bluuebunny/crossref_metadata_2025 huggingface dataset:
Indoor air quality in urban residential: Current status, regulation and future research for Indonesia
Authors: Prihardanu Ezra Ganesha , Kusnoputranto Haryoto , Herdiansyah Herdis
Published: October 2021

Modern society spends more time indoors, which has led to the hypothesis that indoor exposure can better represent the effects of air pollution at the individual level. Studies on the landscape of urban residential indoor air quality have never been carried out nationally in Indonesia. After 70 years of commitment to standardize the health aspects of the home in Indonesia, this study intends to make a chronological reflection on the Indonesian government's policy in residential indoor air quality. This study raised and analyzed several questions in the national and local context from the previous research. The government's various policies and regulations are chronologically listed to see the development and look for regulatory or implementation gaps. The indicators of insufficient ventilation and indoor air quality in much Indonesian urban housing have been shown in previous studies, encouraging this study to be necessary. This study used a chronological review using national and international journals. Previous studies have shown possibilities to estimate the landscape of indoor pollution exposure effectively using a socio-economic approach as a part. The latest national housing survey results can be used as references to discover the housing landscape status in Indonesia for further research suggestions.
Endometrial carcinoma metastatic to the scalp
Authors: Aidos Joana , Gonçalves Sónia , Carvalho Teresa , Martins Nuno Nogueira , Martins Francisco Nogueira
Published: October 2021

Endometrial carcinoma is a very rare cause of cutaneous metastasis. The most frequent presentations of cutaneous metastasis are fast developing nodules or tumors, which are evidence of widespread dissemination in such patients. We report a case of scalp metastasis from an endometrial adenocarcinoma with a fatal prognosis.
Profile of apheresis donors at Professor Alberto Antunes University Hospital of the Federal University of Alagoas
Authors: Loureiro Laís Pereira Leite de Araújo , Zielak Sthephanie de Lima , Almeida Ingryd Leylane de Holanda Galvão , Barbosa Kledson Lopes , Araújo Cinthya Pereira Leite Costa de
Published: October 2021

Hemotherapy services play a key role in attracting donors and providing safe blood to the population. The apheresis platelet collection procedure is a relatively simple, safe and important procedure for increasing the stocks of these services. However, the recruitment and retention of these donors still represent a major challenge. Objective: Evaluating the profile of donors of blood components by apheresis in the Transfusion Unit of Professor Alberto Antunes University Hospital - UFAL, as well as knowing the hematological parameters pre- and post-donation, the occurrence of the main adverse events related to the procedure and the difficulties faced by the donor. Method: This was a cross-sectional observational study. We analyzed a total of 160 forms of apheresis donors from March 2017 to June 2018. The data were tabulated using the Excel program, and then analyzed in order to determinethe objectives. Results: Most donors were male (93.13%), aged between 25 and 40 years (48.75%) and brown (25.62%). There was a slight prevalence of singles (49.37%) and 73.75% were from Maceió. The most prevalent ABO and Rh phenotyping was O+ (39.3%). Most of the procedures were simple platelet collection (75.60%) and the occurrence of adverse events during donations was 30.63%. Conclusion: Evaluation of apheresis donor profile and the knowledge of the possible side effects related to the procedure provided a better understanding of this type of donation and may improve the capture and retention processes of these individuals, minimizing the effects of lack of blood for Alagoana population.
Influence of sodium intake and sociodemographic, lifestyle and anthropometric variables on blood cholesterol of hypertensive women
Authors: Padilha Bruna Merten , Vasconcelos Sandra Mary Lima , Cabral Poliana Coelho , Wanderley Thiago Marques , Gomes Amanda da Silva , Gaia Joice Alves , Rodrigues Letícia Andrade
Published: October 2021

The restriction of sodium intake, one of the pillars of antihypertensive treatment, has been associated with the increase in cholesterol levels. Given this, we hypothesize that a sodium intake restriction may increase cholesterol levels in hypertensive women. The present study aimed to evaluate the influence of sodium intake, sociodemographic, lifestyle and anthropometric variables on the blood cholesterol levels of hypertensive women. This was a cross-sectional study with hypertensive and nondiabetic women aged 20 to 59 years, recruited from the primary healthcare units of Maceio, Alagoas, in the Brazilian Northeast. Sodium intake was estimated by the 24-hour urinary excretion of sodium; and blood cholesterol was estimated by capillary blood. Age (years), education level (<4 or ≥4 years), race (white or nonwhite), smoking and alcohol consumption were evaluated. The weight, height and waist circumference were measured and body mass index, conicity index and waist-to-height ratio were quantified. The percentage of body fat was measured using a tetrapolar bioelectrical impedance device. The relationship between blood cholesterol and other variables was assessed by multiple regression analysis. A significance level of 5% was used in the final model. This study included 165 hypertensive women. In linear regression, blood cholesterol wasdirectly proportional to age (p<0.001), education level (p=0.01) and race (p=0.04). These variables, as well assodium intake (p = 0.07) and conicity index (p = 0.12), were included in the multiple regression analysis. Sodium intake (p=0.03) and age (p=0.001) were related, in an inverse and a direct way, respectively, to the blood cholesterol in the hypertensive women studied.
Acadêmico de medicina em ação: promovendo fatores de proteção à violência sexual em crianças vulneráveis
Authors: Touso Maira Ferro de Sousa , Freitas Ana Clara Souza , Pereira Lis Coimbra , Figueiredo Glória Lucia Alves
Published: October 2021

As Diretrizes Curriculares Nacionais dos cursos de Medicina preveem que desde o início desenvolvam-se competências humanísticas por meio da inserção em cenários de atenção à saúde. Iniquidades sociais implicam em situações de vulnerabilidade e se associam a violências contra a criança. Objetivou-se analisar as repercussões de atividades de educação em saúde sobre a violência sexual com crianças em situação de vulnerabilidade social, possibilitando uma reflexão sobre o exercício de proteção infantil na formação médica. Consistiu em uma pesquisa ação realizada por seis acadêmicos de medicina em uma instituição ligada ao Centro de Referência em Assistência Social; participaram 12 crianças de seis a dez anos. Através de ações lúdicas e literárias, a violência sexual em crianças em situação de vulnerabilidade social foi abordada. As intervenções e coleta de dados aconteceram em três encontros quinzenais intitulados diagnóstico, intervenção e avaliação. O processo formativo acadêmico consolidou-se em grupo focal coordenado pelo docente responsável.Evidenciou-se que a forma interativa de comunicação apresentou potencial para apreensão do conhecimento protetivo à violência infantil por parte das crianças, assim como para o processo formativo e humanístico dos acadêmicos.Conclui-se que a escola médica, ao aplicar suas atividades de educação em saúde sobre a violência sexual no campo de práticas da APS atende à formação de competências humanísticas e abarca a responsabilidade enquanto agente promotor de saúde, reunindo elementos para atuação e engajamento a uma demanda universal, visto o impacto social, econômico e individual dos agravos potencialmente associados à baixa literacia de populações como a estudada.
Drug Reaction with eosinophilia and systemic symptoms with alopecia universalis and vitiligo
Authors: Koseki Ives Alexandre Yutani , Sartori Débora Sarzi , Guarenti Isabelle Maffei , Koseki Fábio Yutani , Gietner Amanda Dagostim , Nunes Simoni Euzébio
Published: October 2021

Drug reactions with eosinophilia and systemic symptoms (DRESS) are rare and potentially fatal adverse hypersensitivity reaction to some drugs, especially anticonvulsants. The syndrome affects not only the skin but also other organs, especially the liver. The incidence can vary from 1 to 5 cases per 10.000 patients exposed to anticonvulsants.The recognition of the syndrome is of fundamental importance since the mortality rate is between 10 and 40%. Once the diagnosis is established, the triggering drug must be identified and discontinued. Corticosteroids are usually associated with therapy. Autoimmune sequelae have been reported, including vitiligo and rarely alopecia. Alopecia universalis is a variant of alopecia areata, characterized by hair loss throughout the body. We report a case of DRESS, associated with two autoimmune dermatological diseases: alopecia universalis and vitiligo.
Síndrome austríaca: uma condição extremamente rara
Authors: Santos Vitorino Modesto dos , Modesto Laura Campos
Published: October 2021

None
Effects of specimen haemolysis on complete blood count results by Abbott Alinity hq System
Authors: Ercan Müjgan , Akbulut Emiş Deniz , Bayraktar Nihayet , Ercan Şerif
Published: October 2021

The current study aimed to assess the interference of in vitro haemolysis on complete blood count (CBC) using Abbott Alinity hq system, and to determine which haemolysis levels affect the reliability of sample results.
Blood samples obtained from 25 volunteers in K3-EDTA tubes were divided into four aliquots. The first aliquot was not subjected to any intervention. The second, third and fourth aliquots were passed through a fine needle 2, 4 and 6 times, respectively. Complete blood count was performed by multi-angle polarized scatter separation technology and haemolysis index (HI) was assessed from the plasma samples separated by centrifugation. Five groups were formed according to the HI values. The percentage biases between the results of non-haemolysed and haemolysed groups were compared with the desirable bias limits from The European Federation of Clinical Chemistry and Laboratory Medicine database and reference change values (RCVs).
In groups 1 to 4, the effects of haemolysis on CBC parameters were acceptable comparing to the analytical bias except for lymphocytes (7.26%-7.42%), MCH (2.59%), and MCHC (0.47%-2.81%). Results of group 5 (gross haemolysis) showed decreases in HCT(- 4.56%), RBC (- 4.07%) count and increase in lymphocyte (11.60%) count higher than the analytical performance specifications. Moreover, variations in MCH (4.65%) and MCHC (5.24%) were exceeding the RCVs.
Gross haemolysis (haemoglobin concentration > 10 g/L) is likely to produce unreliable CBC results on non-pathological samples. Further studies including pathological specimens are needed.
Selaginella qingchengshanensis (sect. Heterostachys; Selaginellaceae), a new species from Sichuan, China
Authors: HE MENG , HE ZHAO-RONG , ZHANG LI-BING , ZHOU XIN-MAO
Published: October 2021

Based on morphological and phylogenetic studies, Selaginella qingchengshanensis, a new species in S. sect. Heterostachys from Sichuan, China is described and illustrated. Morphologically, the new species is similar to S. amblyphylla, but has sterile leaves with denticulate to slightly ciliate margins, dorsal leaves with long arista (as long as leaves) perpendicular to stems and branches in living plants, and axillary leaves triangular-ovate or broadly ovate. Molecular analyses based on ITS+5.8S and rbcL data also support it as a distinct species.
Examination of Social Determinants of Health, District Health Needs, School Nurse Caseload, and Academic Outcomes in Washington State
Authors: Willgerodt Mayumi A. , Griffith Kristin
Published: October 2021

The purpose of this study was to examine associations between caseload, social determinants, health needs, students meeting grade-level English and Math standards, and attendance. Data from the Washington State Open Data Portal and Report Card were combined with District Health Assessment data from 264 school districts. Analyses of variance and linear stepwise regression analyses were conducted. Key findings indicate significant differences in English and Math outcomes by caseloads, with higher caseload districts have lower percentages of students meeting English and Math standards, but not attendance. Caseload is a significant predictor of students meeting English and Math standards, after controlling for social determinants and district health needs. Findings point to the complexity of school nursing work and builds a foundation to guide future nursing research. Large prospective studies that allow for comprehensive measurement of structure, process and outcomes variables are needed to advance school nursing research.
Predictors of hospital mortality among patients with COVID-19 in Tehran, Iran
Authors: Esfahanian Fatemeh , SeyedAlinaghi SeyedAhmad , Janfaza Nazanin , Tantuoyir Marcarious M.
Published: October 2021

Objective:

The coronavirus disease 2019 (COVID-19) has become a global pandemic. Timely and effective predictors of survival and death rates are crucial for improving the management of COVID-19 patients. In this study, we evaluated the predictors of mortality based on the demographics, comorbidities, clinical characteristics, laboratory findings, and vital signs of 500 patients with COVID-19 admitted at Imam Khomeini Hospital Complex, the biggest hospital in Tehran, Iran.

Methods:

Five hundred hospitalized laboratory-confirmed COVID-19 patients were included in this study. Subsequently, electronic medical records, including patient demographics, clinical manifestation, comorbidities, and laboratory test results were collected and analyzed. They were divided into two groups: expired and discharged. Demographics, clinical, and laboratory data were compared among the two groups. The related factors with death in the patients were determined using univariate and multivariate logistic regression approaches.

Results:

Among the 500 hospitalized patients, most patients were male (66.4% versus 33.6%). The expired group had more patients ⩾70 years of age compared with the discharged group (32.9% versus 16.3%, respectively). Almost 66% of the expired patients were hospitalized for ⩾5 days which was higher than the discharge group (26.9%). Patients with a history of opium use in the expired group were significantly higher compared to the discharged group (14.8% versus 8.6%, p = 0.04) as well as a history of cancer (15.5% versus 4.7%, p < 0.001). Out of the 500 patients with COVID-19, four patients (2.6%) were HIV positive, all of whom expired. Dyspnea (76.4%), fever (56.6%), myalgia (59.9%), and dry cough (67%) were the most common chief complaints of hospitalized patients. Age ⩾70 years (adjusted odds ratio = 2.49; 95% confidence interval, 1.02–6.04), being female (adjusted odds ratio = 2.06; 95% confidence interval, 1.25–3.41), days of hospitalization (adjusted odds ratio = 5.73; 95% confidence interval, 3.49–9.41), and having cancer (adjusted odds ratio = 3.23; 95% confidence interval, 1.42–7.39) were identified as independent predictors of mortality among COVID-19 patients.

Conclusion:

Discharged and expired COVID-19 patients had distinct clinical and laboratory characteristics, which were separated by principal component analysis. The mortality risk factors for severe patients identified in this study using a multivariate logistic regression model included elderly age (⩾70 years), being female, days of hospitalization, and having cancer.
Antitumor activity of flavonoids from Alpinia officinarum hance on gastric cancer
Authors: Yakufu Mirensha , Hailiwu Renaguli , Cong Yuanyuan , Habaike Ayijiang , Wang Xiaomei , Abulizi Palida
Published: October 2021

Introduction: To investigate antitumor activity and mechanism of flavonoids from Alpinia officinarum Hance against gastric cancer. Methods: Transplanted mouse fore-stomach carcinoma (MFC) tumor mice were divided into six groups: control group, model group, low dose (20 mg/kg), middle dose (40 mg/kg), and high dose (80 mg/kg) groups of TFAO and 5-Fu group. Mice were treated with TFAO or 5-Fu for 14 days, except those of control and model group. Tumor inhibitory rate, spleen, and thymus index were calculated. Contents of proliferating cell nuclear antigen, MMP-9, vascular endothelial growth factor, IL-1β, IL-6, and IL-17 in serum were detected. Effect of galangin on BGC-823 cell growth was detected. Cell apoptosis and cell cycle distribution were measured. Enzyme activity of Caspase-3, Caspase-8, and Caspase-9 was detected. Western blot was used to detect STAT3, Bcl-2, Bax, Caspase-3, Caspase-8, Caspase-9, CyclinB1, and CyclinD1 protein expression in BGC-823 cell. Results: Compared with model group, tumor weight of mice decreased significantly ( p < .01) in 5-Fu group, low dose, middle dose, and high dose group of TFAO; thymus index of mice decreased significantly ( p < .05) in 5-Fu group; and spleen index decreased significantly ( p < .05) in low dose and middle dose groups of TFAO. Compared with model group, levels of PCNA, MMP-9, IL-1β, and IL-6 in serum of mice decreased obviously ( p < .01) in all administration groups; levels of VEGF in serum of mice decreased obviously ( p < .01) in low dose and high dose group of TFAO and 5-Fu group; and levels of IL-17 in serum of mice decreased significantly ( p < .01) in low-dose and middle-dose groups of TFAO and 5-Fu group. Galangin could inhibit BGC-823 cell growth; accelerate apoptosis; block cell cycle; increase cell Caspase-3, Caspase-8, and Caspase-9 enzyme activity; upregulate expression of Caspase-3, Caspase-8, Caspase-9, and Bax; and downregulate expression of STAT3, CyclinB1, CyclinD1, and Bcl-2 protein. Conclusion: Flavonoids from A. officinarum showed antitumor activity in gastric cancer. Mechanisms may be associated with inhibition of tumor angiogenesis, tumor cell proliferation, and cancer-associated inflammation.
Improved accuracy of intraocular lens power calculation by preoperative management of dry eye disease
Authors: Kim Jinsoo , Kim Mee Kum , Ha Yuseung , Paik Hae Jung , Kim Dong Hyun
Published: October 2021

Background

To evaluate the effects of pretreatment for dry eye disease (DED) on the accuracy of intraocular lens (IOL) power calculation.

Methods

Patients who underwent uneventful cataract surgery were included in the study. IOL power was determined using the SRK/T and Barrett Universal II (Barrett) formulas. The patients were divided into non-pretreatment and pretreatment groups, and those in the pretreatment group were treated with topical 0.5% loteprednol etabonate and 0.05% cyclosporin A for 2 weeks prior to cataract surgery. Ocular biometry was performed in all groups within 2 days before surgery. The mean prediction error, mean absolute error (MAE), and proportions of refractive surprise were compared between the non-pretreatment and pretreatment groups at 1 month postoperatively. Refractive surprise was defined as MAE ≥ 0.75D.

Results

In a total of 105 patients, 52 (52 eyes) were in the non-pretreatment group and 53 (53 eyes) in the pretreatment group. The MAE was 0.42 ± 0.33, 0.38 ± 0.34 (SRK/T, Barrett) and 0.23 ± 0.19, 0.24 ± 0.19 in the non-pretreatment and pretreatment groups, respectively (p < 0.001/=0.008). The number of refractive surprises was also significantly lower in the pretreatment group. [non-pretreatment/pretreatment: 9/2 (SRK/T); 8/1 (Barrett); p = 0.024/0.016]. Pretreatment of DED was related to a reduction in postoperative refractive surprise. [SRK/T/Barrett: OR = 0.18/0.17 (95% CI: 0.05–0.71/0.05–0.60), p = 0.014/0.006].

Conclusions

The accuracy of IOL power prediction can be increased by actively treating DED prior to cataract surgery.
The knowledge, attitudes and beliefs of midwives on the vaccination coverage rates in Perth’s Aboriginal children
Authors: Carman Rebecca , Andrew Lesley , Devine Amanda
Published: October 2021

Background

Midwives are well placed to promote vaccination awareness throughout a women’s pregnancy and strengthen childhood vaccination demand following hospital discharge. In Perth, Western Australia, Aboriginal children experience some of the lowest vaccination coverage rates across the nation. To identify factors preventing greater vaccination uptake amongst the target population, a theory-based study was conducted with midwives across two Perth maternity hospitals to explore behavioural attributes, knowledge, attitudes and beliefs surrounding vaccination provision and the vaccines administered to Aboriginal children.

Methods

A purpose-designed questionnaire was distributed to midwives working in two Perth public maternity hospitals. The proximal constructs of The Theory of Planned Behavior were used to frame the questionnaire to enable the barriers to greater vaccination coverage to be identified and behaviourally situated. Descriptive statistics described the demographics of the study sample. Chi-square and the Fisher’s exact test were used to identify associations between midwife characteristics and awareness of the coverage rates. Significance was set at α = 0.05.

Results

Of the 58 midwives who completed the study questionnaire, 77.2% were unaware of the sub-optimal vaccination coverage in Perth’s Aboriginal children. Level of education (p = 0.53) and years worked as a practising midwife (p = 0.47) were not found to be associated with an awareness of the coverage rates. Approximately, 50% of midwives reported some concern over the efficacy of childhood vaccines, 44.4% did not feel confident with their knowledge of vaccines, while 33.3% do not routinely discuss childhood vaccinations with parents prior to hospital discharge.

Conclusions

Key findings in the study identified that a range of educational, leadership and system-based issues are affecting midwives’ capacity to play a more substantial role in influencing vaccination coverage in Perth’s Aboriginal children.
Spatial analysis and evaluation of medical resource allocation in China based on geographic big data
Authors: Wan Sida , Chen Yanming , Xiao Yijia , Zhao Qiqi , Li Manchun , Wu Shuqi
Published: October 2021

Background

Spatial allocation of medical resources is closely related to people’s health. Thus, it is important to evaluate the abundance of medical resources regionally and explore the spatial heterogeneity of medical resource allocation.

Methods

Using medical geographic big data, this study analyzed 369 Chinese cities and constructed a medical resource evaluation model based on the grading of medical institutions using the Delphi method. It evaluated China’s medical resources at three levels (economic sectors, economic zones, and provinces) and discussed their spatial clustering patterns. Geographically weighted regression was used to explore the correlations between the evaluation results and population and gross domestic product (GDP).

Results

The spatial heterogeneity of medical resource allocation in China was significant, and the following general regularities were observed: 1) The abundance and balance of medical resources were typically better in the east than in the west, and in coastal areas compared to inland ones. 2) The average primacy ratio of medical resources in Chinese cities by province was 2.30. The spatial distribution of medical resources in the provinces was unbalanced, showing high concentrations in the primate cities. 3) The allocation of medical resources at the provincial level in China was summarized as following a single-growth pole pattern supplemented by bipolar circular allocation and balanced allocation patterns. The agglomeration patterns of medical resources in typical cities were categorized into single-center and balanced development patterns. GDP was highly correlated to the medical evaluation results, while demographic factors showed, low correlations. Large cities and their surrounding areas exhibited obvious response characteristics.

Conclusions

These findings provide policy-relevant guidance for improving the spatial imbalance of medical resources, strengthening regional public health systems, and promoting government coordination efforts for medical resource allocation at different levels to improve the overall functioning of the medical and health service system and bolster its balanced and synergistic development.
Identification of Mycoplasma species and related organisms from ruminants in England and Wales during 2005–2019
Authors: Deeney Alannah S. , Collins Rachael , Ridley Anne M.
Published: October 2021

Background

Mycoplasmaspecies have been associated with economically important diseases affecting ruminants worldwide and include contagious bovine pleuropneumonia (CBPP), contagious caprine pleuropneumonia (CCPP) and contagious agalactia, listed by the World Organisation for Animal Health (OIE). The Mycoplasma Team at the Animal and Plant Health Agency provides an identification service forMycoplasmaandUreaplasmaspecies of veterinary importance to the United Kingdom (UK), supporting the detection of new and emerging pathogens, as well as contributing to the surveillance of endemic, and the OIE listed diseases exotic to the UK.Mycoplasmaand otherMollicutesspecies were identified from diagnostic samples from farmed ruminants in England and Wales using a combination of culture and 16S rRNA gene-based PCR-denaturing gradient gel electrophoresis, submitted between 2005 and 2019.

Results

A total of 5578 mollicutes identifications, which include mycoplasmas and the related acholeoplasmas and ureaplasmas, were made from farmed ruminant animals during the study period. Throughout the study period, the pathogenMycoplasma boviswas consistently the most frequently identified species, accounting for 1411 (32%) of 4447 molecular identifications in cattle, primarily detected in the lungs of pneumonic calves, followed by joints and milk of cattle showing signs of arthritis and mastitis, respectively.M. bovirhinis,M. alkalescens,M. dispar,M. argininiandUreaplasma diversum, were also common. Mixed species, principallyM. boviswithM. alkalescens, M. argininiorM. bovirhiniswere also prevalent, particularly from respiratory samples. The non-cultivable blood-borne haemoplasmasCandidatus‘Mycoplasma haemobos’ andMycoplasma wenyoniiwere identified from cattle, with the latter species most often associated with milk-drop.M. ovipneumoniaewas the predominant species identified from sheep and goats experiencing respiratory disease, whileM. conjunctivaepreponderated in ocular samples. The UK remains free of the ruminant mycoplasmas listed by OIE.

Conclusions

The continued high prevalence ofM. bovisidentifications confirms its ongoing dominance and importance as a significant pathogen of cattle in England and Wales, particularly in association with respiratory disease.M. ovipneumoniaehas seen a general increase in prevalence in recent years, notably in coughing lambs and should therefore be considered as a primary differential diagnosis of respiratory disease in small ruminants.
GLP-1 receptor agonists vs. SGLT-2 inhibitors: the gap seems to be leveling off
Authors: Giugliano Dario , Scappaticcio Lorenzo , Longo Miriam , Bellastella Giuseppe , Esposito Katherine
Published: October 2021

Cardiovascular disease (CVD) remains the leading cause of death in patients with type 2 diabetes (T2D). Older age, prior heart failure (HF) and CV events, peripheral artery disease, and kidney complications can identify a subgroup of patients with T2D at high risk of mortality who are likely to achieve the greatest benefit from newer glucose-lowering agents. Both glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors can reduce CV risk in patients with T2D, and both are recommended by the American Diabetes Association to reduce the risk of major cardiovascular events (MACE). The magnitude of the benefits of GLP-1RA and SGLT-2 inhibitors on MACE are similar, ranging from 12 to 14% reduction of risk, but only GLP-1RA may reduce the risk of stroke. The most striking difference between the two classes of drugs relates to the amelioration on hospitalization for HF, as the benefit of SGLT-2 inhibitors surpass by threefold that obtained with GLP-1RA. Despite this, GLP-1RA also exert a significant benefit on HF which suggest their use when SGLT-2 inhibitors are contraindicated or not tolerated. The difference between the two classes is less impressive for the kidney outcome. Overall, the results of CVOTs published so far seems to suggest that the gap between the cardiorenal benefits of SGLT-2 and GLP-1RA is narrowing.
EQ-5D-5L in Schizophrenia: differences between patients and nurses’ reports
Authors: Purba Fredrick Dermawan , Anggriani Yusi , Murtini Tri
Published: October 2021

Purpose

To examine the differences between patient-reports and proxy-reports by nurses of EQ-5D-5L responses among patients with schizophrenia.

Methods

This study was conducted in June–September 2019 in Duren Sawit Regional Public Hospital in Jakarta, Indonesia. The self-report data were obtained by interviewing the patients and the proxy-report data were obtained from the psychiatric nurses. The patients’ Positive and Negative Syndrome Scale (PANSS) scores were obtained from their medical records. The data were collected in two time points: (1) when the patients moved from the acute to the quiet rooms (first-test) and (2) when they were discharged from the hospital (second-test). The self and proxy report scores were analysed by the Wilcoxon matched-pairs signed-ranks test and their relationship with the PANSS scores using Spearman's rank correlation coefficient.

Results

There were 206 patients in the final sample. The majority are male (56.8%) with a mean age of 37.5 years (SD = 12.05). Significant differences between the two reports were found in three domains (i.e., self-care, usual activities, and pain/discomfort) in the first-test and two domains (i.e., usual activities and pain/discomfort) in the second-test. Concerning the relationship with the PANSS scores, only three significant correlations were found, all in the proxy-version and in the second-test: mobility (r = 0.139), anxiety/depression (r = 0.2523), and utility scores (r = − 0.176).

Conclusions

The poor-to-fair agreement between patients and nurses reports and the poor correlation with the PANSS scores suggested that it is difficult to decide which report best represents the patients’ health status.
Prevalence and multivariable predictors of breastfeeding outcomes in the United Arab Emirates: a prospective cohort study
Authors: Radwan Hadia , Fakhry Randa , Metheny Nick , Baniissa Wegdan , Faris Moez Al Islam E. , Obaid Reyad Shaker , Al Marzooqi Suad , Al Ghazal Hessa , ElHalik Mahmoud , Dennis Cindy-Lee
Published: October 2021

Background

Despite considerable policy actions at the national and hospital levels, rates of breastfeeding in the Middle East and North Africa (MENA) region remain below the global average. There is a need to explore the modifiable factors of breastfeeding such as maternal breastfeeding self-efficacy (BSE), support, and mental health among women in this region to guide interventions in the United Arab Emirates (UAE). The aim of this study was to examine the maternal predictors of any and exclusive breastfeeding in a cohort of Emirati and expatriate women residing in the UAE with a specific focus on modifiable factors.

Methods

Using a prospective cohort design, Emirati and expatriate women were recruited in the immediate postpartum period (N = 374) and followed at three and 6 months postpartum between February 2018 and July 2019. Questionnaires with validated tools were used to collect information on sociodemographic characteristics, breastfeeding practices, BSE, postnatal depression, and anxiety. The main outcomes in the study were Any Breastfeeding and exclusivity practices, which were assessed at three and 6 months postpartum by asking the mother about her breastfeeding behaviour during the past 7 days. Multilevel, multivariate logistic regression was used to estimate the association of different variables with breastfeeding outcomes.

Results

Almost all women reported initiating breastfeeding during their stay at the hospital (n = 357), while only 263 (70.3%) initiated breastfeeding within the first hour of delivery. At 6 months postpartum, 301 (81.5%) women continued to breastfeed of whom 100 (26.7%) were doing so exclusively. Older mothers who initiated breastfeeding within 1 h of birth and were satisfied with the breastfeeding support they received from family and friends had significantly greater odds of any breastfeeding at 6 months. Whereas a clinically significant Edinburgh Postnatal Depression Scale (EPDS) score, low BSE score as well as employment outside the home were associated with significantly lower odds of exclusive breastfeeding and any breastfeeding at 6 months postpartum.

Conclusion

This study highlights the need to develop effective education strategies and support programs targeting these modifiable variables to improve breastfeeding outcomes among women in the UAE.
Analysis of canopy phenology in man-made forests using near-earth remote sensing
Authors: Guan Peng , Zheng Yili , Lei Guannan
Published: October 2021

Background

Forest canopies are highly sensitive to their growth, health, and climate change. The study aims to obtain time sequence images in mix foresters using a near-earth remote sensing method to track the seasonal variation in the color index and select the optimal color index. Three different regions of interest (RIOs) were defined and six color indexes (GRVI, HUE, GGR, RCC, GCC, and GEI) were calculated to analyze the microenvironment difference. The key phenological phase was identified using the double logistic model and the derivative method, and the phenology forecast of color indexes was performed based on the long short-term memory (LSTM) model.

Results

The results showed that the same color index in different RIOs and different color indexes in the same RIO present a slight difference in the days of growth and the days corresponding to the peak value, exhibiting different phenological phases; the mean squared error (MSE), root mean squared error (RMSE), mean absolute error (MAE), and mean absolute percentage error (MAPE) of the LSTM model was 0.0016, 0.0405, 0.0334, and 12.55%, respectively, indicating that this model has a good forecast effect.

Conclusions

In different areas of the same forest, differences in the micro-ecological environment in the canopies were prevalent, with their internal growth mechanism being affected by different cultivation ways and the external environment. Besides, the optimal color index also varies with species in phenological response, that is, different color indexes are used for different forests. With the data of color indexes as the training set and forecast set, the feasibility of the LSTM model in phenology forecast is verified.
Approximation algorithm for rearrangement distances considering repeated genes and intergenic regions
Authors: Siqueira Gabriel , Alexandrino Alexsandro Oliveira , Oliveira Andre Rodrigues , Dias Zanoni
Published: October 2021

The rearrangement distance is a method to compare genomes of different species. Such distance is the number of rearrangement events necessary to transform one genome into another. Two commonly studied events are the transposition, which exchanges two consecutive blocks of the genome, and the reversal, which reverts a block of the genome. When dealing with such problems, seminal works represented genomes as sequences of genes without repetition. More realistic models started to consider gene repetition or the presence of intergenic regions, sequences of nucleotides between genes and in the extremities of the genome. This work explores the transposition and reversal events applied in a genome representation considering both gene repetition and intergenic regions. We define two problems called Minimum Common Intergenic String Partition and Reverse Minimum Common Intergenic String Partition. Using a relation with these two problems, we show a $$\Theta \left( k \right)$$

Θ

k

-approximation for the Intergenic Transposition Distance, the Intergenic Reversal Distance, and the Intergenic Reversal and Transposition Distance problems, where k is the maximum number of copies of a gene in the genomes. Our practical experiments on simulated genomes show that the use of partitions improves the estimates for the distances.
Periappendiceal fat-stranding models for discriminating between complicated and uncomplicated acute appendicitis: a diagnostic and validation study
Authors: Lin Hui-An , Tsai Hung-Wei , Chao Chun-Chieh , Lin Sheng-Feng
Published: October 2021

Background

Recent studies have reported promising outcomes of non-operative treatment for uncomplicated appendicitis; however, the preoperative prediction of complicated appendicitis is challenging. We developed models by incorporating fat stranding (FS), which is commonly observed in perforated appendicitis.

Material and methods

We reviewed the data of 402 consecutive patients with confirmed acute appendicitis from our prospective registry. Multivariate logistic regression was performed to select clinical and radiographic factors predicting complicated acute appendicitis in our model 1 (involving backward elimination) and model 2 (involving stepwise selection). We compared c statistics among scoring systems developed by Bröker et al. (in J Surg Res 176(1):79–83. https://doi.org/10.1016/j.jss.2011.09.049, 2012), Imaoka et al. (in World J Emerg Surg 11(1):1–5, 2016), Khan et al. (in Cureus. https://doi.org/1010.7759/cureus.4765, 2019), Kim et al. (in Ann Coloproctol 31(5):192, 2015), Kang et al. (in Medicine 98(23): e15768, 2019), Atema et al. (in Br J Surg 102(8):979–990. https://doi.org/10.1002/bjs.9835, 2015), Avanesov et al. (in Eur Radiol 28(9):3601–3610, 2018), and Kim et al. (in Abdom Radiol 46:1–12, 2020). Finally, we examined our models by performing the integrated discrimination improvement (IDI) test.

Results

Among enrolled patients, 64 (15.9%) had complicated acute appendicitis. We developed new 10-point scoring models by including the following variables: C-reactive protein, neutrophil to lymphocyte ratio, and computed tomography features of FS, ascites, and appendicolith. A cutoff score of ≥ 6 exhibited a high sensitivity of 82.8% and a specificity of 82.8% for model 1 and 81.3% and 82.3% for model 2, respectively, with c statistics of 0.878 (model 1) and 0.879 (model 2). Compared with the model developed by Bröker et al. which included C-reactive protein and the abdominal pain duration (c statistic: 0.778), the models developed by Atema et al. (c statistic: 0.826, IDI: 5.92%, P = 0.0248), H.Y Kim et al. (c statistics: 0.838, IDI: 13.82%, P = 0.0248), and our two models (IDI: 18.29%, P < 0.0001) demonstrated a significantly higher diagnostic accuracy.

Conclusion

Our models and the scoring systems developed by Atema et al. and Kim et al. were validated to have a high diagnostic accuracy; moreover, our models included the lowest number of variables.
Additional nerve blocks are not superior to multiple-site infiltration analgesia in total knee arthroplasty under adductor canal block
Authors: Li Qianhao , Hu Qinsheng , Alqwbani Mohammed , Li Donghai , Yang Zhouyuan , Wang Qiuru , Kang Pengde
Published: October 2021

Background

Adductor canal block (ACB) with additional nerve blocks (ANBs) is reported to provide adequate analgesia and enhanced functional rehabilitation in total knee arthroplasty (TKA). The present study aims to evaluate whether ANBs are superior to multiple-site infiltration analgesia (MIA) in patients undergoing TKA under ACB.

Methods

We enrolled 530 patients undergoing primary TKA from 2015 to 2019 at our institution in this retrospective cohort study. Patients were divided into two groups: Group A was treated with ANBs + ACB; Group B was treated with MIA + ACB. Primary outcomes were pain scores and morphine consumption. Functional recovery was the secondary outcome. Other outcomes included satisfaction score, cost-effectiveness, adverse events, and length of hospital stay (LOS).

Results

Pain scores at rest and morphine consumption were slightly lower in the ANBs + ACB group than in the MIA + ACB group. No significant difference was found in functional recovery, post-operative complications or LOS between the groups. Meanwhile, the cost of analgesic intervention in the MIA + ACB group was less than that in the ANBs + ACB group.

Conclusion

The present study suggests that ANBs do not provide superior pain relief compared to MIA for patients undergoing TKA under ACB.

Trial registration

Chinese Clinical Trial Registry, ChiCTR2100043227. Registered 9 February 2021, https://www.chictr.org.cn/showproj.aspx?proj=121745.
Hepatobiliary disease in XLMTM: a common comorbidity with potential impact on treatment strategies
Authors: D’Amico Adele , Longo Antonella , Fattori Fabiana , Tosi Michele , Bosco Luca , Chiarini Testa Maria Beatrice , Paglietti Maria Giovanna , Cherchi Claudio , Carlesi Adelina , Mizzoni Irene , Bertini Enrico
Published: October 2021

Background

X-linked myotubular myopathy (XLMTM) is a rare congenital myopathy resulting from pathogenic variants in the MTM1 gene. Affected male subjects typically present with severe hypotonia and respiratory distress at birth and they often require intensive supportive care. Long-term survivors are often non-ambulant, ventilator and feeding tube–dependent and they generally show additional organ manifestations, indicating that myotubularin does play a vital role in tissues other than muscle. For XLMTM several therapeutic strategies are under investigation. For XLMTM several therapeutic strategies are under investigation including a study of intravenous MTM1 gene transfer using a recombinant AAV8 vector of which has some concerns arises due to hepatotoxicity.

Results

We report prospective and retrospective clinical data of 12 XLMTM patients collected over a period of up to 10 years. In particular, we carried out a thorough review of the data about incidence and the course of hepatobiliary disease in our case series.

Conclusions

We demonstrate that hepatobiliary disease represents a common comorbidity of XLMTM that seems irrespective to age and diseases severity. We recommend to carefully explore and monitor the hepatobiliary function in XLMTM patients. We believe that a better understanding of the pathogenic mechanisms that induce hepatobiliary damage is essential to understand the fatal events that may occur in the gene therapy program.
Predictive power of extubation failure diagnosed by cough strength: a systematic review and meta-analysis
Authors: Duan Jun , Zhang Xiaofang , Song Jianping
Published: October 2021

Background

The predictive power of extubation failure diagnosed by cough strength varies by study. Here we summarise the diagnostic power of extubation failure tested by cough strength.

Methods

A comprehensive online search was performed to select potentially eligible studies that evaluated the predictive power of extubation failure tested by cough strength. A manual search was also performed to identify additional studies. Data were extracted to calculate the pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) to evaluate the predictive power of extubation failure.

Results

A total of 34 studies involving 45 study arms were enrolled, and 7329 patients involving 8684 tests were analysed. In all, 23 study arms involving 3018 tests measured cough peak flow before extubation. The pooled extubation failure was 36.2% and 6.3% in patients with weak and strong cough assessed by cough peak flow, respectively. The pooled sensitivity, specificity, positive LR, negative LR, DOR, and AUC were 0.76 (95% confidence interval [CI]: 0.72–0.80), 0.75 (0.69–0.81), 2.89 (2.36–3.54), 0.37 (0.30–0.45), 8.91 (5.96–13.32), and 0.79 (0.75–0.82), respectively. Moreover, 22 study arms involving 5666 tests measured the semiquantitative cough strength score (SCSS) before extubation. The pooled extubation failure was 37.1% and 11.3%, respectively, in patients with weak and strong cough assessed by the SCSS. The pooled sensitivity, specificity, positive LR, negative LR, DOR, and AUC were 0.53 (95% CI: 0.41–0.64), 0.83 (0.74–0.89), 2.50 (1.93–3.25), 0.65 (0.56–0.76), 4.61 (3.03–7.01), and 0.74 (0.70–0.78), respectively.

Conclusions

Weak cough is associated with increased extubation failure. Cough peak flow is superior to the SCSS for predicting extubation failure. However, both show moderate power for predicting extubation failure.
Comparison of a tube core and Magill forceps for nasotracheal intubation: a randomised controlled trial
Authors: Hu Rui , Niu Jing-Yi , Wu Li-Ning , Sun Hao , Sun Peng , Huang Jia-Ying , Yu Jun-Ma
Published: October 2021

Background

Magill forceps are frequently used to complete nasotracheal intubation (NTI). We aimed to identify a tube core that could conveniently facilitate the NTI process without using Magill forceps.

Methods

Sixty patients scheduled for oral and maxillofacial surgeries were enrolled in our study and divided into two groups (30 per group) with no differences with regard to demographic data. In the Magill forceps group (Group M), a wire-reinforced endotracheal catheter was inserted into the trachea using Magill forceps. However, in the tube core group (Group T), a tube core bent to the physiological curve of the nasal cavity and lubricated with aseptic paraffin oil was inserted into the endotracheal catheter and was then withdrawn after the endotracheal catheter was advanced through the glottis under direct vision.

Results

All NTIs were completed successfully, and Magill forceps were not used on any patient in Group T. There was a significant difference in total NTI time between the two groups (Group M, 59.7 (5.1) s vs Group T, 52.4 (3.1) s). Mild epistaxis was observed in 6 patients in Group M and 5 patients in Group T (6/30 vs 5/30, respectively). No damage to oral tissue or teeth was observed in either group.

Conclusions

We conclude that using a tube core, consisting of a disposable sterilised stylet, is a convenient choice for NTI.

Trial registration

Patient enrolment was conducted after registration in the Chinese Clinical Trial Registry (www.Chictr.org.cn, ChiCTR190002 7387). This trial was prospectively registered on 11 November 2019.
Bartonella spp. seroprevalence in tick-exposed Swedish patients with persistent symptoms
Authors: Edvinsson Marie , Norlander Camilla , Nilsson Kenneth , Mårtensson Andreas , Skoog Elisabet , Olsen Björn
Published: October 2021

Background

Bartonella spp. are emerging pathogens transmitted by arthropod vectors, possibly including ticks. We have investigated signs of bartonellosis in Swedish patients with presumed tick-bite exposure and symptom duration of at least 6 months.

Methods

Serological testing for Bartonella henselae and Bartonella quintana was performed in 224 patients. Symptoms, tick exposure, evidence of co-infection and previous treatments were evaluated. Seropositive patients were compared to a matched group (twofold larger and negative serology) from the same study cohort.

Results

Seroprevalence was 7% for B. henselae and 1% for B. quintana, with one patient testing positive to both agents. Tick bites were reported by 63% of the patients in the seropositive group and 88% in the seronegative group and presumed tick exposure was more common in the seronegative group. Animal contact was equally common in both groups, along with reported symptoms. The most common symptoms were fatigue, muscular symptoms, arthralgia and cognitive symptoms. Exposure to co-infections was evenly distributed in the seropositive and seronegative groups.

Conclusions

Antibodies to Bartonella were more common in this cohort of patients than in cohorts of healthy Swedish blood donors in previous studies but lower than those in blood donors from southern Europe. Positive Bartonella serology was not linked to any specific symptom, nor to (suspected) tick-bite exposure.

Graphical abstract