bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Optometrists’ Knowledge, Skills and Practice on Cataract: A Case Study from Kisumu County, Western Kenya
Authors: Muma Shadrack , Obonyo Stephen 
Published: June 2020

Abstract
Background: Cataract is a major contributor to avoidable blindness in the world and greatly impact negatively on the quality of life. The prevalence of blindness in Kenya is estimated at 0.7% with cataract contributing 43%. Optometrists being the primary eye care providers for cataract patients, they are well placed to assess and refer cataract patients. Though there is no data on optometrist knowledge, skill and practice on cataract in Kisumu, Kenya. Methods: A cross-sectional study design was used. The study was conducted from June 2019 to August 219 using self-administered questionnaire. We collected basic socio-demographic characteristics and investigated participants’ knowledge, skills and practice on cataract. The primary outcome measures were the proportions of participants who identified the questions related to knowledge, skills and practice on cataract. Chi-square analysis was performed to look at the association between demographic and practice, knowledge and skills. Results: A total of 49 optometrists were interviewed with a male to female ratio of 2:1, mean age of 30.4(72%) years and mean duration of practice of one to ten years. Majority of the optometrists had good knowledge on various aspects of cataract. Like 98% had a good knowledge on the types of cataract. Based on skills, 75.5% could diagnose cataract correctly. However, 57.1% could not identify nuclear cataract. Practice among the optometrists was largely low in the sense that, 61.2% of optometrists did not screen patients aged 40 years and above for cataract. Almost half of the optometrists, 52.6% did a routine eye examination but did not know the importance of examining the crystalline lens for patient above 40 years. Conclusion The study established that despite the good level of knowledge among the optometrist on cataract, there exist gaps in skills in categorizing the type of cataract and practice. The results of this study calls for skills development training for optometrists on cataract and immediate ophthalmic division response for improvement on the scope of training for optometrists. This will eases diagnosis of cataract and its management so as to reduce its burden in Kenya.
Hearing loss and cognitive function among Chinese older adults: The role of participation in leisure activities
Authors: Gao Jiamin , Armstrong Nicole M. , Deal Jennifer A. , Lin Frank R. , He Ping 
Published: June 2020

Abstract
Background Hearing loss, a highly prevalent sensory impairment affecting older adults, is a risk factor for cognition decline. However, there were very limited studies on this association in low-resource countries. This study aimed to assess the association between self-reported hearing loss and cognitive decline, and whether engagement in leisure activities moderated this association among older adults in China.Methods Data were obtained from two waves of the nationally representative survey of China Longitudinal Healthy Longevity Survey (CLHLS) between 2011/12-2014. 8,844 individuals aged 65 years old or above with a dichotomized measure of self-reported hearing status were included. Modified Mini-Mental Examination (MMSE) was used to measure global cognition. Fixed-effects models were used to estimate whether leisure activity engagement moderated the association of self-perceived hearing loss with global cognitive change in the overall sample and sex subsamples.Results Self-reported hearing loss was associated with cognitive impairment, with an odds ratio of 2.48 [1.22, 5.06]. Sex difference in the association of hearing loss and cognitive impairment was not found. Self-reported hearing loss was associated with cognitive decline, with 8% [-1.22, -0.39] increase in risk compared with those with normal hearing. Frequent engagement in leisure activities moderated the association between hearing loss and cognitive decline for the whole and male samples.Conclusion Hearing loss was associated with cognitive decline, and leisure activities engagement moderated the association among males rather than females.
Spatiotemporal association of low birth weight with Cs-137 deposition at the prefecture level in Japan after the Fukushima nuclear power plant accidents: an analytical-ecologic epidemiological study
Authors: Scherb Hagen , Clinic Japan Hayashi Osaka Keiji Hayashi Children's 
Published: June 2020

Abstract
Background: Perinatal mortality increased in contaminated prefectures after the Fukushima Daichi Nuclear Power Plant (FDNPP) accidents in Japan in 2011. Elevated counts of surgeries for cryptorchidism and congenital heart malformations were observed throughout Japan from 2012 onward. The thyroid cancer detection rate (2011 to 2016) was associated with the dose-rate at the municipality level in the Fukushima prefecture. Since the birth weight is a simple and objective indicator for gestational development and pregnancy outcome, the question arises whether the annual birth weight distribution was distorted in a dose-rate-dependent manner across Japan after Fukushima. Methods: The Japanese Ministry of Health, Labour, and Welfare provides prefecture-specific annual counts for 26.158 million live births from 1995 to 2018, of which 2.366 million births (9.04%) with weights < 2500 g. Prefecture-specific spatiotemporal trends of the low birth weight proportions were analyzed. Logistic regression allowing for level-shifts from 2012 onward was employed to test whether those level-shifts were proportional to the prefecture-specific dose-rates derived from Cs-137 deposition in the 47 Japanese prefectures. Results: The overall trend of the low birth weight prevalence (LBWp) in Japan discloses a jump in 2012 with a jump odds ratio (OR) 1.020, 95%-confidence interval (1.003,1.037), p-value 0.0246. A logistic regression of LBWp on the additional dose-rate after the FDNPP accidents adjusted for prefecture-specific spatiotemporal base-line trends yields an OR per µSv/h of 1.098 (1.058, 1.139), p-value < 0.0001. Further adjusting the logistic regression for the annual population size and physician density of the prefectures, as well as for the counts of the dead, the missing, and the evacuees due to earthquake and tsunami (as surrogate measures for medical infrastructure and stress) yields an OR per µSv/h of 1.109 (1.032, 1.191), p-value 0.0046.Conclusions: This study shows increased low birth weight prevalence related to Cs-137 deposition and the corresponding additional dose-rate in Japan from 2012 onward. Previous evidence suggesting compromised gestational development and pregnancy outcome under elevated environmental ionizing radiation exposure is corroborated.
Strategies for Diagnosis of Fetal right atrium dilation: Based on fetal cardiac anatomy and hemodynamics
Authors: Wang Yu , Zhao Leisheng , Zhang Ying 
Published: June 2020

Abstract
Background: Fetal right atrium (RA) dilation is frequently detected in routine screenings while it remains a challenge to clarify the reasons. This study aimed to analyze the cardiac anatomy and hemodynamics of fetal RA dilation and the changes of hemodynamic indexes. Methods: In the retrospective study, 420 fetuses with RA dilation were included, which were classified into the physiological group (n=202), volume overload group (n=142), and the pressure overload group (n=76). The ratio of right atrium to left atrium (RA/LA) were measured at four-chamber view. Peak velocity of tricuspid regurgitation (VTR) was recorded in each case, if existed. Results: The RA/LA ratio in the volume overload group is significantly higher than both the pressure overload group and the physiological group (both P=0.000) throughout the pregnancy while no difference presents between the pressure overload group and the physiological group (P=0.694 for 19-31 GW, and P=0.974 for 32-36 GW, respectively). The VTR in the pressure overload group (3.29±0.58 m/s) is significantly higher than both the volume overload group (1.85±0.45 m/s, P=0.000) and the physiological group (0.88±0.45 m/s, P=0.000). The volume overload group shows a significantly higher VTR than the physiological group (P=0.000). In the volume overload group, the ductal contraction/closure shows a significantly higher VTR than that in the pulmonary valve stenosis/atresia (3.98±0.41 m/s vs. 3.03±0.38 m/s, P=0.000).Conclusions: A strategy proposed herein is useful to clarify the reasons for RA dilatation by systematically assessing fetal hemodynamics, which may facilitate the sonographers to make an accurate diagnosis of CHD.
Epidemiology and risk factors of infective endocarditis in a tertiary hospital in China from 2007 to 2016
Authors: Wu Zhenzhu , Chen Yi , Xiao Tingting , Niu Tianshui , Shi Qingyi , xiao yonghong 
Published: June 2020

Abstract
Background: To explore the trends in epidemiology and risk factors related to the prognosis of infective endocarditis in a teaching hospital over the past ten years.Methods: A retrospective cohort study was performed. A total of 407 consecutive patients were included. The clinical characteristics and risk factors related to the prognosis of infective endocarditis during this period were analyzed. Results: A total of 407 patients with infective endocarditis were included, the average age was 48 ±16 years old with an increasing trend and in-hospital mortality rate was 10.6% and one-year mortality rate was 12.2%. Among patients with underlying heart disease, congenital heart disease was the most common(25.8%), followed by rheumatic heart disease which showed a decreased trend during this period (P<0.001). There were 222(54.5%) positive blood cultures and Streptococci (24.1%) was the main pathogens with an increasing trend. There were 403 patients (99%) with surgical indications, but only 234 patients (57.5%) received surgical treatment. Hemodialysis (P = 0.041, OR = 4.697, 95% CI 1.068-20.665), pulmonary hypertension (P = 0.001, OR = 5.308, 95% CI 2.034-13.852), Pitt score ≥ 4 (P <0.001, OR = 28.594, 95% CI 5.561-148.173) and vegetation length＞30mm (P = 0.011, OR = 13.754, 95% CI 1.832-103.250) were independent risk factors for in-hospital mortality.Conclusions: There was no significant change in the overall incidence of infective endocarditis, the clinical features of infective endocarditis have changed slightly during the past ten years. Streptococci infective endocarditis was still the predominant. Infective endocarditis patients with hemodialysis, pulmonary hypertension, Pitt score ≥ 4 and vegetation length＞30mm had an worse in-hospital outcome.
Antioxidant preconditioning improves therapeutic outcomes of adipose tissue-derived mesenchymal stem cells through enhancing intrahepatic engraftment efficiency in a mouse liver fibrosis model
Authors: Liao Naishun , Shi Yingjun , Wang Yingchao , Liao Fangyu , Zhao Bixing , Zheng Youshi , Zeng Yongyi , Liu Xiaolong , Liu Jingfeng 
Published: June 2020

Abstract
Background: Although it has been pre-clinically suggested that adipose tissue-derived mesenchymal stem cell (ADSCs)-based therapy could effectively treat chronic liver diseases, the hepatic engraftment of ADSCs is still extremely low, which severely limits their long-term efficacy for chronic liver diseases. This study was designed to investigate the impact of antioxidant preconditioning on hepatic engraftment efficiency and therapeutic outcomes of ADSC transplantation in liver fibrotic mice. Methods: Liver fibrosis model was established by using intraperitoneal injection of carbon tetrachloride (CCl 4 ) in the male C57BL/6 mice. Subsequently, the ADSCs with or without antioxidant pretreatment (including melatonin and reduced glutathione (GSH)) were administrated into fibrotic mice via tail vein injection. Afterwards, the ADSC transplantation efficiency was analyzed by ex vivo imaging, and the liver functions were assessed by biochemical analysis and histopathological examination, respectively. Additionally, a typical hydrogen peroxide (H 2 O 2 )-induced cell injury model was applied to mimic the cell oxidative injury to further investigate the protective effects of antioxidant preconditioning on cell migration, proliferation and apoptosis of ADSCs. Results: Our data showed that antioxidant preconditioning could enhance the therapeutic effects of ADSCs on liver function recovery by reducing the level of AST, ALT and TBIL, as well as the content of hepatic hydroxyproline and fibrotic area in liver tissues. Particularly, we also found that antioxidant preconditioning could enhance hepatic engraftment efficiency of ADSCs in liver fibrosis model through inhibiting oxidative injury. Conclusions: Antioxidant preconditioning could effectively improve therapeutic effects of ADSC transplantation for liver fibrosis through enhancing intrahepatic engraftment efficiency by reducing oxidative injuries. These findings might provide a practical strategy for enhancing ADSC transplantation and therapeutic efficiency.
A hypoxia-related signature for clinically predicting diagnosis, prognosis and immune microenvironment of hepatocellular carcinoma patients.
Authors: Zhang Baohui , Tang Bufu , Gao Jianyao , Li Jiatong , Kong Lingming , Qin Ling 
Published: June 2020

Abstract
Background Hypoxia plays an indispensable role in the development of hepatocellular carcinoma (HCC). However, there are few studies on the application of hypoxia molecules in the prognosis predicting of HCC. We aimed to identify the hypoxia-related genes in HCC and construct reliable models for diagnosis, prognosis and recurrence of HCC patients as well as exploring the potential mechanism. Methods Differentially expressed genes (DEGs) analysis was performed using The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database and four clusters were determined by a consistent clustering analysis. Three DEGs closely related to overall survival（OS）were identified using Cox regression and LASSO analysis and the hypoxia-related signature was developed and validated in TCGA and International Cancer Genome Consortium (ICGC) database. Then the Gene Set Enrichment Analysis (GSEA) was performed to explore signaling pathways regulated by the signature and the CIBERSORT was used for estimating the fractions of immune cell types. Results A total of 397 hypoxia-related DEGs were detected and three genes (PDSS1, CDCA8 and SLC7A11) were selected to construct a prognosis, recurrence and diagnosis model. Then patients were divided into high- and low-risk groups. Our hypoxia-related signature was significantly associated with worse prognosis and higher recurrence rate. The diagnostic model also accurately distinguished HCC from normal samples and nodules. Furthermore, the hypoxia-related signature could positively regulate immune response and the high-risk group had higher fractions of macrophages, B memory cells and follicle-helper T cells, and exhibited higher expression of immunocheckpoints such as PD1and PDL1. Conclusions Altogether, our study showed that hypoxia-related signature is a potential biomarker for diagnosis, prognosis and recurrence of HCC, and it provided an immunological perspective for developing personalized therapies.
18F-FDG PET and DCE kinetic modeling and their interlinks in primary NSCLC: First-in human simultaneous [18F]FDG PET-MRI voxel-wise correlation analysis
Authors: Besson Florent L , Fernandez Brice , Faure Sylvain , Mercier Olaf , Seferian Andrei , Mignard Xavier , Mussot Sacha , Péchoux Cécile le , Caramella Caroline , Botticella Angela , Levy Antonin , Parent Florence , Bulifon Sophie , Montani David , Mitilian Delphine , Fadel Elie , Planchard David , Besse Benjamin , Ghigna-Bellinzoni Maria-Rosa , Comtat Claude , Lebon Vincent , Durand Emmanuel 
Published: June 2020

Abstract
Objectives: To decipher the interlinks between PET and DCE kinetic parameters in non-small-cell lung cancer (NSCLC), by using voxel-wise analysis of full dynamic simultaneous [18F]FDG PET-MRI. Material and methods: Fourteen treatment-naïve patients with biopsy proven NSCLC prospectively underwent a one-hour dynamic [18F]FDG thoracic PET-MRI scan including DCE. The PET and DCE data were normalized to their corresponding T1-weighted MR morphological space, and tumors were masked semi-automatically. Voxel-wise parametric maps of PET and DCE kinetic parameters were computed by fitting the dynamic PET and DCE tumor data to the Sokoloff and Extended Tofts models respectively, by using in-house developed procedures. Curve fitting errors were assessed by computing the relative root mean square error (rRMSE) of the estimated PET and DCE signals at the voxel level. For each tumor, Spearman correlation coefficients (r s ) between all the pairs of PET and DCE kinetic parameters were estimated on a voxel-wise basis, along with their respective bootstrapped 95% confidence intervals (n = 1000 iterations). Results: Curve fitting metrics provided fit errors under 20% for almost 90% of the PET voxels (median rRMSE,= 10.3, interquartile ranges IQR = 8.1; 14.3), whereas 73.3% of the DCE voxels showed fit errors under 45% (median rRMSE = 31.8%, IQR = 22.4; 46.6). The PET-PET, DCE-DCE and PET-DCE voxel-wise interlinks were heterogeneous, with variations related to individual tumor behaviors. Beyond this wide variability, the PET-PET and DCE-DCE interlinks were mainly high (absolute r s values > 0.7), whereas the PET-DCE interlinks were mainly low to moderate (absolute r s values < 0.7). Half the tumors showed an hypometabolic with low perfused/vascularized profile, a hallmark of hypoxia and tumor aggressiveness. Conclusion: The interlinks between dynamic PET and DCE kinetic parameters assessed simultaneously with [18F]FDG PET-MRI are heterogeneous among NSCLC tumors. In the era of precision medicine, PET-MRI has unique capability to go further insight the individual tumor behavior in NSCLC.
A Comparison Between the Effectiveness of a Gamified Approach with the Conventional Approach in Point-of-care Ultrasonographic Training
Authors: Lai Aaron Kuo Huo , Azhar Abdul Muhaimin Noor , Bustam Aidawati , Tiong Xun Ting , Chan Hiang Chuan , Ahmad Rashidi , Chew Keng Sheng 
Published: June 2020

Abstract
Background: Although gamification increases user engagement, its effectiveness in point-of-care ultrasonographic training has yet to be fully established. This study was conducted with the primary outcome of evaluating its effectiveness in point-of-care ultrasonographic training as compared to conventional approach. Methods: Participants consisting of junior doctors were randomized into either the (1) gamified or the (2) conventional educational approach for ultrasonographic training. Results: A total of 31 junior doctors participated in this study (16 participants in gamified arm, 15 in the conventional arm after one participant from the conventional arm dropped out due to work commitment). Two-way mixed ANOVA test showed that there was no statistically significant interaction between the types of educational approach and time of testing (pre-test, post-test, 2 months post-training) for both theoretical knowledge score and practical skills score, with F(2, 58) = 39.6, p < 0.001, partial η2 = 0.4 and F(2, 58) = 3.06, p = 0.06, partial η2 = 0.095, respectively. For theoretical knowledge score, pairwise comparisons showed that the mean 2 months post-training scores (20.28 +/- 0.70, 95% CI 18.87-21.69) and mean post-test scores (20.27 +/- 0.65, 95% CI 18.94-21.60) were better than the pre-test scores (12.99 +/-0.50, 95% CI 11.97-14.00) with p-values <0.001 for both comparisons respectively. Similarly, for practical skill score, pairwise comparisons showed that the mean 2 months post-training scores (20.28 +/- 0.70, 95% CI 18.87-21.69) and mean post-test scores (20.27 +/- 0.65, 95% CI 18.94-21.60) were also better than the pre-test scores (12.99 +/-0.50, 95% CI 11.97-14.00) with p-values <0.001 for both comparisons respectively. Participants in the gamification arm generally perceived the various game elements and game mechanics as useful in contributing and motivating them to learn ultrasonography.Conclusions: Gamification approach could be an effective alternative or more effective than face-to-face learning in point-of-care ultrasonographic training.
Total alpha-synuclein assay in cerebrospinal fluid is of interest in the differential diagnosis between Alzheimer's disease and dementia with Lewy bodies from the prodromal stage
Authors: BOUSIGES Olivier , Philippi Nathalie , Lavaux Thomas , Perret-Liaudet Armand , Lachmann Ingolf , Schaeffer-Agalède Caroline , Anthony Pierre , Botzung Anne , Rauch Lucie , Jung Barbara , de Sousa Paulo Loureiro , Demuynck Catherine , Martin-Hunyadi Catherine , Cretin Benjamin , Blanc Frédéric 
Published: June 2020

Abstract
Background: Several studies have investigated the value of alpha-synuclein assay in the cerebrospinal fluid (CSF) of Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB) patients in the differential diagnosis of these two pathologies. However, very few studies have focused on this assay in AD and DLB patients at the MCI stage.Methods: All patients were enrolled under a hospital clinical research protocol from the tertiary Memory Clinic (CM2R) of Alsace, France, by an experienced team of clinicians. A total of 166 patients were included in this study: 21 control subjects (CS), 51 patients with DLB at the prodromal stage (pro-DLB), 16 patients with DLB at the demented stage (DLB-d), 33 AD patients at the prodromal stage (pro-AD), 32 AD patients at the demented stage (AD-d) and 13 patients with mixed pathology (AD+DLB). CSF levels of total alpha-synuclein were assessed using a commercial enzyme-linked immunosorbent assay (ELISA) for alpha-synuclein (AJ Roboscreen). Alzheimer’s biomarkers (t-Tau, P-Tau, Aβ42 and Aβ40) were also measured.Results: The alpha-synuclein assays showed a significant difference between the AD and DLB groups. Total alpha-synuclein levels were significantly higher in AD patients than in DLB patients. Interestingly, the levels appeared to be altered from the prodromal stage in both AD and DLB. Furthermore, alpha-synuclein levels were elevated not only in AD patients with a typical “Alzheimer” profile (i.e. 2 or 3 pathological biomarkers) but also in AD patients with an atypical “Alzheimer” profile (i.e. one or no pathological biomarkers).Conclusions: The modification of total alpha-synuclein levels in the CSF of patients occurs early, from the prodromal stage. Moreover, alpha-synuclein assay appears to be of particular interest in the differential diagnosis of AD in cases where the Alzheimer biomarkers do not have a typical profile of the disease, i.e. when there is only one or no pathological biomarkers.Trial registration: ClinicalTrials.gov, (AlphaLewyMa, Identifier: NCT01876459)