bluuebunny/crossref_metadata_2025 huggingface dataset:
The predictive value of diaphragm ultrasound for weaning outcomes in critically ill children
Authors: Xue Yang , Zhang Zhen , Sheng Chu-Qiao , Li Yu-Mei , Jia Fei-Yong
Published: October 2019

Background: Multiple studies have shown that diaphragmatic ultrasound can better predict the outcome of weaning in adults. However, there are few studies focusing on children, leading to a lack of sufficient clinical evidence for the application of diaphragmatic ultrasound in children. The purpose of this study is to investigate the predictive value of diaphragm ultrasound for weaning outcomes in critically ill children.
Methods: The study included 50 cases whose mechanical ventilation (MV) time was >48 h, and all eligibles were divided into either the weaning success group (n = 39) or the weaning failure group (n = 11). Diaphragm thickness, diaphragmatic excursion (DE), and diaphragmatic thickening fraction (DTF) were measured in the zone of apposition. The maximum inspiratory pressure (PImax) was also recorded.
Results: The ventilatory treatment time ( P = 0.002) and length of PICU stay ( P = 0.013) in the weaning failure group was longer than the success group. Cut-off values of diaphragmatic measures associated with successful weaning were ≥21% for DTF with a sensitivity of 0.82 and a specificity of 0.81, whereas it was ≥0.86 cmH 2 O/kg for PImax with a sensitivity of 0.51 and a specificity of 0.82. The linear correlation analysis showed that DTF had significant correlation with PImax in children ( P = 0.003).
Conclusions: Diaphragm ultrasound has great value in predicting the weaning outcome of critically ill children. DTF and PImax presented better performance than other diaphragmatic parameters. However, DE has limited value in predicting weaning outcomes of children with MV.
Delivery of home-based postpartum contraception in rural Guatemalan women: a cluster-randomized trial protocol
Authors: Harrison Margo , Bunge-Montes Saskia , Rivera Claudia , Jimenez-Zambrano Andrea , Heinrichs Gretchen , Scarbro Sharon , Juarez-Colunga Elizabeth , Bolanos Antonio , Asturias Edwin , Berman Stephen , Sheeder Jeanelle
Published: October 2019

Abstract

Background: Postpartum contraception is important to prevent unintended and closely spaced pregnancies following childbirth.

Methods: This study is a cluster-randomized trial of communities in rural Guatemala where women receive ante- and postnatal care through a community-based nursing program. When nurses visit women for their postpartum visit in the intervention clusters, instead of providing only routine care that includes postpartum contraceptive education and counseling, the nurses will also bring a range of barrier, short-acting, and long-acting contraceptives that will be offered and administered in the home setting, after routine clinical care is provided.

Discussion: A barrier to postpartum contraception is access to medications and devices. Our study removes some access barriers (distance, time, cost) by providing contraception in the home. We also trained community nurses to place implants, which are a type of long-acting reversible contraceptive method that was previously only available in the closest town, which is about an hour away by vehicle. Therefore, our study examines how home-based delivery of routinely available contraceptives and the less routinely available implant may be associated with increased uptake of postpartum contraception within three months of childbirth. The potential implications of this study include: nurses may be able to be trained to safely provide contraceptives, including place implants, in the home setting, and provision of home-based contraception may be an effective way of delivering an evidence-based intervention for preventing unintended and closely spaced pregnancies in the postpartum period.
Implementation of an interactive organ donation education program for Dutch lower-educated students: a process evaluation
Authors: Steenaart Esther , Crutzen Rik , de Vries Nanne K
Published: October 2019

Background As organ donation registration rates remain low, especially among lower-educated people, it is important to support this group in making their registration decision. To prepare lower-educated students in the Netherlands for making a well-informed decision, an interactive educational program was developed. We aim to understand both the (quality of) implementation as well as to contextualize the effect of this program in a lower-educated school setting.
Methods The process evaluation was part of a Cluster Randomized Controlled Trial, in which 11 schools for Intermediate Vocational Education throughout the Netherlands participated. Teachers who taught a course on Citizenship delivered three intervention elements (i.e. video fragments and discussion, quizzes with tailored feedback and an exercise filling out a registration form) to their students. Implementation was assessed by interviews with teachers, questionnaires from students, logbooks from teachers and user data from Google Analytics.
Results The program was well received and implemented, but on-the-spot adaptations were made by teachers to fit their students better. Within the lower-educated target group, differences between students are high in terms of active participation, reading abilities, knowledge and attention span. The program fit well within their regular teaching activities, but the topic of organ donation is not always prioritized by teachers.
Conclusions We see opportunities to disseminate the program on a larger scale and reach a group that has been neglected in organ donation education before. Within the program, there are possibilities to increase the effectiveness of the program, such as alternative delivery methods for the elements with a lot of text, the addition of booster sessions and guidelines for teachers to adapt the program to students of different levels within Intermediate Vocational Education. Moreover, in order to have an impact on a national level, strategies need to be employed to reach high numbers of students and, therefore, support on a higher level is needed (both within schools and at policy level).
Trial registration: Dutch Trial Register, NTR6771. Registered on 24 October 2017. https://www.trialregister.nl/trial/6557
Ability of Real-time PCR for Differential Diagnosis of Various Forms of Cutaneous Leishmaniasis: A Comparative Study with Histopathology
Authors: Abadi Maryam Fekri Soofi , Fekri Meisam , moradabadi alireza , Vahidi Reza , Meymandi Simin Shamsi , Dabiri Donya , dabiri shahriar
Published: October 2019

objective: Histopathological studies suggest that parasite load is different between acute and chronic forms of cutaneous leishmaniasis (CL). However, highly sensitive detection methods are still needed to distinguish different forms of leishmaniasis. In the present study, we developed a quantitative real-time polymerase chain reaction (PCR) to detect and quantify leishmania tropica parasites in paraffin-embedded tissue samples.
Results: The ability of real-time PCR for leishmania detection was higher than histopathological evaluation. The parasite loads were quantified by qPCR assay and microscopic evaluation were highly correlated ( r =0.598; P <0.001). Among patients, the parasite load was inversely correlated with disease duration (acute CL lesions had very higher parasite loads than chronic CL lesions), but there was no difference in parasite load according to the patients’ age and sex as well as location of the lesions. In contrast to Ridley scoring system (P<0.001), there were no statistically significant differences in the relative number of parasites among the lupoid and non-lupoid forms of chronic lesions in real-time PCR (P=0.549), which indicates the superiority of histopathological evaluation in CL forms differentiation.
Physical activity promotion in daily exercise therapy: The perspectives of exercise therapists in German rehabilitation settings
Authors: Geidl Wolfgang , Wais Judith , Fangmann Cheyenne , Demisse Ewnet , Pfeifer Klaus , Sudeck Gorden
Published: October 2019

Abstract
Background
This study aims to explore exercise therapists’ perspectives on the topic of physical activity promotion (PAP) with a focus on identifying (i) the intervention content and methodological approaches used for promoting physical activity (PA) in daily practice and (ii) the barriers and facilitators that affect PAP.
Methods
This qualitative study comprised the heads of exercise therapy departments (n = 58; 41% women; mean age = 45 years) from different rehabilitation clinics in Germany. Each participant took part in a semi-structured focus-group discussion on PAP in exercise therapy. The findings of the focus groups were processed and interpreted using a conventional qualitative content analysis.
Results
The exercise therapists demonstrated detailed didactic–methodological strategies and action orientations for PAP. The identified core topics of the content and methods of PAP were (1) conceptualization, (2) exercise and PA for enjoyment and pleasure, (3) education with practice–theory combinations, (4) media and materials for self-directed training, and (5) strategies to enhance personal responsibility and independence. The core topics for the associated barriers and facilitators were (1) structural conditions, (2) the role of exercise therapists, (3) the interdisciplinary rehabilitation team, (4) rehabilitant experiences and expectations, and (5) aftercare services.
Conclusion
The topic of PAP is addressed with a high level of variability; exercise therapists involved in this study identify various methods and content for the promotion of PA within their individual practices. However, they display a limited awareness of existing evidence- and theory-based concepts for the promotion of PA as well as underlying theories of behavioural change. This variability may be due to the lack of a defined common framework for promoting PA, insufficient emphasis being placed on PA promotion in the current curricula and training, or extensive conceptual differences within German exercise therapy departments (e.g. different weighting of PAP).
Knowledge, uptake of preconception care and associated factors among reproductive age group women in west shoa zone, Ethiopia, 2018.
Authors: Fekene Daniel Belema , WOLDEYES BENYAM SEIFU , ERENA MARU MOSSISA , DEMISSE GETU ALEMU
Published: October 2019

Background

Preconception care is a set of interventions that are to be provided before pregnancy, to promote the health and well-being of women and couples.Methods

A community based cross-sectional study was employed among 669 reproductive aged women from November 2017 to the end of January 2018. The data were collected using pre-tested and structured questionnaire . The collected data were coded and entered into Epi Data version 3.1 and exported to SPSS 25 for analysis. Bivariate and multivariate logistic regression models were utilized to determine factors associated with outcome variable .Association presented in Odds ratio with 95% confidence interval and significance determined at P-value less than 0.05.Result

A total of 669 participants had participated with response rate of 98.3%. Among them only 179(26.8%) had good PCC knowledge and 97(14.5%) of women of reproductive age group have utilized preconception care. Factors that show significant association with good knowledge of PCC are history of institutional delivery (AOR = 1.43 (95%CI (1.31 -7.33), PNC service utilization, (AOR = 5.02 (95%CI (3.22-7.84), history of using modern contraceptive, (AOR = 1.44 (95%CI (1.37-6.98)) higher educational status (AOR= 4.12 (95%CI (1.22-6.52)and being regularly employed (AOR = 1.8 (95%CI (1.01-3.22). Factors like better family monthly income (AOR = 4.1 (95%CI (1.57-9.35)), history of PNC (AOR = 6.33 (95%CI (3.94-10.17) and good knowledge of PCC (AOR = 4.3 (95%CI (2.67-6.98) had showed positive association towards uptake of PCC.
Development and content validity of the Abilitator – a self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position
Authors: Wikström Miia , Anttila Heidi , Savinainen Minna , Kouvonen Anne , Joensuu Matti
Published: October 2019

Background The unemployed have lower work ability and poorer health than the employed. This situation deteriorates when unemployment continues. The long-term unemployed often have co-morbidities and face many other challenges. This increases the need for a multidimensional assessment of work ability and functioning in different service settings. In this study, we describe the development and analyse the content validity of the Abilitator, a self-report questionnaire on work ability and functioning for those in a weak labour market position. Methods The Abilitator was developed in 2014–2017. Its construct was assessed by the members of academic expert panels (n=30), practical expert panels of service actors (n=700) and target group clients (n=28). The structure and the content of the questionnaire was co-developed in 29 workshops and adjusted twice based on the expert panels’ feedback. The Abilitator was also implemented among target group clients (n=3360) in different services and projects. During its development the Abilitator was linked to the International Classification of Functioning, Disability and Health (ICF). The content validation process followed the guidelines recommended by the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) panel. Results The construct of the Abilitator combines the multidimensional and bio-psycho-social models of work ability and functioning. It also includes aspects of social inclusion and employability. It evaluates social, psychological, cognitive and physical functioning, and the ability to cope with everyday life. The content of these concepts was validated by the academic and practical expert panels. The Abilitator’s 79 ICF codes covered 50% of the Generic, 73% of the Brief Vocational Rehabilitation, and 17% of the Minimal Environmental ICF Core Sets. When compared with the Work Ability Index (WAI) and the World Health Organization Disability Assessment Schedule (WHODAS 2.0), the direct equivalences of the ICF codes were 29% and 39%, respectively. Conclusions The Abilitator covers the relevant aspects sufficiently comprehensively to enable the assessment of the overall work ability and functioning of the population with weak position in the labour market.
Caring Behavior And Associated Factors Among Nurses Working In Jimma University Specialized Hospital, Oromia, South West Ethiopia, 2019
Authors: Oluma Adugna , Abadiga Muktar
Published: October 2019

ABSTRACTBACK GROUND: Caring behaviors are actions concerned with the wellbeing of the patients such as sensitivity, comforting, attentive listening, honest and nonjudgmental acceptance. Nurses have an opportunity to convey caring and feeling being cared through their behavior. Behavior associated with caring has a paramount role in linking nursing interaction to the client in experiences but, the concept is ambiguous and elusive toward different scholars to reach on common understanding which is a myth in dealing with caring behavior. Only a few studies have been done on the caring behavior and associated factors globally, and there is a limitation of study done in Ethiopia particularly in this study area. Therefore; the purpose of this study was to assess caring behavior and its associated factors among nurses working in Jimma University specialized hospital, southwest Ethiopia.METHODS: The institutional-based cross-sectional study design was conducted on a sample of 224 nurses working in Jimma university specialized hospital from March 20-April 20, 2019. Data were collected by self-administered questionnaire. Descriptive statistics including frequency table, mean, standard deviation and percentage were employed. Bivariate and multiple linear regression analysis was used with regression coefficient (β), coefficient of the determinant (R²), CI 95% and p<0.05 were used for statistical significance.RESULTS: The overall proportion of nurses caring behavior was 80.3% which was mostly measured in terms of professional –technical (82.9%) and psychosocial (81.3%) dimension. Job satisfaction as personal satisfaction (beta=1.12, p=0.00), professional satisfaction, (beta=1.07, p=0.00), joint participation in caring process (beta=0.58, p=0.00,) satisfaction with nurse management (beta=0.85, p=00) were significantly associated with caring behavior.CONCLUSION: The proportion of nurses who had a high perception of caring behavior was found to be lower. Thus, all predictors have their own effect on enhancing job satisfaction, improving and creating conducive management and working environment to increase caring behavior. Further comparative studies involving a multidisciplinary and patient point of view were recommended.KEYWORDS: Caring, Caring behavior, Nurses, Jimma, Ethiopia
UTILIZATION AND ASSOCIATED FACTORS OF EMERGENCY CONTRACEPTION AMONG WOMEN SEEKING ABORTION SERVICES IN HEALTH INSTITUTIONS OF DESSIE TOWN, NORTH EAST ETHIOPIA,2018
Authors: Feleke Asres Eshetie , Nigussie Tewdros Seyoum , Debele Tibeb Zena
Published: October 2019

Objective

The aim of the study was to assess utilization and associated factors of emergency contraception among women seeking abortion services in Health Institutions of Dessie Town, North East Ethiopia, 2018.Results

Among the interviewed 784 women 400(51%) utilized emergency contraception. Women’s age [AOR: 2.10, (95% CI 1.200, 3.671)], residence [AOR: 2.02 (95% CI1.273, 3.218], marital status [AOR: 1.71, (95%CI: 1.176, 2.485)], knowledge of emergency contraception [AOR: 5.66, (95%CI: 3.976,8.070)], and attitude towards emergency contraception [AOR: 2.75(95%CI: 1.946, 3.881)] were significantly associated factors with the utilization of emergency contraceptives. The emphasis of health education on emergency contraceptives shall focus on those women who are from the rural area, older and married women.
Integrated analysis of miRNA-seq and mRNA-seq reveals immune related miRNA-mRNA regulation network in the DHAV-3-infected duckling liver
Authors: Wu Fengyao , Lu Fengying , Fan Xin , Chao Jin , Liu Chuanmin , Pan Qunxing , Sun Huawei , Zhang Xiaofei
Published: October 2019

Background: Duck hepatitis A virus type 3 (DHAV-3) is one of the most harmful pathogens in the duck industry. However, the molecular mechanism underlying DHAV-3 infection in ducklings is remain poorly understood. To elucidate the genetic regulatory network for miRNA-mRNA and the signaling pathways involved in DHAV-3 infection in ducklings, we conducted global miRNA and mRNA expression profiling of duckling liver tissues infected with lethal DHAV-3 using high-throughput sequencing. Results: We found 156 differentially expressed miRNAs (DEMs) and 7717 differentially expressed miRNAs (DEGs) between mock-infected and DHAV-3-infected duckling livers. A total of 19,606 miRNA-mRNA pairs with negatively correlated expression patterns were identified in miRNA-mRNA networks constructed on the basis of these DEMs and DEGs. Moreover, immune-related pathways including the cytokine-cytokine receptor interaction, apoptosis, Toll-like receptor, Jak-STAT, and RIG-I-like receptor signaling pathway were significantly enriched through analyzing functions of mRNAs in the network in response to DHAV-3 infection. Besides, apl-miR-32-5p, apl-miR-125-5p, apl-miR-128-3p, apl-miR-460-5p, and novel-m0012-3p were identified as potential regulators in the immune-related signaling pathways during the DHAV-3 infection. Conclusions: To our knowledge, this is the first report on integrated analysis of miRNA-seq and mRNA-seq in DHAV-3-infected ducklings. The results indicated the important roles of miRNAs in regulating immune response genes and revealed the immune related miRNA-mRNA regulation network in the DHAV-3-infected duckling liver. Our findings may provide valuable information to further investigate the roles of miRNAs and their target genes in DHAV-3 replication and pathogenesis; additionally, they may offer clues for further understanding host-virus interactions.
Transcriptomic dynamics changes in development of carmine radish (Raphanus sativus L.) fleshy roots using RNA-seq method
Authors: Gao Jian , Luo Mao , Liu Yi , Chen Fabo , Peng Hua , Li Wenbo
Published: October 2019

Radish ( Raphanus sativus L.), belonging to biennial root vegetable crop of Brassicaceae family, is an economically important vegetable crop with an edible taproot. Recently, most of differential expressed genes associating with anthocyanin biosynthesis have been identified in most of important fruit crops. However, transcriptome analysis of anthocyanin biosynthesis and expression of anthocyanin biosynthesis related genes in ‘Hongxin’ radish have not been fully investigated. Here, based on results from HPLC analysis, young fleshy roots obtained from the dynamics development stage of fleshy roots in carmine radish ‘Hongxin 1’ was used for RNA-Seq, including fleshy roots from seedling stage (SS), initial expansion (IE), full-expansion (FE), bolting stage (BS), initial flowering stage (IFS); full-bloom stage (FBS) and podding stage (PS). Subsequently, the putative candidate genes involved in the dynamics development stage of fleshy roots in carmine radish were identified. After that, DGE (differential gene expression) profile analysis was used to identify the pupative transcripts, compared with fleshy roots from seedling stage (SS). In addition, co-modulated DEGs (Common DEGs in the dynamic growing stages of fleshyroot in carmine radish) were also identified, from which most DGEs were more likely to participate in anthocyanin biosynthesis, including two transcription factors RsMYB and Rs RZFP . In addition, some related proteins e.g. RsCHS , RsDFR , RsANS , RsF’3H , RsF3GGT1 , Rs3AT1 , glutathione S-transferase F12, RsUFGT78D2-like and RsUDGT-75C1-like were significantly contributed to the regulatory mechanism during anthocyanin synthesis in the development stage of fleshy roots. Furthermore, GO terms comprised of “anthocyanin-containing compound biosynthetic process” and “anthocyanin-containing compound metabolic process” were commonly overrepresented in the other dynamics growing stages of fleshy roots after initial expansion of fleshy roots. Moreover, these results indicated that five significantly enrichment pathways of DEG were identified for the dynamics growing stages of fleshy roots in carmine radish, including Flavonoid biosynthesis, Flavone and flavonol biosynthesis, Diterpenoid biosynthesis, Anthocyanin biosynthesis, as well as Benzoxazinoid biosynthesis. These results will expand our understanding of complex molecular mechanism of the putative candidate genes involved in the dynamics development stage of fleshyroot in carmine radish.
Evaluating the effects of an exercise program (Staying UpRight) for older adults in long-term care on rates of falls: study protocol for a randomised controlled trial
Authors: Taylor Lynne , Parsons John , Taylor Denise , Binns Elizabeth , Lord Sue , Edlin Richard , Rochester Lynn , Din Silvia Del , Klenk Jochen , Buckley Christopher , Cavadino Alana , Moyes Simon A , Kerse Ngaire
Published: October 2019

BackgroundFalls are two to four times more frequent amongst long-term care (LTC) than community-dwelling older adults and have deleterious consequences. It is hypothesized that a progressive exercise program targeting balance and strength will reduce falls rates when compared to a seated exercise program and do so cost effectively.Methods/DesignThis is a single blind, parallel-group, randomized controlled trial with blinded assessment of outcome and intention-to-treat analysis. LTC residents (age ≥65 years) will be recruited from LTC facilities in New Zealand. Participants (n= 528 total; with a 1:1 allocation ratio) will be randomly assigned to either a novel exercise program (Staying UpRight), comprising strength and balance exercises designed specifically for LTC and acceptable to people with dementia, (intervention group) or a seated exercise program (control group). The intervention and control group classes will be delivered for 1 hour twice weekly over 1 year. The primary outcome is rate of falls (per 1000 person years) within the intervention period.Secondary outcomes will be risk of falling (the proportion of fallers per group), falls rate relative to activity exposure, hospitalisation for fall-related injury, change in gait variability, volume and patterns of ambulatory activity and change in physical performance assessed at baseline, 6 and 12 months. Cost effectiveness will be examined using intervention and health service costs. The trial commenced recruitment on 31 November 2018.DiscussionThis study evaluates the efficacy and cost effectiveness of a progressive strength and balance exercise program for aged-care residents to reduce falls. The outcomes will aid development of evidenced-based exercise programs for this vulnerable population.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12618001827224. Registered on November 9 2018; Universal trial number U1111-1217-7148
Positive deviance for dual-method promotion among women in Uganda: Study protocol for a cluster randomized controlled trial
Authors: Kosugi Hodaka , Shibanuma Akira , Kiriya Junko , Ong Ken Ing Cherng , Mucunguzi Stephen , Muzoora Conrad , Jimba Masamine
Published: October 2019

Background Dual-method use is known as the most reliable protection against unintended pregnancies and sexually transmitted infections, including HIV. However, it is not commonly used in sub-Sharan Africa, especially among women using highly effective contraceptives. This article describes a protocol to evaluate the effect of an intervention formulated under the positive deviance approach for promoting dual-method use in Uganda.Methods One hundred women will be interviewed using a structured questionnaire to find those practicing dual-method use. Then, in-depth interviews will be conducted with all women using dual-method and ten women using only highly effective contraceptives to identify their unique practice. Then, a cluster randomized controlled trial will be conducted to examine the effect of an intervention formulated under the positive deviance approach on dual-method uptake and adherence. Twenty health facilities will be randomized to an intervention or control arm, and 480 women will be enrolled in each group. The participants will be followed up for eight months.Discussion This trial focuses on women who already adapted dual-method use and identifies their unique solutions to promote dual-method use. This trial could tackle barriers for dual-method use, which expert outsiders may fail to recognize, by analyzing and promulgating their unique behaviors. This study could provide evidence that the positive deviance approach can address unintended pregnancies and sexually transmitted infections as well as other health problems which usual approaches have failed to address.
College Students Responding to the Chinese version of Cardiff Fertility Knowledge Scale Show Deficiencies in Their Awareness: A cross-sectional survey in Hunan, China
Authors: Zhou Yanhui , Wang Ting , Cui Yanhui , Chen Mingzhu , Fu Jingxia , Luo Yang
Published: October 2019

Background: The worldwide total fertility rate has declined, and the age pattern of childbearing and marriage has changed markedly. This trend has affected the social and economic development, especially fertility health. Previous studies indicated that incorrect perceptions of fertility can influence the fertility choice, and postponing parenthood is associated with an increase risk of higher maternal age in direction of more pregnancy-related complications. However, little is known in China, which has a low total fertility rate. Hence, understanding the knowledge about fertility is greatly needed. The aim was to investigate the knowledge about fertility issues among college students, the related influence factors, the way of acquiring fertility knowledge, the relationship between fertility knowledge and fertility intention. Methods : An online cross-sectional survey among Chinese college students was conducted in Hunan province from March to April in 2018. A total of 867 college students from three comprehensive universities responded to a poster invitation utilizing the Chinese version of the Cardiff Fertility Knowledge Scale (CFKS-C). Results: The average percent correct score on the CFKS-C was 49.86% (SD=20.817), with greater knowledge significantly related to living in a city district, currently having a stable relationship, majoring in medicine/health, the year 4 or above of study, and intention to have children (all p ＜0.05). The lowest score was “having a healthy lifestyle makes you fertile (false)”, the highest score was “a woman is less fertile after the age of 36 years (true)”. And then, 81.88% participants said that they would like to have children, the average score of the importance of childbearing was 6.34 (SD=2.714), female’s score was lower than male’s ( p =0.001). A small positive relationship was observed between the CFKS-C and the importance of childbearing ( r =0.074, p =0.035). Respondents said they gained most of their knowledge from the media and internet (41.36%) and schools (38.25%). Conclusion: The college students have a modest level of fertility knowledge, a relatively low intention to have a child, and deficiencies in fertility health education. Key words: Fertility knowledge; Fertility intention; Childbearing; College students; Awareness;
Trends in the incidence of diabetes mellitus: results from the Global Burden of Disease Study 2017 and implications for diabetes mellitus prevention
Authors: Liu Jinli , Ren Zhen-Hu , Qiang Hua , Wu Jine , Shen Mingwang , Zhang Lei , Lyu Jun
Published: October 2019

Backgroud:Diabetes mellitus is a common chronic disease and a severe public health issue. The incidence trends for type 1 diabetes (TIDM) and type 2 diabetes (T2DM) have rarely been studied on a global scale. We aimed to determine the temporal and geographical trends of diabetes globally. Methods:We collected detailed information on diabetes during 1990-2017 based on the 2017 Global Burden of Disease Study and calculated the estimated annual percentage changes (EAPCs) in age-standardized incidence rate (ASR) of diabetes mellitus according to sex, region, and disease type. Results:The incidence of diabetes mellitus increased by 102.9% worldwide, from 11,303,084 cases in 1990 to 22,935,630 cases in 2017, while the ASR increased from 233.6 per 100,000 person-year (py) to 284.6 per 100,000py [EAPC=0.87, 95% confidence interval (CI):0.79,0.96]. The global ASRs of T1DM and T2DM demonstrated significantly increasing trends during 1990-2017, with EAPC of 0.34(95% CI:0.30,0.39) and 0.89 (95% CI:0.80,0.97), respectively. The incidence trends also varied considerably by regions and countries. The increase in ASR was largest in high-SDI regions (EAPC=1.05, 95% CI:0.92,1.17) and smallest in low-SDI regions (EAPC=0.79, 95% CI:0.71,0.88).The EAPC of diabetes mellitus showed a declining trend in countries with a high human development index (HDI). Conclusions: Diabetes mellitus is a worldwide public health problem. Both the number of cases and ASR of diabetes mellitus increased significantly during 1990-2017 worldwide, but the temporal trends varied markedly across regions and countries.In addition, the ASR of T1DM differed with latitude and the farther away from the equator, the higher the ASR in 2017.
The Reduction in CD8+PD1+ T Cells in Liver Histological Tissue is Related to Pegylated IFN-α Therapy Outcomes in Chronic Hepatitis B Patients
Authors: Liu Ruyu , Chen Yanhui , Guo Jiang , Li Minghui , Lu Yao , Zhang Lu , Shen Ge , Wu Shuling , Chang Min , Hu Leiping , Hao Hongxiao , Zhang Henghui , Xie Yao
Published: October 2019

Background and Aim Antiviral therapy for patients with immune-active chronic hepatitis B (CHB) should be adopted to decrease the risk of liver-related complications. While antiviral therapy outcomes of PEG-IFN-α vary in different CHB patients. We aimed to identify the factors influencing antiviral therapy outcomes in CHB patients who received PEG-IFN-α therapy.Methods Thirty-two CHB patients who received PEG-IFN-α therapy were enrolled in this study. All of the patients underwent two liver biopsies at baseline and 6 months later. CD8 + T cells, CD4 + T cells, CD68 + mononuclear cells, and PD-1 levels in 64 liver biopsy specimens were tested via immunofluorescence.Results CD8 + T cells in 32 CHB patients’ liver tissue significantly decreased after 6 months of PEG-IFN-α therapy (p<0.01). CD8 + PD1 + T cells significantly decreased after 6 months of PEG-IFN-α treatment in the FIER (fibrosis and inflammation response with HBeAg seroconversion) group (p<0.05), while CD8 + PD1 - T cells had no significant difference. However, in the FIENR (no fibrosis and inflammation response and HBeAg seroconversion) group, CD8 + PD1 - T cells significantly decreased after 6 months of PEG-IFN-α treatment (p<0.05), while CD8 + PD1 + T cells had no significant difference. CD68 + mononuclear cells at baseline were higher in the FIRENR (fibrosis and inflammation response without HBeAg seroconversion) group than the FIENR (no fibrosis and inflammation response and HBeAg seroconversion) group.Conclusions The reduction in CD8 + PD1 + T cells in liver tissue was critical for patients who responded to PEG-IFN-α therapy. High levels of CD68 + mononuclear cells at baseline might be associated with fibrosis and inflammation response to PEG-IFN-α therapy.
Preoperative use of alpha-1 receptor blockers in male patients undergoing extracorporeal shock wave lithotripsy for a ureteral calculus: a retrospective cohort study
Authors: Yoshioka Takashi , Omae Kenji , Kawada Tatsushi , Inoue Yosuke , Sugimoto Morito , Oeda Tadashi , Uehara Shinya , Araki Motoo , Fukuhara Shunichi
Published: October 2019

Purpose To characterize the preoperative use of alpha-1 adrenergic receptor (AR) blockers and investigate its impact on the outcome of single-session extracorporeal shock wave lithotripsy (SWL) for a ureteral calculus in male patients. Methods We conducted a retrospective single-center cohort study involving 193 patients who underwent SWL for a single ureteral calculus between 2006 and 2016. We reviewed their medical records to obtain the data on the preoperative use of alpha-1 AR blocker and, if any, the reason for the prescription. The primary outcome was treatment success after single-session SWL, defined as complete stone clearance or residual fragments <4 mm in size by X-ray imaging. We performed a multivariable logistic regression analysis adjusting for clinically important confounders to examine the association between preoperative use of alpha-1 AR blockers and the treatment success of SWL. We further analyzed this association according to the reason for the prescription. Results Among the 193 patients, 15 (7.8%) were taking an alpha-1 AR blocker preoperatively with 8 (4.1%) for medical expulsive therapy (MET) and 7 (3.7%) for the treatment of benign prostatic hypertrophy (BPH). A multivariate analysis showed that the preoperative use of alpha-1 AR blocker was a significant negative predictor for treatment success of SWL (adjusted odds ratio [aOR] 0.17; 95% confidence intervals [CI], 0.04–0.74). Moreover, the use of alpha-1 AR blocker for MET, but not for BPH, was associated with lower rate of successful treatment (aOR 0.14 and 0.23; 95% CI, 0.02-0.90 and 0.03-1.97, respectively). Conclusions Our findings suggest that the preoperative use of alpha-1 AR blocker, especially for MET, was a negative predictor for treatment success of SWL in male patients with a single ureteral calculus. Clinicians should pay more attention to the preoperative drug use in determining an appropriate stone therapy modality.
Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up.
Authors: Wang Long , Xie Lin , Ruan Weiqiang , Li Tao , Gan Changping , Lin Ke
Published: October 2019

Background: This report presents updated data and mid-term follow-up information to a former study introducing the novel technique of percutaneous-perventricular device closure of doubly committed subarterial ventricular septal defect. Methods: Thirty-eight patients were added to the former series. There are totally 54 patients who had isolated doubly committed subarterial ventricular septal defects underwent percutaneous-perventricular device closure. Closure outcomes and possible complications were measured in the hospital and during the 2.5 years follow-up. Results: Closure was successful in 53 patients (98.1%). There was no mortality, residual shunt, new valve regurgitation or arrhythmia either perioperatively or during the entire follow-up period. Only one patient who developed pericardial effusion and tamponade in the former series. The mean hospital stay was 3.2±0.6 days (range, 3.0 to 6.0 days), one unsuccessful cases needed blood transfusion (1.9%). Conclusions: The percutaneous-perventricular device closure of isolated doubly committed subarterial ventricular septal defects appeared to be efficacious. Close monitoring for bleeding is very necessary postoperatively especially in younger patients. This technique is generally safe in selected group of patients with acceptable mid-term outcomes. Keywords: Ventricular septal defect; Device closure; Minimally invasive surgery
Declining prevalence of Methicillin-resistant Staphylococcus aureus septic arthritis and osteomyelitis in children: implications for treatment
Authors: Weiss Lindsay , Lansell Amanda , Figueroa Janet , Suchdev Parminder , Kirpalani Anjali
Published: October 2019

OBJECTIVES To assess clinical characteristics and differences in outcomes between children with Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-sensitive Staphylococcus aureus (MSSA) osteomyelitis or septic arthritis and whether initial antibiotic regimen affects patient outcomes.STUDY DESIGN We analyzed records of children ages 15 days to 18 years admitted between 2009 and 2016 to two tertiary children’s hospitals who were diagnosed with an osteoarticular infection and had a microorganism identified. We compared the relationship of MRSA versus MSSA and initial antibiotic selection on patient outcomes including length of hospitalization and requiring a PICU transfer.RESULTS A total of 584 patients met inclusion criteria of which 365 (62.5%) had a microbiological diagnosis. MSSA was the most common pathogen identified (45.5%) followed by MRSA (31.2%). The percentage of MRSA cases decreased by 25.4% between 2009 and 2016, whereas MSSA infections increased by 18.6%. Compared to MSSA, patients with MRSA had a higher initial C-reactive protein (median 17.3 mg/dL vs 7.8 mg/dL, p<0.05) and a longer hospitalization (median 8.3 days vs 6.1 days, p<0.05). Patients whose initial antibiotic regimens included vancomycin were more likely to require a PICU transfer (15.0% vs 2.2%, p<0.05) and had a longer hospitalization (median 6.7 days vs 5.5 days, p<0.05) compared to those initiated on clindamycin without vancomycin.CONCLUSIONS While MRSA was associated with increased severity of osteoarticular infections compared to MSSA, the incidence of MRSA has been declining at our institution. Patients with longer lengths of stay and those requiring a PICU transfer were more likely to be on vancomycin. Clindamycin should be considered in the initial antibiotic regimen for osteomyelitis and septic arthritis with ongoing surveillance of local microbiology and outcomes.
Characteristics of babies referred for Retinopathy of prematurity screening and management to a tertiary eye hospital of Bangladesh, a database analysis
Authors: Niyonzima Jean Claude , Nahar Nazmun , Chowdhury Mahjabeen , Das Sanjoy Kumar , Rahman Mostafizur
Published: October 2019

Background: Ispahani Islamia Eye Institute and Hospital (IIEIH) is a leading ROP screening center in Bangladesh. The study had an aim to analyze the characteristics of referred babies and identify possible bottlenecks. Methods : Electronic records of babies referred to IIEIH for a period of three years (2016-2918) were analyzed retrospectively. All the babies registered in the electronic file were screened by any of the three consultants with keen interest in ROP. Variables of interest were ROP stage, gestational age, birth weight, time to screening, referring institution and treatment modalities (laser, Anti-VEGF, retina surgery or combination). Data were exported to SPSS version 23 for Mac for descriptive and correlation analysis. P-value less than 0.05 was considered statistically significant. Results: 887 babies with ROP stage 1 or above were registered, a large majority were referred by private institutions (75%), 60% of babies were moderate pre-terms according to WHO classification, the mean birth weight was 1563±397.1 grams. ROP was largely stage 2 (37%) and 61% of babies had at least one treatment modality. The younger the gestational age and the lower the birth weight, the higher the risk of presenting with ROP with advanced stage. Conclusion : The majority of babies with ROP came from private institutions and more than half of them needed at least one treatment modality. We recommend a large study to analyze the incidence and availability of ROP services in public hospitals. Key words : Retinopathy of prematurity, screening, treatment options, Referrals
Clinical study of 24-hour intraocular pressure curve measurement strategy
Authors: Qin Jiayin , Wang Xijuan , Li Mingwu , Ren Zeqin
Published: October 2019

Background To investigate the measurement time of 24-hour intraocular pressure(IOP) curve: the representativeness of 4 and 6 times IOP to the fluctuation of IOP at night and day. Methods From September 2018 to January 2019, 41 patients with suspected primary open angle glaucoma(POAG), who were admitted to the Department of Ophthalmology, Peking University International Hospital, underwent 24-hour IOP monitoring. The measuring time points were set as: 0:00, 2:00, 5:00, 7:00, 8:00, 10:00, 11:00, 14:00, 16:00, 18:00, 20:00 and 22:00, of which 8:00, 11:00, 14:00, 16:00 were the customary measuring time of IOP daily curve for 4 times; 5:00, 7:00, 10:00, 14:00, 18:00, 22:00 were the conventional measuring time points for IOP curve for 6 times. The time points of the two groups was increased by 0:00, 2:00 and 20:00 to 12 times IOP measurements. Goldmann tonometer was used to measure IOP . Oxybuprocainehydrochloride eye drops were anesthetized by the same ophthalmologist. The sensitivity of the two methods to detect 24-hour intraocular pressure fluctuations was calculated according to whether the peak values of 12 times IOP measurements could be included by 4 or 6 times IOP measurements. Results A total of 41 patients (82 eyes) were enrolled, including 21 males (42 eyes) and 20 females (40 eyes). The age ranged from 23 to 77（44.60±14.67）. The peak IOP measured by 4 times, 6 times and 12 times IOP measurements were 19.91±4.38mmHg、 20.54±4.10 mmHg and 21.09±4.15 mmHg respectively, and there were significant differences between the two methods (P < 0.05); the trough values of IOP were 15.46±3.63 mmHg 、14.63±3.49 mmHg and 13.93±3.38 mmHg respectively, with statistical significance (P < 0.05). The peak IOP co-occurrence is 74.39% between 6 times and 12 times IOP measurements. The peak IOP co-occurrence is 43.90% between 4 times and 12 times IOP measurements. The sensitivity of 4 and 6 times IOP measurements to detect 24-hour IOP fluctuations were 36.11% and 55.56%, respectively. Conclusion For suspected glaucoma patients, neither 4 times IOP measurements nor 6 times IOP measurements during a day can accurately reflect the range of IOP fluctuations, which may easily lead to missed diagnosis.
Correction of Madelung deformity by monorail external fixator in young adults
Authors: Shi Li , Wang Meng-wei , Cheng Dong-dong , Xu Jia , Chai Yimin , Kang Qinglin
Published: October 2019

Aims: Many surgical techniques are proposed to address Madelung deformity, but the most suitable surgical treatment still remains unknown for symptomatic cases. We introduced a modified management by radius osteotomy and Sauvé-Kapandji’s procedure using the monorail external fixator to provide a supplement to the treatment of Madelung deformity. Methods : From January 2013 to October 2018, 12 patients (9 right and 6 left wrists) with a mean age of 18 (16 to 24) years complained of pain, deformities and limited function of effected wrists. These 12 patients received operation for subsequent acute correction by monorail external fixator. The Vas Score, ulnar tilt of the radial articular surface angle, radiopalmar tilt angle, lunate subsidence, volar translation and range of wrist movement were evaluated pre- and postoperatively. Results : Consolidation cost an average time of 87 (66 to 122) days. All patients were followed up for an average time of 24 (8 to 65) months. The Vas score for all patients decreased from 4 (2 to 7) to 0 (p<0.001). The ulnar tilt and radiopalmar tilt were decreased by a mean of 21° (mean changed from 50 to 29) and 21° (from 38 to 17), respectively (both p<0.001). The length of lunate subsidence and volar translation was reduced by a mean of 6 (from 7 to 1) mm and 8 (from 25 to 17) mm, respectively (both p<0.001). Five patients received radius lengthening for an average of 22 (18 to 29) mm. Wrist extension improved by a mean of 8° (from 50 to 58), while flexion decreased by 40° (from 100 to 40). Conclusion : Acute correction by radius osteotomy and Sauvé-Kapandji’s procedure and gradual lengthening with the extendable monorail external fixator can be used for Madelung deformity with little surgical trauma. The radiographic parameters and wrist pain are improved after surgery and postoperative therapy.
Mid-upper arm circumference, central obesity and metabolic syndrome in middle-aged and elderly Chinese: the REACTION study
Authors: Shi Jie , Yang Zhen , Niu Yixin , Zhang Weiwei , Li Xiaoyong , Zhang Hongmei , Lin Ning , Gu Hongxia , Wen Jie , Ning Guang , Qin Li , Su Qing
Published: October 2019

Background The mid-upper arm circumference (MUAC) is a proxy for upper body subcutaneous fat and a reliable screening measure for identification of individuals with abnormal local fat distribution. The purpose of present study was to evaluate the association between MUAC and metabolic syndrome (MetS) as well as other metabolic phenotype in the middle-aged and elderly population. Methods We measured the MUAC in a cross-sectional sample with a total of 9787 subjects aged 40 years and older in Shanghai, China. The measurement of MUAC is performed on the right arm using a non‐elastic tape held midway between the acromion and the olecranon processes in duplicate, with arm hanging loosely at the side of the body. The MetS was defined according to the Joint Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. The association of MUAC with MetS was tested in logistic regression analyses and reported as odds ratio (OR) with 95% confidence interval (CI). Results T he prevalence of MetS, overweight, and central obesity raised sharply from the smaller MUAC groups to the larger MUAC groups both in men and women. MUAC was positively correlated with waist circumference, BMI, fasting insulin, HOMA-IR, triglycerides, systolic and diastolic blood pressure, and inversely correlated with adiponectin and HDL-cholesterol after adjusting for age and gender. As the MetS components accumulated, the MUAC increased concomitantly. The risk of MetS in the highest MUAC quartile was significant higher (odds ratio 1.77; 95% confidence interval 1.51-2.09) than the lowest quartile after adjustment of potential confounders. Conclusion Our results indicated that large MUAC is an independent risk factor of MetS in Chinese individuals.