bluuebunny/crossref_metadata_2025 huggingface dataset:
A mobile phone-based multimedia intervention to support maternal health is acceptable and feasible among illiterate pregnant women in Uganda: Qualitative findings from a pilot randomized controlled trial
Authors: Musiimenta Angella , Tumuhimbise Wilson , Pinkwart Niels , Katusiime Jane , Mugyenyi Godfrey , Atukunda Esther C
Published: February 2021

Background

Uganda’s maternal mortality rate remains unacceptably high. Mobile phones can potentially provide affordable means of accessing maternal health services even among the otherwise hard-to-reach populations. Evidence about the acceptability and feasibility of mobile phone-based interventions targeting illiterate women, however, is limited.

Objective

To assess the acceptability and feasibility of a mobile phone-based multimedia application (MatHealth app) to support maternal health amongst illiterate pregnant women in rural southwestern Uganda.

Methods

80 pregnant women initiating antenatal care from Mbarara regional referral hospital were enrolled in a pilot randomized controlled trial and followed until six weeks after delivery. The 40 women in the intervention group received a MatHealth app composed of educational videos/audios, clinic appointment reminders, and the calling function. Qualitative interviews on acceptability of this technology were carried out with 30 of the intervention participants. An inductive, content analytic approach was used to analyze qualitative data. Quantitative feasibility data were recorded and summarized descriptively.

Results

Participants reported that the intervention is acceptable as it enabled them adopt good maternal health practices, enhanced social support from spouses, provided clinic appointment reminders, and facilitated communication with healthcare providers. Challenges included: phone sharing (74%), accidental deletion of the application 15 (43%), lack of electricity 15 (43%), and inability to set up a reminder function 20 (57%).

Conclusion

The MatHealth app is an acceptable and feasible intervention among illiterate women, in a resource limited setting. Future efforts should focus on optimized application design, spouse orientation, and incorporating economic support to overcome the challenges we encountered.
MyHealthPortal – A web-based e-Healthcare web portal for out-of-hospital patient care
Authors: Tanbeer Syed K , Sykes Edward R
Published: February 2021

Current e-Health portal platforms provide support for patients only if they have previously registered and received service from a healthcare facility (e.g., hospital, healthcare clinic, etc.). These portals are usually connected to a central EMR/EHR system linked to a central system. Furthermore, these portals are restrictive in that they are only accessible by these patients at the exclusion of parents, relatives and others that participate in providing care to the patient. Further complications include the increasing demand from our healthcare systems for patients to receive more off-site, non-primary, in-homecare, and/or specialized healthcare services at home (e.g., therapy, nursing, personal support, etc.). Lastly, an increasing number of people would like to have more autonomy over their health in terms of increased access to their own medical records and the services they receive. In this work, we addressed these limitations by creating MyHealthPortal – a patient portal aimed at non-primary care, in-homecare, and/or special healthcare for patients. MyHealthPortal can assist homecare and clinic-based healthcare services along with the benefits of existing portals (e.g., online appointment scheduling, monitoring, and information sharing). MyHealthPortal is secure, robust, flexible and user-friendly. We developed it in partnership with our industry partner, Closing the Gap Healthcare. Closing the Gap is a prominent homecare and clinic-based healthcare service provider that became the first homecare agency to score 100% on standards from accreditation Canada and was awarded the exemplary standing. In this paper we present MyHealthPortal, the architectural framework that we designed and developed to support the system, and the results of a usability study conducted from real field studies. Our system was tested in a variety of conditions and achieved SUS usability scores of 92.5% (high).
Neurological Complications of Acute Rhinosinusitis: Meningitis
Authors: Bennett Stephen , Meghji Sheneen , Syeda Farahnaz , Bhat Nazir
Published: February 2021

Meningitis remains a rare but potentially life-threatening intracranial complication of acute rhinosinusitis.

We describe a case of a 62-year-old man with a background of chronic rhinosinusitis who presented to hospital with confusion, fever and bilateral green purulent rhinorrhoea. After immediate sepsis management, urgent contrast-enhanced computed tomography head revealed opacification of all paranasal sinuses and bony erosion of the lateral walls of both ethmoid sinuses. He was treated with intravenous antibiotics, topical nasal steroids, decongestants and irrigation. Following a turbid lumbar puncture and multidisciplinary discussion, he was admitted to the critical care unit and later intubated due to further neurological deterioration. After 13 days admission and rehabilitation in the community he made a good recovery.

This case highlights the importance of timely diagnosis and appropriate management of acute rhinosinusitis and awareness of the possible complications. Joint care with physicians and intensivists is crucial in the management of these sick patients.
Comparison study of clinical outcomes and sagittal alignment improvement between anterior and posterior fusion techniques for multilevel cervical spondylotic myelopathy
Authors: Liu Hui , Li Xiang , Wang Jianru , Li Zemin , Li Zihao , Chen Siwen , Wang Hua , Zheng Zhaomin
Published: February 2021

Purpose:

To compare the sagittal alignment of different surgical approaches in patients with multiple levels cervical spondylotic myelopathy and explore the relationship between the cervical sagittal alignment and patient’s health relative quality of life.

Method:

A total of 97 multiple levels cervical spondylotic myelopathy patients who underwent surgery from January 2013 to January 2019 were collected in this study. Patients were divided into three groups: anterior cervical discectomy with fusion, anterior cervical corpectomy with fusion and laminectomy with fusion groups. Clinical outcomes and sagittal alignment parameters were compared preoperative and postoperative.

Results:

There were no significant differences in the average age and sex ratio among the groups. Sagittal parameters correlated to health relative quality of life were C7 slope, occipito-C2 angle, external auditory meatus tilt and cervical sagittal vertical axis. Both anterior cervical discectomy with fusion and anterior cervical corpectomy with fusion groups exhibited better sagittal alignment and clinical outcomes improvement postoperatively. Anterior cervical discectomy with fusion provided better clinical outcomes and the better improvement of cervical lordosis, C7 slope, occipito-C2 angle and cervical sagittal vertical axis compared with patients with Laminectomy with fusion.

Conclusion:

C7 slope, occipito-C2 angle, external auditory meatus tilt and cervical sagittal vertical axis are the most important cervical sagittal parameters correlated to clinical outcomes in patients with multilevels cervical spondylotic myelopathy; anterior cervical discectomy with fusion and anterior cervical corpectomy with fusion provides more efficient to restoration of cervical sagittal alignment.
Clinical analyses of ultrasound-guided nerve block in lower-extremity surgery: A retrospective study
Authors: Kang Chan , Hwang Deuk-Soo , Song Jae-Hwang , Lee Gi-Soo , Lee Jeong-Kil , Hwang Sung-Jin , Jeon Je-Hyung , An Byung-Kuk
Published: February 2021

Purpose:

The purpose of this study is to examine the clinical effects and results of lower-extremity surgery under ultrasound-guided nerve block; time required for nerve block, anesthesia onset time, duration of anesthesia, duration of analgesia, tolerable tourniquet time, visual analog scale (VAS) satisfaction score, and anesthetic-related complications.

Methods:

A total of 3312 cases (2597 patients) from January 2010 to April 2015 were analyzed retrospectively. A senior author performed ultrasound-guided nerve block of the lateral femoral cutaneous nerve (LFCN, 630 cases), femoral nerve (FN, 2503 cases), obturator nerve (ON, 366 cases), sciatic nerve (SN, 3271 cases), or posterior femoral cutaneous nerve (PFCN, 222 cases) depending on the type of surgery. Time required for nerve block, anesthesia onset time, duration of anesthesia, duration of analgesia, tolerable tourniquet time, VAS satisfaction score, and anesthetic-related complications were analyzed.

Results:

The mean times required were 1.1 min for SN block, 2.5 min for FN/SN block (1762 cases), and 4.8 min for FN/SN/LFCN/ON block. The mean anesthesia onset time was 48 min. The mean durations of anesthesia were 4.5 h for FN dermatome and 5.6 h for SN dermatome. The mean duration of analgesia was 11.5 h. The mean tolerable tourniquet times after were 35, 51, and 84 min after SN block, FN/SN block, and FN/SN/LFCN/ON block, respectively. The mean VAS satisfaction score was 9.3. There were no anesthetic-related complications, such as infection, hematoma, paralysis, or nerve irritation.

Conclusion:

Selective block of the LFCN, FN, ON, SN, and PFCN based on the locations of lesions and type of surgery showed favorable clinical results with high efficacy. Ultrasound-guided nerve block may be a good option for anesthesia and analgesia in lower-extremity surgery.
Risk factors of the poor long-term prognosis of osteoporotic vertebral fractures: A multicenter cohort study
Authors: Takahashi Shinji , Terai Hidetomi , Hoshino Masatoshi , Tsujio Tadao , Suzuki Akinobu , Namikawa Takashi , Kato Minori , Matsumura Akira , Takayama Kazushi , Toyoda Hiromitsu , Tamai Koji , Ohyama Shoichiro , Hori Yusuke , Yabu Akito , Nakamura Hiroaki
Published: February 2021

Introduction:

The presence of existing osteoporotic vertebral fracture (OVF) increases the mortality risk. However, the influence of the characteristics of OVF is unclear. This study aimed to investigate the influence of new OVF on patients’ long-term prognosis using our past cohort study.

Method:

This is an extension study of our cohort study carried out between 2005 and 2007. In the present extension study, of 420 patients, 197 whose contact information was available at the 6-month follow-up were included in the telephone survey in 2018. Five patients refused to participate in the survey, and 82 could not be contacted. Eventually, 110 patients were enrolled. Of the Demographic data, radiological findings, medical history, and clinical outcome were investigated at injury onset and at the 6-month follow-up. A proportional hazard model was used to investigate the risk factors for mortality.

Results:

Among 110 patients, 33 died. Male sex and low body mass index (BMI <18.5 kg/m2) were significant risk factors for mortality [hazard ratio (HR) = 6.40, 1.01–40.50; 5.24, 1.44–19.04, respectively]. The history of stroke and liver disease increased the risk of mortality (HR = 13.37, 1.93–92.7; 6.62, 1.15–38.14, respectively). As regards radiological findings, local kyphosis progression per 1° or ≥7° were significant risk factors of mortality (HR = 1.20, 1.06–1.36; 5.38, 1.81–16.03, respectively).

Conclusions:

A telephone survey at 12 years after the occurrence of OVF analyzed risk factors for mortality and showed that a progression of local kyphosis in fractures between injury onset and 6 months after injury was a risk factor of poor prognosis.
Identifying children at high risk for recurrence child abuse
Authors: Wongcharoenwatana Jidapa , Tarugsa Jariya , Kaewpornsawan Kamolporn , Eamsobhana Perajit , Chotigavanichaya Chatupon , Ariyawatkul Thanase
Published: February 2021

Purpose:

To evaluate the characteristics of abused children, families and abusive event and to identify risk factors associated with recurrence of child abuse.

Methods:

Retrospective data from 133 children aged between 2 months to 15 years old who were diagnosed as abuse between year 2002 and 2017. Thirteen items related to characteristics of the child, families, abusive event were selected. These factors were analyzed by multivariate logistic regression model for association with repeated child abuse.

Results:

Total of 133 subjects with average age of 5.25 ± 4.65 years old. There were 54 cases (40.60%) reported of repeated abuse. Majority of repeated abuse type in this study was physical abuse (73.68%). Most perpetrators were child’s own parents (45.10%). Factors associated with increased risk of repeated abuse were child age 1–5 years old (AOR = 4.95/95%CI = 1.06–23.05), 6–10 years old (AOR = 6.80/95%CI = 1.22–37.91) and perpetrator was child’s own parent (AOR = 21.34/95%CI = 3.51–129.72). Three cases of mortality were found with single-visit children and one case in recurrence. Most of death cases were children less than 1-year-old with average age of 7 months. Causes of death were subdural hematoma with skull and ribs fracture.

Conclusions:

Identifying risk factors for repeated child abuse help in recognizing child at risk to provide prompt intervention. This study found two factors associated with higher risk of abuse recurrence: child age 1–10 years old and abusive parents. Children who presented with these risk factors should be recognized and intensively monitored.
Defining the Clinically Meaningful Outcomes for Arthroscopic Treatment of Femoroacetabular Impingement Syndrome at Minimum 10-Year Follow-up: The Timing of Surgery Is Crucial
Authors: Zimmerer Alexander , Janz Viktor , Sobau Christian , Wassilew Georgi I. , Miehlke Wolfgang
Published: February 2021

Background:

Arthroscopic treatment of femoroacetabular impingement syndrome (FAIS) has become a common procedure. However, meaningful long-term clinical outcomes have not been defined.

Purpose:

To define the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) for the modified Harris Hip Score (mHHS) at a minimum 10-year follow-up in patients undergoing arthroscopic treatment for FAIS and identify preoperative predictors for achievement of the MCID, SCB, and PASS.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A consecutive series of patients undergoing arthroscopic treatment for FAIS between 2007 and 2009 with a minimum 10-year follow-up was analyzed. Patient data included patient characteristics, radiographic parameters, and the pre- and postoperative mHHS and visual analog scale (VAS) for pain score. Paired t tests were used to compare the patient-reported outcome measures (PROMs). The MCID was determined by calculating half of the standard deviation, and SCB and PASS were calculated by the anchor method. Correlation and logistic regression analyses were conducted to identify predictors for the achievement of the MCID, SCB, and PASS.

Results:

A total of 44 patients (27 men, 17 women) were included. The mean age and body mass index were 42.2 years (range, 16-67 years) and 22.3 kg/m2 (range, 16.76-29.78 kg/m2), respectively. The MCID, absolute SCB, net change SCB, and PASS of the mHHS were calculated to be 19.6, 90.1, 31.5, and 84.4 points, respectively. Preoperative symptom duration was identified as an independent predictor for the achievement of meaningful clinical outcomes. The median symptom durations for patients who achieved the MCID, absolute SCB, net change SCB, and PASS were 11.7, 9.1, 9.0, and 10.8 months, respectively. The median symptom duration for patients who did not achieve the MCID, absolute SCB, net change SCB, and PASS were 15.8, 17.4, 17.3, and 18.4 months, respectively. No other statistically significant correlations were found.

Conclusion:

The preoperative duration of symptoms was identified as an independent predictor for achievement of the MCID, SCB, and PASS. These findings can be helpful in accelerating the transition to surgical treatment of FAIS.
Dignity Therapy for End-of-Life Care Patients: A Literature Review
Authors: Cuevas Pearl Ed , Davidson Patricia , Mejilla Joylyn , Rodney Tamar
Published: February 2021

Dignity therapy as an intervention has been used for individuals receiving palliative care. The goal of this review is to explore the current state of empirical support to its use for end-of-life care patients. Data sources were articles extracted from search engines PubMed, Cochrane, Embase, CINAHL, Web of Science, and PsycINFO. The years searched were 2009 to 2019 (10-year period). The review process was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results revealed the feasibility, acceptability, satisfaction, and effectiveness of dignity therapy for life-limiting cases/conditions of patients in different age groups. It also highlighted the importance of the therapy setting and the need to apply this in the cultural context. The meaning of dignity therapy to patients and their family care members also emerged. Findings showed most patients displayed the need to leave a legacy and from this their core values surfaced. In conclusion, this review highlighted the contribution of dignity therapy to the holistic care of patients who hope to leave a legacy. The therapy was also relevant to decrease the anxiety; depression, and burden of family members throughout the palliative care period of their loved ones.
Understanding the Needs of Australian Carers of Adults Receiving Palliative Care in the Home: A Systematic Review of the Literature
Authors: Miller Elizabeth M. , Porter Joanne E.
Published: February 2021

Introduction

Caring for someone at home requiring palliative care is an ominous task. Unless the current support systems are better utilised and improved to meet the needs of those carers, the demand for acute hospital admissions will increase as the Australian population ages. The aim of this review was to examine the needs of unpaid carers who were caring for adults receiving palliative care in their home in Australia. Methods: A systematic review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines between 2008–2020. Results: Only Australian papers were selected due to the intent to understand carers’ needs in the Australian context and 17 papers made up the final data set. Four themes emerged: 1) Perceived factors influencing caregiving; 2) Perceived impact and responses to caregiving; 3) Communication and information needs; and 4) Perceptions of current palliative support services and barriers to uptake. Conclusion: Carers reported satisfaction and positive outcomes and also expressed feeling unprepared, unrecognised, stressed and exhausted.
The Reward System and Post-Traumatic Stress Disorder: Does Trauma Affect the Way We Interact With Positive Stimuli?
Authors: Seidemann Rebecca , Duek Or , Jia Ruonan , Levy Ifat , Harpaz-Rotem Ilan
Published: February 2021

Post-traumatic stress disorder (PTSD) is a highly prevalent disorder and a highly debilitating condition. Although anhedonia is an important construct of the disorder, the relationship between PTSD and reward functioning is still under-researched. To date, the majority of research on PTSD has focused on fear: fear learning, maintenance, and extinction. Here we review the relevant literature—including clinical observations, self-report data, neuroimaging research, and animal studies—in order to examine the potential effects of post-traumatic stress disorder on the reward system. Our current lack of sufficient insight into how trauma affects the reward system is one possible hindrance to clinical progress. The current review highlights the need for further investigation into the complex relationship between exposure to trauma and the reward system to further our understandings of the ethology of PTSD.
Glottic Keratosis: Significance and Identification of Laryngoscopic Findings
Authors: Anis Mursalin M. , Diaz Jennylee , Patel Mausam , Lloyd Adam T. , Rosow David E.
Published: February 2021

Objective

Glottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after biopsy. We determined the significance of laryngoscopic findings and agreement among clinicians to identify those specific findings.

Study Design

Retrospective case‐control study.

Setting

Tertiary care university hospital.

Methods

Adults with glottic keratosis with preoperative office laryngoscopies were included. Preoperative videostroboscopies were reviewed by a blinded reviewer. Multivariable logistic regression was used to examine the correlation between laryngoscopic appearance of glottic keratosis and presence or absence of high‐grade dysplasia or carcinoma on biopsies. Consensus among head and neck cancer surgeons to detect specific laryngoscopic findings was evaluated by presenting representative laryngoscopies to a blinded cohort. Interrater reliability was calculated using Fleiss’s κ.

Results

Sixty glottic keratotic lesions met inclusion criteria. On logistic regression, both erythroplakia and aberrant microvasculature like vascular speckling were significantly associated with high‐grade dysplasia and carcinoma, P =. 002 and P =. 03, respectively. Interrater reliability among clinicians to identify erythroplakia and aberrant microvasculature was minimal, κ = 0.35 and κ = 0.29, respectively. Interrater reliability was improved with the use of virtual chromoendoscopy.

Conclusion

The presence of erythroplakia and aberrant microvasculature in glottic keratosis is associated with the presence of high‐grade dysplasia or carcinoma. Virtual chromoendoscopy can be used to improve reliability for detecting erythroplakia and vascular speckling, and this is a potential area for practice‐based learning. Clinicians should identify and consider immediate diagnostic biopsy of suspicious glottic keratosis.
Whipping and jailing: The Kapuria jail, indigenous self-government and the hybridization of punishment in Colombia
Authors: Ariza Libardo José , Iturralde Manuel
Published: February 2021

There are currently 105,148 people imprisoned in Colombia; of these, 777 are indigenous. Although this may seem a small number (especially when compared with the disproportional presence of indigenous people in countries such as Canada, Australia, and New Zealand), their imprisonment shows the persistence of colonial practices within the predominant legal discourse that undermine the indigenous peoples’ right to self-government. However, they also reveal a process of hybridization of punishment, where traditional punishments ( whipping) and Western forms of punishment ( jailing) meet and transform each other, leading to different forms of punishment—and resistance. This article studies how some of the most representative indigenous communities in Colombia have appropriated prison as a form of punishment, the factors that have influenced this process, and its possible outcomes.
The pathophysiological role of novel pulmonary arterial hypertension geneSOX17
Authors: Wu Yukyee , Wharton John , Walters Rachel , Vasilaki Eleni , Aman Jurjan , Zhao Lan , Wilkins Martin R. , Rhodes Christopher J.
Published: February 2021

Pulmonary arterial hypertension (PAH) is a progressive disease predominantly targeting pre-capillary blood vessels. Adverse structural remodelling and increased pulmonary vascular resistance result in cardiac hypertrophy and ultimately failure of the right ventricle. Recent whole-genome and whole-exome sequencing studies have identifiedSOX17as a novel risk gene in PAH, with a dominant mode of inheritance and incomplete penetrance. Rare deleterious variants in the gene and more common variants in upstream enhancer sites have both been associated with the disease, and a deficiency ofSOX17expression may predispose to PAH. This review aims to consolidate the evidence linking genetic variants inSOX17to PAH, and explores the numerous targets and effects of the transcription factor, focusing on the pulmonary vasculature and the pathobiology of PAH.
Does the natural carcinogen ptaquiloside degrade readily in groundwater?
Authors: Wu Jane S. , Clauson-Kaas Frederik , Lindqvist Dan Nybro , Rasmussen Lars Holm , Strobel Bjarne W. , Hansen Hans Christian Bruun
Published: February 2021

Background

Ptaquiloside (PTA) is a natural carcinogen found in bracken ferns. PTA is released from the plants via soil to surface and groundwaters from where humans can be exposed via drinking water. Primary degradation of PTA is due to hydrolysis with formation of pterosin B (PTB). Temperature and pH determine the rate of hydrolysis under pure experimental conditions. To assess the applicability of the experimental model to natural groundwaters, PTA degradation kinetics were examined in a range of natural groundwaters at environmentally relevant conditions.

Results

PTA was quantified by UPLC-MS/MS. Over an 80-day study period, PTA half-lives ranged from 6.5 to 47 days (natural pH; 8.0 °C). The fastest degradation was observed for the most alkaline groundwaters with pH of around 8. Rates of degradation were well predicted using an existing mathematical model for hydrolysis. However, deviations from this model were found, especially at the extremes of the examined pH-range (4.7–8.2). The degree of conversion of PTA to PTB was close to unity around neutral pH. However, at slightly acidic conditions, formation of PTB could only count for 9% of the degraded PTA, indicating formation of other products.

Conclusions

Degradation of PTA in groundwater is determined by pH and temperature, and PTA can prevail for months under slightly acid to neutral pH conditions. The existing laboratory-based model for PTA hydrolysis is generally applicable for groundwaters but needs further validation at high and low pH.
Two novel XRE-like transcriptional regulators control phenotypic heterogeneity in Photorhabdus luminescens cell populations
Authors: Eckstein Simone , Brehm Jannis , Seidel Michael , Lechtenfeld Mats , Heermann Ralf
Published: February 2021

Background

The insect pathogenic bacterium Photorhabdus luminescens exists in two phenotypically different forms, designated as primary (1°) and secondary (2°) cells. Upon yet unknown environmental stimuli up to 50% of the 1° cells convert to 2° cells. Among others, one important difference between the phenotypic forms is that 2° cells are unable to live in symbiosis with their partner nematodes, and therefore are not able to re-associate with them. As 100% switching of 1° to 2° cells of the population would lead to a break-down of the bacteria’s life cycle the switching process must be tightly controlled. However, the regulation mechanism of phenotypic switching is still puzzling.

Results

Here we describe two novel XRE family transcriptional regulators, XreR1 and XreR2, that play a major role in the phenotypic switching process of P. luminescens. Deletion of xreR1 in 1° or xreR2 in 2° cells as well as insertion of extra copies of xreR1 into 2° or xreR2 into 1° cells, respectively, induced the opposite phenotype in either 1° or 2° cells. Furthermore, both regulators specifically bind to different promoter regions putatively fulfilling a positive autoregulation. We found initial evidence that XreR1 and XreR2 constitute an epigenetic switch, whereby XreR1 represses xreR2 expression and XreR2 self-reinforces its own gene by binding to XreR1.

Conclusion

Regulation of gene expression by the two novel XRE-type regulators XreR1 and XreR2 as well as their interplay represents a major regulatory process in phenotypic switching of P. luminescens. A fine-tuning balance between both regulators might therefore define the fate of single cells to convert from the 1° to the 2° phenotype.
Antibiotic practices among household members and their domestic animals within rural communities in Cumilla district, Bangladesh: a cross-sectional survey
Authors: Hicks Joseph Paul , Latham Sophia M. , Huque Rumana , Das Mahua , Newell Jane , Abdullah S. M. , Al Azdi Zunayed , Jahan Ishrat , Rassi Christian , Hamade Prudence , Shafique Muhammad , Islam Mohammad Saiful , King Rebecca
Published: February 2021

Background

Antibiotic resistance is a global threat to human health, and inappropriate use of antibiotics in humans and animals is widely considered to be a key driver of antibiotic resistant infections. Antibiotic use in humans and animals is growing rapidly in low- and, particularly, middle-income countries. However, there is little detailed understanding about practices related to the use of antibiotics in humans and animals within community settings in such countries. Here we aimed to understand the antibiotic practices of rural households across Cumilla district, Bangladesh, in relation to household members and their domestic animals.

Methods

In 2018 we conducted a cross-sectional survey using representative cluster sampling methods. We collected self-reported information from 682 female and 620 male household heads, with women also asked about their children’s antibiotic practices.

Results

Only 48% (95% CI: 40, 56%) of women and men had heard of antibiotics, and among those women and men who were aware of antibiotics and the children of those women 70% (95% CI: 64, 76%) reported having previously taken antibiotics, while among these individuals who reported previously taking antibiotics 21% (95% CI: 18, 25%) said they had done so most recently within the last month. Risky/inappropriate antibiotic practices in humans and animals were often reported. For example, among women and men who were aware of antibiotics and the children of those women 52% (95% CI: 40, 63%) reported previously taking antibiotics for a “cough/cold”, despite antibiotics being typically inappropriate for use against viral upper respiratory tract infections. Among poultry-owning respondents who were aware of antibiotics 11% (95% CI: 8, 15%) reported previously giving healthy poultry antibiotics, mainly for growth/prophylaxis, while among cattle-owning respondents who were aware of antibiotics and reported previously giving their cattle feed 20% (95% CI: 9, 37%) said the feed had contained antibiotics at least sometimes.

Conclusions

Our results highlight the need for context-adapted interventions at both the community level and the health systems level to reduce inappropriate antibiotic use among humans and domestic animals in rural Bangladesh. Successfully reducing inappropriate use of antibiotics among humans and animals is a required and critical step in tackling antimicrobial resistance.
Treatment with endoscopic transnasal resection of hypothalamic pilocytic astrocytomas: a single-center experience
Authors: Zhou Zhuo-Ya , Wang Xiao-Shu , Gong Yang , La Ali Musyafar Ode , Yu Jiao-Jiao , Huo Gang , Mou Jia-Min , Yang Gang
Published: February 2021

Backgrounds

Pilocytic astrocytomas (PAs) are World Health Organization (WHO) grade I tumors, which are relatively common, and are benign lesions in children. PAs could originate from the cerebellum, optic pathways, and third ventricular/hypothalamic region. Traditional various transcranial routes are used for hypothalamic PAs (HPAs). However, there are few studies on hypothalamic PAs treated through the endoscopic endonasal approach (EEA). This study reports the preliminary experience of the investigators and results with HPAs via expanded EEAs.

Methods

All patients with HPAs, undergone EEA in our hospital from 2017 to 2019, were retrospectively reviewed. The demographic data, clinical symptoms, complications, skull base reconstruction, prognosis, and endocrinological data were all recorded and analyzed in detail.

Results

Finally, five female patients were enrolled. The average age of patients was 28.6 ± 14.0. All patients had complaints about their menstrual disorder. One patient had severe bilateral visual impairment. Furthermore, only one patient suffered from severe headache due to acute hydrocephalus, although there were four patients with headache or dizziness. Four cases achieved gross-total resection, and one patient achieved subtotal resection. Furthermore, there was visual improvement in one patient (case 5), and postoperative worsening of vision in one patient (case 4). However, only one patient had postoperative intracranial infection. None of the patients experienced a postoperative CSF leak, and in situ bone flap (ISBF) techniques were used for two cases for skull base repair. In particular, ISBF combined with free middle turbinate mucosal flap was used for case 5. After three years of follow-up, three patients are still alive, two patients had no neurological or visual symptoms, or tumor recurrence, and one patient had severe hypothalamic dysfunction. Unfortunately, one patient died of severe postoperative hypothalamus reaction, which presented with coma, high fever, diabetes insipidus, hypernatremia and intracranial infection. The other patient died of recurrent severe pancreatitis at one year after the operation.

Conclusion

Although the data is still very limited and preliminary, EEA provides a direct approach to HPAs with acceptable prognosis in terms of tumor resection, endocrinological and visual outcomes. ISBF technique is safe and reliable for skull base reconstruction.
Preoperative prediction of pathological grade in pancreatic ductal adenocarcinoma based on 18F-FDG PET/CT radiomics
Authors: Xing Haiqun , Hao Zhixin , Zhu Wenjia , Sun Dehui , Ding Jie , Zhang Hui , Liu Yu , Huo Li
Published: February 2021

Purpose

To develop and validate a machine learning model based on radiomic features derived from 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) images to preoperatively predict the pathological grade in patients with pancreatic ductal adenocarcinoma (PDAC).

Methods

A total of 149 patients (83 men, 66 women, mean age 61 years old) with pathologically proven PDAC and a preoperative 18F-FDG PET/CT scan between May 2009 and January 2016 were included in this retrospective study. The cohort of patients was divided into two separate groups for the training (99 patients) and validation (50 patients) in chronological order. Radiomics features were extracted from PET/CT images using Pyradiomics implemented in Python, and the XGBoost algorithm was used to build a prediction model. Conventional PET parameters, including standardized uptake value, metabolic tumor volume, and total lesion glycolysis, were also measured. The quality of the proposed model was appraised by means of receiver operating characteristics (ROC) and areas under the ROC curve (AUC).

Results

The prediction model based on a twelve-feature-combined radiomics signature could stratify PDAC patients into grade 1 and grade 2/3 groups with AUC of 0.994 in the training set and 0.921 in the validation set.

Conclusion

The model developed is capable of predicting pathological differentiation grade of PDAC based on preoperative 18F-FDG PET/CT radiomics features.
Characterization and comparison of the bacterial community between complete intensive and extensive feeding patterns in pigs
Authors: Li Xin-Jian , Wang Mingyu , Xue Yahui , Duan Dongdong , Li Cong , Ye Jianwei , Han Xuelei , Qiao Ruimin , Wang Kejun , Li Xiu-Ling
Published: February 2021

To investigate and compare the gut microbiota structures in complete intensive feeding pattern (CP) and extensive feeding pattern (EP) groups, a total of 20 pigs were divided into two groups and fed the same diet. The fecal microbial composition was profiled using 16S rRNA gene sequencing. Our results showed that seventeen predominant genera were present in each pig sample and constituted the phylogenetic core of the microbiota at the class level. The abundance of most of the core microbial flora were significantly higher in the CP group than in the EP group (P < 0.05), while the abundance of Gammaproteobacteria was significantly lower in the CP group than in the EP group (P < 0.05). The CP group had significantly greater community diversity, richness, and evenness than the EP group (P < 0.05). Functional prediction analysis indicated that intestinal microbial species potentially led to faster growth and an increased fat accumulation capacity in the CP group; however, disease resistance was weaker in the CP group than in the EP group. In conclusion, EP pigs have a wider range of activity and better animal welfare than CP pigs, which helps reduce the occurrence of diseases and neurological symptoms. To explore the effect of intestinal flora on disease resistance in pigs at the molecular level, Coprococcus, which is a key gut bacterium in the intestine, was selected for isolation and purification and cocultured with intestinal epithelial cells. qPCR was performed to determine the effect of Coprococcus on SLA-DRB gene expression in intestinal epithelial cells. The results showed that Coprococcus enhanced SLA-DRB gene expression in intestinal epithelial cells. The results provide useful reference data for further study on the relationship between intestinal flora and pig disease resistance.
Retraction Note: Minimally thin sets associated with the stationary Schrödinger operator
Authors: Zhao Tao
Published: February 2021

This article has been retracted. Please see the Retraction Notice for more detail: 10.1186/s13660-021-02575-1
Food intake and cardiometabolic risk factors in rural Uganda
Authors: Holmager Therese L. F. , Meyrowitsch Dan W. , Bahendeka Silver , Nielsen Jannie
Published: February 2021

Background

Along with a nutritional transition in Sub-Saharan Africa, the prevalence of non-communicable diseases is increasing rapidly. We assess the association between food intake and cardiometabolic risk factors in a rural population in Uganda.

Methods

The present study was based on data from a household-based case-control study of diabetic and non-diabetic households in Southwestern Uganda, 2012–2013. We analysed food intake in 359 individuals age ≥ 13 years from 87 households, using a household food frequency questionnaire, and measures of glycated haemoglobin (HbA1c), height and weight. We used multinomial logistic regression to model abnormal HbA1c (≥5.7%) and weight status (underweight, normal weight and overweight) as an outcome of total food intake and by nine food groups. Results were reported as odds ratios (OR) with 95% confidence intervals (CI). Models were adjusted for three nested sets of covariates.

Results

The diet primarily consisted of staple food (cassava and plantain). High-Glycaemic Index staple food was the most consumed food group (median = 14 servings/week, p25-p75: 11–17). Milk, meat, fish and vegetables were the least consumed food groups (medians: 0–3 servings/week). Median intake of sugary food was 6 servings/week (p25-p75: 2–9). The OR of having abnormal HbA1c or being overweight increased with every weekly serving of food (1.02, 95% CI: 1.00–1.04 and 1.01 95% CI: 1.00–1.03, respectively). Of specific food groups, each weekly serving of meat increased the OR of being overweight with 33% (95% CI: 1.08–1.64), and fruit intake decreased the OR of abnormal HbA1c (0.94, 95% CI: 0.88–1.00), though this latter association was attenuated after adjustment for weight status, aerobic capacity, and socioeconomic status.

Conclusion

Diet was monotonous, mainly consisting of cassava and plantain, and increasing food intake was associated with abnormal HbA1c and overweight. To prevent non-communicable diseases a diet with higher intake of fish and vegetables, and less sugary food is recommended.
Predictive factors of quality of life among medical students: results from a multicentric study
Authors: Miguel Alice de Queiroz Constantino , Tempski Patricia , Kobayasi Renata , Mayer Fernanda B. , Martins Milton A.
Published: February 2021

Background

Medical students have a worse perception of Quality of Life (QoL) and a high prevalence of psychosocial suffering when compared to the general population. The objective of this study was to investigate associated factors with Quality of Life of Brazilian medical students from an exploratory analysis in a cross-sectional study described in accordance with the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) guidelines.

Methods

This is a cross-sectional and multicenter study with national sample randomized by sex and year of the course. Data were collected between August 2011 and August 2012, using an electronic platform (VERAS platform). Our outcomes included: personal quality of life (QoLp) and quality of life related to medical course activities (QoLmc), both measured using a score ranging from 0 (worst) to 10 (best). Variables as predictors: the World Health Organization Quality of Life Assessment abbreviated version (WHOQOL-BREF); VERAS-Q (a questionnaire created to evaluate the QoL of students in health professions); Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maslach Burnout Inventory (MBI), Resilience Scale (RS-14), Interpersonal Reactivity Multidimensional Scale (IRMS) and Dundee Ready Education Environment Measure (DREEM).

Results

Our sample is comprised of 1350 (81.8%) medical students. When comparing predictors and both quality of life outcome measures, we found a negative correlation between QoL and the BDI, PSQI and ESS scores. Through a multiple linear regression mode we identified the median of significant predictors to higher QoL. We then run a tree regression model that demonstrated that the VERAS-Q—physical health domain (a domain assessing self-care, self-perception of health, sleep, leisure, physical activity and appearance) was the most important factor predicting QoL. Students with a VERAS-Q-physical health score ≥ 60.9 and a VERAS-Q-time management (address the management of the student's time, free time and whether he can dedicate himself to other activities besides the course) score ≥ 55.7 presented the best QoLmc (score: 8.08–9.63%). Students with a VERAS-Q-physical health score ≥ 79.7 presented the highest QoLp (score 8.93–8.74%).

Conclusion

Physical symptoms, self-perception of health and self-care assessed by the VERAS-Q physical domain had association with both final outcomes. Time management seems to have a protective role for better Quality of Life. These variables should be taken in consideration when designing interventions to improve Quality of Life among medical students.
The formation of formates: a review of metal formates on heritage objects
Authors: Eggert Gerhard , Fischer Andrea
Published: February 2021

Metal formates sometimes occur as degradation products on heritage objects due to the use of wood products or other sources of formic acid and formaldehyde. They are often related to alkaline surfaces which transform formaldehyde directly into formate. The dominant role of formate on alkaline surfaces, for example in glass-induced metal corrosion (GIM) or calcium carbonate degradation, was explored in the Stuttgart research on rare heritage corrosion products. This review discusses these findings together with those from the literature: ocurrences of sodium and potassium formate on glass, calcium formate and calcium acetate-formate phases on calcareous materials, magnesium formate on Sorel cement and dolomitic sandstone, lead formate on metal and pigments, cadmium formate on coated objects, as well as various copper and zinc formates on copper alloys. In the latter cases, formates dominate as glass-induced metal corrosion products. The formation of formates constitutes irreversible damage, degrading the material of heritage objects. Therefore, preventive conservation needs to remove all sources of carbonyl pollutants in order to avoid such corrosion.
An alternative approach to dimension reduction for pareto distributed data: a case study
Authors: Roccetti Marco , Delnevo Giovanni , Casini Luca , Mirri Silvia
Published: February 2021

Deep learning models are tools for data analysis suitable for approximating (non-linear) relationships among variables for the best prediction of an outcome. While these models can be used to answer many important questions, their utility is still harshly criticized, being extremely challenging to identify which data descriptors are the most adequate to represent a given specific phenomenon of interest. With a recent experience in the development of a deep learning model designed to detect failures in mechanical water meter devices, we have learnt that a sensible deterioration of the prediction accuracy can occur if one tries to train a deep learning model by adding specific device descriptors, based on categorical data. This can happen because of an excessive increase in the dimensions of the data, with a correspondent loss of statistical significance. After several unsuccessful experiments conducted with alternative methodologies that either permit to reduce the data space dimensionality or employ more traditional machine learning algorithms, we changed the training strategy, reconsidering that categorical data, in the light of a Pareto analysis. In essence, we used those categorical descriptors, not as an input on which to train our deep learning model, but as a tool to give a new shape to the dataset, based on the Pareto rule. With this data adjustment, we trained a more performative deep learning model able to detect defective water meter devices with a prediction accuracy in the range 87–90%, even in the presence of categorical descriptors.
Clinical utility of FDG PET/CT for primary and recurrent papillary renal cell carcinoma
Authors: Hou Guozhu , Zhao Dachun , Jiang Yuanyuan , Zhu Zhaohui , Huo Li , Li Fang , Cheng Wuying
Published: February 2021

Purpose

Papillary renal cell carcinoma (RCC) is the second most common subtype of RCC, after clear cell RCC. This study aimed to investigate the usefulness of FDG PET/CT in primary and recurrent papillary RCC, and the role of staging FDG PET/CT in predicting survival.

Methods

A total of 66 patients with histopathologically confirmed papillary RCC who underwent either staging or restaging FDG PET/CT scans (30 had staging scans only, 28 had restaging scans only, 8 had both) were retrospectively included in this study. The sensitivity and specificity of restaging FDG PET/CT for detecting recurrence were assessed by histopathology and/or clinical follow-up as standard reference.

Results

Staging FDG PET/CT scans were performed in 38 patients, of which 31 (81.5%) showed FDG-positive primary renal lesions. The SUVmax of high-grade (WHO grade 3 and 4) papillary RCCs were significantly higher than that of low-grade (WHO grade 1 and 2) tumors (9.44 ± 6.18 vs 4.83 ± 3.19, P = 0.008). The SUVmax was not significantly different between type 1 and type 2 papillary RCCs (5.71 ± 2.88 vs. 6.99 ± 5.57, P = 0.563). Of the 38 patients, 12 developed disease progression during the follow-up period. Patients with primary tumor SUVmax> 5.85 were associated with significantly shorter progression-free survival (PFS) than those with tumor SUVmax≤5.85 (P = 0.005). Restaging FDG PET/CT scans were performed in 36 patients with suspected recurrent papillary RCCs. FDG PET/CT showed a sensitivity and specificity of 100 and 72.7% for detecting recurrent disease. Comparison of PET/CT scans with CT/MRI imaging was available in 23 patients. FDG PET/CT revealed additional findings in 11 patients, mainly including lymph node and bone metastases. FDG PET/CT findings led to change in management in 5.3% (2/38) of patients in the staging setting and 16.7 (6/36) of patients in the restaging setting.

Conclusions

FDG PET/CT had a sensitivity of 81.5% for detecting primary papillary RCC, and tumor SUVmax derived from staging FDG PET/CT was a predictor of PFS. In the restaging process of papillary RCC, FDG PET/CT was very effective for detecting recurrent disease.