bluuebunny/crossref_metadata_2025 huggingface dataset:
Reporting on Climate Change by Broadcast Meteorologists: A National Assessment
Authors: Timm Kristin M. F. , Perkins David , Myers Teresa , Placky Bernadette Woods , Maibach Edward W.
Published: October 2019

Television weathercasters are uniquely situated to inform their audiences about the local impacts of global climate change and a growing number of them are adopting the role of climate change educator. We surveyed all American broadcast meteorology professionals in 2015 (N= 2,059; response rate = 22.6%), 2016 (N= 2017; response rate = 31.2%), and 2017 (N= 2,177; response rate = 22.1%) to assess weathercasters’ interest in reporting about climate change; if, where, and how they report about climate change; and the reactions they get from their audiences when they do. Many participating weathercasters indicated that they were moderately or very interested in reporting about climate change, especially using local historical climate information (56%). Just over half of the weathercasters (57.9%) had used one or more communication mode to inform their viewers, or other people in their community, about the local impacts of climate change in the prior year. The most commonly used modes were social media (42.7%), school visits (36.3%), community events (33.1%), and on-air broadcasts (31.3%). Most weathercasters who had reported about climate change on air indicated they received either positive viewer feedback or little feedback (61.9%); conversely, weathercasters who had not reported about climate change expected to receive mostly negative feedback (44.2%). In sum, this analysis suggests that large numbers of weathercasters have adopted the role of climate change educator in their communities; they use a range of communication modes to share climate change information with their audiences and receive mostly positive feedback from their audiences when they do.
How Does Hurricane Edouard (2014) Evolve toward Symmetry before Rapid Intensification? A High-Resolution Ensemble Study
Authors: Alvey George R. , Zipser Ed , Zawislak Jonathan
Published: October 2019

A 14-member high-resolution ensemble of Edouard (2014), a moderately sheared tropical storm that underwent rapid intensification (RI), is used to determine causes of vortex alignment and precipitation symmetry prior to RI. Half the members intensify similarly to the NHC’s best track, while the other seven ensemble members fail to reproduce intensification. Analyses of initial conditions (vertical wind shear, sea surface temperatures, relative humidity, vortex structure) reveal that lower humidity and weaker, more tilted vortices in nonintensifying members likely increase their susceptibility to boundary layer flushing episodes. As the simulations progress, vortex tilt, inner-core humidity, and azimuthal variations in the structure of precipitation best differentiate the two ensemble subsets. Although all members initially are slowly intensifying asymmetric storms, the RI members are unique in that they have more persistent deep convection downshear, which favors vortex alignment via the stretching term and/or precession. As deep convection transitions to stratiform precipitation and anvil clouds in the upshear quadrants, evaporation and sublimation of condensate advected from the downshear quadrants moisten the middle to upper troposphere. This is hypothesized to promote an increase in precipitation symmetrization, a necessary precursor for RI.
Support for Older People in Households With Bare Branches in Rural China: Vulnerability, Dilemmas, and Possible Solutions
Authors: Liu Huijun , Feng Zhixin
Published: October 2019

This study explored potential challenges and solutions for the support of older people among households with “bare branches” (unmarried men aged 28 years or older in rural China). Qualitative interviews were conducted in Ankang district of Shaanxi Province with 33 “bare branches” and 18 older parents of “bare branches.” Results showed that support from sons was still the main choice for older parents of “bare branches” in later life, and that most “bare branches” were the primary carers of their older parents. Older unmarried men faced a dilemma between staying at home to provide care to their parents, and migrating to cities to seek economic and marriage opportunities, and this was more common for unmarried men without a married brother. Government support is essential in relieving the challenges in old-age support faced by households with “bare branches”, such as developing social charities, training social workers, and improving social security benefits.
Searching for Rewards Like a Child Means Less Generalization and More Directed Exploration
Authors: Schulz Eric , Wu Charley M. , Ruggeri Azzurra , Meder Björn
Published: October 2019

How do children and adults differ in their search for rewards? We considered three different hypotheses that attribute developmental differences to (a) children’s increased random sampling, (b) more directed exploration toward uncertain options, or (c) narrower generalization. Using a search task in which noisy rewards were spatially correlated on a grid, we compared the ability of 55 younger children (ages 7 and 8 years), 55 older children (ages 9–11 years), and 50 adults (ages 19–55 years) to successfully generalize about unobserved outcomes and balance the exploration–exploitation dilemma. Our results show that children explore more eagerly than adults but obtain lower rewards. We built a predictive model of search to disentangle the unique contributions of the three hypotheses of developmental differences and found robust and recoverable parameter estimates indicating that children generalize less and rely on directed exploration more than adults. We did not, however, find reliable differences in terms of random sampling.
Sport emotions profiles: Relationships with burnout and coping skills among competitive athletes
Authors: González-García Higinio , Martinent Guillaume , Pelegrín Antonia
Published: October 2019

The aims of the study were to identify naturally occurring competitive emotional profiles and examine whether participants from several profiles significantly differed on burnout and coping. A sample of 424 competitive athletes ( Mage = 32.38; SD = 13.16) completed a series of self-report questionnaires. Comparing the sample as a whole, cluster analyses revealed two emotional profiles: (a) High unpleasant emotions and low pleasant emotions; and (b) moderately high pleasant emotions and low unpleasant emotions. Results of MANOVAs showed significant differences across emotional profiles on burnout (emotional/physical exhaustion, reduced accomplishment, sport devaluation) and coping (resignation, distancing, venting emotions and mental distraction). Therefore, results suggested that an emotion profile approach offered a robust heuristic for examining emotions in a more holistic method to unpack their complex associations with key outcomes (coping, burnout) and they have implications for intervention.
GASAL2: a GPU accelerated sequence alignment library for high-throughput NGS data
Authors: Ahmed Nauman , Lévy Jonathan , Ren Shanshan , Mushtaq Hamid , Bertels Koen , Al-Ars Zaid
Published: October 2019

Background

Due the computational complexity of sequence alignment algorithms, various accelerated solutions have been proposed to speedup this analysis. NVBIO is the only available GPU library that accelerates sequence alignment of high-throughput NGS data, but has limited performance. In this article we present GASAL2, a GPU library for aligning DNA and RNA sequences that outperforms existing CPU and GPU libraries.

Results

The GASAL2 library provides specialized, accelerated kernels for local, global and all types of semi-global alignment. Pairwise sequence alignment can be performed with and without traceback. GASAL2 outperforms the fastest CPU-optimized SIMD implementations such as SeqAn and Parasail, as well as NVIDIA’s own GPU-based library known as NVBIO. GASAL2 is unique in performing sequence packing on GPU, which is up to 750x faster than NVBIO. Overall on Geforce GTX 1080 Ti GPU, GASAL2 is up to 21x faster than Parasail on a dual socket hyper-threaded Intel Xeon system with 28 cores and up to 13x faster than NVBIO with a query length of up to 300 bases and 100 bases, respectively. GASAL2 alignment functions are asynchronous/non-blocking and allow full overlap of CPU and GPU execution. The paper shows how to use GASAL2 to accelerate BWA-MEM, speeding up the local alignment by 20x, which gives an overall application speedup of 1.3x vs. CPU with up to 12 threads.

Conclusions

The library provides high performance APIs for local, global and semi-global alignment that can be easily integrated into various bioinformatics tools.
Genome-wide characterization and evolutionary analysis of heat shock transcription factors (HSFs) to reveal their potential role under abiotic stresses in radish (Raphanus sativus L.)
Authors: Tang Mingjia , Xu Liang , Wang Yan , Cheng Wanwan , Luo Xiaobo , Xie Yang , Fan Lianxue , Liu Liwang
Published: October 2019

Background

Abiotic stresses due to climate change pose a great threat to crop production. Heat shock transcription factors (HSFs) are vital regulators that play key roles in protecting plants against various abiotic stresses. Therefore, the identification and characterization of HSFs is imperative to dissect the mechanism responsible for plant stress responses. Although the HSF gene family has been extensively studied in several plant species, its characterization, evolutionary history and expression patterns in the radish (Raphanus sativus L.) remain limited.

Results

In this study, 33 RsHSF genes were obtained from the radish genome, which were classified into three main groups based on HSF protein domain structure. Chromosomal localization analysis revealed that 28 of 33 RsHSF genes were located on nine chromosomes, and 10 duplicated RsHSF genes were grouped into eight gene pairs by whole genome duplication (WGD). Moreover, there were 23 or 9 pairs of orthologous HSFs were identified between radish and Arabidopsis or rice, respectively. Comparative analysis revealed a close relationship among radish, Chinese cabbage and Arabidopsis. RNA-seq data showed that eight RsHSF genes including RsHSF-03, were highly expressed in the leaf, root, cortex, cambium and xylem, indicating that these genes might be involved in plant growth and development. Further, quantitative real-time polymerase chain reaction (RT-qPCR) indicated that the expression patterns of 12 RsHSF genes varied upon exposure to different abiotic stresses including heat, salt, and heavy metals. These results indicated that the RsHSFs may be involved in abiotic stress response.

Conclusions

These results could provide fundamental insights into the characteristics and evolution of the HSF family and facilitate further dissection of the molecular mechanism responsible for radish abiotic stress responses.
SWATH-MS-facilitated proteomic profiling of fruit skin between Fuji apple and a red skin bud sport mutant
Authors: Chen Mo-Xian , Sun Chao , Zhang Kai-Lu , Song Yu-Chen , Tian Yuan , Chen Xi , Liu Ying-Gao , Ye Neng-Hui , Zhang Jianhua , Qu Shenchun , Zhu Fu-Yuan
Published: October 2019

Background

Apple is one of the most popular fruit crops world-wide and its skin color is an important quality consideration essential for commercial value. However, the strategy on genetic breeding for red skin apple and the genetic basis of skin color differentiation is very limited and still largely unknown.

Results

Here, we reported a bud sport mutant of Fuji apple with red skin color and enhanced anthocyanins accumulation. Quantitative SWATH-MS (sequential window acquisition of all theoretical spectra-mass spectrometry) proteomics investigations revealed proteome changes in the apple red skin bud mutation and a total of 451 differentially expressed proteins were identified in apple skin. The mutant showed significantly increased expression levels of photosynthesis-related proteins, stress-related proteins as well as anthocyanins biosynthesis pathway. On the other hand, substantial downregulation of mitogen-activated protein kinase 4 (MAPK4) and mevalonate kinase (MVK) were detected, indicating a promising role for the red skin color development in the mutant. Furthermore, we also hypothesize that a post-transcriptional regulation of the skin color formation occurs in the mutant through the advanced SWATH-MS analysis.

Conclusion

Our work provides important information on the application of proteomic methods for analysing proteomes changes in Fuji apple and highlights a clade of regulatory proteins potentially contributing for the molecular breeding of fruit skin color.
The impact of early comprehensive geriatric screening on the readmission rate in an acute geriatric ward: a quasi-experimental study
Authors: Lin Kun-Pei , Chen Jen-Hau , Lu Feng-Ping , Wen Chiung-Jung , Chan Ding-Cheng
Published: October 2019

Background

Unplanned readmission is an important healthcare quality issue. We studied the effect of a comprehensive geriatric screen (CGS) in the early admission course followed by a comprehensive geriatric assessment on readmission rates in elderly patients.

Methods

This quasi-experimental study with a historical comparison group was conducted in the geriatric ward of a referral centre in northern Taiwan. Older adults (aged > = 65 y/o) admitted from June 2013 to December 2013 were recruited for the geriatric screen group (N = 377). Patients admitted to the same ward from July 2011 to June 2012 were selected for the historical group (N = 380). The CGS was administered within the first 48 h after admission and was followed by a comprehensive geriatric assessment (CGA). Confounding risk factors included age, gender, Charlson comorbidity index, Barthel index score and medical utilization (length of stay and number of admissions), which were controlled using logistic regression models. We also developed a scoring system to identify the group that would potentially benefit the most from the early CGS.

Results

The 30-day readmission rate was significantly lower in the early CGS group than in the historical comparison group (11.4% vs 16.9%, p = 0.03). After adjusting for confounding variables, the hazard ratio of the early CGS group was 0.64 (95% CI 0.43–0.95). After scoring the potential benefit to the patients in the early CGS group, the log rank test showed a significant difference (p = 0.001 in the high-potential group and p = 0.98 in the low-potential group).

Conclusion

An early CGS followed by a CGA may significantly reduce the 30-day readmission rate of elderly patients.
The latent tuberculosis infection cascade of care in Iqaluit, Nunavut, 2012–2016
Authors: Pease Christopher , Zwerling Alice , Mallick Ranjeeta , Patterson Mike , Demaio Patricia , Finn Sandy , Allen Jean , Van Dyk Deborah , Alvarez Gonzalo G.
Published: October 2019

Background

A remote arctic region of Canada predominantly populated by Inuit with the country’s highest incidence of tuberculosis.

Methods

The study was undertaken to describe the latent tuberculosis infection (LTBI) cascade of care and identify factors associated with non-initiation and non-completion of LTBI treatment. Data were extracted retrospectively from medical records for all patients with a tuberculin skin test (TST) implanted in Iqaluit, Nunavut between January 2012 and March 2016. Associations between demographic and clinical factors and both treatment non-initiation among and treatment non-completion were identified using log binomial regression models where convergence could be obtained and Poisson models with robust error variance where convergence was not obtained.

Results

Of 2303 patients tested, 439 (19.1%) were diagnosed with LTBI. Treatment was offered to 328 patients, was initiated by 246 (75.0% of those offered) and was completed by 186 (75.6% of initiators). In multivariable analysis, older age (adjust risk ratio [aRR] 1.17 per 5-year increase, 95%CI:1.09–1.26) and undergoing TST due to employment screening (aRR 1.63, 95%CI:1.00–2.65, compared to following tuberculosis exposure) were associated with increased non-initiation of treatment. Older age (aRR 1.13, 95%CI: 1.03–1.17, per 5-year increase) was associated with increased non-completion of treatment.

Conclusions

A similar rate of treatment initiation and higher rate of treatment completion were found compared to previous North American studies. Interventions targeting older individuals and those identified via employment screening may be considered to help to address the largest losses in the cascade of care.
Informing patients with progressive neurological disease of their health status, and their adaptation to the disease
Authors: Bužgová Radka , Kozáková Radka
Published: October 2019

Background

Progressive neurological diseases, such as multiple sclerosis, Parkinson’s disease, Huntington’s disease, significantly interfere with patients’ lives, and those of their families. The aim of the research was to establish whether the extent of the information on patients’ health conditions, and the way patients learn this information from doctors affect their adaptation to chronic and progressive diseases.

Methods

Qualitative methodology was used for a total of 52 participants (patients with progressive neurological diseases, their family members, and health and social workers). Data were collected using individual, in-depth interviews and focus groups. Analysis of data for interpretation, conceptualization, and re-integration was performed by open, axial, and selective coding.

Results

It was determined that adequate information about patients’ health status, and the use of coping strategies are related to their adaptation to their disease, and consequently, to their quality of life. The participants often considered the extent of the information provided, and the way they were informed to be inadequate. Receiving the diagnosis, the progression of the disease, and the end of life were found to be the most burdensome.

Conclusion

Our results show that Czech neurologist should develop better communication skills, particularly for informing patients with progressive neurological diseases. Open communication, emotional support, and support in selecting effective coping strategies can help patients adapt more readily to their disease, and improve their quality of life.
Scaling up interventions: findings and lessons learned from an external evaluation of Niger’s National Initiative to reduce postpartum hemorrhage
Authors: Mary Meighan , Diop Ayisha , Sheldon Wendy R. , Yenikoye Aichatou , Winikoff Beverly
Published: October 2019

Background

Niger has one of the highest maternal mortality ratios in Sub Saharan Africa, of which postpartum hemorrhage is the leading cause. In 2014, Health and Development International and the Ministry of Health of Niger launched an initiative to introduce and scale-up three PPH interventions in health facilities nationwide: misoprostol, uterine balloon tamponade, and the non-pneumatic anti-shock garment.

Methods

A two-phase mixed-methods evaluation was conducted to assess implementation of the initiative. Health facility assessments, provider interviews, and household surveys were conducted in May 2016 and November 2017.

Results

All evaluation facilities received misoprostol prevention doses. However, shortages in misoprostol treatment doses, UBT kits, and NASG stock were documented. Health provider training increased while knowledge of each PPH intervention varied. Near-universal uterotonic coverage for PPH prevention and treatment was achieved and sustained throughout the evaluation period. Use of UBT and NASG to manage PPH was rare and differed by health facility type. Among community deliveries, fewer than 22% of women received misoprostol at antenatal care for self-administered prophylaxis. Among those who did, almost all reported taking the drugs for PPH prevention in each phase.

Conclusions

This study is the first external evaluation of a comprehensive PPH program taking misoprostol, UBT, and NASG to national scale in a low resource setting. Although gaps in service delivery were identified, results demonstrate the complexities of training, managing stock, and implementing system-wide interventions to reach women in varying contexts. The experience provides important lessons for other countries as they develop and expand evidence-based programs for PPH care.
Non-obstetric surgery during pregnancy – an eleven-year retrospective analysis
Authors: Vujic J. , Marsoner K. , Lipp-Pump A. H. , Klaritsch P. , Mischinger H. J. , Kornprat P.
Published: October 2019

Background

Diagnosis and management of non-obstetric abdominal pathologies during pregnancy are clinically challenging for both obstetricians and general surgeons. Our aim was to evaluate the outcome of pregnant patients who had undergone non-obstetric abdominal surgery.

Methods

We retrospectively reviewed 76 pregnant patients who had required surgery for non-obstetric abdominal pathologies during pregnancy at our department from January 2005 to December 2015. Data were collected retrospectively from medical records as well as from our institutional perinatal database. We evaluated data for clinical presentation, perioperative management, preterm labor, and maternal and fetal outcomes.

Results

The patients’ mean age was 29 (interquartile range IQR 25–33) years. Indications for surgery were acute appendicitis in 63%, adnexal pathology in 11%, cholecystolithiasis in 5% and other indications in 21%; surgery was performed in an elective setting in 18% and in an emergent/urgent setting in 82%. In five cases, complications, three of them oncological, called for further surgery. Ninety-seven percent of operations were conducted under general anesthesia. Median skin-to-skin time was 50 (37–80) minutes, median in-hospital stay was 4 (3.5–6) days, and 5 % required postoperative intensive care. Preterm labor occurred in 15%, miscarriage in 7% (none of them directly related to abdominal surgery).

Conclusion

Abdominal surgery for non-obstetric pathology during pregnancy can be performed safely, if mandatory, without increases in maternal and fetal pathology, miscarriage, and preterm birth rates.
Prognostic significance of 8-hydroxy-2′-deoxyguanosine in solid tumors: a meta-analysis
Authors: Qing Xiangcheng , Shi Deyao , Lv Xiao , Wang Baichuan , Chen Songfeng , Shao Zengwu
Published: October 2019

Background

High level of reactive oxygen species (ROS) has been detected in almost all cancers, which make it become one of the best-characterized phenotypes in cancers. Though ROS plays an important role in tumors, the degree of oxidative stress can be better evaluated by assessing stable metabolites of oxidative reactions because of its high instability. 8-hydroxy-2′-deoxyguanosine (8-OHdG), a product of oxidative damage to 2′-deoxyguanosine, is known as a useful marker for assessing oxidative DNA damage and has been a feature of carcinogenesis in several researches. But the exact prognostic value of 8-OHdG expression in patients with cancer is still unclear.

Methods

A comprehensive search was performed in PubMed, Web of Science, EMBASE. Eligible studies were included based on defined exclusion and inclusion criteria to perform a meta-analysis. STATA 14.0 was used to estimate pooled hazard ratios (HRs) with 95% confidence interval (95% CI), the heterogeneity among studies and publication bias to judge the prognostic value.

Results

A total of 2121 patients from 21 eligible studies were included in the meta-analysis. A significant association was found between elevated 8-OHdG expression and poor OS (overall survival) in cancer patients (pooled HR 1.921, 95% CI: 1.437–2.570); In the subgroup analysis, race of sample, cancer types, detection method of 8-OHdG, sample classification, detection location of 8-OHdG and paper quality (score more or less than 7) did not alter the association between 8-OHdG expression and cancer prognosis. Furthermore, 8-OHdG expression was an independent prognostic marker for overall survival in patients with cancer (pooled HR 2.110, 95% CI: 1.482–3.005) using Cox multivariate analyses.

Conclusions

This meta-analysis found that highly expressed 8-OHdG in tumor tissues may be a predictor of prognosis in most solid tumors. However, especially in breast cancer, low 8-OHdG expression is associated with poor prognosis, which is partly because of the increased antioxidant mechanisms in breast cancer tissues. This study demonstrates for the first time that 8-OHdG expression is associated with the prognosis of cancer patients. In the future, whether the expression level of 8-OHdG can be used as a biomarker for the prognosis of all human cancers requires more research.
Immuno-PET imaging for non-invasive assessment of cetuximab accumulation in non-small cell lung cancer
Authors: Yamaguchi Aiko , Achmad Arifudin , Hanaoka Hirofumi , Heryanto Yusri Dwi , Bhattarai Anu , Ratianto  , Khongorzul Erdene , Shintawati Rini , Kartamihardja A. Adhipatria P. , Kanai Ayaka , Sugo Yumi , S. Ishioka Noriko , Higuchi Tetsuya , Tsushima Yoshito
Published: October 2019

Backgrounds

Overexpression of epidermal growth factor receptor (EGFR) has been established as a valid therapeutic target of non-small cell lung cancer (NSCLC). However, the clinical benefit of cetuximab as an EGFR-targeting drug is still controversial, partially due to the lack of effective means to identify suitable patients. This study aimed to investigate the potential of radiolabeled cetuximab as a non-invasive tool to predict cetuximab accumulation in NSCLC tumor xenografts with varying EGFR expression levels.

Methods

The NSCLC tumors in model mice were subjected to in vivo biodistribution study and positron emission tomography (PET) imaging 48 h after injection of either 111In- or 64Cu-labeled cetuximab. The EGFR expression levels of NSCLC tumors were determined by ex vivo immunoblotting.

Results

We found that tumors with high EGFR expression had significantly higher [111In]In-DOTA-cetuximab accumulation than tumors with moderate to low EGFR expression (P < 0.05). Strong correlations were found between [111In]In-DOTA-cetuximab tumor uptake and EGFR expression level (r = 0.893), and between [64Cu]Cu-DOTA-cetuximab tumor uptake with EGFR expression level (r = 0.915). PET imaging with [64Cu]Cu-DOTA-cetuximab allowed clear visualization of tumors.

Conclusion

Our findings suggest that this immuno-PET imaging can be clinically translated as a tool to predict cetuximab accumulation in NSCLC cancer patients prior to cetuximab therapy.
Study protocol of Diabetes LEAP: a longitudinal study examining emotional problems in adolescents with type 1 diabetes and their parents/caregivers
Authors: Nefs Giesje , Nguyen Linh , Winterdijk Per , Hartman Esther , Sas Theo , Nuboer Roos , De Kruijff Ineke , Bakker-van Waarde Willie , Aanstoot Henk-Jan , Pouwer Frans
Published: October 2019

Background

Type 1 diabetes (T1D) is a chronic metabolic condition requiring intensive daily self-care to avoid both high and low blood glucose levels. Self-care and glycemic outcomes are particularly problematic in adolescence, a period known for its increased risk of emotional problems. However, the true scope of mood and anxiety disorders in adolescents with T1D is unknown. Earlier studies are limited by a small sample size, lack of diagnostic interview data, a focus on depression only, non-adolescent specific estimates, lack of information about parental emotional problems and/or a cross-sectional design. Diabetes LEAP is a two-year prospective observational cohort study examining (a) the prevalence and course of depression and anxiety in adolescents with T1D and their parents/caregivers, (b) the risk factors predicting the presence of these emotional problems, (c) their longitudinal relation with diabetes outcomes, and (d) the psychosocial care currently in place.

Methods

Adolescents (12–18 years) from 8 Dutch pediatric diabetes clinics are interviewed using the DISC-IV to establish the presence of mood and anxiety disorders in the previous 4 weeks, the previous 12 months, and lifetime. They also complete questionnaires, including CDI-2, GAD-7, and PAID-T. Parents/caregivers complete PHQ-9, GAD-7, and PAID-PR. Follow-up assessments take place after 1 and 2 years.

Discussion

This longitudinal study with diagnostic interviews in a large cohort of adolescents with T1D in the Netherlands will provide much needed information regarding the prevalence and course of depression and anxiety in this group, thereby opening avenues for proper recognition, prevention and timely treatment.
A real-world evaluation of a tertiary care childhood obesity intervention to reduce metabolic risk in a hard-to-reach urban population
Authors: Bayoumi Nagla S. , Helzner Elizabeth , Afable Aimee , Joseph Michael A. , Dhuper Sarita
Published: October 2019

Background

Research on outcomes associated with lifestyle interventions serving pediatric populations in urban settings, where a majority have severe obesity, is scarce. This study assessed whether participation in a lifestyle intervention improved body mass index (BMI) percentile, BMI z-score, blood pressure, and lipid levels for children and adolescents.

Methods

The Live Light Live Right program is a lifestyle intervention that uses medical assessment, nutritional education, access to physical fitness classes, and behavioral modification to improve health outcomes. Data was analyzed for 144 subjects aged 2–19 who participated for a minimum of 12 consecutive months between 2002 and 2016. McNemar tests were used to determine differences in the proportion of participants who moved from abnormal values at baseline to normal at follow-up for a given clinical measure. Paired sample t-tests assessed differences in blood pressure and lipid levels. Multiple linear regression assessed the change in blood pressure or lipid levels associated with improvement in BMI%95 and BMI z-score.

Results

The majority were female (62.5%), mean age was 9.6, and 71% were Black. At baseline, 70.1% had severe obesity, systolic hypertension was present in 44, and 13.9% had diastolic hypertension. One-third had abnormally low high-density lipoprotein (HDL) at baseline, 35% had elevated low-density lipoprotein (LDL), and 47% had abnormal total cholesterol (TC). The average difference in percentage points of BMI%95 at follow-up compared was − 3.0 (95% CI: − 5.0, − 1.1; p < 0.003). The mean difference in BMI z-score units at follow-up was − 0.15 (95% CI: − 0.2, − 0.1; p < 0.0001). Participants with systolic or diastolic hypertension had an average improvement in blood pressure of − 15.3 mmHg (p < 0.0001) and − 9.6 mmHg (p < 0.0001), respectively. There was a mean improvement of 4.4 mg/dL for participants with abnormal HDL (p < 0.001) and − 7.8 mg/dL for those with abnormal LDL at baseline (p = 0.036). For those with abnormal baseline TC, a one-unit improvement in BMI%95 was associated with a 0.61 mg/dL improvement in TC while holding constant age, contact hours, and months since enrollment (p = 0.043).

Conclusions

Participation in the program resulted in significant improvements in BMI percentile, BMI z-score, blood pressure, and lipid levels.
Epidemiology of childhood tuberculosis and factors associated with unsuccessful treatment outcomes in Tigray, Ethiopia: a ten-year retrospective cross sectional study
Authors: Mirutse Gebremeskel , Fang Mingwang , Kahsay Alemayehu Bayray , Ma Xiao
Published: October 2019

Background

Childhood TB is an indicator of a recent transmission of the disease in a community and it is estimated to constitute 15–20% of all TB cases in many of developing countries. However, only few studies which dominated by industrial countries were engaged to assess the situation. Therefore, this study was aimed to see epidemiology of childhood TB and factors associated with poor treatment outcome in developing country.

Method

Using retrospective cross-sectional study design; Socio-demographic and clinical data of children aged less than 15 years old, treated for all forms of TB in the past 10 years (2007–2016) was collected from randomly selected eight public hospitals of Tigray. Then, Univariate logistic regression and adjusted multivariate logistic regressions was done to identify variables which had association with unsuccessful treatment outcomes at P-value less than 0.05.

Result

In the past 10 years, a total of 13,345 Tuberculosis cases were observed. Of these, 1086 (8.1%) cases were children aged less than 15 years old. Sixty seven (6.2%) cases were smear positive. Among those that tested for HIV, 69 (8.3%) cases were TB/HIV co-infected. Of those with treatment outcome record 746 (88.7%) were successfully treated. Factors like being female (AOR, 1.79; 95% CI, 1.07–3.00), Age 0–5 years (AOR, 3.35; 95% CI, 2.11–5.33), Unknown HIV status (AOR, 2.44; 95% CI, 1.51–3.95) and pulmonary positive case (AOR, 2.56; 95% CI, 1.13–5.77), were more likely to have unsuccessful treatment outcome than their counterparts.

Conclusion

In Tigray 8.1% all TB cases were children age less than 15 years old. Childhood TB treatment outcome varied with sex, age and HIV status.
Recreational drug and excessive alcohol use among HIV-infected men who have sex with men in Central Israel
Authors: Mor Zohar , Turner Dan , Livnat Yuval , Levy Itzchak
Published: October 2019

Background

HIV-infected men who have sex with men (MSM) who use recreational drugs (RD) or excessive alcohol (EA) may be involved in risky sexual behaviours, including unprotected anal intercourse (UAI). This study describes the prevalence RD/EA-use among HIV-infected MSM, and compares those who used RD/EA with those who did not.

Methods

This cross-sectional study included HIV-infected MSM who were recruited in a convenient sample from two AIDS-treatment centres and events for HIV-infected MSM in Israel in 2016. Participants completed anonymous questionnaires including RD/EA-use and their sexual behaviours. RD/EA-use was defined as consumption of any psychoactive stimulants or dissociative anaesthetics, or an uptake of alcohol until drunkenness before or during sex.

Results

Of all 276 HIV-infected MSM, 202 (73.2%) used RD/EA. Those who used RD/EA were younger, reported earlier sexual debut, had more sexual partners, were more likely to perform UAI with casual partners, more commonly involved in paid sex, used psychiatric medications and more likely to be unsatisfied with their health-status compared to those who did not use RD/EA. HIV-infected MSM who used RD/EA reported a lower CD4-count and higher viral-load than those who did not. In a multivariate analysis, being younger, reported earlier sexual debut and been prescribed psychiatric drugs were associated with RD/EA-use among HIV-infected MSM.

Conclusions

A large proportion of HIV-infected MSM used RD/EA and also engaged in risky sexual behaviours. A subset of HIV-infected MSM can benefit from mental support during their routine treatment at the AIDS treatment centres and should also receive harm reduction intervention by their providers in order to minimize potential risks pertaining to RD/EA-use.
Clinical features, management, and outcome of iliopsoas abscess associated with cardiovascular disorders: a hospital-based observational case series study
Authors: Hu Sung-Yuan , Hsieh Ming-Shun , Chang Yao-Tien , Huang Chih-Che , Tsai Che-An , Tsai Chung-Lin , Hsu Chiann-Yi , Shen Chia-Hui , Chang Yan-Zin
Published: October 2019

Background

Iliopsoas abscess (IPA) is a rare clinical entity and is difficult to diagnose due to its insidious onset and nonspecific symptoms. The association between IPA and cardiovascular disorders (CVD) has been rarely reported. Computed tomographic (CT) scan can provide a definitive diagnosis of IPA and associated foci of adjacent structures. IPA is a life-threatening condition, especially when associated with CVD.

Materials and methods

We conducted a hospital-based observational study of IPA associated with CVD. Data were collected from the electronic clinical database of Taichung Veterans General Hospital (1520-bed tertiary referral hospital in central Taiwan) between July 2007 and December 2017. The diagnosis of IPA associated with CVD was confirmed by classical findings on CT and transesophageal echocardiography with compatible clinical presentation and cultures from pus/tissue and blood.

Results

Fifteen patients of IPA associated with CVD were studied. They included 12 males (80%) and 3 females (20%), with a mean age 63.2 ± 16.9 years (31–85 years). CVD included stent-graft/endograft infection of abdominal aortic aneurysm (AAA) (40%), primary mycotic AAA (33.3%), and infective endocarditis (26.7%).Staphylococcus aureusis the most common microorganism in pus/tissue cultures (n = 3, 37.5%) and in blood cultures (n = 6, 40%). The average length of hospital stay was 33.1 ± 20.5 days (range, 3–81 days; median, 33 days). Hospital stay lasted 42.6 ± 19.2 days in the survival group and 19.0 ± 14.1 days (P = 0.018) in the non-survival group. Incidence of patients staying in the intensive care unit (ICU) with intubation > 3 days was 33% in the survival group and 100% (P = 0.028) in the non-survival group. Intra-hospital mortality rate was 40%. Poor prognostic factors in the non-survival group were hypoalbuminemia, hyponatremia, involved disc/vertebral body and/or epidural abscess, and ICU stay with intubation > 3 days. Cumulative survival rate was 25% under conservative treatments and 66.3% under aggressive treatments (P = 0.038).

Conclusion

Due to high mortality rates, clinicians should keep a high suspicion index for IPA associated with CVD through clinical presentation, physical examination, and imaging study. Timely empiric antibiotics for common bacteria, drainage for IPA, endovascular repair, or vascular reconstruction by graft replacement or bypass with intensive care should be mandatory to shorten the hospital stay, reduce medical costs, and lower mortality rate.
No added value for Computer-Assisted surgery to improve femoral component positioning and Patient Reported Outcomes in Hip Resurfacing Arthroplasty; a multi-center randomized controlled trial
Authors: Koper M. C. , Reijman M. , van Es E. M. , Waarsing J. H. , Koot H. W. J. , Keizer S. B. , Jansen I. , van Biezen F. C. , Verhaar J. A. N. , Bos P. K.
Published: October 2019

Background

Computer Assisted Surgery (CAS) has proven to improve the accuracy in several orthopedic procedures. Therefore we used this technique to evaluate femoral component positioning in Hip Resurfacing Arthroplasty (HRA). The aim of this study was to evaluate imageless CAS compared to manually implanted femoral components and subsequently evaluates Patient Related Outcome Measures (PROMs). We hypothesized that the use of CAS optimizes the position of the femoral component and improves PROMs.

Methods

This is a multicenter, single-blinded, randomized, controlled trial of two groups. In the CAS group guiding of the femoral component was done with imageless navigation. In the Conventional (control) group the femoral component was placed manually according to the preplanned position. The primary outcome measure consists of a maximum of 3 degrees difference between the postoperative Stem Shaft Angle (SSA) and preplanned SSA. Secondary outcome measures consist of the Hip disability and Osteoarthritis Outcome Scale (HOOS), the Harris Hip Score (HHS) and Visual Analogue Scale (VAS) pain score.

Results

A total of 122 patients were randomized, 61 in the CAS group and 61 in the conventional group. There was no significant differences in accuracy of femoral implant position. The mean difference between the postoperative- and preplanned SSA was − 2.26 and − 1.75 degrees (more varus) respectively in the CAS and Conventional group. After surgery both groups show significant improvement in all PROMs compared to the baseline measurements, with no significant differences between the groups.

Conclusion

Our cohort indicates no benefit for the use of CAS in accuracy of placement of the femoral component in HRA compared to manual implantation. There are no clinical differences in PROMs after 1 year follow up. This study showed no added value and no justification for the use of CAS in femoral component positioning in HRA.

Trial registration

This trial is registered at ClinicalTrails.gov (https://clinicaltrials.gov/) on the 25th of October 2006: NCT00391937.

Level of incidence

Level IIb, multicenter randomized controlled trial.
From digital world to real life: a robotic approach to the esophagogastric junction with a 3D printed model
Authors: Marano Luigi , Ricci Alessandro , Savelli Vinno , Verre Luigi , Di Renzo Luca , Biccari Elia , Costantini Giacomo , Marrelli Daniele , Roviello Franco
Published: October 2019

Background

Three-dimensional (3D) printing may represent a useful tool to provide, in surgery, a good representation of surgical scenario before surgery, particularly in complex cases. Recently, such a technology has been utilized to plan operative interventions in spinal, neuronal, and cardiac surgeries, but few data are available in the literature about their role in the upper gastrointestinal surgery. The feasibility of this technology has been described in a single case of gastroesophageal reflux disease with complex anatomy due to a markedly tortuous descending aorta.

Methods

A 65-year-old Caucasian woman was referred to our Department complaining heartburn and pyrosis. A chest computed tomography evidenced a tortuous thoracic aorta and consequent compression of the esophagus between the vessel and left atrium. A “dysphagia aortica” has been diagnosed. Thus, surgical treatment of anti-reflux surgery with separation of the distal esophagus from the aorta was planned. To define the strict relationship between the esophagus and the mediastinal organs, a life-size 3D printed model of the esophagus including the proximal stomach, the thoracic aorta and diaphragmatic crus, based on the patient’s CT scan, was manufactured.

Results

The robotic procedure was performed with the da Vinci Surgical System and lasted 175 min. The surgeons had navigational guidance during the procedure since they could consult the 3D electronically superimposed processed images, in a “picture-in-picture” mode, over the surgical field displayed on the monitor as well as on the robotic headset. There was no injury to the surrounding organs and, most importantly, the patient had an uncomplicated postoperative course.

Conclusions

The present clinical report highlights the feasibility, utility and clinical effects of 3D printing technology for preoperative planning and intraoperative guidance in surgery, including the esophagogastric field. However, the lack of published data requires more evidence to assess the effectiveness and safety of this novel surgical-applied printing technology.
Correction to: Management of duodenal stump fistula after gastrectomy for malignant disease: a systematic review of the literature
Authors: Zizzo Maurizio , Ugoletti Lara , Manzini Lorenzo , Ruiz Carolina Castro , Nita Gabriela Elisa , Zanelli Magda , De Marco Loredana , Besutti Giulia , Scalzone Rocco , Sassatelli Romano , Annessi Valerio , Manenti Antonio , Pedrazzoli Claudio
Published: October 2019

Following publication of the original article [1], the authors have notified us that due to administrative reasons they would like to modify the first affiliation from:
Sex differences in the prevalence and adverse outcomes of sarcopenia and sarcopenic obesity in community dwelling elderly in East China using the AWGS criteria
Authors: Du Yanping , Wang Xiaodong , Xie Hua , Zheng Songbai , Wu Xiaoqing , Zhu Xiaoying , Zhang Xuemei , Xue Sihong , Li Huilin , Hong Wei , Tang Wenjing , Chen Minmin , Cheng Qun , Sun Jianqin
Published: October 2019

Background

Sarcopenia and sarcopenic obesity (SO) have a greater impact on the elderly. This study aimed to explore whether there were sex differences in the prevalence and adverse outcomes of sarcopenia and SO in community-dwelling elderly individuals in East China.

Methods

This was a cross-sectional study that enrolled 213 males and 418 females aged > 65 years. Demographic characteristics, body composition, hand grip, gait speed, and indices of glucose and lipid metabolism were collected. Sarcopenia and SO were diagnosed using the Asian Working Group for Sarcopenia criteria.

Results

(1) The prevalence of sarcopenia was 19.2% in males and 8.6% in females. The prevalence of SO was 7.0% in males and 2.4% in females. (2) In males, the odds ratios (ORs) of osteoporosis and dyslipidemia in the SO group were 4.21-fold and 4.15-fold higher than those in the normal group, respectively. In females, the ORs of osteoporosis and hyperglycemia in the SO group were 1.12-fold and 4.21-fold higher than those in the normal group.

Conclusions

Males were more likely to be sarcopenic and to have SO than females using the AWGS criteria. Females with SO were more likely to have higher blood glucose, whereas males with SO were more likely to have osteoporosis and dyslipidemia.
Effect of single follow-up home visit on readmission in a group of frail elderly patients – a Danish randomized clinical trial
Authors: Lembeck Maurice A. , Thygesen Lau C. , Sørensen Birgitte Dreyer , Rasmussen Lisbeth Lumby , Holm Ellen A.
Published: October 2019

Background

Unplanned hospital admissions are costly and prevention of these has been a focus for research for decades. With this study we aimed to determine whether discharge planning including a single follow-up home visit reduces readmission rate. The intervention is not representing a new method but contributes to the evidence concerning intensity of the intervention in this patient group.

Methods

This study was a centrally randomized single-center controlled trial comparing intervention to usual care with investigator-blinded outcome assessment. Patients above the age of 65 were discharged from a single Danish hospital during 2013–2014 serving a rural and low socioeconomic area. For intervention patients study and department nurses reviewed discharge planning the day before discharge. On the day of discharge, study nurses accompanied the patient to their home, where they met with the municipal nurse. Together with the patient they reviewed cognitive skills, medicine, nutrition, mobility, functional status, and future appointments in the health care sector and intervened if appropriate.

Readmission at any hospital in Denmark within 8, 30, and 180 days after discharge is reported. Secondary outcomes were time to first readmission, number of readmissions, length of stay, and readmission with Ambulatory Care Sensitive Conditions, visits to general practitioners, municipal services, and mortality.

Results

One thousand forty-nine patients aged > 65 years discharged from medical, geriatric, emergency, surgical or orthopedic departments met inclusion criteria characteristic of frailty, e.g. low functional status, need of more personal help and multiple medications. Among 945 eligible patients, 544 were randomized. Seven patients died before discharge. 56% in the intervention group and 54% in the control group were readmitted (p = 0.71) and 23% from the intervention group and 22% from the control group died within 180 days. There were no significant differences between intervention and control groups concerning other secondary outcomes.

Conclusions

There was no effect of a single follow-up home visit on readmission in a group of frail elderly patients discharged from hospital.

Trial registration

https://clinicaltrials.gov(identifier NCT02318680), retrospectively registered December 11, 2014.