bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased Frequency of Virus Shedding by Herpes Simplex Virus 2-Infected Guinea Pigs in the Absence of CD4+T Lymphocytes
Authors: Bourne Nigel , Perry Clarice L. , Banasik Brianne N. , Miller Aaron L. , White Mellodee , Pyles Richard B. , Schäfer Hubert , Milligan Gregg N.
Published: November 2018

Sexual transmission of HSV-2 results from viral shedding following reactivation from latency. The immune cell populations and mechanisms that control HSV-2 shedding are not well understood. This study examined the role of CD4+T cells in control of virus shedding using a guinea pig model of genital HSV-2 infection that recapitulates the shedding of virus experienced by humans. We found that the frequency of virus-shedding episodes, but not the incidence of clinical disease, was increased by depletion of CD4+T cells. The HSV-specific antibody response was not diminished, but frequency of functional HSV-reactive CD8+T cells was significantly diminished by CD4 depletion. These results confirm the role of cell-mediated immunity and highlight the importance of CD4+T cells in controlling HSV shedding, suggesting that therapeutic vaccines designed to reduce transmission by controlling HSV shedding should include specific enhancement of HSV-specific CD4+T cell responses.
Testing the sympathetic nervous system of the foot has a high predictive value for early amputation in patients with diabetes with a neuroischemic ulcer
Authors: Schreuder Sanne M , Nieuwdorp M , Koelemay Marc J W , Bipat Shandra , Reekers Jim A
Published: November 2018

Objective

There is evidence from the literature that dysfunctionality of the sympathetic nervous system of the foot with subsequent loss of local autoregulation could be a predictor of early amputation in patients with diabetes with a neuroischemic ulcer. To confirm this we tested the functionality of the sympathetic nervous system in the foot in a consecutive group of 31 patients with diabetes with critical limb ischemia and non-healing neuroischemic ulcer.

Research design and methods

Prospective cohort with retrospective analysis after 12 months of routinely acquired clinical data. All patients in the study group underwent angiography of the foot as part of a routine angioplasty procedure. Primary study endpoint was lower extremity amputation-free survival at 12 months. Because of the study design no other endpoints could be analyzed. The functionality of the sympathetic nervous system was tested with perfusion angiography.

Results

Thirty-one patients were followed for 12 months. The Capillary Resistance Index (CRI) was used to measure the response of the sympathetic nervous system. CRI≥0.9 is the cut-off point for a non-responsive sympathetic nervous system. All patients (n=11) with a CRI≥0.9 underwent a major amputation before 12 months. Of all patients with a CRI only 15% underwent major amputation. The positive predictive value for major amputation before 12 months for patients with a CRI ≥ 0.9 was 100%.

Conclusions

A non-responsive sympathetic nervous system of the foot is a strong predictor of early major amputation (log rank p<0.001; HR 14.22; 95% CI 3.64 to 55.51).
Exploring the intergenerational effects of undernutrition: association of maternal height with neonatal, infant and under-five mortality in Bangladesh
Authors: Khatun Wajiha , Alam Ashraful , Rasheed Sabrina , Huda Tanvir M , Dibley Michael J
Published: November 2018

Background

Global or regional evidence showed maternal height as a strong predictor of child survival. However, there is limited information that confirms the intergenerational effect of short maternal height on the risk of offspring mortality in Bangladesh. Therefore, this study aimed to examine the association of maternal height with neonatal, infant and under-five mortality in Bangladesh.

Methods

It was a pooled analysis of data from four rounds of Bangladesh Demographic and Health Surveys 2004, 2007, 2011 and 2014. We included singleton children aged 0–59 months born to mothers aged 15–49 years (n = 29 698). Mothers were interviewed to collect data on maternal and child characteristics, and socio-demographic information. Maternal height was measured using an adjustable measuring board calibrated in millimetres. We used STATA V.14.2 and adjusted for the cluster sampling design. Multivariate ‘Modified Poisson Regression’ was performed using stepwise backward elimination procedures to examine the association between maternal height and child death.

Results

In the adjusted model, every 1 cm increase maternal height was associated with a reduced risk of neonatal mortality (relative risk (RR) = 0.973, 95% CI 0.960 to 0.986), infant mortality (RR = 0.980, 95% CI 0.969 to 0.991) and under-five mortality (RR = 0.982, 95% CI 0.972 to 0.992). Children of the shortest mothers (height<145 cm) had 1.73 times greater risk of neonatal mortality, about 1.60 times greater risk of infant mortality and 1.48 times greater risk of under-five mortality compared with those of tall mothers (height≥155 cm). Among the children of the shortest mothers (height<145 cm), the absolute probabilities for neonatal, infant and under-five mortality were 4.4%, 6.0% and 6.5%, respectively, while for the children of the tall mothers (height≥ 155 cm), the absolute probabilities for neonatal, infant and under-five mortality were 2.6%, 3.7 %, and 4.4%, respectively.

Conclusion

These findings suggest a robust intergenerational linkage between short maternal height and the risk of neonatal, infant and under-five mortally in Bangladesh.
External quality assessment for HIV rapid tests: challenges and opportunities in Haiti
Authors: Jean Louis Frantz , Excellent Marie Lina , Anselme Renette , Buteau Josiane , Stanislas Magalie , Boncy Jacques , Domercant Jean Wysler
Published: November 2018

HIV rapid diagnostic tests (RDTs) are instrumental in scaling-up HIV testing services (HTS) in low-income and middle-income countries (LMICs). HIV misdiagnosis is a growing concern in the era of expanded and decentralised access to HTS. External quality assurance (EQA) programme including proficiency testing (PT) for HIV RDTs is a priority to guarantee the accuracy and reliability of the patients’ result. Here we are sharing Haiti’s 11 years’ experience in implementing HIV RDTs EQA programme to help address some of the challenges faced by other LMICs. HTS is expanding beyond laboratory walls and HIV RDTs are increasingly performed by non-laboratory personnel and closer to the community. EQA programmes for HIV RDTs in Haiti have faced significant challenges. In expanded HTS settings, non-laboratory personnel (nurses, aid-nurses) involved in HIV RDT are usually undertrained and participate poorly in PT programs. In more than half of the lab enrolled in the PT programme in Haiti, the panels are always tested by the most experienced technician, defying the purpose of the program which is to evaluate the performance of the technician performing the test daily. EQA programme in Haiti and other LMICs are usually not tailored to address community HIV testing challenges. With decreased funding and absence of government financial commitment to HIV RDTs EQA programmes, more innovative and cost-efficient strategies are sought to ensure the quality of HIV diagnosis in LMICs. Qualified human resources, continuous training, supervision and community-tailored PT programmes remain key components for the success of HIV RDT quality management.
Father’s roles and perspectives on healthcare seeking for children with pneumonia: findings of a qualitative study in a rural community of the Philippines
Authors: Sato Mari , Oshitani Hitoshi , Tamaki Raita , Oyamada Nobuko , Sato Kineko , Nadra Alkaff Raihana , Landicho Jhoys , Alday Portia P , Lupisan Socorro , Tallo Veronica L
Published: November 2018

Objectives

Pneumonia remains a primary cause of death for under-five children. It is possible to reduce the mortality impact from childhood pneumonia if caregivers recognise the danger signs of pneumonia and obtain appropriate healthcare. Among caregivers, research on fathers’ healthcare-seeking behaviours and perceptions are limited, whereas research on mothers is available. This study aims to reveal fathers’ roles and perspectives with respect to the selection of care and treatment for children with pneumonia in a remote island of the Philippines.

Design

A qualitative research was carried out using semistructured interviews.

Setting and participants

The interviews were conducted with 12 fathers whose children had pneumonia-like episodes in the 6 months prior to the interview. Data analysis was performed using the concept analysis method to identify codes which were merged into subcategories and categories. Finally, the themes were identified.

Results

Three themes were identified as part of fathers’ roles, and two were identified as fathers’ perspectives on various treatment options. Fathers took care of their sick children by not entrusting care only to mothers because they considered this as part of their role. Notably, fathers considered that arranging money for the child’s treatment was a matter of prime importance. They selected a particular treatment based on their experiences and beliefs, including herbal medicine, home treatment, and visiting traditional healers and health facilities. Their decision was influenced by not only their perception of the severity of illness but also cultural beliefs on the cause of illness. Visiting health facilities, particularly during hospital admissions, causes significant financial burden for the family which was the main concern of fathers.

Conclusion

It is crucial to consider the cultural background and also imperative to address issues related to medical cost and the credibility of health facilities to improve fathers’ healthcare-seeking behaviour.
Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study
Authors: Hamoen Marleen , Vergouwe Yvonne , Wijga Alet H , Heymans Martijn W , Jaddoe Vincent W V , Twisk Jos W R , Raat Hein , de Kroon Marlou L A
Published: November 2018

Objectives

To develop a dynamic prediction model for high blood pressure at the age of 9–10 years that could be applied at any age between birth and the age of 6 years in community-based child healthcare.

Design, setting and participants

Data were used from 5359 children in a population-based prospective cohort study in Rotterdam, the Netherlands.

Outcome measure

High blood pressure was defined as systolic and/or diastolic blood pressure ≥95th percentile for gender, age and height. Using multivariable pooled logistic regression, the predictive value of characteristics at birth, and of longitudinal information on the body mass index (BMI) of the child until the age of 6 years, was assessed. Internal validation was performed using bootstrapping.

Results

227 children (4.2%) had high blood pressure at the age of 9–10 years. Final predictors were maternal hypertensive disease during pregnancy, maternal educational level, maternal prepregnancy BMI, child ethnicity, birth weight SD score (SDS) and the most recent BMI SDS. After internal validation, the area under the receiver operating characteristic curve ranged from 0.65 (prediction at age 3 years) to 0.73 (prediction at age 5–6 years).

Conclusions

This prediction model may help to monitor the risk of developing high blood pressure in childhood which may allow for early targeted primordial prevention of cardiovascular disease.
Use of multiple antidiabetic medications in patients with diabetes and its association with hypoglycaemic events: a case-crossover study in Jordan
Authors: Naser Abdallah Y , Wong Ian Chi Kei , Whittlesea Cate , Beykloo Maedeh Y , Man Kenneth K C , Lau Wallis C Y , Hyassat Dana Abdel-Halim , Wei Li
Published: November 2018

Objective

To assess whether the use of multiple antidiabetic medications is associated with an increased risk of hypoglycaemia in patients with type 2 diabetes mellitus.

Design

A case-crossover study.

Setting

Cases were enrolled from the National Center for Diabetes, Endocrinology and Genetics in Amman, Jordan.

Participants

Patients were those with diabetes mellitus and reported incident of a hypoglycaemic event in their medical records during the period January 2007 to July 2017. Patients with multiple antidiabetic medications were those with at least two antidiabetic medications.

Primary outcome

History of antidiabetic medication use was extracted from the pharmacy records. The use of multiple antidiabetic medications during the risk window (before hypoglycaemia) was compared with a control window(s) (earlier time) of the same length after a washout period. Conditional logistic regression was applied to evaluate the OR of hypoglycaemia between the treatment groups. A secondary analysis was performed in patients with a blood glucose measurement of ≤70 mg/dL.

Results

182 patients (106 females, 58.2%) were included in the study with an average age of 59.9 years (SD=9.9). The patients’ average body mass index was 31.7 kg/m2(SD=6.2). Compared with monotherapy, the OR of hypoglycaemic events for patients with multiple antidiabetic medications was 5.00 (95% CI 1.10 to 22.82). The OR was 6.00 (95% CI 0.72 to 49.84) for the secondary analysis patient group (n=94). Ten-fold increased risk was found in patients (n=155) with insulin and sulfonylurea-based combination therapy (OR 10.00;95% CI 1.28 to 78.12).

Conclusion

This study shows that the use of multiple antidiabetic medications appears to increase the risk of hypoglycaemic events. Patients and healthcare professionals should be extra vigilant when patients are on multiple antidiabetic medications therapy, especially the combination of sulfonylurea and insulin.
Rehabilitation via HOMe Based gaming exercise for the Upper-limb post Stroke (RHOMBUS): protocol of an intervention feasibility trial
Authors: Kilbride Cherry , Scott Daniel J M , Butcher Tom , Norris Meriel , Ryan Jennifer M , Anokye Nana , Warland Alyson , Baker Karen , Athanasiou Dimitrios A , Singla-Buxarrais Guillem , Nowicky Alexander
Published: November 2018

Introduction

Effective interventions to promote upper-limb recovery poststroke are characterised by intensive and repetitive movements. However, the repetitive nature of practice may adversely impact on adherence. Therefore, the development of rehabilitation devices that can be used safely and easily at home, and are motivating, enjoyable and affordable is essential to the health and well-being of stroke survivors.

The Neurofenix platform is a non-immersive virtual reality device for poststroke upper-limb rehabilitation. The platform uses a hand controller (a NeuroBall) or arm bands (NeuroBands) that facilitate upper-limb exercise via games displayed on a tablet. The Rehabilitation via HOMe Based gaming exercise for the Upper-limb post Stroke trial aims to determine the safety, feasibility and acceptability of the Neurofenix platform for home-based rehabilitation of the upper-limb poststroke.

Methods and analysis

Thirty people poststroke will be provided with a Neurofenix platform, consisting of a NeuroBall or NeuroBands (dependent on impairment level), seven specially designed games, a tablet and handbook to independently exercise their upper limb for 7 weeks. Training commences with a home visit from a research therapist to teach the participant how to safely use the device. Outcomes assessed at baseline and 8 weeks and 12 weeks are gross level of disability, pain, objectively measured arm function and impairment, self-reported arm function, passive range of movement, spasticity, fatigue, participation, quality of life (QOL) and health service use. A parallel process evaluation will assess feasibility, acceptability and safety of the intervention through assessment of fidelity to the intervention measured objectively through the Neurofenix platform, a postintervention questionnaire and semistructured interviews exploring participants’ experiences of the intervention. The feasibility of conducting an economic evaluation will be determined by collecting data on QOL and resource use.

Ethics and dissemination

Ethics approval granted from Brunel University London (10249-MHR-Mar/2018-12322-2). Trial results will be submitted for publication in journals, presented at national and international conferences and distributed to people with stroke.

Trial registration number

ISRCTN60291412; Pre-results.
Distinguishing thymoma from T-lymphoblastic leukaemia/lymphoma: a case-based evaluation
Authors: Boddu Prajwal , Thakral Beenu , Alhuraiji Ahmed , Pemmaraju Naveen , Kadia Tapan , Ohanian Maro , Ravandi Farhad , Jabbour Elias , Wierda William , Khoury Joseph D , Jain Nitin
Published: November 2018

T-lymphoblastic lymphoma and thymoma are distinct primary mediastinal neoplasms that can have similar clinical presentations and overlapping histological features. Microscopic distinction is occasionally difficult because the immature lymphocytes associated with thymoma may resemble T-lymphoblastic leukaemia/lymphoma cells, morphologically and immunohistochemically. An accurate diagnosis assumes particular importance since the treatment approaches for these two entities differ considerably. Multimodality diagnostic approaches incorporating histological, flow cytometry immunophenotypic‚ and molecular approaches are required. In this article, we describe four patients, each presenting with a mediastinal tumour in different clinicopathological settings. A detailed report of each case will follow, illustrating the challenges involved in the diagnosis in patients with these mediastinal neoplasms.
Platinum(II) complexes of pyridine–amine ligands with phenol substituents: isotactic supramolecular polymers
Authors: Fard Mahmood A. , Behnia Ava , Puddephatt Richard J.
Published: November 2018

The platinum(II) complexes [PtCl(SMe2)(κ2-N,N′-L)]Cl and [PtMe(SMe2)(κ2-N,N′-L)]Cl, L = 2-C5H4NCH2NH-x-C6H4OH (x = 2, 3, or 4), have been prepared and structurally characterized. In all cases, the complexes form supramolecular polymers in the solid state by NH··Cl and OH··Cl hydrogen bonding to the chloride anion. The ligands are chiral at the amine nitrogen atom, and in all cases, the polymers are isotactic, formed by self-recognition or narcissistic self-assembly. The structures in the crystalline state all have the Me2S ligand trans to pyridyl, but in solution, the methylplatinum(II) complexes isomerise slowly to give an equilibrium with the isomers having the methyl group trans to the pyridyl donor.
Delineating soil management zones using a proximal soil sensing system in two commercial potato fields in New Brunswick, Canada
Authors: Perron I. , Cambouris A.N. , Chokmani K. , Vargas Gutierrez M.F. , Zebarth B.J. , Moreau G. , Biswas A. , Adamchuk V.
Published: November 2018

Stagnating potato (Solanum tuberosum L.) yields in eastern Canada have resulted in loss of competitive advantage in global potato markets. Therefore, there is a need to investigate the potential to increase yield by adopting precision agriculture technology. This study evaluated the efficiency of an apparent soil electrical conductivity (ECa) sensor to delineate management zones (MZs) in two commercial potato fields in New Brunswick, Canada, using an unsupervised fuzzy k-means clustering algorithm. Georeferenced soil samples from 0 to 15 cm depth were analyzed for physicochemical properties. Tuber yields were recorded using a yield monitor. The two MZs delineated using soil ECa differed significantly in soil physicochemical properties for both fields; however, tuber yield differed significantly between MZs only in Field 1. The yield difference (7.1 Mg ha−1) in Field 1 was attributed to a difference in soil moisture (23.5% vs 28.5%) resulting from a difference in clay content (141 vs 189 g kg−1). The lack of a yield difference between MZs in Field 2 may reflect relatively low within-field spatial variability. The soil ECa sensor showed promise for use in commercial potato production in New Brunswick, especially in fields with high spatial variability.
Dilemma and Solution of Traditional Feature Extraction Methods Based on Inertial Sensors
Authors: Peng Zhiqiang , Zhang Yue
Published: November 2018

Correctly identifying human activities is very significant in modern life. Almost all feature extraction methods are based directly on acceleration and angular velocity. However, we found that some activities have no difference in acceleration and angular velocity. Therefore, we believe that for these activities, any feature extraction method based on acceleration and angular velocity is difficult to achieve good results. After analyzing the difference of these indistinguishable movements, we propose several new features to improve accuracy of recognition. We compare the traditional features and our custom features. In addition, we examined whether the time-domain features and frequency-domain features based on acceleration and angular velocity are different. The results show that (1) our custom features significantly improve the precision of the activities that have no difference in acceleration and angular velocity; and (2) the combination of time-domain features and frequency-domain features does not significantly improve the recognition of different activities.
Thermal Conductivity and Photothermal Conversion Performance of Ethylene Glycol-Based Nanofluids Containing Multiwalled Carbon Nanotubes
Authors: Tam Nguyen Trong , Van Trinh Pham , Anh Nguyen Ngoc , Hong Nguyen Tuan , Hong Phan Ngoc , Minh Phan Ngoc , Thang Bui Hung
Published: November 2018

In this study, the successful hydroxyl functionalization of carbon nanotubes (MWCNT-OH) was prepared by chemical treatments and characterized by Raman and FTIR spectra. MWCNT-OH was successfully dispersed into ethylene glycol (EG) with the Tween-80 surfactant by an ultrasonication method to prepare nanofluids. Thermal conductivity of nanofluid was investigated, and a maximum thermal conductivity enhancement about 24% at 50°C was obtained with nanofluid containing 0.64 vol.% MWCNT concentration. The photothermal conversion performance of nanofluid was also investigated by measuring the change of the temperature under lighting from a solar simulator. The measurement results showed that the highest photothermal conversion was obtained about 4.2% after a 30 min lighting with nanofluid containing 0.48 vol.% CNT concentration compared to ethylene glycol. These obtained results have propose a potential application of CNTs in nanofluids for solar absorption.
Failed Early Intervention of Pyomyositis in an Immunocompetent Individual
Authors: Al-Dossari Ranna , Zekri Sana
Published: November 2018

Pyomyositis is a purulent infection of striated muscle tissue that usually leads to an abscess, commonly due to S. aureus. Pyomyositis is typically found in tropic regions, but it is increasingly being recognized in temperate climates, especially in immunocompromised individuals. Patient presentation ranges from afebrile with mildly elevated WBC to frank sepsis. In many reported cases, patients may develop multiple abscesses at different sites. We report a case of a 54-year-old male with a history of chronic obstructive pulmonary disease (COPD) presenting with right pectoral infection. This case demonstrates the possibility that antibiotic therapy in early presentations may not effectively prevent abscess formation, contrary to treatment suggestions found in the literature.
Corticosteroids for Graves’ Ophthalmopathy: Systematic Review and Meta-Analysis
Authors: Tu Xiaofang , Dong Yan , Zhang Hongmei , Su Qing
Published: November 2018

Background. Graves’ ophthalmopathy (GO) is a complicated autoimmune disease. Various therapies have been used to manage GO; however the optimum therapy is not clear. Glucocorticoids (GCs) therapy is the mainstay of treatment especially for active moderate to severe patients, which needs evidence-based support. Method. We searched all the randomized controlled trials (RCTs) involving corticosteroid treatment for patients diagnosed with GO from EMBASE, Medline, and the Cochrane library and then conducted a system review and meta-analysis. The electronic search covered the period from April 1966 to March 2018. Result. Twenty-nine trials were included. GCs were proved to be beneficial for GO patients [response rate, risk ratio (RR) = 1.72, 95% confidence interval (CI): 1.28~2.31, P=0.0003], and intravenous corticosteroids worked significantly better than oral corticosteroids as ever reported. When compared with the single treatment of GCs, the combination of radiotherapy and GCs showed similar effects on response rate (RR=1.25, 95%CI: 0.91~1.73). A study proved the advantage of mycophenolate mofetil over GCs in three outcomes (response rate, RR=0.74, 95%CI: 0.63~0.88). Additional treatments such as technetium-99 methylene diphosphate (99Tc-MDP) or cyclosporine enhanced the effect of GCs on proptosis reduction, respectively (P<0.00001 and P=0.02). Conclusion. Our meta-analysis confirmed the effects of GCs in the management of GO and intravenous GCs are proved to be better than oral GCs as ever reported. Combination of radiotherapy and GCs did not enhance the effects of GCs. However, if proptosis is the main issue, combination of 99Tc-MDP or cyclosporine with GCs may be taken into consideration. The reported advantages of mycophenolate mofetil over GCs are noteworthy and need more RCTs to confirm.
Putative Systemic Biomarkers of Biomass Smoke-Induced Chronic Obstructive Pulmonary Disease among Women in a Rural South Indian Population
Authors: Vishweswaraiah Sangeetha , Thimraj Tania Ahalya , George Leema , Krishnarao Chaya Sindaghatta , Lokesh Komarla Sundararaja , Siddaiah Jayaraj Biligere , Larsson Kjell , Upadhyay Swapna , Palmberg Lena , Anand Mahesh Padukudru , Ganguly Koustav
Published: November 2018

Rationale. Exposure to biomass smoke (BMS) has been implicated in chronic obstructive pulmonary disease (COPD). About 3 billion people worldwide use biomass fuel for cooking and heating. Women in rural communities of low- and lower-middle-income countries are disproportionately exposed to massive amounts of BMS during active cooking hours (4–6 h/day). Therefore, BMS exposure is considered as a risk factor for COPD in the same order of magnitude as tobacco smoke. In rural India, due to cultural reasons, women are the primary cook of the family and are mostly nonsmokers. Thus, BMS-induced COPD is predominant among rural Indian women. However, BMS-COPD remains a relatively unexplored health problem globally. Therefore, we investigated the serum chemokine and cytokine signatures of BMS-COPD and tobacco smoke-induced COPD (TS-COPD) patients compared to their control in a rural South Indian population for this field study. Methods. Concentrations of 40 serum chemokines and cytokines were measured using a multiplexed immunoassay. The study cohort consisted of BMS-COPD (female; n=29) and BMS-exposed subjects without COPD (BMS-CONTROL; female; n=24). For comparison, data from TS-COPD patients (male, n=23) and tobacco smokers without COPD (TS-CONTROL; male, n=22) were investigated. Subjects were matched for age, sex, and biomass exposure. Tobacco consumption was slightly higher in TS-COPD subjects compared to TS-CONTROL. BMS-exposed and TS-exposed subjects (currently exposed) were from the same locality with similar dwelling habits and socioeconomic status. A validated structured questionnaire-based survey and spirometry was performed. An additional control group with no tobacco and BMS exposure (TS-BMS-CONTROL; n=15) was included. Statistical significance was set at p≤0.01. Results. Serum median concentrations (pg/ml) of CCL15 [8799.35; 5977.22], CCL27 [1409.14; 1024.99], and CXCL13 [37.14; 26.03] were significantly higher in BMS-CONTROL compared to BMS-COPD subjects. Nine analytes exhibited higher concentrations in TS-CONTROL compared to TS-COPD subjects. Comparison of chemokine and cytokine concentrations among BMS-COPD versus TS-COPD and BMS-CONTROL versus TS-CONTROL subjects also revealed distinct molecular signatures. Conclusion. Our data identifies CCL27 and CXCL13 as putative, plausibly homeostatic/protective biomarkers for BMS-COPD within the investigated population that warrants validation in larger and multiple cohorts. The findings further indicate exposure-specific systemic response of chemokines and cytokines.
Knowledge and Practices of Hand Washing among Health Professionals in Dubti Referral Hospital, Dubti, Afar, Northeast Ethiopia
Authors: Jemal Suoud
Published: November 2018

Introduction. Nosocomial infections due to poor hand hygiene are a major cause of increasing morbidity, mortality, and health care costs among hospitalized patients worldwide. Hand hygiene is mandatory to prevent the transmission of health care associated infections especially where infectious diseases are common like Sub-Saharan Africa. Hand washing compliance among health professionals in general is unacceptably low especially in developing countries like Ethiopia. Method. Institution-based cross-sectional study design was used to assess the knowledge and practice of hand washing among health professionals working in Dubti Referral Hospital. Structured self-administered pretested questionnaires were used. The data obtained were analyzed using SPSS version 23. Result. Out of 91 respondents, majority, 60 (65.9%), of them were knowledgeable and 31 (34.1%) were not knowledgeable. However, the majority of health professionals, 51 (56.0%), had poor practice and 40 (43.0%) of them had good practice of hand washing. Conclusion. Majority of health professionals were knowledgeable. However, they had poor practice of hand washing.
Hemophagocytic Lymphohistiocytosis Associated with Salmonella typhi Infection in a Child: A Case Report with Review of Literature
Authors: Uribe-Londono Juanita , Castano-Jaramillo Lina Maria , Penagos-Tascon Laura , Restrepo-Gouzy Andrea , Escobar-Gonzalez Andres-Felipe
Published: November 2018

We present the case of an 8-year-old girl with hemophagocytic lymphohistiocytosis secondary to a Salmonella typhi infection. She received antibiotic treatment and intravenous immunoglobulin with complete resolution of the symptoms. We present a review of previously reported pediatric cases and propose a gradual approach to treatment.
Surface Profile Measurement and Error Compensation of Triangular Microstructures Employing a Stylus Scanning System
Authors: Yin Qin , Xu Bin , Yin Guofu , Gui Peng , Xu Wei , Tang Bin
Published: November 2018

Microstructure-based function components are widely used in precision engineering. Surface profile measurement is an essential tool to verify the manufacturing quality of microstructures and to enhance the working performance of the device employing microstructures as function components. However, highly accurate surface profile measurements are difficult to perform for microstructures owing to their complex surface topographies. In this paper, a measurement system is proposed for the surface profile measurement of microstructures. The main components of the measurement system are a precision displacement stage to move the workpiece, a homemade probing system with a diamond microstylus to sense the surface profile variation of the microstructures on the workpiece, and a vibration isolation table to reduce the disturbance of the measurement environment. In addition, the stability of the measurement was experimentally investigated. Microstructures with shape of equilateral right triangle were employed as the measurement specimen, and the surface profile of triangular microstructures was measured by employing two methods to correct errors caused by the specimen inclination and the radius of the stylus tip. The shape, depth, and period of the measured microstructures were also detected based on the results of the surface profile measurement. Experimental results demonstrate the feasibility of the proposed surface profile measurement for microstructures with complex surface topographies.
Evaluation of the Short- and Long-Term Effectiveness of Pulsed Radiofrequency and Conventional Radiofrequency Performed for Medial Branch Block in Patients with Lumbar Facet Joint Pain
Authors: Çetin Abdurrahman , Yektaş Abdulkadir
Published: November 2018

Background. Diagnosis of lumbar facet joint disease is the sum of the combinations consisting of history, physical activity, and diagnostic imaging frequently including computed tomography and magnetic resonance imaging scans. Prevalence of facet-based chronic low back pain is 15–45%. Intra-articular injections with corticosteroid or medial branch block are traditionally used prevalently in the management of chronic low back pain due to lumbar facet joints. However, the evidence levels of these procedures are at either a low or a medium level. Radiofrequency neurolysis of the lumbar medial branch can be used as an alternative in the management of lumbar facet joint pain. There are two types of radiofrequency applications for radiofrequency neurolysis as pulsed radiofrequency and conventional radiofrequency. Materials and Methods. Patients with lumbar facet pain were separated into 2 groups. Group 1 (n=75): patients were given pulsed radiofrequency under fluoroscopy. Group 2 (n=43): patients were given conventional radiofrequency under fluoroscopy. Pre-op and post-op 1st, 3rd, and 6th month and 1st and 2nd year Visual Analogue Scale values of all patients were asked, recorded, and statistically compared. Visual Analogue Scale values of the groups in the same months were compared as well. At the end of the second year, Odom criteria of both groups were recorded and statistically compared. Results. Preoperation Visual Analogue Scale values and postoperation 1st, 3rd, and 6th month and 1st and 2nd year Visual Analogue Scale values were compared in Group 1 and Group 2, and there was a statistically significant difference between preoperation Visual Analogue Scale values and postoperation 1st, 3rd, and 6th month and 1st and 2nd year Visual Analogue Scale values in both groups. However, the number of repetitions of the operation was higher in Group 1. In the comparison of Odom criteria for both groups at the end of the second year, it was observed that the patients in Group 2 were more satisfied with the treatment. Conclusion. Conventional radiofrequency in patients with lumbar facet joint pain for medial branch neurolysis effectively decreases Visual Analogue Scale values in both short and long term. The quality of life and daily activities of patients were better at conventional radiofrequency.
The Role of Antifungals in Pediatric Critical Care Invasive Fungal Infections
Authors: Kaushik Ashlesha , Kest Helen
Published: November 2018

Invasive fungal infections (IFIs) have seen considerable increase in pediatric intensive care units over the past several decades. IFIs are predominantly caused by Candida species, and candidemia is the third most common cause of healthcare-associated bloodstream infections (BSIs) in children. IFIs are opportunistic infections that affect pediatric patients in critical care resulting in significant morbidity and mortality especially in those with a compromised immune system. IFIs are the leading cause of death in children with comorbidities such as immunosuppression, and pediatric ICU admission has been shown to be an independent risk factor for mortality. Management of IFI and fungal sepsis is broad and encompasses several key components that include prompt initiation of therapy and rapid source identification and control. This study reviews important antifungals in the pediatric critical care setting including the pharmacologic properties, antifungal spectrum, adverse effects, and clinical uses of agents belonging to the four major classes of antifungals—the polyenes, azoles, echinocandins, and pyrimidine analogue flucytosine. The polyenes and azoles are the most often used classes of antifungals. The echinocandins are a relatively newer class of antifungal agents that offer excellent Candida activity and are currently recommended as the first-line therapy for invasive candidiasis.
Experimental Study on Oxygen-Enriched Sintering of Vanadium-Titanium Magnetite
Authors: Liu Hao , Qin Yuelin , Wu Xinlong , Xie Bing
Published: November 2018

The influences of various factors, such as oxygen enrichment time, oxygen enrichment load, and ignition temperature, on the technical indices and sintering performance in the vanadium-titanium magnetite sintering process are simulated using sinter pot experiments. The experiments are based on the field production parameters of a sintering trolley in a steel enterprise in southwest China. Prolonged oxygen enrichment time results in the gradual increase in vertical sintering speed, sintering utilization coefficient, sintered ore yield, sintered ore drum strength, and reductivity. However, the low-temperature reduction pulverability of the sintered ore deteriorates. Oxygen enrichment load increases from 0 m3/h to 2.9 m3/h, and yield increases by 1.1%, while the vertical sintering speed and utilization coefficient increase slightly. Sintered ore drum strength increases from 65.33% to 68.00%, antiwear index decreases to 0.47%, and low-temperature reduction pulverability decreases from 65.07% to 62.85%. The increased ignition temperature is beneficial to improve the drum strength and yield of the ore but reduces the vertical sintering speed and utilization coefficient. With the increase in ignition temperature, the low-temperature reduction pulverability tends to increase first and then decrease. Changes in oxygen time, oxygen enrichment load, and ignition temperature have no significant effects on the soft melting performance of the sintered ore.
Health Outcomes for Definite Concurrent Chemoradiation in Locally Advanced Non-Small Cell Lung Cancer: A Prospective Study
Authors: Nguyen Pham Anh Hong , Vercauter Piet , Verbeke Luc , Beelen Roel , Dooms Christophe , Tournoy Kurt G.
Published: November 2018

Background: In patients with locally advanced lung cancer treated with concurrent chemoradiation, outcome measurements have been mostly limited to survival. Objectives: We aimed to measure outcomes that matter to these patients beyond survival in a general clinical practice. Methods: In a prospective single-centre study, consecutive patients with locally advanced non-small cell lung cancer reported their own outcomes using the EORTC Quality of Life Questionnaire Core 30 at baseline, during therapy, at therapy stop and till 1 year after therapy end every 3 months. Survival, complications, quality of death and case-mix variables were measured. Results: There were 32 consecutive patients included prospectively from June 2013 until September 2016. Median overall survival was 24.3 months (95% CI 12.7–35.9). Severe toxicity (grade III–IV) was frequent (haematologic toxicity III–IV in 59%). Patient-reported outcomes (PROs) documented the burden on global health status and on functional domains (physical, role, social, emotional and cognitive functioning). Deterioration was pronounced during and after treatment with drops over 20 up to 40% points from baseline for physical, role and social functioning. Clinically meaningful negative effects did persist up to 6 and 9 months for physical and role functioning. Fifty-six percent of the deceased patients died in hospital. Conclusions: The assault on health-related quality of life during concurrent chemoradiation for locally advanced lung cancer is considerable. Loss of physical and role functioning persists up to 6 and 9 months after therapy end, respectively. Measuring PROs can help to identify issues for improvement of the value of care delivered.
Small-Cell Lung Cancer Comorbid with Pulmonary Mycobacterium avium Infection: A Case Report
Authors: Yamasaki Masahiro , Funaishi Kunihiko , Saito Naomi , Sakamoto Ken-ichi , Ishiyama Sayaka , Kawamoto Kazuma , Matsumoto Yu , Matsumoto Naoko , Taniwaki Masaya , Ohashi Nobuyuki , Hattori Noboru
Published: November 2018

Background: Small-cell lung cancer (SCLC) rarely coexists with pulmonary Mycobacterium avium intracellular complex (MAC) infection. The key drug for SCLC treatment is etoposide, which is metabolized by cytochrome P-450 (CYP) 3A4. Meanwhile, the key drugs for pulmonary MAC infection are clarithromycin (CAM) and rifampicin (RFP), and their metabolism influences CYP3A4. Therefore, treatment of concurrent SCLC and pulmonary MAC infection is difficult, and to the best of our knowledge, no report of treatments for concurrent SCLC and pulmonary MAC infection has been published. Patient Concerns and Diagnoses: A 65-year-old man presented to our hospital with abnormal findings of chest computed tomography: (1) a hilar region nodule in the left lung and mediastinal lymphadenopathy and (2) a thick-walled cavity lesion in the right upper lobe of the lung. After further examinations, the former lesions were diagnosed as SCLC, cT4N3M0, stage IIIC and the latter as pulmonary MAC infection, fibrocavitary disease. Interventions and Outcomes: Concurrent treatment was conducted with discontinuation of CAM and RFP before and after etoposide administration. Specifically, intravenous cisplatin and etoposide were administered on day 1 and days 1–3, respectively, and CAM, RFP, and ethambutol (EB) were administered orally on days 6–22 every 4 weeks. Concurrent radiotherapy was added to the drug administration on days 1–27 of the first cycle. The chemotherapy was continued for 4 cycles, followed by continuation of CAM and RFP administration. EB was discontinued because of optic nerve disorder. The treatments were conducted completely and safely, and both of the SCLC lesions and the MAC lesion were improved. Conclusions: Treatments for concurrent SCLC and pulmonary MAC infection may be successfully conducted with discontinuation of CAM and RFP before and after etoposide administration.
Facial and Extrafacial Lesions in an Ethnically Diverse Series of 91 Patients with Frontal Fibrosing Alopecia Followed at a Single Center
Authors: Mervis Joshua S. , Borda Luis J. , Miteva Mariya
Published: November 2018

Background: Various facial and extrafacial lesions have been reported in frontal fibrosing alopecia (FFA). Facial papules have been associated with worse prognosis. Objectives: We sought to detect the prevalence of facial and extrafacial lesions and to analyze their relation to demographic and clinical variables in a large and ethnically diverse series of patients with FFA. Methods: Charts of patients diagnosed with FFA between January 1, 2015, and December 31, 2017, at the Department of Dermatology, University of Miami, were reviewed retrospectively. Results: 91 patients (87 women and 4 men) met inclusion criteria: 45% (n = 41) were of Hispanic/Latino ethnicity, and 34% (n = 30) were premenopausal. Facial papules were most commonly detected (41% among Hispanic/Latino patients). Significant associations were found between: (1) Hispanic/Latino ethnicity and any FFA-associated facial lesions, facial papules alone, or lichen planus pigmentosus alone, as well as premenopausal status; (2) any FFA-associated facial lesions or facial papules alone and premenopausal status; and (3) Hispanic/Latino ethnicity and simultaneous presence of facial and extrafacial lesions. Conclusions: There is a significant association among Hispanic/Latino ethnicity, facial papules, and premenopausal status, which may portend a susceptibility to severer disease and prompt early and aggressive treatment in this group.
Sansevieria (Asparagaceae, Nolinoideae) is a herbaceous clade within Dracaena: inference from non-coding plastid and nuclear DNA sequence data
Authors: TAKAWIRA-NYENYA RATIDZAYI , MUCINA LADISLAV , CARDINAL-MCTEAGUE WARREN M. , THIELE KEVIN R.
Published: November 2018

The evolutionary history of the dracaenoid genera Dracaena and Sansevieria (Asparagaceae, Nolinoideae) remains poorly resolved, despite long-recognised issues with their generic boundaries and increased attention paid by both horticulturalists and taxonomists. In this study we aim to: (1) elucidate evolutionary relationships within and between Dracaena and Sansevieria using molecular phylogenetic inference of both nuclear (nDNA) and plastid (cpDNA) markers, (2) examine the infrageneric classifications of each genus, and (3) revise the circumscription of the dracaenoids in light of morphological and phylogenetic evidence. In total, we sampled 21 accessions of Dracaena (ca. 19 species), 27 accessions of Sansevieria (ca. 26 species), and six outgroup taxa. Phylogenetic analyses were based on nucleotide sequences of two non-coding plastid DNA regions, the trnL-F region (trnL intron and trnL-trnF intergenic spacer) and rps16 intron, and the low-copy nuclear region At103. Phylogenetic hypotheses were constructed using maximum parsimony, maximum likelihood, and Bayesian inference. Individual datasets were analysed separately and, after testing for congruence, as combined datasets. We recovered instances of soft incongruence between nDNA and cpDNA datasets in Sansevieria, but general trends in the dracaenoids were congruent, although often poorly supported or resolved. The dracaenoids constitute a strongly supported monophyletic group. Dracaena was resolved as a paraphyletic grade embedded with two clades of Sansevieria, a primary clade comprising most species, and a secondary clade including S. sambiranensis, a distinctive species from Madagascar. The backbone of our phylogeny was only resolved in nDNA analyses, but combined analyses recovered strongly supported species groups. None of the previous infrageneric classifications were supported by our phylogeny, and biogeographic groupings were frequently more significant than morphology. More work is needed to resolve internal relationships in the dracaenoids, but we support a recent proposal to recognise a broadened circumscription of Dracaena that includes Sansevieria. We provide a generic description for the recircumscribed Dracaena and new combinations for several species of Sansevieria in Dracaena.
Comparison of a Smartphone Otoscope and Conventional Otoscope in the Diagnosis and Management of Acute Otitis Media
Authors: Chan K. Ning , Silverstein Anna , Bryan Leah N. , McCracken Courtney E. , Little Wendalyn K. , Shane Andi L.
Published: November 2018

Acute otitis media (AOM) is a leading cause of health encounters and antimicrobial prescriptions in children worldwide. We assessed (1) the rates of antimicrobial prescribing by pediatric emergency department clinicians using a smartphone otoscope device as compared with a conventional otoscope and (2) clinician acceptability of the smartphone device. We conducted a randomized control study in children’s hospital emergency departments over 6 months. More than 1500 encounters were analyzed. The odds of prescribing antibiotics after being given a diagnosis of AOM by clinicians assigned to the smartphone group was 11% higher than the conventional group (18.8% vs 18.0%, odds ratio = 1.106, P = .600). Eight (73%) of the 11 physicians in the smartphone group preferred the smartphone device over the conventional otoscope. Use of a smartphone otoscope for detection of AOM in a pediatric emergency department setting did not lead to an increased likelihood of AOM diagnosis.
Attitudes About Perceived Park Safety Among Residents in Low-Income and High Minority Kansas City, Missouri, Neighborhoods
Authors: Groshong Lisa , Wilhelm Stanis Sonja A. , Kaczynski Andrew T. , Hipp J. Aaron
Published: November 2018

Parks benefit communities by supporting the physical, mental, and social health of their residents. This is especially important in urban areas, where parks provide essential access to green space, and especially among low-income populations who may lack alternative venues for outdoor recreation. However, although urban parks may ostensibly be accessible, their use can be influenced by factors including perceptions and realities of safety. This qualitative study explored the issue of safety as it relates to park use and park-based physical activity from six focus groups with 41 total participants in urban Kansas City, Missouri. As a facilitator to safety, participants described social interactions and structural environment factors. Safety constraints emerged along five main themes: violence, concerning behavior, lack of maintenance, lack of lighting, and traffic/busy roads. This study adds to the literature establishing safety as a complex and multidimensional factor influencing park usage and physical activity.