bluuebunny/crossref_metadata_2025 huggingface dataset:
The Affirmation – Tapping on Pain Perception and Serotonin Serum Level of Post – Caesarian Section patients
Authors: Suwito Joko , Putra Suhartono Taat , Sulistyono Agus
Published: March 2020

Introduction: Affirmation - tapping interventions have been shown to reduce pain complaints in post-operative patients completing conventional treatment. This is thought to be due to serotonin performance but clinical studies have not been conducted. The aim was to compare the mean perception of the pain reported by post-operative patients given affirmation- tapping treatment with another treatment as a complementary nursing intervention. This was to see if the performance of the serotonin serum level is different from in other treatments.Methods: We used a randomized post-test only control group design carried out in parallel in post-caesarean section patients. The sample totaled 40 patients divided into four groups (10 in affirmation, 10 in tapping, 10 in affirmation-tapping and 10 in the control). They were obtained through simple random sampling. The instruments included affirmation-tapping guidelines, Elisa kits and the McGill - Melzack Pain Questionnaire short-form (MPQsf). The independent variable was the intervention of affirmation-tapping and the dependent variables were pain perception and serotonin level. The data was analyzed using simple linear regression.Results: The average variant of the serotonin levels in the affirmation-tapping treatment group was higher and thus differed significantly from the other groups.Conclusion: Affirmation-tapping as a complementary nursing intervention can increase the serotonin serum levels of the post-caesarean section patients by complementing conventional treatments. Participant pain complaints were lowest in the affirmation-tapping group with the highest serotonin levels present and these were significantly different to the other groups. Affirmation – tapping was recommended as a complementary intervention in nursing post-operative patients that complements conventional treatment.
Family Support System as an Effort to Optimize Coping Mechanism of Preschool Children During Hospitalization
Authors: Hasinuddin M. , Noviana Ulva , Fitriah Fitriah
Published: March 2020

Introduction: The condition of the child during hospitalisation can experience stress due to environmental changes. Child coping mechanism is very supportive of the adaptation process. The purpose of this study was to analyze the effect of family support system on coping mechanisms during hospitalisation. Methods: It was quasi-experimental with pre-test post-test with control group design. The study population was preschool children who were treated in the Hospital of Bangkalan, East Java Province, Indonesia. Total sample was 60 respondents in treatment and control group and obtained consecutive sampling. The variables were family support system and coping mechanism. Data collection used Children’s Coping Behavior questionnaire and tested by paired t-test. Results: The treatment group showed the coping mechanism was mostly maladaptive (mean=34.07) and after the intervention most of them had adaptive coping (mean=46.87). Whereas in the control group before the intervention, the coping mechanism was mostly maladaptive (mean=36.22) and after the intervention most of the coping groups had maladaptive coping (mean=36.74). Conclusion: Family support systems play an important role in improving the adaptive coping of preschool children during hospitalisation. Nurses should maximise family support as a strategy in interacting with children to enhance coping mechanisms to reduce the stress of hospitalisation.
Differences in Clinical Simulation with Audiovisual and Practicum-based Standard Operating Procedures in Nursing Student Competencies
Authors: Palupi Hendri , Kusnanto Kusnanto , Yuwono Slamet Riyadi
Published: March 2020

Introduction: The biggest challenge in nursing education is to produce nurses who are professional and competent. Effective and efficient learning through appropriate methods and media is very important. Practical learning based on standard operating procedures (SOP) has been widely applied, but clinical simulation approaches with audio-visual media have not been scientifically proven. The purpose of this study is to compare student competencies through clinical simulation learning with audio-visual media and practicums based on SOP.Methods: This was a quasi-experimental study with a pretest-posttest control group design. The sample consisted of 40 students recruited using simple random sampling and then divided into 2 groups: 20 respondents were given clinical simulation methods using audio-visual materials and 20 respondents were given practicum based on SOP. The independent variables were clinical simulation with audio-visual media and practicum based on standard operating procedures. The dependent variable was student competency, assessed using competency assessment including cognitive, affective, and psychomotor methods. Data analysis was conducted using the Wilcoxon test.Results: The use of clinical simulations with audio-visual media and practicum based on SOP can increase the value of competency in nursing students, but the median value on the use of clinical simulations using audio-visual sources is higher than practicum based on SOP.Conclusion: Clinical simulations with audio-visual media can be recommended as effective learning methods and media for nursing students.
Penerapan Root Cause Analysis pada Penurunan Kinerja Karyawan
Authors: Mega Astuti DR  , Uwes Anis Chaeruman  , Mulyadi
Published: March 2020

This study aims to find out the root cause of the decreasing human performance and provide the right interventions to solve the problem in project payment sub division at PT. Sedayu Utama. The research method used is descriptive analysis with qualitative approach, data is obtained through interview, questionnaire and observation. As the results of this study of root cause analysis, the inability to use electronic equipment, to accept constructive criticism due to high level of superiority and lack of initiative thinking are found. Meanwhile from equipment factor such as computer and scanner, it is found to be underutilized and from management factor, it is found that there’s a lack of commitment, competition, coordination and understanding of the company’s procedure, from motivation factor, it is found that there’s a lack of supervision, reward & punishment and lack of value inconsistent with mission. The solutions advised to solve these problems are coaching, knowledge management, sharing session, on the job training and reward & punishment.
The Relationship Of Elementary Pupils’ Final Test Score And Their Conduct Grades In School Of Saint Anthony, Quezon City
Authors: Mambil William Jerick L. , Erbina Erwin Yancy A. , Pinuela Gene Paula B. , Pecson Ann Stefanie A. , Sugay Jasmer Omaria M.
Published: March 2020

The purpose of this research is to determine the relationship between the Elementary pupils’ final test score in CL/GMRC and their conduct grades. This study was conducted to 941 Elementary pupils of the School of Saint Anthony with ages ranging from 6 to 13 years old. This research is quantitative in nature and used descriptive design. Frequency, percentage, means and Pearson r correlation served as the statistical tools of the study. The gathered means displayed that the elementary girls obtained higher scores in their final written exams and conduct grades than the boys. This is apparent across all grade school levels based on the computed means. The collected data present that most of the girls seemed to be more concerned with their grades and conscious of their school behavior compared to the boys. Weak positive relationships between the final written scores and conduct grades were determined based on the computed Pearson r in each grade level. Grade 1 obtained a person r of .176, grade 2 got an r of .294, grade 4 gained an r of .24, grade 5 obtained and r of .23 and grade 6 gained an r of .28. A moderate positive relationship, on the other hand, was calculated for the grade 3 level (.362). It can be derived from these findings that conduct grades in the Elementary levels may serve as a potential variable for the grade school pupils to achieve higher academic grades, particularly in the grade 3 level which is the transition level from lower school to middle school. Teachers, parents and other adults in the lives of the Elementary pupils play important roles in imbibing to the children the importance of being well-disciplined in class to attain higher scores during exams.
Mga Salik Sa Kakayahan Sa Paggamit Ng Pandiwa At Pang-Uri Sa Mga Isinulat Na Komposisyon Ng Mga Mag-Aaral Sa Sekondarya
Authors: Patilan Josephine C.
Published: March 2020

Tinukoy ng pag-aaral na ito ang antas ng kakayahan sa paggamit ng pandiwa at pang-uri sa mga komposisyong isinulat ng mga mag-aaral sa Sanayan na Mataas na Paaralan ng Pamantasan ng Silanganing Pilipinas. Tinukoy rin ng pag-aaral ang mga salik tulad ng wika/wikaing ginagamit sa bahay, paboritong babasahing Filipino, paboritong panooring pelikula, paboritong asignatura, paboritong leksiyon sa Filipino, at grado sa ikatlong markahan at ang kaugnayan ng mga salik na ito sa kakayahan sa paggamit ng pandiwa at pang-uri ng mga mag-aaral. Kasangkot sa pag-aaral na ito ang 166 mag-aaral sa apat na antas ng mataas na paaralan. Ginamit sa pag-aaral na ito bilang instrument ng pananaliksik ay pagsulat ng isang pormal o pinatnubayang komposisyon at pagsulat ng isang komposisyong impormal o malaya. Ginamit din ang isang checklist para sa mga salik na nabanggit. Ginamitan ang pag-aaral na ito ng istadistikang angkop sa pag-aaral gaya ng bahagdan, mean, weighted mean at regression analysis. Karamihan sa mga kalahok sa pag-aaral ay nagsasalita ng Ninorte-Samarnon sa kanilang mga bahay. Ang paboritong babasahin ng mga mag-aaral ay pahayagan. Marami sa mga kalahok ang nanonood ng mga pelikulang Ingles. Ang kanilang paboritong asignatura ay Araling Panlipunan. Ang paborito nilang leksiyon sa Filipino ay panitikan. Marami sa mga kalahok ay nakakuha ng gradong 85 bahagdan sa ikatlong markahan. Mababa ang antas ng kakayahan ng mga mga-aaral sa paggamit ng pandiwa samantalang katamtaman naman ang kakayahan nila sa paggamit ng pang-uri. Sa pagsusuri ng null hypothesis, ang wika/wikaing ginagamit sa bahay, paboritong babasahing Filipino, paboritong panooring pelikula, paboritong asignatura, at grado sa ikatlong markahan ay may makabuluhang kaugnayan sa kakayahan ng paggamit ng pandiwa samantalang ang paboritong leksiyon sa Filipino ay walang kaugnayan sa paggamit ng pandiwa. Ang lahat ng salik na nabanggit ay may makabuluhang kaugnayan sa paggamit ng pang-uri. Inirekomenda ng pag-aaral ang malimit na pagbibigay ng guro ng pagsasanay sa pagsulat ng komposisyon. Makakatulong din sa mga mag-aaral ang pagbabasa ng diyaryo at iba pang uri ng babasahing Filipino at ang panonood ng mga programang Tagalog o Filipino at pelikulang Filipino.
Distribution of hepatitis B virus genotypes in general population of Myanmar via Nation wide study
Authors: Kyaw Yi Yi , Lwin Aye Aye , Aye Khin Saw , Thu Hlaing Myat , Htun Moh Moh , Soe Hnin Ohmar , Aye Kay Thi , Thant Kyaw Zin , Hwang Hyeon Jeong , Cheong JaeHun
Published: March 2020

Background Hepatitis B virus (HBV) infection is a severe health concern worldwide. HBV is a DNA virus with a rapid rate of mutation. Based on the heterogeneity of the HBV nucleotide sequence, the HBV strains are divided into ten genotypes, A to J, with a characteristic geographical distribution. Identifying and tracking the changes of HBV genotypes is important in epidemiological and transmission studies, predicting the risk for the development of severe liver disease and response to antiviral treatment. The present study was conducted to detect HBV genotypes and sub-genotypes in general population of different states and regions in Myanmar. Methods A total of 5,547 general adult population who residing at seven states, seven regions and Nay Pyi Taw Union Territory were screened for Hepatitis B Surface antigen (HBsAg) by Immunochromatgraphic test (ICT) in 2015. Of 353 HBsAg positive samples, HBV DNA were detected by using polymerase chain reactions (PCR) targeting the DNA sequences encoding the Pre-S region. A total of 153 PCR positive samples were preceded for genotyping by partial genome sequencing of both directions. The resulting sequences were then edited, aligned and compared with reference sequences using National Centre for Biotechnology Information (NCBI) web based genotyping tool. Results Three HBV genotypes; HBV/ C, HBV/ D and HBV/ B were detected in Myanmar, in which genotype HBV/ C (66.7%) was the most prevalent genotype followed by HBV/ D (32%) and HBV/ B (1.3%) respectively. Sub-genotyping revealed a total of 7 sub-genotypes within genotypes B, C and D: two (B4 and B5) in HBV/ B, three (C1, C5 and C7) in HBV/C and two (D3 and D6) in HBV/ D. Conclusion Genotype HBV/C, sub-genotype C1 was the most predominant genotype distributed in all states and regions of Myanmar. This study was first report on Nation- wide distribution of HBV genotype and sub-genotypes in Myanmar and the findings will be a huge support for hepatitis disease surveillance programme which is the one of the National Priority Diseases in Myanmar.
Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A Knowledge, Attitudes and Practices Survey
Authors: Lourens Andrit , Hodkinson Peter , Parker Romy
Published: March 2020

Background: Acute pain is frequently encountered in the prehospital setting, and therefore, a fundamental aspect of quality emergency care. Research has shown a positive association between health care providers’ knowledge of, and attitudes towards pain and pain management practices. This study aimed to describe the knowledge, attitudes, and practices of emergency care providers regarding acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa. The specific objectives were to, identify gaps in pain knowledge; assess attitudes regarding pain assessment and management; describe pain assessment and management behaviours and practices; and identify barriers to and enablers of pain care.
Methods: A web-based descriptive cross-sectional survey was conducted among emergency care providers of all qualifications, using a face-validated Knowledge, Attitudes and Practices of Pain survey.
Results: Responses of 100 participants was included in the analysis. The survey response rate could not be calculated. The mean age of respondents was 34.74 (SD8.13) years and the mean years’ experience 10.02 (SD6.47). Most respondents were male (69%), employed in the public/government sector (93%) as operational practitioners (85%) with 54% of respondents having attended medical education on pain care in the last two years. The mean percentage for knowledge and attitudes regarding pain among emergency care providers was 58.01% (SD15.66) with gaps identified in various aspects of pain and pain care. Practitioners with higher qualifications, more years’ experience and those who did not attend medical education on pain, achieved higher scores. Alcohol and drug use by patients were the most selected barrier to pain care while the availability of higher qualified practitioners was the most selected enabler. When asked to record pain scores, practitioners were less inclined to assign scores which were self-reported by the patients in the case scenarios. The participant dropout rate was 35%.
Conclusion: Our results suggest that there is suboptimal knowledge and attitudes regarding pain among emergency care providers in the Western Cape, South Africa. Further, gaps in pain knowledge, attitudes and practices were identified. Some barriers and enablers of pain care in the South African prehospital setting were identified but further research is indicated.
In-depth immune cellular profiling reveals sex-specific associations with frailty
Authors: Samson Leonard Daniël , Boots A. Mieke H. , Ferreira José A. , Picavet H. Susan J. , De Rond Lia G. H. , de Zeeuw-Brouwer Mary-lène , Verschuren W. M. Monique , Buisman Anne-Marie , Engelfriet Peter
Published: March 2020

Background: With advancing age, the composition of leukocyte subpopulations in peripheral blood is known to change, but how this change differs between men and women and how it relates to frailty is poorly understood. Thus, our aim in this exploratory study was to investigate whether frailty is associated with changes in immune cell subpopulations and whether associations differ between men and women. Therefore, we performed in-depth immune cell phenotyping by enumerating a total of 37 subsets of T cells, B cells, NK cells, monocytes, and neutrophils in peripheral blood of 289 elderly people between 60-87 years of age. Associations between frailty and each immune cell subpopulation were tested separately in men and women and were adjusted for age and CMV serostatus. In addition, a random forest algorithm was used to predict a participant’s frailty score based on enumeration of immune cell subpopulations. Results: In an association study, frailty was observed to be associated with increases in numbers of neutrophils in both men and in women. Furthermore, sex-specific associations were found. Frailer women, but not men, showed higher numbers of total and CD16^-^ monocytes and lower numbers of CD56^+^ T cells. Overall, the accuracy of the predictions in the random forest analysis was low (9.2% explained variance in men and 12.2% in women). Yet, the random forest analysis confirmed all associations mentioned above, but did not confirm a possible negative association in women between frailty and late differentiated CD4^+^ TemRA cells. Moreover, the random forest analysis revealed additional relationships with frailty, with frailer men showing higher CD16^+^ monocyte and lower naïve B cell numbers. Other important variables for predicting frailty were plasmablast numbers in men and total T cell numbers in women. Conclusions: We report on observed associations of frailty with elevated myeloid cell numbers in men and women. In-depth immune cellular profiling also revealed sex-specific associations of frailty with several immune subpopulations. However, an expected positive association between frailty and memory T cells was not observed. We hope that our study will prompt further investigation into the immune mechanisms associated with the development of frailty in men and women.
Low program access despite high burden of sexual, structural, and reproductive health vulnerabilities among young women who sell sex in Mombasa, Kenya
Authors: Roberts Elizabeth , Ma Huiting , Bhattacharjee Parinita , Musyoki Helgar K , Gichangi Peter , Avery Lisa , Musimbi Janet , Tsang Jenkin , Kaosa Shem , Kioko Japheth , Becker Marissa L , Mishra Sharmistha
Published: March 2020

Background: Across Sub-Saharan Africa, young women who sell sex (YSW) face institutional barriers in accessing sexual health and HIV prevention programs designed for female sex workers. In 2018, Kenya developed a national framework to guide service provision for YSW aged 14 – 24 years. To help inform the implementation of the framework, we estimated the burden of vulnerabilities related to the Sustainable Development Goals (SDGs) and program contact among YSW. Methods: We used data from Transitions, a 2015 bio-behavioural cross-sectional survey of 408 YSW aged 14 – 24 years in Mombasa, Kenya. We estimated the prevalence of sexual (inconsistent condom use), structural (financial, violence), and reproductive health vulnerabilities; and characterized engagement with local HIV programs tailored to sex workers. We then compared the prevalence of vulnerabilities by age group (14 – 18 years, N=117; 19 – 24 years, N=291) and by program contact (ever contacted by local program for sex workers). Results: 47.3% reported inconsistent condom use in the previous week with little variability by age. Structural vulnerabilities were common and did not vary by age: 83.6% did not have a regular source of income; 29.9% and 29.2% had experienced physical and sexual violence, respectively. 26.5% reported at least one pregnancy before age 18, and 18.5% used a non-reliable form of contraception with little variability by age. 25.7% were aware of at least one program, and only 13.7% of YSW had ever been contacted by a program (8.5% of those aged 14 – 18 years; and 15.8% of those aged 19 – 24 years, p=0.06). Sexual, structural, and reproductive health vulnerabilities did not vary by program contact. Conclusions: SDG-related vulnerabilities begin early in the lives of YSW and current programs are not reaching them.
In vitro antiviral activity of Echinaforce®, an Echinacea purpurea preparation, against common cold coronavirus 229E and highly pathogenic MERS-CoV and SARS-CoV
Authors: Signer Johanna , Jonsdottir Hulda Run , Albrich Werner C. , Strasser Marc , Züst Roland , Ryter Sarah , Ackermann-Gäumann Rahel , Lenz Nicole , Siegrist Denise , Suter Andreas , Schoop Roland , Engler Olivier B.
Published: March 2020

Background: Coronaviruses (CoVs) were long thought to only cause mild respiratory and gastrointestinal symptoms in humans but recent outbreaks of Middle Eastern Respiratory Syndrome (MERS)-CoV, Severe Acute Respiratory Syndrome (SARS)-CoV, and the newly identified SARS-CoV-2 have cemented their zoonotic potential and their capacity to cause serious morbidity and mortality, with case fatality rates ranging from 2 to 35%. Currently, no specific prophylaxis or treatment is available for CoV infections and therefore we investigated the antiviral potential of Echinacea purpurea (Echinaforce®) against human coronavirus (HCoV) 229E and the highly pathogenic MERS- and SARS-CoVs in vitro.Methods:To evaluate the antiviral potential of Echinaforce we pre-treated virus particles and cells and evaluated remaining infectivity by limited dilution. Furthermore, we exposed cells to the extract post-infection to further estimate its potential as a prophylaxis and treatment against coronaviruses. We also determined the protective effect of Echinaforce in re-constituted nasal epithelium.Results:We found that HCoV-229E was irreversibly inactivated when exposed to Echinaforce at 3.2mg/ml IC50. Pre-treatment of cell lines, however, did not inhibit infection with HCoV-229E and post-infection treatment had only a marginal effect on virus propagation at 50 mg/ml. However, we did observe a protective effect in an organotypic respiratory cell culture system by exposing pre-treated respiratory epithelium to droplets of HCoV-229E, imitating a natural infection. Finally, antiviral activity was not restricted to common cold coronaviruses, as the highly pathogenic SARS- and MERS-CoVs were inactivated at comparable concentrations.Conclusions:These results suggest that Echinacea purpurea preparations, such as Echinaforce, could be effective as prophylactic treatment for all CoVs, including newly occurring strains, such as SARS-CoV-2.
NPF：Network propagation for protein function prediction
Authors: zhao bihai , Zhang Zhihong , Jiang Meiping , Hu Sai , Luo Yingchun , Wang Lei
Published: March 2020

Background: The accurate annotation of protein functions is of great significance in elucidating the phenomena of life, disease treatment and new drug development. Various methods have been developed to facilitate the prediction of functions by combining protein interaction networks (PINs) with multi-omics data. However, how to make full use of multiple biological data to improve the performance of functions annotation is still a dilemma.Results: We presented NPF (Network Propagation for Functions prediction), an integrative protein function predicting framework assisted by network propagation and functional module detection, for discovering interacting partners with similar functions to target proteins. NPF leverages knowledge of the protein interaction network architecture and multi-omics data, such as domain annotation and protein complex information, to augment protein-protein functional similarity in a propagation manner. We have verified the great potential of NPF for accurately inferring protein functions. Comprehensive evaluation of NPF indicates that NPF archived higher performance than competing methods in terms of leave-one-out cross-validation and ten-fold cross validation.Conclusions: We demonstrated that network propagation combined with multi-omics data can not only discover more partners with similar function, but also effectively free from the constraints of the "small-world" feature of protein interaction networks. We conclude that the performance of function prediction depends greatly on whether we can extract and exploit proper functional similarity information from protein correlations.
Impact of Concurrency on the Performance of a Whole Exome Sequencing Pipeline
Authors: Dall'Olio Daniele , Curti Nico , Fonzi Eugenio , Sala Claudia , Remondini Daniel , Castellani Gastone C , Giampieri Enrico
Published: March 2020

Background: Current high-throughput technologies - i.e. Whole Genome Sequencing (WGS), RNA-Seq, ChIP-Seq, etc. - generate huge amounts of data and their usage gets more widespread with each passing year. Complex analysis pipelines involving several computationally-intensive steps have to be applied on an increasing number of samples. Workflow Management Systems (WMSs) allow parallelization and a more efficient usage of computational power. Nevertheless, this mostly happens by assigning the available cores to a single or few samples at a time. We refer to this approach as naive parallel strategy (NPS). Here, we discuss an alternative approach, which we refer to as concurrent execution strategy (CES), which equally distributes the available processors across every sample. Results: Theoretically, we show that the CES results, under loose conditions, in a substantial speedup, with an ideal gain range spanning from 1 to the number of samples. Practically, we tested both strategies on a Whole Exome Sequencing (WES) pipeline applied to three publicly available matched tumour-normal sample pairs of gastrointestinal stromal tumour (GIST). The CES achieved speedups in latency up to 2-2.4. Conclusions: Our results hint that if resources distribution is further tailored to fit specific situations, an even greater gain in performance could be achieved. For this to be feasible, a benchmarking of the tools included in the pipeline would be necessary. It is our opinion these benchmarks should be consistently performed by the tools' developers. Finally, these results suggest that concurrent strategies might also lead to energy and cost savings by making feasible the usage of low power machine clusters.
Adaptive Support Ventilation versus Conventional Ventilation during Hypoxemic Respiratory Failure: A Meta-analysis of Randomized Controlled Trials
Authors: Zhang Wei , Liu Xiaoli , Jin Can , Zhang Longju , Liang Zong’an
Published: March 2020

Background The purpose of the study is to examine whether the adaptive support ventilation (ASV) mode compared with conventional ventilation reduces the duration of mechanical ventilation (MV) in patients with acute respiratory failure. Methods We searched PubMed, the Cochrane Library Central Register of Controlled Trials, EMBASE and Web of Science databases from inception through July 27, 2019. We considered all the randomized controlled studies (RCTs) that examined the efficacy of ASV in comparison with conventional ventilation in mechanically ventilated adults. The primary outcomes were (1) the length of MV, (2) weaning duration and (3) length of stay (LOS) in ICU. Results We included three RCTs for the analysis enrolling a total of 374 patients. Patients treated with ASV had a lower weaning duration than patients treated with conventional ventilation (MD -28.98 [95% CI -42.42, -15.54, p˂0.0001]). Then, 28-day mortality was not different between the two groups (OR 0.95 [95%CI 0.6, 1.52, p=0.83; I2=0%, p=0.96]). The incidence of ventilator-associated pneumonia and sedation level was not included into the quantitative analysis. Conclusions The study showed that a lower number of duration of MV and a shorter number of weaning duration in acute hypoxemic respiratory failure patients treated with ASV than conventional ventilation. Keywords: pulmonary infection; critically ill patients; adaptive support ventilation; hypoxemic respiratory failure Background Acute hypoxemic respiratory failure is a severe disorder of the respiratory system to maintain oxygenation or eliminate carbon dioxide (CO2), leading to a series of metabolic disorders and physiological dysfunction. Mechanical ventilation (MV) serve as a lifesaving therapy is widely employed in intensive care units (ICU) for treating clinical symptoms related to critically illness.[1,2] Employment of mechanical ventilation in patients could help effectively to replace, control and change spontaneous breathing, reduce or eliminate respiratory muscle oxygen consumption, increasing ventilation and improving ventilation[3], removing the residual mucous in airway.[4] The choice of ventilation mode is such a very important issue in ICU that clinicians capable to choose the ventilation mode and adapt the ventilator controls according to the patient's respiratory mechanics.
Can the Apex of Tibial Tubercle Represent the Insertion of Patellar Tendon in Measurement of Quadriceps Angles? Imaging Verification
Authors: Wu Chi-Chuan , Wong Yon-Cheong
Published: March 2020

Background Clinical measurement of a quadriceps angle (Q-angle) has yet achieved consensus. The patellar stability is generally low despite that the tibial tubercle (TT) is fixed. The aim of this retrospective study was to verify whether the lower arm of a Q-angle (i.e. the patellar tendon [PT]) can be represented by the localization of TT. Methods The locations of the apex of TT and the center of PT in magnetic resonance imaging (MRI) were investigated in 100 consecutive young adult patients (50 men and 50 women; average, 27 years). The tibial width (TW), the distance from the apex of TT and the center of PT to the lateral edge of TW, and the PT width were measured. The ratios of the TT and PT to TW were compared statistically. Results The TW was 64 mm (62-66 mm). The apex of TT was 38% (37-39%) from the lateral edge of TW. The center of PT was 37% (36-38%) from the lateral edge of TW. Except the TW and PT width (both, p < 0.001), there was no statistical significance in all other comparisons between sexes ( p > 0.05). The correlation between the TT and PT in 100 patients was 0.84. There was statistical difference between the two parameters ( p = 0.02). Conclusion Although the center of PT is lateral to the apex of TT, the discrepancy is minimal (1% of TW, about 0.6 mm; or 3% of PT width). Clinically, using the TT to represent the insertion of PT may be reasonable.
Two-hour surgical access in South Africa: a useful indicator in a middle-income country?
Authors: Chu Kathryn , Dell Angela J , Moultrie Harry , Day Candy , Naidoo Megan , Straten Stephanie van , Rayne Sarah
Published: March 2020

Background In a robust health care system, at least 80% of a country’s population should be able to access a district hospital that provides surgical care within two hours. The objective was to identify the proportion of the population living within two hours of a district hospital with surgical capacity in South Africa. Methods All government hospitals in the country were identified. Surgical district hospitals were defined as district hospitals with a surgical provider, a functional operating theatre, and the provision of at least one caesarean section annually. The proportion of the population within two-hour access was estimated using service area methods. Results One hundred and thirty-eight of 240 (58%) district hospitals had surgical capacity and 86% of the population had two-hour access to these facilities. Ninety-eight percent of the population had two-hour access to any government hospital in South Africa. Conclusion Improving equitable surgical access is urgently needed in sub-Saharan Africa. This study demonstrated that in South Africa, just over half of district hospitals had surgical capacity but more than 80% of the population had two-hour access to these facilities. Strengthening district hospital surgical capacity is an international mandate and needed to improve access.
WITHDRAWN: Evaluation of immunity and protection in chicken administered a developed vaccine against predominant Middle Eastern strains of genotypes VI and VII of velogenic Newcastle Disease Virus
Authors: Yaghmoor` Soonham Sami , Kumosani Taha Abdullah , Barbour Elie Kamil , Baothman Othman Abubaker
Published: March 2020

Background The velogenic-Newcastle Disease Virus (v-NDV) causes an important disease in chicken, associated with serious economic losses to the global poultry industry. This research evaluated the immunity in broilers administered a developed bivalent vaccine, aiming at protection against predominant Middle Eastern strains of genotypes VI and VII of v-NDV. The completely randomized design implemented in this evaluation included eight treatments, differing in birds being administered or deprived of the developed vaccine, with a difference in type of challenge, either by v-NDV strain(s) of genotype VI, VII, or both. Vaccination was administered subcutaneously at 6 and 21 d of age, followed by an intra-pectoral challenge at the age of 28 d. Results The acquired humoral immunity by vaccinated and challenged birds to Hemagglutinin (H) protein was the highest at market age of 40 d, compared to challenged birds deprived of vaccination, and to vaccinates deprived of challenge (P<0.05). The same statistical difference pattern was obtained by the cell-mediated immunity (CMI), represented by birds’ level of serum IFN- γ . The type of challenge by either strain(s) of genotype VI, VII, or VI+VII did affect statistically the cross reactivity of acquired humoral immunity specific to H protein of homologous versus heterologous strains. The absence of humoral immunity and the low IFN- γ levels at 28 d of age in challenged birds deprived of vaccination lead to highest mortality, and lowest performance compared to vaccinates and challenged, vaccinates and deprived of challenge, and unvaccinated-unchallenged birds (P<0.05). Conclusions The developed bivalent vaccine was able to induce enough humoral and CMI responses, enabling protection of the broilers against production losses by each of the three types of v-NDV challenges. It is recommended to conduct future studies to evaluate such types of vaccines in chicken breeders and commercial layers, reared in various world’s zones with existing endemicity of v-NDV.
Short-latency afferent inhibition and somato-sensory evoked potentials during the migraine cycle: surrogate markers of a cycling cholinergic thalamo-cortical drive?
Authors: Coppola Gianluca , Lenola Davide Di , Abagnale Chiara , Ferrandes Fabio , Sebastianelli Gabriele , Casillo Francesco , Lorenzo Cherubino Di , Serrao Mariano , Evangelista Maurizio , Schoenen Jean , Pierelli Francesco
Published: March 2020

Background: Short-latency afferent inhibition (SAI) consists of motor cortex inhibition induced by sensory afferents and depends on the excitatory effect of cholinergic thalamocortical projections on inhibitory GABAergic cortical networks. Given the electrophysiological evidence for thalamo-cortical dysrhythmia in migraine, we studied SAI in migraineurs during and between attacks and searched for correlations with somatosensory habituation, thalamocortical activation, and clinical features.Methods: SAI was obtained by conditioning the transcranial magnetic stimulation-induced motor evoked potential (MEP) with an electric stimulus on the median nerve at the wrist with random stimulus intervals corresponding to the latency of individual somatosensory evoked potentials (SSEP) N20 plus 2, 4, 6, or 8 ms. We recruited 30 migraine without aura patients, 16 between (MO), 14 during an attack (MI), and 16 healthy volunteers (HV). We calculated the slope of the linear regression between the unconditioned MEP amplitude and the 4-conditioned MEPs as a measure of SAI. We also measured SSEP amplitude habituation, and high-frequency oscillations (HFO) as an index of thalamo-cortical activation.Results: Compared to HV, SAI, SSEP habituation and early SSEP HFOs were significantly reduced in MO patients between attacks, but enhanced during an attack. There was a positive correlation between degree of SAI and amplitude of early HFOs in HV, but not in MO or MI. When the two patient groups were pooled, both the MEP SAI slope and the SSEP habituation slope correlated positively with the number of days elapsed since the last migraine attack.Conclusions: The migraine cycle-dependent variations of SAI and SSEP HFOs are further evidence that facilitatory thalamocortical activation (of GABAergic networks in the motor cortex for SAI), likely to be cholinergic, is reduced in migraine at a distance from an attack, but increased ictally.
Improvement in circulating endothelial progenitor cells pool after cardiac resynchronization therapy: increasing the list of benefits
Authors: Cristóvão Gonçalo , Milner James , Sousa Pedro , Ventura Miguel , Cristóvão João , Elvas Luís , Paiva Artur , Gonçalves Lino , Ribeiro Carlos Fontes , António Natália
Published: March 2020

Background Recent studies suggest that circulating endothelial progenitor cells (EPCs) may influence the response to cardiac resynchronization therapy (CRT). The aim of this study was to evaluate the effect of CRT on EPCs levels and to assess the impact of EPCs on long-term clinical outcomes. Population and methods Prospective study of 50 patients submitted to CRT. Two populations of circulating EPCs were quantified previously to CRT implantation: CD34 + KDR + and CD133 + KDR + cells. EPCs levels were reassessed 6 months after CRT. Endpoints during the long-term follow-up were all-cause mortality, heart transplantation and hospitalization for heart failure (HF) management. Results The proportion of non-responders to CRT was 42% and tended to be higher in patients with an ischemic vs non-ischemic etiology (64% vs 35%, p=0.098). Patients with ischemic cardiomyopathy (ICM) showed significantly lower CD34+KDR+ EPCs levels when compared to non-ischemic dilated cardiomyopathy patients (DCM) (0.0010 ± 0.0007 vs 0.0030 ± 0.0024 cells/100 leukocytes, p=0.032). There were no significant differences in baseline EPCs levels between survivors and non-survivors nor between patients who were rehospitalized for HF management during follow-up or not. At 6-month follow-up, circulating EPCs levels were significantly higher than baseline levels (0.0024 ± 0.0023 vs 0.0047 ± 0.0041 CD34 + KDR + cells/100 leukocytes, p=0.010 and 0.0007 ± 0.0004 vs 0.0016 vs 0.0013 CD133 + /KDR + cells/100 leukocytes, p=0.007). Conclusions Patients with ICM showed significantly lower levels of circulating EPCs when compared to their counterparts. CRT seems to improve the pool of endogenously circulating EPCs and reduced baseline EPCs levels seem not influence long-term outcomes after CRT.
Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana
Authors: Krumkamp Ralf , Oppong Kwabena , Hogan Benedikt , Strauss Ricardo , Frickmann Hagen , Wiafe-Akenten Charity , Boahen Kennedy , Rickerts Volker , McCormick Ilka , Groß Uwe , Schulze Marco , Jaeger Anna , Loderstädt Ulrike , Sarpong Nimako , Owusu-Dabo Ellis , May Jürgen , Dekker Denise
Published: March 2020

Background: Chronic infected wounds are generally difficult to manage and treatment can be particularly challenging in resource-limited settings where diagnostic testing is not readily available. In this study, the epidemiology of microbial pathogens in chronically infected wounds in rural Ghana was assessed to support therapeutic choices for physicians.Methods. Culture-based bacterial diagnostics including antimicrobial resistance testing were performed on samples collected from patients with chronic wounds at a hospital in Asante Akim North Municipality, Ghana. Fungal detection was performed by broad-range fungal PCR and sequencing of amplicons. Results: In total, 105 patients were enrolled in the study, from which 207 potential bacterial pathogens were isolated. Enterobacteriaceae (n=84, 41%) constituted the most frequently isolated group of pathogens. On species level, Pseudomonas aeruginosa (n=50, 24%) and Staphylococcus aureus (n=28, 14%) were predominant. High resistance rates were documented, comprising 29% methicillin resistance in Staphylococcus aureus as well as resistance to 3rd generation cephalosporins and fluoroquinolones in 33% and 58% of Enterobacteriaceae, respectively. One Pseudomonas aeruginosa strain with carbapenem resistance was identified. The most frequently detected fungi were Candida tropicalis.Conclusions: The pathogen distribution in chronic wounds in rural Ghana matched the internationally observed patterns with a predominance of Pseudomonas aeruginosa and Staphylococcus aureus. Very high resistance rates discourage antibiotic therapy but suggest an urgent need for microbiological diagnostic approaches, including antimicrobial resistance testing to guide the management of patients with chronic wounds in Ghana.
Ocular lesions in hereditary hemorrhagic telangiectasia: genetics and clinical characteristics
Authors: Gómez-Acebo Ines , Prado Sara Rodríguez , Mora Angel De la , Puente Roberto Zarrabeitia , Varela Beatriz de la Roza , Dierssen-Sotos Trinidad , Llorca Javier
Published: March 2020

Background The aim of our study is to study the association between eye lesions in Hereditary Hemorrhagic Telangiectasia (HHT) and other signs of the disease, as well as to characterize its genetics.Methods A cross-sectional study was conducted of a cohort of 206 patients studied in the HHT Unit of Hospital de Sierrallana, a reference centre for Spanish patients with HHT. Odds ratios for several symptoms or characteristics of HHT and ocular lesions were estimated using logistic regression adjusting for age and sex.Results The ocular involvement was associated with being a carrier of a mutation for the ENG gene, that is, suffering from a type 1 HHT involvement (OR = 2.09; 95% CI [1.17-3.72]). p = 0.012). In contrast, patients with ocular lesions have less frequently mutated ACVRL1/ALK1 gene (OR = 0.52; 95% CI [0.30- 3.88], p = 0.022).Conclusions In conclusion, half of the patients with HHT in our study have ocular involvement. These eye lesions are associated with mutations in the ENG gene and ACVRL1/ALK1 gene. Thus, the ENG gene increases the risk of ocular lesions, while being a carrier of the mutated ACVRL1/ALK1 gene decreases said risk.
Chinese public’s knowledge, perceived severity, and perceived controllability of the COVID-19 and their associations with emotional and behavioural reactions, social participation, and precautionary behaviour: A national survey
Authors: Li Jian-Bin , Yang An , Dou Kai , Wang Lin-Xin , Zhang Ming-Chen , Lin Xiao-Qi
Published: March 2020

Background The outbreak of the coronavirus disease-19 (COVID-19) has caused enormous stress among the public in China. Intellectual input from various aspects is needed to control the COVID-19, including the understanding of the public’s emotion and behaviour and their antecedents from the psychological perspectives. Drawing upon the cognitive appraisal theory, this study examined three cognitive appraisals (i.e., knowledge, perceived severity and perceived controllability of the COVID-19) and their associations with a wide range of emotional and behavioural outcomes among the Chinese public. Methods Participants were 4607 citizens (age range: 17–90 years, Mage=23.71 years) from 31 provinces in China and they took part in an online survey. Results The results showed that the public’s emotional and behavioural reactions were slightly affected by the outbreak of the COVID-19. Moreover, the public had limited participation in the events regarding the COVID-19 but actively engaged in precautionary behaviour. In addition, results of hierarchical regression analysis revealed that the three appraisals were differentially related to the outcome variables. Conclusions The findings highlight the utility of cognitive appraisal, as a core process of coping stress, in explaining the public’s emotion and behaviour in the encounter of public health concern. Practically, the findings facilitate the government and practitioners to design and deliver targeted intervention programs to the public affected by the COVID-19.
Evaluation of fractional exhaled nitric oxide in interstitial lung disease
Authors: Lin Geng-peng , Guo Yu-biao , Shi Jia , Hui Yi , Liu Yang-li , Xie Can-mao , Luo Yi-feng , CHEN FENG JIA
Published: March 2020

Background No established biomarkers are available to guide the treatment of chronic interstitial lung diseases (ILDs). Nitric oxide reflects the inflammation in the airway, and fractional exhaled nitric oxide (FeNO) is a non-invasive and reproducible biomarker in lung-disease diagnosis and treatment. Whether FeNO can help manage ILDs remains uncertain. This study aimed to determine the role of FeNO in ILDs and the association between FeNO and ILD subtype. Methods 53 patients with ILDs were retrospectively recruited. Patient characteristics, FeNO values, blood tests for inflammatory markers, and pulmonary function test data were obtained. ResultsThis group of patients with ILDs had decreased vital capacity(VC)and total lung capacity(TLC) of 71.75 ± 17.58% and 75.27 ± 14.07%, respectively. The diffusion capacity of the lung for carbon monoxide(DLCO) also declined, with an average level of 38.15 ± 11.10%. The average FeNO value was 20.34 ± 9.97 ppb. According to the characteristics of chest computed tomography, patients were divided into usual interstitial pneumonia (UIP)-ILD (n = 24) and non-UIP-ILD (n = 29). The FeNO value in the UIP-ILD group was 12.58 ± 3.63 ppb. This value was significantly lower than that of the non-UIP-ILD group (26.62 ± 8.61 ppb, P<0.0001).According to the etiology, all patients with ILDs were divided into connective tissue diseases associated with interstitial lung disease (CTD-ILD) (n = 30) and non-CTD-ILD (n = 23). There were more female patients in CTD-ILD group compared to non-CTD ILD group and patients in CTD-ILD group were younger. With regard to the FeNO, PFT values, and systemic inﬂammatory markers, no signiﬁcant differences were observed between groups. In the overall ILD population, FeNO level correlated with blood eosinophil (r = 0.3066, P=0.0333), but no statistical significant correlations were observed between the FeNO and blood eosinophil percentage, IgE or systemic inﬂammatory markers. The FeNO cut-off value of 18.5 ppb showed a sensibility of 83.3% and a speciﬁcity of 95.8% in discriminating non-UIP-ILDs from UIP ILDs. Conclusions Our study suggested the importance of FeNO test in patients with ILDs. High FeNO levels may indicate the need of systemic treatment, and FeNO can be a helpful biomarker for ILD management.