bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating a multidimensional strategy to improve the professional self-care of occupational therapists working with people with life limiting illness.
Authors: Apostol Courtney , Cranwell Kathryn , Hitch Danielle
Published: September 2020

Background: The term ‘’life limiting conditions’ refers to premature death following decline from chronic conditions, which is a common circumstance in which occupational therapists work with people at the end of life. The challenges for clinicians of working with these patients have long been recognised, and may have a significant impact on their professional self-care. This study aimed to evaluate a multidimensional workplace strategy to improve the professional self-care of occupational therapists working with people living with a life limiting condition.Methods: A pre and post mixed methods survey approach were utilised, with baseline data collection prior to the implementation of a multidimensional workplace strategy. The strategy included professional resilience education, targeted supervision prompts, changes to departmental culture and the promotion of self-care services across multiple organisational levels. Follow up data collection was undertaken after the strategy had been in place for two years. Quantitative data were analysed descriptively, while qualitative data were subjected to thematic analysis. Results: 103 occupational therapists responded (n=55 pre, n=48 post) across multiple service settings. Complex emotional responses and lived experiences were identified by participants working with patients with life limiting conditions, which were not influenced by the workplace strategy. Working with these patients was acknowledged to challenge the traditional focus of occupational therapy on rehabilitation and recovery. Participants were confident about their ability to access self-care support, and supervision emerged as a key medium. While the strategy increased the proportion of occupational therapists undertaking targeted training, around half identified ongoing unmet need around professional self-care with this patient group. Demographic factors (e.g. practice setting, years of experience) also had a significant impact on the experience and needs of participants. Conclusions: The multidimensional workplace strategy resulted in some improvements in professional self-care for occupational therapists, particularly around their use of supervision and awareness of available support resources. However, it did not impact upon their lived experience of working with people with life limiting conditions, and there remain significant gaps in our knowledge of support strategies for self-care of occupational therapist working with this patient group.
Validation of the moroccan arabic version of the low anterior resection syndrome score
Authors: Essangri Hajar , Majbar Mohammed Anass , Benkabbou Amine , Amrani Laila , Mohsine Raouf , Amine Souadka
Published: September 2020

Background: Sphincter sparing surgery is oftentimes associated with bowel dysfunction complaints, namely the low anterior resection syndrome (LARS). The LARS questionnaire is widely used to assess this syndrome. The aim of this observational study is to translate this tool into arabic and test its psychometric properties in rectal cancer patients, in order to ease its use in clinical practice and future research.Methods: The LARS questionnaire was translated to arabic and administered to a total of 143 patients. A subgroup of 42 patients took the test twice for test-retest reliability. Internal consistency was examined through cronbach’s alpha. The score results were correlated to the EORTC QLQ-C30 questionnaire for convergent validity assessment, while discriminant validity was established through the ability of the LARS score to differentiate patients with different clinical and pathological criteria.Results: The Moroccan Arabic version of the LARS score was completed by 143 patients. The internal consistency was demonstrated through a cronbach alpha score of 0.66. The agreement between the test and retest was established by a Bland Altman plot with 95% limits of agreement. 85.6% of patients remained in the same LARS category. The LARS score showed negative correlation with all five of the QLQ-C30 functional scales as well as positive correlation to the diarrhea symptom scale. The questionnaire score differed between patients according to their tumor location, chemoradiotherapy, type of mesorectal excision and anastomosis. Conclusion: The Moroccan Arabic version of the LARS score shows good psychometric properties and can be used for bowel dysfunction assessment in clinical and research settings.
Framing and Self-Responsibility Modulate Brain Activities in Decision Escalation
Authors: Liang Ting-Peng , Li Yuwen , Yen Nai-Shing , Turel Ofir , Hsu Sen-Mou
Published: September 2020

Background: Escalation of commitment is a common bias in human decision making. The present study examined (1) differences in neural recruitment for escalation and de-escalation decisions of prior investments, and (2) how the activations of these brain networks are modulated by two contextual/confounding factors: (i) responsibility, and (ii) framing of the success probabilities. Results: Imaging data were obtained from functional magnetic resonance imaging (fMRI) applied to 29 participants. A whole-brain analysis was conducted to compare brain activations between conditions. ROI analysis, then, was used to examine if these significant activations were modulated by two contextual factors. Finally, mediation analysis was applied to explore how the contextual factors affect escalation decisions through brain activations. The findings showed that (1) escalation decisions are faster than de-escalation decisions, (2) the corresponding network of brain regions recruited for escalation (anterior cingulate cortex, insula and precuneus) decisions differs from this recruited for de-escalation decisions (inferior and superior frontal gyri), (3) the switch from escalation to de-escalation is primarily frontal gyri dependent, and (4) activation in the anterior cingulate cortex, insula and precuneus were further increased in escalation decisions, when the outcome probabilities of the follow-up investment were positively framed; and activation in the inferior and superior frontal gyri in de-escalation decisions were increased when the outcome probabilities were negatively framed. Conclusions: Escalation and de-escalation decisions recruit different brain regions. Framing of possible outcomes as negative leads to escalation decisions through recruitment of the inferior frontal gyrus. Responsibility for decisions affects escalation decisions through recruitment of the superior (inferior) gyrus, when the decision is framed positively (negatively).
Prevalence and Risk Factors of Chronic Kidney Disease among Palestinian Type 2 Diabetic Patients: a Cross-Sectional Study
Authors: Nazzal Zaher , Hamdan Zakaria , Masri Donia , Abu-Kaf Oday , Hamad Mohammad
Published: September 2020

Background: Chronic kidney disease (CKD) is a global public health concern and diabetes is one of the main risk factors for its occurrence and progression. The aim of this research is to determine the prevalence of chronic kidney disease in a cross-sectional population of patients with type 2 diabetes in primary health centers in North West Bank.Methods: Patient data including patient characteristics, creatinine level, blood pressure, HbA1c, and hypertension and period of diabetes were obtained from primary health care centers. The eGFR has been determined using the CKD-EPI equation. CKD was staged according to the 2012 Kidney Disease Improving Global Outcomes Framework (KDIGO) guideline. Both univariable and multivariable statistical analysis was conducted using SPSS. Results: The prevalence of chronic kidney disease among diabetic adults in North West Bank was found to be 23.6% (95% CI: 19.4%-28.1%) divided as follows: 19.7% had stage 3 CKD, 2.6% had stage 4 CKD and 1.3% had stage 5 CKD. In multivariable logistic regression, CKD was significantly associated with Age ≥60 years [adjusted OR: 3.2, 95% CI: 1.8-5.9], hypertension [adjusted OR: 5.7, 95% CI: 2.2-15.2], and smoking [adjusted OR: 2.3, 95% CI: 1.3-4.2].Conclusions: CKD is very prevalent among diabetic adults in Palestine. Co-morbid hypertension, smoking and older age has been shown to increase the risk of developing CKD. Extensive screening for diabetic patients to diagnose CKD at an early stage and to follow more aggressive treatment methods for diabetes as well as other important risk factors, especially hypertension and smoking, is recommended.
Effects of β-carotene intake on the risk of fracture: A Bayesian meta-analysis
Authors: Charkos Tesfaye Getachew , Liu Yawen , Oumer Kemal Sherefa , Vuong Ann M , Yang Shuman
Published: September 2020

Background: Epidemiological studies examining the association between β-carotene intake and risk of fracture have reported inconsistent findings. We conducted a meta-analysis to investigate the association between β-carotene intake and risk of fracture. Methods: We systematically searched PubMed, EMBASE and Cochrane library databases for relevant articles that were published until December 2019. We also identified studies from reference lists of articles identified from the clinical databases. The frequentist and Bayesian random-effects model was used to synthesize data. Results: Nine studies with a total of 190,545 men and women, with an average age of 59.8 years, were included in this meta-analysis. For β-carotene intake (1.76 -14.30 mg/day), the pooled risk ratio (RR) of any fracture was 0.67 (95% Credible Interval (CrI): 0.51-0.82; heterogeneity: P = 0.66, I 2 =0.00 %) and 0.63 (95%CrI: 0.44-0. 82) for hip fracture. By study design, the pooled RRs were 0.55 (95% CrI: 0.14-0.96) for case-control studies and 0.82 (95% CrI: 0.58-0.99) for cohort studies. By geographic region, the pooled RRs were 0.58 (95% CrI: 0.28-0.89), 0.86 (95% CrI: 0.35-0.1.37), and 0.91(95% CrI: 0.75-1.00) for studies conducted in China, the United States, and Europe, respectively. By sex, the pooled RRs were 0.88 (95% CrI: 0.73-0.99) for males and 0.76 (95% CrI: 0.44-1.07) for females. There was a 95% probability that β-carotene intake reduces risk of hip fracture and any type of fracture by more than 20%. Conclusions: The present meta-analysis suggests that β-carotene intake was inversely associated with fracture risk, which was consistently observed for case-control and cohort studies. Randomized controlled trials are warranted to confirm this relationship.
Moral neutralization: Nurses' evolution in unethical climate workplaces
Authors: Hakimi Hamideh , Joolaee Soodabeh , Farahani Mansoureh Ashghali , Rodney Patricia , Ranjbar Hadi
Published: September 2020

Introduction: Good quality of care is dependent on nurses’ strong clinical skills and moral competencies, as well. While most nurses work with high moral standards, the moral performance of some nurses in some organizations shows a deterioration in their moral sensitivity and actions. The study reported in this paper aimed to explore the experiences of nurses regarding negative changes in their moral practice.Materials and Methods: This was a qualitative study utilizing an inductive thematic analysis approach, which was conducted from February 2017 to September 2019. Twenty-five nurses participated in semi-structured interviews. Results: The main theme that emerged from our analysis was one of moral neutralization in the context of an unethical moral climate. We found five sub-themes, including: (1) feeling discouraged; (2) normalization; (3) giving up; (4) becoming a justifier; and (5) moral indifference.Conclusions: Unethical moral climates in health organizations can result in deterioration of morality in nurses which can harm both patients and health systems. Some unethical behaviors in nurses can be explained by this process.
Socioeconomic inequalities in women’s access to health care: Has Ecuadorian health reform been successful?
Authors: Quizhpe Edy , Sebastian Miguel San , Teran Enrique , Pulkki-Brännström Anni-Maria
Published: September 2020

Background

Over the last twelve years, Ecuador has implemented comprehensive health sector reform to ensure equitable access to health care services according to need. While there have been important achievements in terms of health care coverage, the effects of these reforms on socioeconomic inequalities in health care have not been analysed. The present study assesses whether the health care reforms implemented in the decade between 2007 and 2017 have contributed to reducing the socioeconomic inequalities in women’s health care access.

Methods

The present study was based on two waves (2006 and 2014) of the Living Standards Measurement Survey conducted in Ecuador. Data from women of reproductive age (15 to 49 years) were analysed to evaluate health care coverage across three indicators: skilled birth attendance, cervical cancer screening, and the use of modern contraceptives. Absolute risk differences were calculated between the heath care indicators and the socioeconomic variables using binomial regression analysis for each time period. The Slope Index of Inequality (SII) was also calculated for each socioeconomic variable and period. A multiplicative interaction term between the socioeconomic variables and period was included to assess the changes in socioeconomic inequalities in health care over time.

Results

Access to health care increased in the three studied outcomes during the health sector reform. Significant reductions in inequality in skilled birth attendance were observed in all socioeconomic variables except in the occupational class. Cervical cancer screening inequalities increased according to education and occupation, but decreased by wealth. Only a poorer education was observed for modern contraceptive use.

Conclusions

While most socioeconomic inequalities in skilled birth attendance decreased during the reform period, this was not the case for inequalities in cervical cancer screening or the use of modern contraceptives. Further studies are needed to address the social determinants of these health inequalities.
A patients’ view of OA: the Global Osteoarthritis Patient Perception Survey (GOAPPS), a pilot study
Authors: Vitaloni Marianna , Bemden Angie Botto-van , Sciortino Rosa , Carné Xavier , Quintero Maritza , Santos-Moreno Pedro , Espinosa Rolando , Rillo Oscar , Monfort Jordi , de Abajo Francisco , Oswald Elisabeth , Matucci Marco , du Souich Patrick , Möller Ingrid , Baures Monserrat Romera , Vinci Arlene , Scotton Deborah , Bibas Marco , Eakin Guy , Verges Josep
Published: September 2020

Background: Globally, osteoarthritis (OA) is the third condition associated with disability. There is still poor treatment in OA but science holds the key to finding better treatments and a cure. It is essential to learn what’s important to patients from them to implement the most effective OA management. The OA Patients Task Force, conducted the Global OA Patient Perception Survey (GOAPPS)-the first global survey made by patients to analize the quality of life (QoL) & patient perceptions of care across countries. The goal was to collect data on OA patients' perception of OA to understand patients’ needs and expectations to improve OA management. Methods: Observational, cross-sectional study by online survey data collection from six countries, translated into three languages. The survey was comprised of 3 sections: patient demographics and clinical symptomology characteristics; relationship with physicians: perception of attention, treatment, and information provided; and OA impact on daily activity and QoL. The results of the survey were evaluated using the Limited Data Set. The survey results were analyzed using descriptive statistics to characterize the patients' answers. Additionally, Cronbach's alpha was calculated to determine internal consistency validity. Results. A total of 1512 surveys were completed in 6 countries. 84.2% of respondents reported pain/tenderness and 91.1% experienced limitations to physical activities. 42.3% of patients were not satisfied with their current OA treatment. 86% had comorbidities, especially hypertension, and obesity. 51.3% and 78% would like access to additional drug or additional non-drug/non-surgical treatments respectively. 48.2% of patients perceived their QoL to be affected by OA. The Cronbach's alpha was 0.61. Conclusions: OA has a significant impact on patients’ daily activities and their desire to play an active role in managing this disease. Patients are seeking additional treatments, especially no pharmacological/no surgical treatments stressing the need for investing in clinical research, implementing OA preventive measures, and managing interventions to improve the healthcare value chain in OA.
Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population
Authors: Yu Qiuli , Liang Ya , Ji Fangfang , Yuan Zhilan
Published: September 2020

Background: To compare the efficacy and safety of focused ultrasound cycloplasty (UCP) and transscleral cyclophotocoagulation (TSCP) in the treatment of refractory glaucoma in a Chinese population. Methods: We retrospective compared twenty-eight eligible patients with refractory glaucoma, who were divided into the UCP group and TSCP group. Patients in these two groups underwent a corresponding procedure from June 2018 to February 2019. The intraocular pressure (IOP), visual acuity, the number of anti-glaucoma agents used and complications were reviewed and compared between groups. Proper statistical methods were selected according to comparison models under IBM SPSS 25 software.Results: After the 12-months follow-up, postoperative IOP and number of anti-glaucoma agents used in the two groups were both reduced than the baseline level, and the differences were statistically significant (P<0.05). There were no significant differences in IOP, number of anti-glaucoma agents and the best-corrected visual acuity between the two groups at each follow-up time point (P＞0.05). In terms of complications, the pain at 1 day after surgery in the UCP group was significantly milder than that in the TSCP group (P<0.05). And there were no significant differences in other complications between the two groups (P>0.05).Conclusions: Both UCP and TSCP are safe and effective methods for the treatment of refractory glaucoma. Nevertheless, pain is less severe after UCP.
Acute hospital staff’s attitudes towards dementia and perceived dementia knowledge: a cross-sectional survey in Ireland
Authors: Keogh Brian , To Wing Ting , Daly Louise , Hynes Geralyn , Kennelly Siobhan , Lawlor Brian , Timmons Suzanne , O’Reilly Susan , Bracken-Scally Mairead , Ciblis Aurelia , Cole Natalie , Drury Amanda , Pittalis Chiara , Kennelly Brendan , McCarron Mary , Brady Anne-Marie
Published: September 2020

Background: Little is known about staff’s attitudes in Irish acute hospital settings towards people living with dementia and their perceived dementia knowledge. The aim of this study was to understand the general level of dementia knowledge and attitudes towards dementia in different types of hospital staff, as well as to explore the potential influence of previous dementia training and experience (having a family member with dementia) and the potential moderating effects of personal characteristics. This data was required to plan and deliver general and targeted educational interventions to raise awareness of dementia throughout the acute services.Methods: A cross-sectional survey was carried out among a diverse range of hospital staff (n = 1795) in three urban acute general hospitals in Ireland, including doctors, nurses, healthcare attendants, allied professionals, and general support staff. Participants’ perceived dementia knowledge and attitudes were assessed as well as their previous dementia training and experience. To measure participant’s attitude towards dementia, the validated Approaches to Dementia Questionnaire (ADQ) was used.Results: Hospital staff demonstrated positive attitudes towards people living with dementia, and believed they had a fair to moderate understanding of dementia. Both ‘having previous dementia training’ and ‘having a relative living with dementia’ predicted attitude towards dementia and perceived dementia knowledge. Interestingly, certain personal staff characteristics did impact dementia training in predicting attitude towards dementia and perceived dementia knowledge.Conclusion: This study provides a baseline of data regarding the attitudes towards dementia and perceived dementia knowledge for hospital staff in Irish acute hospitals. The results can inform educational initiatives that target different hospital staff, in order to increase awareness and knowledge to improve quality of dementia care in Irish hospitals.
Candida tropicalis distribution and drug resistance is correlated with ERG11 and UPC2 expression
Authors: Wang Dan , An Na , Yang Yuwei , Yang Xianggui , Fan Yingzi , Feng Jiafu
Published: September 2020

Objective

This study analyzed the distribution and drug susceptibility of Candida tropicalis ( C. tropicalis ) and the relationship between ERG11 and UPC2 expression and resistance to azole antifungal agents.

Methods

C. tropicalis was cultured and identified by Sabouraud Agar Medium, CHROM Agar Candida and ATB tests (Bio-Mérieux, France). Total RNA was extracted from the collected strains, and the ERG11 and UPC2 mRNA expression levels were analyzed by quantitative real-time PCR.

Results

In total, 2872 clinical isolates of Candida , including 319 strains of C. tropicalis , were analyzed herein; they were mainly obtained from the Departments of Respiratory Medicine and ICU. The strains were predominantly isolated from airway secretion samples, and the detection trend in four years was mainly related to the type of department and specimens. The resistance rates of C. tropicalis to fluconazole, itraconazole and voriconazole had been increasing year by year. The mRNA expression levels of ERG11 and UPC2 in the fluconazole-resistant group were significantly higher than they were in the sensitive group. In addition, there was a significant positive linear correlation between these two genes in the fluconazole-resistant group.

Conclusions

Overexpression of the ERG11 and UPC2 genes in C. tropicalis could increase resistance to azole antifungal drugs. The routine testing for ERG11 and UPC2 in high-risk patients in key departments would provide a theoretical basis for the rational application of azole antifungal drugs.
Consistency between Optical Coherence Tomography and Humphrey Visual Field for Evaluating Glaucomatous Defects in High Myopic Eyes
Authors: Wen Wen , Zhang Yuqiu , Zhang Ting , Sun Xinghuai
Published: September 2020

Background: The study is to investigate the influence of high myopia on the consistency between optical coherence tomography (OCT) and visual field in primary open-angle glaucoma (POAG). Methods: We enrolled 37 patients with POAG with high myopia (POAG-HM group), 27 patients with POAG without high myopia (POAG group), and 29 controls with high myopia (HM group). All subjects underwent Humphrey perimetry (30-2 and 10-2 algorithms). The peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured using Cirrus HD-OCT. Spearman’s rank correlation analysis was used to determine correlations between OCT and perimetric parameters. Agreement was analyzed by cross-classification and weighted κ statistics. Results: In POAG group, the cross-classification analysis showed strong agreement between the inferior temporal GCIPL thickness and 10-2 MS (κ = 0.5447, P = 0.0048), and good agreement between the superior and inferior RNFL thicknesses and 30-2 MS (κ = 0.4407 and 0.4815; P < 0.05). In the POAG-HM group, only the inferior temporal GCIPL thickness showed good agreement with 10-2 MS (κ = 0.3155, P = 0.0289). Conclusions: In POAG patients with high myopia, changes in macular measurements were in accordance with visual field defects, and RNFL thickness did not consistently decline with visual field defects due to the effects of high myopia. This study suggests that during diagnosis and follow-up of glaucoma with high myopia, more attention need to be focused on structure and functional defects in macular areas.
Genetic Map Construction and Functional Characterization of Genes within the Segregation Distortion Regions (SDRs) in the F2:3 Populations Derived from Wild Cotton Species of the D Genome
Authors: KIRUNGU Joy Nyangasi , MAGWANGA Richard Odongo , SHIRAKU Margaret Linyerera , Pu LU , MEHARI Teame Gereziher , Yuanchao XU , Yuqing HOU , AGONG Stephen Gaya , Yun ZHOU , Xiaoyan CAI , Zhou Zhongli , Kunbo WANG , Fang LIU
Published: September 2020

Background: Segregation distortion (SD) is a phenomenon common among stable or segregating populations, and the principle behind it still puzzles many researchers. The F2:3 progenies developed from the wild cotton species of the D genomes were used to investigate the possible plant transcription factors within the segregation distortion regions (SDRs). A consensus map was developed between two maps from the four D genome, map A derived from an F2:3 progenies of Gossypium klotzschianum and G. davidsonii while Map B from G. thurberi and G. trilobum F2:3 generations. In each map 188 individual plants were used. Results: The consensus linkage map had 1492 markers across the 13 linkage groups; with a map size of 1467.445 cM and average marker distance of 1.037 0 cM. Chromosome D502 had the highest percentage of SD with 58.621% followed by Chromosome D507 with 47.887%. Six thousand and thirty eight genes were mined within the SDRs on chromosome D502 and D507 of the consensus map. Within chromosome D502 and D507, 2,308 and 3 730 genes were mined, respectively, and were found to belong to 1 117 domains out of which 622 domains were common across the two chromosomes. Moreover, the first 9 domains were members of the plant resistance genes (R genes), while Pkinase; Protein kinase domain (PF00069) was the dominant group with 188 genes. Further analysis on the dominant domains revealed that 287 miRNAs were found to target various genes, such as the gr-miR398, gra-miR5207, miR164a, miR164b, miR164c among others, which have been found to target top-ranked stress-responsive transcription factors such as NAC genes. Moreover, some of the stress responsive cis-regulatory elements were also detected. Furthermore, RNA profiling of the genes from the dominant family showed that higher numbers of genes were highly upregulated under salt and osmotic stress conditions, and in addition they were highly expressed at different stages of fiber development. Conclusion: The result obtained provided an indication of the important role of the SDRs in the evolution of significant genes in plants.
Spatial and temporal influence of rainfall on crustal pore pressure based on seismic velocity monitoring 
Authors: Andajani Rezkia Dewi , Tsuji Takeshi , Snieder Roel , Ikeda Tatsunori
Published: September 2020

Crustal pore pressure, which controls the activities of earthquakes and volcanoes, varies in response to rainfall. The status of pore pressure can be inferred from observed changes in seismic velocity. In this study, we investigate the response of crustal pore pressure to rainfall in southwestern Japan based on time series of seismic velocity derived from ambient noise seismic interferometry. To consider the heterogeneity of the area, rainfall and seismic velocity obtained at each location were directly compared. We used a band-pass filter to distinguish the rainfall variability from sea level and atmospheric pressure, and then calculated the cross-correlation between rainfall and variations in S-wave velocity (Vs). A mostly negative correlation between rainfall and Vs changes indicates groundwater recharge by rainfall, which increases pore pressure. The correlations differ between locations, where most of the observation stations with clear negative cross-correlations were located in areas of granite. On the other hand, we could not observe clear correlations in steep mountain areas, possibly because water flows through river without percolation. This finding suggests that geographical features contribute to the imprint of rainfall on deep formation pore pressure. We further modelled pore pressure change due to rainfall based on diffusion mechanism. A strong negative correlation between pore pressure estimated from rainfall and Vs indicates that the Vs variations are triggered by pore pressure diffusion in the deep formation. Our modelling results show a spatial variation of diffusion parameter which controls the pore pressure in deep formation. By linking the variations in seismic velocity and crustal pore pressure spatially, this study shows that seismic monitoring may be useful in evaluating earthquake triggering processes or volcanic activity.
An R package for an integrated evaluation of statistical approaches to cancer incidence projection
Authors: Knoll Maximilian , Furkel Jennifer , Debus Jürgen , Abdollahi Amir , Karch André , Stock Christian
Published: September 2020

Background: Projection of future cancer incidence is an important task in cancer epidemiology. The results are of interest also for biomedical research and public health policy. Age-Period-Cohort (APC) models, usually based on long-term cancer registry data (>20yrs), are established for such projections. In many countries (including Germany), however, nationwide long-term data are not yet available. General guidance on statistical approaches for projections using rather short-term data is challenging and software to enable researchers to easily compare approaches is lacking. Methods: To enable a comparative analysis of the performance of statistical approaches to cancer incidence projection, we developed an R package (incAnalysis), supporting in particular Bayesian models fitted by Integrated Nested Laplace Approximations (INLA). Its use is demonstrated by an extensive empirical evaluation of operating characteristics (bias, coverage and precision) of potentially applicable models differing by complexity. Observed long-term data from three cancer registries (SEER-9, NORDCAN, Saarland) was used for benchmarking. Results: Overall, coverage was high (mostly >90%) for Bayesian APC models (BAPC), whereas less complex models showed differences in coverage dependent on projection-period. Intercept-only models yielded values below 20% for coverage. Bias increased and precision decreased for longer projection periods (>15 years) for all except intercept-only models. Precision was lowest for complex models such as BAPC models, generalized additive models with multivariate smoothers and generalized linear models with age x period interaction effects. Conclusion: The incAnalysis R package allows a straightforward comparison of cancer incidence rate projection approaches. Further detailed and targeted investigations into model performance in addition to the presented empirical results are recommended to derive guidance on appropriate statistical projection methods in a given setting.
Predicting EQ-5D-3L index value from the PROMIS-29 profile for the United Kingdom, France, and Germany
Authors: Klapproth Christoph Paul , Bebber Jan van , Sidey-Gibbons Christopher J. , Valderas Jose M , Leplege Alain , Rose Matthias , Fischer Felix
Published: September 2020

Background: EQ-5D health state utilities (HSU) are commonly used in health economics to compute quality-adjusted life years (QALYs). The EQ-5D, which is country-specific, can be derived directly or by mapping from self-reported health-related quality of life (HRQoL) scales such as the PROMIS-29 profile. The PROMIS-29 from the Patient Reported Outcome Measures Information System is a comprehensive assessment of self-reported health with excellent psychometric properties. We sought to find optimal models predicting the EQ-5D from the PROMIS-29 in the United Kingdom, France, and Germany and compared the prediction performances with that of a US model.Methods: We collected EQ-5D-5L and PROMIS-29 profiles and three samples representative of the general populations in the UK (n=1,509), France (n=1,501), and Germany (n=1,502). We used stepwise regression with backward selection to find the best models to predict the EQ-5D from all seven PROMIS-29 domains. We investigated the agreement between the observed and predicted EQ-5D in all three countries using various indices for the prediction performance, including Bland-Altman plots to examine the performance along the HSU continuum.Results: The EQ-5D was best predicted in France (nRMSEFRA = 0.075, nMAEFRA = 0.052), followed by the UK (nRMSEUK = 0.076, nMAEUK = 0.053) and Germany (nRMSEGER = 0.079, nMAEGER = 0.051). The Bland-Altman plots show that the inclusion of higher-order effects reduced the overprediction of low HSU scores.Conclusions: Our models provide a valid method to predict the EQ-5D from the PROMIS-29 for the UK, France, and Germany.
Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence
Authors: Tamuzi Jacques L , Birhanu Ayele T , Shumba Constance S , Adetokunboh Olatunji , Uwimana-Nico Jeannine , Haile Zelalem T , Inugu Joseph , Nyasulu Peter Suwirakwenda
Published: September 2020

Background

The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the 21 st century. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV/TB/COVID-19 as a newly related field and play an important role in the present and future management of the co-infections. However, several gaps are remaining in the knowledge of the burden of COVID-19 on patients with TB and HIV, the diagnosis, and management of these patients.

Objectives

The study was conducted to review different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection or only TB and to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected or TB patients, screening algorithm and clinical management.

Methods

We conducted electronic search of potential eligible studies published in English in the Cochrane Controlled Register of Trials, PubMed, Medrxiv, Google scholar and Clinical Trials Registry databases. We included case studies, case series and observational studies published between January, 2002 and March, 2020 in which SARS-CoV, MERS-CoV and COVID-19 co-infected to HIV/TB or TB were managed in adult patients. We screened titles, abstracts and full articles for eligibility. As we anticipated heterogeneity in the literature, results were reported narratively.

Main results

After removing 69 duplicates, 24 out of 246 articles were assessed for eligibility, of which 9 studies were included for qualitative analysis. Among them, we included two case reports, four case series, one case-control and two retrospective observational studies. The studies have shown that TB may occur during or after SARS-CoV. In terms of severity, the proportion of severe/critical SARS, MERS and COVID cases with TB co-infection was higher than in patients with mild/moderate stages (P= 0.0008).

Conclusion

SARS/MERS-CoV/COVID-19 associated to HIV/TB or TB subjects had a higher risk of developing severe/critical than mild/moderate SARS/MERS-CoV/COVID-19. Diagnostic algorithms and clinical management were suggested for efficiently improving COVID-19/HIV/TB co-infections outcomes.
Selection and validation of reference genes for measuring gene expression in Toona ciliata under different experimental conditions by quantitative real-time PCR analysis
Authors: song Huiyun , Mao Wenmai , Duan Zhihao , Que Qingmin , Zhou Wei , Chen Xiaoyang , Li Pei
Published: September 2020

Background: Before studying gene expression of different organisms, it is important to determine the best reference gene. At present, the most accurate method of detecting gene expression is quantitative real-time PCR (RT-qPCR). With this method, reference genes that are stable in different biological systems and under different conditions can be obtained. Toona ciliata Roem (T. ciliata). is a valuable and fast-growing timber specie. In this study, 20 reference genes were identified using RT-qPCR, as a primary prerequisite for future gene expression analysis. Four different methods, geNorm, NormFinder, BestKeeper, and RankAggreg were used to evaluate the expression stability of the 20 candidate reference genes in various tissues under different conditions. Results: The experimental results showed that TUB-α was the most stably expressed reference gene across all samples and UBC17 was the most stable in leaves and young stems under Hypsipyla robusta (H. robusta) and methyl jasmonate (MeJA) treatments. In addition, PP2C59 and UBC5B were the best-performing genes in leaves under H. robusta treatment, while HIS1 and ACT7 were the best reference genes in young stems. The two best reference genes were 60S-18 and TUB-α after treatment at 4 °C. The expression of HIS6 and MUB1 was the most stable under PEG6000 treatment. The accuracy of the selected reference genes was verified using the transcription factor MYB3 (TcMYB3) gene. Conclusions: This is the first report to verify the best reference genes for normalizing gene expression in T. ciliata under different conditions, which will facilitate future elucidation of gene regulations in this species.
The Impact of COVID-19 on Gastric Cancer Surgery: A Single-Center Retrospective Study
Authors: Li Yu-xuan , He Chang-zheng , Liu Yi-chen , Zhao Peng-yue , Xu Xiao-lei , Wang Yu-feng , Xia Shao-you , Du Xiaohui
Published: September 2020

Background: The coronavirus disease 2019 (COVID-19) has been declared a global pandemic by the World Health Organization. Patients with cancer are more likely to incur poor clinical outcomes. Due to the prevailing pandemic, we propose some surgical strategies for gastric cancer patients. Methods: The ‘COVID-19’ period was defined as occurring between 2020-01-20 and 2020-03-20. The enrolled patients were divided into two groups, pre-COVID-19 group (PCG) and COVID-19 group (CG). A total of 109 patients with gastric cancer were enrolled in this study. Results: The waiting time before admission increased by 4 days in the CG (PCG: 4.5 [IQR: 2, 7.8] vs. CG: 8.0 [IQR: 2,20]; p=0.006). More patients had performed chest CT scans besides abdominal CT before admission during the COVID-19 period (PCG: 22 [32%] vs. CG: 30 [73%], p=0.001). After admission during the COVID period, the waiting time before surgery was longer (PCG: 3[IQR: 2,5] vs. CG: 7[IQR: 5,9]; p<0.001), more laparoscopic surgeries were performed (PCG: 51[75%] vs. CG: 38[92%], p=0.021), and hospital stay period after surgery was longer (7[IQR: 6,8] vs.9[IQR:7,11]; p<0.001). In addition, the total cost of hospitalization increased during this period, (PCG: 9.22[IQR:7.82,10.97] vs. CG: 10.42[IQR:8.99,12.57]; p=0.006). Conclusion: This study provides an opportunity for our surgical colleagues to reflect on their own services and any contingency plans they may have to tackle the COVID-19 crisis.
MiR-7e-5p downregulation promotes transformation of low-grade follicular lymphoma to aggressive lymphoma by modulating an immunosuppressive stroma through the upregulation of FasL in M1 macrophages
Authors: Lou Xiaoli , Fu Jianhong , Zhao Xin , Zhuansun Xuemei , Rong Chao , Sun Maomin , Niu Hui , Wu Lei , Zhang Yongsheng , An Lu , Wan Shan , Wang Shouli
Published: September 2020

Background: In follicular lymphoma (FL), histologic transformation to high-grade FL and diffuse large B-cell lymphoma (DLBCL) is a critical adverse step in disease progression. Activation of the oncogene c-MYC and tumor microenvironment remodeling account for FL progression. A panel of microRNA (miRNA) was downregulated in transformed FL.

Methods: Differentially expressed miRNAs were systematically analyzed compared in eleven lymph nodes tissue samples from patients at different stages of disease. Expression of miR-7e-5p was analyzed in 46 B-cell lymphomas, including 30 FLs and 16 DLBCLs. In FL cells, transcriptional regulation of the oncogene c-MYC on its target miR-7e-5p was revealed by Chromatin Immunoprecipitation (ChIP) assay. Exosome, carrying differentially expressed miR-7e-5p was isolated and visualized by transmission electron microscope and fluorescence tracing. The effect of miR-7e-5p on recipient macrophage was determined by target gene quantification, flow cytometry, and TUNEL method in a cocultured system with miR-7e-5p-mimics or inhibitor treatment. Expression of miR-7e-5p targets, macrophage proportions, and clinical parameters were included for correlation analysis.

Results: We determined that downregulation of miR-7e-5p, driven by c-MYC overexpression, was associated with poorer prognosis in FL patients. The decreased expression of miR-7e-5p in lymphoma cells led to a reduced exosomal transfer to surrounding macrophages. As a result, the target gene of miR-7e-5p, Fas ligand (FasL), was upregulated and activated the caspase signaling, which led to the apoptosis of M1 macrophages in tumor stroma. Finally, in transformed FL tissues, overexpression of FasL and activation of caspase proteins was detected in tumor stromal macrophages. Downregulation of miR-7e-5p was associated with poorer clinical outcomes.

Conclusion: Downregulation of exosomal miR-7e-5p induces stromal M1 macrophage apoptosis, which leads to immunosurveillance and transformation of FL.
Clinical characteristics, treatment status and complications in women with tube ovarian abscess and endometriosis: a retrospective study
Authors: Li Hui , Zhao Yan , Chang Xiao-hong , Wang Yue , Zhu Hong-lan
Published: September 2020

Background: The aim of our present study was to investigate the clinical characteristics, treatment status and complications in women with endometriosis (EM) and tube ovarian abscess (TOA) to determine the possible association between TOA and EM.Methods: Medical records were used to analyze the clinical characteristics, treatment and complications. Twenty women who were diagnosed with TOA with EM were compared with 93 women diagnosed as having TOA without EM between January, 2008 and December, 2018. Results: In this study, TOA patients with EM were significantly more likely to have a lower age range (20–39years) than the non-EM group (11/20 (55.0%) vs 27/93 (29.0%)). In addition, TOA patients with EM were associated with a significantly lower rate of parity (11/20 (55.0%) vs 75/93 (80.6%),), higher rates of infertility (8/20(40%) vs 0/93(0%),) and a significantly lower incidence of elevated blood platelet counts (5/20 (25%) vs 43/93 (53.8%)). Furthermore, women with EM had greater blood loss (347±445.77 vs 204.67±289.46) and an increased complication rate (3/20(15%) vs 0/93(0%)). Among the 3 patients who had complications in the EM group, 2 patients had septic shock and 1 patient had intestinal obstruction. And 1 case who had septic shock followed by IVF treatment. There was no significance difference on other factors.Conclusions: The present study indicated that EM did not increase the difficulty and time of treatment in patients with TOA, but increased bleeding during surgery and serious complications. It is suggested that doctors should pay more attention to postoperative treatment and nursing in women with TOA and EM, especially those who have a history of recent infertility treatment and related procedures.
Short- and long-term outcomes after colonic self-expandable metal stent placement for malignant large-bowel obstruction as a bridge to surgery focus on the feasibility of the laparoscopic approach: a retrospective, single center study
Authors: Tajima Jesse Yu , Matsuhashi Nobuhisa , Takahashi Takao , Mizutani Chika , Iwata Yoshinori , Kiyama Shigeru , Kubota Masaya , Ibuka Takashi , Araki Hiroshi , Shimizu Masahito , Doi Kiyoshi , Yoshida Kazuhiro
Published: September 2020

Purpose Malignant large-bowel obstruction (MLBO) is a highly urgent condition in colorectal cancer with high complication rates. Self-expandable metal stent (SEMS) placement in MLBO is a new decompression treatment in Japan. Preoperative stent placement (bridge to surgery: BTS) avoids emergency surgery, but oncological influences of stent placement and post-BTS surgical approach remain unclear. We examined short- and long-term results of surgery for MLBO after SEMS placement in our hospital.Methods We retrospectively reviewed 75 patients with MLBO who underwent resection after SEMS placement at our hospital from June 2013 to December 2018. Postoperative morbidity and mortality were evaluated by comparison with the surgical approach.Results Tumor location was significantly higher in the left-side colon and rectum (n=59, 78.7%) than right-side colon (n=16, 21.3%). Technical and clinical success rates for SEMS placement were 97.3% and 96.0%, respectively. Laparoscopic surgery was performed in 54 patients (69.0%), and one-stage anastomosis was performed in 73 (97.3%). Postoperative complications were similar in the open surgery (Open) group (n=5, 23.8%) and laparoscopic surgery (Lap) group (n=7, 13.0%), with no severe complications requiring reoperation. Three-year overall survival (OS) and relapse-free survival (RFS) rates were not significantly different in the Lap vs Open group (67.5% vs 66.4%; 82.2% vs 62.5%).Conclusion Preoperative stent treatment avoids stoma construction but allows anastomosis. One-time surgery was performed safely contributing to minimally invasive treatment and acceptable short- and long-term results.
Association of 45-bp ins/del polymorphism of uncoupling protein 2 (UCP2) and susceptibility to nonalcoholic fatty liver and type 2 diabetes mellitus in North-west of Iran
Authors: Rezapour Salehe , Khosroshahi Shiva Ahdi , Farajnia Hadi , Mohseni Fatemeh , Khoshbaten Manouchehr , Farajnia Safar
Published: September 2020

Objective: Uncoupling protein 2 (UCP2) is a regulator of insulin secretion, free fatty acid (FFA) concentrations, and lipid metabolism that plays crucial roles in energy homeostasis. This study aimed to investigate the association of 45-bp ins/del polymorphism of UCP2 and susceptibility to NAFLD and T2DM. DNA was extracted from the white blood cells of the subjects and the gene polymorphism was determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). In this study, 72 patients with NAFLD, 71 healthy individuals as control, 80 patients with T2DM, and 77 age/race matched healthy controls were enrolled in the study.Results: A higher prevalence of insertion/insertion genotype has been observed in T2DM patients compared with the control group (p value˂ 0.05). But, there was no difference in genotype distribution between NAFLD patients and control groups (p value> 0.05). NAFLD patients with D/D, D/I genotype had higher triglyceride, ALT and AST levels, and lower HDL level than healthy controls. Patients with T2DM with D/D or D/I genotype also had significantly higher fasting serum glucose (FSG) level. While we found an association between the 45bp I/D polymorphism in 3ʹUTR of UCP2 and T2DM, no any correlation between this polymorphism and NAFLD was identified.