bluuebunny/crossref_metadata_2025 huggingface dataset:
Short proximal components in modular revision stems carry a higher risk for stem fractures
Authors: Herold Falko , Nötzli Hubert , Eijer Henk
Published: October 2019

Introduction:

Fractures of modular hip revision stems are not uncommon. The current study examined implant-related factors on stem fracture. We hypothesised that in a modular stem the fracture risk is increased with the use of a short proximal implant component.

Materials and methods:

Anonymised data of all 32 patients in Switzerland with a Revitan modular hip system who had a stem fracture were obtained from the manufacturer. Implant and patient data were compared with all components implanted in Switzerland during the same time interval.

Results:

Between 2002 and 2017, 4834 Revitan stems were implanted, of which 32 fractured. A smaller size of the proximal stem component was significantly associated with a higher fracture risk ( p < 0.001). Compared with the control group, the proportion of male patients was higher among the fracture cases, patients were younger, and they had a higher body weight ( p < 0.001, respectively).

Conclusions:

The present study suggests that small proximal stem components increase the load at the modular junction due to size and lack of bony support. Surgeons should therefore avoid short proximal components so that the mid-stem junction lies as distally as possible and the risk of fracture is minimised.
Aerodynamic study of the corrugated airfoil at ultra-low Reynolds number
Authors: Abd El-Latief Mahmoud E , Elsayed Khairy , Madbouli Abdelrahman Mohamed
Published: October 2019

In this study, Aeshna cyanea dragonfly forewing mid-cross-section corrugated airfoil was simulated at ultra-low Reynolds number. The corrugated airfoil was compared with its smooth counterpart to study the effect of the corrugations upon the aerodynamic performance. Unsteady two-dimensional laminar flow was solved using FLUENT. This study was divided into gliding phase and flapping phase. In the gliding phase, the corrugated airfoil produced a higher lift force with respect to the profiled airfoil at both tested Reynolds numbers ([Formula: see text], [Formula: see text]) with comparable drag coefficient for all the tested angles of attack. In the flapping phase, both the corrugated airfoil and the flat-plate have a very similar flow behavior which yields a very similar aerodynamic performance at Re[Formula: see text]. A structural analysis was performed to compare the corrugated airfoil with the flat-plate. The analysis revealed the superiority of the corrugated airfoil over the flat-plate in decreasing the deflection under the applied load. The reduced frequency was varied to study its impact on the aerodynamic performance. By increasing the reduced frequency, the thrust and the lift forces increased by [Formula: see text]% and [Formula: see text]%, respectively. Any increase in the reduced frequency will increase lift and thrust forces, but the propulsive efficiency will deteriorate.
Microbial insurgency: Theorizing global health in the Anthropocene
Authors: Hirschfeld Katherine
Published: October 2019

Several recent international health crises have revealed significant vulnerabilities in global pandemic preparedness. The 2014 Ebola fever epidemic expanded into an international threat far more quickly than experts anticipated, and the 2018 Ebola fever epidemic continues to expand, even with new technological innovations designed to control the disease. The 2015 yellow fever outbreak in Angola exhausted global vaccine supplies and put millions of people at risk. This article argues that global health authorities failed to anticipate the magnitude of these outbreaks because the field has not been updated to address the ways recent changes in international political economy are combining with environmental instabilities of the Anthropocene to increase epidemiological risks. Many public health textbooks and teaching materials continue to rely on variants of 20th-century modernization theory to explain and predict global health trends. Since the end of the Cold War, however, there has been a dramatic reconfiguration of governance in many parts of the world, and these macro-level changes are accelerating ecological destruction and fueling armed conflict in ways that will reduce the range and effectiveness of public health methods and prevention technologies that were successful during the 20th century. The combined effect of these institutional and environmental changes will increase global pandemic risks in the Anthropocene, even for infectious diseases that are easily preventable today.
Patient Perspectives on Short-Course Pharmacotherapy: Barriers and Facilitators to Medication Adherence
Authors: Sherwin LeeAnne B , Ross Diana , Matteson-Kome Michelle , Bechtold Matthew , Deroche Chelsea , Wakefield Bonnie
Published: October 2019

Background:

Medication nonadherence is a public health issue that contributes to poor health outcomes and health-care costs. Factors influencing long-term medication adherence are known; however, little is known about short-course medication adherence.

Objective:

This study examined patient perspectives on adherence and factors that influence adherence to short-course pharmacotherapy in diarrhea-predominant irritable bowel syndrome.

Method:

Twenty-seven participants were interviewed to identify their perceptions of barriers and facilitators to thrice-daily, 14-day rifaximin.

Results:

Participants were primarily female (89%), aged 18 to 65 years. Sixty-eight percent of interviewees were identified as “low-adherers,” meaning the percentage of days with correct daily dosing of rifaximin was <80%. The final coding framework identified social/economic-related (family support and medication expense), system-related (relationship with provider and medication knowledge), condition-related (symptom severity), therapy-related (inconvenient dosing), and patient-related (forgetfulness and busyness of daily life) factors that influenced adherence.

Conclusion:

The resulting patient perspectives highlight a diverse set of factors that influence short-course adherence and the need for tailored interventions that address these various factors resulting in enhanced patient outcomes.
Symbiotic bacteria motivate the foraging decision and promote fecundity and survival of Bactrocera dorsalis (Diptera: Tephritidae)
Authors: Akami Mazarin , Ren Xue-Ming , Qi Xuewei , Mansour Abdelaziz , Gao Bingli , Cao Shuai , Niu Chang-Ying
Published: October 2019

Background

The gut bacteria of tephritid fruit flies play prominent roles in nutrition, reproduction, maintenance and ecological adaptations of the host. Here, we adopted an approach based on direct observation of symbiotic or axenic flies feeding on dishes seeded with drops of full diet (containing all amino acids) or full diet supplemented with bacteria at similar concentrations to explore the effects of intestinal bacteria on foraging decision and fitness of Bactrocera dorsalis.

Results

The results show that intestinal probiotics elicit beneficial foraging decision and enhance the female reproduction fitness and survival of B. dorsalis (symbiotic and axenic), yet preferences for probiotic diets were significantly higher in axenic flies to which they responded faster compared to full diet. Moreover, females fed diet supplemented with Pantoea dispersa and Enterobacter cloacae laid more eggs but had shorter lifespan while female fed Enterococcus faecalis and Klebsiella oxytoca enriched diets lived longer but had lower fecundity compared to the positive control. Conversely, flies fed sugar diet (negative control) were not able to produce eggs, but lived longer than those from the positive control.

Conclusions

These results suggest that intestinal bacteria can drive the foraging decision in a way which promotes the reproduction and survival of B. dorsalis. Our data highlight the potentials of gut bacterial isolates to control the foraging behavior of the fly and empower the sterile insect technique (SIT) program through the mass rearing.
Disaster preparedness among Thai elderly emergency department patients: a survey of patients’ perspective
Authors: Sri-on Jiraporn , Vanichkulbodee Alissara , Sinsuwan Natchapon , Rojsaengroeng Rapeeporn , Kamsom Anucha , Liu Shan Woo
Published: October 2019

Background

In disaster situations, the elderly are considered to be a particularly vulnerable population. Preparedness is the key to reduce post-disaster damage. There is limited research in middle-income countries on how well elderly emergency department (ED) patients are prepared for disaster situations. The objective of this study was to determine the attitudes and behavior of elderly ED patients toward disaster preparedness.

Methods

This study was a cross-sectional face-to-face survey at one urban teaching hospital in Bangkok, Thailand between August 1st and September 30th, 2016. Patients aged 60 and older who presented to the ED were included to this study. We excluded patients who had severe dementia [defined as Short Portable Mental State Questionnaires (SPMSQ) > 8], were unable to speak Thai, had severe trauma and/or needed immediate resuscitation. The survey instruction was adapted from previous disaster surveys. This study was approved by the Vajira Institutional Review Board (IRB).

Results

A total of 243 patients were enrolled. Most of them were female [154 patients (63.4%)]. The median age was 72 [Interquartile range (IQR) 66–81] years and the most common underlying diseases were hypertension [148 patients (60.9%)] and diabetes [108 patients (44.4%)]. The majority of patients [172 patients (72.4%)] reported that they had had some teaching about disaster knowledge from a healthcare provider and had experienced a disaster [138 patients (56.8%)]. While 175/197 (81.8%) patients who had underlying diseases reported that they had a medication supply for disaster situations, only 61 (25.1%) patients had an emergency toolbox for disasters. Most patients (159, 65.4%) did not know the emergency telephone number, and 133 (54.7%) patients reported transportation limitations.

Conclusions

While most Thai elderly ED patients reported having a medication supply for disaster situations, many lacked comprehensive plans for a disaster situation. Work needs to be done to improve the quality of preparedness in disaster situations among elderly patients. Future research should focus on preparedness knowledge regarding evacuation, and shelter/residence for older patients.
Molecular characteristics and virulence gene profiles of Staphylococcus aureus isolates in Hainan, China
Authors: Li Xuehan , Huang Tao , Xu Kai , Li Chenglin , Li Yirong
Published: October 2019

Background

There have been no reports regarding the molecular characteristics, virulence features, and antibiotic resistance profiles of Staphylococcus aureus (S. aureus) from Hainan, the southernmost province of China.

Methods

Two hundred twenty-seven S. aureus isolates, consisting of 76 methicillin-resistant S. aureus (MRSA) and 151 methicillin-susceptible S. aureus (MSSA), were collected in 2013–2014 and 2018–2019 in Hainan, and investigated for their molecular characteristics, virulence genes, antibiotic resistance profiles and main antibiotic resistance genes.

Results

Forty sequence types (STs) including three new STs (ST5489, ST5492 and ST5493), and 79 Staphylococcal protein A (spa) types were identified based on multilocus sequence typing (MLST) and spa typing, respectively. ST398 (14.1%, 32/227) was found to be the most prevalent, and the prevalence of ST398-MSSA increased significantly from 2013 to 2014 (5.5%, 5/91) to 2018–2019 (18.4%, 25/136). Seventy-six MRSA isolates were subject to staphylococcus chromosomal cassette mec (SCCmec) typing. SCCmec-IVa was the predominant SCCmec type, and specifically, ST45-SCCmec IVa, an infrequent type in mainland China, was predominant in S. aureus from Hainan. The antibiotic resistance profiles and antibiotic resistance genes of S. aureus show distinctive features in Hainan. The resistant rates of the MRSA isolates to a variety of antibiotics were significantly higher than those of the MSSA isolates. The predominant erythromycin and tetracycline resistance genes were ermC (90.1%, 100/111) and tetK (91.8%, 78/85), respectively. Eleven virulence genes, including the Panton-Valentine leukocidin (pvl) and eta, were determined, and the frequency of eta and pvl were found to be 57.3 and 47.6%. Such high prevalence has never been seen in mainland China before.

Conclusion

S. aureus isolates in Hainan have unique molecular characteristics, virulence gene and antibiotic resistance profiles, and main antibiotic resistance genes which may be associated with the special geographical location of Hainan and local trends in antibiotic use.
Pathologic tonsillar findings similar to IgA nephropathy and the role of tonsillectomy in a patient with nephrotic syndrome
Authors: Enya Takuji , Miyazawa Tomoki , Miyazaki Kohei , Oshima Rina , Morimoto Yuichi , Okada Mitsuru , Takemura Tsukasa , Sugimoto Keisuke
Published: October 2019

Background: The pathological findings of tonsils in IgA nephropathy include the expansion of T-cell nodules around lymphoid follicles and abnormal reticulation of the crypt epithelium in contrast to chronic tonsillitis. Recently, several studies have reported that regulatory T cells play an important role in the maintenance of self-tolerance, an abnormality that is involved in the onset of nephrotic syndrome (NS). We encountered a patient of 28-year-old male with frequently relapsing nephrotic syndrome (FRNS) and chronic tonsillitis whose tonsils demonstrated pathological findings similar to those of IgA nephropathy.

Case presentation

A patient had developed NS at the age of 5 years, and was pathologically diagnosed with minimal change disease (MCD), for which he received various immunosuppressive agents as treatment for recurrence. Because tonsillitis often triggers the recurrence of NS, a tonsillectomy was performed for chronic tonsillitis at the age of 25 years. Immunohistochemical staining of his tonsils showed the expansion of CD4 positive lymphocytes around the lymphoid follicles and abnormal reticulation of the crypt epithelium. The number of peripheral blood CD4+CD25+ regulatory T cells increased, and the frequency of relapses decreased after tonsillectomy.

Conclusion

A similar self-tolerance abnormality exists in NS and IgA nephropathy; therefore, tonsillectomy might become a novel therapeutic approach for FRNS to redress the unbalanced self-tolerance and to remove the tonsillar focal infection. Further studies are necessary to verify the clinical efficiency of tonsillectomy for FRNS with recurrent episodes triggered by tonsillitis.
Potential gains in reproductive-aged life expectancy if maternal mortality were eradicated from the Kintampo districts of Central Ghana
Authors: Abubakari Sulemana Watara , Bawah Ayaga Agula , Nettey Ernest Obed , Apraku Edward Anane , Zandoh Charles , Amenga-Etego Seeba , Asante Kwaku Poku , Owusu-Agyei Seth , Badasu Delali Margaret
Published: October 2019

Background

Almost 99% of pregnancy or childbirth-related complications globally is estimated to occur in developing regions. Yet, little is known about the demographic impact of maternal causes of death (COD) in low-and middle-income countries. Assuming that critical interventions were implemented such that maternal mortality is eradicated as a major cause of death, how would it translate to improved longevity for reproductive-aged women in the Kintampo districts of Ghana?

Methods

The study used longitudinal health and demographic surveillance data from the Kintampo districts to assess the effect of hypothetically eradicating maternal COD on reproductive-aged life expectancy by applying multiple decrement and associated single decrement life table techniques.

Results

According to the results, on the average, women would have lived an additional 4.4 years in their reproductive age if maternal mortality were eradicated as a cause of death, rising from an average of 28.7 years lived during the 2005-2014 period to 33.1 years assuming that maternal mortality was eradicated. The age patterns of maternal-related mortality and all-cause mortality depict that the maternal-related mortality is different from the all-cause mortality for women of reproductive age.

Conclusion

This observation suggests that other COD are competing with maternal mortality among the WRA in the study area and during the study period.
Epidemiological profile of meningitis in Iran before pentavalent vaccine introduction
Authors: Berangi Zeinab , Karami Manoochehr , Mohammadi Younes , Nazarzadeh Milad , Zahraei Seyed Mohsen , Javidrad Hamidreza , Heidari Saber
Published: October 2019

Background

No reliable and comprehensive study has been published on the incidence and epidemiological profile of meningitis in Iran from 2008 to 2014, before pneumococcal conjugate vaccine (PCV) and pentavalent vaccine (DTPw-Hep B-Hib (PRP-T) vaccine (pentavac) (adsorbed)) introduction. The present study aimed to portray the epidemiological profile of meningitis in Iran from 2008 to 2014.

Methods

Data on meningitis cases aged from 1 day to 110 years were extracted from national notifiable diseases surveillance system from March 2008 to December 2014 in Iran. A total number of 48,006 cases of suspected meningitis were identified and 1468 cases of which met the criteria for diagnosis-confirmed meningitis. Of 1468 cases, 1352 patients were included in the study.

Results

The great number of cases reported from urban areas. Moreover, males were more predominant than females (58.51% vs. 33.81%) in total. The estimated annual incidence rate of meningitis varied from 0.28/100000 in 2008 to 0.09/100000 in 2014. Streptococcus pneumoniae, Haemophilus influenzaeandNeisseria meningitidiswere the most leading pathogens causing bacterial meningitis, accounted for 266(23.44%), 145(12.78%), 95(8.37%) of cases, respectively. Each of the three bacterial species showed a descending trend. The majority of infected subjects are children under five years.

Conclusions

Unlike the decreasing trend of meningitis and high percentage of cultures with negative results, according to World Health Organization recommendation PCV introduction into routine immunization is evident. Implementing an enhanced surveillance system to provide high quality data on epidemiological profile of meningitis in Iran is necessary.
Making decisions about antipsychotics: a qualitative study of patient experience and the development of a decision aid
Authors: Kaar S. J. , Gobjila C. , Butler E. , Henderson C. , Howes O. D.
Published: October 2019

Background

Shared decision making is a widely accepted standard of patient-centred care that leads to improved clinical outcomes, yet it is commonly underutilised in the field of mental health. Furthermore, little is known regarding patient decision making around antipsychotic medication, which is often poorly adhered to. We aim to explore psychiatric patients’ experiences of antipsychotic medication decision making in order to develop a patient decision aid to promote shared decision making.

Methods

Focus groups were conducted with patients with chronic psychotic illnesses (n = 20) who had previously made a decision about taking or changing antipsychotic medication. Transcripts were coded and analysed for thematic content and continued until thematic saturation. These themes subsequently informed the development of a decision aid with the help of expert guidance. Further patient input was sought using the think aloud method (n = 3).

Results

Twenty-three patients participated in the study. Thematic analysis revealed that ‘adverse effects’ was the most common theme identified by patients surrounding antipsychotic medication decision-making followed by ‘mode and time of administration’, ‘symptom control’ and ‘autonomy’. The final decision aid is included to provoke further discussion and development of such aids.

Conclusions

Patients commonly report negative experiences of antipsychotic medication, in particular side-effects, which remain critical to future decision making around antipsychotic medication. Clinical encounters that increase patient knowledge and maximise autonomy in order to prevent early negative experiences with antipsychotic medication are likely to be beneficial.
Citizens’ initiatives for care and welfare in the Netherlands: an ecological analysis
Authors: van der Knaap Thijs , Smelik Jan , de Jong Floor , Spreeuwenberg Peter , Groenewegen Peter P.
Published: October 2019

Background

In the Netherlands as well as in other countries citizens take initiatives to provide or maintain services in the area of care and welfare. Citizens’ initiatives (CI’s) are organisations some of which have a formal structure while others are informally connected groups of citizens, that are established by a group of citizens with the aim to increase the health and welfare within their local community and that are not focused on making a profit. Although CI’s have been around since at least the 1970’s little research has been done on the phenomenon, with most of it consisting of case studies or qualitative exploratory research. To fill part of this gap in knowledge, we have studied the geographical variation in the presence of CI’s in the Netherlands and tried to explain this variation.

Methods

Data on the presence of CI’s were obtained by combining two existing inventories. We did an ecological regression analysis to test hypotheses about the relationship between the presence of CI’s and the existence of a care vacuum, the capacity for self-organisation and models of action in local communities.

Results

We counted 452 CI’s in care and welfare in the Netherlands in January 2016. Our results show a spatial concentration of care initiatives in urban areas in the Randstad cities in the west of the country and in rural areas in the south-east. The presence of CI’s is only weakly associated with a care vacuum, but is related to indicators for the capacity of concerted action and models of action.

Conclusion

There are by now a considerable number of CI’s in the area of care and welfare in the Netherlands. Apparently, citizens take collective initiatives to provide services that are not, or no longer, available to the local community. The initiatives are concentrated in certain parts of the country. However, our theoretical model to explain this geographical pattern is only partially confirmed.
Regular exercise and the trajectory of health-related quality of life among Taiwanese adults: a cohort study analysis 2006–2014
Authors: Chang Huan-Cheng , Liang Jersey , Hsu Hui-Chuan , Lin Sung-Kai , Chang Ting-Huan , Liu Shu-Hui
Published: October 2019

Background

Physical activity is related to health-related quality of life, but little evidence from multiple waves of panel data in Asian countries area available. This study aims to explore the impacts of different degree of regular exercise on the trajectories of physical and mental dimensions of health-related quality of life (HRQOL) for community-dwelling Taiwanese adults during 2006–2014.

Methods

Data were derived from the “Landseed Integrated Outreaching Neighborhood Screening (LIONS)” study, with 6182 adults enrolled at the baseline and subsequently followed up to three times till 2014. Linear mixed-effects modeling approach was employed to evaluate the growth curve models of HRQOL (with 16,281 observations) by linear & quadratic time effects, regular exercise (5-level moderate-intensity physical activity), and major influential factors of HRQOL.

Results

Regular exercise showed significantly positive dose-response effects on physical HRQOL (β =1.27~2.54), and regular exercise of 150 min or more showed positive effects on mental HRQOL (β = 1.55~2.03). Besides, irregular exercise could also improve both physical and mental HRQOL (β = 1.27 & β = 0.87). However, such effects were not significant over time (at time slope) on HRQOL. In addition, physical and mental HRQOL improved across time (β = 1.01 and 1.49, respectively), but the time quadratic effect would significantly offset a little bit on physical dimension (β = − 0.22). Moreover, being female, increasing age, living alone, or poorer health status were related to lower physical HRQOL; and being younger, living alone, or poorer health status were associated with lower mental HRQOL.

Conclusions

The positive dose-response relationship between regular exercise and HRQOL or its domains was demonstrated for community-dwelling Taiwanese adults. Thus, a regular exercise habit (better ≧150 min per week) is advised for community-based healthcare professionals and the government to incorporate into health promotion strategies and plans.
Life on holidays: study protocol for a 3-year longitudinal study tracking changes in children’s fitness and fatness during the in-school versus summer holiday period
Authors: Watson Amanda , Maher Carol , Tomkinson Grant R. , Golley Rebecca , Fraysse François , Dumuid Dorothea , Lewthwaite Hayley , Olds Tim
Published: October 2019

Background

Emerging evidence suggests that children become fatter and less fit over the summer holidays but get leaner and fitter during the in-school period. This could be due to differences in diet and time use between these distinct periods. Few studies have tracked diet and time use across the summer holidays. This study will measure rates of change in fatness and fitness of children, initially in Grade 4 (age 9 years) across three successive years and relate these changes to changes in diet and time use between in-school and summer holiday periods.

Methods

Grade 4 Children attending Australian Government, Catholic and Independent schools in the Adelaide metropolitan area will be invited to participate, with the aim of recruiting 300 students in total. Diet will be reported by parents using the Automated Self-Administered 24-h Dietary Assessment Tool. Time use will be measured using 24-h wrist-worn accelerometry (GENEActiv) and self-reported by children using the Multimedia Activity Recall for Children and Adults (e.g. chores, reading, sport). Measurement of diet and time use will occur at the beginning (Term 1) and end (Term 4) of each school year and during the summer holiday period. Fitness (20-m shuttle run and standing broad jump) and fatness (body mass index z-score, waist circumference, %body fat) will be measured at the beginning and end of each school year. Differences in rates of change in fitness and fatness during in-school and summer holiday periods will be calculated using model parameter estimate contrasts from linear mixed effects model. Model parameter estimate contrasts will be used to calculate differences in rates of change in outcomes by socioeconomic position (SEP), sex and weight status. Differences in rates of change of outcomes will be regressed against differences between in-school and summer holiday period diet and time use, using compositional data analysis. Analyses will adjust for age, sex, SEP, parenting style, weight status, and pubertal status, where appropriate.

Discussion

Findings from this project may inform new, potent avenues for intervention efforts aimed at addressing childhood fitness and fatness. Interventions focused on the home environment, or alternatively extension of the school environment may be warranted.

Trial registration

Australia New Zealand Clinical Trials Registry, identifier ACTRN12618002008202. Retrospectively registered on 14 December 2018.
Design and measurement in a study of war exposure, health, and aging: protocol for the Vietnam health and aging study
Authors: Korinek Kim , Teerawichitchainan Bussarawan , Zimmer Zachary , Brindle Eleanor , Nguyen Thi Kim Chuc , Nguyen Huu Minh , Tran Khanh Toan
Published: October 2019

Background

Survivors of war throughout the world experience illnesses and injuries that are crucial to understand, given the ongoing treatment and adaptation they demand. In developing countries like Vietnam, where population aging and chronic disease burdens are rapidly rising, aging populations have seen a disproportionate share of armed conflict and related casualties. This paper describes the Vietnam Health and Aging Study (VHAS), a unique resource for investigating mechanisms of association between diverse exposures to armed conflict during the Vietnam War and multiple dimensions of older adult health among survivors of that war.

Methods

The VHAS utilizes a longitudinal design, the first wave of data collection conducted in 2018 among 2447 older adults. A second wave of follow-up data collection, scheduled to take place in 2021, will examine life course, social relational and health and mortality transitions. The VHAS was conducted in four northern Vietnamese districts purposively selected to represent a spectrum of war exposure as indicated by intensity of bombings. Additionally, VHAS uses random sampling within gender and military service subdomains to permit unique gender-specific analyses of military service, trauma exposure and health.

The VHAS’ face-to-face interviews include modules detailing war and military service experiences; warzone stressors; and multiple dimensions of health such as chronic disease, functional limitation, disability, health behaviors, cognition and psychological health. Biomarker data collected for the full VHAS sample includes anthropometric and functional tests such as grip strength and blood pressure, hair samples for cortisol assay, and capillary blood samples to assay C-reactive protein, cholesterol, HbA1c, and other markers of interest for cardiovascular and other disease risks and for testing the impact of early life stressors on later life health. Blood samples will also permit epigenetic analysis of biological aging.

Discussion

Future VHAS investigations will examine dynamic linkages between war exposure, mortality and morbidity, while taking into account the selective nature of each of these processes. Longitudinal analyses will examine late-life health transitions and war-related resiliency.
Environmental variation mediates the prevalence and co-occurrence of parasites in the common lizard, Zootoca vivipara
Authors: Wu Qiang , Richard Murielle , Rutschmann Alexis , Miles Donald B. , Clobert Jean
Published: October 2019

Background

Hosts and their parasites are under reciprocal selection, leading to coevolution. However, parasites depend not only on a host, but also on the host’s environment. In addition, a single host species is rarely infested by a single species of parasite and often supports multiple species (i.e., multi-infestation). Although the arms race between a parasite and its host has been well studied, few data are available on how environmental conditions may influence the process leading to multiple infestations. In this study, we examine whether: (1) environmental factors including altitude, temperature, vegetation cover, human disturbance, and grazing by livestock affect the prevalence of two types of ectoparasites, mites and ticks, on their host (the common lizard, Zootoca vivipara) and (2) competition is evident between mites and ticks.

Results

We found the probability of mite infestation increased with altitude and vegetation cover, but decreased with human disturbance and presence of livestock. In contrast, the probability of tick infestation was inversely associated with the same factors. Individuals with low body condition and males had higher mite loads. However, this pattern was not evident for tick loads. The results from a structural equation model revealed that mites and ticks indirectly and negatively affected each other’s infestation probability through an interaction involving the environmental context. We detected a direct negative association between mites and ticks only when considering estimates of parasite load. This suggests that both mites and ticks could attach to the same host, but once they start to accumulate, only one of them takes advantage.

Conclusion

The environment of hosts has a strong effect on infestation probabilities and parasite loads of mites and ticks. Autecological differences between mites and ticks, as indicated by their opposing patterns along environmental gradients, may explain the pattern of weak contemporary interspecific competition. Our findings emphasize the importance of including environmental factors and the natural history of each parasite species in studies of host–parasite coevolution.
Impact of uncomplicated traumatic dental injuries on the quality of life of children and adolescents: a systematic review and meta-analysis
Authors: Lopez Diego , Waidyatillake Nilakshi , Zaror Carlos , Mariño Rodrigo
Published: October 2019

Background

Traumatic dental injuries (TDIs) are highly prevalent during childhood and adolescence and have a significant effect on their oral health related quality of life (OHRQoL). Uncomplicated TDIs, dental trauma involving enamel, enamel and dentin and tooth discolorations, account for approximately two-thirds of all diagnosed TDIs in children and adolescents. Hence, it may be important to understand the impact of uncomplicated TDIs on OHRQoL, by synthesizing the available literature.

Methods

Medline, Embase, Web of Science and Scopus databases were systematically searched from January 1966 to April 2018. Studies that evaluated the effect of TDIs on the OHRQoL of children and adolescents using validated methods were selected for analysis. A narrative synthesis and a meta-analysis were performed. The studies were pooled according to age groups and OHRQoL questionnaire used. A random-effect model was applied to calculate the pooled odds ratios (OR) and their respective 95% confidence intervals.

Results

There were 712 identified studies. Of these, 26 articles were selected for the review and included in the narrative synthesis, 20 of these articles concluded that uncomplicated TDIs were not associated with a negative impact in OHRQoL. Seventeen were included in the meta-analysis. The estimates were pooled by age groups: children (OR: 1.01; 95%CI; 0.85–1.19; I2 = 51.9%) and adolescents (OR: 1.07; 95%CI; 0.91, 1.26; I2 = 50.2%).When pooling all estimates the OR was 0.96 (95% CI: 0.85–1.10; I2 = 61.4%).

Conclusions

Uncomplicated TDIs do not have a negative impact on the OHRQoL of children and adolescents. Further prospective studies are needed to confirm the results of this review. The majority of the studies included were of cross-sectional design, which may have limited the ability to reach conclusions on the nature of this association. The PROSPERO systematic review registry is CRD42018110471.
Burn out among Iranian dental students: psychometric properties of burnout clinical subtype questionnaire (BCSQ-12-SS) and its correlates
Authors: Mohebbi Simin Z. , Yazdani Reza , Talebi Musa , Pakdaman Afsaneh , Heft Marc W. , Bahramian Hoda
Published: October 2019

Background

Burnout Clinical Subtype Questionnaire (BCSQ-12-SS) is a short valid questionnaire for assessment of burnout in students. The aim of the present study was to evaluate the psychometric properties of Persian-translated version of the BCSQ-12-SS and assess the burn out clinical subtypes and their correlates in dental students.

Methods

In this psychometry study, the BCSQ-12-SS questionnaire in domains of overload (4 questions), lack of development (4 questions), and neglect (4 questions) was translated to Persian and back-translated. Six experts determined the content and face validity of the Persian version. The questionnaire was then piloted on 167 dental students of Tehran University of Medical Sciences in 2016. Data were analyzed using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) for construct validity and Linear Regression modeling in IBM SPSS and AMOS SPSS. To assess reliability, the questionnaire was filled out by 15 students twice and Kappa coefficient and Composite Reliability (CR) were calculated.

Results

Content validity Ratio (CVR) and Content Validity Index (CVI) values and Cronbach’s alphas were all over 0.8. Kappa coefficient ranged from 65 to 82.5%. The average burnout score was 29.6 out of maximum score of 60. There were no significant differences in burnout scores across the different semesters (8,10 and 12). Financial support by the family significantly affected the total score of burnout and lack of development. In addition, gender, mother’s education, residential status of student, preparing for post graduate exam and financial support by the family affected the overload.

Conclusion

The BCSQ-12-SS has good psychometric properties and therefore can be used to assess burnout in IRANIAN dental students. The BCSQ-12-SS may provide an opportunity to identify individuals at risk for burn out and provide counseling to assist in dental student development.
Effect of written outcome information on attitude of perinatal healthcare professionals at the limit of viability: a randomized study
Authors: Papadimitriou V. , Tosello B. , Pfister R.
Published: October 2019

Background

Differences in perception and potential disagreements between parents and professionals regarding the attitude for resuscitation at the limit of viability are common. This study evaluated in healthcare professionals whether the decision to resuscitate at the limit of viability (intensive care versus comfort care) are influenced by the way information on incurred risks is given or received.

Methods

This is a prospective randomized controlled study. This study evaluated the attitude of healthcare professionals by testing the effect of information given through graphic fact sheets formulated either optimistically or pessimistically. The written educational fact sheet included three graphical presentations of survival and complication/morbidity by gestational age. The questionnaire was submitted over a period of 4 months to 5 and 6-year medical students from the Geneva University as well as physicians and nurses of the neonatal unit at the University Hospitals of Geneva. Our sample included 102 healthcare professionals.

Results

Forty-nine responders (48%) were students (response rate of 33.1%), 32 (31%) paediatricians (response rate of 91.4%) and 21 (20%) nurses in NICU (response rate of 50%). The received risk tended to be more severe in both groups compared to the graphically presented facts and current guidelines, although optimistic representation favoured the perception of “survival without disability” at 23 to 25 weeks. Therapeutic attitudes did not differ between groups, but healthcare professionals with children were more restrained and students more aggressive at very low gestational ages.

Conclusion

Written information on mortality and morbidity given to healthcare professionals in graphic form encourages them to overestimate the risk. However, perception in healthcare staff may not be directly transferable to parental perception during counselling as the later are usually naïve to the data received. This parental information are always communicated in ways that subtly shape the decisions that follow.
Prevalence of intimate partner violence against women in the Arab world: a systematic review
Authors: Elghossain Tatiana , Bott Sarah , Akik Chaza , Obermeyer Carla Makhlouf
Published: October 2019

Background

Violence against women has particular importance for women’s health and wellbeing in the Arab world, where women face persistent barriers to social, political and economic equality. This review aims to summarize what is known about the prevalence of physical, sexual and emotional/psychological intimate partner violence (IPV) against women in the 22 countries of the Arab League, including geographic coverage, quality and comparability of the evidence.

Methods

A systematic review of IPV prevalence in Arab countries was carried out among peer-reviewed journal articles and national, population-based survey reports published by international research programmes and/or governments. Following PRISMA guidelines, Medline and the Social Sciences Citation Index were searched with Medical Subject Headings terms and key words related to IPV and the names of Arab countries. Eligible sources were published between January 2000 and January 2016, in any language. United Nations databases and similar sources were searched for national surveys. Study characteristics, operational definitions and prevalence data were extracted into a database using Open Data Kit Software. Risk of bias was assessed with a structured checklist.

Results

The search identified 74 records with population or facility-based IPV prevalence data from eleven Arab countries, based on 56 individual datasets. These included 46 separate survey datasets from peer-reviewed journals and 11 national surveys published by international research programmes and/or governments. Seven countries had national, population-based IPV estimates. Reported IPV prevalence (ever) ranged from 6% to more than half (59%) (physical); from 3 to 40% (sexual); and from 5 to 91% (emotional/ psychological). Methods and operational definitions of violence varied widely, especially for emotional/psychological IPV, limiting comparability.

Conclusions

IPV against women in Arab countries represents a public health and human rights problem, with substantial levels of physical, sexual and emotional/psychological IPV documented in many settings. The evidence base is fragmented, however, suggesting a need for more comparable, high quality research on IPV in the region and greater adherence to international scientific and ethical guidelines. There is a particular need for national, population-based data to inform prevention and responses to violence against women, and to help Arab countries monitor progress towards the Sustainable Development Goals.
Mesenchymal stem cells therapy in companion animals: useful for immune-mediated diseases?
Authors: Dias Inês Esteves , Pinto Pedro Olivério , Barros Luís Carlos , Viegas Carlos Antunes , Dias Isabel Ribeiro , Carvalho Pedro Pires
Published: October 2019

Mesenchymal stem cells are multipotent cells, with capacity for self-renewal and differentiation into tissues of mesodermal origin. These cells are possible therapeutic agents for autoimmune disorders, since they present remarkable immunomodulatory ability.

The increase of immune-mediated diseases in veterinary medicine has led to a growing interest in the research of these disorders and their medical treatment. Conventional immunomodulatory drug therapy such as glucocorticoids or other novel therapies such as cyclosporine or monoclonal antibodies are associated with numerous side effects that limit its long-term use, leading to the need for developing new therapeutic strategies that can be more effective and safe.

The aim of this review is to provide a critical overview about the therapeutic potential of these cells in the treatment of some autoimmune disorders (canine atopic dermatitis, feline chronic gingivostomatitis, inflammatory bowel disease and feline asthma) compared with their conventional treatment.

Mesenchymal stem cell-based therapy in autoimmune diseases has been showing that this approach can ameliorate clinical signs or even cause remission in most animals, with the exception of canine atopic dermatitis in which little to no improvement was observed.

Although mesenchymal stem cells present a promising future in the treatment of most of these disorders, the variability in the outcomes of some clinical trials has led to the current controversy among authors regarding their efficacy. Mesenchymal stem cell-based therapy is currently requiring a deeper and detailed analysis that allows its standardization and better adaptation to the intended therapeutic results, in order to overcome current limitations in future trials.
An in vitro confirmation of the ethonopharmacological use of Senna plants as anthelmintic against rumen fluke Paramphistomum gracile
Authors: Roy Saptarshi , Lyndem Larisha Mawkhlieng
Published: October 2019

Background

Paramphistomosis is a pathogenic disease of domesticated ruminants, causing great economic loss in dairy industry and meat production. It is considered as a neglected tropical disease with highest prevalence throughout tropical and subtropical regions, particularly in Africa, Asia, Europe, and Australia. There are few trematocidal drugs available in the market. Most are resistant and have elevated side effects. Therefore, alternative trematocidal drugs need to discover. This study was conducted to evaluate three plants leaf extracts (fromSenna alata,S. alexandrina,andS. occidentalis) as effective remedies against gastrointestinal trematode parasite (Paramphistomum gracile) of ruminants.Live adult parasites were collected in 0.1 M phosphate-buffered saline (PBS) from fresh autopsied goat’s rumen. Parasites were incubated in leaf extracts ofS. alata,S. alexandrinaand,S. occidentalisindividually and in combination (1:1) ratio at 37 ± 1°C. Treatment media contain extracts at different concentrations (10, 20 and 40 mg/mL) in 10 mL of 0.1 M PBS with 1% dimethylsulphoxide (DMSO). Parasites in control group were incubated in PBS without extract. The efficacy of threeSennaextracts was evaluated on the basis of dose-dependent motility and mortality of the trematode. Immediately after paralysis, all treated parasites were collected for histology, SEM and biochemical study.

Results

Dose-dependent efficacy was observed in terms of motility and time of mortality in all treated parasites after exposure in various concentrations of theSennaplant extracts.S. occidentalisandS. alexandrinashowed better efficacy in combination than comparing with individual treatment groups. Histological study and scanning electron microscopic observations revealed conspicuous deformity of surface architecture in all treated parasites. Scanning electron micrographs also revealed shrinkage, vacuolization, infoldings and blebbings on the body surface of treated worms. Activities of tegumental enzymes were inhibited in all treatment groups compared to control.

Conclusion

The overall findings from this study revealed that all threeSennaleaf extracts individually and in combination showed potential antitrematocidal activity againstParamphistomum gracileby damaging body tegument and neural propagation. Thus, this study confirmed that all threeSennaextracts can be considered as a potential drug-like candidate in indigenous system of traditional medicine against trematode infections in livestock.

Graphical abstract