bluuebunny/crossref_metadata_2025 huggingface dataset:
Cause of Death and Factors Associated With 5-Year Mortality After Hip Fracture Surgery
Authors: Wang Xiaowei , Zhao Jianwen , Zheng Huayong , Zhang Jianzhen , Sun Tiansheng
Published: July 2020

Aim: the aims of this study were to identify the 5-year mortality rate after hip fracture, identify factors associated with this mortality, and identify the cause of death in these patients.Materials and Methods: A retrospective cohort study of geriatric patients (≥60 years of age) undergoing a hip fracture surgical procedure admitted to our institution between the 1 January 2012 and 31 December 2016 was performed. Demographic and clinical characteristics were collected. Patients or their careers were contacted by telephone or outpatient to ascertain their vital status, and cause of death if they had died at 5-year post-surgery. According to whether they were alive or death at 5-year post-surgery, patients were divided into survivor or non-survivor group. All variables including demographic data and clinical characteristics were compared for both survivors and non-survivors. Cox proportional hazards were used to determine independent risk factors for 5-year mortality. All cause of 5-year mortality in hip fracture were recorded.Result: A total of 327 patients with a median age of 80.00 years were included. 5-year mortality was 40.1%, and the death peak was concentrated during 6 months after surgery. The final multivariate model included 4 independent mortality risk factors: advanced age, stroke, albumin, delayed surgery, with an HR (95% confidence interval) 1.052(1.025-1.080), 1.612(1.104-2.353), 0.940(0.900-0.982), 1.638(1.072-2.498), respectively. Pulmonary infection, and cardiovascular disease were the most common cause of 5-year death.Conclusion: Our results showed that 5-year mortality was 40.1%. Advanced age, stroke, low albumin, and delayed surgery were associated with 5-year mortality after hip fracture surgery. Pulmonary infection, and cardiovascular disease were the most common cause of death.
Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis
Authors: Currie Shawn , Hodgins David , Williams Robert , Fiest Kirsten
Published: July 2020

Background There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess over a five-year period the risk of gambling problems in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable psychosocial risk factors. Methods Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies (Quinte Longitudinal Study and Leisure, Lifestyle, and Lifecycle Project) who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥ $75CAN per month; percent of household income spent on gambling ≥ 1.7%) on developing gambling problems over time. Covariates included presence of a DSM 5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm within five years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In the QLS sample, the five-year cumulative survival rate among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Conclusions Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.
Differential Expression of HTR2A and MAOA Genes in the Prefrontal Cortex and Hypothalamus of Suicide Victims from a Mexican Population
Authors: Ramos Daniel Francisco , Mendez Edna Madai , Salas José Manuel , Salas Alma Cristina , Urtiz Norma , Barraza Marcelo
Published: July 2020

Background: Suicide is a major public health concern that has been associated with several neurobiological abnormalities, including dysfunction of the serotonin (5-HT) neurotransmission system. The serotonin 2A receptor (5-HT 2A ) and the monoamine oxidase A enzyme (MAO-A), which is responsible for degrading 5-HT, are encoded by the HTR2A and MAOA genes, respectively. These genes have been associated with several psychiatric disorders and an increased risk for suicide. Methods: Our study examined the expression levels of HTR2A and MAOA genes in the postmortem prefrontal cortex (Brodmann area 8/9) and hypothalamus (ventromedial nucleus) tissues from 15 suicide victims and 15 control subjects from a Mexican population. Gene-expression profile quantification was carried out by qPCR and determined by the method. Results: In suicide victims, the expression levels of the HTR2A gene were significantly higher in the prefrontal cortex. In contrast, the expression of the MAOA gene in the hypothalamus of the suicide victims was significantly higher than in the control subjects. When comparing adult controls against adult suicidal victims (25-59 year-old age group), a significant decrease in HTR2A expression in the hypothalamus was observed. These results were consistent regardless of age, sex, postmortem interval, or pH of brain tissue. Conclusions: The evidence suggests that the pattern of differential expression of the HTR2A and MAOA genes in the brain may be involved in suicide, providing a possible molecular basis for the brain abnormalities in suicide victims.
Is Preexisting Mental Illness Associated with Lower Patient Satisfaction for Older Trauma Patients? A Cross-sectional Descriptive Study
Authors: McGraw Constance , Pekarek Jennifer , Redmond Diane , Vogel Rebecca , Tanner Allen , Bar-Or David
Published: July 2020

Background
The purpose of this study was to examine if satisfaction with care differs among older trauma patients with and without preexisting mental illness (PMI+/PMI-).
Methods
Data from two level I trauma centers were examined 11/2016-12/2017. Trauma patients ≥ 55 years were included and satisfaction of those who had a diagnosis of mental illness prior to the trauma admission (PMI+) to those without a diagnosis (PMI-) (n = 299; 62 PMI + and 237 PMI-) were compared. Enrolled patients completed the Family Satisfaction with Advanced Care Cancer Scale Patient Survey (FAMCARE-P13) prior to discharge. Associations between mental illness status and patient baseline characteristics, overall mean satisfaction, and mean satisfaction by question were compared. Generalized linear models adjusted for differences in patient satisfaction by mental illness status. Analyses were stratified by hospital to account for the interaction between hospital and mental illness status.
Results
Compared to PMI- patients, PMI + patients were more likely to be younger, female, have multiple comorbidities, and to report lower overall satisfaction with care. Among PMI + patients, the most common diagnoses were depression and anxiety. After adjustment, PMI + was associated with lower patient satisfaction at hospital 1; after examining individual questions lower satisfaction was associated with information provided on procedures and questions surrounding “Physical care.” Conversely, PMI + did not affect satisfaction at hospital 2 after adjustment.
Conclusions
At hospital 1, room for improvement was identified in providing information about prognosis and procedures, symptom management, and continuity of care. Reexamining practices for older PMI + trauma patients is warranted.
Existential therapy for children: impact of a philosophy for children intervention on positive and negative indicators of mental health in elementary school children
Authors: Malboeuf-Hurtubise Catherine , Tomaso Carina Di , Lefrançois David , Mageau Geneviève A. , Taylor Geneviève , Éthier Marc-André , Gagnon Mathieu
Published: July 2020

BackgroundPhilosophy for children (P4C) was initially developed in the 1970’s, and served as an educational program to promote critical thinking, caring and creative reasoning and inquiry in the educational environment. Quasi-experimental research on P4C, a school-based approach that aims to develop children’s capacity to think by and for themselves, has suggested it could be an interesting intervention to foster greater basic psychological need satisfaction in children in school settings.ObjectiveThe goal of the present study was to evaluate the impact of P4C on basic psychological need satisfaction and mental health in elementary school students. To do so, a randomized cluster trial with a wait-list control group was implemented. MethodStudents from grades one to three (N = 57) took part in this study and completed pre- and post-intervention questionnaires.ResultsANCOVAs revealed a significant effect of group condition on levels of autonomy and anxiety, after controlling for baseline levels. Participants in the experimental group showed higher scores in autonomy, when compared to participants in the control group, whereas for anxiety, participants in the experimental group showed lower scores in anxiety, when compared to participants in the control group.ConclusionOverall, results from this study show that P4C may be a promising intervention to foster greater autonomy in elementary school children, while also improving mental health.
Impact of Procedure Time of Preceding Endoscopic Submucosal Dissection on the Difficulty of Laparoscopic Rectal Surgery
Authors: Nozawa Hiroaki , Kawai Kazushige , Sasaki Kazuhito , Emoto Shigenobu , Murono Koji , Sonoda Hirofumi , Ishii Hiroaki , Ishihara Soichiro
Published: July 2020

Background
Endoscopic treatment for gastrointestinal cancer can cause inflammation, edema, and fibrosis formation in the surrounding tissue. Recently, we reported that preceding endoscopic treatment increased the volume of intraoperative blood loss and slightly prolonged the operative time of laparoscopic surgery for rectal cancer. In this study, we addressed which factors, including endoscopic submucosal dissection (ESD)- related parameters, affect the difficulty of laparoscopic rectal surgery.
Methods
We retrospectively reviewed 24 consecutive patients who underwent ESD followed by laparoscopic surgery for rectal cancer in our hospital. Short-term surgical outcomes were evaluated by intraoperative blood loss and operative time for laparoscopic surgery. The correlations between the surgical outcomes and preoperative parameter were analyzed by scatter diagrams and multiple linear regression analyses.
Results
The patient cohort comprised 12 men and 12 women. The median distance between primary cancer and anal verge was 7 cm. The median procedure time of ESD was 120 minutes (21 available cases). The scatter diagram graph revealed a positive correlation between the ESD procedure time and estimated blood loss during rectal surgery (rs = 0.26). There was no association between the ESD procedure time and operative time for rectal surgery. Based on multiple linear regression analyses, the ESD procedure time (p = 0.007) and tumor location from the anal verge (p = 0.046) were independently predictive of intraoperative blood loss. On the other hand, only tumor location was found an independent predictor of surgical time (p = 0.014).
Conclusions
A long session of ESD for rectal cancer may make subsequent laparoscopic surgery difficult based on intraoperative blood loss.
Investigating the Effect of Self-regulatory Strategy Development on Iranian EFL Learners’ Metadiscoursal Writing Skill
Authors: Eslami Mehrnoosh , Sahrahgard Rahman
Published: July 2020

The current research was an attempt to investigate the effect of self-regulatory strategy instruction on Iranian EFL learners’ metadiscoursal writing skill. To this end, 50 Iranian EFL intermediate learners, studying English language in an institute were selected through convenience random sampling. All of them were Persian native speakers. Three research instruments were utilized to gather the data, namely, Self-regulated Strategies Intervention, and Metadiscoursal writing pretest and posttest. Due to the situation of Covid-19, the instructor made a WhatsApp group, besides the virtual group using Adobe Connect to be in contact with the learners. The learners took a metadiscoursal writing pretest. For the next six sessions, the participants were taught intervention, via self-regulated strategies and they were supposed to follow the instructions. The instructor checked every learner’s progress. Finally, they took a posttest, and the results obtained from the research instruments were analyzed through paired samples t-test. The findings revealed that self-regulatory strategy instruction had a positively significant effect on Iranian EFL learners’ metadiscoursal writing skill and it is suggested that teachers are better to get familiar with the self-regulated strategy and its positive outcomes.
Clinical Outcomes of TESSYS and TESSYS-ISEE Approach on Treatment of Lateral Recess Stenosis: A Comparison Study
Authors: Wu Boyu , Xiong Chengjie , Huang Biwang , Zhao Dongdong , Yao Zhipeng , Yao Yawei , Xu Feng , Kang Hui
Published: July 2020

Background: Lateral recess stenosis (LRS) is a common degenerative disease in the elderly. Since the rise of comorbidity is associated with the increasing age, the percutaneous endoscopic lumbar decompression is advocated. The objective of this study was to compare the clinical outcomes of percutaneous endoscopic lumbar decompression in LRS via TESSYS or TESSYS-ISEE approach. Methods: A total of 45 and 42 consecutive patients with limp or radiculopathy symptoms underwent percutaneous endoscopic lumbar decompression using transforaminal endoscopic spine system (TESSYS) and TESSYS-ISEE, respectively. The radiation exposure and operation time, time to return to work, and complications were compared between two groups. Their clinical outcomes were evaluated with visual analogue scale (VAS) leg pain score, VAS back pain score, Oswestry Disability Index (ODI) and Modified MacNab’s criteria. Results: The average values of radiation exposure and operative time in TESSYS group were significantly higher than those in TESSYS-ISEE group (P<0.05). The postoperative VAS and ODI scores in both groups were significantly improved compared with before the operation (P<0.05). In addition, the VAS score of the leg and ODI score in the TESSYS-ISEE group were significantly lower than those in TESSYS group at 1 week follow-up (P<0.05). The good-to-excellent rates of the TESSYS and TESSYS-ISEE group were 88.89 and 90.48%, respectively, whereas the complication occurrence rates were 6.67 and 4.76% in TESSYS and TESSYS-ISEE groups, respectively. Conclusions: TESSYS-ISEE can be applied to treat LRS safely and effectively with short radiation exposure and operation time. This approach was comparable to the TESSYS approach with improved VAS leg pain and ODI score in short period after operation. However, potential complications and risks still needs to be considered.
A Survey of Seasonal and Perennial Allergic Conjunctivitis in Children in Southwest China: A Case-Control Study
Authors: Gao Xu , Xiang Qin , Hong Lan
Published: July 2020

Background Seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC) were the most usual types of allergic conjunctivitis. House dust mites were the most common sensitization agents for SAC and PAC. This study aimed to explore SAC and PAC risk factors in children.Methods We recruited 176 children suffering from SAC or PAC and 131 control subjects in southwest China. A questionnaire , several eye exams and the skin prick test (SPT) were performed.The scores of the symptoms/signs were recorded.Results The percentage of children that had ever been breastfed in the case group was lower than in the control group (P<0.05). The rate of parental allergy history in the case group was higher than for the control group (P<0.01). Compared with the control group, the case group was more likely to have other systemic allergic diseases (P<0.01).The incidence rate of adenoidal hypertrophy (ATH) in case group was higher than control group (P<0.05). The ocular symptoms and signs scores had significant correlation to the course (P<0.05), but no correlation to the SPT results (P>0.05).Conclusion Allergic conjunctivitis may coexist with a variety of allergic diseases, and SAC and PAC may be a risk factor for ATH. Breastfeeding should be recommended, as it may be an alleviating factor for allergic diseases, especially for children of parents with a history of allergic diseases. The disease severity is closely related to its course. Therefore, to avoid difficulty in treatment caused by the aggravation of symptoms and signs, timely antiallergic treatment was recommended.
In vivo confocal microscopy assessment of meibomian glands microstructure in patients with Graves’ orbitopathy
Authors: Cheng Sheng-Nan , Yu Yue-Qi , Chen Jin , Ye Lin , Wang Xing-Hua , Jiang Fa-Gang
Published: July 2020

Background: To evaluate microstructural changes in the meibomian glands (MGs) in patients with active and inactive Graves’ orbitopathy (GO), using in vivo confocal microscopy (IVCM), and to investigate the correlations between clinical and confocal findings.Methods: Forty patients (80 eyes) with GO (34 eyes with active GO, 46 eyes with inactive GO), and 31 age- and sex-matched control participants (62 eyes) were enrolled consecutively. Each participant completed an Ocular Surface Disease Index (OSDI) questionnaire and underwent a full eye examination, including assessments of clinical activity score (CAS), proptosis, palpebral fissure height (PFH), lagophthalmos, lipid layer thickness (LLT), partial blinking rate, noninvasive first breakup time (NIF-BUT), average breakup time (NIAvg-BUT), tear film breakup area (TBUA), corneal fluorescein staining (CFS), Schirmer I Test (SIT), meibum quality and MG expressibility. IVCM of the MGs was performed to determine the MG acinar density (MAD), MG longest and shortest diameters (MALD and MASD), MG orifice area (MOA), MG acinar irregularity (MAI), meibum secretion reflectivity (MSR), acinar wall inhomogeneity (AWI), acinar periglandular interstices inhomogeneity (API), and severity of MG fibrosis (MF).Results: All parameters demonstrated statistically significant differences among groups (all P＜0.05), except OSDI, LLT and NIAvg-BUT (P＞0.05). Compared to controls, GO groups showed lower MOA and MAD; greater MALD and MASD; and higher degrees of MAI, MSR, AWI, API, and MF (all P＜0.05). Eyes with active GO had higher degrees of MAI, AWI, and API, while eyes with inactive GO had higher degrees of MSR and MF (all P＜0.05). In GO groups, the two measured confocal signs of inflammation (AWI and API) were significantly correlated with CAS, proptosis, PFH, lagophthalmos, OSDI, NIF-BUT, CFS, SIT, meibum quality, and MG expressibility (all P＜0.05). MF was significantly correlated with CAS, OSDI, meibum quality, and MG expressibility (all P＜0.05). Conclusions: IVCM effectively revealed microstructural changes of MGs in eyes with GO and provided strong in vivo evidence for the roles of obstruction and inflammation in the ocular surface disease process. Furthermore, it revealed discernible patterns of MG abnormalities in eyes with active GO and inactive GO, which are not easily distinguishable by typical clinical examinations.
The Difference of Being Overweight or Obese between the North and South of China
Authors: Tang Daisheng , Bu Tao , Liu Yahong , Dong Xuefan
Published: July 2020

Objectives: The geographical environment, dietary culture, food patterns, and obesity rates are substantially different between the North and South of China. Determining the geographical distribution and local dietary patterns involved in being overweight or obese is useful for designing intervention strategies. Methods: Residents between 18 and 65 years old (n=10,863) from 11 Chinese provinces (five Northern provinces and six Southern provinces) were selected to compare dietary patterns, BMI, and health-related information from the China Health and Nutrition Survey packages in 2011. Linear and logistic regression analyses were performed to assess the strength of the association among geographic variables, the obesity problem, and dietary patterns. Results: The overall prevalence of being overweight or obese was 10.51% higher in the North than in the South. Northern dietary patterns feature a high intake of wheat and soybeans, whereas Southern dietary patterns feature a high intake of rice, vegetables, meat, and poultry. The estimated coefficient of regional variables surrounding dietary score is 1.494; surrounding the odds ratio for being overweight is 1.681, whereas surrounding the odds ratio for obesity is 2.035. Multivariate logistic regression including both the variable of South–North areas and Northern dietary patterns showed a significant correlation with being overweight or obese. Conclusion: Northern areas and their local dietary patterns are more likely to contribute to being overweight or obese. These findings provide support for tracking the progression of obesity, epidemics, and policies that target the ‘‘obesogenic’’ environment, promoting opportunities for persons to access healthy dietary patterns and nutritional balance.
WITHDRAWN: Sambucus Ebulus Fruits Extract Ameliorates Eosinophilic Nasal Polyposis: An in vitro Study
Authors: Faghani Masoumeh , Pourgholamali Babak , Ansar Malekmasoud , Zaminy Arash , Nemati Shadman , Ramezani Sina , Yousefbeyk Fatemeh , Bagheri Hamidreza , golshekan Mostafa
Published: July 2020

Background: The Sambucus Ebulus (ES) L. has an anti-inflammatory role by reducing the expression of pro-inflammatory genes and free radicals. The aim of this study was to evaluate the anti-inflammatory effect of hydroalcoholic extract of SE fruits on eosinophilic nasal polyposis (NP) in Vitro.Method: The chemical composition of SE fruits extract was determined by gas chromatography-mass spectrometry. Polyp Samples were collected from 40 patients and were cut into four pieces (control and case groups). Tissue fragments were treated with 0 (control), 50, 315 and 1000µg/ml of SE FRUIT extract in a culture medium for 24 hours. Apoptosis was detected by TUNEL reaction reagent. Real time-PCR was employed to evaluate the expression of Bax and Bad genes. ELISA was used for assay of IL-5 and GM-CSF.Results: Our findings showed SE fruits extract increased apoptosis in nasal polyp tissues compared to the control group (P<0.001). Also, GM-CSF level in the experimental groups was significantly lower than that in the control group (P<0.001). In contrast, the level of IL-5 was not significantly different in the treatment and control groups (P>0.05). Bax and Bad expression showed a significant increase in the experimental groups compared to the control group (P<0.001).Conclusion: Our findings showed that SE fruits hydroalcoholic extract ameliorates NP trough elevation of apoptosis and reduction of inflammatory markers. Our experimental data revealed that SE fruits extract plays an important role in the treatment of nasal polyp through inducing apoptosis and reducing the survival of inflammatory cells.
Prevalence and correlates of metabolic syndrome and its components in nearly 10 million participants of northwestern China: a cross-sectional study
Authors: su yinxia , Li Wenli , Lu Yaoqin , Xue Mingyue , Haireti Muyaseer , Li Yuanyuan , Wang Shuxia , Yao Hua
Published: July 2020

Background

The prevalence of metabolic syndrome (MetS) of comprehensive population are always lower than mono- population. However, studies on MetS and its components of it and its subgroups (different ages, genders, races, regions) based on big data and using a same diagnosis criterion are rare.
Method:

A total of 9,745,640 Chinese adults aged ≥ 18 years in Xinjiang,the largest autonomous region of Multi-ethnic, were enrolled in the study. MetS was defined by modified Adults Treatment Panel (ATP III) criteria.Prevalence of metabolic syndrome and its components were calculated. To further explore the correlates of MetS and its components logistic regression were used.
Results

The overall prevalence of MetS was 20.85% [Sex: 20.06% in female, 21.56% in man; Age: 39.22% in 60 year older followed by 40–59 year 26.32% and 18–39 years 9.56%; Ethnicity: 28.19% in Hui followed by Han (26.39%), Uyghur(18.56%), Other(18.61%), Kazak(17.98%), Mongolian (17.87%), Kyrgyz(14.44%)], living in city and town (23.03%) or north(24.78%) had higher prevalence of MetS than living in rural (19.94%) and South (17.66%). Although the prevalence of hypertension, smoking, drinking and lack of physical activity in Kyrgyz, Mongolian and Kazakh were higher than those of other ethnic groups, the risk of MetS was lower than that of other. The results also showed that although their risk of central obesity and hypertension was higher than that of Han, Hui, Uygur and other, the risk of high-TG, low HDL-C and Elevated-FPG was significantly lower than that of other ethnic groups. Among them, the Mongolian had the lowest risk of high-TG and low-HDL-C, while the Kazakh had the lowest risk of elevated-FPG. In addition, except that the risk of central obesity in males was lower than that in females, the other components of males were higher than those in females, but the risk of MetS was lower than that in females. The risk of MetS and its components in the elderly was significantly higher than that in the young, and physical activity did not show reduce the risk of MetS in the general population.
Conclusion

The reason why the prevalence of MetS in the comprehensive population is lower than that in most mono-population may be that some subgroups of the population have the ability to resist risk factors in terms of genetic structure such as Kyrgyz, Mongolian, Kazak, and the influence in this aspect may exceed that of lifestyle. Within each subgroup, the prevalence of MetS is still increasing. Central obesity is an important risk factor for women with MetS. Elevated-FPG and high-TG are the most important risk factors of MetS in Han, Hui. Climate and lifestyle are the main causes of MetS in northern Xinjiang and city and town residents.
Non-Tuberculous Mycobacterial Pulmonary Disease Prevalence Status in China
Authors: Liu Chunfa , Song Yimeng , He Wencong , Liu Dongxin , He Ping , Bao Jingjing , Wang Xinyang , Ou Xichao , Zhao Bing , Fan Jiale , Cheng Qian , Zhou Yang , Song Yuanyuan , Zheng Yang , Xia Hui , Wang Shengfen , Li Yanming , Zhao Yanlin
Published: July 2020

Introduction: The information on the pulmonary disease caused by non-tuberculosis mycobacterium (NTM) in China is limited, mainly based on local or regional studies.Methods: Retrospective study involving 72 tuberculosis clusters provided sputa of enrolled presumptive cases for mycobacterial and drug-susceptibility testing in 31 provinces of Chinese mainland. Minimal inhibitory concentrations (MICs) test was used to measure the susceptibility of NTM isolates.Results: Of 4917 mycobacterial isolates cultured, 317 (6.4%, 95% confidence interval [CI], 5.8 to 7.2) isolates were confirmed as NTM, among 207 (12.1%, 95% CI, 10.6 to 13.8) isolates were detected from the southeastern region with the highest NTM prevalence. Slow growing mycobacteria (SGM) contributed 93.3% (95% CI, 76.4 to 98.8) and 56.1% (95% CI, 50.1 to 61.9) in northern and southern China, respectively. A total of 29 species were detected, the three most frequently isolated NTM belonged to Mycobacterium abscessus complex (36.0%, 95% CI, 33.3 to 38.7), Mycobacterium avium-intracellulare complex (34.1%, 95% CI, 29.1 to 39.5), Mycobacterium kansasii (9.8%, 95% CI, 8.1 to 11.4), respectively. Clarithromycin and amikacin were showed lower resistant rates to NTM in vitro. Conclusions: The southeastern region should be paid more attention to NTM pulmonary disease. More rapid growing mycobacteria (RGM) were present in southern China than the northern (P < 0.001). Considering clear correlations between in vitro activity and the in vivo outcomes of treatment, macrolides and amikacin were recommended in NTM treatment in China.
Aneurysmal Subarachnoid Haemorrhage After COVID-19 Infection
Authors: Muhammad Sajjad , Naderi Soheil , Ahmadi Mostafa , Ghorbani Askar , Hänggi Daniel
Published: July 2020

BackgroundSARS-CoV-2 virus infection leads to a severe and dysbalanced inflammatory response with hypercytokinemia and immunodepression. Systemic inflammation due to viral infections can potentially cause vascular damage including disruption of blood-brain barrier (BBB) and alterations in coagulation system that may also lead to cardiovascular and neurovascular events. Here, we report the first case of COVID-19 infection leading to aneurysmal subarachnoid haemorrhage (aSAH). Case DescriptionA 61-year-old woman presented with dyspnea, cough and fever. She was over weight with Body mass-index of 34 and history of hypertension. No history of subarachnoid hemorrhage in the family. She was admitted in ICU due to low oxygen saturation (89%). A chest CT showed typical picture of COVID-19 pneumonia. Oropharyngeal swab with a PCR-based testing was COVID-19 positive. She was prescribed with favipiravir and hydroxychloroquine in Addition to oxygen support. On second day she experienced sudden headache and losst conciousness. A computer tomography (CT) with CT-angiography revealed subarachnoid haemorrhage in basal cisterns from a ruptured anterior communicating artery aneurysm. The aneurysm was clipped microsurgically through a standard pterional approach and the patient was admitted again to intensive care unit for further intensive medical treatment. Post-operative the patient showed slight motor dysphasia. No other neurological deficits.ConclusionAneurysmal subarachnoid haemorrhage secondary to COVID-19 infection might be triggered by systemic inflammation. COVID-19 infection could be one of the risk factors leading to instability and rupture of intracranial aneurysm.
Development of the Hausa Version of the Pain Catastrophizing Scale: Translation, Cross-Cultural Adaptation and Psychometric Evaluation in Mixed Urban and Rural Patients with Chronic Low Back Pain
Authors: Ibrahim Aminu A. , Akindele Mukadas O. , Kaka Bashir , Mukhtar Naziru B.
Published: July 2020

Background: Catastrophizing has been recognized as an important contributor to chronicity in individuals with chronic pain syndromes including low back pain (LBP). The Pain Catastrophizing Scale (PCS) is perhaps the most widely used questionnaire to evaluate the degree of pain catastrophizing. However, its use is limited in Hausa-speaking countries due to the lack of a validated translated version.Objective: To translate and cross-culturally adapt the PCS into Hausa (Hausa-PCS) and evaluate its psychometric properties in mixed urban and rural patients with chronic LBP.Methods: The original PCS was translated and cross-culturally adapted into Hausa in accordance with established guidelines. To evaluate psychometric properties, a consecutive sample of 200 patients with chronic LBP was recruited from urban and rural Nigerian hospitals. Validity was evaluated by exploring content validity (skewness and item-total correlation), factorial structure (exploratory factor analysis [EFA] and confirmatory factor analysis [CFA]), concurrent validity (Spearman’s rho) and known-groups validity. Reliability was evaluated by calculating internal consistency (Cronbach’s α), intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC) and limits of agreement with 95% confidence interval (LOA95%).Results: The Hausa-PCS demonstrated good face and content validity. Both EFA and CFA confirmed a 3-factor structure similar to the original English version. The concurrent validity was supported as 83% (5/6) of the a priori hypotheses were confirmed. Known-groups comparison showed that the questionnaire was unable to differentiate between male and female or urban and rural patients (p > 0.05). Internal consistency and ICC was adequate for the Hausa-PCS total score (α = 0.84; ICC = 0.90) and the subscale helplessness (α = 0.78; ICC = 0.89) but for the subscales rumination (α = 0.69; ICC =0.68) and magnification (α = 0.41; ICC = 0.43). The LOA95% for the Hausa-PCS total score was between –8.10 and +9.75, with SEM and MDC of 3.47 and 9.62 respectively. Conclusion: The Hausa-PCS was successfully developed and psychometrically adequate in terms of factorial structure, concurrent validity, internal consistency and test-retest reliability when applied in mixed urban and rural patients with chronic LBP. However, the internal consistency and reliability coefficients (ICC) for the individual subscales are questionable. Thus, we support the use of the total score when evaluating pain catastrophizing for clinical or research purposes.
Increased Leukotriene B4 Plasma Concentration in Type 2 Diabetes Individuals with Cardiovascular Autonomic Neuropathy
Authors: NEVES JOSE ANTONIO JANUARIO , DE MATOS MOZÂNIA REIS , RAMALHO THERESA , SANTOS-BEZERRA DANIELE PEREIRA , CAVALCANTE CRISTIANE DAS GRAÇAS DIAS , ALPINO RENATA D’ , QUEIROZ MÁRCIA SILVA , JANCAR SONIA , CORREA-GIANNELLA MARIA LUCIA
Published: July 2020

Background and Aim: A low-grade inflammation is associated with cardiac autonomic neuropathy (CAN) and increased concentration of leukotriene B4 (LTB4) was found in individuals with type 1 diabetes and definitive CAN. This study evaluated plasma concentration of LTB4 and of other inflammatory mediators, namely, tumor necrosis factor (TNF), interleukin (IL)1B, and IL10 in individuals with T2D and different degrees of CAN, and correlated these inflammatory mediators with the degree of glycemic control and with a surrogate marker of insulin resistance. Methods: TNF, IL1B, IL10 and LTB4 plasma concentrations were measured in 129 T2D subjects (62% women with [median] age of 63 years, disease duration of 8 years and HbA1c of 7.3%) with or without CAN. The Lipid accumulation product (LAP) index was used as a surrogate marker of insulin resistance. Results TNF and LTB4 concentrations were higher in the group with definitive CAN while IL10 concentration was lower in this group versus those without definitive CAN. After adjustment for confounding variables, only LTB4 concentration remained significantly different. Plasma concentration of LTB4 did not correlate with the degree of glycemic control. After sorting the participants by sex, a borderline weak correlation was found between LTB4 and LAP in women. Conclusion: In the T2D setting, circulating LTB4 concentration seems to be associated with cardiovascular dysautonomia.
Safety and Efficacy of the META-TAN in Femoral Shaft Fractures: A Retrospective Case Series of 33 Patients
Authors: De Leon Jorge Clint , Dang Khang H , Tye Cooper Benjamin , Breinholt Connor Scott , Karia Ravi A.
Published: July 2020

Introduction: Despite advances in femoral shaft fracture fixation, the nonunion rate remains relatively high; and there is limited data on the efficacy and failure rate of specific implants. The Smith & Nephew TRIGEN META-TAN provides the ability to treat femur shaft fractures in isolation, with associated ipsilateral femur injuries, and provides various options for proximal and distal fixation. The aim of this study is to evaluate the early failure rate of the META-TAN, while comparing the nonunion rate to what is currently presented in the literature. This study is the first of its kind in evaluation of a specific implant for treatment of femoral shaft fractures and ipsilateral pathology.Material and Methods: Patients over 18 years of age, with traumatic femur shaft fractures, treated with the META-TAN and available for a minimum of 3-month follow-up were included for analysis. Data was collected by retrospective chart review and review of existing radiographs. Demographic data, injury details, AO/OTA fracture classification, and implant details were recorded for each patient. Primary outcome measured was implant failures (screw or nail breakage). Secondary outcomes measured included malunion, nonunion, deep infection, post-operative complications, and need for reoperation.Results: Of the 33 patients included for analysis, 1 patient went on to non-union. There were no cases of implant failure. The single nonunion was a high-energy mechanism, open fracture, and higher level AO/OTA classification. The remaining 32 reached radiographic union at 3 months. Conclusion: The nonunion rate of the META-TAN nail is comparable to what is reported in the literature. The META-TAN is a safe and effective implant to treat femoral shaft fractures with a variety of ipsilateral femoral shaft injuries and reliably leads fracture union. Further studies are needed analyzing implant failure and comparing specific implants.
Perceived Stigma in Epilepsy Patients in a Low Income Country; Ethiopia: A Review and Meta-Analysis of the Prevalence and Related Factors.
Authors: Necho Mogesie , Birkie Mengesha , Gedamu Sisay , Birhan Tesfaye
Published: July 2020

Background: The presence of perceived stigma hinders epilepsy patients from help-seeking behavior and diminishes adherence to medical follow up. Despite this, the limitation of aggregate evidence regarding the prevalence and associated factors of perceived stigma existed in Ethiopia. Methods: Our search for eligible articles was accompanied in the databases of PubMed, Scopus, EMBASE, and African Index Medicus. An additional manual search by the enumeration of the reference list of other articles was done. We used stata-11 and random-effects models to obtain the average prevalence of perceived stigma. Heterogeneity was assured with the Higgs I2 test and Cochran's Q- statistic. Sensitivity analysis and sub-grouping analyses were done. Qualitative checks for symmetry in funnel plot and quantitative description of Egger's test were done to check a publication bias.Results: Of 1524 articles identified by the electronic and manual search, only 10 articles fulfilled the eligibility criteria and included in the analysis. The average prevalence of perceived stigma was found to be 43.79% (95% CI: 31.84, 55.75). The prevalence of perceived stigma varies across the measurement tool used, study location, and year of publication. The average prevalence of perceived stigma in studies measured with the modified FIS scale was 76.3%; higher than those studies measured with the Kilifi stigma scale; 33.63% and three-item stigma scale; 39.5%. Besides, the average prevalence of stigma was higher in Amhara (53.2 %) and the Oromia region (52.2%). Studies published before 2016 provide higher perceived stigma (56.26 %) than studies published after 2016 (35.47%). Our qualitative analysis revealed that rural residence, low level of education and income, age groups of 18 to 24 years, frequent seizure occurrence, contagion believe regarding epilepsy, duration of epilepsy from 1-10 years, depression and anxiety co-morbidity were among the associated factors with perceived stigma in people with epilepsy.Conclusion: The average prevalence of perceived stigma in people with epilepsy was high and varies across study location, measurement tool, and study's publication year. Management of epilepsy should focus on the stigma component besides the biological intervention.
Structured ICU Resource Management in a Pandemic is Associated with Good Outcome in Critically Ill COVID-19 Patients
Authors: Klein Sebastian J , Bellmann Romuald , Dejaco Hannes , Eschertzhuber Stephan , Fries Dietmar , Furtwängler Wilhelm , Gasteiger Lukas , Hasibeder Walter , Helbok Raimund , Hochhold Christoph , Hofer Stefanie , Kirchmair Lukas , Krismer Christoph , Ladner Eugen , Lehner Georg F , Mathis Simon , Mayr Andreas , Mittermayr Markus , Peer Andreas , Hernández Christian Preuß , Reitter Bruno , Ströhle Mathias , Swoboda Michael , Thomé Claudius , Joannidis Michael
Published: July 2020

Introduction On February 25th, 2020, the first two patients were tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Tyrol, Austria. Based on alarming reports from the neighboring region Lombardy in Italy, rapid measures were taken to ensure adequate intensive care unit (ICU) preparedness for a surge of critically ill coronavirus disease 2019 (COVID-19) patients.Methods A coordinated county wide step-up approach ensured adequate ICU bed availability for COVID-19 patients avoiding shortage of mechanical ventilation capacity. All patients admitted to an ICU with confirmed or strongly suspected COVID-19 in the region of Tyrol, Austria were recorded in the Tyrolean COVID-19 Intensive Care Registry. Data were censored on July 17th, 2020.Results From March 9th, 2020 to July 17th, 2020, 106 critically ill patients with COVID-19 were admitted to an ICU. Median age was 64 (interquartile range [IQR], 54-74) years and the majority of patients were male (76 patients [71.7%]). Median simplified acute physiology score III (SAPS III) was 56 (IQR, 49-64) points. The median duration from appearance of first symptoms to ICU admission was 8 (IQR, 5-11) days. Frequently observed comorbidities were arterial hypertension in 71 patients (67.0%), cardiovascular (45 patients [42.5%]) and renal comorbidities (21 patients [19.8%]). Invasive mechanical ventilation was required in 72 patients (67.9%), 6 patients (5.6%) required extracorporeal membrane oxygenation treatment. Renal replacement therapy was necessary in 21 patients (19.8%). Median ICU length of stay (LOS) was 18 (IQR, 5-31) days, median hospital LOS was 27 (IQR, 13-49) days.ICU mortality was 21.7% (23 patients), while only one patient (0.9%) died after ICU discharge on a general ward (hospital mortality 22,6%). As of July 17th, 2020, two patients are still hospitalized, one in an ICU, one on a general ward.Conclusions Critically ill COVID-19 patients admitted to an ICU in the region of Tyrol, Austria, showed a high severity of disease often requiring complex treatments with increased lengths of ICU- and hospital stay. Despite that, we found ICU and hospital mortality in this cohort to be remarkably low. Adaptive surge response providing sufficient ICU resources presumably has contributed to the overall favorable outcome.
Person-centred Quality, Provider Involvement and Family Planning Continuation in India
Authors: Diamond-Smith Nadia , Phillips Beth , Afulani Patience , Srivast Aradhana , Golub Ginger , Sudhinaraset May
Published: July 2020

Background: Quality of care of family planning provision has many dimensions, and measuring and understanding these different components is challenging. Furthermore, understanding which components are most important for women’s experiences and method continuation is essential for improving the quality of care provision. Methods: We use longitudinal data from India to explore the impact of different measures of quality (provider preference, provider involvement, and a newly developed scale of person-centered care experiences) on method continuation. We also look at associations between the quality measures and discuss why different measures may be more salient in different contexts. Results: We find that a woman’s person-centered care experience is not associated with continuation in India. Providers having a strong preference is associated with continuation. Conclusions: Certain measures of person-centered quality appear to impact family planning continuation, but the validated person-centered care measure is not. Socio-cultural factors such as power dynamics and gender norms likely impact expectations, and need to be considered in interpreting and choosing quality measures.
Point-of-care ultrasound for COVID-19 pneumonia patients in the ICU
Authors: bitar zouheir , Shamsah Mohammed , Bamasood Omar , Maadrani Ossama , foudri Huda Al
Published: July 2020

BackgroundPoint-of-care ultrasound (POCUS) has a major role in the management of patients with acute hypoxic respiratory and circulatory failure and guides hemodynamic management. There is scarce literature on POCUS assessment characteristics in COVID-19 pneumonia with hypoxic respiratory failure.MethodsThe study is an observational, prospective, single‐center study conducted in the intensive care unit of Adan General Hospital from May 1st, 2020, to June 25, 2020. The study included adults suspected to have COVID-19 transferred to the intensive care unit (ICU) with fever or suspected respiratory infection. Patients were transferred to the ICU directly from the ED or general medical wards after reverse transcriptase-polymerase chain reaction (RT-PCR) testing. A certified intensivist in critical care ultrasound who was blinded to the RT-PCR results, if available at the time of examination, performed the lung ultrasound and echocardiology within 12 hours of the patient’s admission to the ICU. We calculated the E/e’, E/A ratio, left ventricular ejection fraction EF, IVC diameter, RV size and systolic function. We performed ultrasound in 12 chest areas.ResultsOf 92 patients with suspected COVID-19 pneumonia, 77 (84%) cases were confirmed. The median age of the patients was 53 (82-36) years, and 71 (77%) were men.In the group of patients with confirmed COVID-19 pneumonia, echocardiographic findings showed normal E/e’, deceleration time (DT), and transmittal E/A ratio in comparison to the non-COVID19 patients (P .001 for both). The IVC diameter was <2 cm with > 50% collapsibility in 62 (81%) patients with COVID-19 pneumonia; a diameter of > 2 cm and < 50% collapsibility in all patients, with a P value of 0.001, was detected among those with non-COVID-19 pneumonia. There were 3 cases of myocarditis with poor EF (5.5%), severe RV dysfunction was seen in 9 cases (11.6%), and 3 cases showed RV thrombus.Chest US revealed four signs suggestive of COVID-19 pneumonia in 77 patients (98.6%) (sensitivity 96.9%, CI 85%‐99.5%) when compared with RT-PCR results.ConclusionPOCUS plays an important role in bedside diagnosis, hemodynamic assessment and management of patients with acute hypoxic respiratory and circulatory failure in patients with COVID-19 pneumonia.