bluuebunny/crossref_metadata_2025 huggingface dataset:
Time spent on provision of Antenatal Care and associated factors among public and private health facilities in Axum town, North Ethiopia: Comparative cross sectional study
Authors: Nerea Nigusse Gebremedhn , Alema Haileselasie Berhane , Tesfay Mulubirhan Tirfe
Published: April 2020

BackgroundIn most developing countries contact time between antenatal care attendees and providers have effects on health outcomes and quality of antenatal services. Effectiveness of focused antenatal care relies on standard time spent provisions. Hence this study evaluated the time spent & associated factors on provision of antenatal care in public and private health facilities in Axum Town, Northern Ethiopia.MethodsInstitutional based comparative cross-sectional mixed quantitative and qualitative methods were used. Data was collected through exit interviews with 456 antenatal care attendees. Qualitative data were also collected using an in-depth interview with providers. The collected data were entered using EPI info version 3.5.1 software then exported to SPSS version 21 software for analysis. Finally, multivariate logistic regression was employed to identify determinants of time spent on antenatal care provision at p-value < 0.05.ResultsMajority 378 (84.8%) of pregnant woman were served below the mean standard time in both public and private health facilities. The mean (± SD) time spent for first antenatal care provision in private was 19.7 (± 8.5) minutes, which is higher than public health facilities with mean time spent (± SD) of 13.2 (± 3.8) minutes. The mean time spent on antenatal care was significantly different in public and private health facilities. Factors that significantly affect time spent on provision of antenatal care were: type of health facilities [AOR = 2.60; 95% CI, 1.07–6.33], frequency of antenatal care visit [AOR = 3.50; 95% CI, 1.92–6.36] and language similarity with provider [AOR = 2.74; 95% CI, 1.23–6.12].ConclusionThe mean time spent for first and revisit of ANC in both health facilities was lower than the WHO standards. Type of health facilities, frequency of antenatal care visit and language similarity with provider were predictors for time spent on ANC provision. Efforts should be targeted on standard provision of antenatal care.
Parents’ health information seeking behaviour – does the child’s health status play a role?
Authors: Baumann Isabel , Jaks Rebecca , Robin Dominik , Juvalta Sibylle , Dratva Julia
Published: April 2020

BackgroundDigital media are increasingly abundant and being used to seek health information. To date, very little is known about parental seeking behaviour for child health information outside of English-speaking and Nordic countries. Our study “Digital parental counsellors” examines how parents search for health information in digital media, print media and among personal contacts, distinguishing between the search for information about general child health and development and child’s acute illness, and comparing information seeking behaviour by disability status of the child.MethodsA questionnaire was sent to 2573 parents (response rate: 30%) to a population-based sample of parents with children aged 0–2 years (N = 769). We developed a frequency score of use of different information sources and conducted bivariate and multivariate linear regression analyses to describe parental search behaviour and the association with child’s disability status.ResultsThe sample consists of 88% mothers (mean age: 35.7 years SD 4.33). Children’s mean age is 16 months (SD 7.1), 49% of the children are female and 6% have a disability. Parents use digital media significantly more frequently to search for information about general health and development questions than about an acute child’s illness (p < 0.001). In case of acute child’s illness, parents refer to their paediatrician, family members and other personal contacts significantly more frequently than other information sources (p < 0.001). The use of digital media and personal contacts does not significantly vary between parents with and without a disabled child, whereas the use of print media does (p < 0.02). Moreover, irrespective of disability, 45% of parents resort to the Internet prior to a paediatric visit and 27% after a visit when a visit did not answer all questions.ConclusionsDespite the high prevalence of digital media, personal contacts are still the most frequent health information resource for parents with young children. Parents combine all information resources (online, print, personal network) to improve their understanding or check the validity of information received regarding their child’s health. It is thus of utmost importance, that the increasingly accessed digital information parents search for is correct, understandable and addresses parent’s concerns.Trial registration:BASEC Req-2017-00817 (30 October 2017)
The Benefit of Advanced Age on Survival in Patients Undergoing Laparoscopic Pancreaticodoudenectomy, A Multi-Center, Comparative study-Cohort Study
Authors: Hendi Maher , Mou Yiping , Lu Chao , Zhang Bin , Xu Xiaowu , Zhang Renchao , cheng Zhouyu , Chen Ke
Published: April 2020

Background: Management of malignant diseases in elderly patients has become a global clinical issue because of the increased life expectancy worldwide. The advancements in surgical techniques and perioperative management have reduced age-related contraindications for LPD. Past papers have reported that elderly patients undergoing laproscopic pancreatoduodenectomy (LPD) are at an increased risk compared to non-elderly patients. The aim of this paper is to compare a single centre risk of LPD in elderly and non-elderly patients.Methods: Retrospective review (n = 237) of perisurgical outcomes in patients undergoing LPD during the months of September 2012–December 2017. Outcomes in elderly patients (aged ≥75 years) were compared with those in non-elderly patients.Results: In elderly patients, transfer to ICU was more frequent (odds ratio [OR] 6.49, P = 0.001) and mean hospital stay was lengthier (21.4 days compared with 16.6 days, （P = 0.0033) than for non-elderly patients. There was no statistically significant difference in operation time (P=0.494), estimated blood loss (P=0.0519), blood transfusion (P=0.863), decreased gastric emptying (DGE) (P=0.397), abdominal pain (P=0.454), food intake (P=0.241), time to self ambulation (P=1), reoperation (P=0.543), postoperative pancreatic fistula (POPF) grade A (P=0.454), POPF grade B (P=0.736), POPF grade C (P=0.164), hemorrhage (P=0.319), bile leakage (P=0.428), infection (P=0.259), GI bleeding (P=0.286), morbidity (P=0.272) or mortality (P=0.449) between the two groups.Conclusions: Elderly patients who underwent LPD in this study had significantly good overall survival after LPD and similar to young patients . The perioperative and long term outcomes of LPD are not worse .The Both rate of ICU admission and hospital stay increased in elderly patients undergoing LPD when compared with non-elderly ones. LPD can be performed on elderly patients with similar outcomes as younger patients; therefore Age it self should not be a contraindication to LPD for pancreatic cancer, but it suggests that elderly patients with comorbidities should be more stringently selected for surgery.
Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study.
Authors: Botero-Tovar Natalia , Zuluaga Gina Paola Arocha , Varela Andrea Ramírez
Published: April 2020

Background
Intersectoral actions (ISA) are a recognized relationship between the health sector and other sectors to improve health outcomes. Although a frequent topic in public health, evidence for systematic evaluation of implementation of ISA is scarce. An intersectoral health intervention for infants under one-year-old with, and at risk of, stunting (low height-for-age) was developed by a public-private partnership in Bogotá, Colombia, during 2018 and 2019. Here we report a case study conducted in parallel to the intervention designed to assess factors that influenced implementation of the ISA.
Methods
The case study was developed using a concurrent mixed-methods design, with the qualitative component giving context to the quantitative results. The qualitative component was obtained from four workshops, three focal groups, and 17 semi-structured interviews with actors involved in the intersectoral intervention. The quantitative component was obtained with two questionnaires that evaluated perceptions on improvement and partnership functioning of the ISA.
Results
This study collected information from 122 participants. The intervention demanded intersectoral collaboration. Political will, motivated human resources, and recognition that health results from collaboration facilitated intersectoral actions. Intersectoral actions were limited by difficulties in engaging the health sector, communication challenges related to local health service decentralization, and administrative barriers.
Conclusions
Intersectoral actions have been recently discussed in the literature due to challenges on implementation, idealization, inconsistent demands, and doubts about economic outcomes. The implementation of intersectoral public health interventions can be jeopardized by a lack of coordination and management skills.
Using Behaviour Change Theories to Understand Pediatric Emergency Discharge Communication Interventions
Authors: Gallant Allyson J , Bishop Andrea , Cassidy Christine , Egar Jeanne , Curran Janet
Published: April 2020

Background

Interventions to improve discharge communication in emergency practice settings are inherently complex and incorporate multiple strategies aimed at patient, caregiver and healthcare provider behaviours. Behaviour change theories, including the capability-opportunity-motivation-behaviour (COM-B) model and Behaviour Change Technique Taxonomy version 1 (BCTTv1), provide consistent language for identifying and evaluating the active components of interventions. The objectives of this study were to: (1) identify common barriers and enablers to discharge communication interventions and (2) describe behaviour change techniques (BCTs) present in pediatric emergency discharge communication interventions aimed at patients, caregivers and health care providers.
Methods

We conducted a secondary analysis of 35 experimental and quasi-experimental studies included in a narrative synthesis of discharge communication interventions in pediatric emergency care. Included studies were reviewed to identify reported barriers and enablers to implementation and intervention effectiveness, which were then mapped to the COM-B model. Trained BCT coders independently coded intervention descriptions using the BCTTv1 as a coding framework. Consensus was used to resolve any discrepancies. BCTs were analyzed using descriptive statistics to determine the frequency of the 93 individual BCTs and 16 BCT categories for patient/caregiver and health care provider interventions.
Results

Barriers and enablers were identified at the patient/caregiver, health care provider, intervention and health system levels. Psychological capability was the most frequently coded COM-B component. Of the 33 studies that included BCTs, 29 interventions targeted patients or caregivers. A total of 20 different individual BCTs were identified across the interventions in the 33 studies. The number of BCTs identified in each study ranged from 1–9 BCTs, with most (n = 14, 42%) interventions containing one BCT. Reporting deficiencies were noted related to adequate details of intervention components and implementation fidelity.
Conclusions

The COM-B model and BCTTv1 proved to be useful tools to provide a foundational understanding of the common mechanisms used in pediatric discharge communication interventions. With only a fraction of the available BCTs were used in the included studies, future research is needed to explore the utility of other BCTs to address common implementation barriers and improve the effectiveness of discharge communication interventions.
The role of the General Practitioner in managing age-related hearing loss: Perspectives of General Practitioners, patients and practice staff
Authors: Bennett Rebecca Jane , Fletcher Susan , Conway Nicole , Barr Caitlin
Published: April 2020

Background
For people with hearing loss, the General Practitioner (GP) can play an instrumental role in early detection of hearing loss as well as guiding appropriate and timely choices for addressing hearing concerns. The aim of this study was to generate a conceptual framework for understanding the role of the GP in managing age-related hearing loss.
Methods
Concept mapping techniques were used to gather the perspectives of GPs (n = 8), adults with hearing loss (n = 22), and professionals working with GPs (n = 5), in Australia. Participants generated statements describing the role of the GP in managing age-related hearing loss, and then grouped the statements to identify key themes, via an online portal.
Results
Ninety-eight items describing the role of the GP in managing age-related hearing loss were identified across six concepts: 1) Determine - Diagnose - Discuss, 2) Ask - Assess - Act, 3) Know - Refer - Coordinate, 4) Inform - Advise - Partner, 5) Educate - Strategise - Encourage, 6) Reassure - Support - Empower.
Conclusions
The role of the GP in managing age-related hearing loss is multifaceted and requires partnership that motivates and empowers patients’ to overcome their hearing concerns. Enlisting the help of Practice Nurses, Practice Managers and local audiologists could help GPs improve their hearing loss detection and intervention rates.
Implementation of the Cardiovascular Health Awareness Program (CHAP) for adults on a waiting list for a family physician
Authors: Kaczorowski Janusz , Lussier Marie-Thérèse , Girard Magali , Beaulieu-Carbonneau Audrey
Published: April 2020

Background: The Cardiovascular Health Awareness Program (CHAP) was originally developed and evaluated as a community-based cardiovascular disease (CVD) prevention program in communities where access to family physicians was not a significant issue. Many Canadians now face sub-optimal access to a regular source of primary healthcare. Centralised waiting lists and prioritization based on urgency of medical need were created to address this problem. Our objective was to assess the potential benefits of offering a modified version of the CHAP program to adults on the waiting list.Methods: The implementation was conducted in Laval (Canada), targeting individuals 40 years of age or older who were registered on the waiting list (GACO) and had a priority code of 3. Participants were invited through a personalized letter to attend sessions in community health centres. The sessions were facilitated by trained volunteers and supervised by a nurse. During the sessions, participants completed CVD risk profiles, risk of type 2 diabetes questionnaire (CANRISK); had their blood pressure, height and weight as well as waist circumference measured; received targeted healthy lifestyle and patient education materials; and were referred to local programs including a medical follow-up, when required. Results: A total of 2,036 invitation letters were sent resulting in 281 (14.2%) participants attending one of 26 3-hour sessions held in 4 community health centres, assisted by 33 volunteers and supervised by a nurse. The average age of attendees was 58.1 (SD=8.2) and a majority were female (58%, n=163). Most participants were sedentary (57.3%, n=161), had low fruit and vegetable consumption (54.4%, n=153), and were overweight (38.9%, n=109) or obese (41.7%, n=117). A third of participants (34.2%, n=96) had BP ≥140/90 and 11.4% (n=32) were classified as having a very high risk for developing diabetes. Over 40% (n=117) of participants were referred to health promotion programs offered by local health authorities and 4.6% (n=13) were referred to family physicians or emergency departments (1.8%, n=5) for short-term medical assistance.Conclusions: Many Laval adults on a waiting list for a family physician would greatly benefit from having a regular source of primary healthcare to prevent, delay, and manage their cardiovascular health.
Work related factors affecting the retention of medical officers in the preventive health sector in Sri Lanka
Authors: Arnold Mahendra , Fernando Dinusha , Wickramanayake Kapila , Karunapema Palitha , Wickramatilake Sepali , Fernando Yamuna , Denawaka Chandani , Mahesh Pasyodun Koralage Buddhika , Panditharathna Sujeewa
Published: April 2020

Background

Human resources are the livelihood of all types of organizations. The biggest challenge that organizations are facing today is not only managing these resources but also retaining them. Preventive health sector plays a vital role in the healthcare system. Medical Officers of Health (MOH) are the Medical Officers providing preventive health services in Sri Lanka. This study was carried out to explore the factors affecting retention of Medical Officers of Health in the preventive health sector in Sri Lanka.
Methods

A descriptive cross sectional study was carried out among Medical Officers of Health in the Colombo district which has 18 MOH Offices with 64 Medical Officers. A pre-tested self-administered questionnaire was used as the study instrument. Data were analyzed using descriptive analysis, correlation and regression analysis.
Results

Regression analysis showed that all four variables; recognition, work schedule, remuneration and responsibility are positively and significantly correlated with retention of Medical Officers of Health in the preventive health sector. The variable ‘work schedule’ showed the highest impact to the retention of Medical Officers of Health.
Conclusions

In order to retain trained Medical Officers of Health in the Sri Lankan preventive health sector, health authorities should address the factors that influence retention. If policy makers fail to address these factors the preventive health services will be negative impact due to shortage of key service providers.
A single-center experience with service organization for patients with ARFID
Authors: Norris Mark , Obeid Nicole , Santos Alexandre , Valois Darcie , Isserlin Leanna , Feder Stephen , Spettigue Wendy
Published: April 2020

Background

To date, very little research has explored the impact that the newly articulated diagnosis Avoidant restrictive food intake disorder (ARFID) has had on feeding and eating disorder program service organization and delivery. The purpose of this paper is to provide a descriptive overview of a single-center, ARFID-specific pilot clinic that sought to better understand the specific needs of patients with ARFID and gain insight into treatment requirements.
Methods

A retrospective cohort study was completed on patients with ARFID admitted to a specialized pilot clinic within a tertiary care hospital.
Results

Over an 18 month period, a total of 31 patients were assessed, with 26 patients completing follow-up assessments. Patients presented with heterogeneous manifestations of ARFID, with treatment plans tailored to meet individual needs at assessment and over the treatment period. A multidisciplinary approach was most often administered, including a combination of administered individual therapy, family therapy, medical monitoring, and prescribed medications. Only 30% of patients were treated exclusively by therapists on the eating disorder team.
Conclusions

The experiences gained from this pilot study highlight the need for specialized resources for assessment and treatment of patients with ARFID, the importance of a multidisciplinary approach to treatment, and the necessity of utilization of ARFID-specific measures for program evaluation purposes.
Comparison of Femoral Offset Measurement Accuracy between Three-Dimensional-CT and X-ray in Developmental Dysplasia of the Hip Patients and Normal People
Authors: Han Qing , Xu Xinyu , Zhang Aobo , Chen Bingpeng , Qin Yanguo , Wang Jincheng
Published: April 2020

Background: Femoral offset (FO) is essential for the guidance of prosthesis choice in the Total Hip Arthroplasty (THA). In current clinical practice, X-ray is the primary method to measure FO. However, the X-ray measurement of FO has low accuracy, especially for DDH. In this study, three-dimensional (3D)-CT was conducted to provide more accurate measurements. Methods: 3D-CT and X-ray measurements of FO from 55 DDH patients and 60 normal volunteers were conducted twice by two osteoarticular surgeons. The inter- and intra-observer reproducibility was analyzed by intraclass correlation coefficient (ICC). The FO values measured by 3D-CT and X-ray were compared and the absolute value of the difference was recorded as the error value of X-ray. These values were analyzed by paired-sample t-test, independent-sample t-test and Dunnett's t-tests, p < 0.05 was considered to be significant. Results: Significant differences were founded between 3D-CT and X-ray in the FO measurements, the absolute values of these differences were 5.42 ± 4.66 mm in DDH patients and 3.74 ± 2.80 mm in normal people, which was regarded as the X-ray error values. According to 3D-CT measurement, the FO value of DDH patients (including Hartofilakidis-I, II, III) was lower than that of normal people. The FO value of Hartofilakidis-II DDH patients was lower than that of Hartofilakidis-I patients. Conclusion: 3D-CT is more precise than X-ray in the measurement of FO in DDH patients and normal people. The 3D-CT method should be recommended to measure FO for the choice of prosthesis in DDH patients before THA.
One-stage anterior focus debridement, interbody graft using titamium mesh cages, and anterior instrumentation and fusion in the surgical treatment of short segment thoracic tuberculosis with paraplegia
Authors: zhang huijun , lu zenghui , wei lin , ding chao , yang junsong
Published: April 2020

Purpose The purpose of this study was to evaluate the clinical efficacy of primary anterior debridement, bone graft fusion and internal fixation in the treatment of short segmental thoracic tuberculosis with paraplegia.Methods We performed a retrospective analysis of 16 adult patients with short segment thoracic spinal TB with paraplegia who underwent surgery between September 2013 to March 2017. All the 16 patients were treated using a single primary anterior debridement, bone graft fusion and internal fixation. Clinical manifestations, laboratory, neurological symptoms,bone fusion and imaging results were subjected to statistical analysis.Results All patients underwent operation successfully. The preoperative ESR and CRP level of all patients were 72.6 ± 27.5 mm/h and 75.7 ± 25.9 mg/L, which decreased to 15.9 ± 4.6 mm/h and 4.7 ± 2.0 mg/L at the final follow-up, respectively. The preoperative thoracic kyphosis angle were 30.7 ± 7.1°respectively. The corresponding postoperative angles were ameliorated significantly to 9.1 ±1.9°. During the follow-up, spinal paraplegia was significantly improved in all patients.The symptoms of chest and back pain were alleviated and disappeared at 1–6 months postoperatively.Patients were followed up for 24–48months (average, 35.6 ±9.6 months). Among 16 patients, no recurrence, and bone fusion was achieved at the final follow-up.Conclusion The clinical results of primary anterior debridement, bone graft fusion and internal fixation in the treatment of segmental thoracic tuberculosis with paraplegia were satisfactory.
Effects of 4 weeks of Lactobacillus plantarum 299v supplementation on nutritional status, enteral nutrition tolerance, and quality of life in cancer patients receiving home enteral nutrition – a double-blind, randomized, and placebo-controlled trial
Authors: Karolina Kaźmierczak-Siedlecka , Folwarski Marcin , Ruszkowski Jakub , Skonieczna-Żydecka Karolina , Szafrański Waldemar , Makarewicz Wojciech
Published: April 2020

BackgroundSeveral human trials have confirmed that Lactobacillus plantarum 299v (Lp299v) relief the gastrointestinal symptoms observed in patients with irritable bowel syndrome, such as nausea, vomiting, and diarrhoea. These symptoms are similar to those associated with home enteral nutrition and they affect nutritional status as well as patients’ quality of life.MethodsThe current double-blind, randomized, and placebo-controlled study included 35 cancer patients receiving home enteral nutrition. There were 2 groups of participants consuming either 2 × 1010 CFU of Lp299v (n = 21) or placebo (n = 14) for 4 weeks. The aims of this study were to determine the effect of Lp299v on nutritional status, enteral formula tolerance, and quality of life in cancer patients.ResultsAn increase in serum albumin concentration was significantly higher in the Lp299v group than in the placebo group at the endpoint (p = 0.032). Moreover, the changes in the frequency of vomiting and flatulence were significantly reduced at week 4 compared to baseline in the Lp299v group (p = 0.0117). The improvement of quality of life was observed in both groups; however, with no statistically significant differences between the analysed groups (p > 0.05).ConclusionsWe have demonstrated that administration of Lp299v in cancer patients receiving home enteral nutrition may improve laboratory parameters, predominantly the concentration of albumin, however, overall it does not have an impact on nutritional status. Lp299v may reduce the gastrointestinal symptoms related to enteral nutrition; notwithstanding, the improvement of quality of life may be the result of enteral nutrition rather than the effect of administration of Lp299v.Trial registration ClinicalTrials.gov (identifier: NCT03940768)
Aortic stiffness and central hemodynamics in treatment naïve HIV infection: A cross-sectional study
Authors: Martínez-Ayala Pedro , Alanis-Sánchez Guillermo Adrian , Gonzalez-Hernández Luz Alicia , Álvarez-Zavala Monserrat , Cabrera-Silva Rodolfo Ismael , Andrade-Villanueva Jaime Federico , Sánchez-Reyes Karina , Ramos-Solano Moisés , Castañeda-Zaragoza Diego Alberto , Cardona-Müller David , Tostuka-Sutto Silvia , Cardona-Muñoz Ernesto , Ramos-Becerra Carlos Gerardo
Published: April 2020

Background: Human immunodeficiency virus (HIV) infection is associated with a greater risk of cardiovascular disease (CVD). HIV infection causes a chronic inflammatory state and increases oxidative stress which can cause endothelial dysfunction and arterial stiffness. Aortic stiffness measured by carotid femoral-pulse wave velocity (cfPWV) and central hemodynamics are independent cardiovascular risk factors and have the prognostic ability for CVD. We assessed cfPWV and central hemodynamics in young individuals with recent HIV infection diagnosis not receiving antiretroviral therapy. We hypothesized that HIV individuals would present greater cfPWV and central hemodynamics (central systolic blood pressure and pulse pressure) compared to uninfected controls. Methods. We recruited 51 treatment naïve HIV individuals (HIV(+)) without previous CVD and 51 age- and sex-matched controls (HIV(-)). We evaluated traditional CVD risk factors including metabolic profile, blood pressure (BP), smoking, and immune state. Arterial stiffness and central hemodynamics were evaluated by cfPWV, central systolic BP and central pulse pressure (cPP) via applanation tonometry. Results. HIV(+) individuals presented a greater prevalence of smoking, reduced high density lipoprotein cholesterol, and body mass index. 65.9% of HIV(+) individuals exhibited lymphocytes <500 cell/µL. There was no difference in brachial or central BP between groups; however, HIV(+) individuals showed significantly lower cPP. We observed a greater cfPWV (mean difference= 0.5 m/s; p<0.01) in HIV(+) compared to controls, even after adjusting for heart rate, mean arterial pressure and smoking. Conclusion: In the early stages of infection, non-treated HIV individuals present a greater prevalence of traditional CVD risk factors, arterial stiffness, and normal or decreased central hemodynamics.
Prevalence of Metabolic Syndrome among Breast Cancer Survivors in East Coast of Peninsular Malaysia
Authors: Amirfaiz Syed , Shahril Mohd Razif , Lua Pei Lin , Nurnazahiah Ali , Zakarai Nor Syamimi , Lok Ving , Ahmad Aryati , Sulaiman Suhaina
Published: April 2020

To date, limited data are available on metabolic syndrome (MetS) prevalence among breast cancer survivors in Malaysia. Therefore, this study was conducted to determine the prevalence of MetS and abnormal MetS components among breast cancer survivors in East Coast of Peninsular Malaysia. This cross-sectional study included 95 breast cancer survivors (age 53.7±7.6 years) who have completed main cancer treatments for ≥6 months. Cancer survivors were recruited from two main government hospitals in Kelantan and Terengganu using a purposive sampling method. According to the Harmonized criteria, the MetS prevalence was 50.5%. Among those with MetS, the most prevalent abnormal metabolic components were triglycerides (91.2%), fasting blood glucose (79.6%) and HDL-c level (78.4%). Except for total cholesterol and LDL-c, all other MetS components were significantly different (p<0.05) between those with and without MetS. Significant differences between MetS and non-MetS groups were found for weight, BMI, waist circumference, body fat percentage and cancer stages (p<0.05). Otherwise, no significant difference was reported in other sociodemographic and clinical parameters between cancer survivors with and without MetS. In conclusion, MetS was highly prevalent among breast cancer survivors in this study, with weight, BMI, waist circumference, body fat percentage and cancer stages significantly affect MetS status.
Hyperlipidemia is a risk factor for bladder cancer in young adult men: a population-based cohort study
Authors: Huang Chun-Jen , Shih Hung-Jen , Lin Ke-Hsun , Wen Yu-Ching , Fan Yen-Chun , Tsai Pei-Shan
Published: April 2020

Background: A high-cholesterol diet increases the risk of bladder cancer. This study investigated whether hyperlipidemia is a risk factor for bladder cancer.Methods: Data from Taiwan National Health Insurance Database were analyzed. The primary study end point was the occurrence of newly diagnosed bladder cancer. The relative risk of bladder cancer in a hyperlipidemia cohort was compared with that in an age- and gender-matched non-hyperlipidemia cohort.Results: Our data revealed that the hyperlipidemia cohort had a significantly higher subsequent risk of bladder cancer than did the non-hyperlipidemia cohort (adjusted hazard ratio [HR]=1.37, P=0.005) after propensity score adjustment. Subgroup analyses revealed that men in the hyperlipidemia cohort had a significantly higher subsequent risk of bladder cancer than did those in the non-hyperlipidemia cohort (adjusted HR=1.36, P=0.040). However, the risk of bladder cancer was not significantly different between women in the hyperlipidemia cohort and those in the non-hyperlipidemia cohort. Subgroup analyses further revealed that the risk of bladder cancer was significantly higher in men aged 20–39 years in the hyperlipidemia cohort than in those in the non-hyperlipidemia cohort (adjusted HR=5.45, P=0.029).Conclusions: Hyperlipidemia is a risk factor for bladder cancer in young adult men.
Estimation of Non-invasive Cuff-less Blood Pressure Using the Photoplethysmogram Signal
Authors: Rajagopal SureshKumar , Vairavan Manimegalai , Ramachandaran Dhanagopal
Published: April 2020

Background: This article presents a novel technique relating to the advancement of non-invasive cuff less blood pressure measurement using the PhotoPlethysmoGram (PPG) signals. The morphological characteristics of PPG signal have a strong correlation with the cardiovascular parameters and blood flow. The exact distinguishing feature of the PhotoPlethysmoGram signals is such as height as well as width of the pulse has considered into count for the measurement of blood pressure. In comparison to the existing measurement system like inflatable cuff and electrocardiogram units, this system only requires a pulse plethysomogram unit. The traditional blood pressure unit has many disadvantages such as expert personal, depends on the ability of the person to detect the korotkoff sounds, provides discomfort to the user and is not suitable for long time measurements. Moreover, this is very perceptive to artifacts owing to the existence of cuff. The PAT, PTT of the existing non-invasive techniques need many number of factors for estimation of blood pressure and are highly complex. Results: This method has intended for estimating the cardiovascular parameter of a non-invasive cuff-less blood pressure by utilizing the method of linear regression from PhotoPlethysmoGraphy signal. The real data has obtained using the GUI LabVIEW and further mathematical modelling of the obtained signal has performed by analysis using MATLAB tools. The obtained results had revealed that this technique is simple, non-invasive, cost-effective and consistent for estimating the arterial pulse signal in connection to variation in the amplitude of the waves. The exact distinguished feature of the PhotoPlethysmoGraphy signals like height and width of the pulse, which had considered into the count up for the measurement of blood pressure. The results obtained have been cross validating during the existing blood pressure monitors. Conclusions: The simulated output reveals the height of the pulse (systolic height) is inversely proportional to the systolic blood pressure as well as it rises for increasing cardiac output, however it occurs in less span of time. The pulse width and area is directly proportional to the systolic blood pressure. Our simulation result shows the specific relation between PPG and blood pressure. Error percentages as per the calculation among the extracted features have been less for inflection height ranging from ±10 to a min of ± 2.
mGlu3 receptor regulates microglial cell reactivity in neonatal rats
Authors: Zinni Manuela , Mairesse Jerome , Pansiot Julien , Fazio Francesco , Iacovelli Luisa , Orlando Rosamaria , Nicoletti Ferdinando , Vaiman Daniel , Baud Olivier
Published: April 2020

Background: Perinatal inflammation is a key factor of brain vulnerability in neonates born preterm or with intra-uterine growth restriction (IUGR), two leading conditions associated with brain injury and responsible for neurocognitive and behavioral disorders. Systemic inflammation is recognized to activate microglia, known to be the critical modulators of brain vulnerability. Although some evidence support a role for metabotropic glutamate receptor 3 (mGlu3 receptor) in modulation of neuroinflammation, its functions are still unknown in the developing microglia.Methods: We used a double-hit rat model of perinatal brain injury induced by a gestational low-protein diet combined with interleukin-1β injections (LPD/IL-1β), mimicking both IUGR and prematurity-related inflammation. The effect of LPD/IL-1β on mGlu3 receptor expression and the effect of mGlu3 receptor modulation on microglial reactivity were investigated using a combination of pharmacological, histological, and molecular approaches.Results: Exposure to LPD/IL-1β significantly down-regulated Grm3 gene expression in the developing microglia. Both transcriptomic analyses and pharmacological modulation of mGlu3 receptor demonstrated its central position in the control of inflammation in resting and activated microglia. Microglia hyper-reactivity to inflammatory challenge induced by LPD/IL-1β exposure was reduced by an mGlu3 receptor agonist. Conversely, both specific pharmacological blockade and siRNA knock-down of mGlu3 receptors in control microglia mimicked the pro-inflammatory phenotype observed in microglial cells exposed to LPD/IL-1β.Conclusions: Overall, these data show that Grm3 plays a central role in the regulation of microglial reactivity in the immature brain. Selective pharmacological activation of mGlu3 receptors may prevent inflammatory-induced perinatal brain injury.
Effect of sacral neuromodulation in patients with neurogenic bladder
Authors: Zheng Jianhong , Shi Wenxia
Published: April 2020

Background: Sacral neuromodulation (SNM) is widely used in patients with non-neurogenic overactive bladder and urinary retention but has only been applied recently for the management of the neurogenic bladder, and data are still scarce. Methods: This was a case series of patients who met the diagnosis of neurogenic bladder and received SNM between January 2016 and April 2019. Each participant received SNM. The evaluation of the participants' quality of life and urination diary (bladder symptom tracking form) included urine leaks, if urine pads need to be changed, urgent urination (0-5 points), urinary catheterization, and urinary output. The participants' expected values were analyzed. An effect >50% was considered effective. Results: All participants complied with the preoperative perineal floor exercise training. Among the 14 participants who underwent phase I SNM, one had no response at all and was excluded. After permanent electrode implantation, the urine output of one participant was similar to that of before surgery, and one participant had an incision infection, and the electrode was eventually removed. The postoperative follow-up after stage II SNM was 7.5±2.1 (range, 5-12) months. All 11 patients showed significant improvements in numbers of urination, urgency score, residual volume, and urination volume. The postoperative NEWS pain score was 1.6±0.9. Conclusions: Two-stage SNM can achieve satisfactory results in patients with neurogenic bladder. The key to success might lie in the correct and effective nursing and guidance throughout the perioperative management.
Association between Porphyromonas gingivalis and tumor-promoting status in esophageal squamous cell carcinoma
Authors: Chen Miao-Fen , Lu Ming- Shian , Hsieh Ching-Chuan , Chen Wen-Cheng
Published: April 2020

Background The microbiota is reported to affect tumor growth and the microenvironment of gastrointestinal cancers. However, the possible role of keystone bacterial infection in the development of esophageal squamous cell carcinoma (EsoSCC) remains unclear. In the present study, we studied the relationship between the oral microbiome, the periodontal pathogen Porphyromonas gingivalis (PG), and EsoSCC and elucidated the underlying mechanisms.Methods The microbiota in oral biofilms from patients was studied to identify bacterial biomarkers associated with EsoSCC by bioinformatics analyses. We then performed immunohistochemistry to examine the presence of PG in the esophageal tissues and analyze its relationship with the clinicopathologic characteristics in 156 EsoSCC patients. Furthermore, we investigated the role of PG infection in the progression of EsoSCC and its relationship with tumor microenvironment.Results The microbiota profiles from oral biofilms revealed that the abundance of PG was associated with a higher risk of developing EsoSCC. The presence of PG was detected immunohistochemically in 57% of cancerous tissues and was associated with a higher clinical stage and poor prognosis. Using cellular experiments and a 4-nitroquinoline 1-oxide (4NQO)-induced tumor animal model, the presence of PG was found to be associated with a higher risk of esophageal cancer. Increased IL-6 expression associated with an augmented epithelial-mesenchymal transition and recruitment of myeloid-derived suppressor cells were possible underlying mechanisms. Furthermore, in animal model including 4NQO-induced tumor and xenograft tumor model, we showed that the increased vitamin D3 induced by UVB light treatment obviously down-regulated IL-6 signaling and subsequently attenuated the increased risk of esophageal cancer induced by PG infection.Conclusions Our findings suggested that the presence of PG played an important role in the progression of esophageal cancer. Directly targeting PG or increasing vitamin D3 could be a promising strategy for the treatment of EsoSCC patients with PG infection noted by oral microbiota screening.
Influence of COL9A1 and COL19A1 Polymorphisms on Kaschin-Beck Disease Risk
Authors: He Xue , Zheng Jianwen , Yuan Dongya , Wang Yuhe , He Yongjun , Wang Li , Bai Mei , Jin Tianbo
Published: April 2020

Objective We aimed to determine whether COL9A1 and COL19A1 polymorphisms were associated with Kaschin-Beck disease (KBD) risk.Methods Five single nucleotide polymorphisms (SNPs) in COL9A1 and COL19A1 were genotyped in 316 KBD patients and 320 healthy controls. The association between genetic polymorphisms and KBD risk were assessed using logistic regression model by calculating odds ratio (OR) and 95% confidence interval (CI).Results After adjustment with age and sex, the frequency distributions of genotypes in rs3806093 and rs9346371 were significantly different between cases and controls. COL9A1 rs3806093 significantly increased KBD risk in co-dominant (OR = 14.80, p = 0.024) and recessive (OR = 16.39, p = 0.019) models. Meanwhile, COL9A1 rs555313 was associated with KBD risk in recessive model (OR = 3.80, p = 0.048).Conclusion COL9A1 and COL19A1 polymorphisms were associated with KBD risk in the Chinese Han population, suggesting roles of COL9A1 and COL19A1 in the development of KBD.
Determining whether age retirement for NBA players is associated with injuries and illnesses: A retrospective study
Authors: Chou Po-Hsin , Yeh Yu-Tsen , Wei Chien Tsai , Su Shih-Bin
Published: April 2020

Background: The careers of professional sport players are usually influenced by injuries and skills. The careers of all-star MBA and regular players depend on their health and how rapidly their skills diminish with age, respectively. Whether the above phenomena are considered and supported in the National Basketball Association (NBA) requires verification.Methods: We downloaded injury data from the NBA website in 2010–2018 and extracted all injury events (=9,783) involving 779 NBA players. Among these players, 705 were retired, 236 possessed all-star titles (60 injured and 170 non-injured), and 466 were regular players (408 injured and 58 non-injured) from 2010 to 2018. Both samples of retired all-star (n = 236) and regular players (n = 466) were compared to verify the effect of injury and illness on the retirement age using the bootstrapping method to estimate 95% confidence intervals in medians. We hypothesized that injuries and illnesses are associated with the retirement age of all-star players and irrelative to that of regular NBA players. Social network analysis(SNA) was performed to highlight the top three injuries with the highest degree centralities in their respective clusters.Results: We observed that the top three degree centralities include (1) sprained a left ankle, (2) sprained a right ankle, and (3) illness. The top two most injured NBA teams in 2010-2018, as obtained by the metrics for measurement, were Timberwolves (x-index = 32.86) and Hornets (x-index = 31.42). Most of the careers of NBA all-star players were affected by injuries/illnesses. The NBA careers of regular players were terminated mostly according to their skill.Conclusion: Although a number of things can be debated with regard to NBA, everyone can agree on one thing: Injuries are the worst. We confirmed that injuries and illnesses exhibit significant associations with the retirement age of all-star players and are irrelative to that of regular NBA players. Sports medicine is urgently needed to help players in preventing possible injuries while in the court in the discernable future.
Evaluation Of Blood Processed By Cell Saver In Pediatric Scoliosis
Authors: García Elena , Rey Pilar Del , Martínez Ernesto
Published: April 2020

Introduction We study the hematological and microbiological characteristics from the autologous blood processed through the intraoperative cell saver used in our centre (Orthopat®) during the correction of pediatric scoliosis, which is known to be a potentially bleeding surgery. Material and methods Descriptive analysis of 31 patients undergoing pediatric scoliosis surgery. All of them received blood processed by cell saver intraoperatively. The variables collected were: demographic data, volume of the autogenous red blood cell (RBC) concentrate, blood count, biochemistry, blood culture, preoperative and postoperative blood tests of the patients, incidence of fever during reinfusion of RBC concentrate, postoperative surgical site infections and length of hospital stay. Results Average volume obtained 288.06ml (sd 154.68). Hematocrit 70.38% (ds 10.03) in accordance with cell-saver commercial data (75%). Of the blood samples obtained, 42.86% had blood cultures that were positive for aerobes and 48.28% for anaerobes. The relation between postoperative infections and contamination of blood concentrates was not statistically significant. When comparing the pre-surgery and post-surgery analytical samples, statistically significant differences (p <0.05) were found in the following: hemoglobin and hematocrit decreased in the postoperative period, while coagulation parameters show a tendency to coagulopathy.Conclusion Our cell saver obtains RBC concentrates with a percentage of hematocrit in agreement with available information. The reinfusion of them is safe from an infectious and biochemical point of view, but its immunological implications are not clear. This surgery continues to result in a significant loss of blood. Measures taken to avoid allogenic transfusions remain necessary and should be enhanced.
Primary Dysmenorrhoea: Prevalence and Knowledge assessment in 10 – 18-year-old Syrian female teenagers: A cross-sectional study with pre-post analysis.
Authors: Alhoulaiby Sami , Alkhaledi Ahmad , Isstaif Juman , Yafi Ruba Zuhri , Alkassas Omar , Alakrad Nawwar , Alhalabi Marwan
Published: April 2020

Introduction: Gynaecological complaints and primary dysmenorrhoea among young females are usually managed using popular myths, and have a wide spectrum of consequences on everyday life. Methods: A cross-sectional study to assess the prevalence of dysmenorrhea and basic knowledge, with a pre-post analysis after the intervention was applied. The study was carried in randomly selected female public schools in Damascus on a randomly selected sample of female students aging between 10 and 18 years old. We used a self-report questionnaire immediately before the awareness sessions and two weeks later. The questionnaire included multiple-choice questions on various aspects of the menstrual cycle, dysmenorrhoea and common myths in the Syrian society. The data were analyzed using SPSS ® , Microsoft Excel ® , and Microsoft Access ® software. Results: A total of 579 vs. 261 female students participated. The prevalence of dysmenorrhoea was 87.2%. Only 47.3% of participants knew the correct origin of menstruation blood, and most of them did not consult a doctor regarding the pain (91.6%). The answers were weighed and compared, resulting in an insignificant p-value for the students’ knowledge after the awareness campaign (p = 0.687, CI = 95%). Discussion and conclusion: Dysmenorrhoea is highly prevalent among Syrian school students. The modest knowledge on this condition, the use of home remedies and the insignificant improvement after the sessions indicate the need to focus on creatively improving information delivery methods in a long sustainable timeframe.