bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing Quality of Newborn Care at District Facilities in Malawi
Authors: Kawaza Kondwani , Kinshella Mai-Lei Woo , Hiwa Tamanda , Njirammadzi Jenala , Banda Mwai , Vidler Marianne , Newberry Laura , Nyondo-Mipando Alinane Linda , Dube Queen , Molyneux Elizabeth , Goldfarb David M.
Published: February 2020

Background: Malawi is celebrated as one of the few countries in sub-Saharan Africa to meet the Millennium Development Goal of reducing under-5 mortality by two-thirds between 1990 and 2015. However, within this age range neonatal mortality rates are the slowest to decline, even though rates of facility births are increasing. Examining the quality of neonatal care at district-level facilities where most deliveries occur is warranted.
Objective: The objective of this paper is to evaluate the quality of neonatal care in three district hospitals and one primary health centre in southern Malawi as well as to report the limitations and lessons learned on using the WHO integrated quality of care assessment tool.
Methodology: These facility assessments were part of the “Integrating a neonatal healthcare package for Malawi” project, a part of the Innovating for Maternal and Child Health in Africa (IMCHA) initiative. The WHO integrated quality of care assessment tool was used to assess quality of care and availability and quantity of supplies and resources. The modules on infrastructure, neonatal care and labour and delivery were included. Facility assessments were administered in November 2017 and aspects of care were scored on a Likert scale from one to five (a score of 5 indicating compliance with WHO standards of care; one as lowest indicating inadequate care).
Results: The continuum of labour, delivery and neonatal care were assessed to identify areas that required improvements to meet standards of care. Critical areas for improvements included infection control (mean score 2.9), equipment, supplies and setup for newborn care in the labor ward (2.3), in the surgical theater (3.3), and nursery (3.4 nursery facilities, 3.0 supplies and equipment), as well as for management of sick newborns (3.2), monitoring and follow-up (3.6). Only one of the 12 domains, laboratory, met the standards of care with only minor improvements needed (4.0).
Conclusion: The WHO integrated quality of care assessment tool is a validated tool that can shed light on the complex quality of care challenges faced by district-level health facilities. The results reveal that the quality of care needs improvement, particularly for sick and vulnerable newborns.
Molecular surveillance of the Pfmdr1 N86Y allele among Congolese pregnant women with asymptomatic malaria
Authors: Dossou-Yovo Louis Regis , Ntoumi Francine , Koukouikila-Koussounda Felix , Vouvoungui Jeannhey Christevy , Adedoja Ayodele , Nderu David , Velavan Thirumalaisamy P , Lenga Arsene
Published: February 2020

Background: Malaria in pregnancy is associated with considerable morbidity and mortality Regular surveillance of artemisinin−based combination therapy tolerance or resistance molecular makers is vital for effective malaria treatment, control and eradication programmes. P. falciparum multiple drug resistance-1 gene ( Pfmdr1 ) N86Y mutation is associated with reduced susceptibility to lumefantrine . This study assessed the prevalence of Pfmdr1 N86Y in Brazzaville, Republic of Congo.
Methods: A total 1001 of P. falciparum− infected blood samples obtained from asymptomatic malaria pregnant women having a normal child delivery at the Madibou Integrated Health Center were analysed. Pfmdr1 N86Y genotyping was conducted using PCR-Restriction fragment length polymorphism (RFLP).
Results: The wild type Pfmdr1 N86 allele was predominant (>68 %) in this study whereas a few isolates carrying the either the mutant allele ( Pfmdr1 86Y) alone or both alleles (mixed genotype). The dominance of the wildtype allele ( pfmdr1 N86) indicates the plausible decline P. falciparum susceptibility to lumefantrine.
Conclusion: This study gives an update on the prevalence of Pfmdr1 N86Y alleles in Brazzaville, Republic of Congo. It also raises concern on the imminent emergence of resistance against artemether−lumefantrine in this setting. Our study underscores the importance to regular artemether−lumefantrine efficacy monitoring to inform malaria control programme of the Republic of Congo.
The epidemiology of heart failure in the general Australian community - Study of Heart failure in the Australian Primary carE setting (SHAPE): methods
Authors: Parsons Richard Whaddon , Liew Danny , Neville A Munro , Audehm Ralph G , Haikerwal Deepak , Piazza Peter , Lim Kevin , Sindone Andrew P
Published: February 2020

There is a paucity of information on the epidemiology of heart failure (HF) in Australia. The Study of Heart failure in the Australian Primary carE setting (SHAPE) study aims to estimate the prevalence and annual incidence of HF in the general Australian community and to describe the demographic and key clinical profile of Australians with HF.
Methods : We undertook a retrospective cohort study based on analysis of non-identifiable medical records of adult patients cared for at 43 general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded (diagnosis, pathology and prescription fields) and uncoded fields (clinical notes) in the medical records. The latter searches of free text looked for common synonyms relevant to HF. The population was stratified into three groups based on a hierarchy of selection criteria: (1) definite HF, (2) probable HF and (3) possible HF. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals.
Results: The practices provided care to 2.3 million individual patients over the five-year study period, of whom 1.93 million were aged 18 years and above. Of these patients 16,930 were classified as having ‘definite HF’, 4873 as having ‘probable HF’ and 36,517 as having ‘possible HF’. A further 40,992 were identified as having an aetiological condition associated with HF.
A formal HF diagnosis, HF terms recorded as text in the notes and HF-specific medication were the most common methods to identify ‘definite’ HF patients. Typical signs and symptoms in combination with a diuretic prescription was the most common method to identify ‘probable HF’ patients. The majority of ‘possible’ HF patients were identified by the presence of 2 or more of the typical signs or symptoms. Dyspnoea was the commonest recorded symptom and an elevated jugular venous pressure the commonest recorded sign.
Conclusions: This novel approach to undertaking retrospective research of primary care data successfully analysed a combination of coded and uncoded data from the electronic medical records of patients routinely managed in the GP setting. SHAPE is the first real-world study of the epidemiology of HF in the general Australian community setting.
Development of a novel method for the quantification of tyrosine 39 phosphorylated alpha-synuclein in human cerebrospinal fluid
Authors: Na Chan Hyun , Sathe Gajanan , Rosenthal Liana S. , Moghekar Abhay R. , Dawson Valina L. , Dawson Ted M. , Pandey Akhilesh
Published: February 2020

Background: Parkinson’s disease (PD) is the second most prevalent neurodegenerative disorder. Biomarkers that can help monitor the progression of PD or response to disease-modifying agents will be invaluable in making appropriate therapeutic decisions. Further, biomarkers that could be used to distinguish PD from other related disorders with PD-like symptoms will be useful for accurate diagnosis and treatment. C-Abl tyrosine kinase is activated in PD resulting in increased phosphorylation of the tyrosine residue at position 39 of a-synuclein (a-syn) (pY39 a-syn), which contributes to the death of dopaminergic neurons. Because pY39a-syn may be pathogenic, monitoring pY39 a-syn could allow us to diagnose presymptomatic PD and help monitor disease progression and response to treatment. We sought to investigate if increased phosphorylation of pY39 a-syn can be detected in the CSF of PD patients by targeted mass spectrometry.
Methods: Here, we report a two-step enrichment method in which phosphotyrosine peptides including pY39 a-syn containing peptide were first enriched with an anti-phosphotyrosine antibody followed by a second round of enrichment by titanium oxide (TiO 2 ) beads. Accurate quantification was achieved by the addition of a synthetic heavy version of pY39 a-syn peptide added before enzymatic digestion.
Results: Using the developed enrichment methods and optimized parallel reaction monitoring assays, we detected pY39 a-syn peptide in human CSF and demonstrate that the ratio of pY39 a-syn to total a-syn was significantly increased in the CSF of patients with PD.
Conclusions: We anticipate that this optimized two-step enrichment-based PRM detection method will help monitor c-Abl activation in PD patients and can also be used to quantify other phosphotyrosine peptides of low abundance in biological samples.
Fenobody and RANbody-based sandwich enzyme-linked immunosorbent assay to detect Newcastle disease virus
Authors: Ji Pinpin , Zhu Jiahong , Li Xiaoxuan , Fan Wenqi , Liu Qianqian , Wang Kun , Zhao Jiakai , Sun Yani , Liu Baoyuan , Zhou En-Min , Zhao Qin
Published: February 2020

Background Traditional sandwich enzyme-linked immunosorbent assay (ELISA) using polyclonal and monoclonal antibodies as reagents presents several drawbacks, including limited amounts, difficulty in permanent storage, and required use of a secondary antibody. Nanobodies can be easily expressed with different systems and fused with several tags in their tertiary structure by recombinant technology, thus offering an effective detection method for diagnostic purposes. Recently, the fenobody (ferritin-fused nanobody) and RANbody (nanobody-fused reporter) have been designed and derived from the nanobody for developing the diagnostic immunoassays. However, there was no report about developing the sandwich ELISA using the fenobody and RANbody as pairing reagents. Results A platform for developing a sandwich ELISA utilizing fenobody as the capture antibody and RANbody as the detection antibody was firstly designed in the study. Newcastle disease virus (NDV) was selected as the antigen, from which 13 NDV-specific nanobodies were screened from an immunized Bactrian camel. Then, 5 nanobodies were selected to produce fenobodies and RANbodies. The best pairing of fenobodies (NDV-fenobody-4, 800 ng/well) and RANbodies (NDV-RANbody-49, 1:10) was determined to develop the sandwich ELISA for detecting NDV. The detection limits of the assay were determined to be 2 2 of hemagglutination (HA) titers and 10 ng of purified NDV particles. Compared with two commercial assays, the developed assay shows higher sensitivity and specificity. Meanwhile, it exhibits 98.7% agreement with the HA test and can detect the reference NDV strains belonging to Class II but not Class I. Conclusions In the presented study, the 13 anti-NDV nanobodies binding the NDV particles were first produced. Then, for the first time, the sandwich ELISA to detect the NDV in the different samples has been developed using the fenobody and RANbody as reagents derived from the nanobodies. Considering the rapidly increasing generation of nanobodies, the platform can reduce the cost of production for the sandwich ELISA and be universally used to develop assays for detecting other antigens.
Effects of football versus aerobic exercise training on muscle architecture and patella tendon properties in healthy seniors: A study protocol of a two-armed randomized controlled trial.
Authors: Alkhateeb Guevar , Donath Lars
Published: February 2020

Background: Sports and exercise training can attenuate age-related declines in physical function. Aging is associated with a progressive deterioration of overall muscle structure and function, such as muscle diameter, strength, mass, and power. Loss of lower limb strength can lead to both an increased risk of falls and – as a consequence - an immobile lifestyle. Several forms of exercise (strength, agility, endurance, balance and flexibility) are recommended. In this regard, football has been repeatedly shown to be an integrative approach to promote measures of strength, endurance and agility. However, no previous randomized controlled trial comparatively investigated the effects of football training versus traditional aerobic exercise training on muscle architecture and patella tendon properties in healthy community dwellers. The study protocol is designed to investigate whether football differentially affects muscle thickness, muscle length, fascicle length, pennation angle, patellar tendon length, and thickness compared to a workload matched traditional aerobic exercise training regimen.Methods: The study sample consists of 60 untrained but healthy men (50-60 years old), who will be randomly assigned (Strata: age, activate) to two groups: Football Group (n = 30), Aerobic Group (n = 30). The intervention will take place within 12 consecutive weeks, two times a week for 60 min each session. The football group will perform recreation football training as a large sided game, whereas the aerobic group undergoes a running exercise. Both groups have the same external workload ranging between moderate to high exercise intensity. The outcome measure will be collected before and after the intervention period.Discussion: Findings of this study will provide insight into the effects of 24 sessions of both football and aerobic training program on the selected groups of seniors, including detecting their effects on the thigh muscle architecture and patellar tendon.Trial registration: DRKS - German Clinical Trials Register, DRKS00020536. Registered 30 January 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020536.
Comparative effectiveness of post-discharge strategies for hospitalized smokers: Study protocol for the Helping Hand 4 randomized controlled trial
Authors: Rigotti Nancy A , Schnitzer Kristina , Davis Esa M , Regan Susan , Chang Yuchiao , Kelly Jennifer H.K. , Notier Anna E , Gillam Karen , Douaihy Antoine , Levy Douglas E , Singer Daniel E , Tindle Hilary A
Published: February 2020

Background. Tobacco smoking remains the leading preventable cause of death in the U.S. A hospital admission provides smokers with a unique opportunity to stop smoking because it requires temporary tobacco abstinence while illness may enhance motivation to quit. Hospital interventions must continue post-discharge to increase tobacco abstinence long-term, but how best to accomplish this remains unclear. Building on two previous randomized controlled trials, each of which tested smoking cessation interventions that began in hospital and continued after discharge, this trial compares two interventions that provide sustained smoking cessation treatment after hospital discharge with the goal of improving long-term smoking cessation rates among hospitalized smokers.Methods. Helping Hand 4 is a three-site randomized controlled trial that compares the effectiveness of two active interventions for producing validated past 7-day tobacco abstinence 6 months after hospital discharge. Smokers who are admitted to three hospitals receive a standard in-hospital smoking intervention, and plan to quit smoking after discharge are recruited and randomly assigned to two interventions that begin at discharge, Personalized Tobacco Care Management (PTCM) or Quitline eReferral. Each lasts 3 months. At discharge, PTCM provides 8 weeks of free nicotine replacement (NRT; a participant’s choice of patch, gum, lozenge, or a combination) and then proactive smoking cessation support using an automated communication platform and live contact with a tobacco treatment specialist who is based in the health care system. In the eReferral condition, a direct referral is made from the hospital electronic health record to a community-based resource, the state’s telephone quitline. The quitline provides up to 8 weeks of free NRT and offers behavioral support via a series of phone calls from a trained coach. Outcomes are assessed at 1, 3, and 6 months after discharge. The study hypothesis is that PTCM will produce higher quit rates than eReferral.Discussion. HH4 is a pragmatic trial that aims to evaluate interventions in real-world conditions. This project will give hospital systems critical evidence-based tools for meeting National Hospital Quality Measures for tobacco treatment and maximizing their ability to improve cessation rates and overall health for the millions of smokers hospitalized annually in the U.S.Registration: Prospectively registered prior to start of enrollment at Clinicaltrials.gov # NCT03603496 (July 27, 2018)https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S00084MJ&selectaction=Edit&uid=U00002G7&ts=2&cx=ff0oxn
Child acceptability of a novel provitamin A carotenoid, iron and zinc-rich complementary food blend prepared from pumpkin and common bean in Uganda: A randomised control trial
Authors: Buzigi Edward , Pillay Kirthee , Siwela Muthulisi
Published: February 2020

Background Homemade complementary foods (CFs) fed to children in Uganda are usually devoid of vitamin A, iron and zinc. Novel homemade CFs rich in vitamin A, iron and zinc need to be developed, and assessed for their acceptability among target children. Objective Homemade provitamin A carotenoid (PVAC), iron and zinc-rich complementary food (CF), common bean pumpkin blend (BPB) formulated from pumpkin ( Sweet cream ) and common bean ( Obwelu ) and PVAC-rich pumpkin blend (PB) from Sweet cream were prepared by expert peer mothers. This study compared child acceptability of BPB and PB (control). Methods The cross-over acceptability study randomly assigned Ugandan children 6 to 24 months old to either receive 100g of BPB (n=35) or 100g of PB (n=35) on day one. After a washout period of one day, children crossed over to receive either BPB (n=35) or PB (n=35). The amount of CF consumed, duration of consumption, and micronutrient intake were assessed. CF was acceptable if children consumed ≥ 50g (50%) of served food (100g). A paired t-test was used to determine the mean differences within participants between BPB and PB. Results The mean consumption of BPB and PB was 53.9g and 54.4g, respectively. The mean duration for consumption of BPB and PB was 20.6 and 20.3 minutes, respectively. There was no significant difference in amounts consumed, and duration of consumption in BPB and PB (P>0.05). The mean intake of vitamin A was significantly higher (P<0.00001) in PB (152.5 µgRAE) compared to BPB (100.9 µgRAE). The mean iron intake was significantly higher in BPB (1.1mg) (P<0.00001) compared to BP (0.3mg). Furthermore, zinc intake was significantly higher (P<0.00001) in BPB (0.58mg) compared to BP (0.13mg). Conclusion A homemade CF, BPB, made from locally available common bean and pumpkin is rich in PVAC, iron and zinc and is acceptable to children in the age range of complementary feeding in Uganda.
Risk factors of bronchopulmonary dysplasia in premature infants under 32 weeks of gestation: A retrospective case-control study
Authors: Yue Li , Cui Shu Dong
Published: February 2020

Background: Bronchopulmonary dysplasia (BPD) in preterm infants is one of the most serious complications in neonatology, as it significantly affects the quality of life of preterm children. We retrospectively analyze the incidence and risk factors of BPD in premature infants under 32 weeks of gestation age.Methods: Clinical data of premature infants with gestational age ≤32 weeks admitted to the neonatal intensive care unit of the First Affiliated Hospital of Nanjing Medical University from 2015 to 2017 were selected for this retrospective case-control study. The patients were classified into the BPD and control groups based on the clinical diagnosis. We compared the general condition, treatments, complications, and clinical outcome of premature infants in both groups. Student’s t-test, non-parametric test, and binary logistic regression were used to analyze the occurrence of BPD and its potential risk factors.Results: A total of 213 premature infants aged ≤32 gestational weeks were included in the study; of these, 81 (38%) were diagnosed with BPD. The gestational age (29.14±1.88 weeks vs. 30.82±0.98 weeks, P<0.001) and weight (1240±314.87 g vs. 1584.77±318.18 g, P<0.001) in the BPD group were lower than those in the control group. The liquid quantity, urine volume, and calorie intake of preterm infants in the BPD group within one week after birth were significantly lower than those of infants in the control group. Logistic regression analysis showed that invasive mechanical ventilation (OR=5.065, 95% CI: 1.680–15.266); use of erythrocyte suspension (OR=10.146, 95% CI: 1.860–55.336); and PCO2 in early postnatal arterial blood gas (OR=1.122, 95% CI: 1.024–1.229) were risk factors for BPD. On the other hand, gestational age (OR=0.657, 95% CI: 0.460–0.937); calorie intake (OR=0.917, 95% CI: 0.874–0.963); PO2 (OR=0.925, 95% CI: 0.870–0.985); and pH in early postnatal arterial blood gas (OR<0.001, 95% CI: 0.000–0.156) were protective factors for BPD.Conclusion: The incidence of BPD in very low and extremely low birth weight infants is high. Maintaining early internal environment stability, increasing early calorie intake, shortening invasive mechanical ventilation time, reducing blood transfusion, and closing patent ductus arteriosus could likely reduce the incidence of BPD.
Newborn hearing screening coverage and detection rates of hearing impairment across China from 2008-2016
Authors: Yuan Xuelian , Deng Kui , Zhu Jun , Xiang Liangcheng , Yao Yongna , Li Qi , Li Xiaohong , Liu Hanmin
Published: February 2020

Background: Newborn hearing screening (NHS) can reduce the economic and social burden of hearing impairment. The present study examined NHS coverage and detection of hearing impairment across China for 2008-2010 and 2016. Methods: Medical institutions across China were surveyed in 2012 and 2018 by the National Center for Birth Defects Monitoring of China to collect data for the period 2008-2010 and for 2016 on live births, initial screening rates (total and failed), secondary screening rates (total and failed), and rates of hearing impairment diagnosis among infants who failed secondary screening. To calculate NHS coverage, the number of newborns who received NHS within four weeks after birth was divided by the number of live births. The detection rate of hearing impairment was calculated by combining failure rates on primary and secondary screening with the rate of diagnosis. Results: National NHS coverage increased from 29.9 in 2008 to 86.5 in 2016, with different regions showing different increases. During this period, the number of provinces with NHS coverage over 90.0% increased from 2 to 17, with NHS coverage in 2016 substantially higher in eastern provinces (93.1%) than in western ones (79.4%). In 2016, the detection rate of hearing impairment across the country was 0.23% (95%CI 0.15-0.25%), and it varied from 0.17% in western provinces to 0.22% in central ones and 0.28% in eastern ones. The lowest rate was 0.02% in Heilongjiang and the highest rate was 0.63% in Hainan. Conclusions: National NHS coverage has increased substantially from 2008 to 2016, but provinces and regions still show differences. The detection rate of infant hearing impairment in China is comparable to that in other countries. A national individual-level information system is urgently needed in China to facilitate integration of screening, diagnosis and treatment of infant hearing impairment, which may also lead to a more accurate estimate of the detection rate.
A complete overview of the PhD theses within the field of medicine and health science in Norway in 2018 by using the Health Research Classification System (HRCS)
Authors: Kvalem Helen E , Søreide Frode Hovland , Sarpebakken Bo , Hetland Dyveke L
Published: February 2020

Background: The two-dimensional Health Research Classification System (HRCS) describes health research by the type of research undertaken (Research Activity, RA) and by the health issue or disease addressed (Health Category, HC). This is the first time HRCS has been used to classify PhD theses. Material and methods: All 485 PhD theses within medicine and health in Norway from 2018 were coded with HRCS. Results: Cancer and Neoplasms (12.1%), Cardiovascular (10.7%), Mental Health (10.5%) and Generic Health Relevance (9.8%) were the largest Health Categories whereas Aetiology (32.1%), Evaluation of Treatment (19.7%) and Detection and Diagnosis (13.3%) were the largest Research Activity categories. Interpretation: There is not a perfect overlap in HRCS profiles between the new PhDs in 2018 and the projects awarded from the main research funding organisations in Norway1. In terms of Research Activities, the disparity between HRCS coded PhDs and HRCS-coded research projects is greatest for RAs: Aetiology (higher for PhDs) and Prevention (lower). While some major health challenges in Norway in DALYs like Cancer and Neoplasms, Mental Health and Cardiovascular are accordingly addressed in the PhDs 2018, the Health Categories Musculoskeletal, Respiratory and Injuries and Accidents are not.
Firing activity of locus coeruleus noradrenergic neurons decreases in necdin-deficient mice, an animal model of Prader–Willi syndrome
Authors: Wu Rui-Ni , Hung Wei-Chen , Chen Ching-Tsuey , Tsai Li-Ping , Lai Wen-Sung , Min Ming-Yuan , Wong Shi-Bing
Published: February 2020

Background Prader–Willi syndrome (PWS) is a neurodevelopmental disorder characterized by multiple respiratory, cognitive, endocrine, and behavioral symptoms, such as central apnea, intellectual disabilities, exaggerated stress responses, and temper tantrums. The locus coeruleus noradrenergic system (LC-NE) modulates a diverse range of behaviors, including arousal, learning, pain modulation, and stress-induced negative affective states, which are possibly correlated with the pathogenesis of PWS phenotypes. Therefore, we evaluated the LC-NE neuronal activity of necdin-deficient mice, an animal model of PWS. Methods Heterozygous necdin-deficient mice (B6.Cg-Ndn tm1ky ) were bred from wild-type (WT) females to generate WT (+m/+p) and heterozygotes (+m/−p) animals, which were examined of LC-NE neuronal activity, developmental reflexes and plethysmography. Results On slice electrophysiology, LC-NE neurons of Ndn tm1ky mice with necdin deficiency showed significantly decreased spontaneous activities and impaired excitability, which was mediated by enhanced A-type voltage-dependent potassium currents. Ndn tm1ky mice also exhibited the neonatal phenotypes of PWS, such as hypotonia and blunt respiratory responses to hypercapnia. Conclusions LC-NE neuronal firing activity decreased in necdin-deficient mice, suggesting that LC, the primary source of norepinephrine in the central nervous system, is possibly involved in PWS pathogenesis.
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: February 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 activation 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. 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 outcome as positive or negative activates different brain mechanisms.
Barriers and facilitators for colorectal cancer screening in a low-income urban community in Mexico City
Authors: Unger-Saldaña Karla , Saldaña-Tellez Minerva , Potter Michael B. , Loon Katherine Van , Allen-Leigh Betania , Lajous Martin
Published: February 2020

Background. Colorectal cancer (CRC) incidence and mortality are increasing in many middle- and lower-income countries, possibly due to a combination of changing lifestyles and improved healthcare infrastructure that facilitates diagnosis. Unfortunately, a large proportion of cases may be diagnosed at advanced stages, resulting in poor outcomes. Decreasing trends in higher income countries are likely due to improved early detection combined with best practices in CRC treatment and management. More data on implementation of better quality CRC screening programs are needed for contexts where incidence is increasing. Therefore, we sought to identify potential barriers and facilitators for future implementation of fecal immunochemical test (FIT)-based CRC screening in a public healthcare system in a middle-income country with increasing CRC incidence and mortality.Methods. Qualitative study including semi-structured individual and focus group interviews with different stakeholders of colorectal cancer screening: 30 average-risk lay people, 13 health care personnel from a local public clinic, and 7 endoscopy unit personnel from a cancer referral hospital. All interviews were transcribed verbatim for analysis. Data was analyzed using the constant comparison method, under the theoretical perspectives of the Social Ecological Model (SEM), the PRECEDE-PROCEED Model, and the Health Belief Model. Results. We found multiple barriers and facilitators for implementation of a FIT-based CRC screening program at different levels of the SEM. The main barriers in each of the SEM levels, were: 1) at the social context level: poverty, health literacy and lay beliefs related to gender, cancer, allopathic medicine, and religion; 2) at the health services organization level: the lack of CRC knowledge among health care personnel and the community perception of poor quality of health care; 3) at the individual level: a lack of CRC awareness and therefore lack of risk perception, together with fear of participating in screening activities and finding out about a serious disease. The main facilitators perceived by the participants were CRC screening information and the free provision of screening tests.Conclusions. This study’s findings suggest the need for a multi-level CRC screening program that includes complementary strategies aimed at reducing perceived barriers and enhancing facilitators, starting with: 1) free provision of screening tests, 2) education of primary health care personnel, and 3) promotion of non fear-based CRC screening awareness among the target population, taking into account their lay beliefs.
Sympathetic Ophthalmia Two Weeks After 23-Gauge Vitrectomy
Authors: Khatib Bahaeddin El , Hacopian Alexander , Patel Menka S. , Dalal Monica , Sen H. Nida , Patronas Marena
Published: February 2020

Sympathetic Ophthalmia (SO) is a rare disease that presents as a bilateral, diffuse, granulomatous panuveitis. Sympathetic Ophthalmia is a clinical diagnosis with history of penetrating ocular injury in the inciting eye and presence of panuveitis in the sympathizing eye. Though early enucleation is believed to minimize the risk, there have been reports of SO even after enucleation of inciting eyes. The possible association between vitrectomy and SO has been initially proposed by Gass [9] and later studied extensively in a large cohort in the UK with an estimated SO risk of 1 in 799 vitrectomies [11]. There have been several case series and reports of SO following vitrectomy, however only three documented cases of SO following vitrectomy without use of silicone oil. These cases demonstrated an onset of SO ranging between 4 weeks to 2 months. We present a patient with SO in the sympathizing eye presenting 16 days after an uncomplicated 23-gauge (23G) sutureless pars plana vitrectomy (PPV) without the use of silicone oil.
Circulating metabolites from the choline pathway and acute coronary syndromes in a Chinese case-control study
Authors: Dai Yuxiang , Tian Qianqian , Si Jing , Sun Zhonghan , Shali Shalaimaiti , Xu Lili , Ren Daoyuan , Chang Shufu , Dong Xin , Zhao Hongxia , Zheng Yan , Ge Junbo
Published: February 2020

Background Accumulating evidence shows that circulating levels of trimethylamine N-oxide, which is generated from the metabolism of dietary choline, may predict cardiovascular disease among Caucasians. Acute coronary syndrome (ACS), one common presentation of cardiovascular disease, is a spectrum of signs and symptoms due to acute decreased blood flow in the coronary arteries. The relationship between the metabolites from choline pathway and ACS remains unclear. We aimed to assess the associations of circulating metabolites from the choline pathway with ACS among a Chinese population, who consumes a different dietary pattern than their Western counterparts. Methods We recruited 501 participants who were admitted to the Department of Cardiology, Zhongshan Hospital,Shanghai China between March 2017 and June 2018, including 254 ACS cases and 247 controls. Liquid chromatography-tandem mass spectrometry was used to measure circulating concentrations of metabolites in the choline pathway, including betaine, choline, trimethylamine, and trimethylamine N-oxide. A composite metabolite score using a weighted sum of these four metabolites, and the betaine/choline ratio were calculated. Multivariable logistic regressions were applied to estimate the association of metabolites with ACS, with adjustment of age, sex, body mass index, smoking index, history of diseases, and kidney function. Results After adjusting for traditional risk factors, per 1-standard deviation (SD) increment in choline was positively associated with the odds of ACS [odds ratio (OR), 95% confidence interval (CI), 1.78(1.45-2.21)], and the other metabolites were not associated with ACS at a statistical significance level. Compared with participants in the lowest quartile of the metabolite score, those in the highest quartile had higher odds of ACS [OR (95% CI), 2.24 (1.36-3.71), p <0.001 for trend]. Per 1-SD increment in metabolite score was positively associated with higher odds of ACS [OR (95% CI), 1.76 (1.44-2.17)], and per 1-SD increment in the betaine/choline ratio was inversely associated with the odds of ACS [OR (95% CI), 0.49 (0.39-0.60)]. Conclusions Among our Chinese participants, trimethylamine N-oxide was not associated with ACS, while a composite metabolite score of metabolites from the choline pathway was associated with increased odds of ACS. The choline pathway metabolites may be related to the pathophysiology of ACS among Chinese.
Coffee consumption is associated with a lower risk of prostate cancer: a meta-analysis
Authors: Chen Xiaonan , Zhao Yiqiao , Tao Zijia , Wang Kefeng
Published: February 2020

Background Although in vitro and in vivo experiments have suggested that coffee may exert inhibitory effects on prostate carcinogenesis, epidemiological studies have reported inconsistent results on the association between coffee consumption and prostate cancer. Methods We conducted a meta-analysis of cohort studies to assess the association between coffee consumption and prostate cancer risk. PubMed and Embase were searched for eligible studies up to Jan 2020. Study-specific risk estimates were combined using fixed or random effects models depending on whether significant heterogeneity was detected. Results Fifteen prospective cohort studies, with 50,200 cases of prostate cancer and 949,752 total cohort members, were included in the meta-analysis. A statistically significant inverse association was detected between coffee consumption and prostate cancer risk. The pooled relative risk (RR) was 0.91 (95% CI: 0.84, 0.98; I 2= 53.2%) for the highest coffee consumption compared with lowest consumption. The association exhibited a linear trend ( P =0.006 for linear trend), and the pooled RR was 0.989 (95% CI: 0.982, 0.997) for an increase of 1 cup of coffee per day. The pooled RRs were 0.93 (95% CI: 0.87, 0.99), 0.88 (95% CI: 0.71, 1.09) and 0.84 (95% CI: 0.66, 1.08) for localized, advanced and fatal prostate cancer, respectively. No publication bias was detected. Conclusions Our findings provide more evidence that increased coffee consumption is associated with lower prostate cancer risk. It implies that men might be encouraged to increase the coffee intake to lower their risk of prostate cancer.
Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification
Authors: Ogawa Tomoya , Kawai Nobuyuki , Miyake Keisuke , Shinomiya Aya , Yamamoto Yuka , Nishiyama Yoshihiro , Tamiya Takashi
Published: February 2020

Background The molecular features of isocitrate dehydrogenase (IDH) mutation and chromosome 1p and 19q (1p/19q) codeletion status have pivotal role for differentiating gliomas and have been integrated in the World Health Organization (WHO) classification in 2006. Positron emission tomography (PET) with 18F-fluorothymidine (FLT) has been shown to evaluate tumour grade and proliferative activity more accurately than L-methyl-11C-methionine (MET) in glioma patients. Herein, we compared tracer uptakes of MET-PET/CT and FLT-PET/CT for differentiating glioma according to the 2016 WHO classification especially in relation to IDH1 mutation status.Methods In total, 81 patients with newly diagnosed supratentorial glioma were enrolled in this study. They underwent PET/CT studies with MET and FLT before surgery. The molecular features and histopathological diagnosis based on the 2016 WHO classification were determined using surgical specimens. The ratios of the maximum standardized uptake value (SUV) of the tumours to the mean SUV of the contralateral cortex (T/N ratios) were calculated on MET-PET/CT and FLT-PET/CT images. Results The mean T/N ratios of MET-PET/CT and FLT-PET/CT in IDH1-wildtype tumours were significantly higher than those in IDH1-mutant tumours (P<0.001 and P<0.001, respectively). Receiver operating characteristic analysis for differentiating IDH1 mutation status showed that the area under the curve of the FLT T/N ratio was significantly larger than that of the MET T/N ratio (P<0.01). The mean T/N ratio of FLT-PET/CT in IDH1-wildtype tumours was significantly higher than that in IDH1-mutant tumours among grade Ⅱ and Ⅲ gliomas (P=0.005), but this was not the case for MET-PET/CT. Both MET-PET/CT and FLT-PET/CT were able to distinguish between grade Ⅱ and Ⅲ gliomas in IDH1-mutant tumours (P=0.002 and P<0.001, respectively), but only FLT-PET/CT was able to distinguish between grade Ⅲ and Ⅳ gliomas in IDH1-wildtype tumours (P=0.029).Conclusion This study showed that FLT-PET/CT can be used to determine the IDH1 mutation status and evaluate glioma grade more accurately than MET-PET/CT. The characteristics of FLT-PET/CT can overcome the weakness of MET-PET/CT for differentiating gliomas according to the 2016 WHO classification.
Validity and diagnostic performance of Fluorescence Optical Imaging measuring synovitis in hand osteoarthritis. Baseline results from the Nor-Hand cohort.
Authors: Maugesten Øystein , Mathiessen Alexander , Hammer Hilde Berner , Hestetun Sigrid , Kvien Tore Kristian , Uhlig Till , Ohrndorf Sarah , Haugen Ida Kristin
Published: February 2020

Objective: Fluorescence Optical Imaging (FOI) demonstrates enhanced microcirculation in finger joints as a sign of inflammation. We wanted to assess the validity and diagnostic performance of FOI measuring synovitis in persons with hand OA, comparing it with magnetic resonance imaging (MRI)- and ultrasound-detected synovitis.Methods: 221 participants with hand OA underwent FOI, contrast-enhanced MRI and ultrasound (grey scale synovitis and power-Doppler activity) examinations of the hands. Fifteen joints in each hand were scored on semi-quantitative scales (grade 0-3) for all modalities. Four FOI images were evaluated: one composite image (Prima Vista Mode; PVM) and three images representing phases of fluorescent dye distribution. Spearman’s correlation coefficients were calculated between sum scores of FOI, MRI and ultrasound. Sensitivity, specificity and area under the curve (AUC) was calculated for FOI using MRI or ultrasound as reference.Results: FOI did not demonstrate enhancement in the first carpometacarpal joint, which was excluded from further analyses. FOI sum scores showed poor to fair correlations with MRI (rho 0.01-0.24) and GS synovitis sum scores (rho 0.12-0.25). None of the FOI images demonstrated both good sensitivity and specificity, and the AUC ranged from 0.50-0.61 and 0.51-0.63 with MRI and GS synovitis as reference, respectively. FOI demonstrated similar diagnostic performance with PD activity and GS synovitis as reference.Conclusion: To conclude, FOI enhancement correlated poorly with synovitis assessed by more established imaging modalities, questioning the value of FOI for the evaluation of synovitis in hand OA.
Trends in the utilization of youth primary healthcare services for psychological distress
Authors: Potrebny Thomas , Wiium Nora , Haugstvedt Anne , Sollesnes Ragnhild , Wold Bente , Thuen Frode
Published: February 2020

Background Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the relationship between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need. Methods This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 ( n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time.Results We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 300 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16-66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.Conclusions Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.
Model of burnout, depression, and work performance among nurses in China: a questionnaire survey.
Authors: Li Li , Yao Yongcheng , Lou Xiaoping , Qin Nan , Yao Wu
Published: February 2020

Background: To investigate the relationship of job burnout, depression, with job performance among nurses and to construct a job performance model.
Methods: Questionnaires were administered to 792 nurses working in 5 hospitals in Zhengzhou, Henan province, China from July to August in 2015.
Results: Of the 792 nurses, statistically significant differences were found in the age, educational status, years working, department, job title, and personality types with respect to burnout, depression, and job performance ( P <0.05). The job burnout scores were positively correlated with the depression scores and negatively correlated with the job performance ( P <0.001). Nurses in the 25-29 years age group had the highest burnout scores ( P <0.01). The burnout scores were higher among those who worked 6-15 years than those who worked more than 15 years ( P <0.01). The job performance scores were higher in the ≥16-year than <6-year working group ( P <0.05). The burnout scores were lower among intermediate-level than junior-level nurses ( P <0.05), but the job performance scores were higher than those of junior-level nurses ( P <0.01). Path analysis results showed that among the examined job characteristics, the direct effects of age, years working, and job title were greatest.
Conclusion: This study suggests that the main risk factors among job characteristics were age, years working, and job title. Increased burnout leads to increased depression, which in turn leads to a decline in job performance.
Growth and scale improvement of Israeli carp (Cyprinus carpio) based on genetic breeding
Authors: Kim Jung Eun , Hwang Ju-ae , Kim Hyeong Su , Im Jae Hyun , Lee Jeong Ho
Published: February 2020

Background: There is a need to recover the genetic diversity of Israeli carp by continuous inbreeding and develop genetics-based breeding for rapid growth, better body shape, and improved scales. However, there are no breeding studies on developing domestic Israeli carp since 1973. To develop an Israeli carp breed that grows fast and has improved body shape and scale using genetic breeding methods. Results: Four breeding groups were set. A mating scheme was developed considering the morphological analysis and genetic distance of broodstock. F1 was produced according to the mating scheme. The Korea × China group grew faster in 17 months. Total length in the China × Korea group was small, but body height was similar to that of the other groups, and the condition factor was the highest. Common Israeli carp in Korea reached 1.7 kg in 17 months, and improved Israeli carp reached to 2.2 kg. The scale scores of the F1 group were 1.98 (China × China), 2.68 (China × Korea), 2.36 (Korea × China) and 3.18 (Korea × Korea). The average number of scales crossing between China and Korea was 2.52 and broodstock group was 3.15. F1 showed lower scale score (0.63) than broodstock. Conclusions: The improved carp has better scales than parent group, which improved in weight and scales compared to common Israeli carp. The Israeli carp developed by the genetics-based breeding grew quicker and had improved fewer scales, which will be of great value for domestic Israeli aquaculture industry due to good marketability.