bluuebunny/crossref_metadata_2025 huggingface dataset:
Endosseous distal extension (EDE) blade implant technique useful to provide stable pillars in the ipotrophic lower posterior sector: 22 years statistical survey
Authors: Dal Carlo Luca , Pasqualini Marco , Shulman Mike , Rossi Franco , Comola Giorgio , Manenti Pierangelo , Candotto Valentina , Lauritano Dorina , Zampetti Paolo
Published: October 2019

The aim of this issue is to describe endosseous distal extension (EDE) surgical technique. This implant technique was conceived and applied since 1993 by Dr Luca Dal Carlo, as an evolution of the classical ramus blade implant technique. With this technique, you attain great stability of the blade implant, due to the following difference compared with the classical blade implant technique: the hard and soft tissues lying behind implant abutment are not being destroyed at all. A slot is made on the upper side of the bone ridge, and the blade is inserted into it and pushed backwards, so that the implant is embedded under untouched tissues. Using blade implants specially drawn for this particular surgery, the slot’s length turns out to be about half of the implant’s length. Piezo bistoury is useful to facilitate surgical proceedings. If we compare the regenerated bone on the mesial part of the implant and the bone that had remained untouched on the distal side, we will see a difference in the tissue density even after a long time. EDE technique is suitable for those cases in which the lower distal sector is characterized by scarceness of cancellous bone. Data collected during 22 years of clinical practice (97.7% 5-year success rate) allow to suggest employing this technique with asymmetric blades to treat D3-D4 narrow ridges located in the posterior mandible. Soft tissue response results are very good.
Copy number variation analysis of twin pairs discordant for cleft lip with or without cleft palate
Authors: Scapoli Luca , Carinci Francesco , Palmieri Annalisa , Cura Francesca , Baj Alessandro , Beltramini Giada , Docimo Raffaella , Martinelli Marcella
Published: October 2019

Non-syndromic cleft lip with or without cleft palate (nsCL/P) is a frequent orofacial malformation. The comparison of concordance rate observed in monozygotic and dizygotic twins supports high level of heritability and a strong genetic component. However, phenotype concordance for orofacial cleft in monozygotic twins is about 50%. The aim of the present investigation was to detect postzygotic events that may account for discordance in monozygotic twins. High-density SNP microarrays hybridization was used to genotype two pairs of monozygotic twins discordant for nsCL/P. Discordant SNP genotypes and copy number variants were analyzed to identify genetic differences responsible of phenotype discrepancy. A number of differences were observed, none involving known nsCL/P candidate genes or genomic regions. Considering the limitation of the study, related to the small sample size and to the large-scale investigation method, the results suggest that the detection of discordant events in other monozygotic twin pairs would be remarkable and warrant further investigations.
Performance and Return to Sport After Anterior Cruciate Ligament Reconstruction in Professional Baseball Players
Authors: Erickson Brandon J. , Chalmers Peter N. , D’Angelo John , Ma Kevin , Dahm Diane L. , Romeo Anthony A. , Ahmad Christopher S.
Published: October 2019

Background:

Anterior cruciate ligament reconstruction (ACLR) is the gold standard treatment for ACL tears to allow baseball players to return to sport (RTS). The optimal graft type and femoral tunnel drilling technique are currently unknown.

Hypothesis:

There is a high rate of RTS in professional baseball players after ACLR, with no significant difference in RTS rates or performance between cases and controls or between graft types or femoral drilling techniques.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

All professional baseball players who underwent ACLR between 2010 and 2015 were included. Demographic and performance data (pre- and postoperative) for each player were recorded. Performance metrics were then compared between cases and matched controls.

Results:

A total of 124 players (mean age, 23.7 ± 4.1 years; 83% minor league players) underwent ACLR. Of these, 80% returned to sport (73% to the same or higher level) at a mean 310 ± 109 days overall and 333 ± 126 days at the same or higher level. The most common graft type was an ipsilateral bone–patellar tendon–bone (BTB) autograft (n = 87; 70%). A total of 91 players underwent concomitant meniscal debridement or repair. No significant difference in any of the primary performance metrics existed from before to after ACLR. Compared with matched controls, no significant difference existed in RTS rates or any performance metrics after ACLR. No significant difference existed in RTS rates or primary performance outcome measures between graft types or femoral drilling techniques.

Conclusion:

The RTS rate for professional baseball players after ACLR was 80%. No significant difference in performance metrics existed between BTB and hamstring autografts or between femoral drilling techniques. Furthermore, no significant difference in performance or RTS rates existed between cases and matched controls. Femoral drilling technique and graft type did not affect performance and RTS rates in professional baseball players after ACLR.
ACL Reconstruction Using Autologous Hamstrings Augmented With the Ligament Augmentation and Reconstruction System Provides Good Clinical Scores, High Levels of Satisfaction and Return to Sport, and a Low Retear Rate at 2 Years
Authors: Ebert Jay R. , Annear Peter T.
Published: October 2019

Background:

There are a number of surgical methods for undertaking anterior cruciate ligament (ACL) reconstruction (ACLR), although relatively high rates of ipsilateral retears and contralateral tears exist, with only 65% of patients returning to their preinjury level of sport. ACLR techniques adopting synthetic augmentation have been proposed in an attempt to improve clinical outcomes and reduce reinjury rates.

Purpose:

To determine the efficacy of ACLR using autologous hamstrings augmented with the Ligament Augmentation and Reconstruction System (LARS).

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 65 patients were prospectively treated with arthroscopically assisted single-bundle ACLR using hamstrings augmented with the LARS, of whom 50 were available for 1- and 2-year reviews. Patient-reported outcome measures (PROMs), KT-1000 arthrometer testing, knee range of motion, peak isokinetic knee strength testing, and a battery of 4 hop tests were employed. Limb symmetry indices (LSIs) were calculated. Analysis of variance was used to evaluate differences over time and between limbs. Data on return to the preinjury level of sport, retears, and reoperations were collected.

Results:

High PROM scores were demonstrated at 1 and 2 years. Before the injury, 47 patients (94%) were actively participating in level 1 or 2 sports, with 38 (76%) and 43 (86%) patients having returned at 1 and 2 years, respectively. Normal (<3 mm; 90%) or nearly normal (3-5 mm; 10%) KT-1000 arthrometer side-to-side differences were observed at 2 years. Apart from knee flexion ( P < .0001), extension ( P = .001), and the 6-m timed hop ( P = .039), there were no between-limb differences at 1 year, and there were no differences on any objective measures at 2 years (all P > .05). Mean LSIs across all measures were ≥90%. At 2 years, 84% to 90% of patients were ≥90% on the hop tests, with 72% and 76% of patients having ≥90% for extension and flexion strength, respectively. Two reoperations were undertaken for meniscal tears (7 and 8.5 months), 1 patient (2%) suffered a retear at 7 months, and 2 patients (3%) suffered a contralateral tear (8 and 12 months).

Conclusion:

This augmented ACLR technique demonstrated good clinical scores, a high rate of return to sport, and low rates of secondary ruptures and contralateral ACL tears at 2 years. Some caution should be noted in interpreting these results, as 15 of 65 patients (23%) were not included in the 2-year follow-up.
Interprofessional Education Collaborative Competencies and the Public Health Professional
Authors: Rhodes Darson , Visker Joseph D. , Whitney Elizabeth A. , Cox Carol
Published: October 2019

Interprofessional education involves programs that foster the partnerships of two or more individuals studying different health professions, thus allowing students to learn with and about the other professions. The Interprofessional Education Collaborative Competencies were updated in 2016 with a threefold purpose that included a greater emphasis on population health, thereby encouraging the health professions who typically work on an individual level to broaden their understanding of the field of public health. In the professional preparation of public health professionals and health education specialists, both foundational competencies and areas of responsibility imply and/or explicitly state that public health professionals and health education specialists must be able to work with interprofessional teams. Interprofessional collaborative learning activities have been recommended to be offered early and often during health professions training. Not only do public health and health education students benefit from inclusion in these interprofessional education activities but other health professions students also benefit from exposure to public health students and population health concepts. Public health and health education have contributed to leadership in interprofessional education initiatives and are well-situated to lend population health expertise to improve health care delivery as well as population and patient health outcomes.
The Value of Agile Ways of Working in a Non-Profit Network Organization
Authors: Kramer Willemijn , Heuvel Jaap van den
Published: October 2019

Agile ways of working have been applied to single organizations and corporations. But cases on agility for non-profit associations dealing with a multitude of members, geographies and their own boards are scarce. Can agility also be applied in a non-profit networked organizational setting in a way that creates value, rather than destroying it? The focus of this article will be on the outcomes of piloting agility with a virtual long-distance team across Europe, including benefits and pitfalls. Value should be created through virtual teams of the association: both for the benefit of members and the association itself. If there is no or little value created there, the members will be unlikely to participate in these groups, undermining the added value of the association. Currently, these teams do not all create value for the membership, and sometimes even destroy value by costing the membership time and money and not delivering relevant output.

In this pilot study, one virtual group was followed, interviews with the group members have been held and the members of the association were surveyed about the existing situation in the focal organization.

We found that an agile way of working is beneficial for a virtual team and implementing this in an ailing virtual team can give it new élan. This way, the teams can deliver value to the membership, and thus to the association, instead of the groups not functioning well leading to value destruction for the association, as members might turn away from the association for their sought added value. Further, the network organization itself partially shows traits of organizational agility, which could be improved to fully support virtual teams.
Co-creating Value from Social Media: A Framework
Authors: Brey Eric T.
Published: October 2019

Co-created value occurs when both the customer and provider benefit simultaneously from an interaction. To deliver on these opportunities, marketing has become a means by which organizations across the product-service spectrum directly interact with customers outside of traditional value-creating activities. Via social media, organizations influence customers while supporting value co-creation for the brand and users simultaneously. While this offers a wide range of opportunities to interact with customers, continued saturation of social networks has magnified the importance of engaging in organic dialogue. To that end, the aim of this article is to establish a framework usable across industries, platforms and content types. The social media value creation framework includes six vertical categories, including respond, transact, educate, awareness, stimulate and entertain. Definitions and examples of each vertical, along with theoretical and practical applications, are included.
Psychosexual Dysfunctions Among Alcohol-Dependent Individuals: A Cross-Sectional Study from a Tertiary Care Center of Southern India
Authors: Nair Priya R. , Sam Sivin P. , Kallivayalil Roy Abraham
Published: October 2019

Background: Chronic alcohol dependence is known to cause psychosexual dysfunction, which leads to marked psychiatric morbidity. There is a dearth of studies from India in this area.

Aim: To estimate the frequency of psychosexual dysfunction in individuals with alcohol dependence and to explore the association between psychosexual dysfunction and various socio-demographic and alcohol-related variables.

Materials and Methods: This is a cross-sectional descriptive study conducted on 50 male patients in a tertiary care center. The evaluation was conducted using a specially designed intake pro forma and tools such as the severity of alcohol dependence questionnaire, checklist for sexual dysfunction and International Classification of Disease, Tenth Revision, and diagnostic criteria for research.

Results: Sexual dysfunction was present in 66% of alcohol-dependent individuals. The most common among them was found to be aversion to sex (32%) followed by erectile dysfunction (24%). In most of the cases, patients having erectile dysfunction were also found to have aversion to sex.

Conclusion: Sexual dysfunction is highly prevalent in male patients with alcohol dependence. The study highlights the detrimental effects of alcohol on sexual function apart from other etiological factors.
Results of the standard set for pulmonary sarcoidosis: feasibility and multicentre outcomes
Authors: Kampstra Nynke A. , van der Nat Paul B. , Dijksman Lea M. , van Beek Frouke T. , Culver Daniel A. , Baughman Robert P. , Renzoni Elisabetta A. , Wuyts Wim , Kouranos Vasilis , Zanen Pieter , Wijsenbeek Marlies S. , Eijkemans Marinus J.C. , Biesma Douwe H. , van der Wees Philip J. , Grutters Jan C.
Published: October 2019

Our study presents findings on a previously developed standard set of clinical outcome data for pulmonary sarcoidosis patients. We aimed to assess whether changes in outcome varied between the different centres and to evaluate the feasibility of collecting the standard set retrospectively.

This retrospective observational comparative benchmark study included six interstitial lung disease expert centres based in the Netherlands, Belgium, the UK and the USA. The standard set of outcome measures included 1) mortality, 2) changes in pulmonary function (forced vital capacity (FVC), forced expiratory volume in 1 s, diffusing capacity of the lung for carbon monoxide), 3) soluble interleukin-2 receptor (sIL-2R) change, 4) weight changes, 5) quality-of-life (QoL) measures, 6) osteoporosis and 7) clinical outcome status (COS). Data collection was considered feasible if the data were collected in ≥80% of all patients.

509 patients were included in the retrospective cohort. In total six patients died, with a mean survival of 38±23.4 months after the diagnosis. Centres varied in mean baseline FVC, ranging from 110 (95% CI 92–124)% predicted to 99 (95% CI 97–123)% pred. Mean baseline body mass index (BMI) of patients in the different centres varied between 27 (95% CI 23.6–29.4) kg·m−2and 31.8 (95% CI 28.1–35.6) kg·m−2. 310 (60.9%) patients were still on systemic therapy 2 years after the diagnosis. It was feasible to measure mortality, changes in pulmonary function, weight changes and COS. It is not (yet) feasible to retrospectively collect sIL-2R, osteoporosis and QoL data internationally.

This study shows that data collection for the standard set of outcome measures for pulmonary sarcoidosis was feasible for four out of seven outcome measures. Trends in pulmonary function and BMI were similar for different hospitals when comparing different practices.
A randomised single-centre trial of inhaled liposomal cyclosporine for bronchiolitis obliterans syndrome post-lung transplantation
Authors: Iacono Aldo , Wijesinha Marniker , Rajagopal Keshava , Murdock Natalia , Timofte Irina , Griffith Bartley , Terrin Michael
Published: October 2019

Introduction

No proven treatments exist for bronchiolitis obliterans syndrome (BOS) following lung transplantation. Inhaled liposomal cyclosporine (L-CsA) may prevent BOS progression.

Methods

A 48-week phase IIb randomised clinical trial was conducted in 21 lung transplant patients with BOS assigned to either L-CsA with standard-of-care (SOC) oral immunosuppression (L-CsA group) or SOC (SOC-alone group). Efficacy end-points were BOS progression-free survival (defined as absence of ≥20% decline in forced expiratory volume in 1 s (FEV1) from randomisation, re-transplantation or death) and BOS grade change.

Results

BOS progression-free survival was 82% for L-CsAversus50% for SOC-alone (p=0.1) and BOS grade worsened in 18% for L-CsAversus60% for SOC-alone (p=0.05). Mean changes in ΔFEV1and forced vital capacity, respectively, stabilised with L-CsA: +0.005 (95% CI −0.004– +0.013) and −0.005 (95% CI −0.015– +0.006) L·month−1, but worsened with SOC-alone: −0.023 (95% CI −0.033– −0.013) and −0.026 (95% CI −0.039– −0.014) L·month−1(p<0.0001 and p=0.009). Median survival (4.1versus2.9 years; p=0.03) and infection rate (45%versus60%; p=0.7) improved with L-CsAversusSOC-alone; creatinine and tacrolimus levels were similar.

Conclusions

L-CsA was well tolerated and stabilised lung function in lung transplant recipients affected by BOS without systemic toxicity, providing a basis for a global phase III trial using L-CsA.
Club cell protein 16 in sera from trauma patients modulates neutrophil migration and functionality via CXCR1 and CXCR2
Authors: Xu Baolin , Janicova Andrea , Vollrath Jan Tilmann , Störmann Philipp , Martin Lukas , Marzi Ingo , Wutzler Sebastian , Hildebrand Frank , Ehnert Sabrina , Relja Borna
Published: October 2019

Background

Club Cell protein (CC)16 correlates with lung injury and respiratory complications, which are in part triggered by polymorphonuclear leukocytes (PMNL) in severely traumatized patients (TP). CC16 exerts anti-inflammatory and immunosuppressive effects, however, its influence on PMNL functions after trauma is unknown. Here, we evaluated whether CC16 present in sera from TP could modify the biological functions of PMNL.

Methods

Sera from 16 severely injured TP without pneumonia (no P,n = 8) or with pneumonia (P, n = 8) were collected at admission to emergency department (ED) and 1 day prior pneumonia and pre-incubated with or without anti-CC16 antibody for CC16 neutralization. Samples from the equal post-injury days in the corresponding no P group were used. Neutrophils were isolated from healthy volunteers (HV,n = 5) and incubated with 20% of the serum medium from TP, respectively. In PMNL, CD62L, CD11b/CD18 and CD31 expression, migratory capacity, phagocytosis rate, oxidative burst and apoptosis were investigated. In isolated PMNL, CXCR1 and CXCR2 were neutralized before stimulation with CC16, and oxidative burst, phagocytosis and apoptosis were analyzed in neutrophils and their subsets.

Results

Serum from the P group enhanced significantly PMNL migration compared to no P group, while CC16-neutralization further increased the migratory rate of PMNL in both groups. CC16-neutralization increased significantly the expression of CD62L in the P group at ED. Oxidative burst was significantly increased in the P group vs. no P during the study period. CC16 seemed to have no influence on oxidative burst and phagocytosis in TP. However, in a more controlled study design, CC16 induced a significant increase of oxidative burst and a decrease of apoptosis of CD16+granulocytes. These effects were markedly observed in mature CD16brightCD62Lbrightand immune suppressive CD16brightCD62Ldimneutrophils. In mature subset, CXCR1 and CXCR2 neutralization diminished CC16-induced effects.

Conclusions

CC16 in sera from multiply traumatized patients, notably of those with pneumonia, has significant effects on PMNL. The results suggest an association of CC16 with CXCR1 and CXCR2. Our data suggest that CC16 reduces the migratory capacity of PMNL and thus modulates their function in patients with respiratory complications after trauma.
Outcomes of rapid response team implementation in tertiary private hospitals: a prospective cohort study
Authors: Al-Omari Awad , Al Mutair Abbas , Aljamaan Fadi
Published: October 2019

Background

Cardiopulmonary arrest may result in high mortality rate in hospitals where the rapid response team is not implemented. A rapid response system can recognize patients at high risk of cardiopulmonary arrest and provide the needed medical management to prevent further deterioration. The rapid response system has shown a dramatic reduction in mortality rate and cardiopulmonary arrest.

Objective

To evaluate the effectiveness of the rapid response team (RRT) implementation in reducing the mortality rate, number of cardiopulmonary arrests, and number of ICU admission.

Design

A pre- and post-rapid response team system implementation.

Setting

Four tertiary private hospitals in Saudi Arabia.

Patients

A total of 154,869 patients in the 3-year before rapid response system period (January 2010 to December 2012) and a total of 466,161 during the 2.5-year post-RRT implementation period (January 2014 to June 2016).

Results

Results indicated that ward nurses activated RRT more often than physicians (1104 activations [69%] vs. 499 activations [31%]), with cardiovascular and respiratory abnormalities being the most common triggers. Serious concern about the patient condition by the ward staff was the trigger for 181 (11.29%) activations. The RRT provided a variety of diagnostic and therapeutic interventions. Most patients cared for by RRT were admitted to ICU 1103 (68.81%), and the rest 500 (31.19%) were managed in the ward. After the implementation of the RRT project, the hospital mortality rate dropped from 7.8 to 2.8 per 1000 hospital admission. Hospital cardiopulmonary arrest rate has dropped from 10.53 per 1000 hospital admissions to 2.58. Rapid response team implementation also facilitated end-of-life care discussions.

Conclusion

Implementation of the RRT project has shown a dramatic reduction in the total ICU admissions, average ICU occupancy rate, total hospital mortality, and total ICU mortality. These findings reinforce the evidence that RRT implementation is effective in reducing hospital mortality and cardiopulmonary arrest rates in addition to other outcomes related to healthcare quality.
Weighted single-step GWAS identified candidate genes associated with semen traits in a Duroc boar population
Authors: Gao Ning , Chen Yilong , Liu Xiaohong , Zhao Yunxiang , Zhu Lin , Liu Ali , Jiang Wei , Peng Xing , Zhang Conglin , Tang Zhenshuang , Li Xinyun , Chen Yaosheng
Published: October 2019

Background

In the pig production industry, artificial insemination (AI) plays an important role in enlarging the beneficial impact of elite boars. Understanding the genetic architecture and detecting genetic markers associated with semen traits can help in improving genetic selection for such traits and accelerate genetic progress. In this study, we utilized a weighted single-step genome-wide association study (wssGWAS) procedure to detect genetic regions and further candidate genes associated with semen traits in a Duroc boar population. Overall, the full pedigree consists of 5284 pigs (12 generations), of which 2693 boars have semen data (143,113 ejaculations) and 1733 pigs were genotyped with 50 K single nucleotide polymorphism (SNP) array.

Results

Results show that the most significant genetic regions (0.4 Mb windows) explained approximately 2%~ 6% of the total genetic variances for the studied traits. Totally, the identified significant windows (windows explaining more than 1% of total genetic variances) explained 28.29, 35.31, 41.98, and 20.60% of genetic variances (not phenotypic variance) for number of sperm cells, sperm motility, sperm progressive motility, and total morphological abnormalities, respectively. Several genes that have been previously reported to be associated with mammal spermiogenesis, testes functioning, and male fertility were detected and treated as candidate genes for the traits of interest: Number of sperm cells,TDRD5,QSOX1,BLK,TIMP3,THRA,CSF3, andZPBP1; Sperm motility,PPP2R2B,NEK2,NDRG,ADAM7,SKP2, andRNASET2; Sperm progressive motility,SH2B1,BLK,LAMB1,VPS4A,SPAG9,LCN2, and DNM1; Total morphological abnormalities,GHR,SELENOP,SLC16A5,SLC9A3R1, andDNAI2.

Conclusions

In conclusion, candidate genes associated with Duroc boars’ semen traits, including the number of sperm cells, sperm motility, sperm progressive motility, and total morphological abnormalities, were identified using wssGWAS. KEGG and GO enrichment analysis indicate that the identified candidate genes were enriched in biological processes and functional terms may be involved into spermiogenesis, testes functioning, and male fertility.
The olfactory secretome varies according to season in female sheep and goat
Authors: Cann Paul , Chabi Malika , Delsart Aliénor , Le Danvic Chrystelle , Saliou Jean-Michel , Chasles Manon , Keller Matthieu , Nagnan-Le Meillour Patricia
Published: October 2019

Background

Small ungulates (sheep and goat) display a seasonal breeding, characterised by two successive periods, sexual activity (SA) and sexual rest (SR). Odours emitted by a sexually active male can reactivate the ovulatory cycle of anoestrus females. The plasticity of the olfactory system under these hormonal changes has never been explored at the peripheral level of odours reception. As it was shown in pig that the olfactory secretome (proteins secreted in the nasal mucus) could be modified under hormonal control, we monitored its composition in females of both species through several reproductive seasons, thanks to a non-invasive sampling of olfactory mucus. For this purpose, two-dimensional gel electrophoresis (2D-E), western-blot with specific antibodies, MALDI-TOF and high-resolution (nano-LC-MS/MS) mass spectrometry, RACE-PCR and molecular modelling were used.

Results

In both species the olfactory secretome is composed of isoforms of OBP-like proteins, generated by post-translational modifications, as phosphorylation, N-glycosylation and O-GlcNAcylation. Important changes were observed in the olfactory secretome between the sexual rest and the sexual activity periods, characterised in ewe by the specific expression of SAL-like proteins and the emergence of OBPs O-GlcNAcylation. In goat, the differences between SA and SR did not come from new proteins expression, but from different post-translational modifications, the main difference between the SA and SR secretome being the number of isoforms of each protein. Proteomics data are available via ProteomeXchange with identifier PXD014833.

Conclusion

Despite common behaviour, seasonal breeding, and genetic resources, the two species seem to adapt their olfactory equipment in SA by different modalities: the variation of olfactory secretome in ewe could correspond to a specialization to detect male odours only in SA, whereas in goat the stability of the olfactory secretome could indicate a constant capacity of odours detection suggesting that the hallmark of SA in goat might be the emission of specific odours by the sexually active male. In both species, the olfactory secretome is a phenotype reflecting the physiological status of females, and could be used by breeders to monitor their receptivity to the male effect.
Antibiotics prescription and guidelines adherence in elderly: impact of the comorbidities
Authors: Dylis Anthony , Boureau Anne Sophie , Coutant Audrey , Batard Eric , Javaudin François , Berrut Gilles , de Decker Laure , Chapelet Guillaume
Published: October 2019

Background

Although the interest of antibiotics is well known, antibiotics prescription is associated with side effect, especially in patients with multiples comorbidities. One way to reduce the incidence of side effects is to respect antibiotics prescriptions guidelines. Our objective was to investigated the factors associated with guidelines adherence in elderly patients with multiples comorbidities.

Methods

From October 2015 to December 2016, antibiotics prescription and guidelines adherence were analyzed in two post-acute care and rehabilitation services of a 2600-bed, university-affiliated center.

Results

One hundred and twenty-eight patients were included, fifty-nine (46%) patients had antibiotics prescription according to guidelines. In Multivariable logistic regression analysis, prescription of 2 antibiotics or more (OR = 0.168, 95% IC = 0.037–0.758, p < 0.05), 85 years of age and more (OR = 0.375, 95% IC = 0.151–0.931, p < 0.05) and the Charlson comorbidity index score (OR = 0.750, 95% IC = 0.572–0.984, p < 0.05) were negatively associated with antibiotics prescriptions according to guidelines.

Conclusions

High comorbidity in the elderly was negatively associated with the guidelines adherence of antibiotiсs prescriptions. These criteria should be considered to optimize antibiotics prescriptions in elderly patients.
Associations of BAFF rs2893321 polymorphisms with myasthenia gravis susceptibility
Authors: Deng Hui , Wang Jianjian , Kong Xiaotong , Zhang Huixue , Wang Tianfeng , Tian Wenqi , Yi Tingting , Wang Lihua
Published: October 2019

Background

Myasthenia gravis (MG) is an autoimmune diseases characterized by fatigue and weakness of skeletal muscles. B-lymphocyte-activating factor (BAFF), an essential factor for B cell differentiation and development, is important in the progression of MG. The current study aimed to investigate the association between single nucleotide polymorphism rs2893321 in BAFF with MG susceptibility in Chinese Han population.

Methods

One hundred forty-nine patients with MG and 148 healthy controls were recruited. Using improved multiple ligase detection reaction technology, the polymorphisms of rs2893321 between groups and among MG subgroups have been compared.

Results

A significant differences between the MG group and the healthy control group was observed. Additionally, rs2893321 was found to be associated with gender and age in patients with MG.

Conclusion

Genetic variations of rs2893321 in BAFF might be associated with susceptibility to MG in the Chinese Han population.
Predictors of weight loss outcomes in obesity care: results of the national ACTION study
Authors:   The ACTION Steering Group, Dhurandhar Nikhil V. , Kyle Theodore , Stevenin Boris , Tomaszewski Kenneth
Published: October 2019

Background

A key objective of this study was to examine obesity care attitudes and behaviors of people with obesity (PwO) and determine independent factors associated with a self-reported sustained weight loss success outcome.

Methods

An online survey was conducted in 2015 among 3008 U.S. adult PwO (BMI > 30 through self-reported height and weight). Multivariate logistic models explained variation in weight loss success, defined as ≥ 10% weight loss in previous 3 years and maintained for > 1 year.

Results

Controlling for weight changes over time, we found significant associations between self-reported weight history and weight loss success. PwO who had personal motivation to lose weight, were willing to talk to a diabetes educator about their weight, who had their weight loss attempts recognized by a healthcare provider, and were diagnosed with “obesity” or “overweight” were more likely to report having success losing weight.

Conclusions

This study does not determine causality, but suggests motivation and engagement with PwO may impact weight loss, and presents a basis for assessing the mechanism involved. Determining such mechanisms may identify important targets to improve obesity treatment outcomes.

Trial registration

This study is registered with ClinicalTrials.gov, number NCT03223493, https://clinicaltrials.gov/ct2/show/NCT03223493. Registered July 17, 2017 (retrospectively registered).
Smoking cessation with smartphone applications (SWAPP): study protocol for a randomized controlled trial
Authors: Lüscher Janina , Berli Corina , Schwaninger Philipp , Scholz Urte
Published: October 2019

Background

Tobacco smoking remains one of the biggest public health threats. Smartphone apps offer new promising opportunities for supporting smoking cessation in real-time. The social context of smokers has, however, been neglected in smartphone apps promoting smoking cessation. This randomized controlled trial investigates the effectiveness of a smartphone app in which smokers quit smoking with the help of a social network member.

Methods

This protocol describes the design of a single-blind, two-arm, parallel-group, intensive longitudinal randomized controlled trial. Participants of this study are adult smokers who smoke at least one cigarette per day and intend to quit smoking at a self-set quit date. Blocking as means of group-balanced randomization is used to allocate participants to intervention or control conditions. Both intervention and control group use a smartphone-compatible device for measuring their daily smoking behavior objectively via exhaled carbon monoxide. In addition, the intervention group is instructed to use the SmokeFree Buddy app, a multicomponent app that also facilitates smoking-cessation specific social support from a buddy over a smartphone application. All participants fill out a baseline diary for three consecutive days and are invited to the lab for a background assessment. They subsequently participate in an end-of-day diary phase from 7 days before and until 20 days after a self-set quit date. Six months after the self-set quit date a follow-up diary for three consecutive days takes place. The primary outcome measures are daily self-reported and objectively-assessed smoking abstinence and secondary outcome measures are daily self-reported number of cigarettes smoked.

Discussion

This is the first study examining the effectiveness of a smoking cessation mobile intervention using the SmokeFree Buddy app compared to a control group in a real-life setting around a self-set quit date using a portable objective measure to assess smoking abstinence. Opportunities and challenges with running studies with smoking participants and certain design-related decisions are discussed.

Trial registration

This trial was prospectively registered on 04/04/2018 at ISRCTNregistry:ISRCTN11154315.
Psychometric properties of the Persian version of the Cancer attitude inventory
Authors: Khazaee-Pool Maryam , Shoghli Alireza , Pashaei Tahereh , Ponnet Koen
Published: October 2019

Background

The Cancer Attitude inventory (CAI) was developed to measure attitudes toward cancer. The aim of the present study was to describe the development of the Persian version of the CAI and to evaluate its psychometric properties in an Iranian sample.

Methods

The forward–backward method was used to translate the CAI scale from English into Persian. After linguistic validation and a pilot check, a cross-sectional study was performed and psychometric properties of the Iranian version of the questionnaire were assessed.

The scale validation was conducted with a convenience sample of 820 laypeople. Construct validity was assessed through both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was assessed through Cronbach’s alpha analysis and test-retest analysis.

Results

Five factors were identified in CAI: isolation, helplessness, fear of consequence, belief of control and independence, and fear of death. The results achieved from the CFA displayed that the data fit the model: the relative chi-square (× 2/df) = 2.98 (p < .001), and the root mean square error of approximation (RMSEA) = .07 (90% CI = .06—.07). All comparative indices of the model had scores greater than .80, demonstrating a good fit to the data. Cronbach’s Alpha and the intra-class correlation coefficient (ICC) were .97, which is well above the acceptable threshold.

Conclusions

The results indicate that the Persian version of the CAI is practical, reliable and valid. Consequently, the instrument could be used in plans to create positive attitudes about cancer control and treatment among Persian people.
Epidemiology and antibiotic susceptibility of Vibrio cholerae associated with the 2017 outbreak in Kasese district, Uganda
Authors: Iramiot Jacob Stanley , Rwego Innocent B. , Kansiime Catherine , Asiimwe Benon B.
Published: October 2019

Background

Uganda is among the 51 countries where cholera outbreaks are common with epidemics occurring predominantly along the western border with Democratic Republic of Congo (DRC), Kampala city slums, Busia district which is a border town with Western Kenya, Mbale district and the Karamoja Sub-region. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda.

Methods

A descriptive cross-sectional study was carried out between 2017 and 2018 to describe the epidemiology of the cholera epidemic in Kasese district, Uganda. Rectal swabs were collected from 69 suspected case-persons and cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 37 °C for 18–24 h. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar.

A list of discharged patients was obtained from the isolation units of Bwera hospital and Kagando hospital and the individuals were followed to the community where they live. Questionnaires were administered to a total of 75 participants who were either the cases or relatives to the case. GPS points of the homes of the cases and pictures of potential source infection were also taken and cases were mapped.

Results

A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below 5 years. Culture isolated 69 V. cholerae 01 serotype Inaba from the total of 71 samples. Salmonella typhi was Isolated from the other two samples which were negative for V. cholerae. Antibiotic susceptibility using Kirby-Bauer disc diffusion method was done on isolates from 69 participants and showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/Sulfamethoxazole whereas gentamicin showed 100% susceptibility. Environmental assessment revealed rampant cases of open defecation.

Conclusion

Though we did not culture water to confirm contamination with Vibrio cholerae, we hypothesize that the cholera epidemic in Kasese 2017 was sparked off by consumption of contaminated water following the heavy floods that washed away latrines into water sources in Bwera, Isango and Nakiyumbu sub-counties. V. cholerae was also highly resistant to the commonly used antibiotics.
A novel mutation of the StAR gene with congenital adrenal hyperplasia and its association with heterochromia iridis: a case report
Authors: Splittstösser Vera , Schreiner Felix , Gohlke Bettina , Welzel Maik , Holterhus Paul-Martin , Woelfle Joachim
Published: October 2019

Background

We report a novel mutation within the StAR gene, causing congenital adrenal hyperplasia, with the so far unreported association with heterochromia iridis.

Case presentation

In a now 15-year-old girl (born at 41 + 6 weeks of gestation) adrenal failure was diagnosed in the neonatal period based on the clinical picture with spontaneous hypoglycaemia, hyponatremia and an extremely elevated concentration of ACTH (3381 pmol/l; ref. level 1,1–10,1 pmol/l), elevated renin (836 ng/l; ref. level 5–308 ng/l), and a decreased concentration of aldosterone (410 pmol/l; ref. level 886–3540 pmol/l). In addition to hyperpigmented skin the patient exhibited sectorial heterochromia iridis. Sequence analysis of the steroidogenic acute regulatory protein (StAR) gene showed a novel homozygous mutation (c.652G > A (p.Ala218Thr), which was predicted in-silico to be possibly damaging. Under daily steroid substitution her electrolyte levels are balanced while she became obese. Puberty occurred spontaneously.

Conclusion

A novel mutation in the StAR gene was identified in a patient with severe adrenal hypoplasia and sectorial heterochromia iridis. We discuss a causal relationship between these two rare phenotypes, i.e. whether very high levels of ACTH and alpha-MSH during early development might have disturbed early differentiation and distribution of uveal melanocytes. If confirmed in additional cases, discolorization of the iris might be considered as an additional phenotypical feature in the differential diagnosis of congenital adrenal insufficiency.
Assessment of Leishmania infantum infection in equine populations in a canine visceral leishmaniosis transmission area
Authors: Escobar Taiane Acunha , Dowich Gabriela , dos Santos Thália Pacheco , Zuravski Luísa , Duarte Claudia Acosta , Lübeck Irina , Manfredini Vanusa
Published: October 2019

Background

Leishmaniosis, zoonosis that produces significant public health impacts, is caused by Leishmania infantum. Canines are the main domestic reservoir and, besides humans, other species of mammals could be infected when living in endemic areas. In this study, we detected equine Leishmania infantum infections in a canine visceral leishmaniosis transmission area and evaluated the clinical, haematological, biochemical and oxidative stress disorders. This study was conducted in Uruguaiana, Rio Grande do Sul, south of Brazil. Peripheral blood samples were collected from 124 animals (98 horses and 26 dogs) of both genders and several breeds after they underwent general and dermatologic examinations.

Results

Twenty five Leishmania infantum infected animals (20.16%), 14 horses and 11 dogs were detected by PCR (Polymerase Chain Reaction) amplification of kinetoplast DNA regions with 96% homology to Leishmania infantum (GenBank Accession No. L 19877.1). The clinical and haematological alterations of infected equines were skin lesions, nodules, lymphadenopathy, decreased levels in red blood cells and haematocrit (p < 0.05) and increase in urea serum concentration (p < 0.05), while CVL presented a decrease in red blood cells counts (p < 0.05), increase in lymphocytes (p < 0.05), and decrease in neutrophil-lymphocyte ratio (p < 0.05). Oxidative stress markers of plasma protein carbonyl and plasma lipid peroxidation were not statistically significant (p > 0.05) in both species.

Conclusions

To our knowledge, this has been the first leishmaniosis equine survey performed in south of Brazil, caused by Leishmania infantum that were able to initially identify haematological and biochemical changes in the species, even in asymptomatic animals. We present evidence supporting those findings of haematological and biochemical changes could be related to infection. Surprisingly, the clinical manifestations of equine infection were similar to those found in canine visceral leishmaniosis. The equine population could be play an important role in the cycle of leishmaniosis in south Brazil and consequently indicates a great risk of public health. This evaluation of infected animals is important to establish the clinical and laboratory parameters involved in the disease progression.
Detection of ALV p27 in cloacal swabs and virus isolation medium by sELISA
Authors: Zhou Xiaoyu , Wang Lin , Shen Anning , Shen Xi , Xu Moru , Qian Kun , Shao Hongxia , Yao Yongxiu , Nair Venugopal , Ye Jianqiang , Qin Aijian
Published: October 2019

Background

Avian leukosis (AL), which is caused by avian leukosis virus (ALV), has led to substantial economic losses in the poultry industry. The kit used to detect all ALV-positive chickens in breeder flocks is very important for efficiently controlling AL. However, a new emerging ALV subtype is currently a severe challenge in the poultry industry.

Results

In this paper, we compared different enzyme-linked immunosorbent assay (ELISA) kits for detecting p27 of ALV in the same batch of meconium samples. Different positive samples were further analyzed by PCR or virus isolation. The results showed that 36 positive samples among the 1812 chicken meconium samples could be detected by a sandwich ELISA (sELISA) kit, but only 17 positive samples could be identified by a commercial kit. To verify this result, cloacal swabs and viruses isolated from the positive chickens (2 days old) were used to detect the presence of p27. The results showed that the positive rate of p27 was 100% for the swabs and 40% for virus isolation. Surprisingly, PCR and sequence analysis revealed that the env gene of ALV in these positive samples belonged to the novel subgroup K (ALV-K).

Conclusion

These data not only demonstrate the relatively high sensitivity of the sELISA kit but also highlight the challenge of controlling ALV-K.