bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Results of Patellar Bone-Grafting for Severe Patellar Bone Loss During Revision Total Knee Arthroplasty
Authors: Abdel Matthew P. , Petis Stephen M. , Taunton Michael J. , Perry Kevin I. , Lewallen David G. , Hanssen Arlen D.
Published: September 2019

Background:

There is no consensus on managing severe patellar bone loss after total knee arthroplasty. We previously described an initial series involving a novel technique of patellar bone-grafting with a short follow-up. The purpose of this study was to determine long-term survivorship and the radiographic and clinical results of patellar bone-grafting during revision total knee arthroplasty in a larger series with an extended follow-up.

Methods:

We identified 90 patients from a single institution who underwent 93 patellar bone-grafting procedures for severe patellar bone loss from 1997 to 2014. The mean age of the patients was 70 years, and 46% of patients were female. Forty-five knees (48%) underwent first-time revisions, and 19 knees (20%) had undergone a failed attempt at patellar resurfacings. Intraoperative patellar caliper thickness increased from a mean of 7 to 25 mm after patellar bone-grafting (p < 0.01). Radiographic review determined changes in patellar height, tracking, and remodeling. Knee Society scores (KSSs) were calculated. The mean follow-up was 8 years (range, 2 to 18 years). Kaplan-Meier methods determined survivorship free of any revision and any reoperation. Cox proportional hazards analysis determined predictive factors for failure.

Results:

Survivorship free of patellar revision was 96% at 10 years. Survivorship free of any revision was 84% at 10 years. Survivorship free of any reoperation was 78% at 10 years. Increasing patient age was the only protective factor against further patellar revision (hazard ratio, 0.95; p < 0.01). When comparing initial radiographs with final radiographs, patellar height decreased from 22 to 19 mm (p < 0.01), 80% compared with 59% of patellae articulated centrally in the trochlea (p = 0.01), and 32% compared with 77% had remodeling over the lateral femoral condyle (p < 0.01). Anterior knee pain decreased from 51% to 27% postoperatively (p = 0.01). The mean knee flexion improved from 101° to 108° (p = 0.03). The mean KSS improved from 50 to 85 points (p < 0.01).

Conclusions:

Reliable long-term clinical results can be expected with patellar bone-grafting for severe patellar bone loss during revision total knee arthroplasty. Pain, range of motion, and other reported outcomes improve despite radiographic changes to patellar height, tracking, and remodeling. This technique is a durable and reliable option when standard patellar resurfacing is not possible.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Interventions to Improve Discharge from Acute Adult Mental Health Inpatient Care to the Community: Systematic Review and Narrative Synthesis
Authors: Tyler Natasha , Wright Nicola , Waring Justin
Published: September 2019

Background

The transition from acute mental health inpatient care to community care is often a vulnerable period in the pathway, where people can experience additional risks and anxiety. Researchers globally have developed and tested a number of interventions that aim to improve continuity of care and safety in the transitions. However, there has been little attempt to compare and contrast the interventions and specify the variety of safety threats they attempt to resolve.Methods

The study aimed to identify the evidence base for interventions to support continuity of care and safety in the transition from acute mental health inpatient service to community care services at the point of discharge. Electronic Databases including PsycINFO, MEDLINE, Embase, HMIC, CINAHL, IBSS, Cochrane Library Trials, ASSIA, Web of Science and Scopus, were searched between 2000 and May 2018. Peer reviewed papers were eligible for inclusion if they addressed adults admitted to an acute inpatient mental health ward and reported on health interventions surrounding discharge from the acute ward to the community. The results were analysed using a narrative synthesis technique.Results

The total number of papers from which data was extracted was 45. The review found various interventions implemented across continents, addressing problems related to different aspects of discharge. Some interventions followed a distinct named approach (i.e. Critical Time Intervention, Transitional Discharge Model) others were grouped based on key components (i.e. peer support, pharmacist involvement). The primary problems interventions looked to address were reducing readmission, improving wellbeing, reducing homelessness, improving treatment adherence, accelerating discharge, reducing suicide. The 69 outcomes reported across studies were heterogeneous, meaning it was difficult to conduct comparative quantitative meta-analysis or synthesis.Conclusions

The interventions reviewed are spread across a spectrum ranging from addressing a single problem within a single agency with a single solution, to multiple solutions addressing multi-agency problems. We recommend that future research attempts to improve homogeneity in outcome reporting.
Efficacy of urination in alleviating man’s urethral pain associated with flexible cystoscopy : a single-center randomized trial
Authors: Xie Yingwei , Wang Wei , Yan Wei , Liu Dan , Liu Yuexin
Published: September 2019

Objective: This study aimed to assess whether urethral pain can be alleviated by urination in male patients undergoing flexible cystoscopy. Patient and Methods: Ninety-six male outpatients undergoing flexible cystoscopy were randomly divided into two groups. Patients in the test group urinated during flexible cystoscopy, whilst patients in the control group received no instructions to do so. All patients received 10mL of 2% lidocaine gel prior to assessment. Using 0 (no-pain) to 10 (unbearable severe pain) pain scores (VAS), we assessed patient discomfort prior to anesthesia gel perfusion (baseline), during gel perfusion, during cystoscope insertion through the urethra, and 15minutes post-examination analysis. The entire protocol was completed by a single doctor in our Department of Urology. Results: The groups showed no statistical differences regarding age or examination time. During cystoscope insertion, the test group recorded significantly lower pain scores 2 (IQR 1-3) - compared to the control group 3 (IQR 2-3) , (P = 0.001). No significant differences between other evaluation points were observed between groups. Conclusion: Urethral pain can be significantly alleviated by urination in male patients undergoing flexible cystoscopy through the urethra.
Influence of reduction quality on functional outcome and quality of life in treatment of tibial plafond fractures: a retrospective cohort study
Authors: Privalov Maxim , Euler Finn , Keil Holger , Swartman Benedict , Beisemann Nils , Franke Jochen , Grützner Paul Alfred , Vetter Sven Yves
Published: September 2019

Background: The aim of the study was to evaluate the impact of reduction quality, using intraoperative 3D imaging, on quality of life and functional outcome in the operative treatment of tibial plafond fractures.
Methods: A group of patients with tibial plafond fractures was re-examined. The operative treatment was performed between September 2001 and October 2011. The follow-up examination was at least 2 years after the final surgical procedure. Final reduction result was assessed intraoperatively using a mobile 3D C-arm. A categorization with regard to descriptive parameters as well as type and size of joint surface irregularities was performed. Follow-up results were evaluated using: Olerud and Molander (O & M) score, Short-Form-36 (SF-36) score, movement deficit, Kellgren and Lawrence grade of osteoarthritis, and pain intensity.
Results: 34 patients with operatively treated tibial plafond fracture could be re-examined. Reduction quality had the greatest influence on functional result measured by the O & M score (p=0.001) and the PCS domain of the SF-36 score (p=0.018).
Significant differences with regard to O & M score (p=0.000), SF-36 score (p=0.001 to p=0.02; without MCS domain), movement deficit (p=0.001), grade of osteoarthritis (p=0.005) and pain (p=0.001) could be verified under consideration of the reduction quality. The group with the anatomically more accurate reduction also showed a better result for clinical follow-up and quality of life. Furthermore, it is not the type of joint surface irregularity that is always decisive, but rather the size.
Conclusions: Despite other relevant factors, it appears that reduction quality –which can be analyzed with intraoperative 3D imaging– plays the most important role in postoperative quality of life and functional outcome. Corrections should therefore be performed on joint surface irregularities with a size above 2 mm.
Mortality of site-specific cancer in patients with schizophrenia: A systematic review and meta-analysis
Authors: Ni Liwei , Wu Jian , Long Yuming , Yuan Xuya , Xu Jianhao , Tao Jialong , Wu Runhong , Yu Na , Zhang Yusong
Published: September 2019

Background: Numerous studies have reported contradicting results on the relationship between cancer mortality and schizophrenia. Our aim is to quantify the mortality rate of common site-specific cancers among patients with schizophrenia and to synthesize the available research evidence. Method: We performed a systemic search of the PubMed, EMBASE and Web of Science databases. Studies reporting the mortality rate of different cancer in patients with schizophrenia were included. A random-effects model was applied to calculate the pooled relative risks (RRs) with 95% confidence intervals (95%CIs). Results: Seven studies consisting of a total of 1,162,971 participants with schizophrenia were included in this meta-analysis. Data regarding mortality risk of breast, colon, lung and prostate cancer among schizophrenia patients were subjected to quantitative analysis. Pooled results showed significant increases in mortality risk of breast cancer (RR = 1.97, 95%CI 1.38–2.83), lung cancer (RR = 1.93, 95%CI 1.46–2.54) and colon cancer (RR = 1.69, 95%CI 1.60–1.80) in patients with schizophrenia compared with those in the general population or control group. The mortality risk of prostate cancer increased in male patients, although no significant difference was detected (RR = 1.58, 95% CI 0.79–3.15). Increased risks of mortality from lung and colon cancer were observed in female patients (RR = 2.49, 95%CI 2.40–2.59 and RR = 2.42, 95%CI 1.39–4.22, respectively) and elevated risks of mortality from lung and colon cancer in male patients (RR = 2.40, 95%CI 2.30–2.50 and RR = 1.90, 95%CI 1.71–2.11, respectively) were detected. Conclusions: Individuals with schizophrenia have a significantly high risk of mortality from breast, colon, and lung cancer.
Colchicine causes prenatal cell toxicity and increases tetraploid risk
Authors: Wang Ding , Xie Yingjun , Yan Minyi , Pan Panying , Liang Yi , sun xiaofang
Published: September 2019

Background Colchicine is a clinical medicine used for relief from gout and familial Mediterranean fever. Because of its toxic effects, intravenous injection of colchicine has been banned, but it is still widely administered orally. We assayed the toxic effects of colchicine in cultured primary chorionic villus cells and amniotic fluid cells to interpret its influence on the placenta and foetus. Methods Bright field record and cell count kit 8 were used to value cell viability. Flow cytometer was used to identify cells markers, cell cycle and cell apoptosis. G-banding was used for karyotype analysis for sample genetic and drug effect evaluation. Results Chorionic villus cells and amniotic fluid cells were characterized as mesenchymal cells that share most cell surface markers and have a similar response to colchicine. Colchicine did not induce a decline in cell viability at low concentrations but suppressed cell proliferation by arresting the cell cycle in the G2/M phase and increased the risk of tetraploid generation in a small subset of cases. Conclusions Our study revealed the results of a colchicine-induced toxicity test in prenatal cells and determined the anti-mitotic biologically functional dose and manner of administration that might reduce the risk of tetraploid generation.
Palliative care training addressed to hospital healthcare professionals by palliative care specialists: a mixed-method evaluation
Authors: Artioli Giovanna , Bedini Gabriele , Bertocchi Elisabetta , Ghirotto Luca , Cavuto Silvio , Costantini Massimo , Tanzi Silvia
Published: September 2019

Background: Despite the great advances in the concept of palliative care (PC) and its benefits, its application seems to be delayed, leaving unfulfilled the many needs of patients and family members. One way to overcome this difficulty could be to develop a new training programme by palliative care specialists to improve PC primary skills in healthcare professionals. The aim of this study was to evaluate the training's impact on trainees within a hospital setting using Kirkpatrick’s and Moore's models.
Methods: We adopted a mixed-method evaluation with concurrent triangulation. The evaluation followed the first three steps of Kirkpatrick’s and Moore’s models and included a pre- and post-training evaluation through self-administered questionnaires and focus groups. We used the McNemar statistical test.
Results: The results highlighted the significant amount of knowledge acquired by the hospital professionals after training, in terms of increasing their knowledge of palliative care and in terms of the change in meaning that they attributed to phenomena related to chronicity and incurability, which they encounter daily in their professional practice. In both quantitative and qualitative research, the results, in synthesis, highlight:the development of a new concept of palliative care, centred on the response to the holistic needs of people;
that palliative care can also be extended to non-oncological patients in advanced illness stages (our training was directed to Geriatrics and Nephrology/Dialysis professionals);
the empowerment and the increase in self-esteem that healthcare professionals gained, from learning about the logistical and structural organization of palliative care, to activate and implement PC;
the need to share personal aspects of their professional life (this result emerges only in qualitative research);
the appreciation of cooperation and the joining of multiple competences towards a synergistic approach and enhanced outcomes.

Conclusion: It is necessary to further develop rigorous research on training evaluation, at the most complex orders of the Kirkpatrick and Moore models, to measure primary PC skills in health care professionals. This will develop the effectiveness of the integration of I- and II-level palliative care competencies in hospitals and improve outcomes of patients’ and families’ quality of life.
Analysis of exosomal circRNAs upon irradiation in pancreatic cancer cell repopulation
Authors: Chen Yi-yun , Jiang Ming-jie , Chen Zhi-long , Tian Ling
Published: September 2019

Background : Pancreatic cancer is one of most malignant tumors. However, radiotherapy can lead to tumor recurrence, which is the cause of the residual surviving cells repopulation by some molecular released from dying cells. Exosomes may mediate cell-cell communication and transfer kinds of signals from the dying cells to the surviving cells for stimulating tumor repopulation. Circular RNAs (circRNAs) may be one vital kind of exosomal cargos involving in modulating cancer cell repopulation.
Methods: Next generation sequencing (NGS) and bioinformatics were performed to analysis and annotate the expressions and functions of exosome-derived circRNAs in pancreatic cells during radiation. 4 circRNAs were chosen for qRT-PCR analysis to validate the sequencing.
Results: In this study, 3580 circRNAs were annotated in literatures and circBase among 12572 identified circRNAs. And there were 196 filtered differentially expressed circRNAs (the up-regulation and down-regulation respectively is 182 and 14, fold change >2, p-value <0.05). Regulation of metabolic process and lysine degradation were the main biological processes and pathway enrichment according to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG).
Conclusions: The hsa_circ_0002130-hsa_miR_4482-3p-NBN interaction network suggested potential miRNA sponge and target mRNA. Our results provided potential functions of circRNAs to explore molecular mechanisms and therapeutic targets in pancreatic cancer cell repopulation upon irradiation.
Maternal and Fetal outcomes of Cesarean Delivery and factors associated with its unfavorable management outcomes; In Ayder Specialized Comprehensive Hospital, Mekelle, Tigray, Ethiopia, 2017
Authors: mengesha Meresa Berwo , Adhanu Hadgay Hagos , weldegeorges Desta Abraha , Assefa Natnael Etsay , werid Woldu mammo , weldemariam Mulu Gebretsadik , welay fissaha tekulu , Hidru Hagos Degefa , Gebru Tesfay tsegay
Published: September 2019

Abstract
Objectives: The aim of this study was to determine the unfavorable outcomes and to assess factors contribute for the unfavorable management outcomes after caesarean deliveries in Ayder Specialized Comprehensive Hospital, Mekelle, Tigray, Ethiopia, 2017.
Results: The unfavorable maternal management outcomes were Adhesion 28(8.3%), excessive blood loss and blood transfusion 19(5.6%), caesarean hysterectomy 10(3%), relaparotomy 5(1.5%), wound infection and wound dehiscence 23(6.8%).Unfavorable fetal outcomes were were still birth 9(2.6%), early neonatal death 8(2.4%), low birth weight 58(17.2%). Women’s who did not booked for Antenatal Care and having history of previous Caesarean delivery were found to be associated with unfavorable maternal outcomes and indications of Caesarean delivery as obstructed labor was associated with unfavorable fetal outcomes.
Key words: caesarean delivery, fetal outcomes, maternal outcomes.
Detection of Early Adenocarcinoma of the Esophagogastric Junction by Spraying an Enzyme-Activatable Fluorescent Probe Targeting Dipeptidyl Peptidase-IV
Authors: Yamamoto Keiko , Ohnishi Shunsuke , Mizushima Takeshi , Kodaira Junichi , Ono Masayoshi , Hatanaka Yutaka , Hatanaka Kanako , Kuriki Yugo , Kamiya Mako , Ehira Nobuyuki , Shinada Keisuke , Takahashi Hiroaki , Shimizu Yuichi , Urano Yasuteru , Sakamoto Naoya
Published: September 2019

Background: It is still difficult to detect and diagnose early adenocarcinoma of the esophagogastric junction (EGJ) using conventional endoscopy or image-enhanced endoscopy. A glutamylprolyl hydroxymethyl rhodamine green (EP-HMRG) fluorescent probe that can be enzymatically activated to become fluorescent after the cleavage of a dipeptidyl peptidase (DPP)-IV-specific sequence has been developed and is reported to be useful for the detection of squamous cell carcinoma of the head and neck, and esophagus; however, there is a lack of studies that focuses on detecting EGJ adenocarcinoma by fluorescence molecular imaging. Therefore, we investigated the visualization of early EGJ adenocarcinoma by applying EP-HMRG and using clinical samples resected by endoscopic submucosal dissection (ESD).
Methods: Fluorescence imaging with EP-HMRG was performed in 21 clinical samples resected by ESD, and the fluorescence intensity of the tumor and non-tumor regions of interest was prospectively measured. Immunohistochemistry was also performed to determine the expression of DPP-IV.
Results: Fluorescence imaging of the clinical samples showed that the tumor lesions were visualized within a few minutes after the application of EP-HMRG, with a sensitivity, specificity, and accuracy of 85.7%, 85.7%, and 85.7%, respectively. However, tumors with a background of intestinal metaplasia did not have a sufficient contrast-to-background ratio since complete intestinal metaplasia also expresses DPP-IV. Immunohistochemistry measurements revealed that all fluorescent tumor lesions expressed DPP-IV.
Conclusions: Fluorescence imaging with EP-HMRG could be useful for the detection of early EGJ adenocarcinoma lesions that do not have a background of intestinal metaplasia.
Using the anterior capsule of the hip joint to protect the tensor fascia lata muscle during direct anterior total hip arthroplasty: a randomized prospective trial
Authors: Zhao Gongyin , Zhu Ruixia , Jiang Shijie , Xu Nanwei , Bao Hongwei , Wang Yuji
Published: September 2019

Background The direct anterior approach for total hip arthroplasty (THA) has specific advantages, but injury to the tensor fasciae lata muscle (TFLM) remains a concern. This injury in part negates some of the advantages of the intermuscular approach, because injury of the muscle fibers of the TFLM can lead to less satisfactory clinical results. Thus, in this study, we propose an intraoperative method to protect the TFLM and demonstrate its feasibility.Methods Fifty-six patients undergoing THA by the direct anterior approach were divided randomly into two groups. In group A, the TFLM was protected by an autogenous tissue “pad” created from the anterior capsule of the joint that was rotated to protect the TFLM from direct contact with the retractors needed to expose the joint space. In group B, the operation was carried out in the typical fashion with no other protection of the TFLM except the attempt by the surgeons to consciously avoid compressive injury of the TFLM. We evaluated the magnitude of changes in the muscle cross-sectional area (MSCA) and fatty atrophy (FA) early and postoperatively between groups by magnetic resonance imaging. The differences in blood hemoglobin and serum levels of myoglobin, lactate dehydrogenase (LDH), and creatine phosphokinase (CPK) were compared at 8, 24, and 48 h, postoperatively. Postoperative drainage volume and pain evaluated by visual analogue scores (VAS) were compared between the two groups.Results LDH, CPK and myoglobin in group B were significantly higher than those in group A at 8, 24, and 48 hours after the surgery. (p<0.05) Compared to the group A, the decrease of hemoglobin in group B displayed significantly at 24 and 48 hours after surgery. (P<0.05) The significantly increased MSCA and FA of TFLM were demonstrated in group B. The PDV and VAS in group B were significantly higher compared with those in group A. (P<0.05)Conclusions Using the anterior capsule of the hip joint as an autogenous, protective capsular tissue pad to limit the trauma to the TFLM during a direct anterior approach to THA is an effective method to protect the TFLM and improve the clinical effect.
Overexpression of GNB2L1 is associated with poor prognosis in cervical cancer patients
Authors: Ma Jun Qi , Xu Li-Xiu , Tuerxun Hatila , Xirenbai Talaitiguli , Hasim Ayshamgul
Published: September 2019

Background: Among women, cervical cancer (CC) is the fourth most prevalent cancer worldwide. Multiple bio-makers have been identified for tumor diagnosis and prognosis. However, no single bio-maker for CC detection exists that is both highly sensitive and specific. In this report, we explored the role of guanine nucleotide-binding protein subunit beta-2-like 1 (GNB2L1) in CC progression in Uyghur women. Methods: In the present study, 132 patients with cervical squamous cell carcinoma (CSCC), 56 cases with cervical intraepithelial neoplasia (CIN) were enrolled. GNB2L1 mRNA and protein expression levels were analyzed in CSCC, CIN, and normal cervical (NC) tissues and in CC cell lines using qRT-PCR, western blot, and immunohistochemistry. Stable GNB2L1-knockdown CC cells (shGNB2L1) were also created and lipid accumulation was measured with Oil Red O staining. Additionally, changes in GNB2L1 gene copy number were investigated with qRT-PCR and sequencing. A gene regulatory network was constructed using the STRING database. Finally, patient survival was assessed with Kaplan‑Meier and log-rank tests. Results: Our results indicated that GNB2L1 mRNA and protein are overexpressed in CSCC tumor tissues when compared to CIN and NC tissues. GNB2L1 expression was associated with the degree of cell differentiation (P = 0.001), lymph node metastasis (P = 0.049), and the clinical stage (P = 0.017). Oil Red O staining showed that lipid levels were lower in shGNB2L1 cells, and that GNB2L1 DNA copy number in CC tissues (29,7200 ± 9,815.061) was significantly higher when compared to NC tissues (19,5100 ± 5,676.392 [T=-2.770, P = 0.009]). Furthermore, patients with CSCC and high GNB2L1 expression demonstrated shorter overall survival times when compared to patients with low GNB2L1 expression (P = 0.002). Multivariate analysis indicated that GNB2L1 overexpression is an indepen­dent prognostic factor in patients with CSCC. Conclusions: Overexpression of GNB2L1 may contribute to tumor progression; therefore, it is a potential prognostic biomarker for CSCC patients.
Does anemia risk for pre-eclampsia? A multi-center, Case control study in Amhara region, Ethiopia.
Authors: Getu Almaz Aklilu , Fikadu Gedefawe Abeje , Yenesew Muluken Azage , Getie Simegnew Asmer
Published: September 2019

Objective This study aimed to identify determinants of preeclampsia among women visiting referral hospitals in Amhara region. A hospital-based unmatched case-control study was conducted from February 20, 2016 to May 18, 2016 among 871 women visiting West Amhara referral hospital for prenatal care.Result Advanced age (>35 years) [AOR (95%CI), 3.09(1.80-3.35), being primigravidae [AOR (95%CI), 2.32 (1.61–3.35) family history of hypertension [AOR (95%CI), 4.31 (2.37–7.85)], twin pregnancy [AOR 95%CI, 3.53(1.77–7.06)], and Anemia [AOR (95%CI) = 1.49 (1.06– 2.1)] were determinants of preeclampsia.
Cardiopulmonary resuscitation training for schoolchildren and its effects on their prosocial behavior and knowledge: Mixed methods research design
Authors: Pivač Sanela , Gradišek Primož , Skela-Savič Brigita
Published: September 2019

Background: The benefits of cardiopulmonary resuscitation training for schoolchildren are well known, but the appropriate age for introducing training is still being discussed. This is a very important issue, since out-of-hospital cardiac arrest is a major public health concern. The objective of this study is to investigate the effects of implemented cardiopulmonary resuscitation training on the knowledge and prosocial behavior of children in the last three grades of Slovenian elementary schools, and to identify the experience of training instructors. Methods: A mixed methods research design was employed, using a cohort study with testing before and after training, and focus groups. Research was conducted in 15 Slovenian elementary schools offering cardiopulmonary resuscitation training. Focus groups included training instructors and developers. Data was collected with a structured questionnaire from April to June 2018 and analyzed using univariate, bivariate, and multivariate analyses. The three focus groups were convened in September and October 2018. Content analysis of the discussion transcriptions was conducted. The sample included 764 schoolchildren aged 12.5–14.5 years before cardiopulmonary resuscitation training and 566 schoolchildren after training. Three non-homogeneous focus groups included eight cardiopulmonary resuscitation instructors. Results: Significant progress in knowledge was noted after training implementation, with the greatest progress seen in the youngest age group (mean age 12.5). Male gender increased the level of self-confidence (β=0.114; p=0.007). Cardiopulmonary resuscitation knowledge influenced helping behavior (β=0.111; p=0.008), while internal motivation to help others was influenced by age (β=0.116; p=0.006) and level of knowledge (β=0.111; p=0.008). Analysis of the focus groups yielded two themes: (a) the effects of cardiopulmonary resuscitation training on schoolchildren, and (b) the systemic responsibility of the school system and professional bodies. Conclusions: Significant progress in schoolchildren’s cardiopulmonary resuscitation knowledge after training was established. Early introduction of training is recommended. Cardiopulmonary resuscitation knowledge influences the development of schoolchildren’s prosocial behavior, as it raises awareness of the responsibility to help others and increases self-confidence to provide bystander cardiopulmonary resuscitation. We can conclude that early Cardiopulmonary resuscitation training for children is crucial. It should be a mandatory part of school curricula in those countries where Cardiopulmonary resuscitation is not yet mandatory.
Familial autosomal recessive bestrophinopathy: identification of a novel variant in BEST1 gene and the specific metabolomic profile
Authors: Ye Panpan , Xu Jia , Luo Yueqiu , Su Zhitao , Yao Ke
Published: September 2019

Background Autosomal recessive bestrophinopathy (ARB) is a retinal degenerative disorder caused by BEST1 mutations with autosomal recessive inheritance. We aim to map a comprehensive genomic and metabolic profile of a consanguineous Chinese family with ARB.Methods Ophthalmic examinations were performed on affected patients with ARB. Target capture sequencing was performed to screen causative mutations in 256 known retinal disease genes and Sanger sequencing were used for verification. A UHPLC-MS/MS metabolomic analysis was performed to explore the disease-associated metabolic feature.Results Affected patients from this family are characterized by low vision, the presence of subretinal fluid, macular edema, and hyperopia with coincidental angle closure. DNA sequencing identified a novel missense mutation in BEST1 gene (chr11:61725867G>A) of the proband. Sanger sequencing further confirmed the mutation. The blood metabolic profiles were very similar among all family members probably due to the same life style, habitats and genomic background. However, ARB patients presented significant deregulation of metabolites such as Citric acid, L-Threonic acid, Eicosapentaenoic acid.Conclusions We identified a novel disease-associated variant in BEST1 gene as well as the disease-specific metabolic feature in familial ARB. The findings improved the understanding of mechanisms of ARB and provided a potential therapeutic strategy with application of metabolomics.
Gene Co-expression Networks Are Associated with Obesity-Related Traits in Kidney Transplant Recipients
Authors: Jaime-Lara Rosario B , Roy Abhrarup Abe , Wang Yupeng , Stanfill Ansley , Cashion Ann K , Joseph Paule
Published: September 2019

Background: Weight gain is often observed following kidney transplantation. Biological mediators of weight gain are not well understood in this population. Because subcutaneous adipose tissue can be easily obtained during kidney transplant surgery, it provides a unique avenue for studying the mechanisms of obesity for this group.Although differential gene expression patterns were previously profiled for kidney transplant patients, gene co-expression patterns can shed light on gene modules not yet explored on the coordinative behaviors of gene transcription in biological and disease processes.
Methods: In this study, we collected 29 demographic and clinical variables and matching microarray expression data for 26 kidney transplant patients. We conducted Weighted Gene Co-expression Network Analysis (WGCNA) for 5,758 genes with the highest average expression levels and related gene co-expression to clinical traits.
Results: A total of 35 co-expression modules were detected, seven of which showed association with clinical traits. Gene Ontology (GO) enrichment was found for five clinical trait-associated modules. One module consisting of 129 genes was enriched for metabolic and immune processes. The genes within this module were associated with multiple obesity-related traits, and is consistent with findings of previous studies in other clinically obese populations.
Conclusions : Our study generatedgene coexpression modules associated with obesity-related traits in kidney transplant patients and provided new insights regarding the cellular biological processes underlying obesity.

Trial Registration: N/A

Keywords : co-expression modules, obesity, association, enrichment analysis, gene ontology, kidney transplant
Molecular detection and phylogenetic analysis of Lumpy skin disease virus from outbreaks in Uganda 2017-2018
Authors: Ochwo Sylvester , Vanderwaal Kimberly , Ndekezi Christian , Nkamwesiga Joseph , Munsey Anna , Witto Sarah Gift , Nantima Noelina , Mayanja Franklin , Okurut Anna Rose Ademun , Atuhaire David Kalenzi , Mwiine Frank Norbert
Published: September 2019

Background Lumpy skin disease (LSD) is an infectious viral disease of cattle caused by a capripox virus. LSD has substantial economic implications, with infection resulting in permanent damage to the skin of affected animals which lowers their commercial value. In Uganda, LSD is endemic and cases of the disease are frequently reported to government authorities. This study was undertaken to molecularly characterize lumpy skin disease virus (LSDV) strains that have been circulating in Uganda between 2017 and 2018. Secondly, the study aimed to determine the phylogenetic relatedness of Ugandan LSDV sequences with published sequences, available in GenBank.Results A total of 7 blood samples and 16 skin nodule biopsies were screened for LSDV using PCR to confirm presence of LSDV nucleic acid. PCR positive samples were then characterised by amplifying the GPCR gene. These amplified genes were sequenced and phylogenetic trees were constructed. Out of the 23 samples analysed, 15 were positive for LSDV by PCR (65.2%). The LSDV GPCR sequences analysed contained the unique signatures of LSDV (A11, T12, T34, S99, and P199) which further confirmed their identity. Sequence comparison with vaccine strains revealed a 12bp deletion unique to Ugandan outbreak strains. Phylogenetic analysis indicated that the LSDV sequences from this study clustered closely with sequences from neighboring East African countries and with LSDV strains from recent outbreaks in Europe. It was noted that the sequence diversity amongst LSDV strains from Africa was higher than diversity from Eurasia.Conclusion The LSDV strains circulating in Uganda were closely related with sequences from neighboring countries. Comparison of GPCR gene showed that vaccine strains were not responsible for outbreaks. This means that vaccination with the currently used vaccine will probably be effective for the control of LSD in Uganda. This information is necessary to understand LSDV molecular epidemiology and to contribute knowledge towards the development of more appropriate control strategies by the Government of Uganda.
Socio-demographic, environmental and behavioural factors of the prevalence of diarrhea among children age under-five years in Rural Ethiopia: A Cross-Sectional Study
Authors: Ferede Melkamu Molla
Published: September 2019

Background: Diarrhea is one of the major contributors to deaths for under age five children in Ethiopia. Studies conducted in different countries showed that rural children are highly affected by diarrhea than urban children [11, 26, 27]. Thus, the purpose of this study was to identify the socio-demographic, environmental and behavioural risk factors of the prevalence of diarrhea among children age under five years in Rural Ethiopia.Methods: Data for the study was drawn from the 2016 Ethiopia Demographic and Health Survey. A total of 8,041 under-five children were included in the study. Bivariate and multivariable binary logistic regression were employed for the analysis of the data to assess the relationships between the prevalence of diarrhea and socio-demographic, environmental and behavioural risk factors among under five children. Data was analyzed using SPSS version 23. Results: The multivariable logistic regression analysis revealed that younger mothers’ children and child’s age 6-11 months (AOR: 3.5; 95% CI: 2.58-4.87), 12-23 months (AOR: 3.1; 95% CI: 2.33-4.04) and 24-35 months (AOR: 1.7; 95% CI: 1.26-2.34) were significantly associated with diarrhea. The two week prevalence of diarrhea was also significantly associated with male children (AOR: 1.3; 95% CI: 1.05-1.58), Children in rural Afar and Gambela regions, households who shared toilet facilities with other households (AOR: 1.4; 95% CI: 1.09-1.77), higher birth order number and households with 3 or more under-five children interacted with older mothers (AOR: 4.7; 95% CI: 1.64-13.45). Conclusion: The prevalence of diarrhea among under-five children was strongly associated with younger mothers, child’s age between 6-35 months, male children, children in rural part of Afar and Gambela regions, children with higher birth order numbers, those who shared toilet facility with other households and households with 3 or more number of under-five children interacted with older mothers/primary caregivers. Thus, in order to reduce childhood diarrhea, I suggest that child’s health care programs and other efforts in Ethiopia should give special attention to those categories of children who had highly affected by diarrhea.
Breast self-examination and associated factors among women in Wolaita sodo city, Ethiopia: Community based cross sectional study
Authors: Lera Temesgen Abiso , Beyene Aman , Bekele Befekadu , Baza Daniel
Published: September 2019

Background: Early detection of breast cancer plays an important role in decreasing morbidity and mortality associated with breast cancer. Breast self-examination (BSE) is one of the screening methods for early detection of breast cancer. BSE method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling. BSE is a simple exercise which can potentially save the life of a woman but it is not well focused yet and no study has addressed BSE at community level. So, this was aimed assess breast Self-Examination and associated factors among women in Wolaita Sodo city, Ethiopia.Methods: Community based cross-sectional study design was employed. Systemic random sampling technique was used to select 626 women aged 20-65 years old. The data were collected using pre-tested and structured questionnaire. The data entry was done using Epi data version 3.5.1 and exported to SPSS version 21 software for cleaning and statistical analysis. Bivariable analysis was done and variables with p-value of less than 0.25 were made candidate for multiple logistic regression analysis. The relative contribution of each selected variables to the outcome of interest was assessed using multiple logistic regression and variables with P-value less than 0.05 were considered as statically significant.Results: A total of 629 women between 20 and 65 years old were included in the study. More than half (60.9%) of the participants were in the age range of 20-29 years and 8.2% were less than 50 years old. Two hundred eighteen (34.7%) and 338(53.7%) had primary and secondary/ college/university education, respectively. Women who had mentioned BSE as method for early detection of breast problem were 6.359 times (AOR: 6.359, 95% CI :( 3.719, 10.713) more likely to perform BSE than those who say that they don’t know any method. Conclusion The finding of this study showed that women’s practice of breast self-examination is relatively low. Knowledge of BSE, breast feeding up to 24 months, being employed and being student were factors affecting performing breast self-examination. Therefore, educating girls and increasing awareness on electronics media is important.
Comparison of Postoperative Pain between Patients who underwent Primary and Repeated Caesarean Section: A Prospective Cohort Study
Authors: Duan Guangyou , Yang Guiying , Peng Jing , Duan Zhenxin , Li Jie , Tang Xianglong , Li Hong
Published: September 2019

Background: The presences of differences in post-operative pain are unclear between the primipara who underwent a primary cesarean section and multipara who underwent first repeat cesarean section. The study aimed to explore the possible difference in postoperative pain between primipara and multipara. Methods: A prospective cohort study was carried out, and only women who underwent cesarean deliveries under spinal anesthesia were included. Postoperative patient-controlled intravenous analgesia was performed for all subjects with 0.2 mg/kg hydromorphone and 4 mg/kg flurbiprofen, and the pump was programmed as 2.0 mL/h background infusion, and loading dose of 1 mL with a lockout period of 15 min. Postoperative incision and visceral pain intensity were evaluated using visual analogue scale, and inadequate analgesia was defined as visual analogue scale ≥40 during the postoperative 48 hours. Additionally, the patients’ pain statuses on postoperative week 1 and week 4 were also assessed during follow-up via telephone. Results: From January to May 2017, a total of 168 patients (67 primipara and 101 multipara) were included. The relative risk for multipara to experience inadequate analgesia on incision pain was 0.42 (95% CI: 0.25 to 0.74) compared to primipara. In patients under 30 years old, inadequate analgesia on visceral pain in the multipara was higher than that on the primipara (RR, 3.56 [1.05 to 12.04], P=0.025). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multipara and primipara (33.7%vs.40.2%, P=0.381). No difference was found in PCIA consumption between two groups. (111.1 ± 36.0mL vs. 110.9 ± 37.3mL, P=0.979) Additionally, a significantly higher incidence of pain at 4 weeks after the surgery was noted in the primipara compared to the multipara (62.2%vs.37.7%, P=0.011). Conclusions: Multipara who underwent first repeat cesarean section have lower risk to experience inadequate analgesia on incision pain during the first 48 hours after surgery compared to primipara. While multipara under 30 years may be more prone to experiencing postoperative inadequate analgesia on visceral pain.
Views of healthcare professionals on recruiting to a psychosocial randomised controlled trial: a qualitative study.
Authors: Aspden Trefor , Armstrong Megan , Serfaty Marc
Published: September 2019

Background: Randomised controlled trials, and in particular those of psychosocial interventions, often fail to recruit to target, resulting in underpowered trials with poor generalisability of findings. The objectives of this study were to explore the views of healthcare professionals on recruiting to psychosocial research studies, and to explore their views on factors that may hinder or facilitate recruitment.
Methods: We conducted 14 semi-structured interviews, with healthcare professionals who had been involved in recruitment into a randomised controlled trial of a talking therapy for depression in patients with advanced cancer. Interviews were transcribed and analysed using thematic analysis.
Results: Five primary themes were identified, comprised of 13 subthemes. Attitudes towards research were largely positive. Health care professionals identified lack of time and narrow screening criteria as barriers to recruitment, and also noted the tendency to withhold participants from research for reasons other than eligibility (e.g., gatekeeping). The engagement of the study team with the clinical recruitment site, and the frequent presence of a researcher in clinics, were noted as facilitating recruitment.
Conclusions: Healthcare professionals involved in recruiting to trials of psychosocial interventions hold generally positive views of psychosocial research, but report that constraints limit their ability to recruit. The findings from this study can inform how best to design trials, and in particular trials of psychosocial interventions, and train health care professionals for the study, to maximise recruitment.
Trial registration: Controlled Trials ISRCTN07622709, registered 15 July 2011
El uso de drogas en escolares de Ica: Una explicación desde la familia y el entorno social
Authors: .B Giménez , Guevara Roger , Pargas Antonio
Published: September 2019

El objetivo de este estudio consistió en identificar los factores familiares y socio-demográficos asociados al consumo de drogas lícitas e ilícitas en escolares de una institución escolar de la ciudad de Ica, distrito de La Tinguiña, departamento de Ica, Perú. La población en estudio estuvo integrada por 980 escolares, y la muestra se determinó en 416 adolescentes escolares, entre 11 y 18 años, de ambos sexos. La prevalencia de consumo de drogas lícitas se ubicó en 31,2%, y las variables asociadas fueron: la condición laboral y la estructura familiar; mientras que para el consumo de drogas ilícitas la prevalencia fue de 12,2% y las variables asociadas fueron la función familiar y la educación en valores.
Hallazgos clínicos en perros (Canis familiaris) infectados con Ehrlichia canis
Authors: Shiroma Patricia , Becerra Delzy
Published: September 2019

La investigación tuvo como objetivo identificar los hallazgos clínicos en perros infectados con Ehrlichia canis. Se evaluaron 35 caninos procedentes de una campaña de descarte Ehrlichia canis realizada en el distrito de San Juan de Lurigancho, durante los meses de setiembre de 2018 a enero del 2019. Las muestras de sangre obtenidas mediante venopunción fueron recolectadas en tubos con EDTA – k3.El análisis serológico de Ehrlichia canis se realizó con el inmunoensayo cromatográfico y la medición de valor de hemoglobina con un hemoglobinómetro portátil. Los resultados arrojaron que el 85,7% de los canes compatibles a Ehrlichia canis fueron positivos al inmunoensayo cromatográfico. El 53,30 % era macho y el 43,3% estaban en el rango de edad < 1 año. Asimismo, el 86,7 de los canes tenían un valor de hemoglobina bajo. La exploración física, anamnesis y las pruebas complementarias son necesarias para el confirmar el diagnóstico de la enfermedad.
Experimental setup for unbalance fault detection and vibration analysis in a cardan shaft (Part B)
Authors: Tchomeni Bernard Xavier , Alugongo Alfayo Anyika , Masu Leonard
Published: September 2019

This paper experiments a vibration measurement on a twin-rotor connected by a Hooke’s joints. An experimental set-up for vibration analysis and unbalance fault detection in rotating machinery has been conducted to reveal the unbalance effect in signal transmission of the interconnected shaft through Hooke’s joint. Vibrations signals were measured and analysed using the Fast Fourier Transform (FFT), orbit patterns and time displacement of each rotor centre, to extract the signature of the unbalance fault. The results indicate the accuracy of the discussed approach for the twin-rotor unbalances diagnosis in an interconnected shafts system through a Hooke’s joint.
Fracture strength estimation of L3-L4 intervertebral disc using FEA
Authors: S I Raj Arjun , C V Chandrashekara , Goplani Parth
Published: September 2019

Mechanical stress and fracture analysis of the human lumbar intervertebral discs are important in assessing disorders related to lower back pain and ageing. Finite element modelling and simulation approaches assist in easier prediction of the disc behaviour under different load conditions. The causes of mechanical failure and morphological changes still remain partially speculative. The present study addresses the issue by developing a finite element model of an L3-L4 lumbar intervertebral disc subjected to different axial compressive loadings. The morphological deformations and stress concentration regions within the disc are analyzed and reported. A mathematical relation is established to estimate the breaking strength of an L3-L4 intervertebral disc, thus indicating the risk of disc failure based on the applied load.
Transmission of vibrations from the ground to the foundation from the movement of passenger trains
Authors: Pachla Filip
Published: September 2019

The article presents the results of vibration measurements from passenger train journeys from the ground to the building foundation. The vibration acceleration courses from the Pendolino passenger train were used for the analysis. The measurements were carried out in a single-family brick building at the existing railway line. The measurement results can be used in the future to analyze buildings located at railway lines where passenger traffic takes place. The results of the analyzes can also be useful in assessing the impact of vibrations from the railway line on people staying in buildings.