bluuebunny/crossref_metadata_2025 huggingface dataset:
The prevalence of type 2 diabetes in people with psychiatric disorders: an umbrella review protocol
Authors: Lindekilde Nanna , Scheuer Stine , Rutters Femke , Henriksen Jan Erik , Rubin Katrine Hass , Lasgaard Mathias , Andersen Gregers Stig , Pouwer Frans
Published: March 2020

Background: Many epidemiological studies have investigated the prevalence of type 2 diabetes in individuals with a psychiatric disorder. In an umbrella review, we aim to systematically summarize existing systematic reviews examining the prevalence of type 2 diabetes in people with a psychiatric disorder. When information is available in the identified systematic reviews, comparisons with control groups without a psychiatric disorder will be made. Furthermore, we aim to assess the quality of the included systematic reviews. Methods: The umbrella review will be based on a comprehensive systematic search of systematic reviews of observational (cross-sectional or longitudinal) studies investigating the prevalence of type 2 diabetes in people with a psychiatric disorder. Four electronic databases (Embase, PsycINFO, PubMed and the Cochrane Database of Systematic Reviews) will be searched. Retrieved papers will be screened for eligibility by two independent reviewers. Furthermore, the reference lists of all included publications will be screened. Data will be extracted by using an a priori developed data extraction form and two independent reviewers will assess the risk of bias in the included systematic reviews using with the Risk of Bias in Systematic Reviews (ROBIS) tool. A narrative data-synthesis and a subsequent meta-analysis will be made. Discussion: For each psychiatric disorder, the data regarding the prevalence of type 2 diabetes will be summarized and discussed. When possible, comparisons with control groups will be reported and discussed. Finally, future implications and recommendations for clinical care will be presented. Systematic review registration: (registration number) Keywords: Type 2 diabetes, Psychiatric disorder, Prevalence, Umbrella review, Systematic review
An exploratory study of the acceptability of indoor residual spraying for malaria control in upper western Ghana
Authors: Suuron Vitalis Mwinyuri , Mwanri Lillian , Tsourtos George , Owusu-Addo Ebenezer
Published: March 2020

Background: Despite the implementation of the World Health Organisation’s recommended indoor residual spraying (IRS) intervention in the upper west region of Ghana to reduce malaria morbidity and mortality, the uptake of this intervention remains low. This study explores the facilitators and barriers to the acceptability and community uptake of indoor residual spraying in a highly endemic region of Ghana. Methods: The health belief model (HBM) and realist evaluation framework were used to inform the study. A qualitative enquiry was conducted between April to October 2016. Data were collected through focus group discussions and semi-structured interviews with program stakeholders including community members, AngloGold Ashanti malaria control (AGA Mal) spray operators, and AGA Mal officials. Results: A total of 101 people participated in the study. Considerable barriers to community acceptance of indoor residual spraying (IRS) were found, including, dislike of spray insecticides, inadequate information, religious and cultural beliefs, perceived low efficacy of IRS, difficulties with packing, unprofessional conduct of IRS spray operators, and other operational barriers to spraying. Facilitators of IRS uptake included a perceived effectiveness of IRS in preventing malaria and reducing mosquito bites, incidental benefits, respect for authority, training and capacity building, and sensitization activities. Conclusion: The numerous barriers to indoor residual spraying acceptance and implications show that acceptance levels could be improved. However, measures are required to address householders’ concerns and streamline operational barriers to increase community uptake of indoor residual spraying.
Detection of Quantitative Trait Loci (QTL) associated with the spring regrowth vigor trait in alfalfa (Medicago sativa L.)
Authors: Jiang Xueqian , Zhang Fan , Wang Zhen , Long Ruicai , Li Mingna , He Fei , Yang Xijiang , Yang ChangFu , Jiang Xu , Yang Qingchuan , Wang Quanzhen , Kang Junmei
Published: March 2020

Background: Alfalfa ( Medicago sativa L.) is a perennial forage legume with a reputation as being the “queen of forage”. Spring regrowth vigor refers to the process of perennial alfalfa returning to growth after winter survival. The objective of this research was to identify candidate genes significantly associated with spring regrowth vigor.Results: We used a tetraploid alfalfa F1 population comprised of 392 progenies to identify quantitative trait loci (QTL) that control this trait. The F1 population phenotypic data were collected using a total of three environmental phenotypic data. The mapping population was genotyped using Genotyping-by-sequencing (GBS), and linkage maps were developed based on single nucleotide polymorphism (SNP) markers. Fifteen significant QTL for spring regrowth vigor were detected in both parents. Five QTL were identified in the male genetic map, while ten QTL were identified in the female. Four QTL were located on homolog 7D of the male parent, and two QTL were colocalized. Five QTL were mapped on homolog 6D of the female parent, and two QTL were colocalized.Conclusions: The QTL presented in this study can be used to improve the efficiency of alfalfa breeding programs and provide valuable resources for the genetic improvement of alfalfa using marker-assisted selection (MAS).β These authors contributed equally to this research. *Correspondence:Junmei Kangkangjunmei@caas.cn
Hemodynamic changes in regular antipsychotic users after adrenaline-containing lidocaine injection under general anesthesia: a prospective study
Authors: Shionoya Yoshiki , Nakamura Eishi , Tsujimoto Gentaro , Koyata Takayuki , Yasuda Asako , Nakamura Kiminari , Sunada Katsuhisa
Published: March 2020

The authors have withdrawn this preprint from Research Square
The correlation between ultrasound-detected synovitis of small joints and the clinical disease activity in patients with rheumatoid arthritis
Authors: Deng Xuerong , Sun Xiaoying , Xie Wenhui , Wang Yu , Zhang Zhuoli
Published: March 2020

Background: Rheumatoid arthritis (RA) is chronic inflammatory arthritis with multi-joint involvement, especially small synovial joints in hands and feet. So far, the synovitis of which joint in hands or feet is better correlated with clinical disease activity indices is unknown; the correlation of synovitis detected by ultrasound in an individual joint with global disease activity is unclear either.Objectives: To explore the correlation between the ultrasound-detected synovitis in metacarpophalangeal (MCP), metatarsophalangeal (MTP), proximal interphalangeal (PIP) joints and the clinical disease activity indices in patients with RA.Methods: 30 joints, including bilateral MCP, PIP and MTP, were scanned for synovitis by ultrasound, semi-quantitatively scored for gray scale(GS) and power Doppler(PD). The correlation between Disease Activity Score-28 joints(DAS28), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI) and ultrasound-detected synovitis score in each joint was assessed using Spearman’s rank correlation test. Results: 211 RA patients were included in this study. The whole GS scores of all MCP joints showed highest correlation with all clinical disease activity indices (r=0.403-0.452, p<0.01), followed by PIPs (r=0.318-0.331, p<0.01) and MTPs (r=0.277-0.301, p<0.01). Likewise, the whole PD scores of all MCP joints also showed highest correlation with the disease activity (r=0.332-0.396, p<0.01), followed by PIPs (r=0.211-0.242, p<0.01), and MTPs (r=0.198-0.222, p<0.01). The highest correlation of GS score with DAS28-ESR (r=0.411, p<0.01), DAS28-CRP (r=0.459, p<0.01), SDAI (r=0.444, p<0.01) was observed in MCP3 joint, while with CDAI (r=0.421, p<0.01) in MCP2 joint. The highest correlation of PD score with DAS28-ESR (r=0.353, p<0.01), DAS28-CRP (r=0.399, p<0.01), CDAI (r=0.368, p<0.01), SDAI (r=0.377, p<0.01) was in MCP5 joint. Conclusions: The ultrasound-detected synovitis at MCP joints, especially MCP2, MCP3, and MCP5 joints, was best correlated with composite disease activity of RA, in contrast to PIP and MTP joints. MCP joints should take greater weight in clinical disease activity assessment.
Postoperative C-reactive protein kinetics predict postoperative complications in patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis
Authors: Asmar Antoine El , Bendavides Melissa , Moreau Michel , Hendlisz Alain , Deleporte Amélie , Khalife Maher , Donckier Vincent , Liberale Gabriel
Published: March 2020

Background Relatively high morbidity rates are reported after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). However, early predictors of complications after CRS plus HIPEC have not been identified. The aim of this study was to evaluate the predictive role of early postoperative serum C-reactive protein (CRP) level (Day 2-4) for the detection of post-operative complications. Patients and methods We performed a retrospective study including 94 patients treated with complete CRS (R1) and HIPEC for PC from various primary origins (2011-2016). Post-operative complications were recorded. The values for postoperative inflammatory markers (white blood cells [WBC] and platelet counts, CRP) were compared between the different groups. Results CRP on post-operative days 2-4 was significantly higher in patients with than without complications (124 mg/L vs 46 mg/L; p<0.0001) and higher in those with more major complications (162 mg/L vs 80 mg/L; p< 0.0012). WBC and platelet counts showed no difference within 5 days postoperatively. Conclusion CRP levels, and kinetics mainly, between post-operative day 2 and 4, are decisive predictive markers of early and late post-operative complications after CRS plus HIPEC. The presence of post-operative complications should be suspected in patients with a high CRP mean, and a plateau level (days 2-4).
Prognostic factors for bile leak and long term survival in 23 patients with Klatskin Tumors Type III exclusively
Authors: Asmar Antoine El , Rassi Ziad El
Published: March 2020

Objective A retrospective study, handling the prognostic factors for bile leak and long term survival in 23 patients, with Hilar Cholangiocarcinoma, Bismuth Type III exclusively. Methods Between 2010 and 2017, 23 patients underwent major hepatectomy for Type III Klatskin Tumor at our institution. 11 patients underwent hepatectomy for Type IIIB tumors, 10 patients underwent right hepatectomy for Type IIIA and 2 were omitted for loss of follow-up. Results In 20 patients an R0 resection was achieved. Survival at 1, 3 and 5 years was respectively 78.3%, 61.9% and 38.1%. A BMI > 24 kg/m2 at presentation, was associated with a worse prognosis, at 1, 3 and 5 years, with statistical significance (p<0.05). A Creatinine > 0.74 at presentation, was associated with a decreased 5-year survival, with statistical significance (p<0.05). Conclusion A BMI > 24 kg/m2, a Creatinine > 0.74, are factors of worse prognosis when present in a Type III Klatskin tumor patient. Age, sex, hemoglobin level, tumor size, cusa use, and the correlation of Type IIIB tumors with bile leakage, are all variables that showed borderline significance, and thus warrant further investigations in larger studies, using multicentric data.
The Reducing Effect of Sirolimus on Angiomyolipoma is Determined by Decrease of Its Fat-Poor Compartments and Is Associated with Striking Reduction of Vascular Structures
Authors: Watanabe Elieser Hitoshi , Coelho Fernando Morbeck Almeida , Filho Hilton Leão , Balbo Bruno Eduardo Pedroso , Neves Precil Diego , Franzin Fernanda Maria , Yamauchi Fernando Ide , Onuchic Luiz Fernando
Published: March 2020

Background: Renal angiomyolipomas hemorrhage is strongly associated with their size and vascular constitution. Since previous studies showed that mTOR inhibitors can differentially act in distinct cell lines, we analyzed the effects of sirolimus on the volume of different components of angiomyolipomas in patients with tuberous sclerosis complex, including vascular structures. We retrospectively analyzed 23 angiomyolipomas from 10 patients treated with sirolimus. An approach based on a Hounsfield-unit threshold was used to classify angiomyolipomas in fat-rich, fat-poor and intermediate-fat tumors, and to categorize tumor compartments in fat rich, fat poor, intermediate fat and highly vascularized. Diameter variations were measured to assess the effects on aneurysmatic/ectatic vascular formations. Results: Volume reduction following treatment with sirolimus was higher in fat-poor than fat-rich angiomyolipomas. Tumor reduction was mainly determined by decrease of the fat-poor and highly-vascularized compartments, with a lesser contribution of the intermediate-fat component, while the volume of the fat-rich compartment increased. Broad liposubstitution was observed in some tumors. Massive reduction of aneurysmatic/ectatic vascular structures was observed, with disappearance of such lesions in most cases. Conclusions: Our study showed that sirolimus reduces the size of angiomyolipomas by decreasing primarily their highly-vascularized and fat-poor compartments. This effect is associated with a remarkable reduction of tumoral aneurysms/ectatic vessels and other vascular structures. Our findings revealed, therefore, the likely mechanism responsible for the reported risk-decreasing effect of mTOR inhibitors on angiomyolipoma bleeding. Our findings also expand the understanding the biology of this tumor, supporting a role for mTOR in maintenance, and maybe assembling, of blood vessels in angiomyolipomas.
The epidemiology, risk factors and outcomes of Carbapenem-resistant Klebsiella pneumoniae infections in the intensive care unit from 2012 to 2018
Authors: Wang Ping , Zou Xiaocui , Zhou Boting , Yin Tao
Published: March 2020

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an increasing globally threat for human health, but the trends and clinical characteristics of CRKP infections in the intensive care unit(ICU) remain uninvestigated.Methods: A retrospective study was conducted among ICU patients infected with KP isolates from January 2012 to December 2018. Carbapenem resistant to Klebsiella pneumoniae was defined according to Clinical and Laboratory Standards Institute (CLSI) criteria. The incidence and changing trend of CRKP were determined. CRKP patient sources, specimen types, infection sources and outcomes were investigated. Results: There were 256(40.13%) patients with CRKP and 382(59.87%) patients with CSKP. The incidence of CRKP increased from 2012(11.11%) to 2017(63.48%) and decreased in 2018(51.52%). The proportion of isolates not susceptible to three carbapenems increased from 0 to 98.04%. The rates of CRKP isolated from blood, wound, urine and pleural fluid were higher than that of CSKP. CRKP infections were mainly ICU acquired, rather than input acquired. Conclusion: The incidence of CRKP was high in ICU, but showed a downward trend. Implementation of different infection control measures to different sources of patients, specimen types, and KP infections are necessary. Surveillance data will be needed for ICU patients to decrease the incidence and mortality of CRKP.
Postnatal home visits by health extension workers in rural areas of Ethiopia: a cross-sectional study design
Authors: Tesfau Yemane Berhane , Kahasay Alemayehu Bayray , Gebrehiwot Tesfay Gebregzabher , Medhanyie Araya Abrha , Godefay Hagos
Published: March 2020

Background : In low-income countries like Ethiopia, where families have poor access to or do not utilize services of formal health care systems, community health workers provide postnatal care services through home visits. However, the extent and effectiveness of home-based postnatal visits by community health workers such as the Ethiopian health extension workers (HEWs) are not well explored. This community -based study aimed to determine the coverage, contents of postnatal home visits and associated factors by health extension workers in Northern Ethiopia.Methods : We conducted a community based cross-sectional study in the rural Districts in Northern Ethiopia from August to September 2018. A total of 705 mothers who gave a live birth in the year preceding the survey were selected using multistage random sampling. A structured questionnaire was applied to collect data by interviewing mothers. Data were analyzed using SPSS version 22 statistical software. Association of postnatal home visits with possible explanatory variables was investigated using logistic regression.Results : One hundred two (14.5%) mothers and newborns received PNC home visit within three days after birth from HEW and 170(24.1%) reported postnatal home visits within 42 days. Among the mothers who received postnatal home visits, 6.5% measured their blood pressure, 11.2% measured their temperature, 20% counseled about family planning, 16.5% counseled on newborn danger signs, 11.2% counseled on the skin to skincare of the newborn and 14.1% of their newborns were measured their weight at home. Mothers who received at least one home visit during pregnancy (AOR, 7.58; CI 3.59-15.98), participated in pregnant women forum (AOR, 3.21; CI 1.70-6.05), notified their birth (AOR, 6.15; CI 3.50-10.80) and those member of community health insurance (AOR, 1.88; CI 1.14-3.12) were significantly associated factors with postnatal home visit by a health extension worker.Conclusion : The coverage of postnatal home visits by health extension workers remains low in rural districts of Northern Ethiopia. Existing health systems should consider interventions that improve pregnancy and birth notification strategies and more efforts should be made at improving community-based participation and linkages with community health workers.
Examining the accuracy of trackways for predicting gait selection and speed of locomotion
Authors: Marmol-Guijarro Andres , Nudds Robert , Folkow Lars , Codd Jonathan
Published: March 2020

Background Using Froude numbers (Fr) and relative stride length (stride length: hip height), trackways have been widely used to determine the speed and gait of an animal. This approach, however, is limited by the ability to estimate hip height accurately and by the lack of information related to the substrate properties when the tracks were made, in particular for extinct fauna. By studying the Svalbard ptarmigan moving on snow, we assessed the accuracy of trackway predictions from a species-specific model and two additional Fr based models by ground truthing data extracted from videos as the tracks were being made.Results The species-specific model accounted for more than 60% of the variability in speed for walking and aerial running, but only accounted for 19% when grounded running, likely due to its stabilizing role while moving faster over a changing substrate. The error in speed estimated was 0-35% for all gaits when using the species-specific model, whereas Fr based estimates produced errors up to 55%. The highest errors were associated with the walking gait. The transition between pendular to bouncing gaits fell close to the estimates using relative stride length described for other extant vertebrates. Conversely, the transition from grounded to aerial running appears to be species specific and highly dependent on posture and substrate.Conclusion Altogether, this study highlights that using trackways to derive predictions on the locomotor speed and gait, using stride length as the only predictor, are problematic as accurate predictions require information from the animal in question.
Correlation between carotid stenosis and cognitive impairment
Authors: HUANG YAO , He Lanying , Wang Feng , Ma Yuanye
Published: March 2020

Background Severe internal carotid artery stenosis significantly affects the cognitive function of patients, but the effect of different degree and different side of stenosis on cognitive function was still controversial.This study aims to investigate the correlation between different degrees and different sides of internal carotid artery stenosis and cognitive impairment.Methods There were 34 patients with internal carotid stenosis and 31 controls without stenosis who underwent CTA, DSA, memory scale and modified WCST. Stenosis group was divided into mild stenosis group (n=15) and moderate-severe stenosis group (n=19) according to the degree of stenosis, and was divided into left stenosis group (n=24) and right stenosis group (n=10) according to the sides. Overall vascular examination results,cognitive function scores were computed and analysised.Results Stenosis group and no-stenosis group did not differ in age,education level, BMI, hyperlipidemia, gender, hypertention, diabetes, smoking drinking and right-handedness.Stenosis group had worse memory scale and modified WCST scores for cognitive function. There were statistically significant differences in memory scale and modified WCST scores between mild stenosis group, moderate-severe stenosis group and no-stenosis group,but no differences between mild stenosis group and moderate-severe stenosis group,no differences between left stenosis group and right stenosis group.Conclusions Internal carotid artery stenosis affects the cognitive function represented by memory and executive ability significantly.
Activated CAMKKb-AMPK Signaling Promotes Autophagy in a Spheroid Model of Ovarian Tumour Metastasis
Authors: Laski Jeremi , Singha Bipradeb , Wang Xu , Valdés Yudith Ramos , Collins Olga , Shepherd Trevor
Published: March 2020

Background: A hallmark of epithelial ovarian cancer (EOC) metastasis is the process of spheroid formation, whereby tumour cells aggregate into 3D structures while in suspension in the peritoneal cavity. EOC spheroids are subjected to bioenergetic stress, thereby activating AMP-activated protein kinase (AMPK) signaling to enter a metabolically quiescent state, which can facilitate cell survival under nutrient-limiting conditions. Independently, we have also demonstrated that EOC spheroids induce autophagy, a process that degrades and recycles intracellular components to restore energy and metabolites. Herein, we sought to examine whether AMPK controls autophagy induction as a cell survival mechanism in EOC spheroids.Results: We observed a co-ordinate increase in phosphorylated AMPK and the autophagy marker LC3-II during EOC spheroid formation. Reduced AMPK expression by siRNA-mediated knockdown of PRKAA1 and PRKAA2 blocked autophagic flux in EOC spheroids as visualized by fluorescence microscopy using the mCherry-eGFP-LC3B reporter. A complementary approach using pharmacologic agents Compound C and CAMKKb inhibitor STO-609 to inhibit AMPK activity both yielded a potent blockade of autophagic flux as well. However, direct activation of AMPK in EOC cells using oligomycin and metformin was insufficient to induce autophagy. STO-609 treatment of EOC spheroids resulted in reduced viability in 7 out of 9 cell lines, but with no observed effect in non-malignant FT190 cell spheroids.Conclusions: Our results support the premise that CAMKKb-mediated AMPK activity is required, at least in part, to regulate autophagy induction in EOC spheroids and support cell viability in this in vitro model of EOC metastasis.
LIG4 Syndrome: Clinical and Molecular Characterization in a Chinese Cohort
Authors: Sun Bijun , Chen Qiuyu , Wang Ying , Liu Danru , Hou Jia , Wang Wenjie , Ying Wenjing , Hui Xiaoying , Zhou Qinhua , Sun Jinqiao , Wang Xiaochuan
Published: March 2020

Background: DNA Ligase IV (LIG4) syndrome is a rare disease with few reports to date. Patients suffer from a broad spectrum of clinical features, including microcephaly, growth retardation, developmental delay, dysmorphic facial features, combined immunodeficiency, and malignancy predisposition. There is thought to be a potential association between genotypes and phenotypes. Here, we investigated the characteristics of LIG4 syndrome in a Chinese cohort.Results: All seven patients had growth restriction. Most patients (6/7) had microcephaly (< -3 SD). Recurrent bacterial infections of the lungs and intestines were the most common symptoms. One patient had myelodysplastic syndromes. One patient presented with an inflammatory bowel disease (IBD)-like phenotype. Patients presented with combined immunodeficiency. The proportions of naive CD4+ and naive CD8+ T cells decreased notably in five patients. All patients harbored compound heterozygous mutations in the LIG4 gene, consisting of a missense mutation (c.833G>T, p.R278L) and a deletion shift mutation, primarily c.1271-1275delAAAGA (p.K424Rfs). Two other deletion mutations, c.1144-1145delCT and c.1277-1278delAA, were novel. Patients with p.K424RfsX20/p.R278 might lead to milder dysmorphism, but more significant IgA/ IgM deficiency, compared with the frequent genotype p.R814X/p.K424RfsX20 reported. One patient underwent umbilical cord blood stem cell transplantation (UCBSCT) but died.Conclusions: This study reported the clinical and molecular characteristics of a Chinese cohort, further expanding the phenotypic and genotypic spectrum, and the understanding of genotype-to-phenotype correlations in LIG4 syndrome. The results may help to characterize the status of the disease in China.
Nurse’s clinical skill utilisation: An opinion from public health institutions
Authors: mahindrakar santosh , Jat Man Singh , Varghese Besty Ann
Published: March 2020

Background Nurses are the backbone of health care systems worldwide. In India the assessment of existing knowledge of nursing workforce and the utilization of skills is not evaluated and properly used to ensure good quality in health care. Methods Using the Delphi technique a survey was developed and sent to nurses. Self- rating methods (on a likert scale) were used in order to operationalize the personal skills. Results Almost half (48%) of the participants have a Bachelor degree. Out of this 27.2% qualified for a higher education (e.g. Master in related subject). Most nurses (56% in sample were females) are permanent employed working as staff nurse or nursing officers in the public sector. Among the participants 20% have sufficient teaching experience between 1 to 3 years. Self-rating of skills was high in almost all topics. Conclusion Having attained higher education most of the participants remain working as staff nurses. The good self-rating of participants underlines their ability to take over much higher positions and responsibilities. Moreover, teaching experience is hardly acknowledged by institutions since teaching staff is usually recruited from outside. The study suggests that a majority of the population has an interest to work in rural area. Better work conditions are needed in order to gain workforce in this areas.
Preoperative positive voided urine cytology predicts poor clinical outcomes in patients with upper tract urothelial carcinoma undergoing nephroureterectomy
Authors: Liu Wen , Wang Zhankun , Liu Shuai , Yao Yu , Liu Yong , Zhang Guiming
Published: March 2020

Background: Performance of urinary cytology is recommended as the part of a standard diagnostic workup and base surveillance regimens in upper tract urothelial carcinoma (UTUC). However, the effect of positive voided urine cytology (VUC) on UTUC prognosis, compared with negative VUC, has not been fully demonstrated. This study aimed to evaluate the impact of preoperative VUC on predicting intravesical recurrence, disease recurrence, and mortality in patients with UTUC who underwent nephroureterectomy (RNU). Methods: Clinicopathological information was collected from 315 UTUC patients treated with RNU. The association between VUC and oncological outcomes was analyzed using the Kaplan–Meier method with log-rank test and Cox proportional hazards regression models. Multiple logistic regression analysis was performed to identify the influence of VUC on tumor grade. Results: Preoperative positive VUC, presenting in 101 patients (32.1%), was significantly associated with tumor multifocality (P=0.02) and higher tumor grade (P=0.01). On multivariate Cox regression analyses, preoperative positive VUC was an independent prognostic factor of intravesical recurrence-free survival (RFS) (hazard ratio [HR]=2.21, 95% confidence interval [CI] 1.06–4.64; P=0.03), RFS (HR=1.80, 95% CI 1.08–2.99; P=0.02), and cancer-specific survival (CSS) (HR=1.87, 95% CI 1.10–3.18; P=0.02), but not overall survival (HR=1.32, 95% CI 0.80–2.18; P=0.28). Logistic regression analysis revealed that VUC was related to high tumor grade in UTUC (odds ratio=2.23, 95%CI 1.15–4.52). Conclusion: Preoperative positive VUC significantly increases the risk of intravesical recurrence in UTUC patients undergoing RNU. In addition, positive VUC is an adverse predictor of RFS and CSS, which might be due to the association between positive VUC and high tumor grade.
Raptor and rictor expression in patients with human papillomavirus-related oropharyngeal squamous cell carcinoma
Authors: Kondo Shunsuke , Hirakawa Hitoshi , Ikegami Taro , Uehara Takayuki , Agena Shinya , Uezato Jin , Kinjyo Hidetoshi , Kise Noritomo , Yamashita Yukashi , Tanaka Katsunori , Hasegawa Narumi , Kiyuna Asanori , Maeda Hiroyuki , Suzuki Mikio , Gahana Akira
Published: March 2020

Background Despite reports of a link between human papillomavirus (HPV) infection and mechanistic target of rapamycin (mTOR) signaling activation, the role of the mTOR pathway, especially raptor and rictor, in HPV-related head and neck cancer is still unclear. The aim of the present study was to elucidate the role of the mTOR pathway in HPV-related oropharyngeal squamous cell carcinoma (OPSCC). Methods The present study involved two strategies. The first was to investigate the activity of mTOR and mTOR-related complexes in high-risk HPV-positive (UM-SCC47 and CaSki) and HPV-negative (SCC-4 and SAS) cancer cell lines. The second was to elucidate mTOR complex expression in 80 oropharyngeal cancer tissues and to examine the relationship between mTOR complex expression and survival in patients with OPSCC. Results The UM-SCC47 and CaSki cell lines showed high gene and protein expression of raptor. They also exhibited G1/S and G2/M phase cell cycle arrest following 24 h incubation with 6 μM temsirolimus, a rapamycin analog, and temsirolimus administration inhibited their growth. HPV-related OPSCC samples showed high gene expression of raptor and rictor compared with HPV-unrelated OPSCC. In addition, HPV-related OPSCC patients with high raptor and rictor expression tended to have a worse prognosis than those with low or medium expression. Conclusions These results suggest that raptor has an important role in HPV-related OPSCC and that temsirolimus is a potential therapeutic agent for patients with HPV-related OPSCC. This is the first report to reveal overexpression of raptor and rictor in HPV-related OPSCC.
Sex differences in the association between self-rated health and high-sensitivity C-reactive protein levels in Koreans: A cross-sectional study using Korea National Health and Nutrition Examination Survey (KNHANES)
Authors: Park Se-Won , Park Seong-Sik , Kim Eun-Jung , Sung Won-Suk , Ha In-Hyuk , Jung boyoung
Published: March 2020

Background No studies have investigated the association between self-rated health (SRH) and high-sensitivity C-reactive protein (hs-CRP) in South Koreans. This study explored the association and analyzed any sex differences.Method Using data from the 2015-2017 Korea National Health and Nutrition Examination Survey, we analyzed the association between SRH and high group (>1.0 mg/L) in 14,544 Koreans aged ≥19 years who responded to the SRH survey and who had hs-CRP test results. Results The percentage of having a very poor to poor SRH was higher in the high hs-CRP level group (22.4%) than in the low level group (17.66%). Among males, the risk of a high hs-CRP level increased with worse SRH (adjusted for confounders; P for trend <0.001). After adjusting for all confounders, including chronic diseases, males with a very poor SRH showed higher odds ratio (OR) for high group than those with a very good SRH (fully adjusted OR, 1.74; 95% confidence interval, 1.04-2.90). Significant correlations were absent among females. Conclusions A poor SRH was correlated with low-grade inflammation (high hs-CRP level) among male Korean adults. The findings could be useful for developing health improvement programs and in goal setting at a national scale.
Biosocial and disease conditions is associated with good quality of life among older adults in Eastern Nepal
Authors: Yadav Uday , Thapa Tarka Bahadur , Mistry Sabuj Kanti , Ghimire Saruna , Boateng Godfred O. , O’Callaghan Cathy
Published: March 2020

Background The ageing population in most low-and middle-income countries is accompanied by an increased risk of non-communicable diseases culminating in a poor quality of life. However, the factors accelerating this poor quality of life (QOL) have not been fully examined. Therefore, this study examined the factors influencing the quality of life of Nepali older adults. Methods Data from a previous cross-sectional study, conducted between January and April 2018 in eastern Nepal, was used. The analytical sample included 794 older adults aged ≥60 years, selected by a multi-stage cluster sampling approach. QOL was measured using the Older People’s Quality of Life tool; dichotomized as poor and good QOL. Other measures used included age, gender, ethnicity, religion, marital status, physical activity and chronic diseases such as osteoarthritis, cardiovascular disease, diabetes, chronic obstructive pulmonary disease (COPD), and depression. The factors associated with quality of life were examined using mixed-effects logistic regression. Results Seven in ten respondents (70.4%) reported a poor quality of life. At the bivariate level, increasing age, unemployment, intake of alcohol, lack of physical activity as well as osteoarthritis, COPD and depression were significantly associated with a lower likelihood of a good quality of life. The adjusted model showed that older age (AOR=0.50, p<0.05), the Christian religion (AOR=0.38, p<0.01), and being an Indigenous, Dalit, or Madheshi were associated with a lower likelihood of good quality of life. However, higher income of >Nrs 10,000 (AOR=3.34, p<0.001), daily physical activity (AOR=3.33, p<0.001), and the absence of osteoarthritis and depression were associated with a higher odds of good quality of life. Conclusion The findings of this study echo the need to develop and implement policies aimed at improving the socio-cultural and disease conditions that catalyse poor quality of life in this population.
Comparing two methods for deriving dietary patterns associated with risk of metabolic syndrome among middle-aged and elderly Taiwanese adults with impaired kidney function
Authors: Kurniawan Adi Lukas , Hsu Chien-Yeh , Lee Hsiu-An , Rau Hsiao-Hsien , Paramastri Rathi , Syauqy Ahmad , Chao Jane C-J
Published: March 2020

Background Dietary patterns were associated with the risk of chronic disease development and outcome-related diseases. In this study, we aimed to compare the correlation between dietary patterns and metabolic syndrome (MetS) using two methods for identifying dietary patterns.Methods The participants (n = 25,569) aged ≥ 40 years with impaired kidney function were retrieved from Mei Jau (MJ) Health Screening database from 2008 to 2010. Dietary patterns were identified by principal component analysis (PCA) and reduced rank regression (RRR) from twenty-two food groups using PROC FACTOR and PROC PLS functions.Results We identified two similar dietary pattern characteristics (high intakes of deep fried foods, preserved or processed foods, dipping sauce, meat, sugary drinks, organ meats, jam/honey, fried rice/flour products, instant noodles and eggs) derived by PCA and RRR. Logistic regression analysis revealed that RRR-derived dietary pattern scores were positively associated with an odds ratio (OR = 1.70, 95% CI: 1.56, 1.86) of having MetS than PCA-derived dietary pattern scores (OR = 1.38, 95% CI: 1.27, 1.51). The correlations between RRR-derived dietary pattern scores and elevated systolic and diastolic blood pressure (OR = 1.30 for both) or high density lipoprotein cholesterol in women (OR = 1.32) were statistically significant but not significant in PCA-derived dietary pattern scores.Conclusions Our findings suggest that RRR gives better results when studying behavior related dietary patterns in association with MetS. RRR may be more preferable to provide dietary information for developing dietary guidelines among people with MetS. Further studies with prospective measurements are needed to verify whether RRR is a useful analytic tool for the association between dietary patterns and other chronic diseases.
The Survival Analysis after Symmetric and Asymmetric Surgery in Basic Intermittent Exotropia with Equal Dominance
Authors: Song Desheng , Qian Jing , Chen Zhijun
Published: March 2020

Background: Long-term surgical outcomes were compared between bilateral lateral rectus recession (BLR) and unilateral lateral rectus recession combined with medial rectus resection in the same eye (R&R) for therapy of basic type intermittent exotropia (IXT) with equal dominance.Methods: Eighty-six subjects(3–11 years old) with the basic IXT with equal dominance who underwent surgery were reviewed retrospectively, at least 18-month follow-up. including 48 patients underwent R&R surgery and 38 underwent BLR surgery at a single center. Surgical outcomes between groups were compared.Results: No statistical difference was detected between BLR group and R&R group at all intervals with the exception of the last examination, demonstrating a higher success rate and a lower undercorrection rate in the BLR group than R&R group at the last visit (76.3% vs 60.4%, P =0.04; 15.8% vs 35.4%, P =0.04 ). Postoperative recurrence continued in the R&R group, and it was lower in the BLR group. Stereoacuity and control showed overall improvement following both surgeries for basic intermittent exotropia. but this improvement had no statistical difference between groups(P>0.05). Cumulative probability of survival was lower in the R&R group than in the BLR group (P =0.027, log-rank test).Conclusions: The BLR group had a better outcome than R&R group at final visit, which may be due to the difference in the recurrence rate over time.
Are Blood Lead Levels in the United States Still Declining? The US National Health Nutrition and Examination Survey (NHANES) 1999-2016
Authors: Lui Kelvin KW , Tsoi Man-Fung , Cheung Tommy Tsang , Cheung Ching-Lung , Cheung Bernard MY
Published: March 2020

Background: Lead is toxic without a safe limit. The current upper reference blood lead level (BLL), 5 μg/dL, came from the 97.5th percentile in children aged 1-5 years in NHANES 2007-2010.Objectives: We studied the latest trend in BLL in US NHANES and estimated the proportion of children with BLL ≥5 μg/dL, which would inform the setting of an upper reference level.Methods: We analyzed 68877 participants (aged 1 to 85 years) with BLL measurements in NHANES 1999-2016 using SPSS complex sample module v25.0.Results: In NHANES 2011-2012, 2013-2014, and 2015-2016, the mean and 95% confidence intervals (CIs) of BLLs (μg/dL) were 0.97 (0.96, 0.99), 0.86 (0.85, 0.87), and 0.82 (0.81, 0.83), respectively (P <0.0001). The estimated proportion (95% CI) of children aged 1-5 years with elevated BLL (EBLL) in 2011-2012, 2013-2014, and 2015-2016 were 2.0% (1.3, 3.0), 0.5% (0.4, 0.7), and 1.3% (0.8, 2.3), respectively (P=0.267). In 2015-2016, the proportion of children with EBLL was similar in high- and low-income groups (P = 0.9979). The estimated 97.5th percentile of BLL in children was 3.71 μg/dL in NHANES 2015-2016.Conclusions: BLL continued to decline in the overall US population. The disparity in BLL in children from higher and lower income families has decreased. Our findings support a reduction in the reference BLL, continual monitoring of population BLL and continual efforts to reduce environmental exposure to lead.
Insights into the phylogenetic relationship and drug targets of Babesia infective to small ruminants from its mitochondrial genomes
Authors: Wang Xiaoxing , Wang Jinming , Liu Junlong , Liu Aihong , He Xin , Xiang Quanjia , Li Youquan , Yin Hong , Luo Jianxun , Guan Guiquan
Published: March 2020

Background: Babesiosis, a tick-borne disease caused by protozoans of the genus Babesia, is widespread in subtropical and tropical countries. Mitochondrion is an essential organelle that is responsible for energy transduction and metabolism, calcium homeostasis and cell signaling. Mitochondrial genomes could provide a new insight to understand and explore the population genetics, biological features of the pathogens, and evolutionary relationships. However, there is limied information on the mitochondrial genomes of ovine Babesia spp. in China.Methods: Herein, we sequenced, assembled and annotated the mitochondrial genomes of six ovine Babesia isolates, and analyzed genome size, gene content, genome structure and cytochrome b (cob) amino acid sequences, and performed comparative mitochondrial genomics and phylogenomic analyses among apicomplexan parasites.Results: The mitochondrial genomes range from 5767 to 5946 bp in length with a linear form and contain three protein-encoding genes, cytochrome c oxidase I (cox1), cytochrome c oxidase III (cox3) and cob, six large subunit rRNA gene (LSU), and two terminal inverted repeats (TIR) on both ends. The cob sequence analysis indicated that the binding site of anti-Babesia drugs targeted on the cytochrome bc1 complex. Babesia microti and Babesia rodhaini have a dual flip-flop inversion of 184-1082 bp, whereas other Babesia spp. and Theileria spp. have one pair of TIR, 25-1563 bp. Phylogenetic analysis indicated that six ovine Babesia isolates were divided into two clades, Babesia sp. and Babesia motasi. B. motasi isolates were further separated into two subclades (B. motasi Lintan/Tianzhu and B. motasi Ningxian/Hebei).Conclusions: The data provided new insights into the population genetics, taxonomic relationships, molecular epidemiological studies and drug targets of apicomplexan parasites.
A pilot study evaluating the clinically managed weight loss program at the Wellness Institute at Seven Oaks General Hospital
Authors: Cachero Katrina , Mollard Rebecca C. , Myrie Semone , MacKay Dylan
Published: March 2020

Background: Obesity is a worldwide problem. With the prevalence of obesity increasing, many weight loss programs have been created to aid in the epidemic. Based on the Canadian Clinical Practice Guidelines for obesity management, a weight loss program should involve nutrition, exercise, and psychological components. The Wellness Institute (WI) is a non-profit organization that operates as a medical fitness facility and created the Weight Loss Clinic (WLC) to provide personalized support for individuals based on diet, exercise, and lifestyle, targeting all the core components required for a weight loss program. Since the weight loss industry is dominated by non-evidence-based programs with majority focused on calorie-reduced diets, there is a gap in research on weight loss programs with an exercise and psychological component. Thus, the aim of this pilot study is to collect data on the effectiveness of the comprehensive evidence-based clinically managed weight loss program offered at the WI for future research applications.Materials and Methods: The WLC is a 17-week program during which each participant will progress depending on their personal goals. Population: Inclusion criteria are individuals over the age of 18 years old, are overweight or obese (BMI > 25 kg/m2), have been told by a physician or primary care provider to lose weight, who are concerned with weight and may have other health problems, and have tried to lose weight in the past but have been unsuccessful at maintaining weight loss. Outcome Measures: Outcome measures include: anthropometric measurements, body composition, cardiovascular assessment, clinical chemistry, physical activity assessment, nutrition assessment, behaviour change assessment, and health screenings. Ethics Approval: This evaluation received approval from the University of Manitoba Health Research Ethics Board (Ethics # HS22267 (H2018:401)). Clinicaltrials.gov ID: NCT04290910
Design and Methods of a Randomized Cross-over Clinical Trial of Unfiltered Cigarettes on Smoking Behavior and Toxicant Exposure: Study Protocol for a Randomized Cross-over Clinical Trial
Authors: Oren Eyal , Pulvers Kim , Romero Devan R. , Barber Casey , Carter Erika , Novotny Thomas E.
Published: March 2020

Background: Plastic filters on cigarette butts are a widespread source of non-biodegradable, toxic environmental waste. State and local legislation to ban the sale of single-use cigarettes may be considered to prevent this waste, but scientific evidence on the impact of switching smokers to unfiltered cigarettes on smoking behavior and toxicant exposures is needed to inform this policy. We have designed an open-label, randomized, 9-week, cross-over clinical trial of adult filtered cigarette smokers who switch to unfiltered cigarettes.Methods: The trial involves a 1-week baseline period, 2 weeks of smoking filtered or unfiltered cigarettes (groups randomly assignd), a 3-week washout period, another 1-week baseline period, and a crossover to 2-weeks of smoking the opposite condition (filtered or unfiltered cigarettes). We will determine changes in: 1) observed topography (i.e., puff count, puff volume) and cigarettes smoked per day (via butt counts and self-report); 2) expired carbon monoxide (CO), urinary cotinine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and volatile organic compound (VOC) excretion; and 3) knowledge and attitudes toward unfiltered cigarettes, satisfaction with smoking, and intention to quit if they were not able to smoke filtered cigarettes.Discussion: This comprehensive proof-of-principle study will provide preliminary evidence to develop a research project with a larger sample size. Study results will inform proposed state or local legislation to ban the sale of single-use filtered cigarettes in order to eliminate the environmental impact of cigarette butt waste stemming from the single-use plastic filter. Trial Registration: NCT03749876
The effect of educational method based on theory of planned behavior on childbearing decision in marrying couples
Authors: Kolivand Mitra , solimaniargeneh zomorod , Salari Nader , Safari Yahya
Published: March 2020

Background: The aim of this study was to investigate the effect of educational method, based on the theory of planned behavior on childbearing decision in married couples. Materials and Methods: This study was a semi-experimental investigation. The population under study consisted of 140 marrying couples referred to the pre-marital counseling center in Sahneh city in 2018 [experimental group; n=70 vs. control group; n=70]. The sample method was convenience sampling .The experimental group received educational intervention based on the theory of planned behavior [for 8 sessions]; whereas, the control group participated in the routine pre-marital counseling program. The data was collected using Aattitudes toward fertility and childbearing scale of Soderberg, Lundgren, Christensson & Hildingsson [2013]. The data was analyzed by SPSS 20. Results: The results showed that intervention had an effect on increasing tendency towards childbearing decision in men and women who were about to get married [P<0.05]. The intervention group showed a slight decrease during the follow-up phase, but this was not significant [P> 0.05]. Also, the results showed that men's tendency towards childbearing in the intervention group was different in terms of income, place of residence and housing status [P<0.05]. Conclusion: The results showed that the effectiveness of educational method, based on the theory of planned behavior on childbearing decision. It is recommended that, in view of the importance of childbearing in the family and social systems, in the context of pre-marriage counseling, more effective programs be provided to draw attention of the couples to childbearing at appropriate age and conditions. Study registration : The Ethics Committee of Kermanshah University of Medical Sciences [IR: KUMS.REC.1397.514].