bluuebunny/crossref_metadata_2025 huggingface dataset:
More that unites us than divides us? A qualitative study of integration of community health and social care services
Authors: Mitchell Claire , Tazzyman Abigail , Howard Susan J. , Hodgson Damian
Published: March 2020

Background

The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership organisation, to fully integrate community health and social care services. This led to the development of twelve integrated neighbourhood teams, combining and co-locating professionals across three separate localities. The aim of this research is to identify the context and the factors enabling and hindering integration from a qualitative process evaluation.

Methods

Twenty-four semi-structured interviews were conducted with equal numbers of health and social care staff at strategic and operational level. The data was subjected to thematic analysis.

Results

We describe three key themes: 1) shared vision and leadership; 2) organisational factors; 3) professional workforce factors. We found a clarity of vision and purpose of integration throughout the partnership organisation, but there were challenges related to the introduction of devolved leadership. There were widespread concerns that the specified outcome measures did not capture the complexities of integration. Organisational challenges included a lack of detail around clinical and service delivery planning, tensions around variable human resource practices and barriers to data sharing. A lack of understanding and trust meant professional workforce integration remained a key challenge, although integration was also seen as a potential solution to engender relationship building.

Conclusions

Given the long-term national policy focus on integration this ambitious approach to fully integrate community health and social care has highlighted implications for leadership, organisational design and inter-professional working. Given the ethos of valuing the local assets of individuals and networks within the new partnership organisation we found the integrated neighbourhood teams could all learn from each other. Many of the challenges of integration could benefit from embracing the inherent capabilities across the integrated neighbourhood teams and localities of this city.
WITHDRAWN: Successful implementation of an Enhanced Recovery After Surgery (ERAS) protocol reduces nausea and vomiting after infratentorial craniotomy for tumour resection: a randomized controlled trial
Authors: Lu Dan , Wang Yuan , Zhao Tianzhi , Liu Bolin , Ye Lin , Zhao Lanfu , Zhao Binfang , Li Mingjuan , Ma Lin , Li Zhengmin , Niu Jiangtao , Lv Wenhai , Zhang Yufu , Zheng Tao , Xue Yafei , Chen Lei , Chen Long , Sun Xude , Gao Guodong , Chen Bo , He Shiming
Published: March 2020

BACKGROUND: Infratentorial craniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS) protocols have been shown in multiple surgical disciplines to improve outcomes, including reduced PONV. However, very few studies have described the application of ERAS to infratentorial craniotomy. The aim of this study was to examine whether our ERAS protocol for infratentorial craniotomy could improve PONV. METHODS: We implemented an evidence-based, multimodal ERAS protocol for patients undergoing infratentorial craniotomy. A total of 105 patients who underwent infratentorial craniotomy were randomized into either the ERAS group (n = 50) or the control group (n = 55). Primary outcomes were the incidence of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery. Secondary outcomes included postoperative anxiety level, sleep quality, and complications. RESULTS: Over the entire 72 h post-craniotomy observation period, the cumulative incidence of vomiting was significantly lower in the ERAS group than in the control group. Meanwhile, the incidence of vomiting was significantly lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the proportion of patients with mild nausea (VAS 0-4) was higher in the ERAS group as compared to the control group on PODs 2 or 3. Additionally, the postoperative anxiety level and quality of sleep were significantly better in the ERAS group. CONCLUSION: Successful implementation of our ERAS protocol in infratentorial craniotomy patients could attenuate postoperative anxiety, improve sleep quality, and reduce the incidence of PONV, without increasing the rate of postoperative complications. TRIAL REGISTRATION: ChiCTR-INR-16009662, 27 Oct 2016, Clinical study on the development and efficacy evaluation of Enhanced Recovery After Surgery (ERAS) in Neurosurgery. KEYWORDS: enhanced recovery after surgery (ERAS), postoperative nausea and vomiting (PONV), infratentorial craniotomy, anxiety, sleep quality.
Percutaneous Mastoid Electrical Stimulator improves poststroke depression and cognitive function in patients with ischemic stroke:A Prospective, Randomized, Double-blind, and Sham-controlled Study
Authors: Lu Taoli , he lanying , Zhang Bei , Wang Jian , Zhang Lili , Dong WeiWei , Yang Hao
Published: March 2020

Backgrond : Poststroke depression could lead to functional dependence, cognitive impairment and reduced quality of life. The aim of this study was to evaluate the effects of percutaneous mastoid electrical stimulator (PMES) plus antidepressant on poststroke depression and cognitive function.
Methods: This study was a prospective, randomized, double-blind, and sham-controlled study . 258 clinically depressed ischemic stroke patients within 14 d of index stroke were randomly assigned to PMES plus antidepressant (PMES group, N=125) and sham plus antidepressant (sham group, N=133). All patients underwent Montreal Cognitive Assessment (MoCA) and Hamilton Rating Scale for Depression (HRSD) test at 2 weeks (baseline), and 6 months after the stroke. Primary outcomes were the percentage of treatment response (≥50% reduction in HRSD score) and depression remission (HRSD score≤9) at 6 months. Secondary outcome was the percentage of MoCA score <26.
Results: The percentage of treatment response and depression remission in PMES group were significantly higher than that in the sham group (57.60% vs 41.35%, P=0.009), (44.00% vs 29.32%, P=0.014), respectively. The mean value of HRSD score change(M6-baseline) was significantly greater in the PMES group compared to sham group at 6 months (-11.93 ±5.32 vs -10.48 ± 6.10, P = 0.036). The percentage MoCA score <26 in PEMS group was lower than that in sham group(12.0% vs 24.06%, P=0.012), the mean value of MoCA score change (M6-baseline) was higher in PMES group compared to sham group (3.50±2.55 vs 2.72±2.52; P=0.005).
Conclusion: These findings demonstrate that PMES adjunctive to antidepressant therapy is effective in reducing depression, achieving remission in the short term, and improving cognition.
Trial registration: This trial was retrospectively registered (registration number: ChiCTR1800016463) on 03 June 2018
Does the McRoberts’ manoeuvre need to start with thigh abduction? An innovative biomechanical study.
Authors: Desseauve David , FRADET Laetitia , GHERMAN Robert B. , CHERNI Yosra , GACHON Bertrand , PIERRE Fabrice
Published: March 2020

Background Guidelines and description about the achievement of the McRoberts manoeuvre are discordant, particularly concerning the need for abduction before the beginning of the manoeuvre.We sought to compare the biomechanical efficiency of the McRoberts’ manoeuvre, with and without thigh abduction. Methods In a postural comparative study, twenty-three gravidas > 32 weeks of gestational age and not in labour were assessed during three repetitions of two McRoberts’ manoeuvre that differed in terms of starting position. For the (i) McRoberts, the legs were initially placed in stirrups; for the (m) McRoberts, the legs were resting on the bed, with thighs in wide abduction. For each manoeuvre, flexion of the plane of the external conjugate of the pelvis on the spine (ANGce), hip flexion and abduction, were assessed using an optoelectronic motion capture system. Lumbar curve were assessed with Epionics Spine® system. Temporal parameters including movement duration or acceleration of the external conjugate were also computed. All values ​​obtained for the two types of manoeuvres were compared using a Wilcoxon matched-pairs signed-ranks test. The significance level was defined as p < 0.05. Results The starting position of McRoberts’ otherwise had no effect on the maximum ANGce ( p = 0.199), the minimal lordosis of the lumbar curve ( p = 0.474), or the maximal hip flexion ( p = 0.057). The other parameters were not statistically different according to the starting position ( p > 0.005). Conclusion Regardless of the starting position, the McRoberts’ manoeuvre allows ascension of the pubic symphysis and reduction of the lumbar lordosis. This results imply that the McRoberts’ manoeuvre could be performed with the legs initially placed in the stirrups.
Evidence-based practice work file - A learning strategy for occupational therapy students during clinical placements: a descriptive cross-sectional study
Authors: Johnson Susanne , Bruset Else Britt , Hjelle Kari Margrete , Mongs Malin , Sveen Unni
Published: March 2020

Background

Healthcare professionals and students are expected to work according to evidence-based practice (EBP). The EBP work file, an online learning tool that covers all steps in the EBP process, is an approach to teaching and learning EBP. The aim of this study was to examine possible differences in occupational therapy students’ self-reported attitude, skills, use and implementation of EBP during their second-year clinical placement by comparing students who applied the EBP work file with students who did not use it.

Methods

A descriptive, cross-sectional comparative study was conducted. The sample comprised three cohorts (1, 2 and 3) of second-year occupational therapy students from Western Norway University of Applied Sciences and two cohorts (4 and 5) from Oslo Metropolitan University. Five cohorts in total took part in the study (n = 126 students). The students answered two questionnaires (“EBP Beliefs Scale” and “EBP Implementation Scale”) after completing their second-year clinical placement. The analysis was based on descriptive statistics and calculation of the frequencies, percentages, means and standard deviations of all participating students’ scores on the two questionnaires. ANOVA with Bonferroni correction was conducted to analyse differences between the mean totals of the questionnaires.

Results

The response rate was 57.3%. The average scores were 56.8 on the EBP Beliefs Scale and 15.8 on the EBP Implementation Scale. Students from cohort 5 (who had extra instruction and assignments via the EBP work file) had statistically lower scores than students form cohort 1 on the Implementation Scale. These students believed that EBP results in the best clinical care for patients, but they lacked confidence in their ability to use EBP.

Conclusions

Additional EBP work-file assignments were insufficient to support students in the implementation of EBP during clinical placements. It is important to teach students EBP skills and to demonstrate how they can use this competency in their work with patients. Including clinical instructors in EBP teaching and learning seems essential.
Natural history of gastroesophageal reflux in infancy: new data from a prospective cohort.
Authors: Chotard Marlene Curien- , Jantchou Prévost
Published: March 2020

Objective Gastroesophageal reflux (GER) is common in infants. Gastroesophageal reflux disease (GERD) is defined as GER leading to troublesome symptoms that affect daily functioning and/or complications. This study aimed at determining the prevalence and progression of GER and GERD in a cohort of healthy term infants from birth to 12 months old. Methods We conducted a prospective cohort study including all full-term living neonates born at Besançon Teaching Hospital, France. Exclusion criteria were: congenital anomaly. Parents completed a clinical report form and the Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) at 1, 3, 6, 10, and 12 months of age. GER was defined as score ≥1 to the first question with I-GERQ-R score < 16 ; and GERD as score ≥1 to the first question with I-GERQ-R score ≥ 16. Regurgitation was based on the answer to the first question of the I-GERQ-R as anything coming out of the mouth daily. Findings 157/347 births were included (83 boys). The prevalence of regurgitation at least once a day was 45.7% overall. In total: 72%, 69%, 56%, 18% and 13% of infants regurgitated at least once a day at 1, 3, 6, 10, and 12 months of age, respectively. Physiological GER affected 53%, 59%, 51%, 16%, and 12% of infants; GERD, 19%, 9%, 5%, 2%, and 2%, respectively. Two risk factors were identified: family history of GER and exposure to passive smoking. Treatment included dietary modification (14%) and pharmacotherapy (5%). Conclusion Physiological GER peaked at 3 months, GERD at 1 month. Most cases resolved on their own. GER and GERD are very common in the infant’s population and parents should be reassured/educated regarding symptoms, warning signs, and generally favorable prognosis. I-GERQ-R is useful to the clinical screening and follow up for GER and GERD.
Transcriptome sequencing and iTRAQ of different rice cultivars provide insight into molecular mechanisms of cold-tolerance response in japonica rice
Authors: Jia Yan , Liu Hualong , Qu Zhaojun , Wang Jin , Wang Xinpeng , Wang Zhuoqian , Yang Liang , Zhang Dong , Zou Detang , Zhao Hongwei
Published: March 2020

Background: Rice ( Oryza sativa L.), one of the most important crops cultivated in both tropical and temperate regions, has a high sensitivity to cold stress. Chilling stress limits N uptake and nitrogen metabolism in rice. To identify the genes and pathways involved in cold tolerance, specifically within the nitrogen metabolism pathway, we compared gene and protein expression differences between a cold-tolerant cultivar, Dongnong428 (DN), and a cold-sensitive cultivar, Songjing10 (SJ). Results: Using isobaric tags for relative or absolute quantification (iTRAQ) with high-throughput mRNA sequencing (RNA-seq) techniques, we identified 5,549 genes and 450 proteins in DN and 6,145 genes and 790 proteins in SJ, that were differentially expressed during low water temperature (T w ) treatment. There were 354 transcription factor (TF) genes (212 down, 142 up), and 366 TF genes (220 down, 146 up), including 47 gene families, differentially expressed in the DN under control (CKDN) vs. DN under low-T w (D15DN) and CKSJ vs. D15SJ, respectively. Genes related to rice cold-related biosynthesis pathways, particularly the mitogen-activated protein kinase (MAPK) signaling pathway, zeatin biosynthesis, and plant hormone signal transduction pathways, were significantly differentially expressed in both rice cultivars. Differentially expressed proteins (DEPs) related to rice cold-related biosynthesis pathways and particularly glutathione metabolism were significantly differentially expressed in both rice cultivars. Transcriptome and proteome analysis of the nitrogen metabolism pathways showed that major genes and proteins that participated in γ-aminobutyric acid (GABA) and glutamine synthesis were downregulated. Conclusion: Under cold stress conditions during reproductive growth, genes and proteins related to the biosynthesis pathways of cold stress were significantly differentially expressed in DN and SJ. The present study confirmed the known cold stress-associated genes and identified a number of putative new cold-responsive genes. We also found that translational regulation under cold stress plays an important role in cold-tolerant DN. Low-T w treatments affected N uptake and N metabolism in rice, and promoted Glu metabolism, and the synthesis of ornithine and proline in cold-sensitive SJ.
Protection of L1 nerve roots by pre-relieve tension in parallel endplate osteotomy for severe rigid thoracolumbar spine deformity
Authors: Liao Hang , Miao Houguang , Xie Peng , Wang Yueyue , Li Ningdao , Zheng Guizhou , Li Xuedong , Du Shixin
Published: March 2020

Background: This is a retrospective study of the use of parallel endplate osteotomy (PEO) for correction of severe rigid thoracolumbar spine deformity.
Methods : From July 2016 to January 2019, 12 patients with severe rigid thoracolumbar spine deformity underwent PEO on T12 or L1 vertebrae were studied.
Results : Following PEO at T12 or L1, the mean kyphosis and scoliosis correction rates reached 77.0 ± 8.9% and 75.5 ± 8.0%, respectively and the intraoperative estimated blood loss was 1950 ± 1050 mL, and the mean operative time was 6.98 ± 4.02 h. The SF-36 scores of physical function, role-physical, bodily pain, general health, vitality, social function, role-emotional and mental health changed from 63 ± 28, 50 ± 25, 50 ± 30, 34 ± 19, 53 ± 28, 45 ± 30, 30 ± 36 and 54 ± 18 at baseline to 83 ± 18, 69 ± 19, 72 ± 12, 66 ± 21, 75 ± 15, 72 ± 22, 66 ± 34 and 76 ± 12 at one year postoperatively , 83 ± 8, 68 ± 32, 83 ± 17, 73 ± 17, 82 ± 18, 76 ± 26, 70 ± 37 and 88 ± 12 at 18 months postoperatively, 86 ± 6, 83 ± 33, 90 ± 16, 81 ± 16, 89 ± 14, 88 ± 25, 83 ± 17 and 94 ± 10 at 24 months postoperatively, respectively (P < 0.01). Three patients had symptoms of L1 nerve root injury, as reflected by lower limb weakness and inner thigh numbness on knee extension and hip flexion, which was further confirmed by electromyography.
Conclusions : PEO is easier to operate, and the spinal cord and nerve root are under direct vision and can effectively and safely correct severe rigid thoracolumbar spine deformity with satisfactory clinical results. However, it is important to identify, separate and protect L1 nerve roots during surgery in cases where patients have symptoms of back pain, muscle weakness and leg numbness on the convex side after surgery.
Key words: Thoracolumbar deformity, Nerve roots injury, L1 nerve roots, Parallel endplate osteotomy
Psychometric Evaluation of Persian Version of the Prenatal Health Behavior Scale
Authors: ghiasvand malihe , Ozgoli Giti , kariman Nourossadat
Published: March 2020

Background: The precise measurement of health promoting and health impairing behavior requires a reliable scale that is specifically designed for the Prenatal behavior. The purpose of the present study was to translate and psychometrically evaluate the Prenatal Health Behavior Scale (PHBS) in Iran.
Methods: The present descriptive study was conducted in 2018. The original version was in English, and was then translated into Persian after obtaining permission from scale designer and using Backward-Forward translation.The final Persian version included 240 pregnant mothers who were selected using random cluster sampling from hospitals affiliated to Shahid Beheshti University of Medical Sciences in Tehran. The factor analysis methods (exploratory and confirmatory), Pearson correlation, and Cronbach's alpha coefficient by SPSSV19 and LISRELV8.80 were used to analyze research findings.
Results: Content validity and face validity were assessed by survey of 10 experts and 20 pregnant mothers.In general, the CVI was 94%.The confirmatory factor analysis indicated that all factor loadings were appropriate and significant in the initial model. Furthermore, coefficient alpha was 0.932 for prenatal health promoting behavior and 0.935 for Health-impairing behaviors. The values were acceptable and indicated the high validity of tool in the Iranian sample.

Conclusion: The research findings indicated that the Prenatal Health Behavior Scale (PHBS) had acceptable psychometric properties among Iranian pregnant women and could be used as a valid scale for assessing prenatal health behavior in Iran.
Gene networks and expression quantitative trait loci associated with platinum-based chemotherapy response in high-grade serous ovarian cancer
Authors: Choi Jihoon , Topouza Danai G. , Tarnouskaya Anastasiya , Nesdoly Sean , Koti Madhuri , Duan Qingling
Published: March 2020

Background A major impediment in the treatment of ovarian cancer is the relapse of platinum-resistant tumors, which occurs in approximately 25% of patients. A better understanding of the biological mechanisms underlying platinum-based chemotherapy response will improve treatment efficacy through genetic testing and novel therapies. Methods Using data from high-grade serous ovarian carcinoma (HGSOC) patients in the Cancer Genome Atlas (TCGA), we classified those who remained progression-free for 12 months following platinum-based chemotherapy as “chemo-sensitive” (N=160) and those who had recurrence within six months as “chemo-resistant” (N=110). Univariate and multivariate analysis of expression microarrays identified a differentially expressed gene and co-expression gene networks associated with chemotherapy response. Moreover, we integrated genomics data to determine expression quantitative trait loci (eQTL). Results Differential expression of the Valosin-containing protein ( VCP ) gene and five co-expression gene networks were significantly associated with chemotherapy response in HGSOC. VCP and the most significant co-expression network module contribute to protein processing in the endoplasmic reticulum, which has been implicated in chemotherapy response. Both univariate and multivariate findings were successfully replicated in an independent ovarian cancer cohort. Furthermore, we identified 192 cis-eQTLs associated with the expression of genes in the co-expression networks and 4 cis-eQTLs associated with BRCA2 expression. Conclusion This study implicates both known and novel genes as well as biological processes underlying response to platinum-based chemotherapy among HGSOC patients.
Diagnostic Test Accuracy of New Generation Tympanic Thermometry in Children under different cutoffs: A Systematic Review and Meta-analysis
Authors: Shi Dan , Zhang Liyuan , Li Haixia
Published: March 2020

Purposes: To identify and quantify studies reporting the diagnostic accuracy of the new generation of infrared tympanic thermometer (IRTT) in children and to compare the sensitivity and specificity of IRTT under different cutoffs and give the optimal cutoff. Methods: Articles were derived from a systematic search in PubMed, Web of Science Core Collection, and Embase, and were assessed for internal validity by the Quality Assessment of Diagnostic Accuracy Studies-2　（QUADAS-Ⅱ）. The figure of risk of bias was created by Review Manager 5.3 and data were synthesized by MetaDisc 1.4. Results: Nineteen diagnostic studies, involving 4,639 pediatric patients, were included. The cut-offs varied from 37.0℃ to 38.0℃ among these studies. The cut-off 37.8℃ was with the highest sROC AUC (0.97) and Youden Index (0.83) and was deemed to be the optimal cutoff. Conclusion: The optimal cutoff for infrared tympanic thermometers is 37.8℃. New Generation Tympanic Thermometry is with high diagnostic accuracy in pediatric patients and can be an alternative for fever screening in children.
Association between NAFLD and risk of prevalent chronic kidney disease: Why there is a difference between East and West?
Authors: Zhang Min , Lin Su , Wang Mingfang , Huang Jiaofeng , Liu Shiying , Wu Sumei , Zhang Haoyang , Wu Zimu , Liu Wenyue , Zhang Dongchu , Hao Chuanming , Zhu Yueyong , Zheng Minghua , Wang Xiaozhong
Published: March 2020

Backgrounds: There is a discrepancy between west and east on the relationship between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD). This study aimed to find out the possible reason for this and to clarify the association between NAFLD and CKD by analyzing two population-based datasets from the US and China.
Methods: Two health examination datasets from China and the US were used. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m 2 or and/or abnormal albuminuria and/or overt proteinuria. Binary logistic regression was used to examine the association between NAFLD and CKD.
Results: A total of 60965 participants were analyzed, including 11844 from the US and 51229 from China. The prevalence of NAFLD was 27.12% in the Chinese population and 36.08% in the US population (p<0.001). The proportions of CKD and late stage CKD (stages 3-5) were higher in the US population than the Chinese one. NAFLD was independently associated with an increased risk of CKD in Chinese population, whereas in the US population, the NAFLD was not an independent risk factor of CKD. In subgroup analyses which excluded late stages CKD (stages 3-5), the risks of mild renal function decline became consistent: NAFLD was associated with early stages of CKD but not the late stages of CKD in both populations.
Conclusion: NAFLD increased the risk of early stages of CKD in both Chinese and the US population. The conflicting results reported by previous studies might result from the different proportion of late stages of CKD.
Clinical, Functional and Radiographic Outcomes of Primary Total Hip Arthroplasty between Direct Anterior Approach and Posterior Approach: a Systematic Review and Meta-analysis
Authors: Peng Linbo , Zeng Yi , Wu Yuangang , Zeng Junfeng , Liu Yuan , Shen Bin
Published: March 2020

Background: The purpose of this systematic review and meta-analysis was to compare the direct anterior approach and posterior approach for primary total hip arthroplasty in terms of the clinical, functional and radiographic outcomes.

Methods: We searched the PubMed and EMBASE databases and Cochrane Library from their inception to November 1, 2019. We searched for previously published articles and meta-analyses of randomized controlled trials.

Results: A total of 7 randomized controlled trials with 600 participants met the inclusion criteria. Among these patients, 301 and 299 were included in the DAA and PA groups, respectively. The DAA was associated with a longer surgery by a mean duration of 13.74 min (95% CI 6.88 to 20.61, p < 0.0001, I 2 =93%). The postoperative early functional outcomes were significantly better in the DAA group than in the PA group, such as the Visual Analogue Scale (VAS) score at 1 day postoperatively (MD=-0.65, 95% CI -0.91 to -0.38, p < 0.00001, I 2 =0%), VAS score at 2 days postoperatively (MD=-0.67, 95% CI -1.34 to -0.01, p =0.05, I 2 =88%) and Harris Hip Score (HHS) at 6 weeks postoperatively (MD=6.05, 95% CI 1.14 to 10.95, p =0.02, I 2 =52%). There was no significant difference between the DAA and PA groups in the length of the incision, hospital length of stay (LOS), blood loss, transfusion rates or complication rates. We found no significant difference between the two groups regarding late functional outcomes, such as the VAS score at 12 months postoperatively or the HHS scores at 3, 6, and 12 months postoperatively. A significant difference in the radiographic outcomes was not detected.

Conclusions: The DAA requires a longer surgery time than does the PA in primary total hip arthroplasty. The DAA yields better early functional recovery than does the PA. There was no significant difference between the two groups in terms of other clinical, complication-related, late functional or radiographic outcomes. The evidence on the superiority of the DAA is insufficient and needs to be studied further.
The predictive value of lncRNA MIR31HG expression on clinical outcomes in patients with solid malignant tumors
Authors: Tu Chao , Ren Xiaolei , He Jieyu , Li Shuangqing , Qi Lin , Duan Zhixi , Wang Wanchun , Li Zhihong
Published: March 2020

Background Emerging studies have explored the prognostic value of MIR31HG in cancers, but its role remains elusive. Herein, we aimed to summarize the prognostic potential of MIR31HG in this study. Methods Several databases were searched for literature retrieval on Dec 5, 2019. Overall and subgroup analyses were conducted to measure the relationship between MIR31HG expression and clinical outcomes. Moreover, GEPIA was applied for validation of prognostic value of MIR31HG in tumor patients in TCGA dataset. Results Overall, seventeen studies with 2,573 patients were enrolled. Compared to counterparts, those patients with high MIR31HG expression tended to have shorter RFS. Notably, MIR31HG overexpression predicted unfavorable OS in lung cancer. By contrast, gastrointestinal cancer patients with elevated MIR31HG expression predicted better OS and disease-free survival. Additionally, MIR31HG overexpression was significantly associated with worse clinicopathological features including advanced tumor stage and LNM in lung cancer, but favorable clinical characteristics in gastrointestinal cancer. Moreover, the positive association between MIR31HG and OS in lung cancer was further confirmed in TCGA dataset. Conclusion Overexpression of MIR31HG suggested remarkable association with poor prognosis in terms of OS, tumor stage, and LNM in lung cancer, but favorable prognosis in gastrointestinal cancer. Therefore, MIR31HG may serve as a promising prognostic biomarker in multiple cancers.
Diabetes Mellitus Accelerates Progression of Osteoarthritis in Streptozotocin-induced Diabetic Mice by Deteriorating Bone Microarchitecture, Bone Mineral Composition and Bone Strength of Subchondral Bone
Authors: Wang Hua-Jun , Giambini Hugo , Liu You-Jie , Chen Ji-Wen , Wang Qiu-Shi , Hou Hui-ge , Luo Si-Min , Chen Jun-Yuan , Zhuang Teng-Feng , Chen Yuan-Feng , Wu Ting-Ting , Zha Zhen-gang , Zheng Xiaofei
Published: March 2020

The authors have withdrawn this preprint from Research Square
Does electronic consent improve the logistics and uptake of hpv vaccination in adolescent girls? A mixed methods theory informed evaluation of an intervention
Authors: Chantler Tracey , Pringle Ellen , Bell Sadie , Cooper Rosie , Edmundson Emily , Nielsen Heidi , Roberts Sheila , Edelstein Michael , Jack Sandra Mounier
Published: March 2020

The authors have withdrawn this preprint from Research Square
Leishmania infantum and Dirofilaria immitis infections in Italy, 2009-2019: changing distribution patterns
Authors: Mendoza-Roldan Jairo , Benelli Giovanni , Panarese Rossella , Iatta Roberta , Furlanello Tommaso , Beugnet Frederic , Zatelli Andrea , Otranto Domenico
Published: March 2020

Background: For long time, canine leishmaniosis (CanL) was considered endemic in the southern, central, and insular regions of Italy, whereas heartworm disease (HW) by Dirofilaria immitis in the northern region and in the swampy Po valley. Following the reports of new foci of both diseases, in this study we update the distribution patterns and occurrence of new foci of CanL and HW discussing the main drivers for the changes in the epidemiology of these two important zoonotic canine vector-borne diseases. Methods: Based on the statistical analyses of serological assays (n=90,633) on L. infantum exposure and D. immitisinfection performed by reference diagnostic centres in Italy over a ten-year period (2009–2019), the distribution patterns of both pathogens were herein presented along with the occurrence of new foci. Results: Results highlighted the changing distribution patterns of L. infantum vs D. immitis infection in Italy. CanL is now endemic also in the northern regions and HW has endemic foci in central and southern regions and islands.Significant differences in L. infantum exposure and HW infection prevalence among the study macroareas were detected. The overall prevalence of L. infantum exposure was 28.2% in southern Italy and Islands, 29.6% in central Italy and 21.6% in northern Italy and that of HW of 2.83% in northern Italy, 7.75% in central Italy and 4.97% in southern Italy and islands. HW prevalence significantly varied over years (χ2=108.401, d.f.=10, p<0.0001), gradually increasing from 0.77% in 2009 to 8.47% in 2016-2017. Conclusions: The new epidemiological scenarios have been discussed according to a range of factors (e.g. environmental modifications, occurrence of competent insect vectors, transportation of infected animals to non-endemic areas, chemoprophylaxis or vector preventative measures), which may affect the current distribution. Overall, results advocate for epidemiological surveillance programs, more focussed preventative and control measures even in areas where few or none cases of both diseases have been diagnosed.
Efficacy of revefenacin, a long-acting muscarinic antagonist for nebulized therapy, in patients with markers of more severe COPD: a post hoc subgroup analysis
Authors: Donohue James F. , Kerwin Edward , Barnes Chris N. , Moran Edmund J. , Haumann Brett , Crater Glenn D.
Published: March 2020

Background : Revefenacin, a once-daily, long-acting muscarinic antagonist delivered via standard jet nebulizer, increased trough forced expiratory volume in 1 second (FEV 1 ) in patients with moderate to very severe chronic obstructive pulmonary disease (COPD) in prior phase 3 trials. We evaluated the efficacy of revefenacin in patients with markers of more severe COPD.
Methods: A post hoc subgroup analysis of two replicate, randomized, phase 3 trials was conducted over 12 weeks. Endpoints included least squares change from baseline in trough FEV 1 , St. George’s Respiratory Questionnaire (SGRQ) responders, and transition dyspnea index (TDI) responders at Day 85. This analysis included ​ patient subgroups at high risk for COPD exacerbations and compared patients who received revefenacin 175 μg and placebo: severe and very severe airflow limitation (percent predicted FEV 1 30%–<50% and <30%), 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) D, reversibility (≥12% and ≥200 mL increase in FEV 1 ) to short-acting bronchodilators, concurrent use of long-acting β agonists and/or inhaled corticosteroids, older age (>65 and >75 years), and comorbidity risk factors.
Results: Revefenacin demonstrated significant improvements in FEV 1 versus placebo at Day 85 among the intention-to-treat (ITT) population and all subgroups. Additionally, there was a greater number of SGRQ and TDI responders in the ITT population and the majority of subgroups analyzed among patients who received revefenacin versus placebo. For the SGRQ responders, the odds of response (odds ratio >2.0) were significantly greater in the revefenacin arm versus the placebo arm among the severe airflow obstruction, very severe airflow obstruction and 2011 GOLD D subgroups. For the TDI responders, the odds of response (odds ratio >2.0) were significantly greater among the severe airflow obstruction subgroup and patients aged >75 years.
Conclusions: Revefenacin showed significantly greater improvements in FEV 1 versus placebo in the ITT population and all subgroups. There were a greater number of SGRQ and TDI responders in the ITT population, and in the majority of patient subgroups among patients who received revefenacin versus placebo. Revefenacin could be a therapeutic option among patients with markers of more severe COPD.
Health status and infections in patients with symptomatic primary and secondary immunoglobulin G (IgG) deficiencies receiving intravenous IgG substitution
Authors: Weide Rudolf , Schnell Roland , Schardt Christof , Koenigsmann Michael , Otremba Burkhard , Zahn Mark-Oliver , Wierecky Jan , Braun Ute , Hensel Manfred , Klausmann Martine , Fleckenstein Doris , Ehscheidt Peter , Feiten Stefan
Published: March 2020

Background: The effects of intravenous immunoglobulin G substitution on health status and infections of patients suffering from immunoglobulin G (IgG) deficiencies should be evaluated in a prospective analysis.Methods: Patients with symptomatic primary or secondary IgG deficiencies were interviewed prior to the first IgG infusion (t0) and over the course of their treatment. The respondents rated their current health using a 100-point scale (EQ-5D-5L), ranging from 0 ('worst imaginable health') to 100 ('best imaginable health'). The patients also provided information on the frequency of infections and infections requiring antibiotics in the past 8 weeks. A control group (CG) without oncologic diseases answered the questions on an one-off basis.Results: 106 patients with a median age of 65 years (21-85 years) were investigated. The median serum IgG-concentration changed from 500 mg/dl (t0) to 772 mg/dl (t6). The mean number of infections and of infections requiring antibiotics decreased during IgG substitution significantly. The EQ-5D-5L health status improved from 57 (t0) to 68 (t6), compared to 73 in the CG.Conclusion: During the course of IgG substitution patients reported fewer and less severe infections. Their health status improved but still was inferior to the healthy CG.Previous presentationData were presented in part at the annual meeting of the German, Austrian and Swiss Societies of Hematology and Medical Oncology in Vienna, Austria, 2018.
Clinical characteristics of HIV-negativepatients with cryptococcemia in a Chinese tertiary-care hospital:  A 10-year study
Authors: Liang Liling , Liang Zhixin , Chen Liang-an
Published: March 2020

Objective: Cryptococcosis is a severe opportunistic fungal infection. Cryptococcemia is a rare manifestation of cryptococcosis with high mortality. Objective: To characterize patients with cryptococcemia in Chinese PLA General Hospital since 2010 to 2019.Methods: We identified retrospectively those blood cultures with Cryptococcus sp. growth, and then obtained their clinical information which were analyzed by two independent reviewers.Results: A total of 8 patients withcryptococcemiawere identified, of which only 2 patients survived. There were 3 males and 5 females, whose age ranged from 23 to 72 years. They were all HIV negative. 1 (12.5%) had ovarian adenocarcinoma, 2 (25%) had systemic lupus erythematosus, 3 (37.5%) had primary nephrotic syndrome, 1 (12.5%) had viral myocarditis, and 1 (12.5%) were after lung transplantation. The most common symptoms were fever (100%) and confusion (50%). Out of the 8 episodes, 6 (60%) had meningeal infection and 2 (25%) presented as pulmonary involvement meanwhile. Six patients were dead at half a year follow up.Conclusions: Cryptococcemia is an unusual infection characterized by a high mortality. It requires early identify and prompt antifungal therapy.
A Study of the Prediction of Bowel Resection due to Strangulated Small Bowel Obstruction
Authors: Udaka Tetsunobu , Taniguchi Atsuki , Kouzai Jun , Ootsuka Tomoaki , Watanabe Nobuyuki , Endou Izuru , Yoshida Osamu , Asano Hiroaki , Kubo Masatoshi
Published: March 2020

Background: In this retrospective study, we aimed to assess the predictive factors for bowel resection due to strangulated small bowel obstruction (SSBO). Methods: We enrolled a total of 109 patients diagnosed with SSBO at surgery. They were divided into two groups: those who underwent bowel resection and those who did not. The clinical findings, blood test results, blood gas analysis results, computed tomography (CT) findings, and sequential organ failure assessment (SOFA) scores of the patients were examined and compared between the two groups. Results: A univariate analysis indicated significant predictive factors to be a history of abdominal surgery, prolonged time from the onset of disease to the operation, increased C-reactive protein (CRP) level, decreased albumin, SOFA score, existence of closed-loop obstruction, and reduced enhancement of the intestinal wall at CT. A multivariate analysis indicated that a reduced enhancement of the intestinal wall and the existence of closed-loop obstruction were independent predictive factors. Strangulated bowel obstruction can progress to a serious condition. It is therefore crucial to predict preoperatively those patients who are likely to require bowel resection. Conclusions: Assessing the reduced enhancement of the intestinal wall and the existence of closed-loop obstruction are required in order to determine whether or not resection of the incarcerated intestine with SSBO is necessary. Key words: strangulated small bowel obstruction, prognostic factor, bowel resection, reduced enhancement of the intestinal wall, closed-loop obstruction
Determinants of preference for home childbirth over health facility childbirth among Women of Reproductive Age in Tanzania: An Analysis of Data from the 2015-16 Tanzania HIV and Malaria Indicators Survey
Authors: Moshi Fabiola Vincent , Mbotwa Christopher H.
Published: March 2020

Background While evidence has shown an association between place of childbirth and birth outcomes, still factors contributing to the choice of home childbirth have not been adequately investigated. Childbirth assisted by unskilled birth attendants has been cited as a contributing factor for the high maternal and neonatal mortalities in low resources countries. This study aimed at determining determinants of preference for home childbirth assisted by unskilled attendants in Tanzania.Method The study used the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS) dataset. A total of 2286 women of reproductive age (15-49 years) who had childbirth within one year preceding the survey were included in the analysis. Both univariate and multivariable regression analysis was used to determine predictors for home-based childbirth.Results A total of 805(35.2%) of women had home childbirth assisted by unskilled providers. After adjusting for confounders, the determinants of preference for home childbirth were the level of education (primary education, AOR=0.666; p=0.001; secondary and higher education, AOR=0.417; p<0.001); not owning mobile phone, AOR= 1.312; p=0.018; parity (parity 2-4, AOR=1.594; p=0.004; Parity 5 and above, AOR=2.158; p<0.001); inadequate antenatal visits, AOR=1.406; p=0.001; wealth index (poorest, AOR=9.395; p<0.001; poorer, AOR=7.701; p<0.001; middle, AOR=5.961; p<0.001; richer, AOR=2.557; p<0.001) and Zones (Southern Highlands, AOR=0.189; p<0.001; Southern, AOR=0.225; p<0.001; Zanzibar, AOR=2.55; p<0.001).Conclusion There are large proportions of women who use home childbirth assisted by unskilled birth attendant’s mainly traditional birth attendants (TBA). Predictors for home-based childbirth were being illiterate women, poor access to communication, inadequate antenatal visits, low socio-economic status and those from Zanzibar. Innovative strategies targeting these groups are highly needed to increase the use of health facilities for childbirth and hence reduce maternal and neonatal mortalities in Tanzania.
The incidence of adjuvant chemotherapy-related early-onset cardiac events in breast cancer patients and its relationship with genetic susceptibility: A prospective cohort study
Authors: Liu Binliang , Guan Xiuwen , Wang Yanfeng , Sun Xiaoying , Yi Zongbi , Wang Wenna , Li Lixi , Zhai Jingtong , Li Hong , Ma Fei
Published: March 2020

Background: Although cardiotoxicity has been widely concerned, the study of early-onset cardiotoxicity is insufficient and it is difficult to explain the occurrence of cardiotoxicity only by clinical factors in patients with low cumulative dose of chemotherapy. The purpose of this study was to investigate adjuvant chemotherapy -related cardiac events in breast cancer patients, and to find out the genetic risk factors related to early-onset cardiotoxicity . Methods: A total of 388 recruited patients completed routine blood, liver and kidney function, D-dimer, TnT, NT-proBNP (or BNP), ECG and UCG tests before and after adjuvant chemotherapy. Twenty-five single nucleotide polymorphisms were tested. Univariable and multivariable analyses were performed to identify independent risk factors. Results: A total of 256 adjuvant chemotherapy-related cardiac events were recorded in 180 patients (46.4%), and these included an abnormal ECG (37.4%), an abnormal UCG (8.8%), an elevated BNP (5.7%), and elevated TnT (0.3%). The ATG13 (rs10838611) GG genotype was a protective factor of early-onset cardiotoxicity (10% reduction in the LVEF) ([OR]= 0.188; 95% CI: 0.067-0.525; P=0.001). Conclusion: Adjuvant chemotherapy-related cardiac events are quite common in the real world. Genetic factors were closely related to the susceptibility of early-onset cardiotoxicity.
Consciousness of healthcare professionals on antimicrobial resistance in western Ethiopia
Authors: Muluye Abrham Belachew , Kolech Getachew Alemkere , Tadesse Ayana , Gebyehu Habte , Gebre Mohamed , Bayissa Getu
Published: March 2020

Background: Inappropriate and overuse of antimicrobial drugs by healthcare professionals are a global concern. Exploring healthcare professionals’ consciousness on antimicrobial resistance is important to advance the approaches to improve antibiotic use. Hence, the aim of the current study was to assess the level of healthcare professionals’ consciousness towards antimicrobial resistance and its control measures.Methods: A cross-sectional study design was employed. Data was collected using a self-administered questionnaire to all healthcare professionals from May to June, 2017. Data were entered into Epi info version 7 and analyzed using SPSS version 21. The knowledge and belief scores were summarized using descriptive statistics. Univariate and multivariate logistic regression analysis were used to test the association, which was considered statistically significant if P-value < 0.05.Results : From 269 healthcare professionals participated in the study, 58% were males with a mean age of 31.9 + 7.5 years and 76.6% were degree holders. Most of them were nurses (36.4%) and physicians (24.9%). The median knowledge and belief scores of healthcare professionals on antimicrobial resistance were 35 (range 23-83) and 29 (range 13-47), respectively. Forty seven percent of participants had poor belief score. A correlation test between knowledge and belief scores revealed a significant positive correlation (r = 0.551; P = 0.01). Hospital setting (adjusted odds ratio [AOR]: 4.65; 95% confidence interval [CI]: 2.39-9.06; P < 0.001; and AOR: 3.62; 95% CI: 1.76-7.44; P < 0.001) and training (AOR: 0.43; 95% CI: 0.23-0.83; P < 0.05; and AOR: 0.13; 95% CI: 0.06-0.25; P < 0.001) had significantly associated with good knowledge and belief scores, respectively.Conclusions : More than half of healthcare professionals had good knowledge and belief scores on antimicrobial resistance. Prior training experience, type and setting of health institutions were significantly associated with both knowledge and belief scores. Hence, regular comprehensive educational training on antimicrobial resistance is recommended for healthcare professionals working on healthcare institutions.