bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Obesity on Clinical Outcomes of Patients Treated With Cefepime
Authors: Morrison Austin R. , Loper Johnathon T. , Barber Katie E. , Stover Kayla R. , Wagner Jamie L.
Published: October 2020

Background: As the prevalence of obesity climbs, dosing of antimicrobials, particularly cephalosporins, is becoming a greater challenge for clinicians. Data are lacking for appropriate dosing of cefepime, an anti-pseudomonal cephalosporin that is widely used as an empiric anti-pseudomonal agent. Objective: The purpose of this study was to determine the rate of clinical treatment failure in obese patients compared with nonobese patients receiving cefepime as definitive monotherapy. Methods: Adult inpatients treated with cefepime monotherapy for ≥72 hours were included. Patients were excluded if they (1) were not able to achieve culture clearance within 72 hours and (2) had polymicrobial infections requiring more than one antibiotic for definitive therapy. Results: Fifty-eight obese patients and 56 nonobese patients were included. Pseudomonas aeruginosa, Escherichia coli, and Enterobacter spp were the most prevalent organisms isolated. Most organisms had a minimum inhibitory concentration of ≤1 µg/mL to cefepime with no differences in minimum inhibitory concentration distributions between groups. Definitively, 60% of patients received cefepime 1 g, while almost 40% received cefepime 2 g. Clinical failure occurred in 52% of patients (67% obese vs 36% nonobese; P = .001), with study group (odds ratio = 1.057, 95% confidence interval = 1.008-1.109) and respiratory source (odds ratio = 3.251, 95% confidence interval = 1.378-7.667) being independent predictors of failure. There were no differences in hospital length of stay, all-cause mortality, or 30-day readmissions. Conclusions: Obese patients treated with cefepime are more likely to experience treatment failure than nonobese patients. Larger trials examining the reasons for clinical failure in obese patients treated with cefepime are needed to confirm the findings from this preliminary work.
Transcriptome and metabolite profiling reveals the effects of Funneliformis mosseae on the roots of continuously cropped soybeans
Authors: Lu Cheng-Cheng , Guo Na , Yang Chao , Sun Hai-Bing , Cai Bai-Yan
Published: October 2020

Background

Arbuscular mycorrhizal fungi are the most widely distributed mycorrhizal fungi, which can form mycorrhizal symbionts with plant roots and enhance plant stress resistance by regulating host metabolic activities. In this paper, the RNA sequencing and ultra-performance liquid chromatography (UPLC) coupled with tandem mass spectrometry (MS/MS) technologies were used to study the transcriptome and metabolite profiles of the roots of continuously cropped soybeans that were infected with F. mosseae and F. oxysporum. The objective was to explore the effects of F. mosseae treatment on soybean root rot infected with F. oxysporum.

Results

According to the transcriptome profiles, 24,285 differentially expressed genes (DEGs) were identified, and the expression of genes encoding phenylalanine ammonia lyase (PAL), trans-cinnamate monooxygenase (CYP73A), cinnamyl-CoA reductase (CCR), chalcone isomerase (CHI) and coffee-coenzyme o-methyltransferase were upregulated after being infected with F. oxysporum; these changes were key to the induction of the soybean’s defence response. The metabolite results showed that daidzein and 7,4-dihydroxy, 6-methoxy isoflavone (glycine), which are involved in the isoflavone metabolic pathway, were upregulated after the roots were inoculated with F. mosseae. In addition, a substantial alteration in the abundance of amino acids, phenolic and terpene metabolites all led to the synthesis of defence compounds. An integrated analysis of the metabolic and transcriptomic data revealed that substantial alterations in the abundance of most of the intermediate metabolites and enzymes changed substantially under pathogen infection. These changes included the isoflavonoid biosynthesis pathway, which suggests that isoflavonoid biosynthesis plays an important role in the soybean root response.

Conclusion

The results showed that F. mosseae could alleviate the root rot caused by continuous cropping. The increased activity of some disease-resistant genes and disease-resistant metabolites may partly account for the ability of the plants to resist diseases. This study provides new insights into the molecular mechanism by which AMF alleviates soybean root rot, which is important in agriculture.
Emergency tracheal intubation during off-hours is not associated with increased mortality in hospitalized patients: a retrospective cohort study
Authors: Liu Jun-Le , Jin Jian-Wen , Lai Zhong-Meng , Wang Jie-Bo , Su Jian-Sheng , Wu Guo-Hua , Chen Wen-Hua , Zhang Liang-Cheng
Published: October 2020

Background

The prognosis of hospitalized patients after emergent endotracheal intubation (ETI) remains poor. Our aim was to evaluate the 30-d hospitalization mortality of subjects undergoing ETI during daytime or off-hours and to analyze the possible risk factors affecting mortality.

Methods

A single-center retrospective study was performed at a university teaching facility from January 2015 to December 2018. All adult inpatients who received ETI in the general ward were included. Information on patient demographics, vital signs, ICU (Intensive care unit) admission, intubation time (daytime or off-hours), the department in which ETI was performed (surgical ward or medical ward), intubation reasons, and 30-d hospitalization mortality after ETI were obtained from a database.

Results

Over a four-year period, 558 subjects were analyzed. There were more male than female in both groups (115 [70.1%] vs 275 [69.8%]; P = 0.939). A total of 394 (70.6%) patients received ETI during off-hours. The patients who received ETI during the daytime were older than those who received ETI during off-hours (64.95 ± 17.54 vs 61.55 ± 17.49; P = 0.037). The BMI of patients who received ETI during the daytime was also higher than that of patients who received ETI during off-hours (23.08 ± 3.38 vs 21.97 ± 3.25; P < 0.001). The 30-d mortality after ETI was 66.8% (373), which included 68.0% (268) during off-hours and 64.0% (105) during the daytime (P = 0.361). Multivariate Cox regression analysis found that the significant factors for the risk of death within 30 days included ICU admission (HR 0.312, 0.176–0.554) and the department in which ETI was performed (HR 0.401, 0.247–0.653).

Conclusions

The 30-d hospitalization mortality after ETI was 66.8%, and off-hours presentation was not significantly associated with mortality. ICU admission and ETI performed in the surgical ward were significant factors for decreasing the risk of death within 30 days.

Trial registration

This trial was retrospectively registered with the registration number of ChiCTR2000038549.
Improving knowledge, self-efficacy and collective efficacy regarding the Brazilian dietary guidelines in primary health care professionals: a community controlled trial
Authors: Tramontt C. R. , Jaime P. C.
Published: October 2020

Background

Capacity-building of health professionals regarding to nutrition is a strategy for qualifying public health work to promote healthy diets in primary health care (PHC) services.

Objective

To evaluate the effect of an intervention based on Brazilian Dietary Guidelines (BDG) on the knowledge, self-efficacy (SE) and collective efficacy (CE) of interprofessional teams working in PHC.

Methods

It refers to a pre-post intervention study involving 24 health professionals divided into a control group (CG) and intervention (IG). The IG received a 16-h educational workshop on the BDG, guided by a validated protocol. Knowledge, SE and CE for using the BDG were assessed via a self-administered scale, ranging from 0 to 16 and 0 to 36 points, respectively; the scale was previously validated, completed before and after 2 months of the intervention. The effects of the intervention were estimated by paired t-test for intragroup comparisons over time.

Results

The mean difference in the knowledge and SE scores of the IG pre- and post-intervention was 2.0 (CI 0.49–3.51) and 6.75 (CI 4.05–9.45) points, respectively. These results means the IG participants obtained 59 and 52.8% more points in knowledge and in SE in relation to CG, with significative difference (p = 0.007 and p <  0.00, respectively). There was no significant variation in the CE scores in both groups.

Conclusions

Considering the results presented and due to the originality of the study in question, the educational workshop was effective in increasing the knowledge and SE of professionals working in PHC in using the Dietary Guidelines in their work routines. These findings can assist other research in developing nutrition interventions with interprofessional teams.
Lack of association between circulating apelin level and frailty-related functional parameters in older adults: a cross-sectional study
Authors: Jang Il-Young , Lee Seungjoo , Kim Jeoung Hee , Lee Eunju , Lee Jin Young , Park So Jeong , Kim Da Ae , Hamrick Mark W. , Park Jin Hoon , Kim Beom-Jun
Published: October 2020

Background

Apelin, an active endogenous peptide, has been recently receiving great attention as a promising target for antiaging intervention, primarily based on results from genetically altered mice. To validate previous experimental data and investigate the possible role of apelin in humans, in this study, we examined serum apelin level in relation to frailty and its associated parameters in a cohort of ambulatory, community-dwelling older adults.

Methods

Blood samples were collected from 80 participants who underwent a comprehensive geriatric assessment, and apelin level was measured using an enzyme immunoassay kit. Phenotypic frailty and deficit-accumulation frailty index (FI) were assessed using widely validated approaches, proposed by Fried and Rockwood groups, respectively.

Results

After adjustment for sex, age, and body mass index, serum apelin level was found to be not significantly different according to phenotypic frailty status (P = 0.550) and not associated with FI, grip strength, gait speed, time to complete 5 chair stands, and muscle mass (P = 0.433 to 0.982). To determine whether the association between serum apelin level and frailty has a threshold effect, we divided the participants into quartiles according to serum apelin level. However, there were no differences in terms of frailty-related parameters and the risk for frailty among the quartile groups (P = 0.248 to 0.741).

Conclusions

The serum apelin level was not associated with both phenotypic frailty and functional parameters in older adults, despite its beneficial effects against age-related physiologic decline in animal models. Further large-scale longitudinal studies are necessary to understand the definite role of circulating apelin in frailty risk assessment.
Oral beta-lactam step down in bacteremic E. coli urinary tract infections
Authors: Saad Stephan , Mina Neil , Lee Colin , Afra Kevin
Published: October 2020

Background

Literature is scarce regarding oral step down to beta-lactams in bacteremic urinary tract infections. Oral fluoroquinolones are an accepted and common step down for bacteremic urinary tract infections; however, their use is associated with mounting safety concerns. We compared clinical cure in patients with E. coli bacteremic urinary tract infections who were stepped down to oral beta-lactams compared to oral fluoroquinolones.

Methods

This multicentre retrospective cohort study included patients with first positive concurrent urine and blood cultures from January 2016 to December 2016. Patients were included if they received empiric intravenous beta-lactam therapy with step down to either oral beta-lactam or fluoroquinolone for treatment completion. The primary outcome was clinical cure. Secondary outcomes were length of hospitalization, all-cause mortality and C. difficile infection. Multivariate analysis and propensity score were used to control for confounding.

Results

A total of 207 patients were identified with bacteremic E.coli urinary tract infections. Clinical cure was achieved in 72/77 (94%) in the oral beta-lactam group versus 127/130 (98%) in the oral fluoroquinolone group (absolute difference − 4.2, 95% confidence interval [CI] -10.3 to 1.9%, p = 0.13). The adjusted odds ratio (OR) for clinical cure with oral beta-lactams was 0.31 (95% CI 0.05–1.90, p = 0.21); propensity score adjusted analysis showed a similar result. There was no statistically significant difference in secondary outcomes.

Conclusions

Oral beta-lactams appear to be a safe and effective step down option in bacteremic E. coli urinary tract infections compared to oral fluoroquinolones.
A nonsense variant in FBN1 caused autosomal dominant Marfan syndrome in a Chinese family: a case report
Authors: Niu Yuping , Huang Sexin , Wang Zeyu , Xu Peiwen , Wang Lijuan , Li Jie , Gao Ming , Gao Xuan , Gao Yuan
Published: October 2020

Background

Marfan syndrome (MFS) is a common autosomal dominant inherited disease, and the occurrence rate is around 0.1–0.2‰. The causative variant of FNB1 gene accounts for approximately 70–80% of all MFS cases. In this study, we found a heterozygous c.3217G > T (p.Glu1073*) nonsense variant in the FBN1 gene. This finding extended the variant spectrum of the FBN1 gene and will provide a solution for patients to bear healthy offspring by preimplantation genetic testing or prenatal diagnosis.

Case presentation

The patient was treated due to tachycardia during excitement in a hospital. Echocardiography showed dilatation of the ascending aorta and main pulmonary artery, mitral regurgitation (mild), tricuspid regurgitation (mild), and abnormal left ventricular filling. Electrocardiograph showed sinus rhythm. In addition, flutters of shadows in front of his eyes and vitreous opacity were present in the patient. Genomic DNA was extracted from peripheral blood samples from members of the family and 100 unrelated controls. Potential variants were screened out by next-generation sequencing and confirmed by MLPA & Sanger sequencing. Real-time fluorescence quantitative PCR (RT-qPCR) was performed to detect the relative mRNA quantitation in the patient. A heterozygous nonsense variant c.3217G > T of the FBN1 gene, which resulted in p. Glu1073Term, was identified in both patients. Only wild type bases were found in the cDNA sequence of the patient. Real-time fluorogenic quantitative PCR results showed that the relative expression level of FBN1 cDNA in the patient was only about 21% compared to that of normal individuals. This variant c.3217G > T of the FBN1 gene introduces a Stop codon in the cb-EGF12 domain. We speculated that a premature translational-termination codon (PTC) was located in the mRNA and the target mRNA was disintegrated through a process known as nonsense-mediated mRNA decay (NMD), which led to a significant decrease of the fibrillin-1 protein, eventually causing clinical symptoms in the patient.

Conclusions

In this study, we found a heterozygous c.3217G > T (p.Glu1073*) nonsense variant in the FBN1 gene, which eventually led to Marfan syndrome in a Chinese family.
Diagnostic test accuracy of point-of-care procalcitonin to diagnose serious bacterial infections in children
Authors: Waterfield Thomas , Maney Julie-Ann , Lyttle Mark D , McKenna James P , Roland Damian , Corr Michael , Patenall Bethany , Shields Michael D , Woolfall Kerry , Fairley Derek ,   On behalf of Paediatric Emergency Research in the UK and Ireland (PERUKI)
Published: October 2020

Background

The National Institute for Health and Care Excellence (NICE) have called for research into the role of biomarkers, and specifically procalcitonin (PCT), for the early diagnosis of serious bacterial infections (SBI) in children. The aim of this study was to compare the diagnostic test accuracy of C-reactive protein (CRP) and PCT for the diagnosis of SBI in children.

Methods

Data was collected prospectively from four UK emergency departments (ED) between November 2017 and June 2019. Consecutive children under 18 years of age with fever and features of possible sepsis and/or meningitis were eligible for inclusion. The index tests were PCT and CRP and the reference standard was the confirmation of SBI.

Results

213 children were included in the final analysis. 116 participants (54.5%) were male, and the median age was 2 years, 9 months. Parenteral antibiotics were given to 100 (46.9%), three (1.4%) were admitted to a paediatric intensive care unit and there were no deaths. There were ten (4.7%) confirmed SBI. The area under the curve for PCT and CRP for the detection of SBI was identical at 0.70.

Conclusions

There was no difference in the performance of PCT and CRP for the recognition of SBI in this cohort.

Trial registration

Registered at https://www.clinicaltrials.gov (trial registration: NCT03378258) on the 19th of December 2017.
Association of plasma free fatty acids levels with the presence and severity of coronary and carotid atherosclerotic plaque in patients with type 2 diabetes mellitus
Authors: Zhang Ming-Hua , Cao Ye-Xuan , Wu Li-Guo , Guo Na , Hou Bing-Jie , Sun Li-Jing , Guo Yuan-Lin , Wu Na-Qiong , Dong Qian , Li Jian-Jun
Published: October 2020

Background

Previous studies have suggested that patients with diabetes mellitus (DM) have higher prevalence of atherosclerotic cardiovascular disease (ASCVD), and plasma levels of free fatty acids (FFAs) are a useful marker for predicting ASCVD. We hypothesized that FFAs could predict both coronary and carotid lesions in an individual with type 2 DM (T2DM). The present study, hence, was to investigate the relation of plasma FFA level to the presence and severity of coronary and carotid atherosclerosis in patients with T2DM.

Methods

Three hundred and two consecutive individuals with T2DM who have received carotid ultrasonography and coronary angiography due to chest pain were enrolled in this study. Plasma FFAs were measured using an automatic biochemistry analyzer. Coronary and carotid severity was evaluated by Gensini score and Crouse score respectively. Subsequently, the relation of FFA levels to the presence and severity of coronary artery disease (CAD) and carotid atherosclerotic plaque (CAP) in whole individuals were also assessed.

Results

Increased plasma FFA levels were found in the groups either CAD or CAP compared to those without. Patients with higher level of FFAs had a higher CAD (89.9%) and elevated prevalence of CAP (69.7%). And also, patients with higher level of FFAs had a higher Gensini and Crouse scores. Multivariate regression analysis showed that FFA levels were independently associated with the presence of CAD and CAP (OR = 1.83, 95%CI: 1.27–2.65, P = 0.001; OR = 1.62, 95%CI: 1.22–2.14, P = 0.001, respectively). The area under the curve (AUC) was 0.68 and 0.65 for predicting the presence of CAD and CAP in patients with DM respectively.

Conclusions

The present study firstly indicated that elevated FFA levels appeared associated with both the presence and severity of CAD and CAP in patients with T2DM, suggesting that plasma FFA levels may be a useful biomarker for improving management of patients with T2DM.
Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India
Authors: Mungai Isaac Gikandi , Baghel Sumit Singh , Soni Shuchi , Vagela Shailja , Sharma Megha , Diwan Vishal , Tamhankar Ashok J. , Lundborg Cecilia Stålsby , Pathak Ashish
Published: October 2020

Background

More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge.

Methods

A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to look for association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice.

Results

Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean ± SD score achieved was 22.3 ± 7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75th and q90th) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90th).

Conclusions

The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon by future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population in the study setting and to improve neonatal care services.
The chest CT features of coronavirus disease 2019 (COVID-19) in China: a meta-analysis of 19 retrospective studies
Authors: Yang Haitao , Lan Yuzhu , Yao Xiujuan , Lin Sheng , Xie Baosong
Published: October 2020

Objective

Aimed to summarize the characteristics of chest CT imaging in Chinese hospitalized patients with Coronavirus Disease 2019 (COVID-19) to provide reliable evidence for further guiding clinical routine.

Methods

PubMed, Embase and Web of Science databases were searched to identify relevant articles involving the features of chest CT imaging in Chinese patients with COVID-19. All data were analyzed utilizing R i386 4.0.0 software. Random-effects models were employed to calculate pooled mean differences.

Results

19 retrospective studies (1332 cases) were included. The results demonstrated that the combined proportion of ground-glass opacities (GGO) was 0.79 (95% CI 0.68, 0.89), consolidation was 0.34 (95% CI 0.23, 0.47); mixed GGO and consolidation was 0.46 (95% CI 0.37; 0.56); air bronchogram sign was 0.41 (95% CI 0.26; 0.55); crazy paving pattern was 0.32 (95% CI 0.17, 0.47); interlobular septal thickening was 0.55 (95% CI 0.42, 0.67); reticulation was 0.30 (95% CI 0.12, 0.48); bronchial wall thickening was 0.24 (95% CI 0.11, 0.40); vascular enlargement was 0.74 (95% CI 0.64, 0.86); subpleural linear opacity was 0.28 (95% CI 0.12, 0.48); intrathoracic lymph node enlargement was 0.03 (95% CI 0.00, 0.07); pleural effusions was 0.03 (95% CI 0.02, 0.06). The distribution in lung: the combined proportion of central was 0.05 (95% CI 0.01, 0.11); peripheral was 0.74 (95% CI 0.62, 0.84); peripheral involving central was 0.38 (95% CI 0.19, 0.75); diffuse was 0.19 (95% CI 0.06, 0.32); unifocal involvement was 0.09 (95% CI 0.05, 0.14); multifocal involvement was 0.57 (95% CI 0.48, 0.68); unilateral was 0.16 (95% CI 0.10, 0.23); bilateral was 0.83 (95% CI 0.78, 0.89); The combined proportion of lobes involved (> 2) was 0.70 (95% CI 0.61, 0.78); lobes involved (≦ 2) was 0.35 (95% CI 0.26, 0.44).

Conclusion

GGO, vascular enlargement, interlobular septal thickening more frequently occurred in patients with COVID-19, which distribution features were peripheral, bilateral, involved lobes > 2. Therefore, based on chest CT features of COVID-19 mentioned, it might be a promising means for identifying COVID-19.
Activation of the KDM5A/miRNA-495/YTHDF2/m6A-MOB3B axis facilitates prostate cancer progression
Authors: Du Chen , Lv Caihong , Feng Yue , Yu Siwen
Published: October 2020

Background

Accumulating evidence supports that lysine-specific demethylase 5 (KDM5) family members act as oncogenic drivers. This study was performed to elucidate the potential effects of KDM5A on prostate cancer (PCa) progression via the miR-495/YTHDF2/m6A-MOB3B axis.

Methods

The expression of KDM5A, miR-495, YTHDF2 and MOB3B was validated in human PCa tissues and cell lines. Ectopic expression and knockdown experiments were developed in PCa cells to evaluate their effects on PCa cell proliferation, migration, invasion and apoptosis. Mechanistic insights into the interaction among KDM5A, miR-495, YTHDF2 and MOB3B were obtained after dual luciferase reporter, ChIP, and PAR-CLIP assays. Me-RIP assay was used to determine m6A modification level of MOB3B mRNA in PCa cells. Mouse xenograft models of PCa cells were also established to monitor the tumor growth.

Results

KDM5A was highly expressed in human PCa tissues and cell lines. Upregulated KDM5A stimulated PCa cell proliferation, migration and invasion, but reduced cell apoptosis. Mechanistically, KDM5A, as a H3K4me3 demethylase, bound to the miR-495 promoter, which led to inhibition of its transcription and expression. As a target of miR-495, YTHDF2 could inhibit MOB3B expression by recognizing m6A modification of MOB3B mRNA and inducing mRNA degradation. Furthermore, KDM5A was found to downregulate MOB3B expression, consequently augmenting PCa cell proliferation, migration and invasion in vitro and promoting tumor growth in vivo via the miR-495/YTHDF2 axis.

Conclusion

In summary, our study highlights the potential of histone demethylase KDM5A activity in enhancing PCa progression, and suggests KDM5A as a promising target for PCa treatment.
Probiotics and the envisaged role in treating human infertility
Authors: Younis Nagham , Mahasneh Adel
Published: October 2020

Background

Considerable attention is being directed nowadays towards using probiotics as an alternative therapy in treating several human diseases including gastrointestinal tract diseases especially colorectal cancers, cardiovascular diseases, hyperlipidemia, and blood pressure cases. However, infertility as affected by the microbiome and the probable role of probiotics in alleviating infertility problems did not receive the deserved attention, especially in IVF patients with male or female factors.

Main body

In this review, we tried to draw the attention of researchers in the medical settings to the importance of the forthcoming role of probiotics use in elucidating the role of the microbiome in infertile patients. The hope is to attain the best performance of both male and female reproductive systems and to shed some light on infertility problems.

Conclusion

More in vivo experiments are still needed to address many aspects of probiotics like proper administration, exact functional strains, required dose, application method, duration of treatment, and combination with antibiotics before considering probiotics as an alternative treatment.
Morphological and histopathological study of hypertrophied inferior nasal turbinate in Egyptian patients: in clinical perspective
Authors: El-Demerdash Ashraf Ali , Beheiry Essam Abdel Wanees , El-Aini Sherif Maher , Mohamed Asmaa Shams El-Dein , Khattab Ahmed Mohamed Ibrahim
Published: October 2020

Background

The inferior nasal turbinates have important role in the maintenance of nasal breathing function by providing the nasal valve mechanism necessary for the regulation of air flow through the nose. Hypertrophied inferior nasal turbinates are the second most common cause of chronic nasal obstruction. Our aim of this study is to evaluate the morphological and histopathological features of hypertrophied inferior nasal turbinate in Egyptian patients.

Methods

Our descriptive comparative study was carried on 30 patients presented with hypertrophied inferior nasal turbinate by clinical and radiological assessment. Patients are divided into two groups according to CT scan and endoscopic examination as group A for patients with deviated nasal septum with compensatory hypertrophied inferior nasal turbinate and group B for patients with hypertrophied inferior nasal turbinate due to allergic rhinosinusitis. Both groups underwent the same operation which partial controlled posterior inferior turbinectomy. During the period from June 2018 till May 2019, patients were selected from out-patient’s clinic of Otorhinolaryngology Department at Menoufia University Hospital and Shebin El-Kom Teaching Hospital, and Military Hospital.

Results

By histopathological examination of the specimens, we found out that the bony layer thickness was more prominent in group A and the mucosal layer thickness was more prominent in group B. The prominent inflammatory cells were lymphocytes in group A and eosinophils plus mast cells in group B.

Conclusion

The bony layer thickness should be excised during the surgical treatment of cases presented with deviated nasal septum with hypertrophied inferior turbinate where in cases of allergic rhinitis with hypertrophied inferior turbinate, the mucosal layer is enough to be excised.
Effect of Treatment of Periodontitis on Incretin Axis in Obese and Nonobese Individuals: A Cohort Study
Authors: Suvan Jeanie , Masi Stefano , Harrington Zoe , Santini Eleonora , Raggi Francesco , D’Aiuto Francesco , Solini Anna
Published: October 2020

Context

Periodontitis confers an increased risk of developing type 2 diabetes and, in patients with obesity, it might interfere with the incretin axis. The effect of periodontal treatment on glucoregulatory hormones remains unknown.

Objective

To evaluate the effect of periodontal treatment on incretin axis in obese and lean nondiabetic individuals.

Setting

King’s College Dental Hospital and Institute, London, UK.

Participants and Methods

The metabolic profile of obese and normal-body-mass-index individuals affected by periodontitis was studied at baseline, 2, and 6 months after intensive periodontal treatment, by measuring plasma insulin, glucagon, glucagon-like peptide-1(GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) and markers of systemic inflammation and oxidative stress.

Main Outcome Measure(s)

Circulating levels of incretins and inflammatory markers.

Results

At baseline, periodontal parameters were worse for obese than nonobese; this was accompanied by higher levels of circulating high-sensitivity C-reactive protein (hs-CRP), insulin, and GLP-1. The response to periodontal treatment was less favorable in the obese group, without significant variations of hs-CRP or malondialdehyde. Glucoregulatory hormones changed differently after treatment: while insulin and glucagon did not vary at 2 and 6 months, GLP-1 and GIP significantly increased at 6 months in both groups. In particular, GLP-1 increased more rapidly in obese participants, while the increase of GIP followed similar trends across visits in both groups.

Conclusions

Nonsurgical treatment of periodontitis is associated with increased GLP-1 and GIP levels in nonobese and obese patients; changes in GLP-1 were more rapid in obese participants. This might have positive implications for the metabolic risk of these individuals.
What Is EU Public Health and Why? Explaining the Scope and Organization of Public Health in the European Union
Authors: Greer Scott L. , Jarman Holly
Published: October 2020

Public health is notoriously difficult to define, and that is the case for public health in the European Union as much as other political systems. In this article, the authors try to identify the actual scope and meaning of public health as it is institutionalized in the EU political system. Using a mixture of historical policy and legal analysis, the authors show how the evolution of the institutional space called public health in the EU has been shaped by the EU's distinctive constitutional nature, its focus on regulation, and the legacy of its focus on market making as well as the preferences of its political leaders. The European Union does have an increasingly large space named “public health,” in which health ministers, the health directorate-general, and invocation of its public health treaty article 168 can be found, as well as a much broader and older area of activities justified by the need to manage adverse health consequences of market-making policies in other areas such as labor standards and agriculture. The COVID-19 crisis of 2020 not only led to a strengthening of EU public health but also showed that the EU is one of the many political systems in which the legal and bureaucratic domain of public health is far smaller than the actual issues affecting the public's health.
Health “Brexternalities”: The Brexit Effect on Health and Health Care outside the United Kingdom
Authors: Hervey Tamara , Antova Ivanka , Flear Mark L. , McHale Jean V. , Speakman Elizabeth , Wood Matthew
Published: October 2020

The principal effects of Brexit on health and health care will fall within the United Kingdom, and all forms of Brexit have overwhelmingly negative implications for health care and health within the UK. This article focuses on the external effects of Brexit (“Brexternalities”) for health and health care. The EU is a particularly powerful institutional and legal arrangement for managing economic and political externalities in health policy as in any other policy. Equally, when a state leaves the EU, the manner of leaving will result in better or worse management of relevant externalities. Brexternalities thus involve questions about policy legitimacy and accountability. Health Brexternalities do not fall equally in all EU countries. They are felt more distinctly in the context of those elements of health policy that are most closely entwined with the UK's health policy (e.g., on the island of Ireland, certain areas of Spain, and other parts of southern Europe). Some health Brexternalities, such as in medicine safety, will be imposed on the whole population of the EU. And some health Brexternalities, such as communicable disease control, will be felt globally.
Spatio-temporal distribution of pufferfish (Tetraodontidae) along the Turkish coast of the Mediterranean Sea
Authors: MUTLU ERHAN , DE MEO ILARIA , MIGLIETTA CLAUDIA
Published: October 2020

Pufferfish represent a serious threat to the marine ecosystem in the Mediterranean Sea. To better understand the population dynamics of pufferfish and their relation with ecological parameters, six pufferfish species were studied in two fishing and one non-fishing zone in one of the most oligotrophic regions of the Mediterranean Sea during 2014 and 2015, including different habitats of vegetated and non-vegetated and seasons. The results provide information on pufferfish ecological status compared with more eutrophic zones in which these species could potentially worsen their impact. Four species were common in the study area and two were rare. The dominant species was Lagocephalus suezensis, reaching abundances of 11,000 ind/km2 at 25 m in October, followed by Lagocephalus sceleratus, Lagocephalus guentheri, and Torquigener flavimaculosus. The rarest species, Tylerius spinosissimus and Sphoeroides pachygaster, reached higher abundance and biomass in October and February than the other sampling months. The riverine and meadow habitats played a crucial role for nursing and reproduction in the population dynamics of Lagocephalus species, while T. flavimaculosus was absent in these areas. Sex ratios changed depending on season and location. The occurrence of larger individuals of Lagocephalus spp. and T. flavimaculosus at greater depths evidenced an ontogenetic migration. Overall, length-weight (L-W) relationships indicate isometric growth for each of the species studied. Pufferfish populations were primarily a function of habitat and depth of seafloor and secondarily with water productivity.
Determinants of newborn care utilization in Pakistan: Findings from the Demographic and Health Surveys
Authors: Pongpanich Sathirakorn , Ghaffar Abdul , Ghaffar Najma , Majid Hafiz Abdul
Published: October 2020

Background: Information on determinants of postnatal care is essential for maternal health services, and this information is scarce in Pakistan. This study aimed to determine the factors of newborn postnatal care utilization from the Pakistan Demographic and Health Surveys (PDHS) conducted from 2006–2018.

Methods: We analyzed data from three rounds of cross-sectional, nationally representative PDHS 2006–07, 2012–13, and 2017–18. Multivariable logistic regression models were applied to explore factors associated with utilization of newborn postnatal care within two months.

Results: This study included 5724 women from the 2006–07 PDHS, 7461 from the 2012–13 survey, and 8287 from the 2017–18 survey. The proportion of women receiving newborn postnatal care within the first two months of delivery increased from 13% in 2006–07 to 43% in 2012–13 but dropped to 27% in 2017–18. Respondent’s occupation and prenatal care utilization of maternal health services were common factors that significantly influenced newborn postnatal care utilization within two months. The utilization of postnatal care was greater among women having educated husbands and where the first child was a male in PDHS 2007 round. Higher wealth index and educated respondent had higher postnatal care utilization odds in DHS 2012 and DHS 2018. However, the odds of using postnatal care decreased with the number of household members and total number of children ever born in DHS 2012 and 2018 rounds.

Conclusions: There was a general increase in the proportion of women who utilized postnatal care for their newborns during 2006–2013 but a decrease in 2018. The decreased utilization in 2018 warrants further investigation. Improving women’s economic status, education, employment, and antenatal care attendance and reducing parity may increase newborn postnatal care utilization.
Optimizing Price Menus for Duration Discounts: A Subscription Selectivity Field Experiment
Authors: Tian Longxiu , Feinberg Fred M.
Published: October 2020

To optimize price menus for duration discounts, both randomized field experiments and careful modeling of consumer self-selection are critical.
Hear the child's voice
Authors: Allingham Dr Sue
Published: October 2020

While in these exceptional times we may all be under pressure to adhere to certain policies and documents it is important that we take an informed and nuanced approach. The impact on the child and our work with them is the focus.
Finding new pathways
Authors: Cowley Sue
Published: October 2020

While the revised guidance for the new EYFS, Development Matters, aims to be more accessible and inclusive, has it lost some of the framework's important principles along the way?
Follow a pattern
Authors: Clarke Jenni
Published: October 2020

Seize the moment to support children to explore ideas to do with repeating patterns as they follow their own play and exploration. Snakes can provide the inspiration – by threading beads on to a string or using loose parts outdoors.
Let's get together
Authors: White Hilary
Published: October 2020

Hilary White suggests ways to use art, song and discussion as a starting point for celebrating our differences and exploring togetherness. Children will enjoy creating a picture of their friend and talking about what they like about them.
Who Should be Referred for Lung Volume Reduction Treatment?
Authors: Sharman Jayne , Kutywayo Kudzayi , Oey Inger , Rathinam Sridhar
Published: October 2020

Lung volume reduction treatment can be beneficial for some COPD patients. Jayne Sharman, Kudzayi Kutywayo, Inger Oey and Sridhar Rathinam discuss the process of making the referral
How to Combat Malnutrition: Britain's Lesser Known Epidemic
Authors: Stuart Emily
Published: October 2020

Emily Stuart discusses how nurses can minimise the impact of poor nutrition on their patients
IMPACT-Restart: the influence of COVID-19 on postoperative mortality and risk factors associated with SARS-CoV-2 infection after orthopaedic and trauma surgery
Authors: Clement Nicholas D. , Hall Andrew James , Makaram Navnit S. , Robinson Patrick G. , Patton Robyn F. L. , Moran Matthew , Macpherson Gavin J. , Duckworth Andrew D. , Jenkins Paul J.
Published: October 2020

Aims

The primary aim of this study was to assess the independent association of the coronavirus disease 2019 (COVID-19) on postoperative mortality for patients undergoing orthopaedic and trauma surgery. The secondary aim was to identify factors that were associated with developing COVID-19 during the postoperative period.

Methods

A multicentre retrospective study was conducted of all patients presenting to nine centres over a 50-day period during the COVID-19 pandemic (1 March 2020 to 19 April 2020) with a minimum of 50 days follow-up. Patient demographics, American Society of Anesthesiologists (ASA) grade, priority (urgent or elective), procedure type, COVID-19 status, and postoperative mortality were recorded.

Results

During the study period, 1,659 procedures were performed in 1,569 patients. There were 68 (4.3%) patients who were diagnosed with COVID-19. There were 85 (5.4%) deaths postoperatively. Patients who had COVID-19 had a significantly lower survival rate when compared with those without a proven SARS-CoV-2 infection (67.6% vs 95.8%, p < 0.001). When adjusting for confounding variables (older age (p < 0.001), female sex (p = 0.004), hip fracture (p = 0.003), and increasing ASA grade (p < 0.001)) a diagnosis of COVID-19 was associated with an increased mortality risk (hazard ratio 1.89, 95% confidence interval (CI) 1.14 to 3.12; p = 0.014). A total of 62 patients developed COVID-19 postoperatively, of which two were in the elective and 60 were in the urgent group. Patients aged > 77 years (odds ratio (OR) 3.16; p = 0.001), with increasing ASA grade (OR 2.74; p < 0.001), sustaining a hip (OR 4.56; p = 0.008) or periprosthetic fracture (OR 14.70; p < 0.001) were more likely to develop COVID-19 postoperatively.

Conclusion

Perioperative COVID-19 nearly doubled the background postoperative mortality risk following surgery. Patients at risk of developing COVID-19 postoperatively (patients > 77 years, increasing morbidity, sustaining a hip or periprosthetic fracture) may benefit from perioperative shielding. Cite this article: Bone Joint J 2020;102-B(12):1774–1781.
Die kleine böse Randnotiz: Die DFG verirrt sich im Neuland
Authors: Vollbrecht Ralf
Published: October 2020

Unter Imaging verstehe ich hier sowohl nicht-mediale, vor allem aber mediale Kommunikationen, mittels derer Organisationen und In­­sti­tutionen ein positives Image von sich selbst öffentlich­keits­wirk­sam präsen­tie­ren oder etablieren wollen, um ihr Ansehen zu meh­ren. Manche Ima­ging-Kam­pag­nen bewirken leider das Gegen­teil, wie das Bei­spiel Deut­sche Forschungsgemeinschaft (kurz: DFG) zeigt.
Quantification of iris elasticity using acoustic radiation force optical coherence elastography
Authors: Zhu Yirui , Zhang Yubao , Shi Gang , Xue Qiaoqiao , Han Xiao , Ai Sizhu , Shi Jiulin , Xie Chengfeng , He Xingdao
Published: October 2020

Careful quantification of the changes in biomechanical properties of the iris can offer insight into the pathophysiology of some ocular diseases. However, to date there has not been much information available regarding this subject because clinical detection for iris elasticity remains challenging. To overcome this limitation, we explore, for the first time to our knowledge, the potential of measuring iris elasticity using acoustic radiation force optical coherence elastography (ARF-OCE). The resulting images and shear wave propagation, as well as the corresponding shear modulus and Young’s modulus from ex vivo and in vivo rabbit models confirmed the feasibility of this method. With features of noninvasive imaging, micrometer-scale resolution, high acquisition speed and real-time processing, ARF-OCE is a promising method for reconstruction of iris elasticity and may have great potential to be applied in clinical ophthalmology with further refinement.
Fundamental characterization of a priori measurement accuracy of terrestrial laser scanning
Authors: Brzobohatý Jindřich , Šmejkal Filip , Pokorný Petr
Published: October 2020

This paper summarizes, presents, and derives fundamental formulas and principles of characterization of a priori measurement accuracy of terrestrial laser scanning. The first part is focused on a general mathematical description of geometrical properties of the scanner, and useful general formulas for uncertainty analysis of all types of scanner constructions are presented. Afterwards, a description of physical aspects affecting terrestrial laser scanning follows. The final part of the paper summarizes the presented analysis on examples.
Enhanced spatial resolution of terahertz spectroscopy via semiconductor photoexcitation
Authors: Krotkov Daniel , Flaxer Eli , Fleischer Sharly
Published: October 2020

We utilize the photoexcitation of a semiconductor material as a ‘reflectivity switch’ for a broadband terahertz field. We show that judicious use of this switch enables temporal characterization of the THz field with spatial resolution significantly surpassing the diffraction limit of the terahertz and provides desirable means for spatio-temporal terahertz spectroscopy.
Fundamentos físicos de la informática
Authors: Rengel Estévez Raúl
Published: October 2020

En este libro se abordan los fundamentos que permiten comprender la física subyacente a la operación de los circuitos digitales que constituyen la base de los aparatos electrónicos que utilizamos a diario. Ordenadores personales, teléfonos inteligentes, cámaras digitales, videoconsolas… La nuestra es una sociedad de la información, en la que cada día empleamos multitud de dispositivos. Todo ello ha sido posible gracias a la increíble evolución de la electrónica, y en particular, a los circuitos electrónicos de estado sólido. La informática tal y como la conocemos hoy en día es posible gracias a la física de semiconductores, a los transistores de silicio y a los microchips, temas que aquí se tratan, junto con un repaso a los fundamentos de la teoría de circuitos y las bases del electromagnetismo. Aunque el libro está orientado a estudiantes de primer curso de grados universitarios en informática, se ha intentado que los conceptos explicados puedan ser comprendidos, sin excesiva dificultad, por cualquier persona interesada con formación a nivel de secundaria en física y matemáticas.
Simulation of Lab-scale Leachate Treatment Bioreactor with Application of Logistic Growth Equation for Determining Design and Operational Parameters
Authors: Basnayake B.F.A
Published: October 2020

A laboratory scale Leachate Treatment Bioreactor (LTB) was needed to determine the optimum design and operational parameters because of poor performance of a full scale unit. In order to increase the lifespan of LTB, coconut comb and rubber tyres were included in the partially decomposed Municipal Solid Waste (MSW) as biofilter material inside the reactor. A composite liner of clay and waste polythene was used to mineralize excess inorganic compounds. The parameter reductions were from 26,000 mg/L to 6,832 mg/L of Total Solids (TS), 6,230 mg/L to 2,930 mg/L of Total Disolved Solids (TDS), 12,000 mg/L to 1182.6 mg/L of Volatile Solids (VS), 14,000 mg/L to 4,410 mg/L of Total Fixed Solids (TFS) and 29,700 mg/L to 3,000 mg/L of Biochemical Oxygen Demand (BOD). The kinetic analysis using the logistic growth equation showed cyclic events and the application of separating the growth and decay of microbes based on the Total Fixed Solids (TFS) gave a mineralization rate of 1.83 x 102 kg /m3 of leachate/m height of LTB /day for up scaling.
Listy misjonarza jako źródło misjologiczne - przypadek o. Andrzeja Cierpki OMI
Authors: KOMAN PIOTR
Published: October 2020

Listy misjonarza jako źródło misjologiczne - przypadek o. Andrzeja Cierpki OMI