bluuebunny/crossref_metadata_2025 huggingface dataset:
An acute gastroenteritis outbreak associated with breakfast contaminated with norovirus by asymptotic food handler at a kindergarten in Shenzhen, China
Authors: Li Yuan , Fan Xiangbo , Yu Guangqing , Wei Peinan , Wang Yong , Guo Hongxiong
Published: January 2021

Background

An outbreak of acute gastroenteritis occurred in a kindergarten located Shenzhen City on March 4, 2018. We were invited to investigate to the risk factors associated with this outbreak.

Methods

We conducted retrospective cohort-studies on three different groups of subjects in order to figure out the difference of incidence of acute gastroenteritis among subjects of different activities on March 2: group one consisted of people who attended the Lantern festival activities; group two consisted of children and employees who ate breakfast and bread provided by the kindergarten; and groups three consisted of children and employees who did not eat breakfast or bread provided by the kindergarten. Fecal, anal swabs, dishware swabs and hand swabs specimens were collected in the study. Bacteria known to cause acute gastroenteritis were cultured. Viruses associated with acute gastroenteritis were tested using real-time PCR. Capsid gene fragment of 557 bp of norovirus was amplified and sequenced. The phylogenetic tree was constructed with MEGA 7.0 using neighbor-joining method based on capsid gene fragment of norovirus.

Results

A total of 143 suspected cases were identified in this outbreak. Diarrhea happened more often in adults than in children while emesis and bellyache were more frequently found in children than in adults. Higher AGE incidence was observed in group 2, children and employees who had breakfast in the kindergarten on March 2, as well as in group 3, and among employees who eating bread involved in breakfast provided on March 2. Five anal swab specimens were positive for norovirus. All noroviruses belongs to group II.3 and have an identity more than 99%.

Conclusion

A chef, as an asymptomatic carrier with norovirus, was the infectious resource in this outbreak. He contaminated breakfast food provided on March 2. Although morning check is implemented in kindergartens of China, employees are often excluded in morning check. Our finding highlights the importance of morning check covering employees and periodical training for cooks.
PTGER3 and MMP-2 play potential roles in diabetic nephropathy via competing endogenous RNA mechanisms
Authors: Yu Yue , Jia Yuan-Yuan , Wang Meng , Mu Lin , Li Hong-Jun
Published: January 2021

Background

Diabetic nephropathy (DN) is a primary complication of diabetes mellitus (DM). The pathology of DN is still vague, and diagnostic accuracy is not enough. This study was performed to identify miRNAs and genes that have possibilities of being used as therapeutic targets for DN in type 2 DM.

Methods

Human miRNA data GSE51674 and gene data GSE111154 were downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) and miRNAs (DEmiRNAs) in the kidney between control and DN patients were screened out. The competing endogenous RNA (ceRNA) network was constructed, and key lncRNA-miRNA-mRNA pairs were selected accordingly. Potential drugs targeting DEGs were screened out and validated using PCR analysis.

Results

Totally, 83 DEmiRNAs and 293 DEGs were identified in GSE51674 and GSE111154, respectively. Thirteen of the top 20 DEmiRNAs (10 up and 10 down) targeted to 47 DEGs. In the ceRNA network, RP11-363E7.4/TTN-AS1/HOTAIRM1-hsa-miR-106b-5p-PTGER3 and LINC00960-hsa-miR-1237-3p-MMP-2 interaction pairs were identified as the key ceRNA network. Interestingly, PTGER3 and hsa-miR-1237-3p were downregulated, and MMP-2 and hsa-miR-106b-5p were upregulated in the kidney of patients with DN compared with normal controls, respectively. PTGER3 and MMP-2 were targeted by drugs including iloprost, treprostinil, or captopril, and the deregulation of the two genes was confirmed in the plasma samples from patients with DN as compared with controls.

Conclusions

We speculated that the RP11-363E7.4/TTN-AS1/HOTAIRM1-hsa-miR-106b-5p-PTGER3 and LINC00960-hsa-miR-1237-3p-MMP-2 networks were associated with diabetic renal injury.
Contemporary incidence and risk factors of post transplant Erythrocytosis in deceased donor kidney transplantation
Authors: Alasfar Sami , Hall Isaac E. , Mansour Sherry G. , Jia Yaqi , Thiessen-Philbrook Heather R. , Weng Francis L. , Singh Pooja , Schröppel Bernd , Muthukumar Thangamani , Mohan Sumit , Malik Rubab F. , Harhay Meera N. , Doshi Mona D. , Akalin Enver , Bromberg Jonathan S. , Brennan Daniel C. , Reese Peter P. , Parikh Chirag R.
Published: January 2021

Background

Post-Transplant erythrocytosis (PTE) has not been studied in large recent cohorts. In this study, we evaluated the incidence, risk factors, and outcome of PTE with current transplant practices using the present World Health Organization criteria to define erythrocytosis. We also tested the hypothesis that the risk of PTE is greater with higher-quality kidneys.

Methods

We utilized the Deceased Donor Study which is an ongoing, multicenter, observational study of deceased donors and their kidney recipients that were transplanted between 2010 and 2013 across 13 centers. Eryrthocytosis is defined by hemoglobin> 16.5 g/dL in men and> 16 g/dL in women. Kidney quality is measured by Kidney Donor Profile Index (KDPI).

Results

Of the 1123 recipients qualified to be in this study, PTE was observed at a median of 18 months in 75 (6.6%) recipients. Compared to recipients without PTE, those with PTE were younger [mean 48±11 vs 54±13 years,p< 0.001], more likely to have polycystic kidney disease [17% vs 6%,p< 0.001], have received kidneys from younger donors [36 ±13 vs 41±15 years], and be on RAAS inhibitors [35% vs 22%,p< 0.001]. Recipients with PTE were less likely to have received kidneys from donors with hypertension [16% vs 32%,p= 0.004], diabetes [1% vs 11%,p= 0.008], and cerebrovascular event (24% vs 36%,p= 0.036). Higher KDPI was associated with decreased PTE risk [HR 0.98 (95% CI: 0.97–0.99)]. Over 60 months of follow-up, only 17 (36%) recipients had sustained PTE. There was no association between PTE and graft failure or mortality,

Conclusions

The incidence of PTE was low in our study and PTE resolved in majority of patients. Lower KDPI increases risk of PTE. The underutilization of RAAS inhibitors in PTE patients raises the possibility of under-recognition of this phenomenon and should be explored in future studies.
IgM mesangial deposition as a risk factor for relapses of adult-onset minimal change disease
Authors: Yang Cheng-Wen , Chen Fan-Yu , Chang Fu-Pang , Ho Yang , Wu Bo-Sheng , Yang An-Hang , Tarng Der-Cherng , Yang Chih-Yu
Published: January 2021

Background

Immunoglobulin M (IgM) mesangial deposition in pediatric minimal change disease (MCD) has been reported to be associated with steroid dependence and poor renal outcomes. However, the evidence linking the impacts of IgM mesangial deposition to the treatment prognosis in adult-onset MCD is still elusive.

Methods

In this retrospective cohort study, 37 adult patients with MCD received kidney biopsies from January 2010 to May 2020. Immunofluorescence microscopy was performed and the patients dichotomized according to IgM mesangial deposition (12 patients with positive IgM deposition; 25 patients with negative IgM deposition). We analyzed the clinical features, the dosage of immunosuppressive agents, and the response to treatment for 2 years between the two groups.

Results

Analysis of the clinical symptoms, the dosage of immunosuppressive treatment, and the time to remission revealed no statistical difference between the groups. However, compared to the negative IgM group, the frequency of relapses was significantly higher in the positive IgM group during the two-year follow-up period (the negative IgM group 0.25 episodes/year; the positive IgM group 0.75 episodes/year,p = 0.029). Furthermore, multivariate linear regression revealed that the positivity of IgM mesangial deposition is independently associated with the frequency of relapses (regression coefficient B 0.450, 95% CI 0.116–0.784,p = 0.010).

Conclusions

Our findings indicated that adult-onset MCD patients with IgM mesangial deposition have a high risk of relapses. Therefore, intensive monitoring of disease activity should be considered in MCD adults with IgM mesangial deposition.
Posterior Cortical Atrophy phenotype in a GBA N370S mutation carrier: a case report
Authors: Picillo Marina , Scannapieco Sara , Iavarone Alessandro , Ginevrino Monia , Valente Enza Maria , Barone Paolo
Published: January 2021

Background

Glucocerebrosidase (GBA) heterozygous variants are the most important genetic risk factor for the development of alpha-synucleinopathies (i.e., Parkinson’s disease and Dementia with Lewy Bodies). Herein, we report for the first time on a patient with a clinical diagnosis of Posterior Cortical Atrophy, carrier of the common GBA heterozygous variant N370S (c.1226A > G).

Case presentation

A 44-year-old woman with positive familial history for Dementia with Lewy Bodies disclosed three related signs characterizing the Balint’s syndrome: ocular apraxia, optic ataxia and simultanagnosia. Over 2-year follow up, overt gaze apraxia (psychic paralysis of gaze) appeared leading to functional blindness. Given her young age at onset and positive familial history, she underwent a next-generation-sequencing (NGS) based screening of a panel of 32 genes related to neurodegenerative conditions within the ANAMNESYS (An origiNal Approach to study faMiliarity in NEurodegenerative SYndromeS) study. NGS demonstrated the N370S variant in the GBA gene (rs76763715), confirmed by Sanger sequencing. This is a relatively common variant, with predicted mild impact, already reported to occur in 2.4% of PD Italian patients; however, neither this nor other GBA variants have ever been reported to date in patients with Posterior Cortical Atrophy. Glucocerebrosidase activity was investigated and found to be significantly reduced (4.72 nmol/h/mg) compared to healthy controls as well as patients affected by neurodegenerative diseases, further supporting pathogenicity of the GBA variant.

Conclusions

We report on a patient with a clinical diagnosis of Posterior Cortical Atrophy, carrier of the GBA heterozygous variant N370S (c.1226A > G; p.Asn409Ser) determining reduced GCase activity. This report also confirms the role of NGS-based targeted gene analysis in detecting peculiar clinical phenotypes associated with known pathogenic mutations and reinforces the knowledge that carriers of genetic variants often present phenotypic overlaps across different neurodegenerative syndromes, highlighting the limitations of current clinical diagnostic criteria in defining boundaries between distinct conditions and the difficulties of clinicians in reaching the best clinical diagnosis.
Dorsolateral medullary infarction registry: a study protocol for a prospective, multicentric registry
Authors: Wang Jing , Liu Pei , Liu Zhongzhong , Tian Ye , Zhang Guilian , Guo Jun , Li Li , Liu Zhiqin , Han Zucheng , Lin Wenjuan , Lin Xuemei , Lu Qingli , Liu Yan , Chang Qiaoqiao , Wu Songdi
Published: January 2021

Background

Dorsolateral medullary infarction is a typical cerebral infarction which is characterized by Wallenberg’s syndrome. Neurotrophic keratopathy is an uncommon consequence of dorsolateral medullary infarction. At present, the protocol is aimed to study the dynamic changes in corneal innervation and the ocular surface environment after dorsolateral medullary infarction.

Methods

This study will involve consecutive data from all medical records of patients within 7 days of acute dorsolateral medullary infarction onset at the Departments of Neurology from 10 collaborating stroke centers. Eligible patients will mainly be characterized based on detailed physical examinations, multimodal imaging, and corneal related examinations and patients will be followed-up for 2 years. Neurotrophic keratopathy after dorsolateral medullary infarction is the primary endpoint. The dynamic histological corneal innervation and ocular surface environment after dorsolateral medullary infarction will be observed during the follow-up period.

Discussion

This multicentric, prospective registry is the first to identify and characterize the dynamic changes of corneal innervation and the ocular surface environment after acute dorsolateral medullary infarction. The significance of the study is to emphasize that the curative effect is based on the doctors’ identification of the disease in the earliest stage before irreversible damage occurs to the cornea.

Trial registration

The registry was registered (ChiCTR-OPC-17,011,625) on June 11, 2017.
Prevalence, predictors and outcome of carotid stenosis: a sub study in the Preventive Antibiotics in Stroke Study (PASS)
Authors: van Velzen Twan J , Kuhrij Laurien S , Westendorp Willeke F , van de Beek Diederik , Nederkoorn Paul J
Published: January 2021

Background

The prevalence of carotid artery stenosis (CAS) in acute ischaemic stroke (AIS) patients is historically reported at 15–20%, but an up-to-date estimate is lacking. We hypothesise it is lower than historically reported, due to better risk management to date. The study aims to study prevalence, predictors and survival of CAS in AIS patients.

Methods

We included patients with AIS from the Preventive Antibiotics in Stroke Study (PASS), a large Dutch randomized, multicentre, open-label phase III trial that included 2538 patients with acute stroke and randomised between standard care or preventive ceftriaxone. Patients with stroke in the anterior circulation that underwent diagnostic testing of the internal carotid artery (ICA) were eligible for this sub study and used in these secondary analyses. Logistic regression analyses were performed to identify predictors for CAS ≥ 50%. Additionally, an ordinal regression was performed to assess the association between presence of CAS at baseline and functional outcome at three months on the modified Rankin scale (mRS).

Results

1480 patients with AIS were included; 277 had CAS (18.7%; 95%CI:17.7-19.7). Age, hypertension, smoking and male gender were found as best-fit predictors for presence of CAS. Significant shift in mRS score after 90 days for CAS ≥50% towards a higher mRS score with an OR of 1.66 (95% CI 1.30-2.10) was found.

Conclusions

Current prevalence of CAS is 18.7%, which is higher than we expected. Gender, smoking and hypertension are important factors associated with CAS. Patients with CAS had a significantly higher mRs score after 90 days.

Trial registration

Unique identifier:ISRCTN66140176
What is stopping us? An implementation science study of kangaroo care in British Columbia’s neonatal intensive care units
Authors: Coutts Sarah , Woldring Alix , Pederson Ann , De Salaberry Julie , Osiovich Horacio , Brotto Lori A.
Published: January 2021

Background

The goal of the Neonatal Intensive Care Unit (NICU) is to provide optimal care for preterm and sick infants while supporting their growth and development. The NICU environment can be stressful for preterm infants and often cannot adequately support their neurodevelopmental needs. Kangaroo Care (KC) is an evidence-based developmental care strategy that has been shown to be associated with improved short and long term neurodevelopmental outcomes for preterm infants. Despite evidence for best practice, uptake of the practice of KC in resource supported settings remains low. The aim of this study was to identify and describe healthcare providers’ perspectives on the barriers and enablers of implementing KC.

Methods

This qualitative study was set in 11 NICUs in British Columbia, Canada, ranging in size from 6 to 70 beds, with mixed levels of care from the less acute up to the most complex acute neonatal care. A total of 35 semi-structured healthcare provider interviews were conducted to understand their experiences providing KC in the NICU. Data were coded and emerging themes were identified. The Consolidated Framework for Implementation Research (CFIR) guided our research methods.

Results

Four overarching themes were identified as barriers and enablers to KC by healthcare providers in their particular setting: 1) the NICU physical environment; 2) healthcare provider beliefs about KC; 3) clinical practice variation; and 4) parent presence. Depending on the specific features of a given site these factors functioned as an enabler or barrier to practicing KC.

Conclusions

A ‘one size fits all’ approach cannot be identified to guide Kangaroo Care implementation as it is a complex intervention and each NICU presents unique barriers and enablers to its uptake. Support for improving parental presence, shifting healthcare provider beliefs, identifying creative solutions to NICU design and space constraints, and the development of a provincial guideline for KC in NICUs may together provide the impetus to change practice and reduce barriers to KC for healthcare providers, families, and administrators at local and system levels.
The views of pregnant women in New Zealand on vaginal seeding: a mixed-methods study
Authors: Butler Éadaoin M. , Reynolds Abigail J. , Derraik José G. B. , Wilson Brooke C. , Cutfield Wayne S. , Grigg Celia P.
Published: January 2021

Background

Vaginal seeding is the administration of maternal vaginal bacteria to babies following birth by caesarean section (CS), intended to mimic the microbial exposure that occurs during vaginal birth. Appropriate development of the infant gut microbiome assists early immune development and might help reduce the risk of certain health conditions later in life, such as obesity and asthma. We aimed to explore the views of pregnant women on this practice.

Methods

We conducted a sequential mixed-methods study on the views of pregnant women in New Zealand (NZ) on vaginal seeding. Phase one: brief semi-structured interviews with pregnant women participating in a clinical trial of vaginal seeding (n = 15); and phase two: online questionnaire of pregnant women throughout NZ (not in the trial) (n = 264). Reflexive thematic analysis was applied to interview and open-ended questionnaire data. Closed-ended questionnaire responses were analysed using descriptive statistics.

Results

Six themes were produced through analysis of the open-ended data: “seeding replicates a natural process”, “microbiome is in the media”, “seeding may have potential benefits”, “seeking validation by a maternity caregiver”, “seeding could help reduce CS guilt”, and “the unknowns of seeding”. The idea that vaginal seeding replicates a natural process was suggested by some as an explanation to help overcome any initial negative perceptions of it. Many considered vaginal seeding to have potential benefit for the gut microbiome, while comparatively fewer considered it to be potentially beneficial for specific conditions such as obesity. Just under 30% of questionnaire respondents (n = 78; 29.5%) had prior knowledge of vaginal seeding, while most (n = 133; 82.6%) had an initially positive or neutral reaction to it. Few respondents changed their initial views on the practice after reading provided evidence-based information (n = 60; 22.7%), but of those who did, most became more positive (n = 51; 86.4%).

Conclusions

Given its apparent acceptability, and if shown to be safe and effective for the prevention of early childhood obesity, vaginal seeding could be a non-stigmatising approach to prevention of this condition among children born by CS. Our findings also highlight the importance of lead maternity carers in NZ remaining current in their knowledge of vaginal seeding research.
Single-course antenatal corticosteroids is related to faster growth in very-low-birth-weight infant
Authors: Jing Jiajia , Dai Yiheng , Li Yanqi , Zhou Ping , Li Xiaodong , Mei Jiaping , Zhang Chunyi , Sangild Per Trop , Tang Zhaoxie , Xu Suhua , Su Yanbin , He Xiaoying , Zhu Yanna
Published: January 2021

Background

Antenatal corticosteroids (ACS) treatment is critical to support survival and lung maturation in preterm infants, however, its effect on feeding and growth is unclear. Prior preterm delivery, it remains uncertain whether ACS treatment should be continued if possible (repeated course ACS), until a certain gestational age is reached. We hypothesized that the association of single-course ACS with feeding competence and postnatal growth outcomes might be different from that of repeated course ACS in very-low-birth-weight preterm infants.

Methods

A multicenter retrospective cohort study was conducted in very-low-birth-weight preterm infants born at 23–37 weeks’ gestation in South China from 2011 to 2014. Data on growth, nutritional and clinical outcomes were collected. Repeated course ACS was defined in this study as two or more courses ACS (more than single-course). Infants were stratified by gestational age (GA), including GA < 28 weeks, 28 weeks ≤ GA < 32 weeks and 32 weeks ≤ GA < 37 weeks. Multiple linear regression and multilevel model were applied to analyze the association of ACS with feeding and growth outcomes.

Results

A total of 841 infants were recruited. The results, just in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation, showed both single and repeated course of ACS regimens had shorter intubated ventilation time compared to non-ACS regimen. Single-course ACS promoted the earlier application of amino acid and enteral nutrition, and higher rate of weight increase (15.71; 95%CI 5.54–25.88) than non-ACS after adjusting for potential confounding factors. No associations of repeated course ACS with feeding, mean weight and weight increase rate were observed.

Conclusions

Single-course ACS was positively related to feeding and growth outcomes in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation. However, the similar phenomenon was not observed in the repeated course of ACS regimen.
Maternal post-traumatic stress and depression symptoms and outcomes after NICU discharge in a low-income sample: a cross-sectional study
Authors: Gateau Kameelah , Song Ashley , Vanderbilt Douglas L. , Gong Cynthia , Friedlich Philippe , Kipke Michele , Lakshmanan Ashwini
Published: January 2021

Background

Having a preterm newborn and the experience of staying in the neonatal intensive care unit (NICU) has the potential to impact a mother’s mental health and overall quality of life. However, currently there are few studies that have examined the association of acute post-traumatic stress (PTS) and depression symptoms and infant and maternal outcomes in low-income populations.

Design/ methods

In a cross-sectional study, we examined adjusted associations between positive screens for PTS and depression using the Perinatal Post-traumatic stress Questionnaire (PPQ) and the Patient Health-Questionnaire 2 (PHQ-2) with outcomes using unconditional logistic and linear regression models.

Results

One hundred sixty-nine parents answered the questionnaire with 150 complete responses. The majority of our sample was Hispanic (68%), non-English speaking (67%) and reported an annual income of <$20,000 (58%). 33% of the participants had a positive PPQ screen and 34% a positive PHQ-2 screen. After adjusting for confounders, we identified that a positive PHQ-2 depression score was associated with a negative unit (95% CI) change on the infant’s Vineland Adaptive Behavior Scales, second edition of − 9.08 (− 15.6, − 2.6) (p < 0.01). There were no significant associations between maternal stress and depression scores and infant Bayley Scales of Infant Development III scores or re-hospitalizations or emergency room visits. However, positive PPQ and screening score were associated with a negative unit (95% CI) unit change on the maternal Multicultural Quality of Life Index score of − 8.1 (− 12, − 3.9)(p < 0.01) and − 7.7 (− 12, − 3) (p = 0.01) respectively.

Conclusions

More than one-third of the mothers in this sample screened positively for PTS and depression symptoms. Screening scores positive for stress and depression symptoms were associated with a negative change in some infant development scores and maternal quality of life scores. Thoughtful screening programs for maternal stress and depression symptoms should be instituted.
Mental health problems and social supports in the COVID-19 healthcare workers: a Chinese explanatory study
Authors: Fang Xue-Hui , Wu Li , Lu Lun-Shan , Kan Xiao-Hong , Wang Hua , Xiong Yan-Jun , Ma Dong-Chun , Wu Guo-Cui
Published: January 2021

Background

Coronavirus disease 2019 (COVID-19) has spread rapidly in China and other overseas areas, which has aroused widespread concern. The sharp increase in the number of patients has led to great psychological pressure on health care workers. The purpose of this study was to understand their mental health status and needs, so as to provide a scientific basis for alleviating the psychological pressure of health care workers.

Methods

Using a cross-sectional study design, 540 health care workers were randomly selected from two designated tuberculosis medical institutions in Anhui Province. The basic situation, perceived social support, depression level, loneliness and COVID-19 related knowledge were collected and analyzed by questionnaire.

Results

A total of 511 valid questionnaires were finally retrieved. There were 139 people in epidemic prevention and control positions (27.20%). Depression level: People in isolation ward, fever clinic and pre-check triage were at the level of mild to moderate depression. Female was higher than male; nurse was higher than doctor; middle and junior job titles were higher than senior titles; junior college degree or below were higher than bachelor’s degree, master’s degree and above; isolation ward, fever clinic and pre-check triage were significantly higher than those of non-prevention and control positions (p < 0.05). Loneliness scores: Doctors were higher than that of medical technicians, and isolation ward, fever clinic and pre-check triage were higher than those of other medical departments (p < 0.05). Social support: Doctors were lower than that of medical technicians, and isolation ward, fever clinic and pre-check triage were significantly lower than those of other departments (p < 0.05). The score of social support was negatively correlated with depression and loneliness (p < 0.001), while depression was positively correlated with loneliness (p < 0.001). Health care workers most want to receive one-to-one psychological counseling (29.75%), and provide crisis management (24.07%). The awareness rate of health care workers on COVID-19’s knowledge was relatively high.

Conclusions

The psychological problems of health care workers, especially women, nurses with low educational background, low professional title, and staff in the epidemic prevention and control positions are relatively serious.
The spread of COVID-19 outbreak in the first 120 days: a comparison between Nigeria and seven other countries
Authors: Adebowale Ayo Stephen , Fagbamigbe Adeniyi F. , Akinyemi Joshua O. , Obisesan Olalekan K. , Awosanya Emmanuel J. , Afolabi Rotimi F. , Alarape Selim A. , Obabiyi Sunday O.
Published: January 2021

Background

COVID-19 is an emerging public health emergency of international concern. The trajectory of the global spread is worrisome, particularly in heavily populated countries such as Nigeria. The study objective was to assess and compare the pattern of COVID-19 spread in Nigeria and seven other countries during the first 120 days of the outbreak.

Methods

Data was extracted from the World Bank’s website. A descriptive analysis was conducted as well as modelling of COVID-19 spread from day one through day 120 in Nigeria and seven other countries. Model fitting was conducted using linear, quadratic, cubic and exponential regression methods (α=0.05).

Results

The COVID-19 spread pattern in Nigeria was similar to the patterns in Egypt, Ghana and Cameroun. The daily death distribution in Nigeria was similar to those of six out of the seven countries considered. There was an increasing trend in the daily COVID-19 confirmed cases in Nigeria. During the lockdown, the growth rate in Nigeria was 5.85 (R2=0.728, p< 0.001); however, it was 8.42 (R2=0.625, p< 0.001) after the lockdown was relaxed. The cubic polynomial model (CPM) provided the best fit for predicting COVID-19 cumulative cases across all the countries investigated and there was a clear deviation from the exponential growth model. Using the CPM, the predicted number of cases in Nigeria at 3-month (30 September 2020) was 155,467 (95% CI:151,111-159,824, p< 0.001), all things being equal.

Conclusions

Improvement in COVID-19 control measures and strict compliance with the COVID-19 recommended protocols are essential. A contingency plan is needed to provide care for the active cases in case the predicted target is attained.
Body image perception, smoking, alcohol use, indoor tanning, and disordered eating in young and middle-aged adults: findings from a large population-based Swedish study
Authors: Strand Mattias , Fredlund Peeter , Boldemann Cecilia , Lager Anton
Published: January 2021

Background

Body image concerns may give rise to a multitude of risk behaviors, such as unhealthy weight control practices, disordered eating behaviors (e.g., compensatory purging or preoccupation with food), smoking, excessive alcohol intake, or sunbed use. However, the distribution of these risk behaviors across adulthood has rarely been studied.

Methods

The aim of this study was to explore health risk behaviors as correlates of body image perception in a randomly selected study population of 30,245 individuals aged 30–66 in Stockholm, Sweden, utilizing data from the Stockholm Public Health Cohort. Bivariate correlations were explored and a hierarchic binary logistic regression analysis was performed.

Results

The prevalence of body image discrepancy was higher among smokers and respondents displaying disordered eating behaviors. In contrast, alcohol and sunbed use were inversely correlated to body image discrepancy. Body mass index was the substantially strongest explanatory factor behind the observed variance in body image discrepancy, followed by loss-of-control eating. Notably, no major gender differences in body image perception were detected. Some unexpected patterns of association between variables other than body image perception, such as those between smoking, alcohol use, and sunbed use, were seen.

Conclusions

Overall, the patterns differ substantially from what has previously been found in adolescent and young adult samples, indicating that the synergy and aggregation of risk behaviors observed among younger individuals may not apply to adults aged 30–66.
Physical activity in an air-polluted environment: behavioral, psychological and neuroimaging protocol for a prospective cohort study (Healthy Aging in Industrial Environment study – Program 4)
Authors: Elavsky S. , Jandačková V. , Knapová L. , Vašendová V. , Sebera M. , Kaštovská B. , Blaschová D. , Kühnová J. , Cimler R. , Vilímek D. , Bosek T. , Koenig J. , Jandačka D.
Published: January 2021

Background

Air pollution has been linked to increased mortality and morbidity. The Program 4 of the Healthy Aging in Industrial Environment study investigates whether the health and wellbeing benefits of physical activity (PA) can be fully realized in individuals living in highly polluted environments. Herein, we introduce the behavioral, psychological and neuroimaging protocol of the study.

Methods

This is a prospective cohort study ofN = 1500 individuals aged 18–65 years comparing: (1) individuals living in the highly polluted, industrial region surrounding the city of Ostrava (n = 750), and (2) controls from the comparison region with relative low pollution levels in Southern Bohemia (n = 750). Quota sampling is used to obtain samples balanced on age, gender, PA status (60% active runners vs. 40% insufficiently active). Participants are screened and complete baseline assessments through online questionnaires and in-person lab-based assessments of physiological, biomechanical, neuroimaging and cognitive function parameters. Prospective 12-month intensive monitoring of air pollution and behavioral parameters (PA, inactivity, and sleep) follows, with a focus on PA-related injuries and psychological factors through fitness trackers, smartphones, and mobile apps. Subsequently, there will be a 5-year follow-up of the study cohort.

Discussion

The design of the study will allow for (1) the assessment of both short-term variation and long-term change in behavioral parameters, (2) evaluation of the incidence of musculoskeletal injuries and psychological factors impacting behavior and injury recovery, and (3) the impact that air pollution status (and change) has on behavior, psychological resilience, and injury recovery. Furthermore, the integration of MRI techniques and cognitive assessment in combination with data on behavioral, biological and environmental variables will provide an opportunity to examine brain structure and cognitive function in relation to health behavior and air pollution, as well as other factors affecting resilience against and vulnerability to adverse changes in brain structure and cognitive aging. This study will help inform individuals about personal risk factors and decision-makers about the impact of environmental factors on negative health outcomes and potential underlying biological, behavioral and psychological mechanisms. Challenges and opportunities stemming from the timing of the study that coincided with the COVID-19 pandemic are also discussed.
Salbutamol-induced lactic acidosis in status asthmaticus survivor
Authors: Phoophiboon Vorakamol , Singhagowinta Parima , Boonkaya Sangdao , Sriprasart Thitiwat
Published: January 2021

Background

Salbutamol-induced lactic acidosis is a rare presentation that could manifest in specific clinical context as acute asthmatic attack treatment. An increase of glycolysis pathway leading to pyruvate escalation is the mechanism of hyperlactatemia in β2-adrenergic agonist drug.

Case presentation

A 40-year-old man who had poor-controlled asthma, presented with progressive dyspnea with coryza symptom for 6 days. He was intubated and admitted into medical intensive care unit due to deteriorated respiratory symptom. Severe asthmatic attack was diagnosed and approximate 1.5 canisters of salbutamol inhaler was administrated within 24 h of admission. Initial severe acidosis consisted of acute respiratory acidosis from ventilation-perfusion mismatch and acute metabolic acidosis resulting from bronchospasm and hypoxia-related lactic acidosis, respectively. The lactate level was normalized in 6 h after hypoxemia and ventilation correction. Given the lactate level re-elevated into a peak of 4.6 mmol/L without signs of tissue hypoxia nor other possible etiologies, the salbutamol toxicity was suspected and the inhaler was discontinued that contributed to rapid lactate clearance. The patient was safely discharged on the 6th day of admission.

Conclusion

The re-elevation of serum lactate in status asthmaticus patient who had been administrated with the vast amount of β2-adrenergic agonist should be considered for salbutamol-induced lactic acidosis and promptly discontinued especially when there were no common potentials.
Comparison of three treatment methods for simple bone cyst in children
Authors: Zhang Ke-Xue , Chai Wei , Zhao Jia-Jia , Deng Jun-Hao , Peng Zhan , Chen Ji-Ying
Published: January 2021

Background

The unicameral bone cyst (UBC) is a kind of benign tumor whose clinical treatments and efficacy are controversial. The purpose of this study was to evaluate the efficacy of the elastic stable intramedullary nail (ESIN), the injection of autologous bone marrow (ABM), and the combination of ESIN and ABM in the treatment of bone cyst in children.

Methods

Eighty-three cases with simple bone cyst were analyzed retrospectively. Twenty-eight cases were treated with ABM. Twenty-eight cases were treated with ESIN. Twenty-seven cases were treated with ABM and ESIN. All cases were diagnosed through X-ray, CT, or MRI scans. For the suspicious ones, the pathological biopsy was performed for an accurate diagnosis. X-ray examinations were carried out for the postoperative follow-up. Capanna criteria for bone cyst was used for postoperative evaluation of three methods.

Results

All cases accomplished the follow-up. The effective rate of the ABM + ESIN group was significantly higher than that of the ABM group (P < 0.05), and the cure rates of the ESIN group and the ABM + ESIN group were higher than that of the ABM group (P < 0.05, respectively). The cure time in the ESIN group was lower than that of the other two groups (P < 0.05, respectively). The times for admission were 2.0 ± 0.0 in the ESIN group, 5.7 ± 1.9 in the ABM group, and 4.7 ± 2.4 in the ABM + ESIN group (P < 0.05 when compared with each other).

Conclusions

The method of ABM combined with ESIN for children’s bone cyst has the highest effective rate and curative rate. For the individual method, ESIN has a higher effective rate and curative rate than that of ABM. Meanwhile, it has the fewest time of hospitalization.
A cluster-randomized trial of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion for office workers to manage neck pain – a secondary outcome analysis
Authors: Johnston Venerina , Chen Xiaoqi , Welch Alyssa , Sjøgaard Gisela , Comans Tracy A. , McStea Megan , Straker Leon , Melloh Markus , Pereira Michelle , O’Leary Shaun
Published: January 2021

Background

Neck pain is prevalent among office workers. This study evaluated the impact of an ergonomic and exercise training (EET) intervention and an ergonomic and health promotion (EHP) intervention on neck pain intensity among the All Workers and a subgroup of Neck Pain cases at baseline.

Methods

A 12-month cluster-randomized trial was conducted in 14 public and private organisations. Office workers aged ≥18 years working ≥30 h per week (n = 740) received an individualised workstation ergonomic intervention, followed by 1:1 allocation to the EET group (neck-specific exercise training), or the EHP group (health promotion) for 12 weeks. Neck pain intensity (scale: 0–9) was recorded at baseline, 12 weeks, and 12 months. Participants with data at these three time points were included for analysis (n = 367). Intervention group differences were analysed using generalized estimating equation models on an intention-to-treat basis and adjusted for potential confounders. Subgroup analysis was performed on neck cases reporting pain ≥3 at baseline (n = 96).

Results

The EET group demonstrated significantly greater reductions in neck pain intensity at 12 weeks compared to the EHP group for All Workers (EET: β = − 0.53 points 95% CI: − 0.84– − 0.22 [36%] and EHP: β = − 0.17 points 95% CI: − 0.47–0.13 [10.5%], p-value = 0.02) and the Neck Cases (EET: β = − 2.32 points 95% CI: − 3.09– − 1.56 [53%] and EHP: β = − 1.75 points 95% CI: − 2.35– − 1.16 [36%], p = 0.04). Reductions in pain intensity were not maintained at 12 months with no between-group differences observed in All Workers (EET: β = − 0.18, 95% CI: − 0.53–0.16 and EHP: β = − 0.14 points 95% CI: − 0.49–0.21, p = 0.53) or Neck Cases, although in both groups an overall reduction was found (EET: β = − 1.61 points 95% CI: − 2.36– − 0.89 and EHP: β = − 1.9 points 95% CI: − 2.59– − 1.20, p = 0.26).

Conclusion

EET was more effective than EHP in reducing neck pain intensity in All Workers and Neck Cases immediately following the intervention period (12 weeks) but not at 12 months, with changes at 12 weeks reaching clinically meaningful thresholds for the Neck Cases. Findings suggest the need for continuation of exercise to maintain benefits in the longer term.

Clinical trial registration

hACTRN12612001154897 Date of Registration: 31/10/2012.
Proper positioning of mice for Cobb angle radiographic measurements
Authors: Chen Zhe Yi , Luk Keith Dip Kei , Song You Qiang , Gao Bo , Cheung Jason Pui Yin
Published: January 2021

Background

There is no recommended standard for positioning of a mouse for radiographic assessment of the spine. This is necessary to have reproducible radiographic data and avoid false positive results. The objective of this study was to investigate the impact of various postures on Cobb angle measurements and to set up a positioning standard for imaging mouse spines.

Methods

This study was conducted in three parts. Firstly, we identified the problem of lack of posture standardization for radiographs. We collected 77 C57BL/6 J mice for spine radiographs and found a scoliosis prevalence of 28.6% with large variations in curve magnitude. Secondly, 24 C57BL/6 J mice underwent 4 consecutive weekly radiographs and observed high variations (relative standard deviation: 125.3%) between radiographs. Thirdly, we collected another 82 C57BL/6 J mice and designed 14 different postures that could take place during imaging. These postures were related to curling of the limbs, and head, pelvic and tail tilting.

Results

The results showed that head and pelvic tilting significantly affects the curve magnitude with effect size (Glass’s delta) over 1.50. Avoiding these incorrect positions during radiographs is warranted. The standard recommended posture for mouse imaging entails positioning the snout, interorbital space, neck and whole spine in one line, and with the limbs placed symmetrical to the trunk, whilst avoiding stretching the body of the mouse.

Conclusions

Our work exemplified the importance of standard protocol during imaging when using an animal model in the scoliosis study. We recommend utilizing this standard in studying various disorders of the spine to avoid technical causes for the appearance of a curve.
Characterization of bone metabolism in hungarian psoriatic arthritis patients: a case–control study
Authors: Pethő Zsófia , Kalina Edit , Pap Zoltán , Hodosi Katalin , Falcsik Rebeka , Balogh Ádám , Szekanecz Zoltán , Bhattoa Harjit Pal
Published: January 2021

Background

Skeletal manifestations are predominant in psoriatic arthritis (PsA). The aim of this cross-sectional, case-control study is the complex assessment of areal and volumetric bone mineral density (BMD), fracture risk, vitamin D status and bone turnover markers, and its association with disease-related variables.

Methods

Lumbar spine (L1-L4) and femoral neck (FN) areal, and distal radius (DR) volumetric BMD, 10-year probability of major and hip osteoporotic fracture as assessed by the fracture risk assessment (FRAX) tool, markers of bone metabolism and disease activity were assessed.

Results

Upon comparison of the disease and age- and sex-matched control groups, there was a statistically significant difference in FN areal (0.952 (0.607–1.292) g/cm2 vs. 1.016 (0.760–1.550) g/cm2; p = 0.001) and DR total volumetric (284.3 (138.9–470.3) mg/cm3 vs. 367.0 (287.0–412.0) mg/cm3; p < 0.001) BMD, 10 year probability for major osteoporotic (3.7% (0.7–32%) vs. 2.6% (0–17.5%); p = 0.003) and hip (0.4% (0–16%) vs. 0.05% (0–6.1%); p = 0.002) fracture and 25-hydroxyvitamin D status (47.5 (10–120) nmol/L vs. 64 (10–137; p < 0.001) nmol/L). As compared to areal assessment, volumetric BMD measurements identified a significantly higher number of patients with low bone mineral density (T-Score ≤ − 1.00) (34% vs. 88%, p < 0.001). Upon multiple linear regression analysis, disease activity score, as determined by DAS28 assessment, was an independent predictor of 10-year probability for major osteoporotic fracture (B (95%CI) = 1.351 (0.379–2.323); p = 0.007).

Conclusion

In the studied PsA cohort, disease activity was an independent predictor of 10-year probability for a major osteoporotic fracture, and complemented assessment of volumetric and areal BMD assured better efficacy at identifying those with low bone mineral density.
Oral health status of 12-year-old children in Lisu minority ethnic group in China: a cross-sectional study
Authors: Chen Kitty Jieyi , Liu Juan , Xu Biao , Li Yuexiao , Li Yanhong , Zhang Shinan , Chu Chun Hung
Published: January 2021

Background

Lisu is an ethnic minority group and most of them are living in Yunnan, China. This study investigated the oral health status among 12-year-old Lisu children in Yunnan.

Method

This survey employed a multistage sampling method to recruit 12-year-old Lisu children. Two calibrated dentists performed the oral examinations in the primary schools. They examined dental caries, gingival bleeding and dental fluorosis using the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed to the children to collect their sociodemographic background information and oral health-related behaviours. A chi-square test, the Mann–Whitney U test, zero-inflated negative binomial (ZINB) regression and multivariate logistic regression were used for statistical analysis.

Results

This survey invited 512 children, and 482 children (48% boys) participated in the study (response rate: 94%). Their caries prevalence was 35% and their caries experience in mean (SD) DMFT scores was 0.63 (0.10). The mean (SD) DT score was 0.60 (1.10), consisting 95% of the mean DMFT scores. No dental fluorosis was observed; whereas 426 children (88%) had gingival bleeding. Results of ZINB model indicated sex and sugary-snacking habits were related to the dental caries experience (p < 0.05). The gingival-bleeding prevalence was associated with the mother’s education level, the child’s monthly-pocket money and daily toothbrushing frequency (p < 0.05).

Conclusion

Dental caries and gingival bleeding were prevalent among 12-year-old Lisu children in the Yunnan province in China, and most of the decayed teeth were unrestored. Dental fluorosis was not observed in the children.
The use of social media for professional purposes among dentists in Saudi Arabia
Authors: Al-Khalifa Khalifa S. , Al-Swuailem Abdullah S. , AlSheikh Rasha , Muazen Yasmeen Y. , Al-Khunein Yazeed A. , Halawany Hassan , Al-Abidi Khalid S.
Published: January 2021

Aim

To investigate the dentists’ opinions towards social media (SM) use in daily practice and the expected limitations from its use in Saudi Arabia.

Methods

An electronic survey was carried out throughout May–June 2020 among a sample of dentists in Saudi Arabia. The survey covered three parts: the first part covered professional and demographic information, the second part covered the use of mobile phones and SM in dental practice, while the third part assessed dentists’ opinion on SM use. Descriptive statistics included frequency distributions and percentages and independent t test/ANOVA test for the relationship between the mean of dentists’ opinion towards SM and demographic variables. A p value of 0.05 or less was considered statistically significant.

Results

The majority of respondents (80%) believe that SM plays an active role in patients’ decisions regarding the selection of a healthcare provider. The mean dentists’ opinion scores on the use of SM were significantly lower among participants working more than 50 h per week compared with other participants (p = 0.014).

Conclusion

The majority of sampled dentists believe that SM plays an active role in patients’ decisions regarding the healthcare provider’s selection. Directed campaigns can help dentists optimize the use of SM for both professional and personal purposes.