bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of resistance to pyrethroid and organophosphate adulticides and kdr genotyping in Aedes aegypti populations from Roraima, the Northernmost Brazilian State
Authors: Hayd Ramão Luciano Nogueira , Carrara Luana , Lima Joel de Melo , de Almeida Nathalia Coelho Vargas , Lima José Bento Pereira , Martins Ademir Jesus
Published: April 2020

Background. Roraima, the northernmost State in Brazil, borders Venezuela and Guyana. Although mostly covered by the tropical forests, the urban centers of this State are highly infested with Ae. aegypti and endemic for dengue, Zika and chikungunya. Herein we present the levels of Ae. aegypti infestation and number of arboviruses cases between 2015 and 2018 in the studied localities. We accessed the insecticide resistance status of Ae. aegypti populations from the capital Boa Vista, two cities on international borders (Pacaraima and Bonfim) and Rorainópolis bordering Amazonas State, in order to evaluate the chemical control efficacy in these localities. Methods. Tests with World Health Organization (WHO)-like tubes impregnated with the pyrethroid deltamethrin (0.05 and 0.12%) and the organophosphate malathion (0.7%) were conducted with Ae. aegypti from Boa Vista, Pacaraima, Bonfim and Rorainópolis, collected in 2016 and 2018. Genotyping of kdr mutations, related to resistance to pyrethroids, was performed for the SNP variations in the sites 1016 and 1534 of the voltage gated sodium channel gene (NaV) with a TaqMan qPCR approach. Results. Ae. albopictus was absent in our collections, and therefore only Ae. aegypti was tested. All Ae. aegypti populations were susceptible to 0.7% malathion in 2016, however mortality dropped to under 90% in Bonfim and Pacaraima populations in 2018. All populations were resistant to 0.05% deltamethrin in both years. The time that 50% of females suffered knockdown (KdT50) under exposition to 0.05% deltamethrin was 3.3-5.9 fold longer in mosquitoes from the populations compared to the susceptible strain Rockefeller. Only Pacaraima population (2018) remained resistant to 0.12% deltamethrin. The kdr genotyping revealed the absence of the wild-type NaVS haplotype (1016Val + 1534Phe) in the populations from Roraima, signifying that all tested insects had a genetic background for pyrethroid resistance. The double kdr NaVR2 haplotype (1016Ile + 15434Cys) was present in higher frequencies in all populations except Rorainópolis, where this haplotype seems to have arrived recently. Conclusions. These results are important for the knowledge about insecticide resistance status of Ae. aegypti populations from Roraima and will help to improve vector control strategies that may be applied to diverse localities under similar geographical and urban conditions.
Physiological Effects of Different Recruitment Maneuvers for Improved Lung Inhomogeneity in a Pig Model of ARDS
Authors: Xia Feiping , Pan Chun , Wang Lihui , Liu Ling , Liu Songqiao , Guo Fengmei , Yang Yi , Huang Yingzi
Published: April 2020

Background: In acute respiratory distress syndrome (ARDS), lung recruitment maneuvers can recruit collapsed alveoli in gravity-dependent lung regions, improving the homogeneity of ventilation distribution. This study used electrical impedance tomography (EIT) to investigate the physiological effects of different recruitment maneuvers for alveolar recruitment in a pig model of ARDS. Methods: ARDS was induced in ten healthy male pigs with repeated bronchoalveolar lavage until the arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) (P/F ratio) was < 100 mmHg and remained stable for 30 minutes (TARDS). ARDS pigs underwent three sequential recruitment maneuvers, including sustained inflation (SI), increments of positive end-expiratory pressure (PEEP) (IP), and pressure-controlled ventilation (PCV) applied in random order, with 30 mins at a PEEP of 5 cmH2O between maneuvers. Respiratory mechanics, hemodynamics, arterial blood gas, and EIT were recorded at baseline, TARDS, and before and after each recruitment maneuver.Results: In all ten pigs, ARDS was successfully induced with a mean 2.8±1.03L (2800±1032.80ml) bronchoalveolar lavages. PaO2, SO2, P/F, and compliance were significantly improved after recruitment with SI, IP or PCV (all p<0.05), and there were no significant differences between maneuvers. Global inhomogeneity (GI) was significantly decreased after recruitment with SI, IP, or PCV. There were no significant differences in GI before or after recruitment with the different maneuvers. The decrease in GI (ΔGI) was significantly greater after recruitment with IP compared to SI (p=0.023), but there was no significant difference in ΔGI between IP and PCV.Conclusion: SI, IP, and PCV increased oxygenation, and regional and global compliance of the respiratory system, and decreased inhomogeneous gas distribution in ARDS pigs. IP significantly improved inhomogeneity of the lung compared to SI.
Clinicopathological and Prognostic Value of SNHG6 in Cancers: a Systematic Review and a Meta-analysis
Authors: Zhang Shuo , Qiu Dandan , Xie Xiaohong , Shen Yong
Published: April 2020

Background The long non-coding RNA small nucleolar RNA host gene 16 (lncRNA SNHG6) is dysregulated in various malignant tumor. However, a definite conclusion on the clinical value of lncRNA SNHG6 expression in human cancers has not been determined. The purpose of the present meta-analysis was to comprehensively elucidate the association between SNHG6 expression and clinical outcomes in cancers. Methods A systematic search was performed through the PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and Wangfang databases for relevant studies. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were collected to estimate the prognostic value, and the odds ratios (ORs) with 95% CIs were used to evaluate the relationship between lncRNA SNHG6 expression and clinicopathological features, including tumor invasion depth, lymph node metastasis (LNM), distance metastasis (DM), and TNM stage. Results A total of 914 patients from 13 studies were included in this meta-analysis. The pooled results suggested that evaluated SNHG6 expression could predict an unfavorable overall survival (OS) (HR = 2.04, 95% CI:1.56~2.52) with no heterogeneity ( I 2 = 0.0%, p = 0.996). Subgroup analysis indicated a significant association between high SNHG6 expression and shorter OS in studies with digestive system cancers (HR = 2.05, 95%CI: 1.47-2.62), sample size < 70 (HR = 2.70, 95%CI: 1.29-4.11), and univariate and multivariate analysis (HR = 2.04, 95%CI: 1.44-2.64). Moreover, high SNHG6 expression was positively correlated with tumor invasion depth (OR = 1.76, 95%CI: 1.18-2.63), LNM (OR = 1.60, 95%CI: 1.18-2.17), DM (OR = 1.90, 95%CI: 1.37-2.64) and advanced TNM stage (OR = 1.88, 95%CI: 1.36-2.60) in patients with cancers. Conclusions High lncRNA SNHG6 expression was correlated with tumor invasion depth, LNM, DM, and advanced TNM stage, suggesting that SNHG6 may serve as a promising prognostic biomarker of human cancers.
Association of MC4R (rs17782313) with diabetes and cardiovascular disease in Korean men and women
Authors: Sull Jae Woong , Kim Gitae , Jee Sun Ha
Published: April 2020

Background: Diabetes is mostly assessed by the fasting glucose level. Several studies reported that serum fasting glucose levels and cardiovascular disease are associated with MC4R. Methods: A total of 4,294 subjects participated in this study. There were 1810 subjects with cardiovascular disease among the 4294 subjects. We used multivariate linear regression models and multiple logistic regression analysis. Results: Individuals with the TC/CC genotype had a 1.29-fold higher risk of diabetes than did those with the TT genotype when adjusting for age, sex, and BMI (OR, 1.29; 95% CI, 1.04-1.60). For healthy subjects, the association was significant in women (OR, 1.99; 95% CI, 1.01-3.93). Men with the TC/CC genotype had a 1.21-fold higher risk of cardiovascular disease than did those with the TT genotype when adjusting for age, sex, and BMI (OR, 1.21; 95% CI, 1.04-1.41). The relationship between MC4R and cardiovascular disease was stronger in lean men (OR, 1.40; 95% CI, 1.12–1.74, p = 0.0028) than in overweight men.Conclusions: This study suggests that the rs17782313 SNP in MC4R is related to diabetes and the SNP is also associated with cardiovascular disease in lean men.
Clinical characteristics and prenatal diagnosis for 22 families in Henan Province of China with X-linked agammaglobulinemia (XLA) related to Bruton’s tyrosine kinase (BTK) gene mutations.
Authors: gao shanshan , Hu Shuang , Duan Huikun , Wang Li , Kong Xiangdong
Published: April 2020

Background: X-linked agammaglobulinaemia (XLA) is a rare immunodeficiency disease for which recurrent severe infection is the major clinical symptom. BTK is the main causative gene, with X chromosome recessive inheritance. However, the mutations reported to date do not fully explain the disorder.Methods: We detected the percentage of CD19+ B cells and serum immunoglobulin (IgG, IgA, and IgM) levels by flow cytometry and rate scatter immunoturbidimetry, and investigated the BTK mutation profile in 22 XLA patients using Sanger sequencing and real-time PCR .Results: We evaluated the clinical symptoms of 22 XLA patients and investigated genetic mutations present, identifying six novel mutations in the BTK gene: 2 missense mutations (c.23G>T and c.112T>C), 2 frameshift mutations (c.522_523insC and c.1060delA), 1 large deletion (deletion of exon 2 to 5), and 1 splice-site mutation (c.1631+2T>C). Prenatal diagnoses were performed in six families (F10, F11, F15, F18, F20 and F21), with the following results: the male fetus in Family 10 (F10) did not carry the c.922_923delGA mutation; the male fetus in Family 15 (F15) did not carry the c.1631+1G>T splicing mutation; the female fetus in Family 20 (F20) did not carry the c.1931T>C mutation; the male fetus in Family 21 (F21) did not carry the large deletion mutation. Hence, these four fetuses are not likely to develop XLA. Male fetuses with c.1060delA and c.1684C>T mutations were identified in Family 11 and Family 18, respectively. The pregnant woman in F18 chose to terminate the pregnancy, whereas the pregnant woman in F11 chose to continue the pregnancy.Conclusion: We confirmed the diagnosis of 22 XLA patients from 22 unrelated families and detected six new pathogenic mutations. Prenatal diagnosis was performed in six families. Early genetic diagnosis and routine lifelong immunoglobulin replacement therapy can prevent and treat infections in XLA children, saving their lives.
Application of Real-Time Simultaneous Amplification and Testing Method to Accurately and Rapidly Detect Extra-pulmonary Tuberculosis
Authors: Li Tongxin , Shi Tao , Sun Ying , Zhou Kan , Huang Zhenggu , Wang Pengsen , Luo Ming , Nie Xiaoping , Yang Guoqing , Chen Yu , Chen Yaokai
Published: April 2020

Background: This study aimed to establish and evaluate a simultaneous amplification and testing method for detection of extra-pulmonary tuberculosis (EPTB). Methods: From January 2016 and December 2017 the pus or surgical excision from the lesions of inpatients admitted from Chongqing Public Health Treatment Center were collected. According to the clinical diagnosis, the samples were divided into two groups including EPTB (Group A) and other diseases excluded from tuberculosis diseases (Group B). Simultaneous detection of Mycobacterium tuberculosis (MTB) used Roche culture method, liquid culture method and simultaneous amplification and testing (SAT) method. The sensitivity and specificity of the SAT method were compared with culture methods and clinical diagnosis of EPTB. Results: For 433 EPTB specimens and 49 non-TB specimens, the simultaneous amplification and testing tuberculosis (SAT-TB) results correlated with 80.5% (388/482 specimens) of the culture assay results. The sensitivity, specificity, and positive and negative predictive values of the SAT-TB test for the diagnosis of EPTB were 83.6%, 79.4%, 59.4%, and 93.0%, respectively, compared to culture methods. Compared with the clinical diagnosis of patients, the sensitivity and specificity of the SAT-TB test were 41.6% and 100%, respectively, the cultures test were 29.3% and 98.0%. Conclusions: SAT test is a simple and rapid test with high specificity which may enhance the detection of EPTB. SAT-TB is a higher clinical diagnosis value for EPTB in clinical microbiology laboratories.
The Effect of Antimicrobial Activity of Teucrium Polium on Oral Streptococcus Mutans: A Randomized Cross-over Clinical Trial Study
Authors: Tusi Somayeh Khoramian , Jafari Ahmad , Marashi Seyed Mahmoud Amin , Niknam Salomeh Faramarzi , Farid Malihe , Ansari Mehdi
Published: April 2020

Background: The purpose of this study is to determine the effect of a mouthwash containing Teucriumpolium herb on Streptococcus mutans in mouth. Methods: This study was a randomized, crossover, double-blind clinical trial, where we selected twenty-two volunteers (dental students) randomly and we divided them into two groups. The study had two phases. In each phase, one group acted as the intervention group, while the other one was the control group. Both the intervention and control groups were given the mouthwash with and without Teucriumpolium, respectively. S. mutans of saliva were measured before and after each phase to compare the effects of the mouthwashes. A three-week washout period was considered between the two phases. An independent two-sample t-test was utilized to compare the mean of S. mutans colonies. Additionally, we used a standard AB/BA crossover model to find the results of the treatment and the impact of carryover on the residual’s biological effects. The significance level was considered 0.05 in this experiment. Results: There is no significant difference observed between the two groups in the number of S. mutans before using the mouthwashes. When the mouthwash containing Teucriumpolium was used, there was a significant decrease in the number of S. mutans colonies in both phases’ extract (P = 0.002). Conclusion: The results of this study indicate the mouthwash containing aqueous extract of Teucrium polium can majorly reduce the colonization of S. mutans in human saliva. Trial registration: Ethical issues approved by the Ethics Committee of the Rafsanjan University of Medical Sciences with the approval number of 937/9/31, IRCT code Number of IRCT2013121815842N1 and it was approved on 06/16/2014. The study was conducted in the period of September to November 2014.
Multiple Cross Displacement Amplification-a more applicable technique in detecting Pseudomonas Aeruginosa of Ventilator-associated Pneumonia ( VAP)
Authors: Wang Juxiang , Chen Huimin , Lin Xiaomin , Ji Chengyi , Chen Bin
Published: April 2020

Background Early and rapid identification of Pseudomonas aeruginosa (P. aeruginosa) in patients with suspected ventilator-associated pneumonia (VAP) provides theoretical clinical advantages in therapeutic optimization strategies.Methods The PA-MCDA assay was conducted at an isothermal temperature during the amplification stage, and products were visually detected by color changes. The entire process was completed within 1 h. A total of 77 strains, including P. aeruginosa species and various other species of non-P. aeruginosa were used to evaluate PA-MCDA assays. Bronchoalveolar lavage fluid (BALF) of suspected VAP patients were examined by the MCDA assay. Results The MCDA assay exhibited a 100 percent analytical specificity in detecting PA from all 77 strains, and the limit of detection were as low as 100 fg DNA per reaction. A temperature of 65ºC was recommended as standard during the amplification stage. The agreement between PA-MCDA and bacteria culture was 91.18% (κ= 0.787; p =0.000) in identification of P. aeruginosa in BALF from suspected VAP. The PA-MCDA assay showed values of 92.31%, 90.78%, 77.41% and 97.18% for sensitivity, specificity, positive predictive value and negative predictive value, respectively. PA-MCDA had higher detective rate of P. aeruginosa than bacteria culture in patients with antipseudomonal therapy.Conclusions The instrument-free platform of the MCDA assay makes it a simple, rapid and applicable procedure for “on-site” diagnosis and point-of-care testing for the presence of P. aeruginosa without the need for specific bacterial culture.
Underdiagnoses of Rickettsia in patients hospitalized with acute fever in Indonesia: Observational study results
Authors: Lokida Dewi , Hadi Usman , Lau Chuen-Yen , Kosasih Herman , Liang C. Jason , Rusli Musofa , Sudarmono Pratiwi , Lukman Nurhayati , Laras Kanti , Asdie Rizka Humardewayantie , Murniati Dewi , Susila I Made , Mubin Risna Halim , Karyana Muhammad , Gasem Muhammad Hussein , Alisjahbana Bachti
Published: April 2020

Background: Reports of human rickettsial infection in Indonesia are limited. This study sought to characterize the epidemiology of human rickettsioses amongst patients hospitalized with fever at 8 tertiary hospitals in Indonesia. Methods: Acute and convalescent blood from 975 hospitalized non-dengue patients was tested for Rickettsia IgM and IgG by ELISA. Specimens from cases with seroconversion or increasing IgM and/or IgG titers were tested for Rickettsia IgM and IgG by IFA and Rickettsia genomes using primers for Rickettsia (R.) sp , R . typhi , and Orientia tsutsugamushi . Testing was performed retrospectively on stored specimens; results did not inform patient management. Results: R . typhi, R. rickettsii , and O. tsutsugamushi IgG antibodies were identified in 269/872 (30.8%), 36/634 (5.7%), and 19/504 (3.8%) of samples, respectively. For the 103/975 (10.6%) non-dengue patients diagnosed with acute rickettsial infection, presenting symptoms included nausea (72%), headache (69%), vomiting (43%), lethargy (33%), anorexia (32%), arthralgia (30%), myalgia (28%), chills (28%), epigastric pain (28%), and rash (17%). No acute rickettsioses cases were suspected during hospitalization. Discharge diagnoses included typhoid fever (44), dengue fever (20), respiratory infections (7), leptospirosis (6), unknown fever (6), sepsis (5), hepatobiliary infections (3), UTI (3), and others (9). Fatalities occurred in 7 (6.8%) patients, mostly with co-morbidities. Conclusions: Rickettsial infections are consistently misdiagnosed, often as leptospirosis, dengue, or Salmonella typhi infection. Clinicians should include rickettsioses in their differential diagnosis of fever to guide empiric management; laboratories should support evaluation for rickettsial etiologies; and public policy should be implemented to reduce burden of disease.
Furosemide stress test as a predictive marker of acute kidney injury progression or renal replacement therapy: a systemic review and meta-analysis
Authors: Chen Jia-Jin , Chang Chih-Hsiang , Huang Yen Ta , Kuo George
Published: April 2020

Background: The use of the furosemide stress test (FST) as an acute kidney injury (AKI) severity marker has been described in several trials. However, the diagnostic performance of the FST in predicting AKI progression has not yet been fully discussed. Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the PubMed, Embase, Cochrane databases up to March, 2020. The diagnostic performance of the FST (in terms of sensitivity, specificity, number of events, true positive, false positive) was extracted and evaluated. Results: We identified eleven trials that enrolled a total of 1366 patients, including 517 patients and 1017 patients for whom the outcomes in terms of AKI stage progression and renal replacement therapy (RRT), respectively, were reported. The pooled sensitivity and specificity results of the FST for AKI progression prediction were 0.81 (95% CI: 0.74 - 0.87) and 0.88 (95% CI: 0.82- 0.92), respectively. The pooled positive likelihood ratio (LR) was 5.45 (95% CI: 3.96-7.50), the pooled negative LR was 0.26 (95% CI: 0.19-0.36), and the pooled diagnostic odds ratio (DOR) was 29.69 (95% CI: 17.00-51.85). The summary receiver operating characteristics (SROC) with pooled diagnostic accuracy was 0.88. The diagnostic performance of the FST in predicting AKI progression was not affected by different AKI criteria or underlying chronic kidney disease. The pooled sensitivity and specificity results of the FST for RRT prediction were 0.84 (95% CI: 0.72-0.91) and 0.77 (95% CI: 0.64-0.87), respectively. The pooled positive LR and pooled negative LR were 3.16 (95% CI: 2.06-4.86) and 0.25 (95% CI: 0.14-0.44), respectively. The pooled diagnostic odds ratio (DOR) was 13.59 (95% CI: 5.74-32.17) and SROC with pooled diagnostic accuracy was 0.86. The diagnostic performance of FST for RRT prediction is better in stage 1-2 AKI comparing to stage 3 AKI (relative DOR: 5.75, 95% CI: 2.51-13.33) Conclusion: The FST is a simple tool for the identification of AKI populations at high risk of AKI progression and the need for RRT and the diagnostic performance of FST in RRT prediction is better in early AKI population.
Significance of incident reports by medical doctors for organizational transparency and driving forces for patient safety
Authors: Fukami Tatsuya , Uemura Masakazu , Nagao Yoshimasa
Published: April 2020

Background: Incident reporting is an effective strategy used to enhance patient safety and quality improvement in healthcare. An incident is an event that could eventually result in harm to a patient. The aim of this study is to re-evaluate the importance of reporting by medical doctors to improve quality in healthcare and patient safety. Methods: We conducted a retrospective analysis of the reported incidents registered in our institutional database from April 1st 2015 to March 31st 2019, classified according to eight variables proposed by the National University Hospital Council of Japan, to determine the type of incidents and their potential harm to patients. Results: Registered reports totalled 43,775, approximately 8% of which arise annually from medical doctors in clinical departments. Incidents with higher impact on patients have significantly increased the rate of reporting by medical doctors. The most frequent types of report overall concerned medication incidents, followed by infusion lines, drainage-tube devices, cure, examination, and treatment outside the operating room. The most frequent reports by medical doctors involved operation-related incidents, followed by cure, examination, treatment outside the operation room, and medications. Conclusion: Reporting by medical doctors reflects the organizational transparency and the driving forces behind patient safety and quality improvement in healthcare. Efforts toward seamless improvement in patient safety and quality at our hospital continue apace.
Detection of endometriosis using immunocytochemistry of P450 Aromatase expressions in eutopic endometrial cells obtained from menstrual sloughing: A diagnostic study
Authors: Madjid Tita Husnitawati , Jumadi Jumadi , Judistiani Raden Tina Dewi , Hernowo Bethy Suryawathy , Faried Ahmad
Published: April 2020

Objective. To explore the possibility of a new diagnostic approach of endometriosis based on immunocytochemistry scoring of Aromatase P450 expressions in endometrial cells collected from menstrual sloughing. This is a case control study. Immuncytochemistry scores vs. histopathological examination in one tertiary- and secondary-level hospital in Bandung; two secondary level hospital in Garut and Sumedang, West Java, Indonesia. Thirty five patients with and without endometriosis were enrolled. All subjects had diagnostic procedures for endometriosis suspicion, with addition menstrual blood samples for cytopathological examination. The specimens were sent for immunocytochemistry assessment of P450 Aromatase expressions (ICAPEC). The previous procedure resulted in cut-off point of histo score (H-score), sensitivity, specificity, (+) and (-) ICAPEC predictive value.Results. The P450 Aromatase expression in endometrial cells of women with endometriosis was significantly stronger than without one. The cut-off point of H-scores to detect endometriosis was >4. By this criteria, H-score had 94.6% sensitivity, 90.9% specificity, 92% positive predictive value and 93% negative predictive value. Immunocytochemistry scoring of Aromatase P450 expression in endometrial cells (ICAPEC) derived from menstrual blood specimen was a good candidate as alternatives approach in diagnostic procedure of endometriosis. Application and evaluation in clinical practice would provide the economically benefit in diagnostic procedure.
Prevalence of hypertension and its risk factor among cotton textile workers in low-and-middle-income countries: A systematic review protocol
Authors: Ali Naureen , Feroz Anam
Published: April 2020

Background: Cotton workers are exposed to various hazards in the textile industry that might result in different ailments including hypertension (HTN). However, few attempts have been made to systematically review the prevalence of hypertension and its risk factor among cotton textile workers in low-and-middle-income countries (LMICs). The objective of this study will be to evaluate the prevalence of hypertension and its risk factors among adult cotton textile workers in low- and middle-income countries. Methods: We designed and registered a study protocol for a systematic review of descriptive epidemiology data. We will include observational studies (e.g. cross-sectional, cohort, surveys) on the epidemiology of hypertension among adult cotton textile workers in low- and middle-income countries. The primary outcome will be the prevalence of hypertension. Secondary outcomes will be the prevalence of risk factors of hypertension. Literature searches will be conducted in multiple electronic databases (from January 2000 onwards), including PubMed/MEDLINE, CINAHL, Science Direct, and Cochrane Library. Grey literature will be identified through searching conference abstracts, thesis dissertations and public repositories. Two investigators will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct random effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g. age, gender, years of service, textile department). Discussion: This review will highlight the proportion of hypertension along with its risk factor among cotton textile workers in LMICs. Given that, some of the factors can be prevented in this high-risk population, we will call on health, experts to prioritize policies and commission and conduct programs to support the improvement in their health. This systematic review will identify, evaluate and integrate evidence on the prevalence and risk factors of hypertension among adult cotton textile workers in low- and middle-income countries. Our findings will be made publicly available in a repository and published in a peer-reviewed journalSystematic Review Registration: The present protocol has been registered within the PROSPERO database (registration ID: CRD42020167175)
Timely completion of vaccination and its determinants among children in Northwest, Ethiopia: A multilevel analysis
Authors: Mekonnen Zeleke Abebaw , Gelaye Kassahun Alemu , Were Martin C. , Tilahun Binyam
Published: April 2020

Background: Timely vaccination is key to prevent unnecessary childhood mortality from vaccine-preventable diseases. Despite the substantial efforts to improve vaccination completeness, the effort towards timeliness of vaccination is limited with non-attendance and delays to vaccination appointments remaining a big challenge in developing countries. There is also a limited evidence on timeliness of vaccination. Therefore, this study aimed to determine the magnitude and associated factors for timely completion of vaccination among children in Gondar city administration, north-west, Ethiopia.Method: This study employed a community-based cross sectional study design. A sample size of 821 children aged 12 to 23 months were considered. Two stages random sampling technique was used to select study subjects. To account the effect of clustering, bivariable and multivariable multilevel logistic regression analysis were applied. The measures of association estimates were expressed as adjusted odds ratio (AOR) with their 95 % confidence intervals (CIs).Results: Of the 774 children included for analysis, 498 (64.3%) were fully vaccinated while 247 (31.9%) were fully vaccinated on-time. Caregivers aged above 35 years (AOR= 0.469; 95 % CI: 0.253-0.869], who had secondary education and above (AOR = 2.391; 95 % CI: 1.317- 4.343), from richest households (AOR = 2.381; 95 % CI: 1.502-3.773), children whose mother attended four or more ante natal care visits (AOR = 2.844; 95 % CI: 1.310-6.174) and whose mother had two or more post natal care visits (AOR =2.054; 95%CI:1.377-3.063) were positively associated with on-time full vaccination. In contrary, being vaccinated at health post (AOR=0.144; 95%CI: 0.048-0.428) and travelling more than 30 minutes to the vaccination site (AOR= 0.158; 95%CI: 0.033-0.739) were negatively associated with on-time full vaccination. The random effects indicated that 26% of the variability in on-time full vaccination was attributable to differences between communities.Conclusion: In this study, untimely vaccination was found to be high. Different individual and contextual factors were found to be associated with on-time full vaccination. Therefore, tailored strategies have to be designed and implemented to address people and the communities where they live. Moreover, timeliness of vaccination should be considered as important indicator of the immunization program performance in Ethiopia.
Indonesian adolescents’ perspectives on smoking habits as a reference for a prevention program: a qualitative study
Authors: fithria fithria , Adlim Muhammad , Jannah Syarifah Rauzatul , Tahlil Teuku
Published: April 2020

Background: Religious factors have been used in tobacco control campaigns but due to different perceptions among Muslim scholars that might have an effect on followers, the strategies of control programs are still interesting. Therefore, this qualitative research aimed to explore the perspectives of Muslim adolescents on smoking habits as a reference for developing effective prevention programs.Methods: Three focus group discussions involving 24 junior high school students (mean age=13.75 years) were the main source of data for this phenomenological qualitative study. The discussion guide was developed by the researchers based on the reviewed literature and validated by experts. The research findings were analyzed using an inductive content method with systematic steps based on the stages of qualitative data analysis.Results: Adolescent perspectives on smoking were grouped into two themes: (a) perception, which encompassed three sub-themes: smoking as a social habit, contradictive feelings, and the Islamic perspective; (b) smoking-related factors involving peer pressure, the parents’ smoking status, curiosity, and masculinity.Conclusion: The results indicated that adolescents consider smoking as a social habit but with contradictive feelings. From an Islamic perspective, smoking is not forbidden by the religion’s beliefs. The smoking habit was also stimulated by peer pressure, imitating parents who smoke, curiosity, and feeling masculine. We suggest that health professionals who are interested in developing smoking prevention programs should consider the adolescent perspective on smoking so that the prevention program will be more effective and appropriate for adolescents.
Adverse influence of multilevel socioeconomic status on physical activity: results from a national survey in Vietnam
Authors: Vu Lan , Bui Quyen , Nguyen Ngan , Hoang Minh
Published: April 2020

Background: This study aims to explore associations of individual- and provincial-level socioeconomic status (SES) and the combined interaction among these SES with individual physical activity (PA). Method: This analyze used data of 3068 Vietnamese people aged 18-65 years from the national representative STEPS survey in 2015 (STEPS2015). The survey collected PA-related data using the Global PA Questionnaire Version 2 and those on provicial-level characteristics from two surveys in 2014, namely the Intercensal Population and Housing Survey (IPHS) and The Vietnam Household Living Standard Survey (VLSS2014). Multilevel linear analyze was performed with individual and provincial characteristics as independent variables and the metabolic equivalent (MET) score – the indicator of individual PA – as the dependent variable.Results: Male and female participants with insufficient PA accounted for 20.2% and 35.7%, respectively. Both individual- and provicial-level SES were inversely associated with the individual PA level . As the provincial-level monthly income increased by 1 million Vietnam Dongs, the total PA score of individuals residing in that province reduced by 1,900 METS. A buffering effect was reported between provincial and individual SES, as the provincial average income increased, the differences in PA scores between different SES groups decreasedConclusion: Our data suggest that Vietnamese individuals in low SES groups tended to be more physically active than those in high SES groups because their PA was largely related to work.
Burden of caregivers of children with cerebral palsy: an intersectional analysis of gender, poverty, stigma, and public policy.
Authors: Vadivelan K , Sekar P , Sru S Shri , Gopichandran Vijayaprasad
Published: April 2020

Background: Caregivers of children with cerebral palsy suffer from substantial psycho-social burden. However, there is scarcity of documentation of the various sources of burden in the low- and middle-income settings. Methods: We conducted qualitative in-depth interviews among mothers of children with cerebral palsy attending a physiotherapy facility. We purposively sampled mothers from rural and peri-urban areas in Tamil Nadu, India, till the point of data saturation. We analysed the transcripts using the socio-ecological model to identify major dimensions of psycho-social burden among these mothers. Results: At the individual level the mothers perceived aches and pains due to the heavy physical activity of caregiving. They also suffered from a feeling of guilt about the child’s condition. Due to difficulty in balancing family and work, they had significant financial burdens. They also perceived a lack of knowledge and awareness about possible options for treatment of their child. At the interpersonal level, the mothers lacked support from their husband and family in the process of caregiving. They also had to suffer the ill effects of alcoholism and domestic violence from the husbands. They had to compromise on the care they provided to the other family members and their children without cerebral palsy. At the community level the mothers had no support from the community members and felt isolated from others. The mothers also reported discrimination and lack of participation in social events. Environmental stressors like lack of inclusive public spaces, lack of options for public transport and unfriendly work timings and environment were a major source of burden. The mothers felt that the disability welfare support offered by the government was grossly insufficient and there was no platform for interactions with other peers and mothers suffering from similar burden. Conclusion: Caregivers of children with cerebral palsy have unique burdens in a typical low- and middle-income setting including an intersection of gender norms, poverty, stigmatization and non-inclusive public policy, which need to be addressed to improve the quality of life of caregivers.
Availability, Accessibility, and Quality of Adolescent Sexual and Reproductive Health Services in Urban Health Facilities of Rwanda: A survey among social and healthcare providers
Authors: Ndayishimiye Pacifique , Uwase Rosine , Kubwimana Isabelle , Niyonzima Jean de la Croix , Dzekem Roseline Dine , Nyandwi Jean Baptiste , Kadima Justin Ntokamunda
Published: April 2020

Background: Access and utilization of quality and comprehensive sexual and reproductive health services (SRHS) is crucial for the health of young adolescents worldwide. This study assessed the quality of SRHS provided to Rwandan adolescents in urban health facilities in terms of availability, accessibility, cost, and counseling, with particular emphasis on HIV and family planning-related education.Method: The study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach, including semi-structured questionnaire administration and in-depth interviews with 159 conveniently selected SRH services providers. All survey tools had been previously validated. SPSS version 20 was used for descriptive statistical analysis of quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically.Results: Overall, the availability of adolescent SRHS is satisfactory in more than 80% of health facilities surveyed, including access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV, and counselling. However the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. In-depth interviews revealed that 94.3% of centers provide information to adolescents on SRHS available and 51.6% affirmed delivering services at a low cost. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Private health facilities offer HIV testing for free, but for treatment and other services, they channel adolescents to public health facilities. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities. Religious leaders and family members may hinder adolescents from seeking behavior by promoting only abstinence and discouraging using protective means.Conclusion: SRHS were generally available for distribution to adolescents at most of the facilities but limited in access. Adolescents were said to face structural and social challenges towards accessing services. There is a need to improve the accessibility of SRH services delivery sites while considering innovative methods to broaden access to services.
Association between social capital and mental health among older people living with HIV: The Sichuan Older HIV-Infected Cohort Study (SOHICS)
Authors: Han Jiayu , Jia Peng , Huang Yuling , Gao Bo , Yu Bin , Yang Shifan , Yu Jun , Xiong Jun , Liu Chang , Xie Tian , Dong Peijie , Yang Chao , Wang Zixin , Yang Shujuan
Published: April 2020

Background: Mental health problems are common among older people living with HIV and associated with poorer health outcomes. Social capital is an important determinant of mental health problems but under-studied in this population. This study investigated the association between social capital and mental health problems among older people living with HIV in China.Methods: The study was based on the baseline data of a cohort study investigating mental health among older people living with HIV in Sichuan, China during November 2018 to February 2019. Participants were people living with HIV aged ≥50 years living in Sichuan province. Stratified multi-stage cluster sampling was used to recruit participants from 30 communities/towns; 529 out of 556 participants being approached completed the face-to-face interview. Social capital was measured by two validated health-related social capital scales: the Individual and Family scale and the Community and Society scale. Presence of probable depression (CES-D-10 score ≥10) and probable anxiety (GAD-7 score ≥5) were used as dependent variables. Two-level logistic regression models were applied to examine the association between social capital and probable depression/anxiety. Results: The prevalence of probable depression and probable anxiety was 25.9% (137/529) and 36.3% (192/529), respectively. After adjusting for significant covariates, the individual/family level of social capital was inversely associated with both probable depression (odds ratios (OR): 0.89, 95%CI: 0.84-0.93, p<0.001) and probable anxiety (OR: 0.90, 95%CI: 0.86-0.95, p<0.001). The community/society level social capital was associated with probable depression (OR: 0.91, 95%CI: 0.84-0.99, p<0.001) but not probable anxiety (p>0.05).Conclusions: Interventions building up social capital should be considered to improve mental health of older people living with HIV. Some useful strategies include cognitive processing therapy, improving community networking and engagement, and promoting social bonding with neighborhood.
Clinical observation of extensive fascial resection combined with autologous limbal stem cell sharing transplantation for treatment of pterygium
Authors: Zhang Wen-Jia , Kong Lei , Feng Xiao-Xiao , Yang Ji , Liu Hai , Ke Hong-Qin , Zhang Qian , Wang Yin-Ting , Li Yan , Hu Zhulin
Published: April 2020

Introduction To observe the short-term and long-term effects of extensive fascial resection combined with autologous limbal stem cell sharing transplantation for pterygium. Methods A retrospective case series analysis was performed with 403 patients (420 eyes) who underwent extensive fascial resection combined with autologous limbal stem cell sharing transplantation in the Department of Ophthalmology, Second People's Hospital of Yunnan Province from January 2017 to June 2018. Before, and 10 days, 1 month, 3 months, and 6 months after surgery, the tear film rupture time (BUT), the height of the tear river (SLT), and the anterior segment of the fluoroscopy staining were recorded to record the scar on the conjunctiva and corneal surface. Patient self-consciousness and satisfaction with the appearance of the survey. Results BUT after surgery was prolonged than before operation, and there was no significant difference in tear height preoperative and postoperative. The postoperative follow-up period (6 months), the recurrence rate of pterygium was 0.21%.Patients have higher satisfaction with appearance, and have no obvious foreign body sensation, photophobia, tearing and other subjective symptoms. Discussion and conclusion Extensive fascial resection combined with autologous limbal stem cell sharing transplantation for the treatment of pterygium, the patient's appearance satisfaction is higher, and the recurrence probability is lower than the average recurrence rate of limbal stem cell transplantation. The operation is simple and easy to learn. This is a surgical procedure worth promoting.
Younger age of patients with myocardial infarction correlates with higher number of relatives with history of premature atherosclerosis
Authors: Ambroziak Michał , Niewczas-Wieprzowska Katarzyna , Maicka Agnieszka , Budaj Andrzej
Published: April 2020

Background. Premature coronary artery disease belongs to the most pressing global issues in a modern cardiology. Family history appears to be one of the most important and significant risk factors in young patients with myocardial infarction (MI). The aim of the study was to investigate the role of family history of premature cardiovascular disease (CVD) in patients <50 years with myocardial infarction (MI) compared to patients ≥ 50 years with MI and to young healthy people.Methods. The studied group (MI<50) consisted of 240 patients aged 26-49 years with MI. The control groups consisted of 240 patients (MI≥50) with MI aged 50-92 years and 240 healthy people aged 30-49 years.Results. There were statistically significant differences between the MI<50 and MI≥50 and young healthy groups regarding family history of premature MI/ischaemic stroke and percent of patients with of ≥2 relatives affected including parents, children, siblings, siblings of parents and grandparents (10.8%, 2.9%, 3.7%, respectively; p<0.0001). There was a statistically significant negative correlation between the age of the first episode of MI and the number of relatives with a history of premature MI/stroke (r=0.249, p<0.05) within all MI patients. Statistically significant differences between MI<50 and MI≥50 groups as well as young healthy control group were revealed regarding prevalence of smoking, body mass index (BMI), LDL, HDL, triglycerides (TG) and glucose levels.Conclusions. Younger age of patients with myocardial infarction correlates with a higher number of relatives with a history of premature MI/ischemic stroke. Thus, the family history of premature atherosclerosis involving not only the first-, but also the second-degree relatives, seems to be valuable and could be considered in an individual CVD risk evaluation in young people.
Analysis of axial length, retinal nerve fiber layer, macular area and estimated retinal ganglion cell count in myopic preperimetric glaucomatous eyes: an observational study
Authors: Rolle Teresa , Bonetti Beatrice , Mazzucco Alberto , Dallorto Laura
Published: April 2020

BACKGROUND: The aim of the study is to evaluate the diagnostic ability of OCT parameters and retinal ganglion cells (RGCs) count in identify glaucomatous disease in myopic preperimetric eyes.METHODS: This was a cross-sectional observational study. The study group consisted of 154 eyes: 36 healthy, 64 preperimetric (PPG), and 54 primary openangle glaucoma (POAG) eyes. Each group was divided into three subgroups based on axial length: emmetropic, myopic with axial length (AL) <25 mm, and myopic with AL>25 mm, to analyze the effect of myopia. The RGCs count was obtained using a model described later. As regard the influence of myopia on OCT parameters and RGC count, we performed Pearson’s correlation. The Area Under Receiver Operator Characteristics Curves (AUROC curves) evaluated which parameter had the best sensitivity and specificity in identifying glaucoma in myopic eyes.RESULTS: In Pearson’s test, all Ganglion Cell Complex (GCC) thicknesses showed the weakest and less significant correlation with AL in all groups. All the AUROCs were statistically significant, and above 0.5. Inferior GCC and Global Loss Volume (GLV) showed the highest AUCs in all myopic group and the best diagnostic ability in distinguishing healthy from glaucomatous eyes. RGCcount showed good AUROC in all groups, with sensitivities of about 83% in myopic eyes, and specificity over 91% in all groups.CONCLUSIONS: GCC is the parameter less influenced by the AL, and the inferior GCC and the GLV have the best diagnostic performance. The RGCcount has good sensitivity and specificity, so it can be used as a complementary test in the diagnosis of glaucoma in myopic preperimetric eyes.