bluuebunny/crossref_metadata_2025 huggingface dataset:
Teledermatology in paediatrics: Health-care impact on the early treatment of infantile haemangiomas
Authors: Betlloch-Mas Isabel , Martínez-Miravete María-Teresa , Berbegal-DeGracia Laura , Sánchez-Vázquez Laura , Sánchez-Payá José
Published: March 2020

Introduction

Teledermatology can solve diagnostic and therapeutic problems in paediatrics, for example in infantile haemangiomas (IHs) requiring early treatment with propranolol. This study aims to assess the impact of teledermatology following its implementation in a health area of Spain, specifically analysing its effectiveness in reducing the age of first propranolol treatment for IH.

Methods

This was a descriptive study of paediatric teledermatology from 2015 to 2018, studying age, sex, diagnosis, time and mode of resolution. All IHs referred via teledermatology were analysed, and age at propranolol initiation was compared to the period prior to implementation (2008–2014). We also analysed IHs according to referral pathways (teledermatology vs. conventional pathways).

Results

We included 432 consultations (47.7% boys). The main diagnoses were IH, erythematous-desquamative diseases and infections. Concordance in diagnosis between paediatricians and dermatologists was good, and 48.12% of cases consulted via teledermatology were resolved remotely. Response time was 2.81 days on average. Children younger than two months of age showed the highest proportion of in-person visits. In 2015–2018, children with IHs began treatment with propranolol at a mean age of 4.5 months (1.9 months in those referred via teledermatology vs. 5.6 months in those using conventional referral pathways). In 2008–2014, the mean age at referral was 7.1 months. These differences were significant.

Discussion

Teledermatology is a fast and effective tool to resolve paediatric cases, enabling a significant decrease in the age of treatment in infants with IH.
Parents’ perceived social support and children’s psychological adjustment
Authors: Nunes Cristina , Martins Cátia , Ayala-Nunes Lara , Matos Filomena , Costa Emilia , Gonçalves Andrea
Published: March 2020

Perceived social support has often been investigated due to its direct and indirect effects in reducing the impact of several risk factors on physical and psychological well-being. Moreover, many studies have revealed a link between social support and positive parenting, which in turn has an impact on children’s well-being. In Portugal, there is a significant lack of studies in this area. The aim of the present study was to analyze the relationship between parents’ perceived social support and children’s psychological adjustment. The sample consisted of 409 parents (83.13% mothers) living in the region of Algarve (South of Portugal). The Duke-UNC Functional Social Support and the Strengths and Difficulties Questionnaires were used.

Findings

The results showed that, on average, families had a social support network of nine people, with a balanced presence of family ( M = 4.25, SD = 3.54) and friends ( M = 4.36, SD = 3.17). Parents reported medium-high levels of confidant and affective support, but instrumental support was lower. However, single-parent families, immigrant families, and divorced parents were found to be more socially isolated and received less support than they needed. Affective social support showed predictive value for child psychological adjustment.

Applications

These findings suggest that developing universal and selective parental education and support programs that focus on strengthening informal social support networks is needed, especially for vulnerable families. Implications for social workers who intervene with families are discussed.
Impact of fibre orientation on thickness and tensile strength of needle-punched nonwoven: Optimization of carding parameters
Authors: Roy Rupayan , Ishtiaque SM , Dixit Priyal
Published: March 2020

In this research work, the authors have investigated the influence of fibre orientation on thickness and tenacity of needle-punched nonwoven fabrics by using three-factor three-level Box–Behnken Design. Three carding parameters such as feeder speed, cylinder speed and doffer speed, which are primarily responsible for fibre orientation, were considered as three factors with three different levels. Fibre orientation was evaluated in terms of anisotropy by using tracer fibre technique. Anisotropy was measured in both un-punched and punched fibrous structure. Tenacity was measured in both machine and cross directions. It was found that the tenacity in the cross direction and thickness decreases but the tenacity in the machine direction increases with the increase of anisotropy as well as fibre orientation.
Use of low-dose acetylsalicylic acid for cardiovascular disease prevention: A practical, stepwise approach for pharmacists
Authors: Barry Arden R. , Semchuk William M. , Thompson Ann , LeBras Marlys H. , Koshman Sheri L.
Published: March 2020

Low-dose acetylsalicylic acid (ASA) is recommended in patients with established cardiovascular disease. However, the role of ASA in those without cardiovascular disease (i.e., primary prevention) is less clear, which has led to discordance among Canadian guidelines. In 2018, 3 double-blind, randomized controlled trials were published that evaluated ASA 100 mg daily versus placebo in patients without established cardiovascular disease. In the ASPREE trial, ASA did not reduce the risk of all-cause death, dementia, or persistent physical disability in patients ≥70 years of age but increased the risk of major bleeding. In the ARRIVE trial, ASA failed to lower the risk of a composite of cardiovascular events but increased any gastrointestinal bleeding in patients at intermediate risk of cardiovascular disease. In the ASCEND trial, ASA significantly reduced the primary composite cardiovascular outcome in patients with diabetes for a number needed to treat of 91 over approximately 7.4 years. Yet major bleeding was increased with ASA for a number needed to harm of 112. Therefore, in most situations, ASA should not be recommended for primary cardiovascular prevention. However, there are additional indications for ASA beyond cardiovascular disease. Thus, a sequential algorithm was developed based on contemporary evidence to help pharmacists determine the suitability of ASA in their patients and play an active role in educating their patients about the potential benefits (or lack thereof) and risks of ASA. Can Pharm J (Ott) 2020;153:xx-xx.
Common Data Fusion Framework: An open-source Common Data Fusion Framework for space robotics
Authors: Dominguez Raul , Post Mark , Fabisch Alexander , Michalec Romain , Bissonnette Vincent , Govindaraj Shashank
Published: March 2020

Multisensor data fusion plays a vital role in providing autonomous systems with environmental information crucial for reliable functioning. In this article, we summarize the modular structure of the newly developed and released Common Data Fusion Framework and explain how it is used. Sensor data are registered and fused within the Common Data Fusion Framework to produce comprehensive 3D environment representations and pose estimations. The proposed software components to model this process in a reusable manner are presented through a complete overview of the framework, then the provided data fusion algorithms are listed, and through the case of 3D reconstruction from 2D images, the Common Data Fusion Framework approach is exemplified. The Common Data Fusion Framework has been deployed and tested in various scenarios that include robots performing operations of planetary rover exploration and tracking of orbiting satellites.
Natural History of 321 Flatfoot Reconstructions in Adult Acquired Flatfoot Deformity Over a 14-Year Period
Authors: Goss Madison , Stauch Christopher , Lewcun Joseph , Ridenour Ryan , King Jesse , Juliano Paul , Aynardi Michael
Published: March 2020

The purpose of this study was to report the natural history, demographics, and mechanisms of requirement for additional surgery in patients undergoing flatfoot reconstruction for adult acquired flatfoot. A total of 321 consecutive patients undergoing flatfoot reconstruction over a 14-year period were included (2002-2016). All procedures were performed by a senior orthopaedic foot and ankle surgeon at our institution. Demographic data, operative reports, clinic notes, and radiographs were available for review. Statistical analysis included calculation of relative risk (RR) ratios. The majority of patients were female (83.2%,) and most patients were overweight with a body mass index greater than 25 kg/m2 (56.4%). Patient comorbidities included diabetes (13.7%) and rheumatoid arthritis (3.7%). Additional surgery was required for 54 patients (16.8%). The most common reasons for additional surgery were the following: painful calcaneal hardware (57.4%), conversion to triple arthrodesis (16.7%), and wound healing complications (9.1%). An increased risk of need for additional surgery was associated with female gender (RR = 3.4; P = .0005), smoking status (RR = 1.9; P = .0081), and age (<60 years of age; RR = 1.8; P = .042). Although retrospective, the results provide insight into the natural history of this procedure. Clinicians may use these data to appropriately counsel patients who are at increased risk of requirement for additional surgery, such as smokers, women, and patients <60 years old, regarding treatment options.

Levels of Evidence: Level IV
Pilot Investigation: Prospective Needs Assessment of Knowledge, Attitude, and Insight About Mental Health Treatment Options in Patients With Chronic Rhinosinusitis
Authors: Mattos Jose L. , Ashby Shaelene , Payne Spencer C. , Newberry Ian , Alt Jeremiah
Published: March 2020

Introduction

Mood disorders frequently coexist with chronic rhinosinusitis (CRS), yet patient views of how mental health impacts their disease, and their willingness to engage in treatment is not well understood.

Methods

Subjects with CRS were enrolled regardless of their mental health status and completed a needs questionnaire on mental health as it related to CRS. In addition, demographic and disease-specific data were collected.

Results

We enrolled 55 subjects. In addition, 29.1% of them had polyps, with mean endoscopy/computed tomography (CT)/Sino-Nasal Outcome Test (SNOT-22) scores of 3.9/9.7/41.2, respectively and 45% thought depression was common in CRS patients. In total, 78.2% were open to taking a depression screener and would be comfortable discussing mental health with their Ear Nose and Throat provider, 76.4% of patients felt that treating mental health problems could improve sinus-related quality of life (QOL), and 87.3% were open to meeting with a mental health professional or participating in a course on managing stress/anxiety/mental health issues. The multivariate regression model of whether patients felt that treating the mind would improve sinus-related QOL as predicted by age, gender, SNOT-22, CT scores, and endoscopy scores was statistically significant ( P = .027) and explained 42% of the variance in answers, but only age and gender approached statistical significance ( P = .06 and .04).

Conclusions

CRS patients acknowledged the high prevalence of comorbid mood disorders and were willing to discuss and be treated for mental health issues. Many patients felt that treating their mental health would improve their disease-specific QOL. These findings warrant further study of how to incorporate the management of metal health into CRS treatment algorithms.
Refreshing China’s Labor Education in the New Era: Policy Review on Education Through Physical Labor
Authors: Fan Guorui , Zou Jiaxin
Published: March 2020

Purpose:

This study reviews China’s labor education theories and policies to reveal the main objectives, contents, and methods of the new era, as well as analyzes future development in labor education.

Design/Approach/Methods:

In addition to reviewing the relevant labor education theories, this study examines China’s labor education policies using historical documents and current policy texts. Marxist and traditional approaches to labor education, as well as the historical development of education in China, provide the macroscopic backdrop of this study’s analysis of the persistence and innovativeness of China’s labor education policies.

Findings:

China’s labor education policy has placed labor education on the same level as that in morality, intellect, sports, and aesthetics, thereby endowing labor education with new meaning. Labor education seeks to cultivate workers with all-round physical and mental development. Becoming more varied over time, labor education now involves the cultivation of skills, technological capacities, creative thinking, labor habits, and emotional development. Approaches and methods include formal programs and teaching, education in daily life at home and school, as well as practical activities outside of school.

Originality/Value:

This study identifies the meaning of labor education in different eras and analyzes the objectives, contents, and methods of China’s current policies on labor education, as well as its future developmental trends. In doing so, this study provides a useful reference for the implementation of labor education in elementary and middle schools.
Skateboarding Injuries in Spain: A Web-Based Survey Approach
Authors: Rodríguez-Rivadulla Adrián , Saavedra-García Miguel Ángel , Arriaza-Loureda Rafael
Published: March 2020

Background:

The inclusion of skateboarding in the Tokyo 2020 Olympic Games reinforces this activity as a sport. As the number of skateboarders around the world and the difficulty of skateboarding maneuvers continue to increase, the number of skateboarding injuries may also rise. Thus, there is a need for more comprehensive investigations into the practice habits and injuries of skateboarders.

Purpose:

To describe the sports habits and skateboarding injuries of a sample of skateboarders in Spain.

Study Design:

Descriptive epidemiology study.

Methods:

A web-based survey was shared among skateboarders in Spain. The survey collected data related to sports habits, skateboarding practice habits, and injury history. Comparisons between subgroups of sex, age, and experience were also conducted.

Results:

The survey was completed by 197 participants (89.3% male) with a mean age of 24.4 ± 7.1 years and a mean experience of 9.7 ± 7.2 years. Most respondents (87.8%) reported not participating in any type of skateboarding-specific physical training program. Only 27.4% took part in skateboarding competitions, with a larger number of respondents younger than 18 years participating in competitive events. The mean number of sessions per week was 3.3 ± 1.7, and the mean length of sessions was 3.3 ± 1.5 hours. The majority of participants (87.8%) reported having suffered injuries (n = 323) as a result of skateboarding, mainly affecting the lower limbs (69.7%). The most common injury type was a ligament sprain (39.6%), especially of the ankle (39.3%). This injury was also reported as the most likely to recur (70.1%). A large number of injuries (54.2%) were considered severe (ie, >21 days to recover). Most injuries occurred while skateboarding gaps or stairs, including any type of a jump that involved a difference in height between the take-off and landing surfaces (25.7%). Female participants accounted for a larger number of ligament sprains than expected, and experienced skateboarders were more likely to suffer more severe injuries and head/trunk injuries.

Conclusion:

Respondents to this survey were mainly young male adults who practiced skateboarding recreationally. Respondents of different sexes, ages, and experiences demonstrated different habits and injury patterns. The greater number of severe injuries highlights the need for injury surveillance in skateboarding to inform better prevention and rehabilitation practices.
Novel Chemo-Photothermal Therapy in Breast Cancer Using Methotrexate-Loaded Folic Acid Conjugated Au@SiO2 Nanoparticles
Authors: Agabeigi Reza , Rasta Seyed Hossein , Rahmati-Yamchi Mohammad , Salehi Roya , Alizadeh Effat
Published: March 2020

Low level laser therapy (LLLT) is known as a safe type of phototherapy to target tumor tissue/cells. Besides, using targeted nanoparticles increases the successfulness of cancer therapy. This study was designed for investigating the combined effect of folate (FA)/Methotrexate (MTX) loaded silica coated gold (Au@SiO2) nanoparticles (NPs) and LLLT on the fight against breast cancer.

NPs were synthesized and characterized using FTIR, TEM and DLS-Zeta. The NPs had spherical morphology with mean diameter of around 25 nm and positive charge (+13.3 mV) while after conjugation with FA and MTX their net charge reduced to around -19.7 mV.

Our findings in cell uptake studies clearly showed enhanced cellular uptake of NPs after FA and MTX loaded NPs in both breast cancer cell lines especially on MDA-MB-231 due to high expression of folate receptors. The results indicated that LLLT had a proliferative effect on both breast cancer cell lines but in the presence of engineered breast cancer targeted nanoparticle, the efficacy of combination chemo-photothermal therapy was significantly increased using MTT assay (p<0.05), DAPI staining, and cell cycle findings. The highest apoptotic effect on breast cancer cell lines was observed in the cells exposed to a combination of MTX-FA loaded Au@SiO2 NP and LLLT proved by DAPI staining and cell cycle(by increasing the cell arrest in subG0/G1). Taken together a combination of chemotherapy and LLLT improves the potential of breast cancer therapy with minimum side effects.
Association between motoric cognitive risk syndrome and frailty among older Chinese adults
Authors: Shen Shanshan , Zeng Xingkun , Xu Liyu , Chen Lingyan , Liu Zixia , Chu Jiaojiao , Yang Yinghong , Wu Xiushao , Chen Xujiao
Published: March 2020

Background

Motoric cognitive risk syndrome (MCR) is a newly proposed predementia syndrome incorporating subjective cognitive complaints and slow gait. Previous studies have reported that subjective cognitive complaints and slow gait are associated with frailty in cognitively unimpaired older adults, but little is known about the link between MCR and frailty in older adults. Therefore, the aim of the study was to explore the associations of MCR and its components with frailty in older Chinese adults.

Methods

In an observational cross-sectional study, a total of 429 older adults aged 60 years and older were admitted to the geriatric department. According to MCR criteria, all participants were classified into 4 groups: 1) the MCR group; 2) the subjective cognitive complaints only group; 3) the slow gait only group; and 4) the healthy control group. Physical frailty was assessed by the Clinical Frailty Scale (CFS). Multivariate logistic regression analysis was used to examine the association between MCR and frailty in older adults.

Results

The prevalence rates of subjective cognitive complaints, slow gait and MCR were 15.9, 10.0 and 4.0%, respectively. After adjusting for confounding variables, the logistic regression analysis showed that slow gait (odds ratio [OR]: 3.40, 95% confidence interval [CI]: 1.40–8.23, P = 0.007) and MCR (OR: 5.53, 95% CI: 1.46–20.89, P = 0.012) were independently associated with frailty, but subjective cognitive complaints were not.

Conclusions

MCR and slow gait were significantly associated with frailty in older Chinese adults. Further studies should prospectively determine the causal relationship between MCR and frailty.
Evaluation of efficacy and recurrence for anti-vascular endothelial growth factor therapy in idiopathic choroidal neovascularization
Authors: Wu Qianru , Chen Xiaoyong , Feng Kang , Liu Yuling , Zhang Chun , Zhao Lin
Published: March 2020

Background

This study aimed to evaluate the visual and morphological outcomes of intravitreal anti-VEGF therapy and the recurrence for idiopathic choroidal neovascularization (ICNV).

Methods

This retrospective study included 35 patients (35 eyes) with ICNV from July 2012 to October 2017. All patients received 1 intravitreal anti-VEGF injection followed by pro re nata injections until there was no sign of ICNV activity. This was defined as the first follow-up period. To evaluate ICNV recurrence, we continued to follow-up 27 of the 35 patients for at least 2 years after the initial diagnosis, and the longest follow-up period was 5 years. Additional injection was performed when ICNV recurred. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were recorded and morphological improvement in optical coherence tomography (OCT) was assessed. Parameters that affect prognosis and recurrence were analysed.

Results

The mean follow-up period was 168.0 ± 34.82 weeks. Mean BCVA improved from 56.20 ± 14.13 letters at baseline to 73.31 ± 12.57 letters (P<0.01); Mean CRT decreased from 353.6 ± 98.70 μm at baseline to 273.1 ± 53.56 μm (P < 0.001) at the end of the first follow-up period. Better baseline BCVA indicated a better morphological improvement (P = 0.026) in OCT: the lesion had completely subsided with recovery of the foveal contour. Those with high baseline BCVA (more than 60 letters) showed significant resolution of CNV lesions (P = 0.036). ICNV recurred in six patients (22.2%), 1 of whom experienced 2 recurrences. The mean timing of recurrence was 90.83 ± 49.02 weeks after diagnosis. There was no significant correlation between ICNV recurrence and the morphological improvement (P = 0.633). The final BCVA in patients with recurrence did not differ from that in patients without recurrence (P = 0.065).

Conclusions

Intravitreal anti-VEGF therapy on a pro re nata basis was effective for treating ICNV. High baseline BCVA indicated a better prognosis. Re-treatment with anti-VEGF could effectively lead to resolution of recurrent ICNV. Disease recurrence had no significant effect on final visual prognosis and had no correlation with the morphological improvement during treatment, suggesting that follow-up for subsequent monitoring should be performed in all ICNV patients.
Association of sugar-sweetened drinks with caries in 10- and 15-year-olds
Authors: Pitchika Vinay , Standl Marie , Harris Carla , Thiering Elisabeth , Hickel Reinhard , Heinrich Joachim , Kühnisch Jan
Published: March 2020

Background

Sugar-sweetened drinks (SSDs) are known to be cariogenic, but this association has not been well investigated in population-based repeated cross-sectional studies in recent years. Therefore, this study examined whether SSD intake is associated with higher caries experience in 10- and 15-year-olds.

Methods

The study sample included participants from the Munich study centre of two birth cohorts with data on non-cavitated caries lesions (NCCL/S), caries experience (DMF/S index), overall caries burden (DMF + NCCL/S) and SSD intake. In total, 915 and 996 children were included from the 10- and 15-year follow-ups, respectively. Intake (g/day) of SSDs, comprising cola, lemonade, ice-tea, sport/energy drinks, fruit squashes and nectars, was calculated from food frequency questionnaires. For analyses, the SSD intake was converted into portions (250 ml/day). Multiple logistic regression and prospective analysis models were performed to test associations between SSD intake and various definitions of caries, adjusting for sex, parental education, body mass index (BMI) categories, study cohort, plaque-affected sextants, mode of SSD consumption, energy content of SSDs, and total energy intake.

Results

The mean overall caries burden at 10 and 15 years of age was 1.81 (SD: 2.71) and 6.04 (SD: 8.13), respectively. The average consumption of SSDs at the 10- and 15-year follow-ups was 0.48 (SD: 0.85) and 0.83 (SD 1.40) portions/day, respectively. After adjusting for confounders, in 10-year-olds, SSD intake was significantly associated with higher caries experience based on the indices DMF/S (adjusted odds ratio: 1.29; 95% CI: 1.06–1.57), NCCL/S (1.24; 1.03–1.49) and DMF + NCCL/S (1.27; 1.05–1.55). At the 15-year follow-up, SSD consumption was significantly associated with increased DMF/S index (1.12; 1.01–1.25) only. Prospective model associating 10-year SSD intake with 15-year caries experience was not significant.

Conclusions

SSD intake significantly increases the caries burden in 10-year-olds, with attenuated effects in 15-year-olds. To prevent caries, SSD consumption should be reduced, especially in children and adolescents.
Practical example of multiple antibody screening for evaluation of malaria control strategies
Authors: Varela Marie-Louise , Koffi David , White Michael , Niang Makhtar , Mbengue Babacar , Diene Sarr Fatoumata , Touré André Offianan , Perraut Ronald
Published: March 2020

Background

Ongoing efforts to fight Plasmodium falciparum malaria has reduced malaria in many areas, but new tools are needed to monitor further progress, including indicators of decreasing exposure to parasite infection. Sero-surveillance is considered promising to monitor exposure, transmission and immunity.

Methods

IgG responses to three antigen biomarkers were evaluated in a retrospective study involving: (i) surveys of 798 asymptomatic villagers from 2 Senegalese endemic settings conducted before 2002 and after the 2013 intensification of control measures, and (ii) in 105 symptomatic individuals from different settings in Côte d’Ivoire. Response to up to eight P. falciparum antigens, including recombinant MSP1p9 antigen and LSA141 peptide, were analysed using multiplex technology and responses to whole P. falciparum schizont extract (SE, local strain adapted to culture) were measured by ELISA.

Results

MSP1p9 and LSA141 IgG responses were shown to be relevant indicators monitoring immune status in the different study sites both from Côte d’Ivoire and Senegal. Between 2002 and 2013, individuals participating in both studies showed higher decline of sero-positivity in young (< 15 years: range 12% to 50%) than older (> 15 years: no decline to 15%) individuals from Dielmo and Ndiop. A mathematical sero-catalytic model from the complete Dielmo/Ndiop survey was used to reconstruct declining levels of sero-positivity in more detail, demonstrating that anti-SE seroprevalence levels most accurately reflected malaria exposure in the two villages.

Conclusion

For standard screening of population immune status at sites envisaging elimination, the use of ELISA-based assays targeting selected antigens can contribute to provide important epidemiologic surveillance data to aid malaria control programmes.
Noncoding RNAs in gastric cancer: implications for drug resistance
Authors: Wei Ling , Sun Jujie , Zhang Nasha , Zheng Yan , Wang Xingwu , Lv Liyan , Liu Jiandong , Xu Yeyang , Shen Yue , Yang Ming
Published: March 2020

Gastric cancer is the fourth most common malignancy and the third leading cause of cancer-related deaths worldwide. Advanced gastric cancer patients can notably benefit from chemotherapy including adriamycin, platinum drugs, 5-fluorouracil, vincristine, and paclitaxel as well as targeted therapy drugs. Nevertheless, primary drug resistance or acquisition drug resistance eventually lead to treatment failure and poor outcomes of the gastric cancer patients. The detailed mechanisms involved in gastric cancer drug resistance have been revealed. Interestingly, different noncoding RNAs (ncRNAs), such as microRNAs (miRNAs), long noncoding RNAs (lncRNAs) and circular RNAs (circRNAs), are critically involved in gastric cancer development. Multiple lines of evidences demonstrated that ncRNAs play a vital role in gastric cancer resistance to chemotherapy reagents and targeted therapy drugs. In this review, we systematically summarized the emerging role and detailed molecular mechanisms of ncRNAs impact drug resistance of gastric cancer. Additionally, we propose the potential clinical implications of ncRNAs as novel therapeutic targets and prognostic biomarkers for gastric cancer.
Latent class instrumental variables and the monotonicity assumption
Authors: Baker Stuart G.
Published: March 2020

A key aspect of the article by Lousdal on instrumental variables was a discussion of the monotonicity assumption. However, there was no mention of the history of the development of this assumption. The purpose of this letter is to note that Baker and Lindeman and Imbens and Angrist independently introduced the monotonicity assumption into the analysis of instrumental variables. The letter also places the monotonicity assumption in the context of the method of latent class instrumental variables.
Mapping and comparing French people’s positions regarding restrictive control policies: a pilot study
Authors: Castanié Sylvie , Munoz Sastre Maria Teresa , Kpanake Lonzozou , Mullet Etienne
Published: March 2020

Background

Public authorities resort to various control policies in order to curb the prevalence of unhealthy behaviors. As these policies can only succeed to the extent that people agree with them, this study mapped French people’s positions regarding restrictive control policies in general.

Method

A sample of 344 adults (among them health professionals and lawyers) were presented with 54 vignettes depicting a control policy. Each vignette contained four pieces of information: the type of addictive behavior targeted (smoking, drinking, or gambling), the nature of preventive measures (e.g., information campaigns), the degree of regulative measures (e.g., prohibition to minors), and the severity of sanctions.

Results

Through cluster analysis, eight qualitatively different positions were found: Never acceptable (9%), Weak or moderate regulation (5%), Moderate regulation associated with strong prevention (11%), Strong or moderate regulation (11%), Strong regulation in association with strong prevention (23%), Moderate sanctions in association with strong prevention and moderate regulation (9%), Severe sanctions (9%), and Always acceptable (9%). Some participants (14%) expressed no opinion at all.

Conclusion

French people’s positions regarding control policies were extremely diverse. Regarding tobacco, however, one type of policy would likely be supported by a majority of people: Moderate regulation associated with at least a moderate level of prevention and low-level sanctions. Regarding alcohol, an acceptable position would be: Moderate regulation associated with at least a moderate level of prevention and high-level sanctions. Regarding gambling, an acceptable position would be: Strong regulation associated with at least a moderate level of prevention and low-level sanctions.
Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity
Authors: Hu Xinyue , Zhong Meiling , Lou Yue , Xu Peng , Jiang Bo , Mao Fengyong , Chen Dan , Zheng Pengfei
Published: March 2020

Background

Cubitus varus deformity is a common sequela of elbow fractures in children. Cubitus varus deformity treatment is tending toward 3D correction, which is challenging for orthopedic surgeons. This study aims to explore whether individualized 3D-printed navigation templates can assist with accurate and effective corrective treatment of children with cubitus varus deformity.

Methods

Thirty-five patients were treated for cubitus varus deformity from June 2015 to April 2017, including 21 boys and 14 girls, aged 4.6–13.2 years (average, 7.5 years). Of these cases, 17 deformities were on the left side and 18 were on the right side. All were treated with wedge osteotomy of the lateral distal humerus. 3D-printed navigation templates were used in 16 cases, while traditional surgery was used in 19 cases. All patients underwent computed tomography scans before surgery. Computer software was used to analyze the measurements and design and print individualized navigation templates. The navigation templates were matched, and surgery was initially simulated. Intraoperative individualized navigation templates were used to assist with accurate osteotomy and Kirschner wire fixation. Operation times were recorded in all cases, the carrying angles before and after surgery were assessed by computer, and postoperative elbow joint function was evaluated using Bellemore criteria. All measurement data were presented as means ± SD, and Student’s t test was used to examine differences between groups. All count data between both groups were compared using the chi-square test or Fisher’s exact test analysis.

Results

All individualized navigation templates matched well with the corresponding anatomical markers and were consistent with preoperative planning, simulated surgery, and intraoperative procedures. Average operation times from clear exposure to fixed Kirschner wire were 11.69 min (9.6–13.5 min) for the individualized navigation template group and 22.89 min (17.7–26.8 min) for the traditional operation group (p < 0.001). Average differences in postoperation carrying angles between affected and healthy sides were 1.13° (0–2.0°) and 4.21° (0–7.5°), respectively (p < 0.001). Follow-up 6–12 months postoperation showed that elbow function did not differ significantly between groups using the Bellemore criteria (p > 0.05).

Conclusions

Individualized navigation templates simplify procedures, reduce operation time, and improve accuracy when used in orthopedic surgery to treat children with cubitus varus deformity.
Intrathecal versus local infiltration analgesia for pain control in total joint arthroplasty
Authors: Cai Ai-Lan , Liu Sheng-Jie , Wu Bin , Liu Geng
Published: March 2020

Background

The purpose of this meta-analysis was to assess the efficacy of intrathecal morphine (ITM) analgesia and local infiltration analgesia (LIA) for pain control in total joint arthroplasty (TJA).

Methods

Embase, PubMed, the Cochrane Library, and Web of Science were systematically searched for randomized controlled trials (RCTs). All RCTs were comparing intrathecal analgesia and local infiltration analgesia in TJA. Primary outcomes were the visual analog scale (VAS) score with rest or mobilization up to 72 h. Secondary outcomes were the total morphine consumption, length of hospital stay, and morphine-related complications.

Results

Compared with the intrathecal analgesia group, the LIA group was associated with a reduction in VAS score with rest up to 72 h. Moreover, LIA was associated with a decrease in VAS score with mobilization at 6 h, 12 h, 48 h, and 72 h. Moreover, LIA significantly reduced total morphine consumption (weighted mean difference (WMD)  = − 15.37, 95% CI − 22.64 to − 8.83, P  = 0.000), length of hospital stay (WMD  =  − 1.39, 95% CI − 1.67 to − 1.11, P  = 0.000), and morphine-related complications (nausea and pruritus).

Conclusions

Local infiltration provided superior analgesia and morphine-sparing effects within the first 72 h compared with ITM following TJA.
An investigation on parenting stress of children with cystic fibrosis
Authors: Continisio Grazia Isabella , Serra Nicola , Guillari Assunta , Civitella Maria Teresa , Sepe Angela , Simeone Silvio , Gargiulo Gianpaolo , Toscano Silvia , Esposito Maria Rosaria , Raia Valeria , Rea Teresa
Published: March 2020

Background

The management of chronic diseases, particularly in children, requires an integrated physical and psychological approach to both sick children and their family. This is the case of Cystic Fibrosis (CF), a complex genetic chronic disease, where, a comprehensive evaluation of the emotional impact and an effective multidimensional approach are indicated.

Aim

This study investigates on parenting stress in children and adolescents with CF and its determinants related to parents, children and the disease severity.

Methods

The study involved 34.04% adult males and 65.96% adult females (range 21-55 years) and 47 children with CF, 54.35% males and 45.65% females (range 1-17 years). The data were obtained through a Parenting Stress Index – Short Form (PSI-SF) questionnaire. According to the PSI-SF scoring system, three types of stress were detected: a typical stress pattern (normal), a high stress pattern (increased) and a defensive response, which may be considered as a high stress feature in children which requires monitoring and clinical evaluation.

Results

This study shows a significant presence of stress in females (60.23%), of subject married (84.62%), unemployed (69.23%) and with education level such as “middle School” (61.54%). Concerning children of parents with high stress, it resulted most frequent children with one sibling (53.85%). Finally, by univariate analysis, it resulted a significant positive correlation between parenting stress and disease degree of children. Instead by multivariate analysis, we found that the variables: Number of siblings and Birth order were a significant positive and negative predictor of parenting stress respectively.

Conclusion

An increased stress level was detected in less than one third of parents of subjects with CF. These data may be related to the psychological support which is part of the routine management of CF care team. However, as children’s features seem to act as a determinant of stress more than parental ones, the parental-child dysfunction should be the target for further integrated interventions.
Impact of continuous Kangaroo Mother Care initiated immediately after birth (iKMC) on survival of newborns with birth weight between 1.0 to < 1.8 kg: study protocol for a randomized controlled trial
Authors:   WHO Immediate KMC Study Group
Published: March 2020

Background

Globally, about 15% of newborns are born with a low birth weight (LBW) as a result of preterm birth or intrauterine growth restriction or both. Up to 70% of neonatal deaths occur in this group within the first 3 days after birth. Kangaroo Mother Care (KMC) applied after stabilization of the infant has been shown to reduce mortality by 40% among hospitalized infants with a birth weight of less than 2.0 kg. In these studies, infants were randomly assigned and KMC was initiated after about 3 days of age, when the majority of neonatal deaths would have already occurred. The aim of this trial is to evaluate the safety and efficacy of continuous KMC initiated as soon as possible after birth compared with the current recommendation of initiating continuous KMC after stabilization in neonates with a birth weight between 1.0 and less than 1.8 kg.

Methods

This randomized controlled trial is being conducted in tertiary-care hospitals in five low- to middle-income countries (LMICs) in South Asia and sub-Saharan Africa. All pregnant women admitted to these hospitals for childbirth are pre-screened. After delivery, all neonates with a birth weight between 1.0 and less than 1.8 kg are screened for enrollment. Eligible infants are randomly assigned to intervention and control groups. The intervention consists of continuous skin-to-skin contact initiated as soon as possible after birth, promotion and support for early exclusive breastfeeding, and provision of health care for mother and baby with as little separation as possible. This efficacy trial will primarily evaluate the impact of KMC started immediately after birth on neonatal death (between enrollment and 72 h of age and deaths between enrollment and 28 days of age) and other key outcomes.

Discussion

This is the first large multi-country trial studying immediate KMC in LMICs. Implementation of this intervention has already resulted in an important enhancement of the paradigm shift in LMIC settings in which mothers are not separated from their baby in neonatal intensive care units (NICUs). The findings of this trial will have future global implications not only on how the LBW newborns are cared for immediately after birth but also for the dissemination of designing NICUs in accordance with the mother-neonatal intensive care unit (M-NICU) model.

Trial registration

Clinical Trials Registry - India (CTRI): CTRI/2018/08/01536 (retrospectively registered); Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12618001880235 (retrospectively registered).
How pragmatic are the randomised trials used in recommendations for control of glycosylated haemoglobin levels in type 2 diabetic patients in general practice: an application of the PRECIS II tool
Authors: Ettori-Ajasse Isabelle , Tatin Elise , Forbes Gordon , Eldridge Sandra , Dibao-Dina Clarisse
Published: March 2020

Background

Recommendations for good clinical practice have been reported to be difficult to apply in real life by primary care clinicians. This could be because the clinical trials at the origin of the guidelines are based on explanatory trials, conducted under ideal conditions not reflecting the reality of primary care, rather than pragmatic trials conducted under real-life conditions. The objective of this study was to evaluate how pragmatic are the clinical trials used to build the French High Authority of Health’s recommendations on the management of type II diabetes.

Methods

Trials from the 2013 Cochrane meta-analysis that led to the 2013 French High Authority of Health’s recommendations on the management of type II diabetes were selected. Each trial was analysed by applying the PRECIS-2 tool to evaluate whether the trial was pragmatic or explanatory, according to the nine domains of PRECIS-2. Each domain was scored between 1 (very explanatory) and 5 (very pragmatic) by two blinded researchers, and consensus was reached with a third researcher in case of discrepancy. Median scores were calculated for each of the nine domains.

Results

Twenty-three articles were analysed. Eight out of nine domains – namely eligibility, recruitment, setting, organisation, flexibility of delivery, flexibility of adherence, follow-up, and primary outcome – had a median score of less than 3, indicating a more explanatory design. Only the primary analysis domain had a score indicating a more pragmatic approach (median score of 4). In more than 25% of the articles, data to score the domains of recruitment, flexibility of delivery, flexibility of adherence, and primary analysis were missing.

Conclusions

Trials used to build French recommendations for good clinical practice for the management of type 2 diabetes in primary care were more explanatory than pragmatic. Policy-makers should encourage the funding of pragmatic trials to evaluate the different strategies proposed for managing the patient’s treatment according to HbA1C levels and give clinicians feasible recommendations.
Cis-regulatory analysis of Onecut1 expression in fate-restricted retinal progenitor cells
Authors: Patoori Sruti , Jean-Charles Nathalie , Gopal Ariana , Sulaiman Sacha , Gopal Sneha , Wang Brian , Souferi Benjamin , Emerson Mark M.
Published: March 2020

Background

The vertebrate retina consists of six major classes of neuronal cells. During development, these cells are generated from a pool of multipotent retinal progenitor cells (RPCs) that express the gene Vsx2. Fate-restricted RPCs have recently been identified, with limited mitotic potential and cell fate possibilities compared to multipotent RPCs. One population of fate-restricted RPCs, marked by activity of the regulatory element ThrbCRM1, gives rise to both cone photoreceptors and horizontal cells. These cells do not express Vsx2, but co-express the transcription factors (TFs) Onecut1 and Otx2, which bind to ThrbCRM1. The components of the gene regulatory networks that control the transition from multipotent to fate-restricted gene expression are not known. This work aims to identify and evaluate cis-regulatory elements proximal to Onecut1 to identify the gene regulatory networks involved in RPC fate-restriction.

Method

We identified regulatory elements through ATAC-seq and conservation, followed by reporter assays to screen for activity based on temporal and spatial criteria. The regulatory elements of interest were subject to deletion and mutation analysis to identify functional sequences and evaluated by quantitative flow cytometry assays. Finally, we combined the enhancer::reporter assays with candidate TF overexpression to evaluate the relationship between the TFs, the enhancers, and early vertebrate retinal development. Statistical tests included ANOVA, Kruskal-Wallis, or unpaired t-tests.

Results

Two regulatory elements, ECR9 and ECR65, were identified to be active in ThrbCRM1(+) restricted RPCs. Candidate bHLH binding sites were identified as critical sequences in both elements. Overexpression of candidate bHLH TFs revealed specific enhancer-bHLH interactions. Nhlh1 overexpression expanded ECR65 activity into the Vsx2(+) RPC population, and overexpression of NeuroD1/NeuroG2/NeuroD4 had a similar effect on ECR9. Furthermore, bHLHs that were able to activate ectopic ECR9 reporter were able to induce endogenous Otx2 expression.

Conclusions

This work reports a large-scale screen to identify spatiotemporally specific regulatory elements near the Onecut1 locus. These elements were used to identify distinct populations in the developing retina. In addition, fate-restricted regulatory elements responded differentially to bHLH factors, and suggest a role for retinal bHLHs upstream of the Otx2 and Onecut1 genes during the formation of restricted RPCs from multipotent RPCs.
Heteroexpression of Osa-miR319b improved switchgrass biomass yield and feedstock quality by repression of PvPCF5
Authors: Liu Yanrong , Yan Jianping , Wang Kexin , Li Dayong , Han Yejun , Zhang Wanjun
Published: March 2020

Background

Switchgrass (Panicum virgatum L.), a C4 perennial grass, has been recognized as one of the most potentially important lignocellulose biofuel crops. MicroRNA319 (miR319) plays a key role in plant development, abiotic resistance, and cell wall biosynthesis by repressing expression of its target TCP genes. We hypothesized miR319–TCP pathway could play important roles in switchgrass feedstock characteristics for biofuel production, and produced switchgrass transgenic plants overexpressing miR319 (by ectopic expressing Osa-MIR319b gene), blocking miR319 (by overexpressing a target mimicry of miR319/MIM319) and repression of miR319 target gene PvPCF5. Plant phenotype, biomass yield, and feedstock quality of transgenic plants were analyzed.

Results

Overexpression of miR319 in switchgrass promoted leaf elongation and expansion of transgenic plants, increased plant height, stem diameter, and resulted in a significant increase in plant biomass yield. Transgenic plants overexpressing of miR319 reduced lignin content, showed significantly higher enzymatic hydrolysis efficiency compared to the wild type plant. However, opposite results were observed in the MIM319 plants. Furthermore, suppression of miR319 target gene PvPCF5 activity also reduced lignin content, increased lignin monomer S/G ratio and the proportion of β-O-4 linkages, while significantly improving the sugar production per plant. Quantitative real-time (qRT-PCR) analysis indicated that expression of PvMYB58/63B and PvHCT with predicted TCP binding sites in their promoter regions was negatively regulated by miR319–PvPCF5 module.

Conclusions

MiR319–PvPCF5 module plays positive roles in regulating biomass yield and quality of switchgrass. It can be utilized as a candidate molecular tool in regulating biomass yield and feedstock quality. The finding could also be transferred to other grasses for forage quality improvement through genetic manipulation.