bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic nomogram for patients with non-metastatic HER2 positive breast cancer in a prospective cohort
Authors: Luo Chuanxu , Zhong Xiaorong , Wang Zhu , Wang Yu , Wang Yanping , He Ping , Peng Qian , Zheng Hong
Published: March 2019

Purpose:

A nomogram is a reliable tool to generate individualized risk prediction by combining prognostic factors. We aimed to construct a nomogram for predicting the survival in patients with non-metastatic human epidermal growth factor receptor 2 (HER2) positive breast cancer in a prospective cohort.

Methods:

We analyzed 1304 consecutive patients who were diagnosed with non-metastatic HER2 positive breast cancer between January 2008 and December 2016 in our institution. Independent prognostic factors were identified to build a nomogram using the COX proportional hazard regression model. The prediction of the nomogram was evaluated by concordance index (C-index), calibration and subgroup analysis. External validation was performed in a cohort of 6379 patients from the Surveillance, Epidemiology, and End Results (SEER) database.

Results:

Through the COX proportional hazard regression model, five independent prognostic factors were identified. The nomogram predicting overall survival achieved a C-index of 0.78 in the training cohort and 0.74 in the SEER cohort. The calibration plot displayed favorable accordance between the nomogram prediction and the actual observation for 3-year overall survival in both cohorts. The quartiles of the nomogram score classified patients into subgroups with distinct overall survival.

Conclusion:

We developed and validated a novel nomogram for predicting overall survival in patients with non-metastatic HER2 positive breast cancer, which presented a favorable discrimination ability. This model may assist clinical decision making and patient–clinician communication in clinical practice.
Accuracy and Precision of a Point-of-Care HbA1c Test
Authors: Arnold William D. , Kupfer Kenneth , Little Randie R. , Amar Meera , Horowitz Barry , Godbole Narendra , Hvidsten Swensen Monica , Li Yin , San George Richard C.
Published: March 2019

Background:

Point-of-care (POC) hemoglobin A1c (HbA1c) testing has advantages over laboratory testing, but some questions have remained regarding the accuracy and precision of these methods. The accuracy and the precision of the POC Afinion™ HbA1c Dx test were investigated.

Methods:

Samples spanning the assay range were collected from prospectively enrolled subjects at three clinical sites. The accuracy of the POC test using fingerstick and venous whole blood samples was estimated via correlation and bias with respect to values obtained by an NGSP secondary reference laboratory (SRL). The precision of the POC test using fingerstick samples was estimated from duplicate results by calculating the coefficient of variation (CV) and standard deviation (SD), and separated into its components using analysis of variance (ANOVA). The precision of the POC test using venous blood was evaluated from samples run in four replicates on each of three test cartridge lots, twice per day for 10 consecutive days. The SD and CV by study site and overall were calculated.

Results:

Across the assay range, POC test results from fingerstick and venous whole blood samples were highly correlated with results from the NGSP SRL ( r = .99). The mean bias was −0.021% HbA1c (−0.346% relative) using fingerstick samples and −0.005% HbA1c (−0.093% relative) using venous samples. Imprecision ranged from 0.62% to 1.93% CV for fingerstick samples and 1.11% to 1.69% CV for venous samples.

Conclusions:

The results indicate that the POC test evaluated here is accurate and precise using both fingerstick and venous whole blood.
Management of severe arterial hypertension associated with serotonin syndrome: a case report analysis based on systematic review techniques
Authors: Ott Michael , Mannchen Julie K. , Jamshidi Fariba , Werneke Ursula
Published: March 2019

Serotonin syndrome is thought to arise from serotonin excess. In many cases, symptoms are mild and self-limiting. But serotonin syndrome can become life threatening, when neuromuscular hyperexcitability spins out of control. Uncontainable neuromuscular hyperexcitability may lead to cardiovascular complications, linked to extreme changes in blood pressure. Currently, there is little guidance on how to control blood pressure in hyperserotonergic states. We report a case with treatment-resistant arterial hypertension, followed by a clinical review (using systematic review principles and techniques) of the available evidence from case reports published between 2004 and 2016 to identify measures to control arterial hypertension associated with serotonin syndrome. We conclude that classic antihypertensives may not be effective for the treatment of severe hypertension associated with serotonin syndrome. Benzodiazepines may lower blood pressure. Patients with severe hypertension not responding to benzodiazepines may benefit from cyproheptadine, propofol or both. In severe cases, higher cyproheptadine doses than currently recommended may be necessary.
Distinct plasma gradients of microRNA‐204 in the pulmonary circulation of patients suffering from WHO Groups I and II pulmonary hypertension
Authors: Estephan Leonard E. , Genuardi Michael V. , Kosanovich Chad M. , Risbano Michael G. , Zhang Yingze , Petro Nancy , Watson Annie , Al Aaraj Yassmin , Sembrat John C. , Rojas Mauricio , Goncharov Dmitry A. , Simon Marc A. , Goncharova Elena A. , Vaidya Anjali , Smith Akaya , Mazurek Jeremy , Han Yuchi , Chan Stephen Y.
Published: March 2019

Pulmonary hypertension (PH), a heterogeneous vascular disease, consists of subtypes with overlapping clinical phenotypes. MicroRNAs, small non‐coding RNAs that negatively regulate gene expression, have emerged as regulators of PH pathogenesis. The muscle‐specific micro RNA (miR)‐204 is known to be depleted in diseased pulmonary artery smooth muscle cells (PASMCs), furthering proliferation and promoting PH. Alterations of circulating plasma miR‐204 across the trans‐pulmonary vascular bed might provide mechanistic insights into the observed intracellular depletion and may help distinguish PH subtypes. MiR‐204 levels were quantified at sequential pulmonary vasculature sites in 91 patients with World Health Organization (WHO) Group I pulmonary arterial hypertension (PAH) (n = 47), Group II PH (n = 22), or no PH (n = 22). Blood from the right atrium/superior vena cava, pulmonary artery, and pulmonary capillary wedge was collected. Peripheral blood mononuclear cells (PBMCs) were isolated (n = 5/group). Excretion of miR‐204 by PAH‐PASMCs was also quantified in vitro. In Group I patients only, miR‐204 concentration increased sequentially along the pulmonary vasculature (log fold‐change slope = 0.22 [95% CI = 0.06–0.37], P = 0.008). PBMCs revealed insignificant miR‐204 variations among PH groups (P = 0.12). Cultured PAH‐PAMSCs displayed a decrease of intracellular miR‐204 (P = 0.0004), and a converse increase of extracellular miR‐204 (P = 0.0018) versus control. The stepwise elevation of circulating miR‐204 across the pulmonary vasculature in Group I, but not Group II, PH indicates differences in muscle‐specific pathobiology between subtypes. Considering the known importance of miR‐204 in PH, these findings may suggest pathologic excretion of miR‐204 in Group I PAH by PASMCs, thereby accounting for decreased intracellular miR‐204 concentration.
Pediatric meningitis due to Neisseria meningitidis, Streptococcus pneumoniae and Group B Streptococcus in Tijuana, Mexico: active/prospective surveillance, 2005–2018
Authors: Chacon-Cruz Enrique , Roberts Christopher , Rivas-Landeros Rosa Maria , Lopatynsky-Reyes Erika Zoe , Almada-Salazar Lucila Alejandra , Alvelais-Palacios Jorge Arturo
Published: March 2019

Introduction:

In Mexico, Neisseria meningitidis is considered to be a rare cause of bacterial meningitis (BM), however, one national publication using active surveillance has suggested the opposite. Group B Streptococcus (GBS) is also considered to be infrequent in young infants as a cause of BM in central Mexico. Streptococcus pneumoniae vaccination using the 13-valent conjugate vaccine (PCV13) started in our region in May 2012. We focused our research on whether N. meningitidis and GBS are important causes of BM, and to examine the effectiveness of PCV13 on pneumococcal BM.

Methods:

From October 2005 to September 2018, active/prospective surveillance looking for all patients admitted with suspected BM <16 years of age was performed at the Tijuana, Mexico, General Hospital. Tijuana, Mexico to San Diego, Unites States of America (USA), is the most transited border in the world. Isolation of pathogens was by either conventional culture or Real Time-polymerase chain reaction (RT-PCR), all patients were followed during and 3 months after discharge, and a descriptive analysis was performed. The effectiveness of PCV13 was determined by comparing the proportion of cases per month on pneumococcal BM before and after its implementation.

Results:

There were 86 confirmed BM cases. N. meningitidis was the leading cause (60.5%, and 61.5% caused by serogroup C), followed by S. pneumoniae (18.6%). PCV13 effectiveness on pneumococcal BM was of 64.3% and was associated with the disappearance of serotype 19A. A total of 22 infants <3 months old had BM; GBS was the leading cause at this age group (27.3%), followed by N. meningitidis (22.7%). The overall mortality was 24%.

Conclusions:

BM by N. meningitidis is endemic in Tijuana, Mexico, and meningococcal vaccination should be seriously considered in the region. PCV13 is currently showing high effectiveness on pneumococcal BM, and we need to continue active surveillance to see whether maternal screening/prophylaxis for GBS should also be introduced in the region.
Adverse event profiles of solvent-based and nanoparticle albumin-bound paclitaxel formulations using the Food and Drug Administration Adverse Event Reporting System
Authors: Naganuma Misa , Tahara Kohei , Hasegawa Shiori , Fukuda Akiho , Sasaoka Sayaka , Hatahira Haruna , Motooka Yumi , Nakao Satoshi , Mukai Ririka , Hirade Kouseki , Yoshimura Tomoaki , Kato Takeshi , Takeuchi Hirofumi , Nakamura Mitsuhiro
Published: March 2019

Objectives:

Paclitaxel is a highly effective antitumor agent with notable adverse events, including hypersensitivity reactions, peripheral neuropathy, arthralgia, myalgias, and neutropenia. Solvent-based paclitaxel causes severe allergic, hypersensitivity, and anaphylactic reactions. Nanoparticle albumin-bound paclitaxel was recently developed and provides an advantage over solvent-based paclitaxel in avoiding solvent/surfactant-related adverse events. The aim of this study was to assess the adverse event profiles of solvent-based paclitaxel and nanoparticle albumin-bound paclitaxel formulations using data from the spontaneous adverse event reporting system of the US Food and Drug Administration Adverse Event Reporting System database.

Methods:

This study relied on Medical Dictionary for Regulatory Activities preferred terms and standardized queries, and calculated the reporting ratio and reporting odds ratios of paclitaxel formulations.

Results:

Of 8,867,135 reports recorded in the US Food and Drug Administration Adverse Event Reporting System database from January 2004 to December 2016, 3469 and 4447 adverse events corresponded to solvent-based paclitaxel and nanoparticle albumin-bound paclitaxel, respectively. Reporting odds ratios (95% confidence interval) for anaphylactic reaction (standardized MedDRA query code: 20000021) associated with the use of solvent-based paclitaxel and nanoparticle albumin-bound paclitaxel were 1.69 (1.56–1.84) and 0.75 (0.68–0.83), respectively. Reporting odds ratio signal for anaphylactic reaction was not detected for nanoparticle albumin-bound paclitaxel. Reporting odds ratios (95% confidence interval) for acute renal failure (standardized MedDRA query code: 20000003) associated with the use of solvent-based paclitaxel and nanoparticle albumin-bound paclitaxel were 0.75 (0.58–0.98) and 1.60 (1.37–1.89), respectively.

Conclusion:

This is the first study to evaluate the adverse event profile of nanoparticle albumin-bound paclitaxel using US Food and Drug Administration Adverse Event Reporting System data. Considering that the US Food and Drug Administration Adverse Event Reporting System database does not allow to infer causality or risk ranking, the different reporting frequencies of anaphylactic reaction and acute renal failure between solvent-based paclitaxel and nanoparticle albumin-bound paclitaxel must be further investigated via analytical observational research.
Detection and significance of TNF-α and hs-CRP in the pleural effusion of patients with diabetes and pulmonary tuberculosis
Authors: Xue Xin , Qiu Yi , Cao Sizhe , Yue Ying , Sun Xiaofang , Yan Wen
Published: March 2019

It is postulated that high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor α (TNF-α) are diagnostic utilities for pleural effusion. This study was designed to explore the detection and significance of TNF-α and hs-CRP in the pleural effusion of patients with diabetes and pulmonary tuberculosis. A total of 60 patients with diabetes and pulmonary tuberculosis pleural effusion were selected as the study group, while 60 patients with pulmonary tuberculosis pleural effusion were considered as the control group. The expression of TNF-α and hs-CRP in the two groups was determined from pleural effusion by enzyme-linked immunosorbent assay (ELISA). The expression levels of TNF-α and hs-CRP in pleural effusion of the study group were significantly ( P < 0.05) higher than the control group, and the sensitivity and specificity of the combined detection were significantly ( P < 0.05) higher than those of the separate detection. The expression of TNF-α and hs-CRP in the pleural effusion of patients with diabetes and pulmonary tuberculosis increased remarkably, which plays an important role in the diagnosis and treatment helping with differential diagnosis and evaluation of severity and prognosis by related detection of changes of these indexes, especially the combined detections.
Oral administration of Lactobacillus plantarum attenuates inflammatory damage in mice challenged with two pathogens
Authors: Ren Dayong , Wang Di , Rong Fengjun , Liu Hongyan , Shen Minghao , Yu Hansong
Published: March 2019

This study aimed to determine the immunomodulatory effect of Lactobacillus plantarum on Salmonella typhimurium and Staphylococcus aureus infection. A mouse inflammation model was established using S. aureus and S. typhimurium. The infected mice were treated with low, medium, and high doses (2 × 108, 4 × 108, and 8 × 108 colony forming units (CFU)/mL, respectively) of three antibacterial L. plantarum strains. The body weight changes, spleen and thymus indexes, cytokines (interleukin (IL)-4 and interferon (IFN)-γ), and secreted immunoglobulin A levels were measured. Compared with the model group, all the L. plantarum-treated groups show increased body weight, reduced spleen swelling, decreased IFN-γ content, significantly increased IL-4 content, and significantly decreased ratio of IFN-γ to IL-4. sIgA levels increased at the end of the experiment. The three L. plantarum strains can effectively attenuate the symptoms of S. typhimurium and S. aureus infection by regulating the Th1/Th2 response and enhancing sIgA secretion.
Who Pays the Price for Parental Education–Occupation Mismatch? Evidence From an Israeli City
Authors: Feniger Yariv , Gorodzeisky Anastasia , Krumer-Nevo Michal
Published: March 2019

In recent years, education–occupation mismatch has become an important area of social research. However, little is known about its impact on the intergenerational transmission of educational attainment. This study investigates the possible negative consequences of a specific aspect of parental education–occupation mismatch, also known as overeducation, for high school students. Drawing from a sample of high school students in an Israeli city with a high incidence of overeducation, our analysis suggests that parental education–occupation mismatch does not affect student expectations for progressing to higher education. The results did reveal, however, that maternal education–occupation mismatch is related to school truancy among boys and girls, and that paternal education–occupation mismatch contributes to lower odds of enrollment in advanced science courses, especially among boys.
Social Inclusion of Marginal in the Great Climate Change Debate: Case of Slums in Dehradun, India
Authors: Habeeb Riyan , Javaid Sana
Published: March 2019

In times of climate change, it is said that the marginal population shall be the most adversely affected. This article attempts to explore the state of slums in Dehradun city and their susceptibility to climate change events, especially urban flooding. Taking the case of the state capital, we attempt to identify and demonstrate how the slum population is vulnerable to climate change events in the present and the future. Following risk-hazard approach, this article identifies and distinguishes vulnerable slums, per their sensitivity toward climate-led events using geographic information system (GIS) spatial analysis. Climate change trends show increasing precipitation and temperature trends, which is in agreement with current events of such phenomena in the city. Through GIS, the slums were mapped and their proximity to streams and roads were taken into account to generate vulnerable hotspots with respect to numbers, population, and location. The article then inquires into the inclusion of such vulnerable slums in various relevant state- and national-level policies discussing challenges and issues in implementation. The article finally derives the possibilities for inclusion of such marginalized classes through ongoing Government of India missions.
Vocabulary Learning Strategies Through Secondary Students at Saudi School in Malaysia
Authors: Yaacob Aizan , Shapii Aspalila , Saad Alobaisy Ayman , Al-Rahmi Waleed Mugahed , Al-Dheleai Yahya M. , Yahaya Noraffandy , Alamri Mahdi M.
Published: March 2019

This study is dedicated to the research of vocabulary learning strategies (VLSs) employed by a group of Saudi Arabian learners in an EFL (English as a foreign language) context. The rationale for the study is to clarify a pronounced lack of research on the EFL context in Saudi Schools Abroad (SSA), and a dearth of prior research into VLSs in this context. In particular, this research intends to explore how do students at Saudi School Malaysia (SSM) employ VLSs in their actual learning process. Therefore, this study is conducted on cognitive theory of learning studies, the mental processes involved in the learning process. Moreover, this study conducted an analysis of studies dedicated to VLSs through secondary students at Saudi school in Malaysia based on previous research problems of models and theories. In addition, this study applied quantitative approach, and the questionnaire was conducted using 105 students. The results of this study revealed the percentage and frequency have further underscored this role and the significance of vocabulary learning in both students and teachers. Also, the results show that students at SSM have employed the five categories of VLSs at a medium level and almost at a close range.
Scope of Practice Issues for Occupational and Environmental Health Nurses
Authors: Strasser Patricia B.
Published: March 2019

This article discusses scope of practice issues among various levels of professional nurses within the United States. It raises awareness that all occupational and environmental health nurses must be knowledgeable about workplace activities that may be permitted or prohibited by their state practice acts.
Contingent Workers
Authors: Guerrina Ryan T. , Burns Candace M. , Conlon Helen
Published: March 2019

Contingent workers compose a large portion of the U.S. work force. Contingent workers include temporary employees, contracted employees, day laborers, and freelancers. The skill level and educational requirements for their jobs vary from basic to highly advanced. Construction, housekeeping, engineering, and nursing have such positions. U.S. contingent workers are more likely to engage in occupations associated with increased risk of injury, and a variety of factors increase their risk of work injuries, particularly those leading to death. This article focuses on select occupational health and safety issues affecting contingent workers and their implications for occupational health nurses.
Indoor Air Problems in Hospitals
Authors: Hellgren Ulla-Maija , Reijula Kari
Published: March 2019

Indoor air problems, caused by moisture damage and limited ventilation, have been detected in Finnish hospital buildings. A recent survey found that hospital personnel experience indoor air-related symptoms more often than office workers. The aim of this study was to assess the role, capabilities, and methods of hospital occupational health professionals in handling indoor air problems. Data were generated through semi-structured interviews. Representatives of occupational health, occupational safety, and infection control were interviewed in seven central hospitals. The data were analyzed using qualitative methods. According to interviewed professionals, indoor air problems are difficult to tackle. The evaluation of health risks and risk communication were considered particularly difficult. A uniform action model for resolving indoor air problems should be created. An interprofessional indoor air group to handle indoor air problems should be created in all hospitals.
Borderline Personality Disorder and Disability
Authors: Arvig Tyler J.
Published: March 2019

Assessing functional impairment of individuals with borderline personality disorder is challenging. This article discusses the diagnosis of borderline personality disorder, examines the most common iterations of this disorder In disability claims, explores cases in which borderline personality disorder may cause impairment, and identifies signs of the impairment due to this disorder.
Arthritis and the Workplace
Authors: Olga S. Tompkins
Published: March 2019

The 2009 National Health Interview Survey estimates that 50 million adults have self-reported, physician-diagnosed arthritis, and 21 million adults have arthritis and arthritis-attributable activity limitation. These data have implications for occupational health nurses.
Relationship of Cardiovascular Disease to Stress and Vital Exhaustion in an Urban, Midwestern Police Department
Authors: Ramey Sandra L. , Perkhounkova Yelena , Downing Nancy R. , Culp Kennith R.
Published: March 2019

This study explored risk factors for cardiovascular disease (CVD) among 336 officers of a Midwestern police force. Instruments used included the Perceived Stress Scale, the Maastricht Questionnaire (measuring vital exhaustion), and a general Health Risk Appraisal. Rates of CVD, hypertension, and hypercholesterolemia were 3%, 28%, and 43%, respectively. The relative risk of hypercholesterolemia for male officers, compared to female officers, was 1.98 (95% confidence interval [CI], 1.10 to 3.56). The officers' average body mass index was 28.6 ( SD = 4.9), with 80% being overweight or obese. The average vital exhaustion score was higher for female officers than male officers ( p < .05). Bivariate relationships of CVD with perceived stress, vital exhaustion, and age were statistically significant (p < .05). When controlling for age, odds ratios were 1.20 (95% CI, 1.03 to 1.39; p< .05) for perceived stress and 1.31 (95% CI, 1.12 to 1.53; p < .01) for vital exhaustion.
Phthalate Exposures and Human Health Concerns
Authors: Pak Victoria M. , McCauley Linda A. , Pinto-Martin Jennifer
Published: March 2019

High levels of exposure to phthalates have been associated with an increased risk for adverse male fetal reproductive development. Although animal studies have consistently demonstrated reproductive health effects, additional human epidemiological studies are needed to fully understand the potential harm to humans. Recent findings reported for humans have demonstrated endocrine-disrupting action similar to that associated with phthalate exposures in animals. As a result, phthalate exposure is an emerging public health concern that warrants further review. This article explores the state of the science on phthalate exposure, reviews the literature, and provides recommendations occupational health nurses can use to optimize the health of susceptible populations.
Health Behaviors of Operating Engineers
Authors: Duffy Sonia A. , Missel Amanda L. , Waltje Andrea H. , Ronis David L. , Fowler Karen E. , Hong OiSaeng
Published: March 2019

Operating Engineers (heavy equipment operators in construction) may be at particular risk for heart disease and cancer related to their exposure to environmental dust and smoking, the sedentary nature of their job, and long hours of exposure to the sun. The aim of this study was to characterize the health behaviors of Operating Engineers. This cross-sectional survey from a convenience sample of Operating Engineers ( N = 498) used validated instruments to measure smoking, drinking, diet, exercise, sleep, and sun exposure. Univariate and bivariate analyses to detect differences by age were conducted. The sample scored significantly worse on all five health behaviors compared to population norms. Those who were older were less likely to smoke and chew tobacco and more likely to eat fruits and vegetables. Many were interested in services to improve their health behaviors. Health behavior interventions are needed and wanted by Operating Engineers.
A Lift Assist Team in an Acute Care Hospital— Prevention of Injury or Transfer of Risk during Patient-Handling Tasks?
Authors: Schoenfisch Ashley L. , Lipscomb Hester J. , Myers Douglas J. , Fricklas Ethan , James Tamara
Published: March 2019

A Lift Assist Team (LAT) was created on three units at a medical center where nursing staff were at high risk for patient-handling injuries. LAT members were drawn from the hospital's pool of patient transporters. Using qualitative and quantitative data, this case study summarizes the development, implementation, and experiences of the LAT. Nursing staff valued the LAT, reporting increased staff safety and improved patient care. LAT members reported greater job satisfaction and a newfound sense of assimilation into the nursing group compared to when their role was patient transport only. However, over time, their job responsibilities expanded beyond those officially designated for LAT members. Active, ongoing surveillance of the LAT's exposures and outcomes is warranted to understand whether patient-handling injury risk is shifting from nursing personnel to LAT members.
To Lift or Not to Lift
Authors: de Ruiter Hans-Peter , Liaschenko Joan
Published: March 2019

Musculoskeletal injury is common among nurses as a result of lifting and handling patients. In response to musculoskeletal injuries, safe patient-handling programs are being instituted to decrease the risk of injuries and resulting impaired function. This study was designed to identify patient-handling practices in clinical practice. This qualitative study used 128 hours of observations of patient-handling practices and interviews of 32 nursing staff who discussed these practices. Findings demonstrated five factors impact nurses' judgment regarding the best way to move patients: complexity of everyday care, patient treatment goals, time, knowledge, and equipment issues.
Low Back Pain among Personal Care Workers in an Old Age Home
Authors: Yeung Simon S.
Published: March 2019

This cross-sectional study explored the work-related and individual factors that contributed to the occurrence of low back pain and affected activities of 36 personal care workers at an old age home in Hong Kong. The study was divided into four parts: (1) a questionnaire documenting workload exposure factors; (2) a musculoskeletal symptoms survey documenting the prevalence of low back pain in this group of workers; (3) a worksite evaluation focusing on personal care workers' work postures and the work environment; and (4) an evaluation of physical fitness and lifting capacities of personal care workers. Univariate followed by multiple logistic regression analyses were used to identify the risk factors associated with low back pain that affected work activities. The results revealed that low back pain was associated with the perceived physical demands of cleaning tasks (odds ratio [OR] = 7.28, 95% confidence interval [CI] = 1.35–39.35, p < .05), perceived demands of awkward sustained back (OR = 4.46, CI = 0.86–22.97, p = .074) and neck (OR = 0.18, CI = 0.04–0.81, p < .05) postures, and thermal stress at work (OR = 49.80, CI = 0.70–3541.79, p = .072). The results of the current study indicated that the work environment contributed to low back pain at work. Workers perceived that exertion in workplaces has a role in assessing workplace risk. To avoid progression of low back pain in the workplace, work adjustment or modification should be considered when workers report high levels of perceived exertion at work.
Vitamin D
Authors: Tompkins Olga
Published: March 2019

Evidence is increasing that vitamin D insufficiency is widespread in the general population and that vitamin D plays a key role in bone health and the prevention of chronic health conditions. Nutrition education and risk awareness can be effective in reducing musculoskeletal injuries.
Eating Disorders at Work
Authors: Tompkins Olga
Published: March 2019

CDC statistics reflect the dramatic increase in obesity in the United States in the past 20 years, with 33 states having a prevalence of 25% or greater. Eating disorders and obesity have major implications for occupational health nurses.
Body Mass Index Misclassification of Obesity among Community Police Officers
Authors: Alasagheirin Mohammad H. , Clark M. Kathleen , Ramey Sandra L. , Grueskin Esack F.
Published: March 2019

Occupational health nurses are at the forefront of obesity assessment and intervention and must be aware of potential inaccuracies of obesity measurement. The purpose of this study was to identify the prevalence of obesity among a sample of 84 male police officers 22 to 63 years old and determine the accuracy of body mass index (BMI) in estimating obesity compared to body fat percent (BF %). BMI identified 39.3% of the participants as obese, compared to 70.2% by BF %. BMI misclassified normal-weight officers as obese or overweight and obese officers as normal 48.8% ( n = 41) of the time. The two misclassified groups had similar average BMIs but significantly different BF %. BMI was not an accurate measure of obesity among adult males. BMI underestimated the true prevalence of obesity and could represent a missed opportunity for early intervention and disease prevention.
Meetings—The Good, the Bad, and the Ugly
Authors: Lukes Eileen
Published: March 2019

Much has been written about how to facilitate an effective meeting, but apparently not every meeting facilitator has read the literature because every occupational health nurse has endured a “bad” meeting. Individuals who chair meetings have a responsibility to create meetings that are worthwhile to the attendees; attendees have a responsibility to be prepared for meetings so meetings are productive. This article reviews key meeting strategies, providing readers with ways to improve meetings they attend or facilitate.
Working at High Altitude
Authors: Tompkins Olga S.
Published: March 2019

High altitude is not just an issue for mountain climbers. Elevation can have implications for employees ranging from laborers to office workers to scientists. Awareness is key to effective management.
Shepherd’s crook deformity: How to set it straight. A five-step surgical guide
Authors: Dheenadhayalan Jayaramaraju , Avinash M , Lakhani Azhar , Rajasekaran S
Published: March 2019

Purpose:

Fibrous dysplasia (FD) of the proximal femur can result in severe deformity and disability. The results of surgical management in such situations have been reported to be poor. We present a novel, five-step surgical treatment to correct proximal femoral deformity in FD.

Material and methods:

This study is a review of prospectively collected data of cases of proximal femur polyostotic FD managed at our institute from 2012 onward. We managed three patients with FD involving four femora (one patient had bilateral disease). Mean age at presentation was 16 years with an average follow-up of 46 months. All underwent five steps, that is, (1) curettage/excision of the lesion, (2) allograft in intramedullary region, (3) lateral closing wedge valgus osteotomy, (4) fixation with extramedullary implant, and (5) augmentation of osteotomy site with autograft. Functional outcome was assessed using Harris Hip Score preoperatively and at the final follow-up.

Results:

The neck shaft angle was corrected from an average of 91.7° to 152.1°, while the Harris Hip Score improved from an average of 59 to 95. There was no clinical or radiological evidence of recurrence of disease or deformity in any patient till the last follow-up.

Conclusion:

This five-step technique ensures good functional and radiological outcomes in the management of proximal femur FD.
The influence of tibial slope on anterior cruciate ligament graft failure risk is dependent on graft positioning
Authors: Sauer Steffen , English Robert , Clatworthy Mark
Published: March 2019

Background:

Increased lateral tibial posterior slope (LTPS) is associated with higher anterior cruciate ligament (ACL) reconstruction (ACLR) failure rate. Transportal central femoral footprint ACLR is associated with higher failure rate compared to transtibial high anteromedial footprint ACLR due to graft anisometry. The purpose of this study was to investigate whether the influence of tibial slope on ACL graft failure risk is dependent on graft positioning.

Material:

Of the 1480 consecutive hamstring ACLRs, 30 transportal (central femoral tunnel placement) and 30 transtibial (high anteromedial tunnel placement) ACLR failures were evaluated and matched one-to-one with non-failure control participants by age, sex, graft and surgical technique. Lateral tibial slope was assessed on MRI.

Results:

The risk of graft failure in the transportal group increased by 40.5% per degree of increasing LTPS (odds ratio 1.4; 95% confidence interval 1.05–1.87; p = 0.02). The transportal failure group showed a significantly higher mean tibial slope of 8.6° compared to both the transportal control group with 7.1° ( p = 0.03) and the transtibial failure group with 7.2° ( p = 0.04). Increased tibial slope was associated with shorter time to reconstruction failure ( p = 0.002). The difference between slopes in the transtibial failure group (7.2°) compared to the transtibial control group (7.1°) was not significant ( p = 0.56).

Conclusion:

Increased LTPS is associated with significantly increased risk of graft failure only in transportal ACLR, not in transtibial ACLR. Slope-related graft strain may be potentiated by anisometric ACL graft placement.
An Insider View of the Cancer Radiation Experience Through the Eyes of a Cancer Patient
Authors: Leotin Sylvie
Published: March 2019

While oncology providers see and treat thousands of cancer patients every year, few have had cancer themselves, or know what’s it like to be in the shoes of a cancer patient days in and days out. This article written by a cancer survivor, writer, and experience design consultant lifts the lid on the cancer patient experience, for the benefit of noncancer patients. Through visual imageries, the author helps oncology providers and caregivers visualize and realize the vulnerability of the cancer experience and discover the treatment experience through new eyes. The article reveals emotional, mental, and somatic stressors, which add stress and/or trauma to the treatment experience and have been largely overlooked by health-care providers.
Low vs high hemoglobin trigger for transfusion in vascular surgery: a randomized clinical feasibility trial
Authors: Møller Anders , Nielsen Henning B. , Wetterslev Jørn , Pedersen Ole B. , Hellemann Dorthe , Winkel Per , Marcussen Klaus V. , Ramsing Benedicte G. U. , Mortensen Anette , Jakobsen Janus C. , Shahidi Saeid
Published: March 2019

Current guidelines advocate to limit red blood cell (RBC) transfusion during surgery, but the feasibility and safety of such a strategy remain unclear, as the majority of evidence is based on postoperatively stable patients. We assessed the effects of a protocol aiming to restrict RBC transfusion throughout hospitalization for vascular surgery. Fifty-eight patients scheduled for lower limb bypass or open abdominal aortic aneurysm repair were randomly assigned, on hemoglobin drop below 9.7 g/dL, to either a low-trigger (hemoglobin < 8.0 g/dL) or a high-trigger (hemoglobin < 9.7 g/dL) group for RBC transfusion. Near-infrared spectroscopy assessed intraoperative oxygen desaturation in brain and muscle. Explorative outcomes included nationwide registry data on death and major vascular complications. The primary outcome, mean hemoglobin within 15 days of surgery, was significantly lower in the low-trigger group, at 9.46 vs 10.33 g/dL in the high-trigger group (mean difference, −0.87 g/dL; P = .022), as were units of RBCs transfused (median [interquartile range (IQR)], 1 [0-2] vs 3 [2-6]; P = .0015). Although the duration and magnitude of cerebral oxygen desaturation increased in the low-trigger group (median [IQR], 421 [42-888] vs 127 [11-331] minutes × %; P = .0036), muscle oxygenation was unaffected. The low-trigger group associated to a higher rate of death or major vascular complications (19/29 vs 8/29; hazard ratio, 3.20; P = .006) and fewer days alive outside the hospital within 90 days (median [IQR], 76 [67-82] vs 82 [76-84] days; P = .049). In conclusion, a perioperative protocol restricting RBC transfusion successfully separated hemoglobin levels and RBC units transfused. Exploratory outcomes suggested potential harm with the low-trigger group and warrant further trials before such a strategy is universally adopted. This trial was registered at www.clinicaltrials.gov as #NCT02465125.
Enhancing the antitumor functions of invariant natural killer T cells using a soluble CD1d-CD19 fusion protein
Authors: Das Rupali , Guan Peng , Wiener Susan J. , Patel Nishant P. , Gohl Trevor G. , Evans Elizabeth , Zauderer Maurice , Nichols Kim E.
Published: March 2019

Invariant natural killer T (iNKT) cells comprise a unique lineage of CD1d-restricted lipid-reactive T lymphocytes that potently kill tumor cells and exhibit robust immunostimulatory functions. Optimal tumor-directed iNKT cell responses often require expression of the antigen-presenting molecule CD1d on tumors; however, many tumor cells downregulate CD1d and thus evade iNKT cell recognition. We generated a soluble bispecific fusion protein designed to direct iNKT cells to the site of B-cell cancers in a tumor antigen-specific but CD1d-independent manner. This fusion protein is composed of a human CD1d molecule joined to a single chain antibody FV fragment specific for CD19, an antigen widely expressed on B-cell cancers. The CD1d-CD19 fusion protein binds specifically to CD19-expressing, but not CD19-negative cells. Once loaded with the iNKT cell lipid agonist α-galactosyl ceramide (αGC), the CD1d-CD19 fusion induces robust in vitro activation of and cytokine production by human iNKT cells. iNKT cells stimulated by the αGC-loaded CD1d-CD19 fusion also strongly transactivate T-, B-, and NK-cell responses and promote dendritic cell maturation. Importantly, the αGC-loaded fusion induces robust lysis of CD19+CD1d− Epstein-Barr virus immortalized human B-lymphoblastoid cell lines that are otherwise resistant to iNKT cell killing. Consistent with these findings; administration of the αGC-loaded fusion protein controlled the growth of CD19+CD1d− tumors in vivo, suggesting that it can “link” iNKT cells and CD19+CD1d− targets in a therapeutically beneficial manner. Taken together, these preclinical studies demonstrate that this B cell–directed fusion protein can be used to effectively induce iNKT cell antitumor responses in vitro and in vivo.
Diagnosis and management of α1-antitrypsin deficiency in Europe: an expert survey
Authors: Horváth Ildikó , Canotilho Maria , Chlumský Jan , Chorostowska-Wynimko Joanna , Corda Luciano , Derom Eric , Ficker Joachim H. , Kneussl Meinhard , Miravitlles Marc , Sucena Maria , Thabut Gabriel , Turner Alice M. , van ’t Wout Emily , McElvaney N. Gerard
Published: March 2019

Despite recent improvements, α1-antitrypsin deficiency (AATD) remains a rarely diagnosed and treated condition. To assess the variability of AATD diagnosis/treatment in Europe, and to evaluate clinicians’ views on methods to optimise management, specialist AATD clinicians were invited to complete a web-based survey.

Surveys were completed by 15 physicians from 14 centres in 13 European countries. All respondents perceived the AATD diagnosis rate to be low in their country; 77% of physicians believed that ∼15% of cases were diagnosed. Low awareness was perceived as the greatest barrier to diagnosis. Spirometry was considered more practical than quantitative computed tomography (QCT) for monitoring AATD patients in clinical practice; QCT was considered more useful in trials. AAT therapy provision was reported to be highly variable: France and Germany were reported to treat the highest proportion (∼60%) of diagnosed patients, in contrast to the UK and Hungary, where virtually no patients receive AAT therapy. Most clinicians supported self-administration and extended dosing intervals to improve convenience of AAT therapy.

This survey indicates that AATD diagnosis and management are highly heterogeneous in Europe; European cooperation is essential to generate data to support access to AAT therapy. Improving convenience of AAT therapy is an ongoing objective.
RETRACTED ARTICLE: Circular RNA hsa_circ_0055538 regulates the malignant biological behavior of oral squamous cell carcinoma through the p53/Bcl-2/caspase signaling pathway
Authors: Su Wen , Sun Shuai , Wang Feng , Shen Yuehong , Yang Hongyu
Published: March 2019

Background

Oral squamous cell carcinoma (OSCC) is a common oral and maxillofacial malignant tumor with high rates of metastasis and mortality. Circular RNAs (circRNAs), a type of non-coding RNA, are involved in the development of a variety of tumors. The roles of circRNAs in OSCC are unclear; in this study, the correlation between the circRNA hsa_circ_0055538, previously identified by high-throughput sequencing, and the biological behavior of OSCC was evaluated.

Methods

circRNA expression was evaluated using patient tissue samples and various OSCC cell lines. The effects of overexpression and knockdown were evaluated by lentiviral infection and siRNA transfection of the SCC9 and CAL27 cell lines. Migration, invasion, apoptosis, and the expression of proteins in the p53 signaling pathway were evaluated. Infected cells were injected into nude mice to evaluate tumorigenesis.

Results

Low hsa_circ_0055538 expression levels were verified in tumor tissues and OSCC cell lines. Clinical data analysis showed that the expression level is related to the degree of tumor differentiation. Lentiviral infection and siRNA transfection of SCC9 and CAL27 cell lines revealed that changes in circRNA expression significantly affected the malignant biological behavior of OSCC cells. Importantly, nude mouse experiments showed that high expression of hsa_circ_0055538 inhibited tumor growth. Finally, hsa_circ_0055538 may affect the development of OSCC via the p53/Bcl-2/caspase signaling pathway.

Conclusions

Our results indicated that hsa_circ_0055538 is involved in OSCC via the p53 signaling pathway and may be a diagnostic and/or prognostic marker as well as a therapeutic target.
Infrared bundle adjusting and clustering method for head-mounted display and Leap Motion calibration
Authors: Park San , Cho Seoungjae , Park Jisun , Huang Kaisi , Sung Yunsick , Cho Kyungeun
Published: March 2019

Leap Motion has become widely used due to its ability to recognize intuitive hand gestures or accurate finger positions. Attaching a Leap Motion to a virtual reality head-mounted display (VR HMD) is highly interoperable with virtual objects in virtual reality. However, it is difficult for a virtual reality application to identify the accurate position where the Leap Motion is attached to the HMD. This causes errors in the positions of the actual user’s hands and the virtual hands, which makes the interaction in virtual reality difficult. In this paper, a method that calibrates an output area in VR HMD and a sensing area in Leap Motion is proposed. The difference in the origin coordinate between VR HMD and Leap Motion is derived using the proposed method. The position of the Leap Motion attached to the HMD was determined through an experiment using the proposed calibration technique, and the error was approximately 0.757 cm. Accordingly, it enables more intuitive interactions in virtual reality applications.
Earthquake-induced prompt gravity signals identified in dense array data in Japan
Authors: Kimura Masaya , Kame Nobuki , Watada Shingo , Ohtani Makiko , Araya Akito , Imanishi Yuichi , Ando Masaki , Kunugi Takashi
Published: March 2019

Earthquake ruptures cause mass redistribution, which is expected to induce transient gravity perturbations simultaneously at all distances from the source before the arrival of P-waves. A recent research paper reported the detection of such prompt gravity signals from the 2011 Tohoku-Oki earthquake by comparing observed acceleration waveforms and model simulations. The 11 observed waveforms presented in that paper recorded in East Asia shared a similar trend above the background seismic noise and were in good agreement with the simulations. However, the signal detection was less quantitative because the significance of the observed signals was not discussed and the waveforms at other stations in the region were not shown. In this study, similar trends were not observed in most of the data recorded near the stations used in the aforementioned study, suggesting that the reported signals were only local noises. We thus took a different approach to identify the prompt signals. We optimized the multi-channel data recorded by superconducting gravimeters, broadband seismometers, and tiltmeters. Though no signal was identified in the single-trace records, the stacked trace of the broadband seismometer array data in Japan showed a clear signal above the reduced noise level. The signal amplitude was 0.25 nm/s2 for an average distance of 987 km from the event hypocenter. This detection was confirmed with a statistical significance of $$7\sigma$$

7
σ

, where $$\sigma$$
σ
is the standard deviation of the amplitude of the background noise. This result provided the first constraint on the amplitude of the observed prompt signals and may serve as a reference in the detection of prompt signals in future earthquakes.