bluuebunny/crossref_metadata_2025_split huggingface dataset:
CT, US and MRI of Xanthine Urinary Stones: In-Vitro and In-Vivo Analyses
Authors: Shamir Stephanie , Peng Qi , Schoenfeld Alan , Drzewiecki Beth , Liszewski Mark 
Published: September 2020

Abstract
Background: Xanthine urinary stones are a rare entity that may occur in patients with Lesch-Nyhan Syndrome receiving allopurinol. There is little literature describing imaging characteristics of these stones, and the most appropriate approach to imaging these stones is therefore unclear. We performed in-vitro and in-vivo analyses of xanthine stones using computed tomography (CT) at different energy levels, ultrasound (US), and magnetic resonance imaging (MRI). Methods: Five pure xanthine stones from a child with Lesch-Nyhan were imaged in-vitro and in-vivo. CT of the stones was performed at 80kVp, 100kVp, 120kVp and 140kVp and CT numbers of the stones were recorded in Hounsfield units (HU). US of the stones was performed and echogenicity, acoustic shadowing and twinkle artifact were assessed. MRI of the stones was performed and included T2-weighted, ultrashort echo-time (UTE)-weighted and T2/T1-weighted 3D bFFE sequences and signal was assessed. Results: In-vitro analysis on CT demonstrated that xanthine stones were radiodense and the average attenuation coefficient did not differ with varying kVp, measuring 331.0+/-51.7HU at 80kVp, 321.4+/-63.4HU at 100kVp, 329.7+/-54.2HU at 120kVp and 328.4+/-61.1HU at 140kVp. In-vivo analysis on CT resulted in an average attenuation of 354+/-35HU. On US, xanthine stones where echogenic with acoustic shadowing and twinkle artifact. On MRI, stones lacked signal on all tested sequences.Conclusion: Xanthine stone analyses, both in-vitro and in-vivo, demonstrate imaging characteristics typical of most urinary stones: dense on CT, echogenic on US, and lacking signal on MRI. Therefore, the approach to imaging xanthine stones should be comparable to that of other urinary stones.
The effect of dexmedetomidine with bupivacaine combination and only bupivacaine on sensory and motor block time and pain score in supraclavicular block
Authors: Sane Shahryar , Shokouhi Shahram , Golabi Parang , Rezaeian Mona , Haki Behzad Kazemi 
Published: September 2020

Abstract
Background: This study was designed to assess the effect of dexmedetomidine on the effect of dexmedetomidine with bupivacaine combination and only bupivacaine on sensory and motor block time, pain score, and hemodynamic variations in supraclavicular block in upper extremity orthopedic surgery.Methods: This prospective double-blind study was performed on 60 patients aged 20-60 years who were candidates for upper extremity orthopedic surgeries. The sensory block was evaluated using the pinprick method and motor block by the modified Bromage scale method. The post-operative pain was assessed by a visual analog scale. Results: The mean onset time of sensory and motor block in patients receiving bupivacaine alone was respectively 31.03± 9.65 min and 24.66 ± 9.2 min and in the dexmedetomidine receiving group was about 21.36±8.34 min and 15.93 ± 6.36 minutes. The changes in heart rate and mean arterial blood pressure was similar in both groups. The duration of sensory and motor block and the time of the first analgesia request in the intervention group were longer. Postoperative pain was lower in the intervention group for 24 hours (P = 0.001).Conclusion: The use of dexmedetomidine plus bupivacaine, without side effects, reduced the onset time of sense and motor blocks and increased the duration of numbness and immobility. Also, dexmedetomidine reduced postoperative pain significantly in use with bupivacaine for supraclavicular blocks.Trial registration: IRCT, IRCT20160430027677N15. Registered 05/28/2019, http:// https://www.irct.ir/trial/39463
Clinicopathological Characteristics and Endoscopic Features of Early Gastric Cancers Diagnosed After Helicobacter pylori Eradication: A Retrospective Study
Authors: Ishibashi Hideki , Takedatsu Hidetoshi , Tanabe Taro , Imakiire So , Matsuoka Hiroki , Yasuda Hideki , Sakisaka Hideto , Matsuoka Satoshi , Kayashima Yoshiyuki , Kuno Nobuaki , Abe Koichi , Funakoshi Sadahiro , Hirai Fumihito 
Published: September 2020

Abstract
Background: Helicobacter pylori (H. pylori) infection is an important risk factor for developing gastric cancer. However, even after H. pylori eradication, early gastric cancer (EGC) can develop. We elucidated the characteristics of EGCs diagnosed after H. pylori eradication. Methods: Thirty-six EGCs in 32 patients diagnosed after H. pylori eradication were defined as the eradication group (H. pylori-EG). The clinicopathological and endoscopic features were compared with those of 156 EGCs in 140 patients in the H. pylori-positive group (H. pylori-PG). Twenty-nine EGC lesions in the H. pylori-EG were further divided into two subgroups: the first included six lesions of no to mild atrophic mucosa around the EGC, and the second included 23 lesions of moderate to severe atrophic mucosa around the EGC. We compared them between the two subgroups. Results: Endoscopic features of EGCs in the H. pylori-EG were characterized as small (P = 0.049) and of the depressed type (P = 0.022) compared with those in the H. pylori-PG. EGCs in the H. pylori-EG were detected in the upper region of the stomach more frequently than those in the H. pylori-PG (P = 0.002). Submucosal ECGs in the H. pylori-EG were more likely to be seen in the no to mild atrophic mucosa subgroup (4/6, 67%) compared with the moderate to severe atrophic gastric mucosa subgroup (1/23, 4%) (P = 0.003). Conclusions: Careful follow-up endoscopies are necessary after H. pylori eradication.
The association of serum gamma-glutamyltransferase and the incidence of type 2 diabetes mellitus based on propensity score matching: a retrospective observational cohort study
Authors: Dong Buyuan , Ji Ziwei , He Leye , Chen Hao , Chen Mengxia , Feng Qian , Jin Rong , Hu Sunkuan 
Published: September 2020

Abstract
Background: Previous studies reported that gamma-glutamyltransferase (GGT) may play an important role in the development of diabetes. The purpose of this study is to demonstrate that GGT is an independent risk factor for diabetes and to explore whether the association between GGT and the incidence of diabetes is affected by age and gender in the general Japanese population.Methods: This study is a retrospective observational cohort study. The study included 15464 men and women with an average age of 43.71 years from the Japanese health checkup program at Murakami Memorial Hospital from 2004 to 2015. The serum gamma-glutamyltransferase was stratified by quartiles. Patients were stratified by gender and age. Results: After adjusting for potential confounders, each additional standard deviation (SD) of GGT increases the risk of diabetes by 9%. The hazard ratio (HR) is 1.09 and the confidence interval (CI) is (1.01, 1.17). Participants in the fourth quartiles (Q4,≥ 22IU/L) had a higher risk of diabetes than the first to third quartiles (Q1-Q3) of GGT (HR: 1.47, 95 % CI: 1.15-1.87). Compared with males with lower GGT activity, males aged 40 to 50 years with GGT activity in the fourth quantile had a 53% increased risk of diabetes mellitus. Conclusions: GGT was positively correlated with the incidence of diabetes in the Japanese population. Especially in males aged 40-50 y, the higher the GGT, the higher the risk of developing diabetes.
Wolbachia infection in wild mosquitoes (Diptera: Culicidae): implications for transmission modes and host-endosymbiont associations in Singapore
Authors: Ding Huicong , Yeo Huiqing , Puniamoorthy Nalini 
Published: September 2020

Abstract
Background: Wolbachia is an intracellular bacterial endosymbiont found in most insect lineages. In mosquitoes, the endosymbiont’s influence on host reproduction and arboviral transmission has spurred numerous studies aimed at using Wolbachia-infection as a vector control technique. However, there are several knowledge gaps in the literature and little is known about natural Wolbachia infection across species, transmission modes as well as the associations between various Wolbachia lineages and their hosts. This study aims to address these by exploring mosquito-Wolbachia associations and their evolutionary implications.Methods: We conducted tissue-specific PCR screening for Wolbachia infection in the leg, gut and reproductive tissues of wild mosquitoes from Singapore using the Wolbachia surface protein (wsp) molecular marker. Mosquito-Wolbachia associations were explored using three methods – a tanglegram, distance-based, and event-based method, and inferred instances of vertical transmission and host shifts.Results: Adult mosquitoes (271 specimens) representing 14 genera and 40 species were screened for Wolbachia. Overall, 21 species (51.2%) were found positive for Wolbachia, including Aedes (5 species) and Culex (5 species). Seven out of the 21 infected species were not previously reported: Aedes nr. fumidus, Aedes annandaelei, Uranotaenia obscura, Uranotaenia trilineata, Verrallina butleri, Verrallina sp., and Zeugnomyia gracilis. Wolbachia was predominantly detected in the reproductive tissues, an indication of vertical transmission. Despite this, Wolbachia infection rates vary widely within a mosquito host species. There is no clear signal of co-phylogeny between the mosquito hosts and the twelve putative Wolbachia strains observed in this study. Host shift events were also observed.Conclusions: Our results suggest that the mosquito-Wolbachia relationship is complex and that a combination of transmission modes and multiple evolutionary events likely explain the distribution of Wolbachia diversity observed across mosquito hosts. This has implications towards understanding Wolbachia’s diversity, ecology, and utility as a biocontrol method.
Characteristics of patients who access zero, one or multiple General Practices and reasons for their choices: a study in regional Australia.
Authors: Glenister Kristen Maree , Guymer John , Bourke Lisa , Simmons David 
Published: September 2020

Abstract
Background: Most people in Australia visit a General Practitioner each year and are free to choose their General Practitioner and/or practice on each occasion. A proportion of people visit multiple general practices, which can reduce continuity of care, a core value of general practice. Utilisation of multiple general practices is associated with metropolitan residence and younger age. However, it is unclear which factors are associated with utilisation of multiple general practices in rural areas, where there are often General Practitioner workforce shortages and higher proportions of patients who may benefit from continuity of care such as older people or those with chronic disease. The aim of this study was to compare the characteristics of people in a rural Australian area who accessed multiple general practices in the previous year with people who had accessed one practice or none.Methods: A cross-sectional survey assessed self-reported utilisation and perspective of general practice services, uses of multiple practices, associated reasons, lifestyle advice and screening services received in four regional Victorian towns. Households were randomly selected and residents aged 16+ were eligible to participate in the adult survey.Results: Most people had attended a single general practice (78.9%), while 14.4% attended more than one practice and 6.7% attended no practices in the previous 12 months. Compared with utilisation of a single general practice, multiple general practice attendance in the previous year was associated with younger age (adjusted odds ratio (aOR 95% confidence interval) 0.98 per year (0.97-0.99), residence in the regional centre aOR 2.90(2.22-3.78), emergency department (ED) attendance in the last 12 months aOR 1.65(1.22-2.21) and no out of pocket costs aOR 1.36(1.04-1.79)). Reasons for multiple general practice attendance were reported as availability of appointments, cost and access to specific services. Compared with multiple general practice attendance, those attending single practices reported more screening tests but similar frequency of lifestyle advice. People who accessed multiple practices were less likely to report very high satisfaction (51.7% vs 62.9% p<0.001) or excellent degree of confidence in their doctor (42.0% vs 49.8% p=0.006) than single practice attendees.Conclusions: Those attending single practices report higher satisfaction and confidence in their GP and were less likely to attend ED. Further studies are required to test whether increasing availability of appointments and reducing out-of-pocket expenses would increase single practice attendance and/or decrease healthcare costs overall.
Association between circulating microRNAs 486, 146b and 15b and serum betatrophin levels in obese; type 2 diabetic and non-diabetic children
Authors: Mohany khalid Mohammad , Alrugaie Osamah , Alwutayd Osama , Al-Nafeesah Abdullah , Saleem Tahia H. 
Published: September 2020

Abstract
Background: This study tested the association between serum levels of microRNA-486, -146b and -15b and betatrophin in normal and obese children with/without type 2 diabetes mellitus (T2DM).Methods: the study included 120 children; divided into three groups: G1 (50 healthy), G2 (35 obese) and G3 (35 obese with T2DM). The levels of microRNA-486, 146b and 15b and serum betatrophin were measured by their corresponding methods. Results: serum microRNA-486, -146b, -15b and betatrophin levels were significantly high in G3 followed by G2 then G1 (p=0.002, > 0.001, > 0.001, and > 0.001, respectively). Especially in G3, these levels correlated positively with the BMI percentile (r=0.44, 0.58, 0.38, and 0.46, p=0.007, > 0.001, 0.021, and 0.005, respectively), serum glucose (r=0.56, 0.49, 0.82, 0.60, and 0.42, p > 0.001, 0.003, > 0.001, and > 0.001, respectively) and HbA1c% (r=0.56, 0.39, 0.66, and 0.42, p > 0.001, 0.019, > 0.001, and 0.032, respectively) while, showed negative correlations with correlated with serum insulin levels (r=-0.37, -0.42, -0.58, and -0.41, p=0.021, 0.012, > 0.001 and 0.013, respectively) and with serum C-peptide levels (r=-0.76, -0.50, -0.35 and -0.42, p > 0.001, 0.002, 0.036 and 0.011, respectively). Serum betatrophin levels correlated positively with microRNA-486, -146b and -15b levels in G2 (r=0.35, 0.80, and 0.67, p= 0.036, > 0.001, and, > 0.001, respectively), and in G3 (r=0.57, 0.36, and 0.38, p > 0.001, 0.029 and, 0.023, respectively). Conclusions: Circulating microRNA-486, 146b and 15b increase significantly in obese children with T2DM and these levels correlate positively with serum betatrophin levels. Further studies are required to test the role of targeting of these microRNAs and betatrophin in the timely management of obesity and/or T2DM in children.
Promoting Sustainable Physical Activity Among Iranian Middle-Aged Women: An Interventional Study
Authors: Shariati Mohammad , Astaneh Houra Pourrajabali , Khedmat Leila , Khatami Farnaz 
Published: September 2020

Abstract
Background: The physical inactivity can enhance the risk of adverse health conditions such as non-communicable diseases, morbidity, and mortality among middle- and older-aged population. This study aimed to design, implement, and evaluate a conceptual model of physical activity (PA) promotion among Iranian middle-aged women (IMGW). Methods: An interventional study with 80 women aged 30-59 years in intervention and control groups was conducted in 2018-2019. The subjects referred to health centers were selected by the available convenience sampling method. The data collection tools including face-to-face interviews, body mass index (BMI) measurements, the four-question form of PA vital signs in the framework of the Iran's Package of Essential Non-communicable (IraPEN) program, and the questionnaire based on Health Belief Model (HBM) constructs were used to assess the IMGW' PA level (metabolic equivalent tasks (MET)-min/week). Results: The intervention led to a three-fold increase in the average PA (from 280.63 to 927.70 MET-min/week) of the intervention group. Although there was no significant difference in the BMI between both the groups before the intervention, this educational program decreased the mean BMI from 30.36 to 28.83 kg/m2 (p=0.01). The HBM-based perceived sensitivity/severity and self-efficacy values after the intervention were increased from 62.09 to 71.03% and from 27.01 to 83.15%, respectively (p<0.0001). No significant difference in the cue to action and perceived benefits and barriers after the intervention was found. Conclusion: The developed model through increasing the motivation of IMGW could remarkably improve the PA level with a decrease in their BMI.Trial register: Iranian Registry of Clinical Trials (IRCT): IRCT20200717048124N1 at 2020-08-05, retrospectively registered.
Self-poisoning with pesticides in Jiangsu Province, China: a cross-sectional study on 24,602 subjects
Authors: Wang Boshen , Han Lei , Wen Jinbo , Zhang Juan , Zhu Baoli 
Published: September 2020

Abstract
Background: With an estimated >800,000 suicide-related deaths and potentially several attempts for each death in the world. The purpose of this study was to determine the epidemiological characteristics of self-poisoning with pesticides within the Jiangsu province in China. Methods: Suicide rate was calculated the Routine Surveillance System by Jiangsu Provincial Center for Disease Control and Prevention, stratified by gender, age and region, combined with socioeconomic and agriculture-related factors to investigate trends in suicide over the study period. A logistic regression model was used to investigate the associations between pesticide types and pesticide-related deaths. Results: In recent years, Jiangsu Province has witnessed a decrease in pesticide self-poisoning cases and consequent deaths. Among all suicides by deliberate ingestion of pesticides, the proportion of cases were mainly in the age 40, accounting for 3.43% of all cases with pesticide suicide. The proportion of suicide due to pesticide poisoning in females was markedly higher than that in males ( p <0.001). Suicide using organophosphate and carbamate insecticides was most common, with 10,303 reported cases accounting for 42.02% of all suicides.Conclusions: For national responses to be effective, the characteristics of pesticide suicides should be comprehensively investigated for the formulation of corresponding prevention strategies. At present, more pesticide suicide prevention policies for the elderly people and women should be implemented, and stronger pesticide management policies should be implemented for rural areas.
Clinical Variables Responsible for Early and Late Diagnosis of Foreign Body Aspiration in Pediatrics Age Group
Authors: Goyal Samarth , Jain Shubhika , Rai Guruprasad , Vishnu Rajkamal , Kamath Ganesh Sevagur , Bishnoi Arvind Kumar , Gaude Yogesh , Kumara Vijaya , Joshi Harshil , Reddy Revanth 
Published: September 2020

Abstract
Background: Incidence of foreign body aspiration has been noticed predominantly in age group ranging from 12 months-3 years. Foreign body in the trachea is a medical emergency as presentation is in respiratory distress. Obstruction of only one main or distal bronchus, leads to severe cough, choking sensation and breathlessness. Without early intervention, it can lead to collapse, consolidation and pneumonia of the affected lung. Methods: We retrospectively analyzed 37 pediatric case records who presented from January 2014-December 2018 with foreign body aspiration. Our primary aim was to assess the parameters responsible for early and late diagnosis of foreign body aspiration. We concluded with a diagnostic algorithm for management of foreign body aspiration on the basis of this outcome.Results: Around 32.5% came with a history of aspiration, 43% were referred from the primary centers with a suspicion for the same and the rest came to our tertiary care hospital directly. Those who presented within a week came with complaints of wet cough, wheeze and tachypnea. Furthermore, those who came in after a week had a dry cough and fever as their main complaint. Majority of ingested foreign bodies was a vegetative type (80%) as compared to the non –vegetative.Conclusion: Unlike adults, foreign body aspiration in children is most commonly diagnosed on history, suspicion and clinical findings. Chest x ray has been the primary investigation of choice but in the majority of the cases it was normal with subtle changes. Early diagnosis is the key to avoid complication.
A cohort study to identify risk factors for malaria in Burkinabe children: implications for other high burden high impact countries
Authors: Yaro Jean Baptiste , Ouedraogo Alphonse , Ouedraogo Z Amidou , Diarra Amidou , Lankouande Malik , Agboraw Efundem , Worrall Eve , Toe Kobié Hyacinthe , Sanou Antoine , Guelbeogo W Moussa , Sagnon N’Fale , Ranson Hilary , Tiono Alfred B. , Lindsay Steven W , Wilson Anne L 
Published: September 2020

Abstract
Background: Progress in controlling malaria has stalled in recent years. Today the malaria burden is increasingly concentrated in a few countries, including Burkina Faso, where malaria is not declining. We carried out a cohort study to identify risk factors for malaria infection in children in south-west Burkina Faso, an area with high insecticide-treated net (ITN) coverage and insecticide-resistant vectors.Methods: Incidence of Plasmodium falciparum infection was measured in 252 children aged 5 to 15 years, using active and passive detection, during the 2017 transmission season, following clearance of infection. Demographic, socioeconomic, environmental and entomological risk factors, including use of ITNs and insecticide resistance were monitored.Results: During the six-month follow-up period, the overall incidence of P. falciparum infection, was 2.78 episodes per child (95% CI= 2.66-2.91) by microscopy, and 3.11 (95% CI= 2.95-3.28) by polymerase chain reaction. The entomological inoculation rate (EIR) was 80.4 infective bites per child over the six-month malaria transmission season. At baseline, 80.6% of children were reported as sleeping under an ITN the previous night, although at the last survey, 23.3% of nets were in poor condition and considered no longer protective. No association was found between the rate of P. falciparum infection and either EIR (Incidence Rate Ratio, IRR: 1.00, 95% CI: 1.00–1.00, p=0.08) or mortality in WHO tube tests when vectors were exposed to 0.05% deltamethrin (IRR: 1.05, 95% CI: 0.73–1.50, p=0.79). Travel history (IRR: 1.52, 95% CI: 1.45–1.59, p<0.001) and higher socio-economic status were associated with an increased risk of P. falciparum infection (IRR: 1.05, 95% CI: 1.00–1.11, p=0.04).Conclusions: Incidence of P. falciparum infection remains overwhelmingly high in the study area. Our findings suggest that because of the exceptionally high levels of malaria transmission in the study area, malaria elimination cannot be achieved solely by mass deployment of ITNs and additional control measures are needed.