bluuebunny/crossref_metadata_2025 huggingface dataset:
What is the impact of user preferences on the design of the hospital online registration system: An integrated approach
Authors: Lin Chin-Feng , Fu Yin-Chih , Lin Liang-Shiun , Fu Chen-Su
Published: January 2020

Background An efficient registration system for all these types of Taiwan medical institutions will enable outpatients to register online and inform them of the best time to go to the hospital and when their turn for medical treatment is. Hence, understanding the outpatients’/users’ actual needs is important for hospital managers to design a user-friendly registration system. Purpose This study, based on means-end chain (MEC) theory and the Kano model, aims to: 1) understand user preferences toward using a hospital online registration system by constructing the Kano–MEC hierarchical value map, and 2) deduce and formulate effective system planning and promotion strategies. Methodology/approach Mixed methods research was employed to collect data. A total of 16 hospital registration websites were examined and 34 in-depth interviews were conducted. All the interview transcripts were analyzed, and 16 attribute, 13 consequence, and 4 value variables were obtained for a final questionnaire design. A total of 376 valid samples were collected from a questionnaire survey to construct a Kano–MEC hierarchical value map. Results The Kano–MEC hierarchical value map depicts hospital online registration users’ innermost thoughts and cognitive structure with regard to their attribute/consequence/value preferences and their attribute performance, as categorized by Kano’s quality classifications. Conclusions The Kano–MEC map showed that “right-clicking the registration by department tab,” “modifying or canceling one’s appointment,” “downloading doctor’s schedule,” “doctor introduction,” “right-clicking the registration by doctor’s name,” and “instant messaging” are classified as Kano’s one-dimensional attributes that can improve users’ satisfaction and reduce their dissatisfaction by increasing quality fulfillment. Practice Implications Evidently, managers should focus on “right-clicking the registration by department tab,” “modifying or canceling one’s appointment,” “downloading doctor’s schedule,” “doctor introduction,” “right-clicking the registration by doctor’s name,” and “instant messaging” to formulate their system planning for enhancing the functions of their online registration system and increasing user satisfaction.
Different screening frequency of carbapenem-resistant Enterobacteriaceae in patients undergoing hematopoietic stem cell transplantation: which one is better?
Authors: Yang Tingting , Luo Xueping , Yang Qing , Chen Hongchao , Luo Yi , Zhao Yanmin , Ye Yishan , Lai Xiaoyu , Yu Jian , Tan Yamin , Wei Guoqing , Huang He , Shi Jimin
Published: January 2020

BackgroundConsensus has been reached that carbapenem-resistant Enterobacteriaceae (CRE) screening in immunosuppressed individuals can reduce the incidence of severe CRE infection. However, there is no standard for effective screening and relevant studies has been fewer reported, especially for hematopoietic stem cell transplantation (HSCT) population. Methods We retrospectively studied the clinical data of 395 consecutive HSCT patients admitted in our center from September 2017 to April 2019 during two periods, single screening and continuous screening. During period 1 (September 2017 to June 2018), 200 patients received single stool CRE screening within one week before transplantation. During period 2 (July 2018 to April 2019), we implemented continuous weekly stool CRE screening after admission. For patients colonized with CRE, target management were received:(1) contact precaution;(2) preemptive CRE-targeted treatment if necessary. Results During period 1 , three patients with CRE colonization were detected (1.5%). The BSI percent of CRE was 2.0% (4 patients) and related 30-day mortality was 50.0% (2 out of 4 patients). During period 2, twenty-one patients with CRE colonization were detected and the detection rate was significantly higher than that in period 1(P<0.001). The CRE BSIs rate decreased to 0.5% (1/195) and there was no CRE-related mortality. Conclusion The increase of screening frequency contributed to the detection of patients with CRE colonization. Targeted management for these colonized patients may contribute to reduce the incidence and related mortality of CRE bloodstream infection, therefore improving the prognosis of HSCT patients.
Lifestyle Factors Associated with Prevalent and Exacerbated Musculoskeletal Pain After the Great East Japan Earthquake: A Cross-Sectional Study from the Fukushima Health Management Survey
Authors: Jinnouchi Hiroshige , Ohira Tetsuya , Kakihana Hironobu , Matsudaira Ko , Maeda Masaharu , Yabe Hirooki , Suzuki Yuriko , Harigane Mayumi , Iso Hiroyasu , Kawada Tomoyuki , Yasumura Seiji , Kamiya Kenji
Published: January 2020

Background: While the prevalence of post-disaster musculoskeletal pain has been documented, its associated disaster-related factors have not been investigated. This study determined the prevalence of and lifestyle factors associated with musculoskeletal pain among evacuees of the Great East Japan Earthquake. Methods: We conducted a cross-sectional study of 34,919 evacuees, aged 40-89 years, without obvious disabilities in activities of daily living at about 1 year after the disaster. The evacuees were asked about their musculoskeletal pain (low back and limb pain) and lifestyle factors: use of evacuation shelters or temporary housing at any point of time, job loss after the disaster, decreased income after the disaster, current smoking status, current drinking status, lack of sleep, regular exercise, and participation in recreational or community activities. Furthermore, psychological factors, such as traumatic reactions, psychological distress, and somatic symptoms, affecting musculoskeletal pain were assessed. We used multinomial logistic regression analysis to calculate odds ratios of each lifestyle factor for prevalent and prevalent plus exacerbated musculoskeletal pain. Results: Musculoskeletal pain prevalence was 32.8%: 27.6% for prevalent and 5.2% for prevalent plus exacerbated musculoskeletal pain. Multivariable adjusted odds ratios and 95% confidence intervals of lifestyle factors associated with prevalent and prevalent plus exacerbated musculoskeletal pain were as follows: shelter use (prevalent: 1.02, 0.96-1.08; exacerbated: 1.44, 1.29-1.60), job loss (prevalent: 1.03, 0.96-1.10; exacerbated: 1.30, 1.16-1.47), decreased income (prevalent: 1.13, 1.05-1.21; exacerbated: 1.29, 1.14-1.45), current heavy drinking (prevalent: 1.33, 1.21-1.47; exacerbated: 1.38, 1.14-1.68), insomnia (prevalent: 1.22, 1.15-1.29; exacerbated: 1.50, 1.36-1.65), exercising almost daily (prevalent: 0.83, 0.77-0.91; exacerbated: 0.80, 0.68-0.95), and participating in community activities often (prevalent: 0.83, 0.75-0.92; exacerbated: 0.76, 0.61-0.95). Conclusions: Prevalent and exacerbated musculoskeletal pain were inversely associated with frequencies of exercise and participating in recreational or community activities and positively associated with decreased income, current heavy drinking, and insomnia. The use of evacuation shelters or temporary housing/job loss was positively associated only with exacerbated musculoskeletal pain. These results suggest that post-disaster lifestyle factors are potentially associated with musculoskeletal pain. For better post-disaster pain management, further studies are needed to confirm these results in other disasters and highlight underlying mechanisms.
An Assessment Of The Food Safety Knowledge and Attitudes Of Food Handlers In Hospitals
Authors: Tabit Frederick Tawi , Teffo Lesiba A
Published: January 2020

Background: The possession of inadequate food safety knowledge (FSK) by food handlers poses a serious threat to food safety in service establishments. The aim of this research was to investigate factors that influenced the FSK and food safety attitudes (FSA) of employees involved in the preparation and/or the serving of food from nine hospitals in the Capricorn District Municipality (CDM) in Limpopo Province, South Africa.Method: Up to 210 individuals (18-65 years) who were employed in these hospitals, and who were involved in the preparation and serving of food to patients were purposefully selected. Data collection was by means of an interview using a questionnaire design for this study. The FSK and FSA scores of hospital food handlers were obtained by adding the correct response to FSK or FSA questions.Results: Only 29% of the hospital food handlers have attended a food safety-training course. Many food handlers were not knowledgeable on the correct temperature for handling foods, and on the correct minimum internal cooking temperature for poultry, seafood and egg. Only the minority of food handlers knew that Salmonella is the main foodborne bacteria pathogen mostly associated with poultry products (47.1%) and that food borne bacteria will grow quickly in food at a temperature of 37 ˚C (38.1%). Hospital food handlers with higher academic qualifications do not possess more FSK than those with lower academic qualifications. 51% of the hospital food handlers possessed a Satisfactory FSK while 10% possessed a Good FSK and 39% possessed an Inadequate FSK.Conclusion: More than 60% of the hospital food handlers possesses either Good FSK or Satisfactory FSK. Higher levels of education, experience in food handling and job position did not lead to better FSK outcome. All the hospital food handlers possess at least a Satisfactory FSA. There was a weak positive but significant correlation between the FSK and FSA of hospital food handlers. It is recommended all employees involved in food handlers be subjected to food safety training programmes on a regular basis irrespective of their academic, employment and training details.
Evaluating the effect of increased physical activity in lower secondary school adolescents: The study protocol for the School in Motion (ScIM) study – a cluster-randomized controlled trial.
Authors: Kolle Elin , Solberg Runar Barstad , Grydeland May , Säfvenbom Reidar , Anderssen Sigmund Alfred , Ekelund Ulf , Berntsen Sveinung , Resaland Geir Kåre , Dyrstad Sindre M. , Steene-Johannessen Jostein
Published: January 2020

Background: Participation in regular physical activity (PA) is important for both physical and mental health, and positive associations have also been reported between PA and academic performance. However, PA levels decline markedly during adolescence. School in motion (ScIM) is a school-based PA intervention carried out over one school year, in a sample of 14-year-old girls and boys. The primary aim was to investigate whether two extra hours of PA weekly lead to increases in the adolescents’ accelerometer assessed PA levels. Secondary aims were to investigate the intervention effects on time spent in PA of different intensities, muscle strength, cardiorespiratory fitness, mental health, academic performance and learning environment. ffigMethods & design: This is a multicenter, school-based, three-arm cluster randomized controlled trial (RCT) recruiting ninth graders from lower secondary schools in Norway. A total of 2084 14-year-olds from 29 schools were included, yielding a participation rate of 76 %. Schools (clusters) were randomly assigned to one of three study arms: (1) the physical active learning (PAL) intervention arm, (2) the don't worry-be happy (DWBH) intervention arm, or (3) current practice (control arm). All schools participating in ScIM had two or three mandatory PE-lessons per week. Schools in the two intervention arms added two hours of PA and PE to the class schedule each week. PA was assessed by accelerometers at baseline, midpoint and at the end of the intervention. All other variables were tested at baseline and at the end of the intervention. The measures included cardiorespiratory fitness, muscle strength, mental health (general mental health, quality of life and self-perception) academic performance (standardized national tests in reading and numeracy) and learning environment. Qualitative interviews were performed with students, teachers and school management to obtain an in-depth understanding of pedagogical processes taking place during the intervention.Discussion: This study will inform what effect two added hours of PA during the school week can have on adolescents’ PA levels, their health, academic performance and learning environment. Further, the study will add valuable information if the two PA interventions will generate different effects on important factors for learning and health.Trial registration: Clinicaltrials.gov ID nr: NCT03817047. Registered 01/25/2019 ‘retrospectively registered’
Global 11 beta-hydroxysteroid dehydrogenase activity assessed by the circulating cortisol to cortisone ratio is associated with features of metabolic syndrome
Authors: Chailurkit La-or , Aekplakorn Wichai , Paiyabhroma Nitchawat , Ongphiphadhanakul Boonsong
Published: January 2020

Background 11 Beta-hydroxysteroid dehydrogenases (11HSD) are enzymes involved in the interconversion of cortisol and cortisone. There are two isoenzymes of 11HSD, 11HSD1 and 11HSD2. A causative role of 11HSD, particularly 11HSD1, in metabolic syndrome is well established in experimental animals. However, its role in human metabolic syndrome is less clear. We examined the influence of global 11HSD activity on metabolic syndrome in the general population, using the circulating cortisol:cortisone ratio as an index of global 11HSD activity.Methods A subsample of 269 sera randomly selected from the Thai National Health Examination Survey IV samples was analyzed for serum cortisol and cortisone levels by liquid chromatography-tandem mass spectrometry.Results There was no association between serum cortisol and age. However, circulating cortisone was negatively correlated with age (r = −0.12, p < 0.001), and the serum cortisol:cortisone ratio was positively associated with age (r = 0.03, P < 0.001). No association was found between serum cortisol:cortisone ratio and BMI or serum lipids. Multivariate analyses showed that the serum cortisol:cortisone ratio was associated with high blood pressure (P < 0.05) independent of age, BMI and sex. In subjects without hypertension, the serum cortisol to cortisone ratio was associated with mean systolic blood pressure after controlling for age, BMI and sex. The cortisol:cortisone ratio was not significantly different between subjects with and without diabetes. After excluding the 16 subjects with diabetes, it was found that the serum cortisol:cortisone ratio was positively associated with fasting plasma glucose independent of age, BMI and sex (P < 0.01).Conclusions The global index of 11HSD activity, assessed by the circulating cortisol:cortisone ratio, was related to high blood pressure and fasting plasma glucose. Modulation of 11HSD may help treat hypertension and diabetes but probably not other features of metabolic syndrome.
Association of Vitamin D Receptor gene polymorphisms with the occurrence of low bone density, osteopenia, and osteoporosis in patients with type 2 diabetes
Authors: Ghodsi Maryam , Keshtkar Abbas Ali , Razi Farideh , Amoli Mahsa Mohammad , Nasli-Esfahani Ensieh , Zarrabi Fariba , Khashayar Patricia , Khajavi Alireza , Larijani Bagher , Mohajeri Mohamad Reza
Published: January 2020

Background Diabetes, osteoporosis, and Vitamin D deficiency are interrelated. The association of the Vitamin D receptor (VDR) gene with bone density is not established in different populations. This study analyze the association between five VDR gene polymorphisms (Fok1 (rs2228570), Taq1 (rs731236), Bsm1 (rs1544410), Apa1 (rs7975232), and EcoRV (rs4516035)) and the occurrence of low bone density (LBD)/osteopenia/osteoporosis in Iranian type 2 diabetics (T2D).Methods This study contained 165 patients with T2D. Separated for gender and polymorphism, crude and adjusted (for age and BMI), logistic regression analysis provided odds ratios (ORs). The most common haplotype was used as the reference for each type of VDR gene polymorphism.Results The occurrence of T2D was 13.03% (165/1266) for the people dwelling in the city of Sanandaj in 2012, until 2013. 13.92% and 81.29% of participants with T2D had osteoporosis and vitamin D deficiency, respectively. In women, tt genotype significantly decreased the risk of LBD/osteopenia/osteoporosis versus Tt genotype, after adjusting for BMI and age (OR=0.18, CI: 0.03-0.97). Conversely, the EE genotype increased the risk of LBD/osteopenia/osteoporosis versus Ee genotype (OR=7.64, CI: 2.03-28.72).Conclusions Among the patients with T2D, Vitamin D deficiency and osteoporosis were prevalent, and some genetic variations in VDR were significantly associated with osteoporosis. In women, a weak protective role in LBD/osteopenia/osteoporosis was found for tt variant of TaqI polymorphism. More importantly, EE variant of EcoRV polymorphism had a strong significant association with increasing the risk of LBD/osteopenia/osteoporosis. Further ethnicity-based cohort studies based on a large study group of T2D patients are recommended.
Bergenin-activated SIRT1 inhibits TNF-a-induced pro-inflammatory response via blocking NF-kB signaling pathway 
Authors: Zhou Bei xian , Wu Bin , Chen Min , Chen Cuifen , Gao Yun , Li Dongming , Huang Dan , Chen Ziyu , Zhao Xuanna , Huang Qiu , Wu Dong , Lai Tianwen , Su Guomei
Published: January 2020

BackgroundBergenin, a kind of polyphenol compound, has been showed to exhibit antiulcerogenic, anti-inflammatory, antitussive and burn wound healing properties, However, its therapeutic effect on TNF-a induced pro-inflammatory response in airway and its potential mechanisms of actions were still unclearAim of this studyThis study aimed to investigate the anti-inflammatory effects and possible mechanism of bergenin in TNF-a-stimulated 16-HBE cells.Materials and methodsCCK8 was used to determine the cytotoxicity. Cytokines expression were analyzed by qRT-qPCR and ELISA. Immunofluorescence, western blotting and SIRT1 activity assay were employed to investigate the possible molecular mechanism. ResultsOur results showed that bergenin treatment obviously decreased the mRNA and protein expressions of IL-6 and IL-8 in TNF-a-stimulated 16-HBE cells. Bergenin blocked TNF-a-mediated the activation of NF-kB signaling and NF-kB nuclear translocation. Interestingly, RT‑qPCR and western blotting revealed that bergenin did not affect the expression of sirtuin-1 (SIRT1), but significantly increased the activity of SIRT1. Furthermore, bergenin-mediated SIRT1 activation was further confirmed by the resulted that bergenin decreased acetylation levels of NF-kB-p65 and p53. The inhibitory effects of bergenin on the mRNA and protein expression levels of IL-6 and IL-8 were reversed by addition of SIRT1 inhibitor. In addition, combination of bergenin and dexamethasone showed additive effects on the reduction of IL-6 and IL-8.ConclusionsThese findings demonstrated that bergenin could suppress TNF-α-induced pro-inflammatory response via augmenting SIRT1 activity to block NF-kB signaling pathway, which may contribute to provide beneficial effect for the treatment of airway inflammation in asthma.
In vitro/vivo Mechanism of Action of S100A12 in Sepsis-induced ARDS
Authors: zhang Zhenen , Han Nannan , Shen Ye
Published: January 2020

ObjectiveSepsis is a multiple organ dysfunction elicited by the dysregulated host immune response to microbial infection. Acute respiratory distress syndrome (ARDS) is a serious and acute inflammatory lung injury resulting from sepsis and other serious diseases. The present study aims to investigate the role of S100A12, a pro-inflammatory factor, in the pathophysiologic mechanism underlying the process in sepsis-induced ARDS.MethodsThe blood samples and clinical base line of study subjects were collected. C57BL/6 mice underwent cecal ligation and puncture (CLP) to establish sepsis models. Hematoxylin and Eosin (H&E) Staining was performed to observe pathological changes. Enzyme-Linked Immunosorbent Assay (ELISA) and specific commercial assay kits were employed to analyze the levels of inflammatory cytokines and antioxidant capacity, respectively. Western blot, immunohistochemistry (IHC) staining and reverse-transcriptase quantitative real-time PCR (RT-qPCR) were performed to determine target gene and protein expression. TUNEL Assay and Flow Cytometry were performed to assay cell apoptosis.ResultsThe levels of S100A12 and sRAGE are upregulated in the serum of patients with Sepsis-induced ARDS and sepsis mice. Furthermore, higher cell apoptosis rate was observed in lung tissue of sepsis mice. In addition, S100A12 resulted in excessive mucins and the secretion of inflammatory cytokines secretion, and promoted the expression of chemokines and cell adhesion molecules via activating NLRP3 inflammasome pathway in NHBE cells. Finally, S100A12 increased oxidative stress status and cell apoptosis in NHBE cells.ConclusionThe present study provides evidence that S100A12 is closely related to pathogenesis of sepsis-induced ARDS. Hence, S100A12 may be a useful biomarker of pulmonary injuries for clinical diagnosis of sepsis-induced ARDS.
Prediction of Clostridium difficile infection in patients with polymerase chain reaction using a classification and regression tree
Authors: Martínez-Ruíz Diana , Parra-Lara Luis Gabriel , Rosso Fernando
Published: January 2020

BackgroundClostridium difficile infection (CDI) is commonly diagnosed with the polymerase chain reaction (PCR), but this test finds a high percentage of false positives, so their use and interpretation in CDI is a challenge in the clinical practice. That is why it is necessary to define an algorithm to optimize the use of PCR that considers clinical characteristics to classify patients with diarrhea as CDI or without CDI. ObjectiveTo identify a predictive algorithm with the clinical features that best classify patients with CDI vs. without CDI, to help physicians in making decisions to request PCR. Materials and methodsA case-control study was conducted at Fundación Valle del Lili. The population was inpatients between 2012 and 2016, with 18 or more years, and diarrhea, abdominal pain, or other nonspecific gastrointestinal symptoms who underwent PCR. Cases were defined as patients with positive PCR for C. difficile and as controls patients with negative PCR for C. difficile. Predictive algorithms to classify patients was constructed using a classification tree, classification and regression tree (CART). ResultsA total of 149 patients were included (48 cases with positive PCR and 99 controls with negative PCR). The CART has a high capacity to classify patients with a negative PCR correctly. It includes variables about the history of antibiotics use, the use of proton-pump inhibitor, the use of ranitidine, and the use of antifungal drugs. The CART showed sensitivity 64.6%, specificity 85.8%, positive predictive value 68.8%, negative predictive value 83.3%. and AUC 79.7%.DiscussionCART had good specificity and a high negative predictive value; it could be considered as an algorithm to identify conditions that indicate when it is not necessary to perform a PCR test in a patient symptom of CDI.
Financial Risk Protection of Thailand Universal Health Coverage: results from series of national household surveys between 1996 and 2015.
Authors: Tangcharoensathien Viroj , Tisayaticom Kanjana , Suphanchaimat Rapeepong , Vongmongkol Vuthiphan , Viriyathorn Shaheda , Limwattananon Supon
Published: January 2020

Background Thailand, an upper-middle country, had demonstrated exemplary outcomes of Universal Health Coverage (UHC). The country has achieved UHC since 2002 when the whole population was covered by the three public health insurance schemes. Prior studies do not provide long series of UHC financial risk protection. This study assessed financial risk protection as measured by the incidence of catastrophic health spending and impoverishment in Thai households prior to and after UHC in 2002.Methods We used data from a fifteen-year series of annual national household socioeconomic surveys between 1996 and 2015, which were conducted by the National Statistical Office. The survey covered about 52,000 nationally representative households in each round. Descriptive statistics were used to assess the incidence of catastrophic payment as measured by the share of out-of-pocket payment for health by households exceeding 10% and 25% of household total consumption expenditure, and the incidence of impoverishment as determined by additional number of non-poor households falling below the national and international poverty lines after health payment.Results Using the 10% threshold, the incidence of catastrophic spending dropped from 6.0% in 1996 to 2% in 2015. This incidence reduced more significantly when 25% threshold was applied (from 1.8% to 0.4% in the same period). The incidence of impoverishment against national poverty line reduced considerably, from 2.2% in 1996 to approximately 0.3% in 2015. When the international poverty line of US$ 3.1 per capita per day was used, the incidence of impoverishment was 1.4% and 0.4% in 1996 and 2015 respectively; and when US$ 1.9 per day was applied, the incidence was negligibly low.Conclusion The significant decline in the incidence of catastrophic health spending and impoverishment was attributed to the deliberate design on the Thai UHC that provides comprehensive benefit package, zero co-payment at point of services. The well-founded healthcare delivery systems also play critical role in supporting and sustaining the function of the UHC.
Call for Collaboration: Characterization of a Multicenter Hydrocephalus Shunt Biobank
Authors: Gluski Jacob , Zajciw Paul , Hariharan Prashant , Morgan Amanda , Morales Diego , Jea Andrew , Whitehead William , Marupudi Neena , Ham Steven , Sood Sandeep , II James P. McAllister , Limbrick David D. , Harris Carolyn
Published: January 2020

Background Pediatric hydrocephalus is a devastating and costly disease. The mainstay of treatment is still surgical shunting of cerebrospinal fluid (CSF). These shunts fail at a high rate and impose a significant burden on patients, their families and society. The relationship between clinical decision making and shunt failure is poorly understood and multifaceted, but catheter occlusion remains the most frequent cause of shunt complications. In order to investigate factors that affect shunt failure, we have established the Wayne State University (WSU) shunt biobank.Methods To date, six hospital centers have contributed various components of failed shunts and CSF from patients diagnosed with hydrocephalus at a young age. The hardware samples are transported in paraformaldehyde and transferred to phosphate-buffered saline with sodium azide upon deposit into the biobank. Once in the bank, they are then available for study. Informed consent is obtained by the local center before corresponding clinical data are entered into a REDCap database. All data are entered under a coded identifier. Collaborators may then correlate biologic findings against the clinical database.Results 295 shunt samples were collected from 228 patients starting from May 2015 to September 2019. Patients with multiple samples in the bank provide a unique opportunity to study longitudinal changes in disease. With the clinical data alone, we saw a significant difference in the number of revisions per patient between centers (Kruskal-Wallis H test, p-value= 0.000022). There was no significant difference between the distributions of hydrocephalus etiologies between centers, and the leading etiology at all centers was post-hemorrhagic hydrocephalus.Conclusion Hospital center and patient recruitment for the biobank is ongoing. The biobank will yield insights for future collaborators, allow centers to benchmark their performance, and offer a unique-longitudinal perspective on the pathology of this lifelong condition. Future work will expand on the contribution of different site-specific and patient-specific factors to identify potential cause and effect relationships.
Role of the ClC-2 Chloride Channel in TGF-β1-induced Proliferation, Collagen Synthesis, and Collagen Gel Contraction Mediated by Human Conjunctival Fibroblasts
Authors: Sun Lixia , chui Renzhe , Huan Meng , Liu Xiwen , Liu Xin , Liu Kun , Jia Liang , Zheng Yajuan
Published: January 2020

Background: Excessive scar tissue can reduce postoperative survival of filtering blebs in patients with glaucoma. Previous studies have highlighted the role of chloride channels in wound healing. whereas The role of chloride channels in the formation of follicular scar has not been studied. Objectives: To investigate the effects of the ClC-2 chloride channel on scar formation of filtering blebs after glaucoma filtering surgery. Methods: We Inhibited ClC-2 chloride channels of Human Conjunctival Fibroblasts (HConFs) by transfecting HConFs with ClC-2 siRNA, Then cell proliferation, cycle and collagen synthesis of HConFs were measured. ClC-2 siRNA-transfected HConFs were cultured in type I collagen gels in the presence of transforming growth factor (TGF)-β1. Collagen gel contraction was evaluated based on the gel area. The expression levels of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in HConFs were assessed by western blotting and q-PCR. Results: TGF-β1induced cell proliferation, cell cycle progression, collagen synthesis, and collagen gel contraction in HConFs. TGF-β1 increased MMP-2 and MMP-9 levels but inhibited the expression of TIMPs. ClC-2 siRNA transfection inhibited TGF-β1-induced cell proliferation, cell cycle progression, collagen synthesis, and collagen gel contraction, mediated by HConFs. TGF-β1-induced increases in MMP-2 and MMP-9 were also inhibited by NPPB and ClC-2 siRNA transfection, but TIMP expression was increased by ClC-2 siRNA transfection. Conclusions: These findings demonstrate that ClC-2 gene knockout inhibited TGF-β1-induced cell proliferation, collagen synthesis, and collagen gel contraction of HConFs by attenuating MMP-2 and MMP-9 production and by stimulating TIMP-1 production. Keywords: ClC-2 chloride channel; conjunctival fibroblasts; TGF-β1; wound heal
Responsiveness of Occupational Health Risk and Preventive Measures Practice by the Workers Employed in Tannery Occupation in Kanpur, India
Authors: Kashyap Gyan Chandra , Chokhandre Praveen , Singh Shri Kant
Published: January 2020

Background: Occupational health covers all aspects of health and safety in the workplace and has a strong focus on primary prevention of hazards. There are several health risks, such as respiratory problems, injuries/accidents, musculoskeletal disorders, cancers, mental health disorders, skin ailments, infectious diseases, and many more involved in the occupation, which exclusively depends on workplace conditions. Objectives: The objective of the study was to understand the extent of awareness about occupational health risks involved in tannery occupation and adopted preventive measures by the tannery workers of Kanpur, India. Methods: Information for the present research was strained from a cross-sectional household study of tannery workers in the Jajmau area of Kanpur, India. The survey was piloted through the period January-June 2015, and 284 samples were collected. This study has adopted a three-stage sampling design. The frequency distribution and cross-tabulation were used. The difference in the awareness of various morbidities was tested using the chi-square test. A logistic regression analysis was used to identify individual risk factors. Results: The prevalence of awareness of tannery work is very hazardous in nature varies from 73% to 93% among the tannery workers. Tannery workers having a middle-school level of education were 3.01 times more likely to be aware of the hazards as compared to the illiterate workers. Tannery workers aged 36 and above were 0.34 times were 0.58 times less likely to aware of a hazardous work environment. Tannery workers who belong to the younger cohort (16-24 years) reported a higher awareness of respiratory problems (38%), skin complaints (59%), and gastrointestinal issues (21%) than those aged 36 years and above. About one-third of Beamhouse workers (33%) and over a quarter (26%) of the wet finishing had moderate to high dermal contact with the chemicals. The highest use of gloves and masks is seen in Beamhouse work (12 & 13%). Conclusions: The outcomes of the study give a clear indication of the effect of the workstation environment on the health status of workers and require the use of adequate measures to improve the facilities and thereby the health status of tannery workers.
Cause and predictors of neonatal mortality among neonates admitted to the Neonatal Intensive Care Units of public Hospitals in eastern Ethiopia: Facilities based prospective follow-up study
Authors: Desalew Assefa , Sintayehu Yitagesu , Teferi Nardos , Amare Firehiwot , Geda Bifitu , Worku Teshager , Abera Kebebush , Asefaw Abiyot
Published: January 2020

Background: The first month is the most crucial period for child survival and neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa including Ethiopia. This region shows the least progress to reducing this high mortality rate and it continues to be a significant public health issue. The facilities-based cause and predictors of neonatal death in the neonatal intensive care unit are not well documented in this study setting. Hence, the aim of this study was to determine the cause and predictors of neonatal mortality among infants admitted to the neonatal intensive care units in Eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted to the neonatal intensive care units of public hospitals in Eastern Ethiopia from November to December 2018. Data was collected using a pre-tested, structured questionnaire and a follow-up checklist. The main outcomes and cause of death was set by pediatricians and residents. Epi-Data 3.1 and SPSS 25 Version software were used for data entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality. Result: The proportion of facilities-based neonatal mortality was 20%. The top five causes of death were a complication of prematurity (49%), birth asphyxia (37.8%), infection (32.6%), meconium aspiration syndrome (17.3%) and congenital malformation (6.1%). Low birth weight, preterm births, length of stay in NICU , low 5 minute Apgar score , hyperthermia and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals, Eastern Ethiopia. Conclusion In summary, the proportion of facilities-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving ANC and this would lead to early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could lead to a reduction of neonatal death in this setting.
Comparison of Therapeutic Effects of Modified Stoppa Approach and Rectus Lateral Approach on Treating Pelvic Acetabular Fractures
Authors: Wang Xujin , Yang Jiazhao , Xu Lei , Fang Shiyuan
Published: January 2020

Objective To investigate the effect of modified Stoppa approach and lateral rectus abdominis in the treatment of pelvic acetabular fractures.Methods The clinical data of 30 patients with acetabular fractures with ipsilateral pelvic fractures were collected from March 2010 to August 2017. Fifteen patients were treated with modified Stopp incision approach (group A) Abdominal rectus lateral incision approach (group B). According to the surgical approach were divided into group A and group B, 15 cases, A group improved Stoppa approach, B rectus abdominis lateral approach.Results Compared with Stoppa approach, the operation time, intraoperative blood loss and postoperative drainage volume (P <0.05) were obtained by lateral rectus incision. There was no significant difference between the two surgical groups in terms of postoperative complications and fracture reduction. But the rectus abdominis lateral incision approach can fully reveal the acetabular anterior column and the quadratic body, can face under the reduction and fixation of the acetabular fracture sacroiliac joint and iliac crest fractures, and surgery revealed simple, less damage, less surgical complications.Conclusions The rectus abdominis lateral incision approach is the treatment of pelvic and acetabular fractures, especially with sacroiliac joint iliac crest fractures in the ideal surgical approach.
A comparative study of partial-threaded cannulated screws and double-threaded cannulated screws in the fixation of vertical femoral neck fractures
Authors: Zhang Yuelei , Wang Gang , Zhang Wei
Published: January 2020

Background This study purposed to compare the partial- threaded cannulated screws (PTCS) and the double-threaded cannulated screws (DTCS) in vertical shear femoral neck fractures both clinically and biomechanically. Methods Clinally, the radiographs of 81 patients with Pauwels Ⅲ femoral neck fractures, including 54 fractures fixed with PTCS and 27 fractures fixed with DTCS were analyzed. Complications consist of fixation failure (nail withdrawal, obvious fracture displacement, varus deformity or femoral neck shortening), bony nonunion and avascular necrosis (AVN) were determined. Biomechanically, twenty femur synthetic bones were equally divided and made to a vertical femoral neck fracture model, then fixed with three parallel PTCSs or DTCSs respectively. All specimens were tested for axial stiffness and a maximum load to failure with a loading rate of 2 mm/min. Results Clinically , 22 fractures in the PTCS group experienced fixation failure, including 19 nail withdrawal, 18 femoral neck shortening, 14 varus deformity and 8 obvious fracture displacement; while only 5 fractures showed up with fixation failure in the DTCS group, including 3 nail withdrawal, 4 femoral neck shortening, 4 varus deformity and 1 obvious fracture displacement. Additionally, 11 fractures in the PTCS group had nonunion while only 3 in the DTCS group and 9 fractures with AVN in the PTCS group while only 2 in the DTCS group. Biomechanically, The axial stiffness of DTCS was 152.89±22.74 N/mm, greater than PTCS (134.68±26.61), moreover, the failure load in DTCS was significantly greater than PTCS (1148.11±124.80 vs 795.88±162.50). Conclusion DTCS may exert more advantages than PTCS for vertical femoral neck fractures, including stronger fixation stability, lower rate of fixation failure and nonunion.
Incomplete Eradication of Persistent Infection May Impede Union: Our Experience in Treating Fracture Non-Unions with Allogenic MSC
Authors: Dilogo Ismail Hadisoebroto , Hanitya Alberto Lastiko , Pawitan Jeanne Adiwinata , Liem Isabella Kurnia , Yulisa Nyimas Diana
Published: January 2020

Introduction : Non-union remains a major clinical challenge for orthopaedic surgeons, as the treatments are associated with risks for complications, and sometimes multiple surgeries are required. Mesenchymal stem cells (MSCs) have been found to aid in osteogenesis and fracture healing; however, the number of studies on MSC application for treating non-unions is still sparse. We present a translational study of 8 subjects treated with MSC implantation, along with those considered as standard treatments in treating non-unions. To our knowledge, this is the most extensive clinical study on the use of MSCs to treat fracture non-unions. Methods: We performed 20x10 6 units of MSC implantations derived from adipose tissue, bone marrow, and umbilical cord on subjects diagnosed with fracture non-union of the long bone, along with internal fixation and hydroxyapatite-calcium sulphate (HA-CaSO 4 ) pellets. We excluded pathological fractures, subjects with immunological deficiencies (type II diabetes mellitus, and HIV/AIDS), and subjects with a history of immunosuppressive therapies. All subjects were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) or Lower Extremities Functional Scale (LEFS), and visual analog score (VAS). Serial radiological images were also assessed using Tiedeman and Lane-Sandhu scoring to determine union. Follow up assessments were performed every three months for at least 12 months or until clinical and radiological union was achieved. Results: Four (50%) out of eight subjects developed union in a median of five (3-12) months. There was a reduction of VAS, from a median of 1 (0-6) to 0 (0-4), and an increase in mean LEFS/DASH of 56.25 ± 10.71 to 65 ± 22.72. However, the infection was identified in 3 (37.5%) subjects. Methicillin-resistant Staphylococcus aureus (MRSA) was identified in two (25%) subjects, while one was infected with Escherichia coli . No other adverse events occurred during the follow-up period. Conclusion: Allogenic MSC implantation can be used as a potential and safe therapy for fracture non-union. However, the presence of infection may interfere with bone healing; thus, thorough eradication of infection must be ensured to achieve fracture union. Further clinical studies are required to investigate the safety and efficacy of allogeneic MSC implantation.
Imputation benchmark of β-value and M-value from DNA methylation data under different missing data mechanisms.
Authors: Lena Pietro Di , Sala Claudia , Prodi Andrea , Nardini Christine
Published: January 2020

Background: High-throughput technologies enable the cost-effective collection and analysis of DNA methylation data throughout the human genome. This naturally entails missing values management that can complicate the analysis of the data. Several general and specific imputation methods are suitable for DNA methylation data. However, there are no detailed studies of their performances under different missing data mechanisms -(completely) at random or not- and different representations of DNA methylation levels (β and M-value). Results: We make an extensive analysis of the imputation performances of seven imputation methods on simulated missing completely at random (MCAR), missing at random (MAR) and missing not at random (MNAR) methylation data. We further consider imputation performances on the β- and M-value popular representations of methylation levels. Overall, β -values enable better imputation performances than M-values. Imputation accuracy is lower for mid-range β -values, while it is generally more accurate for values at the extremes of the β -value range. The MAR values distribution is on the average more dense in the mid-range in comparison to the expected β -value distribution. As a consequence, MAR values are on average harder to impute. Conclusions: The results of the analysis provide guidelines for the most suitable imputation approaches for DNA methylation data under different representations of DNA methylation levels and different missing data mechanisms.
Risk profile of Qatari women treated for infertility, 2018
Authors: Musa Sarah Rashid , Osman Sherif
Published: January 2020

Background: female infertility is a multifactorial condition constituting a worldwide public health problem. Although many potential risk factors of female infertility can be preventable, there is no much attention directed toward preconception care. Aim: to explore the risk profile of infertility among Qatari women and compare risk factors distribution among primary vs. secondary infertility. Methodology: A hospital-based case control study was conducted from September 17th, 2017- February 10th, 2018. Cases (n=136) were enrolled from infertility clinics and controls (pregnant women, n=272), were enrolled from antenatal clinic, Women Hospital, Hamad Medical Corporation. Interview questionnaire was utilized to collect data about sociodemographic, history of marriage, lifestyle, menstrual, obstetric, gynaecological, medical, medication, surgical, birth-control, sexual and family, depression screening using PHQ-2 score, and anthropometric measurements. Logistic regression was used to identify the associated factors to infertility. Statistical significance was set at 0.05. Results: 43 primary and 93 secondary infertility cases were included. Risk factors were age>35 years (OR=3.7), second-hand smoking (OR=2.44), steady weight gain (OR=4.65), recent weight gain (OR=4.87), menstrual cycle irregularities (OR=4.20), fallopian tube blockage (OR=5.45), and symptoms suggestive of sexually transmitted infections (STIs) including chronic lower abdominal/pelvic pain (OR=3.46), abnormal vaginal discharge (OR=3.32) and dyspareunia (OR=7.04). Predictive factors for secondary infertility were; longer time from previous conception (OR=5.8), history of stillbirth (OR=2.63) or miscarriage (OR=2.11) and postpartum infection (OR=3.75). Protective factors were higher education level (OR=0.44), higher income (OR=0.17), and awareness of fertility window (OR=0.33) Conclusion: awareness, prevention, and early management of modifiable risk factors is important for women at pre/post-conception periods.
Dental care for drug users in Norway: Dental professionals’ attitudes to treatment and experiences with interprofessional collaboration
Authors: Hovden Ewa , Ansteinsson Vibeke , Klepaker Ingrid Volden , Widström Eeva , Skudutyte-Rystad Rasa
Published: January 2020

Objective: The present study aimed to assess dental professionals’ attitudes and experiences related to the dental treatment of drug users and experiences with interprofessional collaboration with the rehabilitation institutions. Materials and methods: The study population comprised 141 dentists and dental hygienists (response rate 73%) working in the Public Dental Service (PDS) in three counties in Norway. All of the participants completed an electronically distributed questionnaire on existing practices and experiences regarding dental treatment for drug users and interprofessional collaboration with rehabilitation institutions (RIs). The Norwegian Centre for Research Data (NSD) approved the study. Results: The majority of dentists and dental hygienists in the present study used more time for examination and treatment of drug users compared to other patient groups. Over 70% of dental clinicians considered drug users as demanding patients due to fear, missing appointments, and poor compliance with oral hygiene advice. The overall perception was that drug users often had higher expectations of dental treatment than what could be defined as necessary care and provided by the PDS. One-third of dental professionals reported that they were satisfied with the collaboration they had with RIs . Most of the respondents agreed that personnel from rehabilitation institutions could positively influence interprofessional collaboration by having sufficient knowledge of drug users statutory rights to free of charge dental treatment, as well as by close follow-up and motivation of patients before dental treatment. Conclusions: Dental professionals perceived the management of drug users as demanding due to dental fear, difficulties in coping with appointments, poor compliance to preventive measures, and disagreement between dental treatment defined as necessary and drug users’ expectations. Organizational barriers regarding leadership, accessibility, and collaborative routines, as well as lack of interprofessional communication, suggest current models of health care delivery to drug users need reviewing.