bluuebunny/crossref_metadata_2025 huggingface dataset:
Canada’s response to international travel during COVID-19 pandemic – a media analysis
Authors: Reddy K. Srikanth , Mithani Salima S. , Wilson Lindsay , Wilson Kumanan
Published: May 2021

Background

The media play a critical role in informing the public about the COVID-19 pandemic. Throughout the pandemic, international travel has been a highly contested subject at both the international and national levels. We examined Canadian media reporting on international travel restrictions during the pandemic, how these restrictions aligned with the International Health Regulations (IHR 2005), and how the narrative around international travel evolved over time.

Methods

We analysed articles from Canada’s top three national newspapers by circulation – The Globe and Mail, The National Post and The Toronto Star - published between Jan 1, 2020 - May 31, 2020. Our search yielded a total of 378 articles across the three newspapers. After removing duplicates and screening the remaining articles, we included a total of 62 articles for the analysis. We conducted a qualitative media content analysis by using an inductive coding approach.

Results

Three major themes were identified within the articles. These included: 1) The role of scientific and expert evidence in implementing travel restrictions; 2) Federal legislation, regulation and enforcement of international travel measures; and 3) Compliance with World Health Organization (WHO) guidelines in travel restriction policy- and decision-making. The federal government relied primarily on scientific evidence for implementing international travel restrictions and fully exercised its powers under the Quarantine Act to enforce travel regulations and comply with the IHR 2005. The government embraced a rules-based international order by following WHO recommendations on international travel, contributing to a delay in border closure and travel restrictions until mid-March.

Conclusion

The media focussed significantly on international travel-related issues during the early phase of the pandemic. The dominant media narrative surrounded the need for earlier travel restrictions against international travel.
Targeting the hallmarks of cancer: the effects of silibinin on proliferation, cell death, angiogenesis, and migration in colorectal cancer
Authors: Sameri Saba , Mohammadi Chiman , Mehrabani Mehrnaz , Najafi Rezvan
Published: May 2021

Background

Silibinin, as a chemopreventive agent, has shown anti-cancer efficacy against different types of cancers. In the present study, we investigated the anti-cancer activities of silibinin on CT26 mouse colon cell line.

Methods

CT26 cells were treated with different concentrations of silibinin. To examine the cytotoxic effect of silibinin on proliferation, apoptosis, autophagy, angiogenesis, and migration, MTT, colony-forming assay, Annexin V/PI flow cytometry, RT-qPCR, and Scratch assay were used.

Results

Silibinin was found to significantly reduce CT26 cells survival. Furthermore, silibinin strongly induced apoptosis and autophagy by up-regulating the expression of Bax, Caspase-3, Atg5, Atg7 and BECN1 and down-regulating Bcl-2. Silibinin considerably down-regulated the expression of COX-2, HIF-1α, VEGF, Ang-2, and Ang-4 as well as the expression of MMP-2, MMP-9, CCR-2 and CXCR-4.

Conclusions

The present study revealed that silibinin shows anticancer activities by targeting proliferation, cell survival, angiogenesis, and migration of CT26 cells.
Participatory geographic mapping and activity space diaries: innovative data collection methods for understanding environmental risk exposures among female sex workers in a low-to middle-income country
Authors: Felker-Kantor Erica , Polanco Caluz , Perez Martha , Donastorg Yeycy , Andrinopoulos Katherine , Kendall Carl , Kerrigan Deanna , Theall Katherine P.
Published: May 2021

Background

A common approach for measuring place-based exposure is to use geographically-defined administrative boundaries and to link neighborhood characteristics at this level. This approach, however, may not be feasible in low-to middle-income countries where neighborhood-level data are limited or unavailable, and administrative boundaries are often unstandardized and not proportional to population size. Furthermore, such traditional approaches may not be appropriate for marginalized populations whose environments can be more difficult to study. In this paper, we describe two innovative and feasible methods to generate geospatial data to characterize and assess the role of risk environments on drug use among female sex workers living with HIV in the Dominican Republic.

Methods

Participatory geographic mapping and daily activity space travel diaries were employed.

Results

The methods presented in this study were feasible to implement, acceptable by study participants, and yielded rich geospatial data to analyze the impact of contextual factors on risk behaviors of female sex workers in a low-to middle-income country.

Conclusion

Participatory geographic mapping and activity space diaries are two alternative methods for collecting geospatial data among hard-to-reach populations in resource constrained settings. Moreover, the methods are interactive and educational, allowing study participants to take an active role in the data collection process and potentially allowing for a deeper understanding of place-based effects on health and behavior.
Measurement properties of the 12-item Short Form Health Survey version 2 in Australians with lung cancer: a Rasch analysis
Authors: Soh Sze-Ee , Morello Renata , Ayton Darshini , Ahern Susannah , Scarborough Ri , Zammit Claire , Brand Margaret , Stirling Robert G. , Zalcberg John
Published: May 2021

Background

The 12-item Short-Form Health Survey version 2 (SF-12v2), a widely used, generic patient-reported measure of health status that provides summary scores of physical and mental health. No study to date has examined the measurement properties of the SF-12v2 in patients with lung cancer using Rasch analysis. The aim of this study was to extend the psychometric evaluations of the SF-12 within the lung cancer population to ensure its validity and reliability to assess the health status in this population.

Methods

Participants in the Victorian Lung Cancer Registry (VLCR) who completed the SF-12v2 between 2012 and 2016 were included in this study. The structural validity of the SF-12v2 was assessed using Rasch analysis. Overall fit to the Rasch measurement model was examined as well as five key measurement properties: uni-dimensionality, response thresholds, internal consistency, measurement invariance and targeting.

Results

A total of 342 participants completed the SF-12v2 three months following their lung cancer diagnosis. The SF-12 Physical Component Score (PCS-12) did not fit the overall Rasch measurement model (χ2107.0;p < 0.001). Three items deviated significantly from the Rasch model (item fit residual beyond ± 2.5) with signs of dependency between item responses and disordered thresholds. Nevertheless, the PCS-12 was uni-dimensional with good internal consistency (person separation index [PSI] 0.83) and reasonable targeting. In contrast, the SF-12 Mental Component Score (MCS-12) had good overall model fit (χ235.1;p = 0.07), reasonable targeting and good internal consistency (PSI 0.81).

Conclusions

Rasch analysis suggests that there is general support for the reliability of the SF-12v2 as a measure of physical and mental health in people with lung cancer. However, the appropriateness of some items (e.g. pain) in the PCS-12 is questionable and further refinement of the scale including changing the response options may be required to improve the ability of the SF-12v2 to more appropriately assess the health status of this population.
A large-scale investigation into the role of classical HLA loci in multiple types of severe infections, with a focus on overlaps with autoimmune and mental disorders
Authors: Nudel Ron , Allesøe Rosa Lundbye , Thompson Wesley K. , Werge Thomas , Rasmussen Simon , Benros Michael E.
Published: May 2021

Background

Infections are a major disease burden worldwide. While they are caused by external pathogens, host genetics also plays a part in susceptibility to infections. Past studies have reported diverse associations between human leukocyte antigen (HLA) alleles and infections, but many were limited by small sample sizes and/or focused on only one infection.

Methods

We performed an immunogenetic association study examining 13 categories of severe infection (bacterial, viral, central nervous system, gastrointestinal, genital, hepatitis, otitis, pregnancy-related, respiratory, sepsis, skin infection, urological and other infections), as well as a phenotype for having any infection, and seven classical HLA loci (HLA-A, B, C, DPB1, DQA1, DQB1andDRB1). Additionally, we examined associations between infections and specific alleles highlighted in our previous studies of psychiatric disorders and autoimmune disease, as these conditions are known to be linked to infections.

Results

Associations between HLA loci and infections were generally not strong. Highlighted associations included associations between DQB1*0302 and DQB1*0604 and viral infections (P = 0.002835 and P = 0.014332, respectively), DQB1*0503 and sepsis (P = 0.006053), and DQA1*0301 with “other” infections (a category which includes infections not included in our main categories e.g. protozoan infections) (P = 0.000369). Some HLA alleles implicated in autoimmune diseases showed association with susceptibility to infections, but the latter associations were generally weaker, or with opposite trends (in the case ofHLA-Calleles, but not with alleles of HLA class II genes). HLA alleles associated with psychiatric disorders did not show association with susceptibility to infections.

Conclusions

Our results suggest that classical HLA alleles do not play a large role in the etiology of severe infections. The discordant association trends with autoimmune disease for some alleles could contribute to mechanistic theories of disease etiology.
Relevant mediators involved in and therapies targeting the inflammatory response induced by activation of the NLRP3 inflammasome in ischemic stroke
Authors: Xu Qingxue , Zhao Bo , Ye Yingze , Li Yina , Zhang Yonggang , Xiong Xiaoxing , Gu Lijuan
Published: May 2021

The nucleotide-binding oligomerization domain (NOD)-like receptor (NLR) family pyrin domain-containing 3 (NLRP3) inflammasome is a member of the NLR family of inherent immune cell sensors. The NLRP3 inflammasome can detect tissue damage and pathogen invasion through innate immune cell sensor components commonly known as pattern recognition receptors (PRRs). PRRs promote activation of nuclear factor kappa B (NF-κB) pathways and the mitogen-activated protein kinase (MAPK) pathway, thus increasing the transcription of genes encoding proteins related to the NLRP3 inflammasome. The NLRP3 inflammasome is a complex with multiple components, including an NAIP, CIITA, HET-E, and TP1 (NACHT) domain; apoptosis-associated speck-like protein containing a CARD (ASC); and a leucine-rich repeat (LRR) domain. After ischemic stroke, the NLRP3 inflammasome can produce numerous proinflammatory cytokines, mediating nerve cell dysfunction and brain edema and ultimately leading to nerve cell death once activated. Ischemic stroke is a disease with high rates of mortality and disability worldwide and is being observed in increasingly younger populations. To date, there are no clearly effective therapeutic strategies for the clinical treatment of ischemic stroke. Understanding the NLRP3 inflammasome may provide novel ideas and approaches because targeting of upstream and downstream molecules in the NLRP3 pathway shows promise for ischemic stroke therapy. In this manuscript, we summarize the existing evidence regarding the composition and activation of the NLRP3 inflammasome, the molecules involved in inflammatory pathways, and corresponding drugs or molecules that exert effects after cerebral ischemia. This evidence may provide possible targets or new strategies for ischemic stroke therapy.
Clinical effectiveness of the sequential 4-channel NMES compared with that of the conventional 2-channel NMES for the treatment of dysphagia in a prospective double-blind randomized controlled study
Authors: Seo Kyoung-Ho , Jang Joonyoung , Jang Eun Gyeong , Park Yulhyun , Lee So Young , Kim Bo Ryun , Park Donghwi , Park Sungwon , Hwang Hyeoncheol , Kim Nam Hun , Oh Byung-Mo , Seo Han Gil , Lee Jun Chang , Ryu Ju Seok
Published: May 2021

Background

To date, conventional swallowing therapies and 2-channel neuromuscular electrical stimulation (NMES) are standard treatments for dysphagia. The precise mechanism of 2-channel NMES treatment has not been determined, and there are controversies regarding the efficacy of this therapy. The sequential 4-channel NMES was recently developed and its action is based on the normal contractile sequence of swallowing-related muscles.

Objective

To evaluate and compare the rehabilitative effectiveness of the sequential 4-channel NMES with that of conventional 2-channel NMES.

Methods

In this prospective randomized case–control study, 26 subjects with dysphagia were enrolled. All participants received 2- or 4-channel NMES for 2–3 weeks (minimal session: 7 times, treatment duration: 300–800 min). Twelve subjects in the 4-channel NMES group and eleven subjects in the 2-channel NMES group completed the intervention. Initial and follow-up evaluations were performed using the videofluoroscopic dysphagia scale (VDS), the penetration-aspiration scale (PAS), the MD Anderson dysphagia inventory (MDADI), the functional oral intake scale (FOIS), and the Likert scale.

Results

The sequential 4-channel NMES group experienced significant improvement in their VDS (oral, pharyngeal, and total), PAS, FOIS, and MDADI (emotional, functional, and physical subsets) scores, based on their pretreatment data. VDS (oral, pharyngeal, and total) and MDADI (emotional and physical subsets) scores, but not PAS and FOIS scores, significantly improved in the 2-channel NMES group posttreatment. When the two groups were directly compared, the 4-channel NMES group showed significant improvement in oral and total VDS scores.

Conclusions

The sequential 4-channel NMES, through its activation of the suprahyoid and thyrohyoid muscles, and other infrahyoid muscles mimicking physiological activation, may be a new effective treatment for dysphagia.

Trial registration: clinicaltrial.gov, registration number: NCT03670498, registered 13 September 2018, https://clinicaltrials.gov/ct2/show/NCT03670498?term=NCT03670498&draw=2&rank=1.
Existence results for coupled nonlinear fractional differential equations of different orders with nonlocal coupled boundary conditions
Authors: Alsaedi Ahmed , Hamdan Soha , Ahmad Bashir , Ntouyas Sotiris K.
Published: May 2021

This paper is concerned with the solvability of coupled nonlinear fractional differential equations of different orders supplemented with nonlocal coupled boundary conditions on an arbitrary domain. The tools of the fixed point theory are applied to obtain the criteria ensuring the existence and uniqueness of solutions of the problem at hand. Examples illustrating the main results are presented.
Disruption of orbitofrontal-hypothalamic projections in a murine ALS model and in human patients
Authors: Bayer David , Antonucci Stefano , Müller Hans-Peter , Saad Rami , Dupuis Luc , Rasche Volker , Böckers Tobias M. , Ludolph Albert C. , Kassubek Jan , Roselli Francesco
Published: May 2021

Background

Increased catabolism has recently been recognized as a clinical manifestation of amyotrophic lateral sclerosis (ALS). The hypothalamic systems have been shown to be involved in the metabolic dysfunction in ALS, but the exact extent of hypothalamic circuit alterations in ALS is yet to be determined. Here we explored the integrity of large-scale cortico-hypothalamic circuits involved in energy homeostasis in murine models and in ALS patients.

Methods

The rAAV2-based large-scale projection mapping and image analysis pipeline based on Wholebrain and Ilastik software suites were used to identify and quantify projections from the forebrain to the lateral hypothalamus in the SOD1(G93A) ALS mouse model (hypermetabolic) and the FusΔNLS ALS mouse model (normo-metabolic). 3 T diffusion tensor imaging (DTI)-magnetic resonance imaging (MRI) was performed on 83 ALS and 65 control cases to investigate cortical projections to the lateral hypothalamus (LHA) in ALS.

Results

Symptomatic SOD1(G93A) mice displayed an expansion of projections from agranular insula, ventrolateral orbitofrontal and secondary motor cortex to the LHA. These findings were reproduced in an independent cohort by using a different analytic approach. In contrast, in the FusΔNLS ALS mouse model hypothalamic inputs from insula and orbitofrontal cortex were maintained while the projections from motor cortex were lost. The DTI-MRI data confirmed the disruption of the orbitofrontal-hypothalamic tract in ALS patients.

Conclusion

This study provides converging murine and human data demonstrating the selective structural disruption of hypothalamic inputs in ALS as a promising factor contributing to the origin of the hypermetabolic phenotype.
Platelet-driven coagulopathy in COVID-19 patients: in comparison to seasonal influenza cases
Authors: Zhang Jianguo , Huang Xing , Ding Daoyin , Tao Zhimin
Published: May 2021

Background

One year into the coronavirus diseases 2019 (COVID-19) pandemic we analyzed the blood coagulopathy in severe and non-severe COVID-19 patients and linked to those of influenza patients for a comparative study.

Methods

We reported 461 COVID-19 patients and 409 seasonal influenza patients admitted at separated medical centers. With their demographic data and medical history, hematological profiles with coagulation characters were emphasized, and compared between two cohorts before and after treatment.

Results

For 870 patients included in this study, their median age was (64.0, 51.0–76.0), and among them 511 (58.7%) were male. Hypertension, diabetes, cardiovascular diseases, and bronchitis constituted the leading comorbidities. Upon hospital admission blood test results differentiated COVID-19 patients from influenza cases, and for COVID-19 patients, leukocytosis, neutrophilia, lymphocytopenia, and thrombocytopenia were associated with disease severity and mortality. In addition, COVID-19 cohort demonstrated a prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), increased INR, shortened thrombin time and decreased fibrinogen, compared to those in influenza cohort, leaving D-dimer levels indistinguishably high between both cohorts. Platelet hyperreactivity in COVID-19 is more evident, associated with worse hyper-inflammatory response and more refractory coagulopathy. For severe COVID-19 patients administered with anticoagulants, bleeding incidence was substantially higher than others with no anticoagulant medications.

Conclusions

Comparison of coagulation characteristics between COVID-19 and influenza infections provides an insightful view on SARS-CoV-2 pathogenesis and its coagulopathic mechanism, proposing for therapeutic improvement.
Dynamics of the terrestrial radiation belts: a review of recent results during the VarSITI (Variability of the Sun and Its Terrestrial Impact) era, 2014–2018
Authors: Kanekal Shrikanth , Miyoshi Yoshizumi
Published: May 2021

The Earth’s magnetosphere is region that is carved out by the solar wind as it flows past and interacts with the terrestrial magnetic field. The inner magnetosphere is the region that contains the plasmasphere, ring current, and the radiation belts all co-located within about 6.6 Re, nominally taken to be bounding this region. This region is highly dynamic and is home to a variety of plasma waves and particle populations ranging in energy from a few eV to relativistic and ultra-relativistic electrons and ions. The interplanetary magnetic field (IMF) embedded in the solar wind via the process of magnetic reconnection at the sub-solar point sets up plasma convection and creates the magnetotail. Magnetic reconnection also occurs in the tail and is responsible for explosive phenomena known as substorms. Substorms inject low-energy particles into the inner magnetosphere and help generate and sustain plasma waves. Transients in the solar wind such as coronal mass ejections (CMEs), co-rotating interaction regions (CIRs), and interplanetary shocks compress the magnetosphere resulting in geomagnetic storms, energization, and loss of energetic electrons in the outer radiation belt nad enhance the ring current, thereby driving the geomagnetic dynamics. The Specification and Prediction of the Coupled Inner-Magnetospheric Environment (SPeCIMEN) is one of the four elements of VarSITI (Variability of the Sun and Its Terrestrial Impact) program which seeks to quantitatively predict and specify the inner magnetospheric environment based on Sun/solar wind driving inputs. During the past 4 years, the SPeCIMEN project has brought together scientists and researchers from across the world and facilitated their efforts to achieve the project goal. This review provides an overview of some of the significant scientific advances in understanding the dynamical processes and their interconnectedness during the VarSITI era. Major space missions, with instrument suites providing in situ measurements, ground-based programs, progress in theory, and modeling are briefly discussed. Open outstanding questions and future directions of inner magnetospheric research are explored.
Drug-related problems and its determinant among hospitalized neonates with sepsis at Jimma University Medical Center, Ethiopia: a prospective observational study
Authors: Awoke Mengist , Melaku Tsegaye , Beshir Mohammed
Published: May 2021

Background

Neonatal populations are quite susceptible to drug-related problems (DRPs) because of clinical heterogeneity and clinical practice trends. However, studies reporting DRPs in the neonatal population are quite limited.

Objective

This study aimed to assess the magnitude and types of DRPs and determinant factors among neonates admitted with neonatal sepsis at the Neonatal Intensive Care Unit (NICU) of the Jimma University Medical Center (JUMC), Ethiopia.

Methods

A hospital-based prospective observational study was conducted involving 201 neonates with sepsis admitted to the NICU from May to August 30, 2018. DRPs were classified using Cipolle’s classification method. Statistical Package for Social Science Version 22 was employed for data analysis. Logistical regression was carried out to determine the determinants of DRPs. A p-value < 0.05 was considered to be statistically significant.

Results

Of 201 neonates with sepsis included in this study, 125 (62.2%) were males and the median age of the neonate was 5 days. The mean (±standard deviation) number of medications taking during their hospital stay was 2.6 ± 0.7. DRPs were identified in 98 neonates, at a rate of 48.8% (95% CI, 41.7–55.9). Dose too high (42, 35.8%) and need additional drug therapy (40, 34.1%) were the commonly identified DRPs. Taking antibiotics plus other medications (Adjusted Odds Ratio (AOR) =5.2, 95%CI [1.2–22.0], p = 0.02) was a determinant factor for the occurrence of DRPs.

Conclusion

The burdens of DRPs occurrence were high in hospitalized neonates with sepsis. The most common DRPs identified were dose too high and need additional drug therapy. Combined use of other medicines with antibiotics was a predictor of DRP occurrence. The innovative way to tackle the occurrence of DRPs, such as the incorporation of clinical pharmacy service provider into the neonatal care team, which will prevent, detect and/or minimize the occurrence of DRPs, is highly recommended.
Enhancement and evaluation of a prescription audit system for direct oral anticoagulants using a check sheet
Authors: Ishikawa Naoto , Oshikiri Hanae , Takasaki Shinya , Kikuchi Masafumi , Obara Taku , Akasaka Kazutoshi , Matsuura Masaki , Yamaguchi Hiroaki , Mano Nariyasu
Published: May 2021

Background

Renal function and use of concomitant medications should be carefully monitored in patients subjected to treatment with direct oral anticoagulants (DOACs); the dose should be individually designed for each patient. Owing to the complex therapeutic indications and dose reduction criteria, pharmacists exercise caution when determining the optimal dose for each patient. A DOAC check sheet has been developed that is automatically printed in the dispensing room at the same time as the prescription and can be used by pharmacists to dispense DOACs promptly and correctly. The purpose of this study was to evaluate the system for dispensing DOACs using a check sheet.

Methods

The study was conducted at Tohoku University Hospital in Japan; prescriptions containing DOACs dispensed by the hospital pharmacists were evaluated. The DOAC check sheet described indications, dosage regimens, dose reduction criteria, and contraindications for each drug and included the patient’s information. The check sheet was set to print automatically in the dispensing room at the same time as the prescription when an inpatient was prescribed DOACs. This check sheet was evaluated using a prescription survey and a questionnaire for pharmacists.

Results

The usefulness of this check sheet for the correct use of DOACs was evaluated. There were four inquiries out of 642 (0.6%) prescriptions from pharmacists to physicians regarding DOAC prescriptions, such as the dose introduced before DOAC check sheet utilization, and there were 21 out of 905 (2.3%) prescriptions when the DOAC check sheet was used it, showing a significant increase (p = 0.0089). After the introduction of this sheet, overdoses of DOACs were identified at the time of dispensing. Of the 52 pharmacists who responded to the questionnaire, 51 (98%) stated that the check sheet was useful.

Conclusion

The use of the DOAC check sheet is likely to render safety to DOAC drug therapy for individual patients.
Contraceptive prevalence rate and associated factors among reproductive age women in four emerging regions of Ethiopia: a mixed method study
Authors: Bekele Delayehu , Surur Feiruz , Nigatu Balkachew , Teklu Alula , Getinet Tewodros , Kassa Munir , Gebremedhin Merhawi , Gebremichael Berhe , Abesha Yonas
Published: May 2021

Background

Ethiopia is the second most populous country in Africa, known for its high fertility and low contraceptive use. The magnitude of contraceptive use in the emerging regions of the country is below the national average. However, there is a paucity of evidence regarding the reasons for low contraceptive use in these regions. Therefore, this study aimed to assess contraceptive use and associated factors in the emerging regions of Ethiopia.

Methods

For the quantitative part, a community based cross-sectional study was conducted among 2891 reproductive age women who were selected by multistage sampling technique. Data were collected face to face using an open data kit software, and STATA version 14 was used for data analysis. Frequencies, percentages, summary measures and tables were used to summarize and present the data. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with contraceptive use, by computing odds ratio with 95% confidence interval. Level of significance was considered at p-value < 0.05. For the qualitative part, phenomenological study was conducted among 252 health care workers and community members who were selected purposely. The data were collected by focused group discussions, in-depth interviews and key informant interviews. The data were audio-recorded in the local languages, and then translated to English verbatim. NVivo version 11 was used to analyze the data through a thematic analysis method.

Results

The overall contraceptive prevalence rate was 22.2%; with 11.7, 38.6, 25.5 and 8.8% for Afar, Benshangul Gumuz, Gambela and Somali Regions, respectively. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. Additionally, the qualitative study identified three themes as barriers to contraceptive use: individual, health care system and sociocultural factors.

Conclusions

Contraceptive prevalence rate was low in this study compared to the national average. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. From the qualitative aspect, individual, health care system and sociocultural factors were identified as barriers to contraceptive use. Therefore, the emerging regions of Ethiopia need special focus in increasing contraceptive use through behavioral influence/change.
Development and double cross-validation of new spot urine sodium equation to predict 24-h urine sodium in the Malaysian population
Authors: Othman Fatimah , Ambak Rashidah , Omar Mohd Azahadi , Shahar Suzana , Nor Noor Safiza Mohd , Ahmad Mohamad Hasnan , Yusoff Muhammad Fadhli Mohd , Haron Hasnah , Noh Mohd Fairulnizal Md , Aris Tahir
Published: May 2021

Background

Monitoring sodium intake through 24-h urine collection sample is recommended, but the implementation of this method can be difficult. The objective of this study was to develop and validate an equation using spot urine concentration to predict 24-h sodium excretion in the Malaysian population.

Methods

This was a Malaysian Community Salt Study (MyCoSS) sub-study, which was conducted from October 2017 to March 2018. Out of 798 participants in the MyCoSS study who completed 24-h urine collection, 768 of them have collected one-time spot urine the following morning. They were randomly assigned into two groups to form separate spot urine equations. The final spot urine equation was derived from the entire data set after confirming the stability of the equation by double cross-validation in both study groups. Newly derived spot urine equation was developed using the coefficients from the multiple linear regression test. A Bland-Altman plot was used to measure the mean bias and limits of agreement between estimated and measured 24-h urine sodium. The estimation of sodium intake using the new equation was compared with other established equations, namely Tanaka and INTERSALT.

Results

The new equation showed the least mean bias between measured and predicted sodium, − 0.35 (− 72.26, 71.56) mg/day compared to Tanaka, 629.83 (532.19, 727.47) mg/day and INTERSALT, and 360.82 (284.34, 437.29) mg/day. Predicted sodium measured from the new equation showed greater correlation with measured sodium (r = 0.50) compared to Tanaka (r =0.24) and INTERSALT (r = 0.44), P < 0.05.

Conclusion

Our newly developed equation from spot urine can predict least mean bias of sodium intake among the Malaysian population when 24-h urine sodium collection is not feasible.
Sodium intake assessed by 24-h urine excretion and its relationship with anthropometric measurements in Malaysian adults
Authors: Sallehuddin Syafinaz Mohd , Ambak Rashidah , Othman Fatimah , Aziz Nur Shahida Abd , Palaniveloo Lalitha , Nor Noor Safiza Mohd , Jamaluddin Rasidah , Baharudin Azli , Zaki Nor Azian Mohd , Ahmad Mohamad Hasnan
Published: May 2021

Background

Sodium intake is associated with anthropometric measurement including weight, waist circumference (WC), and body mass index (BMI). Higher intake of sodium is usually linked to higher risk of obesity among adults globally, especially in developing countries. This study aims to explore the probable relationship between sodium intake by 24-h urine excretion assessment and anthropometric measurement of adults in Malaysia.

Methods

A cross-sectional study was conducted from October 2017 to March 2018 using a multi-stage stratified sampling method among Malaysian adults aged 18 years old and above. Sodium intake was determined by 24-h urinary sodium excretion, estimated from the respondents’ 24-h urinary sample. Height was obtained based on standard protocol. Weight and WC were measured twice using validated anthropometric equipment and BMI was calculated according to World Health Organization (WHO) 1998 classification. Descriptive analysis was done to describe socio-demographic characteristics. A simple linear regression and multiple linear regression tests were done to assess the relationship of 24-h urinary excretion and anthropometric measurement. All statistical analysis was done using SPSS version 22.0.

Results

Of 1047 interviewed respondents, 798 respondents had done the 24-h urine collection (76.0% response rate). Majority was between 40 and 59 years old (43.5%) and married (77.7%). Simple linear regression showed a significant positive linear association between 24-h urinary excretion and household income, WC, and obese group. In the multivariate analysis, it was indicated that, an increase of 1 unit of BMI will significantly increase the sodium intake by 129.20 mg/dl and an increase of 1 cm of WC will significantly increase the sodium intake by 376.45 mg/dl.

Conclusion

Our study showed a positive significant relationship between sodium intake estimated by 24-h urinary sodium excretion and BMI of Malaysian adults. More research is suggested on how sodium control can potentially contribute to obesity prevention.
Knowledge, attitude and behaviour on salt intake and its association with hypertension in the Malaysian population: findings from MyCoSS (Malaysian Community Salt Survey)
Authors: Baharudin Azli , Ambak Rashidah , Othman Fatimah , Michael Viola , Cheong Siew Man , Mohd. Zaki Nor Azian , Abdul Aziz Nur Shahida , Mohd. Sallehuddin Syafinaz , Ganapathy Shubash Shander , Palaniveloo Lalitha , He Feng J.
Published: May 2021

Background

High blood pressure or hypertension has become one of the main health problems, worldwide. A number of studies have proven that an increased intake of salt was related to an increased prevalence of cardiovascular diseases. Of late, its relationship with high salt intake has received a lot of attention. Studies in Malaysia have shown both rising hypertension over time as well as high salt consumption. Actions to reduce salt intake are essential to reduce hypertension and its disease burden. As such, we carried out a study to determine associations between knowledge, attitude and behaviour towards salt intake and hypertension among the Malaysian population.

Methods

Data obtained from the Malaysian Community Salt Survey (MyCoSS) was used partially for this study. The survey used a cross-sectional two-stage sampling design to select a nationally representative sample of Malaysian adults aged 18 years and above living in non-institutional living quarters (LQ). Face-to-face interviews were done by trained research assistants (RA) to obtain information on sociodemography, medical report, as well as knowledge, attitude and behaviour of the respondents towards salt intake and blood pressure.

Results

Majority of the respondents have been diagnosed with hypertension (61.4%) as well as knowledge of the effects of high salt intake on blood pressure (58.8%). More than half of the respondents (53.3%) said they controlled their salt intake on a regular basis. Those who knew that a high salt diet could contribute to a serious health problem (OR=0.23) as well as those who controlled their salt intake (OR=0.44) were significantly less likely to have hypertension.

Conclusion

Awareness of the effects of sodium on human health, as well as the behaviour of controlling salt intake, is essential towards lowering the prevalence of hypertension among Malaysians.
Low potassium intake and its association with blood pressure among adults in Malaysia: findings from the MyCoSS (Malaysian Community Salt Survey)
Authors: Palaniveloo Lalitha , Ambak Rashidah , Othman Fatimah , Mohd Zaki Nor Azian , Baharudin Azli , Abdul Aziz Nur Shahida , Salleh Ruhaya
Published: May 2021

Background

High blood pressure or hypertension is well recognized as an important modifiable risk factor for cardiovascular diseases. Several studies had indicated potassium intake has a blood pressure lowering effect. This study aimed to estimate potassium intake via 24-h urinary potassium excretion and to determine the association between potassium intake and blood pressure among adults in Malaysia.

Methods

Data for 424 respondents in this study were drawn from MyCoSS, a nationwide cross- sectional study conducted among Malaysians who were 18 years and above. Respondents were recruited using stratified cluster sampling, covering urban and rural areas in each state in Malaysia. Data collection was undertaken from October 2017 until March 2018. A single urine sample was collected over 24 h for quantification of potassium excreted. Information on socio-demography and medical history of the respondents were collected by interviewer-administered questionnaires. Anthropometric measurements were measured using validated equipment. BMI was estimated using measured body weight and height. Digital blood pressure monitor (Omron HBP-1300) was used to measure blood pressure. Descriptive statistics, analysis of variance (ANOVA), and multivariable linear regression were used to analyze the data in SPSS Version 21.

Results

Mean 24-h urinary potassium excretion for the 424 respondents was 37 mmol (95% CI 36, 38). Gender and ethnicity showed statistically significant associations with 24-h urinary potassium excretion. However, potassium excretion was not significantly associated with blood pressure in this study.

Conclusion

Potassium intake is very low among the adults in Malaysia. Therefore, further education and promotional campaigns regarding daily consumption of potassium-rich diet and its benefits to health need to be tailored for the Malaysian adult population.
Additional cost of end-stage kidney disease in diabetic patients according to renal replacement therapy modality: a systematic review
Authors: Vanorio-Vega Isabella , Constantinou Panayotis , Tuppin Philippe , Couchoud Cécile
Published: May 2021

The prevalence of end-stage kidney disease (ESKD) is growing worldwide; the survival of these patients requires renal replacement therapy (RRT, a complex and costly treatment). Over 20% of the patients that start RTT had diabetes. Limited evidence on the effect of comorbidities on the cost of RRT exists. This review summarizes the available evidence on the effect of diabetes mellitus (DM) on the cost of RRT. Electronic databases were searched using key words that combined RRT with DM and cost. References were identified with title, abstract, and full-text screening. The studies included were published in English and presented data on the cost of RRT in ESKD patients with comparison between DM status. Seventeen studies were included in this review. The crude and adjusted cost of care estimates for patients on dialysis was generally higher for DM patients. The cost of care of ESKD patients differed according to various treatment modalities and these differences, mainly driven by inpatient costs. Overall, we found an increased cost of RRT care in patients with DM regardless of the type of treatment. Future analysis of the effects of multiple comorbidities should be considered to better understand the effect of DM on the cost of RRT.
Sensory trick effect in craniofacial dystonia as one of the possible impacts of wearing face masks during the COVID-19 pandemic
Authors: Erbguth Frank , Lange Rüdiger
Published: May 2021

Background

The report of a patient with blepharospasm during the COVID-19 pandemic suggested a potential ameliorating effect of wearing a face mask.

Objective

We prospectively evaluated a possible symptom change through wearing a face mask in all consecutive patients with craniofacial hyperkinesias in our botulinum toxin outpatient treatment cohort.

Methods

Patients with craniofacial hyperkinesia were asked to rate changes of symptoms between − 2 (markedly worsened), − 1 (slightly worsened), 0 (no change), + 1 (slightly improved) and + 2 (markedly improved).

Results

Of 101 patients (19 with blepharospasm [BSP], 54 with cervical dystonia [CD], 6 with oromandibular dystonia [OMD], and 22 with hemifacial spasm [HFS]) 81 (80%) rated no symptom change, 11 (11%) symptom improvement, and 9 (9%) symptom worsening. Improvements in 9 of the 82 dystonia patients (BSP, CD, OMD) consisted of a perceived decrease in dystonic activity. 33% of dystonia patients had previously noticed or used a sensory trick. Its presence turned out to be a significant predictor of improvement during mask wearing. Deteriorations were attributed from all patients to disturbing effects of the mask interacting with facial muscle overactivity. Improvements in HSF patients were attributed to the symptom-hiding nature of the mask and not to an effect on the spasm activity itself.

Conclusions

Wearing a face mask did not affect self-perceived symptoms in 80% of patients with craniofacial hyperkinesis. 11% of patients reported an improvement, which occurred as sensory trick in dystonia patients and as a concealment of a stigmatizing facial expression in patients with HSF.
Functional model modification of precise point positioning considering the time-varying code biases of a receiver
Authors: Zhang Baocheng , Zhao Chuanbao , Odolinski Robert , Liu Teng
Published: May 2021

Precise Point Positioning (PPP), initially developed for the analysis of the Global Positing System (GPS) data from a large geodetic network, gradually becomes an effective tool for positioning, timing, remote sensing of atmospheric water vapor, and monitoring of Earth’s ionospheric Total Electron Content (TEC). The previous studies implicitly assumed that the receiver code biases stay constant over time in formulating the functional model of PPP. In this contribution, it is shown this assumption is not always valid and can lead to the degradation of PPP performance, especially for Slant TEC (STEC) retrieval and timing. For this reason, the PPP functional model is modified by taking into account the time-varying receiver code biases of the two frequencies. It is different from the Modified Carrier-to-Code Leveling (MCCL) method which can only obtain the variations of Receiver Differential Code Biases (RDCBs), i.e., the difference between the two frequencies’ code biases. In the Modified PPP (MPPP) model, the temporal variations of the receiver code biases become estimable and their adverse impacts on PPP parameters, such as ambiguity parameters, receiver clock offsets, and ionospheric delays, are mitigated. This is confirmed by undertaking numerical tests based on the real dual-frequency GPS data from a set of global continuously operating reference stations. The results imply that the variations of receiver code biases exhibit a correlation with the ambient temperature. With the modified functional model, an improvement by 42% to 96% is achieved in the Differences of STEC (DSTEC) compared to the original PPP model with regard to the reference values of those derived from the Geometry-Free (GF) carrier phase observations. The medium and long term (1 × 104to 1.5 × 104 s) frequency stability of receiver clocks are also significantly improved.
Infantile haemangioma: 5-year experience at the vascular anomaly clinic
Authors: AbouZeid Amr Abdelhamid , Ragab Iman A. , Mohammad Shaimaa Abdelsattar , Ghanem Wael Ahmed , Nasser Haytham Mohamed , El-Naggar Osama
Published: May 2021

Background

Infantile haemangiomas (IH) represent a common benign vascular tumour affecting the paediatric population. Infantile haemangiomas are characterised by a natural history differentiating it from other vascular anomalies. After a transient proliferative phase in early infancy, the tumour passes through a plateau phase before going into spontaneous involution. In this report, we tried to share our experience over the last 5 years in managing cases presenting with IH at a specialised vascular anomaly clinic.

Main body of abstract

This report included cases of IH who were attending the vascular anomaly clinic during the period 2015 through 2019. Data of all patients attending the clinic were retrospectively examined. Files of 103 cases with IH were available for review. The diagnosis of IH was usually straight forward owing to the typical history and characteristic findings at clinical examination. A significant female predominance was noticed. Generally, IH were more common in the head and neck region (70%). Active intervention was necessary in specific situations (eye occlusion, airway involvement, large lesions with skin ulcerations). Whenever intervention proved to be necessary, propranolol was chosen as the first line of treatment with a favourable response detected in about 90% of cases. Surgery was still a valid option (6%) for lesions amenable to resection; however, we must put in consideration that most lesions will spontaneously regress.

Conclusion

Infantile haemangiomas are common benign vascular tumours of infancy with relatively few complications. Cosmesis is a major concern especially for lesions affecting the face. Propranolol can induce tumour regression in most cases, and generally, a favourable outcome can be anticipated.
Chest CT features of COVID-19 pediatric patients presented with upper respiratory symptoms
Authors: Samy Marwa , Khalaf Lamiaa M. R.
Published: May 2021

Background

An outbreak of coronavirus disease 2019 (COVID-19) infection caused by a novel coronavirus began in December 2019 in Wuhan in central China that affect the children and adult and causes respiratory disease. This study aimed to highlight the CT features of pediatric patients with COVID-19 with upper respiratory symptoms.

Results

The mean age of the 53 patients who enrolled in this study were 14.06 ± 4.12 years (range 1-18 years). Majority (75.5%) of them were adolescent. Running nose and fever were the most common symptoms. Forty-four (83%) patients had normal CT with no ground glass opacity (GGO) or consolidation, only 9 patients showed lung opacities; 5 cases showed consolidation, 2 cases with GGO, while consolidation with GGO was noted in another 2 patients. Among these 9 patient, six (66.7%) of them show unilateral lung opacities with peripheral distribution of these opacities in eight (88.9%) patients. The most frequently affected lobes were right and left lower lung lobes that were noted in 6 out of 9 patients with lung opacities (66.7%) in each lobe. Bronchitis was predominant in 23 (43.4%) cases.

Conclusions

RT-PCR is a gold slandered test in the diagnosis of COVID-19 in children with upper respiratory tract symptoms as Chest CT cannot standalone as a diagnostic tool owing to high prevalence of normal chest CT in these patients. However, in case of lung affection, the presence of unilateral, peripheral consolidation with lower lobe predominance, in addition to bronchial wall thickening should be considered as a hallmark of chest CT in diagnosis of pediatric patients with COVID-19 with upper respiratory symptoms.