bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma Macrophage Inhibitory Cytokine-1 as a Complement of Epstein-Barr Virus Related Markers in Identifying Nasopharyngeal Carcinoma
Authors: Xing Shan , Li Huilan , Pi Yingqi , Zeng Tao , Huang Qi , Ou Guoping , Xue Ning
Published: October 2020

Background:

We evaluated the diagnostic value of plasma Macrophage inhibitory cytokine-1 (MIC-1) in distinguishing patients with nasopharyngeal carcinoma (NPC) and explored its complementary role with widely used Epstein-Barr virus (EBV) related markers, EBV capsid antigen-specific IgA (VCA-IgA) and EBV copy number.

Methods:

ELISA was used to analyze the plasma MIC-1 levels in 190 NPC patients, 72 VCA-IgA-positive healthy donors (VP), and 219 normal subjects with negative VCA-IgA (VN). 10 pairs of plasma samples before and after radiotherapy were also included.

Results:

The plasma MIC-1 levels were significantly higher in NPC patients (Median: 678.39 ng/mL) than those in VN and VP (310.29 and 294.59, p < 0.001). Receiver operating characteristic (ROC) curves of the MIC-1 concentrations revealed that the area under the ROC curve (AUC) was 0.790 (95% confidence interval [CI]: 0.748-0.832), with a sensitivity of 63.7%, and a specificity of 85.9% respectively, for distinguishing NPC patients from the healthy donors. Similarly, between NPC and VP, ROC was 0.796 (0.738-0.853) with sensitivity of 63.7%, and specificity of 88.9%. In addition, between NPC and VN, ROC was 0.788(0.744-0.832) with sensitivity of 63.7%, and specificity of 84.9%. Further, we found that MIC-1 could complement VCA-IgA and EBV DNA markers, with a negative rate of 88.9% in VCA-IgA-positive healthy controls, and a positive rate of 59.0% in EBV DNA negative NPC patients, respectively. Also, the MIC-1 plasma concentration dropped significantly after radiotherapy ( p = 0.027).

Conclusions:

MIC-1 can complement VCA-IgA titers and EBV DNA copy number tests in NPC detection, improve identification of EBV DNA-negative NPC patients, and distinguish NPC from VCA -IgA positive healthy controls.
Adaptations and Safety Modifications to Perform Safe Minimal Access Surgery (Minimally Invasive Surgery: Laparoscopy and Robotic) during the COVID-19 Pandemic
Authors: Somashekhar SP , Acharya Rudra , Manjiri S , Talwar Sumit , Ashwin KR , Rohit Kumar C
Published: October 2020

It is inevitable that some patients with suspected or confirmed COVID-19 may require urgent surgical procedures. The objective of this review was to discuss the modifications required in the operating room during COVID-19 times for minimal access, laparoscopy, and robotic surgery, especially with regard to minimally invasive surgical instruments, buffalo filter, trocars with smoke evacuator, and special personal protection equipment. We have discussed the safety measures to be followed for the suspected or confirmed COVID-19 patient. In addition to surgical patients, health care workers should also protect themselves by following the guidelines and recommendations while treating these patients. Although there is little evidence of viral transmission through laparoscopic or open approaches, we recommend modifications to surgical practice such as the use of safe smoke evacuation and minimizing energy device use to reduce the risk of exposure to aerosolized particles to the health care team. Therefore, hospitals must follow specific protocols and arrange suitable training of the health care workers. Following well-established plans to accomplish un-deferrable surgeries in COVID-19–positive patients is strongly recommended.
A Simple Brochure Improves Disposal of Unused Opioids: An Observational Cross-Sectional Study
Authors: Bettlach Carrie L. Roth , Hasak Jessica M. , Santosa Katherine B. , Larson Ellen L. , Tung Thomas H. , Fox Ida K. , Moore Amy M. , Mackinnon Susan E.
Published: October 2020

Background

We evaluated the effectiveness of a simple, low-cost educational brochure in improving disposal rates of unused opioids after outpatient upper extremity surgery.

Methods

This cross-sectional study enrolled eligible adult patients from a peripheral nerve clinic between November 2017 and September 2018. Patients either received or did not receive the educational brochure, which outlined a simple method to dispose of unused opioids and completed a survey at 2 weeks after surgery. We compared the proportion of patients who disposed of unused opioids after surgery between the group that had received the brochure and the group that had not. Categorical data were analyzed with χ2 test, proportions data with binomial tests, and numerical data with Mann-Whitney U test, all with a significance level of P < .05.

Results

There were 339 survey respondents. Nineteen patients who did not meet inclusion criteria were excluded. Of the 320 remaining patients, 139 received the brochure and 181 did not. An additional 55 patients were excluded due to preoperative opioid use. Overall, 35.3% of recipients and 38.3% of those who did not receive the brochure used all of their prescribed opioid medication ( P = .625; confidence interval = −14.6%-8.8%). Among patients with unused opioid medication, a significantly higher proportion of brochure recipients disposed of the medicine compared with those who did not receive the brochure (46.7% vs 19.6%, P < .001).

Conclusions

Distribution of an educational brochure significantly improved disposal of unused opioids after surgery. This easily implemented intervention can improve disposal of unused opioids and ultimately decrease excess opioids available for diverted use in the community.
Pedagogical leadership and children’s well-being in Finnish early education
Authors: Fonsén Elina , Lahtinen Leena , Sillman Mari , Reunamo Jyrki
Published: October 2020

In this paper, we present research that focuses on pedagogical leadership that is evaluated by the staff in the early education unit. The evaluations relate to the observed indicators of the well-being of children and leadership evaluations conducted by the early education centre directors. The methods include systematic observation of children, educators’ evaluation of leadership and directors’ evaluation of their leadership. The measurements are independent of each other. The data were collected between 2017 and 2019 in Finnish early education units. The results indicate the connection between the pedagogical leadership of director and observed activities of children, including involved learning, positive emotion, physical activity and participation. The connection between pedagogical leadership evaluated by the staff was also connected with leadership evaluated by the director, highlighting the need for the director to focus on pedagogical leadership and staff involvement. The results provide a perspective to help the director to focus on the main task of early education, the well-being of the children.
What is a minor international theory? On the limits of ‘Critical International Relations’
Authors: Michelsen Nicholas
Published: October 2020

This article argues that ‘Critical International Relations’, often counterpoised to ‘mainstream IR’, has come to function as a major theoretical category in its own right. It argues that critique involves ‘minor theorising’, defined as the practice of disturbing settled theoretical assumptions in the discipline. The article examines the role and significance of ‘minor theories’ in the context of ongoing debates about Critical IR. It argues that critique is defined by context, and is politically and ethically ambiguous. The article concludes that the scope for critique could be advanced if the terms ‘Critical IR’ and ‘Critical IR Scholar’ are dropped from scholarly parlance.
COVID-19: disease of global capitalism excursions into spatial epidemiology
Authors: Peet Eric R. , Peet Richard
Published: October 2020

COVID-19 is not deadly in terms of its mortality rate—3.1% in the US. And almost as many people die because of wrong medication or hospital errors. It is deadly in terms of the ease and rapidity with which it spreads—through droplets of spit. And when economies and societies were local and regional in scale, spit did not travel far. But with globalization, especially under finance capitalism, spit travels far, as its carriers move freely—from Wuhan to wherever in a week. COVID-19 is a disease of globalization. It needs to be countered by instantaneous intervention by the WHO and by National Health Services.
The Effect of Body Mass Index and Metformin on Matrix Gene Expression in Arthritic Primary Human Chondrocytes
Authors: Schadler Paul , Lohberger Birgit , Stündl Nicole , Stradner Martin Helmut , Glänzer Dietmar , Sadoghi Patrick , Leithner Andreas , Steinecker-Frohnwieser Bibiane
Published: October 2020

Objective

Obesity is a known risk factor for knee osteoarthritis (OA). Diabetes has been associated with progression of OA and metformin is the first-line treatment in type 2 diabetes. The effect of the body mass index (BMI) and metformin on the expression of certain matrix genes in human chondrocytes is unclear. The purpose of this study was to investigate the effect of BMI and metformin on the expression of matrix genes in primary human chondrocytes.

Design

Adult female patients undergoing knee arthroplasty for end-stage OA were enrolled. Primary chondrocytes were cultivated and stimulated with metformin. Matrix gene expression was analyzed using polymerase chain reaction. Clinical data were used in multivariable regression models to assess the influence of BMI and metformin stimulation on gene expression.

Results

A total of 14 patients were analyzed. BMI was a predictor of increased expression in ADAMTS5 (β = −0.11, P = 0.03). Metformin slightly reduced expression in ADAMTS5 (β = 0.34, P = 0.04), HIF-1a (β = 0.39, P = 0.04), IL4 (β = 0.30, P = 0.02), MMP1 (β = 0.47, P < 0.01), and SOX9 (β = 0.37, P = 0.03). The hip-knee-ankle angle and proton pump inhibitors (PPIs) intake were associated with reduced SOX9 expression (β = 0.23, P < 0.01; β = 2.39, P < 0.01). Higher C-reactive protein (CRP) levels were associated with increased MMP1 expression (β = −0.16, P = 0.02).

Conclusion

We found that BMI exerts a destructive effect via induction of ADAMTS5. Metformin reduced the expression of catabolic genes ADAMTS5 and MMP1 and might play a role in disease prevention. Limb malalignment and PPI intake was associated with a reduced expression of SOX9, and higher CRP levels correlated with increased MMP1 expression, indicating a destructive process.
Balloon atrial septostomy as initial therapy in pediatric pulmonary hypertension
Authors: Critser Paul J. , Evers Patrick D. , McGovern Eimear , Cash Michelle , Hirsch Russel
Published: October 2020

Balloon atrial septostomy is a palliative procedure currently used to bridge medically refractory pulmonary hypertension patients to lung transplantation. In the current report, we present balloon atrial septostomy as an initial therapy for high‐risk pediatric pulmonary hypertension patients at our institution. Nineteen patients with median age of 4.3 years (range 0.1–14.3 years) underwent balloon atrial septostomy during initial admission for pulmonary hypertension. There were no procedural complications or deaths within 24 h of balloon atrial septostomy. Patients were followed for a median of 2.6 years (interquartile range 1.0–4.8 years). Three (16%) patients died, 3 (16%) underwent lung transplantation, and 1 (5%) underwent reverse Potts shunt. Transplant‐free survival at 30 days, 1 year, and 3 years was 84%, 76%, and 67% respectively. This single‐center experience suggests early‐BAS in addition to pharmacotherapy is safe and warrants consideration in high‐risk pediatric pulmonary hypertension patients.
Prioritisation of catheterised patients for elective bladder outflow obstruction surgery in the current coronavirus disease 2019 era to reduce catheter-associated morbidity
Authors: Lam Angela Kit Ying , Wong Kathie , Nitkunan Tharani
Published: October 2020

Objectives:

This study aimed to audit the waiting times for a transurethral resection of prostate (TURP) at our institution, and to evaluate the extent of catheter-associated morbidity in this population.

Methods:

This was a retrospective closed-loop audit, with cycle one between 1 January 2018 and 31 December 2018 and cycle two between 1 October 2019 and 29 February 2020. Data collected included patient demographics, catheter status, catheter-associated presentations to accident and emergency (A&E), admissions and waiting times for TURP. The waiting-list form now has a catheter box, and a goal of 30 days from waitlisting to operation was set for those catheterised.

Results:

In cycle 1, 36% of the 181 patients were catheterised, and waited a median of 119 days (interquartile range (IQR) 59–163 days) for their TURP, while those not catheterised waited a median of 118 days (IQR 57.75–188.25 days). Catheterised patients presented to A&E 93 times, resulting in 13 admissions, compared to two presentations and zero admissions for those not catheterised. The median time from catheter insertion to first A&E attendance was 20 days (IQR 2–101 days). In cycle 2, 33% of the 55 patients were catheterised, with the median waiting-list time falling to 32 days (IQR 22–46 days) in those catheterised and 33 days (IQR 20–49 days) in those not catheterised. All 11 A&E attendances were from catheterised patients, with no admissions. The median time from insertion to first A&E attendance was nine days (IQR 4–40 days). Eighty-eight per cent of the waiting-list forms had appropriately ticked the catheter box.

Conclusion:

Our study shows that catheterised patients awaiting a TURP are more likely to have complications necessitating A&E attendance. Prioritisation of these patients on the waiting list for bladder outflow obstruction surgery may help to reduce catheter-associated morbidity.

Level of evidence:

Level 2c.
BMI, Body Perception, and Approach to Eating and Diet in Adolescent Girls
Authors: Sadowska Joanna , Dziaduch Izabela , Bruszkowska Magda , Ziółkowska Karolina
Published: October 2020

The aim of this study was to assess the effect of weight status on body perception and satisfaction, occurrence of Anorexia Readiness Syndrome (ARS), and dietary behaviors in adolescent girls. The study was conducted among 516 girls aged 14 to 16 living in Szczecin (Poland). The ARS Diagnosis Questionnaire designed by Ziółkowska and the author’s own questionnaire about self-perception of body were used, and anthropometric assessment was performed. The weight status significantly affected weight status perception, body satisfaction, and dietary behaviors. The girls with a body mass index (BMI) > 50th percentile more often were dissatisfied with their bodies and more often showed at least a medium ARS level. The girls with a BMI ≤ 50th percentile more often overestimated their body weight, and transferred the feeling of being unattractive to their faces. Results of this study demonstrate the importance of education for adolescent girls to help realistically assess body size and promote healthy bodies and eating behaviors, regardless of the weight status.
Video-Based Intervention to Improve Storytelling Ability in Job Interviews for College Students With Autism
Authors: Munandar Vidya D. , Bross Leslie A. , Zimmerman Kathleen N. , Morningstar Mary E.
Published: October 2020

Job seekers with autism will likely benefit from explicit instruction in job interviewing skills given their social communication support needs. The purpose of this study was to examine the effects of a video-based intervention (VBI) to increase storytelling ability in responding to Patterned Behavior Description Interview (PBDI) questions in mock job interviews for college students with autism. This type of question is increasingly used in job interviews as a tool to select and hire candidates. A concurrent multiple-probe across participants design was used for four college students with autism (ages 19–38 years). Results indicated a functional relation between VBI and storytelling abilities was present for all participants. Implications for practice and research related to enhancing the job interviewing skills of college students with autism are discussed.
Validation of finger test for necrotising soft tissue infection
Authors: Lau Jimmy KY , Kwok KB , Hung YW , Fan CH
Published: October 2020

Background:

Necrotising soft tissue infection (NSTI) is rare but fatal. Andreasen proposed finger test as an early diagnostic tool to differentiate NSTI from other soft tissue infections. We aim to evaluate the accuracy and reproducibility of the test for the diagnosis of NSTI.

Methods:

Patients who were admitted to our department from 2012 to 2016 with suspicion of NSTI and finger test done were retrospectively reviewed. Finger test was done and interpreted as described by Andreasen. Definitive diagnosis of NSTI was confirmed with surgical and pathological findings.

Results:

Among the 35 patients included in the study, NSTI was confirmed in 10 cases. Finger test had a sensitivity of 100%, a specificity of 80%, positive predictive value of 66.7%, negative predictive value of 100% and an overall accuracy of 85.7%. There was no difference in demographics or comorbidities between NSTI and non-NSTI groups. Surgeons involved had 76.7% agreement and moderate reproducibility (kappa = 0.48) on the diagnostic criteria of finger test.

Conclusion:

A negative finger test was reliable to exclude NSTI and a positive test suggested further surgical exploration. Yet, clinical judgement was still of paramount importance to treat NSTI promptly.
Frontline Nursing Care: The COVID-19 Pandemic and the Brazilian Health System
Authors: Bolina Alisson Fernandes , Bomfim Emiliana , Lopes-Júnior Luís Carlos
Published: October 2020

Emerging and reemerging infectious diseases are constant challenges for global public health. After the World Health Organization declared COVID-19 a pandemic on March 11, 2020, the spread of SARS-CoV-2 has been the focus of attention for scientists, governments and populations worldwide. In Brazil, the first case of COVID-19 was identified on February 26 2020, being the first country in Latin America to have affected patients. Almost four months later, more than one million confirmed cases of COVID-19 have been identified in the country, and the virus has spread across all 27 states and is responsible for at least 48,954 deaths until June 19, 2020. In addition, a global outbreak requires the active participation of the nursing workforce in clinical care, education, and sharing of accurate information of public health and policies. This year is particularly important for Nursing, as 2020 is the international year for Nursing and Midwifery Professionals. Nursing professionals corresponds to more than half of the health workforce in the country, being crucial in implementing public health policies and programs. Nurses and frontline health care workers have a critical role in the COVID-19 prevention and response, not only by providing direct assistance to patients and communities, but also in the implementation of health promotion and prevention strategies. Hence, we provide a reflection on the strengths and weaknesses of how the nursing profession is engaged with the COVID-19 response in Brazil.
Retinoschisis in Coats Disease: Clinical Picture, Therapeutic Considerations, and Management Outcomes
Authors: Scott Nathan L. , Cernichiaro-Espinosa Linda A. , Russell Jonathan F. , Murray Timothy G. , Dubovy Sander R. , Berrocal Audina M.
Published: October 2020

Purpose:

Retinoschisis in inflammatory and exudative retinopathy is a known but rare entity. We describe the presentation and clinical and surgical outcomes of a series of patients with retinoschisis in the setting of Coats disease.

Methods:

This retrospective case series of patients with Coats disease recorded visual acuity and the number and type of treatments (eg, angiography-guided photocoagulation, intravitreal bevacizumab, sub-Tenon triamcinolone, or vitreoretinal surgery).

Results:

Eighteen of 133 patients with Coats disease were diagnosed with retinoschisis by color imaging. All (100%) of the areas of schisis or macrocyst were associated with dense subretinal exudation, whereas only 7 (38.8%) were associated with exudative retinal detachment. Initial best-corrected visual acuity in the schisis cohort was 1.14 ± 1.19 (Snellen equivalent, 20/276) vs 1.42 ± 1.40 (Snellen, 20/526) in those without ( P = .56). Final best-corrected visual acuity was 1.76 ± 1.37 (Snellen, 20/1150) and 1.45 ± 1.44 (Snellen, 20/563), respectively ( P = .43). The mean number of treatments in individuals with schisis was 4.8 ± 2.9 for angiography-guided photocoagulation, 4.5 ± 2.9 for intravitreal bevacizumab, and 1.7±1.2 for sub-Tenon triamcinolone. Intraocular surgery was required in 39% (7 of 18) of patients with schisis vs 22% (25 of 115) for patients without schisis ( P = .14). One eye required enucleation, and histopathology of the schisis pocket was obtained.

Conclusions:

The pathophysiology of retinoschisis in Coats disease is not completely understood. We propose that telangiectatic leakage, hypoxia, and toxicity to the retinal pigment epithelial cells play a role in cavity development, and therefore may represent a clinical feature of advanced or uncontrolled disease.
Enhancing Professional Development for Educators: Adapting Project ECHO From Health Care to Education
Authors: Hardesty Canyon , Moody Eric J. , Kern Shira , Warren Wendy , Cooley Hidecker Mary Jo , Wagner Susan , Arora Sanjeev , Root-Elledge Sandra
Published: October 2020

Adequately prepared educators are critical to the success of children in rural settings, but many educators receive little training on how to support students with disabilities. Professional development for educators is challenging in rural areas due to the lack of opportunities and travel requirements. Project ECHO™ was originally developed to overcome similar challenges facing physicians. The ECHO Model overcomes these challenges by creating a hub and spoke network that connects local providers with experts. These networks meet regularly over teleconferencing technology to conduct a short professional development workshop, followed by a case-study from one of the local sites. We adapted the ECHO Model for use in education and since 2014 implemented four networks: autism, assistive technology, secondary transitions, and behavioral supports. Educators found ECHO highly acceptable and reported improved skills and knowledge. ECHO for Education is effective and has the potential to improve capacity of education systems in rural settings.
Risk factors in multiple myeloma: is it time for a revision?
Authors: Corre Jill , Munshi Nikhil C. , Avet-Loiseau Hervé
Published: October 2020

Although therapeutic strategies have been adapted to age and comorbidities for a long time, almost all multiple myeloma (MM) patients currently receive similar treatment, whatever their disease risk category. However, high-risk MM patients still constitute an unmet medical need and should benefit from the most efficient drug combinations. Herein, we review and discuss how to optimally define risk and why a revision of the current definition is urgently needed.
The impact of training on data from genetically-related lines on the accuracy of genomic predictions for feed efficiency traits in pigs
Authors: Aliakbari Amir , Delpuech Emilie , Labrune Yann , Riquet Juliette , Gilbert Hélène
Published: October 2020

Background

Most genomic predictions use a unique population that is split into a training and a validation set. However, genomic prediction using genetically heterogeneous training sets could provide more flexibility when constructing the training sets in small populations. The aim of our study was to investigate the potential of genomic prediction of feed efficiency related traits using training sets that combine animals from two different, but genetically-related lines. We compared realized prediction accuracy and prediction bias for different training set compositions for five production traits.

Results

Genomic breeding values (GEBV) were predicted using the single-step genomic best linear unbiased prediction method in six scenarios applied iteratively to two genetically-related lines (i.e. 12 scenarios). The objective for all scenarios was to predict GEBV of pigs in the last three generations (~ 400 pigs, G7 to G9) of a given line. For each line, a control scenario was set up with a training set that included only animals from that line (target line). For all traits, adding more animals from the other line to the training set did not increase prediction accuracy compared to the control scenario. A small decrease in prediction accuracies was found for average daily gain, backfat thickness, and daily feed intake as the number of animals from the target line decreased in the training set. Including more animals from the other line did not decrease prediction accuracy for feed conversion ratio and residual feed intake, which were both highly affected by selection within lines. However, prediction biases were systematic for these cases and might be reduced with bivariate analyses.

Conclusions

Our results show that genomic prediction using a training set that includes animals from genetically-related lines can be as accurate as genomic prediction using a training set from the target population. With combined reference sets, accuracy increased for traits that were highly affected by selection. Our results provide insights into the design of reference populations, especially to initiate genomic selection in small-sized lines, for which the number of historical samples is small and that are developed simultaneously. This applies especially to poultry and pig breeding and to other crossbreeding schemes.
Integrated GP care for patients with persistent physical symptoms: feasibility cluster randomised trial
Authors: Patel Meenal , James Kirsty , Moss-Morris Rona , Ashworth Mark , Husain Mujtaba , Hotopf Matthew , David Anthony S. , McCrone Paul , Landau Sabine , Chalder Trudie ,   on behalf of the PRINCE Primary trial team, Ferreira Nicola , Watts Katie , Turner Richard , Carnemolla Alisia , Robertson Jennifer , Patel Shinal , Frank Philipp , Fisher-Smith Paige , Childs Abigale , Mosweu Iris , Willis Claire , Simiao Fabio
Published: October 2020

Background

Patients continue to suffer from medically unexplained symptoms otherwise referred to as persistent physical symptoms (PPS). General practitioners (GPs) play a key role in the management of PPS and require further training. Patients are often frustrated with the care they receive. This study aims to assess the acceptability of an ‘integrated GP care’ approach which consists of offering self-help materials to patients with PPS and offering their GPs training on how to utilise cognitive behavioural skills within their consultations, as well as assessing the feasibility of conducting a future trial in primary care to evaluate its benefit.

Methods

A feasibility cluster randomised controlled trial was conducted in primary care, South London, UK. GP practices (clusters) were randomly allocated to ‘integrated GP care plus treatment as usual’ or ‘treatment as usual’. Patients with PPS were recruited from participating GP practices before randomisation. Feasibility parameters, process variables and potential outcome measures were collected at pre-randomisation and at 12- and 24-weeks post-randomisation at cluster and individual participant level.

Results

Two thousand nine hundred seventy-eight patients were identified from 18 GP practices. Out of the 424 patients who responded with interest in the study, 164 fully met the eligibility criteria. One hundred sixty-one patients provided baseline data before cluster randomisation and therefore were able to participate in the study. Most feasibility parameters indicated that the intervention was acceptable and a future trial feasible. 50 GPs from 8 GP practices (randomised to intervention) attended the offer of training and provided positive feedback. Scores in GP knowledge and confidence increased post-training. Follow-up rate of patients at 24 weeks was 87%. However estimated effect sizes on potential clinical outcomes were small.

Conclusions

It was feasible to identify and recruit patients with PPS. Retention rates of participants up to 24 weeks were high. A wide range of health services were used. The intervention was relatively low cost and low risk. This complex intervention should be further developed to improve patients’/GPs’ utilisation of audio/visual and training resources before proceeding to a full trial evaluation.

Trial registration

NCT02444520 (ClinicalTrials.gov).
Women’s perceptions of COVID-19 and their healthcare experiences: a qualitative thematic analysis of a national survey of pregnant women in the United Kingdom
Authors: Karavadra Babu , Stockl Andrea , Prosser-Snelling Edward , Simpson Paul , Morris Edward
Published: October 2020

Background

The aim of this national survey was to explore pregnant women’s perceptions of COVID-19 and their healthcare experiences.

Methods

Through patient and public involvement, a questionnaire was developed and advertised via the BBC website, Twitter and other online media during May 2020. The findings were analysed by qualitative thematic analysis. Women who are currently pregnant, or who have delivered during the COVID-19 pandemic were invited to partake in a national online survey.

Results

One thousand four hundred fifty-one participants replied to the online questionnaire. Participants provided significant insight into the perceived barriers to seeking healthcare during this pandemic. These include ‘not wanting to bother anyone’, ‘lack of wider support from allied healthcare workers’ and the influence of the media. Other concerns included the use of virtual clinics antenatally and their acceptability to patients, the presence of birthing partners, and the way in which information is communicated about rapidly changing and evolving services. The influence of the media has also had a significant impact on the way women perceive hospital care in light of COVID-19 and for some, this has shaped whether they would seek help.

Conclusions

This is the first ever reported study in the United Kingdom to explore pregnant women’s perceptions of COVID-19 and their subsequent healthcare experiences. It has also provided insight into perceived barriers into seeking care as well as maternal concerns antenatally, intrapartum and postpartum.
Prognosis prediction model based on competing endogenous RNAs for recurrence of colon adenocarcinoma
Authors: Jin Li Peng , Liu Tao , Meng Fan Qi , Tai Jian Dong
Published: October 2020

Background

Colon adenocarcinoma (COAD) patients who develop recurrence have poor prognosis. Our study aimed to establish effective prognosis prediction model based on competing endogenous RNAs (ceRNAs) for recurrence of COAD.

Methods

COAD expression profilings downloaded from The Cancer Genome Atlas (TCGA) were used as training dataset, and expression profilings of GSE29623 retrieved from Gene Expression Omnibus (GEO) were set as validation dataset. Differentially expressed RNAs (DERs) between non-recurrent and recurrent specimens in training dataset were screened, and optimum prognostic signature DERs were revealed to establish prognostic score (PS) model. Kaplan-Meier survival analysis was conducted for PS model, and GEO dataset was used for validation. Prognosis prediction efficiencies were evaluated by area under curve (AUC) and C-index. Meanwhile, ceRNA regulatory network was constructed by using signature mRNAs, lncRNAs and miRNAs.

Results

We identified 562 DERs including 42 lncRNAs, 36 miRNAs, and 484 mRNAs. PS prediction model, consisting of 17 optimum prognostic signature DERs, showed that high risk group had significantly poorer prognosis (5-year AUC = 0.951, C-index = 0.788), which also validated in GSE29623. Prognosis prediction model incorporating multi-RNAs with pathologic distant metastasis (M) and pathologic primary tumor (T) (5-year AUC = 0.969, C-index = 0.812) had better efficiency than clinical prognosis prediction model (5-year AUC = 0.712, C-index = 0.680). In the constructed ceRNA regulatory network, lncRNA NCBP2-AS1 could interact with hsa-miR-34c and hsa-miR-363, and lncRNA LINC00115 could interact with hsa-miR-363 and hsa-miR-4709. SIX4, GRAP, NKAIN4, MMAA, and ERVMER34–1 are regulated by hsa-miR-4709.

Conclusion

Prognosis prediction model incorporating multi-RNAs with pathologic M and pathologic T may have great value in COAD prognosis prediction.
Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study
Authors: Zheng Xiao-Yu , Choy Bonnie Nga Kwan , Zhou Ming-Ming , Shi Cai-Ping , Zhao Zheng-Yan
Published: October 2020

Background

Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of patients. The aim of this study was to evaluate the microbiology of lacrimal sac (LS) in Chinese children with CNLDO in their first year of life.

Methods

Patients with CNLDO between May 1, 2017 and August 31, 2018 at a tertiary care children’s hospital were enrolled. The study recruited infants who received lacrimal probing under 1 year old, and refluxed discharge from LS was collected. Samples were cultured and susceptibility test was performed for positive culture.

Results

Thirty-two patients with CNLDO were included. The ratio of male to female was 23:9. The mean age was 6.7 ± 2.4 (1.7–12) months. Positive cultures was identified in 87.5% of the sample, and presented 38 strains of bacteria. Mixed infection was identified in 10 (31.3%) children. Gram-positive bacteria accounted for 60.5% of all the strains, withStreptococcus(50%) being the most frequent species, whereasHaemophilus(21.1%) andNeisseriae(13.2%) were most common isolates for Gram-negative organisms.Methicillin-resistant Staphylococcus aureus(MRSA) was detected in 2 infants whose symptoms resolved by a routine probing. No difference of bacteriology pattern was detected between patients under 6 months old and those beyond. The pathogens were highly sensitive to chloramphenicol (88%) and levofloxacin (84%), but resistant to erythromycin (40%) and sulfamethoxazole (32%).

Conclusions

Infants with CNLDO under 1 year of age presented predominance ofStreptococcusas Gram-positive organism, andHaemophilusas Gram-negative organism. Levofloxacin was an active topical antibiotic agent with few chance of resistance especially for Chinese children. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments.
Never and under cervical cancer screening in Switzerland and Belgium: trends and inequalities
Authors: Jolidon Vladimir , De Prez Vincent , Willems Barbara , Bracke Piet , Cullati Stéphane , Burton-Jeangros Claudine
Published: October 2020

Background

Research on inequalities in cervical cancer screening (CCS) participation has overlooked the distinction between ‘never-’ and ‘under-screeners’ while different socioeconomic and demographic determinants may underlie ‘non-’ and ‘under-’ screening participation. This study examines socioeconomic and demographic inequalities in never and under CCS participation. We compare cross-national prevalence and trends among these two groups in Switzerland and Belgium, two countries with similar opportunistic CCS strategy but different healthcare systems.

Methods

Data on 38,806 women aged 20–70 from the Swiss Health Interview Survey (1992–2012) and 19,019 women aged 25–64 from the Belgian Health Interview Survey (1997–2013), both population-based cross-sectional nationally representative surveys, was analysed. Weighted adjusted prevalence ratios were estimated with multivariate Poisson regressions.

Results

Over the studied period, never screening prevalence was about 15% in both Switzerland and Belgium and under screening prevalence about 14.0%. Socioeconomic gradients were found among both never- and under-screeners. Higher income women had lower never and under screening prevalence in Switzerland and a similar gradient in education was observed in Belgium. Importantly, distinct socioeconomic and demographic determinants were found to underlie never and under screening participation. Never screening was significantly higher among foreign nationals in both countries and this association was not observed in under screening. Never screening prevalence was lower among older age groups, while under screening increased with older age. Over time, age inequalities diminished among never- and under- screeners in Switzerland while educational inequalities increased among never-screeners in Belgium.

Conclusion

Findings revealed that determinants of screening inequalities differed among never- and under-screeners and hence these should be addressed with different public health strategies. Crucially, socioeconomic and demographic inequalities were more pronounced among never-screeners who appeared to face more structural and persistent inequalities. Differences between the two countries should also be noted. The more liberal-type Swiss healthcare systems appeared to shape income-related screening inequalities, while education appeared to be a stronger determinant of never- and under-screening in Belgium.
Ruptured liver abscess presenting as pneumoperitoneum caused by Klebsiella pneumoniae: a case report
Authors: Pham Van Thuong , Vu Ngoc Son , Nguyen Hoang Ngoc Anh , Hoang Huu Doan , Dinh Duong Tung Anh
Published: October 2020

Background

Spontaneous gas-forming pyogenic liver abscess (GFPLA) is a rare complication with a high fatality rate in spite of aggressive management. Clinical spectrum of GFPLA can mimic hollow viscus perforation as it usually accompanied by pneumoperitoneum and peritonitis. Up to now, GFPLA has not been well studied in Vietnam.

Case presentation

We reported here a case with pneumoperitoneum caused by ruptured liver abscess in a 41-year-old man with a history of treated duodenal ulcer and uncontrolled type II diabetes mellitus. He had an epigastric pain associated with a high fever. Patient was diagnosed peritonitis and pneumoperitoneum presumed to be secondary to perforation of a hollow viscus and subjected to emergency laparotomy. We did not find any gastrointestinal perforation. Surprisingly, we detected a 4 cm × 4 cm pus-containing abscess in the left liver lobe of the liver. The abscess was ruptured. Pus was running into abdominal cavity through one hole. The abscess and abdominal cavities were cleaned up and abscess and abdominal drainages were performed. K. pneumoniae was isolated from culture of the abscess. The histopathological examination of the abscess did not yield any evidence of malignancy. Blood glucose levels were controlled. Antibiotic therapy was used according to antibiogram. A reassessment chest X-ray showed no air-fluid level or subdiaphragmatic air by the hospital day 14. Patient eventually made a full recovery and was discharged home 23 days after the operation.

Conclusions

Ruptured GFPLA is a life-threatening complication. It is usually accompanied by peritonitis and pneumoperitoneum and can imitate hollow viscous perforation. In these cases, CT scan should be performed whenever it is possible to make a correct diagnosis. When the abscess has small size, partial hepatectomy might not be necessary and could be replaced by a careful cleaning and drainage of the abscess. Patient could show a good postoperative recovery following an appropriate antibiotic therapy.
Zonal adjusted PSA density improves prostate cancer detection rates compared with PSA in Taiwanese males with PSA < 20 ng/ml
Authors: Chang Tsung-Hsin , Lin Wun-Rong , Tsai Wei-Kung , Chiang Pai-Kai , Chen Marcelo , Tseng Jen-Shu , Chiu Allen W.
Published: October 2020

Background

The current study aimed to compare the efficacy of transition zone PSA density (TZPSAD) with traditional PSA and PSA density (PSAD), for the diagnosis of prostate cancer (PCa) in Taiwanese males.

Methods

Men with PSA between 4.0 and 20.0 ng/ml who underwent a transrectal ultrasound (TRUS) guided prostate biopsy between the studied period were retrospectively identified. The demographic data, PSAD and TZPSAD were calculated in all patients. Receiver operating characteristic (ROC) curves were used to analyze the accuracy of a positive PCa diagnosis.

Results

The area under the ROC (AUC) was 0.615, 0.748 and 0.746 for PSA, PSAD and TZPSAD, respectively. The best cut-off of value for TZPSAD in predicting PCa in men with a PSA of 4.0–10.0 ng/ml was 0.367 ng/ml/ml with a sensitivity of 50% and a specificity of 77.5%. In men with a PSA of 10.1–20.0 ng/ml, the best cut-off value was 0.454 ng/ml, with a sensitivity of 74.8% and specificity of 70.9%.

Conclusion

The use of TZPSAD can improve the efficiency and specificity of PSA for the diagnosis of PCa in Taiwanese men with PSA 4.0–20.0 ng/ml. TZPSAD efficiency was similar to PSAD but TZPSAD had better cancer specificity.
Piperine ameliorates insulin resistance via inhibiting metabolic inflammation in monosodium glutamate-treated obese mice
Authors: Liu Chaolong , Yuan Yanting , Zhou Ji , Hu Ruixin , Ji Lixia , Jiang Guohui
Published: October 2020

Background

Metabolic inflammation is an essential event in obesity-induced diabetes and insulin resistance. In obesity, an increasing number of macrophages recruited into visceral adipose tissues undergo significant M1-like polarization, secreting variable amounts of pro-inflammatory cytokines and causing insulin resistance. Piperine has excellent anti-inflammatory activities and may be used in the treatment of a variety of inflammatory diseases. In this study, we investigated the effect of piperine on adipose tissue inflammation and insulin resistance in obese mice.

Methods

Newborn mice were subcutaneously (s.c.) injected with monosodium glutamate (MSG) to establish a diabetes model. After 24 weeks, the MSG obese mice were divided into three groups and treated with piperine (40 mg/kg/day), metformin (150 mg/kg/day) and vehicle for 10 successive weeks, respectively.

Results

The obesity model was successfully established, as the body weight, insulin resistance, fasting blood glucose (FBG) and dyslipidemia were significantly increased. The 10-week administration of piperine to the obese mice not only significantly decreased the elevated FBG (Model: 6.45 ± 0.41 mM; Piperine: 4.72 ± 0.44 mM, p < 0.01), serum TC (Model: 5.66 ± 0.66 mM; Piperine: 3.55 ± 0.30 mM, p < 0.01) and TG (Model: 1.41 ± 0.08 mM; Piperine: 0.94 ± 0.05 mM, p < 0.001), but also enhanced the glucose infusion rate in the hyperglycemic clamp experiment. Meanwhile, piperine improved glucose intolerance and insulin resistance in MSG obese mice. Piperine markedly decreased the total and differential white blood cell (WBC) count, the serum levels of lipopolysaccharide (LPS) and pro-inflammatory cytokines such as galectin-3 (Gal-3) and interleukin-1β (IL-1β). Furthermore, piperine clearly down-regulated the mRNA levels of pro-inflammatory cytokines and the protein levels of M1-like polarization marker CD11c and Gal-3 in adipose tissues. The in vitro study showed that piperine inhibited LPS-stimulated polarization of RAW 264.7 cells toward the M1 phenotype.

Conclusions

Piperine served as an immunomodulator for the treatment of obesity-related diabetes through its anti-inflammatory effects, which might be achieved by inhibiting macrophages M1 polarization in adipose tissues.
Individual mandibular movement registration and reproduction using an optoeletronic jaw movement analyzer and a dedicated robot: a dental technique
Authors: Carossa Massimo , Cavagnetto Davide , Ceruti Paola , Mussano Federico , Carossa Stefano
Published: October 2020

Background

Fully adjustable articulators and pantographs record and reproduce individual mandibular movements. Although these instruments are accurate, they are operator-dependant and time-consuming. Pantographic recording is affected by inter and intra operator variability in the individuation of clinical reference points and afterwards in reading pantographic recording themselves. Finally only border movements can be reproduced.

Methods

Bionic Jaw Motion system is based on two components: a jaw movement analyzer and a robotic device that accurately reproduces recorded movements. The jaw movement analyzer uses an optoelectronic motion system technology made of a high frequency filming camera that acquires 140frames per second and a custom designed software that recognizes and determines the relative distance at each point in time of markers with known geometries connected to each jaw. Circumferential modified retainers connect markers and do not cover any occlusal surfaces neither obstruct occlusion. The recording process takes 5 to 10 s. Mandibular movement performance requires six degrees of freedom of movement, 3 rotations and 3 translations. Other robots are based on the so-called delta mechanics that use several parallel effectors to perform desired movements in order to decompose a complex trajectory into multiple more simple linear movements. However, each parallel effector introduces mechanical inter-component tolerances and mathematical transformations that are required to transform a recorded movement into the combination of movements to be performed by each effector. Bionic Jaw Motion Robot works differently, owing to three motors that perform translational movements and three other motors that perform rotations as a gyroscope. This configuration requires less mechanical components thus reducing mechanical tolerances and production costs. Both the jaw movement analyzer and the robot quantify the movement of the mandible as a rigid body with six degrees of freedom. This represents an additional advantage as no mathematical transformation is needed for the robot to reproduce recorded movements.

Results

Based on the described procedure, Bionic Jaw Motion provide accurate recording and reproduction of maxillomandibular relation in static and dynamic conditions.

Conclusion

This robotic system represents an important advancement compared to available analogical and digital alternatives both in clinical and research contexts for cost reduction, precision and time saving opportunities.
Newly graduated dentists’ knowledge of temporomandibular disorders compared to specialists in Saudi Arabia
Authors: Al-Huraishi Haila A. , Meisha Dalia E. , Algheriri Wafa A. , Alasmari Wejdan F. , Alsuhaim Abdulmalik S. , Al-Khotani Amal A.
Published: October 2020

Background

General dentists are often the first healthcare professionals to see patients with orofacial pain (OFP). OFP conditions associated with the temporomandibular joint are often confused with dentoalveolar disorders, which leads to mismanagement. The objective of this study was to evaluate the level of knowledge of temporomandibular disorders (TMD) among newly graduated dentists compared to OFP specialists in Saudi Arabia.

Methods

This was a descriptive cross-sectional study utilizing an anonymous validated questionnaire assessing professional knowledge regarding TMDs in newly qualified dentists and OFP specialists. The questionnaire interrogated four domains including chronic pain/pain behavior, etiology, diagnosis/classification, and treatment/prognosis. OFP specialists were used as the reference group.

Results

A total of 393 dentists participated, a response rate of 67.6% in newly graduated dentists and 77.3% in OFP specialists. The degree of agreement between newly graduated general dentists and OFP specialists was highest for the “chronic pain and pain behavior” domain. The consensus among specialists was highest for the “treatment and prognosis” domain and the least for the “chronic pain and pain behavior” domain.

Conclusion

Newly graduated general dentists have limited knowledge of TMD in almost all domains compared to specialists. Given that a lack of knowledge of TMD can lead to clinical mismanagement, dental school curricula must address this important knowledge gap.