bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in Male Contraceptive Use in Ghana: An Analysis of Self-Reported Contraceptive Use from GDHS 2003, 2008 and 2014
Authors: Alando Cyril , Manu Adom , Habib Helen , Modey Emefa , Torpey Kwasi , Adanu Richard , Ankomah Augustine
Published: September 2020

Background: Male participation in contraception is proven to have positive outcomes on reproductive health and remains a critical issue of public health importance. However, there is a dearth of evidence on men’s share of the contraceptive burden among couples in Ghana. Knowledge of the trends and trajectories of men’s contraceptive practice could inform male focused programmatic interventions to boost contraceptive use for effective fertility regulation. This study examined the trends in contraceptive use as reported by men. Methods: This paper examines trends in self-reported contraceptive use among sexually active Ghanaian males, using data from the three most recent national Demographic and Health Surveys (2003, 2008 and 2014). Frequency distributions of socio-demographic and background characteristics were used to describe the sample by each survey year. The Z test of proportions was used to identify significant differences in the estimated proportions and subgroups of men using contraceptives by survey year. The Combined data from the three nationally representative surveys were analyzed, accruing a sample of 9,008, comprising (GDHS 2003=3,104; GDHS 2008=3,007; and GDHS 2014=2,897) male respondents who met the inclusion criteria.Results: Men’s contraceptive use appears to have declined over the last three demographic surveys despite an increase in the proportion of sexually active males. However, a significant proportion of men who used contraception (44.5% - 41.5%) still relied on the male condom as their primary choice of contraception. Place of residence, educational attainment, occupation, region of residence and religious affiliation were all found to be significantly associated with contraceptive use consistency.Conclusion: There has been a significant decrease in contraceptive use by Ghanaian men between 2003 and 2014. Although the male condom appears to be the most popular modern male contraceptive method, especially during adolescence, along the life course the phenomenon changes, with a shift towards modern female methods. There is therefore, the need for family planning service providers, policymakers and all relevant stakeholders to consciously target men with contraceptive products and services and community engagement to improve FP uptake
All-in-one dual CRISPR-Cas12a (AIOD-CRISPR) assay protocol for SARS-CoV-2 detection
Authors: Ding Xiong , Yin Kun , Li Ziyue , Lalla Rajesh V. , Sfeir Maroun M. , Liu Changchun
Published: September 2020

This protocol presents the all-in-one dual CRISPR-Cas12a (AIOD-CRISPR) assay to ultra-sensitively and visually detect SARS-CoV-2. The procedure of AIOD-CRISPR assay typically consists of three parts including sample preparation, AIOD-CRISPR reaction, and fluorescence detection. Sample preparation involves the synthetic RNA preparation and the nucleic acid extraction from SARS-CoV-2 samples. The prepared nucleic acids were then added into the AIOD-CRISPR reaction systems as templates, followed by incubation at 37°C for 20-40 min. After incubation, visual detection was immediately conducted by placing the tubes in a portable LED blue transilluminator (Maestrogen UltraSlim) or the ChemiDoc™ MP Imaging System (Bio-Rad) with its built-in UV channel. In addition to endpoint visual detection, real-time fluorescence detection was also available for AIOD-CRISPR assay. This protocol is helpful for applying AIOD-CRISPR assay to rapid, sensitive, one-pot point-of-care SARS-CoV-2 detection.
Chronic Exposure to Ambient Particulate Matter Induces Gut Microbial Dysbiosis in a Rat COPD Model
Authors: Li Naijian , Yang Zhaowei , Liao Baoling , Pan Tianhui , Pu Jinding , Hao Binwei , Fu Zhenli , Cao Weitao , Zhou Yuming , He Fang , Li Bing , Ran Pixin
Published: September 2020

Background: The role of the microbiota in the pathogenesis of chronic obstructive pulmonary disease (COPD) following exposure to ambient particulate matter (PM) is largely unknown.Methods: Fifty-four male Sprague-Dawley rats were exposed to clean air, biomass fuel (BMF), or motor vehicle exhaust (MVE) for 4, 12, and 24 weeks. We performed pulmonary inflammation evaluation, morphometric measurements, and lung function analysis in rat lung at three different times points during exposure. Lung and gut microbial composition was assessed by 16S rRNA pyrosequencing. Serum lipopolysaccharide levels were measured and short-chain fatty acids in colon contents were quantified.Results: After a 24-week PM exposure, rats exhibited pulmonary inflammation and pathological changes characteristic of COPD. The control and PM exposure (BMF and MVE) groups showed similar microbial diversity and composition in rat lung. However, the gut microbiota after 24 weeks PM exposure was characterized by decreased microbial richness and diversity, distinct overall microbial composition, lower levels of short-chain fatty acids, and higher serum lipopolysaccharide.Conclusion: Chronic exposure to ambient particulate matter induces gut microbial dysbiosis and metabolite shifts in a rat model of chronic obstructive pulmonary disease.
Predictors of resignation and sick leave after cancer dianosis among Japanese breast cancer survivors: a cross-sectional study
Authors: Mitsui Kiyomi , Endo Motoki , Imai Yuya , Ueda Yuito , Ogawa Hiroko , Muto Go , Yan Yan , Deshpande Gautam A. , Terao Yasuhisa , Takeda Satoru , Tanigawa Takeshi , Nishimura Katsuji , Hayashi Kazuhiko , Saito Mitsue , Kokaze Akatsuki
Published: September 2020

Background: In Japan, 55.5% of breast cancer survivors (BCSs) are of working age, so various perspectives regarding return to work (RTW) after cancer diagnosis need to be considered. Therefore, this study aimed to clarify the risk factors for resignation and taking sick leave (SL) among BCSs in continued employment at the time of diagnosis.Methods: A web-based retrospective cross-sectional survey was conducted on BCSs using data from a 2018 Japanese national research project (Endo-Han) commissioned by the Ministry of Health, Labour and Welfare of Japan. The subjects were women aged 18–69 years who had been diagnosed with breast cancer for the first time at least 1 year previously. The risk factors for resignation and taking SL after breast cancer diagnosis, including age at diagnosis, education level, cancer stage, surgery, chemotherapy, radiotherapy, employment status, and occupational type, were then analyzed using a logistic regression model.Results: In total, 40 (14.9%) of 269 BCSs quit their jobs at least 1 year after being diagnosed with breast cancer. The results of the multivariable analysis indicated that lower education level (odds ratio [OR]: 3.802; 95% confidence interval [CI]: 1.233–11.729), taking SL (OR: 2.514; 95%CI: 1.202–5.261), and younger age at diagnosis (OR: 0.470; 95%CI: 0.221–0.998) were predictors of resignation. Of 229 patients who continued working, SL was taken by 72 (31.4%). In addition, undergoing surgery was found to be a predictor of taking SL (OR: 8.311; 95%CI: 1.007–68.621).Conclusions: In total, 40 (14.9%) of 269 BCSs quit their jobs at least 1 year after being diagnosed with breast cancer. The results of this study indicated that younger age, lower education level, and taking SL were predictors of resignation after breast cancer diagnosis.
Primarily Treated Patients versus Referred Patients in the Treatment of Native Septic Arthritis of Digits: A Retrospective Comparative Study
Authors: Kwak Sang Ho , Bae Jung Yun , Oh Youngkwang , Jang Hyo Seok , Ahn Tae Young , Lee Sang Hyun
Published: September 2020

Background Septic arthritis of digits needs urgent treatment. When treatments delayed or insufficient, patients may be referred to the upper-level hospital due to uncontrolled infection. We reviewed the treatment history of referred patients and compared the microorganisms and the clinical course of both primary and referred patients as relevant studies are rare. Methods In this retrospective review of consecutive case series, 45 patients (primary, n=11; referred, n=34) were treated with multiple irrigation and debridement. Cefazolin was used as empiric antibiotics, then changed according to microbiologic study. Previously used antibiotics, treatment delay, surgical history of the referred patients were reviewed. Identified microorganisms, required surgical intervention, hospital stay, radiologic outcome, functional outcomes were compared between both groups. Results In the referred patients, methicillin-resistant Staphylococcus aureus (MRSA) was commonly found and cefazolin was susceptible in only 15% of the cases. Longer hospital stay, prolonged antibiotic therapy, more surgical intervention including flap surgery was required to treat the referred patients. Postoperative pain was not severe in daily activities, but the final range of motion was significantly less in the referred patients compared to the primary patients.Conclusions This study suggests that in the treatment of uncontrolled septic arthritis of the digits, antibiotic agents covering MRSA may shorten the duration of antibiotic therapy in areas of high MRSA incidence. Besides, more number of I & D including flap surgery may be required for the referred patients compared with the primary patients. These findings can help the surgeon in setting up a treatment plan or in counseling of referred patients with uncontrolled septic arthritis of the digits.
Sex and FOXP3 gene rs2232365 polymorphism may be associated with the clinical and pathological aspects of chronic viral diseases
Authors: Pereira Leonn Mendes Soares , Madureira Max Willy da Silva , de Castro Renata Bezerra Hermes , Abreu Isabella Nogueira , Conde Simone Regina Souza da Silva , Demachki Sâmia , de Sousa Maisa Silva , Queiroz Maria Alice Freitas , Silva Andrea Nazaré M. Rangel da , Ishak Marluísa de Oliveira Guimarães , Ishak Ricardo , Vallinoto Antonio C. R.
Published: September 2020

Background: The forkhead box protein 3 (FOXP3) transcription factor is one of the main markers of immunological suppression in different pathological profiles, and the presence of polymorphic variants may alter the gene expression of this factor. Despite descriptions of an association between the presence of the rs2232365 polymorphism and chronic diseases, the role of the sex variant in this context has not yet been elucidated, as the FOXP3 gene is located on the human sex chromosome X. Results: To contribute to this topic, 323 women and 373 men were enrolled in the study, of which 101 were diagnosed with chronic viral liver diseases (39 women and 62 men), 67 with HTLV-1 infection (44 women and 23 men), 230 with coronary artery disease (91 women and 139 men) and 298 healthy and uninfected blood donors (149 women and men). They were genotyped for the rs2232365 polymorphism. The rs2232365 polymorphism was associated with clinical and pathological aspects and biomarkers of viral infections only in men, with functional differences between different infections. Conclusions: A relationship is suggested between sex and FOXP3 rs2232365 polymorphism, resulting in different biological repercussions.
The HDL from septic-ARDS patients with composition changes exacerbates pulmonary endothelial dysfunction and acute lung injury induced by cecal ligation and puncture (CLP) in mice
Authors: Yang Liu , Liu Sijie , Han Silu , Hu Yuhan , Wu Zhipeng , Shi Xiaoqian , Pang Baosen , Ma Yingmin , Jin Jiawei
Published: September 2020

Background: Septic-acute respiratory distress syndrome (ARDS), characterized by the acute lung injury (ALI) secondary to aberrant systemic inflammatory response, has high morbidity and mortality. Despite increased understanding of ALI pathogenesis, the therapies to prevent lung dysfunction underlying systemic inflammatory disorder remain elusive. The high density lipoprotein (HDL) has critical protective effects in sepsis and its dysfunction has a manifested contribution to septic organ failure. However, the adverse changes in HDL composition and function in septic-ARDS patients are large unknown.Methods: To investigate HDL remodeling in septic-ARDS, we analyzed the changes of HDL composition from 40 patients with septic-ARDS (A-HDL) and 40 matched normal controls (N-HDL). To determine the deleterious functional remodeling of HDL, A-HDL or N-HDL was administrated to C57BL/6 and apoA-I knock-out (KO) mice after cecal ligation and puncture (CLP) procedure. Mouse lung microvascular endothelial cells (MLECs) were further treated by these HDLs to investigate whether the adverse effects of A-HDL were associated with endothelial dysfunction.Results: Septic-ARDS patients showed significant changes of HDL composition, accompanied with significantly decreased HDL-C. We further indicated that A-HDL treatment aggravated CLP induced ALI. Intriguingly, these deleterious effects of A-HDL were associated with pulmonary endothelial dysfunction, rather than the increased plasma lipopolysaccharide (LPS). Further in vitro results demonstrated the direct effects of A-HDL on MLECs, including increased endothelial permeability, enhanced expressions of adhesion proteins and pro-inflammatory cytokines via activating NF-κB signaling and decreased junction protein expression.Conclusions: Our results depicted the remodeling of HDL composition in sepsis, which predisposes lung to ARDS via inducing ECs dysfunction. These results also demonstrated the importance of circulating HDL in regulating alveolar homeostasis.
Quantitative CT-based Image Registration Metrics Provide Different Ventilation and Lung Motion Patterns in Prone and Supine Positions in Healthy Subjects
Authors: Shin Kyung Min , Choi Jiwoong , Chae Kum Ju , Jin Gong Yong , Eskandari Ali , Hoffman Eric A. , Hall Chase , Castro Mario , Lee Chang Hyun
Published: September 2020

Background Previous studies suggested that the prone position (PP) improves oxygenation and reduces mortality among patients with acute respiratory distress syndrome (ARDS). However, the mechanism of this clinical benefit of PP is not completely understood. The aim of the present study was to quantitatively compare regional characteristics of lung functions in the PP with those in the supine position (SP) using inspiratory and expiratory computed tomography (CT) scans.Methods 90 subjects with normal pulmonary function and inspiration and expiration CT images were included in the study. Thirty-four subjects were scanned in PP, and 56 subjects were scanned in SP. Non-rigid image registration-based inspiratory-expiratory image matching assessment was used for regional lung function analysis. Tissue fractions (TF) were computed based on the CT density and compared on a lobar basis. Three registration-derived functional variables, relative regional air volume change (RRAVC), volumetric expansion ratio (J), and three-dimensional relative regional displacement (s*) were used to evaluate regional ventilation and deformation characteristics. Results J was greater in PP than in SP in the right middle lobe (P = 0 .025), and RRAVC was increased in the upper and right middle lobes (P < 0.001). The ratio of the TF on inspiratory and expiratory scans, J, and RRAVC at the upper lobes to those at the middle and lower lobes and that ratio at the upper and middle lobes to those at the lower lobes of were all near unity in PP, and significantly higher than those in SP (0.98-1.06 vs 0.61-0.94, P < 0.001).Conclusion We visually and quantitatively observed that PP not only induced more uniform contributions of regional lung ventilation along the ventral-dorsal axis but also minimized the lobar differences of lung functions in comparison with SP. This may help in the clinician’s search for an understanding of the benefits of the application of PP to the patients with ARDS or other gravitationally dependent pathologic lung diseases.Trial registration Retrospectively registered.
Characteristics and predictors of muscle strength deficit in mechanical ankle instability
Authors: Hou Zong-chen , Miao Xin , Ao Ying-fang , Hu Yue-lin , Jiao Chen , Guo Qin-wei , Xie Xing , Zhao Feng , Pi Yan-bin , Li Nan , Zhang Zhi-yu , Jiang Dong
Published: September 2020

Purpose: Muscle strength training is a common strategy for treating chronic ankle instability (CAI), but the effectiveness decreases for mechanical ankle instability (MAI) patients with initial severe ligament injuries. The purpose of this study was to investigate the characteristics and the potential predictors of muscle strength deficit in MAI patients, with a view to proposing a more targeted muscle strength training strategy.Methods: A total of 220 MAI patients with confirmed initial lateral ankle ligament rupture and a postinjury duration of more than 6 months were included. All patients underwent a Biodex isokinetic examination of the ankle joints of both the affected and unaffected sides. Then, the associations between the limb symmetry index (LSI) (mean peak torque of the injury side divided by that of the healthy side) and the patients’ sex, body mass index, postinjury duration, presence of intra-articular osteochondral lesions, presence of osteophytes and ligament injury pattern (i.e., isolated anterior talofibular ligament (ATFL) injury or combined with calcaneofibular ligament injury) were analysed.Results: There was significantly weaker muscle strength on the affected side than on the unaffected side in all directions (p<0.05). The LSI in plantar flexion was significantly lower than that in dorsiflexion at 60°/s (0.87 vs 0.98, p<0.001). A lower LSI in eversion was significantly correlated with female sex (0.82 vs 0.94, p=0.016) and isolated ATFL injury (0.86 vs 0.95, p=0.012). No other factors were found to be associated with muscle strength deficits.Conclusion: MAI patients showed significant muscle strength deficits on the affected side, especially in plantar flexion. There were greater strength deficits in eversion in females and individuals with an isolated ATFL injury. Thus, a muscle strength training programme for MAI patients was proposed that focused more on plantar flexion training and eversion training for females and those with an isolated ATFL injury.
Mechanical ventilation of patients in helicopter emergency medical service transport: An international survey.
Authors: Hilbert-Carius Peter , Struck Manuel , Hofer Veronika , Hinkelbein Jochen , Rognas Leif , Adler Jörn , Christian Michael D. , Wurmb Thomas , Bernhard Michael , Hossfeld Björn
Published: September 2020

Background: Mechanical ventilation in helicopter emergency medical service (HEMS) environments is a procedure which carries a significant risk of complications. Limited data on the quality and performance of mechanical ventilation in HEMS are available in the literature.Method: We conducted an international survey to evaluate mechanical ventilation infrastructure in HEMS and collect data of transported ventilated patients. From June 20-22, 2019, the participating HEMS bases were asked to provide data via a web-based platform. Vital parameters and ventilation settings of the patients at first patient contact and at handover were compared using non-parametric statistical tests. Results: Out of 215 invited HEMS bases, 53 responded. Respondents were from Germany, Denmark, United Kingdom, Luxembourg, Austria and Switzerland. Of the HEMS bases, all teams were physician staffed, mainly anesthesiologists (79%), the majority were board certified (92.5%) and trained in intensive care medicine (89%) and had a median (range) experience in HEMS of 9 (0-25) years. HEMS may provide a high level of expertise in mechanical ventilation whereas the majority of ventilators are able to provide pressure controlled ventilation and continuous positive airway pressure modes (77%). Data of 30 ventilated patients with a median (range) age of 54 (21-100) years and 53% male gender were analyzed. Of these, 24 were primary missions and 6 interfacility transports. At handover, oxygen saturation (p<0.01) and positive end-expiratory pressure (p=0.04) of the patients were significantly higher compared to first patient contact.Conclusion: In this survey, the management of ventilated HEMS-patients was not associated with ventilation related serious adverse events. Patient conditions, training of medical crew and different technical and environmental resources are likely to influence management. Further studies are necessary to assess safety and process quality of mechanical ventilation in HEMS.Trial Registration: The survey was prospectively registered at Research Registry (researchregistry2925).
Identifying conflict of interest disclosure in systematic reviews of surgical interventions and devices: a cross-sectional survey
Authors: Yu Jiajie , Su Guanyue , Hirst Allison , Yang Zengyue , Zhang You , Li Youping
Published: September 2020

Background: Conflict of interest (COI) is an important source of bias in research and disclosure is the most frequent strategy to manage COI. Considering the importance of systematic reviews (SRs) and the prevalence of COI is varying among different research fields, we conducted a survey to identify the range of conflict of interest in SRs assessing surgical intervention and devices, and explored the association between COI disclosure and conclusion.Methods: We retrieved SRs of surgical interventions and devices published in 2017 via PubMed. Information regarding general characteristics, funding source and COI disclosure were extracted. We conducted descriptive analyses of study characteristics of included systematic reviews. The difference between groups in the authors’ conclusions were compared using the Chi-square test. Results were expressed as odds ratio and its 95% confidence interval.Results: 155 SRs were finally identified in 2017, more than half of SRs (58.7%) reported their funding source and 94.2% reported authors’ COI disclosure. Among 146 SRs that stated COI disclosures, only 35 (22.6%) SRs declared at least one author had a COI. More than 40 terms were used to describe COI. Cochrane SRs were more likely to provide a detail description of COI comparing with those in non-CSR (48.0% versus 25.4%, P=0,023). No association between a positive conclusion and COI disclosure was found (P=0.484, OR=0.43, 95%CI: 0.08, 2.16). In the subgroup analyses, SRs stating no COI disclosure were more likely to report positive conclusion than those stating at least one type of COI, but the difference is not significantly different (P=0.406, OR=1.38, 95%CI: 0.64, 2.98)Conclusion: A high rate of COI disclosure without any detailed information. The identification and statement of COI, particularly nonfinancial interests, are still needed to be improved. Some efficient and effective methods/tools for identifying, quantifying, and minimizing potential COI in systematic reviews are necessary.
Analysis on risk factors for neck shortening after internal fixation for Pauwels II femoral neck fracture in young patients
Authors: Zhao Fulong , Guo Lijuan , wang xuefei , Zhang Yakui
Published: September 2020

Background: Femoral neck shortening can occur in young patients receiving closed reduction and internal fixation for Pauwels type II femoral neck fracture. The risk factors for neck shortening, which can affect hip function, are not clear. This study aimed to retrospectively identify risk factors for neck shortening after closed reduction and internal fixation with parallel partially threaded cannulated cancellous screws for Pauwels type II femoral neck fracture in young patients.Methods: Clinical data from 122 cases with Pauwels type II femoral neck fracture from February 2014 to February 2019 were reviewed and analyzed, and causes of neck shortening were statistically analyzed. These patients were followed (average follow-up: 12 months). And the chi-square test or t test was used to compare indicators. Multivariate analysis was conducted with non-conditional logistic regression analysis. Results: Statistically significant differences were found in age, sex, BMD, BMI, fracture type, posterior medial cortex comminution, and reduction quality between patients with femoral neck shortening and those without femoral neck shortening. Logistic regression analysis showed that fracture type, posterior medial cortex comminution, and reduction quality were the main risk factors for neck shortening. Conclusion：Fracture type, posterior medial cortex comminution, and reduction quality can be used as important reference indexes to predict the possibility of neck shortening after closed reduction and internal fixation with parallel, partially threaded, cannulated cancellous screws for Pauwels type II femoral neck fracture in young patients.BMD and BMI may be also risk factors.
Data quality of the routine health management information system at the primary healthcare facility and district levels in Tanzania
Authors: RUMISHA SUSAN F. , LYIMO EMANUEL P. , MREMI IRENE R. , TUNGU PATRICK K. , MWINGIRA VICTOR S. , MBATA DORIS , MALEKIA SIA E. , JOACHIM CATHERINE , Mboera Leonard
Published: September 2020

Background: Effective planning for disease prevention and control requires accurate, adequately-analysed, interpreted and communicated data. In recent years, efforts and investments have been put in strengthening health management information systems (HMIS) in Sub-Saharan Africa to improve data accessibility to decision-makers. This study assessed the quality of routine HMIS data at primary healthcare facility (HF) and district levels in Tanzania. Methods: The assessment involved Outpatient, Inpatient, Antenatal care, Family Planning, Post-natal care, Labour and Delivery, and Provider-initiated Testing and Counselling service areas in primary health care facilities. Records were tracked and compared at different phases of the data journey i.e. registers, tally-sheets, HF monthly reports submitted to the district level, and electronic database. We assessed the availability and utilization of each HMIS tool and quantified completeness and accuracy levels of the collected data in each phase of the reporting system. Results: A total of 115 HFs (including hospitals, health centres, and dispensaries) in 11 districts were assessed. Registers (availability rate=91.1%; interquartile range (IQR):66.7%-100%) and report forms (86.9%; IQR:62.2%-100%) were the most utilized HMIS tools. There was a limited use of tally-sheets (77.8%; IQR:35.6%-100%). Tools availability at the dispensary was 91.1%, health-centre 82.2% and hospital 77.8%, and was low in urban districts. The availability rate at the district level was 65% (IQR:48%-75%). Reports were highly over-represented in comparison to registers’ records, with large differences observed at the HF phase of the data journey and more profound in hospitals. Tool availability and data quality in the reproductive health service area outperformed the general services (outpatient and inpatient) areas. Indicators with large number of clients, multiple variables, disease categorization, or those linked with dispensing of medicine performed poorly. Conclusion: There are high variations in the tool utilisation and data accuracy at facility and district levels. A significant improvement on patient registration and use of tally-sheets was observed over the years. The routine HMIS is weak and data at district level inaccurately reflects what is available at the source (HFs). These results highlight the need to design tailored and inter-service strategies for improving data quality.
Airway Obstruction as the Primary Manifestation of Infantile Thyroid Hemangioma: A Case Report and Literature Review
Authors: Liang Yujian , Pu Ronghui , Huang Xueqiong , Li Suping , Chen Yingqian , Tang Wen
Published: September 2020

Background: Thyroid hemangioma mostly occurs in adults and is extremely rare in infants. So far, only four pediatric cases of thyroid hemangioma have been reported, one of which has only been clinically diagnosed. Most of the reported cases are of cavernous hemangiomas; capillary hemangioma cases are very rare. To date, there are no reports on capillary thyroid hemangioma in an infant. Therefore, here we present the case of an infant with a primary capillary hemangioma of the thyroid gland, and discuss its treatment and follow-up. Case Presentation: A 2-month-old infant with normal thyroid function presented with airway obstruction as the primary manifestation of thyroid hemangioma. The main symptoms were laryngeal wheezing and dyspnea. Ultrasonography revealed hypoechoic lesions at the lower pole of the bilateral thyroid. Computed tomography revealed enlargement of the thyroid gland, inhomogeneous parenchyma enhancement, and multiple thyroid nodules. However, these imaging modalities were unable to provide an exact diagnosis and the nature of the tumor remained unknown prior to an operation. Therefore, a postoperative histopathological examination was undertaken, which revealed capillary thyroid hemangioma. The symptoms significantly improved by a combined treatment involving surgery and oral propranolol (2 mg/kg per day). Conclusion: When a well-defined capsulate mass is detected on the medical image, the possibility of primary thyroid hemangioma must be considered.
Risk areas for tuberculosis among children and their inequalities in a city from Southeast Brazil.
Authors: Alves Yan Mathias , Berra Thais Zamboni , Alves Luana Seles , de Assis Ivaneliza Simionato , Arcoverde Marcos Augusto Moraes , Ramos Antônio Carlos Vieira , Arroyo Luiz Henrique , Campoy Laura Terenciani , Bruce Alexandre Tadashi Inomata , Santos Felipe Lima dos , Souza Ludmilla Leidianne Limírio , Crispim Juliane de Almeida , Arcêncio Ricardo Alexandre
Published: September 2020

BACKGROUND: The objective of the study was to identify areas of risk for the appearance of tuberculosis in children and their association with social inequalities in a municipality in southeastern Brazil. METHODS: Ecological study conducted in Ribeirão Preto, Brazil. To identify areas of spatial risk for tuberculosis in children, we used spatial scanning statistics. To analyze the association of cases of childhood tuberculosis with social vulnerability, we used the Social Vulnerability Index of São Paulo, and four explanatory statistical models were listed. RESULTS: There were 96 cases of childhood tuberculosis, of which 90 were geocoded through a process of converting addresses to geographic coordinates. A risk area was identified in the municipality, where children under 15 years old have 3.14 times greater risk of contracting tuberculosis than those living outside this area. The variables identified as risk factors were: number of private and collective households, proportion of children aged 0 to 5 years in the population, proportion of households without per capita income, and the proportion of private households with monthly nominal incomes of up to one quarter of wage minimums. The variables identified as protection factors were the proportion of women under the age of 30 years responsible for the household under and women responsible for the household with an average income over BRL 2,344. CONCLUSION: The study showed areas of risk for the occurrence of tuberculosis in children. The study is in line with the End TB Strategy and the 2030 Agenda, which aim to support strategic actions and, therefore, save the lives of children through the systematic, intensified, and comprehensive identification of children with tuberculosis respiratory symptoms in the community.
LncRNA LEF1-AS1 promotes metastasis of prostatic carcinoma via the Wnt/β-catenin pathway
Authors: Li Weiyuan , Yang Ganggang , Yang Dengke , Li Dong , Sun Qian
Published: September 2020

Background

Long noncoding RNAs (lncRNAs), which are important functional regulators in cancer, have emerged as critical molecular regulators in various biological processes. However, the mechanisms by which LEF1-AS1 modulates Androgen-Independent Prostate Cancer (AIPC) development remain largely unknown.

Methods

The LEF1-AS1 expression level was detected in tumour tissues and adjacent normal tissues of AIPC patients by using next-generation sequencing technology and qRT-PCR. Cell proliferation, migration and invasion were assessed by colony formation, EDU assays and transwell assays, respectively. Xenograft assay was conducted to determine the effect of LEF1-AS1 on cell proliferation in vivo.

Results

LEF1-AS1 promoted the proliferation, migration, invasion and angiogenic ability of AIPC cells in vitro and in vivo. In this mechanism, LEF1-AS1 recruited the transcription factor C-myb to the promoter region of FZD2, which activated FZD2 transcription. Moreover, LEF1-AS1 functioned as a competing endogenous RNA (ceRNA) acting as a sponge for miR-328, which activated CD44.

Conclusion

Collectively, these data indicate that LEF1-AS1 is a tumour promoter in the development of AIPC and that it may contribute to the improvement of AIPC diagnosis and therapy.
Contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa: a qualitative study
Authors: Harries Jane , Constant Deborah , Cairncross Lydia , Moodley Jennifer
Published: September 2020

Background:No known studies have been undertaken in South Africa exploring the contraceptive and fertility needs and preferences of women of reproductive age (18-49) diagnosed with breast cancer. This study set out to understand the contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa.Methods:Qualitative in-depth interviews were conducted with 24 women diagnosed with breast cancer and 4 health care providers at a tertiary hospital in Cape Town, South Africa. We explored contraceptive use prior to diagnosis; the impact of breast cancer on future fertility intentions and contraceptive use; understanding of suitable contraceptive methods during and after treatment and women’s fertility related counseling needs during their continuum of care. Data were analysed using a thematic analysis approach. Results: Since being diagnosed with breast cancer, of those women using a contraceptive method, the non-hormonal intrauterine device (IUD) was the most commonly used method. However, women reported receiving limited information from health care providers about contraceptive use and future fertility planning post treatment when fertility desires might change. Many women reported limited information received from healthcare providers about the impact of cancer treatment on their future fertility. Most women did not receive information around fertility preservation options, and few were familiar with the concept. Providers focus was more on preventing pregnancy during treatment and ensuring a patient was on a non-hormonal contraceptive method. Providers supported a more holistic, multidisciplinary approach to breast cancer patient’s contraceptive and future fertility needs. Conclusions:Limited contraceptive and future fertility counseling were reported by women despite many women being provided with the IUD. There is a need for improved information and counseling regarding the impact of treatment on contraceptive and fertility options. It is important that cancer care providers provide timely information regarding fertility options and communicate with patients about their fertility concerns prior to treatment and throughout the course of survivorship. The development of evidence-based information tools to enhance patient- provider communication and counseling could address knowledge gaps
Investigation of the differences between the medical personnel’s and general population’s view on the doctor-patient relationship in China by a cross-sectional survey
Authors: Sang Tianqing , Zhou Hongli , Li Muhan , Li Wenting , Shi Haibo , Chen Haibin , Zhou Hongguang
Published: September 2020

Background: Due to economic development and an increase in the aging population, the demand for medical resources is increasing. A good doctor-patient relationship (DPR) can optimize patients’ medical experience and improve treatment efficiency. The DPR, however, is currently in crisis in China. To explore ways to improve DPR, this study assessed the views on the status of the DPR, medical services, and the general situation of medical work among medical personnel (MP) and the general population (GP). Methods: This cross-sectional study, conducted between December 2019 and March 2020, targeted the MP and the GP in Nanjing City, Jiangsu Province, and Zhengzhou City, Henan Province. A total of 154 MP and 329 GP answered a self-administered questionnaire through Questionnaire Star and WeChat apps. Wilcoxon's Sign Rank Test, Chi-square test, and frequency distributions and percentages were used to process the data. Results: Only 11.04% of the MP and 14.89% of the GP believed that the current DPR was harmonious. Moreover, 54.55% of the MP and 71.12% of the GP believed that the medical industry was a service industry. While 14.29% of the MP and 64.44% of the GP thought medical stuff earned high salaries, 19.48% of the MP and 47.11% of the GP wanted their children to be in the medical industry. The recognition of the current status of the DPR did not affect the GP’s preference for their children's practice (p<0.05). Most MP hoped to improve salaries (40.26%), followed by safety (17.53%) and social status (12.99%); only 8.44% of the MP wanted to improve the DPR. Conclusion: The MP’s and GP’s views on the current status of DPR, the importance of medical service attitudes, and the general sense of the medical industry were similar. However, there was a significant difference in the perception of the nature of medical services and the income of the people employed in the medical industry between the two groups. Balancing the expectations of patients in the medical industry and increasing public awareness of the actual situation in the medical industry may be a feasible way to improve the DPR.
A 4-gene signature predicts prognosis of uterine serous carcinoma
Authors: Chen Hui , Li Lingjun , Qin Ping , Xiong Hanzhen , Chen Ruichao , Zhang Minfen , Jiang Qingping
Published: September 2020

Background: Uterine serous carcinoma (USC) is an aggressive type of endometrial cancer that accounts for up to 40% of endometrial cancer deaths, creating an urgent need for prognostic biomarkers. Methods: USC RNA-Seq data and corresponding patients’ clinical records were obtained from The Cancer Genome Atlas and Genotype-Tissue Expression datasets. Univariate cox, Lasso, and Multivariate cox regression analyses were conducted to forge a prognostic signature. Multivariable and univariable cox regression analysis and ROC curve evaluated the prediction efficiency both in the training and testing sets. Results: We uncovered 1385 genes dysregulated in 110 cases of USC tissue relative to 113 cases of normal uterine tissue. Functional enrichment analysis of these genes revealed the involvement of various cancer-related pathways in USC. A novel 4‐gene signature (KRT23, CXCL1, SOX9 and ABCA10) of USC prognosis was finally forged by serial regression analyses. Overall patient survival (OS) and recurrence-free survival (RFS) were significantly lower in the high-risk group relative to the low-risk group in both the training and testing sets. The area under the ROC curve of the 4-gene signature was highest among clinicopathological features in predicting OS and RFS. The 4-gene signature was found to be an independent prognostic indicator in USC and was a superior predictor of OS in early stage of USC. Conclusions: Our findings highlight the potential of the 4-gene signature as a guide for personalized USC treatment.
Comparison Between the Velocity-specific Exercise and Isometric Exercise on Neck Muscle Functions and Performance: A Randomised Clinical Trial
Authors: Tsang Sharon Man Ha , Chan Kenneth TK , Ho Parco LT , Kwok Jacky CY , Tse Daniel HT , Tsoi Henry HT
Published: September 2020

Background: Evidences showed that the additional benefits of velocity-specific exercise for improving functions of peripheral joint muscles. Its effects for spinal muscles is yet to be investigated. This study aimed to compare the effects of velocity-specific exercise to isometric exercise on cervical muscle functions and performance in healthy adults.Methods: Thirty healthy adults received either a 6-week velocity-specific (VSE, n=15) or isometric exercise program (IE, n=15) of their neck muscles. Cervical muscle functions and performance were assessed pre- and post-program, using isokinetic assessment, electromyography and cross-sectional area assessment of deep neck muscles. A self-reported level of difficulty and post-exercise soreness was also recorded during the program.Results: Both exercises programs showed significant increase in cross-sectional area of longus colli and semispinalis capitis; EMG amplitude in sternocleidomastoid and cervical erector spinae, and flexion and extension torque values, at reassessment, without between-groups difference. However, correlation between extension torque and EMG amplitude of cervical erector spinae increased in both groups and a significant correlation found in VSE group post-program. No significant differences found between groups on the self-reported scales.Conclusions: Both exercises promoted cervical muscle functions and performance significantly with velocity-specific exercise contributes to a greater enhancement of torque production efficiency of superficial neck muscles. This novel exercise may consider as a safe alternative for neck muscle rehabilitation. Further study to examine the effects of velocity-specific exercise in symptomatic individuals to unravel its potential application and benefit for promoting the functional recovery is recommended.
An Automatic Estimation of the Rest-Interval for MotionWatch8© Using Uniaxial Movement and Lux Data
Authors: Backhouse Daniel , Falck Ryan Stanley , Liu-Ambrose Teresa
Published: September 2020

Background: Poor sleep is linked with chronic conditions common in older adults, including diabetes, heart disease, and dementia. Valid and reliable field methods to objectively measure sleep are thus greatly needed to examine how poor sleep impacts older adults. Wrist-worn actigraphy (WWA) is a common objective measure of sleep that uses motion and illuminance data to estimate sleep. The rest-interval marks the time interval between when an individual attempts to sleep and the time they get out of bed to start their day. Traditionally, the rest-interval is scored manually by trained technicians, however algorithms currently exist which automatically score WWA data, saving time and providing consistency from user-to-user. However, these algorithms ignore illuminance data and only considered motion in their estimation of the rest-interval. This study therefore examines a novel algorithm that uses illuminance data to supplement the approximation of the rest-interval from motion data. Methods: We examined a total of 1086 days of data of 129 participants who wore the MotionWatch8© WWA for ≥14 nights of observation. Resultant sleep measures from three different parameter settings were compared to sleep measures derived following a standard scoring protocol and self-report times. Results: The algorithm showed the strongest correlation to the standard protocol (r= 0.92 for sleep duration). There were no significant differences in sleep duration, sleep efficiency and fragmentation index estimates compared to the standard scoring protocol. Conclusion: These results suggest that an automated rest-interval scoring method using both light exposure and acceleration data provides comparable accuracy to the standard scoring method.
Facilely reducing recalcitrance of lignocellulosic biomass by a newly developed ethylamine based deep eutectic solvent for biobutanol fermentation
Authors: Xu Guochao , Li Hao , Xing Wanru , Gong Lei , Dong Jinjun , Ni Ye
Published: September 2020

Background: Biobutanol is promising and renewable alternative to traditional fossil fuels and could be produced by Clostridium species from lignocellulosic biomass. However, biomass is recalcitrant to be hydrolyzed into fermentable sugars attributed to the densely packed structure by layers of lignin. Development of pretreatment reagents and processes for increasing surface area, removing hemicellulose and lignin, and enhancing the relative content of cellulose is currently an area of great interest. Deep eutectic solvents (DESs), a new class of green solvents, are effective in the pretreatment of lignocellulosic biomass. However, it remains challenging to achieve high titers of total sugars and usually requires combinatorial pretreatment with other reagents. In this study, we aim to develop novel DESs with high application potential in biomass pretreatment and high biocompatibility for biobutanol fermentation.Results: Several DESs with betaine chloride and ethylamine chloride (EaCl) as hydrogen bond acceptors were synthesized. Among them, EaCl:LAC with lactic acid as hydrogen bond donor displayed the best performance in the pretreatment of corncob. Only by single pretreatment with EaCl:LAC, total sugars of as high as 53.5 g·L–1 could be reached. Consecutive batches for pretreatment of corncob were performed using gradiently decreased cellulase by 5 FPU·g–1. At the end of the sixth batch, the concentration and specific yield of total sugars were 58.8 g·L–1 and 706 g·kg–1 pretreated corncob, saving a total of 50% cellulase. Utilizing hydrolysate as carbon source, butanol titer of 10.4 g·L–1 was achieved with butanol yield of 137 g·kg–1 pretreated corncob by Clostridium saccharobutylicum DSM13864.Conclusions: Ethylamine and lactic acid based deep eutectic solvent is promising in pretreatment of corncob with high total sugar concentrations and compatible for biobutanol fermentation. This study provides an efficient pretreatment reagent for facilely reducing recalcitrance of lignocellulosic materials and a promising process for biobutanol fermentation from renewable biomass.
Quarantine At Home May Not Enough!-From the Epidemiological Data In Shaanxi Province of China
Authors: Shi Lei , Li Qian , Li Kang , Zheng Jie , He Yingli , Zhang Xi , Gong Xianfeng , Wang Wei , Zhang Qing , Dai Chao , Zhao Wenxuan , Meng Xuefei , Du Feng , Fan Pei , Li Chunyan , Gao Chunyan , Yang Yuan , Liu Xiaojing , Chen Yunru , Liu Jinfeng , Li Jianzhou , Yang Nan , Niu Yinghua , Chen Hongmei , Zhang Guoyu , Yan Taotao , Zhu Li , Han Qunying , Fan Wanhu , Ye Feng , Liu Zhengwen , Lin Shumei , Zhao Yingren , Chen Tianyan
Published: September 2020

Objectives: A pneumonia associated with 2019 novel coronavirus (2019-nCoV, subsequently named SARS-CoV2) emerged worldwide since December, 2019. We aimed to describe the epidemiological characteristics of 2019 coronavirus disease (COVID-19) in Shaanxi province of China. Results: 1. Among the 245 patients, 132 (53.9%) were males and 113 (46.1%) were females. The average age was 46.15±16.43 years, ranging from 3 to 89 years. 2. For the clinical type, 1.63% (4/245) patients were mild type , 84.90% (208/245) were moderate type, 7.76% (19/245) were severe type, 5.31% (13/245) were critical type and only 0.41% (1/245) was asymptomatic. 3. Of the 245 patients, 116 (47.35%) were input case, 114 (46.53%) were non-input case , and 15 (6.12%) were unknown exposure. 4. 48.57% (119/245) cases were family cluster , involving 42 families. The most common pattern of COVID-19 family cluster was between husband and wife or between parents and children.