bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitrectomy for Vitreous Hemorrhage Secondary to Branch Retinal Vein Occlusion
Authors: Tong Gengmin , Pan Qintuo , Hu Yishan , Wang Dawei , Jin Yanhua
Published: December 2020

PurposeTo investigate the long-term surgical outcomes after treatment with pars plana vitrectomy (PPV) combined with photocoagulation in different severities of branch retinal vein occlusion (BRVO) with vitreous hemorrhage (VH).MethodsWe retrospectively reviewed the medical records of 117 eyes of 117 patients who underwent PPV for VH associated with BRVO and who were followed up for at least 12 months. Preoperative best-corrected visual acuity (BCVA), surgical intervention, final BCVA, and central foveal thickness (CFT) were evaluated using optical coherence tomography. According to the intraoperative observation, we divided them into four different types: Grade I, pure persistent VH; Grade II,VH with epiretinal membrane (EM) (Grade IIa, VH with EM without macular involvement; Grade IIb, VH with EM with macular involvement); and Grade III,VH with tractive retinal detachment. Different surgical methods were applied according to the different retinal conditions.ResultsBCVA significantly improved at final follow-up in all groups. There was no significant difference among the four groups in terms of preoperative BCVA, final BCVA, CFT, and the number of patients whose macular edema recurred after surgery(p>0.05), but there was a significant difference in vision improvement(p<0.05). Vision improvement in the Grade IIb group was significantly worse than in the Grade I group(p=0.006) and Grade IIa group(p=0.046).The percentage of patients in the Grade I, Grade IIa, Grade IIb, and Grade III groups underwent further laser treatment after surgery was 0%,8.3%,16.3%, and 23.5%, respectively(p<0.05).ConclusionVitrectomy is a safe and effective treatment for BRVO with VH. Visual acuity improvement was significantly worse when the EM had macular involvement (Grade IIb).
Association Between Visual Acuity, Ocular Pathology and Refractive Error with Computer Vision Syndrome: Cross Sectional University Study in Kenya
Authors: Muma Shadrack Lusi , Aduda Dickens Omondi , Ogola Patrick Onyango
Published: December 2020

Background: Numerous factors have been shown to reduce symptomatic and non-symptomatic forms for computer vision syndrome. However, little is known on the impact among computer users diagnosed with severe symptoms of computer vision syndrome. The study assessed whether reduced visual acuity, ocular pathology and refractive error are associated with computer vision syndrome. Methods: A cross sectional university based study in Kenya. Seven hundred and eighty three participants were included in the study. Visual acuity was determined using snellens chart and converted to logMAR chart. Ocular pathology was determined through comprehensive examination using a slit lamp. Computer vision syndrome was determined using a validated questionnaire. Finally Retinoscopy was conducted to determine the type of refractive error. Results: Participants with refractive error above ± 0.50 dioptres had a greater odds, multivariate adjusted ratio 0.73 (95% CI 0.63-0.90) for developing computer vision syndrome. Similar to visual acuity with multivariate adjusted odds ratio of 0.31 (95% CI 0.24-0.47) and ocular pathologies being significantly associated with computer vision syndrome (p=.04). Ocular condition like sub conjunctival hemorrhage was not significantly associated with computer vision syndrome (P=.12). Conclusion: Reduced visual acuity, presence of ocular pathology and refractive error were associated with greater likelihood of computer vision syndrome. Particularly among those who had never had optical correction. Eye care providers are well placed to come up with proper diagnosis of CVS.
Inversion of the Slip Distribution of the 2017 Ms7.0 Jiuzhaigou Earthquake From InSAR
Authors: Tang Xiongwei , Guo Rumeng , Xu Jianqiao , Sun Heping , Chen Xiaodong , Zhou Jiangcun
Published: December 2020

On 8 August 2017, an Ms 7.0 earthquake occurred on a buried fault extending to the north of the Huya fault. Based on the coseismic deformation field obtained from Interferometric Synthetic Aperture Radar (InSAR) data and a series of finite fault model tests, we proposed a brand new two-fault model composed of a main fault and a secondary fault as the optimal model for the Jiuzhaigou earthquake, in which the secondary fault is at a large obtuse angle to the northern end of the main fault plane. Results show that the slip distribution is dominated by sinistral slip, with a significant shallow slip deficit. The main fault consists of two asperities, which is bounded by an aftershock gap may representing a barrier. In addition, we find that most of the aftershocks were located down-dip of the high-slip areas and laid in stress shadows. We deduce that the aftershocks may be controlled by the background tectonic stress field, and may be related to the velocity-strengthening zones.
Analytical Protocols for Phobos Regolith Samples Returned by the Martian Moons Exploration (MMX) Mission
Authors: Fujiya Wataru , Furukawa Yoshihiro , Sugahara Haruna , Koike Mizuho , Bajo Ken-ichi , Chabot Nancy L. , Miura Yayoi N. , Moynier Frederic , Russell Sara S. , Tachibana Shogo , Takano Yoshinori , Usui Tomohiro , Zolensky Michael E.
Published: December 2020

Japan Aerospace Exploration Agency (JAXA) will launch a spacecraft in 2024 for a sample return mission from Phobos (Martian Moons eXploration: MMX). Touchdown operations are planned to be performed twice at different landing sites on the Phobos surface to collect >10 g of the Phobos surface materials with coring and pneumatic sampling systems on board. The Sample Analysis Working Team (SAWT) of MMX is now designing analytical protocols of the returned Phobos samples to shed light on the origin of the Martian moons as well as the evolution of the Mars-moon system. Observations of petrology and mineralogy, and measurements of bulk chemical compositions and stable isotopic ratios of, e.g., O, Cr, and Ti can provide crucial information about the origin of Phobos. If Phobos is a captured asteroid composed of primitive chondritic materials, as inferred from its reflectance spectra, the nature of organic matter as well as bulk H, N, and Zn isotopic compositions characterize the volatile materials in the samples and constrain the type of the captured asteroid. Cosmogenic and solar wind components, most pronounced in noble gas isotopic compositions, can reveal surface processes on Phobos. Long- and short-lived radionuclide chronometry such as 53Mn-53Cr and 87Rb-87Sr systematics can date pivotal events like impacts, thermal metamorphism, and aqueous alteration on Phobos. It should be noted that the Phobos regolith is expected to contain a small amount of materials delivered from Mars, which may be physically and chemically different from any Martian meteorites in our collection and thus are particularly precious. The analysis plan will be designed to detect such Martian materials, if any, from the returned samples dominated by the Phobos building blocks in curation procedures at JAXA before they are processed for further analyses.
Combined Detection of Circulating Tumor Cells, α-fetoprotein Heterogene-3 and α-fetoprotein in the Early Diagnosis of HCC for the Prediction of Efficacy, Prognosis, Recurrence after Microwave Ablation
Authors: Zhou Jian , Zhu Yue , Li Yi , Liu Kun , He Fei , Xu Sihuan , Li Xin , Li Li , Hu Junfang , Liu Yan
Published: December 2020

Background: Early diagnosis can significantly improve treatment outcomes for HCC patients. Microwave ablation (MWA) is an important treatment for HCC, there's a lack of specific tests for prognosis. This study investigated the predictive value of combined of AFP, AFP-L3, CTCs. Methods: 143 HCC patients as research subjects (HCC group), 102 liver cirrhosis patients as liver cirrhosis group, 127 hepatitis patients as hepatitis group, 110 healthy outpatients as normal control group. The levels of AFP, AFP-L3 and CTCs were detected, and ROC curve was used to analyze the clinical value of the detection with single and combined indicators in HCC diagnosis. Results: Compared with cirrhosis group, hepatitis group and normal control group, the levels of AFP, AFP-L3, CTCs in HCC group were significantly higher. AFP, AFP-L3, CTCs of patients in non-recurrent group, CR+PR group and OS>3 group were significantly lower than the recurrent group, SD+PD group, OS<3 years group. Conclusion: Combined detection of AFP, AFP-L3, CTCs can effectively make up for the shortcomings of the detection with single and pairwise indicators. It can’t only diagnose HCC in early, but also has a high clinical value in predicting the short-term efficacy, prognosis and recurrence of HCC patients after MWA treatment.
SRT2183 and SRT1720, but not Resveratrol, Inhibit Osteoclast Formation and Resorption in the Presence or Absence of Sirt1
Authors: Thiyagarajan Ramkumar , Rodríguez-Gonzalez Maria , Zaw Catherine , Seldeen Kenneth Ladd , Hernandez Mireya , Pang Manhui , Troen Bruce Robert
Published: December 2020

Background: Osteoclastic bone resorption markedly increases with aging, leading to osteoporosis characterized by weak and fragile bones. Mice exhibit greater bone resorption and poor bone mass when Sirt1 is removed from their osteoclasts. Here we investigated the ex vivo impacts of putative Sirt1 activators, resveratrol (RSV), SRT2183 and SRT1720, on osteoclast formation and activity in primary mouse bone marrow cells (BMCs) derived from wild type (WT) and osteoclast specific Sirt1 knockout (OC-Sirt1KO) mice and in the RAW264.7 mouse macrophage cell line. Results: We found that SRT2183 and SRT1720 inhibit formation of osteoclasts and actin belts in both BMCs and RAW264.7 cells, whereas RSV does not. We also observed that the OC-Sirt1KO mice exhibited less bone mineral density, and the BMCs harvested from these mice yielded more osteoclasts than BMCs harvested from littermate controls. Interestingly, both SRT2183 and SRT1720 reduced osteoclast and actin belt formation in BMCs from OC-Sirt1KO mice. SRT2183 and SRT1720 also significantly disrupted actin belts of mature osteoclasts from WT mice BMCs, within 3 and 6 hours of administration. Furthermore, these compounds inhibited resorption activity of mature osteoclasts, while RSV did not. Conclusion: Our findings suggest SRT2183 and SRT1720 impede bone resorption by disrupting actin belts of mature osteoclasts, inhibit actin belt formation, and inhibit osteoclastogenesis even in the absence of Sirt1. Thus, further understanding the mechanism of action of these compounds may pave the way for potential new therapies in alleviating osteoporosis associated bone loss.
As a Newly-Discovered Component in Tumor Microenvironment RUFY4 Participates in Regulation of T cell via Cytokine-Interaction and Predicts Prognosis and Immunotherapy Responsiveness of Clear Cell Renal Carcinoma Patients
Authors: Miao Daojia , Shi Jian , Xiong Zhiyong , Yuan Changfei , Xiao Wen , Meng Xiangui , Chen Zhixian , Lv Qingyang , Xie Kairu , Yang Hongmei , Zhang Xiao-ping
Published: December 2020

Background: clear cell renal cell carcinoma (ccRCC) is one of the most lethal kinds of malignancies in urinary system and the existing immunotherapy have not achieved satisfactory outcomes. Therefore, this study aims to establish a brand-new gene signature for immune-infiltration and clinical outcome (overall survival and immunotherapy responsiveness) of patients with ccRCC. Methods: Based on RNA sequencing data and clinical information in the Cancer Genome Atlas Project (TCGA) database, we investigated proportions of immune cells in 611 samples by an online tool CIBERSORTx. Multivariate survival analysis was used to determine crucial survival-associated immune cells and immune-infiltration-related genes (IIRGs). Next ROC analysis was carried on to evaluate the ability of IIRGs to distinguish patients and functional enrichment analysis were implemented to explore potential interaction network between immune cells and IIRGs. Results: T cells follicular helper (TFHs) and T cells regulatory (Tregs) were highly infiltrated in the tumor microenvironment and their abundance ratios were independent prognostic factors for overall survival. Among IIRGs of TFHs and TREGs, RUFY4 was found to be highly activated in tumor microenvironment and its co-expression network was enriched in regulation of T cells via cytokine-cytokine receptor interactions.Conclusion: These two cells and RUFY4, considered prognostic biomarkers and immunotherapeutic predictors of ccRCC patients, might also simultaneously affect the regulatory network in tumor microenvironment (TME) through cytokine interactions.
Development and Testing of Relative Risk-Based Health Messages for Electronic Cigarette Products
Authors: Kimber Catherine , Cox Sharon , Frings Daniel , Albery Ian P. , Dawkins Lynne
Published: December 2020

Background: Health messages on e-cigarette packs emphasise nicotine addiction or harms using similar wording to warnings on cigarette packs. These may not be appropriate for e-cigarettes which constitute a reduced risk alternative for smokers. This research aimed to i) develop and test a selection of relative risk messages for e-cigarette products; ii) compare these to the two current EU Tobacco Products Directive (TPD) nicotine addiction messages; and iii) explore differences between smokers, non-smokers and dual users. Method: Twenty-six messages focusing on either harm-reduction or cessation were developed and rated by multidisciplinary experts for accuracy, persuasiveness and clarity. The eight highest ranking messages were compared alongside the TPD messages in a sample of 983 European residents (316 smokers, 327 non-smokers, 340 dual users) on understandability, believability and convincingness. Results: On all three constructs combined, the two TPD messages rated the highest, closely followed by four relative risk messages “Completely switching to e-cigarettes lowers your risk of smoking related diseases”, “Use of this product is much less harmful than smoking”, “Completely switching to e-cigarettes is a healthier alternative to smoking”, and “This product presents substantially lower risks to health than cigarettes” which did not differ statistically from the TPD messages. Non-smokers rated TPD1 significantly higher overall than dual users. Dual users rated “This product is a safer alternative to smoking” significantly higher than non-smokers. Messages did not differ on understandability. Conclusions: These alternative messages provide a useful resource for future research and for policy makers considering updating e-cigarette product labelling.
A Novel Staging System and Clinical Predictive Nomogram for More Accurate Staging and Prognosis of Malignant Pancreatic Intraductal Papillary Mucinous Neoplasms: A Population-Based Study
Authors: Zhang Haoxiang , Gao Chenggang , Chen Jiaoshun , Wu Shihong , Bai Jianwei , Yin Tao
Published: December 2020

Background: The current guidelines of the American Joint Committee on Cancer (AJCC) for the staging of exocrine pancreatic tumors seem inapplicable to malignant pancreatic intraductal papillary mucinous neoplasms (IPMN). Therefore, we aimed to improve the accuracy of clinical staging and prognosis for malignant IPMN.Methods: We extracted data of 2001 patients with malignant IPMN from the Surveillance, Epidemiology, and End Results database between 2000 and 2016. Of these, 1401 patients were assigned to the primary cohort and 600 patients to the validation cohort.Results: In Kaplan-Meier analysis of the primary cohort, the current AJCC guidelines were unable to distinguish between certain tumor substages (IA and IB in the 7th, IB and IIA in the 8th). The modified system we regrouped based on the median overall survival and hazard ratios was superior in tumor stage classifications. Age > 70 years, tumors located in the body or tail, high-grade differentiated tumors, surgery, chemotherapy, and TNM stage were identified as independent predictive factors of overall survival. Compared to that of TNM-based systems, the concordance index of the clinical predictive nomogram significantly improved (0.819; 95% confidence interval, 0.805–0.833), with excellent area under the receiver operating characteristic curves (1-, 3-, and 5-year: 0.881, 0.889, and 0.879, respectively). The calibration curves also showed good agreement between prediction and actual observation. In the analysis of treatment modalities, surgery resulted in better survival for all resectable IPMN. Chemotherapy is the treatment of choice for locally advanced or distant metastases patients.Conclusion: Our modified staging system improves the distinction of tumor stages. The nomogram was a more accurate and clinically reliable tool in prognosis prediction of patients with IPMN.
Prediction of Differentially Expressed miRNAs as Potential Biomarkers for Aniridia-Associated Keratopathy based on Expression Profile Analyses
Authors: Zhang Daowei , Zhang Shenghai
Published: December 2020

Background: Aniridia is a rare hereditary disorder that affects most structures of the eyes. This autosomal dominant disorder is caused by haploinsufficiency of Pax6, a critical gene for proper development of the eye. This study attempted to identify novel diagnostic differentially expressed miRNAs and related mRNAs to develop a deeper understanding of the molecular mechanisms and to provide new ideas for the diagnosis and treatment of aniridia-associated keratopathy (AAK). Methods: The miRNA and mRNA expression data were downloaded from GEO for differential expression analysis. R programs, WGCNA, and miRNA targets were used to identify differentially expressed genes (DEGs). The R package was used to screen candidate miRNAs as potential biomarkers, and predicted targets and DEG intersections were determined. A regulatory network between optimal differentially expressed miRNA and DEGs was then constructed. Function analysis and pathway enrichment of miRNA and mRNA were both performed. In addition, transcription factors (TFs) of differential miRNAs and molecular compounds that may be efficient were predicted.Results: We used three methods to identify DEGs: 509 differential genes were screened by R, 1522 by WGCNA, and 732 by prediction of different miRNA targets. In total, 18 DEGs were found, encompassing 9 upregulated genes and 9 downregulated genes. Eight differentially expressed miRNAs were identified using the R package: five were upregulated and three were downregulated. Among them, three miRNAs (miR-204-5p, miR-224-5p, and miR-30a-5p) were considered optimal potential biomarkers, and their regulatory network with DEGs was created by Cytoscape. IL-4-mediated signaling events were the most enriched signaling pathways. Based on these DEGs, CHL1 and SOCS3 were most closely associated with clinical characteristics, which related to sex and stage separately.Conclusions: This study identified novel diagnostic differentially expressed miRNAs and related mRNAs by developing a deeper understanding of the molecular mechanisms, based on that we provided new ideas for the diagnosis and treatment of AAK.
Slope Analysis for the Prediction of Fluid Responsiveness by a Stepwise PEEP Elevation Recruitment Maneuver in Mechanically Ventilated Patients
Authors: VALLIER Sylvain , BOUCHET Jean-Baptiste , DESEBBE Olivier , FRANCOU Camille , RAPHAEL Darren , MOLLIEX Serge , GERGELE Laurent , MOREL Jerome
Published: December 2020

Objective:Assessment of fluid responsiveness is problematic in intensive care unit patients. Lung recruitment maneuvers (LRM) can be used as a functional test to predict fluid responsiveness. We propose a new test to predict fluid responsiveness in mechanically ventilated patients, analyzing the variations of central venous pressure (CVP) and systemic arterial parameters during a prolonged sigh breath LRM without the use of a cardiac output measuring device. Design:Prospective observational cohort study.Setting:Intensive Care Unit, Saint-Etienne University Central Hospital.Patients:Patients under mechanical ventilation, equipped with invasive arterial blood pressure, CVP, pulse contour analysis (PICCOTM), requiring volume expansion, with no right ventricular dysfunction.Interventions:None.Measurements and Main Results:CVP, systemic arterial parameters and stroke volume (SV) were recorded during prolonged LRM followed by a 500mL fluid expansion to asses fluid responsiveness. 25 patients were screened, 18 patients were analyzed. 9 patients were responders to volume expansion and 9 were not. Evaluation of hemodynamics parameters suggested the use of a linear interpolation model. Slopes for systolic aortic pressure, pulse pressure (PP), CVP and SV were all significantly different between responders and non-responders during pressure increase phase of LRM (STEP-UP) (p = 0.022, p = 0.014, p= 0.006 and p = 0.038, respectively). PP and CVP slopes during STEP-UP were strongly predictive of fluid responsiveness with an AUC of 0.926 (95% CI, 0.78 to 1.00), sensitivity = 100%, specificity = 89% and an AUC = 0.901 (95% CI, 0.76 to 1.00), sensibility = 78%, specificity = 100%, respectively. Combining sensitivity of PP and specificity of CVP, fluid responsiveness prediction can be obtained with 100% sensibility and 100% specificity (AUC=0.96; 95% CI, 0.90 to 1.00). 1 patient presented inconclusive values using the grey zone approach (5.5%).Conclusions:In patients under mechanical ventilation with no right cardiac dysfunction, the association of PP and CVP slope analysis during a prolonged sigh breath lung recruitment maneuver seems to offer a very promising method for fluid responsiveness prediction without the use and cost of a cardiac output measurement device.Trial registration: NCT04304521, IRBN902018/CHUSTERegistered 11 March 2020, Fluid responsiveness predicted by a stepwise PEEP elevation recruitment maneuver in mechanically ventilated patients (STEP-PEEP)https://www.clinicaltrials.gov/ct2/show/NCT04304521?term=NCT04304521&cntry=FR&draw=2&rank=1
Prognostic Value of Muscle Mass Measured via Brain Computed Tomography in Neurocritically Ill Patients
Authors: Lee Yun Im , Ko Ryoung-Eun , Ahn Joonghyun , Carriere Keumhee C. , Ryu Jeong-Am
Published: December 2020

Background

To investigate whether skeletal muscle mass estimated via brain computed tomography (CT) can be used to predict neurological outcomes in neurocritically ill patients.
Methods

This is a retrospective, observational study. Adult patients who were admitted to the neurosurgical intensive care unit (ICU) in tertiary hospital from January 2010 to September 2019 were eligible. We included patients who were hospitalized in the neurosurgical ICU for more than 7 days. Cross-sectional areas of paravertebral muscle at the first cervical vertebra level (C1-CSA) and temporalis muscle thickness (TMT) on brain CT were measured to evaluate skeletal muscle mass. Primary outcome was Glasgow Outcome Scale score at 3 months.
Results

Among 189 patients, 167 (88.4%) survived until discharge from the hospital. Of these survivors, 81 (42.9%) patients had favorable neurologic outcomes. Initial TMT values and follow-up TMT values were higher in patients with favorable neurologic outcome compared to those with poor neurological outcome (p = 0.003 and p = 0.001, respectively). Initial the C1-CSA/body surface area was greater in patients with poor neurological outcome than in those with favorable outcome (p = 0.029). In multivariable analysis, age (adjusted odds ratio [OR]: 2.05, 95% confidence interval [CI]: 1.543–2.724), BMI (adjusted OR: 0.74, 95% CI: 0.638–0.849), use of mannitol (adjusted OR: 27.45, 95% CI: 4.833–155.860), change of C1-CSA (adjusted OR: 1.36, 95% CI: 1.054–1.761), and change of TMT (adjusted OR: 1.27, 95% CI: 1.028–1.576) were significantly associated with poor neurological outcome (Hosmer–Lemeshow test, Chi-square = 11.4, df = 8, p = 0.178) with the areas under curve of 0.803 (95% CI 0.740–0.866) using 10-fold cross validation method. Especially, the risk of poor neurologic outcome was proportional to changes of C1-CSA and TMT.
Conclusions

In this study, the follow-up skeletal muscle mass at first week from ICU admission, based on changes in C1-CSA and TMT, was associated with neurological prognosis in neurocritically ill patients. Eventually, brain CT-measured sarcopenia may be helpful in predicting poor neurological outcomes in these patients.
A machine-learning approach for dynamic prediction of sepsis-induced coagulopathy in critically ill patients with sepsis: an integrated analysis of the MIMIC-IV and eICU-CRD databases
Authors: Zhao Qin-Yu , Liu Le-Ping , Luo Jing-Chao , Luo Yan-Wei , Wang Huan , Zhang Yi-Jie , Gui Rong , Tu Guo-Wei , Luo Zhe
Published: December 2020

Background

Sepsis-induced coagulopathy (SIC) denotes an increased mortality rate and poorer prognosis in septic patients.
Methods

Machine-learning models were developed based on septic patients who were older than 18 years and stayed in intensive care units (ICUs) for more than 24 hours in Medical Information Mart for Intensive Care (MIMIC)-IV. Eighty-eight potential predictors were extracted, and 15 various machine-learning models assessed the daily risk of SIC. The most potent model was selected based on its accuracy and Area Under the receiver operating characteristic Curve (AUC), followed by fine-grained hyperparameter adjustment using the Bayesian Optimization Algorithm. The effects of features on prediction scores were measured using the SHapley Additive exPlanations (SHAP) values. A compact model was developed, based on 15 features selected according to their importance and clinical availability. Two models were compared with Logistic Regression and SIC scores in terms of SIC prediction. Additionally, an external validation was performed in the eICU Collaborative Research Database (eICU-CRD).
Results

Of 11362 patients in MIMIC-IV included in the final cohort, a total of 6744 (59%) patients had SIC during sepsis, and 16183 samples were extracted. The model named Categorical Boosting (CatBoost) had the greatest AUC in our study (0.869 [0.850, 0.886]). Coagulation profile and renal function indicators are the most important features to predict SIC. A compact model was developed with the AUC of 0.854 [0.832, 0.872], while the AUCs of Logistic Regression and SIC scores were 0.746 [0.735, 0.755] and 0.709 [0.687, 0.733], respectively. A cohort of 35252 septic patients in eICU-CRD was analyzed. The AUCs of the full and the compact models in external validation were 0.842 [0.837, 0.846] and 0.803 [0.798, 0.809], respectively, which were still larger than those of Logistic Regression (0.660 [0.653, 0.667]) and SIC scores (0.752 [0.747, 0.757]). Prediction results can be illustrated by using SHAP values in the instance level, which makes our models clinically interpretable.
Conclusions

We developed two models which were able to dynamically predict the risk of SIC in septic patients better than conventional Logistic Regression and SIC scores. Prediction results of our two models can be interpreted by using SHAP values.
Utilization of mechanical ventilators in low resource Faculty: a cross sectional study
Authors: Bacha Tigist , Tsegaye Netsanet , Tuli Wagari
Published: December 2020

Background

Few studies are available from Africa on the use of mechanical ventilation (MV) in the pediatric intensive care unit (PICU). Knowledge of the outcome of patients on MV is critical for better use of resources and clinical decision making. We aimed to see the outcome and pattern of patients treated in a pediatric intensive care unit in a teresery hospital, which is the first study to evaluate an Ethiopian PICU.
Methods

A cross-sectional study with retrospective data collection was employed. Data were abstracted from the patients’ medical records by trained health professionals. SPSS version 21 software was used for data entry and analysis. The reports were depicted descriptively using measures of central tendency, dispersion, and displayed through tables and graphs.
Results

There were 536 patients admitted during the study period. 202 (41.2%) incidence of mechanical ventilation (MV) rate 63.6% of the participants were males and 130 (59.1%) died. The most common indication for the initiation of MV was respiratory problems 46 (20.9%). we identified 30.59/1000 ventilator days developed complications.Ventilator-associated pneumonia accounted for 18.6% of the complications with 20.9/1000 ventilator days. Survival of medical cases was better than the surgical cases (including trauma); [AOR = 0.13, 95% CI(0.04–0.413)] and those who have MV for more than 3 days are 79% more likely to die than those of less than 3 days ventilated; (p = 0.003). Those who have multi-organ dysfunction syndrome die more likely than the other group of patients; [AOR = 0.181, 95% CI (0.08, 0.412)] and the patient who had high PIM II severity score had higher mortality rate; [AOR = 35, 95% CI (1.7, 11)].
Conclusions

In the current study, the mortality rate of mechanically ventilated pediatric patients was high. Severity score, multi-organ dysfunction syndrome, length of stay, and being a surgical patient increased the risk of mortality. Adequate education of PICU staff on the use of mechanical ventilator and prevention of complications as well as the use of severity score is necessary.
Critical Appraisal of Clinical Practice Guidelines for the Management of COVID-19: Protocol for a Systematic Review
Authors: Dhivagaran Thanansayan , Abbas Umaima , Butt Fahad Rasool , Arunasalam Luckshann , Chang Oswin
Published: December 2020

BackgroundIn December 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 was identified as the cause of an acute respiratory disease, coronavirus disease 2019 (COVID-19). Given the lack of validated treatments, there is an urgent need for the high-quality management of COVID-19. Clinical practice guidelines (CPGs) are one tool that healthcare providers may use to enhance patient care. As such, it is necessary that they have access to high-quality evidence-based CPGs upon which they may base decisions regarding the management and use of therapeutic interventions (TI) for COVID-19. The purpose of the proposed study is to assess the quality of CPGs that make management or TI recommendations for COVID-19 using the AGREE II instrument. Methods‌The proposed systematic review will identify CPGs for TI use and/or the management of COVID-19. MEDLINE, EMBASE, CINAHL and Web of Science will be searched from December 2019 up to December 2020. The primary outcome of this study is the assessed quality of the CPGs. The quality of eligible CPGs will be assessed using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Descriptive statistics will be used to quantify the quality of the CPGs. The secondary outcomes of this study are the types of management and/or TI recommendations made. Inconsistent and duplicate TI and/or management recommendations made between CPGs will be compared across guidelines. DiscussionThe results of this study will be of utmost importance to enhancing clinical decision-making among healthcare providers caring for patients with COVID-19. Moreover, the results of this study will be relevant to guideline developers in the creation of CPGs or improvement of existing ones, researchers who want to identify gaps in knowledge, and policy-makers looking to encourage and endorse the adoption of CPGs into clinical practice. The results of this review will be published in a peer-reviewed journal and presented at conferences. Systematic Review ‌Registration‌ ‌International‌ ‌Prospective‌ ‌Register‌ ‌for‌ ‌Systematic‌ ‌Reviews‌ ‌(PROSPERO)‌ ‌—‌ ‌CRD42020219944
WITHDRAWN: Classification of Megathyrsus maximus Accessions Grown in The Colombian Dry Tropical Forest by Nutritional Assessment during contrasting seasons
Authors: Tapia Juliana Isabel Carvajal , Mazabel Johana , Vivas-Quila Nelson
Published: December 2020

Background: Nutritional quality of forages is a strategy of continuous research in animal feeding to help mitigate the environmental impact generated by Tropical livestock. The aim of this study is to describe and classify the nutritional profile of the M maximus collection in Dry Tropics as a contribution to the selection of high-quality grassland for sustainable livestock production. The selection criteria were based in the potential of materials to mitigate climate change effects and to support plant breeding processes. For this, the nutritional composition of 129 CIAT accessions of Megathyrsus maximus was evaluated in representative cultivation conditions of Colombian Dry Tropical Forest by means of Near-Infrared Spectroscopy (NIRS) technique, Crude Protein (CP), Neutral Detergent Fiber (NDF), Acid Detergent Fiber (ADF), and in vitro Dry Matter Digestibility (IVDMD) was determined with rainy and dry seasons as fixed effects. Results: genotype and precipitation affect the nutritional value. However, there is relative nutritional steadiness in the NDF, ADF, and IVDMD among seasons for some accessions. According to the nutritional composition index (ICN), half of the evaluated collection had nutritional potential. From this group, 15 accessions showed higher values during rainy and dry seasons. Conclusions: M. maximus has an adequate nutritional profile for animal feeding in dry tropics agroecosystems. It generates alternative materials to project and sustain eco-efficient livestock production in the tropics.
The association between serum copper concentrations and elevated blood pressure in US youths: National Health and Nutrition Examination Survey 2011-2016
Authors: Li Li , Liu Changsong , Liao Yanfen , Zhu Zongyuan , Yang Lili , Zhang Qin
Published: December 2020

Background
Copper is an essential trace metal with potential interest for cardiovascular effects. Few studies have explored the association between copper and blood pressure in children and adolescents (hereafter referred to as youths).
Method:
We conducted a cross-sectional analysis of 1242 youths aged 8–17 years who participated in the 2011 to 2016 National Health and Nutrition Examination Survey. Using 2017 American Academy of Pediatrics guidelines, Elevated Blood Pressure (EBP) was defined as a mean systolic and/or diastolic blood pressure (BP) ≥ 90th percentile for sex, age, and height for children aged 1–12 years and systolic BP ≥ 120 mmHg or diastolic BP ≥ 80 mmHg for adolescent age 13–17 years. Mean serum copper was 114.17 µg/dL.
Results
After multiple adjustments, dose-response analyses revealed that EBP was associated with progressively higher serum copper concentrations in a nonlinear trend. In comparison with the lowest quartile of serum copper concentrations, the adjusted odds of EBP for the highest quartile was 5.26 (95% confidence interval [CI], 2.76–10.03).
Conclusion
Our results suggested that high serum copper concentrations were significantly associated with EBP in US youths.
Parents’ health information seeking behaviour – does the child’s health status play a role?
Authors: Baumann Isabel , Jaks Rebecca , Robin Dominik , Juvalta Sibylle , Dratva Julia
Published: December 2020

Background: Digital media are increasingly abundant, providing a wide scope of health information. To date, very little is known about parental health information seeking behaviour for child health outside of English-speaking and Nordic countries. Our study “Digital parental counsellors” examines how parents search for health information in digital media, print media and among “personal contacts”, distinguishing between the search for information about general child health and development and child’s acute illness, and comparing information seeking behaviour by disability status of the child. Methods: The population-based sample consisted of 769 parents with children aged 0-2 in the German-speaking region of Switzerland returning the study questionnaire (30% response rate). We developed a frequency score of use of different information sources and conducted bivariate and multivariate linear regression analyses to describe parental search behaviour and the association with child’s disability status. Results: The sample consists of 88% mothers (mean age: 35.7 years SD 4.33). Children’s mean age is 16 months (SD 7.1), 49% of the children are female and 6% have a disability. Parents use digital media significantly more frequently to search for information about general health and development questions than about an acute child’s illness (p<0.001). In case of acute child’s illness, parents refer to their paediatrician, family members and other personal contacts significantly more frequently than other information sources (p<0.001). The use of digital media and “personal contacts” does not significantly vary between parents with and without a disabled child, whereas the use of print media does (p<0.02). Moreover, irrespective of disability, 45% of parents resort to the Internet prior to a paediatric visit and 27% after a visit when a visit did not answer all questions. Conclusions: Despite the high prevalence of digital media, personal contacts are still the most frequent health information resource for parents with young children, irrespective of the child’s health. Parents combine all information resources (online, print, personal network) to improve their understanding or check the validity of information received regarding their child’s health. It is thus of utmost importance, that the increasingly accessed digital information parents search for is correct, understandable and addresses parent’s concerns.
Socio-demographic characteristics associated with emotional and social loneliness among older adults in five European countries
Authors: Fierloos Irene Noëlla , Tan Siok Swan , Williams Greg , Alhambra-Borrás Tamara , Koppelaar Elin , Bilajac Lovorka , Verma Arpana , Markaki Athina , Mattace-Raso Francesco , Vasiljev Vanja , Franse Carmen Betsy , Raat Hein
Published: December 2020

Background: International studies provide an overview of socio-demographic characteristics associated with loneliness among older adults, but few studies distinguished between emotional and social loneliness. This study examined socio-demographic characteristics associated with emotional and social loneliness. Methods: Data of 2251 community-dwelling older adults, included at the baseline measure of the Urban Health Centers Europe (UHCE) project, were analysed. Loneliness was measured with the 6-item De Jong-Gierveld Loneliness Scale. Multivariable logistic regression models were used to evaluate associations between age, sex, living situation, educational level, migration background, and loneliness. Results: The mean age of participants was 79.7 years (SD=5.6 years); 60.4% women. Emotional and social loneliness were reported by 29.2% and 26.7% of the participants; 13.6% experienced emotional and social loneliness simultaneously Older age (OR: 1.16, 95% CI: 1.06-1.28), living without a partner (2.16, 95% CI: 1.73-2.70), and having a low educational level (OR: 1.82, 95% CI: 1.21-2.73), were associated with increased emotional loneliness. Women living with a partner were more prone to emotional loneliness than men living with a partner (OR: 1.78, 95% CI: 1.31-2.40). Older age (OR: 1.11, 95% CI: 1.00-1.22) and having a low educational level (OR: 1.77, 95% CI: 1.14-2.74) were associated with increased social loneliness. Men living without a partner were more prone to social loneliness than men living with a partner (OR: 1.94, 95% CI: 1.35-2.78). Conclusions: Socio-demographic characteristics associated with emotional and social loneliness differed regarding sex and living situation. Researchers, policy makers, and healthcare professionals should be aware that emotional and social loneliness may affect older adults with different socio-demographic characteristics.
Compassion Fatigue and perceived of social support among polish nurses
Authors: Metko Paulina Pergol- , Czyżewski Lukasz
Published: December 2020

Background:Social support has an important role to prevent traumatic stress connected with performing a nurse profession. The aim of the study was to measure the relationship between compassion fatigue and perceived social support in polish nurses.Methods:The study was conducted in a group of 862 professionally active nurses in Poland using the CAWI method (Computer-Assisted Web Interview). Professional Quality of Life scale (ProQOL) and the Multidimensional Scale of Perceived Social Support (MSPSS) were used for collecting the data. StatSoft, Inc. (2014) was used for data analysis. For comparisons between the groups: Mann-Whitney U test, ANOVA Kruskal Wallis test, multiple comparisons (post-hoc). Relationships between variables were tested using the Spearman's R test, Tau Kendall's test and chi 2 test. The level of significance in all calculations was assumed p <0.05.Results:The research showed the presence of Compassion Satisfaction, Compassion Fatigue and Burnout in the group of Polish hospital nurses. A higher level of perceived social support was associated with a lower level of compassion fatigue (r=-0,35; p<0,001). A higher level of social support was associated with higher job satisfaction (r = 0.40; p <0.001). The study also found that a higher level of social support was associated with a lower risk of Burnout (r = -0.41; p <0.001). Conclusions:Preventing of Compassion fatigue and Burnout should be a priority for health care managers. It is worth noting that an important predictor of Compassion Fatigue is the fact that Polish nurses often work overtime. It is necessary to pay more attention to the key role of Social Support in preventing CF and BO.
Smart@Home – Supporting safety and mobility of elderly and care dependent people in their own homes through the use of technical assistance systems and conventional mobility supporting tools: A cross-sectional survey
Authors: Jachan Deborah Elisabeth , Müller-Werdan Ursula , Lahmann Nils Axel , Strube-Lahmann Sandra
Published: December 2020

BACKGROUND: The use of technical solutions and conventional mobility supporting aids can support the independence of people into old age in their own homes. However, we found relatively few empirical investigations on the effects and costs of these systems.METHODS: The aim of the study was to investigate usability, user satisfaction and the correlation between costs and benefits of different built-in smart home solutions and conventional mobility supporting tools in the home of elderly, partially care-dependent tenants (>65 years). A cross-sectional survey was conducted from February to March 2018 with tenants of a housing association in apartments equipped with smart home technology and conventional mobility supporting tools. The response rate in the intervention group was n=37 persons (out of 46 tenants with installed smart home and conventional solutions) and in the control group n=64 persons (out of 100 tenants without built-in smart home and conventional solutions). Data were collected by a written questionnaire regarding usability and satisfaction of the tenants with the built-in smart home solutions and conventional mobility supporting tools. In addition, both the intervention and the control group were asked general questions about communication, safety and how to deal with the need for long-term care in their own living environment.RESULTS: Results showed that with regard to usability, satisfaction and price performance ratio of the installed smart home solutions, the installation of the corresponding solutions with an overall score of 1.41 (on a scale of 1 (very good) to 6 (unsatisfactory)) was mostly positively evaluated by the tenants. Overall, users rated the installed smart home solutions better than the conventional mobility supporting tools (such as handholds and increased balcony floor level).CONCLUSIONS: Analysis of the price performance ratio showed that smart home solutions are generally more expensive than conventional tools, but also contribute significantly to an increased security of the tenants, and thus may enable longer living in a familiar environment. We recommend modularized offers consisting of various components of smart home solutions, since this significantly reduces installation costs and allows for an individual composition according to requirements. Moreover, smart home solutions should be considered to be listed as medical aids.
End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study
Authors: Ho Kevin Ki-Wai , Lau Lawrence Chun-Man , Chau Wai Wang , Poon Queena , Chung Kwong-Yin , Wong Ronald Man-Yeung
Published: December 2020

Background: Sarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-sarcopenic subjects remains unexplored. This study aimed to examine the dynamic, mutual impact of sarcopenia and TKA in a one-year post-operative period.Methods: This prospective cohort study was conducted between 2015 to 2018 at our hospital. Patients with end-stage OA of the knee waiting for TKA were recruited into the study. Primary outcome measures were change in muscle strength, mass and function. Secondary outcome measures were quality of life (QOL) measurements for pain, psychological and physical health.Results: Fifty-eight patients were recruited, of which 79.3% were female and 32.8% already had sarcopenia at baseline. The average age of sarcopenic subjects and non-sarcopenic subjects was comparable (67.89±7.07 vs. 67.92±6.85; p=0.99), but sarcopenic subjects had a lower body mass index (BMI) (25.64±2.64 vs. 28.57±4.04; p=0.01). There was a statistically significant improvement in walking speed (10.24±5.35 vs. 7.69±2.68, p<0.01) and muscle strength in both sarcopenic and non-sarcopenic patients after TKA. This was accompanied by an improvement trend in muscle mass in all subjects. There was no change in handgrip power before and after TKA and subsequent follow-up (19.31±5.92 vs. 18.98±6.37 vs. 19.36±7.66; p=0.97). QOL measured before, after and at follow-up with WOMAC (total: 42.27±15.98 vs. 20.65±15.24 vs. 16.65±18.13) and SF12v2 (PCS: 33.06±8.55 vs. 38.96±8.01 vs. 40.67±7.93) revealed progressive significant improvement (both comparisons p≤0.01). Further analysis with the IPAQ also found increased engagement of high-intensity activities.Conclusions: This study showed that sarcopenia among patients with end-stage OA of the knee is not uncommon, but both sarcopenic and non-sarcopenic OA patients achieved significant clinical and functional improvement after TKA. Further studies with a larger sample size and different ethnicities could help ascertain a beneficial role of TKA in sarcopenic OA subjects.