bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Parent Educational Attainment in Parenting and Children’s Development
Authors: Davis-Kean Pamela E. , Tighe Lauren A. , Waters Nicholas E.
Published: April 2021

Socioeconomic status (SES)—indexed via parent educational attainment, parent occupation, and family income—is a powerful predictor of children’s developmental outcomes. Variations in these resources predict large academic disparities among children from different socioeconomic backgrounds that persist over the years of schooling, perpetuating educational inequalities across generations. In this article, we provide an overview of a model that has guided our approach to studying these influences, focusing particularly on parent educational attainment. Parents’ educational attainment typically drives their occupations and income and is often used interchangeably with SES in research. We posit that parent educational attainment provides a foundation that supports children’s academic success indirectly through parents’ beliefs about and expectations for their children, as well as through the cognitive stimulation that parents provide in and outside of the home environment. We then expand this model to consider the intergenerational contributions and dynamic transactions within families that are important considerations for informing potential avenues for intervention.
Left orbital compartment syndrome and right anterior ischemic optic neuropathy in a patient with severe burns despite non-aggressive fluid resuscitation
Authors: Pircher Achmed , Holm Sebastian , Huss Fredrik
Published: April 2021

Introduction:

Ophthalmological complications such as orbital compartment syndrome (OCS) and ischemic optic neuropathy are rare complications in patients with burns and have been described in patients where aggressive fluid resuscitation was performed. While OCS requires urgent surgical intervention, no current treatment is established to treat, or prevent, ischemic optic neuropathy in patients with burns.

Methods:

The authors report a case of a 38-year-old woman with flame burns including the periorbital regions who developed OCS on the left side and anterior ischemic optic neuropathy (AION) on the right side despite non-aggressive fluid resuscitation. Immediate lateral canthotomy combined with inferior cantholysis was performed on the left side.

Discussion and Conclusion:

OCS and AION need to be considered as potential complications even in critically ill patients with facial burns who do not receive aggressive fluid resuscitation. Whether an early surgical intervention will lower the risk of AION development is, however, speculative.

Lay Summary

Ophthalmological complications such as orbital compartment syndrome and ischemic optic neuropathy are rare complications in patients with burns and have been described in patients where aggressive fluid resuscitation was performed. We present a case of a critically ill patient with severe facial burns who developed orbital compartment syndrome on the left side and anterior ischemic optic neuropathy on the right side even though our patient did not receive aggressive fluid resuscitation. Our case is particular because both of these rare complications are seen in a single patient and neither received aggressive fluid resuscitation. The fact that the patient did not develop ischemic optic neuropathy on the side where the lateral canthotomy was performed (only on the side where the patient had orbital compartment syndrome), this case might raise the discussion of whether an early surgical intervention might lower the risk of ischemic optic neuropathy development in patients with facial burns.
New-onset systemic sclerosis and scleroderma renal crisis under docetaxel
Authors: Debien Véronique , Petitdemange Arthur , Bazin Dorothée , Ederle Carole , Nespola Benoit , Merdji Hamid , Olagne Jérome , Martin Thierry , Guffroy Aurélien , Pflumio Carole
Published: April 2021

Systemic sclerosis is a rare systemic autoimmune disease characterized by microvascular impairment and fibrosis of the skin and other organs with poor outcomes. Toxic causes may be involved. We reported the case of a 59-year-old woman who developed an acute systemic sclerosis after two doses of adjuvant chemotherapy by docetaxel and cyclophosphamide for a localized hormone receptor + human epithelial receptor 2—breast cancer. Docetaxel is a major chemotherapy drug used in the treatment of breast, lung, and prostate cancers, among others. Scleroderma-like skin-induced changes (morphea) have been already described for taxanes. Here, we report for the first time a case of severe lung and kidney flare with thrombotic microangiopathy after steroids for acute interstitial lung disease probably induced by anti-RNA polymerase III + systemic sclerosis after docetaxel.
The prevalence and related factors of fatigue in patients with COPD: a systematic review
Authors: Ebadi Zjala , Goërtz Yvonne M.J. , Van Herck Maarten , Janssen Daisy J.A. , Spruit Martijn A. , Burtin Chris , Thong Melissa S.Y. , Muris Jean , Otker Jacqueline , Looijmans Milou , Vlasblom Christel , Bastiaansen Joëlle , Prins Judith , Wouters Emiel F.M , Vercoulen Jan H. , Peters Jeannette B.
Published: April 2021

Background

Fatigue is a distressing symptom in patients with COPD. Little is known about the factors that contribute to fatigue in COPD. This review summarises existing knowledge on the prevalence of fatigue, factors related to fatigue and the instruments most commonly used to assess fatigue in COPD.

Methods

Pubmed, PsycINFO, EMBASE, Cochrane and CINAHL databases were searched for studies from inception up to 7 January 2020 using the medical subject headings “COPD” and “Fatigue”. Studies were reviewed in accordance with PRISMA guidelines.

Results

196 studies were evaluated. The prevalence of fatigue ranged from 17–95%. Age (r=−0.23 to r=0.27), sex (r=0.11), marital status (r=−0.096), dyspnoea (r=0.13 to r=0.78), forced expiatory volume in 1 s % predicted (r=−0.55 to r=−0.076), number of exacerbations (r=0.27 to r=0.38), number of comorbidities (r=0.10), number of medications (r=0.35), anxiety (r=0.36 to r=0.61), depression (r=0.41 to r=0.66), muscle strength (r=−0.78 to r=−0.45), functional capacity (r=−0.77 to r=−0.14) and quality of life (r=0.48 to r=0.77) showed significant associations with fatigue.

Conclusions

Fatigue is a prevalent symptom in patients with COPD. Multiple physical and psychological factors seem to be associated with fatigue.Future studies are needed to evaluate these underlying factors in integral analyses in samples of patients with COPD.
The molecular signatures of compatible and incompatible pollination in Arabidopsis
Authors: Kodera Chie , Just Jérémy , Da Rocha Martine , Larrieu Antoine , Riglet Lucie , Legrand Jonathan , Rozier Frédérique , Gaude Thierry , Fobis-Loisy Isabelle
Published: April 2021

Background

Fertilization in flowering plants depends on the early contact and acceptance of pollen grains by the receptive papilla cells of the stigma. Deciphering the specific transcriptomic response of both pollen and stigmatic cells during their interaction constitutes an important challenge to better our understanding of this cell recognition event.

Results

Here we describe a transcriptomic analysis based on single nucleotide polymorphisms (SNPs) present in twoArabidopsis thalianaaccessions, one used as female and the other as male. This strategy allowed us to distinguish 80% of transcripts according to their parental origins. We also developed a tool which predicts male/female specific expression for genes without SNP. We report an unanticipated transcriptional activity triggered in stigma upon incompatible pollination and show that following compatible interaction, components of the pattern-triggered immunity (PTI) pathway are induced on the female side.

Conclusions

Our work unveils the molecular signatures of compatible and incompatible pollinations both at the male and female side. We provide invaluable resource and tools to identify potential new molecular players involved in pollen-stigma interaction.
Transcriptome architecture reveals genetic networks of bolting regulation in spinach
Authors: Abolghasemi Reza , Haghighi Maryam , Etemadi Nematollah , Wang Shui , Soorni Aboozar
Published: April 2021

Background

Bolting refers to the early flowering stem production on agricultural and horticultural crops before harvesting. Indeed, bolting is an event induced by the coordinated effects of various environmental factors and endogenous genetic components, which cause a large reduction in the quality and productivity of vegetable crops like spinach. However, little is known about the signaling pathways and molecular functions involved in bolting mechanisms in spinach. The genetic information regarding the transition from vegetative growth to the reproductive stage in spinach would represent an advantage to regulate bolting time and improvement of resistant cultivars to minimize performance loss.

Results

To investigate the key genes and their genetic networks controlling spinach bolting, we performed RNA-seq analysis on early bolting accession Kashan and late-bolting accession Viroflay at both vegetative and reproductive stages and found a significant number of differentially expressed genes (DEGs) ranging from 195 to 1230 in different comparisons. These genes were mainly associated with the signaling pathways of vernalization, photoperiod/circadian clock, gibberellin, autonomous, and aging pathways. Gene ontology analysis uncovered terms associated with carbohydrate metabolism, and detailed analysis of expression patterns for genes of Fructose-1, 6-bisphosphate aldolase, TREHALOSE-6-PHOSPHATE SYNTHASE 1, FLOWERING PROMOTING FACTOR 1, EARLY FLOWERING, GIGANTEA, and MADS-box proteins revealed their potential roles in the initiating or delaying of bolting.

Conclusion

This study is the first report on identifying bolting and flowering-related genes based on transcriptome sequencing in spinach, which provides insight into bolting control and can be useful for molecular breeding programs and further study in the regulation of the genetic mechanisms related to bolting in other vegetable crops.
A prediction model using machine-learning algorithm for assessing intrathecal hyperbaric bupivacaine dose during cesarean section
Authors: Wei Chang-na , Wang Li-ying , Chang Xiang-yang , Zhou Qing-he
Published: April 2021

Background

The intrathecal hyperbaric bupivacaine dosage for cesarean section is difficult to predetermine. This study aimed to develop a decision-support model using a machine-learning algorithm for assessing intrathecal hyperbaric bupivacaine dose based on physical variables during cesarean section.

Methods

Term parturients presenting for elective cesarean section under spinal anaesthesia were enrolled. Spinal anesthesia was performed at the L3/4 interspace with 0.5% hyperbaric bupivacaine at dosages determined by the anesthesiologist. A spinal spread level between T4-T6 was considered the appropriate block level. We used a machine-learning algorithm to identify relevant parameters. The dataset was split into derivation (80%) and validation (20%) cohorts. A decision-support model was developed for obtaining the regression equation between optimized intrathecal 0.5% hyperbaric bupivacaine volume and physical variables.

Results

A total of 684 parturients were included, of whom 516 (75.44%) and 168 (24.56%) had block levels between T4 and T6, and less than T6 or higher than T4, respectively. The appropriate block level rate was 75.44%, with the mean bupivacaine volume [1.965, 95%CI (1.945,1.984)]ml. In lasso regression, based on the principle of predicting a reasonable dose of intrathecal bupivacaine with fewer physical variables, the model is “Y=0.5922+ 0.055117* X1-0.017599*X2” (Y: bupivacaine volume; X1: vertebral column length; X2: abdominal girth), with λ 0.055, MSE 0.0087, and R2 0.807.

Conclusions

After applying a machine-learning algorithm, we developed a decision model with R2 0.8070 and MSE due to error 0.0087 using abdominal girth and vertebral column length for predicting the optimized intrathecal 0.5% hyperbaric bupivacaine dosage during term cesarean sections.
Chronic polytherapy after myocardial infarction: the trade-off between hospital and community-based providers in determining adherence to medication
Authors: Di Martino Mirko , Alagna Michela , Lallo Adele , Gilmore Kendall Jamieson , Francesconi Paolo , Profili Francesco , Scondotto Salvatore , Fantaci Giovanna , Trifirò Gianluca , Isgrò Valentina , Davoli Marina , Fusco Danilo
Published: April 2021

Background

The benefits of chronic polytherapy in reducing readmissions and death after myocardial infarction (MI) have been clearly shown. However, real-world evidence shows poor medication adherence and large geographic variation, suggesting critical issues in access to optimal care. Our objectives were to measure adherence to polytherapy, to compare the amount of variation attributable to hospitals of discharge and to community-based providers, and to identify determinants of adherence to medications.

Methods

This is a population-based study. Data were obtained from the information systems of the Lazio and Tuscany Regions, Italy (9.5 million inhabitants). Patients hospitalized with incident MI in 2010–2014 were analyzed. The outcome measure was medication adherence, defined as a Medication Possession Ratio (MPR) ≥ 0.75 for at least 3 of the following drugs: antiplatelets, β-blockers, ACEI/ARBs, statins. A 2-year cohort-study was performed. Cross-classified multilevel models were applied to analyze geographic variation. The variance components attributable to hospitals of discharge and community-based providers were expressed as Median Odds Ratio (MOR).

Results

A total of 32,962 patients were enrolled. About 63% of patients in the Lazio cohort and 59% of the Tuscan cohort were adherent to chronic polytherapy. Women and patients aged 85 years and over were most at risk of non-adherence. In both regions, adherence was higher for patients discharged from cardiology wards (Lazio: OR = 1.58, p < 0.001, Tuscany: OR = 1.59, p < 0.001) and for patients with a percutaneous coronary intervention during the index admission. Relevant variation between community-based providers was observed, though when the hospital of discharge was included as a cross-classified level, in both Lazio and Tuscany regions the variation attributable to hospitals of discharge was the only significant component (Lazio: MOR = 1.30, p = 0.001; Tuscany: MOR = 1.31, p = 0.001).

Conclusion

Adherence to best practice treatments after MI is not consistent with clinical guidelines, and varies between patient groups as well as within and between regions. The variation attributable to providers is affected by the hospital of discharge, up to two years from the acute episode. This variation is likely to be attributable to hospital discharge processes, and could be reduced through appropriate policy levers.
Myocardial bridging presenting as myocardial ischaemia induced cardiac arrest: a case report
Authors: Ki Young-Jae
Published: April 2021

Background

Myocardial bridging is a congenital anomaly defined as a segment of epicardial coronary arteries running through the myocardium. Various complications related to myocardial bridging have been reported, but at present, cardiac arrest has rarely been reported.

Case presentation

We report one case of a patient who was successfully resuscitated from ventricular fibrillation cardiac arrest and was diagnosed with myocardial bridging accompanied by myocardial ischaemia. A 50-year-old woman who had been resuscitated from cardiac arrest transferred to our institution for evaluation and management of out-of-hospital cardiac arrest. We confirmed the diagnosis of significant myocardial bridging with evident myocardial ischaemia by coronary angiography, resting echocardiography and heart MRI. Vasospasm was thought to be a trigger factor judging from the transient ST elevation on electrocardiography. In addition, the finding of septal buckling was detected for the first time throughout the whole cardiac cycle by resting echocardiography in MB.

Conclusion

We report a rare case of survival after out-of-hospital cardiac arrest that might be caused by significant myocardial bridging-induced myocardial ischaemia, which was objectively confirmed by echocardiography and heart MRI. Although myocardial bridging is often overlooked as an aetiology for sudden cardiac death, this case highlights the importance of expanding the differential diagnosis to myocardial bridging in the work-up for the cause of sudden cardiac death.
Patient experiences with the role of physical activity in inflammatory bowel disease: results from a survey and interviews
Authors: Lamers Carlijn R. , de Roos Nicole M. , Koppelman Lola J. M. , Hopman Maria T. E. , Witteman Ben J. M.
Published: April 2021

Background

Physical activity may affect disease activity in patients with inflammatory bowel disease. We used a survey to investigate this association and performed interviews to get a better understanding of patient experiences, and therefore the nature of this association.

Methods

Patients with Crohn’s disease (CD, n = 176) and ulcerative colitis (UC, n = 162) completed the short Crohn’s Disease Activity (sCDAI) or Patient Simple Clinical Colitis Activity Index (P-SCCAI) and the Short Questionnaire to Assess Health-enhancing physical activity (SQUASH). Associations were investigated by multiple linear regression. Semi-structured interviews (7 CD, 7 UC) were conducted to assess patient experiences with the role of physical activity in their disease.

Results

The majority of survey participants were in remission (70%) and adhered to the Dutch physical activity guidelines (61%). In Crohn’s disease, the total physical activity score was inversely associated with disease activity, even after adjustment for confounders (β = − 0.375; p = 0.013). No association between physical activity and disease activity was found in ulcerative colitis. Of the interviewees, 86% experienced beneficial effects of physical activity, such as improved general fitness, quality of life and self-image. However, during periods of active disease they struggled to find the motivation and perseverance to be physically active due to physical barriers.

Conclusions

Crohn’s disease participants with a higher physical activity level had a lower disease activity. This inverse association was not found in ulcerative colitis. Interviews revealed that IBD patients generally experience beneficial effects from physical activity, although the barriers caused by active disease may put them off to be physically active.
Serum and urine ANGPTL8 expression levels are associated with hyperlipidemia and proteinuria in primary nephrotic syndrome
Authors: Li Yue , Liu Qingju , Kang Chengdong , Cui Weijing , Xu Zichuan , Zhong Fu , Gao Xia
Published: April 2021

Background

This study aimed to investigate the expression characteristics of ANGPTL8 in patients with primary nephrotic syndrome and its possible correlation with hyperlipidemia and proteinuria.

Methods

ANGPTL8 levels were determined using an enzyme-linked immunosorbent assay in 133 subjects with PNS and 60 healthy controls.

Results

Compared with healthy controls, subjects with primary nephrotic syndrome had higher levels of serum and urine ANGPTL8 (P < 0.001). In primary nephrotic syndrome patients, serum ANGPTL8 was positively correlated with cholesterol (r = 0.209, P < 0.05) and triglycerides (r = 0.412, P < 0.001), while there was no correlation with 24 hUTP. Urine ANGPTL8 was positively correlated with high-density lipoprotein cholesterol (r = 0.181, P < 0.05) and was significantly negatively correlated with creatinine (r = − 0.323, P < 0.001), eGFR (r = − 0, P < 0.001) and 24 hUTP (r = − 0.268, P = 0.002). Interestingly, the urine ANGPTL8 concentrations in membranous nephropathy and mesangial proliferative glomerulonephritis pathological types were different.

Conclusions

Serum and urine ANGPTL8 levels in primary nephrotic syndrome patients were correlated with blood lipid levels and proteinuria, respectively, suggesting that ANGPTL8 may play a role in the development of primary nephrotic syndrome hyperlipidemia and proteinuria.
Factors related to the practice of vacuum-assisted birth: findings from provider interviews in Kigoma, Tanzania
Authors: Dominico Sunday , Kasanga Mkambu , Mwakatundu Nguke , Chaote Paul , Lobis Samantha , Bailey Patricia E.
Published: April 2021

Background

Vacuum-assisted birth is not widely practiced in Tanzania but efforts to re-introduce the procedure suggest some success. Few studies have targeted childbirth attendants to learn how their perceptions of and training experiences with the procedure affect practice. This study explores a largely rural cohort of health providers to determine associations between recent practice of the procedure and training, individual and contextual factors.

Methods

A cross-sectional knowledge, attitudes and practice survey of 297 providers was conducted in 2019 at 3 hospitals and 12 health centers that provided comprehensive emergency obstetric care. We used descriptive statistics and binary logistic regression to model the probability of having performed a vacuum extraction in the last 3 months.

Results

Providers were roughly split between working in maternity units in hospitals and health centers. They included: medical doctors, assistant medical officers (14%); clinical officers (10%); nurse officers, assistant nurse officers, registered nurses (32%); and enrolled nurses (44%). Eighty percent reported either pre-service, in-service vacuum extraction training or both, but only 31% reported conducting a vacuum-assisted birth in the last 3 months. Based on 11 training and enabling factors, a positive association with recent practice was observed; the single most promising factor was hands-on solo practice during in-service training (66% of providers with this experience had conducted vacuum extraction in the last 3 months). The logistic regression model showed that providers exposed to 7–9 training modalities were 7.8 times more likely to have performed vacuum extraction than those exposed to fewer training opportunities (AOR = 7.78, 95% CI: 4.169–14.524). Providers who worked in administrative councils other than Kigoma Municipality were 2.7 times more likely to have conducted vacuum extraction than their colleagues in Kigoma Municipality (AOR = 2.67, 95% CI: 1.023–6.976). Similarly, providers posted in a health center compared to those in a hospital were twice as likely to have conducted a recent vacuum extraction (AOR = 2.11, 95% CI: 1.153–3.850), and finally, male providers were twice as likely as their female colleagues to have performed this procedure recently (AOR = 1.95, 95% CI: 1.072–3.55).

Conclusions

Training and location of posting were associated with recent practice of vacuum extraction. Multiple training modalities appear to predict recent practice but hands-on experience during training may be the most critical component. We recommend a low-dose high frequency strategy to skills building with simulation and e-learning. A gender integrated approach to training may help ensure female trainees are exposed to critical training components.
The risk of clinical complications and death among pregnant women with COVID-19 in the Cerner COVID-19 cohort: a retrospective analysis
Authors: Qeadan Fares , Mensah Nana A. , Tingey Benjamin , Stanford Joseph B.
Published: April 2021

Background

Pregnant women are potentially a high-risk population during infectious disease outbreaks such as COVID-19, because of physiologic immune suppression in pregnancy. However, data on the morbidity and mortality of COVID-19 among pregnant women, compared to nonpregnant women, are sparse and inconclusive. We sought to assess the impact of pregnancy on COVID-19 associated morbidity and mortality, with particular attention to the impact of pre-existing comorbidity.

Methods

We used retrospective data from January through June 2020 on female patients aged 18–44 years old utilizing the Cerner COVID-19 de-identified cohort. We used mixed-effects logistic and exponential regression models to evaluate the risk of hospitalization, maximum hospital length of stay (LOS), moderate ventilation, invasive ventilation, and death for pregnant women while adjusting for age, race/ethnicity, insurance, Elixhauser AHRQ weighted Comorbidity Index, diabetes history, medication, and accounting for clustering of results in similar zip-code regions.

Results

Out of 22,493 female patients with associated COVID-19, 7.2% (n = 1609) were pregnant. Crude results indicate that pregnant women, compared to non-pregnant women, had higher rates of hospitalization (60.5% vs. 17.0%,P < 0.001), higher mean maximum LOS (0.15 day vs. 0.08 day,P < 0.001) among those who stayed < 1 day, lower mean maximum LOS (2.55 days vs. 3.32 days,P < 0.001) among those who stayed ≥1 day, and higher moderate ventilation use (1.7% vs. 0.7%,P < 0.001) but showed no significant differences in rates of invasive ventilation or death. After adjusting for potentially confounding variables, pregnant women, compared to non-pregnant women, saw higher odds in hospitalization (aOR: 12.26; 95% CI (10.69, 14.06)), moderate ventilation (aOR: 2.35; 95% CI (1.48, 3.74)), higher maximum LOS among those who stayed < 1 day, and lower maximum LOS among those who stayed ≥1 day. No significant associations were found with invasive ventilation or death. For moderate ventilation, differences were seen among age and race/ethnicity groups.

Conclusions

Among women with COVID-19 disease, pregnancy confers substantial additional risk of morbidity, but no difference in mortality. Knowing these variabilities in the risk is essential to inform decision-makers and guide clinical recommendations for the management of COVID-19 in pregnant women.
Cystic fibrosis in disguise – the wolf in sheep’s clothing, a case report
Authors: Wilbert Friederike , Grünert Sarah C. , Heinzmann Andrea , Bode Sebastian F. N.
Published: April 2021

Background

Childhood hypoglycemia in combination with hepatomegaly is suspicious for inborn errors of metabolism. Cystic fibrosis typically presents with failure to thrive, pulmonary and gastrointestinal symptoms. Hepatic involvement and hypoglycemia can occur in a significant number of patients, although hepatomegaly is uncommon.

Case presentation

A 28 months old boy was presented with recurrent upper airways infections, progressive lethargy and weight loss. Clinically hepatomegaly was the main presenting feature and hypoglycemia (minimum 1.4 mmol/l) was noted as were elevated transaminases. The patient did not produce enough sweat to analyze it. Infectious causes for hepatitis were excluded and a broad metabolic work-up initiated. A therapy with starch was initiated to control hypoglycemia. In further course loose stools were reported and pancreatic elastase was found to be reduced. A further sweat test yielded pathological chloride concentration and genetic testing confirmed the diagnosis of cystic fibrosis.

Conclusions

Cystic fibrosis is a systemic disease and less common presentations need to be considered. Even in the age of CF-newborn screening in many countries CF needs to be ruled out in typical and atypical clinical presentations and diagnostics need to be repeated if inconclusive.
Occupational lifting and risk of hypertension, stratified by use of anti-hypertensives and age - a cross-sectional and prospective cohort study
Authors: Korshøj Mette , Hannerz Harald , Frikke-Schmidt Ruth , Marott Jacob L. , Schnohr Peter , Clays Els , Holtermann Andreas
Published: April 2021

Background

Heavy occupational lifting is prevalent in the general working population and is sparsely reported to associate with hypertension, especially among older and hypertensive workers. We investigated if heavy occupational lifting is associated with hypertension and blood pressure (BP) in both cross-sectional and prospective study designs in the Copenhagen General Population Study, stratified by age, and use of anti-hypertensives.

Methods

Participation was conducted following the declaration of Helsinki and approved by the ethical committee (H-KF-01-144/01). By multivariable logistic and linear regression models, we investigated the association between heavy occupational lifting and hypertension, in a cross-sectional design (n = 67,363), using anti-hypertensives or BP ≥140/≥90 mmHg as outcome, and in a prospective design (n = 7020) with an above-median change in systolic BP (SBP) from baseline to follow-up and/or a shift from no use to use of anti-hypertensives as outcome, with and without stratification by age and use of anti-hypertensives.

Results

The odds ratio for hypertension was estimated at 0.97 (99% CI: 0.93–1.00) in the cross-sectional analysis, and at 1.08 (99% CI: 0.98–1.19) in the prospective analysis. The difference in SBP among workers with versus without heavy occupational lifting was estimated at − 0.29 mmHg (99% CI -0.82 – 0.25) in the cross-sectional and at 1.02 mmHg (99% CI -0.41 – 2.45) in the prospective analysis. No significant interaction between heavy occupational lifting and age, nor use of anti-hypertensives were shown.

Conclusions

Only the prospective analysis indicated heavy occupational lifting to increase the risk of hypertension. Further research on the association between occupational lifting and hypertension are needed.
Modeling of suppression and mitigation interventions in the COVID-19 epidemics
Authors: Han Yuexing , Xie Zeyang , Guo Yike , Wang Bing
Published: April 2021

Background

The global spread of the COVID-19 pandemic has become the most fundamental threat to human health. In the absence of vaccines and effective therapeutical solutions, non-pharmaceutic intervention has become a major way for controlling the epidemic. Gentle mitigation interventions are able to slow down the epidemic but not to halt it well. While strict suppression interventions are efficient for controlling the epidemic, long-term measures are likely to have negative impacts on economics and people’s daily live. Hence, dynamically balancing suppression and mitigation interventions plays a fundamental role in manipulating the epidemic curve.

Methods

We collected data of the number of infections for several countries during the COVID-19 pandemics and found a clear phenomenon of periodic waves of infection. Based on the observation, by connecting the infection level with the medical resources and a tolerance parameter, we propose a mathematical model to understand impacts of combining intervention measures on the epidemic dynamics.

Results

Depending on the parameters of the medical resources, tolerance level, and the starting time of interventions, the combined intervention measure dynamically changes with the infection level, resulting in a periodic wave of infections controlled below an accepted level. The study reveals that, (a) with an immediate, strict suppression, the numbers of infections and deaths are well controlled with a significant reduction in a very short time period; (b) an appropriate, dynamical combination of suppression and mitigation may find a feasible way in reducing the impacts of epidemic on people’s live and economics.

Conclusions

While the assumption of interventions deployed with a cycle of period in the model is limited and unrealistic, the phenomenon of periodic waves of infections in reality is captured by our model. These results provide helpful insights for policy-makers to dynamically deploy an appropriate intervention strategy to effectively battle against the COVID-19.
Higher maternal BMI early in pregnancy is associated with overweight and obesity in young adult offspring in Thailand
Authors: Ounjaijean Sakaewan , Wongthanee Antika , Kulprachakarn Kanokwan , Rerkasem Amaraporn , Pruenglampoo Sakda , Mangklabruks Ampica , Rerkasem Kittipan , Derraik José G. B.
Published: April 2021

Background

Rates of overweight and obesity among women of reproductive age have been steadily increasing worldwide and in Thailand. There is mounting evidence that maternal obesity during pregnancy is associated with an increased risk of obesity and other adverse health outcomes in the offspring, but such data are lacking for Thailand. We examined the associations between maternal body mass index (BMI) and anthropometry (particularly the likelihood of obesity) and cardiometabolic parameters in young adult offspring.

Methods

This was a prospective follow-up study of a birth cohort in Chiang Mai (Thailand). Pregnant women carrying singletons were recruited at their first antenatal visit (< 24 weeks of gestation) and followed until delivery in 1989–1990. Participants were their young adult offspring followed up in 2010. Maternal BMI was recorded at the first antenatal visit. The offspring underwent clinical assessments, including anthropometry, lipid profile, insulin sensitivity (HOMA-IR), blood pressure, and carotid intima-media thickness. The primary outcome of interest was the likelihood of obesity in the offspring.

Results

We assessed 628 young adults (54% were females) at 20.6 ± 0.5 years of age (range 19.1–22.1 years). The young adult offspring of mothers with overweight/obesity was 14.1 kg (95%CI 9.7, 18.5; p < 0.0001) and 9.4 kg (95% CI 6.1, 12.8; p < 0.0001) heavier than those born to mothers with underweight or normal weight, respectively, and had BMI 3.46 kg/m2 (95%CI 2.26, 4.67; p < 0.0001) and 5.27 kg/m2 (95%CI 3.67, 8.68; p < 0.0001) greater, respectively. For every 1-kg/m2 increase in maternal BMI, the adjusted odds ratio (aOR) of offspring obesity was 25% greater (95%CI 1.10, 1.42; p < 0.001). Thus, the aOR of obesity in offspring of mothers with overweight/obesity was 4.6 times greater (95%CI 1.86, 11.26; p < 0.001) and nearly 17-fold greater (95%CI 1.96, 146.4; p = 0.010) compared to young adults born to mothers with normal weight or underweight, respectively. There were no observed associations between maternal BMI status and offspring metabolism or blood pressure.

Discussion

Maternal overweight/obesity early in pregnancy was associated with increased BMI and greater odds of obesity in their young adult offspring in Thailand. These findings highlight the public health importance of fostering healthier lifestyle choices among women of reproductive age.
Analysis of work-related accidents and ill-health in Brazil since the introduction of the accident prevention factor
Authors: Shimizu Helena Eri , Bezerra Josierton Cruz , Arantes Luciano José , Merchán-Hamann Edgar , Ramalho Walter
Published: April 2021

Background

Since 2004, Brazil has had a national policy for occupational health and safety. This policy means companies’ tax burden is altered according to the numbers of work-related accidents and ill-health amongst their workers. In 2010, a multiplication factor was introduced to this policy, called the Accident Prevention Factor. The idea of this new multiplication factor is to encourage individual employers to take initiatives to prevent accidents and ill health in the workplace. This study was designed to investigate the incidence of work-related accidents and ill-health in Brazil according to their causes, their severity, and the economic activity in which they occur, and to compare the data before and after the introduction of the Accident Prevention Factor.

Methods

An ecological study was conducted by analyzing the time series of work-related accidents/ill-health between 2008 and 2014 from the Brazilian social security system (Previdência Social) statistical yearbooks. Incidences were calculated per cause, economic activity, and severity of the accident/ill-health. Data from before and after the introduction of the Accident Prevention Factor were compared using the Mann-Whitney test per cause and per economic activity. Statistical analyses were made using the SPSS software, with significance set at 5%.

Results

A reduction in the incidence of work-related accidents/ill-health was found across all the groups of causes analyzed, except for the groups “external causes of morbidity and mortality” and “factors influencing health status and contact with health services.” Greater reductions were found for diseases of the musculoskeletal system and connective tissue and diseases of the nervous system. Reductions in work-related accidents/ill-health were found in the different economic activities and in the different severity groups. The highest reduction after the introduction of the Accident Prevention Factor was in manufacturing and production (p < 0.05).

Conclusions

Overall, the incidence of accidents/ill-health was found to be on decline, except those with external causes of morbidity and mortality and those involving factors influencing health status and contact with health services. The biggest reduction was found in manufacturing and production. However, generally speaking progress still needs to be made in accident prevention and occupational health across a whole range of work environments.
Prevalence and factors associated with alcohol consumption among persons with diabetes in Kampala, Uganda: a cross sectional study
Authors: Salama Maki Sifa , Isunju Jonh Bosco , David Salama Kaishusha , Muneza Fiston , Ssemanda Sylvester , Tumwesigye Nazarius Mbona
Published: April 2021

Background

The prevalence of diabetes has been rising increasing rapidly in middle- and low-income countries. In Africa, the World Health Organization projections anticipate diabetes mellitus to be the seventh leading cause of death in by 2030. Alcohol consumption influences diabetes evolution, in such a way that it can interfere with self-care behaviours which are important determinants of diabetes prognosis. In this study, we evaluated factors associated with alcohol consumption among persons with diabetes in Kampala to inform management policies and improve comprehensive diabetes care.

Methodology

A cross-sectional study was conducted systematically among 290 adults with diabetes, attending diabetic clinics at Mulago National Referral Hospital and St Francis Hospital Nsambya. Data were entered and analysed in Epi-Info version 7 and STATA 13 software. Modified Poisson regression was used to identify factors associated with alcohol consumption among persons with diabetes. All tests were two-sided and the significance level for all analyses was set to p < 0.05.

Results

The prevalence of alcohol consumption among persons with diabetes was 23.45% [95% CI: 18.9–28.7%]. Divorced, separated and widowed patients (Adj PR: 0.42, 95% CI: 0.21–0.83); and Protestant (Adj PR: 0.44, 95% CI: 0.24–0.82); Muslim (Adj PR: 0.30, 95% CI: 0.14–0.62); and Pentecostal (Adj PR: 0.32, 95% CI: 0.15–0.65) patients were less likely to consume alcohol. Diabetic patients who had a diabetes duration greater than 5 years were more likely to consume alcohol (Adj PR: 1.90, 95% CI: 1.25–2.88).

Conclusion

Approximately one-quarter of participants consumed alcohol. However being catholic, never being married and having diabetes for more than 5 years predisposed persons with diabetes to alcohol consumption. Sensitization messages regarding alcohol consumption among persons with diabetes should be target patients who have never been married and those who have spent more than 5 years with diabetes; religion should also be considered as an important venue for health education in the community.
The effect of cognition and affect on preventive behaviors during the COVID-19 pandemic: a cross-sectional study in China
Authors: Shen Fei , Min Chen , Lu Ye , Chu Yajie
Published: April 2021

Background

The global outbreak of COVID-19 has become an international public health crisis. Specific antiviral treatments for COVID-19 are not yet available, and prevention is of particular importance to fight the virus. This study tends to explore and compare the roles of cognitive and affective factors in predicting preventive behavior adoption during the COVID-19 pandemic in China.

Methods

An online survey using a quota sampling method to collect responses from 3000 Chinese adults was conducted from March 2, 2020 to March 23, 2020. Questions included sociodemographic features, coronavirus knowledge, negative emotion, risk perception, and behavioral responses. Multiple regression analyses were conducted to examine the predictors of behavioral responses toward COVID-19.

Results

On average, respondents had low levels of knowledge about COVID-19 (the overall correct response rate was 7.5%). Most respondents reported moderate to strong negative emotions towards the virus (3.47 out of 5). The average reported perceived chance of infection was 23.89%. For behavioral responses, respondents reported low frequencies of going out for activities (1.98 out of 4) and high frequencies of taking preventive measures (3.22 out of 4). Behavioral responses toward COVID-19 were found to be determined by cognitive and affective variables. Knowledge was negatively related to frequency of going out for activities (β = − 0.11, p < .001). Negative emotion (β = 0.34, p < .001), and risk perception (β = 0.05, p = .007) were positively associated with going out for activities. The explanatory power of affective variables (ΔR2 = 12.1%) was greater than cognitive variables (ΔR2 = 1.0%). For preventive behaviors, knowledge was positively associated with preventive behaviors (β = 0.22, p < .001). Negative emotion (β = − 0.28, p < .001) and risk perception (β = − 0.05, p = .002) were all negatively associated with preventive measures. Affective variables still showed stronger explanatory power (ΔR2 = 8%) than cognitive variables (ΔR2 = 4.4%) in predicting preventive behaviors.

Conclusions

After the rising period of the COVID-19 outbreak in mainland China, cognitive and affective variables still played important roles in predicting behavioral responses. Compared with cognitive factors, affective factors demonstrated stronger explanatory power in predicting behavioral responses toward COVID-19. The findings may have implications for enhancing individual compliance with guidelines of adopting preventive behaviors in response to COVID-19.
Risk stratification scores for hospitalization duration and disease progression in moderate and severe patients with COVID-19
Authors: Huang Jiaqi , Xu Yu , Wang Bin , Xiang Ying , Wu Na , Zhang Wenjing , Xia Tingting , Yuan Zhiquan , Li Chengying , Jia Xiaoyue , Shan Yifan , Chen Menglei , Li Qi , Bai Li , Li Yafei
Published: April 2021

Background

During outbreak of Coronavirus Disease 2019 (COVID-19), healthcare providers are facing critical clinical decisions based on the prognosis of patients. Decision support tools of risk stratification are needed to predict outcomes in patients with different clinical types of COVID-19.

Methods

This retrospective cohort study recruited 2425 patients with moderate or severe COVID-19. A logistic regression model was used to select and estimate the factors independently associated with outcomes. Simplified risk stratification score systems were constructed to predict outcomes in moderate and severe patients with COVID-19, and their performances were evaluated by discrimination and calibration.

Results

We constructed two risk stratification score systems, named as STPCAL (including significant factors in the prediction model: number of clinical symptoms, the maximum body temperature during hospitalization, platelet count, C-reactive protein, albumin and lactate dehydrogenase) and TRPNCLP (including maximum body temperature during hospitalization, history of respiratory diseases, platelet count, neutrophil-to-lymphocyte ratio, creatinine, lactate dehydrogenase, and prothrombin time), to predict hospitalization duration for moderate patients and disease progression for severe patients, respectively. According to STPCAL score, moderate patients were classified into three risk categories for a longer hospital duration: low (Score 0–1, median = 8 days, with less than 20.0% probabilities), intermediate (Score 2–6, median = 13 days, with 30.0–78.9% probabilities), high (Score 7–9, median = 19 days, with more than 86.5% probabilities). Severe patients were stratified into three risk categories for disease progression: low risk (Score 0–5, with less than 12.7% probabilities), intermediate risk (Score 6–11, with 18.6–69.1% probabilities), and high risk (Score 12–16, with more than 77.9% probabilities) by TRPNCLP score. The two risk scores performed well with good discrimination and calibration.

Conclusions

Two easy-to-use risk stratification score systems were built to predict the outcomes in COVID-19 patients with different clinical types. Identifying high risk patients with longer stay or poor prognosis could assist healthcare providers in triaging patients when allocating limited healthcare during COVID-19 outbreak.
Use of the supraclavicular artery island flap for reconstruction of maxillofacial defects: a case report and literature review
Authors: Sheng J. F. , Tang P. , Ma L. Y. , Cai Y. C. , Hu J. , Xu T. , Liao C. L. , Deng C. , Li C.
Published: April 2021

Background

Free flaps are widely used in maxillofacial reconstruction; however, this approach was not feasible in the current case. It was not possible because the free flap method requires microvascular anastomosis expertise, which is difficult, time-consuming and costly.

Case presentation

An 86-year-old woman suffered squamous cell carcinoma on the right side of her face, which resulted in a large soft-tissue defect. Here, we present a case of facial reconstruction from the inferior margin of the jaw to the top of the head. The size of the defect was 18.5 cm × 7.5 cm, which is rare for a patient of this age in the maxillofacial area. We used the supraclavicular artery island flap (SCAIFP) which measured 19.3 cm × 8.3 cm to repair the defect. After the operation, the flap survived without complications. Then, the patient was followed for 10 months and was satisfied with the aesthetic and functional results at the donor and recipient sites following the tumour resection. The tumour did not recur, and facial nerve function was preserved.

Conclusion

Our results provide a new choice for the reconstruction of large defects of the head and face, and expand the potential applications of the SCAIFP.
Lung Adenocarcinoma with Metachronous Ovarian Metastasis: a long survival case report
Authors: Yao Shuyang , Wang Leiming , Tian Xiaoru , Zhang Yi
Published: April 2021

Background

Lung adenocarcinoma which invades ovaries is very rare. However, with the increase of long-survival female lung cancer, more patients will suffer ovarian metastasis. On grounds of the paucity of reported cases, the clinicopathological features and treatment strategies remain unknown.

Case presentation

This patient was stage IV lung adenocarcinoma at first diagnosis. Following multiple-line systemic treatments, she experienced extensive pelvic metastasis. After debulking surgery and reevaluation about the drive genes, she was administered by targeted therapy. Up to now, the patient has shown no evidence of progression for 8 years after the initial diagnosis of primary lung cancer and 46 months after her ovarian metastasis.

Conclusion

The comprehensive treatment modality for the bilateral ovarian metastasis is effective in clinical course.