bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomized controlled trials between dorsal root ganglion thermal radiofrequency, pulsed radiofrequency and steroids for the management of intractable metastatic back pain in thoracic vertebral body
Authors: Fanous Sherry Nabil , Saleh Emad Gerges , Abd Elghafar Ekramy Mansour , Ghobrial Hossam Zarif
Published: August 2020

Background: Bone metastasis is a complication of various cancers causing severe pain. The current modalities for the treatment of metastatic axial pain include pharmacological, surgical and vertebral augmentation techniques, each of which has its own challenges. Objectives: To evaluate the effectiveness of pulsed radiofrequency (PRF), thermal radiofrequency (RF) and steroids on dorsal root ganglion (DRG) in patients with thoracic axial pain due to vertebral metastasis. Methods: In this randomized controlled prospective study, 140 patients were assessed for eligibility, of which only 69 fulfilled the criteria. Patients were randomly divided into three equal groups, PRF, RF and steroid. Results: During the assessment of pain using Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Opioid consumption using oral Morphine Equivalence (OME) and Analgesic Quantification Algorithm (AQA) – at baseline, 1 week, 1 month and 3 months – 81 patients were assessed for final eligibility, of which 12 were excluded before intervention due to drop-out. The remaining 69 were randomized (mean age: 53.87 ± 10.55, 55.78 ± 7.34 and 59.39 ± 13.72) for PRF, RF and steroid, respectively with no statistical difference. VAS% and ODI% decreased significantly at 3 months in RF group ( p <0.001, 0.014, respectively), as did the AQA ( p <0.027). Steroid group was the worst. Discussion: RF on DRG is the main stay for controlling intractable metastatic pain. PRF is a good alternative.
Multifocal cocaine-induced pyoderma gangrenosum: A report of two cases and review of literature
Authors: Lemieux Alexandre , Ran Cai Zhuo , Belisle Annie , Chartier Suzanne , Bolduc Chantal
Published: August 2020

Pyoderma gangrenosum is often associated with a systemic disease. Cocaine-induced pyoderma gangrenosum, most probably caused by levamisole, has been described recently and typically presents as multiple, large cribriform ulcers. Peri-nuclear antineutrophil cytoplasmic antibody is the most common serological finding. A strong counseling for cocaine cessation, combined with wound care and immunosuppressive therapy, is the mainstay of treatment. We present two cases of cocaine-induced pyoderma gangrenosum and correlate their findings with the typical clinical, histological and serological presentation.
Fatal COVID-19 in an MS patient on natalizumab: A case report
Authors: Rimmer Kathryn , Farber Rebecca , Thakur Kiran , Braverman Genna , Podolsky Dina , Sutherland Lauren , Migliore Christopher , Ryu Yun Kyoung , Levin Seth , De Jager Philip L , Vargas Wendy , Levine Libby , Riley Claire S
Published: August 2020

We report a fatal case of COVID-19 in a 51-year-old African American woman with multiple sclerosis on natalizumab. She had multiple risk factors for severe COVID-19 disease including race, obesity, hypertension, and elevated inflammatory markers, but the contribution of natalizumab to her poor outcome remains unknown. We consider whether altered dynamics of peripheral immune cells in the context of natalizumab treatment could worsen the cytokine storm syndrome associated with severe COVID-19. We discuss extended interval dosing as a risk-reduction strategy for multiple sclerosis patients on natalizumab, and the use of interleukin-6 inhibitors in such patients who contract COVID-19.
Cumulative Trauma Disorders
Authors: Frederick Linda J.
Published: August 2020

Data from individual studies and worksites indicate that CTDs are a major problem in some industries. Evidence exists for an association between symptoms of CTDs and occupational risk factors such as forceful exertion, repetitiveness, and extreme postures. Although the pathogenesis of these disorders is not known, they are believed to involve physiological and mechanical responses of soft tissues to repeated or sustained biomechanical stress.

The efficacy of ergonomic interventions or programs must be evaluated using the same methods as used to identify problems initially. User (worker) feedback about any job or tool redesigns is essential.

Implementing ergonomic interventions likely will be an ongoing, iterative process. The ability of the occupational health nurse to carry out basic nursing functions of health promotion and prevention of injury and illness will be enhanced through the application of the ergonomic principles.
On-Site Occupational Health Nursing Services
Authors: Davidson Gestur , Widtfeldt Anne , Bey Jean
Published: August 2020

This article has described a quantitative assessment model that was developed to provide useful information to a large corporation about the benefits and costs of an on-site occupational health nursing program. The number and complex nature of the effects of such programs both complicate this task and necessarily restrict the comprehensiveness of its assessment. The model focuses on estimating the net cost savings arising from the direct substitution of on-site for off-site occupational health nursing services.

Part II of this article discussed applications of this quantitative assessment model that could be useful to management decision making; identifying assumptions, interpretations, and limitations of the model and illustrating approaches for reducing these limitations.

The on-site provision of occupational health nursing services clearly continues to be an issue of interest to large corporations concerned with cost-containment, productivity, and employee relations. While the model and approaches described here are restricted to measurable, short term benefits, the careful measurement of these benefits and costs can usefully inform management decision making until more comprehensive, longer term assessment models can be empirically implemented.
Machine Safety
Authors: Martin Karen J.
Published: August 2020

Machine operators are at increased risk for certain machine injuries, including amputation. OSHA provides standards of safety for machine guarding during operation and machine lockout during maintenance. The role of the occupational health nurse in machine safety is to conduct worksite analyses to identify proper safeguarding and to communicate deficiencies to appropriate personnel; to train workers in safe work practices and observe compliance in the use of machine guards; to provide care for workers injured by machines, especially in managing amputations; and to reinforce safe work practices among machine operators.
Quality and Quality Improvement in Occupational Health Nursing
Authors: Widtfeldt Anne Keenan
Published: August 2020

The definition of quality in health care is changing to incorporate the industrial definition, which is “conformance to technical specifications and customer requirements” (Conbere, 1992). A quality assurance program is the basis of a qualThis article is reprinted from AAOHN Update Series, Volume 4 with permission from the Continuing Professional Education Center, Inc., Skill-man, NJ.
National Asthma Education Program Expert Panel Report
Authors: Fitzgerald Sheila T.
Published: August 2020

The Expert Panel Report* covers a comprehensive set of issues that reflects the complexity of asthma. It emphasizes throughout that appropriate therapy must be based on a clinician-client partnership in care as well as the role of the nurse in management and client and family education. Asthma is a dynamic disorder. Therefore, the report will be revised as scientific advances warrant. The current report reflects the NAEP's best current understanding of the disease.
Developing Health Service Staff
Authors: Wachs Joy E.
Published: August 2020

Professional nurses frequently view continuing education and staff development narrowly, as in the form of an annual offsite seminar. Staff development is a year around, planned program, adequately funded and creatively administered. Development needs can be identified during annual performance appraisals and strategies to meet the needs written into a formal plan. These strategies might include a variety of educational and vocational opportunities within the organization and in the community.

An effective development program should lead to more staff with a wider repertoire of skills and a new vision of their role and responsibility. The nurse manager should see these changes reflected in a more effective and efficient health service and in personal accolades from the organization.
Role of the Occupational Health Nurse in the Year 2000
Authors: Barlow Ruth
Published: August 2020

In the last 100 years, the occupational health nurse has been instrumental in providing direct care, promoting safety, and offering disease prevention and health promotion programs to America's work force. With a clear vision of how, where, and why occupational health nurses are an invaluable resource in the public health arena, occupational health nurses can continue to make significant contributions. The demand for the knowledge, skills, and contributions of the occupational health nurse at the worksite in research and in policy making will continue well beyond the year 2000.
Health and Safety Hazards Associated with Farming
Authors: Ehlers Janet K. , Connon Catherine , Themann Christa L. , Myers John R. , Ballard Tern
Published: August 2020

Farming is a hazardous occupation with a unique combination of exposures and psychosocial factors that often vary with the type of operation. Some hazards are unique to farming; others are common in industry. Many who farm also work at other jobs. Even for non-agricultural companies, farm related illnesses and injuries can be costly in terms of lost work time, medical insurance, and life insurance.

According to a former U.S Surgeon General, “Because of agriculture's diversity and geographic distribution, we must depend on local action to deal practically with the problem” (Novello, 1991). Occupational health nurses in both agricultural and non-agricultural industries can play an important role in local action to protect their workers, neighbors, friends, and families.
Job Stress and Occupational Health Nursing
Authors: Crawford Susan Lee
Published: August 2020

Job stress is a condition or event in the workplace that induces strain (a physical, psychological, or behavioral response to a stressor). The outcome of unrelieved job stress can be burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. Identification and treatment of job stress falls into four conceptual models: medical, clinical/ counseling psychology, engineering psychology, and organizational psychology.

Occupational health nurses can experience job stress in the areas of intrinsic job factors, organizational structures, reward systems, human resource systems, and leadership. Because occupational health nurses promote stress reduction strategies in worker populations, modeling these behaviors is important to enhance the credibility of those promoting such strategies.
Drug Testing for Current Employees
Authors: Morris Judy A.
Published: August 2020

Occupational health nurses who assist in the development of substance abuse testing policies for current employees should thoughtfully examine the issues of who is to be tested, when they are to be tested, which test methodology is to be used, and how the confidentiality of the individual's health status will be maintained. Will certain employees be tested routinely at the time of health examinations? Will employees be tested only for cause? Is the cause to be only when impairment becomes visible or job performance is compromised? Will employees be tested after an accident occurs? Which accidents? Which test method will be used—one that measures current impairment or one that measures lifestyle?

Resolving ethical dilemmas requires that one be cognizant of personal values, use critical reflection, and apply ethical principles. One can then make appropriate decisions in the context of the legal and moral climate of society, the culture of the workplace, and the individual rights and civil liberties of employees.
Molecular dynamics study on the effect of hydrophilicity on thin film evaporation over biphilic surface
Authors: Paul Sudipta , Rownak Md. Ragib , Hasan Mohammad Nasim
Published: August 2020

The objective of this study is to understand the effect of surface wettability and how nano-scale heat transfer is affected by different surface wetting conditions over biphilic surface by molecular dynamics simulations. The system of 3 nm liquid Argon film over Platinum surface is equilibrated at 90 K and then wall temperature is raised to higher value to study the effect of temperature. According to this study at low wall temperature and low surface wetting conditions, liquid temperature increases proportionally with the increment of hydrophilic portion but at higher wall temperature and better surface wetting conditions, maximum value of liquid Argon temperature increases with increasing hydrophobic portion. Evaporation number, evaporative mass flux and heat flux increase significantly with slight increment of hydrophilic portion. Inception time decreases with increasing hydrophilic portion and surface wettability. Also, for better surface wetting conditions, average evaporative mass flux is more sensitive to wall temperature and increases significantly at higher wall temperature.
Otoplasty Using Dermoperichondrial Flap as an Adjunct to Mustarde Suture Technique
Authors: Pasick Christina M. , Margulies Ilana G. , Sayegh Farah , Taub Peter J.
Published: August 2020

Prominent ears are congenital deformities that are challenging to correct due to the risk of postoperative recurrence. While they have been traditionally reconstructed with cartilage excision or scoring and with cartilaginous sutures, flap techniques have been developed over the last 2 decades to improve the structural integrity of these repairs. The addition of a local flap helps to sustain long standing operative correction while maintaining optimal cosmetic outcomes that have been reported, particularly after cartilage sparing techniques. The authors describe a lateral dermoperichondrial flap on the posterior ear as an adjunct to the use of Mustarde sutures and contextualize its use in the landscape of existing otoplasty techniques.
Efficient intensity measures and machine learning algorithms for collapse prediction of tall buildings informed by SCEC CyberShake ground motion simulations
Authors: Bijelić Nenad , Lin Ting , Deierlein Gregory G
Published: August 2020

In contrast to approaches based on scaling of recorded seismograms, using extensive inventories of numerically simulated earthquakes avoids the need for any selection and scaling of motions which implicitly requires assumptions on intensity measures (IMs) that correlate with structural response. This study has the objectives to examine seismogram features that control the collapse response of tall buildings and to develop efficient and reliable collapse classification algorithms. To that end, machine learning techniques are applied to the results of nonlinear response history analyses of a 20-story tall building performed using about two million simulated ground motions. Feature selection of ground motion IMs generally confirms current understanding of collapse predictors based on previous studies using scaled recorded motions. In addition, interrogations of the large collection of hazard-consistent simulations demonstrate the utility of different IMs for collapse risk assessment in a way that is not possible with recorded motions. Finally, a small subset of IMs is identified and used in development of an efficient collapse classification algorithm which is tested on benchmark simulated data at several sites in the Los Angeles basin.
The development of ruxolitinib for glucocorticoid-refractory acute graft-versus-host disease
Authors: Zeiser Robert , Socié Gérard
Published: August 2020

Acute graft-versus-host disease (aGVHD) is a life-threatening complication after allogeneic hematopoietic cell transplantation (allo-HCT). Despite the use of prophylactic immunosuppression including calcineurin inhibitors, antimetabolites, antithymocyte globulin, or posttransplant cyclophosphamide, patients still develop severe aGVHD. In particular, patients with glucocorticoid-refractory GVHD (SR-GVHD) have a dismal prognosis with a low 1-year post–allo-HCT survival rate. Most classical drugs used to prevent or treat aGVHD target 1 specific pathway such as calcineurin inhibitors or mammalian target of rapamycin inhibitors, or they interfere with fast-dividing activated cells (eg, methotrexate, mycophenolate, and cyclophosphamide). In contrast to these drugs, inhibition-of-signaling molecules, used by multiple immune cells and critical for signal transduction of multiple proinflammatory cytokines, could be more efficacious at blocking GVHD. Ruxolitinib blocks Janus kinases 1 and 2, which are required to mediate the downstream signaling of multiple cytokine receptors. Recently, a multicenter phase 3 clinical trial showed that ruxolitinib led to significant improvements in efficacy outcomes compared to best available therapy, which will lead to a paradigm shift in the treatment of SR-GVHD.
The burden of exacerbations in mild asthma: a systematic review
Authors: FitzGerald J. Mark , Barnes Peter J. , Chipps Bradley E. , Jenkins Christine R. , O'Byrne Paul M. , Pavord Ian D. , Reddel Helen K.
Published: August 2020

Background

Although most patients with asthma have mild disease, data on how mild asthma is defined, and how frequently exacerbations occur in this patient population are scarce, so we aimed to redress this.

Methods

We searched Medline and Medline In-Process (PubMed), and Embase in OVID for English-language publications containing “mild asthma” plus at least one relevant therapy and outcome/keyword, limited to randomised controlled trials (RCTs) and observational studies published between January 1990 and February 2019. Publications were filtered to ensure appropriate data extraction. The main outcomes were the definitions of mild asthma and exacerbations, baseline exacerbation rates and exacerbation data for placebo recipients in prospective studies. Meta-analysis of exacerbation rates was planned.

Findings

Of 4064 articles identified, 64 were included in our review (49 743 subjects); 54 RCTs and 10 observational/other studies. Six main types of definitions of mild asthma were identified. While care was taken to ensure inclusion only of patients with mild asthma, marked heterogeneity was revealed in the definitions of mild asthma and hence the study populations. Reporting of exacerbations also varied widely between studies, precluding meta-analysis. Between 0–22% of patients were hospitalised for asthma or had a severe exacerbation in the previous year, according to baseline data from prospective studies. In RCTs, severe exacerbation rates in placebo recipients taking only short-acting β2-agonist therapy ranged from 0.20–2.88 per year.

Conclusions

These data provide new evidence of the burden of exacerbations in mild asthma and highlight the need for standardised definitions of mild asthma and of exacerbations to progress further research.
Correction to: RNA-sequencing reveals positional memory of multipotent mesenchymal stromal cells from oral and maxillofacial tissue transcriptomes
Authors: Onizuka Satoru , Yamazaki Yasuharu , Park Sung-Joon , Sugimoto Takayuki , Sone Yumiko , Sjöqvist Sebastian , Usui Michihiko , Takeda Akira , Nakai Kenta , Nakashima Keisuke , Iwata Takanori
Published: August 2020

An amendment to this paper has been published and can be accessed via the original article.
Sex chromosome and sex locus characterization in goldfish, Carassius auratus (Linnaeus, 1758)
Authors: Wen Ming , Feron Romain , Pan Qiaowei , Guguin Justine , Jouanno Elodie , Herpin Amaury , Klopp Christophe , Cabau Cedric , Zahm Margot , Parrinello Hugues , Journot Laurent , Burgess Shawn M. , Omori Yoshihiro , Postlethwait John H. , Schartl Manfred , Guiguen Yann
Published: August 2020

Background

Goldfish is an important model for various areas of research, including neural development and behavior and a species of significant importance in aquaculture, especially as an ornamental species. It has a male heterogametic (XX/XY) sex determination system that relies on both genetic and environmental factors, with high temperatures being able to produce female-to-male sex reversal. Little, however, is currently known on the molecular basis of genetic sex determination in this important cyprinid model. Here we used sequencing approaches to better characterize sex determination and sex-chromosomes in an experimental strain of goldfish.

Results

Our results confirmed that sex determination in goldfish is a mix of environmental and genetic factors and that its sex determination system is male heterogametic (XX/XY). Using reduced representation (RAD-seq) and whole genome (pool-seq) approaches, we characterized sex-linked polymorphisms and developed male specific genetic markers. These male specific markers were used to distinguish sex-reversed XX neomales from XY males and to demonstrate that XX female-to-male sex reversal could even occur at a relatively low rearing temperature (18 °C), for which sex reversal has been previously shown to be close to zero. We also characterized a relatively large non-recombining region (~ 11.7 Mb) on goldfish linkage group 22 (LG22) that contained a high-density of male-biased genetic polymorphisms. This large LG22 region harbors 373 genes, including a single candidate as a potential master sex gene, i.e., the anti-Mullerian hormone gene (amh). However, no sex-linked polymorphisms were detected in the coding DNA sequence of the goldfishamhgene.

Conclusions

These results show that our goldfish strain has a relatively large sex locus on LG22, which is likely the Y chromosome of this experimental population. The presence of a few XX males even at low temperature also suggests that other environmental factors in addition to temperature could trigger female-to-male sex reversal. Finally, we also developed sex-linked genetic markers, which will be important tools for future research on sex determination in our experimental goldfish population. However, additional work would be needed to explore whether this sex locus is conserved in other populations of goldfish.
Joint analysis of duration of ventilation, length of intensive care, and mortality of COVID-19 patients: a multistate approach
Authors: Hazard Derek , Kaier Klaus , von Cube Maja , Grodd Marlon , Bugiera Lars , Lambert Jerome , Wolkewitz Martin
Published: August 2020

Background

The clinical progress of patients hospitalized due to COVID-19 is often associated with severe pneumonia which may require intensive care, invasive ventilation, or extracorporeal membrane oxygenation (ECMO). The length of intensive care and the duration of these supportive therapies are clinically relevant outcomes. From the statistical perspective, these quantities are challenging to estimate due to episodes being time-dependent and potentially multiple, as well as being determined by the competing, terminal events of discharge alive and death.

Methods

We used multistate models to study COVID-19 patients’ time-dependent progress and provide a statistical framework to estimate hazard rates and transition probabilities. These estimates can then be used to quantify average sojourn times of clinically important states such as intensive care and invasive ventilation. We have made two real data sets of COVID-19 patients (n = 24* andn = 53**) and the corresponding statistical code publically available.

Results

The expected lengths of intensive care unit (ICU) stay at day 28 for the two cohorts were 15.05* and 19.62** days, while expected durations of mechanical ventilation were 7.97* and 9.85** days. Predicted mortality stood at 51%* and 15%**. Patients mechanically ventilated at the start of the example studies had a longer expected duration of ventilation (12.25*, 14.57** days) compared to patients non-ventilated (4.34*, 1.41** days) after 28 days. Furthermore, initially ventilated patients had a higher risk of death (54%* and 20%** vs. 48%* and 6%**) after 4 weeks. These results are further illustrated in stacked probability plots for the two groups from time zero, as well as for the entire cohort which depicts the predicted proportions of the patients in each state over follow-up.

Conclusions

The multistate approach gives important insights into the progress of COVID-19 patients in terms of ventilation duration, length of ICU stay, and mortality. In addition to avoiding frequent pitfalls in survival analysis, the methodology enables active cases to be analyzed by allowing for censoring. The stacked probability plots provide extensive information in a concise manner that can be easily conveyed to decision makers regarding healthcare capacities. Furthermore, clear comparisons can be made among different baseline characteristics.
Mycoplasma and Ureaplasma carriage in pregnant women: the prevalence of transmission from mother to newborn
Authors: Peretz Avi , Tameri Oran , Azrad Maya , Barak Shay , Perlitz Yuri , Dahoud Wadie Abu , Ben-Ami Moshe , Kushnir Amir
Published: August 2020

Background

Mycoplasma and Ureaplasma have been extensively studied for their possible impact on pregnancy, and their involvement in newborn diseases. This work examined Mycoplasma and Ureaplasma carriage among gravidas women and newborns in Israel, as well as associations between carriage and demographic characteristics, risk factors, pregnancy outcomes, and newborn morbidity rates.

Methods

A total of 214 gravidas women were examined for vaginal pathogen carriage through standard culture and polymerase chain reaction assay. Pharyngeal swabs were collected from newborns of carrier mothers. Clinical and demographic data were collected and infected newborn mortality was monitored for 6 months.

Results

Nineteen mothers were carriers, with highest prevalence among younger women. Pathogen carriage rates were 2.32% for Mycoplasma genitalium (Mg), 4.19% for Ureaplasma parvum (Up) and 2.32% for Ureaplasma urealyticum (Uu). Arab ethnicity was a statistically significant risk factor (p = 0.002). A higher prevalence was seen among women residing in cities as compared to villages. Thirteen (68%) newborns born to carrier mothers were carriers as well, with a higher prevalence among newborns of women delivering for the first time, compared to women that had delivered before. Infection rates among newborns were 20% for Mg (p = 0.238), 100% for Up (p < 0.01), and 28.5% for Uu (p = 0.058), with more male than female newborns being infected. No association was found between maternal carriage and newborn morbidity.

Conclusions

Maternal Mycoplasma or Ureaplasma carriage may be associated with ethnicity and settlement type. Further studies will be needed to identify factors underlying these associations and their implications on delivery.
Neutrophil to lymphocyte ratio, not platelet to lymphocyte or lymphocyte to monocyte ratio, is predictive of patient survival after resection of early-stage pancreatic ductal adenocarcinoma
Authors: Pointer David T. , Roife David , Powers Benjamin D. , Murimwa Gilbert , Elessawy Sameh , Thompson Zachary J. , Schell Michael J. , Hodul Pamela J. , Pimiento Jose M. , Fleming Jason B. , Malafa Mokenge P.
Published: August 2020

Background

NLR, PLR, and LMR have been associated with pancreatic ductal adenocarcinoma (PDAC) survival. Prognostic value and optimal cutpoints were evaluated to identify underlying significance in surgical PDAC patients.

Methods

NLR, PLR, and LMR preoperative values were available for 277 PDAC patients who underwent resection between 2007 and 2015. OS, RFS, and survival probability estimates were calculated by univariate, multivariable, and Kaplan-Meier analyses. Continuous and dichotomized ratio analysis determined best-fit cutpoints and assessed ratio components to determine primary drivers.

Results

Elevated NLR and PLR and decreased LMR represented 14%, 50%, and 50% of the cohort, respectively. OS (P = .002) and RFS (P = .003) were significantly decreased in resected PDAC patients with NLR ≥5 compared to those with NLR < 5. Optimal prognostic OS and RFS cutpoints for NLR, PLR, and LMR were 4.8, 192.6, and 1.7, respectively. Lymphocytes alone were the primary prognostic driver of NLR, demonstrating identical survival to NLR.

Conclusions

NLR is a significant predictor of OS and RFS, with lymphocytes alone as its primary driver; we identified optimal cutpoints that may direct future investigation of their prognostic value. This study contributes to the growing evidence of immune system influence on outcomes in early-stage pancreatic cancer.
Relationship between internet addiction and sleep disturbance in high school students: a cross-sectional study
Authors: Tokiya Mikiko , Itani Osamu , Otsuka Yuichiro , Kaneita Yoshitaka
Published: August 2020

Background

The increase in the number of Internet users has increased Internet dependence worldwide. In adolescents, this dependence may interfere with sleep, which is important for the development of psychophysiological capabilities. However, few large-scale surveys have described the relationship between Internet addiction (IA) and sleep disturbance using standardized questionnaires. We conducted a survey in one prefecture in Japan to determine the relationship between sleep disturbance and IA in adolescents based on the categories of the Young Diagnostic Questionnaire (YDQ).

Methods

In 2016, high school students (N = 10,405, age range: 15–16 years) in all 54 daytime high schools in the selected prefecture were surveyed using a self-administered questionnaire. Participants with scores > 5.5 points on the Japanese version of the Pittsburgh Sleep Quality Index were defined as having a sleep disturbance. IA was evaluated using the YDQ: Participants with five to eight YDQ items present were classified as having IA; those with three or four items present were classified as “at risk of IA”; and those with two or less YDQ items were classified as “non-IA”. Multiple logistic regression analysis was performed with sleep disturbance as the dependent variable, IA as the explanatory variable, and adjustments for eight other variables.

Results

High YDQ scores were associated with a high prevalence of sleep disturbance in boys and girls. These findings persisted after controlling for other factors in the multiple regression model.

Conclusions

Among Japanese adolescents, there was a significant independent relationship between IA and sleep disturbance.
Tuberculosis treatment outcomes: a fifteen-year retrospective study in Jos-North and Mangu, Plateau State, North - Central Nigeria
Authors: Sariem Comfort Nanbam , Odumosu Patricia , Dapar Maxwell Patrick , Musa Jonah , Ibrahim Luka , Aguiyi John
Published: August 2020

Background

Globally, tuberculosis (TB) is the leading cause of death from a single infectious agent. Adherence to TB therapy is an important factor in treatment outcomes, which is a critical indicator for evaluating TB treatment programs. This study assessed TB treatment outcomes using a fifteen-year record of tuberculosis patients who received treatment in Jos-North and Mangu Local Government Areas of Plateau State, North-Central Nigeria.

Methods

The retrospective facility based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State. Data were collected from 10,156 TB patient’s health records between 2001 and 2015. Treatment outcomes were categorized as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). A descriptive analysis was done to assess the factors associated with treatment outcomes. Relevant bivariate and multivariate logistic regression were done. All statistical analyses were performed on Stata version 11, College station, Texas, USA.

Results

During the study period, 58.1% (5904/10156) of the TB patients who received treatment were males. The Mean age ± SD was 35.5 ± 15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment. The sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes rate from 83.8% in 2001 to 64.4% in 2015 was observed. The factors associated with treatment success were gender, age, year of enrollment, and HIV status. Extrapulmonary TB was less likely associated with treatment success (AOR:95% CI- 0.72:0.61–0.84,p < 0.001).

Conclusion

With the decrease in treatment success rates, underlying reasons for medication non-adherence and treatment failure should be resolved through adherence counseling involving the patient and treatment supporters, with education on voluntary counseling and testing for HIV among TB patients.
Acceptability and practicability of self-management for patients with Parkinson’s disease based on smartphone applications in China
Authors: Hu J. , Yuan D. Z. , Zhao Q. Y. , Wang X. F. , Zhang X. T. , Jiang Q. H. , Luo H. R. , Li J. , Ran J. H. , Li J. F.
Published: August 2020

Background

China has had about 1.2 billion mobile-phone users, and this number continues to grow. However, mobile-health services (mHealth) are currently in the initial stage, and have not yet prevailed in China. Additionally, the prevalence of Parkinson’s disease (PD) in China is 1700/100,000 (≥65 years). Indeed, these PD patients would benefit from mHealth to manage their disease. Therefore, we designed a study to determine attitudes toward smartphone applications (apps) for chronic condition self-management, and to discover the practicality of these apps among PD patients in China.

Methods

We selected 204 participants with PD between 52 and 87 years old and surveyed their attitudes concerning the use of smartphone apps for chronic condition management via questionnaires.

Results

Among the participants, 65.19% had smartphones. Among these smartphone users, 82.84% expressed a preference for using apps for PD management. This group tended to be younger and more frequent web users with higher education and better medication compliance, and they tended to have a longer PD course and worse conditions (P < 0.001, P = 0.001, P < 0.001, P = 0.041, P < 0.001, P = 0.013). Additionally, the willingness to apply apps for PD self-management was positively related to education (P < 0.001) and negatively related to age and PD course (P = 0.017, P < 0.001).

Conclusion

In China, patients with PD have a generally positive attitude towards self-management through smartphone apps. Consequently, improving the coverage of smartphones with practical and handy apps is a promising strategy for PD self-management.
Developing and validating an algorithm to identify incident chronic dialysis patients using administrative data
Authors: Gibertoni Dino , Voci Claudio , Iommi Marica , D’Ercole Benedetta , Mandreoli Marcora , Santoro Antonio , Mancini Elena
Published: August 2020

Background

Administrative healthcare databases are widespread and are often standardized with regard to their content and data coding, thus they can be used also as data sources for surveillance and epidemiological research. Chronic dialysis requires patients to frequently access hospital and clinic services, causing a heavy burden to healthcare providers. This also means that these patients are routinely tracked on administrative databases, yet very few case definitions for their identification are currently available. The aim of this study was to develop two algorithms derived from administrative data for identifying incident chronic dialysis patients and test their validity compared to the reference standard of the regional dialysis registry.

Methods

The algorithms are based on data retrieved from hospital discharge records (HDR) and ambulatory specialty visits (ASV) to identify incident chronic dialysis patients in an Italian region. Subjects are included if they have at least one event in the HDR or ASV databases based on the ICD9-CM dialysis-related diagnosis or procedure codes in the study period. Exclusion criteria comprise non-residents, prevalent cases, or patients undergoing temporary dialysis, and are evaluated only on ASV data by the first algorithm, on both ASV and HDR data by the second algorithm. We validated the algorithms against the Emilia-Romagna regional dialysis registry by searching for incident patients in 2014 and performed sensitivity analyses by modifying the criteria to define temporary dialysis.

Results

Algorithm 1 identified 680 patients and algorithm 2 identified 676 initiating dialysis in 2014, compared to 625 patients included in the regional dialysis registry. Sensitivity for the two algorithms was respectively 90.8 and 88.4%, positive predictive value 84.0 and 82.0%, and percentage agreement was 77.4 and 74.1%.

Conclusions

Algorithms relying on retrieval of administrative records have high sensitivity and positive predictive value for the identification of incident chronic dialysis patients. Algorithm 1, which showed the higher accuracy and has a simpler case definition, can be used in place of regional dialysis registries when they are not present or sufficiently developed in a region, or to improve the accuracy and timeliness of existing registries.
Investigating the healthcare pathway through patients’ experience and profiles: implications for breast cancer healthcare providers
Authors: Cherif Emna , Martin-Verdier Elisabeth , Rochette Corinne
Published: August 2020

Background

Healthcare systems are facing many changes. Particularly, patients are more engaged in the care process. The medical perspective of the process is insufficient to provide patients with high quality care and service personalisation. This research presents an attempt to complete this medical perspective through an experiential perspective, especially for chronic diseases such as cancer. We investigated patients’ experiences and profiles to reach a deeper understanding of their needs and expectations when they confront the disease.

The objectives of this research were to model the key stages underling the patient pathway and to identify the challenging touch points of the interactions between patients and healthcare providers. Bringing together findings of patient experience, pathway, and profiles would help all the stakeholders involved to develop better practices for the healthcare process.

Methods

A qualitative observational nethnography on a French specialized forum for breast cancer patients “les Impatientes” was conducted. A total of 967 reviews were collected over a complete year period from all over France. Thematic and lexicometric content analysis were performed according to the experience dimensions, the pathway stages and touch points, as well as the patients’ profiles.

Results

Data analysis shows that the healthcare pathway experienced by the patients is built around three stages. The discovery stage is closely related to the emotional dimension regarding the patient and physician relationship. The examination stage is characterized by a more technical and informational needs for the types of treatments. The follow-up and survivorship stage illustrates the patients’ need to assess the treatments’ effectiveness and the quality of the follow-up. Moreover, three profiles of patients were identified. The newcomers, the altruists and the autonomous are characterized by different attitudes depending on the stage of the healthcare pathway they were living.

Conclusions

Our research presents an original modelling of the patient pathway and profiles beyond the medical process. It gives practical tracks to improve the healthcare pathway. Patients expect healthcare providers to integrate and strengthen several challenging touch points in order to create satisfactory patient experiences and high quality service.
Circular RNA circ_0020123 promotes non-small cell lung cancer progression by sponging miR-590-5p to regulate THBS2
Authors: Wang Liang , Zhao Lantao , Wang Yonghong
Published: August 2020

Background

The incidence and death rate of non-small cell lung cancer (NSCLC) in China ranks the first among the malignant tumors. Circular RNA (circRNA) was reported to be involved in the progression of NSCLC. Our study aimed to investigate the underlying mechanism of circ_0020123 in NSCLC progression.

Methods

Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of circ_0020123, miR-590-5p and Thrombospondin 2 (THBS2) in NSCLC tissues and cells. Cell proliferation and migration were examined by Cell Counting Kit-8 (CCK-8) assay and Transwell assay, respectively. Flow cytometry assay was used to detect the apoptosis of NSCLC cells. The protein levels of Ki-67, matrix metalloprotein-9 (MMP-9), Cleaved-caspase9 (Cleaved-casp9) and THBS2 were detected by Western blot. The targets of circ_0020123 and miR-590-5p were predicted by starBase 3.0 and TargetScan, and then confirmed by dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay. The animal experiment showed the effect of circ_0020123 on tumor growth in vivo.

Results

The expression of circ_0020123 was upregulated in NSCLC tissues and cells. Functionally, circ_0020123 downregulation inhibited the proliferation and migration and promoted the apoptosis of NSCLC cells. Interestingly, circ_0020123 directly targeted miR-590-5p, and inhibition of miR-590-5p reversed the knockdown effects of circ_0020123 on NSCLC cells. More importantly, THBS2 was a target of miR-590-5p, and THBS2 overexpression reversed the effects of circ_0020123 knockdown on cell proliferation, migration and apoptosis in NSCLC cells. Finally, suppression of circ_0020123 inhibited tumor growth in vivo through miR-590-5p/THBS2 axis.

Conclusion

Circular RNA circ_0020123 regulated THBS2 by sponging miR-590-5p to promote cell proliferation and migration and inhibit cell apoptosis in NSCLC cells.
POLE2 knockdown reduce tumorigenesis in esophageal squamous cells
Authors: Zhu Yongjun , Chen Gang , Song Yang , Chen Zhiming , Chen Xiaofeng
Published: August 2020

Background

Esophageal squamous cell carcinoma (ESCC) is one of the most frequent malignant tumors originated from digestive system around the world and the treatment was limited by the unclear mechanism. DNA polymerase epsilon 2, accessory subunit (POLE2) is involved in DNA replication, repair, and cell cycle control, whose association with ESCC is still not clear.

Methods

In this study, the expression level of POLE2 in ESCC tissues was detected by IHC. The POLE2 knockdown cell line was constructed, identified by qPCR and western blot and used for detecting cellular functions and constructing xenotransplantation mice model. MTT Assay, colony formation assay, flow cytometry, wound-healing assay and Transwell assay were used to detected cell proliferation, apoptosis and migration.

Results

We firstly identified that the expression of POLE2 was overexpressed in ESCC. Moreover, the high expression of POLE2 can predict the tumor deterioration and poor prognosis of ESCC patients. Additionally, downregulation of POLE2 was involved in ESCC progression by promoting proliferation, migration, and inhibiting apoptosis in vitro. In vivo studies proved that POLE2 was positively correlated with ESCC tumor formation, which was consistent with the results in vitro. We also illuminated that POLE2 knockdown upregulated pro-apoptotic proteins (Bax, Caspase3, CD40L, FasL, IGFBP-5 and P21) and downregulated anti-apoptotic proteins (CLAP-2, IGF-I and sTNF-R2). In addition, POLE2 was involved in ESCC via targeting PI3K/Akt, Cyclin D1 signaling pathway.

Conclusions

Therefore, POLE2 was proved to be involved in the development of ESCC, which may be a potential therapeutic target and bring new breakthroughs in the treatment of ESCC.
Predictors of low back disability in chiropractic and physical therapy settings
Authors: Petrozzi M. John , Rubinstein Sidney M. , Ferreira Paulo H. , Leaver Andrew , Mackey Martin G.
Published: August 2020

Background

Predicting ongoing disability for chronic non-specific low back pain (LBP) is important to avoid prolonged disability.

Objective

Determine predictors of disability at 6 month follow-up in patients with LBP at medium risk of ongoing disability.

Methods

Baseline data was collected from 108 patients with medium-risk chronic non-specific LBP (mean age 50.4 years, SD 13.6) from six private chiropractic and physiotherapy clinics in Australia who took part in a randomised control trial. All patients received a pragmatic course of multimodal physical treatments [e.g., manual therapy (spinal manipulation or mobilization and/or soft tissue massage)] combined with advice, education and exercise. Baseline prognostic variables included sociodemographic, physical and psychological characteristics. Primary outcome was disability (Roland Morris Disability) at 6 month follow-up. Multivariable linear regression analysis was conducted.

Results

Variables remaining in the final multivariable model: lower work ability (β = − 1.05, 95% CI − 1.40 to − 0.70; p < 0.0001) and consultation with a medical specialist for back pain in the preceding 3 months (β = 3.35, 95% CI 1.14 to 5.55; p < 0.003), which significantly predicted higher disability at 6 months (unadjusted R2 = 0.31). Those with a lower work ability (scale 1 to 10) and who had seen a medical specialist for their back pain were more likely to report greater LBP-related disability at 6 months.

Conclusion

Patients with chronic LBP presenting to primary care with lower work ability and recent consultation with a medical specialist for LBP are more likely to have a worse prognosis; these are indicators to clinicians that standard conservative care may not adequately manage the patients’ needs.