bluuebunny/crossref_metadata_2025 huggingface dataset:
Head and Neck cancer patients’ preferences for individualized prognostic information: a focus group study.
Authors: Hoesseini Arta , Dronkers Emilie A. C. , Sewnaik Aniel , Hardillo Jose A. U. , de Jong Robert J. Baatenburg , Offerman Marinella P. J.
Published: January 2020

Background: Head and Neck cancer (HNC) is characterized by significant mortality and morbidity. Treatment is often invasive and interferes with vital functions, resulting in a delicate balance between survival benefit and deterioration in quality of life (QoL). Therefore, including prognostic information during patient counseling can be of great importance. The first aim of this study was to explore HNC patients’ preferences for receiving prognostic information: both qualitative (general terms like ‘’curable cancer’’), and quantitative information (numbers, percentages). The second aim of this study was to explore patients’ views on ‘’OncologIQ’’, a prognostic model developed to estimate overall survival in newly diagnosed HNC patients. Methods: We conducted a single center qualitative study by organizing five focus groups with HNC patients (n= 21) and their caregivers (n= 19), categorized in: 1) small laryngeal carcinomas treated with radiotherapy or laser, 2) extensive oral cavity procedures, 3) total laryngectomy, 4) chemoradiation, 5) other treatments. The patients’ perspective was the main focus. The interview guide consisted of two main topics: life-expectancy and the prognostic model OncologIQ. All focus groups were recorded, transcribed and coded. Themes were derived using content analysis. Results: While all patients considered it somewhat to very important to receive information about their life-expectancy, only some of them wanted to receive quantitative information. Disclosing qualitative prognostic information like ‘’the cancer is curable’’ would give enough reassurance for most patients. Overall, patients thought life-expectancy should not be discussed shortly after cancer diagnosis disclosure, as a certain time is needed to process the first shock. They had a stronger preference for receiving prognostic information in case of a poor prognosis. Prognostic information should also include information on the expected QoL. The pie chart was the most preferred chart for discussing survival rates. Conclusions: The participants found it important to receive information on their life-expectancy. While most patients were enough reassured by qualitative prognostic information, some wanted to receive quantitative information like OncologIQs’ estimates. A tailor-made approach is necessary to provide customized prognostic information. A clinical practice guideline was developed to support professionals in sharing prognostic information, aiming to improve shared decision making and patient-centered care.
Effects of an mHealth voice message service (mMitra) on maternal health knowledge and practices of low-income women in India: findings from a pseudo-randomized controlled trial
Authors: Murthy Nirmala , Chandrasekharan Subhashini , Muthuperumal Prakash , Ganju Aakash , Peter Joanne , Kaonga Nadi , Mechael Patricia
Published: January 2020

Background: Mobile Health (mHealth) is becoming an important tool to improve health outcomes in maternal, newborn and child health (MNCH). Studies of mHealth interventions, have demonstrated their effectiveness in improving uptake of recommended maternal services such as antenatal visits. However, evidence of impact on maternal health outcomes is still limited. Methods: A pseudo-randomized controlled trial was conducted to assess the impact of a voice-message based maternal intervention on maternal health knowledge, attitudes, practices and outcomes over time: Pregnancy (baseline/Time 1); Post-partum (Time 2) and when the infant turned one year old (Time 3). Women assigned to the mMitra intervention arm received gestational age- and stage-based educational voice messages via mobile phone in Hindi and Marathi, while those assigned to the control group did not. Both groups received standard care. Results: 2,016 women were enrolled. Interviews were conducted with 1,516 women in the intervention group and 500 women in the control group at baseline and post-partum. The intervention group performed significantly better than controls on four maternal health practice indicators: receiving the tetanus toxoid injection (OR: 1.6, 95% Confidence Interval (CI): 1.05-2.4, p=0.028), consulting a doctor if spotting or bleeding (OR: 1.72, 95%CI: 1.07-2.75, p=0.025), saving money for delivery expenses (OR: 1.79, 95%CI: 1.38-2.33, p=0.0001), and delivering in hospital (OR: 2.5, 95%CI: 1.49-4.35, p=0.001). The control group performed significantly better than the intervention group on two practice indicators: resting regularly during pregnancy (OR: 0.7, 95%CI: 0.54-0.88, p=0.002) and having at-home deliveries attended by a skilled birth attendant (OR: 0.46, 95%CI: 0.23-0.91, p=0.027). Both groups’ knowledge improved from Time 1 to Time 2. One knowledge indicator, seeking medical care during pregnancy, was statistically increased in the intervention group compared to controls. Anemia status at or near the time of delivery was unable to be assessed due to missing maternal health cards. Conclusions: This study provides evidence that mobile voice messages providing tailored and timed information about pregnancy can positively impact maternal health care practices proven to improve maternal health outcomes. Additional research is needed to assess whether voice messaging can motivate behavior change better than text messaging, particularly in low literacy settings.
Efficacy and tolerability of DAAs in HCV-monoinfected and HCV/HIV-coinfected patients with psychiatric disorders
Authors: de Gennaro Nicolò , Diella Lucia , Monno Laura , Angarano Gioacchino , Milella Michele , Saracino Annalisa
Published: January 2020

Background few data are available regarding use of direct antiviral agents (DAAs) for chronic hepatitis C in psychiatric patients. The aim of the study is to assess safety and outcome of DAAs in patients with psychiatric comorbidities. Methods this retrospective, observational, single-centre study enrolled patients treated with psychiatric drugs who initiated DAAs between 2015-2018. Patients were classified into two groups: A (on anxiolitycs/antidepressant) and B (on antipsychotics). Week-12 sustained virological response (SVR-12) and adverse events (AEs) were evaluated. Results 144 patients were included (A:101; B:43). Patients were 49.3% males, mean age 60 years (SD±13.5); 31.9% cirrhotic; 125 (86.8%) HCV-monoinfected and 19 (13.2%) HIV/HCV-coinfected. Twenty patients (13.8%) required a change of psychiatric therapy before DAAs-initiation. Overall, SVR-12 was achieved in 88.2% of subjects in intention-to-treat(ITT)-analysis. Lower SVR rates were observed in group B vs A (79% vs 92%, p=0.045) and in those changing psychiatric drugs vs others (30% vs 8%, p=0.015). At least one AE occurred in 60 patients (41.6%), including 10 SAEs, leading to 3 discontinuations. AEs were more frequently reported in group A (p=0.015). Conclusions the study confirms effectiveness and safety of DAA-based treatment also in this special population, even if a careful evaluation of history and drug-drug interactions is warranted.
BRAF mutant colorectal cancer: ErbB2 expression levels as predictive factor for the response to combined BRAFi/ErbB1 inhibitors
Authors: Miele Evelina , Abballe Luana , Spinelli Gian Paolo , Besharat Zein Mersini , Catanzaro Giuseppina , Chiacchiarini Martina , Vacca Alessandra , Po Agnese , Capalbo Carlo , Ferretti Elisabetta
Published: January 2020

Background: Colorectal cancer (CRC) is a heterogeneous disease with a complex biology and has a wide number of altered genes such as BRAF, KRAS and PIK3CA. Advances with new-targeted therapies have been achieved and available treating options have prolonged patient’s survival. However, BRAF-mutated CRC patients remain unresponsive to available therapies with RAF inhibitors (RAFi) alone or combined with ErbB inhibitors (ErbBi). These unmet needs require further exploitation of oncogenic signaling in order to set up individualized treatments. Methods: To this end, we tested the efficacy of single agent or combined treatments using the BRAFi, vemurafenib and two different ErbBi: panitumumab and afatinib in CRC cells characterized by different molecular phenotypes. Results: Combination strategies with BRAFi and ErbBi achieved a better response in BRAF V600E mutated cells expressing high levels of ErbB2. Conclusions: In conclusion our findings allow us to indicate that high ErbB2 expression levels is a positive predictor factor since those patients are responsive to BRAFi/ErbBi combination.
End-of-life care for people with advanced dementia and pain: A qualitative study in Swedish nursing homes
Authors: Lundin Emma , Godskesen Tove
Published: January 2020

Background Of the Swedish people with advanced dementia, the majority die in nursing homes. Unresolved pain can occur in people with a terminal illness such as dementia. However, pain management in people with advanced dementia is often suboptimal and inadequate, with fewer palliative care interventions than offered to cancer patients. Although they are largely responsible for the care of these people, few studies have addressed the experiences of registered nurses in this respect. Therefore the aim of this study was to describe the experiences of nurses in caring for people with advanced dementia and pain at the end of life. Methods The study had a descriptive explorative design. Individual qualitative, semi-structured interviews were carried out with thirteen nurses from twelve nursing homes in Sweden. The results were analysed using thematic content analysis. Results The nurses described communicative, relational and organisational challenges. One major issue involved difficulties in communicating with the person with advanced dementia, resulting in uncertain pain assessment. Other difficulties involved the differentiation of pain from anxiety, the balance of benefits and risks with morphine administration, and the creation of good relationships with healthcare personnel and the persons’ relatives. Relatives can greatly affect the assessment and management of pain, both because of their ability to interpret pain behaviour and by questioning the care given. Good pain management was facilitated by good communication and relationships with healthcare staff and relatives, extensive professional nursing experience, and already knowing the person with advanced dementia. Conclusions This study highlights the need for nursing homes to employ specialist nurses who have been trained in the appropriate knowledge and skills to deal with the challenges of end-of-life care for people with advanced dementia and pain. Additionally, there should be resources and strategies available for providing information to family members and for involving them in the decision-making process, as they are often unfamiliar with the multitude of considerations involved in decisions such as whether to administer morphine or not.
Substance P participates in periodontitis by upregulating HIF-1α and RANKL/OPG ratio
Authors: Yan Kaixian , Lin Qin , Tang Kailiang , Liu Shuang , Du Yi , Yu Xijiao , Li Shu
Published: January 2020

Background Both substance P and hypoxia-inducible factor 1 alpha (HIF-1α) are involved in inflammation and angiogenesis. However, the relationship between substance P and HIF-1α in rat periodontitis is still unknown. Methods Ligation‐induced rat periodontitis was established to observe the distribution and expression of substance P and HIF-1α by immunohistochemistry. Rat gingival fibroblasts were cultured and stimulated with Porphyromonas gingivalis lipopolysaccharide (LPS). Recombinant substance P was applied to elaborate the relationship between substance P and HIF-1α in gingival fibroblasts in vitro. Primary mouse bone marrow-derived macrophages (BMMs) were isolated and cultured to observe the effect of substance P on receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis by TRAP staining. Western blotting was used to investigate the expression of HIF-1α, osteoprotegerin (OPG) and RANKL. Results Rat experimental periodontitis was successfully established six weeks after ligation. Gingival inflammatory infiltration and alveolar bone loss were observed. Positive expression of substance P was found in the infiltrating cells. Higher HIF-1α levels were observed in periodontitis compared to that of normal tissues. Substance P upregulated the level of HIF-1α in gingival fibroblasts with or without 1 µg/ml LPS in vitro (*P<0.05). Substance P upregulated the expression of HIF-1α in RANKL-stimulated BMMs in vitro. Substance P also increased the RANKL/OPG ratio in gingival fibroblasts (*P<0.05). Both 10 nM and 50 nM substance P promoted RANKL-induced osteoclast differentiation (*P<0.05). Conclusion Substance P participates in periodontitis by upregulating HIF-1α and the RANKL/OPG ratio.
The construction of a conceptual framework explaining the relation between barriers to change of management of neuropsychiatric symptoms in nursing homes: a qualitative study using focus groups
Authors: Teunenbroek Charlotte Frederike van , Verhagen Kim , Smalbrugge Martin , Persoon Anke , Zuidema Sytse U. , Gerritsen Debby L.
Published: January 2020

Background. Several efforts have been made to change management of neuropsychiatric symptoms (NPS) in nursing homes, however only few were successful. Numerous barriers to change in healthcare were identified, yet only one conceptual model is known to study their interrelationships . Unfortunately, this model does not discuss specific barriers encountered in nursing home practice. The aim of this study is to explore perceived barriers to change in the management of NPS in nursing homes and to construct a conceptual framework providing insight into the relative importance and interrelationships of these barriers when improving quality of care.
Methods. Four focus groups were conducted in different dementia special care units of one Dutch nursing home. Participants were either nursing staff, treatment staff or relatives of residents. Qualitative thematic analysis was conducted according to the five phases defined by Braun & Clarke. Finally, a conceptual framework showing the interrelations of barrier-themes was constructed using text fragments of the focus groups.
Results. We constructed a conceptual framework consisting of eight themes of barriers explaining the extent to which change in NPS-management can be achieved: 'organizational barriers', 'personal barriers', 'deficiency of staff knowledge', 'suboptimal communication', 'inadequate (multidisciplinary) collaboration', 'disorganization of processes', 'reactive coping' and 'differences in perception'. Addressing 'organizational barriers' and 'deficiency of staff knowledge' is a precondition for change. 'Suboptimal communication' and 'inadequate (multidisciplinary) collaboration' play a key role in the extent of change achieved via the themes 'differences in perception' and 'disorganization of processes'. Furthermore, 'personal barriers' influence all themes - except 'organizational barriers' - and may cause 'reactive coping', which in turn may lead to 'difficulties to structure processes'.
Conclusions. A conceptual framework was created explaining the relationships between barriers towards achieving change focused on improving management of NPS in nursing homes. After this framework has been confirmed and refined in additional research, it can be used to study the interrelatedness of barriers to change, and to determine the importance of addressing them for achieving change in the provided care.
Current status of the clinical use of PD-1/PD-L1 inhibitors: a questionnaire survey of oncologists in China
Authors: Zhang Bicheng , Song Yuxiao , Fu Yang , Zhu Bo , Wang Baocheng , Wang Jun
Published: January 2020

Objective : The purpose of the present study was to obtain information on the use of PD-1/PD-L1 inhibitors by oncologists in China through a national questionnaire survey.
Materials and Methods : Between the 7th and 25th of July in 2019, a questionnaire designed by the Chinese Society of Clinical Oncology Immuno-Oncology (CSCO IO) Committee on the current status of the use of PD-1/PD-L1 inhibitors was distributed online and offline to cancer-related medical departments in thirty different provinces and autonomous regions of China. The national questionnaire consisted of three sections as follows: general information, current status of the application of PD-1/PD-L1 inhibitors in the clinic, and oncologists’ concerns regarding utilization.
Results : The valid response rate of the current status survey was 76.3%. The proportion of senior doctors (physician-in-charge or a more superior position for more than three years) among the respondents was relatively high (67.0% in 588). Ofthe respondents,59.2% had prescribed PD-1/PD-L1 inhibitors during clinical treatment, and the most frequent reason for not prescribing these inhibitors was the choice "do not understand the mechanism and the efficacy of PD-1/PD-L1 inhibitors". In addition, 77.9% of the prescribers used the medications in an off-labelsituation, and the most important motivation for this use was the fact that "there were indications abroad but not domestically". In addition, 77.9% of the prescribers believed that “immunotherapy-related adverse effects could be controlled or intervened through follow-up management”. The prescribers were mostly concerned about "how to identify pseudoprogression and hyperprogression" and "immunity-related adverse effects management".
Conclusion : The present study highlights the current status of PD-1/PD-L1 inhibitors in China. Increasing numbers ofmedical oncologists are interested in PD-1/PD-L1 inhibitors, andthey are in need of immunotherapyeducation.
Augmented Exercise in Hospital Improves Physical Performance and Reduces Negative Post Hospitalization Events: A Randomized Controlled Trial
Authors: McCullagh Ruth , O'Connell Eimear , O'Meara Sarah , Dahly Darren , O'Reilly Eilis , O'Connor Kieran , Horgan N.Frances , Timmons Suzanne
Published: January 2020

Background: To measure the effects of an augmented prescribed exercise programme versus usual care, on physical performance, quality of life and healthcare utilisation for frail older medical patients in the acute setting.

Methods: This was a parallel single-blinded randomised controlled trial. Within two days of admission, older medical inpatients with an anticipated length of stay ≥3 days, needing assistance/aid to walk, were blindly randomly allocated to the intervention or control group. Until discharge, both groups received twice daily, Monday-to-Friday half-hour assisted exercises, assisted by a staff physiotherapist. The intervention group completed tailored strengthening and balance exercises; the control group performed stretching and relaxation exercises. Length of stay was the primary outcome measure. Blindly assessed secondary measures included readmissions within three months, and physical performance (Short Physical Performance Battery) and quality of life (EuroQOL-5D-5L) at discharge and at three months. Time-to-event analysis was used to measure differences in length of stay, and regression models were used to measure differences in physical performance, quality of life, adverse events (falls, deaths) and negative events (prolonged hospitalisation, institutionalisation).

Results: Of the 199 patients allocated, 190 patients’ (aged 80 ±7.5 years) data were analysed. Groups were comparable at baseline. In intention-to-treat analysis, length of stay did not differ between groups (HR 1.09 (95% CI, 0.77-1.56) p=0.6). Physical performance was better in the intervention group at discharge (difference 0.88 (95% CI, 0.20-1.57) p=0.01), but lost at follow-up (difference 0.45 (95% CI, -0.43 – 1.33) p=0.3). An improvement in quality of life was detected at follow-up in the intervention group (difference 0.28 (95% CI, 0.9 – 0.47) p=0.004). Overall, fewer negative events occurred in the intervention group (OR 0.46 (95% CI 0.23 – 0.92) p=0.03).

Conclusion: Improvements in physical performance, quality of life and fewer negative events suggest that this intervention is of value to frail medical inpatients. Its effect on length of stay remains unclear.
Resident bacterial populations mediating biogeochemical dynamics in a Uranium roll front deposit
Authors: Jrou Fadwa , Descostes Michael , Povedano-Priego Cristina , Sanchez-Castro Iván , Suvannagan Vitthavat , Grizard Pierre , Merroun Mohamed L.
Published: January 2020

The authors have withdrawn this preprint from Research Square
Dental Anxiety and Fear among a University Population in a Sample from Yemen
Authors: Madfa Ahmed A. , Al-Zubaidi Saad M. , Shibam Ahmed H. , Al-ansi Waled A. , AL-Beshari Lamis A. , Al-Haj Arwa M. , AL-Jawfi Khaled A.
Published: January 2020

Background: Many patients and clinicians consider dental fear to be a major challenge. Knowledge about dental students’ own experiences with dental anxiety is very important. The present study, therefore, aimed to examine the levels of dental anxiety and fear among students in relation to their field of study and gender. Methods: This cross-sectional study involved 720 (360 women and 360 men) recruited from the College of Dentistry and the College of the Humanities and Social Sciences at the University of Science and Technology in Sana'a, Yemen. Corah’s Dental Anxiety Scale (DAS) and Dental Fear Survey (DFS) were used to measure anxiety and fear among the study population. Spearman's correlation was applied to analyse the relationships among the anxiety measurements and the relationship between the DAS and DFS tests. Chi-square tests and linear regression analyses were applied to analyse the associations between dental anxiety or fear and contextual variables. Results: Out of the 720 students enrolled, 713 students (354 men and 359 women) completed and returned the questionnaire, yielding a response rate of 99.03%. The associations among dental anxiety measurements and the DAS and DFS was statistically significant ( p < 0.01). Students from the dental colleges had less anxiety and fear than did those from the humanities and social sciences college ( p < 0.05). Men were less anxious and fearful than women ( p < 0.05). Dental anxiety and fear were more associated with women than were other contextual variables [for fear (OR = 1.14, p = 0.001); for anxiety (OR = 1.90, p = 0.001)]. Conclusions: Dental anxiety was found to be related to dental fear. Women were more anxious and fearful than men. Dental students were less anxious and fearful than those from the humanities and social sciences college. A lack of suitable dental health education may result in higher levels of anxiety and fear among students from non-dental colleges in Yemen.
Women’s Experiences following Emergency Peripartum Hysterectomy at St. Francis Hospital Nsambya. A Qualitative study.
Authors: PILLI PATRICK ICEANYI , Sekweyama Peter , Kayira Anthony
Published: January 2020

Background Women who undergo emergency peripartum hysterectomy (EPH) are at greater risk of experiencing severe negative psychosocial sequelae. However at St. Francis Hospital Nsambya and much of Sub-Saharan Africa, these women are not routinely followed up to explore these experiences. This study sought to explore women’s experiences and coping strategies following EPH St. Francis Hospital Nsambya, Kampala, Uganda. Methods This qualitative study was based on in-depth interviews of women who had undergone EPH at St. Francis Hospital Nsambya EPH between January 2015 to August 2018. Out of 66 women who had undergone EPH during this period, 18 were purposively selected and interviewed between August to December 20018. All the information obtained was audio-recorded, transcribed and then analyzed in three phases of pre-analysis of intense reading, exploration and comparison and then interpretation. Results These women disclosed feelings of loss of womanhood, Uncertainty about the future, Joy for being Alive, and professional abandonment. Their coping strategies were living in denial, believing in God and acceptance. Conclusion Women experience severe negative psychosocial sequelae following EPH therefore routine ongoing psychotherapy should be offered to these women until full acceptance is achieved.
Stable high frequencies of sulfadoxine-pyrimethamine resistance associated mutations and absence of K13 mutations in Plasmodium falciparum 3 and 4 years after the introduction of artesunate plus sulfadoxine-pyrimethamine in Ujjain, Madhya Pradesh, India
Authors: Pathak Ashish , Mårtensson Andreas , Gawariker Sudhir , Sharma Ashish , Diwan Vishal , Purohit Manju , Ursing Johan
Published: January 2020

Background Artesunate plus sulfadoxine-pyrimethamine (ASP) are first line treatment for uncomplicated Plasmodium falciparum malaria in most of India, except for six North-eastern provinces where treatment failure rates were high. In Ujjain, central India, the frequency of mutations associated with increased drug tolerance, but not overt resistance to sulfadoxine and pyrimathamine were 9% and >80%, respectively, in 2009 and 2010, just prior to the introduction of ASP. The frequency of drug resistance associated mutations in Ujjain in 2015-2016 after 3-4 years of ASP use, are reported. Methods Blood samples from patients with P. falciparum mono-infection verified by microscopy were collected on filter-paper at all nine major pathology laboratories in Ujjain city. Codons pfdhfr 16-185, pfdhps 436-632 and K13 407-689 were identified by sequencing. Pfcrt K76T and pfmdr1 N86Y were identified by restriction fragment length polymorphism. Results Sulfadoxine-pyrimethamine resistance-associated pfdhfr 108N and 59R alleles were found in 100/104 (96%) and 87/91 (96%) samples, respectively. Pfdhps 437G was found in 10/105 (10%) samples. Double mutant pfdhfr 59R+108N were found in 75/81 (93%) samples. Triple mutant pfdhfr 59R + 108N and pfdhps 437G were found in 6/78 (8%) samples. Chloroquine-resistance-associated pfcrt 76T was found in 102/102 (100%). Pfmdr1 N86 and 86Y were identified in 83/115 (72%) and 32/115 (28%) samples, respectively. Conclusion The frequency of P. falciparum with reduced susceptibility to sulfadoxine-pyrimethamine remained high but did not appear to have increased significantly since the introduction of ASP. No polymorphisms in K13 associated with decreased artemisinin susceptibility were found. ASP probably remained effective, supporting continued ASP use.
Cattle gastrointestinal nematode egg-spiked faecal samples: high recovery rates using the Mini-FLOTAC technique
Authors: Amadesi Alessandra , Bosco Antonio , Rinaldi Laura , Cringoli Giuseppe , Claerebout Edwin , Maurelli Maria Paola
Published: January 2020

Background: Faecal egg count (FEC) techniques are commonly used to detect gastrointestinal nematode (GIN) in cattle and to determine anthelmintic efficacy/resistance through the faecal egg count reduction test (FECRT). Mini-FLOTAC is one of the techniques recommended for a standardised FEC/FECRT of helminth eggs in cattle. However, only one paper evaluated the recovery rate of GIN eggs by Mini-FLOTAC (compared to McMaster and modified-Wisconsin) in cattle, using only the level of contamination of 200 eggs per gram (EPG) of faeces and using GIN eggs collected from goat faeces to spike faecal samples from cattle. To further study the recovery rate of added GIN eggs from cattle, this study was conducted in two laboratories in Belgium and Italy to evaluate sensitivity, accuracy, precision and reproducibility of Mini-FLOTAC and McMaster (at two reading levels: grids and chambers) for the detection of GIN eggs in spiked bovine faecal samples. Methods: In both countries, spiked cattle faecal samples with five different levels of egg contamination (10, 50, 100, 200 and 500 EPG) of GINs were used. The study was performed in both laboratories by the same expert operator and using the same standard operating procedures (SOPs) for Mini-FLOTAC and McMaster. Sensitivity, accuracy and precision were calculated for each technique and for each level of contamination. Moreover, statistical analyses were performed to evaluate differences between performances of techniques used. Results: Mini-FLOTAC had a higher sensitivity (100% at all EPG levels for Mini-FLOTAC vs 0-66.6% for McMaster chambers and grids at levels <100 EPG), a higher accuracy (98.1% mean value for Mini-FLOTAC vs 83.2% for McMaster grids and 63.8% for McMaster chambers) and a lower coefficient of variation (10.0% for Mini-FLOTAC vs 47.5% for McMaster grids and 69.4% for McMaster chambers) than McMaster. There was no significant difference between the recovery of GIN eggs from the two studies performed in Belgium and in Italy. Conclusions: The high GIN eggs recovery rate detected by Mini-FLOTAC and the similar results obtained in Belgium and in Italy indicated that the diagnostic performance of a FEC technique was not regard to the laboratory environment.
Categorization of medical causes of maternal deaths and delays in care: Comparison between routine Maternal Death Surveillance and Response system and an obstetrician expert panel in Tanzania
Authors: Said Ali , Malqvist Mats , Pembe Andrea B. , Massawe Siriel , Hanson Claudia
Published: January 2020

Background To reduce high maternal mortality Tanzania introduced Maternal Death Surveillance and Response (MDSR) system in 2015 as recommended by World Health Organization. All health facilities are supposed to identify, notify and review all maternal deaths inorder to recommend quality improvement actions to prevent deaths in future. The system relies on consistent and correct categorization of causes of maternal deaths and three phases of delays. To assess its adequacy we compared the routine MDSR categorization of cause of deaths and care delays with those assigned by an obstetrician expert panel with additional information from Verbal Autopsy (VA). Methods Our cross-sectional study included 109 reported and reviewed maternal deaths from two regions in Tanzania for the year 2018. We abstracted the recorded underlying medical cause of death and reported delays of care from MDSR system records. We interviewed bereaved families using the standard World Health Organization VA questionnaire. The obstetrician expert panel assigned underlying medical cause of deaths based on information from medical files and VA according to International Classification of Disease to Death in Pregnancy Childbirth and Puerperium (ICD-MM).They assigned causes to nine ICD-MM groups and identified the three phases of delays. We used Cohen`s K statistic and proportional differences to compare causes of deaths and delays in care categorization. Results Ten deaths were excluded in analysis of underlying medical causes and 25 for delays. Expert panel and MDSR system assigned same underlying medical cause for 64.6% of deaths, K statistic 0.60. The agreement increased (80.8%) when causes were assigned by ICD-MM groups, K statistic 0.76. The obstetrician expert panel identified phase one delays in 67.9%, phase two in 22.0% and phase three delays in 100% of the deaths while MDSR system identified delays in 50.0%, 11.9% and 92.9% respectively. The expert panel found human errors in management in 93.1% while MDSR system reported in 67.9% of deaths. Conclusion The MDSR committees performed reasonably well in assigning the underlying cause of deaths. The obstetrician expert panel found more delays to care than what was reported in MDSR system indicating difficulties within MDSR teams to critically review.
Treatment of myofascial trigger points of the infraspinatus is effective in relieving shoulder pain and improving shoulder functions: A randomized clinical trial
Authors: Park Sungeon , Cho Joochul , Lee Seungwon
Published: January 2020

Background This study aimed to investigate the effects of ischemic compression treatment (ICT) and low-level laser therapy (LLLT) applied on the trigger points of the infraspinatus muscle on shoulder pain and function in patients with shoulder pain. Methods Thirty patients with shoulder pain were randomly categorized into the ICT group (n = 15) and LLLT groups (n = 15). ICT was performed on three myofascial trigger points (MTrPs) of the infraspinatus muscle twice a week for 4 weeks (eight sessions), with 5 minutes of treatment per trigger point. LLLT was performed similarly. Shoulder pain was assessed using the visual analogue scale (VAS) and pain pressure threshold (PPT), and shoulder function was assessed using the Korean Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, rotator cuff strength, and range of motion (ROM) of shoulder flexion and abduction. Results Significant changes in VAS score and PPT were found after the intervention in both groups (p < 0.05). Significant changes were observed in the Korean DASH score, rotator cuff strength, and ROM of shoulder flexion (p < 0.05) but not in the ROM of shoulder abduction (p < 0.05). There were no significant differences between the two groups. Conclusion This study showed that both ICT and LLLT applied on the MTrPs of the infraspinatus muscle were effective for relieving shoulder pain and improving shoulder functions in patients with shoulder pain.
Nutrition status and functional prognosis among elderly patients with distal radius fracture: a retrospective cohort study
Authors: nagai takako , Tanimoto Koji , Tomizuka Yoshiaki , Uei Hiroshi , Nagaoka Masahiro
Published: January 2020

Background Distal radius fractures (DRF) are common in the elderly and are typical of hand fractures during falls. Malnutrition has also been identified as a poor prognostic factor in elderly patients with fractures. However, the relationship between nutritional status and subsequent falls and functional prognosis in the elderly DRF is not clear. The aim of the present study was to investigate the association between nutritional status and functional prognosis in patients with elderly DRF. Methods Study participants included 229 outpatients who required surgical treatment with DRF. The patients’ clinical information, including age, sex, body mass index, bone mineral density, Geriatric Nutritional Risk Index (GNRI), total number of drugs being treated with on admission, use of drugs for osteoporosis, comorbidity severity, Barthel Index(BI), presence of subsequent falls, fracture type, postoperative follow-up period, and Mayo wrist score was reviewed. The subjects were further divided into two groups according to their GNRI: the malnutrition group and the normal group. Propensity score matching was used to confirm the factor affecting BI and subsequent fall. Results Thirty-one patients (13.5%) were malnutrition before surgery for DRF. According to the multiple liner regression analysis, GNRI positively affected BI efficiency (β=0.392, 95% confidence interval, 0.001 to 0.351, p=0.039). Furthermore, on logistic regression analysis, subsequent fall was correlated with the serum albumin (odds ratio=0.033, 95% confidence interval,0.002 to 0.477, p=0.012). Conclusion Malnutrition impaired the improvement of the activity of daily living (ADL) and increased the incidence of subsequent fall. Improvement of nutritional status before DRF surgery may further improve ADL and prevent falls.
Particulate matter and emergency visits for asthma: a time-series study of their association in the presence and absence of wildfire smoke in Reno, Nevada, 2013-2018
Authors: Kiser Daniel , Metcalf William J. , Elhanan Gai , Schnieder Brendan , Schlauch Karen , Joros Andrew , Petersen Craig , Grzymski Joseph
Published: January 2020

Background: Health risks due to particulate matter (PM) from wildfires may differ from risk due to PM from other sources. In places frequently subjected to wildfire smoke, such as Reno, Nevada, it is critical to determine whether wildfire PM poses unique risks. Our goal was to quantify the difference in the association of adverse asthma events with PM on days when wildfire smoke was present versus days when wildfire smoke was not present. Methods: We obtained counts of visits for asthma at emergency departments and urgent care centers from a large regional healthcare system in Reno for the years 2013-2018. We also obtained dates when wildfire smoke was present from the Washoe County Health District Air Quality Management Division. We then examined whether the presence of wildfire smoke modified the association of PM 2.5 , PM 10-2.5 , and PM 10 with asthma visits using generalized additive models. We improved on previous studies by accounting for possible non-linearity in the association between PM concentration and asthma visits: wildfire-smoke days where the PM concentration exceeded the maximum PM concentration on other days were excluded. Results: Air quality was affected by wildfire smoke on 188 days between 2013 and 2018. We found that the presence of wildfire smoke increased the association of a 5 µg/m 3 increase in daily and three-day averages of PM 2.5 with asthma visits by 6.1% (95% confidence interval (CI): 2.1-10.3%) and 6.8% (CI: 1.2-12.7%), respectively. Similarly, the presence of wildfire smoke increased the association of a 5 µg/m 3 increase in daily and three-day averages of PM 10 with asthma visits by 5.5% (CI: 2.5-8.6%) and 7.2% (CI: 2.6-12.0%), respectively. We did not observe any significant increases in association for PM 10-2.5 or for seven-day averages of PM 2.5­ and PM 10 . Conclusions: Since we found significantly stronger associations of PM 2.5 and PM 10 with asthma visits when wildfire smoke was present, our results suggest that wildfire PM is more hazardous than non-wildfire PM for patients with asthma.
The relationship between cancer and medication exposure in patients with systemic lupus erythematosus: a nested case-control study
Authors: Guo Jinyan , Ren Zhigang , Li Jianhao , Li Tianfang , Liu Shengyun , Yu Zujiang
Published: January 2020

Background Systemic lupus erythematosus (SLE) is associated with increased risk of cancer and the mechanism remains unclear. Here, we examined the level of auto-antibodies and disease activity index scores in SLE patients with cancers, and analyzed whether medications for SLE management might contribute higher cancer risk in SLE patients. Methods In this retrospective study, we carried out a nested case-control study in a large cohort of SLE patients. We screened 5858 SLE patients to identify the newly diagnosed and yet to be treated cancers. The following clinical features were evaluated: auto-antibodies levels, SLE disease activity index scores and previous medication used for SLE management. Systemic glucocorticoid, cyclophosphamide, hydroxychloroquine (HCQ), methotrexate and azathioprine were considered the main medication indices. Results Our analyses identified 51 SLE patients who also had cancer, and 204 matched control patients who had SLE but not cancer. Of the 51 SLE patients, thyroid cancer (14/51, 27.45%), cervical cancer (10/51, 19.61%) and lung cancer (7/51, 13.73%) were the most common types. Our analyses did not reveal any significant differences in the levels of auto-antibodies in SLE patients with cancers relative to the control group. Further, we observed that disease activity was significantly lower in SLE patients with cancers relative to the matched control SLE group. There was no statistically significant association between the cancer risk and the use of systemic glucocorticoid, cyclophosphamide, methotrexate or azathioprine. Importantly, the administration of HCQ was significantly lower in SLE patients suffering cancers relative to the cancer free matched control group. Conclusions Our analyses indicate that SLE patients with cancers might have a lower disease activity at the time of cancer diagnosis. HCQ was negatively correlated with cancer risk in SLE patients. These findings highlight a potential and novel prevention strategy for SLE.
Associations of leptin with incident type 2 diabetes and interactions among African Americans: the Jackson Heart Study
Authors: Bidulescu Aurelian , Dinh Paul C. , Sarwary Shabir , Forsyth Emily , Luetke Maya C. , King David B. , Liu Jiankang , Davis Sharon K. , Correa Adolfo
Published: January 2020

Background: Growing evidence suggests that leptin is critical for glycemic control. We assessed the association of leptin and adiponectin with incident type 2 diabetes (T2D), their interactions with sex and obesity status, and mediation by insulin resistance. Methods: Study participants from the Jackson Heart Study, a prospective cohort of adult African Americans in Jackson, Mississippi, included those free of T2D at the baseline Exam 1. Incident T2D was defined as new cases at Exam 2 or Exam 3. We created separate Cox regression models (hazard ratios per log-transformed ng/mL of leptin) with and without insulin resistance, HOMA-IR. Mediation by insulin resistance was analyzed. Several interactions were assessed, including by sex, HbA1c, and obesity. Results: Among 3,363 participants (mean age 53 years, 63% women), 584 developed incident T2D. Leptin was associated with incident T2D when modeled without HOMA-IR (HR=1.32, 95% CI=1.08-1.61). Among men, this positive association between leptin and T2D was significant (HR=1.33, 95% CI=1.05-1.69), but it was nonsignificant among women (HR=1.24, 95% CI=0.94-1.64); statistical interaction with sex was nonsignificant (p=0.65). The associations in all participants and in men were nullified by HOMA-IR (HR=0.99, 95% CI=0.80-1.22; HR=1.00, 95% CI=0.78-1.28, respectively), indicating mediation through insulin resistance (proportion mediated: 1.04), and were not observed in abdominally obese participants. Conclusions: The leptin and incident T2D association mediated by insulin resistance was observed only among abdominally non-obese African Americans in the Jackson Heart Study, suggestive of a ‘leptin resistance’ phenomenon. Differences by sex appeared: men showed a significant association mediated by insulin resistance.
The assessment of quality of life and satisfaction with life of patients before and after surgery of an isolated apical defect using synthetic materials
Authors: Zalewski Maciej , Kołodyńska Gabriela , Mucha Anna , Bełza Łukasz , Nowak Krzysztof , Andrzejewski Waldemar
Published: January 2020

Background Pelvic floor static disorders constitute a significant clinical and social problem. The incidence of the problem increases with the age of female patients up to 80 years of age. Due to various methods of procedural treatment, eligibility for surgery should be carefully discussed with the patient. Ideally, the surgery should be effective, applicable in patients with a positive family history and with the least possible number of complications. Such procedures seemed to be transvaginal surgeries performed under block anaesthesia, using synthetic materials, giving good results in most studies. The objective of this study was to assess the quality of life of patients before and after the surgery of an isolated apical defect with the use of synthetic materials. Methods The study included 60 patients who were diagnosed with pelvic floor static disorder on the basis of physical examination. Standardised questionnaires were used to assess the quality of life and satisfaction with life: the Perceived Quality of Life (P-QOL) and the Satisfaction With Life Scale (SWLS). Results The P-QOL results for each domain were higher in patients before surgery compared to the results obtained after the surgery. For almost all domains, the results obtained were statistically significant. The results of the SWLS questionnaire in most answers also show that after the procedure there was an improvement in satisfaction with life in the examined female patients. Conclusion In most patients, surgical treatment of an isolated apical defect using synthetic materials results in clearance of burdensome symptoms and improves the quality of life.
Sand Size Affects Topdressing Removed by Mowing and Anthracnose on Annual Bluegrass Putting Green Turf
Authors: Wang Ruying , Hempfling James W. , Clarke Bruce B. , Murphy James A.
Published: January 2020

Sand size can affect the ability to incorporate topdressing into the turf canopy and thatch on golf course putting greens; unincorporated sand interferes with mowing and play. This 3-year field trial was initiated to determine the effects of sand size on sand incorporation, surface wetness, and anthracnose (caused by Colletotrichum cereale Manns sensu lato Crouch, Clarke, and Hillman) of annual bluegrass [Poa annua L. f. reptans (Hausskn) T. Koyama] maintained as a putting green. The experimental design was a randomized complete block with four replications; treatments included a non-topdressed control and three topdressing sands (medium-coarse, medium, or medium-fine) applied every 2 weeks at 0.15 L·m−2 during the summer. Topdressing with medium-coarse sand was more difficult to incorporate than the medium and medium-fine sands, resulting in a greater quantity of sand collected with mower clippings. Analyzing the particle distribution of sand removed by mowing confirmed that coarser sand particles were more likely to be removed in mower clippings. Surface wetness measured as volumetric water content (VWC) at the 0- to 38-mm depth zone was greater in non-topdressed plots than topdressed plots on 35% of observations. Few differences in VWC were found among sand size treatments. Turf responses to topdressing were not immediate; however, as sand accumulated in the turf canopy, topdressed plots typically had lower anthracnose severity than non-topdressed turf after the first year. Additionally, topdressing with medium and medium-fine sands produced similar or occasionally lower disease severity than topdressing with medium-coarse sand. The lack of negative effects of medium and medium-fine sands combined with better incorporation after topdressing and less disruption to the putting surface should allow golf course superintendents to apply topdressing at frequencies and/or quantities needed during the summer to maintain high-quality turf and playing conditions.
Different Microgreen Genotypes Have Unique Growth and Yield Responses to Intensity of Supplemental PAR from Light-emitting Diodes during Winter Greenhouse Production in Southern Ontario, Canada
Authors: Jones-Baumgardt Chase , Llewellyn David , Zheng Youbin
Published: January 2020

Low natural daily light integrals (DLIs) are a major limiting factor for greenhouse production during darker months (e.g., October to February in Canada). Supplemental lighting (SL) is commonly used to maintain crop productivity and quality during these periods, particularly when the supply chain demands consistent production levels year-round. What remains to be determined are the optimum SL light intensities (LIs) for winter production of a myriad of different commodities. The present study investigated the growth and yield of sunflower (Helianthus annuus L., ‘Black oil’), kale (Brassica napus L., ‘Red Russian’), arugula (Eruca sativa L.), and mustard (Brassica juncea L., ‘Ruby Streaks’), grown as microgreens, in a greenhouse under SL light-emitting diode (LED) photosynthetic photon flux density (PPFD) levels ranging from 17.0 to 304 μmol·m−2·s−1 with a 16-hour photoperiod (i.e., supplemental DLIs from 1.0 to 17.5 mol·m−2·d−1). Crops were sown in a commercial greenhouse near Hamilton, ON, Canada (lat. 43°14′N, long. 80°07′W) on 1 Feb. 2018, and harvested after 8, 11, 12, and 12 days, resulting in average natural DLIs of 6.5, 5.9, 6.2, and 6.2 mol·m−2·d−1 for sunflower, kale, arugula, and mustard, respectively. Corresponding total light integrals (TLIs) ranged from 60 to 188 mol·m−2 for sunflower, 76 to 258 mol·m−2 for kale, 86 to 280 mol·m−2 for arugula, and 86 to 284 mol·m−2 for mustard. Fresh weight (i.e., marketable yield) increased asymptotically with increasing LI and leaf area increased linearly with increasing LI, in all genotypes. Hypocotyl length of mustard decreased and hypocotyl diameter of sunflower, arugula, and mustard increased with increasing LI. Dry weight, robust index, and relative chlorophyll content increased and specific leaf area decreased in kale, arugula, and mustard with increasing LI. Commercial microgreen greenhouse growers can use the light response models described herein to predict relevant production metrics according to the available (natural and supplemental) light levels to select the most appropriate SL LI to achieve the desired production goals as economically as possible.