bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of human papillomavirus genotyping for detecting high-grade intraepithelial neoplasia or cancer in HPV-positive women with normal cytology: a study from a hospital in northeastern China
Authors: Zhang Jing , Zhang Deyu , Yang Zhuo , Wang Xiaobin , Wang Danbo
Published: May 2020

Background

Human papillomavirus (HPV) testing is more sensitive than cytology for detecting cervical cancer and its precursors. This study aimed to analyze the prevalence of high-risk HPV genotypes and evaluate the role of HPV genotyping triage for detecting high-grade squamous intraepithelial lesions, adenocarcinoma in situ and cervical cancer (HSIL+) in HPV-positive women with normal cytology.

Methods

A retrospective study was performed in women who had undergone co-screening at the China Medical University-affiliated Shengjing Hospital between 2012 and 2014.

Results

Of the 34,587 women, 2665 HPV-positive women with normal cytology who had received colposcopy were eligible for analysis. In HSIL+ groups of 204 women, the common genotypes were HPV16, HPV52, HPV58, HPV33, HPV31 and HPV18 in order of prevalence. The proportion of histological HSIL+ in women infected with HPV33 or HPV31 was not significantly different compared to women infected with HPV16 (P = 0.30, P = 0.19, respectively). The odds ratios for histological HSIL+ were 3.26 (95% confidence interval [CI]: 2.41–4.40) in women with HPV16/18, 4.21 (95% CI: 2.99–5.93) in those with HPV16/18/31/33, and 5.73 (95% CI: 3.30–9.97) in those with HPV16/18/31/33/52/58. Including HPV31/33 genotyping together with HPV16/18 significantly increased the proportion of HSIL+ detection from 63.2 to 77.5% (P = 0.002) without significantly increasing the colposcopy per HSIL+ detection ratio (7.7 to 8.1, P = 0.66).

Conclusions

HPV genotyping played an important role in managing HPV-positive women with normal cytology. Genotyping for HPV31/33 should be added to the previously recommended HPV16/18 genotyping in triaging HPV-positive women in northeastern China.
Multiple HPV 16 infection with two strains: a possible marker of neoplastic progression
Authors: Bruno Maria Teresa , Scalia Guido , Cassaro Nazario , Boemi Sara
Published: May 2020

Background

We studied the cases of single and multiple HPV infection and analyzed the correlation with negative cases, and preneoplastic and neoplastic lesions of the uterine cervix with the aim of making a contribution to the prognostic factor under discussion.

Methods

Nine hundred nine women undergoing second level screening because they had been positive at cervical cytology were enrolled.

All the patients underwent colposcopy and cervical biopsy with viral genotyping. We divided mHPV infection based on the number of genotypes present: infections with 2 strains, 3 strains, 4 strains and 5 or more strains.

Statistical analysis

The analysis of the data was made using the χ2 test. Contingency tables were created to evaluate the correlation between single, multiple and CIN2+ infections. Values with p < 0.05 were considered statistically significant.

Results

The presence of genotype HPV16 in our study was associated with a 12 times greater risk of developing a high-grade lesion, OR = 12.70. The patients with single infections had the highest incidence of CIN2+ (34.1%) with respect to those with multiple infections (10.6%).When we studied in the mHPV infection the prevalence of the combinations between the genotypes, we found that in mHPV16 infections, the combinations HPV16, 18 and HPV16, 31 were the most frequent (55.5%) in CIN3 lesion.

Conclusions

Our results suggest that single HPV infections have a greater risk of developing SCC with respect to multiple infections. Multiple HPV infections are relevant only in the first phase of the lesion (CIN1-CIN2), while they are absent in carcinomas, where infections are of a single genotype. In particular, among multiple infections, HPV16 infection with 2 HR genotypes is associated significantly with CIN2 / CIN3 (21/30) and has 4 times greater risk of developing a high-grade lesion. Thus, it is probable that only specific combinations of HPV (HPV16,18 - HPV 16,31) can be associated with a clinically significant impact, while other combinations can simply be correlated because of a common infection or diagnostic method used. Therefore, multiple HPV16 infections with two high-risk genotypes is a major risk of CIN2/CIN3.
Exploratory analysis of immune checkpoint receptor expression by circulating T cells and tumor specimens in patients receiving neo-adjuvant chemotherapy for operable breast cancer
Authors: Wesolowski Robert , Stiff Andrew , Quiroga Dionisia , McQuinn Christopher , Li Zaibo , Nitta Hiroaki , Savardekar Himanshu , Benner Brooke , Ramaswamy Bhuvaneswari , Lustberg Maryam , Layman Rachel M. , Macrae Erin , Kassem Mahmoud , Williams Nicole , Sardesai Sagar , VanDeusen Jeffrey , Stover Daniel , Cherian Mathew , Mace Thomas A. , Yu Lianbo , Duggan Megan , Carson William E.
Published: May 2020

Background

While combinations of immune checkpoint (ICP) inhibitors and neo-adjuvant chemotherapy (NAC) have begun testing in patients with breast cancer (BC), the effects of chemotherapy on ICP expression in circulating T cells and within the tumor microenvironment are still unclear. This information could help with the design of future clinical trials by permitting the selection of the most appropriate ICP inhibitors for incorporation into NAC.

Methods

Peripheral blood samples and/or tumor specimens before and after NAC were obtained from 24 women with operable BC. The expression of CTLA4, PD-1, Lag3, OX40, and Tim3 on circulating T lymphocytes before and at the end of NAC were measured using flow cytometry. Furthermore, using multi-color immunohistochemistry (IHC), the expression of immune checkpoint molecules by stromal tumor-infiltrating lymphocytes (TILs), CD8+ T cells, and tumor cells was determined before and after NAC. Differences in the percentage of CD4+ and CD8+ T cells expressing various checkpoint receptors were determined by a paired Student’s t-test.

Results

This analysis showed decreased ICP expression by circulating CD4+ T cells after NAC, including significant decreases in CTLA4, Lag3, OX40, and PD-1 (all p values < 0.01). In comparison, circulating CD8+ T cells showed a significant increase in CTLA4, Lag3, and OX40 (all p values < 0.01). Within tumor samples, TILs, CD8+ T cells, and PD-L1/PD-1 expression decreased after NAC. Additionally, fewer tumor specimens were considered to be PD-L1/PD-1 positive post-NAC as compared to pre-NAC biopsy samples using a cutoff of 1% expression.

Conclusions

This work revealed that NAC treatment can substantially downregulate CD4+ and upregulate CD8+ T cell ICP expression as well as deplete the amount of TILs and CD8+ T cells found in breast tumor samples. These findings provide a starting point to study the biological significance of these changes in BC patients.

Trial registration

NCT04022616.
Derivation and validation of a prognostic score for neonatal mortality in Ethiopia: a case-control study
Authors: Mediratta Rishi P. , Amare Ashenafi Tazebew , Behl Rasika , Efron Bradley , Narasimhan Balasubramanian , Teklu Alemayehu , Shehibo Abdulkadir , Ayalew Mulugeta , Kache Saraswati
Published: May 2020

Background

Early warning scores for neonatal mortality have not been designed for low income countries. We developed and validated a score to predict mortality upon admission to a NICU in Ethiopia.

Methods

We conducted a retrospective case-control study at the University of Gondar Hospital, Gondar, Ethiopia. Neonates hospitalized in the NICU between January 1, 2016 to June 31, 2017. Cases were neonates who died and controls were neonates who survived.

Results

Univariate logistic regression identified variables associated with mortality. The final model was developed with stepwise logistic regression. We created the Neonatal Mortality Score, which ranged from 0 to 52, from the model’s coefficients. Bootstrap analysis internally validated the model. The discrimination and calibration were calculated. In the derivation dataset, there were 207 cases and 605 controls. Variables associated with mortality were admission level of consciousness, admission respiratory distress, gestational age, and birthweight. The AUC for neonatal mortality using these variables in aggregate was 0.88 (95% CI 0.85–0.91). The model achieved excellent discrimination (bias-corrected AUC) under internal validation. Using a cut-off of 12, the sensitivity and specificity of the Neonatal Mortality Score was 81 and 80%, respectively. The AUC for the Neonatal Mortality Score was 0.88 (95% CI 0.85–0.91), with similar bias-corrected AUC. In the validation dataset, there were 124 cases and 122 controls, the final model and the Neonatal Mortality Score had similar discrimination and calibration.

Conclusions

We developed, internally validated, and externally validated a score that predicts neonatal mortality upon NICU admission with excellent discrimination and calibration.
Determinants of road traffic injuries in Iranian children; results from a National Representative Demographic- Health Survey 2010
Authors: Ghiasvand Hesam , Roshanfekr Payam , Ali Delaram , Ardakani Hossein Malekafzali , Stephens Amanda N. , Armoon Bahram
Published: May 2020

Background

Road Traffic Injuries (RTIs) are a leading cause of disabilities and mortalities in Iran. The occurrence of RTIs among children is increasing. This study aims are to assess RTIs among Iranian children and to determine the main socio-economics determinants.

Methods

The National Institute of Health Research (NIHR) in collaboration with the Iran Ministry of Health (MoH) conducted a nationwide survey: The Multiple Indicator Demographic and Health Survey 2010 (IrMIDHS 2010). The Survey was undertaken by Medical Universities in Iran. Based on multistage clustered randomized sampling, 30,960 households were included in the survey. We performed a multivariate logistic regression to determine the main socio-economic factors associated with RTIs among children.

Results

Approximately 0.9% of the children received RTIs in 2010. Main socio-economics contributors to RTIs involving Iranian children included household size (Adjusted OR: 1.06 (CI 95% 1.01, 1.14), sex (Adjusted ORfemale: 0.38 (CI 95% 0.29, 0.50), living with both parents (Adjusted OR: 0.55 (CI 95% 0.13, 0.95), being in the 2nd (Adjusted OR: 0.81 (CI 95%: 0.60, 0.90) or 4th income quartile (Adjusted OR: 0.13 (CI 95%: 0.02, 0.92) rather than the 1st income quartile, being aged five to nine (Adjusted OR: 1.39 (CI 95%: 1.10, 2.10), or aged 15 to 18 (Adjusted OR: 2.94 (CI 95%: 2.07, 4.97), and residency in a non- owned or non-tenancy house (Adjusted OR: 0.42 (CI 95%: 0.23 0.74).

Conclusions

Children need safe places for playing and doing their daily activities. Policy and regulation development aimed at protecting children from road traffic injuries needs to take into consideration the socio-economic factors associated with risk of road traffic injury among children.
Microbiological analyses of nasally guided catheters after less invasive surfactant administration – a pilot study
Authors: Maiwald Christian A. , Dick Julia , Marschal Matthias , Gille Christian , Franz Axel R. , Poets Christian F.
Published: May 2020

Background

Respiratory distress syndrome (RDS) is a frequent complication of premature birth. Treating RDS by continuous positive airway pressure and less invasive surfactant administration (LISA) may reduce bronchopulmonary dysplasia. Surfactant, however, can be inactivated by bacterial infection. Therefore, potential routes of microbe transmission into the airway are of interest. The aim of this study was to evaluate microbiological contamination of catheters used for LISA procedures and its association with postnatal age.

Methods

Catheter tips used for LISA procedures via the nasal route (LISA-n) in infants with RDS were placed into a sterile eSwab container directly after the procedure, cultured and examined for microbiological contamination.

Results

Interpretable results could be collected from 20 catheter tips. Four showed positive culture results (20%) with microbes potentially associated with the development of early onset neonatal sepsis. Risk of positive microbe detection increased with postnatal age (< 4 h: 10%; 4–18 h: 20%; > 18 h: 40%).

Conclusions

In this pilot study, the risk of tracheal microbe transmission following the LISA-n procedure increased with postnatal age. Although the clinical relevance of this finding is unclear, earlier surfactant administration might reduce the risk of catheter contamination.

Trial registration number

Substudy of the registered Trial: feasibility study – Neofact: NCT04086095, www.ClinicalTrials.gov, September 11, 2019.
Improving mental health literacy in year 9 high school children across Wales: a protocol for a randomised control treatment trial (RCT) of a mental health literacy programme across an entire country
Authors: Simkiss Nicola J. , Gray Nicola S. , Malone Greg , Kemp Andrew , Snowden Robert J.
Published: May 2020

Background

Adolescence is a crucial period for developing and maintaining good habits for mental health and well-being. This is important for future mental health, as most mental health problems manifest during adolescence. Mental health literacy is the foundation for mental health prevention, stigma reduction, and increased help-seeking efficacy particularly among adolescents. The mental health literacy programme “The Guide”, which was developed in Canada, has shown success in increasing mental health literacy in North American 16–17 year olds. “The Guide Cymru” is an adaptation of The Guide designed for a younger age group (13–14 year olds) and for the Welsh culture and context and is being offered to all state schools in Wales.

Methods

This two-armed cluster randomised control trial (RCT) will evaluate the effectiveness of The Guide Cymru. All 205 secondary schools in Wales will be invited to take part, involving up to 30,000 year 9 pupils. Schools will be randomised to either the immediate implementation of The Guide Cymru or to a wait-list control. The wait-list control will receive The Guide Cymru around 12 weeks later. Measures of mental health literacy (assessed via the Knowledge and Attitudes to Mental Health scale) and mental health problems (via the PedsQL and Strengths and Difficulties Questionnaire) will be taken at baseline (pre-intervention), 12 weeks later (after the active group has received The Guide Cymru), and 24 weeks later (after the wait-list control has received The Guide Cymru).

Discussion

The trial aims to evaluate if The Guide Cymru increases mental health literacy, including reduced stigma to others and to the self, and increased levels of good mental health behaviours and help-seeking for mental health problems.

Trial registration

ISRCTN15462041. Registered 03/10/2019.
HIV understanding, experiences and perceptions of HIV-positive men who have sex with men in Amazonian Peru: a qualitative study
Authors: Tattsbridge Jasmine , Wiskin Connie , de Wildt Gilles , Clavé Llavall Anna , Ramal-Asayag César
Published: May 2020

Background

HIV-related incidence and mortality is increasing across Peru, with highest mortality rates recorded in the Amazonian region of Loreto. This epidemic is concentrated in men who have sex with men, a population with 14% HIV treatment adherence despite free national provision. This study investigates barriers and facilitators to following healthcare advice through experiences and perceptions of HIV-positive men who have sex with men and healthcare professionals in Loreto.

Methods

Twenty qualitative interviews with HIV-positive men who have sex with men and one focus group with HIV-specialist healthcare professionals were conducted in Loreto, January–February 2019. Interviews were transcribed per verbatim. Thematic content analysis and deviant case analysis were used.

Results

A culture of isolation and discrimination was identified, propagated by poor public knowledge surrounding HIV transmission and treatment. Employment potential was hampered and 7/20 patients had suicidal thoughts post-diagnosis. Barriers to care included: shame, depression, travel cost/times, a preference for traditional plant-based medicine and side-effects of antiretroviral therapy. Facilitators included: education, family and clinic support, disease acceptance and lifestyle changes.

Conclusion

More effective, focussed community education and workplace discrimination investigations are recommended to reduce stigma and increase adherence to treatment in this population.
Spatial analysis of individual- and village-level sociodemographic characteristics associated with age at marriage among married adolescents in rural Niger
Authors: Shakya Holly B. , Weeks John , Challa Sneha , Fleming Paul J. , Cislaghi Beniamino , McDougal Lotus , Boyce Sabrina C. , Raj Anita , Silverman Jay G.
Published: May 2020

Background

Niger has the highest prevalence of child marriage in the world. While child marriage in Niger is clearly normative in the sense that it is commonly practiced, the social and contextual factors that contribute to it are still unclear.

Methods

Here, we tested the importance of village-level factors as predictors of young age at marriage for a group of married adolescent girls (N = 1031) in the Dosso district of rural Niger, using multi-level and geographic analyses. We aggregated significant individual level factors to determine whether, independent of a girl’s own sociodemographic characteristics, the impact of each factor is associated at the village level. Finally, we tested for spatial dependence and heterogeneity in examining whether the village-level associations we find with age at marriage differ geographically.

Results

The mean age of marriage for girls in our study was 14.20 years (SD 1.8). Our statistical results are consistent with other literature suggesting that education is associated with delayed marriage, even among adolescent girls. Younger ages at marriage are also associated with a greater age difference between spouses and with a greater likelihood of women being engaged in agricultural work. Consistent with results at the individual level, at the village level we found that the proportion of girls who do agricultural work and the mean age difference between spouses were both predictive of a lower age at marriage for individual girls. Finally, mapping age at marriage at the village level revealed that there is geographical variation in age at marriage, with a cluster of hot spots in the Hausa-dominated eastern area where age at marriage is particularly low and a cluster of cold spots in the Zarma-dominated western areas where age at marriage is relatively high.

Conclusions

Our findings suggest that large-scale approaches to eliminating child marriage in these communities may be less successful if they do not take into consideration geographically and socially determined contextual factors at the village level.
Reaching hard-to-reach men through home-based couple HIV testing among pregnant women and their male partners in western Kenya: a qualitative study
Authors: Krakowiak Daisy , Makabong’o Pamela , Goyette Marielle , Kinuthia John , Osoti Alfred Onyango , Asila Victor , Gone Molly Ann , Mark Jennifer , Farquhar Carey
Published: May 2020

Background

Globally only 79% of adults living with HIV (human immunodeficiency virus) know their status and men in sub-Saharan Africa are considered a particularly hard-to-reach population for HIV testing. Home-based HIV couple testing during the antenatal period is a safe and effective method that has been used to test male partners of pregnant women. The goal of this qualitative study was to identify elements that made couple testing successful and describe important characteristics of this home-based intervention from couples’ perspectives.

Methods

Couples who received scheduled home-based couple testing during pregnancy in Kisumu, Kenya, were purposively sampled based on HIV status from January to May 2015. An interviewer administered all of the in-depth interviews and two coders were directly involved in the data analysis and reconciled codes several times in the process.

Results

Twenty-one couples were enrolled: 9 concordant HIV-negative couples, 8 HIV discordant couples, 3 HIV concordant HIV-positive couples, and 1 whose concordance status was unknown. Median age at the time of home-based couple testing was 24 and 28 years for women and men, respectively. Median relationship duration was 3 years and couples had a median of two pregnancies. The major themes that emerged were that home-based couple testing 1) removed the female burden of requesting couple testing, 2) overcame logistical barriers associated with clinic-based testing, 3) encouraged participants to overcome their fear of testing and disclosure, 4) provided privacy in the home, and 5) provided quality time with the health advisors. Importantly, some women appreciated individual testing at the clinic before couple testing and some couples preferred skilled, anonymous health advisors delivering the intervention rather than known community health workers.

Conclusions

The results of this qualitative study suggest that home-based couple testing during pregnancy overcame many of the barriers that limit men’s access to and uptake of clinic-based testing. It encouraged participants to overcome their fear of testing and disclosure through a setting that afforded privacy and quality time with skilled health advisors. These qualitative results may help design effective partner and couple HIV testing programs in the antenatal setting and alongside or within other assisted partner notification services.

Trial Registration

Clinicaltrials.gov registry: NCT01784783. Registered prospectively on June 15, 2012.
Prevalence and healthcare seeking practice of work-related musculoskeletal disorders among informal sectors of hairdressers in Ethiopia, 2019: findings from a cross-sectional study
Authors: Mekonnen Tesfaye Hambisa , Kekeba Getachew Guteta , Azanaw Jember , Kabito Gebisa Guyasa
Published: May 2020

Background

Work-related musculoskeletal disorders (MSDs) are the major threats to public health, with a significant impact on workers, employers, and the general population. Musculoskeletal disorder related to work not only results in adverse health effects such as physical injury, disability, and a reduction in workers’ quality of life, but it also places immense burdens on the use of healthcare facilities and a substantial loss of productivity. The purpose of this research was to discover the prevalence and associated factors of work-related MSDs among hairdressers in Oromia Special Zone Surrounding Finfine, Ethiopia.

Methods

A cross-sectional survey was carried out between March and April 2019. We included a total of 699 hairdressers with a systematic random sampling technique. Work-related MSDs was evaluated with the standardized Nordic Musculoskeletal survey, and the survey was administered by the interviewer. We employed SPSS version 20 software to perform a bivariate and multivariate analysis. A p-value of < 0.05 was considered a significant association.

Results

In total, 652 hairdressers were interviewed with a response rate of 93.2%. Participants’ mean age was 33.19 (SD ± 9.639) years. The prevalence of work-related MSDs was 70.2% (N = 458) [95% CI (66.7, 73.9)] and 55.7% in the past 12-months and 7 days, respectively. The study showed the highest prevalence rate was observed in shoulder 53.7% (n = 350) followed by 53.4% (n = 348) neck and 53.2% (n = 347) low back. Of the participants, 33.4% (n = 153) perceived their pain to be severe whereas 28% (n = 128) a high disabling. Almost one-third (n = 187) of the respondents used healthcare services. Age [AOR = 2.73; 95% CI (2.55, 5.46)], work experience [AOR = 1.51; 95% CI (1.03, 2.20)], number of customers served per day [AOR = 2.35; 95% CI (1.35, 4.11)], and hours spent standing to make hair [AOR = 3.4; 95% CI (2.49, 7.77)] were significantly associated factors.

Conclusion

This study found work-related MSDs were prevalent among hairdressers, but the use of healthcare services remains low. Age, length of employment, number of customers served per day, and number of hours spent standing per day to make hair were significantly associated. Therefore, we recommend employers need to develop health and safety programs that account for factors related to the workplaces. The findings also demonstrate that health practitioners would encourage pain management procedures.
The relationship between individual characteristics and HIV-related stigma in adults living with HIV: medical monitoring project, Florida, 2015–2016
Authors: Williams Renessa , Cook Robert , Brumback Babette , Cook Christa , Ezenwa Miriam , Spencer Emma , Lucero Robert
Published: May 2020

Background

Human Immunodeficiency Virus (HIV) disproportionately affects the Southern United States, accounting for approximately 46% of people living with HIV. HIV-related stigma is recognized as a barrier to testing, treatment, and prevention efforts. However, little is known about HIV-related stigma experiences in Florida. Using data collected from the Florida Medical Monitoring Project, we sought to examine individual characteristics associated with HIV-related stigma.

Methods

We analyzed secondary data from the 2015–2016 Medical Monitoring Project in Florida (n = 603). Stigma was measured using the 10-item HIV Stigma Scale. Exploratory factor analysis of the HIV Stigma Scale revealed three subscales: negative self-image, anticipated, and personalized stigma. Bivariate and multivariate regression models were used to determine the individual characteristics associated with the HIV Stigma Scale.

Results

Multivariate analysis indicated that people with severe depression scores (OR: 3.13; CI: 1.38–7.13) and persons with disability (OR: 1.64; CI: 1.03–2.61) had significantly increased odds of higher overall stigma. In the subscale analyses, negative self-image was significantly associated with alcohol misuse (OR: 2.02; CI: 1.15–3.56) depression (OR: 2.81; CI: 1.38–5.72) and/or those who identify as homosexual (OR: 0.54; CI: 0.31–0.93). Anticipated stigma was significantly associated with people who had mild-moderate depression (OR: 3.03; CI: 1.20–7.65), severe depression (OR: 2.87; CI: 1.38–5.98), identified as Black (OR: 0.60; CI: 0.37–0.98), non-injection drug use (OR: 0.55; CI: 0.33–0.91), and/or people aged 50 years and older (OR: 0.28; CI: 0.09–0.82). Personalized stigma was not associated with any of the variables examined.

Conclusions

The implications of these findings reveal that certain individuals are more vulnerable to stigma. Researchers could consider distinct stigma interventions strategies based on the characteristics of specific individuals (i.e., targeting depression, disability, sexual orientation, avoidant coping, racial/ethnic groups, and youth) in Florida.
Multiple-scale spatial analysis of paediatric, pedestrian road traffic injuries in a major city in North-Eastern Iran 2015–2019
Authors: Shabanikiya Hamidreza , Hashtarkhani Soheil , Bergquist Robert , Bagheri Nasser , VafaeiNejad Reza , Amiri-Gholanlou Malihe , Akbari Toktam , Kiani Behzad
Published: May 2020

Background

Paediatric, pedestrian road traffic injuries (PPRTIs) constitute a major cause of premature death in Iran. Identification of high-risk areas would be the primary step in designing policy intervention for PPRTI reduction because environmental factors play a significant role in these events. The present study aims to determine high-risk areas for PPRTIs at three different geographical scales, including the grid network, the urban neighbourhood and the street levels in Mashhad, Iran during the period 2015–2019.

Methods

This cross-sectional retrospective study was based on all pedestrian accidents with motor vehicles involving children (less than 18 years of age) between March 2015 and March 2019 in the city of Mashhad, which is the second-most populous city in Iran. The Anselin Local Moran’s I statistic and Getis-Ord Gi* were performed to measure spatial autocorrelation and hotspots of PPRTIs at the geographical grid network and neighbourhood level. Furthermore, a spatial buffer analysis was used to classify the streets according to their PPRTI rate.

Results

A total of 7390 PPRTIs (2364 females and 4974 males) were noted during the study period. The children’s mean age was 9.7 ± 5.1 years. Out of the total PPRTIs, 43% occurred on or at the sides of the streets, 25 of which labelled high-risk streets. A high-high cluster of PPRTI was discovered in the eastern part of the city, while there was a low-low such cluster in the West. Additionally, in the western part of the city, older children were more likely to become injured, while in the north-eastern and south-eastern parts, younger children were more often the victims.

Conclusions

Spatial analysis of PPRTIs in an urban area was carried out at three different geographical scales: the grid network, the neighbourhood and the street level. The resulting documentation contributes reliable support for the implementation and prioritization of preventive strategies, such as improvement of the high-risk streets and neighbourhoods of the city that should lead to decreasing numbers of PPRTIs.
Results of 198 primary total hip arthroplasties using the Delta PF-FIT system with ceramic-on-ceramic articulating surfaces with average seven years follow up
Authors: Fulin Petr , Pokorny David , Hert Jan , Sosna Antonin
Published: May 2020

Background

The lifetime implants is a key parameter that the surgeon should take into account at the time of the primary total hip arthroplasty (THA). The aim of this study was a clinical and radiographical evaluation of the Delta PF-FIT (LimaCorporate, Italy) THA system with ceramic-on-ceramic articulations. We have not found a clinical or radiographical assessment of this implant in available published literature.

Methods

A total of 197 (F = 94, M = 103) primary THAs were evaluated in 163 patients with a mean follow-up of 7.7 years (range 5.1–11.2 years (SD ± 1.5)) Harris hip Score (HHS) and the Western Ontario and McMaster Universities Arthritis index (WOMAC) were used for the clinical evaluation. The statistical evaluation was processed by standard statistical methods. The study was approved by Ethic Committee of the University Hospital Motol (Reference No. EK-73/19).

Results

The mean HHS score was found to be 97.59 points (61–100 range with a ± 5.13 SD, preoperative HSS was 51.21, range 28–73 with a ± 4,77 SD). 186 THAs were evaluated as excellent (90–100 points), 9 THAs rated as good (80–89 points), 1 THA was rated as fair (70–79) points and 1 THA rated as poor (less than 70 points). The mean WOMAC score was 97.38 points (65–100 range with a ± 5.18 SD, preoperative was 50,12, range 27–69 with a ± 4.85 SD). We documented an overall 99.49% Kaplan-Meier survival with a mean follow-up of 7.7 years with the FIT (LimaCorporate) stem revision and any component revision as the endpoint. With the Delta PF (LimaCorporate) cup revision as the endpoint, the survival was 100%. We have not found a previously published clinical or radiographical review of this THA system, the study shows a comparison with other THA implants.

Conclusion

Evaluation of the Delta-PF-FIT (LimaCorporate, Italy) THA system with the use of ceramic-on-ceramic BIOLOX®Delta articulation surfaces shows very good outcomes.
The association between denture self-satisfaction rates and OHRQoL - a follow-up study
Authors: Teng Chia-Jen , Lin Sheng-Che , Chen Jen-Hao , Chen Yi , Kuo Hsiao-Ching , Ho Pei-Shan
Published: May 2020

Backgroud

The objectives of this study were to try to identify the key dimension in satisfaction from the combination of satisfaction clusters, and its effect on the change of OHRQoL(Oral Health-related Quality of Life) of elderly denture users.

Methods

This follow-up study was conducted in subjects aged 65 years and over. All participants (n = 2128) completed questionnaires before and approximately 6 months after receiving complete denture. Information obtained by questionnaire included demographic characteristics, patients’ self-satisfaction rate and OHRQoL. The 6 satisfaction dimensions (including speaking, stability, esthetic, chewing, doctor and general dimensions) were classified as 5 cluster groups, which is the group of not at all satisfied in all dimensions (NAS); only satisfied with doctor and general dimensions(SDG); moderate satisfaction group(MS); quite satisfied group(QS); the highly satisfied group(HS) by an analysis of PCA (Principle component analysis) and CA (cluster analysis). Multiple linear regression was adapted to estimate the association between satisfaction and the responsiveness of OHIP-7T (Oral Health Impact Profile).

Results

When compared to the cluster “NAS”, the greatest improvement of OHRQoL after treatment was found in the group “HS” (β = 7.31(6.26–8.36), followed by group “QS” (β = 4.71(3.54–5.87)), group “MS” (β = 4.33(2.92–5.74)) and group “SDG” (β = 3.25(2.10–4.41)). An increasing trend was detected in patient-rating satisfaction and OHRQoL. The satisfaction cluster group is an important factor of OHRQoL after adjusting for other confounders.

Conclusion

Psychological-related aspects is the greatest impacting dimension on OHRQoL among denture wearers in Taiwan elderly. Better communication from the dental professional team with denture patients would improve their OHRQoL.
Polygonum multiflorum extract support hair growth by elongating anagen phase and abrogating the effect of androgen in cultured human dermal papilla cells
Authors: Shin Jae Young , Choi Yun-Ho , Kim Jaeyoon , Park Se Young , Nam You Jin , Lee So Young , Jeon Jeong Hoon , Jin Mu Hyun , Lee Sanghwa
Published: May 2020

Background

Dermal papilla cells (DPCs) play a key role in hair growth among the various cell types in hair follicles. Especially, DPCs determine the fate of hair follicle such as anagen to telogen transition and play a pivotal role in androgenic alopecia (AGA). This study was performed to elucidate the hair growth promoting effects of Polygonum multiflorum extract (PM extract) in cultured human DPCs and its underlying mechanisms.

Methods

The effects of PM extract on cultured DPCs were investigated. Cell viability and mitochondrial activity were measured by CCK-8 and JC-1 analysis, respectively. Western blotting, dot blotting, ELISA analysis, immunocytochemistry and real-time PCR analysis were also performed to elucidate the changes in protein and mRNA levels induced by PM extract. 3D cultured DPC spheroids were constructed for mimicking the in vivo DPs. The hair growth stimulatory effect of PM extract was evaluated using human hair follicle organ culture model.

Results

PM extract increased the viability and mitochondrial activity in cultured human DPCs in a dose dependent manner. The expression of Bcl2, an anti-apoptotic protein expressed dominantly in anagen was significantly increased and that of BAD, a pro-apoptotic protein expressed in early catagen was decreased by PM extract in cultured DPCs and/or 3D DPC spheroid culture. PM extract also decreased the expression of catagen inducing protein, Dkk-1. Growth factors including IGFBP2, PDGF and VEGF were increased by PM extract, revealed by dot blot protein analysis. We also have found that PM extract could reverse the androgenic effects of dihydrotestosterone (DHT), the most potent androgen. Finally, PM extract prolonged the anagen of human hair follicles by inhibiting catagen entry in human hair follicle organ culture model.

Conclusion

Our data strongly suggest that PM extract could promote hair growth by elongating the anagen and/or delaying the catagen induction of hair follicles through activation of DPCs.
Clinical reasoning for acute dyspnoea: comparison between final-year medical students from discipline- and competency-based undergraduate programmes
Authors: Czeskleba Anja , Holzhausen Ylva , Peters Harm
Published: May 2020

Clinical reasoning for acute dyspnoea: Comparison of final-year medical students from discipline- and competency-based undergraduate programmes.

Background

The global shift to competency-based medical education aims to improve the performance of its trainees, including in the key competency domain of clinical reasoning. However, research on whether such education actually improves clinical reasoning is sparse. The purpose of this study is to compare assessed clinical reasoning performance in digitally presented cases of acute dyspnoea between final-year medical students from a traditional, discipline-based and those from an integrated, competency-based undergraduate programme.

Methods

A total of 60 medical students in their final-year clerkships participated in the study; 30 were from a discipline-based programme, and 30 were from a competency-based programme of the same faculty. The students completed a knowledge test consisting of 22 single choice items and a computer-based test of clinical reasoning with six video-based case scenarios with different underlying diseases leading to dyspnoea. The operationalized measures of clinical reasoning were the number and relevance of the diagnostic tests chosen, time to diagnosis and diagnostic accuracy.

Results

The two groups did not differ in their knowledge of the acute dyspnoea content domain. With regard to clinical reasoning, the selection of relevant tests, time required to make a diagnosis and accuracy of the diagnosis varied across the six case scenarios in both groups. However, the results from the measures of the clinical reasoning process did not differ between the students from the two types of undergraduate medical programmes. No significant differences were found with regard to the selection of relevant diagnostic tests (M = 63.8% vs. M = 62.8%), the time to a diagnosis (M = 128.7 s vs. M = 136.4 s) or the accuracy of diagnosis (M = 82.2% vs. M = 77.0%).

Conclusions

Key indicators of the clinical reasoning process, when assessed with objectively measured parameters, did not differ between final-year medical students from a traditional, discipline-based and those from an integrated, competency-based undergraduate programme in the domain of acute dyspnoea. The results substantiate and expand those of previous studies based on subjective assessor ratings that showed limited change in the clinical reasoning performance of medical students with competency-based undergraduate education.
Evaluation of integrated modular teaching in Chinese ophthalmology trainee courses
Authors: Xin Wei , Zou Yuxian , Ao Yong , Cai Yu , Huang Zheqian , Li Miaoling , Xu Chaochao , Jia Yu , Yang Ying , Yang Yangfan , Lin Haotian
Published: May 2020

Background

Before attending ophthalmology trainee courses in Zhongshan Ophthalmic Centre, the medical students from Sun Yat-sen University had finished two years of premedical education after the six-year medical courses including basic medical courses, clinical medical courses, clerkship, and research training in medical college. Integrated modular teaching using different problem-based teaching methods in ophthalmology was designed by the teaching steering committee of Zhongshan Ophthalmic Centre. This study aimed to evaluate the effectiveness and satisfaction scales of the integrated modular teaching among the trainee students.

Methods

A total of 100 medical students attending ophthalmology trainee courses in Zhongshan Ophthalmic Centre were enrolled and randomly allocated into 4 groups according to the teaching arrangement. The trainee courses consisted of several sessions delivered in multiple methods, such as “flipped classroom” session and team-based learning session. The pre- and post-class tests were delivered to evaluate the effectiveness of the integrated modular teaching. The satisfaction survey questionnaire was collected from all participants to investigate the degree of satisfaction.

Results

Compared with the first-day-test score, the total last-day-test score was significantly improved by a paired t-test (t = 3.288, P = 0.001). Nineteen students obtained a significant improvement in ranking increased by more than 10 in the last-day-test, whereas they failed to obtain a higher average score for daily performance than other students (t = 0.469, P = 0.654). According to the participant satisfaction questionnaires, these innovative teaching methods were considered as effective and satisfactory.

Conclusions

Integrated modular teaching in ophthalmology trainee courses is effective and appreciated by the medical college students.
Managing complexity in the operating room: a group interview study
Authors: Göras Camilla , Nilsson Ulrica , Ekstedt Mirjam , Unbeck Maria , Ehrenberg Anna
Published: May 2020

Background

Clinical work in the operating room (OR) is considered challenging as it is complex, dynamic, and often time- and resource-constrained. Important characteristics for successful management of complexity include adaptations and adaptive coordination when managing expected and unexpected events. However, there is a lack of explorative research addressing what makes things go well and how OR staff describe they do when responding to challenges and compensating for constraints. The aim of this study was therefore to explore how complexity is managed as expressed by operating room nurses, registered nurse anesthetists, and surgeons, and how these professionals adapt to create safe care in the OR.

Method

Data for this qualitative explorative study were collected via group interviews with three professional groups of the OR-team, including operating room nurses, registered nurse anesthetists and operating and assisting surgeons in four group interview sessions, one for each profession except for ORNs for which two separate interviews were performed. The audio-taped transcripts were transcribed verbatim and analyzed by inductive qualitative content analysis.

Results

The findings revealed three generic categories covering ways of creating safe care in the OR: preconditions and resources, planning and preparing for the expected and unexpected, and adapting to the unexpected. In each generic category, one sub-category emerged that was common to all three professions: coordinating and reaffirming information, creating a plan for the patient and undergoing mental preparation, and prioritizing and solving upcoming problems, respectively.

Conclusion

Creating safe care in the OR should be understood as a process of planning and preparing in order to manage challenging and complex work processes. OR staff need preconditions and resources such as having experience and coordinating and reaffirming information, to make sense of different situations. This requires a mental model, which is created through planning and preparing in different ways. Some situations are repetitive and easier to plan for but planning for the unexpected requires anticipation from experience. The main results strengthen that abilities described in the theory of resilience are used by OR staff as a strategy to manage complexity in the OR.
Using virtual worlds as a platform for collaborative meetings in healthcare: a feasibility study
Authors: Taylor Michael J. , Shikaislami Chiya , McNicholas Chris , Taylor David , Reed Julie , Vlaev Ivo
Published: May 2020

Background

Healthcare teams often consist of geographically dispersed members. Virtual worlds can support immersive, high-quality, multimedia interaction between remote individuals; this study investigated use of virtual worlds to support remote healthcare quality improvement team meetings.

Methods

Twenty individuals (12 female, aged 25–67 [M = 42.3, SD = 11.8]) from 6 healthcare quality improvement teams conducted collaborative tasks in virtual world or face-to-face settings. Quality of collaborative task performances were measured and questionnaires and interviews were used to record participants’ experiences of conducting the tasks and using the virtual world software.

Results

Quality of collaborative task outcomes was high in both face-to-face and virtual world settings. Participant interviews elicited advantages for using virtual worlds in healthcare settings, including the ability of the virtual environment to support tools that cannot be represented in equivalent face-to-face meetings, and the potential for virtual world settings to cause improvements in group-dynamics. Reported disadvantages for future virtual world use in healthcare included the difficulty that people with weaker computer skills may experience with using the software. Participants tended to feel absorbed in the collaborative task they conducted within the virtual world, but did not experience the virtual environment as being ‘real’.

Conclusions

Virtual worlds can provide an effective platform for collaborative meetings in healthcare quality improvement, but provision of support to those with weaker computer skills should be ensured, as should the technical reliability of the virtual world being used. Future research could investigate use of virtual worlds in other healthcare settings.
Quality of intrapartum care at health centers in Jabi Tehinan district, North West Ethiopia: clients’ perspective
Authors: Asrese Kerebih
Published: May 2020

Background

Despite progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal deaths. As facility-based childbirth and skilled-birth attendant at birth reduces maternal morbidity and mortality, the country has been implementing expansions in infrastructure during the past decades. Whether this phenomenal expansion in infrastructure and improvement in coverage of healthcare services matched with quality of maternal health service is not well investigated. This study assessed the quality of intrapartum care experienced by mothers at health centers in Jabi Tehinan district, North West Ethiopia.

Method

An institution-linked community-based cross-sectional study was carried out from August to September 2018 to assess the quality of intrapartum care experienced by mothers during facility deliveries. Quantitative data were collected from 378 women who had uncomplicated births at health centers within 6 months preceding the survey and interviews were held with 25 women. The quantitative data were entered into SPSS for Windows versions 23 for analyses. Qualitative data were transcribed verbatim and data were used to substantiate the quantitative data.

Result

The results indicated that 13% of mothers experienced good quality of intrapartum care services. About 49, 45, 31, and 25% of mothers respectively experienced good quality of human and physical resources; respect, dignity, and equity; emotional support; and cognition. Only 2% of mothers experienced good quality of services on the four dimensions and 15% did not experience good quality of services on neither of the dimensions. Mothers from rural areas and mothers who did not use ANC services for recent born children were found more likely to experience good quality of intrapartum care. Informants discussed poor quality of labor environment, lack of privacy, and poor client-provider communications at health facilities.

Conclusion

The results indicated that the quality of intrapartum care experienced by mothers were minimal. The findings highlighted that efforts exerted to increase infrastructure and improve maternal health service coverage did not ensure quality maternal health services. Therefore, to increase the uptake of facility births and improved maternal health outcomes, stakeholders should make the health system humane, respectful, equitable, and responsive to mothers’ concerns.