework.

Results: Overall, the items on the Short-WORC were well received by participants. Through the interviews, the 6 themes of: Comprehension, Inadequate response definition, Reference Point, Relevance, Perspective Modifiers and Calibration Across Items emerged. The items of working above the shoulder (90%), compensating with the unaffected arm (88%) and lifting heavy objects (92%) were the most relevant to participants. Participants calibrated their scores on the items of sleeping and styling (19%) the most. Perspective modifiers of gender, influenced the calibrations of items of styling your hair (30%) and dressing or undressing (19%). Compensatory strategies of task-re allocation and using assistive devices/resources were frequently mentioned by participants. Overall, participants had minor comprehension issues, but found the 7- items of the Short-WORC to be relevant to QoL.

Conclusions: Therefore, the findings demonstrate that the Short-WORC is not cognitively complex, but varies with patient perspectives. Overall, the Short-WORC provides evidence of demonstrating strong content validity when used for rotator cuff disorder patients.
Investigation of the antigenicity and protective efficacy of Leishmania promastigote membrane antigens in search of potential diagnostic and vaccine candidates against visceral leishmaniasis
Authors: Ejazi Sarfaraz Ahmad , Ghosh Smriti , Bhattacharyya Anirban , Kamran Mohd , Das Sonali , Bhowmick Sudipta , Rahaman Mehebubar , Goswami Rama Prosad , Ali Nahid
Published: March 2020

Background
Visceral leishmaniasis (VL), a parasitic disease causes serious medical consequences if treatment is delayed. Despite a decline in the number of VL cases in the Indian Subcontinent, commencement of the disease in newer areas continues to be a major concern. Although serological diagnosis mainly by immunochromatographic tests has been found to be effective, test for cure in different phases of treatment is still desired. Even though good prophylactic response has been obtained in murine models by a number of vaccine candidates, few have been proposed for human use.
Methods
In this study, nine antigenic components (31, 34, 36, 45, 51, 63, 72, 91 and 97 kDa) of Leishmania promastigote membrane antigens, LAg, were electroeluted and evaluated through ELISA to diagnose and distinguish active VL from one month cured and six month past infection. Further, to investigate the immunogenicity of electroeluted proteins, humans PBMCs of cured VL patients were stimulated with 31, 34, 51, 63, 72, and 91 kDa proteins.
Results
We found that 34 and 51 kDa fractions show 100% sensitivity and specificity with healthy controls and other diseases. After six months post treatment antibodies to 72 and 91 kDa antigens show a significant decline to almost normal levels. This suggests that 34 and 51 kDa are efficient in diagnosis whereas 72 and 91 kDa may be used to monitor treatment outcome. In another study, 51 and 63 kDa proteins demonstrated maximum ability for up-regulate IFN-g and IL-12 with minimum induction of IL-10 and TGF-β. The results indicating that 51 and 63 kDa proteins could be strong candidates for human immunization against VL. In contrast, 34 and 91 kDa demonstrated a reverse profile and may not be a good vaccine candidate.
Conclusions
The preliminary data obtained in this study proposes the potential of some of the antigens in Leishmania diagnosis and for test of cure. Additionally, some antigens demonstrated good immunoprophylactic cytokine production through T cell mediated immune response suggesting future vaccine candidates for VL. However, further studies are necessary to explore these antigens in diagnosis and to access long-term immune response.
Sentiment Analysis of Online Product Reviews Using DLMNN and Future Prediction of Online Product Using IANFIS
Authors: p Sasikala , Sheela Mary Immaculate
Published: March 2020

A major task that the NLP (Natural Language Processing) has to follow is Sentiments analysis (SA) or opinions mining (OM). For finding whether the user's attitude is positive, neutral or negative, it captures each user's opinion, belief, and feelings about the corresponding product. Through this, needed changes can well be done on the product for better customer contentment by the companies. Most of the existing techniques on SA for these online products encompass very low accuracy and also consumed more time during training. By utilizing a Deep learning modified neural network (DLMNN), a method is proposed for SA of online product review and by means of Improved Adaptive Neuro-Fuzzy Inference System (IANFIS), a method is proposed for future prediction of online products to trounce the above-stated issues. Initially, the data values are partitioned into Grade-based (GB), Content-based (CB), and Collaboration based (CLB) scenarios from the dataset. After that, each scenario goes through review analysis (RA) by utilizing DLMNN, which brings about the results as positive, negative, as well as neutral reviews. IANFIS performs a weighting factor and classification on the product for future prediction. In the experimental evaluation, the proposed system gave a better performance compared to the existing methods.
Mixture toxicity of zinc oxide nanoparticle and chemicals with different mode of action upon Vibrio fischeri
Authors: Chen Fen , Wu Ligui , Xiao Xiaoyu , Rong Lingling , Li Mi , zou xiaoming
Published: March 2020

Background: Zinc oxide nanoparticle ( n ZnO) and chemicals with different mode of action (MOA, i.e., narcotic and reactive) were frequently detected in the Yangtze River. Organisms are typically exposed to mixtures of n ZnO and other chemicals rather than individual n ZnO. Toxicity of n ZnO is caused by the dissolution of Zn 2+ , which has been proved in the field of single toxicity. However, it is still unclear whether the released Zn 2+ plays a critical role in the n ZnO toxicity of n ZnO-chemicals mixtures. In the present study, the binary mixture toxicity of n ZnO/Zn 2+ and chemicals with different MOA was investigated in acute (15 min) and chronic (12 h) toxicity test upon Vibrio fischeri ( V. fischeri ). The joint effects of n ZnO and tested chemicals were explored. Moreover, two classic models, concentration addition (CA) and independent action (IA) were applied to predict the toxicity of mixtures.
Results: The difference of toxicity unit (TU) values between the mixtures of Zn 2+ -chemicals with those of n ZnO-chemicals was not significant ( P > 0.05), not only in acute toxicity test but also in chronic toxicity test. The antagonistic or additive effects for n ZnO-chemicals can be observed in most mixtures, with the TU values ranging from 0.75-1.77 and 0.47-2.45 in acute toxicity test and chronic test, respectively. We also observed that the prediction accuracy of CA and IA models was not very well in the mixtures where the difference between the toxicity ratios of the components was small (less than about 10), with the mean absolute percentage error (MAPE) values ranging from 0.14-0.67 for CA model and 0.17-0.51 for IA model, respectively.
Conclusion: We found that the dissolved Zn 2+ mainly accounted for the n ZnO toxicity in the mixtures of n ZnO-chemicals, and the joint effects of these mixtures were mostly antagonism and additivity. CA and IA models were unsuitable for predicting the mixture toxicity of n ZnO-chemicals at their equitoxic ratios.
Dissection of the mutation accumulation process during bacterial range expansions
Authors: Bosshard Lars , Peischl Stephan , Ackermann Martin , Excoffier Laurent
Published: March 2020

Background

Recent experimental work has shown that the evolutionary dynamics of bacteria expanding across space can differ dramatically from what we expect under well-mixed conditions. During spatial expansion, deleterious mutations can accumulate due to inefficient selection on the expansion front, potentially interfering with and modifying adaptive evolutionary processes.

Results

We used whole genome sequencing to follow the genomic evolution of 10 mutator Escherichia coli lines during 39 days ( ~1650 generations) of a spatial expansion, which allowed us to gain a temporal perspective on the interaction of adaptive and non-adaptive evolutionary processes during range expansions. We used elastic net regression to infer the positive or negative effects of mutations on colony growth. The colony size, measured after three day of growth, decreased at the end of the experiment in all 10 lines, and mutations accumulated at a nearly constant rate over the whole experiment. We find evidence that beneficial mutations accumulate primarily at an early stage of the experiment, leading to a non-linear change of colony size over time. Indeed, the rate of colony size expansion remains almost constant at the beginning of the experiment and then decreases after ~12 days of evolution. We also find that beneficial mutations are enriched in genes encoding transport proteins, and genes coding for the membrane structure, whereas deleterious mutations show no enrichment for any biological process.

Conclusions

Our experiment shows that beneficial mutations target specific biological functions mostly involved in inter or extra membrane processes, whereas deleterious mutations are randomly distributed over the whole genome. It thus appears that the interaction between genetic drift and the availability or depletion of beneficial mutations determines the change in fitness of bacterial populations during range expansion.
Performance of TGSE BLADE DWI compared with RESOLVE DWI in the diagnosis of cholesteatoma
Authors: Author) Yaru Sheng(Former Corresponding , Hong Rujian , Author) Yan Sha(New Corresponding , Zhang Zhongshuai , Zhou Kun , Fu Caixia
Published: March 2020

Background :Based on its high resolution in soft tissue, MRI, especially diffusion-weighted imaging (DWI), is increasingly important in the evaluation of cholesteatoma. The purpose of this study was to evaluate the role of the 2D turbo gradient- and spin-echo (TGSE) diffusion-weighted (DW) pulse sequence with the BLADE trajectory technique in the diagnosis of cholesteatoma at 3T and to qualitatively and quantitatively compare image quality between the TGSE BLADE and RESOLVE methods.Method:A total of 42 patients (23 males, 19 females; age range, 7-65 years; mean, 40.1 years) with surgically confirmed cholesteatoma in the middle ear were enrolled in this study. All patients underwent DWI (both a prototype TGSE BLADE DWI sequence and the RESOLVE DWI sequence) using a 3-T scanner with a 64-channel brain coil.Qualitative imaging parameters (imaging sharpness, geometric distortion, ghosting artifacts, and overall imaging quality) and quantitative imaging parameters (apparent diffusion coefficient [ADC], signal-to-noise ratio [SNR], contrast, and contrast-to-noise ratio [CNR]) were assessed for the two diffusion acquisition techniques by two independent radiologists.Result: A comparison of qualitative scores indicated that TGSE BLADE DWI produced less geometric distortion, fewer ghosting artifacts (P<0.001) and higher image quality (P<0.001) than were observed for RESOLVE DWI. A comparison of the evaluated quantitative image parameters between TGSE and RESOLVE showed that TGSE BLADE DWI produced a significantly lower SNR (P<0.001) and higher parameter values (both contrast and CNR (P < 0.001)) than were found for RESOLVE DWI.The ADC (P<0.001) was significantly lower for TGSE BLADE DWI (0.763×10-3 s/mm2) than RESOLVE DWI (0.928×10-3 s/mm2).Conclusion: Compared with RESOLVE DWI, TGSE BLADE DWI significantly improved the image quality of cholesteatoma by reducing magnetic sensitive artifacts, distortion, and blurring. TGSE BLADE DWI is more valuable than RESOLVE DWI for the diagnosis of small-sized (2 mm) cholesteatoma lesions. However, TGSE BLADE DWI also has some disadvantages: the whole image intensity is slightly low, so that the anatomical details of the air-bone interface are not shown well, and this shortcoming should be improved in the future.
Microaneurysms detection in color fundus images using machine learning based on directional local contrast
Authors: Long Shengchun , Chen Jiali , Hu Ante , Liu Haipeng , Chen Zhiqing , Zheng Dingchang
Published: March 2020

Background: As one of the major complications of diabetes, diabetic retinopathy (DR) is a leading cause of visual impairment and blindness due to delayed diagnosis and intervention. Microaneurysms appear as the earliest symptom of DR. Accurate and reliable detection of microaneurysms in color fundus images has great importance for DR screening.

Methods: A microaneurysms detection method using machine learning based on directional local contrast (DLC) is proposed for the early diagnosis of DR. First, blood vessels were enhanced and segmented using improved enhancement function based on analyzing eigenvalues of Hessian matrix. Next, with blood vessels excluded, microaneurysm candidate regions were obtained by using shape characteristics and connected components analysis. After image segmented to patches, the features of each microaneurysm candidate patch were extracted, and each candidate patch was classified into microaneurysm or non-microaneurysm. The main contributions of our study are: 1) Making use of directional local contrast in microaneurysms detection for the first time, which does make sense for better microaneurysms classification. 2) Applying three different machine learning techniques for classification and comparing their performance for microaneurysms detection. The proposed algorithm was trained and tested on e-ophtha MA database, and further tested on another independent DIARETDB1 database. Results of microaneurysms detection on the two databases were evaluated on lesion level and compared with existing algorithms.

Results: The proposed method has achieved better performance compared with existing algorithms on accuracy and computation time. On e-ophtha MA and DIARETDB1 databases, the area under curve (AUC) of receiver operating characteristic (ROC) curve was 0.87 and 0.86, respectively. The free-response ROC (FROC) score on the two databases was 0.374 and 0.210, respectively. The computation time per image with resolution of 2544×1969, 1400×960 and 1500×1152 is 29 seconds, 3 seconds and 2.6 seconds respectively.

Conclusions: The proposed method using machine learning based on directional local contrast of image patches can effectively detect microaneurysms in color fundus images and provide an effective scientific basis for early clinical DR diagnosis.

Keywords: color fundus image; microaneurysms detection; patch; features extraction; directional local contrast; machine learning
An Investigation of the Expression of 2019 Novel Coronavirus Cell Receptor Gene ACE2 in a Wide Variety of Human Tissues
Authors: Li Mengyuan , Li Lin , Zhang Yue , Wang Xiaosheng
Published: March 2020

Background: The 2019 novel coronavirus (2019-nCoV) has affected more than 72,000 people worldwide and caused more than 1,800 deaths so far. 2019-nCoV uses the angiotensinconverting enzyme 2 (ACE2) as the cell receptor to invade the human host and primarily causes pneumonia. Thus, ACE2 is the key to understanding the mechanism of 2019-nCoV infection. Methods: We compared ACE2 expression levels across 31 human normal tissues, between males and females, and between younger (ages <= 49 years) and older (ages > 49 years) persons in these tissues. We also investigated the correlations between ACE2 expression and immune signatures in various tissues. Results: ACE2 expression levels were the highest in small intestine, testis, kidney, heart, thyroid, and adipose tissue, and were the lowest in blood, spleen, bone marrow, brain, blood vessel, and muscle. In lungs, colon, liver, bladder, and adrenal gland, ACE2 showed the medium expression levels. ACE2 was not differentially expressed between males and females and between younger and older persons in any tissue. In skin, digestive system, brain, and blood vessel, ACE2 expression levels were positively associated with immune signatures in both males and females. In thyroid and lungs, ACE2 expression levels were positively and negatively associated with immune signatures in males and females, respectively.Conclusions: Our data provide potential cues for the 2019-nCoV epidemic may infect other tissues outside lungs, affect males and females and young and old persons equally, and old age and male are associated with higher mortality risk for 2019-nCoV infection.
Relapse of undernutrition and food insecurity in a nutritional program in HIV care: mixed-methods study in Tigray region, Ethiopia.
Authors: Tesfay Fisaha , Ziersch Anna , Javanparast Sara , Mwanri Lillian
Published: March 2020

Background Food insecurity is one of the major contributors to poor attainment of nutritional recovery among people living with HIV who are enrolled in nutritional programs. Nevertheless, nutritional programs in HIV care settings implemented in many countries are not designed to address food insecurity. This study in Tigray region Ethiopia examined relapse of undernutrition, and in particular how food insecurity had an impact on effectiveness of the nutritional program, specifically relapse of undernutrition after nutritional recovery Methods This study employed mixed-methods approach involving quantitative and qualitative methods. In the quantitative part, hospital records were collected of 1757 adults and 236 children living with HIV who were enrolled in the nutritional program. Logistic and cox-regression analysis were used to analyse the data. In the qualitative study, data was collected through in-depth interviews with 20 adults, 15 caregivers of children living with HIV, and 13 health providers and program managers. Thematic framework analysis was used to analyse the qualitative data. Results Among those who graduated from the nutritional program, 18% of adults and 7% of children relapsed. Lower educational status (primary and secondary), no membership of a community HIV support group, ambulatory and bedridden functional status, longer periods on ART (more than 24 months), presence of an opportunistic infection and poor baseline nutritional status were associated with relapse. Furthermore, those from rural areas, who did not attend formal education, were employed and had bedridden functional status, anaemia and worst nutritional status were likely to have more frequent episodes of relapse than their counterparts. Findings of the qualitative study also highlighted that poverty, poor livelihood, and food insecurity were the fundamental challenges to the effectiveness of nutritional programs in HIV care including relapse. Household food insecurity contributed to the selling and sharing of the nutritional supports and negatively impacted program effectiveness by contributing to relapse of undernutrition. Conclusions Unless nutritional programs take into consideration the underlying determinants of food insecurity in the design, implementation, and funding of nutritional programs in HIV care, the success of the nutritional programs like those implemented in Ethiopia will be undermined.
Prevalence and Factors Associated with Malnutrition in Children Aged 6-59 Months in Jubek State, South Sudan.
Authors: Iyya Martin Adelino , Grace Ndeezi , Nicolette Nabukeera Barungi , Chollong Hassan
Published: March 2020

Background: South Sudan is the world’s youngest nation which gained independence from Sudan on the 9th of July, 2011. Rates of acute malnutrition have been consistently higher in South Sudan than any other country in sub-Saharan Africa, more than twice the average reported for countries in Sub-Saharan Africa. This study sought to determine the prevalence and factors associated with malnutrition among children aged 6-59 months in Jubek State, South Sudan.Methods: This was a cross sectional analytical community based study to assess the prevalence and factors associated with malnutrition among children aged 6-59 months in Jubek State, South Sudan. Data was collected using a structured questionnaire from 396 children. Anthropometric measurements including weight, length/ height, mid upper arm circumference (MUAC) were taken and a blood sample by finger prick was removed for HIV test. The equipment which were used included: WHO recommended MUAC tape for 6months to 59 months old children, digital weighing scale (SECCA) and portable Stadiometers. Data were collected using a pretested semi- structured questionnaire. Results: The analysis of this study revealed that, 32.2%, 28.2% and 32.3% of children were stunted, wasted and underweight respectively. The main associated factors of stunting were age older than one year (p= 0.004), children from households who were renting their houses and children who defecate in open spaces with no latrine at their homes (p= 0.015). Underweight was associated with child’s age (p= 0.001), loss of appetite (p=<0.001), children who ate from own plate (p=0.001) and children who didn’t consume meat (p=0.007). Male genders (p=0.022), households with two or more children aged zero to five years (0.010) not consuming vitamin A rich vegetable (p=0.002), diarrheal disease within two weeks prior to interview (p=0.006) and those from households with water sources other than piped (<0.001) were also associated with wasting. Conclusion:The findings of this study indicate that malnutrition is still a serious public health problem among children below five years of age in Jubek state, South Sudan. Emergency intervention measures to address this critical levels of malnutrition are required.
Contextual factors of self-regulation in adolescent medical rehabilitation patients—a qualitative study
Authors: Höhn Cindy , Metzner Gloria , Waldeck Edith , Glattacker Manuela
Published: March 2020

Background:In recent decades, the prevalence of chronic diseases in children and adolescents has increased significantly. Contextual factors play a central role in the self-regulation of chronic diseases. They influence illness and treatment representations, disease management, and health outcomes. While previous studies have investigated the influence of contextual factors on children's beliefs about their illness, little is known about subjective contextual factors of treatment representations of children and adolescents with chronic diseases, especially in the context of rehabilitation. Therefore, the aim of this qualitative analysis was to examine the contextual factors reported by chronically ill adolescents in relation to their treatment representations. Furthermore, we aimed to assign the identified themes to classifications of environmental and personal contextual factors in the context of the ICF.Methods:Between July and September 2018, semi-structured interviews were conducted with N=13 adolescent rehabilitants to explore their rehab-related treatment representations and associated contextual factors. The interviews started with an open narrative question about expectations and beliefs about rehabilitation, followed by further detailed questions. The interviews were recorded on audio tape, transcribed, and analysed using thematic content analysis. Results:Participants raised six themes associated with their rehab-related treatment representations that were interpreted as contextual factors: the living situation before rehabilitation, characterised by school and family problems, few social contacts, and intensive media consumption; the idea of rehabilitation, which mostly came from various people in the adolescent’s social environment; previous solution attempts; rehab pre-experiences; information that the adolescents received from the clinic or sought themselves; and the assumed attitudes of their parents concerning the presumed necessity of rehabilitation and expectations regarding the process and its outcome. All the themes could be assigned to the classification of environmental and personal factors in the context of the ICF for children and youth.Conclusions:Although contextual factors have an important impact on self-regulation, little attention is paid to their investigation. Personal and environmental factors probably influence patients’ treatment representations in terms of expectations and concerns as well as emotions regarding the treatment. Considering contextual factors could lead to the more appropriate allocation of medical care and the better customisation of treatment.
Spatial patterns and associated factors’ of Early Marriage among Reproductive age women in Ethiopia: a Secondary Analysis of Ethiopian Demographic and Health Survey 2016
Authors: Tadesse Zemenu Tessema
Published: March 2020

Background: Besides, the presence of national law, the country has to set up its own mid-term and long term goals to bring about a significant reduction in child marriages in Ethiopia. To achieve this, determining the spatial pattern of early marriage and factors associated is important for government, other concerned bodies, program implementers and policy developers to end up early childhood marriage. Thus, the aim of this study was to assess the spatial patterns and associated factors of Early marriage among reproductive-age women in Ethiopia.Methods: This study analyzed retrospectively a cross-sectional data on a weighted sample of 11,646 women aged 15-49 years after requesting from Ethiopian Demographic and Health Survey 2016 via the link www.measuredhs.com. ArcGIS version 10.7 software was used to visualize spatial distribution for Early marriage. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for Early marriage in Ethiopia multiple logistic regression analysis was used to identify factors associated with early marriage. Finally, variables with a p-value<0.05 were considered as statistically significant.Results: In this analysis, about 62.8% (95%CI: 61.9, 63.74%) of the study participants were married before they reached 18 years. The overall median age at first marriage was 17.1 with IQR 5 years. The high clustering of early marriage was located in Amhara, Afar, and Gambella Regions. In spatial Scan statistics 87 clusters (RR = 1.28, P-value < 0.001) significant primary clusters were identified. The associated factors of early marriage were lesser among women’s attending primary (AOR=0.60; 95%CI: 0.51, 0.71), secondary (AOR=0.19; 95%CI: 0.13, 0.26) and tertiary education (AOR=0.11; 95%CI: 0.07, 0.18). Similarly, women found in Addis Ababa were at a lesser risk of early marriage compared to other regions of the country.Conclusion: Marriage below age 18 was high in Ethiopia. High-risk area of early marriage was located in Amhara, Afar, and Gambella and special attention should be given for identified risk areas. Therefore, providing educational opportunities to young girls was important in addition to inhibiting the marriage of girls under 18 years.
Depression, Physical activity, and self-rated health: Panel analysis of adults in South Korea
Authors: Yoon Hee-sang
Published: March 2020

Background: The health status of an individual is determined by socio-economic factors and behavioral factors. Socio-economic factors include marital status, educational level, living expenses, and housing type, among others. The differences of health status across individuals are mainly determined by these socioeconomic factors, which cannot be altered in a short run. However, even if the socioeconomic factors cannot be altered in the short run, there are ways for an individual to improve the health status in a relatively short period of time. These are behavioral factors, such as physical activities and management of depression. Methods: We provided evidence of the first statement by running a pooled OLS regression with self-rated health (SRH) as dependent variable and with walking, management of depression, sex, age, marital status, educational level, housing type, living expenses, and economic activity as independent variables. We proved the second statement by running a fixed-effect panel regression with the same dependent and independent variables. The 2010–2013 Korea Health Panel Survey data were used for analysis. Subjects were 34,436 adults (≥19 years) in 8,609 panel groups. Results: All the variables, including socio-economic variables as well as behavioral variables, were significant in the Pooled OLS regression. Whereas behavioral variables, such as walking and management of depression, were significant in the fixed-effect panel regression, socio-economic variables were not. The reason is that socio-economic variables are stable and not variant for an individual in the short-run.Conclusion: Whereas the differences of health status across individuals are mainly determined by socioeconomic factors, the health of an individual is significantly affected by his/her behavior. It is shown that regular walking and reduction of depression are important in improving SRH. There is a need for strategies designed to address depression and aging and encourage walking.
Age specific trends in prostate cancer tests, incidence and mortality in Australia since the introduction of the Prostate Specific Antigen (PSA) test
Authors: Pathirana Thanya , Sequeira Rehan , Mar Chris Del , Dickinson James A , Bell Katy J L , Glasziou Paul
Published: March 2020

BackgroundPopulation trends in PSA screening and prostate cancer incidence do not perfectly correspond. We aimed to better understand relationships between trends in PSA screening, prostate cancer incidence and mortality in Australia.MethodsDescription of age standardised time trends in PSA tests, prostate biopsies, cancer incidence and mortality within Australia for the age groups: 45-74, 75-84, and 85+ years.ResultsPSA testing increased from its introduction in 1989 to a peak in 2008. It then declined in men aged 45-84 years. Prostate biopsies and cancer incidence declined from 1995 to 2000, in parallel with decrease in trans-urethral resections of prostate (TURP). After 2000, changes in biopsies and cancer incidence paralleled PSA screening in men 45-84 years, while in men ≥85 years, biopsies stabilised and incidence declined. More recently a reduction in TURP correlated with increased Dutasteride and Tamsulosin usage. Prostate cancer mortality in men aged 45-74 years remained low throughout. Mortality in men 75-84 years gradually increased until the mid 1990s, then gradually decreased. Mortality in men ≥85 years increased until the mid 1990s, then stabilised.ConclusionsAge specific prostate cancer incidence largely mirrors PSA screening rates. Most deviation may be explained by changes in management of benign prostatic disease and incidental cancer detection. The timing of the small mortality reduction in men 75-84 years is more consistent with benefits from advances in treatment than with early detection through PSA. The large increases in prostate cancer incidence with minimal changes in mortality suggest overdiagnosis.
Age differences in associations of different indicators of socioeconomic status with social isolation: A cross-sectional study
Authors: Ge Lixia , Heng Bee Hoon , Tan Woan Shin
Published: March 2020

Background Socioeconomic status is a crucial determinant of social isolation. However, little is known whether the associations between different indicators of socioeconomic status and social isolation vary across age groups. This study examined the association of individual socioeconomic status indicators with social isolation in three age groups: young (21-44 years), middle-aged (45-64 years), and older adults (≥65 years). Methods Cross-sectional data for 1,930 representative community-dwelling adults aged 21 and above in the Central region of Singapore was used. The 6-item Lubben Social Network Scale was used to assess social isolation. Socioeconomic status was measured using education level, employment status, personal income, housing type and self-perceived money sufficiency). Separate logistic regression analyses were conducted to examine the association between each SES indicator and social isolation in each age group. Results Each socioeconomic indicator showed a clear gradient with social isolation and significant age disparities were found in their relationship. Socioeconomic status indicators significantly associated with social isolation were income (R2 change=2.5%) and self-perceived money insufficiency (R2 change=1.5%) in young adults, education (R2 change=0.5%), employment status (R2 change=1.3%), income (R2 change=0.8%), housing type (R2 change=1.9%) and self-perceived money insufficiency (R2 change=2.0%) in middle-aged adults, and housing type (R2 change=1.3%) and self-perceived money insufficiency (R2 change=3.7%) in older adults when adjusting for demographics and other indicators. Conclusions The influence of individual socioeconomic status indicators on social isolation varied across age groups. This study provides a rationale for the choice of socioeconomic status indicator and specific interventions need to target different socioeconomic status groups for different age groups.
Shorter delay to treatment by integrated diagnostic services and NGO- provided support among breast cancer patients in two Brazilian referral centres
Authors: Andrade Lorena Sofia dos Santos , Santos Tácila Thamires de Melo , Oliveira Milena Edite Case de , Gomes Kedma Anne Lima , Soares Adriana Raquel Araújo Pereira , Oliveira Tiago Almeida de , Weller Mathias
Published: March 2020

Background: The diagnosis of breast cancer, from first medical visit until treatment initiation, requires a complicated series of diagnostic exams. The present study addressed the delay of patients who used publicly and privately financed diagnostic services. Non-governmental organizations (NGOs) donated diagnostic mammograms and biopsies. Methods: Data from 304 patients were obtained from two Brazilian referral centres. In one referral centre (FAP), diagnostic mammography, clinic-histopathological exam and immunohistochemistry were outsourced, whereas in the other centre (HNL), these services were integrated. Cox regression, Kaplan-Meier analysis and non-parametric tests were used to compare variables and time intervals among patient groups. Results: If diagnostic mammography was financed privately and covered by private health insurance, the likelihood of a delay of >90 days between the first medical visit and the initiation of treatment decreased 2.15-fold (95%CI: 1.06- 4.36; p= 0.033) and 4.44-fold (95%CI: 1.58-12.46; p= 0.004), respectively. The median time between the first medical visit and the diagnostic result and between the first medical visit and the initiation of treatment was, respectively, 56.0 and 116.5 days. For these time intervals, 54 (34.8%) and 114 (64.8%) patients had a delay of >90 days for diagnostic results and the initiation of treatment, respectively. For patients in the FAP and HNL who had a delay of >90 days, the median time between the first medical visit and the diagnostic results was 180 and 158 days, respectively (p= 0.032). If the clinic-histopathological exam was outsourced (FAP) and publicly or privately financed, the median delay between diagnostic mammography and the diagnostic result was 65.0 or 29.0 days, respectively, compared to 53.0 days in the integrated (HNL) publicly financed system (p < 0.050). The median time between the first medical visit and the diagnostic results of all patients who were supported by NGOs, who financed their diagnostic services privately, and who used exclusively public diagnostic services was, respectively, 28.0, 48.5 and 77.5 days (p < 0.050).Conclusions: Patients who used privately financed health services had shorter delays. Compared to outsourcing, the integration of the publicly financed clinic-histopathological exam diminished the delay. The support of patients by NGOs accelerated patient flow.
Trend and factors associated with under-five mortality in Ethiopia further analysis of 2000-2016 Ethiopian demographic and health survey: A Multivariate decomposition analysis
Authors: Sisay Wullo , Tesema Getayeneh Antehunegn , Worku Misganaw Gebrie , Angaw Dessie Abebaw
Published: March 2020

Background: The under-five mortality rate is the probability that a newborn will die before reaching the age of five years. It is usually expressed as a rate per 1000 live births. Nearly 7 million children worldwide die before their fifth birthdays, with almost all of such death occurring in developing countries Objective: To assess the trend and factors associated with under-five mortality in Ethiopia further analysis of 2000-2016 Ethiopian demographic and health survey: a decomposition analysis Methods: A secondary serial cross-sectional analysis was conducted utilizing data from four rounds of EDHS administered in 2000, 2005, 2011 and 2016. The Ethiopian health and demographic survey in 2000-2016 used a two-stage stratified sampling technique to select a nationally representative sample. In the first stage the total number of enumeration areas was 539 in 2000, 540 in 2005, 624 in 2011 and 645 EAs in 2016 were selected with probability proportional to EA size and with independent selection in each sampling stratum. In the second stage of selection, a fixed number of 28 households per cluster were selected with an equal probability systematic selection from the newly created household listing. Result: Looking at the overall trend, Ethiopia has shown a significant decrease in under-five mortality over the study period from 166 per 1000 births in 2000 to 67 per 1000 birth in 2016 with annual rate of reduction of 3.7%. The trends in under-five mortality showed a variation according to their characteristics. Among home delivery, the largest decrement was observed around 6.5% decrease from 2000 to 2016 and in health facility delivery decreased by 8.3% The decomposition analysis shows that 100.74% of the decrease in under-five mortality was accredited to the difference in the effects of characteristics. Conclusion: Under-five mortality decreased significantly over the last one and a half decades. One of the remarkable findings from the decomposition analysis is the effect of education, place of delivery and maternal age. the government of Ethiopia shall do all daughters will be educated and to build health facilities the whole place of the country Keywords: Under-five mortality decomposition analysis, trend
Effects of physical exercise on cognitively impaired older adults: a meta-analysis of randomized control trials
Authors: Sontakova Lenka , Bartova Alzbeta , Dadova Klara , Holmerova Iva , Steffl Michal
Published: March 2020

Objectives: The main aim of this meta-analysis was to compare the effects of different physical activities on cognitive functions in older adults divided according to cognitive impairment levels. Methods: We searched Web of Science, Scopus, and PubMed for randomized control trials (RCT). A standardized mean difference (SMD) of the pre-post intervention score of global cognitive function tests were calculated by the random model in the Cochrane meta-analyses for people with cognitive impairment generally and across three levels - mild, mild to moderate, and moderate to severe cognitive impairment separately. Additionally, an unstandardized coefficient beta (B) was calculated in generalized linear models to estimate the effects of exercise, cognitive impairment severity, age, female ratio, length of intervention, and time of exercise a week on the global cognitive function. Results: Data from 26 studies involving 1,137 participants from intervention groups and 1,187 participants from control groups were analyzed. Physical exercise had a positive effect on cognitive functions in people across all levels of cognitive impairments SMD (95 % confidence interval [CI]) = 1.19 (0.77 - 1.62); however, heterogeneity was considerably high I 2 = 95%. Aerobic (B = 8.881) and resistance exercise (B = 4.464) was significantly associated with better results in global cognitive functions when compared to active control. A higher number of female participants cin intervention groups had a statistically significant effect on the global cognitive function (B = 0.229). onclusions: Physical exercise was associated with cognitive function improvement in older people with cognitive impairments. Aerobic exercise was more strongly associated than resistance exercise to combat cognitive decline. Keywords: Physical activity, Dementia, Aging, Meta-analysis, Aerobic exercise, Cognitive function
A retrospective study on Tuberculous Lymphadenitis; A retrospective finding from multicenters referal hospitals
Authors: Mohiuddin Syed Ghouse , Maisharah Siti , Albitar Orwa , Iqbal Muhammad Shahid , Khan Amer Hayat
Published: March 2020

Background Extra-pulmonary tuberculosis (EPTB) represents about 14% of all cases of tuberculosis (TB) in Malaysia. The aims of the study include evaluation of socio-demographic factors, clinical manifestations, co-morbidities among patients with Tuberculous Lymphadenitis and their treatment outcomes.Methods The retrospective study was conducted from 2006 to 2008. Data on socio-demographic along with histopathological results were collected. Signs and symptoms were also recorded from TB registers, treatment cards and TB medical personal files using standard data collection tool. Among multiple variables significant factors identified by univariate analysis, were included in multivariate logistic regression to estimate the odds ratios (ORs) with the 95% confidence intervals (CIs). The statistically significant p value was considered as < 0.05.Results There were 348 (57%) males and on the other hand 262 (43%) females which shows almost equal incidence rate of Lymphadenitis in both genders. Mean age was found as 34.3 ± 14.6 years were majorly reported with positive diagnosis. 196 (32.1%) Malay was found with Tuberculous lymphadenitis followed by Chinese population of 148 (24.3%). Geographically from 386 (63.3%) urban population were found positive for lymphadenitis and over 224 (36.7%) of rural region. treatment outcome was observed 444 (72.8%) with successful treatment. WHO states the types of treatment failures and accordingly 85 (13.9%) patients were continued with the therapy that can be due to non-compliance or relapse of Tb. Among unsuccessful outcomes 194 patients of age group 26 -35 years, 65 (33.5%) were reported and 38 (29.7%) patients out of 128 between 16 – 25 years. Blood results showed erythrocyte sedimentation rate greater than 10 in 280 (45.9%) patients. Therefore, among 280 there were 115 (41.1%) patients found to have unsuccessful treatment showing strong association with p-value of <0.001.Conclusion Finding signifies that effect of weight loss on poor treatment outcomes` and active screening measures for patients with comorbidities are therefore recommended in patients with Tb lymphadenitis along with improvements in the diagnosis and early management of co-morbidities complications. As young age group were found to have poor or unsuccessful treatment outcomes and required aggressive strategy together with educating patients can further increase the treatment success rate.