bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between parity and spontaneous preterm birth: a population based study
Authors: Koullali Bouchra , van Zijl Maud D. , Kazemier Brenda M. , Oudijk Martijn A. , Mol Ben W. J. , Pajkrt Eva , Ravelli Anita C. J.
Published: April 2020

Background

Preterm birth is the leading cause of perinatal mortality and neonatal morbidity worldwide. Many factors have been associated with preterm birth, including parity. The aim of the present study was to investigate associations between parity and risk of spontaneous preterm birth.

Methods

We conducted a retrospective study including live singleton births (≥22 weeks) of women with a first, second, third, fourth or fifth pregnancy in The Netherlands from 2010 through 2014. Our primary outcome was risk of spontaneous preterm birth < 37 weeks. Secondary outcomes were spontaneous preterm birth < 32 and < 28 weeks.

Results

We studied 802,119 pregnancies, including 30,237 pregnancies that ended spontaneously < 37 weeks. We identified an increased risk for spontaneous preterm birth < 37 weeks in nulliparous women (OR 1.95, 95% CI 1.89–2.00) and women in their fifth pregnancy (OR 1.26, 95% CI 1.13–1.41) compared to women in their second pregnancy. Similar results were seen for spontaneous preterm birth < 32 and < 28 weeks.

Conclusion

Our data show an independent association between nulliparity and spontaneous preterm birth < 37, < 32 and < 28 weeks. Furthermore, we observed an increased risk for spontaneous preterm birth in women in their fifth pregnancy, with highest risk for preterm birth at early gestational age.
Indirect choroidal neovascularization secondary to a posterior-segment intraocular foreign body – case report
Authors: Lin Yu-Shiuan , Peng Kai-Ling
Published: April 2020

Background

We reported a rare case of indirect choroidal neovascularization (CNV) secondary to a posterior-segment intraocular foreign body (IOFB) that was not located in the area of direct injury but in the fovea. After intravitreal injections (IVIs) of aflibercept, the choroidal neovascularization (CNV) lesion disappeared and vision improved.

Case presentation

A 26-year-old male patient suffered from a fast-shot metallic IOFB in his right eye. He underwent primary corneal repair, pars plana vitrectomy, IOFB removal and an IVI of antibiotics in the right eye. Two weeks later, cataract surgery was performed on the right eye for traumatic cataract after an episode of acute phacolytic glaucoma. The best-corrected visual acuity (BCVA) of the right eye improved to 20/20 5 months after the first surgery. However, the vision of the right eye worsened suddenly with metamorphopsia 1 year after the first surgery. Color fundus images showed a whitish lesion with faint retinal hemorrhage and surrounding sensory elevation. Fluorescein angiography (FA) revealed a lesion with early- and late-phase severe leakage. Optical coherence tomography (OCT) demonstrated a CNV lesion with surrounding subretinal fluid. The patient received an IVI of aflibercept every 8 weeks for 3 times. Finally, the BCVA of the right eye improved to 20/25.

Conclusions

For rare cases of fovea-spared injury by a metallic IOFB, it is still necessary to pay close attention to the foveal microstructure to avoid possible CNV formation. Treatment with IVIs of anti-VEGF, aflibercept, as early as possible could provide good visual outcomes.
Prevalence and determinants of gender-based violence among high school female students in Wolaita Sodo, Ethiopia: an institutionally based cross-sectional study
Authors: Tantu Temesgen , Wolka Sintayehu , Gunta Muluken , Teshome Million , Mohammed Hangatu , Duko Bereket
Published: April 2020

Background

Gender-based violence (GBV) often occurs in resource-limited settings such as Ethiopia. It could result in psychological and physical adverse outcomes such as stress, anxiety, depression, unsafe abortion, unwanted pregnancy, and sexually transmitted infections. This study aimed to assess the prevalence and factors associated with gender-based violence among female high school students in Wolaita Sodo, Ethiopia.

Methods

An institutionally based-cross-sectional study was conducted in Wolaita Sodo, Ethiopia. A total of 604 female high school students were recruited through multi-stage stratified sampling techniques. The gender-based-violence assessment tool, validated by the World Health Organization, was used to assess gender-based-violence and other determinants. The strength of statistical association was measured by adjusted odds ratios and 95% confidence intervals. Statistical significance was declared at p-value < 0.05.

Results

The lifetime prevalence of GBV, sexual violence, and physical violence were found to be 63.2, 37.2, and 56.3%, respectively. The prevalence of sexual violence before and after joining the current school as well as in the current academic year were 30.5, 37.2, and 22% respectively. Having regular boy-friends (AOR = 2.02; 95% CI:1.07–3.79), being sexually active (AOR = 6.10; 95% CI: 2.49–14.92), having female or male friends who drink alcohol (AOR = 2.18; 95% CI:1.26–3.77), students witnessed their mothers being beaten by their partners or husband (AOR = 1.92; 95% CI:1.19–3.11) and joining public school (AOR = 1.74; 95% CI:1.11–2.76) were significantly associated with gender-based violence.

Conclusion

The prevalence of gender-based-violence was high. This needs a due concern from governmental, non-governmental and civic organizations as well as other responsible bodies to tackle factors associated with GBV in this study. Further large scale studies incorporating male students are warranted to elucidate the factors associated with GBV in Ethiopia.
Quality of life in chronic musculoskeletal symptomatic Chilean population: secondary analysis of National Health Survey 2009–2010
Authors: Mena-Iturriaga Maria Jesus , Mauri-Stecca Manuel Vicente , Sizer Phillip S. , Leppe Jaime
Published: April 2020

Background

Health-related quality of life (HRQoL) is defined as the patient’s perception of their health status. HRQoL can be modified by illnesses, treatments or social and health policies. Chronic musculoskeletal pain is a modifying factor of HRQoL that leads to lower quality of life, elevated suffering and disability. Knowing HRQoL in subjects reporting chronic musculoskeletal symptoms (cMSS), like pain, discomfort or swollenness lasting more than 3 months, will provide information to health teams and organizations engaged in the Chilean health system. This study aim was to determine the relationship between HRQoL and musculoskeletal symptoms measured in three different Chilean groups: [1] without symptoms; [2] with acute symptoms; and [3] with cMSS.

Methods

A secondary analysis of the 2009–10 Chilean National Health Survey (NHS) was executed to determine the relationship between HRQoL (measured with SF-12) in three MSS groups. The Chilean NHS considered a national, probabilistic, stratified and multistage sample of 5293 participants aged 15 and older; it was representative at the national, urban-rural and regional levels. A multivariate logistic regression model studied the relationship between cMSS and HRQoL, adjusted for age, sex, educational level and residence area as control variables (p < 0.05).

Results

Out of 5293 participants in the NHS 2009–10, 5276 subjects were included for analysis. The median age was 46 years (IQR 31–60), 59.4% women, a median of 10 years formal education (IQR 7–12) and an urban residence in 85.2% of the population of the NHS 2009–10. The observed population prevalence of people with cMSS was 42.6% (95% CI 40.4–44.9). Presence of cMSS is a risk factor for low HRQoL, exhibited both in the physical (OR 3.1 95% CI 2.7–3.5) and mental (OR 1.9 95% CI 1.6–2,) HRQoL dimensions, independent of control variables.

Conclusions

Physical and mental HRQoL are affected in people with cMSS, low educational level and advanced age. This is especially seen in women. This information will facilitate assessment and treatment of cMSS as a prevalent and multidimensional health problem.
Adults’ dental treatment in 2001–2013 in Finnish public dental service
Authors: Linden J. , Widström E. , Sinkkonen J.
Published: April 2020

Background

All adults over 17 years of age have access to the Public Dental Service after the Finnish Dental Care Reform in 2001–2002. This study aimed to survey the treatment needs and treatment measures provided for adult patients and changes in these during the period 2001–2013.

Methods

Sing each person’s unique identifier, demographic data on dental visits during the period 2001–2013 were collected from municipal databases in five PDS-units covering 320,000 inhabitants. The numbers of visitors, those in need of basic periodontal or caries treatment (CPI > 2 and D + d > 0) were calculated for three age groups. Treatment provided was also calculated in 13 treatment categories. Trend analyses were performed to study changes during the study period.

Results

Restorative treatments (968,772; 23.6%), examinations (658,394; 16.1%), radiographs taken (529,875; 12.9%) anaesthesia used (521,169; 12.7%) and emergency treatments (348,229; 8.5%) made up 73.8% of all treatment measures during the entire study period. Periodontal treatment (7.8%) and caries prevention (3.9%) made up a small part of the care provided and prosthetics and treatment of TMJ disorders were extremely uncommon (fewer than 1%). Treatments related to caries (restorative treatment, examinations, endodontics, emergencies, anaesthesia and radiographs) made up 60.4% of the dental personnel’s treatment time. During the study period, statistically significant increasing trends were found for radiographs (p < 0.001***), anaesthesia (p = 0.003**) and total number of treatments (p = 0.009**). There was a slight decreasing trend in treatment need among the youngest adults (18–39 years; p = 0.033*).

Conclusion

Compared with the results of national epidemiological studies, insufficient periodontal treatment is provided and prosthetic treatment is almost totally neglected in the PDS. Rather, adults’ dental treatment concentrates on treatment of caries. The unmet needs may be due to tradition, inadequate treatment processes or a lack of resources or failed salary incentives.
The prevalence, perceptions and behaviors associated with traditional/complementary medicine use by breastfeeding women living in Macau: a cross-sectional survey study
Authors: Zheng Tingyun , Chen Weijie , Hu Hao , Wang Yitao , Harnett Joanna E. , Ung Carolina Oi Lam
Published: April 2020

Background

There is a long history of traditional/complementary medicine (T/CM) use by women during lactation. While it is important to evaluate such use within a scientific paradigm to ensure efficacy and safety, knowledge about the prevalence and characteristics of T/CM use during lactation is limited. This study aimed to generate preliminary data on the prevalence, perceptions and behaviors related to T/CM use by women living in Macau during lactation.

Methods

Between April to June 2018, women aged 18 years or above who had breastfed within the previous 12 months were invited to complete a questionnaire which asked about their perceptions and behaviors related to the use of T/CM while breastfeeding. Chi-square analysis and logistic regressions were used to conduct data analysis.

Results

A total of 500 women completed the survey with 62.6% (95% CI 58.37–66.83) reporting use of at least 1 T/CM while breastfeeding. Of these 48.9% (95% CI 44.67 to 53.13) believed T/CM were safe to take during lactation and 55.6% (95% CI 51.37 to 59.83) suggested there were inadequate resources to assist making an informed decision. Working status, monthly family income and the presence of a breastfeeding-related health problems were associated with T/CM use (all p < 0.05). The most commonly used T/CM were Tetrapanax papyriferus, lecithin, Vaccaria segetalis, docosahexaenoic acid and Trigonella foenum-graecum commonly referred to as Fenugreek. The most common reasons for using T/CM were “to unblock milk ducts”, “to increase milk supply” and “to improve baby development”. Women were recommended to use T/CM from multiple sources; 15.0% from health personnel (HP) only, 40.0% received recommendations from non-HP only; and 42.2% from both.

Conclusions

The use of T/CM by women during lactation is common in Macau. The current support and resources available to women during the breastfeeding period to make informed decisions about T/CM use is not standardized nor integrated. The gaps identified in this study provide an opportunity to develop resources and a more defined role for HPs to ensure the appropriate and safe use of T/CM in this population.
Enhancing independent eating among older adults with dementia: a scoping review of the state of the conceptual and research literature
Authors: Palese Alvisa , Bressan Valentina , Hayter Mark , Watson Roger
Published: April 2020

Background

Addressing eating difficulties among older individuals with dementia living in nursing homes requires evidence-based interventions. However, to date, there is limited evidence of effective interventions designed to maintain and/or increase independent eating. In a field in which evidence is still lacking, a critical analysis of the state of research describing its main features can help identify methodological gaps that future studies should address. Hence, the aim of this study was to map the state of the research designed to maintain and/or promote independent eating in older individuals with dementia living in nursing homes.

Methods

A scoping review was performed by following the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Reviews and conceptual analyses performed with different methodological approaches, published in indexed journals, and written in English were included. Keywords Were searched for in the MEDLINE, the Cumulative Index of Nursing and Allied Health, and in the Scopus databases to identify papers published up to 31 May 2018.

Results

17 reviews were included, assessing interventions’ effectiveness (n = 15) and providing conceptual frameworks for eating/mealtime difficulties (n = 2). Conceptual frameworks supporting interventions’ effectiveness have rarely been described in available studies. Moreover, interventions tested have been categorized according to non-homogeneous frameworks. Their effectiveness has been measured against (1) eating performance, (2) clinical outcomes, and (3) adverse event occurrence.

Conclusion

An increased use of conceptual frameworks in studies, as well as greater clarity in intervention categorization and outcomes, is necessary to enhance the reviews’ value in providing useful cumulative knowledge in this field. Interventions delivered should embody different components that integrate individual, social, cultural, and environmental factors, while when evaluating an intervention’s effectiveness, eating performance, clinical outcomes and adverse events should be considered. Together with more robust studies, involving clinicians could prove to be useful, as their knowledge of practice developed from direct experience can help develop innovative research questions.
Effect of the cagW-based gene vaccine on the immunologic properties of BALB/c mouse: an efficient candidate for Helicobacter pylori DNA vaccine
Authors: Chehelgerdi Mohammad , Doosti Abbas
Published: April 2020

Background

Helicobacter pylori(H. pylori) infect more than half of the world population, and they cause different serious diseases such as gastric carcinomas. This study aims to design a vaccine on the basis ofcagWagainstH. pylori infection. After pcDNA3.1 (+)-cagW–CS-NPs complex is produced, it will be administered into the muscles of healthy BALB/c mice in order to study the effect of this DNA vaccine on the interleukin status of mice, representing its effect on the immune system. After that, the results will be compared with the control groups comprising the administration ofcagW-pCDNA3.1 (+) vaccine, the administration of chitosan and the administration of PBS in the muscles of mice.

Methods

The cagW gene of H. pylori was amplified by employing PCR, whose product was then cloned into the pcDNA3.1 (+) vector, and this cloning was confirmed by PCR and BamHI/EcoRV restriction enzyme digestion.CagWgene DNA vaccine was encapsulated in chitosan nanoparticles (pcDNA3.1 (+)-cagW-CS-NPs) using a complex coacervation method. The stability and in vitro expression of chitosan nanoparticles were studied by DNase I digestion and transfection, and the immune responses elicited in specific pathogen-free (SPF) mice by the pcDNA3.1 (+)-cagW-CS-NPs were evaluated. Apart from that, the protective potential pcDNA3.1 (+)-cagW-CS-NPs was evaluated by challenging withH. pylori.

Results

The pcDNA3.1 (+)-cagW-CS-NPs comprisescagW gene of H. pylorithat is encapsulated in chitosan nanoparticles, produced with good morphology, high stability, a mean diameter of 117.7 nm, and a zeta potential of + 5.64 mV. Moreover, it was confirmed that chitosan encapsulation protects the DNA plasmid from DNase I digestion, and the immunofluorescence assay showed that thecagWgene could express in HDF cells and maintain good bioactivity at the same time. In comparison to the mice immunized with the control plasmid, in vivo immunization revealed that mice immunized with pcDNA3.1 (+)-cagW-NPs showed better immune responses and prolonged release of the plasmid DNA.

Conclusions

This research proves chitosan-DNA nanoparticles as potent immunization candidates against H. pylori infection and paves the way for further developments in novel vaccines encapsulated in chitosan nanoparticles.
Progressive multifocal leukoencephalopathy in a patient post allo-HCT successfully treated with JC virus specific donor lymphocytes
Authors: Steinhardt M. J. , Wiercinska E. , Pham M. , Grigoleit G. U. , Mazzoni A. , Da-Via M. , Zhou X. , Meckel K. , Nickel K. , Duell J. , Krummenast F. C. , Kraus S. , Hopkinson C. , Weissbrich B. , Müllges W. , Stoll G. , Kortüm K. M. , Einsele H. , Bonig H. , Rasche L.
Published: April 2020

Background

Progressive multifocal leukoencephalopathy is a demyelinating CNS disorder. Reactivation of John Cunningham virus leads to oligodendrocyte infection with lysis and consequent axonal loss due to demyelination. Patients usually present with confusion and seizures. Late diagnosis and lack of adequate therapy options persistently result in permanent impairment of brain functions. Due to profound T cell depletion, impairment of T-cell function and potent immunosuppressive factors, allogeneic hematopoietic cell transplantation recipients are at high risk for JCV reactivation. To date, PML is almost universally fatal when occurring after allo-HCT.

Methods

To optimize therapy specificity, we enriched JCV specific T-cells out of the donor T-cell repertoire from the HLA-identical, anti-JCV-antibody positive family stem cell donor by unstimulated peripheral apheresis [1]. For this, we selected T cells responsive to five JCV peptide libraries via the Cytokine Capture System technology. It enables the enrichment of JCV specific T cells via identification of stimulus-induced interferon gamma secretion.

Results

Despite low frequencies of responsive T cells, we succeeded in generating a product containing 20 000 JCV reactive T cells ready for patient infusion. The adoptive cell transfer was performed without complication. Consequently, the clinical course stabilized and the patient slowly went into remission of PML with JCV negative CSF and containment of PML lesion expansion.

Conclusion

We report for the first time feasibility of generating T cells with possible anti-JCV activity from a seropositive family donor, a variation of virus specific T-cell therapies suitable for the post allo transplant setting. We also present the unusual case for successful treatment of PML after allo-HCT via virus specific T-cell therapy.
Physiologic requirement for iron in pregnant women, assessed using the stable isotope tracer technique
Authors: Cai Jie , Ren Tongxiang , Lu Jiaxi , Wu Jinghuan , Mao Deqian , Li Weidong , Zhang Yu , Li Min , Piao Jianhua , Yang Lichen , Ma Yuxia , Wang Jun , Yang Xiaoguang
Published: April 2020

Background

Knowledge of the physiologic requirement for iron, the core index for the formulation of a dietary reference intake (DRI), is of great importance for the health of a pregnant woman and her fetus, and can help a mother accurately plan her iron supplementation. However, direct measurements of the physiologic requirement for iron during pregnancy are still lacking.

Method

Eleven women of reproductive age from Hebei Province, China, who planned to become pregnant in the near future, were enrolled between January and March 2015 and included in the final analysis. Subjects participated in a 2-week metabolic trial in which they consumed 50 mg of the stable isotope 58Fe, and were then followed for ~ 2 years. The abundance of 58Fe and the total iron concentration in the circulation were measured using Multi-collector Inductively-Coupled Plasma Mass Spectrometry and Atomic Absorption Spectroscopy, respectively. The physiologic requirement for iron during pregnancy was then calculated by the formula derived from our previously published work.

Results

The mean physiologic requirement for iron in the 11 subjects, across their entire pregnancies, was 3.05 mg.d− 1 in total and 44.0 μg.kg− 1.d− 1 after adjustment for body mass. The physiologic requirements for iron in the first, second, and third trimesters were 2.04 mg.d− 1, 3.26 mg.d− 1, and 4.13 mg.d− 1, respectively. When adjusted for body mass, the physiologic requirements for iron in different trimesters were 32.3 μg.kg− 1.d− 1, 46.9 μg.kg− 1.d− 1, and 55.7 μg.kg− 1.d− 1, respectively.

Conclusion

We preliminarily explored the physiologic requirement for iron in pregnant women. The data demonstrated that pregnant women needed about twice iron than non-pregnant women. This research may be helpful for the design of future studies and the modification of iron DRIs.

Trial registration

ChiCTR, ChiCTR-OCH-14004302. Registered 14 February 2014, http://www.chictr.org.cn/showproj.aspx?proj=5267
Plant, space and time - linked together in an integrative and scalable data management system for phenomic approaches in agronomic field trials
Authors: Honecker Andreas , Schumann Henrik , Becirevic Diana , Klingbeil Lasse , Volland Kai , Forberig Steffi , Jansen Marc , Paulsen Hinrich , Kuhlmann Heiner , Léon Jens
Published: April 2020

Background

To ensure further genetic gain, genomic approaches in plant breeding rely on precise phenotypic data, describing plant structure, function and performance. A more precise characterization of the environment will allow a better dealing with genotype-by-environment-by-management interactions. Therefore, space and time dependencies of the crop production processes have to be considered. The use of novel sensor technologies has drastically increased the amount and diversity of phenotypic data from agronomic field trials. Existing data management systems either do not consider space and time, are not customizable to individual needs such as field trial handling, or have restricted availability. Hence, we propose an integrative data management and information system (DMIS) for handling of traditional and novel sensor-based phenotypic, environmental and management data. The DMIS must be customizable, applicable and scalable from individual users to organizations.

Results

Key element of the system is a dynamic PostgreSQL database with GIS-extension, capable of importing, storing and managing all types of data including images. The database references every structural database object and measurement in a threefold approach with semantic, spatial and temporal reference. Timestamps and geo-coordinates allow automated linking of all data. Traits can be precisely defined individually or uploaded as predefined lists. Filtering and selection routines allow compilation of all data for visualization via tables, charts or maps and for export and external statistical analysis. New possibilities of environmental information-based planning of field trials, weather-guided phenotyping and data analysis for outlier or hot-spot detection are demonstrated.

Conclusions

The DMIS supports users in handling experimental field trials with crop plants and modern phenotyping methods. It focuses on linking all space and time dependent processes of plant production. Weather, soil and management, as well as growth and yield formation of the plants can be depicted, thus allowing a more precise interpretation of the results in relation to environment and management. Breeders, extension specialists, official testing agencies and agricultural scientists are assisted in all steps of a typical workflow with planning, designing, conducting, controlling and analyzing field trials to generate new information for decision support in the crop improvement process.
Impact of surgeon handedness in manual and robot-assisted total hip arthroplasty
Authors: Kong Xiangpeng , Yang Minzhi , Li Xiang , Ni Ming , Zhang Guoqiang , Chen Jiying , Chai Wei
Published: April 2020

Background

The purpose of this study was to examine whether surgeon handedness could affect cup positioning in manual total hip arthroplasty (THA), and whether robot could diminish or eliminate the impact of surgeon handedness on cup positioning in robot-assisted THA.

Methods

Fifty-three patients who underwent bilateral robot-assisted THA and sixty-two patients who underwent bilateral manual THA between August 2018 and July 2019 in our institute were respectively analyzed in this study. When the difference between the bilateral anteversion and inclination was greater than 5°, the patient was regarded as having different cup positioning between bilateral THA. Their demographics, orientation of acetabular cup, and postoperative 3 month Harris hip score (HHS) were recorded for analysis.

Results

There were no significant differences in the gender, age, BMI, diagnosis’s composition, and preoperative and postoperative HHS between the robotic and manual group. Two left hips dislocated in the manual group. The anteversion of left hip was significantly larger than that of right hip (24.77 ± 10.44 vs 22.44 ± 8.67, p = 0.043) in the manual group. There were no significant differences of cup positioning between bilateral robot-assisted THA. The patients in manual group were significantly more likely to have different cup positioning between bilateral hips than those in robotic group (77% vs 45%, p = 0.000). More manual THA were located out of the target zone than robot-assisted THA (70% vs 48%, p = 0.001).

Conclusions

Surgeon’s handedness showed a trend towards an impact on cup positioning in manual THA and robot might help surgeon eliminate the adverse impact. However, the impact of handedness on the clinical outcomes still needs further observation.
Case report: early aortic valve degeneration associated with interstitial deletion of chromosome 2–46,XX,del (2)(q31.3; q32.2)
Authors: Pfister Raymond , Knowles Clara , Kirsch Matthias
Published: April 2020

Background

Interstitial deletions within the long arm of chromosome 2, involving the 2q31q33 region, are rare but are known to be associated with delays in development, behavioral problems, facial dysmorphism and various hand/foot anomalies.

Case presentation

Here, we describe a case with an interstitial 2q31.3.q32.2 deletion, presenting the previously described phenotype, exhibiting fibromyxoid degeneration of the aortic valve in addition to previously described clinical features.

Conclusion

Interstitial deletion in chromosome 2q31.2q32.3 might be associated to a fibromyxoid degeneration of valvular leaflets generating regurgitation. Patients diagnosed with this mutation may require investigation to rule out a valvular disease.
Minimization of the complications associated with bar removal after the Nuss procedure in adults
Authors: Hsieh Min-Shiau , Tong Shao-Syuan , Wei Bo-Chun , Chung Cheng-Chin , Cheng Yeung-Leung
Published: April 2020

Background

Pectus bar removal after Nuss repair is associated with the risk of major complications that are underreported. Of these, surgical bleeding is the main concern. Old age and placement of more than one bar are reported risk factors for pectus bar removal. In this study, we presented our experience regarding the modified skills required to minimize complications during bar removal, especially in adult patients.

Methods

Consecutive patients who underwent pectus bar removal as the final stage of Nuss repair between August 2014 and December 2018 were included. The patients were positioned in the supine position. The bar(s) was (were) removed from the left side via the bilateral approach using the previous surgical scars after full dissection of the ends of the bar lateral to the hinge point and after straightening the right end of the bar. Bleeding was carefully checked after removal. An elastic bandage was wrapped around the chest after wound closure to prevent wound hematoma/seroma formation.

Results

A total of 283 patients (260 male and 23 female), with a mean age of 22.8 ± 6.6 years at the time of the Nuss repair were included. The mean duration of pectus bar maintenance interval was 4.3 years (range: 1.9 to 9.8 years). A total of 200 patients (71%) had two bars. The mean estimated blood loss was 11.7 mL (range: 10 mL to 100 mL). Nine patients (3.1%) experienced complications, six had pneumothorax and three had wound hematoma. No major bleeding occurred. Adults and the use of more than one bar were not associated with a significantly higher rate of complications (P = 0.400 and P = 0.260, respectively).

Conclusions

Adult patients and removal of multiple bars were not risk factors for complications in our cohort. Skill in preventing intraoperative mediastinal traction, carefully controlling bleeding, and reducing the effect of dead space around the wounds could minimize the risk of bleeding complications. A multicentric study or case accumulation is needed to further evaluate the risk factors of removal pectus bar(s).
Qualitative research to inform hypothesis testing for fidelity-based sub-group analysis in clinical trials: lessons learnt from the process evaluation of a multifaceted podiatry intervention for falls prevention
Authors:   on behalf of the REFORM study, Scantlebury Arabella , Cockayne Sarah , Fairhurst Caroline , Rodgers Sara , Torgerson David , Hewitt Catherine , Adamson Joy
Published: April 2020

Background

Ensuring fidelity to complex interventions is a challenge when conducting pragmatic randomised controlled trials. We explore fidelity through a qualitative process evaluation, which was conducted alongside a pragmatic, multicentre, two-arm cohort randomised controlled trial: the REFORM (Reducing Falls with Orthoses and a Multifaceted podiatry intervention) trial. The paper aims, through a qualitative process evaluation, to explore some of the factors that may have affected the delivery of the REFORM intervention and highlight how project-specific fidelity can be assessed using a truly mixed-methods approach when informed by qualitative insights.

Design

Semi-structured qualitative interviews carried out as part of a process evaluation. Interviews were analysed thematically.

Setting

Seven NHS trusts in the UK and a University podiatry school in Ireland. Interviews were undertaken face-to-face or over the telephone.

Participants

Twenty-one REFORM trial participants and 14 podiatrists who delivered the REFORM intervention.

Results

Factors affecting fidelity included: how similar the intervention was to routine practice; the challenges of delivering a multifaceted intervention to a heterogeneous older population; and practical issues with delivery such as time and training. Trial participants’ views of the intervention, whether falls prevention is a personal priority, their experience of being part of a trial and individual factors such as medical conditions may also have affected intervention fidelity.

Conclusions

Our process evaluation highlighted factors that were perceived to have affected the fidelity of the REFORM intervention and in doing so demonstrates the importance of considering fidelity when designing and evaluating pragmatic trials. We propose a number of recommendations of how important project-specific insights from qualitative work can be incorporated into the design of fidelity measurement of future trials, which build on existing conceptual fidelity frameworks. In particular, we encourage adopting a mixed-methods approach whereby qualitative insights can be used to suggest ways to enhance quantitative data collection facilitating integration through hypothesis generation, hypothesis testing and seeking explanation for trial findings. This will provide a framework of enabling measures of fidelity to be incorporated into the understanding of trial results which has been relatively neglected by existing literature.

Trial registration

ISRCTN Registry: ISRCTN68240461. Registered on 01/07/2011.
Ultrasound-guided insertion of intra-aortic balloon counterpulsation in intensive care: description of the technique
Authors: Rodriguez Lima David Rene , Duran Ever Julián , Rojas Díaz Ever Leonardo , Pinilla Rojas Darío Isaías , Mercado Díaz Mario Andrés , Bustos Martínez Yury Forlán
Published: April 2020

Intra-aortic balloon counterpulsation (IAoBC) is a mechanical circulatory support device that has been used for more than 50 years, mainly for cardiogenic shock. Although its effect on mortality is controversial, IAoBC is still used in a wide variety of pre- and postoperative clinical settings in cardiac surgery centers. IAoBC has a complication rate of approximately 30%, mostly associated with problems during insertion and malpositioning. Thus, an insertion technique based on the use of ultrasound at the patient’s bedside in the intensive care unit (ICU) is proposed.
A selective p38α/β MAPK inhibitor alleviates neuropathology and cognitive impairment, and modulates microglia function in 5XFAD mouse
Authors: Gee Min Sung , Son Seung Hwan , Jeon Seung Ho , Do Jimin , Kim Namkwon , Ju Yeon-Joo , Lee Soo Jin , Chung Eun Kyoung , Inn Kyung-Soo , Kim Nam-Jung , Lee Jong Kil
Published: April 2020

Background

Chronic neuroinflammation, aggressive amyloid beta (Aβ) deposition, neuronal cell loss, and cognitive impairment are pathological presentations of Alzheimer’s disease (AD). Therefore, resolution of neuroinflammation and inhibition of Aβ-driven pathology have been suggested to be important strategies for AD therapy. Previous efforts to prevent AD progression have identified p38 mitogen-activated protein kinases (MAPKs) as a promising target for AD therapy. Recent studies showed pharmacological inhibition of p38α MAPK improved memory impairment in AD mouse models.

Methods

In this study, we used an AD mouse model, 5XFAD, to explore the therapeutic potential of NJK14047 which is a novel, selective p38α/β MAPK inhibitor. The mice were injected with 2.5 mg/kg NJK14047 or vehicle every other day for 3 months. Morris water maze task and histological imaging analysis were performed. Protein and mRNA expression levels were measured using immunoblotting and qRT-PCR, respectively. In vitro studies were conducted to measure the cytotoxicity of microglia- and astrocyte-conditioned medium on primary neurons using the MTT assay and TUNEL assay.

Results

NJK14047 treatment downregulated phospho-p38 MAPK levels, decreased the amount of Aβ deposits, and reduced spatial learning memory loss in 9-month-old 5XFAD mice. While the pro-inflammatory conditions were decreased, the expression of alternatively activated microglial markers and microglial phagocytic receptors was increased. Furthermore, NJK14047 treatment reduced the number of degenerating neurons labeled with Fluoro-Jade B in the brains of 5XFAD mice. The neuroprotective effect of NJK14047 was further confirmed by in vitro studies.

Conclusion

Taken together, a selective p38α/β MAPK inhibitor NJK14047 successfully showed therapeutic effects for AD in 5XFAD mice. Based on our data, p38 MAPK inhibition is a potential strategy for AD therapy, suggesting NJK14047 as one of the promising candidates for AD therapeutics targeting p38 MAPKs.
Ensuring user authentication and data integrity in multi-cloud environment
Authors: Megouache Leila , Zitouni Abdelhafid , Djoudi Mahieddine
Published: April 2020

The necessity to improve security in a multi-cloud environment has become very urgent in recent years. Although in this topic, many methods using the message authentication code had been realized but, the results of these methods are unsatisfactory and heavy to apply, which, is why the security problem remains unresolved in this environment. This article proposes a new model that provides authentication and data integrity in a distributed and interoperable environment. For that in this paper, the authors first analyze some security models used in a large and distributed environment, and then, we introduce a new model to solve security issues in this environment. Our approach consists of three steps, the first step, was to propose a private virtual network to secure the data in transit. Secondly, we used an authentication method based on data encryption, to protect the identity of the user and his data, and finally, we realize an algorithm to know the integrity of data distributed on the various clouds of the system. The model achieves both identity authentication and the ability to inter-operate between processes running on different cloud’s provider. A data integrity algorithm will be demonstrated. The results of this proposed model can efficiently and safely construct a reliable and stable system in the cross-cloud environment.
Metabarcoding reveals distinct microbiotypes in the giant clam Tridacna maxima
Authors: Guibert Isis , Lecellier Gael , Torda Gergely , Pochon Xavier , Berteaux-Lecellier Véronique
Published: April 2020

Background

Giant clams and scleractinian (reef-building) corals are keystone species of coral reef ecosystems. The basis of their ecological success is a complex and fine-tuned symbiotic relationship with microbes. While the effect of environmental change on the composition of the coral microbiome has been heavily studied, we know very little about the composition and sensitivity of the microbiome associated with clams. Here, we explore the influence of increasing temperature on the microbial community (bacteria and dinoflagellates from the family Symbiodiniaceae) harbored by giant clams, maintained either in isolation or exposed to other reef species. We created artificial benthic assemblages using two coral species (Pocillopora damicornisandAcropora cytherea) and one giant clam species (Tridacna maxima) and studied the microbial community in the latter using metagenomics.

Results

Our results led to three major conclusions. First, the health status of giant clams depended on the composition of the benthic species assemblages. Second, we discovered distinct microbiotypes in the studiedT. maximapopulation, one of which was disproportionately dominated by Vibrionaceae and directly linked to clam mortality. Third, neither the increase in water temperature nor the composition of the benthic assemblage had a significant effect on the composition of the Symbiodiniaceae and bacterial communities ofT. maxima.

Conclusions

Altogether, our results suggest that at least three microbiotypes naturally exist in the studied clam populations, regardless of water temperature. These microbiotypes plausibly provide similar functions to the clam host via alternate molecular pathways as well as microbiotype-specific functions. This redundancy in functions among microbiotypes together with their specificities provides hope that giant clam populations can tolerate some levels of environmental variation such as increased temperature. Importantly, the composition of the benthic assemblage could make clams susceptible to infections by Vibrionaceae, especially when water temperature increases.
What did we learn from preparing for cross-border transmission of Ebola virus disease into a complex humanitarian setting – The Republic of South Sudan?
Authors: Olu Olushayo Oluseun , Lako Richard , Wamala Joseph Francis , Ramadan Patrick Otim , Ryan Caroline , Udenweze Ifeanyi , Berta Kibebu , Guyo Argata Guracha , Sokemawu Alex , Tukuru Michael , Gray Henry John , Chimbaru Alex
Published: April 2020

Background

Following the West Africa Ebola virus disease (EVD) outbreak (2013–2016), WHO developed a preparedness checklist for its member states. This checklist is currently being applied for the first time on a large and systematic scale to prepare for the cross border importation of the ongoing EVD outbreak in the Democratic Republic of Congo hence the need to document the lessons learnt from this experience. This is more pertinent considering the complex humanitarian context and weak health system under which some of the countries such as the Republic of South Sudan are implementing their EVD preparedness interventions.

Main text

We identified four main lessons from the ongoing EVD preparedness efforts in the Republic South Sudan. First, EVD preparedness is possible in complex humanitarian settings such as the Republic of South Sudan by using a longer-term health system strengthening approach. Second, the Republic of South Sudan is at risk of both domestic and cross border transmission of EVD and several other infectious disease outbreaks hence the need for an integrated and sustainable approach to outbreak preparedness in the country. Third, a phased and well-prioritized approach is required for EVD preparedness in complex humanitarian settings given the costs associated with preparedness and the difficulties in the accurate prediction of outbreaks in such settings. Fourth, EVD preparedness in complex humanitarian settings is a massive undertaking that requires effective and decentralized coordination.

Conclusion

Despite a very challenging context, the Republic of South Sudan made significant progress in its EVD preparedness drive demonstrating that it is possible to rapidly scale up preparedness efforts in complex humanitarian contexts if appropriate and context-specific approaches are used. Further research, systematic reviews and evaluation of the ongoing preparedness efforts are required to ensure comprehensive documentation and application of the lessons learnt for future EVD outbreak preparedness and response efforts.
Social stigma is an underestimated contributing factor to unemployment in people with mental illness or mental health issues: position paper and future directions
Authors: Brouwers Evelien P. M.
Published: April 2020

Background

As yet, little is known about the effects of mental health stigma on sustainable employment. This is surprising, as mental health stigma is common, and because people with severe and common mental disorders are 7 and 3 times more likely to be unemployed, respectively, than people with no disorders. As the global lifetime prevalence of mental disorders is 29%, the high unemployment rates of people with these health problems constitute an important and urgent public health inequality problem that needs to be addressed.

Main text

The aim of this position paper is to illustrate the assumption that stigma contributes to the unemployment of people with mental illness and mental health issues with evidence from recent scientific studies on four problem areas, and to provide directions for future research. These four problem areas indicate that: (1) employers and line managers hold negative attitudes towards people with mental illness or mental health issues, which decreases the chances of people with these health problems being hired or supported; (2) both the disclosure and non-disclosure of mental illness or mental health issues can lead to job loss; (3) anticipated discrimination, self-stigma and the ‘Why Try’ effect can lead to insufficient motivation and effort to keep or find employment and can result in unemployment; and (4) stigma is a barrier to seeking healthcare, which can lead to untreated and worsened health conditions and subsequently to adverse occupational outcomes (e.g. sick leave, job loss).

Conclusions

The paper concludes that stigma in the work context is a considerable and complex problem, and that there is an important knowledge gap especially regarding the long-term effects of stigma on unemployment. To prevent and decrease adverse occupational outcomes in people with mental illness or mental health issues there is an urgent need for high quality and longitudinal research on stigma related consequences for employment. In addition, more validated measures specifically for the employment setting, as well as destigmatizing intervention studies are needed.
Transforming corporate headquarters: a case study of a collaborative journey
Authors: Chasserio Stephanie , Botte Sophie
Published: April 2020

Transforming the organizational structure of a headquarters in order to decentralize authority and decrease its size remains a huge challenge for international corporations looking for agility. One of the main issues is how to overcome the inertia of corporate headquarters (CHQ). This paper examines a CHQ transformation at an industrial multinational that has developed its own participative method with strong reliance on internal resources and an intensive pace of change. It outlines how internal change agents orchestrate and implement this change at the level of CHQ—but not without some tradeoffs. While the approach adopted has helped CHQ and the organization to develop news skills and ways of working, at the same time some tradeoffs—such as the pace of change and the exclusion of managers from the consultative process—may have had effects on the implementation of change.
Effect of bio-stimulants foliar applications on growth, yield, and product quality of two Cassava cultivars
Authors: Hassan Nagwa M. K. , Marzouk Neama M. , Fawzy Zakaria F. , Saleh Said A.
Published: April 2020

Background

Cassava is a major staple food crop for the people in tropical and sub-tropical areas, a non-traditional vegetable root crop in Egypt. It has important industrial raw materials for the production of starch, alcohol, pharmaceuticals, and livestock feed. The current study is evaluating two cassava cultivars: American and Brazilian types under three bio-stimulants: glutamine, lysine, and active dry yeast, as foliar applications. Vegetative growth characters, tuber yield, and its quality as well as chemical contents of cassava tubers were evaluated.

Results

The results showed that American cassava cultivar recorded the highest vegetative growth characters (plant height, leaves number, main stems, lateral branches, leaf area, and chlorophyll content), tuber yield (number and weight), and tuber quality (length, diameter, dry matter, and tubers-shoots ratio) as well as chemical composition (starch, total carbohydrates, N, P, and K). The foliar application of glutamine at the rate of 200 mg/L increased vegetative growth characters and tuber yield as well as tuber quality and improved chemical contents of cassava tubers. On the contrary, the lowest values of cassava growth and its productivity as well as chemical composition were associated to Brazilian cultivar when foliar sprayed by yeast at the concentration of 2 g/L.

Conclusion

From this study, it could be concluded that American type of cassava is the most suitable under Egyptian conditions, which ranked the first in all vegetative growth characters, tuber yield, tuber quality, and chemical composition, with foliar sprayed by glutamine at the rate of 200 mg/L.