bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical significance of self-reported cough intensity and frequency in patients with interstitial lung disease: a cross-sectional study
Authors: Sato Ryuhei , Handa Tomohiro , Matsumoto Hisako , Kubo Takeshi , Hirai Toyohiro
Published: December 2019

Background

The intensity and frequency of cough remain unclear in interstitial lung disease (ILD). The aim of this study was to evaluate the intensity and frequency of cough in idiopathic interstitial pneumonias (IIPs), connective tissue disease-associated interstitial lung disease (CTD-ILD), and chronic hypersensitivity pneumonia (CHP), and examine their associations with clinical indices.

Methods

In this cross-sectional study, the intensity and frequency of cough were evaluated using a 100-mm visual analogue scale. Scores on the Leicester Cough Questionnaire, chronic dyspnoea scale, and a frequency scale for symptoms of gastro-oesophageal reflux disease (FSSG) were collected. The correlations of cough intensity and frequency with potential predictor variables were tested using bivariate and multiple logistic regression analysis.

Results

The study included 70 patients with IIPs, 49 with CTD-ILD, and 10 with CHP. Patients with IIPs had the most severe cough intensity among the three patient groups. In patients with IIPs, both the intensity and frequency of cough were negatively associated with the diffusing capacity of the lung for carbon monoxide and positively with the Composite Physiologic Index (CPI). In CTD-ILD, both the intensity and frequency of cough were correlated with a higher FSSG score. In multivariate analysis of patients with ILD, IIPs and the FSSG score were independently associated with both components of cough, and CPI tended to be independently associated with cough frequency. Finally, we examined the features of the differences between cough intensity and frequency in all patients with ILD. Patients in whom cough frequency was predominant had a greater impairment of health status relative to other patients.

Conclusions

Cough intensity was greater in IIPs than in other ILDs. Different clinical indices were associated with patient-reported cough intensity and frequency according to the subtype of ILD. Cough frequency was more strongly associated with health status than was cough intensity. These findings suggest that medical staff could manage patients with ILD by considering cough-related factors when assessing the intensity and frequency of cough.
IPF patients are limited by mechanical and not pulmonary-vascular factors – results of a derivation-validation cohort study
Authors: Fox Benjamin D. , Shostak Yael , Pertzov Barak , Vainshelboim Baruch , Itzhakian Shimon , Terner Irit , Kramer Mordechai R.
Published: December 2019

Background

During cardiopulmonary exercise testing (CPET), Idiopathic Pulmonary Fibrosis (IPF) patients do not reach their direct maximum voluntary ventilation (MVV) and have deranged gas exchange. Their exercise limitation is therefore attributed to a pulmonary vascular mechanism.

Methods

We studied two cohorts (derivation and validation) of IPF patients with lung function testing and CPET. Maximal ventilation at exercise (VEpeak) was compared to direct MVV by Bland-Altman analysis.

Results

In the derivation cohort (n = 101), direct MVV over-estimated VEpeak by a factor of 1.51, driven by respiratory rate during MVV that was 1.99 times higher at rest as compared to VEpeak at exercise. The formula (FEV1 × 20.1) + 15.4 was shown to predict VEpeak (r2 = 0.56) in the derivation cohort. In the validation cohort of 78 patients, VEpeak was within a factor of 1.27 (6.8 l/min) of predicted according to the novel formula. According to the novel prediction formula the majority of patients (58%) in the entire cohort have VEpeak within 85% of their predicted MVV, which would indicate a mechanical respiratory limitation to exercise.

Conclusion

Estimation of direct MVV performed at rest leads to significant over-estimation of the breathing reserve in IPF patients. This may lead to over-diagnosis of pulmonary vascular limitation in these patients. Expected maximal ventilation at exercise may be accurately predicted indirectly by an IPF-specific formula.
Systematic review on the needle and suture types for uterine compression sutures: a literature review
Authors: Matsuzaki Shinya , Jitsumori Mariko , Hara Takeya , Matsuzaki Satoko , Nakagawa Satoshi , Miyake Tatsuya , Takiuchi Tsuyoshi , Kakigano Aiko , Kobayashi Eiji , Tomimatsu Takuji , Kimura Tadashi
Published: December 2019

Background

This study aimed to identify and review associations between the types of sutures used for uterine compression suture (UCS) and its outcomes in postpartum hemorrhage.

Methods

An electronic search using PubMed and Scopus databases was performed. We included the English articles reported from January 1, 1997, to May 31, 2017, using search words or terms regarding the types of suture and needle used for UCSs. We only included studies describing the sutures in the systematic review.

Results

We found 196 studies and included 76 (38.8%) in our analysis. We collected data on maternal outcomes for 924 patients and categorized them. Of the 76 studies, suture sizes 0, 1, and 2 were used in 6, 44, and 32 articles, respectively (some studies used multiple sutures). Of the 45 studies mentioning the needles, curved and straight needles were used in 35 and 10, respectively. The results of our review revealed that about 80% of previous articles used Catgut and Polyglactin 910 sutures. Because no studies that compared the efficacy of different size of sutures were identified, we investigated the differences using the cases reported in previous studies mentioned above. In the first analysis, we compared the uterine preservation rate between size 1 and size 2 sutures. We found no significant difference in uterine preservation rate (92.8%: size 1 vs. 94.2%: size 2,p > 0.05) but found significant difference in transfusion rate (62.4% vs. 79.1%,p < 0.01). With the hypothesis that non-transfusion cases were less severe, we excluded these cases from second analysis. Although our second analysis of only Catgut or Polyglactin showed strong selection bias, we observed that uterine preservation rate was significantly higher in cases with size 2 suture than in those with size 1 suture (86.9% vs. 93.5%,p = 0.033).

Conclusions

Our systematic review showed that approximately 80% of cases were treated by Catgut and Polyglactin 910. Due to the heterogeneity of cases included in this review, it is difficult to estimate which suture is better for UCSs. More robust studies are necessary to enable the identification of the superior suture for performing UCSs.
An examination of home-based end-of-life care for cancer patients: a qualitative study
Authors: Lai Xiao Bin , Chen Li Qun , Chen Shu Hui , Xia Hai Ou
Published: December 2019

Background

Only a small number of patients have utilized the home-based end-of-life care service in Shanghai that has been offered since 2012. This study explores how home-based end-of-life care is delivered in community health service centers in Shanghai and examines the difficulties in the delivery of the care.

Methods

This was a qualitative study in which data were collected from interviews and analyzed using qualitative content analysis. Nineteen health care providers with experience in delivering home-based end-of-life care in 12 community health service centers were recruited. The interviews were conducted between August 2018 and February 2019.

Results

Four themes emerged from the interviews: (i) Patients under home-based end-of-life care: Patients receiving the care were cancer patients with less than 1 year of life expectancy. The criteria for patients were broad. (ii) Service structure: The service was delivered regularly by the physicians and nurses using the approaches of home visits and/or telephone follow-ups. (iii) Service process: The service consisted of multiple components, including monitoring the patient’s condition, managing the patient’s symptoms, giving daily care instructions, performing nursing procedures, and giving psychological support. However, most of the care focused on monitoring the patients and managing their physical discomfort. (iv) Difficulties in delivering care: Being unable to provide the service and feeling powerless when facing psycho-spiritual problems were the two major difficulties. Three factors contributed to the suspension of the service: The gap between the service and the needs of the patients, a lack of patients, and low work motivation. The demand that the truth be concealed from the families and their attitude of avoiding talking about death were the key factors of the failure of psycho-spiritual care.

Conclusions

Several issues should be addressed before the service can be further developed, including fully understanding the needs and preferences of local patients and their families, securing more financial support and a better supply of drugs, delivering better training for staff, and ensuring greater rewards for individuals and institutions providing the service.
‘Leaving no one behind’: a scoping review on the provision of sexual and reproductive health care to nomadic populations
Authors: Ali Moazzam , Cordero Joanna Paula , Khan Faria , Folz Rachel
Published: December 2019

Backgrund

Marginalized groups, such as nomadic populations across the world, have perhaps the least access to modern reproductive health (RH) services. This scoping review aims to identify barriers to access to RH services faced by nomadic populations from the existing literature and to highlight possible opportunities to address them.

Methods

Key databases, including PubMed, Popline, Google Scholar, and Google Advanced were searched for relevant articles published between 2002 and 2019. A total 344 articles were identified through database online searches, and 31 were included in the review.

Results

Nomadic people face complex barriers to healthcare access that can be broadly categorized as external (geographic isolation, socio-cultural dynamics, logistical and political factors) and internal (lifestyle, norms and practices, perceptions) factors. To effectively address the needs of nomadic populations, RH services must be available, accessible and acceptable through tailored and culturally sensitive approaches. A combination of fixed and mobile services has proven effective among mobile populations. Low awareness of modern RH services and their benefits is a major barrier to utilization. Partnership with communities through leveraging existing structures, networks and decision-making patterns can ensure that the programmes are effectively implemented.

Conclusion

Further research is needed to better understand and address the RH needs of nomadic populations. Though existing evidence is limited, opportunities do exist and should be explored. Raising awareness and sensitization training among health providers about the specific needs of nomads is important. Improved education and access to information about the benefits of modern RH care among nomadic communities is needed. Ensuring community participation through involvement of nomadic women and girls, community leaders, male partners, and trained traditional birth attendants are key facilitators in reaching nomads. However, participatory programmes also need to be recognized and supported by governments and existing health systems.
Treatment of migraines with Tianshu capsule: a multi-center, double-blind, randomized, placebo-controlled clinical trial
Authors: Yu Shengyuan , Ran Ye , Xiao Wei , Tang Wenjing , Zhao Jianjun , Chen Wei , Zhuang Huikui , Ouyang Cun , Lin Hai , Liu Dequan , Chen Tongjun , Huang Hui , Wang Baoshen , Hao Yanlei , Yan Zhongrui , Zhao Shike , Wang Yanling , Ni Jinjun , Wang Chaodong , Ding Wentao , Li Guoqian , Cao Jianhua , Tian Shujuan
Published: December 2019

Background

Tianshu capsule (TSC), a formula of traditional Chinese medicine, has been widely used in clinical practice for prophylactic treatment of headaches in China. However, former clinical trials of TSC were small, and lack of a standard set of diagnostic criteria to enroll patients. The study was conducted to re-evaluate the efficacy and safety of TSC post-marketing in an extending number of migraineurs who have diagnosed migraine with the International Classification of Headache Disorders, 3rd edition (beta version, ICHD-3β).

Methods

The study was a double-blind, randomized, placebo-controlled clinical trial that conducted at 20 clinical centers in China. At enrollment, patients between 18 and 65 years of age diagnosed with migraine were assigned to receive either TSC (4.08 g, three times daily) or a matched placebo according to a randomization protocol. The primary endpoint was a relative reduction of 50% or more in the frequency of headache attacks. The secondary outcomes included a reduction in the incidence of headache, the visual analogue scale of headache attacks, days of acute analgesic usage, and percentage of patients with a decrease of 50% or more in headache severity. Accompanying symptoms were also assessed.

Results

One thousand migraine patients were initially enrolled in the study, and 919 of them completed the trial. Following the 12-week treatment, significant improvement was observed in the TSC group concerning both primary and secondary outcomes. After therapy discontinuation, the gap between the TSC group and the placebo group in efficacy outcomes continued to increase. There were no severe adverse effects.

Conclusions

TSC is an effective, well-tolerated medicine for prophylactic treatment of migraine, and still have prophylactic effect after medicine discontinuation.

Trial registration

ClinicalTrials.gov Identifier: NCT02035111; Data of registration: 2014-01-10.
Evaluation of a bronchoscopy guidance system for bronchoscopy training, a randomized controlled trial
Authors: Follmann Andreas , Pereira Carina Barbosa , Knauel Julia , Rossaint Rolf , Czaplik Michael
Published: December 2019

Background

Conventional training in bronchoscopy is performed either on patients (apprenticeship model) or phantoms. While the former is associated with increased rate of patient complications, procedure time, and amount of sedation, the latter does not offer any form of feedback to the trainee. This paper presents a study which investigates whether a bronchoscopy guidance system may be a helpful tool for training of novice bronchoscopists.

Methods

A randomized controlled study with 48 medical students was carried out with two different groups (control and test group, each N = 24). Whereas the control group performed a conventional bronchoscopy on phantom the test group carried out an Electromagnetic Navigation Bronchoscopy (ENB) for tracking of the bronchoscopal tip in the bronchial system. All volunteers had a common task: to perform a complete and systematic diagnostic bronchoscopy within 10 min.

Results

The test group examined significantly more lobes than the control group (p = 0.009). Due to the real-time feedback of the system, all students of test group felt more confident having analyzed the entire lung. Additionally, they were unanimous that the system would be helpful during the next bronchoscopy.

Conclusions

In sum, this technology may play a major role in unsupervised learning by improving accuracy, dexterity but above all by increasing the confidence of novices, students as well as physicians. Due to good acceptance, there may be a great potential of this tool in clinical routine.
Student nurses’ career intentions following placements in general practice through the advanced training practices scheme (ATPS): findings from an online survey
Authors: Lewis Robin , Ibbotson Rachel , Kelly Shona
Published: December 2019

Background

The demand for General Practice services in the UK, and elsewhere, is rising quickly. In part, the increasing demand is from an aging population that requires management of multiple long-term conditions. The General Practice Nurse is increasingly taking on the role. It is acknowledged that if general practice is to be able to recruit sufficient General Practice Nurses (GPNs) to meet this increasing demand in the future, new graduate nurses must be encouraged to consider general practice as a viable career option. This research is part of a review of the Advanced Training Practice Scheme (ATPS) which supported clinical placements in participating general practices.

Methods

The aim of the study was to examine nursing students’ perceptions of GP placements, and their effect upon career intentions following graduation from Sheffield Hallam University (SHU), in the UK. Interviews and an online survey were used collect data. Only the survey is reported here. The bespoke survey examined students’ views of: opportunities for learning new clinical skills and consolidating existing clinical skills; the learning environment in general practice and their views on a career in general practice.

Results

One thousand one hundred twenty undergraduate adult-field nursing students were contacted, with a response rate of 41% (N = 462). Ninety respondents had a placement and, 92% (N = 84) viewed practice nursing positively, and 77% (N = 70) felt that the placement had transformed their views on general practice. The opportunity to participate in the management of the various aspects of chronic disease was identified by 84% (N = 76) of the students as a key new skill they had acquired. They also reported that they valued a team ethos, control over aspects of work, and the variety of health problems they encountered.

Conclusion

The findings from this study demonstrate a positive experience arising from the provision of General Practice placements for nursing students. The use of ‘targeted’ placement schemes with appropriate support such as this may be seen as a viable way of exposing nursing students to General Practice nursing, and of encouraging new graduate nurses to consider General Practice nursing as a viable career option.
Does case-based blended-learning expedite the transfer of declarative knowledge to procedural knowledge in practice?
Authors: Turk Bela , Ertl Sebastian , Wong Guoruey , Wadowski Patricia P. , Löffler-Stastka Henriette
Published: December 2019

Background

Case-Based Learning (CBL) has seen widespread implementation in undergraduate education since the early 1920s. Ample data has shown CBL to be an enjoyable and motivational didactic tool, and effective in assisting the expansion of declarative and procedural knowledge in academia. Although a plethora of studies apply multiple choice questions (MCQs) in their investigation, few studies measure CBL or case-based blended learning (CBBL)-mediated changes in students’ procedural knowledge in practice or employ comparison or control groups in isolating causal relationships.

Methods

Utilizing the flexibilities of an e-learning platform, a CBBL framework consisting of a) anonymized patient cases, b) case-related textbook material and online e-CBL modules, and c) simulated patient (SP) contact seminars, was developed and implemented in multiple medical fields for undergraduate medical education. Additionally, other fields saw a solo implementation of e-CBL in the same format. E- cases were constructed according to the criteria of Bloom’s taxonomy.

In this study, Objective Structured Clinical Examination (OSCE) results from 1886 medical students were analyzed in total, stratified into the following groups: medical students in 2013 (n = 619) before CBBL implementation, and after CBBL implementation in 2015 (n = 624) and 2016 (n = 643).

Results

A significant improvement (adjustedp = .002) of the mean OSCE score by 1.02 points was seen between 2013 and 2015 (min = 0, max = 25).

Conclusion

E-Case-Based Learning is an effective tool in improving performance outcomes and may provide a sustainable learning platform for many fields of medicine in future.
Self-perceived competencies in the diagnosis and treatment of mental health disorders among general practitioners in Lima, Peru
Authors: Zafra-Tanaka Jessica Hanae , Pacheco-Barrios Kevin , Inga-Berrospi Fiorella , Taype-Rondan Alvaro
Published: December 2019

Aim

To assess the self-perceived competencies in diagnosing and treating patients with mental health disorders, among recently graduated general practitioners (GPs) from Lima, Peru.

Methods

A cross-sectional study was performed in April 2017 at a General Practitioner’s meeting held for those who were going to perform the social service, by the Peruvian College of Physicians in Lima. Attendees were invited to answer a questionnaire that evaluated their self-perception of competence in diagnosing and treating four different mental health disorders; major depression, anxiety disorder, alcohol dependence, and schizophrenia.

Results

Out of 434 evaluated GPs, the following percentages were self-perceived as competent in their adequate diagnosis of depression (70.5%), anxiety (73.3%), alcohol dependence (67.6%), and schizophrenia (62.0%). Concerning pharmacological treatment, these percentages were 46.6, 47.5, 39.0 and 37.6%, respectively. Referring to all the studied mental disorders, 41.6% of participants self-perceived competence in providing an adequate diagnosis, 36.1% in providing non-pharmacological treatment, and 20.1% in providing pharmacological treatment.

Conclusion

The rate of adequate self-perceived competences was higher for diagnosis than for treatment of patients with mental health disorders. These results highlight the importance of designing and implementing interventions to improve medical education so as to develop the skills necessary to confront mental health disorders.
Is selecting better than modifying? An investigation of arguments against germline gene editing as compared to preimplantation genetic diagnosis
Authors: v. Hammerstein Alix Lenia , Eggel Matthias , Biller-Andorno Nikola
Published: December 2019

Background

Recent scientific advances in the field of gene editing have led to a renewed discussion on the moral acceptability of human germline modifications. Gene editing methods can be used on human embryos and gametes in order to change DNA sequences that are associated with diseases. Modifying the human germline, however, is currently illegal in many countries but has been suggested as a ‘last resort’ option in some reports. In contrast, preimplantation genetic (PGD) diagnosis is now a well-established practice within reproductive medicine. Both methods can be used to prevent children from being born with severe genetic diseases.

Main text

This paper focuses on four moral concerns raised in the debate about germline gene editing (GGE) and applies them to the practice of PGD for comparison: Violation of human dignity, disrespect of the autonomy and the physical integrity of the future child, discrimination of people living with a disability and the fear of slippery slope towards immoral usage of the technology, e.g. designing children for specific third party interests. Our analysis did not reveal any fundamental differences with regard to the four concerns.

Conclusion

We argue that with regard to the four arguments analyzed in this paper germline gene editing should be considered morally (at least) as acceptable as the selection of genomes on the basis of PGD. However, we also argue that any application of GGE in reproductive medicine should be put on hold until thorough and comprehensive laws have been implemented to prevent the abuse of GGE for non-medical enhancement.
The emotional labour of quality improvement work in end of life care: a qualitative study of Patient and Family Centred Care (PFCC) in England
Authors: Boulton Richard , Boaz Annette
Published: December 2019

Background

There is a growing emphasis on understanding patient experience in order to inform efforts to support improvement. This paper reports findings from an implementation study of an evidence-based intervention called Patient and Family Centred Care (PFCC) designed to tap into patient experiences as a basis for improvement. In this study the PFCC intervention was spread to a new service area (end of life care) and delivered at scale in England. The findings presented here focus specifically on one key aspect of the intervention: staff shadowing of patients, and the experiences of staff carrying out shadowing for the purposes of service improvements.

Methods

The study methods were ethnographic observations of key events, semi-structured interviews with members of participating teams and the programme implementation support team and managers, and a review of the documents used in the set up and running of the programme.

Results

One of the key strengths of the PFCC approach is to encourage staff through shadowing to engage with patient experience of services. Many staff described the process of shadowing as a transformative experience that alerted them to immediate areas where their services could be improved. However, engaging with patient experience of end of life care services also had unintended consequences for some staff in the form of emotional labour. Furthermore, we observed difficulties encountered by staff that are not accounted for in the existing PFCC literature relating to how care service structures may unevenly distribute the amount of ‘emotional labour’ that staff members need to invest in implementing the programme.

Conclusions

Connecting with patient experience is a crucial aspect of a number of quality improvement interventions that aim to help staff to engage with the lived experience of their services and reconnect their motivations for working in the health care system. However, there may be unintended consequences for health care service staff, particularly in sensitive areas of service delivery such as end of life care. The ‘emotional labour’ for staff of engaging in quality improvement work informed by patient experience should be considered in planning and supporting patient experience led quality improvement.
Effect of gamma-mangostin on testosterone levels in Leydig cell culture of Sprague-Dawley rat induced by advanced glycation end products: a preliminary study
Authors: Rizal Dicky Moch , Fauzi Aditya Rifqi , Rustamaji
Published: December 2019

Background

Advanced glycation end products (AGE) is a toxic compound in the human body that can deteriorate health and induce an inflammatory response. One of the type of cells affected is Leydig cells, cells that produce testosterone and located in interstitial areas of the testes. Pericarp extract of Garcinia mangostana contains an antioxidant compound called gamma-mangostin that can decrease inflammatory responses and toxic effects of AGE. We aimed to compare the testosterone levels in Leydig cell culture of Sprague-Dawley rat induced by AGE only and following gamma-mangostin.

Methods

An experimental laboratory study was conducted on testosterone level in Leydig cell culture of Sprague-Dawley rats induced by advanced glycation end products 200 μg/mL and given gamma-mangostin 5 μM compared to cell cultures that were not given gamma-mangostin.

Results

Nine Leydig cell cultures were ascertained and divided into three groups. No significant difference was found in the testosterone level of Leydig cell culture given AGE only (1.33 ng/105 cells/24 h) compared to the group given AGE and gamma-mangostin (1.30 ng/105 cells/24 h) (p = 0.535).

Conclusion

The testosterone level in Leydig cell cultures induced by AGE were lower than those not given, but similar in the AGE-only group and group given gamma-mangostin. The mean testosterone levels in all groups were in the range of expected levels (0.025–15 ng/105 cells/24 h). Further study with larger samples is important to clarify and confirm our findings.
Risk factors of grade ≥ 2 radiation pneumonitis after gemcitabine induction chemotherapy for patients with non-small cell lung cancer
Authors: Sheng Liming , Cui Xiaoying , Cheng Lei , Chen Ying , Du Xianghui
Published: December 2019

Objectives

To observe the risk factors affecting the occurrence of RP after gemcitabine-based induction chemotherapy.

Methods

Between January 2010 and December 2017, patients with NSCLC received gemcitabine or docetaxel chemotherapy, followed by radiotherapy at Zhejiang cancer hospital were enrolled in this study. Patients were treated with gemcitabine or docetaxel induction chemotherapy, followed by radiotherapy or concurrent chemoradiotherapy. Acute radiation pneumonitis was scored post chemoradiotherapy.

Results

One hundred and eighty-four patients with NSCLC were included in the gemcitabine group and 144 in the docetaxel group. The gemcitabine group experienced a higher incidence of grade ≥ 2 RP, compared with docetaxel group (25.5% Vs. 13.2%, P = 0.005). The optimal cutoff values of lung V5, V20, V30 and MLD were set at 44% (AUC [area under the curve] = 0.593), 24% (AUC = 0.607), 14.2% (AUC = 0.622) and 1226 cGy (AUC = 0.626). On multivariate analysis, only lung V30 was identified as a predictor for grade ≥ 2 RP (P = 0.03). The grade ≥ 2 RP rate was only 9.4% for the low-risk group (Lung V5 ≤ 44%, V20 ≤ 24%, V30 ≤ 14.2%, and MLD ≤ 1226 cGy) in patients received gemcitabine induction chemotherapy.

Conclusions

Gemcitabine chemotherapy before thoracic radiotherapy in NSCLC patients was related to a higher incidence of grade ≥ 2 RP, compared with docetaxel chemotherapy. The Lung dose-volume variable V30 was the best predictor of grade ≥ 2 RP.
deSALT: fast and accurate long transcriptomic read alignment with de Bruijn graph-based index
Authors: Liu Bo , Liu Yadong , Li Junyi , Guo Hongzhe , Zang Tianyi , Wang Yadong
Published: December 2019

The alignment of long-read RNA sequencing reads is non-trivial due to high sequencing errors and complicated gene structures. We propose deSALT, a tailored two-pass alignment approach, which constructs graph-based alignment skeletons to infer exons and uses them to generate spliced reference sequences to produce refined alignments. deSALT addresses several difficult technical issues, such as small exons and sequencing errors, which break through bottlenecks of long RNA-seq read alignment. Benchmarks demonstrate that deSALT has a greater ability to produce accurate and homogeneous full-length alignments. deSALT is available at: https://github.com/hitbc/deSALT.
Correction to: The life expectancy of patients with metabolic syndrome after weight loss: study protocol for a randomized clinical trial (LIFEXPE-RT)
Authors: Ospanov Oral , Yeleuov Galymzhan , Kadyrova Irina , Bekmurzinova Farida
Published: December 2019

Following publication of the original article [1], the authors notified us of a typing error in spelling Dr. Yeleuov’s name. The original publication has been corrected.
Serum levels of reactive oxygen metabolites at 12 weeks during tocilizumab therapy are predictive of 52 weeks-disease activity score-remission in patients with rheumatoid arthritis
Authors: Nakajima Arata , Terayama Keiichiro , Sonobe Masato , Aoki Yasuchika , Takahashi Hiroshi , Akatsu Yorikazu , Saito Junya , Taniguchi Shinji , Yamada Manabu , Kubota Ayako , Nakagawa Koichi
Published: December 2019

Background

To verify whether serum levels of reactive oxygen metabolites (ROM) are predictive of future clinical remission in patients with rheumatoid arthritis (RA) receiving tocilizumab (TCZ) therapy.

Methods

A total of 46 patients with RA receiving TCZ therapy were enrolled in this study. Patients were divided into remission and non-remission groups based on disease activity score 28 (DAS28)-erythrocyte sedimentation rate (ESR) or clinical disease activity index (CDAI) at 52 weeks. Associations between serum levels of ROM, C-reactive protein (CRP), and matrix metalloproteinase-3 (MMP-3) at 4 and 12 weeks and the remission by DAS28-ESR and CDAI at 52 weeks were investigated.

Results

There were no significant differences in CRP and MMP-3 between DAS- or CDAI-remission and non-remission groups at 12 weeks. However, ROM in DAS-remission group were significantly lower than those in the non-remission group. For ROM, the area under the curve of the receiver operating characteristic curve was 0.735 and the cut-off value that distinguished DAS-remission group from non-remission group was 305.5 U. Carr (sensitivity: 70.0%, specificity: 72.2%). A multivariate logistic regression analysis revealed that ROM at 12 weeks was associated with DAS-remission at 52 weeks (odds ratio: 6.067, 95% confidence interval: 1.305–28.203).

Conclusion

Serum levels of ROM at 12 weeks during TCZ therapy may be predictive of DAS-remission at 52 weeks in patients with RA.
Correction to: Mycotic aortic aneurysms post-Intravesical BCG treatment for early-stage bladder carcinoma
Authors: Wadhwani Aman , Moore Randy D. , Bakshi Darshan , Mirakhur Anirudh
Published: December 2019

In the published article [1] the statement under the subheading ‘Consent for publication’ is incorrect.
Response of Bambara groundnut (Vigna subterranean L.) and Maize (Zea mays L.) to heavy metal stress
Authors: Oladele E. O. , Adewumi O. O. , Yahaya T. , Taiwo I. A.
Published: December 2019

Background

Plants are usually the target of environmental pollution. This study, therefore, investigates the effects of Zinc (Zn) and lead Pb on Bambara nut (Vigna subterranean) and Maize (Zea mays) at different concentrations, as well as the possible ameliorating effect of the chelant; ethylene diamine acetate (EDTA) and farmyard manure, on the enzymatic activities, the chlorophyll, total protein, and carbohydrate contents.

Results

Findings revealed that Pb and Zn increased the superoxide dismutase (SOD), peroxidase, glutathione synthetase (GSH), malondialdehyde (MDA), and catalase levels with increased concentrations from 100 mg/kg to 200 mg/kg significantly (p< 0.05) compared to the control Maize plants. While in Bambara nut, the superoxide dismutase (SOD), peroxidase, glutathione synthetase (GSH), and catalase levels decreased with increased concentrations from 100 mg/kg to 200 mg/kg compared to control except for the malondialdehyde (MDA) which was increased. For Bambara groundnut, with increased Pb concentrations, the chlorophyll content reduced from 2.94 to 2.00 mg/g. However, there was an increase (up to 4.918 mg/g) in the chlorophyll content with increased zinc nitrate concentrations augmented with EDTA at the highest concentration. Maize plants treated with Pb augmented with farmyard manure showed an increase in chlorophyll content with increased concentrations while those assisted with EDTA still experienced a decrease as metal concentrations increased. Bambara groundnut plant had a mean carbohydrate (%) of 14.79 (control), 17.60 (100 mg/kg of Pb concentration) and 11.20 (200 mg/kg of Pb concentration), indicating a decrease in carbohydrate content with increased Pb concentrations. The same trend was observed for the different Zn and Pb concentrations on the mean total proteins and carbohydrates of both test plants. Generally, Pb and Zn induced oxidative stress in treated plants.

Conclusions

Elevated activity of anti-oxidative enzymes can assist as important components of antioxidative defense mechanism against oxidative damage. The results of this study could be beneficial in the understanding of the role of the defense system as well as the detoxification mechanism ofVigna subterraneanandZea maysin efficient tolerance and response to Pb and Zn. This signifies that these plants can act as bioindicators in environmental quality assessment.
Transition of Patients to and from Insulin Degludec: A Clinical Challenge
Authors: Hirsch Irl B , Draznin Boris
Published: December 2019

With appearance of new insulins on the market, new clinical challenges, much like unintended consequences, came into light in our daily practice. One of the most pressing issues has become an issue of switching patients to and from newer insulins in various clinical situations. A proper switch from 1 medication to another requires understanding of pharmacokinetics (PK) and pharmacodynamics (PD) of both drugs. Unfortunately, there is no research in this area and, as a result, there are no guidelines nor is there even a consensus. We present 5 clinical scenarios in which the patients were transitioned to or from insulin degludec. Because there are no data and no current consensus, we have polled 200 diabetes care providers soliciting their opinion as to how they would handle these clinical situations. Our poll of endocrinologists revealed multiple approaches as well as elements of confusion among providers. Even though all answers, summarized following each case, might be reasonable, and there might not be a single correct answer, we wish to express our opinion that is based on PK and PD of these insulins. Because there is more than 1 correct way of implementing these transitions, we urge our colleagues to institute a very close follow-up of these patients with frequent adjustments of insulin dose to avoid stacking with potential hypoglycemia.
Effect of pre-endoscopy intake of simethicone solution on endoscopic mucosal visibility: A single blinded, placebo control, randomized trial
Authors: Zuberi Bader Faiyaz , Shaikh Majid Ahmed , Ali Faiza Sadaqat , Rasheed Tazeen , Nawaz Zunaira
Published: December 2019

Objective: To determine effect of pre-endoscopy intake of simethicone solution on endoscopic mucosal visibility.

Methods: A randomized, single blinded placebo control trial was done in patients undergoing oesophago-gastro-duodenoscopy for any indication at DOTs Endoscopy Suite, CHK during the period of April to June 2019. Informed consent was taken. Patients were randomly allocated in two groups. Group-A received placebo while Group-B received Simethicone. Evaluation of mucosal visibility was assessed at 4 sites (oesophagus, fundus, antrum & duodenum) by previously validated scoring. Mean of visibility scores were compared in two groups.

Results: Two hundred and forty-eight patients were inducted and randomly allocate to two groups of 124 each. Mean of total sum of scores in Group-A was 8.14 ±2.44 and that of Group-B was 5.80 ±1.75 (p<0.001). Adequate visibility in Group-A was seen in 41.1% and that in Group-B was 78.2% (p<0.001).Conclusion: Use of Simethicone significantly improves mucosal visibility during OGD.

doi: https://doi.org/10.12669/pjms.36.2.1241

How to cite this:Zuberi BF, Shaikh MA, Ali FS, Rasheed T, Nawaz Z. Effect of pre-endoscopy intake of simethicone solution on endoscopic mucosal visibility: A single blinded, placebo control, randomized trial. Pak J Med Sci. 2020;36(2):172-176.  doi: https://doi.org/10.12669/pjms.36.2.1241

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Kawasaki disease: Clinico-laboratory spectrum and outcome in a cohort of children treated at a tertiary care hospital in Islamabad, Pakistan
Authors: Sakina Seema , Owais Syeda Sobya , Khan Ejaz Ahmed , Sheikh Abdul Malik
Published: December 2019

Objective: To describe the demographics; clinical, laboratory, echocardiographic findings; treatment and outcome in a cohort of children with Kawasaki disease in a tertiary care hospital.

Methods: This is a descriptive, observational, retrospective cohort study conducted at Shifa International Hospital, Islamabad, from January 2013-June 2019. Children who met the criteria for Kawasaki disease according to the American Heart Association and American Academy of Pediatrics guidelines were included.

Results: A total of 25 children who met the criteria of Kawasaki disease were included. Their mean age was 43 months (4-150 months). Majority (76%) were males. Eighteen (72%) had complete Kawasaki disease and 7 (28%) had incomplete Kawasaki disease. Fever (> five days) was present in 20 (80%) patients. Eight patients (32%) had echocardiographic changes, out of which two patients (25%) had complete Kawasaki disease and six patients (75%) had incomplete Kawasaki disease. Intravenous immunoglobulin was given to all patients. Fifteen children (60%) received intravenous immunoglobulin within 10 days of fever. None required a second dose. All patients received high dose aspirin at diagnosis which was reduced to antiplatelet dose after resolution of fever for ≥48hrs. Eighteen patients (72%) came for regular follow up. Follow up at 6 months showed complete resolution of echocardiographic changes in six patients (75%), 1 (12.5%) was lost to follow up and one (12.5%) child had persistent coronary artery dilatation.

Conclusion: Complete KD was present in 72% of our cohort of children. Coronary artery abnormalities were present in one third of these children, at younger age and more common in those with incomplete KD but recovered in most.

doi: https://doi.org/10.12669/pjms.36.2.910

How to cite this:Sakina S, Owais SS, Khan EA, Sheikh AM. Kawasaki disease: Clinico-laboratory spectrum & outcome in a cohort of children treated at a tertiary care hospital in Islamabad, Pakistan. Pak J Med Sci. 2020;36(2):260-264. doi: https://doi.org/10.12669/pjms.36.2.910

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Youth as a Subject of Strategic Communication: Structure and Phenomenological Characteristics of Social Categories
Authors: Shakalov I.
Published: December 2019

The article is devoted to one of the key problems arising in the formation of the state youth policy — the subject of strategic communication in this area. The car explores the semantic structure of the concept of “youth” taking into account the peculiarities of national consciousness, the achievements of modern humanitarian science and regulatory settings created in the modern Russian official business discourse.
Visual Communication in the Social and Cultural Internet Reality
Authors: Ryabova M.
Published: December 2019

The article touches interrelated complex of problems characterizing visual communication in the digital space of modern society. The idea of forming of visual culture with a special mental constitution is being actualized. It is revealed that visual communication is a key phenomenon of the social and cultural reality of the Internet. The collision of verbal and visual that is exposed to changes in perception between the subject and the other is considered taking into account its specific qualities. If you look at the representational turn as a phenomenon of cultural consciousness opening in the space of the Internet, its quixotic duality could be noticed. The author believes that the conceptual discourse of visualization reveals new meanings and ideas, both in the thinking of some individual (as a part) and in the space of a multicode universe as a whole. It is concluded that an increasing role of visual communication in the perception of the world at all levels leads to a new type of personality.
Clinical Guideline Highlights for the Hospitalist: Diagnosis and Management of Measles
Authors: Wang Marie E , Ratner Adam J
Published: December 2019

GUIDELINE TITLE

(1) Measles (Rubeola): For Healthcare Professionals and (2) Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings

RELEASE DATE

(1) February 5, 2018, and (2) July 2019

PRIOR VERSION(s)

n/a

DEVELOPER

Centers for Disease Control and Prevention (CDC)

FUNDING SOURCE

CDC

TARGET POPULATION

Children and adults with suspected or confirmed measles
O TABULEIRO DE DECIMAIS EM UMA CLASSE INCLUSIVA: UMA POSSIBILIDADE PARA ALUNOS COM DEFICIÊNCIA VISUAL
Authors: Araujo Marcelo Marques
Published: December 2019

O presente estudo teve como objetivo investigar quais as contribuições do Tabuleiro de Decimais voltado ao processo de ensino e aprendizagem as operações aditivas com os números decimais a educação de uma aluna com deficiência visual no terceiro ciclo do Ensino Fundamental. A pesquisa foi desenvolvida na perspectiva qualitativa, tendo como participantes oito discentes participantes de uma turma inclusiva do município de Belém (PA), sendo um destes alunos um com deficiência visual. A pesquisa teve a abordagem qualitativa e utilizou como metodologia a pesquisa ação e a aplicação de metodologia: Tabuleiro de Decimais, a fim de entendermos quais os aspectos propositivos desta ferramenta ao processo de ensino e aprendizagem dos números decimais aditivos voltados aos discentes com deficiência visual e sem deficiência. Os resultados obtidos pela pesquisa demonstraram que o uso do Tabuleiro de Decimais foi propositivo não só para o aprendizado e compreensão dos números decimais em operações aditivas com o discente com deficiência visual, bem como que para os demais alunos participantes sem deficiência visual.
Editorial | Editorial
Authors: Keller Clara Iglesias , Celeste Edoardo
Published: December 2019

Editorial of volume 5, issue 2 (2019) of Publicum ReviewEditorial do volume 5, número 2 (2019) da Revista Publicum
Manutenção da permeabilidade dos dispositivos de acesso venoso central em pacientes com câncer
Authors: Cabreira Valdemar Franco , Suguimoto Juliana Coutinho de Paula , Dini Ariane Polidoro , Cornélio Marília Estêvam , Lima Maria Helena Melo
Published: December 2019

Objetivo: atualizar o conhecimento sobre a manutenção da permeabilidade dos Dispositivos de Acesso Vascular Central (DAVC) em paciente com câncer. Conteúdo: os pacientes que fazem uso de quimioterápicos muitas vezes necessitam de DAVC seguros e de longa permanência; a obstrução ocorre em 36% dos pacientes com DAVC inseridos no período de 2 anos, que pode ser classificada como mecânica, por precipitação de medicamento/minerais e pela formação de coágulos. A equipe de enfermagem é responsável por realizar os cuidados para manter a permeabilidade desses dispositivos através do Flushing e Locking. O uso de heparina demonstrou baixa evidência quando comparado ao Soro Fisiológico (SF), em relação a diminuição da obstrução. Conclusão: o uso de SF na manutenção dos DAVC mostra-se seguro, eficaz e com menor custo financeiro.
O exercício de advocacy no âmbito da enfermagem: uma análise filosófica gadameriana
Authors: Mendes Daniel Pinho , Barlem Edison Luiz Devos , Tomaschewisk-Barlem Jamila Geri , Castanheira Janaína Sena , Dalmolin Graziele De Lima , Teixeira Clarice De Oliveira
Published: December 2019

Objetivo: conhecer as percepções de enfermeiros acerca do exercício de advocacy sob perspectiva filosófica gadameriana. Método: estudo descritivo, com abordagem qualitativa, com base no referencial teórico da Hermenêutica Filosófica. Participaram treze enfermeiros de duas unidades de internação de um hospital de ensino na região sul do Brasil. A coleta de dados ocorreu entre abril a junho de 2019, com utilização da técnica de entrevista semiestruturada e tratados por análise textual discursiva. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultados: da análise dos depoimentos emergiram duas categorias: formação ética e o exercício de advocacy por enfermeiros: fragilidades ou fortalezas? e situações de conflitos emergentes do exercício de advocacy. Conclusão: a formação profissional e a experiência prática constituem a base para o exercício de advocacy em enfermagem, fortalecendo-se com a consolidação de conhecimento e o tempo de atuação profissional.
A CORPOREIDADE E A ANÁLISE FUNCIONAL DO CORPO NO MOVIMENTO DANÇADO EM DIÁLOGO COM OUTRAS PRÁTICAS CORPORAIS
Authors: Teixeira Letícia Pereira
Published: December 2019

Este texto traz a Análise Funcional do Corpo no Movimento Dançado em diálogo com as práticas corporais de Angel Vianna, Klauss Vianna e a Eutonia de Gerda Alexander, articulada ao conceito de corporeidade com as estruturas lançadas por Hubert Godard – somática, perceptiva, coordenativa e simbólica, apoiada em Christine Roquet. O texto ainda apresenta o tema do funcionamento quiasmático – intrasensorial, intersensorial, parasensorial e inter-corporeidade de Michel Bernad aliado ao pensamento de José Gil com o conceito de sensório-motor, contato improvisação e de Daniel Stern com o conceito de percepção amodal e afetos de vitalidade.