bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-exertional increase in first-phase ejection fraction in recreational marathon runners
Authors: Faconti Luca , Parsons Iain , Farukh Bushra , McNally Ryan , Nesti Lorenzo , Fang Lingyun , Stacey Michael , Hill Neil , Woods David , Chowienczyk Phil
Published: May 2020

Objectives

Running a marathon has been equivocally associated with acute changes in cardiac performance. First-phase ejection fraction is a novel integrated echocardiographic measure of left ventricular contractility and systo-diastolic coupling which has never been studied in the context of physical activity. The aim of this study was to assess first-phase ejection fraction following recreational marathon running along with standard echocardiographic indices of systolic and diastolic function. Design and participants: Runners (n = 25, 17 males), age (mean ± standard deviation) 39 ± 9 years, were assessed before and immediately after a marathon race which was completed in 4 h, 10 min ± 47 min.

Main outcome measures

Central hemodynamics were estimated with applanation tonometry; cardiac performance was assessed using standard M-mode two-dimensional Doppler, tissue-doppler imaging and speckle-tracking echocardiography. First-phase ejection fraction was calculated as the percentage change in left ventricular volume from end-diastole to the time of peak aortic blood flow.

Results

Conventional indices of systolic function and cardiac performance were similar pre- and post-race while aortic systolic blood pressure decreased by 9 ± 8 mmHg ( P < 0.001) and first-phase ejection fraction increased by approximately 48% from 16.3 ± 3.9% to 22.9 ± 2.5% ( P < 0.001). The ratio of left ventricular transmitral Doppler early velocity (E) to tissue-doppler imaging early annular velocity (e′) increased from 5.1 ± 1.8 to 6.2 ± 1.3 ( P < 0.01).

Conclusion

In recreational marathon runners, there is a marked increase in first-phase ejection fraction after the race despite no other significant change in cardiac performance or conventional measure of systolic function. More detailed physiological studies are required to elucidate the mechanism of this increase.
Cycling and men’s health: A worldwide survey in association the Global Cycling Network
Authors: Koupparis Anthony , Mehmi Ashley , Rava Matteo , Kearley Sam , Aning Jon , Rowe Edward , Richardson Simon
Published: May 2020

Objectives:

This study aimed to examine the association between cycling and men’s health issues, including prostate cancer (CaP), erectile dysfunction (ED), chronic pelvic pain syndrome (CPPS) and lower urinary tract symptoms (LUTs).

Methods:

Information regarding CaP, ED, CPPS and LUTs were collected from 8074 male cyclists via a unique online men’s health and cycling video produced in conjunction with the Global Cycling Network (GCN) using validated questionnaires. Logistic regression analyses were used to evaluate any relationship between cycling and men’s health issues, including the effect of risk factors.

Results:

The GCN video received 619,105 views, and completed data were collected on 8074 male cyclists. Of these, 0.57% had a diagnosis of CaP, 14.5% described ED, 8.82 reported symptoms of CPPS and 12.5% reported LUTs. All reported symptoms were mild, and no correlation was found between cycling and CaP or ED on statistical analyses.

Conclusions:

This is the largest worldwide cross-section observational study on the association between cycling and men’s health. It demonstrates no negative association between cycling and CaP, ED, CPPS or LUTs.

Level of evidence:

Not applicable for this multicentre audit.
An Investigation of the Appropriate Level(s) and Ratio of Value Contrast for Partially Sighted Individuals
Authors: Fallatah Samaher , Gaines Kristi S. , Adams Nicole G. , Schambureck Erin
Published: May 2020

The present study aimed to investigate the appropriate level of value contrast in built environments, including the ratio of dark value to light value color, to enable people with low vision to distinguish elements more readily from the surroundings. The study included a total of 20 participants from four locations in Texas. Participants received a two-part questionnaire: Part 1 recorded demographic information including age, gender, and visual acuity; Part 2 presented the central questions of the study relating to given images. All of the participants agreed that high value contrast images with at least 60% variance between the dark and light values were very easy to see. Participants also indicated that medium value contrast images with a variance of 30% were recognizable. Most of the participants also indicated a preference for light value to dark value in a built environment.
Rural Transportation Conference Participants’ Opinions and Concerns Pertaining to Transit for Older Adults
Authors: Mjelde James W. , Dudensing Rebekka M. , Battista Geoffrey , Brooks Jonathan , Carrillo Maria , Counsil Blane , Giri Anil , Kim Man-Keun , Pyrialakou V. Dimitra
Published: May 2020

Mobility remains a vital part of the well-being of rural-living, older adults and transportation disadvantaged persons. This study seeks to identify research and policy needs related to rural transit for older people and the transportation disadvantaged. To obtain this goal, the multidisciplinary study team conducted two activities as part of a 2016 rural transportation conference: a survey of conference attendees and open discussion to elicit additional information. Results suggest the attendees felt the need for rural transit for older adults would continue to increase with public and private funding being critical issues. Respondents had similar opinions about challenges and opportunities across socioeconomic characteristics including age, gender, political leaning, rurality, and organizational function. This suggests an opportunity to mobilize support for public transportation.
Ecotourism Research Progress: A Bibliometric Analysis During 1990–2016
Authors: Liu Shaoai , Li Wan-Yi
Published: May 2020

The study aims to evaluate research trends of ecotourism, which has attracted wide attention by both researchers and policymakers as an important way to realize sustainable tourism. Bibliometric analysis was carried through the 2,531 records related to ecotourism searching from Science Citation Index (SCI), Social Science Citation Index (SSCI), Arts & Humanities Citation Index (A&HCI), and Index to Scientific & Technical Proceedings (ISTP) databases from 1990 to 2016. A total of 4,138 keywords were divided into three categories: topical keywords, case-related keywords, and research methods–related keywords. They, respectively, were analyzed on overall development as well as the dynamic changes by three divided stages of ecotourism research. The results showed that Tourism Management was the most prolific journal. U.S.-based authors published more often than those from any other country, whereas among research institutions, the Chinese Academy of Sciences was the most prolific contributor. It also revealed that conservation was the key focus, protected area was the main study object, and sustainable tourism was the main aim. The top three countries for cases study were China, the United States, and South Africa, and the main methodologies were contingent valuation method and geographic information system. According to the dynamic analysis, research perspectives changed from ecotourism resources to management and subsequently expanded to multistakeholders involvement, with a rapid expansion of the case and implementation of quantitative research methods. With multidisciplinary involvement and multistakeholders participation, the study of tourist awareness and behavior on ecotourism would become the main aspects for deepening and concreting ecotourism research. Our findings provide a quantitative understanding of global ecotourism research features.
Students’ Perspectives on Engagement, Learning, and Pedagogy: Self-Evaluations of University Students in Spain
Authors: Padilla-Petry Paulo , Vadeboncoeur Jennifer A.
Published: May 2020

Student engagement in higher education has been studied from different theoretical perspectives and in different countries. Current issues include both concerns regarding students’ attitudes and ambivalence and, in addition, the definition of the concept of student engagement and how various pedagogical approaches may contribute to contrasting definitions. The present study thematically analyzed self-evaluations of 46 students attending two pedagogy courses of the University of Barcelona; both courses included lectures and discussions. Special attention was given to how participants described their engagement and related it to their learning, the teacher’s pedagogy, and the course content. Different forms of engagement emerged, both with the lecture and discussion sessions of the classes, that suggest some aspects of student engagement may (a) be invisible to the teacher and (b) follow an independent decision-making process that may favor passing over learning.
Elderly People With Drug-Related Problems Identified in the Emergency Department: Impact of Therapeutic Complexity on Consultations to the Health System
Authors: Ruiz Ramos Jesus , Juanes Borrego Ana María , Blazquez Andion Marta , Mangues Bafalluy Maria Antonia , Puig Campmany Mireia
Published: May 2020

Different scales have been validated to assess the medication regimen complexity. However, the effect of this complexity on the risk of health care center consultations in patients with drug-related problems is unknown. This study’s objective is to evaluate the association between the Medication Regimen Complexity Index (MCRI) and the number of drugs prescribed and new consultations to the health care system in patients who visit an emergency service due to drug-related problems. This is a retrospective observational study. We included patients >65 years who attended in an emergency service for drug-related problems. To identify variables associated with health care center reconsultation, a multivariate analysis was performed, including demographic and comorbidity variables, number of drugs prescribed, and MCRI value. Two hundred and one patients were included. A significant association was found between the prescription of more than five drugs (odds ratio [OR] = 2.50, 95% confidence interval [CI] = [1.08, 5.79]), an MCRI > 20 (2.98 [1.46–6.09]), and an increase in the number of drugs prescribed (2.87 [1.57–5.21]) and its MCRI (2.06 [1.13–3.77]) at discharge and a new visit to the emergency department. An association was found between the prescription of more than five drugs, an MCRI > 20, an increase in the number of drugs, and in MCRI value at discharge and a new visit to any other health care center. The number of prescribed drugs and the medication complexity of patients who visit the emergency department for drug-related problems was associated with an increase in the number of revisits to the emergency department and to other health care centers.
If You Travel, I Travel: Testing a Model of When and How Travel-Related Content Exposure on Facebook Triggers the Intention to Visit a Tourist Destination
Authors: Latif Kashmala , Malik Muhammad Yousaf , Pitafi Abdul Hameed , Kanwal Shamsa , Latif Zara
Published: May 2020

This study aims to examine the role of exposure to travel-related content posted by friends on Facebook in triggering the intention to visit a tourist destination (IVTD). The study further examines how travel-related content exposure is linked with IVTD, and why some travel consumers, unlike others, tend to trigger more IVTD in response to travel-related content exposure. The sample of the present study included 295 travel consumers who are users of Facebook in Pakistan. The hypothesized model is tested using PROCESS macros in SPSS 24.0. The findings of the study reveal that travel-related content exposure is positively associated with IVTD. The benign envy mediates the relationship between exposure to travel-related content posted by friends on Facebook and IVTD, but the online social identity moderated the relationship between exposure to travel-related content posted by friends on Facebook and IVTD such that high online social identity strengthened the impact of travel-related content exposure on IVTD, thus highlighting the pivotal role of online social identity in the comparison process. The study contributes to the tourism literature on social media and has practical implications for social media travel managers and advertisers. The travel managers and advertisers should develop marketing and communication strategies considering friends’ communications on Facebook as a factor that can influence travel consumers’ behavior and decision making.
What Happens During Teacher–Student Interaction in the First Year of Primary School? A New Explanation
Authors: Coşkun Kerem , Kara Cihan
Published: May 2020

The present research aims to develop a theory on teacher–student interaction in the first year of primary school period. The present research was designed in grounded theory research which is one of the qualitative research traditions. A total of 18 primary school children started the first year of primary school. Data were collected through participant observation. Participant observation was launched after all necessary ethical permissions were taken from local education authority, the participant children, their teacher, and parents. Data were analyzed through constant comparison within three stages as open coding, axial coding, and selective coding. It was reported that the teacher and the first graders mutually developed strategies and there were several circumstances in the interaction that nested behavioral problems.
Comparison of Functional Outcomes Between Lumbar Interbody Fusion Surgery and Discectomy in Massive Lumbar Disc Herniation: A Retrospective Analysis
Authors: Gupta Anuj , Chhabra H. S. , Nagarjuna D. , Arora Mohit
Published: May 2020

Study Design:

Retrospective analysis.

Objective:

Lumbar disc herniation is one the most common condition responsible for low back and radicular pain. Although the symptoms are not proportional to the size of disc prolapse but massive disc herniation frequently needs surgical management. According to literature, the incidence of low back pain, recurrent disc herniation and segmental instability are more in discectomy whereas incidence of adjacent segment degeneration (ASD) is more after fusion surgery. There are very few studies that directly compare long-term functional outcome of both these procedures. We compared the functional outcome of both the procedures in this study.

Methods:

All patients of massive disc prolapse, operated at our center between 2011 to 2017, were contacted. All the patients underwent either discectomy or transforaminal lumbar interbody fusion (TLIF). Functional outcomes of all the patients were collected using visual analogue scale (VAS) (back), VAS (leg), modified Oswestry Disability Index (mODI), Sciatica Bothersomeness Index (SBI), and McNab’s criterion. Various complications were also analyzed.

Results:

There were 144 patients in the discectomy group and 123 patients in the TLIF group. Mean duration of follow-up was 55.07 months and 51.86 months, respectively. Both the groups show no significant difference in VAS. Significant difference was seen in mODI and SBI favoring discectomy. McNab’s criterion showed excellent result in 80% of patients of discectomy compared with 68% patients of TLIF. Overall complication rate in discectomy group was 11% whereas 13% in TLIF group.

Conclusion:

Both show good functional outcome but better in discectomy. Recurrent herniation and instability were noticed more with discectomy and ASD was more common after fusion surgeries. The choice of procedure should be individualized, and it also depends on surgical expertise, but in developing countries where resources are constrained, discectomy should be preferred.
SuperShip: Journey of a Successful Entrepreneur
Authors: Cao Viet Quoc
Published: May 2020

SuperShip Vietnam, a Joint Stock Company, founded in 2015, specializes in freight forwarding and express delivery services for e-commerce transactions in Vietnam. In 4 years, it has come a long way from a start-up with only five members and VNĐ 40 million (~US$1,800) as the capital. Difficulties and challenges faced by the firm were incredibly huge. Nevertheless, with slow but steady growth, the company utilized the quality of services as the foundation to build customer satisfaction and loyalty rather than taking the route of price-based competition. SuperShip has grown steadily to become a prestigious and well-established enterprise in the fast-moving freight forwarding market. SuperShip is not yet satisfied with its multiple accomplishments as there are still many peaks to conquer to achieve the company’s vision.

The case highlights as to how through participation in union-association and volunteering activities; implementing small business plans to earn extra money during college days can help in developing leadership, negotiation and interpersonal skills and hone the entrepreneurship trait.

Dilemma

For steady growth, should the company utilize the quality of services as the foundation to build customer satisfaction and loyalty or take the route of price-based competition. Theory: Sustainability of a business in goods delivery sector Type of the case: Experience-based applied single case study Protagonist: The owner of the firm

Options

Copy the business model of the two large players in the existing market and offer similar services. Raise the benchmark of customer satisfaction and loyalty by designing and delivering superior quality of service with the help of well trained and empowered employees.

Discussions and Case Questions

For a training firm is it better to focus on a single service and performing it with excellence than offering many courses. How did SuperShip created its point of difference? How the firm can grow further while raising funds at a low cost? What is the next level of quality of service that the firm should target?
National Multidisciplinary Survey of Regional Anesthesia Preferences in Breast Reconstruction
Authors: Head Linden K. , Lui Anne , Cordeiro Erin , Boyd Kirsty U.
Published: May 2020

Background:

The purpose of this work was to determine the regional anesthesia preferences of plastic surgeons (PS) and anesthesiologists (A) involved in breast reconstruction in Canada.

Methods:

Online surveys were sent to members of the Canadian Society of Plastic Surgeons (CSPS) and the Canadian Anesthesiologists Society (CAS). The primary outcome was regional anesthesia preferences in breast reconstruction (delayed, immediate, alloplastic, autologous). Secondary outcomes included the availability and the influence of specialty and academic status on preferences. Statistical analysis used descriptive statistics and Pearson χ2 test.

Results:

Responses from CSPS and CAS totaled 141 (response rate = 30%) and 217 (response rate = 14%), respectively. Compared with non-academic centres (NAC), academic centres (AC) had significantly greater access to (AC = 60%, NAC = 39%, P = .001) and preferred to use regional anesthesia more often (AC = 36%, NAC = 10%, P < .001). The following proportions of physicians preferred to use regional anesthesia: 40% (PS = 32%, A = 44%, P = .081) for immediate alloplastic reconstruction, 23% (PS = 24%, A = 22%, P = .821) for delayed alloplastic reconstruction, 34% (PS = 18%, A = 41%, P < .001) for immediate autologous reconstruction, and 19% (PS = 13%, A = 21%, P = .195) for delayed autologous reconstruction. Regional anesthesia preferences were significantly different between plastic surgeons and anesthesiologists ( P < .001)—anesthesiologists favoured paravertebral blocks for all reconstructions, while plastic surgeons favoured pectoral nerve blocks for immediate alloplastic reconstruction and intercostal nerve blocks for all other reconstructions.

Conclusions:

Plastic surgeons and anesthesiologists prefer not to use regional anesthesia in the majority breast reconstructions. Among those who deploy regional anesthesia, plastic surgeons and anesthesiologist have divergent preferences with respect to modality. There is a need for a prospective study comparing paravertebral blocks and intercostal nerve blocks.
Genu varum deformity due to premature epiphyseal closure after treatment with isotretinoin for neuroblastoma: A case report
Authors: Park Won Keun , Choi Hyoung Soo , Chung Chin Youb , Park Moon Seok , Sung Ki Hyuk
Published: May 2020

Isotretinoin, a vitamin A derivative, is known to induce premature epiphyseal closure. We report the case of a 9-year-old boy with neuroblastoma who demonstrated premature epiphyseal closure after 1 year of isotretinoin treatment (72.3 mg/m2/day). A bone bridge developed on the bilateral proximal tibial growth plate resulting in genu varum. We performed hemiepiphysiodesis on the bilateral proximal tibia in anticipation of the spontaneous resolution of the bone bridge. Genu varum on the left side was corrected with the resolution of bone bridge. For the remaining bone bridge on the right side, arthroscopy-assisted physeal bar resection was performed, and genu varum on the right lower extremity was also corrected. A regular review of the alignment of the upper and lower limbs is necessary to provide timely intervention in patients using isotretinoin, considering the possibility of premature epiphyseal closure.
Efficient Adaptive Speech Reception Threshold Measurements Using Stochastic Approximation Algorithms
Authors: Dingemanse Gertjan , Goedegebure André
Published: May 2020

This study examines whether speech-in-noise tests that use adaptive procedures to assess a speech reception threshold in noise ( SRT50n) can be optimized using stochastic approximation (SA) methods, especially in cochlear-implant (CI) users. A simulation model was developed that simulates intelligibility scores for words from sentences in noise for both CI users and normal-hearing (NH) listeners. The model was used in Monte Carlo simulations. Four different SA algorithms were optimized for use in both groups and compared with clinically used adaptive procedures. The simulation model proved to be valid, as its results agreed very well with existing experimental data. The four optimized SA algorithms all provided an efficient estimation of the SRT50n. They were equally accurate and produced smaller standard deviations (SDs) than the clinical procedures. In CI users, SRT50n estimates had a small bias and larger SDs than in NH listeners. At least 20 sentences per condition and an initial signal-to-noise ratio below the real SRT50n were required to ensure sufficient reliability. In CI users, bias and SD became unacceptably large for a maximum speech intelligibility score in quiet below 70%. In conclusion, SA algorithms with word scoring in adaptive speech-in-noise tests are applicable to various listeners, from CI users to NH listeners. In CI users, they lead to efficient estimation of the SRT50n as long as speech intelligibility in quiet is greater than 70%. SA procedures can be considered as a valid, more efficient, and alternative to clinical adaptive procedures currently used in CI users.
“We Are Here to Assist All Individuals Who Need Hospice Services”: Hospices’ Perspectives on Improving Access and Inclusion for Racial/Ethnic Minorities
Authors: Hughes M. Courtney , Vernon Erin
Published: May 2020

Background: Racial/ethnic minority populations in the United States are less likely to utilize hospice services nearing their end of life, potentially diminishing their quality of care while also increasing medical costs. Objective: Explore the minority hospice utilization gap from the hospice perspective by examining perceived barriers and facilitators as well as practices and policies. Method: Qualitative surveys were conducted with 41 hospices across the United States. Qualitative data analysis included performing a limited content analysis, including the identification of themes and representative quotations. Results: Commonly reported barriers to hospice care for racial/ethnic minorities included culture/beliefs, mistrust of the medical system, and language barriers. A major theme pertaining to successful minority hospice enrollment was an inclusive culture that provided language services, staff cultural training, and a diverse staff. Another major theme was the importance of community outreach activities that extended beyond the medical community and forming relationships with churches, racial/ethnic minority community leaders, and Native American reservations. Conclusion: The importance of incorporating a culture of inclusivity by forming committees, providing language services, and offering culturally competent care emerged in this qualitative study. Building strong external relationships with community groups such as churches is a strategy used to increase racial/ethnic minority utilization of hospice.
Evaluation of Patient Engagement in a Clinical Emergency Care Network: Findings From the BC Emergency Medicine Network
Authors: Drebit Sharla , Eggers Kim , Archibald Chantel , Abu-Laban Riyad , Ho Kendall , Khazei Afshin , Lindstrom Ronald , Marsden Julian , Martin Ed , Christenson Jim
Published: May 2020

The British Columbia Emergency Medicine Network (EM Network) has collaborated with patient partners to utilize their experiential knowledge to inform planning and implementation. Patient partners participated in several EM Network committees and initiatives. This study evaluated how patient partners and other leaders in the EM Network perceived patient engagement efforts 1 year after launch. The Public and Patient Engagement Evaluation Tool V2.0 found that there was an appropriate level of patient engagement at this early stage, an opportunity to attract more patient partners as the EM Network grows, and a need to ensure adequate resources to support more activities.
Onco-nephrology highlights: Chronic kidney disease, end-stage kidney disease, and cancer patients
Authors: Lynch Matthew R , Hu Susie L
Published: May 2020

With increasing prevalence of both kidney disease and cancer, patients who have both are common. Toxicity from treatment or direct kidney injury by the cancer itself can lead to acute kidney injury or progression of pre-existing chronic kidney disease. Management of advanced chronic kidney disease or end-stage kidney disease among those with concomitant cancer is challenging; however, better understanding of complications in this population will allow for optimization of treatments. Strategies for medication dosing, judicious use of erythropoiesis-stimulating agents in anemia, and treatment options for mineral bone disorders will be reviewed. Among those who require dialysis, special consideration should be made surrounding medication dosing, and end-of-life care should be addressed as early as possible in a patient-centered manner.
Cultural Modification and Cultural Alignment in Police Services: An Empirical Analysis of Select Variables
Authors: Aryasri A. Ramachandra , Jitender  , P. Mahapatra Gopal
Published: May 2020

Police forces, traditionally, were tacitly assumed to be rule-bound, legalistic, bureaucratic organisations, in which top-down policies prevailed through a quasi-militaristic rank hierarchy and strict discipline code ( Reiner,2016 ). The profile of the police organisations has been radically transforming, in view of the wider politico-economic and cultural context of re-emerging conflicts and social divisions in the recent past. Because of loose ends in the legal powers and processes, police officers at the operational level were characterised by the extent of discretion on how to behave or misbehave ( Newburn & Reiner, 2012 ).

An empirical study was carried out in Visakhapatnam, Andhra Pradesh using Convenience sampling on 680 (340 respondents from police from different cadres and public each through separate structured questionnaires for each category of respondents), covering three variables, namely police beat, patrolling and responding to public calls.

This article presents how Visakhapatnam Police could focus on the beat and patrolling, responding to public calls as part of aligning its working processes and bring in the cultural change not only in the Police Organisation as a whole, but also among the stakeholders. The Visakha Police is today known to be more citizen-friendly, tech-savvy and relatively fast in addressing and resolving issues.
SMART and as-needed therapies in mild-to-severe asthma: a network meta-analysis
Authors: Rogliani Paola , Ritondo Beatrice Ludovica , Ora Josuel , Cazzola Mario , Calzetta Luigino
Published: May 2020

To date, there are no network meta-analyses comparing the impact of as-needed treatments in asthma, including the single maintenance and reliever therapy (known as “SMART” or “MART”; for simplicity, SMART will be used hereafter) and the use of inhaled corticosteroid (ICS)/long-acting β2-agonist (LABA) combination exclusively on an as-needed basis. Therefore, we performed a systematic review and network meta-analysis concerning the efficacy and safety of SMART and as-needed therapies in asthma. Data from 32 096 asthmatic patients were extracted from 21 studies, lasting from 6 to 12 months. In adult mild-to-moderate asthmatic patients low-dose SMART and as-needed low-dose ICS/LABA combination were significantly (relative effect <0.78; p<0.05) more effective than the other as-needed therapies in reducing the risk of exacerbation, and both were ranked as the first treatment option reaching the first quartile of the surface under the cumulative ranking curve analysis (SUCRA). In adult moderate-to-severe asthmatic patients, low-dose to medium-dose SMART and high-dose ICS/LABA+as-needed short-acting β2-agonist were equally effective in reducing the risk of severe asthma exacerbation (p>0.05), although only low- to medium-dose SMART was ranked as the first treatment option (first SUCRA quartile). Overall, these treatments were well tolerated, and effective also on lung function and disease control. This study supports SMART and as-needed therapies as a suitable therapeutic option for asthma, by providing the most effective positioning of each specific treatment according to the disease severity.
Factors associated with prolonged viral shedding and impact of lopinavir/ritonavir treatment in hospitalised non-critically ill patients with SARS-CoV-2 infection
Authors: Yan Dan , Liu Xiao-Yan , Zhu Ya-nan , Huang Li , Dan Bi-tang , Zhang Guo-jun , Gao Yong-hua
Published: May 2020

Background

The duration of viral shedding is central to the guidance of decisions about isolation precautions and antiviral treatment. However, studies regarding the risk factors associated with prolonged shedding of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the impact of lopinavir/ritonavir (LPV/r) treatment on viral shedding remain scarce.

Methods

Data were collected from all SARS-CoV-2 infected patients who were admitted to isolation wards and had reverse transcription PCR conversion at the No. 3 People's Hospital of Hubei province, China, between 31 January and 9 March 2020. We compared clinical characteristics and SARS-CoV-2 RNA shedding between patients initiated with LPV/r treatment and those without. Logistic regression analysis was employed to evaluate the risk factors associated with prolonged viral shedding.

Results

Of 120 patients, the median age was 52 years, 54 (45%) were male and 78 (65%) received LPV/r treatment. The median duration of SARS-CoV-2 RNA detection from symptom onset was 23 days (interquartile range 18–32 days). Older age (OR 1.03, 95% CI 1.00–1.05; p=0.03) and the lack of LPV/r treatment (OR 2.42, 95% CI 1.10–5.36; p=0.029) were independent risk factors for prolonged SARS-CoV-2 RNA shedding. Patients who initiated LPV/r treatment within 10 days from symptom onset, but not initiated from day 11 onwards, had significantly shorter viral shedding duration compared with those without LPV/r treatment (median 19 daysversus28.5 days; log-rank p<0.001).

Conclusion

Older age and the lack of LPV/r treatment were independently associated with prolonged SARS-CoV-2 RNA shedding in patients with coronavirus disease 2019 (COVID-19). Earlier administration of LPV/r treatment could shorten viral shedding duration.
Day-to-day variability of forced oscillatory mechanics for early detection of acute exacerbations in COPD
Authors: Zimmermann Sabine C. , Huvanandana Jacqueline , Nguyen Chinh D. , Bertolin Amy , Watts Joanna C. , Gobbi Alessandro , Farah Claude S. , Peters Matthew J. , Dellacà Raffaele L. , King Gregory G. , Thamrin Cindy
Published: May 2020

Background

Telemonitoring trials for early detection of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have provided mixed results. Day-to-day variations in lung function measured by the forced oscillation technique (FOT) may yield greater insight. We evaluated the clinical utility of home telemonitoring of variability in FOT measures in terms of 1) the relationship with symptoms and quality of life (QoL); and 2) the timing of variability of FOT measures and symptom changes prior to AECOPD.

Methods

Daily FOT parameters at 5 Hz (resistance (R) and reactance (X); Resmon Pro Diary, Restech Srl, Milan, Italy), daily symptoms (COPD Assessment Test (CAT)) and 4-weekly QoL data (St George's Respiratory Questionnaire (SGRQ)) were recorded over 8–9 months from chronic obstructive pulmonary disease (COPD) patients. Variability of R and X was calculated as the standard deviation (sd) over 7-day running windows and we also examined the effect of varying window size. The relationship of FOTversusCAT and SGRQ was assessed using linear mixed modelling, daily changes in FOT variability and CAT prior to AECOPD using one-way repeated measures ANOVA.

Results

Fifteen participants with a mean±sdage of 69±10 years and a % predicted forced expiratory volume in 1 s (FEV1) of 39±10% had a median (interquartile range (IQR)) adherence of 95.4% (79.0–98.8%). Variability of the inspiratory component of X (indicated by the standard deviation of inspiratory reactance (SDXinsp)) related to CAT and weakly to SGRQ (fixed effect estimates 1.57, 95% CI 0.65–2.49 (p=0.001) and 4.41, 95% CI −0.06 to 8.89 (p=0.05), respectively). SDXinspchanged significantly on the same day as CAT (1 day before AECOPD, both p=0.02) and earlier when using shorter running windows (3 days before AECOPD, p=0.01; accuracy=0.72 for 5-day windows).

Conclusions

SDXinspfrom FOT telemonitoring reflects COPD symptoms and may be a sensitive biomarker for early detection of AECOPD.
Power analysis for RNA-Seq differential expression studies using generalized linear mixed effects models
Authors: Yu Lianbo , Fernandez Soledad , Brock Guy
Published: May 2020

Background

Power analysis becomes an inevitable step in experimental design of current biomedical research. Complex designs allowing diverse correlation structures are commonly used in RNA-Seq experiments. However, the field currently lacks statistical methods to calculate sample size and estimate power for RNA-Seq differential expression studies using such designs. To fill the gap, simulation based methods have a great advantage by providing numerical solutions, since theoretical distributions of test statistics are typically unavailable for such designs.

Results

In this paper, we propose a novel simulation based procedure for power estimation of differential expression with the employment of generalized linear mixed effects models for correlated expression data. We also propose a new procedure for power estimation of differential expression with the use of a bivariate negative binomial distribution for paired designs. We compare the performance of both the likelihood ratio test and Wald test under a variety of simulation scenarios with the proposed procedures. The simulated distribution was used to estimate the null distribution of test statistics in order to achieve the desired false positive control and was compared to the asymptotic Chi-square distribution. In addition, we applied the procedure for paired designs to the TCGA breast cancer data set.

Conclusions

In summary, we provide a framework for power estimation of RNA-Seq differential expression under complex experimental designs. Simulation results demonstrate that both the proposed procedures properly control the false positive rate at the nominal level.
MtOrt: an empirical mitochondrial amino acid substitution model for evolutionary studies of Orthoptera insects
Authors: Chang Huihui , Nie Yimeng , Zhang Nan , Zhang Xue , Sun Huimin , Mao Ying , Qiu Zhongying , Huang Yuan
Published: May 2020

Background

Amino acid substitution models play an important role in inferring phylogenies from proteins. Although different amino acid substitution models have been proposed, only a few were estimated from mitochondrial protein sequences for specific taxa such as the mtArt model for Arthropoda. The increasing of mitochondrial genome data from broad Orthoptera taxa provides an opportunity to estimate the Orthoptera-specific mitochondrial amino acid empirical model.

Results

We sequenced complete mitochondrial genomes of 54 Orthoptera species, and estimated an amino acid substitution model (named mtOrt) by maximum likelihood method based on the 283 complete mitochondrial genomes available currently. The results indicated that there are obvious differences between mtOrt and the existing models, and the new model can better fit the Orthoptera mitochondrial protein datasets. Moreover, topologies of trees constructed using mtOrt and existing models are frequently different. MtOrt does indeed have an impact on likelihood improvement as well as tree topologies. The comparisons between the topologies of trees constructed using mtOrt and existing models show that the new model outperforms the existing models in inferring phylogenies from Orthoptera mitochondrial protein data.

Conclusions

The new mitochondrial amino acid substitution model of Orthoptera shows obvious differences from the existing models, and outperforms the existing models in inferring phylogenies from Orthoptera mitochondrial protein sequences.
Deep vein thrombosis due to May-Thurner syndrome: a case report
Authors: Meng Yan , Qin Hao , Ma Qiang , Zhang Junbo , Zhang Bo , Pang Honggang , Yin Qian , Tian Hongyan
Published: May 2020

Background

May-Thurner syndrome (MTS) or Cockett’s syndrome is a rare clinical syndrome, which refers to the compression of the left common iliac vein (LCIV) by right common iliac artery and vertebral body. Complications of MTS include deep vein thrombus formation and even life-threatening pulmonary embolism.

Case presentation

Here, we report the case of a 60-year-old female patient with a complaint of swelling in the left lower limb and pain for 5 days. Computed tomography angiography indicated MTS, and thrombus formation of left external iliac vein and femoral vein. The patient was diagnosed with deep venous thrombosis (DVT) and MTS. The patient underwent ascending venography from the lower extremity to inferior vena cava (IVC) and then to the pulmonary artery with IVC filter implantation, left iliac vein balloon plasty, and stent placement. The patient visited the hospital for the removal of IVC filter, 28 days after the operation. After the interventional therapy, the patient had no in-stent restenosis and had remission during the 2-year follow-up.

Conclusions

This case presents a successful management of MTS in presence of DVT. Although clinicians are rarely aware, the presence of unilateral lower limb swelling and thrombosis may be the manifestations of MTS.
Ion-Channel modulator TH1177 reduces glomerular injury and serum creatinine in chronic mesangial proliferative disease in rats
Authors: Cove-Smith Andrea , Sharpe Claire C. , Shattock Michael J. , Hendry Bruce M.
Published: May 2020

Background

T-type calcium channels (TTCC) are involved in mesangial cell proliferation. In acute thy-1 nephritis in the rat TTCC inhibition reduces glomerular damage and cell proliferation. This work is extended here by a study of the non-selective TTCC inhibitor TH1177 in a chronic model of proliferative glomerulonephritis (GN) including late treatment starting after the initial inflammation has resolved. The objective was to determine the effects of TH1177 in a model of chronic mesangioproliferative renal disease.

Methods

Chronic GN was induced in WKY rats by unilateral nephrectomy (day − 7) followed by day 0 injection of Ox7 thy-1 mAb. Treatment with TH1177 (10–20 mg/Kg daily IP) was started on day 2 (early treatment) or on day 14 (late treatment) and compared to vehicle-treated controls until sacrifice at day 42. Glomerular disease was assessed with a damage score, fibrosis assay, cellular counts and renal function measured by serum creatinine.

Results

Treatment with TH11777 was associated with reduced serum creatinine, less glomerular damage, reduced fibrosis and reduced glomerular cellularity. The results for early and late TH1177 treatments were essentially the same and differed significantly from vehicle.

Conclusions

The ion-channel modulator TH1177 is capable of improving glomerular outcome in chronic rat GN even when treatment starts 14 days after initiation of the disease. These data are discussed in the context of the possible targets of TH1177 including TTCC, TRP family, Stim/Orai group and other cation channels. The work supports the use of genetic models to examine the roles of individual cation channels in progressive glomerulonephritis to further define the targets of TH1177.
Paternal violent criminality and preterm birth: a Swedish national cohort study
Authors: Liu Can , Långström Niklas , Ekéus Cecilia , Frisell Thomas , Cnattingius Sven , Hjern Anders
Published: May 2020

Background

Fathers may affect expectant mothers’ daily living situations, which in turn might influence pregnancy outcomes. We investigated the association between paternal violent criminality and risk of preterm birth (≤36 weeks).

Methods

We conducted a register-based study with all live singleton births in the Swedish Medical Birth Register from 1992 to 2012, linked with records of paternal violent crime convictions from the National Crime Register from 1973 to 2012.

Results

Paternal violent criminality was associated with increased risk of preterm birth and lower gestational age. The association was especially pronounced among infants of reoffenders: men convicted of three or more violent crimes (adjusted odds ratio [aOR] 1.23 [95% CI 1.17, 1.29]). Maternal half sibling-comparisons, an analytic approach controlling for maternal factors stable across pregnancies, also suggested increased risk of preterm birth and lower gestational age when exposed to a violently reoffending father compared to a father without violent criminal convictions (aOR 1.30 [0.99, 1.72], adjusted mean difference − 1.07 [− 1.78, − 0.36]).

Conclusions

Persistent paternal violent criminality was associated with increased risk of preterm birth, even after controlling for maternal characteristics that did not change between pregnancies.
Why women chose unassisted home birth in Malaysia: a qualitative study
Authors: Ahmad Tajuddin Nur Amani Natasha , Suhaimi Julia , Ramdzan Siti Nurkamilla , Malek Khasnur Abd , Ismail Ilham Ameera , Shamsuddin Nurainul Hana , Abu Bakar Ahmad Ihsan , Othman Sajaratulnisah
Published: May 2020

Background

Incidences of unassisted home birthing practices have been increasing in Malaysia despite the accessibility to safe and affordable child birthing facilities. We aimed to explore the reasons for women to make such decisions.

Methods

Twelve women participated in in-depth interviews. They were recruited using a snowballing approach. The interviews were supported by a topic guide which was developed based on the Theory of Planned Behaviour and previous literature. The interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.

Results

Women in this study described a range of birthing experiences and personal beliefs as to why they chose unassisted home birth. Four themes emerged from the interviews; i) preferred birthing experience, ii) birth is a natural process, iii) expressing autonomy and iv) faith. Such decision to birth at home unassisted was firm and steadfast despite the possible risks and complications that can occur. Giving birth is perceived to occur naturally regardless of assistance, and unassisted home birth provides the preferred environment which health facilities in Malaysia may lack. They believed that they were in control of the birth processes apart from fulfilling the spiritual beliefs.

Conclusions

Women may choose unassisted home birth to express their personal views and values, at the expense of the health risks. Apart from increasing mothers’ awareness of the possible complications arising from unassisted home births, urgent efforts are needed to provide better birth experiences in healthcare facilities that resonate with the mothers’ beliefs and values.
Mother’s satisfaction with the existing labor and delivery care services at public health facilities in West Shewa zone, Oromia region, Ethiopia
Authors: Bulto Gizachew Abdissa , Demissie Dereje Bayissa , Tasu Tefera Likasa , Demisse Getu Alemu
Published: May 2020

Background

Mothers’ satisfaction with care during childbirth is indicators of the quality care which affects skilled birth attendance. Negative client’s experiences at health facilities cause them to delay or avoid seeking care, which highlights services providers should consider and act on the expectations and experiences of women and their families. Though there are few studies conducted in Ethiopia on maternal satisfaction with Labor and Delivery (LAD) services, there is no study conducted in the study area. Therefore the study aims to assess the mother’s satisfaction with existing LAD services and associated factors at all levels of health care in the West Shewa zone.

Methods

An institution-based cross-sectional study was conducted at public health facilities in West Shewa zone, Central Ethiopia. A systematic sampling technique was used to select 560 respondents by using their delivery registration number and data were collected through face to face interview. Mothers were considered satisfied if they responded satisfied/very satisfied with 75% or more of the questions assessing satisfaction. Binary and multivariable logistic regression analysis was used to identify associated factors.

Results

The overall proportion of mothers who were satisfied with the current LAD care services were 60.8%. The main areas of dissatisfaction were; accessibility and cleanness of toilets/shower 72.6%, overall cleanness of the facility/including waiting-area 40.1% and presence of support a person during birth 38.0%. The presence of cultural practices (AOR = 2.5), discussion on the place of delivery with health worker during ANC (AOR = 1.75), providers asks for consent before procedure (AOR = 2.77), encouraging companion to remain with mother (AOR = 2.22), never leave mother alone or unattended (AOR = 2.56), giving periodic updates on status and progress of labor (AOR = 2.04) and explaining what is being done and to expect during LAD (AOR = 2.20) were factors identified to be significantly associated with satisfaction on LAD services.

Conclusion

The overall satisfaction of mothers with LAD services at public health facilities in the West-Shewa zone was relatively low.Presence of cultural practices, discussion on the place of delivery, asking for consent before the procedure, encouraging companion to remain with mothers and explaining what is being done were factors identified. Therefore, all stakeholders have to emphatically work on those identified factors to improve mothers’ satisfaction with LAD services.
Correction to: Postnatal care service utilization and associated factors among women who gave birth in Debretabour town, North West Ethiopia: a community- based cross-sectional study
Authors: Wudineh Kihinetu Gelaye , Nigusie Azezu Asres , Gesese Shumiye Shiferaw , Tesfu Azimeraw Arega , Beyene Fentahun Yenealem
Published: May 2020

An amendment to this paper has been published and can be accessed via the original article.