Group Of Comparison Research Articles

Abstract 063: Emergent versus delayed carotid artery stenting in tandem occlusion strokes treated with thrombectomy

Introduction It is controversial when to pursue carotid artery stenting (CAS) after acute tandem occlusion (TO) strokes treated with endovascular thrombectomy (EVT). We conducted a retrospective observational study to evaluate the clinical and safety outcomes of emergent versus delayed CAS in the first week of EVT. Methods In this retrospective cohort study, using 2016‐19 Nationwide Readmissions Database, we identified patients with acute ischemic stroke who had EVT for anterior circulation large vessel occlusions (LVOs) and CAS up to 7 days of EVT. CAS performed on day ‐1, 0 or 1 day after admission was considered as emergent CAS. CAS performed 2‐7 days after EVT was defined as delayed CAS. The primary clinical outcomes were all‐cause mortality during same admission. Secondary safety outcomes included intracranial hemorrhage (ICH), seizures, gastric tube (G‐tube) insertion, > 24‐hours mechanical ventilation, tracheostomy, length of stay (LOS), and discharge location (home vs. others). Multivariate logistic regression analysis was used to compare outcomes in emergent CAS group in comparison to delayed CAS group. Age, sex, hypertension, diabetes mellitus, hyperlipidemia, and use of thromobolytics were considered as covariates. Results We identified total of 1990 hospitalizations meeting the study inclusion criteria (mean age: 67 years ± standard deviation:12 years, female 612 (31%). Of these, 1745 (87%) had undergone emergent CAS with EVT and 245 (13%) had delayed CAS (2‐7 days) pos‐EVT. Baseline characteristics were similar between the two cohorts. Delayed CAS cohort had significantly less mortality rates [6 vs 13%; OR 0.43, 95% CI 0.24‐0.78], less ICH [20 vs 30%; OR 0.6, 95% CI 0.43‐0.82¬¬], less cerebral edema [16 vs 23%; OR 0.65, 95% CI 0.44‐0.96], and less mechanical ventilation for >24‐hours [11 vs 18%; OR 0.54, 95% CI 0.34‐0.85]. There was no significant difference between the two treatment groups for tracheostomy, G‐tube placements, new‐onset seizure, and mean LOS. Conclusion Delaying CAS for 2‐7 days after EVT might be a safer approach for endovascular revascularization in anterior circulation LVO strokes secondary to tandem lesions.

Safety and Efficacy of Citicoline among Acute Ischemic Stroke Bangladeshi Patients: A Randomized Control Trial

Background: Ischemic stroke is the most common type of all stroke events. About 2.7 million people die each year from ischemic stroke. Facilities for reperfusion therapy in hyper-acute state is not widely available in our country. Use of neuro-protective agents like citicoline may be considered as a reasonable adjunct with antiplatelet agents. Objective: The objective of this study was to evaluate the safety and efficacy of citicoline in treatment of acute ischemic stroke as a neuro-protective agent. Methodology: This was a randomized controlled trial which was conducted in Neurology Unit of National Institute of Neurosciences & Hospital, Dhaka, Bangladesh from January 2017 to December 2017. Acute ischemic stroke patients presented with National Institute of Health Stroke Scale (NIHSS) ≥ 5 were recruited for this study. The study population were divided into 2 groups designated as study and control groups. Control group received standard treatment of acute ischemic stroke whereas study participants were treated with standard stroke medications along with citicoline. Outcome and adverse events were recorded at one week and at twelve weeks of treatment onset. The primary end points of outcome were assessed using NIHSS and mRS at twelve weeks. NIHSS ≤1 and/or mRS ≤2 were considered as good functional outcome. Results: A total number of 109 acute ischemic stroke patients were recruited for this study of which 53 cases in the study group and 56 cases in the control group. More number of patients achieved good functional outcome (mRS ≤2) in citicoline group in comparison to control group, 62.96% and 37.03% in study and control group respectively (p=0.362), though this difference was not statistically significant. There were no significant changes of biochemical parameters, major and minor adverse events between two groups at 1 week and 12 weeks follow up. A significant number of patients died in control group in comparison of study group, 45.45% vs. 23.8% (p=0.0483) within 12-week period. Conclusion: In this study, functional outcome is found better in citicoline group. Survival benefit is observed with citicoline group in comparison to control which is statistically significant. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):3-10

Comparison of post-operative outcomes in laparoscopic and open right colectomy for colon cancer: A 4-year single centre experience

Background: Laparoscopic right colectomy (LRHC) is a procedure which has been getting more popular compared to traditional open right colectomy (ORHC) over the last three decades. This study compares the post-operative outcomes in laparoscopic and open right colectomy for colon cancer.
 Patients and Methods: This is a retrospective study of right colectomy at a single institution from January 2018 to December 2021. The factors that were studied included postoperative HDU admission, the incidence of post-operative ileus (POI) and the length of hospital stay.
 Results: During the study period, 161 patients underwent right hemicolectomy. Sixty-seven (42%) underwent LRHC, 73 (45%) ORHC, and 21 (13%) laparoscopic converted to open procedure. The overall incidence of POI was 56 (35%), 14 (21%) among the LRHC and 28 (38%) among the ORHC group (p=0.024). The length of hospital stay was 7.1 (±4.8) days after the laparoscopic procedure compared to 8.7 (±4.4) in the open group (p=0.048). Forty-two patients out of 161 (26%) needed post-operative HDU admissions; out of these 11 (16%) were in the laparoscopic group and 29 (40%) among the open group (p=0.023).
 Conclusion: Post-operative recovery was significantly quicker among the laparoscopic right hemicolectomy group incomparison to the open right hemicolectomy group.

Clinical value of serum miR-1-3p as a potential circulating biomarker for abdominal aortic aneurysm

Background Although abdominal aortic aneurysm (AAA) is associated with life-threatening complications, there are still limited reliable biomarkers for diagnostic purpose. MicroRNAs (miRNAs) have been proposed as the potential diagnostic and risk stratification markers of AAA patients, and we aim to evaluate the serum level of miR-1-3p and its diagnostic value in AAA. Methods This study included 200 AAA patients and 200 controls. Demographic data and clinical information were collected from the subjects’ medical records. Individual image analyses of AAA morphology were determined based on computed tomography angiography (CTA). The levels of serum miRNA expression were detected by quantitative real-time PCR. Bioinformatics tools were used to identify the target genes of miR-1-3p and their potential biological functions were further enriched. Results Serum miR-1-3p levels in the AAA group were significantly lower when compared with those in the control group in overall and subgroup comparisons. It was negatively related to WBC, CRP, maximal aneurysm diameter, area, and volume in AAA patients. Circulating miR-1-3p levels could significantly discriminate between AAA patients and healthy individuals with an area under the curve (AUC) of 0.672 (95% CI = 0.619-0.724, p < 0.001), a sensitivity of 84.5% and a specificity of 45.5%. Serum miR-1-3p was associated with a reduced risk of AAA even after adjustment for possible risk factors (OR = 0.440 per unit increase, 95% CI = 0.301-0.643, p < 0.001). And low levels of serum miR-1-3p could significantly elevate the risk of AAA in both univariate and multivariate logistic regression analyses with ORs of 4.076 and 4.136, respectively (all p < 0.001). Further GO enrichment analysis revealed that miR-1-3p was mainly involved in negative regulation of apoptotic process, sprouting angiogenesis, angiogenesis, positive regulation of blood vessel endothelial cell migration, positive regulation of cell proliferation, regulation of cell shape, etc. Conclusions MiR-1-3p can be used as a promising circulating biomarker in the development of AAA, and it may participate in multiple biological processes to play a crucial role in AAA pathogenesis.

An algorithm for discovering vital nodes in regional networks based on stable path analysis

Vital node discovery is a hotspot in network topology research. The key is using the Internet’s routing characteristics to remove noisy paths and accurately describe the network topology. In this manuscript, a vital regional routing nodes discovery algorithm based on routing characteristics is proposed. We analyze the stability of multiple rounds of measurement results to overcome the single vantage point’s path deviation. The unstable paths are eliminated from the regional network which is constructed through probing for target area, and the pruned topology is more in line with real routing rules. Finally, we weight the edge based on the actual network’s routing characteristics and discover vital nodes in combination with the weighting degree. Unlike existing algorithms, the proposed algorithm reconstructs the network topology based on communication and transforms unweighted network connections into weighted connections. We can evaluate the node importance in a more realistic network structure. Experiments on the Internet measurement data (275 million probing results collected in 107 days) demonstrate that: the proposed algorithm outperforms four existing typical algorithms. Among 15 groups of comparison in 3 cities, our algorithm found more (or the same number) backbone nodes in 10 groups and found more (or the same number) national backbone nodes in 13 groups.

Bone Transport through Induced Membrane versus Conventional Bone Transport in Management of Infected long bone defects of Lower Limbs: a randomized controlled trial.

To compare bone transport through induced membrane (BTM) and conventional bone transport (BT) regarding docking site union and infection recurrence in management of infected long bone defects. prospective randomized controlled study. tertiary level center. 30 patients with infected non-united long bone fractures of lower limbs. 15 patients treated by BTM in group (A) and 15 patients treated by BT in group (B). External fixation time (EFT), External fixation index (EFI), Docking time (DT). Bone and functional outcomes evaluated by the Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system. Postoperative complications evaluated according to Paley's classification. The mean docking time (DT) was significantly lower in BTM group in comparison to BT group (3.6 ± 0.82 months vs 4.8 ± 0.86 months respectively; P value 0.001). Docking site non-union and infection recurrence were significantly lower in BTM group in comparison to BT group (0% vs 40%; P value 0.02 and 0% vs 33.3%; P value 0.04 respectively) with no significant difference in EFI (P value 0.08). This is the first prospective randomized controlled study comparing BTM and BT techniques showing that BTM had significantly faster docking site union, lower incidence of postoperative complications including docking site non-union and infection recurrence rates and lower number of additional procedures needed at the expense of two staged operation in comparison to BT.

Bipolar Hemiarthoplasty versus Proximal Femoral Nail in Management of Unstable Intertrochanteric Femur Fracture

Background Intertrochanteric fractures (ITFs), commonly occurred in the elderly, are still a big challenge for orthopedic surgeons due to the multitude of co-morbidities and high 1-year mortality rate associated with them. Aim of the Work The aim of this study is to review systematically studies about the use of bipolar hemiarthoplasty versus proximal femoral nail in management of unstable intertrochanteric femur fracture. Patients and Methods We included randomized control trails (RCTs), controlled clinical trials, retrospective comparative cohort studies and prospective comparative cohort studies and we excluded case reports, case series studies, cross sectional studies and non English studies. Search results was conducted to systematic review management software and manually screened for eligibility to be included. Surgical treatment of unstable intertrochanteric femur fractures by bipolar hemiarthoplasty versus proximal femoral nail. Results Regarding the patients included in the review there is no significant difference in the age or sex between the two groups of comparison. This review provides us with enough evidence regarding the superiority of PFN, which being a significantly faster surgery and has relatively lower incidence of intraoperative blood loss this in turn provides general wellbeing to the patient and gives better function. Although there is no significant difference between two group of comparison regarding percentage of failure and percentage of reoperation, PFN shows the superiority of duration of hospital stay which could be beneficial for the mental health of the patients, which adds to their overall quality of life, also PFN show the superiority regarding percentage of infection, decreasing patient suffering and risk of reoperation, also PFN show the superiority regarding percentage of mortality increasing life expectancy of patients, percentage of DVT decreasing pulmonary complications and also PFN show the superiority regarding Harris hip score so show better outcomes. Conclusion PFN proves itself as a better modality than hemiarthroplasty in unstable intertrochanteric femur fractures in the elderly, with decreased post-operative mortality and better functional results. Hemiarthroplasty is best reserved for individuals with short life expectancies who require immediate weight bearing and mobilization.

The safety and efficacy of remimazolam tosylate combined with propofol in upper gastrointestinal endoscopy: A multicenter, randomized clinical trial.

Hypotension is the most common adverse event under propofol-mediated sedation and is possible to cause varying degrees of damage to patients. Whereas remimazolam has a poorer sedative effect than propofol. The aim of this study was to explore the advantages of the combination of remimazolam tosylate and propofol. 304 patients were divided into the remimazolam tosylate group (RT group), the propofol group (P group), and the remimazolam tosylate plus propofol group(R+T group). The primary outcome was the incidence of hypotension. Secondary outcomes included the results of sedation and recovery. The safety results mainly include the incidence of Hypotension, adverse respiratory events, postoperative nausea and vomiting, hiccup, cough, body movement and bradycardia. The incidence of hypotension was 56.7% in the P group, 12.6% in the RT group, and 31.3% in the R+P group, three groups of pairwise comparisons showed statistical differences, with P< 0.001. The incidence of body movement was significantly higher in the RT group (26.1%) than in the P group (10.3%) and the R+P group (12.5%), P = 0.004. The endoscopist satisfaction was higher in the P (3.87±0.44) and R+P (3.95±0.22)groups than in the RT(3.53±0.84) group. The incidence of adverse events, in descending order, was P group, RT group, and R+P group (93.8%vs.61.3%vs.42.7%). Co-administration had fewer adverse events than propofol monotherapy, also had a better sedative effect and higher endoscopist satisfaction than remimazolam monotherapy. Clinical trial registration number: NCT05429086.

Effect of Fenton pre-oxidation on the physicochemical properties of sludge-based biochar and its adsorption mechanisms for ammonia nitrogen removal

Fenton pre-oxidation, as a promising technology for sludge deep dehydration, has been used intensively; however, the outputs (i.e., low-water-content sludge cakes) need to be further disposed for a full line sludge resource utilization. Carbonization presents a promising approach for disposing of the sludge cake within the process. Here, the physicochemical properties of sludge-based char obtained after Fenton pre-oxidation were studied. Both Fenton pre-oxidized sludge-based char (FSC) and raw sludge-based char (RSC) were produced within the temperature range of 400–600 ℃, and the adsorption performance of the prepared chars, exemplified by their ability to adsorb ammonia nitrogen (NH4+), was tested under various conditions. FSC exhibited superior char yield and adsorption performance compared to RSC, with chemical adsorption being the primary controlling factor. The optimum conditions for FSC were observed at 400 ℃, resulting in a char yield of 72.2 %, and an adsorption capacity of 221.7 mg/g. Notably, FSC demonstrated an increase in C-C, C-N, OC-O, C-O and CC functional groups in comparison to RSC, which suggests that pre-oxidation increases organic matter decomposition and chemical reactivity of the sludge. The introduction of Si-O-Si, Si-O-C and Fe-O-H functional groups in the FSC facilitated ion exchange with NH4+ in an aqueous solution. The key findings indicate that Fenton pre-oxidation not only enhances the adsorption performance of FSC but also reduces the required carbonization temperature for excellent-char preparation. These results demonstrated the potential to integrate sludge deep dewatering, including pre-oxidation, with char preparation.

Randomized Controlled Trial on the ASSYST Treatment Intervention with Female Children Polytraumatized by Adverse Childhood Experiences, Neglect, and Maltreatment

The aim of this randomized controlled trial with an intention-to-treat analysis was to evaluate the effectiveness, efficacy, and safety of the Acute Stress Syndrome Stabilization Individual (ASSYST-I) treatment intervention in reducing posttraumatic stress disorder (PTSD) symptoms in female children polytraumatized by adverse childhood experiences, neglect, and maltreatment. A total of 40 female children met the inclusion criteria and participated in the study. Participants’ ages ranged from 8 to 17 years old (M =14.67 years). A two-arm randomized controlled trial (RCT) design was applied. PTSD symptoms were measured in three-time points for all participants in the study. Results showed that the intervention had a significant effect for time on PTSD symptoms (F (2,76) = 36.92 p &lt;.000, η² = .493). A significant effect for group was also found (F (1, 38 = 32.7, p&lt;.005, η² = .896) with a large effect, and a significant interaction between time and group, (F (2, 76) = 56.00, p &lt;.000, η² = .600). Means comparison using t test between groups showed significant differences between the Treatment Group (TG) and the Control Group (CG) in the three-time points comparisons showing a large effect on Time 2 (Post-treatment assessment) which was maintained on Time 3 (Follow-up assessment). Results on the Reliable Change Index (RCI) and the Clinically Significant Change (CSC) Margin showed that the ASSYST-I treatment intervention exhibited reliable change on PTSD symptom reduction and clinically significant change, indicating that the treatment group participants are more likely to belong to the non-PTSD population after the intervention. Conversely, the control group participants are more likely to belong to the PTSD population. No adverse effects or events were reported by the participants during the treatment procedure administration or at follow-up. None of the participants showed clinically significant worsening/exacerbation of symptoms after treatment. Participants in the control group received the intervention treatment after the follow-up assessment, fulfilling our ethical criteria.

Comparison of the effects of high-intensity interval and moderate-intensity continuous training on inflammatory markers, cardiorespiratory fitness, and quality of life in breast cancer patients

BackgroundAs the effectiveness of breast cancer treatment has improved, a growing number of long-term breast cancer survivors are seeking help for unique health problems. These patients may be at increased risk of cardiovascular disease due to the side effects of treatment. The positive impact of most types of exercise has been repeatedly reported in people with cancer, but the most effective exercise approaches for maximum beneficial adaptations remain controversial. Thus, this study aimed to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on inflammatory indices, adipokines, metabolic markers, body composition, cardiorespiratory fitness, and quality of life in breast cancer patients during adjuvant endocrine therapy. MethodsThirty non-metastatic breast cancer patients during adjuvant endocrine therapy who had been treated with chemotherapy and/or radiotherapy were recruited from Iran and randomized to HIIT, MICT, or control groups for a supervised exercise intervention that took place 3 times a week for 12 weeks. The training intensity was determined based on the peak oxygen uptake (VO2peak), and the volume of training was matched in HIIT and MICT based on the VO2peak. Body composition, functional capacity, cardiorespiratory fitness, metabolic indices, sex hormones, adipokines, and inflammatory markers were assessed before and after the intervention. ResultsThe VO2peak increased by 16.8% in the HIIT group in comparison to baseline values (mean difference = 3.61 mL/kg/min). HIIT significantly improved the VO2peak compared to control (mean difference = 3.609 mL/kg/min) and MICT (mean differences = 2.974 mL/kg/min) groups. Both HIIT (mean difference = 9.172 mg/dL) and MICT (mean difference = 7.879 mg/dL) interventions significantly increased high-density lipoprotein cholesterol levels compared to the control group. The analysis of covariance showed that physical well-being significantly improved in MICT compared to control group (mean difference = 3.268). HIIT significantly improved the social well-being compared to the control group (mean difference = 4.412). Emotional well-being subscale was significantly improved in both MICT (mean difference = 4.248) and HIIT (mean difference = 4.412) compared to the control group. Functional well-being scores significantly increased in HIIT group compared with control group (mean difference = 3.35) . Significant increase were also observed in total functional assessment of cancer therapy-General scores in both HIIT (mean difference = 14.204) and MICT groups (mean difference = 10.036) compared with control group. The serum level of suppressor of cytokine signaling 3 increased significantly (mean difference = 0.09 pg/mL) in the HIIT group compared to the baseline. There were no significant differences between groups for body weight, body mass index, fasting blood glucose, insulin resistance, sex hormone binding globulin, total cholesterol, low-density lipoprotein cholesterol, adipokines, interleukin-6, tumor necrosis factor-α, or interleukin-10. ConclusionHIIT can be used as a safe, feasible, and time-efficient intervention to improve cardiovascular fitness in breast cancer patients. Both HIIT and MICT modalities enhance quality of life. Further large-scale studies will help determine whether these promising results translate into improved clinical and oncological outcomes.

Life events in obsessive-compulsive disorder: A cross-sectional study

Background: Obsessive compulsive disorder (OCD) is a chronic psychiatric disorder having significant deterioration in patients’ socio-occupational functioning. Stressful life events (SLE) were noted before onset of this disorder. The previous study with Indian population found positive correlation between stressful and traumatic life events and OCD, but was with small sample size and thus result couldn’t be generalized. Aims and Objectives: The aim of the study was to examine the role of life events in patients with OCD and to find out correlation between them, if any. Materials and Methods: Consecutive 30 OPD patients fulfilling ICD-10 DCR criteria for OCD were rated with Yale Brown Obsessive Compulsive Scale (YBOCS), Hamilton Rating Scale for Depression (HAM-D), Hamilton Rating Scale for Anxiety (HAM-A), and Presumptive Stressful Life Events Scale (PSLES). A group of 30 healthy controls from unrelated patient party were also rated on PSLES. Finally, both groups were statistically compared in terms of life events. Results: Two groups were identical in distribution of age and sex. The frequency of life events, 1-year (P=0.000) and lifetime (P=0.000), were significantly higher in OCD group in comparison to healthy controls. There was significant positive correlation between PSLES scores and YBOCS scores. Step-wise linear regression analysis found positively predictability of PSLES score to OCD severity. Conclusion: OCD patients have statistically significant SLE before the onset of their disorder and total number of life events has positive correlation with severity of OCD.

Comparison of the effect of olive oil and its derivatives with atorvastatin in mitigating physiological and histological disorders due to hyperlipidemia in male rats

Introduction: Hyperlipidemia destroys liver tissue, increasing liver enzymes. Increases liver extract ferritin, kidney and liver iron, while decreasing Hepcidin hormonal levels. Olive oil, hydroxytyrosol, and Atorvastatin were compared on liver enzymes, HMG-reductase activity, ferritin, hepcidin hormone, and iron deposition in liver and kidney tissues in experimental hyperlipidemic albino male rats. Methodology: The experiment involved 50 albino rats grouped into two (control and test) of 25 rats each, then divided into 5 groups of 5 rats each. Animals in the first control group (blank) were fed the standard diet and gavaged distilled water for eight weeks, whereas the second to fifth groups of the first subgroup were fed the same standard diet for eight weeks followed by oral gavage with olive oil, hydroxytyrosol, olive oil + hydroxytyrosol, and atorvastatin, respectively, from the third week. Animals in the first test group were fed a diet containing 2% cholesterol for the duration of the experiment, whereas rats in the seventh, eighth, ninth, and tenth test groups were fed a high-cholesterol diet 2% for two weeks, followed by oral gavage with olive oil extract for the seventh group, hydroxytyrosol for the eighth group, olive oil extract + hydroxytyrosol for the ninth group, and a drug Atorvastatin for the tenth. Results: Hyperlipidemia significantly increased the concentrations of liver enzyme in serum, ferritin and iron deposition in liver and kidney tissues, while decreasing the HMG-reductase activity and hepcidin hormonal levels in liver extract was seen in hyperlipidemia group in comparison to healthy controls. While the groups of treated animals showed a significant enhancement in each of the aforementioned factors, as olive oil extract + hydroxytyrosol outperformed all treatments. Conclusion: Hypercholesterolemia increases liver enzymes, ferritin, and iron deposition while lowering hepcidin hormone and HMG-reductase activity. Hypercholesterolemia was mitigated by olive oil extract and hydroxytyrosol.

Victimization among adolescents of female sex workers: findings from the children of at-risk parents (CARP) study in Uganda

BackgroundFemale sex workers (FSWs) live and work in high-risk environments, experience high levels of adversity, and have multigenerational trauma that can negatively affect their children. Yet not much is known about the prevalence of victimization (i.e., exposure to maltreatment and trauma) among children of FSWs. This study compared the prevalence of lifetime victimization among adolescents of FSWs and adolescents of non-FSWs in Gulu City, Northern Uganda.MethodsA comparative cross-sectional study was conducted among adolescents (10–17 years) enrolled in the Children of At-Risk Parents (CARP) study. This study included 147 adolescents of FSWs and 147 adolescents of non-FSWs selected for comparison in Gulu City, Northern Uganda. The adolescents of FSWs were identified through their mothers using respondent-driven sampling. Data on the residence of FSWs guided a proportionate stratified sampling of adolescents of non-FSWs. Using the Juvenile Victimization Questionnaire, we screened for 34 different types of victimization during participants’ lifetimes. Percentage point differences within groups of adolescents and comparison between adolescents of FSWs and non-FSWs were calculated using STATA version 14.1. Statistical significance was set to p < 0.05.Results99.3% of the participants experienced at least one form of lifetime victimization. The median number of lifetime victimizations was 12.4. Overall, lifetime victimization was higher among adolescents of FSWs than non-FSWs (13.4 vs. 11.5), male vs. female adolescents (13.4 vs. 11.9), and older [14–17 years] vs. younger (10–13 years) adolescents (14.0 vs. 11.7). Further, more adolescents of FSWs experienced lifetime victimization in the following domains and subdomains, all of which were statistically significant: kidnap (15.8% vs. 4.8%), emotional abuse (65.8% vs. 50.0%), emotional neglect (37.4% vs. 21.1%), physical intimidation (10.2% vs. 4.1%), relational aggression (36.4% vs. 18.4%), verbal aggression (68.7% vs. 46.9%), sexual victimization (31.3% vs. 17.7%), verbal sexual harassment (20.4% vs. 5.4%), exposure to murder scene (42.9% vs. 26.5%), witness to domestic violence (39.5% vs. 26.5%), and witness to the murder of relatives (31.3% vs. 21.1%). Conversely, more adolescents of non-FSWs experienced caregiver victimization than the adolescents of FSWs (98.0 vs. 92.5; p < 0.05).ConclusionsChildhood victimization is highly prevalent in Northern Uganda and disproportionately affects the adolescents of FSWs. Therefore, government and development partners should urgently develop policies and interventions targeting prevention, early detection, and timely management of victimization in this vulnerable population.

Epicardial adipose tissue and its association with atrial fibrillation in middle-aged patients without overt heart disease

Abstract Funding Acknowledgements Type of funding sources: None. Background Obesity and atrial fibrillation (AF) are emerging health problem, associated with significant morbidity and mortality. There is a significant relation between body mass index (BMI) on one hand and the amount of visceral fat and epicardial adipose tissue (EAT) on the other (1,2). EAT volume is positively related to the incidence, duration, and recurrence of AF (2,3). Aim The aim of the study was to assess echocardiographic variables and their association with BMI and EAT in middle-aged patients with AF. Methods Prospective consecutive patients with AF (n= 936), who had been admitted for sinus rhythm restoration in our hospital for the period January 2016- December 2018, were screened for participation in the study. A total of 70 patients met the inclusion criteria- stable sinus rhythm, age between 40–60 years, without over heart disease. They were separated in two groups: with new onset AF (n=33) and recurrent episode of AF(n=37); 30 healthy subjects were enrolled in the control group. All patients underwent 2DE assessment with speckle tracking analyses. EAT thickness was measured perpendicularly on the free wall of the right ventricle at end-systole when both walls collapse and allow the widest measurement. Results There were significant differences in global longitudinal strain (GLS) of left ventricle (LV) and EAT between AF groups and healthy controls, but not in the other LV parameters. There were significant differences in left atrial (LA) structural and functional indices in AF groups in comparison to healthy controls- picture 1. There were significant correlations between BMI and EAT ( p = 0.001;r=0,710), GLS ( p = 0.001;r=0,557), LA volume index ( p = 0.001;r=0,701), LA reservoir strain ( p = 0.001;r=-0,626), LA stiffness index ( p = 0.001;r=0,557)- picture 2 .There were significant correlations between EAT and GLS ( p = 0.001;r=0,478), LA volume index ( p = 0.001;r=0,539), LA reservoir strain (p = 0.001;r=-0,479),LA stiffness index ( p = 0.001;r=0,487). Conclusion Epicardial adipose tissue, assessed by 2DE, was increased in middle-aged patients with obesity and AF. Obesity is significant risk factor for LA remodelling and AF, but further prospective investigation need to define the causality role of EAT in AF initiation and progression.

Human Neutrophil Peptide 1- 3 and Vitamin D levels in periodontitis

Human neutrophil peptides 1-3 (HNP1-3) contribute to oral health by playing a role in innate response against oral diseases, owing to their antimicrobial, antiplaque and immunomodulatory activity. Vitamin D may reduce the risk of infection through multiple mechanisms and boosts innate immunity by modulating the production of antimicrobial peptides and cytokine response. This study was performed to evaluate the level of human HNP1-3 in periodontitis patients and controls and to study the effect of vitamin D on the levels of peptides in periodontitis. Eighty-five subjects were enrolled in this observational case-control study aged 20-59 years. The subjects were divided into fifty patients with periodontitis and 35 healthy controls. Periodontal parameters used in this study were plaque index, gingival index bleeding on probing, probing pocket depth and clinical attachment loss. Blood samples were collected from all subjects, and then ELISA was done to estimate the levels of HNP1-3 and vitamin D in patients and controls. The finding revealed a significant increase (P˂0.01) in the mean level of HNP1-3 among the patient's group compared to the control group. Moreover, there is no significant correlation with all parameters except the gingival index, which has a considerable result (r=0.367, p=0.009). On the other hand, this study showed a significant decrease (P&lt;0.01) in the mean level of vitamin D in patients compared to controls, and also that there was no significant decrease in the serum level of HNP1-3 among vitamin D insufficient group in comparison to vitamin D sufficient group. These results indicated that the increased levels of HNP1-3 and its correlation with GI provide evidence for the critical role of neutrophils in the inflammatory process in periodontitis and vitamin D, which plays a role in antimicrobial peptide production. Keywords: periodontitis, antimicrobial peptides, human neutrophils peptides

Comparison of patterns and rates of cement leakage in percutaneous sacroplasty for sacral insufficiency fractures versus neoplasia.

Percutaneous sacroplasty is a minimally invasive procedure which utilises injection of bone cement into the sacrum for stabilisation of osteoporotic sacral insufficiency fractures (SIF) and neoplastic lesions to relieve pain and improve function. While effective, cement leakage is an important complication associated with the procedure. This study aims to compare the incidence and patterns of the cement leakages following sacroplasty for SIF versus neoplasia and discuss the various patterns of cement leakage and their implications. This retrospective study analysed 57 patients who underwent percutaneous sacroplasty at a tertiary orthopaedic hospital. Patients were divided into 2 groups of SIF (n=46) and neoplastic lesions (n=11) based on their indication for sacroplasty. Pre- and post-procedural CT fluoroscopy was used to assess for cement leakage. The incidence and patterns of cement leakage were both compared among the two groups. A Fisher's exact test was used for statistical analysis. Eleven (19%) patients had cement leakage on post-procedural imaging. The most common sites of cement leakage were into the presacral region (6), followed by sacroiliac joints (4), sacral foramina (3) and posterior sacral (1). There was a statistically significant higher incidence of leakage in the neoplastic group in comparison to SIF group (P-value <0.05). The incidence of cement leakage in the neoplastic group was 45% (n = 5/11) versus SIF 13% (n=6/46). There was a statistically significant higher incidence of cement leak in sacroplasties conducted for the treatment of neoplastic lesions compared to those with sacral insufficiency fracture.

The interaction of Schistosoma mansoni infection with diabetes mellitus and obesity in mice

Human schistosomiasis is one of the most prevalent parasitic diseases worldwide. Various host factors can affect the host–parasite interactions. Therefore, the aim of the present work was to determine the parasitological, histopathological, biochemical, and immunological status of Schistosoma mansoni-infected hosts with metabolic disorders to identify the underlying possible mechanisms of these comorbidities. The study animals were divided into four groups. Group I represented the control groups, namely, the normal control group, the S. mansoni-infected control group, and the noninfected type 1 diabetes (T1DM), type 2 diabetes (T2DM), and obesity groups. The mice of the other three groups underwent induction of T1DM (Group II), T2DM (Group III) and obesity (Group IV) before being infected with S. mansoni. All mice were subjected to body weight measurement, blood glucose and insulin assessment, parasitological evaluation of adult worm count, tissue egg count and intestinal oogram. Histopathological and immunohistochemical study using anti-glial fibrillary acidic protein (GFAP) in hepatic stellate cells (HSCs) and image analysis of Masson’s trichrome-stained liver sections using ImageJ (Fiji) software were carried out. Additionally, immunological analysis of tumour necrosis factor (TNF) beta, interleukin-5 (IL-5), IL-10, Forkhead box P3 (FOXP3) and pentraxin 3 (PTX3) levels besides biochemical study of total lipid profile were evaluated. The present study revealed a significant increase in the adult worm count and tissue egg output in the obesity group compared to the infected control group. The oogram of counted eggs showed prevalence of immature eggs in T1DM group, while T2DM and obese groups showed prevalence of mature eggs. The fibrosis area percentage showed significant increase in T2DM and obese groups while it was decreased in T1DM group in comparison to infected control group. Our data also showed significant increase in the levels of TNF-β, IL-5, PTX3 in T1DM, T2DM and obesity groups in comparison to infected control group, whilst the levels of FOXP3 and IL-10 were increased in the infected groups in comparison to their noninfected controls. Moreover, infected T1DM, T2DM and obesity groups showed higher blood glucose and lipid profile in comparison to the infected control group. However, these parameters were improved in comparison to their noninfected controls. In sum, induction of T2DM and obesity increased tissue egg counts, mature egg percentage, and fibrosis density, while schistosome infection induced changes in the lipid profile and blood glucose levels in infected diabetic and obese groups and impacted favorably insulin levels in obese mice. By better understanding the complexities of host–parasite interactions, efforts to reduce the burden of these debilitating diseases can be improved.

Strategic reading comprehension in L2 and L3: assuming relative interdependence within Cummins’ linguistic interdependence hypothesis

Abstract This experimental study attempts to put to the test Cummins’ (1978) Linguistic Interdependence Hypothesis (LIH) in reading between English (L2) and Arabic (L3). Two groups of comparison and experimental attended this study. The experimental group received reading strategy instruction while the comparison group received the traditional form of reading instruction in L2. Both groups received reading comprehension tests in L2 and L3 before and after the instructions. An interview was finally conducted for a more in-depth investigation. Analysis of quantitative data evinced overall reading comprehension ability significantly improved only in the experimental group in both languages, supporting Cummins’ LIH. Componentially, only the inferential component improved significantly for the experimental group, showing different components contribute differently to the interdependence between languages. Qualitative findings showed miscellaneous results in linguistic, cognitive, and affective domains which were evidence of both interdependence and non-interdependence between L2 and L3. The pedagogical implication is further discussed.

The Relationship between a Cognitive Linguistic Approach and the Right-Hemisphere

This study investigated the relationship between a metaphor-based approach to teaching English as a foreign language (EFL) and involvement of the brain’s right hemisphere. Specifically, it examined learners’ understanding of three levels of sureness associated with different expressions in English – those that are certain, probable, and possible items. The three target items were chosen because they are frequently used by native English speakers although Japanese EFL learners often fail to distinguish between them. The metaphor-based learners and the control group engaged in computer-based explicit learning based on the meaning of the target expressions with three-dimensional (3D) animated illustrations. The images were based on the spatial concept of distance for the metaphor-based learners and a list of target items for the control group. At post-test, it was found that the metaphor-based learners performed better than the control group in both comparison and speaking tests. Obviously, the participants better understood the degrees of certainty in relation to distance. This shows that teaching the degrees of certainty by applying the spatial concept of distance could help in second-language (L2) learning. The metaphor approach allowed participants to link the spatial concept of distance to the degree of certainty associated with expressions of certitude. In addition, recordings of lip movements showed that participants remembered the target items better by opening the left side of their mouths more than the right side. This indicates that the brain’s right hemisphere is involved in deep processing of expressions that reflect different levels of certitude and creating stronger memory traces.