bluuebunny/crossref_metadata_2025 huggingface dataset:
New insights into the lithostratigraphy and paleogeography of the Messinian Kasterlee Formation from the analysis of a temporary outcrop
Authors: VERHAEGEN Jasper , FREDERICKX Lander , SCHILTZ Marco
Published: June 2020

Previous studies have shown that the Kasterlee Formation occurs as far south as the hilltops of Heist-op-den-Berg and Beerzel in the south of the province of Antwerp. In fragmentary outcrops on these hills, a clear threefold subdivision can be recognized. In the current study, a large temporary outcrop on the Heist-op-den-Berg hill was studied, providing a unique view into the small-scale vertical and lateral variations in the Kasterlee Formation. Based on field observations, grain size analyses and mineralogy, the characteristics of the three units could be clearly defined. Cone penetration test logs show that these units can also be traced further north in the basin. As the three units can be easily identified based on the parameters provided in this paper and as they occur over a wide area, it is proposed to introduce them as formal members of the clayey Kasterlee unit. The observations made in this outcrop also allowed to refine the paleogeographic model of the Kasterlee Formation, with deposition of sand-clay alternations in restricted lagoons, separated from the marine environment by a coastal barrier, during an overall regression. Coastal barrier deposits are found in the south and northwest, but in the northeast only deposition in restricted lagoons occurred.
PENGEMBANGAN BUKU AJAR PENGAJARAN REMEDIAL DALAM PENDIDIKAN JASMANI UNTUK MAHASISWA S1 PENDIDIKAN JASMANI DAN KESEHATAN UNIVERSITAS NEGERI MALANG
Authors: Mustafa Pinton Setya , Winarno M.E.
Published: June 2020

Tujuan penelitian ini adalah mengembangkan produk berupa buku ajar mata kuliah pengajaran remedial dalam pendidikan jasmani untuk mahasiswa Pendidikan Jasmani dan Kesehatan (PJK) Fakultas Ilmu Keolahragaan (FIK) Universitas Negeri Malang (UM). Model penelitian dan pengembangan ini menggunakan model konseptual yang diadaptasi dari Analyze, Design, Develop, Implement, Evaluate (ADDIE). Instrumen yang digunakan adalah dokumentasi, wawancara, dan penyebaran angket. Adapun analisis data menggunakan analisis kuantitatif dan kualitatif. Hasil dari evaluasi ahli materi diperoleh persentase sebesar 89,84% (sangat valid), hasil uji coba kelompok kecil sebesar 89,53% (sangat valid), dan hasil uji coba kelompok besar diperoleh persentase sebesar 88,60% (sangat valid). Produk buku ajar mata kuliah pengajaran remedial dalam pendidikan jasmani ini terdiri dari 9 Bab dan disertai contoh. Buku ajar ini valid dan praktis digunakan dalam perkuliahan pengajaran remedial dalam pendidikan jasmani.
Les mycotoxines dans les aliments des ruminants, leur devenir et leurs effets chez l’animal
Authors: YIANNIKOURIS A. , JOUANY J.P.
Published: June 2020

Les mycotoxines sont des métabolites secondaires sécrétés par des moisissures appartenant principalement aux genres Aspergillus, Penicillium et Fusarium. Elles sont produites sur une large variété de denrées alimentaires avant, pendant et après récolte. En raison de la diversité de leurs effets toxiques et de leurs propriétés synergiques, les mycotoxines présentent un risque pour le consommateur d’aliments contaminés. Le métabolisme des mycotoxines est complexe et comprend plusieurs voies de bioactivation et de détoxication régies par des mécanismes de biotransformation résultant de l’action d’enzymes de l’hôte et de la flore microbienne présente dans le tube digestif. Une partie des toxines ou de leurs métabolites peut se fixer dans les tissus biologiques ; la majorité est éliminée par voie urinaire, fécale et lactée. Des différences de sensibilité sont observées entre espèces animales. Chez les ruminants, la toxicité se manifeste généralement par des troubles chroniques légers et n’aboutit que rarement à la mort. Une diminution de l’ingestion et des performances zootechniques est généralement observée. Le problème de la présence éventuelle de résidus toxiques se pose pour les produits animaux destinés à la consommation humaine (lait, viande, abats).
La réduction des risques passe par un contrôle de la contamination fongique des végétaux résultant de la maîtrise des méthodes de culture, de récolte et de conservation, par des techniques d’élimination des toxines sur l’aliment contaminé, et par une réduction de leur biodisponibilité dans le tractus digestif des animaux par l’emploi d’adsorbants.
Les radicaux libres dans l’organisme des animaux d’élevage : conséquences sur la reproduction, la physiologie et la qualité de leurs produits
Authors: AUROUSSEAU B.
Published: June 2020

Les phénomènes radicalaires sont omniprésents dans la vie des animaux domestiques. Les radicaux libres oxygénés en sont à l’origine : leur structure électronique déséquilibrée leur confère une grande réactivité sur les constituants tissulaires qui leur permet d’entrer en jeu dans le contrôle d’une grande variété de réactions d’oxydo-réduction indispensables à la vie et à la croissance. Ils sont formés de façon continue dans l’organisme sain, en particulier par fuite d’électrons à partir de la chaîne respiratoire et au cours de l’élimination des composés tissulaires peroxydés. Les stress de toutes natures augmentent leur flux, épuisent les réserves de l’organisme en composés protecteurs qui les capturent (en particulier les vitamines et le glutathion) et augmentent donc les besoins correspondants des animaux. Pour finir, ils peuvent conduire à l’altération des structures cellulaires. Les conséquences intéressent une grande variété de fonctions animales, de façon directe (immédiatement après une série de chocs) ou indirecte (affaiblissement à long terme de l’organisme). Les attaques radicalaires peuvent ainsi conduire à une diminution du pouvoir fécondant des spermatozoïdes, à une baisse de la fertilité des femelles, à des mortalités embryonnaires et à une baisse de la vitalité des nouveau-nés. Par ailleurs, elles peuvent ralentir la croissance des animaux et conduire à l’obtention de carcasses et de viandes de qualités inférieures au potentiel des animaux. Ces baisses de qualité sont caractérisées par une durée de conservation plus courte et par une diminution de la teneur des tissus en composés intéressants pour la santé de l’homme. Le plus grand soin doit donc être apporté à la conduite des animaux d’élevage, afin de respecter l’équilibre entre l’attaque et la défense de l’organisme des animaux domestiques.

 
Documents à télécharger
T Cell Metabolism in Cancer Immunotherapy
Authors: Aksoylar Halil-Ibrahim , Tijaro-Ovalle Natalia M. , Boussiotis Vassiliki A. , Patsoukis Nikolaos
Published: June 2020

Immune checkpoint therapies aiming to enhance T cell responses have revolutionized cancer immunotherapy. However, although a small fraction of patients develops durable anti-tumor responses, the majority of patients display only transient responses, underlying the need for finding auxiliary approaches. Tumor microenvironment poses a major metabolic barrier to efficient anti-tumor T cell activity. As it now well accepted that metabolism regulates T cell fate and function, harnessing metabolism may be a new strategy to potentiate T cell-based immunotherapies.
A Comparative Study on Register and Genre of Review Texts in Teen Ink Magazine
Authors: Rodhiya Qudwatu Nabila
Published: June 2020

This research focuses on two review texts published in a teenage magazine called Teen Ink. It is aimed to discover the language style and text structure used by the same text producer. Using Systemic Functional Linguistics (SFL) approach, this research describes the register and genre employed in the two analyzed texts. The analysis was done by examining and comparing the generic structure and the metafunctions of each text. The description of data led to the interpretation of field, tenor, and mode. From the genre analysis, it can be seen that the text producer follows the same text structure for both texts, though differences were found in the technique used to compose each stage of the text. In terms of register, different dominant transitivity and circumstance types were found in both texts. Meanwhile, the text producer puts all participants surrounding the texts in equal position, and positive assessment is implied in both texts. In addition, as the texts are written in a language style that tends to be spoken, the texts are considered appropriate for the medium, namely the review column of Teen Ink magazine.
Changes in Vestibular Symptoms and Function After Cochlear Implantation: Relevant Factors and Correlations With Residual Hearing
Authors: Jang Jeong Hun , Kim Hantai , Choo Oak-Sung , Park Hun Yi , Choung Yun-Hoon
Published: June 2020

Objectives. The aim of this study was to evaluate vestibular function loss after cochlear implantation (CI) and the relationship between vestibular function and hearing changes.Methods. Seventy-five patients with CI were enrolled and divided into those with normal preoperative caloric function (group I) and those with a normal preoperative waveform in cervical vestibular evoked myogenic potential (c-VEMP) testing (group II). The relationship between hearing and changes in the vestibular system was analyzed preoperatively and at 3 and 6 months postoperatively.Results. In group I, unilateral weakness on the implanted side was detected in five (7.7%) and eight (12.3%) patients at 3 and 6 months post-CI, respectively. By 3 months post-CI, the total slow-phase velocity (SPV; warm and cold stimulations) was significantly different between the implanted and non-implanted sides (P=0.011), and the shift in total SPV from pre- to post-CI was significantly correlated with the average hearing threshold at 6 months post-CI. In group II, an abnormal c-VEMP was detected on the implanted side in six patients (16.2%) at 3 months post-CI, and in six patients (16.2%) at 6 months post-CI. Significant changes were noticed in the P1 and N1 amplitude at 3 months postCI (P=0.027 and P=0.019, respectively).Conclusion. Vestibular function and residual hearing function should be afforded equal and simultaneous consideration in terms of preservation.
Juncturae Tendinum Transfer for Extensor Tendon Reconstruction
Authors: Dhal Anil , Prakash Saket , Kalra Pulkit
Published: June 2020

Case:

A 9-year-old girl, with a history of crush injury to her right hand 2 years ago, presented with inability to extend her index finger. Exploration revealed segmental loss of extensor tendons to the index finger with a pre-existing scar in the route of tendon transfer. The juncturae tendinum (JT) between extensor digitorum communis of the middle and ring fingers (Von Schroeder -3y) was transferred to reconstruct the extensor tendon. At 1-year follow-up, finger extension was restored, with improved grasp and release.

Conclusion:

JT transfer could prove useful in reconstructing zone II extensor tendon injuries with scarring and fibrosis in the route of conventional tendon transfer/graft.
The effect of anti-cancer and anti-tuberculosis treatments in lung cancer patients with active tuberculosis: a retrospective analysis
Authors: CHAI MEI , Shi Qingming
Published: June 2020

Background: Lung tuberculosis (TB) and lung cancer have a complex relationship. Data concerning TB treatment in lung cancer patients are still incomplete. The aim of this study was to investigate the effects of anti-cancer and anti-tuberculosis treatments in lung cancer patients with active lung TB. Methods: In a retrospective cohort study, lung cancer patients with active lung TB were identified between January 2013 and December 2016. Age- and sex-matched lung cancer patients without tuberculosis were selected as control subjects. Anti-cancer and anti-tuberculosis treatments were administered according to the national guidelines. The clinical courses and responses of lung cancer patients with and without active lung TB were examined and compared. Results: A total of 31 consecutive lung cancer patients were diagnosed with active lung TB. Fifty-one lung cancer patients without TB were enrolled as control subjects. Most patients in the two groups were elderly, had advanced non-small cell lung cancer and had tumor burdens. The anti-cancer treatment completion rate and response rate were not different between two group (87.1% in TB treatment patients vs. 92.2% in lung cancer patients; 77.4% in TB treatment patients vs. 88.2% in lung cancer patients, respectively). The anti-tuberculosis treatment completion rate and success rate was 87.1% and 80.7%. The median survival times were not different between two groups (52 weeks in TB treatment patients vs. 57 weeks in lung cancer patients). The change in Karnofsky performance score was also not different between two groups. The most common side effect in TB treatment patients was liver injury (61.3%). The most serious side effect in TB treatment patients was leukocyte deficiency (9.7% in Grade 3). Both of side effects mentioned above were not different between two groups. Conclusion: Both anti-cancer and anti-tuberculosis treatments can be safely and effectively administered in lung cancer patients with active lung TB. Attention should be paid to the risk of tuberculosis in lung cancer patients in TB high-burden countries. Keywords Lung cancer, tuberculosis, prognosis.
Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery - A cross-sectional study in Norway
Authors: Berg Matilde Risopatron , Sahlin Ylva Ingrid
Published: June 2020

Background:Aim of the study was to estimate the prevalence of postpartum anal incontinence among women who delivered vaginally, and to assess the extent to which obstetric injuries to the anal sphincters are missed.Methods:All women (both primiparous and multiparous) who delivered vaginally and received any kind of sutures in the perineal area at Innlandet Hospital Trust Elverum in Norway between January 1, 2015 and June 30, 2016 were invited to answer a questionnaire on St. Mark’s incontinence score and to participate in a clinical examination of the pelvic floor including endoanal sonography.Results:In total 52,3% (n=207) of the 396 invited women participated in the study. Mean St. Mark’s score was 1.8 points (95% CI 1.4 to 2.1) at examination 14 months (mean) postpartum, and none of the participants suffered from weekly fecal leakage. Fecal urgency affected 11.7% (95% CI 7.1 to 16.3) of the participants, and 8.7% (95%CI 5.1 to 12.8) had weekly involuntary leakage of flatus. Nine women (9.3%, 95% CI 4.1 to 15.5) had a previously undetected third degree obstetric anal sphincter injury.Conclusion:The prevalence of anal incontinence among women who have delivered vaginally and received sutures due to 1stand 2nddegree perineal lacerations is low. Some obstetric anal sphincter injuries remain unrecognized at the time of delivery, but the symptoms of anal incontinence due to these injuries are in the lower half of the St. Mark’s incontinence score. Women with persistent symptoms like fecal urgency or leakage of gas and/or feces should be referred to evaluation by a colorectal surgeon in order to achieve optimal treatment.
The statistical importance of a study for a network meta-analysis estimate
Authors: Rücker Gerta , Nikolakopoulou Adriani , Papakonstantinou Theodoros , Salanti Georgia , Riley Richard D. , Schwarzer Guido
Published: June 2020

Background
In pairwise meta-analysis, the contribution of each study to the pooled estimate is given by its weight, which is based on the inverse variance of the estimate from that study. For network meta-analysis (NMA), the contribution of direct (and indirect) evidence is easily obtained from the diagonal elements of a hat matrix. It is, however, not fully clear how to generalize this to the percentage contribution of each study to a NMA estimate.MethodsWe define the importance of each study for a NMA estimate by the reduction of the estimate's variance when adding the given study to the others. An equivalent interpretation is the relative loss in precision when the study is left out. Importances are values between 0 and 1. An importance of 1 means that the study is an essential link of the pathway in the network connecting one of the treatments with another. ResultsImportances can be defined for two-stage and one-stage NMA. These numbers in general do not add to one and thus cannot be interpreted as `percentage contributions'. After briefly discussing other available approaches, we question whether it is possible to obtain unique percentage contributions for NMA. ConclusionsImportances generalize the concept of weights in pairwise meta-analysis in a natural way. Moreover, they are uniquely defined, easily calculated, and have an intuitive interpretation. We give some real examples for illustration.
Traditional and Cortical Trajectory Screws of Static and Dynamic Lumbar Fixation- A Finite Element Study
Authors: Liu Che-Wei , Wang Lu-Lin , Xu Yu-Kun , Chen Chun-Ming , Wang Jian-Cyuan , Tsai Wei-Tsung , Lin Shang-Chih
Published: June 2020

Background: Two types of screw trajectories are commonly used in lumbar surgery. Both traditional trajectory (TT) and cortical bone trajectory (CBT) were shown to provide equivalent pull-out strengths of a screw. CBT utilizing a laterally-directed trajectory engaging only cortical bone in the pedicle is widely used in minimal invasive spine posterior fusion surgery. It has been demonstrated that CBT exerts a lower likelihood of violating the facet joint, and superior pull-out strength than the TT screws, especially in osteoporotic vertebral body. No design yet to apply this trajectory to dynamic fixation. To evaluate kinetic and kinematic behavior in both static and dynamic CBT fixation a finite element study was designed. This study aimed to simulate the biomechanics of CBT-based dynamic system for an evaluation of CBT dynamization. Methods: A validated nonlinearly lumbosacral finite-element model was used to simulate four variations of screw fixation. Responses of both implant (screw stress) and tissues (disc motion, disc stress, and facet force) at the upper adjacent (L3-L4) and fixed (L4-L5) segments were used as the evaluation indices. Flexion, extension, bending, and rotation of both TT and CBT screws were simulated in this study for comparison. Results: The results showed that the TT static was the most effective stabilizer to the L4-L5 segment, followed by CBT static, TT dynamic, and the CBT dynamic, which was the least effective. Dynamization of the TT and CBT fixators decreased stability of the fixed segment and alleviate adjacent segment stress compensation. The 3.5-mm diameter CBT screw deteriorated stress distribution and rendered it vulnerable to bone-screw loosening and fatigue cracking. Conclusions: Modeling the effects of TT and CBT fixation in a full lumbosacral model suggest that dynamic TT provide slightly superior stability compared with dynamic CBT especially in bending and rotation. In dynamic CBT design, large diameter screws might avoid issues with loosening and cracking.
Comparison of Methods for Handling Covariate Missingness in Propensity Score Estimation with a Binary Exposure
Authors: Coffman Donna , Zhou Jiangxiu , Cai Xizhen
Published: June 2020

Background: Causal effect estimation with observational data is subject to bias due to confounding, which is often controlled for using propensity scores. One unresolved issue in propensity score estimation is how to handle missing values in covariates.Method: Several approaches have been proposed for handling covariate missingness, including multiple imputation (MI), multiple imputation with missingness pattern (MIMP), and treatment mean imputation. However, there are other potentially useful approaches that have not been evaluated, including single imputation (SI) + prediction error (PE), SI+PE + parameter uncertainty (PU), and Generalized Boosted Modeling (GBM), which is a nonparametric approach for estimating propensity scores in which missing values are automatically handled in the estimation using a surrogate split method. To evaluate the performance of these approaches, a simulation study was conducted. Results: Results suggested that SI+PE, SI+PE+PU, MI, and MIMP perform almost equally well and better than treatment mean imputation and GBM in terms of bias; however, MI and MIMP account for the additional uncertainty of imputing the missingness. Conclusions: Applying GBM to the incomplete data and relying on the surrogate split approach resulted in substantial bias. Imputation prior to implementing GBM is recommended.
Modified prediction system using combined preoperative anthropomorphic imbalance and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy
Authors: Abe Tomoyuki , Amano Hironobu , Kobayashi Tsuyoshi , Hanada Keiji , Hattori Minoru , Nakahara Masahiro , Ohdan Hideki , Noriyuki Toshio
Published: June 2020

Background

This study aimed to evaluate the efficacy of the combination of fistula risk score (FRS) and preoperative body composition factors for predicting the occurrence of clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD).

Methods

In this study, 136 consecutive patients who underwent PD between 2006 and 2018 were enrolled. The risk factors of CR-POPF (grades B and C) were analyzed. Preoperative visceral adipose tissue area (VATA), skeletal mass index (SMI), and subcutaneous adipose tissue area (SATA) were calculated from computed tomography data.

Results

The overall 30-day mortality and morbidity rates were 0.7% and 38%, respectively. The incidence of grade B and C CR-POPF was 27% and 4%, respectively. Univariate analysis revealed that male sex, habitual smoking, prognostic nutritional index (PNI) < 45, VATA ≥ 90, VATA/SATA ≥ 0.9, VATA/SMI ≥ 1.4, and FRS > 4 were significantly associated with the incidence of CR-POPF. Multivariate analysis revealed that PNI < 45, VATA/SMI ≥ 1.4, and FRS > 4 were the independent risk factors of CR-POPF. A modified prediction score using the combination of VATA/SMI and FRS significantly predicted CR-POPF after PD.

Conclusions

Preoperative anthropomorphic imbalance and FRS were equally accurate in predicting CR-POPF. Patients with high-risk factors should be closely monitored during the postoperative period.
Validity, reliability and feasibility of a new observation rating tool and a post encounter rating tool for the assessment of clinical reasoning skills of medical students during their internal medicine clerkship. A pilot study.
Authors: Haring Catharina Maria , Klaarwater Claudia , Bouwmans Geert , Cools Bernadette , Gurp Petra van , Meer Jos van der , Postma Cornelis
Published: June 2020

Background Systematic assessment of clinical reasoning skills of medical students in clinical practice is very difficult. This is partly caused by the lack of understanding of the fundamental mechanisms underlying the process of clinical reasoning. Methods We previously developed an observation tool to assess the clinical reasoning skills of medical students during clinical practice. This observation tool consists of an 11-item observation rating form (ORT). In the present study we verified the validity, reliability and feasibility of this tool and of an already existing post-encounter rating tool (PERT) in clinical practice among medical students during the internal medicine clerkshipResults Six raters each assessed the same 15 student-patient encounters. The internal consistency (Cronbach’s alfa) for the (ORT) was 0.87 (0.71-0.84) and the 5-item (PERT) was 0.81 (0.71-0.87). The intraclass-correlation coefficient for single measurements was poor for both the ORT; 0.32 (p<0.001) as well as the PERT; 0.36 (p<0.001). The Generalizability study (G-study) and decision study (D-study) showed that 6 raters are required to achieve a G-coefficient of > 0.7 for the ORT and 7 raters for the PERT. The largest sources of variance are the interaction between raters and students. There was a consistent correlation between the ORT and PERT of 0.53 (p=0.04)Conclusions The ORT and PERT are both feasible, valid and reliable instruments to assess students’ clinical reasoning skills in clinical practice.
Onset and remission of common mental disorders among adults living in temporary housing for three years after the triple disaster in Northeast Japan: comparisons with the general population
Authors: Kawakami Norito , Fukasawa Maiko , Sakata Kiyomi , Suzuki Ruriko , Tomita Hiroaki , Nemoto Harumi , Yasumura Seiji , Yabe Hirooki , Horikoshi Naoko , Umeda Maki , Suzuki Yuriko , Shimoda Haruki , Tachimori Hisateru , Takeshima Tadashi , Bromet Evelyn J
Published: June 2020

Background: People living in temporary housing for long periods after a disaster are at risk of (developing) poor mental health. This study investigated the post-disaster incidence and remission of common mental disorders among adults living in temporary housing for the three years following the 2011 Great East Japan Earthquake.Methods: Three years after the disaster, face-to-face interviews were conducted with 1,089 adult residents living in temporary housing in the disaster area, i.e., the shelter group, and a random sample of 852 community residents of East Japan. The World Health Organization Composite International Diagnostic Interview was used to diagnose DSM-IV mood, anxiety, and alcohol use disorders. Information on demographic variables and disaster experiences was also collected. Results: Response rates were 49% and 46%, for the shelter group and the community residents, respectively. The incidence of mood/anxiety disorder in the shelter group was elevated only in the first year post-disaster compared to that of the general population. The rate of remission for mood and anxiety disorders was significantly lower in the shelter group than in the community residents. The proportion seeking medical treatment was higher in the shelter group.Conclusions: The onset of common mental disorders increased in the first year, but then levelled off in the following years among residents in temporary housing after the disaster. Remission from incident post-disaster mental disorders was slower in the shelter group than in the general population. Post-disaster mental health service could consider the greater incidence in the first year and prolonged remission of mental disorders among survivors with a long-term stay in temporary housing after a disaster.
Symptoms in the general Norwegian adult population - prevalence and associated factors
Authors: Krogstad Hilde , Loge Jon Håvard , Grotmol Kjersti , Kaasa Stein , Kiserud Cecilie Essholt , Salvesen Øyvind , Hjermstad Marianne Jensen
Published: June 2020

Background: Patients´ own perceptions and evaluations of symptoms, functioning and other health-related factors, i.e. Patient Reported Outcomes (PROs), are important elements for providing good patient care. Symptoms are subjective and best elicited by the patient orally or by using PRO measures (PROMs), be it on paper, or as electronic assessment tools. Reference values on frequently used PROMs facilitate the interpretation of scores for use in clinics and research settings, by comparing patient data with relevant samples from the general population. Study objectives were to (1) present reference values for the M.D. Anderson Symptom Inventory (MDASI) (2) examine the occurrence and intensity of symptoms assessed by the MDASI in a general Norwegian adult population sample, and (3) examine factors associated with higher symptom burden defined as the sum score of all symptoms, and factors associated with symptoms` interference on functions.Methods: In 2015, MDASI was sent by mail as part of a larger survey, to a representative sample of the general Norwegian adult population (N = 6165). Medical comorbidities were assessed by the Self-Administered Comorbidity Questionnaire. Depression was self-reported on the Patient Health Questionnaire 9 (PHQ-9). Linear multivariable regression analysis was used to examine for factors associated with MDASI sum score and factors associated with symptoms’ interference on functions. Results: The response rate was 36%. More women (54%) than men (46%) responded. Mean age was 55 years (SD 14). The most frequent symptoms were fatigue (59.7%), drowsiness (56.2%) and pain (56.1%). Fatigue, pain and disturbed sleep had the highest mean scores. The presence of one or more comorbidities, increasing PHQ-9 score and lower level of education were associated with higher MDASI sum score (p<0.001). The MDASI sum score and the PHQ-9 score were positively associated with all interference items (p<0.001) except for walking (p=0.22). Conclusion: This study provides the first Norwegian reference values for MDASI. The presence of one or more comorbidities, higher level of depressive symptoms and lower level of education were significantly associated with higher MDASI sum score. These covariates must be controlled for when using the reference values.
Barriers and opportunities for management of shared sanitation facilities in low-income settlements in Kenya
Authors: Simiyu Sheillah , Kweyu Raphael M. , Antwi-Agyei Prince , Adjei Kwaku A.
Published: June 2020

Background: Sharing of sanitation is commonly being practiced in low income areas in Sub Saharan Africa. However, the Joint Monitoring Program (JMP) categorizes shared sanitation as a limited sanitation service. These shared facilities are often the only option available for most of the residents in low income settlements, and improving their management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved management of shared sanitation in low income settlements of Kisumu in Kenya. Methods: Thirty-nine In-depth interviews and 11 focus group discussions were held with residents, who mainly included tenants and landlords. Analysis followed a thematic approach to define the problem, specify the target behaviour and define what needs to change. Results: Pit latrines were commonly shared among landlords and tenants. Shared sanitation facilities were unclean due to poor use and lack of cleaning. Participants identified behavioural challenges such as poor use of the shared toilets, and social challenges such as lack of cooperation in cleaning. These results led to identification of opportunities for improvement such as instituting clear cleaning plans, communication among users, and problem solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the management of shared sanitation. Conclusion: The results highlight the need to focus on social aspects for improvement of shared sanitation management in low income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to afford the millions of low income dwellers an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the JMP’s recommendation for high quality shared facilities.
Routine Health Information System in the Health Facilities in Yaoundé-Cameroon: Assessing the Gaps for Strengthening
Authors: Tamfon Brian Bongwong , Ndongo Chanceline Bilounga , Bataliack Serge Marcial , Ngoufack Marie Nicole , Nguefack-Tsague Georges
Published: June 2020

Background: Management of health data and its use for informed decision making is a challenging health sector aspect in developing countries. Monitoring and evaluation of health interventions for meeting health-related Sustainable Development Goals (SDGs), and Cameroon Health Sector Strategy (HSS) targets is facilitated through evidence-based decision-making and public health action. Thus, a Routine Health Information System (RHIS) producing quality data is imperative. The objective of this study was to assess the RHIS in the health facilities (HFs) in Yaoundé in order to identify gaps and weaknesses and to propose measures for strengthening. Methods: A health facility-based cross-sectional descriptive study was carried out in the six health districts (HDs) of Yaoundé; followed by a qualitative aspect consisting of in-depth interviews of key informants at the Regional Health Office. HFs were selected using a stratified sampling method with probability proportional to the size of each HD. Data were collected (one respondent per HF) using the World Health Organization (WHO) and MEASURE Evaluation RHIS rapid assessment tool. Data were entered into Microsoft Excel 2013 and analyzed with IBM-SPSS version 20. Results: A total of 111 HFs were selected for the study. Respondents aged 24-60 years with an average of 38.3±9.3 years; 58 (52.3%) male and 53(47.7%) female. Heads of HFs and persons in charge of statistics/data management were most represented with 45.0% and 21.6% respectively. All the twelve subdomains of the RHIS were adequately functioning at between 7% and 30%. These included Human Resources (7%), Data Analysis (10%), Information and Communication Technology (11%), Standards and System Design (15%), Policies and Planning (15%), Information Dissemination (16%), Data Demand and Use (16%), Management (18%), Data Needs (18%), Data Quality Assurance (20%), Collection and Management of Individual Client Data (26%), Collection, Management, and Reporting of Aggregated Facility Data (30%). Conclusions: The level of functioning of subdomains of the RHIS in Yaoundé was low; thus, immediate and district-specific strengthening actions should be implemented if health-related SDGs and HSS targets are to be met. A nation-wide assessment should be carried out in order to understand the determinants of these poor performances and to strengthen the RHIS.
Utilization of Denture Adhesives and the Factors Associated with its Use: A Cross-Sectional Survey
Authors: BO TUN MIN , Hama Yohei , AKIBA NORIHISA , MINAKUCHI SHUNSUKE
Published: June 2020

Background: An increase in the number of elderly edentulous patients likely leads to a greater demand for dentures and denture adhesives. As denture adhesives have both positive and negative features, dentists need to know the types of denture adhesive users to be able to provide instruction to denture wearers on how to use denture adhesives effectively. This study aims to examine the utilization of denture adhesives and associated factors.Methods: Seven closed-ended questionnaires were developed for a web-based survey. After that, Fisher’s exact tests were performed to determine the difference in the denture adhesive usage rate by gender, type of denture, last dental visit, and smoking status. A multivariate-adjusted logistic regression analysis was performed with denture adhesive use or non-use as the dependent variable and the other items as independent variables. Next, Fisher’s exact tests and a multivariate-adjusted logistic regression analysis were performed with the type of denture adhesives as the dependent variable in the same way. Statistical analyses were performed for all denture wearers, complete denture wearers, and partial denture wearers. The level of statistical significance was set at p=0.05. Results: A total of 1470 denture wearers in Japan participated in this study. Of these, 318 used denture adhesives, while 212 (66.7%) used cream; 74 (23.3%) used home liner; 25 (7.9%) used powder; four (1.3%) used sheets; and three (0.9%) used several types. The Fisher’s exact tests revealed that the ratios of using denture adhesives were significantly higher for complete denture wearers (p<0.001), last dental visit over one year (p=0.005), and smokers (p=0.005). For partial denture wearers, the ratio was significantly higher in smokers (p=0.262). The multivariate adjusted logistic regression revealed that denture adhesive use or non-use were significantly associated with the type of denture and smoking status in all denture wearers, and just smoking status in partial denture wearers. There were no significant results about the type of denture adhesive selection.Conclusions: From all denture wearers, complete denture wearers and smokers are more likely to use denture adhesives. In addition, smokers significantly use denture adhesives if they are partial denture wearers.
Adult spinal deformity and its relationship with height loss: A 34-year longitudinal cohort study
Authors: Shimizu Mutsuya , Kobayashi Tetsuya , Chiba Hisashi , Senoo Issei , Ito Hiroshi , Matsukura Keisuke , Saito Senri
Published: June 2020

Background: Age-related height loss is a normal physical change that occurs in all individuals over 50 years of age. Although many epidemiological studies on height loss have been conducted worldwide, none have been long-term longitudinal epidemiological studies spanning over 30 years. This study was designed to investigate changes in adult spinal deformity and examine the relationship between adult spinal deformity and height loss.Methods: Fifty-three local healthy subjects (32 men, 21 women) from Furano, Hokkaido, Japan, volunteered for this longitudinal cohort study. Their heights were measured in 1983 and again in 2017. Spino-pelvic parameters were compared between measurements obtained in 1983 and 2017. Individuals with height loss were then divided into two groups, those with degenerative spondylosis and those with degenerative lumbar scoliosis, and different characteristics were compared between the two groups.Results: The mean age of the subjects was 44.4 (31-55) years at baseline and 78.6 (65-89) years at the final follow-up. The mean height was 157.4 cm at baseline and 153.6 cm at the final follow-up, with a mean height loss of 3.8 cm over 34.2 years. All parameters except for thoracic kyphosis were significantly different between measurements taken in 1983 and 2017 (p<0.05). Height loss in both sexes was related to changes in pelvic parameters including pelvic incidence-lumbar lordosis (R=0.460 p=0.008 in men, R=0.553 p=0.012 in women), pelvic tilt (R=0.374 p=0.035 in men, R=0.540 p=0.014 in women), and sagittal vertical axis (R=0.535 p=0.002 in men, R=0.527 p=0.017 in women). Greater height loss was more commonly seen in women (p=0.001) and in patients with degenerative lumbar scoliosis (p=0.02).Conclusions: This longitudinal study revealed that height loss is more commonly observed in women and is associated with adult spinal deformity and degenerative lumbar scoliosis. Height loss is a normal physical change with aging, but excessive height loss is due to spinal kyphosis and scoliosis leading to spinal malalignment. Our findings suggest that height loss might be an early physical symptom for spinal malalignment.
Utility of FDG PET/CT for Assessment of Lung Nodules Identified During Low Dose Computed Tomography Screening
Authors: Hadique Sarah , Jain Pranav , Hadi Yousaf , Baig Aneeqah , Parker John E
Published: June 2020

Background: Many clinical guidelines recommend FDG PET/CT for the evaluation of pulmonary nodules ≥ 8mm detected during low dose computed tomography (LDCT) lung cancer screening. However, its added value in this setting requires confirmation. We evaluated the clinical utility of FDG PET/CT, including incidental findings, during the evaluation of lung nodules detected on LDCT screening. Methods: A retrospective cohort study was performed among 75 patients who completed FDG PET/CT between January 2010 and December 2017, after lung nodules > 8mm had been detected on LDCT lung cancer screening. We report demographic variables, characteristics of the initial nodules on LDCT and FDG PET/CT, incidental findings on FDG PET/CT, as well as further work up performed and the influence of FDG PET/CT findings on management.Results: Nodules were reported to be benign on FDG PET/CT in 38/75 (50.6%) patients. Physicians chose either radiological follow-up or no further work up in all 38. FDG PET/CT was indeterminate or suggested malignancy in 37 (49.3%) patients. Biopsy was performed in 32 (86%) of these patients. Incidental findings on FDG PET/CT were reported in 37/75 (49%) patients. Further work-up of incidental findings was performed in 21/75 (28%) of patients. Conclusions: In this study, for majority of individuals with lung nodules identified during LDCT lung cancer screening, FDG PET/CT results were able to guide physicians in choosing between routine follow up or invasive biopsies. Conversely, 28% of these patients required additional investigations to address incidental findings.
Metabolic and Clinical responses to Bunium Persicum (Black Caraway) supplementation in overweight and obese patients with type 2 diabetes: a double-blind randomized placebo-controlled clinical trial
Authors: Jafari-Maskouni Saber , Shahraki Mansour , Daneshi-Maskooni Milad , Dashipour Alireza , Shamsi-Goushki Ali , Mortazavi Zinat
Published: June 2020

Background: Diabetes mellitus is the most common metabolic disorder worldwide. We aimed to determine the effects of Bunium Persicum (BP) on serum glucose indices, lipid profile, and nesfatin-1 levels in overweight or obese T2DM patients.Methods: Participant recruitment took place in the diabetic clinic of Bu-Ali hospital in Zahedan. Based on the eligibility criteria, 60 participants were randomly divided into two groups, namely BP (n=30) and placebo (n=30). The supplementation was one 1000 mg capsule 2 times /day BP with meals (lunch and dinner) for 8 weeks. Bodyweight, waist circumference, serum nesfatin-1, fasting blood sugar (FBS) and insulin (FBI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured. Quantitative insulin sensitivity checks index (QUICKI), homeostasis model assessment-insulin resistance (HOMA-IR), and Body Mass Index (BMI) were also calculated.Results: In comparison with placebo, BP significantly decreased FBS, HOMA-IR, and BMI (P<0.05). The differences in the FBI, QUICKI, TG, TC, LDL, HDL, WC, and Nesfatin-1 were not significant (P>0.05).Conclusion: BP supplement improved serum glucose indices and decreased BMI among overweight or obese T2DM patients; though, further trials are suggested to confirm results.Trial Registration: Iranian Registry of Clinical Trials (IRCT), IRCT20181207041876N1, Registered 18/01/2019, https://irct.ir/trial/35752
Prevalence of and Risk Factors for Anxiety and Depression in Chinese Patients With Unruptured Intracranial Aneurysms Treated by Endovascular Intervention
Authors: Zhai Xiao-Dong , Yu Jia-Xing , Ma Yong-Jie , Xiang Si-Shi , Li Gui-Lin , He Chuan , Hu Peng , Zhang Hong-Qi
Published: June 2020

Background: Studies on anxiety and depression in unruptured intracranial aneurysm (UIA) patients after treatment via endovascular intervention are rare and controversial. We aimed to explore the prevalence of anxiety and depression among Chinese patients with UIAs treated by endovascular intervention and to identify which factors contribute to the development of these symptoms.Methods: We performed a cross-sectional study on anxiety and depression in patients who underwent endovascular treatment for UIAs using the Hospital Anxiety and Depression Scale (HADS). The demographic, clinical and radiological data for all patients were retrospectively collected from the aneurysm database and medical records. Moreover, we utilized data from a large sample of 200 UIA patients and multivariate logistic regression analysis to investigate the risk factors for anxiety and depression in these patients. Candidate variables with P values less than 0.20 in univariate analysis were included in the multivariate logistic regression analysis.Results: Two hundred patients returned completed questionnaires in this study. Of these 200 patients, 34 (17.0%) suffered from anxiety and 31 (15.5%) suffered from depression 30.67±8.6 months after being discharged. The multivariate analysis results indicated that treatment costs exceeding the annual household income was significantly associated with anxiety (AOR = 2.42, 95% CI: 1.08~5.41, P= 0.03). Shorter sleep times were significantly associated with anxiety (AOR= 1.51, 95% CI: 1.06~2.14, P= 0.02) and depression (AOR = 1.62, 95% CI: 1.14~2.29, P= 0.007).Conclusion: The prevalences of anxiety and depression in UIA patients treated by endovascular intervention were 17.0% and 15.5%, respectively. Treatment costs exceeding the annual household income was significantly associated with anxiety. Shorter sleep times were significantly associated with anxiety and depression. Our findings provide valuable evidence for the clinical and psychological management of these patients.
Metapristone (RU486 derivative) inhibits endometrial cancer cell progress through regulating miR-492/Klf5/Nrf1 axis
Authors: Chang Yue , Hao Min , Jia Ru , Zhao Yihui , Cai Yixuan , Liu Yun
Published: June 2020

Background: Endometrial cancer is one of the most common cancers affecting women's health. The pathogenesis of endometrial cancer involves many signaling pathways which are related with transcription factors or microRNAs. Recent studies have reported that endometrial cancer is also related with the sexual-mediated hormones. The purpose of this research is to treat the endometrial cancer with the hormone-related drugs, and find out the specific molecular mechanism. Methods: In this study, RL95-2 cells and Ishikawa cells were used as the endometrial cancer cell models. miR-492 was transfected into RL95-2 cells and Ishikawa cells. The miRNA expression was measured by qRT-PCR. The protein expression was measured by western blot. Cell proliferation was monitored using the MTT assay and cell colony formation assay. Cell apoptosis was monitored using EdU assay. Results: Firstly, the results indicated that metapristone as a kind of hormone-related drugs could significantly inhibit the endometrial cancer cell growth through regulating cell apoptosis-related gene expression. Meanwhile, miR-492 was detected to be highly expressed in the endometrial cancer cell lines. Overexpression of miR-492 could promote the cell proliferation and inhibit the cell apoptosis. Furthermore, the results demonstrated that the downstream target genes of miR-492 were Klf5 and Nrf1, which were inhibited by metapristone. At the animal level, metapristone also inhibited the endometrial cancer cell growth through down-regulating the expression of miR-492 and decreasing the protein level of Klf5 and Nrf1. Conclusion: Taken together, this study indicated that metapristone inhibited the endometrial cancer cell growth through regulating the cell apoptosis related signaling pathway and the expression of miR-492 and its downstream target genes (Klf5 and Nrf1), which provided the theoretical basis of endometrial cancer in clinical treatment.