bluuebunny/crossref_metadata_2025 huggingface dataset:
Protective Effect of Mito-TEMPO on Sodium Valproate-Induced Hepatotoxicity in Mice
Authors: Jamshidi Hamid Reza , Emami Azadeh , Golmohammadi Hossein , Tavakoli Fatemeh
Published: October 2020

Valproic acid is a broad-spectrum anticonvulsant drug that is also useful for other diseases such as bipolar disorder and migraines. The most important side effect of this drug is hepatotoxicity. Oxidative stress and mitochondrial dysfunction play a role in the pathogenesis of liver toxicity of valproic acid. Mito-TEMPO is an antioxidant-based compound, which is selectively accumulated in mitochondria. The effects of its mitochondrial protection against oxidative damage in various pathologies, such as liver damage, have been observed. The aim of this study was to evaluate the protective effect of Mito-TEMPO on liver toxicity induced by sodium valproate in mice. Animals were divided into five groups and treated intraperitoneally over a 4-week period. Group 1 received normal saline, served as vehicle control, group 2 treated with 12.5 mg/kg of sodium valproate, group 3 was treated with 1 mg/kg of Mito-TEMPO, group 4 received both sodium valproate (12.5 mg/kg) and Mito-TEMPO (1 mg/kg), and group 5 received sodium valproate (12.5 mg/kg), and vitamin E (5 mg/kg) served as a positive control. At the end of the experiment, blood samples were collected by cardiac puncture, and all the animals were killed under ether anesthesia. Biochemical parameters including AST, ALT, ALP, and GGT in serum samples and glutathione (GSH) and malondialdehyde (MDA) contents in liver homogenates were determined. The findings of this study showed that the activity of AST and ALT were significantly lower in the sodium valproate+Mito-TEMPO treated animals as compared to the sodium valproate group (group 2). Furthermore, Mito-TEMPO was able to recover glutathione content (GSH) of liver tissue. The effect of Mito-TEMPO on the activity of ALP and GGT and serum level of MDA was not significant. Taken collectively, Mito-TEMPO has a protective role in sodium valproate hepatotoxicity. Considering the present results, further studies, in view of the potential therapeutic properties of Mito-TEMPO in improving liver damage caused by the use of valproic acid, may lead to the clinical applications of Mito-TEMPO in the treatment of liver disease.
A Rare Inflammatory Myofibroblastic Tumor of Pancreas in a Child With Cholestasis Presentation
Authors: Mehrabani Sanaz , Shokri-Shirvani Javad
Published: October 2020

Inflammatory myofibroblastic tumors (IMTs) are rare with unknown etiology. As pancreas involvement is rare in IMTs, here, we report a case of a girl with IMT, referred to our hospital. A 4-year-old girl presented with chief complaints of generalized itching and jaundice. Abdominopelvic computed tomography (CT) scans with contrast showed a homogeneous isodense mass lesion in the head of the pancreas with a compressive effect on the distal part of the common bile duct (CBD). Dilatation of intrahepatic bile ducts and CBD (8 mm) was observed. Magnetic resonance cholangiopancreatography (MRCP) examination showed a dilated gallbladder without stones and intrahepatic/extrahepatic bile ducts. The CBD was dilated, and a mass was found in the head of the pancreas. Immune-histochemical studies revealed spindle myoﬁbroblastic tissues with lymphoplasmacytic and eosinophil inﬁltration. All of them were compatible with pancreatic IMTs. The surgery improved the symptoms. The IMTs of the pancreas can have symptoms like pancreatic cancer. The careful evaluation by imaging and pathology is recommended.
Multiple CNS Tumors in a Patient With Neurofibromatosis Type 2: Classical Presentation of a Rare Disease
Authors: Ubaid Aamer , Waheed Farishta , Naeem Awais
Published: October 2020

Neurofibromatosis type 2 is a genetic autosomal dominant disorder caused by a spontaneous mutation in the gene located on chromosome 22 q11-13.1, which usually emerges in adolescence or early adulthood and is characterized by the development of bilateral vestibular schwannoma. We hereby report the classical case of Neurofibromatosis type 2 in a 25-year-old young male with multiple tumors associated with the disease. This patient presented to us with 3 years history of multiple painless nodules on his skin, facial weakness, left-sided progressive hearing loss, and 20 days history of weakness in the left lower limb. On Examination, he was vital with a GCS of 15/15. He was anemic with no jaundice. He had left inguinal lymphadenopathy along with multiple subcutaneous nodules on different areas, including the scalp, face, left mid-axillary line over the abdomen. He also had Right-sided facial palsy and horizontal nystagmus. CNS examination revealed an upgoing plantar on the left side, right facial nerve palsy, and bilateral vestibulocochlear nerve paralysis. Spine examination revealed spinal tenderness in the lower lumbar region. Superficial abdominal reflexes were absent. Upper limb and right lower limb power, tone, and reflexes were normal while the tone and power in the left lower limb were reduced power being ⅗. Reflexes were also exaggerated in the left lower limb. The right ankle showed swelling, most probably a plexiform neuroma. On investigations, he had normochromic normocytic anemia with mild leucocytosis. Platelets were normal. The rest of the biochemical investigations, including serum electrolytes, liver function tests, and renal function tests, were also normal.MRI brain and spine confirmed bilateral acoustic neuroma and multiple cranial and peripheral nerve tumors i.e., classical presentation of a rare disease neurofibromatosis. He was referred to the neurology unit for further assessment and treatment.
Ege Üniversitesi hastanesi veri tabanındaki pankreas kanserlerinin epidemiyolojik ve genel sağkalım özellikleri
Authors: SERT Fatma , ÖZKÖK Serdar , ORUÇ Nevin , ÜNALP Ömer , YALMAN Deniz , NART Deniz , AYDIN Ahmet , UGUZ Alper , KARABULUT Bülent , YILMAZ Funda , ŞANLI Ulus Ali , HAYDAROĞLU Ayfer
Published: October 2020

Amaç: Pankreas kanserlerinin epidemiyolojisi ve genel sağkalım (GSK) özelliklerinin araştırılmasıdır.
Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Uygulama ve Araştırma Merkezine (EÜKAM) 1992-2017 yıllarında kayıtlı Ege Üniversitesi Tıp Fakültesi (EÜTF) kanser verileri retrospektif olarak taranmıştır. CANREG özel bilgisayar programına kayıtlı veriler, WHO ve Surveillance, Epidemiology, and End Results (SEER) sistemlerinde gruplanarak analizler yapılmıştır. İstatistiksel analizlerde Ki-kare, General Linear Model (GLM), Kaplan-Meier sağ kalım analizleri kullanılmıştır.
Bulgular: Toplam 117.139 kanser olgusunun 2.507’si pankreas kanseridir. Olgularımızın 1.493’ü (%59,5) erkek, 1.014’ü (%40,5) kadın olup pankreas kanseri iki cinsiyette benzer oranlarda izlenmektedir. Pankreas başı, en sık yerleşim yeridir. Genellikle ileri evrede tanı konulan kuyruk yerleşimli tümörler, erkeklerde daha sıktır (%11,5 vs. %6,2; p=0,047). Erkeklerde en sık 60 69 yaş arasında, kadınlarda ise 70 yaş üzerinde izlenmektedir. Ekzokrin tümörler, endokrin tümörlerden anlamlı oranda fazla karşılaşılmaktadır (%95 vs. %5; p=0,002). 1992 yılından 2014 yılı sonuna kadar kaydedilen pankreas kanseri olgularında doğrusal bir artış mevcuttur ve yıllara göre olan bu artış anlamlıdır (GLM: F=10,91, p<0,001). Artış cinsiyetler arasında farklılık göstermektedir. Erkeklerde daha yüksek ve doğrusal artış olduğu saptanmıştır (GLM: F=4,988, p=0,026). Hastalık prognozu oldukça kötü olup 2-, 5- ve 10-yıllık GSK oranları sırasıyla %15,9, %8,3 ve %6,0; ortanca GSK 7 aydır. Beş yıllık GSK erkeklerde %11,3 iken; kadınlarda %15,4 olup fark anlamlı bulunmuştur (p<0,001).
Sonuç: EÜTF’de EÜKAM tarafından 1992-2017 arasında, 117.139 kanser kaydı gerçekleştirilmiş, bunların 2507’si pankreas kanseridir. Pankreas kanserinde yıllara göre doğrusal artış vardır ve uzak metastatik evrede tanı konulmaktadır. En sık görülme yaş grubu olan 60-69 yaş grubu için 5 yıllık GSK %1,4 olarak bulunmuştur. Kadınlarda GSK erkeklere göre daha iyidir.
Ege Ünı̇versı̇tesı̇ hastanesı̇ veri tabanındaki mide kanserlerinin epidemiyolojisi ve sağkalım özellikleri
Authors: ÜNAL Nalan Gülşen , YALMAN Deniz , DEMİR Halit Batuhan , SEZAK Murat , SEZER Taylan Özgür , BURÇAK KARACA Şaziye , ELMAS Nevra , ÖZÜTEMİZ Ahmet Ömer , ÖZKÖK Serdar , ERSİN Muhtar Sinan , DOĞANAVŞARGİL Başak , KARABULUT Bülent , BOR Serhat , FIRAT Özgür , AYDIN Ahmet , VARDAR Rukiye , ORUÇ Nevin , TEKİN Fatih , TURAN İlker , ÇAKAR Burcu , CANER Ayşe , ERDEM Sevgi , HAYDAROĞLU Ayfer
Published: October 2020

Amaç: Bu çalışmada mide kanserinin (MK) epidemiyolojik ve genel sağkalım (GSK) özelliklerinin
araştırılması amaçlanmıştır.
Gereç Yöntem: Ege Üniversitesi Kanserle Savaş Uygulama ve Araştırma Merkezine (EÜKAM) 1992-
2017 yıllarında kayıtlı Ege Üniversitesi Tıp Fakültesi Hastanesi kanser verileri retrospektif olarak
taranmıştır. CAN-REG-4 bilgisayar programına kayıtlı veriler, Dünya Sağlık Örgütü ve Surveillance,

Epidemiology, and End Results sistemlerinde gruplanarak analizler yapılmıştır. İstatistik analizlerde ki-
kare, General Linear Model (GLM), Kaplan Meier sağkalım analizleri uygulanmıştır. Etik kurul onayı

alınmıştır.
Bulgular: EÜKAM veri tabanına kayıtlı toplam 117.139 kanserden 4.212’si (%3,6) MK’dir.
Gastrointestinal sistem kanserler içinde kolorektal kanserlerden sonra ikinci sıklıkta MK (%21,6) yer
almıştır. Olguların 2.692’si (%63,9) erkek, 1.520’si (%36,1) kadındır, arasındaki fark istatistiksel olarak
anlamlıdır (p<0,0001). Erkek/kadın oranı 1,8’dir. MK en sık 60-69 yaşlarda (%28,9) görülmüştür. En
sık tümör yerleşimi korpusdur (%31,2), bunu antrum ve kardia izlemektedir. Distal (kardia dışı)
tümörler, proksimal (kardia) tümörlerine göre yaklaşık 2,5 kat daha fazladır. Adenokarsinom en sık
(%73,6) görülen histolojik alt tiptir. MK, erkeklerde kadınlara göre daha geç evrelerde saptanmış olup,
fark istatistiksel olarak anlamlı bulunmuştur (p<0,0001). Tanı anında olgularının çoğu lokal ileri evre ve
metastatik evrede bulunmuştur. Veri toplanan son 25 yıl içinde MK olgularında sayısal olarak doğrusal
artış saptanmıştır (GLM:F=15,9;p<0,0001). MK’de medyan sağkalım 16 aydır. Beş-yıllık sağkalım
%28,1 saptanmıştır, erkeklerde %25,2 kadınlarda %32’dir, kadınlarda istatistiksel olarak anlamlı
yüksektir (p<0,0001). Adenokarsinomlar 5-yıllık %22,1 GSK oranı ile en kötü prognozu
göstermektedir. Diffüz tip adenokarsinomlarda prognoz, intestinal tipe göre daha kötüdür (p=0,020).
En iyi sağkalım oranları beklendiği gibi erken evrededir. Lokalize dönemde tanı konanlarda 5-yıllık
GSK %61,8 iken, lokal ileri evrede %32,4 e düşmektedir (p<0,0001).
Sonuç: Son 25 yıldaki verilerimizin analizinde yıllar içindeki olgu sayısında doğrusal bir artış
görülmüştür. MK erkeklerde ve 60-69 yaş arasında daha sıktır. 5-yıllık sağkalım kadınlarda erkeklere
göre daha yüksektir. MK evresi prognozda en önemli parametredir.
Ege Ünı̇ versı̇tesı̇ hastanesı̇ veri tabanındaki özofagus kanserlerinin epidemiyolojisi ve sağkalım özellikleri
Authors: ÜNAL Nalan Gülşen , DEMİR Halit Batuhan , SEZAK Murat , ÖZKÖK Serdar , KARACA Burçak , KARABULUT Bülent , ÇAKAR Burcu , CANER Ayşe , ÖZÜTEMİZ Ahmet Ömer , ERSİN Sinan , BOR Serhat , AYDIN Ahmet , ORUÇ Nevin , VARDAR Rukiye , TEKİN Fatih , TURAN İlker , KAVAKALAN Gülin , HAYDAROĞLU Ayfer
Published: October 2020

Amaç: Bu çalışmada özofagus kanserlerinin (ÖK) epidemiyolojik ve genel sağkalım (GSK) özelliklerinin
araştırılması amaçlanmıştır.
Gereç Yöntem: Ege Üniversitesi Kanserle Savaş Uygulama ve Araştırma Merkezinin 1992-2017 yılları
arasındaki verileri retrospektif olarak taranmıştır. CANREG-4 bilgisayar programına kayıtlı kanser verileri,
Dünya Sağlık Örgütü ve Surveillance, Epidemiology, and End Results sisteminde gruplanmış ve
analizleri yapılmıştır. İstatistik analizlerde ki-kare testi, General Linear Model ve Kaplan Meier sağkalım
analizleri uygulanmıştır.
Bulgular: Toplam 117.139 kanserden 19.542’u gastrointestinal sistem (GİS) kanserleridir. GİS
kanserlerinin 1.009’u (%5,2) ÖK olup, GİS kanserleri içinde 6. sıklıktadır. ÖK’de 25 yılda doğrusal artış
izlenmemiştir. Medyan yaş 60 (15-90) yıldır. Olguların 573’ü (%56,8) erkektir. ÖK, erkeklerde en sık 60-
69 yaşlarda (%31), kadınlarda 50-59 yaşlarda (%25,2) görülmektedir. En sık yerleşim torasik
özofagustur (%79) ve yerleşim yeri açısından cinsiyetler arasında fark saptanmamıştır (p=0,33).
Skuamöz hücreli karsinom (SHK) en sık rastlanan histolojik tiptir (%64,2). Servikal ve torasik özofagusda
SHK, abdominal özofagusta adenokarsinom daha fazladır. Vakaların yaklaşık yarısı tanıyı lokal ileri
evrede almıştır. Medyan sağkalım 12 aydır. Bir, 5 ve 10-yıllık GSK oranları, sırasıyla %50,1, %17,7 ve
%12’dir. Erkeklerde 5-yıllık GSK oranı %11,2 ve kadınlarda %25,8’dir, cinsiyetler arası fark anlamlıdır
(p<0,0001). SHK’da 5-yıllık GSK oranı %20, adenokanserlerde %11,5 saptanmıştır. Evrelere göre 5-
yıllık GSK oranı; lokalize evrede %35,1, lokal ileri evrede %15,1 ve metastatik evrede %7,8 saptanmıştır.
Sonuç: ÖK, daha çok erkeklerde, torasik segmentte (orta özofagus) ve SHK histolojisinde saptanmıştır.
Cinsiyet ve evre prognozda önemlidir.
Ege Üniversitesi Hastanesi veri tabanında kayıtlı larinks kanserli olguların epidemiyolojik ve genel sağkalım özellikleri
Authors: TURHAL Göksel , ŞAHİN Fetih Furkan , ÖZTÜRK Kerem , AKAGÜNDÜZ Özlem , AKYILDIZ Serdar , ESASSOLAK Mustafa Esassolak , ULUÖZ Ümit , VERAL Ali , ŞANLI Ulus Ali , CANER Ayşe
Published: October 2020

Amaç: Bu çalışmada Ege Üniversitesi Kanserle Savaş Uygulama ve Araştırma Merkezi (EÜKAM) sisteminde kayıtlı olan larinks kanseri tanısı alan hastaların demografik özellikleri ile birlikte malignite kliniğine göre genel sağkalımlarının araştırılması amaçlanmıştır.
Gereç ve Yöntem: EÜKAM’da görevli kanser kayıt teknik ekibi tarafından kaydedilen 1992-2016 yılları arasında Ege Üniversitesi’nde tanı, tedavi ve takip sürecinde yer alan 3144 olgunun yaşı,cinsiyeti, histopatolojisi, tümör evresi, uygulanan tedavi şekli, takip süresi ve sağkalım durumu retrospektif olarak analiz edilmiştir.
Bulgular: 3144 olgunun ortalama yaşı 59.4±10.5 saptanmıştır. En sık histopatolojik tip %97.4 ile karsinom olarak, en sık gözlenen evre durumu %47.1 ile lokal sınırlı evre olarak saptanmıştır. Tüm olgu serisinin 5, 10, 15 ve 20 yıllık genel sağkalımları ise sırasıyla %67, %48.6, %33.8 ve %23.5 olarak bulunmuştur.
Sonuç: Larinks kanserleri genel sağkalımında tümör evresi, yaş gibi faktörlerin anlamlı olarak etkili olduğu saptanırken cinsiyetin sağkalım üzerinde anlamlı etkisinin olmadığı görülmüştür. Ayrıca son yıllarda organ koruyucu tedavi modellerindeki alternatif seçenek ve başarı oranlarında artış olduğu, bunun yanında larinks kanseri insidansında artışın günümüze kadar devam ettiği saptanmıştır.
Ege Üniversitesi Hastanesinde görülen deri melanomlarının epidemiyolojik ve genel sağ kalım özellikleri
Authors: ACAR Ayda , YOLDAŞ Ayşe Hande , YAMAN Banu , CEYLAN Can , KARACA Şaziye Burçak , ESASSOLAK Mustafa , AKALIN Taner , GÜRLER Tahir , ÖZDEMİR Fezal , KANDİLOĞLU Gülşen , HAYDAROĞLU Ayfer , CANER Ayşe , KARAARSLAN Işıl
Published: October 2020

Amaç: Bu çalışmada Ege Üniversitesi Hastanesi veri tabanındaki 1992-2017 yılları arası melanom
tanısı alan hastaların epidemiyolojik ve genel sağ kalım özelliklerinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezinin özel eğitimli
ve sertifikalı kanser kayıt elemanları tarafından CANREG-4 programı ile kaydedilen 1992-2017 yılları
arasında Ege Üniversitesinde kayıtlı 1530 melanom tanılı hastanın verileri toplanmıştır. Kategorik
değişkenler arası ilişki varlığı Ki-Kare yöntemiyle değerlendirilirken, gruplar arası nümerik değişkenler
Tek Yönlü Varyans Analizi ve Tukey HSD Testi ile karşılaştırıldı. Sağ kalım üzerine kategorik değişkenlerin

etkileri Kaplan Meier ve LogRank (Mantel-Cox) yöntemleri ile incelenirken, nümerik değişkenler için Cox-
Regresyon analizi kullanıldı. Tüm Hipotez testleri 0,05 önem seviyesinde uygulandı.

Bulgular: Bin beş yüz otuz melanom olgusunun %53,1’i erkek, %46,9’u kadındı. Yaş ortalaması
54,14±16,537’ydi. Yüzeyel yayılan melanom ve lentigo malign melanom en sık görülen alt tiplerdi.
Hastaların takip süresi 0 ile 313 ay arasında değişmekteydi. Ortalama genel sağ kalım (GSK) süresi
147,4 ± 5,3 aydı. Yaş artışı ile GSK süresi azalmaktaydı (p<0,01). Kadınlarda erkeklere göre GSK
süresi daha yüksekti (p<0,001).
Sonuçlar: Çalışmamızda tanı sırasında ileri yaş, erkek cinsiyet, tümörün in situ olmaması, lenf bezi
tutulumu ve metastaz varlığı sağ kalımı azaltan faktörlerdir. Beş yıllık GSK nodüler melanomda diğer
histopatolojik alt tiplere göre daha kısadır. Beş yıllık GSK; lokalize hastalıkta %90, lokal yayılım
durumunda %52, bölgesel yayılımda %56, ilerlemiş metastatik hastalıkta ise %15’tir. Kutanöz
melanomda erken tanı prognozu önemli ölçüde etkilemektedir. Melanomun yüksek mortalite oranı
dikkate alındığında; daha erken dönemde başvuruyu sağlamak açısından; toplumsal bilinç düzeyinin
olabildiğince arttırılması son derece önemlidir.
Are young people aged 16-19 using or expecting to use the gig economy for their careers?
Authors: Galfalvi Esther , Hooley Tristram , Neary Siobhan
Published: October 2020

Amid growing precarity and zero hour contracts, the ‘gig economy’ represents a new way of working mediated by web technology. Workers can sign up to a work platform – a website or smartphone program that manages the work automatically – and take on work at the tap of a button. Some platforms manage labour, such as driving for Uber or delivering food for Deliveroo, while others manage retail activity, such as Ebay or Etsy. Recent research has shown that a significant number of people are using platform work to earn money, with over half being young people aged 16-34. While there are some data regarding satisfaction levels and attractors, there is little research examining specific age segments of workers, or the relationship between platform work and career. Using data from focus group interviews with school and Further Education college students, this paper will discuss findings from research investigating how young people in England aged 16-19 perceive the gig economy and whether they feel that it will be relevant to their careers, with a view to discussing whether it may be necessary to include in careers education programmes or guidance. The interview data indicate that these participants were occasionally using platforms to make money, and a few were earning regularly, usually on retail platforms. While some interviewees appreciated the autonomy and flexibility promised by gig economy work, the uncertainty, perceived low status, and lack of career progression prevented them from taking it seriously as a career option. Instead, they preferred traditional forms of work that provide more stability and organisational support - an increasingly rare commodity in a labour market that is changing rapidly in the opposite direction. We conclude that while there may be little value in giving detailed individual guidance on the gig economy, it could be valuable to use it as a way of teaching young people about the labour market and different types of employment
Rewriting the future: Young people's stories of educational engagement
Authors: Crook Deborah
Published: October 2020

Young people's educational trajectories are always provisional. This article considers young people's perspectives about enablers and barriers to continued education, and questions models of aspiration-raising that prioritise particular trajectories and are critical when young people
cannot engage. Participatory methods enabled 30 young people aged 12-24 from disadvantaged areas in northwest England to imagine steps towards future possible selves. Through collaborative story-making with researchers, they established that inter-generational relationships are important to
these journeys, especially support from adults who believed in their capabilities and encouraged young people's influence over decisions for change.
Career counselling with life design in a collectivist cultural context: An action research study
Authors: Bhalla Aparna , Frigerio Gill
Published: October 2020

Large-scale macro forces are restructuring forms of work in urban India creating the need for alternative methods of career counselling. This research explores the application of a US-based approach to constructing careers i.e. Life-Design Career Counseling (i. e., LDC) with two mid-career
professionals in India. Data consisted of client responses to different narrative career counselling exercises such as a lifeline activity, a career construction interview and semi-structured feedback interviews. Action research's focus on reflexivity helped integrate theory with practice
to contribute to knowledge production and meaningful innovations within practice. Findings from this research underscored the importance of relationship, reflection and sense-making and the need for India to utilise a culturally resonant career intervention. The study holds value for career
professionals, in India and beyond where LDC is still unexplored. Moreover, LDC practitioners in non-Western countries and collectivist societies will benefit from a contextual adaptation that encourages focus on client learning.
Perceptions and experiences of lifestyle interventions in women with polycystic ovary syndrome (PCOS), as a management strategy for symptoms of PCOS.
Authors: Arentz Susan , Smith Caroline A , Abbott Jason , Bensoussan Alan
Published: October 2020

Background
The international clinical practice guidelines for PCOS emphasize diet and exercise as first-line management of clinical signs and symptoms. This study aimed to describe the patterns, perceptions and experiences of lifestyle interventions for women in the community with self-reported PCOS.
Method
An electronic survey of 493 members of two PCOS consumer support groups, collected by cloud-based Survey Monkey, described women’s types and patterns of diet and exercise, experiences and perceptions of effectiveness. Women were recruited from the Polycystic Ovary Association of Australia (POSAA) and from the Facebook group, PCOS University Research Group. Associations between participants perceptions of effectiveness, and diet types and exercise patterns were assessed using logistic regression. Response bias for the POSAA group was assessed with a continuum of resistance model.
Results
91% of POSAA members and 311 Facebook group members aged 16-50 years responded to the survey . Nearly all women reported adjusting their dietary and exercise practices with the aim to improve their health and/or PCOS (82% and 73% respectively), however less than 13% reported achievement of health goals (12.2% and 8.1% respectively). Low carbohydrate, high protein diets, and vigorous activity were associated with self-perceived effectiveness (r.0.16, p<0.01; r.0.15 p<0.01 and r.0.2 p<0.01 respectively). Barriers for lifestyle interventions included psychosocial factors. Response bias was not assessed for the Facebook group, however self-reported PCOS aligned with prevalence of clinical phenotypes and suggests results are generalizable to clinical populations of women with PCOS, who are responsible for self-directing and administering lifestyle interventions to manage their PCOS.
Conclusions
Perceptions of effectiveness for lifestyle interventions by women with PCOS may be complicated by a lack of rigorous evidence. The strength of recommendations in clinical practice guidelines may be enhanced by clinical trials investigating flexible and feasible lifestyle interventions for women in the community with PCOS.
“Who is watching the watchdog?”: ethical perspectives of sharing health-related data for precision medicine in Singapore
Authors: Lysaght Tamra , Ballantyne Angela , Xafis Vicki , Ong Serene , Schaefer Gerald Owen , Ling Jeffrey Min Than , Newson Ainsley J , Khor Ing Wei , Tai E Shyong
Published: October 2020

Background We aimed to examine the ethical concerns Singaporeans have about sharing health-data for precision medicine (PM) and identify suggestions for governance strategies. Just as Asian genomes are under-represented in PM, the views of Asian populations about the risks and benefits of data sharing are under-represented in prior attitudinal research.Methods We conducted seven focus groups with 62 participants in Singapore from May to July 2019. They were conducted in three languages (English, Mandarin and Malay) and analysed with qualitative content and thematic analysis. Results Four key themes emerged: nuanced understandings of data security and data sensitivity; trade-offs between data protection and research benefits; trust (and distrust) in the public and private sectors; and governance and control options. Participants were aware of the inherent risks associated with data sharing for research. Participants expressed conditional support for data sharing, including genomic sequence data and information contained within electronic medical records. This support included sharing data with researchers from universities and healthcare institutions, both in Singapore and overseas. Support was conditional on the perceived social value of the research and appropriate de-identification and data security processes. Participants suggested that a data sharing oversight body would help strengthen public trust and comfort in data research for PM in Singapore.Conclusion Maintenance of public trust in data security systems and governance regimes can enhance participation in PM and data sharing for research. Contrary to themes in much prior research, participants demonstrated a sophisticated understanding of the inherent risks of data sharing, analysed trade-offs between risks and potential benefits of PM, and often adopted an international perspective.
Prevalence and associated risk factors for childhood strabismus in Lhasa, Tibet, China: a cross-sectional, school-based study
Authors: He Hailong , Fu Jing , Meng Zhaojun , Chen Weiwei , Li Lei , Zhao Xinyu
Published: October 2020

Background: To estimate the prevalence of strabismus and associated risk factors among grade one school children in Lhasa, Tibet, China.Methods: The Lhasa Childhood Eye Study (LCES) was a cross-sectional, school-based childhood study conducted in Grade one students from primary schools in Lhasa, Tibet, China. Comprehensive ophthalmic examinations and basic systematic examinations were evaluated. A questionnaire survey contained information about children, as well as parents’ information was sent to the corresponding parents of eligible children. The prevalence of strabismus and its 95% confidence interval was estimated. Univariate and multivariate logistic regression analyses were conducted to determine the associated risk factors.Results: A total of 1942 eligible grade one students were enrolled, of which 1856 participants completed all procedures. The average age was 6.83±0.46 years, 53% of participants were boys and 1762 were the Tibetan Minority. Over all, the prevalence of strabismus was 68/1856(3.7%) (95%CI: 2.81,4.52), with no difference between the ages, genders, ethnics and BMI, while tilt one's head when writing may be a risk factor for strabismus (P=0.004). Strabismus students had the mean best corrected visual acuity 0.16±0.28(LogMAR), over 50% patients with esotropia are hyperopia, participants who have stereopsis impairments showed a significant difference between esotropia and exotropia (P=0.026).Conclusions: The prevalence of strabismus in LCES was 3.7%, higher than previous reports from Chinese childhood epidemiology studies. Strabismus is a common contributing factor to amblyopia. Tilt one's head when writing may be a risk factor. Patients with esotropia are more likely to affect stereopsis and be the refractive state of hyperopia.
Intrinsic laws of k-mer spectra of genome sequences and evolution mechanism of genomes
Authors: Yang Zhenhua , Li Hong , Jia Yun , Zheng Yan , Meng Hu , Bao Tonglaga , Li Xiaolong , Luo Liaofu
Published: October 2020

Background

K-mer spectra of DNA sequences contain important information about sequence composition and sequence evolution. We want to reveal the evolution rules of genome sequences by studying the k-mer spectra of genome sequences.

Results

The intrinsic laws of k-mer spectra of 920 genome sequences from primate to prokaryote were analyzed. We found that there are two types of evolution selection modes in genome sequences, named as CG Independent Selection and TA Independent Selection. There is a mutual inhibition relationship between CG and TA independent selections. We found that the intensity of CG and TA independent selections correlates closely with genome evolution and G+C content of genome sequences. The living habits of species are related closely to the independent selection modes adopted by species genomes. Consequently, we proposed an evolution mechanism of genomes in which the genome evolution is determined by the intensities of the CG and TA independent selections and the mutual inhibition relationship. Besides, by the evolution mechanism of genomes, we speculated the evolution modes of prokaryotes in mild and extreme environments in the anaerobic age and the evolving process of prokaryotes from anaerobic to aerobic environment on earth as well as the originations of different eukaryotes.

Conclusion

We found that there are two independent selection modes in genome sequences. The evolution of genome sequence is determined by the two independent selection modes and the mutual inhibition relationship between them.
Clients and professionals elicit long-term care preferences by using ‘What matters to me’: A process evaluation
Authors: Leersum Catharina Margaretha van , Moser Albine , Steenkiste Ben van , Wolf Judith R.L.M. , Weijden Trudy van der
Published: October 2020

Background: ‘What matters to me’ is a five-category preference elicitation tool to assist clients and professionals in choosing long-term care. This study aimed to evaluate the use of and experiences with this tool.Methods: A mixed-method process evaluation was applied. Participants were clients, relatives, and professionals. They were all involved in decision-making on long-term care. Data collection comprised online user activity logs (N=71), questionnaires (N=38), and interviews (N=20). Descriptive statistics was used for quantitative data, and a thematic analysis for qualitative data.Results: Sixty-nine percent of participants completed one or more categories in an average time of 6.9 (±0.03) minutes. The tool was rated 6.63 (±0.88) out of seven in the Post-Study System Usability Questionnaire (PSSUQ). Ninety-five percent experienced the tool as useful in practice. Suggestions for improvement included a separate version for relatives and a non-digital version. Although professionals thought the potentially extended consultation time could be problematic, all participants would recommend the tool to others.Conclusion: ‘What matters to me’ seems useful to assist clients and professionals with preference elicitation in long-term care. Evaluation of the impact on consultations between clients and professionals by using ‘What matters to me’ is needed.
Development and evaluation of a monoclonal antibody-based competitive ELISA for the detection of antibodies against H7 avian influenza virus
Authors: Li Yuan , Ye Hongliu , Liu Meng , Song Suquan , Chen Jin , Cheng Wangkun , Yan Liping
Published: October 2020

Background: H7 subtype avian influenza have caused great concern in the global poultry industry and public health. The conventional serological subtype-specific diagnostics is implemented by hemagglutination inhibition (HI) assay despite lengthy operation time. In this study, an efficient, rapid and high-throughput competitive enzyme-linked immunosorbent assay (cELISA) was developed for detection of antibodies against H7 avian influenza virus (AIV) based on a novel monoclonal antibody specific to the hemagglutinin (HA) protein of H7 AIV.
Results: The reaction parameters including antigen coating concentration, monoclonal antibody concentration and serum dilution ratio were optimized for H7 antibody detection. The specificity of the cELISA was tested using antisera against H1~H9, H11~H14 AIVs and other avian viruses. The selected cut-off values of inhibition rates for chicken, duck and peacock sera were 30.11%, 26.85% and 45.66% by receiver-operating characteristic (ROC) curve analysis, respectively. With HI test as the reference method, the minimum detection limits for chicken, duck and peacock positive serum reached 2 0 , 2 1 and 2 -1 HI titer, respectively. Compared to HI test, the diagnostic accuracy reached 100%, 98.6%, and 99.3% for chicken, duck and peacock by testing a total of 400 clinical serum samples, respectively.
Conclusions: In summary, the cELISA assay developed in this study provided a reliable, specific, sensitive and species-independent serological technique for rapid detection of H7 antibody, which was applicable for large-scale serological surveillance and vaccination efficacy evaluation programs.
Assessment of Immunization data quality of routine reports in Ho Municipality of Volta Region, Ghana
Authors: Asem Livingstone , Ziema Sorengmen Amos
Published: October 2020

Background: Immunization has been an important public health intervention for preventing and reducing child morbidity and mortality over the years and coverage has increased in the past decades. However, the validity of the data from immunization coverages is usually disputed. Immunization data from health facilities show poor concordance between tallied registers and monthly reports as they are reported to higher levels of the health system. The study assessed the quality of data from routine immunization of some health facilities in the Ho central municipality in the Volta region of Ghana.Methods: A descriptive cross-sectional study was used to review routine immunization data in tallied registers and reports submitted to the Municipal Health Directorate (MHD) from January to December, 2015. Simple random sampling was used to select three health facilities in Ho central municipality. The World Health Organization (WHO) Data Quality Self-assessment (DQS) tool was the main instrument used to present and analyze data for accuracy and discrepancy level between the tallied registers and reports. A template was created in Microsoft excel which automatically presented accuracy and discrepancy levels when data was entered. Ethical approval for the study was obtained from Ghana Health Service Ethics Review Committee. Results: The result showed discrepancies between recounted tallies at the facilities and reports submitted to the MHD. Accuracy ratios of 102%, 64% and 94% for Bacillus Calmette Guerin (BCG), Pentavalent (Penta) vaccine dose 3 and Measles 2 respectively indicating underreporting for BCG and over reporting for the rest were obtained. There was 460 over reported data to the municipal level representing accuracy ratio of 80% and discrepancy level of 20%. Conclusions: Immunization data was characterized by underreporting and overreporting, hence not accurate and lacked quality. Immunization data quality should be a priority among health staff at health facilities.
An online survey to explore the awareness and acceptance of geothermal energy among an educated segment of the population in five European and American countries
Authors: Balzan-Alzate Daniel , López-Sánchez Jacqueline , Blessent Daniela , Raymond Jasmin , Dezayes Chrystel , Portela Juan Pablo , Restrepo Estefania Ramírez , Rendón David Moreno , Malo Michel , Goderniaux Pascal , Daniele Linda , Borgne Tanguy Le
Published: October 2020

Advances in new technologies and the desire to achieve a sustainable and safe energy supply, enable communities to transition from conventional to renewable resources, such as geothermal energy. Perception and acceptance amongst different audiences have a high impact on the feasibility of energy projects, which is an important aspect to analyze. For this reason, this study focuses on describing the level of awareness and acceptance of deep geothermal energy within an educated segment of the population in five European and American countries (Canada, Colombia, Chile, Belgium, and France) at different stages of geothermal development. This study was conducted through an online survey, which was targeted to post-secondary students and professionals. Some of the most significant conclusions are: 1) there is a high degree of awareness of geothermal energy among the respondents in Chile and Canada, a medium level in Belgium and France, and a low one in Colombia; 2) there is a favorable acceptance of a geothermal project in each country, even when hydraulic stimulation is considered; 3) environmental aspects and community safety are the most important issues that must be addressed to support a pilot geothermal project.
Long-period ground motion simulation using centroid moment tensor inversion solutions based on the regional three-dimensional model in the Kanto region, Japan
Authors: Takemura Shunsuke , Yoshimoto Kazuo , Shiomi Katsuhiko
Published: October 2020

We conducted centroid moment tensor (CMT) inversions of moderate (Mw 4.5–6.5) earthquakes in the Kanto region, Japan, using a local three-dimensional (3D) model. We then investigated the effects of our 3D CMT solutions on long-period ground motion simulations. Grid search CMT inversions were conducted using displacement seismograms for the periods of 25–100 s. By comparing our 3D CMT solutions with those from the local one-dimensional (1D) catalog, we found that our 3D CMT inversion systematically provides magnitudes smaller than those in the 1D catalog. The Mw differences between 3D and 1D catalogs tend to be significant for earthquakes within the oceanic slab. By comparing the ground motion simulations of the 1D and 3D velocity models, we confirmed that the observed Mw differences could be explained by the differences in the rigidity structures around the source regions in the two models. The 3D velocity structures (especially oceanic crust and mantle) are important for estimating seismic moments in intraslab earthquakes. The seismic moments directly affect the amplitudes of ground motions. Thus, 3D CMT solutions are essential for precise forward and inverse modeling of long-period ground motion. We also conducted long-period ground motion simulations using our 3D CMT solutions to evaluate the reproducibility of long-period ground motions at stations within the Kanto Basin. The simulations of our 3D CMT solutions well-reproduced observed ground motions for periods longer than 10 s, even at stations within the Kanto Basin. The reproducibility of simulations using our 3D CMT solutions was better than those based on the solutions in the 1D catalog.
Prevalence of Asymptomatic Hiatal Hernia in Obese Patient in Routine Upper Gastrointestinal Endoscopy Screening and Correlation with BMI
Authors: Assakran Bandar Saad , Alrakbi Khaled Mohammed , Alharbi Meshari Abdulrahman , Almatroudi Moath Abdullah , Alshowaiman Asim Nizar , Alromaih Abdullah Homood , Alharbi Basil Abdulrahman , Alaqil Naif Suliman , Alsoghayer Ali Saleh
Published: October 2020

Background
In obese patients, hiatus hernia (HH) can be asymptomatic or it may present with one or few symptoms such as heartburn, nausea, or vomiting. Routine upper gastrointestinal endoscopy is the most frequent method to determine the presence of any abnormalities including hiatus hernia.
The aim of this study is to assess the prevalence of asymptomatic hiatal hernia in obese patients in routine upper GI endoscopy assessment and correlation with BMI.

Methods
This was an observational retrospective cohort study conducted at King Fahad Specialist hospital - Buraydah, Qassim, Saudi Arabia. The data were extracted from the medical records and electronic charts of all obese patients who had preoperative upper gastrointestinal endoscopy assessment between January 2017 – December 2019. Data were tabulated in Microsoft Excel and were analyzed using SPSS version 21.

Results
Among the 690 obese patients, the prevalence of HH was 103 yielding an overall percentage of 14.9%. Chi-square test revealed that the abdominal pain (X2=3.885; p=0.049), shortness of breath (X2=8.057; p=0.005), vomiting (X2=4.302; p=0.038), nausea (X2=4.090; p=0.043) and other HH symptoms (X2=3.897; p=0.048) significantly influenced HH but the BMI level did not (X2=2.126; p=0.345). In multivariate regression model, the use of PPI medication (AOR=0.237; CI=0.074 – 0.760; p=0.023), while vomiting (AOR=1.722; CI=1.025 – 2.890; p=0.040) and nausea (AOR=1.698; CI=1.012 – 2.849; p=0.045) significantly increased the risk of HH.

Conclusion
Asymptomatic HH among obese patients is not widely prevalent in our region. The use of PPI medications was found to decrease the symptoms associated with HH while symptoms such as vomiting and nausea increased the risk of HH. However, there was no evidence found linking BMI to HH as shown in this study.
Research on Image Recognition of Intangible Cultural Heritage Based on CNN and Wireless Network
Authors: Liu Enmao
Published: October 2020

The image of national costumes is the main way of presenting the digitalization of intangible cultural heritage and provides important resources for educational informatization. How to use modern information technology to efficiently retrieve images of national costumes has become a hot research topic. Due to the diverse styles and colorful colors of ethnic costumes, it is difficult to accurately describe and extract visual features. In view of the above problems, this paper proposes an image recognition model of intangible cultural heritage based on CNN and wireless network. First of all, the clothing images of ethnic settlements and ethnic museums are acquired through wireless network transmission, so as to construct an image material library of intangible cultural heritage. Secondly, the CNN algorithm is used to train and optimize the national costume image samples, extract the high-level semantic features of the national costume image, and finally realize the efficient retrieval of the national costume image educational resources. This model lays a good foundation for the informatization of national costumes and contributes to the inheritance and protection of intangible cultural heritage.
Numerical prediction of sporadic E layer occurrence using GAIA
Authors: Shinagawa Hiroyuki , Tao Chihiro , Jin Hidekatsu , Miyoshi Yasunobu , Fujiwara Hitoshi
Published: October 2020

A sporadic E layer has significant influence on radio communications and broadcasting, and predicting the occurrence of sporadic E layers is one of the most important issues in space weather forecast. While sporadic E layer occurrence and the magnitude of the critical sporadic E frequency ( foEs ) have clear seasonal variations, significant day-to-day variations as well as regional and temporal variations also occur. Because of the highly complex behavior of sporadic E layers, the prediction of sporadic E layer occurrence has been one of the most difficult issues in space weather forecast. To explore the possibility of numerically predicting sporadic E layer occurrence, we employed the whole atmosphere–ionosphere coupled model GAIA, examining parameters related to the formation of sporadic E layer such as vertical ions velocities and vertical ion convergences at different altitudes between 90 km and 150 km. By comparing those parameters in GAIA with observed foEs data obtained by ionosonde observations in Japan, we found that variations in the vertical ion convergence at 120 km altitude agree fairly well with variations in foEs . This result suggests that sporadic E layer occurrence can be numerically predicted using the parameters derived from GAIA. We have recently developed a real-time GAIA simulation system that can predict atmosphere–ionosphere conditions for a few days ahead. We present an experimental prediction scheme and a preliminary result for predicting sporadic E layer occurrence.
Breast Cancer In Togolese Women: Immunohistochemistry Subtypes
Authors: ADANI-IFE Ablavi , AMEGBOR Koffi , DOH Kwamé , DARRE Tchin
Published: October 2020

Background: Molecular classification of breast cancer is an important factor for prognostic and clinical outcomes. There are no data regarding molecular breast cancer subtypes among Togolese women. The objective of this study was to evaluate the expression of ER, PR, HER2, and molecular subtypes of breast cancer receptors in Togolese patients and to establish the correlation between clinical and histological data and molecular types.Methods: Clinicopathologic data of patients were collected from clinical records. Immunohistochemistry biomarkers (ER, PR, and HER2) were assessed in patients who have been diagnosed with invasive breast cancer from March 2016 to March 2020 in the department of oncology. The analysis of variance and the Chi-square Test was used to analyze the data.Results: A total of 117 cases were collected. The mean age of patients was 52.05±12.38 with an age range of 30 to 85 years. Half of the patients were over 50 years old and the majority (70.9%) was postmenopausal. More than half of patients (52.1%) presented with T3-T4tumors.The most common histologic subtype of breast cancer was invasive ductal carcinoma of no special type (95.7%). Tumors grade 2 were predominant (51.3%) followed by grade 3 (42.7%). Advanced carcinomas were found in 69 patients (59%). The percentage of ER+, PR+, and HER2 positive tumors was 54.7%, 41%, and 15.4% respectively. The predominant molecular subtype was Triple negative (37.6%), followed by Luminal A (30.8.7%), Luminal B subtype (23.9%), and HER2 enriched (7.7%). There was a significant association between stage and breast cancer subtypes (p 0.025), histologic grade, and subtype (p<0.0001) but no correlation was found with age, menopausal status, and tumor size.Conclusion: Breast carcinoma in our patients are high grade tumors and are diagnosed at an advanced stage. Triple negative and Luminal A are the two predominant breast cancer subtypes in Togolese women. Consequently, Receptor testing availability should be a priority to offer the best breast cancer treatment.
Cardiotoxicity associated with immune checkpoint inhibitors: A retrospective analysis of patients at an academic tertiary care center
Authors: Waheed Nida , Fradley Michael G. , DeRemer David , Mahmoud Ahmad , Shah Chintan P. , Langaee Taimour Y. , Lipori Gloria P. , March Keith , Pepine Carl J. , Cooper-DeHoff Rhonda M. , Wu Yonghui , Gong Yan
Published: October 2020

Background

Immune checkpoint inhibitors (ICIs) are a novel class of anticancer agents that have demonstrated clinical response for both solid and hematological malignancies. ICIs are associated with development of immune-related adverse events including cardiotoxicity. We estimated the incidence of newly diagnosed cardiovascular disease ICI-related cardiotoxicity in patients treated with ICIs at a large, tertiary care center.

Methods

All patients with a cancer diagnosis who received any ICI treatment in the University of Florida’s Integrated Data Repository from 2011-2017 were included. Cardiovascular disease was defined as a new ICD diagnosis code for cardiomyopathy, heart failure, arrhythmia, heart block, pericardial disease, or myocarditis after initiation of ICI treatment.

Results

Of 102,701 patients with a diagnosis of malignancy, 424 patients received at least one ICI. Sixty-two (14.6%) patients were diagnosed with at least one new cardiovascular disease after initiation of ICI therapy. Of the 374 patients receiving one ICI, 21 (5.6%) developed heart failure. Of the 49 patients who received two ICIs sequentially, three (6.1%) developed heart failure and/or cardiomyopathy. Incident cardiovascular disease was diagnosed at a median of 63 days after initial ICI exposure. One patient developed myocarditis 28 days after receiving nivolumab. Mortality in ICI treated patients with a concomitant diagnosis of incident cardiovascular disease was higher compared to those who did not (66.1% vs. 41.4%, odds ratio = 2.77, 1.55-4.95, p = 0.0006).

Conclusions

This study suggests a high incidence of newly diagnosed cardiovascular disease after the initiation of ICI therapy.