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Introduction. Ethiopia has made significant efforts to enhance family planning services despite variations in the community's use of modern contraception in different parts of the country. Various studies have reported the proportion and determinant factors of adolescents' contraceptive uptake in Ethiopia. These studies are not consistent in terms of size, scope, and geographic coverage, and the results need to be systematically collated to inform policies. Therefore, this review was aimed at analyzing the findings of those primary studies to obtain more representative evidence of adolescents' contraceptive uptake in Ethiopia. Methods. Five databases (MEDLINE via PubMed, Google Scholar, Scopus, ScienceDirect, and CINAHL) were searched for papers published from January 2000 up to June 2022 in English. Of thirty eligible studies, eight papers were included in this meta-analysis. Between-study heterogeneity was evaluated by the forest plot and inconsistency index ( I 2 ). A random-effects model was used to calculate the pooled estimates of adolescents' contraceptive uptake. Results. The overall pooled proportion of adolescents' contraceptive uptake was 40% ( I 2 = 99.70 , p ≤ 0.001 ; 95 % CI = 19 , 61). Adolescents' usage of contraception was influenced by a number of factors: individual-, sociocultural-, knowledge- (about contraceptive methods), and healthcare service-related factors. Individual-related factors include the educational status of adolescents, being of young age, and the income status of adolescents' families. Sociocultural-related factors comprise discussion with the family/relatives, parent disapproval and pressure from partners, and being married or having a partner. Healthcare service-related factors include the availability of youth clubs and inconvenient service hours for SRH services. Knowing contraceptive methods and SRH services was also positively associated with adolescents' contraceptive utilization. Conclusions. The proportion of adolescents who used contraception in Ethiopia was 40%. Adolescents' use of contraceptives was influenced by a variety of factors: individual-, sociocultural-, healthcare-, and knowledge-related factors. Hence, integrated interventions targeted at tackling barriers to contraceptive uptake may be helpful to improve adolescents' contraceptive utilization in Ethiopia. [ABSTRACT FROM AUTHOR]

Introduction. The wide variety of methods for recording occlusal contacts and the contradictory data on the interpretation of the obtained markings provoked us to make a comparative laboratory study between different occlusal indicators. Purpose. Evaluation of a qualitative and quantitative method for registration of occlusal contacts in static occlusion in laboratory conditions. Materials and Methods. In completion of the objective, we designed an apparatus for registration of the occlusal contacts (AROC) in static occlusion which is used, corresponding to the MIP in clinical conditions. The occlusal indicators that were included in the study were articulating paper 100 μ, articulating foil 12 μ, and T-Scan Novus system with a sensor thickness of 100 μ. The collected primary statistical information was entered and processed with the statistical package SPSS Statistics 19.0, and the graphs were prepared using Microsoft Office 2019. We performed descriptive statistical analysis in this study. Comparisons were performed using one-way analysis of variance (ANOVA), Student's t -test, and Pearson coefficient method. For a significance level, p < 0.05 was chosen. Result and Discussion. With quality occlusal indicators, it is possible only to visually determine the size, number, and intensity of the marked contacts. After the statistical processing of the obtained data on the number of registered contacts, a significant difference is found in the number of contacts of certain teeth (18, 24, 25, 28, 38, 35, 34, 33, 44, 45, and 48) registered with articulating paper and articulating foil. The maximum force that is reported during the study with the T-Scan system is 93.72% and the forces in the right half of the dentition are 51.7% and in the left 48.9%. To visualize the location of the registered occlusal contacts with the system, it is intraoral to use a quality indicator and we recommend the use of articulating foil. Conclusion. Based on findings from the current in vitro simulation, we can conclude that the type of occlusal indicator influences the registration of contacts, and therefore, we propose as a method of choice to achieve a balanced occlusion in clinical practice to combine the use of one conventional and one quantitative method. [ABSTRACT FROM AUTHOR]

Background. Among the surgical methods for lumbar disc herniation, open lumbar microdiscectomy is considered the gold standard. Recently, percutaneous endoscopic lumbar discectomy is also commonly performed for lumbar disc herniation for its various strong points. Objectives. The present study aims to examine whether percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy show better results as surgical treatments for lumbar disc herniation in the Korean population. Methods. In the present meta-analysis, papers on Korean patients who underwent open lumbar microdiscectomy and percutaneous endoscopic lumbar discectomy were searched, both of which are surgical methods to treat lumbar disc herniation. The papers from 1973, when percutaneous endoscopic lumbar discectomy was first introduced, to March 2018 were searched at the databases of MEDLINE, EMBASE, PubMed, and Cochrane Library. Results. Seven papers with 1254 patients were selected. A comparison study revealed that percutaneous endoscopic lumbar discectomy had significantly better results than open lumbar microdiscectomy in the visual analogue pain scale at the final follow-up (leg: mean difference [MD]=-0.35; 95% confidence interval [CI]=-0.61, -0.09; p=0.009; back: MD=-0.79; 95% confidence interval [CI]=-1.42, -0.17; p=0.01), Oswestry Disability Index (MD=-2.12; 95% CI=-4.25, 0.01; p=0.05), operation time (MD=-23.06; 95% CI=-32.42, -13.70; p<0.00001), and hospital stay (MD=-4.64; 95% CI=-6.37, -2.90; p<0.00001). There were no statistical differences in the MacNab classification (odds ratio [OR]=1.02; 95% CI=0.71, 1.49; p=0.90), complication rate (OR=0.72; 95% CI=0.20, 2.62; p=0.62), recurrence rate (OR=0.83; 95% CI=0.50, 1.38; p=0.47), and reoperation rate (OR=1.45; 95% CI=0.89, 2.35; p=0.13). Limitations. All 7 papers used for the meta-analysis were non-RCTs. Some differences (type of surgery (primary or revisional), treatment options before the operation, follow-up period, etc.) existed depending on the selected paper, and the sample size was small as well. Conclusion. While percutaneous endoscopic lumbar discectomy showed better results than open lumbar microdiscectomy in some items, open lumbar microdiscectomy still showed good clinical results, and it is therefore reckoned that a randomized controlled trial with a large sample size would be required in the future to compare these two surgical methods. [ABSTRACT FROM AUTHOR]

Background. Brown adipose tissue generates heat instead of storing energy. It is important in the regulation of body weight, and individual variation in adaptive thermogenesis can be attributed to variations in the amount or activity of BAT. Objective. The objective of this study was to systematically review different articles to assess the prevalence of BAT and its associated factors and relation with obesity and diabetes mellitus. Methods. A systematic review and meta-analysis were employed on published research works from different electronic databases using keywords. Cross-sectional studies and a few experimental studies were included for systematic review, and only studies done on human population were used for quantitative analysis. Twenty-two peer-reviewed papers were included in the systematic review, and eight papers were used for the meta-analysis for estimation of pooled prevalence of brown adipose tissue using selection criteria. Results. The pooled prevalence of brown adipose tissue among adults was 6.97% (95% CI: 6.51–7.43), and it was 7.4% (95% CI 6.51-7.43) after sequential omission of a single study. The heterogeneity in estimating the pooled prevalence among the studies was statistically significant (Cochran Q test, P < 0.001 , I 2 = 71.2 %), and after sequential omission of a single study, it becomes Cochran Q test, P = 0.065 , I 2 = 49.4 %. The brown adipose tissue activity was significantly lower in overweight or obese subjects than in lean subjects. Conclusion. The percentage of adult individuals with brown adipose tissue was high, and its activity was reduced in obese individuals. Although it is reduced in amount, still it presents in obese individuals. So, activation of the brown adipose tissue in adult and older individuals should be a target for the treatment of obesity. [ABSTRACT FROM AUTHOR]

Background. A large amount of publications had reported the association between incidence of esophageal cancer (EC) and type 2 diabetes mellitus (T2DM) in the past decade. However, those papers' results are inconsistent on relationships between T2DM the incidence of EC. Therefore, the objective of this meta-analysis was to determine the relationship between T2DM and the risk of EC (including 2 histological types, esophageal adenocarcinoma [EADC] and esophageal squamous cell carcinoma [ESCC]). Method. We finally extracted 19 articles though Pubmed, Embased, and Cochrane library. Those identify extraction date including 14,312 cases and 24,959,067 control records and then mixed the relative risks (RRs) and corresponding 95% confidence intervals (95%CIs) through STATA. Results. We observed that there are significantly positive correlation between T2DM and EC risk (R R = 1.28 , 95% CI: 1.05-1.57, P = 0.015).Also, our study showed positive correlation between T2DM and EADC (esophageal adenocarcinoma) risk (R R = 1.28 , 95% CI: 1.05-1.57, P < 0.001). What's more, subgroup analysis based on ethnicity represented the Caucasian is more susceptible to EC (R R = 1.28 ,95% CI: 1.10-1.49, P = 0.001). Conclusion. Those results offer a recent epidemiological and integrated evidence to ascertain the correlations between T2DM and incidence of EC. Those results take public health implications on preventing T2DM and then depress the occurrence of EC. Our study also provides referenced information for the prevention. However, some data is still insufficient, and more research should be carried out. [ABSTRACT FROM AUTHOR]

Aim. This paper investigates the risk factors preventing the reversal and nonreversal of Hartmann's procedure, as a surgical technique that has been performed in our clinic for ten years. Methods. The study involved a ten-year Hartmann's procedure followed up at our center. The patients were divided into Hartmann reversal and nonreversal groups. Groups were examined in terms of age, gender, diagnosis, stage of malignancy, ASA score, comorbidity, perioperative morbidity-mortality, and the length of the operation. Results. Age (p < 0.001), ASA score (p < 0.001), stage in case of malignancy (p = 0.002), and comorbidities (p < 0.001) were significant risk factors. The ratio of patients without any comorbidities to those with one or more comorbidities was 2.63 (95% CI 1.12–6.20). Among the malignant patients, the ratio of early-stage patients to advanced-stage patients in the group with reversal of Hartmann's colostomy was 2.82 (95% CI 1.30–6.10). In addition, the ratio of older patients to younger patients in group 2 was 0.95 (95% CI 0.92–0.98). A univariate analysis revealed that younger patients, those with lower ASA scores, those without comorbidities, and those with early-stage malignancy had a greater chance of closure of the stoma. Conclusion. Although Hartmann's procedure is performed in emergency surgery, the nonreversal of the colostomy is a problem in itself. It should be kept in mind that patients who have high risks are likely to have a permanent stoma. [ABSTRACT FROM AUTHOR]

Background. About 83% and 49% of Liberians live beneath the poverty line of US$1.25/day and experience hunger, respectively. Studies have established that hunger has long-term adverse consequence on truancy among students. However, no national level study has investigated contribution of hunger on truancy among in-school students in Liberia. This paper therefore seeks to examine the association between hunger and truancy among students in Liberia. The study hypothesises that there exists a positive association between hunger and truancy. Methods. This study used the 2017 Liberia Global School-Based Student Health Survey (LGSSHS) and sampled 2,744 students. However, the present study was restricted to 1,613 respondents who had complete information about variable of interest analysed in the study. Hunger and truancy are the main explanatory and outcome variables for this study. At 95% confidence interval, two binary logistic regression models were built with Model I examining relationship between hunger and truancy and Model II controlled for the influence of covariates on truancy. Our findings were reported in odds ratio (OR) and adjusted odds ratio (AOR). All the analysis was done using STATA version 14.0. Results. Descriptively, 46% were truant, and 65% of students ever experienced hunger. Inferentially, students that ever-encountered hunger had higher odds to truancy (AOR = 1.32 , CI = 1.06 -1.65). The odds to be truant also increased among those at 15 years and above (AOR = 2.00 , CI = 1.46 -2.72), who witnessed bullying (AOR = 1.36 , CI = 1.10 -1.68), that felt lonely (AOR = 1.35 , CI = 1.06 -1.71), that currently smoke cigarette (AOR = 2.58 , CI = 1.64 -4.06), and wards whose parents go through their things (AOR = 1.26 , CI = 1.03 -1.55). Conclusions. The study concluded that hunger was associated with truancy among students in Liberia. Additionally, students' age, bullying, feeling lonely, cigarette use, and parental concern also determined truancy. Governments, policy makers, and other partners in education should therefore roll out some school-based interventions, such as the school feeding program, which will help minimise the incidence of hunger among students. Such programs should consider the variations in students' background characteristics in its design. [ABSTRACT FROM AUTHOR]

Background. A lot of effort is being done in the electronic medical record (EMR) system. However, it has not been implemented and used at the expected scale for maximal effectiveness. There is limited evidence on the factors affecting the utilization of EMR in this particular context, which are critical for targeted strategies. Objective. To assess the magnitude and factors affecting the utilization of EMR among health professionals in eastern Ethiopia. Methods. An institutional-based cross-sectional study was conducted among randomly selected 412 health professionals from Harari and Dire Dawa, eastern Ethiopia, using a pretested self-administered questionnaire. The tool was developed from previous literature, and a pilot survey was done before the actual study. Bivariable and multivariable binary logistic regression were done to assess the relationship between an independent variable with EMR use. Crude and an adjusted odds ratio with a 95% confidence interval were reported. A P value of less than 0.05 was used to declare a statistically significant association. Results. A total of 412 health professionals with a mean age of 29 years (±6.4 years) were included. A total of 229 (55.6%) and 300 (72.8%) of them had good knowledge and attitude towards the EMR, while 279 (67.7%) used the service (54% used it on a daily basis). About 272 (66%) of the respondents reported that they prefer EMRs to paper-based systems. Health professionals with more than five years of experience had two times higher odds of using the service (AOR = 2.22 ; 95% CI; 1.12-4.42) than early-career workers. Health professionals trained in EMR would use the service more (AOR = 5.88 ; 95% CI; 2.93-11.88) compared to those who did not take the training. In addition, having good knowledge (AOR = 1.52 ; 95% CI; 0.92-1.5) and a good attitude towards the EMR system (AOR = 2.4 ; 95% CI; 1.35-4.31) showed to use EMR as compared to counterparts. Conclusions. The utilization of EMR was found to be optimal. Age, work experience, knowledge, attitude, and training of professionals were positively associated with the use of the service in their facility. [ABSTRACT FROM AUTHOR]

Objectives. We aimed to summarize the current evidence regarding the impact of extraction vs. nonextraction in orthodontic treatment on patients' soft-tissue profile with malocclusion. Methods. Between April 30th and November 30th, 2020, we searched PubMed and SCOPUS for published papers from inception to November 2020 using "orthodontic," "extraction," "nonextraction," and "Malocclusion." Included studies were summarized, and relevant data were extracted and analyzed using Review Manager 5.4. Results. Pooled data from four controlled trials demonstrated a nonsignificant difference between extraction and nonextraction in terms of SNA (MD = 0.50 , 95% CI: -0.37, 1.38; p = 0.26), SNB (MD = 0.11 , 95% CI: -1.23, 1.44; p = 0.88), FMA (MD = 1.82 , 95% CI: -2.39, 6.02; p = 0.40), IMPA (MD = 0.06 , 95% CI: -8.83, -8.94; p = 0.99), overjet (MD = − 1.47 , 95% CI: -6.21, 3.26; p = 0.54), and overbite (MD = 0.50 , 95% CI: -1.40, 2.40; p = 0.60). On the other hand, the extraction method significantly increased the ANB compared with the nonextraction group (MD = 0.78 , 95% CI: 0.25, 1.31; p = 0.004). Conclusion. The current evidence demonstrated that nonextraction protocols for orthodontic treatment are a safe and effective alternative to extraction protocols; individually tailored treatment strategies should be applied. More randomized controlled trials are critically needed to safely make an evidence-based treatment conclusion. [ABSTRACT FROM AUTHOR]

Background. Coinfections have a potential role in increased morbidity and mortality rates during pandemics. Our investigation is aimed at evaluating the viral coinfection prevalence in COVID-19 patients. Methods. We systematically searched scientific databases, including Medline, Scopus, WOS, and Embase, from December 1, 2019, to December 30, 2020. Preprint servers such as medRxiv were also scanned to find other related preprint papers. All types of studies evaluating the viral coinfection prevalence in COVID-19 patients were considered. We applied the random effects model to pool all of the related studies. Results. Thirty-three studies including 10484 patients were identified. The viral coinfection estimated pooled prevalence was 12.58%; 95% CI: 7.31 to 18.96). Blood viruses (pooled prevalence: 12.48%; 95% CI: 8.57 to 16.93) had the most frequent viral coinfection, and respiratory viruses (pooled prevalence: 4.32%; 95% CI: 2.78 to 6.15) had less frequent viral coinfection. The herpesvirus pooled prevalence was 11.71% (95% CI: 3.02 to 24.80). Also, the maximum and minimum of viral coinfection pooled prevalence were in AMRO and EMRO with 15.63% (95% CI: 3.78 to 33.31) and 7.05% (95% CI: 3.84 to 11.07), respectively. Conclusion. The lowest rate of coinfection belonged to respiratory viruses. Blood-borne viruses had the highest coinfection rate. Our results provide important data about the prevalence of blood-borne viruses among COVID-19 patients which can be critical when it comes to their treatment procedure. [ABSTRACT FROM AUTHOR]

Background. The present study was aimed to investigate the value of blood interleukin-27 (IL-27) as a diagnostic biomarker of sepsis. Methods. We searched PubMed, EMBASE, the Cochrane Library, and the reference lists of relevant articles. All studies published up to October 21, 2020, which evaluated the accuracy of IL-27 levels for the diagnosis of sepsis were included. All the selected papers were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). We used a bivariate random effects model to estimate sensitivity, specificity, diagnostic odds ratios (DOR), and a summary receiver operating characteristic curve (SROC). Deeks' funnel plot was used to illustrate the potential presence of publication bias. Results. This meta-analysis included seven articles. The pooled sensitivity, specificity, and DOR were 0.85 (95% CI, 0.72-0.93), 0.72 (95% CI, 0.42-0.90), and 15 (95% CI, 3-72), respectively. The area under the summary receiver operating characteristic curve was 0.88 (95% CI, 0.84-0.90). The pooled I 2 statistic was 96.05 for the sensitivity and 96.65 for the specificity in the heterogeneity analysis. Deeks' funnel plot indicated no publication bias in this meta-analysis (P = 0.07). Conclusions. The present results showed that IL-27 is a reliable diagnostic biomarker of sepsis, but it should be investigated in combination with other clinical tests and results. [ABSTRACT FROM AUTHOR]

The nose is the most prominent structure of the face, influencing facial appearance and profile. Orthodontists have an awareness of facial structures, including nasal morphology, when diagnosing and treatment planning. Maxillofacial surgeons influence facial profile by bimaxillary surgery, improving facial aesthetics and harmony. The aim of this review was to summarize the available methods of analysing nasal morphology and profile, and to assess their complexity. A literature search was conducted in PubMed, Scopus, Web of Science, and Embase using the following search terms: "nasal profile analysis", "nasolabial angle", and "nasal profile cephalometric" in order to select studies providing knowledge on correlations between occlusion and nasal development, differences between skeletal classes, ethnic variability, and differences between the sexes. Studies concerning genetic disorders were excluded. Finally, 17 full-text papers were analysed, which pertained to nasolabial angle, or facial profile including the nose. Data concerning methods, ethnic group, reference landmarks used, and measurements made were extracted and placed in tables. Numerous methods of nasal profile analysis can be found in the literature. These methods describe various numbers of parameters, which have influence on facial aesthetic. Nasal parameters are correlated to skeletal class and nasolabial angle, positions of upper incisors, and maxillary inclination. [ABSTRACT FROM AUTHOR]

Objective. This meta-analysis aimed at exploring the predictive value of CHA2DS2-VASc score for the left atrial thrombus (LAT) or left atrial spontaneous echo contrast (LASEC) in patients with nonvalvular atrial fibrillation (NVAF). Methods. PubMed, Embase, Web of Science, ScienceDirect, Cochrane Library, and Chinese core journals of the CNKI and Wanfang databases were searched to identify all the relevant papers that were published up to January 2020. The data were extracted for pooled odds ratios (ORs) with 95% confidence intervals (CIs), heterogeneity, subgroup, publication bias, and sensitivity analysis. Results. Overall, 15 studies containing 6223 patients with NVAF were enrolled. All studies were evaluated for LAT, and 12 studies were evaluated for LASEC. The pooled analysis using a random-effects model showed that a high CHA2DS2-VASc score was related with LAT/LASEC (pooled OR = 1.59 , 95% CI: 1.35–1.88, P < 0.001) with high heterogeneity ( I 2 = 76.9 % , P < 0.001) and LAT (pooled OR = 1.83 , 95% CI: 1.44–2.33, P < 0.001) with high heterogeneity ( I 2 = 79.4 % , P < 0.001). The subgroup analysis demonstrated that the sample size may be the main source of heterogeneity. Although the Begg's funnel plot based on 15 studies for LAT/LASEC (P = 0.029) and 12 studies for LAT (P = 0.046) indicated the presence of publication bias among the included studies, the trim-and-fill method verified the stability of the pooled outcomes. In addition, sensitivity analysis indicated that all effects were stable. Conclusion. The results of this meta-analysis showed that the CHA2DS2-VASc score is related with LAT and LASEC in patients with NVAF. However, more studies are warranted to address this issue. [ABSTRACT FROM AUTHOR]

Background. Staples closure technology has been widely used in total knee arthroplasty (TKA) and achieved good results. In recent years, a new type of material called skin closure tape (SCT) has been applied to TKA which also showed good treatment results. However, since it is still not clear yet which one is better, this paper collects literatures for statistical analysis so as to provide evidence for the use of SCT in TKA. Methods. The comparative study on effects between SCT and staples is reviewed after the primary release of TKA in PubMed, the Cochrane library, and the EMBASE database up to March 2019. The two researchers independently screened the literature and evaluated the quality of the literature using bias risk tools. Results. A total of four studies (3330 knees) have been included in our meta-analysis. For the main point, the results show that the SCT can reduce readmission rates compared to staples (RR 0.68, 95% CI 0.49–0.95, P = 0.03), with no significant difference in complications (RR 0.85, 95% CI 0.27–2.64, P = 0.77). Secondly, the results suggest that although there is no significant difference in removal time between the two groups, the SCT can reduce pains, save time and costs, and have a better cosmetic effect. Conclusions. Our study indicates SCT as a closure method with fewer complications and faster speed compared with staples. Nevertheless, the cost and pain need to be further confirmed because of the small sample size included in this study. [ABSTRACT FROM AUTHOR]

Background: Over the past decade, 3D printing technology has revolutionized various fields, including dentistry. Provisional restorations play a crucial role in prosthetic rehabilitation, necessitating the evaluation of their bond strength with different provisional cement agents. Aims: This study is aimed at assessing the immediate and long‐term bond strength of 3D‐printed dental crowns using three provisional cement agents. Materials and Methods: Provisional crowns (N = 36) were manufactured using 3D modeling software and cemented in dentin analogues (G10 Nema resin). After the crowns' fabrication, they were randomly divided into three groups (n = 12) for cementation with Relyx Temp 3M ESPE, Provicol—VOCO, and Meron—VOCO. Tensile strength tests were conducted using a universal testing machine, with half of the specimens subjected to 2000 thermal cycles before testing. Finite element analysis was employed to assess tensile stress distribution. Results: Statistical analysis (two‐way ANOVA and Tukey's test at a 95% confidence level) revealed significant effects of cement type (p = 0.006) and thermal aging (p = 0.001) on bond strength. Glass ionomer cement exhibited the highest immediate resistance, while all types of cement were adversely affected by thermal aging, resulting in decreased bond strength. Conclusion: Thermal aging significantly alters the properties of 3D printing resin and affects the bond strength of provisional cement with 3D‐printed crowns. Despite the adverse effects of thermal aging, glass ionomer cement demonstrated the highest immediate resistance. Clinicians should carefully consider these findings when selecting provisional cements for 3D‐printed crowns. [ABSTRACT FROM AUTHOR]

Objectives. This papers aims to investigate the association between different levels of postpartum weight retention (PPWR) and cardiometabolic risk among the Saudi women 12 months postpartum. Methods. This study is a follow-up of subgroup of cohort from Riyadh mother and baby multicenter cohort study. Clinical data were collected from participants 12 months after delivery and included current Body Mass Index (BMI), waist circumference, hip circumference, and blood pressure. In addition the following blood tests done were fasting blood glucose (FBG), glycosylated haemoglobin (HbA1c) levels, and lipids profile to assess the participants' cardiometabolic risks. The participants were categorized into three groups based on the level of PPWR: weight retention < 3kg; weight retention 3 to < 7kg; and weight retention ≥ 7kg. Subsequently, the prevalence of cardiometabolic risk factors was compared in the three groups to assess the association between different levels of PPWR and cardiometabolic risk factors. Logistic regression was used to test the effect of PPWR in the development of metabolic syndrome and Adjusted Odds Ratio (AOR) was calculated. Results. A total of 115 women participated in this study. Around 35% of the study population retained ≥ 7 kg of weight. The prevalence of cardiometabolic risk factors, including metabolic syndrome (MetS), increases with the increase of PPWR (p<0.01). The prevalence of MetS is 13% with highest frequency in the group with the highest weight retention. The determinants developing MetS were prepregnancy weight; AOR (95% CI); 1.08 (1.02-1.14), P< 0.01, current BMI, AOR (95% CI); 1.30 (1.12-1.51), P< 0.01, and FBG during pregnancy, AOR (95% CI); and 4.82 (1.72-13.48), P < 0.01. Conclusion. Increased weight retention after delivery augments the rate of occurrence of cardiometabolic risk factors. Determinants of the development of MetS in postpartum Saudi women are increased prepregnancy weight, current BMI, and FBG during pregnancy. [ABSTRACT FROM AUTHOR]

Numerous reports have been done to seek the relationship between sleep apnea hypopnea syndrome (SAHS) and the risk of atrial fibrillation (AF). However, definite conclusion has not yet been fully established. We examined whether SAHS increases AF incidence in common population and summarized all existing studies in a meta-analysis. We summarized the current studies by searching related database for potential papers of the association between SAHS and the risk of AF. Studies that reported original data or relative risks (RRs) with 95% confidence intervals (CIs) for the associations were included. Sensitivity analyses were performed by omitting each study iteratively and publication bias was detected by Begg’s tests. Eight eligible studies met the inclusion criteria. Fixed effects meta-analysis showed that SAHS increased AF risk in the common population (RR = 1.70, 95% CI: 1.53–1.89, P=0.002, I2=69.2%). There was a significant association between mild SAHS and the risk of AF (RR = 1.52, 95% CI: 1.28–1.79, P=0.01, I2=78.4%), moderate SAHS (RR = 1.88, 95% CI: 1.55–2.27, P=0.017, I2=75.6%), and severe SAHS (RR = 2.16, 95% CI: 1.78–2.62, P<0.001, I2=91.0%). The results suggest that sleep apnea hypopnea syndrome could increase the risk of AF, and the higher the severity of SAHS, the higher risk of atrial fibrillation. [ABSTRACT FROM AUTHOR]

The presence of positive bile culture during intraoperative procedures has been associated with elevated morbidity and mortality rates in hepatobiliopancreatic surgeries, contributing to increased healthcare expenditures. However, the precise impact of bactobilia on the development of postoperative complications remains uncertain due to existing disparities in the published literature. In this retrospective cohort study, we assessed 137 patients who underwent major hepatobiliopancreatic surgery to examine the relationship between intraoperative bile culture outcomes and subsequent postoperative infectious complications. Among patients with bactobilia, a significant 35.1% exhibited systemic or local infectious complications, whereas only 11.1% of those with negative culture results experienced any infectious complications (p = 0.002). Similarly, a notable difference was observed in the incidence of surgical site infections, with 24.3% in the bactobilia group compared to 7.9% in the negative culture group (p = 0.01). A total of 74 monomicrobial cultures with microbiological growth were isolated, predominantly featuring Gram-negative microorganisms, primarily Enterobacteriaceae in 49 cultures. Escherichia coli was identified in 37.8% of positive cultures, while Klebsiella pneumoniae was evident in 21.6%. Gram-positive microorganisms were present in 10 cultures, with Enterococcus emerging as the prevailing species. The logistic regression model identified a positive bile culture as an independent factor significantly associated with infection development (OR: 2.26; 95% confidence interval: 1.23-11; p = 0.02). Considering the limitations of the study, these findings underscore the critical importance of conducting bile cultures during the intraoperative phase to enable vigilant monitoring and prompt management of infectious complications. [ABSTRACT FROM AUTHOR]

Background. Although inappropriate gestational weight gain is considered closely related to adverse maternal and birth outcomes globally, little evidence was found in low- and middle-income countries. Study Objectives. This study is aimed at identifying the determinants of gestational weight gain and examine the association between gestational weight gain and maternal and birth outcomes in the Northern Region of Ghana. Study Methods. The study used a facility-based cross-sectional study design involving 611 antenatal and delivery records in Tatale district, Tamale west, and Gushegu municipal hospitals. A two-stage sampling method involving cluster and simple random sampling was employed. Descriptive statistical analysis and measures of central tendency were used to describe the sample. The multinomial logistic regression model was used to determine the determinants of gestational weight gain and its association with maternal and birth outcomes. Results. Among the 611 women included in the study, 516 (84.45%) had inadequate gestational weight gain, and 19 (3.11%) had excessive gestational weight gain. The gestational weight gain ranged from 2 kg to 25 kg with a mean of 7.26 ± 3.70 kg. The risk factor for inadequate gestational weight gain was low prepregnancy BMI (adjusted odds ratio AOR = 1.33 , 95% CI = 1.18 − 2.57 , P = 0.002). Pregnant women who had inadequate gestational weight gain were significantly less likely to deliver through caesarean section (AOR = 0.27 , 95% CI = 0.12 − 0.61 , P = 0.002), and those who had excessive weight gain were more likely to undergo caesarean section (AOR = 19.81 , 95% CI = 5.38 − 72.91 , P = 0.001). The odds of premature delivery (birth < 37 weeks) among pregnant women with inadequate weight gain were 2.88 (95% CI = 1.27 − 6.50 , P = 0.011). Furthermore, subjects who had excessive weight gain were 43.80 times more likely to give birth to babies with macrosomia (95% CI = 7.07 − 271.23 , P = 0.001). Conclusion. Inappropriate gestational weight gain is prevalent in Ghana, which is associated with caesarean section, preterm delivery, delivery complications, and macrosomia. Urgent policy interventions are needed to improve on the frequent monitoring and management of gestational weight gain of pregnant women till term. [ABSTRACT FROM AUTHOR]

Background. Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of morbidity and mortality among neonates admitted to neonatal intensive care units (NICUs). The MRSA colonization of neonates, attributed to various sources, including mothers, healthcare workers, and environmental surfaces, can lead to severe infection, prolonged hospital stays, and even death, imposing substantial economic burdens. Given the pressing need to mitigate MRSA spread in these vulnerable environments, further examination of the subject is warranted. This systematic review is aimed at synthesizing available evidence on MRSA carriage proportions among mothers of newborns, healthcare workers, and environmental surfaces in NICUs. Methodology. We included observational studies published in English or French from database inception to March 21, 2023. These studies focused on MRSA in nonoutbreak NICU settings, encompassing healthy neonate mothers and healthcare workers, and environmental surfaces. Literature search involved systematic scanning of databases, including Medline, Embase, Web of Science, Global Health, and Global Index Medicus. The quality of the selected studies was assessed using the Hoy et al. critical appraisal scale. The extracted data were summarized to calculate the pooled proportion of MRSA positives, with a 95% confidence interval (CI) based on the DerSimonian and Laird random-effects model. Results. A total of 1891 articles were retrieved from which 16 studies were selected for inclusion. Most of the studies were from high-income countries. The pooled proportion of MRSA carriage among 821 neonate mothers across four countries was found to be 2.1% (95% CI: 0.3-5.1; I 2 = 76.6 %, 95% CI: 36.1-91.5). The proportion of MRSA carriage among 909 HCWs in eight countries was determined to be 9.5% (95% CI: 3.1-18.4; I 2 = 91.7 %, 95% CI: 87.1-94.6). The proportion of MRSA carriage among HCWs was highest in the Western Pacific Region, at 50.00% (95% CI: 23.71-76.29). In environmental specimens from five countries, a pooled proportion of 16.6% (95% CI: 3.5-36.0; I 2 = 97.7 %, 95% CI: 96.6-98.4) was found to be MRSA-positive. Conclusion. With a significant heterogeneity, our systematic review found high MRSA carriage rates in neonate mothers, healthcare workers, and across various environmental surfaces in NICUs, posing a potential risk of nosocomial infections. Urgent interventions, including regular screening and decolonization of MRSA carriers, reinforcing infection control measures, and enhancing cleaning and disinfection procedures within NICUs, are crucial. This trial is registered with CRD42023407114. [ABSTRACT FROM AUTHOR]

Nowadays, several screening strategies are available to prevent cervical cancer, but inadequate resources, sociocultural barriers, and sampling issues impede their success in low-income countries. To overcome these issues, this study aimed to evaluate the performance of human papillomavirus (HPV) testing from dried urine spots (DUS). Eighty-eight urine samples (including 56 HPV DNA positive specimens) were spotted on filter paper, dried, and stored in paper-bags. HPV DNA was detected from the DUS after 1 week and 4 weeks of storage using a polymerase chain reaction (PCR) assay. The sensitivity, specificity, and concordance of the DUS-based HPV test were evaluated by comparing the results with those of HPV testing on fresh urine samples as the gold standard. The sensitivity of the test was 98.21% (95% CI: 90.56–99.68) for DUS stored for 1 week and 96.42% (95% CI: 87.88–99.01) for DUS stored for 4 weeks. The specificity was 100% (95% CI: 89.28–100) at both time points. The concordance between DUS and fresh urine HPV testing was “almost perfect” using the κ statistic. These preliminary data suggest that a DUS-based assay could bypass sociocultural barriers and sampling issues and therefore could be a suitable, effective tool for epidemiological surveillance and screening programs, especially in low-income countries. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the effects of cardiac rehabilitation on exercise tolerance and cardiac function in heart failure patients undergoing cardiac resynchronization therapy (CRT). Methods. Randomized controlled trials were initially identified from systematic reviews of the literature about cardiac rehabilitation and heart failure patients with CRT. We undertook updated literature searches of the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, CBM, CNKI, and Wanfang databases until July 1, 2017. STATA12.0 software was used. Results. Four randomized controlled studies were included. The total sample size was 157 patients, including 77 in the control group. Cardiac rehabilitation treatment affected the peak VO2 in heart failure patients with CRT (Pheterogeneity=0.491, I2 = 0%). The results lacked heterogeneity, and the data were merged in a fixed-effects model (WMD = 2.17 ml/kg/min, 95% CI (1.42, 2.92), P<0.001). The peak VO2 was significantly higher in the cardiac rehabilitation group than in the control group. The sensitivity analysis showed that the results of the meta-analysis were robust. Cardiac rehabilitation treatment affected LVEF in heart failure patients with CRT (Pheterogeneity=0.064, I2 = 63.6%); the heterogeneity among the various research results meant that the data were merged in a random-effects model (WMD = 4.75%, 95% CI (1.53, 7.97), P=0.004). The LVEF was significantly higher in the cardiac rehabilitation group than in the control group. The sources of heterogeneity were analyzed, and it was found that one of the studies was the source of significant heterogeneity. After the elimination of that study, the data were reanalyzed, and the heterogeneity was significantly reduced. There were still significant differences in the WMD and 95% CI. Conclusion. Cardiac rehabilitation can improve exercise tolerance and cardiac function in heart failure patients with CRT. Future studies are needed to evaluate whether these beneficial effects of cardiac rehabilitation may translate into an improvement in long-term clinical outcomes among these patients. [ABSTRACT FROM AUTHOR]

Prostate cancer accounts for 20.3% of all cancers in men in sub-Saharan Africa. Early screening among at-risk groups is challenging in Uganda, with limited data on prostate cancer screening uptake in most districts, including newly established ones. The purpose of this study was to determine factors influencing the uptake of prostate cancer screening among men aged ≥ 40 in Kazo Town Council, Kazo District, a newly created district. We used a descriptive cross-sectional study design that employed both quantitative and qualitative data collection methods. Participants were recruited through simple random sampling between November 2020 and January 2021. Structured questionnaires were used for quantitative data (n = 300). Statistical analyses to determine associations were carried out using inferential and chi-square tests followed by logistic regression. In-depth interviews were conducted with 10 key informants and analyzed thematically to explore a range of perceptions related to prostate cancer screening. Only 10 (3.33%; 95% CI: 0.018-0.60) respondents had ever screened for prostate cancer. Lack of privacy (p < 0.033), access to prostate cancer information (p < 0.014), and distance to health facilities (p < 0.001) were significantly associated with the uptake of prostate cancer screening. Marital status (OR = 7.93 ; 95% CI: 1.85-33.99; p = 0.005), positive health worker attitudes (OR = 0.002 ; 95% CI: 0.000-0.023, p < 0.001), and perceived affordability (OR = 0.001 ; 95% CI: 0.000-0.011, p < 0.001) were independently associated with uptake of prostate cancer screening. Key barriers included lack of information, access to screening centres, and fear of screening. The level of uptake of prostate cancer screening was considerably low among men aged 40 and above in the Kazo District. Targeted community interventions to improve access to prostate cancer information, screening, sensitization, and addressing perceived and actual barriers are needed in newly created districts to bolster the uptake of prostate cancer screening. This has implications for prioritizing research evaluating district resource allocation to support optimized and integrated evidence-based service delivery in primary healthcare centres, especially for specialized services in newly created districts. [ABSTRACT FROM AUTHOR]

Introduction. "Evidence-based practice" (EBP) is the process of incorporating clinical expertise and taking patient values and preferences into consideration when making clinical decisions. It is used to describe the provision of high-quality patient care. Objective. This study is aimed at assessing evidence-based practice and associated factors among health professionals working at public hospitals in Illu Aba Bora and Buno Bedele Zones, Oromia Region, Southwest Ethiopia, in 2022. Methods. An institution-based cross-sectional study design was conducted from May 8 to June 20 at public hospitals in Illu Aba Bora and Buno Bedele Zones, Oromia Region, Southwest Ethiopia. A total of 423 health professionals were included, using proportional allocation and simple random sampling. The data were collected using a self-administered questionnaire. Data was entered using EpiData version 4.6, and the collected data was cleared, arranged, coded, and then analyzed using Statistical Package for the Social Sciences version 26. Descriptive statistics and bivariable and multivariable analyses of logistic regression with AOR (95% CI) were performed at p < 0.05. Result. The study revealed that 36.2% of health professionals had good evidence-based practice. The factors found to be significantly associated with good EBP include having training in EBP (AOR = 5.43 ; 95% CI: 4.323, 9.532), good knowledge (AOR = 1.91 ; 95% CI: 1.065, 3.541), a favorable attitude (AOR = 1.91 ; 95% CI: 1.884, 2.342), and work experience greater than 5 years (AOR = 1.58 ; 95% CI: 1.482, 2.437). Conclusion. The evidence-based practice of health professionals was poor. Evidence-based practice should included in the curriculum, and also planned trainings need to be delivered to all health professionals, inorder to enhancing their knowledge as well as their attitudes by motivating them to increase evidence-based practice. [ABSTRACT FROM AUTHOR]

A range of procedural errors can occur when performing endodontic treatment on posterior teeth. These errors may decrease the success rate in endodontic practice. This study assessed the prevalence of procedural errors and the quality of endodontic treatments in maxillary molars and premolars using cone-beam computed tomography (CBCT). CBCT scans from two private radiology centers were assessed retrospectively to ensure the same calculated sample size of 327 teeth for each of the four maxillary posterior tooth types (a total of 1,308 endodontically treated teeth). Image sets were evaluated for procedural errors categorized as follows: obturation length (overfilling or underfilling by >2 mm short of the root apex), missed canals, perforations, strip perforations (with extrusion of material into the furcation area), separated instruments in the root canal space, and root fracture. Data were analyzed with SPSS version 20 (SPSS Inc., Chicago, IL, USA), and frequency data was assessed using the Monte Carlo test at the 0.05 level of significance. The procedural errors most commonly reported in the present study were from most frequent to least frequent: underfilled canals (50.0%), missed canals (27.5%), overfilled canals (12.5%), apical perforations (5.0%), separated instruments (3.1%), and root fractures (1.9%). No strip perforations (with extrusion of material into the furcation area) were seen in the study (0%). Underfilled and missed root canals were the most frequent procedural errors identified in the present study. These findings underline the importance of more consideration of critical working length management during all stages of root canal treatment, greater awareness of root canal anatomy, and the use of imaging and diagnostic devices that enhance the ability to identify and treat root canals both safely and effectively. [ABSTRACT FROM AUTHOR]

Membrane-bound angiotensin-converting enzyme 2 (ACE2) receptor acts as the entry point for the novel coronavirus, SARS-CoV-2. Polymorphisms in the ACE2 gene may alter viral binding, regulate the expression of ACE2, and thus, affect disease severity. In this study, 68 COVID-19 patients with varying degrees of severity and 40 healthy controls were enrolled. The genetic landscape of the ACE2 gene was explored by whole exome sequencing of 29 individuals, and specific regions of ACE2 were analyzed for the rest of the participants via PCR, followed by barcode-tagged sequencing. The mean soluble ACE2 level in the plasma of healthy controls and patients did not vary significantly but was higher in the patient group (3.77 ± 1.55 ng/mL vs. 3.94 ± 1.42 ng/mL). Analysis of exon 1, exon 2, and exon 8 of the ACE2 gene revealed that these regions are highly conserved in our population. Investigation of exon 11 and its flanking intronic region revealed that deletions in a stretch of 18T nucleotides in the noncoding region significantly decrease ACE2 levels in plasma, as individuals harboring wild-type variants had higher plasma ACE2 levels compared to those harboring T1del, T2del, and T3del variants. However, the intronic variants were not found to be significantly associated with disease severity. [ABSTRACT FROM AUTHOR]

Leishmania parasites, which are spread by infected female sand flies, are the cause of the disease leishmaniasis. Although cutaneous leishmaniasis has been found to occur in the Volta Region, there is limited data on vector species and reservoirs. This study focused on the Tsatee community, in the South Dayi District of the Volta Region, and is aimed at identifying the sand fly fauna and detecting the presence of Leishmania DNA by the use of primers that target the conserved region of Leishmania spp. minicircle DNA of the parasite kinetoplast. The miniature light traps and hand aspirators provided by the Centers for Disease Control and Prevention (CDC) were used to collect outdoor and indoor sand flies for five months in a guinea woodland and semideciduous forest area. From the collections, 4,580 phlebotomine sand flies were obtained and identified, and females were examined for Leishmania DNA using PCR. The male flies were 1,202 (26.24%), non-blood-fed females were 3,321 (72.51%), and 57 (1.25%) were blood-fed females. It was observed that Sergentomyia species constituted 99.91% of the total collected sand flies with S. africana (76.77%) as the predominant species. Phlebotomus rodhaini (0.09%) was the only Phlebotomus species identified from the study area. From 283 non-blood-fed sand fly pools and 57 individual blood-fed species screened, Leishmania DNA was detected in 12 (4.24%) pools and 8 (14.04%) individuals, respectively. It was observed that Leishmania DNA was detected in all the sand fly species identified except S. collarti. This study reports the first detection of Leishmania DNA in P. rodhaini in Ghana, with an infection rate of 33.33% (95% CI, 1.23-88.32). The findings suggest that the role of Phlebotomus in disease transmission in the study area cannot be discounted. Future studies should include continuous surveillance, blood meal preferences, and vector competence of the various infected phlebotomine sand flies to create effective control measures. [ABSTRACT FROM AUTHOR]

Background. In recent times, cervical dysbiosis which mostly causes and aggravates infections is highlighted for its role in immune modulation in cervical dysplasia, which promotes the shifting of Th1 phenotype immunity to Th2 phenotype immunity. This study therefore estimated and compared the levels of circulatory IL-4, IL-6, IL-10, TNF-α, and IFN-γ cytokines among adult women identified to have different grades of cervical intraepithelial neoplasia (CIN) and with cervicovaginal infection. Methods. A total of 157 participants were recruited from the Akyemansa District of Ghana, and cervical swabs and blood samples were taken. The Pap smear test, microbiological culture, and ELISA were employed for cytology analysis, bacteria isolation, and identification and estimation of IL-4, IL-6, IL-10, TNF-α, and IFN-γ cytokines, respectively. Results. Overall, 14/157 (8.9%) had CIN with 7.6% having CIN 1 and 1.3% having CIN 2. The main predictor for CIN was age above 46 years (OR 11.16, 95% CI: 2.4-51.8). Bacterial vaginosis (p = 0.003) and Candida infection (p = 0.012) were significantly higher in CIN. Again, Staphylococcus aureus (60% vs. 17.6%, p = 0.005), Citrobacter sp. (40.0% vs. 13.2%, p = 0.017), and Morganella morganii (40.0% vs. 4.4%, p = 0.002) isolates were significantly higher in CIN-positive participants. IL-10 and TNF-α concentrations were elevated in participants with CIN 1+ (TNF-α NIL vs. CIN 1+ only, p < 0.05) while IL-6 was decreased among participants with CIN 1+. In the presence of vaginal infection, TNF-α decreased among CIN 1+ participants while IL-10 remained elevated. Conclusion. The findings of this study suggest that cervical dysbiosis causes immune suppression, which creates a suitable microenvironment for the development of CIN. [ABSTRACT FROM AUTHOR]

Background. The youth in Uganda, as in much of sub-Saharan Africa, face numerous sexual and reproductive health (SRH) challenges, from human immunodeficiency virus HIV infection, and unsafe abortions to unwanted pregnancies. This study, therefore, assessed the utilization of sexual and reproductive health services and associated factors among the youth in Lira city west, northern Uganda. Methods. This was a cross-sectional study conducted in January 2023 among 386 young people (15-24 years) in Lira city west division, Lira city. Multistage cluster sampling technique was used to recruit our study participants. Data were collected using an interviewer-administered questionnaire. Data were analyzed using SPSS version 23, descriptive statistics, cross-tabulation, bivariate, and multivariate logistic regression analyses. All variables were set by p values less than 0.05 and reported adjusted odds ratio with its 95% confidence interval. Results. The utilization of SRH services was 42.0% (162/386) among the study participants. Family planning, voluntary HIV counseling and testing (VCT), and general counseling services were the most utilized SRH services in the past 12 months. Young people who were aware of SRH services (AOR: 0.24; 95% CI: 0.08-0.74), were aware of a reproductive health facility (AOR, 4.24; 95% CI: 1.62-11.09), discussed SRH issues with peers/friends (AOR, 3.98; 95% CI: 1.53-10.33), had a sexual partner (AOR, 10.00; 95% CI: 4.05-24.69), had sexual intercourse (AOR, 4.59; 95% CI: 2.18-9.69), and had access to SRH services (AOR, 2.68; 95% CI: 1.12-6.40) were more likely to utilize SRH services compared to their counterparts. Conclusion. This study showed a low utilization of sexual and reproductive health services among youth in Lira city west, northern Uganda. Being aware of SRH services, awareness of reproductive health facilities, discussing SRH issues with peers, having sexual intercourse, having a sexual partner, and access to SRH services were independently associated with the utilization of SRH services. Therefore, there is a need to strengthen sustainable multisector approaches aimed at improving awareness and access to sexual and reproductive health services among the youth. [ABSTRACT FROM AUTHOR]

Purpose. This paper aims to analyze the household financial burden and poverty impacts of cancer treatment in Vietnam. Methods. Under the “ASEAN CosTs in ONcology” study design, three major specialized cancer hospitals were employed to assemble the Vietnamese data. Factors of socioeconomic, direct, and indirect costs of healthcare were collected prospectively through both individual interviews and hospital financial records. Results. The rates of catastrophic expenditure based on the cut-off points of 20%, 30%, 40%, and 50% of household’s income were 82.6%, 73.7%, 64.7%, and 56.9%, respectively. 37.4% of the households with patient were impoverished by the treatment costs for cancer. The statistically significant correlates of the impoverishment problem were higher among older patients (40–60 years: 1.77, 95% CI 1.14–2.73; above 60 years: 1.75, 95% CI 1.03–2.98); poorer patients (less than 100% national income: 29, 95% CI 18.6–45.24; less than 200% national income: 2.89, 95% CI 1.69–4.93); patients who underwent surgery alone (receiving nonsurgery treatment: 2.46, 95% CI 1.32–4.59; receiving multiple treatments: 2.4, 95% CI 1.38–4.17). Conclusions. Lots of households were pushed into poverty due to their expenditure on cancer care; more actions are urgently needed to improve financial protection to the vulnerable groups. [ABSTRACT FROM AUTHOR]

Objective. To provide a scientific basis for the prevention and treatment of cervical intraepithelial neoplasia grade 1 (CIN1). This study evaluated the impact of human papillomavirus (HPV) infection on the natural history of CIN1. Methods. Electronic databases of Cochrane Library, EMBASE, PubMed, CNKI, CBM, and Wanfang were searched in April 2016. The eligibility criteria were documented by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We used the Newcastle-Ottawa scale (NOS) to assess study quality. Results. Thirty-eight studies out of 3,246 identified papers were eligible for inclusion. The risk of CIN1 progression (relative risk [RR]: 3.04; 95% confidence interval [CI]: 2.41–3.83; P<0.00001) and persistence (RR: 1.48; 95% CI: 1.17–1.87; P=0.001) was higher in the HPV-positive group than HPV-negative group. Specifically, the risk of CIN1 progression (RR: 13.91; 95% CI: 3.46–55.90; P=0.000) was higher among persistent high-risk HPV-positive patients and the ratio of CIN1 regression (RR: 0.65; 95% CI: 0.59–0.71; P<0.00001) was lower in the HPV-positive group than HPV-negative group. Conclusion. HPV infection resulted in an increased risk of CIN1 progression and decreased disease reversibility. Persistent high-risk HPV infection resulted in a further increased risk of CIN1 progression. [ABSTRACT FROM AUTHOR]

Background. Precisely predicting cancer is crucial for cancer treatment. Gene expression profiles make it possible to analyze patterns between genes and cancers on the genome-wide scale. Gene expression data analysis, however, is confronted with enormous challenges for its characteristics, such as high dimensionality, small sample size, and low Signal-to-Noise Ratio. Results. This paper proposes a method, termed RS_SVM, to predict gene expression profiles via aggregating SVM trained on random subspaces. After choosing gene features through statistical analysis, RS_SVM randomly selects feature subsets to yield random subspaces and training SVM classifiers accordingly and then aggregates SVM classifiers to capture the advantage of ensemble learning. Experiments on eight real gene expression datasets are performed to validate the RS_SVM method. Experimental results show that RS_SVM achieved better classification accuracy and generalization performance in contrast with single SVM, K-nearest neighbor, decision tree, Bagging, AdaBoost, and the state-of-the-art methods. Experiments also explored the effect of subspace size on prediction performance. Conclusions. The proposed RS_SVM method yielded superior performance in analyzing gene expression profiles, which demonstrates that RS_SVM provides a good channel for such biological data. [ABSTRACT FROM AUTHOR]

Nicotinamide N-methyltransferase (NNMT) catalyzes the methylation of nicotinamide. Our previous works indicate that NNMT is involved in the body mass index and energy metabolism, and recently the association between a SNP (rs694539) of NNMT and a variety of cardiovascular diseases was reported. At present, more than 200 NNMT single nucleotide polymorphisms (SNPs) have been identified in the databases of the human genome projects; however, the association between rs694539 variation and hyperlipidemia has not been reported yet, and whether there are any SNPs in NNMT significantly associated with hyperlipidemia is still unclear. In this paper, we selected 19 SNPs in NNMT as the tagSNPs using Haploview software (Haploview 4.2) first and then performed a case-control study to observe the association between these tagSNPs and hyperlipidemia and finally applied physiological approaches to explore the possible mechanisms through which the NNMT polymorphism induces hyperlipidemia. The results show that a SNP (rs1941404) in NNMT is significantly associated with hyperlipidemia, and the influence of rs1941404 variation on the resting energy expenditure may be the possible mechanism for rs1941404 variation to induce hyperlipidemia. [ABSTRACT FROM AUTHOR]

Background. Electronic medical record (EMR) systems have become essential for the proper management of patients' information. Electronic medical record systems are on the rise in developing countries due to the need to ensure improved quality of healthcare. However, EMR systems can be ignored, if users are not satisfied with the implemented system. User dissatisfaction has been associated with the failure of EMR systems as a primary factor. There is also limited research done in the Ethiopian context on EMR user satisfaction at private hospitals. This study is aimed at assessing user satisfaction with electronic medical records and associated factors among health professionals working at private hospitals in Addis Ababa. Methods. Institution-based cross-sectional quantitative study was conducted among health professionals working at private hospitals in Addis Ababa, from March to April 2021. A self-administered questionnaire was used to collect the data. EpiData version 4.6 and Stata version 25 were used for data entry and analysis, respectively. Descriptive analyses were computed for the study variables. Bivariable and multivariable logistic regression analyses were carried out to assess the significance of independent variables on dependent variables. Results. A total of 403 (95.33% response rate) participants completed all the questionnaires. More than half of 214 (53.10%) of the participants were satisfied with the EMR system. Factors associated with user satisfaction with electronic medical records were good computer literacy (AOR = 2.92 , 95% CI: [1.16-7.37]), perceived information quality (AOR = 3.54 , 95% CI: [1.55-8.11]), perceived service quality (AOR = 3.15 , 95% CI: [1.58-6.28]), perceived system quality (AOR = 3.05 , 95% CI: [1.32-7.05]), EMR training (AOR = 4.00 , 95% CI: [1.76-9.03]), computer access (AOR = 3.17 , 95% CI: [1.19-8.46]), and HMIS training (AOR = 2.05 , 95% CI: [1.22-6.71]). Conclusions. In this study, health professionals' EMR satisfaction was moderate. The result showed that EMR training, computer literacy, computer access, perceived system quality, information quality, service quality, and HMIS training were associated with user satisfaction. Improving computer-related training, system quality, information quality, and service quality is an important intervention to improve the healthcare professional's satisfaction towards using electronic health record systems in Ethiopia. [ABSTRACT FROM AUTHOR]

Background. Risky sexual behaviour raises serious public health concerns. The pooled prevalence of risky sexual behaviours among adults living with HIV/AIDS in sub-Saharan Africa was unknown. This systematic review determined the pooled prevalence of risky sexual behaviours and associated factors among HIV-infected adults in sub-Saharan Africa. Methods. International databases such as PubMed, CINAHL, Google Scholar, and African Journals OnLine were systematically searched to identify articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used to conduct the review. All necessary data were extracted independently. Heterogeneity and publication bias were assessed by I -squared statistics and Egger's test, respectively. The random-effects meta-analysis model was used to estimate the pooled prevalence. The association between predictors and dependent variable was determined by a pooled odds ratio (OR) with a 95% confidence interval (CI). Result. In this study, 3713 articles were retrieved from various databases, and 22 of them were included. The pooled prevalence of risky sexual behaviour in sub-Saharan Africa was 36.16% (95% CI: 28.36-44.34) with significant heterogeneity among studies ( I 2 = 98.86 % , p < 0.001). Risky sexual behaviour was significantly associated with the nondisclosure of HIV status (AOR = 1.97 , 95% CI: 1.18, 2.76) and alcohol consumption (AOR = 2.29 , 95% CI: 1.21, 3.36). Conclusion. A significant percentage of participants engaged in risky sexual behaviour. Risky sexual behaviour was associated with failure to disclose HIV status and alcohol consumption. Healthcare professionals should advise HIV-positive patients on risk reduction measures like disclosing their HIV status to their sexual partners and avoiding alcohol use in order to promote consistent condom use. PROSPERO Protocol Registration. The protocol for this systematic review and meta-analysis has been registered (record ID: CRD42020170967, 09/06/2022). [ABSTRACT FROM AUTHOR]

Background. Cervical cancer is one of the most prevalent and fatal malignancies in women worldwide. Despite the fact that vaccination is an effective method in reducing cervical cancer, its uptake varies between public and private school adolescents and remains a challenge in low- and middle-income countries, including Ethiopia. Empirical evidence on how much variation there is among public and private school adolescent in their willingness to uptake human papillomavirus (HPV) vaccination is also limited. Thus, the aim of this study was to compare levels of willingness to uptake HPV vaccination among public and private school female adolescents and associated factors in Bahir Dar City, Ethiopia. Methods. A comparative cross-sectional study was conducted on 844 adolescents aged 10 to 19 in primary schools in Bahir Dar, Ethiopia. Multistage sampling was used. A self-administered, structured, and pretested questionnaire was used to collect data. The determinants of willingness to accept HPV vaccination were identified using logistic regression, and exploratory factor analyses were performed to determine load and mean. The level of statistical significance was determined using a P - value of 0.05. Results. The overall proportion of willing to uptake HPV vaccination was 50.6% (95% CI: 47.4-54), whereas in public and private primary schools, the magnitude was 61% (95% CI: 56.3-65.4%) and 40.2% (95% CI: 35.6-44.9), respectively. In terms of willingness to uptake HPV vaccination, the odds were likely to be significantly higher among those whose mothers had a postsecondary education (AOR = 2.0 , 95% CI: 1.29-3.05), a high cue to action (AOR = 1.92 , 95% CI: 1.20-3.05), and high self-efficacy (AOR = 2.34 , 95% CI: 1.58-3.48). High perceived barriers likely decreased the willingness to uptake HPV vaccination (AOR = 0.49 , 95% CI: 0.34-0.70). Conclusion. Adolescent girls in public primary schools were more likely to uptake HPV vaccination than those in private provided that income status and socioeconomic factors became less important. Willingness to uptake HPV vaccination was found to be low as compared to the WHO target for Ethiopian context and was influenced by maternal education status, perceived barriers, cues to action, and self-efficacy. As a result, greater emphasis should be placed on implementing a school-based and maternal educational program on cervical cancer prevention and control focusing on the behavioral contexts. [ABSTRACT FROM AUTHOR]

In this study, we aim to investigate retinal thickness (RT) and superficial vascular density (SVD) differences between patients with systemic sclerosis (SSc) and healthy controls (HCs) by optical coherence tomography angiography (OCTA). Sixteen patients with a definitive SSc diagnosis without clinical signs of retinopathy and 16 normal control subjects were recruited. All individuals underwent OCTA scanning to assess macular RT and SVD. We divided each image into nine subregions as the early treatment diabetic retinopathy study (ETDRS). Visual acuity (VA) was considerably different between patients with SSc (32 eyes) and control subjects (32 eyes) (p < 0.001). Compared to the control group, individuals with SSc had decreased inner RT in inner superior, outer superior, outer temporal, inner temporal, center, and inner nasal regions (p < 0.05). Outer RT was decreased in the outer and inner temporal regions, and full RT was decreased in the regions of outer superior, inner superior, inner temporal, and outer temporal, in comparison to the control group (p < 0.05). Patients with SSc had significant reduction of SVD in the inner and outer of both superior and temporal, besides outer nasal regions than controls. (p < 0.05). Moreover, SVD was significantly associated with the outer temporal region of patients suffering from SSc (p < 0.05). Diagnostic Sensitivity of RT and SVD of Inner Superior Regions in SSc, as indicated by areas under curves of the Receiver Operating Characteristic (ROC), were 0.874 (95% CI: 0.786–0.962) and 0.827 (95% CI: 0.704–0.950), respectively. In conclusion, VA may be affected by RT variations inside the macula in patients with SSc. Measuring RT with OCTA could be a useful predictor of early diagnosis. [ABSTRACT FROM AUTHOR]

Background and Aims. In recent years, various studies have been conducted worldwide to investigate the relationship between receiving the flu vaccine with acute cerebrovascular accident or stroke and its hospitalization in the elderly; however, the results of these studies are contradictory. Therefore, this study was aimed at investigating the relationship between receiving the flu vaccine with stroke and its hospitalization in the elderly. Methods. This study is a systematic review and meta-analysis of studies examining the relationship between receiving the flu vaccine with stroke and its hospitalization in the elderly during the years 1980 to 2021 which have been published in ISI Web of Science, Scopus PubMed, Cochrane, Science Direct, Google Scholar, and Embase. All analyses were performed by Stata 15, and the significance level in this study was considered <0.05. Results. In the systematic search, 3088 articles were retrieved, considering the study criteria; finally, 14 studies were included in the meta-analysis. Based on the results of the meta-analysis, the odds ratio (OR) of occurrence and hospitalization of stroke compared to the nonvaccinated group in vaccine recipients is equal to 0.84 (95% confidence interval (CI): 0.78-0.90, P value ≤ 0.001). Publication bias was not observed in this study (P value = 0.101). Conclusion. Getting the flu vaccine can reduce the risk of occurrence and hospitalization of stroke in the elderly by 16% (10%-22%). Therefore, receiving this vaccine as a preventive intervention for stroke in the elderly may be promising. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is a significant public health issue in Bangladesh like many other developing countries where data on resistance trends are scarce. Moreover, the existence of multidrug-resistant (MDR) Escherichia coli exerts an ominous effect on the poultry sector. Therefore, the current systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was conducted to find out the AMR scenarios in E. coli isolates sourced from poultry and poultry environments in Bangladesh between 2010 and 2021. Following the PRISMA guidelines, a total of 17 published scientific articles were selected for this systematic review. This review revealed that 18 out of 64 districts in Bangladesh reported E. coli in poultry, having a higher prevalence (combined prevalence: 69.3%, 95% confidence interval, CI: 67.3-71%). Moreover, the prevalence ranged from 24.3% to 100%. This review found that E. coli isolates showed resistance to 14 antimicrobial classes and 45 different antimicrobial agents, including the last-line (reserve group) antibiotics and banned antimicrobial categories for the treatment of infections in agricultural animals. Phenotypic resistance of E. coli against penicillins and beta-lactamase inhibitors (20.2%-100%), cephalosporins (1.9%-100%), fluoroquinolones (5.98%-100%), aminoglycosides (6%-100%), tetracyclines (17.7%-100%), carbapenems (13.6%-72.7%), macrolides (11.8%-100%), polymyxins (7.9%-100%), phenicols (20%-97.2%), sulfa drugs (44.7%-100%), cephamycins (21.4%-48.8%), nitrofurans (21.4%-63.2%), monobactams (1.2%), and glycylcyclines (2.3%) was recorded in the last decades in Bangladesh. Also, 14 articles reported MDR E. coli in poultry, including a 100% MDR in nine articles and a 92.7% (95% CI: 91.2-94%) combined percentage of MDR E. coli isolates. Twenty-four different AMR genes encoding resistance to beta-lactams (blaTEM, blaCTX-M-1, blaCTX-M-2, blaCTX-M-9, blaOXA-1, blaOXA-47, blaSHV, and CITM), colistin (mcr1 and mcr3), fluoroquinolones (qnrB and qnrS), tetracyclines (tetA, tetB, and tetC), sulfonamides (sulI and sulII), trimethoprim (dfrA1), aminoglycosides (rmtB), streptomycin (aadA1), gentamicin (aac-3-IV), erythromycin (ereA), and chloramphenicol (catA1 and cmlA) were detected in E. coli isolates. The presence of MDR E. coli and their corresponding resistance genes in poultry and poultry environments is an alarming issue for all health communities in Bangladesh. We suggest a regular antimicrobial surveillance program with a strong One Health approach to lessen the hazardous effects of AMR E. coli in poultry industries in Bangladesh. [ABSTRACT FROM AUTHOR]

Background. The current study is aimed at updating the observational studies on the relationship between threatened abortion and the risk of ASD. Methods. The search keywords were covered in three electronic databases PubMed, Web of Science, and Scopus up to April 2022. The modified Newcastle–Ottawa scale (NOS) was applied to detect the quality of epidemiological studies. We used the chi-square test and the I 2 statistic to show the heterogeneity among articles. I 2 more than 50% was considered high heterogeneity. Egger's and Begg's line regression tests were used for evaluating the publication bias. The random-effects model was applied for the analysis of the findings. The Stata 13.0 software package was applied for analysis and indicated p value less than 0.05 as a significant level. Results. The pooled analysis reported significant differences between threatened abortion and the risk of ASD in adjusted studies (OR = 1.93 ; 95% CI: 1.12, 2.73; I 2 = 59.5.0 %) and in crude studies (OR = 2.17 ; 95% CI: 1.46, 2.88; I 2 = 39.5 %). The evidence of publication bias was not found. Conclusions. The findings suggest that threatened abortion is a risk factor for ASD. As a result, screening tools to detect are necessary in mothers facing a threatened abortion. [ABSTRACT FROM AUTHOR]

Objective. To establish and validate a nomogram to predict the overall survival (OS) and cancer-specific survival (CSS) in patients with nasopharyngeal carcinoma (NPC) receiving radiotherapy by integrating multiple independent prognostic factors. Materials and Methods. Data from 5663 patients with NPC who received definite radiotherapy between 2004 and 2018 were included and divided into training and validation cohorts. Univariate and multivariate Cox regression analyses were performed to determine the independent prognostic factors of patients with NPC after radiotherapy. Thereafter, the predictive accuracy of the nomogram model was evaluated. Results. Age, race, marital status, pathological type, tumor size, T stage, N stage, M stage, American Joint Committee on Cancer stage, and chemotherapy were independent factors affecting the prognosis of patients with NPC receiving radiotherapy. Nomograms with a concordance index of 0.726 (95% confidence interval (CI): 0.675–0.777) and 0.732 (95% CI: 0.680–0.785) were able to predict OS and CSS, respectively. The area under the curve showed excellent predictive performance. Additionally, the calibration curve indicated that the predicted survival rate was consistent with the actual survival rate, and the decision curve indicated its clinical value. The established risk stratification system was able to accurately stratify patients receiving radiotherapy for NPC into three risk subgroups with significant differences in prognosis (P < 0.05). Conclusions. The constructed nomogram had good prognostic performance and could be used as an effective tool to evaluate the prognosis of patients with NPC after radiotherapy. This nomogram could be further used to guide clinical decisions and personalized treatment plans. [ABSTRACT FROM AUTHOR]

Background. This study is aimed at constructing a nomogram to predict the risk of clinically significant prostate cancer (csPCa) based on the aggregate index of systemic inflammation (AISI) and prostate imaging-reporting and data system version (PIRADS) score. Methods. Clinical data on patients who had undergone initial prostate biopsy from January 2019 to December 2021 were collected. Patients were randomized in a 7 : 3 ratio to the training cohort and the validation cohort. Potential risk factors for csPCa were identified by univariable and multivariate logistic regression. Nomogram was conducted with these independent risk factors, and calibration curves, the receiver operating characteristic (ROC), and decision curve analysis (DCA) were employed to assess the nomogram's ability for prediction. Results. A total of 1219 patients were enrolled in this study. Multivariate logistic regression identified that age, AISI, total prostatic specific-antigen (tPSA), free to total PSA (f/tPSA), prostate volume (PV), and PIRADS score were potential risk predictors of csPCa, and the nomogram was developed based on these factors. The area under the curve (AUC) of the training cohort and validation cohort was 0.884 (95% CI: 0.862-0.906) and 0.899 (95% CI: 0.867-0.931). The calibration curves showed that the apparent curves were closer to the ideal curves. The DCA results revealed that the nomogram model seemed to have clinical application value per DCA. Conclusion. The nomogram model can efficiently predict the risk of csPCa and may assist clinicians in determining if a prostate biopsy is necessary. [ABSTRACT FROM AUTHOR]

Background. Biliary atresia (BA) is a type of severe cholestatic childhood disease that may have a genetic component. miR-100 plays a key role in regulating cell apoptosis, proliferation, and inflammatory reactions. A single-nucleotide polymorphism in miR-100 has been proven to modulate susceptibility to various diseases. Methods. We conducted a case-control retrospective study to explore the correlation between miR-100 gene polymorphism (rs1834306 A>G) and biliary atresia susceptibility in 484 Chinese patients and 1445 matched control subjects. Results. Our results showed that rs1834306 A>G was correlated with a significantly increased risk for BA (GG vs. AA: adjusted odds ratio OR = 1.44 , 95 % confidence interval CI = 1.02 – 2.03 , p = 0.041 ; and GG vs. AA/AG: adjusted OR = 1.39 , 95 % CI = 1.02 – 1.89 , p = 0.036). Conclusions. Our results showed that the rs1834306 A>G polymorphism is associated with an increased risk for BA and contributes to BA susceptibility. [ABSTRACT FROM AUTHOR]

Background. Suicidal ideation among textile factory workers is a major public health concern worldwide and is associated with a higher risk of completed suicide. However, there are limited studies that determined the prevalence and the potential determinants of suicidal ideation in Africa, including Ethiopia. Therefore, this study is aimed at exploring the prevalence of suicidal ideation and associated factors among textile factory workers in Almeda textile factory in Adwa, Ethiopia. Methods. An institutional-based cross-sectional study design was conducted from May 3, 2020, to June 16, 2020, at Almeda textile factory in Adwa. A total of 409 workers were identified using a systematic random sampling technique. Data were collected using a self-administered questionnaire using suicidality module of Composite International Diagnostic Interview. Data were analyzed using SPSS version 22.0, and logistic regression model was employed. Adjusted odds ratio with a 95% confidence interval was computed, and statistical significance was declared at p value < 0.05. Result. In this study, the prevalence of suicidal ideation was found to be 8.8% (95% CI: 6.1, 11.5). Working more than 48 hours per week (AOR = 2.88 , 95% CI: 1.18, 7.04), depression (AOR = 3.90 , 95% CI: 1.60, 9.50), work-related physical injury (AOR = 5.95 , 95% CI: 2.37, 14.94), and interpersonal conflict (AOR = 3.54 , 95% CI: 1.40, 8.90) were the significant factors associated with suicidal ideation. Conclusion and Recommendation. In this study, suicidal ideation among Almeda textile production workers was a significant problem. Factors including depression, work-related exposure to physical injury, long working hour, and interpersonal conflict can enlarge suicidal ideation. [ABSTRACT FROM AUTHOR]

Background. Neonatal sepsis is a leading cause of morbidity and mortality in low-and middle-income countries (LMICs). There are several sophisticated biomarkers; however, they are still insufficient in precision. In this perspective, our study aims to search for a pragmatic diagnostic biomarker in the age category. Methods. A cross-sectional study was conducted over six months(April-September 2018). All neonates with a diagnosis of probable sepsis were included. Logistic regression analysis of demographic variables was done to elucidate any association with confirmed sepsis cases. The median with interquartile range (IQR)] and mean with standard deviation (SD) were calculated, and then compared. The area under the receiver operating characteristic curve (AUROC) of the commonly opted biomarker tests [distribution width of red blood cells (RDW) and platelets(PDW), mean platelet volume(MPV), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)] was compared to the culture-confirmed case. Results. Of the 171 suspected sepsis subjects, we discovered a significant burden of newborn sepsis, with 18.7% of cases being culture-confirmed. 66 Early-onset sepsis(EOS) and 105 Late-onset sepsis(LOS) probable sepsis cases were enrolled. A higher incidence was revealed among male infants 24(14%) compared to females 8(4.7%). On logistic regression analysis, preterm birth [odds ratio (OR): 10.9, 95% confidence interval (CI): 4.5-26.9] and low birth weight (OR: 6.5, 95% CI: 2.4-17.9) were significantly associated. Coagulase-negative Staphylococcus aureus (CoNS) (n =6) among gram-positive, and Pseudomonas aeruginosa (n =6) was among gram-negative, were the leading etiologies. Escherichia coli (n =3) was the predominant bacteria in EOS subjects, while Pseudomonas aeruginosa (n =6) among LOS. Median interquartile range(IQR): platelet count 144.5(99-192), red cell distribution width 18(16.9-20), CRP 6(3-18.3); and mean ± SD: MPV (11.7 ± 1.7); PDW (15.2 ± 3.5) were attained, among confirmed cases. The AUROC, of biomarker tests was attained in the order: PDW(0.86) > MPV(0.81) > RDW(0.76) > CRP(0.67) > ESR(0.59); similarly, the cut-off order was >11.2, >10.4, >16.8, >2.9, >4.5, respectively. Conclusions. Our finding shows an increment in the width and volume of RBCand platelet: RDW, MPV, and PDW have a diagnostic role in neonatal sepsis. [ABSTRACT FROM AUTHOR]

Cervical cancer is one of the most common malignancies in women with high morbidity and mortality. Human papillomavirus (HPV) infection is the primary cause of cervical cancer, of which HPV 16 is the predominant. Early detection and effective treatment of cervical precancerous lesions are the key to preventing cervical cancer. Vitamin D receptor (VDR) gene polymorphism is considered to be an important cause of cancer development. Here, we studied the association of VDR polymorphisms (FOKI, BsmI, ApaI, and TaqI) in HPV16-positive cervical intraepithelial neoplasia (CIN)2+ patients. HPV16-positive patients who visited the Colposcopy Clinic of Obstetrics and Gynecology, the Second Hospital of Shanxi Medical University for biopsy due to abnormal HPV and/or Thinprep cytologic test (TCT) from September 1, 2020 to October 1, 2021 were grouped by pathological results. The fasting blood samples were collected and VDR polymorphisms were detected using TaqMan fluorescent probes, and the three sites of BsmI-ApaI-TaqI were subjected to haplotype analysis. FOKI ff genotype (OR = 2.01 ; 95% CI = 1.12 − 3.59 ; p = 0.019) and f allele (OR = 1.48 ; 95% CI = 1.10 − 1.98 ; p = 0.009) were found to be associated with the risk of CIN2+. TaqI Tt genotype (OR = 2.03 ; 95% CI = 1.20 − 3.43 ; p = 0.008), tt genotype (OR = 2.09 ; 95% CI = 1.09 − 4.02 ; p = 0.028), and t allele (OR = 1.35 ; 95% CI = 1.01 − 1.80 ; p = 0.041) were associated with the risk of CIN2+. No haplotype was associated with CIN2+ risk. According to the results, FOKI and TaqI polymorphisms are associated with CIN2+ risk. [ABSTRACT FROM AUTHOR]

We aimed to determine prognostic factors and develop an effective and practical nomogram for predicting cancer-specific survival in gastrointestinal stromal tumor (GIST) patients. Postoperative data were obtained from the SEER database (2000-2018). Patients were divided into training and validation cohorts at random (7 : 3). Prognostic factors were screened, and a prognostic nomogram was established using log-rank testing and Cox regression. We used DCA, ROC curves, C-index, and calibration curves to evaluate our model's predictive performance. The clinical value of the nomogram and the modified National Institute of Health (M-NIH) classification were compared using the NRI and IDI. The Kaplan-Meier method was applied to examine survival by risk group, and log-rank tests were applied to compare variations in survival curves. Independent prognostic risk factors associated with cancer-specific survival on multivariate Cox proportional hazards regression analysis were age, race, and tumor location, size, grade, and stage. Clinically relevant variables need to be considered in addition to statistically significant variables when developing prognostic models to aid clinical decision-making. We included two additional variables (mitotic rate and chemotherapy) when constructing the prognostic model. The C-index was 0.766 (95% confidence interval (CI): 0.737-0.794) in the training cohort and 0.795 (95% CI: 0.754-0.836) in the internal validation group suggesting robustness. The areas under the ROC curve for three-year and five-year survival were >0.700, indicating satisfactory discrimination. The calibration curves showed good agreement between the predictions of the nomogram and the actual results. The NRI (0.346 for 3-year and 0.265 for 5-year cancer-specific survival for patients with GIST (GSS) prediction; validation cohort: 0.356 for 3-year and 0.246 for 5-year GSS prediction) and IDI values (0.047 for 3-year and 0.060 for 5-year GSS prediction; validation cohort: 0.071 for 3-year and 0.084 for 5-year GSS prediction) suggested that the established nomogram performed significantly better than the M-NIH classification. The DCA indicated that the nomogram was clinically useful and had a high discriminative ability in identifying patients who were at high risk of poor outcomes. According to nomogram findings, patients were divided into three groups (high, moderate, and low risk), with significantly different prognoses in both cohorts. Our nomogram satisfactorily predicted survival in postsurgical GIST patients, which may assist clinicians to evaluate the postoperative status and guide subsequent treatments. [ABSTRACT FROM AUTHOR]

Background. Roxadustat is a newly listed oral hypoxia-inducible factor-proline enhancing enzyme inhibitor (HIF-PHI) in recent years. There have been some studies that have proved the efficacy of roxadustat on the treatment of renal anemia in patients with chronic kidney disease (CKD), but there are still different conclusions on its safety. Methods. PubMed, Embase, Cochrane, and ClinicalTrials were searched for randomized controlled trials (RCTs) that assess efficacy and safety of roxadustat treatment for anemia in CKD patients. The Cochrane Literature Quality Evaluation Scale was used to evaluate the quality of included literature. We choose fixed-effects model or random effects model for data processing based on heterogeneity. It was considered statistically significant when p value <0.05. Results. A total of 842 articles were retrieved, and 16 trials in the 15 articles were finally included. Roxadustat treatment significantly increased Hb levels. Iron (SMD 1.43, 95% CI 0.31 to 2.55), total iron-binding capacity (SMD 2.06, 95% CI 0.91 to 3.22), ferritin (WMD 21.33, 95% CI 3.04 to 39.62), transferrin saturation (SMD 4.17, 95% CI 3.90 to 4.45), and LDL-cholesterol (SMD -0.64, 95% CI -0.73 to -0.55) showed statistical significance in dialysis-dependent (DD) study. And hepcidin (SMD -1.56, 95% CI -2.63 to -0.50), transferrin (SMD 1.80, 95% CI 1.53 to 2.06), total iron-binding capacity (SMD 1.62, 95% CI 1.39 to 1.86), total cholesterol (SMD -0.88, 95% CI -1.68 to -0.09), ferritin (WMD -52.68, 95% CI -62.68 to -42.67), transferrin saturation (SMD -5.57, 95% CI -7.47 to -3.68), and LDL-cholesterol (SMD -0.85, 95% CI -1.37 to -0.34) showed statistical significance in not dialysis-dependent (NDD) study. In terms of safety, roxadustat treatment did not increase risk of total adverse events either in dialysis-dependent or not dialysis-dependent patients. Conclusion. Roxadustat can effectively improve anemia in patients with chronic kidney disease. There was no significant difference in total adverse events compared with the control group. [ABSTRACT FROM AUTHOR]

Background. Accurate, cost-effective, and noninvasive alternative molecular methods are needed for detecting low malaria parasitemia. The currently-used nested polymerase chain reaction (nPCR) requires blood as well as skilled personnel in order to minimise the risk of bloodborne disease transmission. Therefore, this study is aimed at assessing the accuracy of a noninvasive and more affordable malaria diagnosis with saliva using the loop-mediated isothermal amplification (LAMP) technique. Methods. A cross-sectional study was conducted in the Centre and Southwest regions of Cameroon. Matched blood and saliva samples collected from symptomatic and asymptomatic participants were tested for malaria using rapid diagnostic tests, microscopy, PCR, and LAMP. Statistics were performed using R studio software at 95% confidence interval. Results. A total of 100 participants (65% symptomatic and 35% asymptomatic) aged between 1 and 74 years with a balanced gender distribution ratio of 1.08 were included in our study. The prevalence of malaria was 61%, 57%, 59%, 42%, 35%, 17%, and 16% for blood-RDT, blood-PCR, blood-LAMP, blood-RT-LAMP, saliva-PCR, saliva-RT-LAMP, and saliva-LAMP, respectively. Both saliva and blood showed a sensitivity of 43.90% and respective specificities of 68.75% and 57.62%. When using RT-LAMP, sensitivities of 49.38% and 48.21% and specificities of 94.11% and 66.67% were recorded for saliva and blood, respectively. Sensitivities of 70.23% and 73.49% and specificities of 62.5% and 76.47% were recorded, respectively, for saliva-LAMP and saliva-RT-LAMP when compared to saliva-PCR as the gold standard. Saliva-LAMP and saliva-RT-LAMP had a fair agreement (к = 0.221 and 0.352, respectively) with saliva-PCR. Homemade LAMP and RT-LAMP technologies match the WHO recommendations and after proper validation in a larger sample size, could serve for malaria diagnosis in developing countries. [ABSTRACT FROM AUTHOR]

Background and Aims. Abnormal expression of lncRNAs is relevant to the occurrence and development of gastric cancer (GC), but the significance remains inconclusive. We performed a diagnostic meta-bioinformatics analysis to elucidate the association between lncRNA expression and GC risk. Methods. Published datasets were selected from PubMed, Embase, CNKI, and Web of Science, up to 1st December 2021. The pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to evaluate the diagnostic value. RNA sequencing data were downloaded for validation. Results. 54 studies with 4671 patients and 4652 matched controls were included in the meta-analysis. The pooled SEN, SPE, PLR, NLR, DOR, and AUC were 0.71, 0.76, 2.9, 0.39, 8, and 0.79, respectively. Subgroup analyses showed that the DOR and AUC of intergenic lncRNAs, circulating lncRNAs, larger sample size (>200), and high-quality (NOS score ≥ 7) groups were superior to antisense lncRNAs, tissue lncRNAs, smaller sample size (≤200), and low-quality (NOS score < 7) groups, respectively. However, only circulating lncRNAs had significantly higher diagnostic utility than that tissue lncRNAs. Nine differentially expressed lncRNAs in the meta-analysis were verified in TCGA-STAD. PVT1 was the most effective single lncRNA, with AUC of 0.949, SEN of 0.808, and SPE of 0.969, while PVT1 and C5orf66-AS1 were the most effective combination, with AUC of 0.972, SEN of 0.941, and SPE of 0.937. Conclusion. Abnormally expressed lncRNAs, especially circulating lncRNAs, might be potential diagnostic biomarkers for GC risk. A novel combined model of lncRNAs might achieve better GC diagnosis performance. [ABSTRACT FROM AUTHOR]