bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of long term inhaled corticosteroid therapy on adrenal suppression, growth and bone health in children with asthma
Authors: KWDA Anuradha , GLDC Prematilake , BAUI Batuwita , KASR Kannangoda , US Hewagamage , S Wijeratne , Kantha Lankatilake , KSH de Silva
Published: November 2019

Background

Inhaled corticosteroids (ICS) are the most effective treatment for children with persistent asthma. However adverse effects of ICS on Hypothalamo Pituitary Adrenal (HPA) axis, growth and bone metabolism are a concern. Hence the primary objective of this study was to describe the effects of long term inhaled corticosteroid therapy (ICS) on adrenal function, growth and bone health in children with asthma in comparison to an age and sex matched group of children with asthma who were not on long term ICS. Describing the association between the dose of ICS and duration of therapy on the above parameters were secondary objectives.

Method

Seventy children with asthma on ICS and 70 controls were studied. Diagnosis of asthma in selected patients was reviewed according to the criteria laid down by GINA 2018 guidelines. The estimated adult heights were interpreted relative to their Mid Parental Height (MPH) range. Serum calcium, alkaline phosphatase and vitamin D levels were analyzed in both groups and cortisol value at 30 min following a low dose short synacthen test was obtained from the study group. The average daily dose of ICS (Beclamethasone) was categorized as low, medium and high (100–200, 200–400, > 400 μg /day) respectively according to published literature.

Results

Heights of all children were within the MPH range. There was no statistically significant difference in the bone profiles and vitamin D levels between the two groups (Ca: p = 0.554, vitamin D: p = 0.187) but vitamin D levels were insufficient (< 50 nmol/l) in 34% of cases and 41% of controls. Suppressed cortisol levels were seen in 24%. Doses of ICS were low, medium and high in 56, 32 and 12% of children respectively. The association between adrenal suppression with longer duration of therapy (p < 0.01) and with increasing dose of ICS (p < 0.001) were statistically significant.

Conclusion

ICS had no impact on the growth and bone profiles but its dose and duration were significantly associated with adrenal suppression.
Epidemic characteristics and related risk factors of occupational exposure for pediatric health care workers in Chinese public hospitals: a cross-sectional study
Authors: Ma Yuanshuo , Ni Xin , Shi Yu , Yan Chunmei , Shi Lei , Li Zhe , Gao Xiangxu , Wang Dinan , Yang Xi , Fan Lihua , Wang Yongchen
Published: November 2019

Background

Health care workers have a high risk of occupational exposure. However, the risk of occupational exposure for pediatric health care workers has not been acknowledged in previous studies. The purpose of this study was to investigate the occupational exposure rate of pediatric health care workers in Chinese public hospitals, to explore risk factors for occupational exposure, and to put forward corresponding countermeasures to reduce occupational exposure of pediatric health care workers and protect their physical and mental health.

Methods

A cross-sectional study was conducted with pediatric health care workers in 43 hospitals in 15 provinces in eastern, central, and western China between July and October 2018. With this sample, we computed the descriptive statistics of the demographic characteristics, calculated the frequency of various types of occupational exposure, and tested risk factors for occupational exposure using a chi-squared test and binary logistic regression analysis.

Results

Most respondents were nursing staff (61.1%) and workers with a low-ranking professional title (50.5%). The most common style of occupational exposure in our sample was a hazard in the work environment (62.6%). Notably, physicians were less likely to experience occupational exposure than nurses (OR = 0.320, 95% CI = 0.241, 0.426). Meanwhile, pediatric health care workers who interpreted the doctor-patient relationship as harmonious (OR = 0.304, 95% CI = 0.152, 0.607) were less likely to suffer occupational exposure.

Conclusion

Pediatric health care workers in Chinese public hospitals have a high occupational exposure risk and the risk factors are complex and diverse. The state, society, hospitals should acknowledge this issue and develop strategies to protect the physical and mental health of pediatric health care workers.
Clinical outcomes of metallic Y-shaped covered stents for bronchopleural fistula around upper carina after lobectomy
Authors: Bi Yonghua , Zhu Xiaoyan , Yu Zepeng , Wu Gang , Han Xinwei , Ren Jianzhuang
Published: November 2019

Background

Few studies have reported the placement of metallic Y-shaped covered stents (Y stents) for bronchopleural fistula around the upper carina.

Methods

Eighteen patients were treated with Y stents insertion under the guidance of fluoroscopy. All covered stents were custom-designed and inserted to fit the upper carina anatomy. Clinical data and medical imaging data were analyzed retrospectively.

Results

The stents were implanted successfully for the first time in 17 patients, and one patient needed a second attempt due to stent migration during withdrawal of the guide wires. In total, 19 small Y single-plugged stents were inserted in the upper carina and 5 large Y stents additionally in the main carina. Nineteen complications were observed in 14 patients, including 4 major complications. Stents were successfully removed in 12 patients due to complications or cure efficacy, for a median duration in place of 89.5 days. One patient lost follow-up. Nine patients were cured, and three had clinical improvement. One patient died of ventricular fibrillation the second day after the procedure and 4 patients died of tumors 7.8 to 91.7 months after stent placement. The 1-, 3-, and 5-year survival rates were 87.5, 80.8 and 80.8%, respectively.

Conclusions

Metallic Y stent placement is technically feasible, effective and safe for bronchopleural fistula disease around the upper carina.
The shape of the glucose response curve during an oral glucose tolerance test heralds β–cell function in a large Chinese population
Authors: Cheng Xinqi , Yang Na , Li Yuxiu , Sun Qi , Qiu Ling , Xu Lingling , Ping Fan , Li Wei , Zhang Huabing
Published: November 2019

Background

The shape of the glucose response curve during an oral glucose tolerance test (OGTT) can predict β-cell function and insulin resistance. However, there have been few studies conducted on Chinese people. Thus, we aimed to verify the usefulness of the glucose response curve in a large Chinese population.

Methods

A total of 9059 OGTT (3-h tests) were categorized into either a monophasic or a multiphasic group based on the shape of the glucose response. Homeostasis model assessments of fasting insulin resistance, the Matsuda Index, the insulinogenic index, and the disposition index were assessed by plasma glucose and serum insulin concentration obtained at fasting or during an OGTT.

Results

The shape of the OGTT glucose response curve was monophasic in 87.3% and multiphasic in 12.7% of participants. Individuals in the multiphasic group were younger compared to those in the monophasic group (38.6 ± 13.6 vs. 35.4 ± 13.5, P < 0.001). Individuals in the monophasic group had significantly higher fasting plasma glucose (FPG 5.6 ± 13.5 vs. 5.2 ± 0.6, P < 0.001), fasting insulin (FINS 14.8 ± 8.7 vs. 13.5 ± 7.9, P < 0.01), and homeostasis model assessment of insulin resistance (HOMA-IR 3.8 ± 2.6 vs. 3.1 ± 2.0, P < 0.001) and impaired β-cell function (disposition index 12.7 ± 14.1 vs. 16.6 ± 17.8, P < 0.001) compared to those in the multiphasic group.

Conclusion

The monophasic OGTT glucose response curve could reflect impaired β-cell function in a large Chinese population.
Exploring the relationship between medical student basic psychological need satisfaction, resilience, and well-being: a quantitative study
Authors: Neufeld Adam , Malin Greg
Published: November 2019

Background

There is increasing acknowledgment that medical training is stressful for students and can impact their well-being. An important aspect of this is self-determination and basic psychological need satisfaction. A better understanding of how medical student perceptions of the learning environment impacts their basic psychological needs for motivation, resilience, and well-being may help to create learning environments that support the needs of medical students and help them become better healthier physicians. We aim to add to the literature on this topic by examining this relationship through the lens of Self-Determination Theory.

Methods

A total of 400 students from all 4 years of the medical program at our institution were invited to complete an anonymous online survey, measuring basic need satisfaction/frustration (autonomy, competence, relatedness) within the learning environment, resilience, and psychological well-being. We used analysis of variance to assess the effect of gender, age, and year on all variables, with t-tests to compare subgroups. Structural equation modelling was performed to test a hypothesized model in which support of medical students’ basic needs would positively relate to their resilience and well-being.

Results

The response rate was 183/400 (46%). After data cleaning, 160 remained: 67 males (42%) and 93 females (58%). There were 67 first years (42%), 35 second years (22%), 30 third years (19%), and 28 fourth years (18%). The sample mean age was 25.8 years (SD = 4.1). A well-fitting model was confirmed to fit the data, χ2 = 3.15, df = 3, p = 0.369, RMSEA = 0.018, SRMR = 0.022, CFI = 0.999. Autonomy and relatedness satisfaction exerted direct effects on well-being. Competence satisfaction did so indirectly, through its direct effect on resilience. Female medical students had lower resilience scores compared to their male peers.

Conclusions

When medical students perceived their learning environment as supportive to their basic needs, it was associated with an increase in their psychological well-being. Satisfaction of competence, but not autonomy or relatedness, predicted an increase in their resilience. Fostering medical students’ basic needs for motivation, especially competence, is recommended to support their resilience and well-being. Further research is required to generalize these results further.
Correction to: The cost-effectiveness of incentive-based active case finding for tuberculosis (TB) control in the private sector Karachi, Pakistan
Authors: Hussain Hamidah , Mori Amani Thomas , Khan Aamir J. , Khowaja Saira , Creswell Jacob , Tylleskar Thorkild , Robberstad Bjarne
Published: November 2019

In the original publication of this article [1], an author’s name needs to be revised from Jacob Creswel to Jacob Creswell.
Metabolic engineering and transcriptomic analysis of Saccharomyces cerevisiae producing p-coumaric acid from xylose
Authors: Borja Gheorghe M. , Rodriguez Angelica , Campbell Kate , Borodina Irina , Chen Yun , Nielsen Jens
Published: November 2019

Background

Aromatic amino acids and their derivatives are valuable chemicals and are precursors for different industrially compounds. p-Coumaric acid is the main building block for complex secondary metabolites in commercial demand, such as flavonoids and polyphenols. Industrial scale production of this compound from yeast however remains challenging.

Results

Using metabolic engineering and a systems biology approach, we developed a Saccharomyces cerevisiae platform strain able to produce 242 mg/L of p-coumaric acid from xylose. The same strain produced only 5.35 mg/L when cultivated with glucose as carbon source. To characterise this platform strain further, transcriptomic analysis was performed, comparing this strain’s growth on xylose and glucose, revealing a strong up-regulation of the glyoxylate pathway alongside increased cell wall biosynthesis and unexpectedly a decrease in aromatic amino acid gene expression when xylose was used as carbon source.

Conclusions

The resulting S. cerevisiae strain represents a promising platform host for future production of p-coumaric using xylose as a carbon source.
PADI3 plays an antitumor role via the Hsp90/CKS1 pathway in colon cancer
Authors: Chai Zhengbin , Wang Li , Zheng Yabing , Liang Na , Wang Xiwei , Zheng Yingying , Zhang Zhiwei , Zhao Chuanxi , Zhu Tingting , Liu Chunyan
Published: November 2019

Background

CKS1 is highly expressed in colon cancer tissues, and is essential for cancer cell proliferation. The downstream molecular mechanism of CKS1 has been fully studied, but the upstream regulatory mechanism of it is still unclear. Earlier research found that PADI3 plays its anti-tumor roles via suppress cell proliferation, in this study, we found that the expression pattern of PADI3 and CKS1 are negatively correlated in colon cancer tissues, and overexpression of PADI3 can partly reverse CKS1 induced cancer cell proliferation. However, the regulatory mechanism of PADI3 and CKS1 in the tumorigenesis of colon cancer is still unclear and need to do further research.

Methods

Western blot and real-time PCR were used to detect the expression levels of genes. CCK-8 and colony formation assays were used to examine cell proliferation and colony formation ability. Overexpression and rescue experiments were used to study the molecular mechanism of CKS1 in colon cancer cells, BALB/c nude mice were used to study the function of CKS1 in vivo.

Results

CKS1 is highly expressed in colon cancer tissues, and the overexpression of CKS1 promotes cell proliferation and colony formation in both HCT116 (originating from primary colon cancer) and SW620 (originating from metastatic tumor nodules of colon cancer) cells. CKS1-expressing HCT116 cells produced larger tumors than the control cells. The expression pattern of PADI3 and CKS1 are negatively correlation in clinical samples of colon cancer, further study indicates that PADI3 can significantly decrease Hsp90 and CKS1 expression, and Hsp90 is essential for PADI3 to downregulate CKS1expression in colon cancer cells.

Conclusions

PADI3 exerts its antitumor activity by inhibiting Hsp90 and CKS1 expression, and Hsp90 is essential for PADI3 to suppress CKS1 expression.
Determinants of arsenic methylation efficiency and urinary arsenic level in pregnant women in Bangladesh
Authors: Gao Shangzhi , Lin Pi-I , Mostofa Golam , Quamruzzaman Quazi , Rahman Mahmudur , Rahman Mohammad Lutfar , Su Li , Hsueh Yu-mei , Weisskopf Marc , Coull Brent , Christiani David Chistopher
Published: November 2019

Background

Prenatal inorganic arsenic (iAs) exposure is associated with pregnancy outcomes. Maternal capabilities of arsenic biotransformation and elimination may influence the susceptibility of arsenic toxicity. Therefore, we examined the determinants of arsenic metabolism of pregnant women in Bangladesh who are exposed to high levels of arsenic.

Methods

In a prospective birth cohort, we followed 1613 pregnant women in Bangladesh and collected urine samples at two prenatal visits: one at 4–16 weeks, and the second at 21–37 weeks of pregnancy. We measured major arsenic species in urine, including iAs (iAs%) and methylated forms. The proportions of each species over the sum of all arsenic species were used as biomarkers of arsenic methylation efficiency. We examined the difference in arsenic methylation using a paired t-test between first and second visits. Using linear regression, we examined determinants of arsenic metabolism, including age, BMI at enrollment, education, financial provider income, arsenic exposure level, and dietary folate and protein intake, adjusted for daily energy intake.

Results

Comparing visit 2 to visit 1, iAs% decreased 1.1% (p <  0.01), and creatinine-adjusted urinary arsenic level (U-As) increased 21% (95% CI: 15, 26%;p <  0.01). Drinking water arsenic concentration was positively associated with iAs% at both visits. When restricted to participants with higher adjusted urinary arsenic levels (adjusted U-As > 50 μg/g-creatinine) gestational age at measurement was strongly associated with DMA% (β = 0.38, p <  0.01) only at visit 1. Additionally, DMA% was negatively associated with daily protein intake (β = − 0.02, p <  0.01) at visit 1, adjusting for total energy intake and other covariates.

Conclusions

Our findings indicate that arsenic metabolism and adjusted U-As level increase during pregnancy. We have identified determinants of arsenic methylation efficiency at visit 1.
Parenteral systems for statin delivery: a review
Authors: Korani Shahla , Bahrami Samira , Korani Mitra , Banach Maciej , Johnston Thomas P. , Sahebkar Amirhossein
Published: November 2019

The oral route of drug administration is the most common and convenient route for dosing statin drugs, and, in fact, most medications, because of ease of drug delivery, patient compliance, and cost-effectiveness. However, the oral administration of statin drugs has disadvantages such as hepatic first-pass metabolism and degradation within the gastrointestinal tract that limit their overall bioavailability. This review introduces several diverse non-oral delivery methods for the administration of statins. These alternative delivery systems and routes of administration are varied and are capable of improving the bioavailability and therapeutic efficacy of statin drugs.
Does stigmatization moderate the association between intention and implementation of learned prevention-strategies at work after a depressive episode? – a cross-sectional pilot study
Authors: Gaum Petra Maria , Brey Franziska , Kraus Thomas , Lang Jessica
Published: November 2019

Background

A depressive episode is a frequent reason for production loss due to long periods of absence at work. To maintain work ability after depression, affected employees need to implement learned coping strategies from interventions at work. Based on the theory of planned behavior, this paper examines how stigmatization relates to the implementation of the learned strategies at the workplace. Further, differences between employees with single or recurrent depressive episode were considered.

Methods

Data of an online survey from 112 participants who returned to work after sick leave because of a depressive episode were analyzed [men = 28 (25%); Age: mean = 42.3, SD = 10.9]. The strategies learned were asked openly, intention and implementation with a questionnaire based on the theory of planned behavior and stigmatization with an adapted version of the German inventory of subjective stigma experience.

Results

Intention is positively (β = .46, p < .001) and anticipated (β = −.18, p = .052) and experienced stigmatization not (β = −.11, p = .27) correlated with implementation. Only anticipated stigmatization moderates the association between intention and implementation (β = .26, p = .003). If individuals report a high intention to implement the learned strategies, stigmatization has no influence on implementation. Under low intention, stigmatization leads to less implementation. Participants with recurrent depressive episodes report higher anticipated stigmatization than participants with a single episode.

Conclusion

When employees return to work after a depressive episode, it is important to address anticipated stigmatization and to develop an organizational culture that helps them to reduce their fear of stigmatization and strengthens their work ability via implementing learned prevention-strategies. The reduction of patient’s anticipated stigmatization should already be considered in the therapy and reduced in cooperation with occupational physicians.
Spatiotemporal climate and vegetation greenness changes and their nexus for Dhidhessa River Basin, Ethiopia
Authors: Wedajo Gizachew Kabite , Muleta Misgana K. , Gessesse Berhan , Koriche Sifan A.
Published: November 2019

Background

Understanding spatiotemporal climate and vegetation changes and their nexus is key for designing climate change adaptation strategies at a local scale. However, such a study is lacking in many basins of Ethiopia. The objectives of this study were (i) to analyze temperature, rainfall and vegetation greenness trends and (ii) determine the spatial relationship of climate variables and vegetation greenness, characterized using Normalized Difference in Vegetation Index (NDVI), for the Dhidhessa River Basin (DRB). Quality checked high spatial resolution satellite datasets were used for the study. Mann–Kendall test and Sen’s slope method were used for the trend analysis. The spatial relationship between climate change and NDVI was analyzed using geographically weighted regression (GWR) technique.

Results

According to the study, past and future climate trend analysis generally showed wetting and warming for the DRB where the degree of trends varies for the different time and spatial scales. A seasonal shift in rainfall was also observed for the basin. These findings informed that there will be a negative impact on rain-fed agriculture and water availability in the basin. Besides, NDVI trends analysis generally showed greening for most climatic zones for the annual and main rainy season timescales. However, no NDVI trends were observed in all timescales for cool sub-humid, tepid humid and warm humid climatic zones. The increasing NDVI trends could be attributed to agroforestry practices but do not necessarily indicate improved forest coverage for the basin. The change in NDVI was positively correlated to rainfall (r2 = 0.62) and negatively correlated to the minimum (r2 = 0.58) and maximum (r2 = 0.45) temperature. The study revealed a strong interaction between the climate variables and vegetation greenness for the basin that further influences the biophysical processes of the land surface like the hydrologic responses of a basin.

Conclusion

The study concluded that the trend in climate and vegetation greenness varies spatiotemporally for the DRB. Besides, the climate change and its strong relationship with vegetation greenness observed in this study will further affect the biophysical and environmental processes in the study area; mostly negatively on agricultural and water resource sectors. Thus, this study provides helpful information to device climate change adaptation strategies at a local scale.
A serious adverse drug reaction probably induced by clonazepam: a case report of myotoxicity
Authors: Han Xiaonian , Wang Jinping
Published: November 2019

Background

The adverse drug reactions (ADRs) related to clonazepam are mild, and only two cases of myotoxicity induced by clonazepam have been reported, with both patients recovering well. We present a unique case of a serious ADR outcome after taking clonazepam.

Case presentation

A 24-year-old woman with a long-standing history of polio and a 2-year history of epilepsy developed a serious ADR after repeated exposure to oral clonazepam combined with sodium valproate that manifested as myotoxicity and elevated levels of creatine phosphokinase. The patient is currently bedridden and unable to take care of herself.

Conclusion

Clinicians should be vigilant of the possibility of myotoxicity induced by clonazepam, especially in specific populations such as polio patients or when clonazepam is used in combination therapies.
A website for pilot and feasibility studies: giving your research the best chance of success
Authors: Chan Claire Louise
Published: November 2019

This editorial introduces a website for pilot and feasibility studies. Pilot and feasibility studies are about giving research the best chance of success, but must be performed well to have the greatest benefit. The website was developed by the Pilot and Feasibility Studies collaboration who developed the CONSORT Extension to Pilot and Feasibility Trials as a resource to help triallists and researchers perform well conducted pilot and feasibility studies. The website is also aimed at those interested in the latest methodology for these studies. We aim to keep the site updated with the latest publications and events related to pilot and feasibility studies and welcome feedback and suggestions from the research community on further resources or events to add.
Phase I Study of DSTP3086S, an Antibody-Drug Conjugate Targeting Six-Transmembrane Epithelial Antigen of Prostate 1, in Metastatic Castration-Resistant Prostate Cancer
Authors: Danila Daniel C. , Szmulewitz Russell Z. , Vaishampayan Ulka , Higano Celestia S. , Baron Ari D. , Gilbert Houston N. , Brunstein Flavia , Milojic-Blair Marija , Wang Bei , Kabbarah Omar , Mamounas Michael , Fine Bernard M. , Maslyar Daniel J. , Ungewickell Alexander , Scher Howard I.
Published: November 2019

PURPOSE

Six-transmembrane epithelial antigen of the prostate 1 (STEAP1) is highly expressed in prostate cancers. DSTP3086S is a humanized immunoglobulin G1 anti-STEAP1 monoclonal antibody linked to the potent antimitotic agent monomethyl auristatin E. This study evaluated the safety and activity of DSTP3086S in patients with metastatic castration-resistant prostate cancer.

METHODS

Patients were enrolled in a 3 + 3 dose escalation study to evaluate DSTP3086S (0.3 to 2.8 mg/kg intravenously) given once every 3 weeks followed by cohort expansion at the recommended phase II dose or weekly (0.8 to 1.0 mg/kg).

RESULTS

Seventy-seven patients were given DSTP3086S once every 3 weeks, and seven were treated weekly. Two patients in the once-every-3-weeks dose escalation had dose-limiting grade 3 transaminitis. Grade 3 hyperglycemia and grade 4 hypophosphatemia were dose-limiting toxicities in one patient treated at 1.0 mg/kg weekly. Initial cohort expansion evaluated dosing at 2.8 mg/kg once every 3 weeks (n = 10), but frequent dose reductions led to testing of 2.4 mg/kg (n = 39) in the expansion phase. Common related adverse events (> 20%) across doses (once every 3 weeks) were fatigue, peripheral neuropathy, nausea, constipation, anorexia, diarrhea, and vomiting. DSTP3086S pharmacokinetics were linear. Among 62 patients who received > 2 mg/kg DSTP3086S once every 3 weeks, 11 (18%) demonstrated a ≥ 50% decline in prostate-specific antigen; two (6%) of 36 with measurable disease at baseline achieved a radiographic partial response; and of 27 patients with informative unfavorable baseline circulating tumor cells ≥ 5/7.5 mL of blood, 16 (59%) showed conversions to favorable circulating tumor cells < 5. No prostate-specific antigen or RECIST responses were seen with weekly dosing.

CONCLUSION

DSTP3086S has acceptable safety at the recommended phase II dose level of 2.4 mg/kg once every 3 weeks. Antitumor activity at doses between 2.25 and 2.8 mg/kg once every 3 weeks supports the potential benefit of treating STEAP1-expressing metastatic castration-resistant prostate cancer with an STEAP1-targeting antibody-drug conjugate.
In-hospital mortality in acute promyelocytic leukemia patients: A study of national inpatient sample.
Authors: Uprety Dipesh , Vallatharasu Yazhini , Bista Amir , Gaddam Mamatha , Borgert Andrew J , Rosenstein Lori J.
Published: November 2019

e18521

Background: Acute Promyelocytic Leukemia (APL), a subtype of acute myeloid leukemia, has excellent outcomes, but continues to show high rates of early mortality. An epidemiologic study utilizing SEER between 1992 & 2007 showed an early death rate of 17.3%. There is limited data on the incidence of inpatient mortality in APL patients in the United States and the factors that contribute to early death. Methods: National Inpatient Sample was utilized to identify adult patients (≥18 years) diagnosed with APL using International Classification of Diseases, 10th edition (ICD-10-CM) code C92.40. Since the United States transitioned from using ICD-9-CM to ICD-10-CM on October 2015, we included APL patients diagnosed between 2015 & 2016. Clinical, sociodemographic and hospital characteristic data were examined; hospital volume was divided into quartiles. The association between overall inpatient survival & receipt of chemotherapy was examined in a propensity score matched cohort of patients not discharged to another acute care facility. Statistical analyses were conducted utilizing SAS version 9.4. Results: In total, 433 APL patients were identified (median age 52 years, 52% males, 65% whites). The inpatient mortality rate was 9.93%. 59.5% (n = 258) of patients did not receive chemotherapy. On univariate-analysis, patients with younger age, black-race, transfer in from other hospital, elective admissions, private insurance, large bed size hospital & large hospital volume were more likely to receive chemo. In the matched-cohort, receipt of chemo was associated with decreased mortality (Hazard Ratio 0.27, 95% CI: 0.12-0.60). We ran additional mortality analysis landmarked at 3 days and 7 days: 75% of chemo patients receiving treatment within 3 days had survival advantage with chemo (HR: 0.35 [0.15-0.82]). 90% of chemo patients receiving treatment within 7 days didn’t show any difference in survival (HR: 0.49 [0.18-1.32]) but the sample size was small. Conclusions: Our study showed an early survival benefit when patient with APL received chemotherapy within 3 days of admission. Early recognition & prompt treatment initiation will help reduce the rate of early mortality in patients with APL.
Phenotypic Spectrum of Idiopathic Hypogonadotropic Hypogonadism Patients With CHD7 Variants From a Large Chinese Cohort
Authors: Li Jia-Da , Wu Jiayu , Zhao Yaguang , Wang Xinying , Jiang Fang , Hou Qiao , Chen Dan-Na , Zheng Ruizhi , Yu Renhe , Zhou Wei , Men Meichao
Published: November 2019

Purpose

Idiopathic hypogonadotropic hypogonadism (IHH) and CHARGE (C, coloboma; H, heart abnormalities; A, choanal atresia, R, retardation of growth and/or development; G, gonadal defects; E, ear deformities and deafness) syndrome are 2 distinct developmental disorders sharing features of hypogonadism and/or impaired olfaction. CHD7 variants contribute to >60% CHARGE syndrome and ~10% IHH patients. A variety of extended CHARGE-like features are frequently reported in CHARGE patients harboring CHD7 variants. In this study, we aimed to systematically analyze the diagnostic CHARGE features and the extended CHARGE-like features in patients with IHH with CHD7 variants.

Methods

Rare sequencing variants (RSVs) in CHD7 were identified through exome sequencing in 177 IHH probands. Detailed phenotyping was performed in the IHH patients harboring CHD7 variants and their available family members.

Results

CHD7 RSVs were identified in 10.2% (18/177) of the IHH probands. Two diagnostic CHARGE features, hearing loss and ear deformities, were significantly enriched in patients with CHD7 variants. Furthermore, CHD7 variants were significantly associated with a panel of extended CHARGE-like phenotypes, including mild ocular defects, dyspepsia/gastroesophageal reflux disease and skeletal defects. We also developed a predictive model for prioritizing CHD7 genetic testing in IHH patients.

Conclusion

CHD7 variants rarely cause isolated IHH. Surveillance of symptoms in CHARGE syndrome-affected organs will facilitate the proper treatment for these patients. Certain clinical features can be useful for prioritizing CHD7 genetic screening.
Dudley Seers, the Institute for Development Studies, and the Fracturing of International Development Thought in the 1960s and 1970s
Authors: Macekura Stephen
Published: November 2019

This article explores Dudley Seers’s efforts to reform international development during the 1960s and 1970s. In particular, it emphasizes Seers’s criticisms of conventional economic metrics, such as Gross National Product (GNP), and his efforts to find alternative ways to measure and define developmental success. The article shows how Seers’s research on measurement contributed to a growing set of reforms that shifted developmental goals away from national economic growth toward achieving a more equitable distribution of wealth, more meaningful and stable employment, and the provision of basic needs. In addition, the article reveals how Seers’s work with the Institute for Development Studies reshaped the production of development knowledge. At the institute, Seers cultivated a multidisciplinary approach to development studies that linked economic, sociological, historical, and anthropological analysis and favored context-specific empirical research over schematic growth theories.
Long-time clinical experience in patient setup for several particle therapy clinical indications: management of patient positioning and evaluation of setup reproducibility and stability
Authors: Ricotti Rosalinda , Pella Andrea , Tagaste Barbara , Elisei Giovanni , Fontana Giulia , Bonora Maria , Ciocca Mario , Valvo Francesca , Orecchia Roberto , Baroni Guido
Published: November 2019

Objective:

Accurate patient positioning is crucial in particle therapy due to the geometrical selectivity of particles. We report and discuss the National Center for Oncological Hadrontherapy (CNAO) experience in positioning accuracy and stability achieved with solid thermoplastic masks fixed on index base plates and assessed by daily orthogonal X-ray imaging.

Methods:

Positioning data were retrospectively collected (between 2012 and 2018) and grouped according to the treated anatomical site. 19696 fractions of 1325 patients were evaluated.

The study was designed to assess:

(i) the number of fractions in which a single correction vector was applied(SCV);

(ii) the number of fractions in which further setup verification was performed (SV);

(iii) the number of fractions in which SV lead to an additional correction within (MCV<5min) or after (MCV>5min) 5 minutes from the first setup correction;

(iv) the systematic (Σ) and random (σ) error components of the correction vectors applied.

Results:

A SCV was applied in 71.5% of fractions, otherwise SV was required. In 30.6% of fractions with SV, patient position was not further revised. In the remaining fractions, MCV<5min and MCV>5min were applied mainly in extracranial and cranial sites respectively.

Interfraction Σ was ≤ 1.7 mm/0.7° and σ was ≤ 1.2 mm/0.6° in cranial sites while in extracranial sites Σ was ≤ 5.5 mm/0.9° and σ was ≤4.4 mm/0.9°. Setup residuals were submillimetric in all sites. In cranial patients, maximum intrafractional Σ was 0.8 mm/0.4°.

Conclusion:

This report extensively quantifies inter- and intrafraction setup accuracy on an institutional basis and confirms the need of image guidance to fully benefit from the geometrical selectivity of particles.

Advances in knowledge:

The reported analysis provides a board institutional data set on the evaluation of patient immobilization and bony anatomy alignment for several particle therapy clinical indications.
The diversity of Anopheles blood feeding patterns suggests different malaria protection strategies in different localities
Authors: Chakim Irfanul , Pumpaibool Tepanata
Published: November 2019

Background: Malaria is a significant health burden for many countries worldwide. Insecticide-treated bed nets and mosquito repellent are considered effective methods for preventing Anopheles bites. However, changes in the biological properties of the vector have led to a reduction in their effectiveness. Most published studies have only investigated the human population factor, not the dynamics of vector behavior. Therefore, this study aims to investigate the importance of primary vector activity for selecting an appropriate malaria protection strategy.

Methods: Initially, active case detection (ACD) was carried out in western and eastern parts of Indonesia, Jambi and Sumba, to confirm their endemicity level. According to the 2016 national health report of Indonesia, Jambi has an annual parasite index (API) of 0.14 and Sumba has an API of 5.41.

A series of entomological observations were carried out to compare the biting activity of Anopheles vector in two localities, with a total of 216 houses and 216 catchers (108 in each study site).

Results: The results indicated that endemicity at the sub-district level is higher than that at the provincial level. Only Anopheles balabacensi was found to be exophagic. Multiple comparisons found different biting times between the sites, suggesting that early evening (18.00-20.00) is most likely to be the time when mosquitoes transmit the Plasmodium parasite in Jambi, while during sleeping hours (21.00-01.00) is the peak biting time of Anopheles mosquitoes in Sumba.

Conclusions: The study demonstrates the importance of Anopheles species blood feeding patterns in selecting an appropriate malaria protection strategy.
Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study
Authors: Mpairwe Harriet , Tumwesige Pius , Namutebi Milly , Nnaluwooza Marble , Katongole Tonny , Tumusiime Josephine , Apule Barbara , Onen Caroline , Mukasa Mike , Kahwa Joseph , Webb Emily L. , Pearce Neil , Elliott Alison M.
Published: November 2019

Background: Children from low- and middle-income countries have poor asthma control, mainly because of poor management. The extent of this problem in Uganda is not well known, but such information would be useful to guide policy and practice. We therefore conducted a cross-sectional study among schoolchildren with asthma in urban Uganda, to assess the level of asthma control and management.

Methods: Schoolchildren aged 5-17 years were enrolled, asthma was diagnosed by the study medical team. Asthma control was assessed using the Asthma Control Test and the childhood Asthma Control Test. Data on previous asthma management was obtained using interviewer-led questionnaires. Data were analysed using multiple linear and multiple logistic regression.

Results: We enrolled 561 children with asthma, of whom only 56% had ever had an asthma diagnosis. We categorised asthma as well-controlled (55.5%), partly-controlled (29.5%) and poorly-controlled (15.0%). Poor asthma control was associated with increasing age (adjusted regression coefficient [95% confidence interval], p-value: -1.07 [-1.20, -0.94], p<0.0001), concurrent allergic rhinitis (-1.33 [-2.28, -0.38], p=0.006), and city residence in early life (-1.99 [-3.69, -0.29], p=0.06). Regular use of inhaled asthma medication in the last 12 months was very low; 18.1% for salbutamol and 6.7% for inhaled corticosteroids. The main barriers to inhaled asthma medication use were lack of prescription (47.6%) and inaccurate diagnosis (38.8%). Increased inhaler use was associated with tertiary education of the fathers (adjusted odds ratio [95% confidence interval], p-value: 5.19 [2.39-11.28], p<0.0001), city residence in early life (4.66 [1.79-12.43], 0.002) and an asthma diagnosis prior to enrolment (11.39 [6.35-20.43], p<0.0001).

Conclusions: This study confirms that children with asthma in Uganda generally have inadequate asthma control, which is attributable to poor asthma management. This could be improved through re-training of medical workers and patient education, and by increasing availability and affordability of essential asthma medications.
Movilización del conocimiento: aportes para los estudios sociales de la salud
Authors: Rojas Rajs Soledad , Natera José Miguel
Published: November 2019

Introducción: las brechas entre la investigación en salud y su aplicación práctica constituyen un objeto de estudio y un campo de intervención en la esfera sanitaria. La traducción y uso del conocimiento basado en investigación se consideran cruciales para mejorar la salud pública y los sistemas de salud. Desarrollo: el objetivo de este trabajo es revisar y comparar los enfoques conceptuales investigación traslacional (translational research), traslación del conocimiento (knowledge translation) y movilización del conocimiento (knowledge mobilization). Estos enfoques se han desarrollado teórica e institucionalmente en países con fuertes sistemas de investigación en salud, como Estados Unidos, Canadá y Reino Unido, mientras que en Latinoamérica han sido poco trabajados. Se identifican sus objetivos, concepción de los procesos de transferencia de conocimiento, principales aportes y limitaciones. El enfoque movilización del conocimiento en salud se destaca como una propuesta más amplia, que aborda el carácter social de la producción, transferencia y uso del conocimiento. Conclusiones: el enfoque de movilización de conocimiento puede ser un marco útil para el estudio y sistematización de experiencias sobre el uso del conocimiento en salud en la región latinoamericana, a fin de fortalecer los sistemas nacionales de investigación en salud.
Gender Stereotype in Joyce Lebra’s The Scent of Sake
Authors: Arifatin Fais Wahidatul
Published: November 2019

Gender stereotype should be understood as negative beliefs shared by a particular group due to over-simplification and generalization. In this study, gender stereotype is used to mean negative beliefs toward women, which is based on their sexual or gender identity instead of their personal quality and individual competence. The writer try to show that in The Scent of Sake by Joyce Lebra is considered as a novel depicting the issue of gender stereotype in Japanese family culture, especially in managing the sake business which is represented trough Rie as the main character. Hence, in this study try to answer What are gender stereotypes experienced by Rie as reflected in Joyce Lebra’s The Scent of Sake and how does Rie struggle against gender stereotype as reflected in the novel. The research design used by the writer is literary criticism; it is liberal feminism especially the theory of Mary Wollstonecraft. The results of the study show that women as represented by Rie, is stereotyped in the family’s sake business through many negative stigmas. Such stereotypes have given negative influences toward Rie in terms of marginalization in management, in educational access and women’s lack of decision making in marriage. To reduce the effects, Rie struggles against gender stereotype by performing the stereotypes. Through considerable struggles, Rie has proven that women should not be viewed as inferior to men. Rie has tried very hard to play an active role as a subject in her own family’s business of sake production.
Comparison of two high doses of subcutaneous buprenorphine in cats undergoing ovariohysterectomy
Authors: Leedham Rosa , White Kate L , Yates David , Brown Lauren
Published: November 2019

Objectives:

The aim of the study was to evaluate the analgesia and recovery effects of two doses (0.12 mg/kg and 0.24 mg/kg) of subcutaneous buprenorphine in cats undergoing ovariohysterectomy.

Methods:

This was an assessor-blinded, randomised, clinical study. A total of 83 cats were recruited and randomly allocated to receive 0.12 mg/kg buprenorphine or 0.24 mg/kg buprenorphine subcutaneously, followed 30 minutes later by 40 μg/kg medetomidine intramuscularly. Anaesthesia was induced with intravenous alfaxalone to effect and maintained with isoflurane in oxygen. All cats received meloxicam before surgery. Temperament score, quality of sedation, induction of anaesthesia, dose of alfaxalone and recovery were scored using simple descriptive scales. Atipamazole was administered following surgery. Physiological variables during anaesthesia were recorded. Cats were assessed postoperatively by the same blinded observer at 2, 4 and 24 hours using a modified Colorado Feline Acute Pain scale. The presence or absence of mydriasis was noted.

Results:

No significant differences were identified between groups. Three cats in the 0.12 mg/kg group and four in the 0.24 mg/kg group required rescue analgesia. Mydriasis persisting for at least 24 hours was evident in 75 cats.

Conclusions and relevance:

No differences in analgesia were detected between groups with these protocols; mydriasis was common in both groups.
Respecting duty of care and patient safety when training and prescribing
Authors: Bennett Sharon
Published: November 2019

Non-medical personnel providing injectable aesthetic treatments is often a hot topic, which is met with unanimous disapproval from aesthetic nurses. Sharon Bennett details why this is the case, highlighting the nurses's code of conduct and how patient safety is at the heart of the profession
Effect of placental transfusion on neonatal resuscitation attempts
Authors: Emerson Lydia , Laws Samantha
Published: November 2019

Objective:

Overall, neonatal mortality has been shown to be reduced by: placental transfusion (the transfer of blood from the placenta to the neonatal circulation after birth); delayed cord clamping (DCM) (waiting for the umbilical cord to stop pulsating before clamping and cutting the cord); and umbilical cord milking (UCM) (clamping and cutting the cord immediately before milking the cord towards the neonate to expel remaining volume). This systematic review aimed to determine whether placental transfusion negatively impacts resuscitation by delaying it or has any effect on infant mortality, and to identify any barriers to performing it.

Methods:

CINAHL, MEDLINE, AMED and the British Nursing Index were searched using key terms to identify relevant English language publications between 2017 and 2019.

Results:

Five papers were selected for critical analysis—three randomised control trials and two cohort studies.

Conclusion:

Placental transfusion was not found to have a negative impact on neonatal resuscitation but, equally, had no significant effect on Apgar at 5 minutes; however, Apgar is a crude measure of infant mortality. The question remains around the proven multifaceted benefit of placental transfusion in the prehospital environment, which requires further research. There is evidence to suggest prehospital clinicians should be looking to change practice. Further research, considerations and consultations are required to ascertain the best way to implement the procedure with a balanced and proportionate approach considering neonatal thermoregulation and maternal management. The main reported barrier to placental transfusion was a lack of appropriate equipment.
Portugal en los albores de la modernidad científica (siglo XVI)
Authors: Almeida Onésimo T.
Published: November 2019

In following a sequence of articles published in the last thirty years which discuss, on the one hand, a series of Portuguese exaggerations, and on the other, attempt to shed contemporary historiographic light on some important omissions regarding the era in which Portugal its discoveries, the present article discusses what are currently understood as the Portuguese contributions to scientific modernity. Though this recognition is generally accepted by Portuguese historians, this article locates these accomplishments within the global framework of the development of a scientific mentality and methodology, and within the general history of science.
Metaphors for comic relief: Satirists’ self-reported contribution to democratic dialogue in difficult times
Authors: Álvarez Fuentes Mario
Published: November 2019

This article aims at enriching the debate on the role of political satire when politics becomes troublesome. It takes an ethnographic approach to the production of the TV programme Polònia, which has been broadcast weekly in Catalonia since 2006 and consists of satirical impersonations of politicians. The first section tries to understand the role programme-makers attribute to Polònia within Catalan politics. Participants regard themselves as a central part of the political institutions in Catalonia and recognize a commitment with democratic values. This contests the normative approach in political communication studies which does not assign a role for entertainment in fostering democratic dialogue. The second section has to do with the main characteristic of Polònia’s language: experiential metaphors. Politics is ‘re-described’ in terms of everyday situations by transposing politicians into situations easily recognisable for the audience. It is concluded that Polònia uses a verisimilitude-oriented language rather than the veracity-oriented language of journalism.