bluuebunny/crossref_metadata_2025 huggingface dataset:
SUBSTANTIATION OF HYGIENIC REQUIREMENTS TO SANITARY TO TRANSPORT STATIONS THE FIRST HELP TO THE POPULATION (ANALYTICAL REVIEW)
Authors: Krasovsky Vladimir O.
Published: October 2019

Rapid growth of automotive industry has led to emergence of cars of new brands and designs. On this background, the existing health regulations on occupational health of drivers have become outdated and cannot provide requirement of practice of departments of supervision on transport of Public health service. Last years, a motor pool of the first help it was essentially updated. Therefore, earlier extended cars “UAZ” and “vans” differing in high levels of vibration have replaced cars with the Gazelle chassis. However, still risks of development of somatic diseases of personnel of the mobile teams caused by specifics of work remain. The overview systematizes the hygienic requirements to cars, analyzes features of tool and laboratory control and tactics of sanitary inspection of working conditions of employees of the stations of emergency medical service.
The matrix of tasks, resources and competences for research libraries
Authors: Guskov A. E. , Kosyakov D. V. , Makeeva O. V.
Published: October 2019

The lag of Russia in the development of the fifth technological order has had a dramatic impact on research and technological libraries. Until the early 1990s, they were rightfully considered unique access points to relevant scientific knowledge, and now they are experiencing an acute crisis, looking for their place in the radically changed landscape of scholarly communications

The article identifies the main challenges that led to the crisis. The aim of the study is to find answers to these challenges, namely: new tasks that libraries can take on and that will be in demand by the scientific community. However, their solution is possible only after mastering new competencies and providing necessary resources. To systematize this picture, a matrix of tasks, resources and competencies is constructed.
Whole Genome Alignment Based Development of Molecular Marker for Detecting Leptosphaeria maculans and Leptosphaeria biglobosa, the Causal Agent of Blackleg Disease in Brassicas
Authors: Ferdous Mostari Jahan , Hossain Mohammad Rashed , Jesse Denison Michael Immanuel , Park Jong-In , Jung Hee-Jeong , Kim Hoy-Taek , Nou Ill-Sup
Published: October 2019

Background: Accurate diagnosis of the differentially aggressive fungus Leptosphaeria maculans and Leptosphaeria biglobosa causing Blackleg in crucifers is crucial. Available markers were designed decades ago which may become ineffective due to the ever evolving nature of the fungus, requiring the development of more precise molecular markers. Methods: The whole genomes of available isolates belonging to this two species were aligned using progressive MAUVE tool, species specific genomic regions were extracted and species specific primers were designed from the sequences that encode for effector proteins. Results: Three (Lm1, Lm2 and Lm5) and two (Lb3 and Lb3’) primer sets specifically detected the isolates of target species in PCR based assay, of which the primers Lm5 and Lb3’ were multiplexed for detection of Leptosphaeria maculans and Leptosphaeria biglobosa, generating PCR amplicons of 230 and 834 bp, respectively from a single PCR reaction. The markers were highly sensitive and were able to amplify target species from crude ‘pseudothecia and ascospores suspension’ without requiring DNA extraction. Conclusions: These markers, solitarily or in combination, designed from species specific genomic segments will serve as precise, sensitive and rapid detection of Leptosphaeria maculans and Leptosphaeria biglobosa species and will be helpful for surveillance, management and transboundary quarantine of the devastating disease.
Establishing Safe Zones to Avoid Nerve Injury in the Approach to the Humerus in Pediatric Patients
Authors: O’Shea Ryan , Panwar Jyoti , Chu Kwan William , Stimec Jennifer , Camp Mark W. , Gargan Martin
Published: October 2019

Background:

The surgical anatomy of upper-extremity peripheral nerves in adults has been well described as “safe zones” or specific distances from osseous landmarks. In pediatrics, relationships between nerves and osseous landmarks remain ambiguous. The goal of our study was to develop a model to accurately predict the location of the radial and axillary nerves in children to avoid iatrogenic injury when approaching the humerus in this population.

Methods:

We conducted a retrospective review of 116 magnetic resonance imaging (MRI) scans of entire humeri of skeletally immature patients; 53 of these studies met our inclusion criteria. Two independent observers reviewed all scans. Arm length was measured as the distance between the lateral aspect of the acromion and the lateral epicondyle. We then calculated the distances (defined as the percentage of arm length) between the radial nerve and distal osseous landmarks (the medial epicondyle, transepicondylar line, and lateral epicondyle) as well between the axillary nerve and the most lateral aspect of the acromion.

Results:

The axillary nerve was identified at a distance equaling 18.6% (95% confidence interval [CI], ±0.62%) of arm length inferior to the lateral edge of the acromion. The radial nerve crossed (1) the medial cortex of the posterior part of the humerus at a distance equaling 63.19% (95% CI: ±0.942%) of arm length proximal to the medial epicondyle, (2) the middle of the posterior part of the humerus at a distance equaling 53.9% (95% CI: ±1.08%) of arm length proximal to the transepicondylar line, (3) the lateral cortex of the posterior part of the humerus at a distance equaling 45% (95% CI: ±0.99%) of arm length proximal to the lateral epicondyle, and (4) from the posterior to the anterior compartment at a distance equaling 35.3% (95% CI: ±0.92%) of arm length proximal to the lateral epicondyle. A strong linear relationship between these distances and arm length was observed, with an intraclass correlation coefficient of >0.9 across all measurements.

Conclusions:

The positions of the radial and axillary nerves maintain linear relationships with arm lengths in growing children. The locations of these nerves in relation to palpable osseous landmarks are predictable.

Clinical Relevance:

Knowing the locations of upper-extremity peripheral nerves as a proportion of arm length in skeletally immature patients may help to avoid iatrogenic injuries during surgical approaches to the humerus.
Graft Preparation with Intraoperative Vancomycin Decreases Infection After ACL Reconstruction
Authors: Baron J.E. , Shamrock A.G. , Cates W.T. , Cates R.A. , An Q. , Wolf B.R. , Bollier M.J. , Duchman K.R. , Westermann R.W.
Published: October 2019

Background:

Reported infection rates following anterior cruciate ligament (ACL) reconstruction are low, but infections are associated with high morbidity including reoperations and inferior clinical outcomes. The purpose of the current study was to investigate the rate of infection after ACL reconstruction with and without graft preparation with a vancomycin irrigant.

Methods:

All ACL reconstructions performed between May 2009 and August 2018 at a single academic institution were reviewed and categorized based on vancomycin use. Patients with <90-day follow-up, intraoperative graft preparation with an antibiotic other than vancomycin, or previous ipsilateral knee infection were excluded. Infection was defined as a return to the operating room for irrigation and debridement within 90 days after ACL reconstruction. Descriptive and inferential statistical analysis using t tests and Poisson regression were performed, with significance defined as p < 0.05.

Results:

In total, 1,640 patients (952 males; 58.0%) with a mean age (and standard deviation) of 27.7 ± 11.4 years underwent ACL reconstruction (1,379 primary procedures; 84.1%) and were included for analysis. Intraoperative vancomycin was used in 798 cases (48.7%), whereas 842 ACL reconstructions (51.3%) were performed without intraoperative vancomycin. In total, 11 reconstructions (0.7%) were followed by infection, which occurred in 10 (1.2%) of the patients in whom the graft was not soaked in vancomycin and in 1 (0.1%) of the patients in whom the graft was soaked in vancomycin (p = 0.032). Age (p = 0.571), sex (p = 0.707), smoking (p = 0.407), surgeon (p = 0.124), and insurance type (p = 0.616) were not associated with postoperative infection risk. Autograft use was associated with decreased infections (p = 0.045). There was an 89.4% relative risk reduction with the use of intraoperative vancomycin. An increased body mass index (BMI) (p = 0.029), increased operative time (p = 0.001), and the absence of ACL graft preparation with vancomycin (p = 0.032) independently predicted postoperative infection.

Conclusions:

The use of vancomycin-soaked grafts was associated with a 10-fold reduction in infection after ACL reconstruction (0.1% versus 1.2%; p = 0.032). Other risk factors for infection after ACL reconstruction included increased BMI and increased operative time.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Work Relative Value Units Do Not Adequately Support the Burden of Infection Management in Revision Knee Arthroplasty
Authors: Samuel Linsen T. , Grits Daniel , Acuña Alexander J. , Piuzzi Nicolas S. , Higuera-Rueda Carlos A. , Kamath Atul F.
Published: October 2019

Background:

Revision total knee arthroplasty for infection is challenging. Septic revisions, whether 1-stage or 2-stage, may require more time and effort than comparable aseptic revisions. However, the burden of infection may not be reflected by the relative value units (RVUs) assigned to septic revision compared with aseptic revision. The purposes of this study were to compare the RVUs of aseptic and septic revision total knee arthroplasties and to calculate the RVU per minute for work effort.

Methods:

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was analyzed for the years 2006 to 2017. The Current Procedural Terminology (CPT) code 27487 and the International Classification of Diseases, Ninth Revision (ICD-9) code 996.XX, excluding 996.6X, were used to identify all aseptic revision total knee arthroplasties (n = 12,907). The CPT code 27487 and the ICD-9 code 996.6X were used to determine all 1-stage septic revision total knee arthroplasties (n = 891). The CPT codes 27488 and 11981 were used to identify the first stage of a 2-stage revision (n = 293). The CPT codes 27447 and 11982 were used to identify the second stage of a 2-stage revision (n = 279). After 4:1 propensity score matching, 274 cases were identified per septic cohort (aseptic single-stage: n = 1,096). The RVU-to-dollar conversion factor was provided by the U.S. Centers for Medicare & Medicaid Services (CMS), and RVU dollar valuations were calculated.

Results:

The septic second-stage revision was used as the control group for comparisons. The RVU per minute for the aseptic 2-component revision was 0.215, from a mean operative time of 148.95 minutes. The RVU per minute for the septic, 2-component, 1-stage revision was 0.199, from a mean operative time of 160.6 minutes. For septic, 2-stage revisions, the first-stage RVU per minute was 0.157, from a mean operative time of 138.1 minutes. The second-stage RVU per minute was 0.144, from a mean operative time of 170.0 minutes. Two-component aseptic revision total knee arthroplasty was valued the highest.

Conclusions:

Despite the increased complexity and worse postoperative outcomes associated with revision total knee arthroplasties for infection, the current physician reimbursement does not account for these challenges. This inadequate compensation may discourage providers from performing these operations and, in turn, make it more difficult for patients with periprosthetic joint infection to receive the necessary treatment. Therefore, the CPT code revaluation may be warranted for these procedures.
Novel Treatment for Recurrent Posttraumatic Hip Instability
Authors: Christian Robert A. , Butler Bennet A. , Weber Timothy G. , Stover Michael D.
Published: October 2019

Case:

A 26-year-old woman sustained a traumatic right hip dislocation with posterior wall component in a motor vehicle collision. Initial treatment consisted of open reduction internal fixation of her posterior wall fracture. Six years later, she developed low-energy recurrent hip instability. Imaging demonstrated posterior capsular insufficiency and femoral retrotorsion. The patient underwent intertrochanteric femoral rotational osteotomy. Nine years postoperatively, the patient has returned to activity without restriction or subsequent dislocations.

Conclusions:

Recurrent posttraumatic hip instability requires careful identification of the etiology of instability. This case provides long-term follow-up after successful treatment with intertrochanteric femoral rotational osteotomy.
Risk factors of prostate cancer
Authors: Siraziev A. M. , Khasanova G. R. , Ulyanin M. Y.
Published: October 2019

Prostate cancer is characterized by high morbidity and mortality rates. According to the World Health Organization data, 1.2 million cases of the disease and 358,000 deaths because of prostate cancer were recorded in 2018. This nosology takes the second place in the structure of oncological morbidity, and the sixth place in the structure of cancer-associated mortality. A large number of works have been devoted to the study of the etiopathogenesis of prostate cancer. In this review, we attempted to summarize some of the results of studies of risk factors for this disease. The article analyzes the results of studies on the possible impact on the development of the disease of both biological factors (age, race, the presence of certain genetic polymorphisms), and lifestyle-related factors (nutrition, obesity, alcohol use, smoking). Despite the urgency of the problem and the huge number of studies conducted, up to date, only for a number of unmodifiable factors, such as age, race, heredity, their unconditional role in the development of prostate cancer have proved. There is no clarity regarding the significance of the role of modifiable, factors, including behavioral, in the development of the disease. The data from the studies are contradictory and not very convincing. Further research in this direction is necessary to get information about the contribution of potential risk factors to the etiopathogenesis of prostate cancer.
Tuberculosis as a socially significant disease. The organization of medical care for patients with tuberculosis in Khanty-Mansiysk Autonomous District – Ugra
Authors: Krivykh E. A. , Revyakin E. A. , Malkhasyan M. V.
Published: October 2019

Introduction. In the world (and in the Russian Federation) the situation caused by the increase in the number of socially significant diseases continues to be quite tense. The most important in this group is tuberculosis, which causes significant damage to society, due to the loss of temporary and permanent disability, an increase in the number of disabled people and destabilization of the demographic situation in the country. In this regard, an integrated approach to the implementation of therapeutic and preventive measures in patients suffering from tuberculous lesions is a priority in addressing the spread of this pathology. Purpose of the study. Analysis of data on the epidemiological situation, morbidity, prevalence, mortality, prevention and treatment of tuberculosis patients in the Khanty-Mansiysk Autonomous District – Ugra in 2017, comparing the figures for the first half of 2017 and 2018. Materials and methods. To assess the parameters characterizing the organization of early diagnosis of tuberculosis, hospitalization of patients of the relevant cohort of the population, the effectiveness of therapeutic measures taken, the quality of preventive measures among the population of the Khanty-Mansiysk Autonomous District – Ugra, the data of annual reports of relevant medical organizations for 2017–2018 are used. Results. In 2017, the coverage of examinations for tuberculosis of the population with the use of all survey methods amounted to 78,6%, while the target indicator of the state program «Health Development 2014–2020» was 78,0%. The number of patients effectively treated at the studied stages was more than 50% of cases for each. Conclusion. In the Autonomous District – Ugra, the work of all services and institutions for the treatment and prevention of tuberculosis is recognized as systematic and effective according to the results of events held.
Clinical and epidemiological features of viral infections in the children's non-infectious multidisciplinary medical organization
Authors: Poslova L. Yu.
Published: October 2019

The article presents generalized clinical and epidemiological features of viral infections in children's noninfectious multidisciplinary hospital based on the results of a multi-year comprehensive study. The study was conducted for 12 years (2006–2017), included 16615 patients, including those diagnosed with «Acute respiratory viral infection» – 6104 patients, with a diagnosis of «Acute intestinal viral infection» – 1934 patients. A total of 193017 microbiological studies were conducted, including molecular genetic studies. It was found that the overall incidence of viral infections in children's non-infectious multidisciplinary hospital was 21.1 [95% CI 20.3-21.9] per 1000 hospitalized patients (according to long-term average data). The main nosological groups of viral infections were respiratory infections, enteric infections, intrauterine infections and parenteral viral hepatitis. Viral infections in in children's non-infectious multidisciplinary hospital were characterized by the following clinical and epidemiological features: high incidence; age group at risk – children under 3 years; features of clinical picture with «masks» of noncommunicable pathology; presence of combined infections; high level of virus transmission; high frequency of infections, brought into the hospital; prevalence of healthcare-associated infections in the general structure of morbidity with outbreak and involvement in the epidemic process of children and adults; uneven distribution of morbidity and carriers in departments; presence of nosocomial circulation of viruses.
The analysis of quantitative and specific structure of the mould fungi circulating in air of multipurpose health center
Authors: Kryazhev D. V.
Published: October 2019

Numerous studies have proved that microscopic fungi take part in the pathogenesis of various human diseases, so micromycetes in the air of indoor spaces are considered as a factor that negatively affects to human health. Concentration in medical institutions sick persons pertain to groups of high risk of development of opportunistic infectious diseases dictates the need of conducting control of mycetogenic contamination of rooms. Purpose of the study: research of quantitative structure and specific variety of a mykobiota of the department’s air in one of health care centers of Nizhny Novgorod. Materials and methods. Sampling of air was made by an aspiration method on Petri dish with solid mediums. Then was defined the maintenance of colony forming units (CFU) in 1000 liters of air. Specific identification of the marked-out cultures was carried out by classical bacteriological methods on their morphological and cultural features. Results. It was established that in air of the surveyed departments 32 various species of the mold fungi belonging to the class Hyphomycetes in total circulates. At assessment of specific structure it was established that representatives of two species – Aspergillus niger and Penicillium simplicissium most often met. Except them Alternaria longipes, Fusarium gibbosum, Cladosporium elatum were most often allocated. Conclusion. The conducted researches have shown that in air of the surveyed departments the microscopic fungi relating to pronounced aeroallergens are circulate. The obtained data can serve as a prerequisite for development of a microbiological method of assessment of a sanitary condition of health care centers and degree of their potential health hazard to patients.
A Feasible Method for the Trajectory Measurement of Radial Jet Drilling Laterals
Authors: Huang Zhe , Huang Zhongwei , Su Yinao , Bi Gang , Li Weichang , Liu Xin , Jiang Tianwen
Published: October 2019

Radial jet drilling (RJD) is an unconventional drilling technology that uses high-pressure liquid jet to drill multiple radial laterals. It is a cost-effective alternative for bypassing damage zones near the wellbore, restimulating the production of old wells, and developing unconventional reservoirs. However, because of the structure of the deflector and the diameter of the radial laterals, traditional well-trajectory measuring tools cannot be applied in RJD wells, which hinders the conduct of some significant operations. The unknown trajectory is a crucial limitation to further development and field application of RJD technology.

In this paper, along with an introduction to RJD technology, a measuring system and a mini-tool are proposed for attitude measurement and motion-state recognition. With an extra tripping stage, the tool is tripped down to the bottom of the RJD laterals after the jet drilling is completed, and then tripped out at a constant speed. The measured data stored in memory media could be downloaded after the measurement. On the basis of navigation theory, a reckoning method was proposed to obtain the trajectory parameters by using the recorded data of the tool and the operational data of the coiled tubing (CT). After that, an experimental study was carried out to test the performance of the measuring tool and the reckoning method. As results of the experiments demonstrate, the average errors of the measured length, inclination, and azimuth are 3.94, 2.62, and 4.54%, respectively.
Association between NMD3 and symptoms of Parkinson’s disease in Chinese
Authors: Wu Hui , Li Hui , Shi Zhiqiang , Tang Jiajia , Mei Shuya , Ai Tianyi , He Zhenzhou
Published: October 2019

Bcakground Parkinson's disease (PD) is a progressive degenerative disorder of the basal ganglia that not only affects the initiation and execution of voluntary movements, but also nonmotor features. The aim was to investigate the association between NMD3 and symptoms of PD patients in Chinese. Methods 217 PD patients were recruited in this study. All patients were evaluated by Sniffin’ Sticks 16 (SS-16), Hamilton anxiety rating scale and Hamilton depression rating scale, 39-item Parkinson's disease Questionnaire (PDQ-39) and MDS - Unified PD Rating Scale (MDS-UPDRS). Symptoms were also recorded. Results NMD3 carriers had worse cognitive function (MMSE: p 0.042, NMD3 wildtype: 27.44 ± 2.89, NMD3 carriers: 26.31 ± 3.79; MoCA: p 0.005, NMD3 wildtype: 23.15 ± 4.20, NMD3 carriers: 20.75 ± 6.68). Conclusions The recessive and overdominant model of GALC rs8001572 was associated with the presence of sensitive to light.
Using poster presentation to assess large classes: A case study for first year undergraduate module in a South African University
Authors: Ross Andrew , Dlungwane Thembelihle , Wyk Jacqueline Van
Published: October 2019

Background
The massification of higher education is often associated with poor student engagement, poor development of their critical thinking, inadequate feedback and poor student throughput. These factors necessitate the need to devise novel, innovative methods to teach, assess and provide feedback to learners to counter the restrictions imposed due to the large class learning environments. This study was conducted to ascertain the perceptions of 1st year medical students and staff at the Nelson Mandela School of Medicine regarding the value of poster presentations as a strategy to enhance learning, assessment and feedback.

Methods
This was an exploratory observational, descriptive cross-sectional, case study. Data was collected through separate student and staff questionnaires that required participant responses on a five-point Likert scale. The data was extracted into Excel spreadsheets for quantitative analysis.

Results
Two-hundred- and-thirty (92%) student questionnaires were returned (N=250). Most students indicated that the design and presentation of the poster had helped them to select important material (92%), understand and describe disadvantage (86%) and to make a difference in the community (92%). The students agreed that the poster assessment was an efficient (81%) and fair method (75%) that provided opportunities for meaningful feedback. Ten staff members responded to the questionnaire. Most staff members (90%) indicated that the poster presentation had allowed students to demonstrate their engagement in a meaningful and appropriate way around issues of disadvantage and HIV and agreed that the poster presentations allowed for immediate and effective feedback.

Discussion and conclusions
Students’ interactions in the tasks promoted active engagement with others and course material; the development of higher order thinking and skills which added to students’ accounts of transformative learning experiences. They could describe and illustrate the difference that they had made in their chosen community. The poster presentations allowed for quick and efficient marking, immediate feedback and an opportunity to validate the students’ participation.
Poster presentations offered an innovative way to encourage deep meaningful engagement and learning amongst peers and facilitators. Poster presentations should be more widely considered as an innovative way of encouraging deeper engagement and learning in a large class setting.
Linguistic Analysis of Pediatric Residency Personal Statements: Gender Differences
Authors: Babal Jessica , Gower Aubrey , Frohna John , Moreno Megan
Published: October 2019

Background: All US residency programs require applicants to submit personal statements. Prior studies showed gender differences in personal statement writing, which has implications for gender bias in the application process, but previous studies have not considered the dual influence of specialty-specific values on personal statement writing by applicants of each gender.
Objective: To understand gender differences in pediatric residency personal statements
Methods: From 2017-2018, we performed linguistic analysis of personal statements written by interviewees at a mid-size US pediatrics residency during two prior academic years. We assessed writing tone, communal language, and agentic language. We performed t-tests to evaluate for gender differences, p<0.05.
Results: We analyzed personal statements from 85 male and 85 female interviewees. Average word count was 676 words. Personal statements demonstrated analytic writing style with authentic and positive emotional tone. We found no gender differences in communal language for social affiliation (p=0.31), adjectives (p=0.49), or orientation (p=0.48), which deviates from typical gender norms for male language use. Males used agentic language of reward more frequently (p=0.02).
Conclusions: Findings suggest that social language is valued in pediatrics, a predominantly female specialty, regardless of applicant gender. Use of reward language by males is consistent with previous findings. Future studies should evaluate gender differences in residency applications across specialties to advance understanding of the role gender plays in the application process.
Genetic diversity and population structure of black cottonwood (Populus deltoides) revealed using simple sequence repeat markers
Authors: Chen Cun , Chu Yanguang , Ding Changjun , Su Xiaohua , Huang Qinjun
Published: October 2019

Background: Black cottonwood (Populus deltoides) is one of the keystone forest tree species, and has become the main breeding parents in poplar hybrid breeding. However, the genetic diversity and population structure of the introduced resources are not fully understood. Results: In the present study, five loci containing null alleles were excluded and 15 pairs of SSR (simple sequence repeat) primers were used to analyze the genetic diversity and population structure of 384 individuals from six provenances of P. deltoides. Ultimately, 108 alleles (Na) were detected; the expected heterozygosity (He) ranged from 0.070 to 0.905, and the average locus polymorphic information content (PIC) was 0.5354. The provenance ‘Was’ had the lowest genetic diversity, while ‘Que’, ‘Lou’, and ‘Ten’ provenances had high genetic diversity, with Shannon's information index (I) above 1.0. The mean coefficient of genetic differentiation (Fst) and gene flow (Nm) were 0.129 and 1.931 respectively. Analysis of molecular variance (AMOVA) showed that 84.88% of the genetic variation originated from individuals. Based on principal coordinate analysis (PCoA) and STRUCTURE cluster analysis, clones distributed in Mississippi River Basin were roughly classified as one group, while those distributed in the St. Lawrence River Basin and Columbia River Basin were classified as another group. The cluster analysis based on the population level showed that provenance ‘Iow’ had a smaller gene flow and higher degree of genetic differentiation compared with the other provenances, and was classified into one group. There was no significant relationship between genetic distance and geographical distance. Conclusions: P. deltoides resources have high genetic diversity and there is a moderate level of genetic differentiation among provenances. Geographical isolation and natural conditions may be the main factors causing genetic differences among individuals; however, the genetic variation among provenances has no clear correlation with their geographical locations. Clones reflecting population genetic information can be selected to build a core resource bank, which could provide effective protection and promote the scientific utilization of the P. deltoids resource, laying a solid foundation for poplar breeding.
Heterogeneous Neurodevelopmental Disorders in Children with Kawasaki Disease: What is New Today?
Authors: Lin Chien-Heng , Lin Wei-De , Chou I-Ching , Lee Inn-Chi , Hong Syuan-Yu
Published: October 2019

Background: Kawasaki disease (KD) is a common vasculitis of childhood in East Asia. The complications of KD ascribed to long-term cardiovascular sequelae are considerably diverse. Although studies have investigated neurodevelopmental problems following KD in the past few decades, they have reported inconsistent conclusions. This study investigated potential epilepsy and associated neurodevelopmental disorders (NDDs) following KD in Taiwanese children.
Methods: We retrospectively analyzed the data of children aged <18 years with clinically diagnosed KD from January 1, 2005, to December 31, 2015. These patients were followed up to estimate the prevalence of epilepsy and associated NDDs in comparison with the prevalence in general pediatric population in Taiwan and worldwide.
Results: A total of 612 patients with an average age of 1.6 years were included. The prevalence of associated NDDs was 16.8% (n = 103/612) in the study group, which consisted of epilepsy, intellectual disability (ID), autism spectrum disorders , Tourette syndrome (TS), attention deficit hyperactivity disorder, (ADHD), and others. Moreover, children with KD had a higher prevalence of epilepsy and TS in both Taiwan and worldwide (epilepsy: 2.61% in the KD group vs 0.33% in Taiwan and 0.05%–0.8% in worldwide, p < 0.05; TS: 2.77% in the KD group vs 0.56% in Taiwan and 0.3%–1% in worldwide, p < 0.05). The prevalence of ID, ADHD, and developmental language disorders was not significantly different between our study patients and those in Taiwan or worldwide.
Conclusions: Results revealed a higher prevalence rate of NDDs, especially epilepsy and TS, in Taiwanese children with KD than in the general pediatric population in Taiwan. However, these NDDs could be heterogeneous. Children diagnosed with KD were followed up because they had a higher risk of heterogeneous NDDs.
Keywords: Kawasaki disease, Neurodevelopmental Disorders, Children, Epilepsy, Tourette syndrome
Nursing students’ knowledge, attitude, self-efficacy in blended learning of cardiopulmonary resuscitation: a randomized controlled trial
Authors: Moon Hyunjung , Hyun Hye Sun
Published: October 2019

Background: Although various forms of online education are on the rise worldwide, effects of such innovative approach are yet to be validated. This study analyzes whether blended learning cardiopulmonary resuscitation (CPR) education that integrates e-learning and face-to-face education is effective in improving nursing students’ knowledge, attitude, and self-efficacy.Methods: A randomized controlled design was used. The participants of this study were 120 nursing students randomly assigned to the intervention group (n = 60) or the control (n = 60). The intervention group was trained using a blended learning CPR education program. Self report questionnaires with knoweldge, attitude, and self-efficacy were all used in the pre and post intervention. Differences before and after the education of each group were analyzed with a paired t-test, and the differences between the two groups were analyzed with ANCOVA with knowledge as the covariate.Results: The findings indicated that the intervention group had significantly higher knowledge scores (intervention: 16.40±1.56, control: 6.46±2, p <.001), and emotional attitude (intervention: 40.85±8.01, control: 36.05±6.87, p = .002) about CPR than the control group, but other outcomes did not differ between groups.Conclusions: In this monocentric study, a blended learning CPR program that integrated videos and face to face lecture was found effective in improving nursing students' knowledge and attitudes regarding CPR.
Screening differentially expressed genes of pancreatic cancer between Mongolian and Han people using bioinformatics technology
Authors: Xu Jiasheng , Liao Kaili , FU ZHONGHUA , XIONG ZHENFANG
Published: October 2019

Objective: To screen and analyze differentially expressed genes in pancreatic carcinoma tissues taken from Mongolian and Han patients by Affymetrix Genechip. Methods: Pancreatic ductal cell carcinoma tissues were collected from the Mongolian and Han patients undergoing resection in the Second Affiliated Hospital of Nanchang University from March 2015 to May 2018 and the total RNA was extracted. Differentially expressed genes were selected from the total RNA qualified by Nanodrop 2000 and Agilent 2100 using Affymetrix and a cartogram was drawn; The gene ontology (GO) analysis and Pathway analysis were used for the collection and analysis of biological information of these differentially expressed genes. Finally, some differentially expressed genes were verified by real-time PCR.
Results: Through the microarray analysis of gene expression, 970 differentially expressed genes were detected by comparing pancreatic cancer tissue samples between Mongolian and Han patients. A total of 257 genes were significantly up-regulated in pancreatic cancer tissue samples in Mongolian patients; while a total of 713 genes were down-regulated. In the Gene Ontology database, 815 differentially expressed genes were identified with clear GO classification, and CPB1 gene showed the highest increase in expression level (multiple difference: 31.76). The pathway analysis detected 28 signaling pathways that included these differentially expressed genes, involving a total of 178 genes. Among these pathways, the enrichment of differentially expressed genes in the FAK signaling pathway was the strongest and COL11A1 gene showed the highest multiple difference (multiple difference: 5.02). The expression of differentially expressed genes CPB1, COL11A1、ITGA4、BIRC3、PAK4、CPA1、CLPS、PIK3CG and HLA-DPA1 determined by real-time PCR were consistent with the results of gene microarray analysis.
Conclusions: The results of microarray analysis of gene expression profiles showed that there are a large number of differentially expressed genes in pancreatic cancer tissue samples comparing Mongolian and Han population. These genes are closely related to the cell proliferation, differentiation, invasion, metastasis and multi-drug resistance in pancreatic cancer. They are also involved in the regulation of multiple important signaling pathways in organisms.
A preliminary assessment of vital-signs-integrated patient-assisted intravenous opioid analgesia (VPIA) for postsurgical pain: a case series
Authors: SNG Ban Leong , Tan Daryl Jian'an , TAN Chin Wen , HAN Nian-Lin Reena , SULTANA Rehena , SIA Alex Tiong Heng
Published: October 2019

Background

We developed a Vital-signs-integrated Patient-assisted Intravenous opioid Analgesia (VPIA) analgesic infusion pump, a closed-loop vital signs monitoring and drug delivery system which embodies in a novel algorithm that takes into account patients’ vital signs (oxygen saturation, heart rate). The system aims to allow responsive titration of personalized pain relief to optimise pain relief and reduce the risk of respiratory depression. Moreover, the system will be important to enable continuous monitoring of patients during delivery of opioid analgesia.Methods

Nineteen patients who underwent elective gynecological surgery with postoperative patient controlled analgesia (PCA) with morphine were recruited. The subjects were followed up from their admission to the recovery room/ ward for up to 24 hours until assessment of patient satisfaction on the VPIA analgesic infusion pump.Results

The primary outcome measure of incidence of oxygen desaturation showed all patients had at least one episode of oxygen desaturation (<95%) during the study period. Only 6 (31.6%) patients had oxygen desaturation that persisted for more than 5 minutes. The average percentage time during treatment that oxygen saturation fell below 95% was 4.6%. Fourteen (73.7%) out of 19 patients encountered safety pause, due to transient oxygen desaturation or bradycardia. The patients’ median [IQR] pain scores at rest and at movement after post-op 24 hours were 0.0 [2.0] and 3.0 [2.0] respectively. The average ± SD morphine consumption in the first 24 hours was 12.5 ± 7.1mg. All patients were satisfied with their experience with the VPIA analgesic infusion pump.Conclusions

We have demonstrated the potential of VPIA analgesic infusion pump to increase the safety and patient satisfaction by incorporating vital signs monitoring to intravenous opioid analgesia.
A Retrospective Study of the Clinical Phenotype and Predictors of Survival in non-Caucasian Hispanic Patients with Amyotrophic Lateral Sclerosis.
Authors: Sánchez-Martínez Claudia Marisol , Choreño-Parra José Alberto , Nuñez-Orozco Lilia , Placencia-Álvarez Noel Isaías , Alvis-Cataño Laura Marcela , Guadarrama-Ortiz Parmenides
Published: October 2019

Background. Little is known about the clinical phenotype of amyotrophic lateral sclerosis (ALS) in non-Caucasian populations. Here, we aimed to describe the clinical characteristics, prognostic factors and survival of Mexican patients with ALS.
Methods. We conducted a retrospective study by reviewing the medical records of patients with ALS that attended and were regularly followed at a third level hospital in Mexico City from 2000 to 2015. We calculated absolute and relative frequencies of the clinical characteristics from all the participants. We also estimated correlation coefficients between clinical features and overall survival. Additionally, survival rates were compared for all participants grouped according to different clinical features using the Kaplan-Meier method and the log-rank test.
Results. We enrolled 45 ALS patients, 53.33% had spinal-onset ALS and 46.66% presented bulbar ALS. The male/female ratio was 0.8. The mean age at onset of symptoms was 58.11 years. Mean survival time from onset was 64.73 ± 34.83 months. Cumulative survival rate after 5 years of disease onset was 44.44%. Age at onset and age at diagnosis inversely correlated with overall survival time. Also, we found that bulbar-onset, short diagnostic delay, percutaneous endoscopic gastrostomy, mechanical ventilation, and lower total cholesterol serum levels were associated with short survival.
Conclusions. The clinical characteristics of Mexican ALS patients differ from the disease phenotype observed in Caucasians. Nonetheless, the predictive value of certain well-recognized prognostic factors remains consistent in our population. The current study provides relevant information for a better understanding of prognostic factors in ALS patients from Mexico and other Latin American countries.
Sensory processing of women diagnosed with genito-pelvic pain/penetration disorder: a research proposal
Authors: Labuschagne Elsie , Niekerk Matty van
Published: October 2019

Objectives: The study objectives are to describe the sensory processing patterns of women diagnosed with genito-pelvic pain/penetration disorder (GPPPD), to explore the level of anxiety when both GPPPD and sensory processing disorder (SPD) are present and to investigate participants’ experience of participating in a sensory-based home programme.
Methods: A descriptive two-phased study design will be used. Phase one is a quantitative, cross sectional non-experimental descriptive study, using the Adolescent/Adult Sensory History (ASH) and Hospital Anxiety and Depression Scales (HADS) to obtain data from purposive sampling.
Phase two is an exploratory qualitative study involving participants who were identified with SPD in phase one. They will participate in a sensory-based home programme and their experience thereof will be established during semi-structured interviews.
Outcomes: Descriptive studies are known to be useful in planning health services and to develop hypotheses for future testing. This study could improve practitioners’ understanding of GPPPD and SPD and make alternative, non-invasive, non-pharmacological treatment options available to better assist these patients. The study could further clarify the role of the occupational therapist in sexuality. Exploring participants’ anxiety has important implications for treatment protocols in occupational therapy and assisting in describing the signs and symptoms of GPPPD.
A randomised controlled trial exploring the impact of a dedicated Health and Social Care Professionals team in the Emergency Department on the quality, safety, clinical and cost-effectiveness of care for older adults: Study Protocol
Authors: Cassarino Marica , Robinson Katie , O’Shaughnessy Íde , Smalle Eimear , White Stephen , Devlin Collette , Quinn Rosie , Trépel Dominic , Boland Fiona , Ward Marie E. , McNamara Rosa , O’Connor Margaret , McCarthy Gerard , Ryan Damien , Galvin Rose
Published: October 2019

Background : Older people are frequent Emergency Department (ED) users who present with complex issues that are linked to poorer health outcomes post-index visit, often have increased ED length of stay and tend to have raised healthcare costs. Encouraging evidence suggests that ED teams involving health and social care professionals (HSCPs) can contribute to enhanced patient flow and improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCPs teams assessing and intervening with older adults in the ED is limited and identifies important methodological limitations, highlighting the need for more robust and comprehensive investigations of this model of care. This study aims to evaluate the impact of a dedicated ED-based HSCP team on the quality, safety, clinical and cost-effectiveness of care of older adults when compared to usual care.
Methods : The study is a single-site randomised controlled trial whereby patients aged ≥65 years who present to the ED of a large Irish hospital will be randomised to the experimental group (ED-based HSCP assessment and intervention) or the control group (usual ED care). The recruitment target is 320 participants. The HSCP team will provide a comprehensive functional assessment as well as interventions to promote a safe discharge for the patient. The primary outcome is ED length of stay (from arrival to discharge). Secondary outcomes include: rates of hospital admissions from the ED, ED re-visits, unplanned hospital admissions and healthcare utilisation at 30-days, four and six-month follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; costs-effectiveness in terms of costs associated with ED-based HSCP compared to usual care; and perceptions on implementation by ED staff members.
Discussion : This is the first randomised controlled trial testing the impact of HSCPs working in teams in the ED on the quality, safety, clinical and cost-effectiveness of care for older patients. The findings of the study will provide important information on the effectiveness of this model of care for future implementation.
Trial registration : ClinicalTrials.gov, NCT03739515; registered on 12 th November 2018. Protocol version 1. URL: https://clinicaltrials.gov/ct2/show/NCT03739515
Determinants of effective organizational capacity training: lessons from a training programme on health workforce development with participants from three African Countries
Authors: Amde Woldekidan Kifle , Marchal Bruno , Sanders David , Lehmann Uta
Published: October 2019

Background
Health systems in sub-Saharan Africa face multifaceted capacity challenges to fulfil their mandates of service provision and governance of their resources. Four academic institutions in Africa implemented a World Health Organisation-funded collaborative project encompassing training, curriculum development, and partnership to strengthen national leadership and training capacity for health workforce development. This paper looks into the training component of the project, a blended Masters programme in public health that sought to improve the capacity of personnel involved in teaching or management/development of human resources for health. The paper aims to explore factors influencing contribution of training to organisational capacity development.

Methods
We chose a case study design. Semi-structured interviews were held with 18 trainees that were enrolled in the training programme, and who were affiliated to health ministries or public health training institutions. We gathered additional data through document reviews, observation, and interviews with 14 key informants associated with the programme and/or working in the collaborating institutions. The evidence gathered were analysed thematically.

Results
Thirteen of the eighteen training participants stayed in the target institutions and contributed to improved capacity of their institutions in the fields of management, policy, planning, research, training, or curriculum development. Five left for private and international agencies due to dissatisfaction with payment, work conditions, or career prospect.

Factors that were associated with the training, trainees, and the institutional and broader context, determine contribution of training to organisational capacity development. These include relevance of newly acquired knowledge and skills set of trainees to the role/position they assume in the organisation; recognition of trainees by employing organisations in terms of promotion or assignment of challenging tasks; and motivation and retention of trained staff.

Conclusion
Training, even if relevant and applicable, makes no more than a ‘latent’ contribution, one which is activated and realised through alignment of clusters of interacting contextual and relational factors related to the target institutions and trained personnel. While not predictable, implementers need to focus more deliberately on the likely interaction and best possible alignments between training relevance, student selection for potential to contribute, recognition and career advancement potential.