bluuebunny/crossref_metadata_2025 huggingface dataset:
Algunas cuestiones relevantes que suscita la regulación contenida en la Directiva (UE) 2019/1023 del Parlamento Europeo y del Consejo, de 20 de junio de 2019, en materia de instrumentos de alerta, exoneración de deudas y segunda oportunidad
Authors: Brenes Cortés Josefa
Published: July 2020

En este trabajo se analiza con carácter general la regulación de algunas de las cuestiones interesantes que establece la Directiva 2019/1023 de 20 de junio de 2019 sobre instrumentos de alerta temprana y exoneración del pasivo insatisfecho con objeto de proponer las opciones regulatorias que consideramos más adecuadas para su transposición en el Derecho español y que, indudable, exigirán determinadas modificaciones en nuestra Ley Concursal.
Serum 25 hydroxyvitamin D levels and affecting factors among preconception fertile women
Authors: Fan Haiyan , Hui Lingyun , Yan Xiaoting , Hou Wei , Bai E , Wang Li , Yu Xuewen
Published: July 2020

Background: Recent study found that vitamin D before conception was considered as a potential additional determinant for achieving pregnancy and live births. The study aimed to evaluate the serum 25 hydroxyvitamin D (25(OH)D) levels and its affecting factors among preconception fertile women. Methods: This cross-sectional study enrolled 410 women aged 22-44 years who attended a preconception genetic counseling clinic from January 2018 to May 2019. Sociodemographic characteristics and reproductive history of women were collected, and height and weight were measured. Serum 25(OH)D concentration was assayed with chemiluminescence immunoassay. Descriptive statistics were used to examine serum 25(OH)D concentration, and socio-demographic characteristics and reproductive history among preconception women. Determinants of vitamin D deficiency and its affecting factors were assessed using χ2 test. Results: Findings showed 84.4% of women had serum 25(OH)D concentration below 20 ng/mL. Women working indoors as well as without a history of childbirth had significantly lower 25(OH)D levels compared with those non-working individuals and having delivered a previous child (both P <0.05). The 25(OH)D levels were the lowest in winter than in spring, summer, and autumn (all P <0.001). Women in winter have significantly elevated OR of 5.00 (95%CI 1.75–14.25) to develop vitamin D deficiency. Seasonal variation in serum 25(OH)D levels was not present in non-working individuals and women aged 31-44 years. Conclusions: Vitamin D deficiency is common among preconception women especially nulliparous women and working women, which propose to screen serum 25(OH)D on preconception evaluation and emphasize need vitamin D supplements and get sunshine exposure.
The Effect of Air Pollution and Temperature on Pulmonary Function in Healthy People in Xi’an, China
Authors: Yao Yang , Zhou Jing , Tian Yao , Zhang Hongmei , Diao Xin , Chen Hui , Zhang Jinzhao , Wang Shengyu
Published: July 2020

Background: Temperature and air pollution has been reported to be associated with respiratory diseases. However, little is known about these effects on healthy people, and the potential interaction between the two factors is still uncertain. This study aims to estimate the effects of air pollution combined with temperature on lung function in healthy people. Methods: The lung function of 428 healthy people was measured in Xi’an, Shaanxi province of Northwest China in summer and winter. Meanwhile, the daily concentrations of air pollution and temperature were obtained from monitoring stations. Statistical analyses were assessed by generalized estimating equations (GEEs). Results: In winter, Every 10μg/m 3 increase of PM 2.5 concentration, PEF change amount is -0.015L/S(-0.028,-0.002), FEV1 is -0.007 L/S(-0.012,-0.001). The change is -0.022(-0.043,-0.001) and -0.010(-0.011,-0.009) after adjusting for SO 2 . In summer, PEF and FEV1 were were negatively correlated with the concontration of O3. We also found that temperature weaken the adverse effect of PM 2.5 on lung PEF in winter but aggravated effect of O3 on FEV1 in summer. Lag effects showed that Lag0 of FEV1, FEV1/FVC and FEF25-75% were more strongly associated with PM 2.5 . Conclusions: Our findings indicate that Lung function was significantly negative correlated with O3 in summer and PM 2.5 in winter, and a higher temperature has a greater impact on lung function in both summer and winter in Xi’an.
Respiratory, birth and health economic measures for use with Indigenous Australian infants in a research trial: A modified Delphi with an Indigenous panel
Authors: Perkes Sarah Jane , Bonevski Billie , Mattes Joerg , Hall Kerry , Gould Gillian
Published: July 2020

Background: There is significant disparity between the respiratory health of Indigenous and non-Indigenous Australian infants. There is no culturally accepted measure to collect respiratory health outcomes in Indigenous infants. The aim of this study was to gain end user and expert consensus on the most relevant and acceptable respiratory and birth measures for Indigenous infants at birth, between birth and 6 months, and at 6 months of age follow-up for use in a research trial. Methods: A three round modified Delphi process was conducted from February 2018 to April 2019. Eight Indigenous panel members, and 18 Indigenous women participated. Items reached consensus if 7/8 (≥80 %) panel members indicated the item was ‘very essential’. Qualitative responses by Indigenous women and the panel were used to modify the 6 months of age surveys. Results: In total, 15 items for birth, 48 items from 1 to 6 months, and five potential questionnaires for use at 6 months of age were considered. Of those, 15 measures for birth were accepted, i.e., gestational age, birth weight, Neonatal Intensive Care Unit (NICU) admissions, length, head circumference, sex, Apgar score, substance use, cord blood gas values, labour, birth type, health of the mother, number people living in the home, education of mother and place of residence. Seventeen measures from 1-to 6 months of age were accepted, i.e., acute respiratory symptoms (7), general health items (2), health care utilisation (6), exposure to tobacco smoke (1) and breastfeeding status (1). Three questionnaires for use at 6 months of age were accepted, i.e., a shortened 33-item respiratory questionnaire, a clinical history survey and a developmental questionnaire. Conclusions: In a modified Delphi process with an Indigenous panel, measures and items were proposed for use to assess respiratory, birth and health economic outcomes in Indigenous Australian infants between birth and 6 months of age. This initial step can be used to develop a set of relevant and acceptable measures to report respiratory illness and birth outcomes in community based Indigenous infants.
Prevalence and Predictors of Anxiety and Depressive Symptoms among Patients Diagnosed with Oral Cancer in China: A cross-sectional study
Authors: Yuan Lulu , Pan Bochen , Wang Weiren , Wang Lie , Zhang Xujie , Gao Yuqin
Published: July 2020

Background Anxiety and depression are common mental health problems among patients with cancer. While many psychological variables have been proven to influence anxiety and depressive symptoms, the variables are not mutually exclusive and their integrated effects on patients with oral cancer are yet unknown. The present study aims to explore the prevalence of anxiety and depressive symptoms among patients with oral cancer, to find out key potentially predictive factors associated with anxiety and depressive symptoms. Method A cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in two Grade-A Tertiary Hospitals in Shenyang, China. 230 patients with oral cancer were interviewed with questionnaires on demographic variables, Zung Self-Rating Anxiety Scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), Herth Hope Index (HHI), Social Impact Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10), and General Perceived Self-efficacy Scale(GSE). Chi-square test, nonparametric test, t-test and logistic regression analyses were conducted where appropriate to explore predictive factors of anxiety symptoms and depressive symptoms. Result The prevalence of anxiety symptoms and depressive symptoms in the sample population was 36.96% (85/230) and 65.21% (150/230), respectively. Social isolation dimension of stigma (β=0.436, OR=1.547, CI:1.211~1.975), optimism (β=-0.276, OR=0.759, CI:0.624~0.922), and perceived stress (β=0.217, OR=1.243, CI:1.092~1.414) were predictors of anxiety symptoms. Marriage (β=1.648, OR=5.198, CI:1.427~18.924), positive readiness and expectancy dimension of hope (β=-0.505, OR=0.604, CI:0.395~0.923), social isolation dimension of stigma (β=0.314, OR=1.368, CI:1.054~1.776) and perceived stress (β=0.273, OR=1.314, CI:1.134~1.524) were predictors of depressive symptoms among oral cancer patients. Conclusion The prevalence of anxiety symptoms and depressive symptoms was high among oral cancer patients in China. The communal predictors of anxiety and depressive symptoms in patients with oral cancer were levels of perceived stress and social isolation of stigma. In addition, optimism was a predictor of anxiety symptoms and hope was a predictor of depressive symptoms.
Accuracy of cone-beam computed tomography for the evaluation of mandible invasion by oral squamous cell carcinoma
Authors: Wang Zezheng , Zhang Shuang , Pu Yumei , Wang Yuxin , Lin Zitong , Wang Zhiyong
Published: July 2020

Background: Accurate evaluation of mandible invasion and resection with appropriate boundary for oral squamous cell carcinoma (OSCC) are important for preserving structure and function of mandible and preventing local recurrence. Although cone-beam computed tomography (CBCT), which has high spatial resolution, is now widely used in the diagnosis of oral and maxillofacial bone lesions. There were no studies systematically evaluate the accuracy of CBCT for evaluation of presence of bone invasion, boundary of bone invasion and presence of nerve invasion. Therefore, this study aimed to systemically explore the accuracy of CBCT in preoperative assessment of mandibular invasion by OSCC. Methods: Thirty mandibular specimens from OSCC patients were collected in this study. The samples were marked and subjected to CBCT examination. Hematoxylin–eosin staining was used for histopathological assessment and used as golden standard. The evaluation included the presence of bone invasion, boundary of bone invasion and presence of nerve invasion. The CBCT and histopathological boundaries of bone invasion were delineated and merged to compare and calculate the deviation of CBCT in boundary evaluation. Results: The accuracy of CBCT in evaluation of presence of mandible invasion was 100%, and the accuracy of CBCT in evaluation of presence of nerve invasion was 69.2%. A mean deviation of 2.97 mm was found for assessment the boundary of bone invasion using CBCT compared with the histopathological standard. Conclusion: CBCT is quite reliable in determine the presence or absence of mandible invasion, while not so reliable for nerve invasion. The deviation in bone invasion boundary estimation should be considered in the osteotomy for OSCC.
RE-AIM Evaluation of a Multilevel Decision Support and Navigation Intervention for Colorectal Cancer Screening in Hispanic Primary Care Patients
Authors: Careyva Beth , Johnson Melanie , Sifri Randa , DiCarlo Melissa , Daskalakis Constantine , Shaak Kyle , Payton Colleen , Stello Brian , Myers Ronald
Published: July 2020

Background: Hispanic adults in the United States have low colorectal cancer (CRC) screening rates and are more likely than non-Hispanic adults to be diagnosed with advanced-stage CRC. We evaluated the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of a novel multilevel decision support and navigation intervention (DSNI) designed to increase CRC screening among Hispanic primary care patients.Methods: The trial enrolled 400 consented participants from a health system sampling frame of 2,720 Hispanic patients eligible for CRC screening in five primary care practices. We randomized 203 patients to receive a mailed standard intervention (SI Group) that included informational material, a fecal immunochemical test kit, a reminder versus 197 patients who received the SI plus a telephone screening DSNI (DSNI Group). We assessed DSNI effects using health system and study administrative data.Results: 1) Reach: DSNI delivery reached 84% of participants. 2) Effectiveness: The DSNI group produced a screening rate that was significantly greater (p < .001) than in the SI group (78% and 43%, respectively). 3) Adoption: All participating primary care practices and patients remained in the study. 4) Implementation: DSNI delivery required an average of 4.1 decision support and navigation call attempts with the total call effort averaging 35 minutes. 5) Maintenance: Health system leaders have acknowledged DSNI benefits and are actively engaged in determining how to sustain DSNI implementation.Conclusion: The DSNI achieved high levels of reach, effectiveness, adoption, and implementation with a modest investment of resources. The project team is addressing the challenge of DSNI maintenance in the health system. Further work is needed to determine intervention effectiveness in other health systems and in the general patient population. Trial Registration: ClinicalTrials.gov identifier : NCT02272244
Completed Absorption of Coronavirus Disease 2019 (COVID-19) Pneumonia Lesions: A Preliminary Study
Authors: Chu Zhi-gang , Liu Xue-yan , Lv Sheng-xiu , Fu Bin-jie , Li Wang-jia , Ouyang Yu , Lv Fajin
Published: July 2020

Background Complete absorption of coronavirus disease 2019 (COVID-19) pneumonia in a short term was not detailedly reported. We aimed to investigate the clinical and imaging characteristics of COVID-19 patients with complete absorption of pulmonary lesions.Methods Retrospectively collected the clinical and chest CT data of 224 patients with COVID-19 in one regional medical center. Currently, pulmonary lesions in 37 patients were completely absorbed. The clinical manifestations, laboratory examinations, and CT findings of lesions for these patients were summarized. Results Among the 37 patients (age, 39.0 ± 12.4 [14 - 63] years, 20 males), disease in 36 (97.3%) was mild and in 1 (3.7%) was from severe to mild. The most common symptoms were cough (24/37, 64.9%) and fever (23/37, 62.2%). Their laboratory indicators at admission were usually normal, while the white blood cell and neutrophil count significantly increased at discharge (p = 0.004, p = 0.006). On initial CT images, all patients had various pulmonary lesions (mean involved lobes:2.8 ± 1.5, range:1-5; mean involved segments: 6.6 ± 4.3, range: 1-16), which mainly manifested as multiple patchy and or spherical ground glass opacities (GGOs) (30/37, 81.1%) with fibrous strips (19/30, 63.3%) or consolidation (11/30, 36.7%). After treatment, lesions in most (33/37, 89.2%) patients were continuously absorbed. At discharge, previous lesions were mostly absorbed in 11 patients (11/37, 29.7%), the main residues were GGOs (24/37, 64.9%), followed by fibrous strips (13/37, 35.1%). On the latest CT, all the pulmonary lesions were completely absorbed, the duration of lesions was 31.6 ± 11.4 days (range: 5 - 50 days). Conclusion The pulmonary lesions in some mild COVID-19 patients (generally with normal laboratory indicators at admission, GGOs as the main manifestation on initial CT, and representation of continuous absorption after treatment) could be completely absorbed with a mean duration of 31.6 days.
Cross-Cultural Adaptation and Exploratory Factor Analysis of The Person-Centred Practice Inventory-Staff (PCPI-S) Questionnaire Among Malaysian Primary Healthcare Providers
Authors: Balqis-Ali Nur Zahirah , Saw Pui San , Jailani Anis Syakira , Fun Weng Hong , Saleh Noridah Mohd , Bahanuddin Tengku Putri Zaharah Tengku , Sararaks Sondi , Lee Shaun Wen Huey
Published: July 2020

Background: The Person-Centred Practice Inventory-Staff (PCPI-S) instrument was developed to measure healthcare providers’ perception towards their person-centred practice. The study aimed to explore the influence of culture, context, language and local practice towards the PCPI-S instrument adaptation process for use among public primary care healthcare providers in Malaysia.Methods: The original PCPI-S was reviewed and adapted for cultural suitability by an expert committee to ensure conceptual and item equivalence. The instrument was subsequently translated into the local Malay language using the forward-backward translation by two independent native speakers, and modified following pre-tests involving cognitive debriefing interviews. The psychometric properties of the corresponding instrument were determined by assessing the internal consistency, test-retest reliability, and correlation of the instrument, while the underlying structure was analysed using exploratory factor analysis.Results: Review by expert committee found items applicable to local context. Pre-tests on the translated instrument found multiple domains and questions were misinterpreted. Many translations were heavily influenced by culture, context, and language discrepancies. Results of subsequent pilot study found mean scores for all items ranged from 2.92 to 4.39. Notable ceiling effects were found. Internal consistency was found to be high (Cronbach’s alpha > 0.9). Exploratory factor analysis found formation of 11 components as opposed to the original 17 constructs. Conclusion: The results of this study provide evidence regarding the reliability and underlying structure of the PCPI-S instrument with regard to primary care practice. Culture, context, language and local practice heavily influenced the adaptation as well interpretation of the underlying structure and should be given emphasis when translating person-centred into practice.Trial registration: NMRR-18-309-40447
Normal Reference Range of Fetal Nuchal Translucency Thickness Among Pregnant Women of Igbo Extraction in Enugu, South-East Nigeria
Authors: Eze Charles Ugwoke , Okenwa Sandra Nnenna , Abonyi Everistus obinna , Agbo Julius Amechi , Onwuzu Sobechukwu Warric Iwene , Nwadike Innocent Uchenna
Published: July 2020

Background: Screening of fetus for congenital anomaly has posed a great challenge to obstetricians and other caregivers even as early identification can improve the chances of getting the best possible outcome. Early fetal anomaly screening is usually done using nuchal translucency scan and other invasive procedures such Chorionic villus sampling and amniocentesis. Increase in Nuchal translucency thickness (NTT) above a certain baseline values has been found to predict fetus with anomaly. Baseline values in use are generated from Caucasian population even though these values are known to be population specific. Hence, their use on any given population may lead to errors and introduce potential misdiagnosis. Therefore, there is need for population specific baseline values of NTT.Objectives: The study is aimed at developing baseline values of NTT among apparently normal fetuses from pregnant women of Igbo ethnic group and to assess the relationship of NTT with maternal age and fetal gestational age (FGA).Methods: This cross-sectional study involved 658 pregnant women of Igbo Origin between 11-14 weeks of gestation at Esut Teaching Hospital (Parklane) Enugu from August 2017 to February 2018. Pilot study was done to determine the interobserver variation between sonographers while final NTT was calculated as mean of three separate measurements. The 5th, 50th and 95th percentiles were calculated using polynomial regression while Pearson correlation was used to determine the relationship between NTT, maternal age and FGA. Results: The NTT measurement was shown to be reliable and reproducible. Mean ± S/D NTT obtained was 0.92 ± 0.23 mm. There was a strong positive correlation between NTT measurements and FGA (r = 0.823, p < 0.001); while there was weak but positive correlation between NTT measurements and Maternal age (r = 0.055, p > 0.001). Conclusion: Nuchal translucency thickness measurement increases with increase in FGA while a baseline value of NTT among pregnant women of Igbo extraction has been generated.
Expression of Photosynthesis Pathway Gene From Rice and Maize for Understanding Role in Plant Stress and Development Using Bioinformatics Approaches
Authors: pandey saurabh , Raina Vaibhav
Published: July 2020

Background Rice and maize go to family Poaceae contains many crops of agronomic trait and also represent two carbon metabolism systems, C3 and C4. Analysis of the maize sequence provides new insights into the employment of C3 genes to the C4 mechanism which allowed us to identify more orthologs in other crops. This investigation reports comparative account of genome wide in silico identification of C4 pathway related genes from Zea maize (Zm) and Oryza sativa (Os) from the available whole genome sequence information. The annotation of gene sequences, signature motif analysis, protein phophorylation analysis, study of upstream cis-acting elements, phylogenetic tree construction, chromosomal locations, syntenic mapping and microarray expression analysis of C4 pathway related gene family from both the genomes have been attempted. Results A total of 30 and 37 C4-pathway genes have been predicted from rice and maize genome respectively. Multiple-sequence-alignment and signature motif analysis of these proteins of rice and maize revealed high conserveness. Phophorylation analysis revealed that maize have high number than rice. The phylogenetic analysis of C4 related genes across both plant species clearly resulted in four sub-groups in both plants. In Rice, the 30 genes of C4 pathway related genes family are distributed on eleven out of twelve chromosomes, while in maize, they are randomly distributed on all the chromosomes. Most of the genes of Zm’s chromosome 1 show syntenic relationship with chromosome 1. The cis-regulatory-elements of Zm and Os genes suggested its diverse functions associated with plant growth development, stress and hormone responsiveness as well as endosperm and meristem speciﬁc gene expression. This investigation of Zm and Os can now offer new insights into the role of different C4 pathway related genes and examine the comparative syntenic mapping between two monocot models and allows for better understanding about how genes evolve within monocots. Therefore, in silico investigation of C4-photosynthetic-pathway gene family needs to be supported by wet lab experimentation of the novel genes for elucidating their function in many biological courses.Conclusion Results revealed that photosynthetic pathway related gene play a potent role in stress response and plant growth and development.
Prevalence of depression symptoms among Tibetan Buddhist monastic science scholars in India
Authors: Mascaro Jennifer , Shellman Danielle , Samphel Tsondue , Chang Hope , Zivot Joel , Eisen Arri
Published: July 2020

Background

Depression is the largest contributing factor to global disability, and the translation and validation of depression screening instruments is vital toward understanding the prevalence of depression symptoms around the world. The aim of this study was to translate a widely used depression screening instrument, the Patient Health Questionnaire (PHQ), for use with Tibetan populations, and to explore the prevalence of depression symptoms in a population of Tibetan-speaking Buddhist monastic science scholars.
Methods

A total of 384 monastics (363 monks, 21 nuns) completed the Tibetan PHQ-9. We computed measures of internal consistency and conducted factor analysis to evaluate scale performance, and describe the prevalence of depression symptoms among the monastic population and subgroups.
Results

The Tibetan PHQ-9 had acceptable reliability and demonstrated a single-factor structure. While having low energy was the most commonly endorsed symptom, monastics did not have overall higher rates of other somatic symptoms. Over 10% of the monastics scored in the moderately severe to severe range, using standard diagnostic criteria cut-offs. First year monks had the highest mean score, and there was not a significant difference between monks and nuns.
Conclusion

These preliminary findings indicate that the Tibetan PHQ-9 is a reliable instrument for exploring and assessing depression symptoms and that it will be useful toward examining how symptoms are experience, interpreted, and communicated among Buddhist monastics.
Can Remote Ischemic Preconditioning Counteract the Renal Functional Deterioration Attributable to Partial Nephrectomy Under Warm Ischemia? Results of an Animal Study
Authors: Mut Tuna Till , Acar Ömer , Armutlu Ayse , Incir Said , Uhlig Annemarie , Ertuglu Lale A. , Özel Melis , Taskin Ali Cihan , Baydar Dilek Ertoy , Kanbay Mehmet , Esen Tarik
Published: July 2020

Background: To investigate if remote ischemic preconditioning (RIPC) can offer any renoprotective value by counteracting the deleterious effect of partial nephrectomy (PN) under warm ischemia on renal function. Methods: Four groups, each with 5 Wistar albino rats, were constructed; RIPC + PN, PN, RIPC and sham. Right nephrectomy was performed to constitute a solitary kidney model. RIPC denoted sequential clamping/declamping of the femoral artery. PN was performed under warm-ischemia following RIPC. Blood samples were collected on multiple occasions until sacrification on day 7. Immunoassays were conducted to measure the serum and tissues levels of KIM-1, aldose reductase, IL-33, NGAL, creatinine. All kidneys were examined histologically and morphometric analyzes were performed using digital scanning. Results: IL-33 levels did not differ significantly between the groups. Serum levels of KIM-1, NGAL and aldose reductase in RIPC + PN, PN and RIPC groups were significantly lower than that of sham group. Tissue biomarker levels were not significantly different from the values recorded in the sham group. Mean necrosis area of PN group was greater than that of RIPC + PN group (p>0.05). The transitional zone between necrosis and healthy tissue was wider in the rats subjected to RIPC before PN vs. those who underwent PN without RIPC (p>0.05). Conclusion: RIPC failed to counteract the renal functional consequences of PN under warm ischemia in a solitary kidney animal model. The supportive but marginal histological findings in favor of RIPC’s renoprotective potential were not supplemented with the changes in serum and tissue biomarker levels.
Psychological status and intervention strategy of maintenance hemodialysis patients in COVID-19 epidemic
Authors: Nie Jingwen , Zhu Shuang , Cui Wenlong , Wu Huixin , Cai Yaping , Wen Xi , Li Qing
Published: July 2020

Background An outbreak of novel coronavirus disease 2019 (COVID-19) is a newly discovered contagious disease, which first broke out in China.Based on the psychological state, maintenance hemodialysis (MHD) patients might bear psychological problemsunder the COVID-19epidemic situation.To evaluate the psychological health of MHDpatients and explore the corresponding intervention strategies.Methods Acluster sampling approach was employed to obtain a sample of 206 MHD patients from two hospitals in Yunnan province: a COVID-19-designated hospital and a non-COVID-19-designated hospital. Post-traumatic stress disorder (PTSD) checklistwas used to assess the psychological status,while Kidney Diseaseand Quality of Life --Short Form(KDQOL-SF)was applied to assess the quality of life(QOL). The factorsinfluencing thepsychological status in MHD patients were employed by binary logistic regression.Results Among MHD participants (age 53.4 ± 15.3 years), 61 cases showed mild to moderate positive PTSD, and 72 casespresented severe positive PTSD.The level of education, capital income, hospital, depressive tendency, and QOL were the influence factors for the occurrence of PTSD. Moreover, the PTSD was negatively correlated with QOL and positively correlated with COVID-19-designated hospital and the depressive tendency.Conclusion During the COVID-19 epidemic, MHD patients, especially in COVID-19-designated hospitals, with low QOL and depressive tendency had a high incidence of positive PTSD, which requires prompt psychological counseling and effective measures from medical staff to ensure timely treatment of patients.
A Randomized Trial of Ivermectin-Doxycycline and Hydroxychloroquine-Azithromycin therapy on COVID19 patients.
Authors: Chowdhury Abu Taiub Mohammed Mohiuddin , Shahbaz Mohammad , Karim Md Rezaul , Islam Johirul , Guo Dan , He Shuixiang
Published: July 2020

Background The worldwide COVID-19 pandemic was caused by a newly discovered Coronavirus. The treatment methods for COVID-19 are emerging and rapidly evolving. Existing drugs, including Ivermectin and Hydroxychloroquine, offer the hope of effective treatment in early disease. In this study, we investigated and compared outcomes of Ivermectin-Doxycycline vs. Hydroxychloroquine-Azithromycin combination therapy COVID19 patients with mild to moderate disease.Methods Patients with mild to moderate COVID-19 disease, tested positive by RT PCR for SARS-CoV-2 infection at Chakoria Upazilla Health Complex, Cox's Bazar, Bangladesh, were included in this study. Patients were divided randomly into two groups: Ivermectin 200µgm/kg single dose + Doxycycline 100 mg BID for 10days in group A, and Hydroxychloroquine 400 mg 1st day, then200mg BID for 9days + Azithromycin 500 mg daily for 5 days in group B. PCR for SARS-CoV-2 was repeated in all symptomatic patients on the second day onward without symptoms, or, for those who were asymptomatic (throughout the process), on the 5th day after taking medication and repeated every two days onward if the result is positive. Time to negative PCR and time to full symptomatic recovery was measured for each group.Results All subjects in the Ivermectin-Doxycycline group (group A) reached a negative PCR for SARS-CoV-2, at a mean of 8.93days, and all reached symptomatic recovery, at a mean of 5.93days, with 55.10% symptom-free by the 5th day. In the Hydroxychloroquine-Azithromcyin group (group B), 96.36% reached a negative PCR at a mean of 6.99days and were symptoms-free at 9.33days. Group A patients had symptoms that could have been caused by the medication in 31.67% of patients, including lethargy in 14(23.3%), nausea in 11(18.3%), and occasional vertigo in 7(11.66%) of patients. In Group B, 46.43% had symptoms that could have been caused by the medication, including 13(23.21%) mild blurring of vision and headache; 22(39.2%) increased lethargy and dizziness, 10(17.85%) occasional palpitation, and 9(16.07%) nausea and vomiting.Conclusion The Ivermectin-Doxycycline combination showed a trend toward superiority to the Hydroxychloroquine-Azithromycin combination therapy in the case of patients with mild to moderate COVID19 disease, though the difference in time to becoming symptom-free and the difference in time to negative PCR was not statistically significant.
Ultrasound-guided versus Shikani optical stylet-aided tracheal intubation: a prospective randomized study
Authors: Ma Yuanyuan , Wang Yan , Shi Ping , Cao Xue , Ge Shengjin
Published: July 2020

Background To compare ultrasound-guided tracheal intubation (UGTI) versus Shikani optical stylet (SOS)-aided tracheal intubation in patients with anticipated normal airway.Methods Sixty patients aged 18–65 years old who presented for elective surgery under general anesthesia were recruited in this prospective randomized study. They were assigned into two equal groups, either an ultrasound-guided group (Group UG, n = 30) or an SOS-aided group (Group SOS, n = 30). After the induction of anesthesia, the tracheal intubation was performed by a specified skilled anesthesiologist. The number of tracheal intubation attempt and the duration of successful intubation on the first attempt were recorded. Complications relative to tracheal intubation including desaturation, hoarseness and sore throat were also recorded.Results The first-attempt success rate is 93.3% (28/30) in Group UG and 90% (27/30) in Group SOS (P = 0.64). The second-attempt was all successful for the 2 and 3 patients left in the two groups, and the overall success rate of both groups was 100%. The duration of successful intubation on the first attempt of Group UG was not significantly different from that of Group SOS (34.0 ± 20.8 s vs 35.5 ± 23.2 s, P = 0.784). One patient in Group SOS had desaturation (P = 0.313), and there was none hoarseness in the two groups. Sore throat was detected in both group (4 in Group UG, 5 in Group SOS, P = 0.718).Conclusion Ultrasound-guided tracheal intubation was as effective as Shikani optical stylet-aided tracheal intubation in adult patients with anticipated normal airway.Trial registration: Chinese Clinical Trial Registry, ChiCTR-IIC-17010875. Date of Registration: 15 March 2017.
Improving safety and effectiveness of awake endotracheal intubation with a novel method: A prospective, double-blind, randomized controlled trial
Authors: Han Chunji , Li Peng , Guo Zhenggang , Guo Ying , Sun Li , Chen Gang , Qiu Xiaojue , Mi Weidong , Zhang Changsheng , Berra Lorenzo
Published: July 2020

Background: Topical anesthesia is a crucial step in awake endotracheal intubation for providing favorable intubation conditions. The standard of care technique for awake intubation, which consists of oropharyngeal tetracaine spray, can result in inadequate mucosal anesthesia. Therefore, we sought to compare the effectiveness of dyclonine hydrochloride mucilage to the standard of care tetracaine in achieving anesthesia of the upper airways for awake endotracheal intubation. Methods: This randomized, double-blind, prospective study included 60 patients scheduled for either endoscopic submucosal dissection or peroral endoscopic myotomy. Patients were randomly allocated into two groups: patients allocated to novel awake intubation care (Group N-AIC) received a single administration of oral dyclonine hydrochloride mucilage, whereas patients allocated to standard awake intubation care (Group S-AIC) received three oropharyngeal tetracaine sprays before transcricoid tetracaine injection before awake intubation. Feeling of numbness and nausea, as well as intubation conditions after topical anesthesia were assessed. Hemodynamic parameters were recorded throughout the procedure and compared between the two groups. Results: The degree of numbness of the oropharynx mucosa after topical anesthesia did not differ between the two groups, neither did the feeling of nausea during laryngoscopy. The amount of pharyngeal secretions before intubation was less in Group N-AIC. Total intubation time was significantly shorter (3.9s, 95%CI 1.282-6.452, P=0.004) in Group N-AIC. Baseline mean arterial pressure and heart rate were similar between the two groups. Hemodynamic responses to intubation and gastrointestinal endoscopy, especially mean arterial pressure, were significantly less elevated in Group N-AIC. Extubation bucking was significantly less frequent in Group N-AIC (13.3% vs. 76.7%). Patients received in Group N-AIC had a lower rate of post-extubation sore throat compared to Group S-AIC (6.7% vs. 43.3%). No adverse side effects attributable to either tetracaine or dyclonine were observed in this study. Conclusions: In awake endotracheal intubation, novel care using oral dyclonine hydrochloride mucilage can provide more favorable intubation conditions and more stable hemodynamics compared to standard of care practice using oropharyngeal tetracaine spray. Chinese Clinical Trial Registry: ChiCTR1900023151 ( http://www.chictr.org )
The CEBPE rs2239633 genetic polymorphism on susceptibility to childhood acute lymphoblastic leukemia: An updated meta-analysis
Authors: Liu Jin , Weiling Gu , Xueqin Li , Liang Xie , Linhong Wang , Chen Zhongwen
Published: July 2020

Background: We performed an updated meta-analysis to clarify the relationship between the CEBPE rs2239633 polymorphism and the CALL susceptibility.Methods: All the case-control studies updated on July 31, 2019 through Web of Science, Pubmed, Cochrane Library, Embase, China Nationa Knowledge Infrastructure (CNKI) electronic database. The heterogeneity in the study was tested by the Q-test and I2, and then the random ratio or fixed effect was utilized to merge the odds ratios (OR) and 95% confidence interval (CI). To estimate the impact of individual studies on aggregate estimates, we performed sensitivity analysis. Using funnel plot and Begger’s regression test investigated the publication bias. All data Statistical analyses were performed using Stata 12.0.Results: A total of 23442 participants (7014 patients; 16428 controls) were included in twenty case-control studies selected. There was no association of CEBPE rs2239633 polymorphism with CALL (CC vs CT + TT: OR = 1.08, 95% CI = 0.94 –1.26; CC + CT vs TT: OR = 1.10, 95% CI = 0.94–1.30; C vs T: OR =1.02, 95% CI = 0.92–1.13). In the subgroup analysis by ethnicity, no significant association of this polymorphism and CALL risks among Asia and Caucasian populations for the comparison of CC vs CT + TT, CC + CT vs TT and C vs T genetic models .Conclusion: This meta-analysis did not find the CEBPE rs2239633 polymorphism can increase and decrease the risk of susceptibility to CALL.
WITHDRAWN: Mathematical Modelling on Double Quarantine Process in the Spread and Stability of Covid-19
Authors: Behera Jangyadatta , Rauta Aswin Kumar , Rao Yerra Shankar , Patnaik Sairam
Published: July 2020

In this paper, a mathematical model is proposed on the spread and control of corona virus disease2019 (COVID19) to ascertain the impact of pre quarantine for suspected individuals having travel history ,immigrants and new born cases in the susceptible class following the lockdown or shutdown rules and adopted the post quarantine process for infected class. Set of nonlinear ordinary differential equations (ODEs) are generated and parameters like natural mortality rate, rate of COVID-19 induced death, rate of immigrants, rate of transmission and recovery rate are integrated in the scheme. A detailed analysis of this model is conducted analytically and numerically. The local and global stability of the disease is discussed mathematically with the help of Basic Reproduction Number. The ODEs are solved numerically with the help of Runge-Kutta 4th order method and graphs are drawn using MATLAB software to validate the analytical result with numerical simulation. It is found that both results are in good agreement with the results available in the existing literatures. The stability analysis is performed for both disease free equilibrium and endemic equilibrium points. The theorems based on Routh-Hurwitz criteria and Lyapunov function are proved .It is found that the system is locally asymptotically stable at disease free and endemic equilibrium points for basic reproduction number less than one and globally asymptotically stable for basic reproduction number greater than one. Finding of this study suggest that COVID-19 would remain pandemic with the progress of time but would be stable in the long-term if the pre and post quarantine policy for asymptomatic and symptomatic individuals are implemented effectively followed by social distancing, lockdown and containment.
Psychological Distress during COVID-19 Curfews and Social Distancing in Saudi Arabia: A Cross-Sectional Study
Authors: Alghamdi Badrah S , AlAtawi Yasser , AlShehri Fahad S. , Tayeb Haythum O. , Taleb Hanin Abo Abo , Binsalman Amal
Published: July 2020

Background
Coronavirus disease 2019 (COVID-19) has spread to over 150 countries worldwide. Since the first case of COVID-19 was confirmed in Saudi Arabia, cases have continued to escalate exponentially. The COVID-19 outbreak has had a negative effect on mental health and well-being. The study aim was to investigate the effects of the strict national regulations associated with the COVID-19 pandemic on the population’s mental health.
Methods
This was a cross-sectional study of a convenience sample of Saudi residents. Participants completed an online questionnaire after 1 month of a nationwide 24-hour curfew. We measured psychological distress using the Depression, Anxiety and Stress Scale-21 (DASS-21). We ran binary logistic regression analyses to detect variables that significantly predicted DASS-21 scores.
Results
The sample comprised 2252 Saudi residents. The DASS-21 score means and standard deviations for depression and anxiety for the whole sample (10.73 ± 10.29 and 6.98 ± 8.30, respectively) were in the range of mild depression and anxiety. In contrast, the mean DASS-21 stress score was within the normal range (11.97 ± 10.80). The mean stress score for healthcare workers was within normal range (13.70 ± 10.68), but was significantly higher than the mean score for the public (11.56 ± 10.89; P = .0006). Several variables (e.g. age, gender and history of contact with confirmed COVID-19 cases) were significantly associated with higher DASS-21 scores.
Conclusions
The COVID-19 pandemic has created a psychological burden. Therefore, there is an urgent need to implement emergency psychological interventions to reduce the negative psychosocial effects of the pandemic on public mental health.
Flaws of universal salt iodization programmes in nutrition transition contexts: is there a risk of a double burden of inadequate iodine intake and excess adiposity? A case study in Tunisia
Authors: DOGGUI Radhouene , Ati-Hellal Myriam El , Ati Jalila El , Traissac Pierre
Published: July 2020

Background In the Middle East and North Africa (MENA) region, universal salt iodization (USI) programs defaults were sometimes shown to increase the risk of iodine excess. Also, the nutrition transition which underlies the obesity epidemic in the MENA region is characterized by salt-rich diets, so that there could be a cumulative effect with respect to iodine status. We assess the within-subject co-existence of overweight and inadequate iodine intake, and associated factors.Methods A national cross-sectional study used a stratified, clustered random sample and conducted among Tunisian school-age children aged from 6 to 12 y. (n = 1560). Overweight (Ow) was body mass index (BMI)-for-age ≥ + 1z. Iodine deficiency was UIC (Urinary Iodine Content) < 100 µg/L and iodine intake above requirements (IAR) UIC ≥ 200 µg/L. Association of covariables with the within-subject double burden Ow–IAR was assessed by multinomial regression.Results The prevalences of Ow-ID or Obe-ID were marginal, but not so for excess adiposity and IAR as for example prevalence of Ow-IAR was 9.8% (95% CI:[7.7–12.3]). OW and IAR were found to co-occur independently (P = 0.29). Socio-economic patterning of Ow-IAR was mild. Nevertheless, prevalence were the lowest among children of mother with no formal schooling and in the South-East region. Beyond school-age children, we estimated that this double burden of overweight and excess iodine could concern a third of Tunisian adults (all the more for women).Conclusions Among Tunisian children, iodine deficiency coupled with excess adiposity was quite marginal. Coexistence of overweight and excess iodine may affect a tenth of these children. More data would be needed to document a possibly even higher rate among adults. Cumulative effects of unhealthy lifestyle due to the nutrition transition interacting with metabolic pathways may be involved in this potential overweight-high iodine intake double burden. In the MENA region, obesity and salt reduction policies should continue to be monitored.
A review of the inclusion of equity stratifiers for the measurement of health inequalities within health and social care data collections in Ireland
Authors: Carroll Christopher , Evans Katie , Elmusharaf Khalifa , O'Donnell Patrick , Dee Anne , O'Donovan Diarmuid , Casey Marie
Published: July 2020

Background
Health equity differs from the concept of health inequality by taking into consideration the fairness of an inequality. Inequities may be culturally specific, based on social relations within a society. Measuring these inequities often requires grouping individuals. These groupings can be termed equity stratifiers. The most common groupings affected by health inequalities are summarised by the acronym PROGRESS. The aim of this review was to examine the use of equity stratifiers in routinely collected health and social care data collections in Ireland.
Methods
One hundred and twenty data collections were identified from the Health Information and Quality Authority (HIQA) document, “Catalogue of national health and social care data collections: Version 3.0”. Managers of all the data collections included were contacted and a data dictionary was requested where one was not available via the HIQA website. Each of the data dictionaries available was reviewed to identify the equity stratifiers recorded.
Results
Eighty-three of the 120 data collections were considered eligible to be included for review. Twenty-nine data dictionaries were made available. There was neither a data dictionary available nor a response to our query from data collection managers for twenty-three (27.7%) of the data collections eligible for inclusion. Data dictionaries were from national data collections, regional data collections and national surveys. All data dictionaries contained at least one of the PROGRESS equity stratifiers. National surveys included more equity stratifiers compared with national and regional data collections. There was a lack of consistency in the definitions used for recording social groups for the stratifiers examined.
Conclusions
While there has been much discussion on tackling health inequalities in Ireland in recent years, health and social care data collections do not always record the social groupings that are most commonly affected. In order to address this, it is necessary to consider which equity stratifiers should be used for the Irish population and, subsequently, for agreed standardised statifiers to be incorporated into routine health data collection. These are lessons that can be shared internationally as other countries begin to address deficits in the use of equity stratifiers.
Sensitivity of Lung US compared to Chest CT for the screening of COVID-19: preliminary report of our experience
Authors: Quarato Carla Maria Irene , Mirijello Antonio , Lacedonia Donato , Venuti Mariapia , Russo Raffaele , Maggi Michele Maria , Rea Gaetano , Simeone Anna , Ferragalli Beatrice , Cosmo Salvatore De , Sperandeo Marco
Published: July 2020

As lung ultrasound (LUS) is a noninvasive, radiation-free, repeatable and portable imaging tool suitable for a point-of-care use, several recent literature reports have emphasized its role as the ideal screening tool for SARS-CoV2 pneumonia. To evaluate the actual diagnostic accuracy of LUS for this purpose, we performed a systematic comparative study between LUS and CT scan findings in a population of 82 patients hospitalized because of COVID-19. LUS and Chest CT have been performed in all patients within 6-12 hours from the admission. The sensitivity of LUS in assessing typical CT findings was 60%. Despite LUS detected consolidations adherent to pleural surface in all cases, it was not able to detect all the consolidations assessed at CT scan (p=0.002), showing a risk to underestimate the actual disease’s extent. Moreover, only 70% of pleural surface is visible by LUS. Considering that the specificity and the positive predictive value of the same LUS signs may be lowered in a normal setting of non epidemic COVID-19 and in case of pre-existing cardio-pulmonary diseases, LUS use should not be indicated for diagnosis of COVID-19. However, it may be very useful for the assessment of pleural effusion and to guide safer fluid drainage.