bluuebunny/crossref_metadata_2025 huggingface dataset:
Biotrauma during ultra-low tidal volume ventilation and venoarterial extracorporeal membrane oxygenation in cardiogenic shock: a randomized crossover clinical trial
Authors: Amado-Rodríguez Laura , Del Busto Cecilia , López-Alonso Inés , Parra Diego , Mayordomo-Colunga Juan , Arias-Guillén Miguel , Albillos-Almaraz Rodrigo , Martín-Vicente Paula , López-Martínez Cecilia , Huidobro Covadonga , Camporota Luigi , Slutsky Arthur S. , Albaiceta Guillermo M.
Published: August 2021

Background

Cardiogenic pulmonary oedema (CPE) may contribute to ventilator-associated lung injury (VALI) in patients with cardiogenic shock. The appropriate ventilatory strategy remains unclear. We aimed to evaluate the impact of ultra-low tidal volume ventilation with tidal volume of 3 ml/kg predicted body weight (PBW) in patients with CPE and veno–arterial extracorporeal membrane oxygenation (V–A ECMO) on lung inflammation compared to conventional ventilation.

Methods

A single-centre randomized crossover trial was performed in the Cardiac Intensive Care Unit (ICU) at a tertiary university hospital. Seventeen adults requiring V–A ECMO and mechanical ventilation due to cardiogenic shock were included from February 2017 to December 2018. Patients were ventilated for two consecutive periods of 24 h with tidal volumes of 6 and 3 ml/kg of PBW, respectively, applied in random order. Primary outcome was the change in proinflammatory mediators in bronchoalveolar lavage fluid (BALF) between both ventilatory strategies.

Results

Ventilation with 3 ml/kg PBW yielded lower driving pressures and end-expiratory lung volumes. Overall, there were no differences in BALF cytokines. Post hoc analyses revealed that patients with high baseline levels of IL-6 showed statistically significant lower levels of IL-6 and IL-8 during ultra-low tidal volume ventilation. This reduction was significantly proportional to the decrease in driving pressure. In contrast, those with lower IL-6 baseline levels showed a significant increase in these biomarkers.

Conclusions

Ultra-low tidal volume ventilation in patients with CPE and V–A ECMO may attenuate inflammation in selected cases. VALI may be driven by an interaction between the individual proinflammatory profile and the mechanical load overimposed by the ventilator.

Trial registrationThe trial was registered in ClinicalTrials.gov (identifier NCT03041428, Registration date: 2nd February 2017).
Risk and protective factors for GBV among women and girls living in humanitarian setting: systematic review protocol
Authors: Murphy Maureen , Ellsberg Mary , Balogun Aminat , Garcia-Moreno Claudia
Published: August 2021

Background

While one in three women around the world are estimated to have experienced intimate partner or sexual violence, these rates are often exacerbated during conflict and humanitarian crisis. This systematic review seeks to provide an overview of existing research on risk and protective factors associated with gender-based violence (GBV) in conflict and humanitarian settings.

Methods

Studies will be searched from the following databases: PubMed (Medline); PsycINFO; Scopus; Global Health; and Cochrane Center trials registrar. In addition, targeted searches of the internet repositories for GBV will be conducted. We will include studies that are published between January 1995 and December 2020 and document risk or protective factors for gender-based violence against women and girls in conflict or humanitarian settings. Two reviewers will independently screen and extract data for the review, with a third reviewer arbitrating disputes and ensuring quality. A quality assessment of the included studies will be undertaken using a modified GRADE system. Narrative synthesis will be utilized to analyze the data.

Discussion

The results of this study will inform the design and delivery of GBV prevention programs in conflict and humanitarian settings as well as contribute to the attainment of Sustainable Development Goal 5. The results will be published in a peer-reviewed journal and will be utilized at the World Health Organization to inform efforts to prevent GBV in conflict and humanitarian settings.

Systematic review registration

The protocol has been registered with PROSEPERO (CRD42020198695).
Functional inequalities for generalized multi-quadratic mappings
Authors: Bodaghi Abasalt
Published: August 2021

In this article, we introduce some special several variables mappings which are quadratic in each variable and show that such mappings can be defined as a single equation that is the generalized multi-quadratic functional equation. We also apply a fixed point theorem to establish the Hyers–Ulam stability for the generalized multi-quadratic functional equations. Furthermore, we present an example and a few corollaries corresponding to some known stability results.
A solution to nonlinear Fredholm integral equations in the context of w-distances
Authors: Dhivya P. , Marudai M. , Rakočević Vladimir , Fulga Andreea
Published: August 2021

In this paper we propose a solution to the nonlinear Fredholm integral equations in the context of w-distance. For this purpose, we also provide a fixed point result in the same setting. In addition, we provide best proximity point results. We give examples and present numerical results to approximate fixed points.
Spatiotemporal patterns induced by four mechanisms in a tussock sedge model with discrete time and space variables
Authors: Li You , Cao Jingjing , Sun Ying , Song Dan , Wu Xiaoyu
Published: August 2021

In this paper, we investigate the spatiotemporal patterns of a freshwater tussock sedge model with discrete time and space variables. We first analyze the kinetic system and show the parametric conditions for flip and Neimark–Sacker bifurcations respectively. With spatial diffusion, we then show that the obtained stable homogeneous solutions can experience Turing instability under certain conditions. Through numerical simulations, we find periodic doubling cascade, periodic window, invariant cycles, chaotic behaviors, and some interesting spatial patterns, which are induced by four mechanisms: pure-Turing instability, flip-Turing instability, Neimark–Sacker–Turing instability, and chaos.
Visibility estimation via deep label distribution learning in cloud environment
Authors: Song Mofei , Han Xu , Liu Xiao Fan , Li Qian
Published: August 2021

The visibility estimation of the environment has great research and application value in the fields of production. To estimate the visibility, we can utilize the camera to obtain some images as evidence. However, the camera only solves the image acquisition problem, and the analysis of image visibility requires strong computational power. To realize effective and efficient visibility estimation, we employ the cloud computing technique to realize high-through image analysis. Our method combines cloud computing and image-based visibility estimation into a powerful and efficient monitoring framework. To train an accurate model for visibility estimation, it is important to obtain the precise ground truth for every image. However, the ground-truth visibility is difficult to be labeled due to its high ambiguity. To solve this problem, we associate a label distribution to each image. The label distribution contains all the possible visibilities with their probabilities. To learn from such annotation, we employ a CNN-RNN model for visibility-aware feature extraction and a conditional probability neural network for distribution prediction. The estimation result can be improved by fusing the predicting results of multiple images from different views. Our experiment shows that labeling the image with visibility distribution can boost the learning performance, and our method can obtain the visibility from the image efficiently.
Substance use and HIV stage at entry into care among people with HIV
Authors: Parrish Canada , Whitney Bridget M. , Nance Robin M. , Puttkammer Nancy , Fishman Paul , Christopoulos Katerina , Fleming Julia , Heath Sonya , Mathews William Christopher , Chander Geetanjali , Moore Richard D. , Napravnik Sonia , Webel Allison , Delaney Joseph , Crane Heidi M. , Kitahata Mari M.
Published: August 2021

Background

Information regarding the impact of substance use on the timing of entry into HIV care is lacking. Better understanding of this relationship can help guide approaches and policies to improve HIV testing and linkage.

Methods

We examined the effect of specific substances on stage of HIV disease at entry into care in over 5000 persons with HIV (PWH) newly enrolling in care. Substance use was obtained from the AUDIT-C and ASSIST instruments. We examined the association between early entry into care and substance use (high-risk alcohol, methamphetamine, cocaine/crack, illicit opioids, marijuana) using logistic and relative risk regression models adjusting for demographic factors, mental health symptoms and diagnoses, and clinical site.

Results

We found that current methamphetamine use, past and current cocaine and marijuana use was associated with earlier entry into care compared with individuals who reported no use of these substances.

Conclusion

Early entry into care among those with substance use suggests that HIV testing may be differentially offered to people with known HIV risk factors, and that individuals with substances use disorders may be more likely to be tested and linked to care due to increased interactions with the healthcare system.
Investigation of possible transmission of a susceptible microorganism through a contaminated duodenoscope; a case report
Authors: Kwakman Judith A. , Rauwers Arjan W. , Klaassen Corné H. W. , Bruno Marco J. , Vos Margreet C.
Published: August 2021

Background

Despite compliance to extensive reprocessing protocols, duodenoscopes have been linked to outbreaks of susceptible and multi-drug resistant organisms (MDRO) due to persistent duodenoscope contamination. Duodenoscope-associated infections (DAIs) based on transmission of susceptible microorganisms are likely to be underreported due to detection bias.

Case presentation

We describe the retrospective detection of a DAI case caused by a susceptible microorganism which at the time of clinical infection was not recognized as such. During 2017 and 2018, duodenoscopes were cultured on a daily basis due to research activities. While analyzing this data, it was found that a duodenoscope had been contaminated with Enterobacter cloacae complex over a period of 3 months. We checked whether patients treated with this duodenoscope had developed infections and found one patient with an E. cloacae cholangitis 3 months after the ERCP (Endoscopic retrograde cholangiopancreaticography) procedure. The isolates on the duodenoscope and in the patients’ blood culture were indistinguishable by amplified fragment length polymorphism (AFLP). By classical multi-locus sequence typing (MLST), both strains were of the same (but novel) sequence type. Application of whole genome MLST showed 93 (out of 3757) allelic differences.

Conclusion

This case report describes a plausible link between a contaminated duodenoscope and a patient infection with E. cloacae. Transmission of susceptible E. cloacae was highly suspected from AFLP and MLST results; by WGS, 93 allelic differences were found which proves closely related strains. This report shows that DAIs by susceptible microorganisms can be easily missed and therefore its true prevalence remains underscored.
First case of low-dose umbilical cord blood therapy for pediatric acute respiratory distress syndrome induced by Pneumocystis carinii pneumonia
Authors: Liu Shuang , Shen Huili , Huang Siyuan , Liu Rong , Qu Dong
Published: August 2021

Objective

This study aimed to present the case of a boy with acute distress syndrome (ARDS) treated with low-dose umbilical cord blood (UCB) therapy and explore the underlying possible mechanism.

Methods

A 7-year-old boy with severe Pneumocystis carinii pneumonia and severe ARDS was treated with allogeneic UCB as salvage therapy.

Results

The patient did not improve after being treated with lung protective ventilation, pulmonary surfactant replacement, and extracorporeal membrane oxygenation (ECMO) for 30 days. However, his disease reversed 5 days after allogeneic UCB infusion, and he weaned from ECMO after 7 days of infusion. Bioinformatics confirmed that his Toll-like receptor (TLR) was abnormal before UCB infusion. However, after the infusion, his immune system was activated and repaired, and the TLR4/MyD88/NF-κB signaling pathway was recovered.

Conclusion

Allogenic UCB could treat ARDS by repairing the TLR4/MyD88/NF-κB signaling pathway, thereby achieving stability of the immune system.
Forecasting potential yields under uncertainty using fuzzy cognitive maps
Authors: Al-Gunaid Mohammed A. , Salygina Irina I. , Shcherbakov Maxim V. , Trubitsin Vladislav N. , Groumpos Peter P.
Published: August 2021

Background

The aim of the study is identification of factors influencing the reduction of the potential maximum yield of winter wheat in weather conditions of dry farming in European part of Russia, Volgograd region. The novelty of the work is forecasting potential yields under uncertainty that allows to assess the risks and potential threats that can influence and maximize the potential yield. To solve this problem, the tool for formalization, analysis and modeling of semi-structured systems and processes Fuzzy Cognitive Maps (FCM) is used.

Results

Based on disparate and heterogeneous information about the multitude of external influences on crop formation during plant photosynthesis, a model for analyzing the level of influencing factors on the target factor is constructed and an effective control impact scenario is developed. This model is used to identify the factors, where each one of them iteratively passes from the initial value to the stable one according to the chosen formula, based on which, the influence of the factors on each other are determined.

Conclusions

The conclusions obtained as a result of the work confirm the concept of precision farming: the quantity and quality of innovation in agriculture depends on the ability to apply it effectively in the field. Developed method of predicting potential yield levels can be used not only to model future agricultural performance, but also to estimate harvested yields.
Amateur ballet practicing, body image and eating behaviors: a comparative study of classical ballet dancers, gym users and sedentary women
Authors: de Medeiros Eufrásio Ruty Eulália , Ferreira Rannapaula Lawrynhuk Urbano , Leal Leilane Lílian Araújo , Avelino Erikarla Baracho , da Costa Pelonha Rafaela Nayara , da Cruz Carvalho Maria Clara , de Medeiros Torres Carlos Henrique , de Sousa Praseres Ana Luísa , de Paiva Lima Filho Marcos , Mota Ana Carolina Costa Campos , Nunes Adriana Bezerra , Ferreira Diana Quitéria Cabral , de Lima Vale Sancha Helena , Maciel Bruna Leal Lima
Published: August 2021

Background

Ballet dancers are a risk group for body image (BI) distortion, dissatisfaction and eating disorders (ED), but few studies have investigated these aspects in amateur adult practitioners. This study aimed to evaluate if amateur female adult classical ballet dancers presented different BI and behaviors for ED than gym users and sedentary women.

Methods

This is a cross-sectional study where classical ballet dancers (n = 19) were compared to gym users (n = 19) and sedentary women (n = 19). Body mass index (BMI) was assessed, and a figure rating scale was applied to assess BI distortion/dissatisfaction. The body shape questionnaire (BSQ) was used to measure BI concern. The eating attitudes test (EAT-26) and the bulimic investigatory test, Edinburgh (BITE) were used for behaviors toward anorexia and bulimia.

Results

BMI was significantly lower in ballet dancers than gym users and sedentary women (F, p = .04). BI distortion did not differ among the studied groups. BI dissatisfaction was lower (X2, p = .041) in ballet dancers (75.0%) and gym users (70.6%) compared to sedentary women (100%). Correspondence analysis showed ballet dancers were mostly not concerned with BI, which was not observed among the other groups. The EAT-26 did not differ between the studied groups. The BITE score was lower (Tukey’s post hoc test,p = .005) in the ballet dancers [mean 5.3 (5.6)] compared to the sedentary women [mean 10.9 (4.8)].

Conclusions

Data suggest that amateur classical ballet practicing is associated to better BI and fewer behaviors for ED in the studied population. The lower BMI in ballet dancers might explain these findings, and further studies should explore these associations.
Prion strains associated with iatrogenic CJD in French and UK human growth hormone recipients
Authors: Douet Jean-Yves , Huor Alvina , Cassard Hervé , Lugan Séverine , Aron Naïma , Mesic Chloé , Vilette Didier , Barrio Tomás , Streichenberger Nathalie , Perret-Liaudet Armand , Delisle Marie-Bernadette , Péran Patrice , Deslys Jean-Philippe , Comoy Emmanuel , Vilotte Jean-Luc , Goudarzi Katayoun , Béringue Vincent , Barria Marcelo A. , Ritchie Diane L. , Ironside James W. , Andréoletti Olivier
Published: August 2021

Treatment with human pituitary-derived growth hormone (hGH) was responsible for a significant proportion of iatrogenic Creutzfeldt–Jakob disease (iCJD) cases. France and the UK experienced the largest case numbers of hGH-iCJD, with 122 and 81 cases respectively. Differences in the frequency of the three PRNP codon 129 polymorphisms (MM, MV and VV) and the estimated incubation periods associated with each of these genotypes in the French and the UK hGH-iCJD cohorts led to the suggestion that the prion strains responsible for these two hGH-iCJD cohorts were different. In this study, we characterized the prion strains responsible for hGH-iCJD cases originating from UK (n = 11) and France (n = 11) using human PrP expressing mouse models. The cases included PRNP MM, MV and VV genotypes from both countries. UK and French sporadic CJD (sCJD) cases were included as controls. The prion strains identified following inoculation with hGH-iCJD homogenates corresponded to the two most frequently observed sCJD prion strains (M1CJD and V2CJD). However, in clear contradiction to the initial hypothesis, the prion strains that were identified in the UK and the French hGH-iCJD cases were not radically different. In the vast majority of the cases originating from both countries, the V2CJD strain or a mixture of M1CJD + V2CJD strains were identified. These data strongly support the contention that the differences in the epidemiological and genetic profiles observed in the UK and France hGH-iCJD cohorts cannot be attributed only to the transmission of different prion strains.
Diabetes mellitus and HIV infection among active tuberculosis patients in Northwest Ethiopia: health facility-based cross-sectional study
Authors: Tulu Begna , Amsalu Eden , Zenebe Yohannes , Abebe Melkamu , Fetene Yeshimebet , Agegn Manamnot , Abate Alemayehu , Ponpetch Keerati , Bekana Teshome , Gumi Balako , Ameni Gobena
Published: August 2021

Background

The prevalence of diabetes mellitus (DM) is increasing globally and its comorbidity with tuberculosis (TB) is re-emerging, especially in low- and middle-income countries.

Objective

The main aim of this study is to determine the prevalence of DM and HIV infection and their associated risk factors among active tuberculosis patients in Northwest Ethiopia.

Methods

This hospital-based cross-sectional study was conducted between February 1st and June 30th, 2017 among active TB patients in two hospitals of Northwest Ethiopia. Two hundred and sixty-seven active TB cases aged 18 years or older were screened for diabetes using fasting blood glucose (FBG) test. Semi-structured questionnaires were used to collect demographic data, lifestyle habits and clinical data. Identification of pre-diabetes or diabetes in TB patients was achieved according to American Diabetes Association guidelines (2016).

Results

Prevalence of DM and TB comorbidity was 11.5% (95% confidence interval, CI 7.8–15.2) compared to 24.9% (95% CI 20.1–30.1) for pre-diabetes. Prevalence of HIV/TB co-infection was 21.9% (95% CI 16.7–26.8). Risk of DM was higher in TB patients from a rural location (adjusted odds ratio, aOR 3.13, 95% CI 1.02–9.62, p = 0.046). Similarly, DM was higher in TB patients who have a family history of DM (aOR 4.54, 95% CI 1.31–15.68, p = 0.017). Furthermore, HIV/TB co-infection was identified as a predictor of DM comorbidity in active TB patients (aOR 5.11, 95% CI 2.01–12.98, p = 0.001).

Conclusion

The magnitude of DM and pre-diabetes in active TB patients in Northwest Ethiopia was high, warranting collaborative efforts to improve screening and adopt better clinical management strategies for DM–TB comorbid patients. Furthermore, being rural residents, family history of DM and HIV/TB co-infection were found to associate with DM among TB patients, highlighting the importance of the above-mentioned risk factors in the clinical management of this comorbidity.
From “satisfaction of search” to “subsequent search misses”: a review of multiple-target search errors across radiology and cognitive science
Authors: Adamo Stephen H. , Gereke Brian J. , Shomstein Sarah , Schmidt Joseph
Published: August 2021

For over 50 years, the satisfaction of search effect has been studied within the field of radiology. Defined as a decrease in detection rates for a subsequent target when an initial target is found within the image, these multiple target errors are known to underlie errors of omission (e.g., a radiologist is more likely to miss an abnormality if another abnormality is identified). More recently, they have also been found to underlie lab-based search errors in cognitive science experiments (e.g., an observer is more likely to miss a target ‘T’ if a different target ‘T’ was detected). This phenomenon was renamed the subsequent search miss (SSM) effect in cognitive science. Here we review the SSM literature in both radiology and cognitive science and discuss: (1) the current SSM theories (i.e., satisfaction, perceptual set, and resource depletion theories), (2) the eye movement errors that underlie the SSM effect, (3) the existing efforts tested to alleviate SSM errors, and (4) the evolution of methodologies and analyses used when calculating the SSM effect. Finally, we present the attentional template theory, a novel mechanistic explanation for SSM errors, which ties together our current understanding of SSM errors and the attentional template literature.
Impact of body mass index on duplex parameters of cranial vessels among the Egyptian population
Authors: Rageh Tarek A. , Ghazally Mostafa , Mohamed Khaled O.
Published: August 2021

Background

Obesity is a major health problem that affects different vascular systems, including cerebrovascular circulation. Carotid duplex is the best screening tool for early diagnosis of cerebrovascular changes in relation to different risk factors including obesity. The present study aims to evaluate the effect of body mass index on the parameters of extracranial vessels in healthy subjects using vascular duplex ultrasonography.

Results

The intimal medial thickness in the common carotid is found to increase as the body mass index and body weight increase (directly related), with this increase being significant (P-value < 0.05).

Conclusion

These findings indicate that increase in body mass index can adversely affect duplex parameters of the common carotid artery.

Clinical trial registration NCT03252652. Registered August 16th 2017
Temporal and nutritional effects on the weaner pig ileal microbiota
Authors: Pollock Jolinda , Glendinning Laura , Smith Lesley A. , Mohsin Hamna , Gally David L. , Hutchings Michael R. , Houdijk Jos G. M.
Published: August 2021

Background

The porcine gastrointestinal microbiota has been linked to both host health and performance. Most pig gut microbiota studies target faecal material, which is not representative of microbiota dynamics in other discrete gut sections. The weaning transition period in pigs is a key development stage, with gastrointestinal problems being prominent after often sudden introduction to a solid diet. A better understanding of both temporal and nutritional effects on the small intestinal microbiota is required. Here, the development of the porcine ileal microbiota under differing levels of dietary protein was observed over the immediate post-weaning period.

Results

Ileal digesta samples were obtained at post-mortem prior to weaning day (day − 1) for baseline measurements. The remaining pigs were introduced to either an 18% (low) or 23% (high) protein diet on weaning day (day 0) and further ileal digesta sampling was carried out at days 5, 9 and 13 post-weaning. We identified significant changes in microbiome structure (P = 0.01), a reduction in microbiome richness (P = 0.02) and changes in the abundance of specific bacterial taxa from baseline until 13 days post-weaning. The ileal microbiota became less stable after the introduction to a solid diet at weaning (P = 0.036), was highly variable between pigs and no relationship was observed between average daily weight gain and microbiota composition. The ileal microbiota was less stable in pigs fed the high protein diet (P = 0.05), with several pathogenic bacterial genera being significantly higher in abundance in this group. Samples from the low protein and high protein groups did not cluster separately by their CAZyme (carbohydrate-active enzyme) composition, but GH33 exosialidases were found to be significantly more abundant in the HP group (P = 0.006).

Conclusions

The weaner pig ileal microbiota changed rapidly and was initially destabilised by the sudden introduction to feed. Nutritional composition influenced ileal microbiota development, with the high protein diet being associated with an increased abundance of significant porcine pathogens and the upregulation of GH33 exosialidases—which can influence host-microbe interactions and pathogenicity. These findings contribute to our understanding of a lesser studied gut compartment that is not only a key site of digestion, but also a target for the development of nutritional interventions to improve gut health and host growth performance during the critical weaning transition period.
Implementation of a community-based low-calorie dietary intervention for the induction of type-2 diabetes and pre-diabetes remission: a feasibility study utilising a type 2 hybrid design
Authors: Quimby Kim R. , Sobers Natasha , George Colette , Greaves Natalie , Browman-Jones Francine , Samuels T. Alafia
Published: August 2021

Objectives

The aims of this feasibility study were to (1) examine the implementation of a community-based health advocate (CHA) training programme to develop the clinical skills needed to support a diabetes remission protocol based on a low-calorie diet (LCD) and (2) investigate if participant weight loss can be achieved and diabetes remission induced under these conditions.

Methods

This tripartite study followed a type 2 implementation-effectiveness design. Three faith-based organisations (FBOs) were purposively selected as study sites. Implementation outcomes were guided by the Consolidated Framework for Implementation Research. During the pre-implementation phase, site ‘readiness’ to facilitate the intervention was determined from a site visit and an interview with the FBOs’ leadership. During the implementation phase, congregants could volunteer for the 10-week CHA training which included practical exercises in weight, glucose and blood pressure (BP) measurement, and a summative practical assessment. Acceptability and implementation effectiveness were assessed via survey. During the intervention phase, other congregants and community members with T2DM or pre-diabetes and overweight were invited to participate in the 12-week LCD. Anti-diabetic medication was discontinued on day 1 of the intervention. Clinical effectiveness was determined from the change in weight, fasting blood glucose (FBG) and BP which were monitored weekly at the FBO by the CHA. HbA1C was performed at weeks 1 and 12.

Results

The FBOs were found to be ready as determined by their adequate resources and engagement in health-related matters. Twenty-nine CHAs completed the training; all attained a passing grade at ≥1 clinical station, indicating implementation effectiveness. CHA feedback indicated that the programme structure was acceptable and provided sufficient access to intervention-related material. Thirty-one persons participated in the LCD (11 T2DM:20 pre-diabetes). Mean (95%CI) weight loss was 6.0 kg (3.7 to 8.2), 7.9 kg in males vs 5.7 kg in females; A1C (%) decreased from 6.6 to 6.1, with a greater reduction in those with T2DM when compared to pre-diabetes. FBG decreased from 6.4 to 6.0mmol/L. T2DM remission rates were 60% and 90% by A1C<6.5% and FBG<7mmol/L respectively. Pre-diabetes remission was 18% and 40% by A1C<5.7% and FBG<5.6 respectively.

Conclusion

Implementation of a community-based diabetes remission protocol is both feasible and clinically effective. Its sustainability is to be determined. Adaptability to other disorders or other settings should be investigated.

Trial registration

NCT03536377 registered on 24 May 2018.
The role of tumour-associated tissue eosinophilia as a prognostic indicator in head and neck squamous cell carcinoma
Authors: Sharma Naveen , Salaria Neha , Kumar Surender , Thomas Nimmy , Beniwal Nidhi , Singh Ranvir
Published: August 2021

Background

Eosinophils are bone marrow-derived granulocytes known to have an imperative role in tissue inflammation. The mechanism of tumour-associated tissue eosinophilia (TATE) in head and neck cancers is however not well understood, and its role as a prognosticator is under evaluation. The aim of this study was to evaluate the association of TATE with factors associated with head and neck cancer and to assess its role as a prognostic marker in such patients.

Results

102 males and 24 females comprised the study population, and 34.9% of which were in the age group of 41 to 50 years. Amongst these 126 patients, most (37.3%) presented in stage III followed by stage IV (28.6%). 29.4% had well-differentiated SCC, 55.6% had moderately differentiated SCC, and 15% were diagnosed with poorly differentiated SCC. 42.8% had TATE grade II, followed by grade III (29.4%) and grade I (27.8%). Correlation studies showed that factors significantly associated with TATE were age, site and tumour differentiation. While 45.7% poorly differentiated tumours showed grade I eosinophilia, 51.4% of well-differentiated tumours had grade III TATE.

Conclusions

TATE showed a highly significant association with tumour differentiation, suggestive of eosinophils partaking a tumouricidal role. This association may be utilised as a convenient early prognosticator for head and neck cancers and should be made a regular feature of biopsy reports. Furthermore, it may be utilised in planning and adopting appropriate treatment modalities in malignancies predicted to have an aggressive course.
Association between house dust mites sensitization and level of asthma control and severity in children attending Mansoura University Children’s Hospital
Authors: Okasha Nahla Mohamed , Sarhan Amr Ali , Ahmed Engy Osman
Published: August 2021

Background

House dust mites (HDM) are considered as a major source of indoor aeroallergen all over the world that precipitate allergic reactions including rhinoconjunctivitis, food allergy, atopic dermatitis, and allergic asthma. In this study, we aimed to assess the clinical and laboratory profile of some Egyptian asthmatic children who are sensitized to house dust mites and determine the association of HDM sensitization and severity of asthma according to recent GINA guidelines.

Results

The most frequent clinical phenotype among the HDM-positive group was a cough (96.7%), while the clinical phenotypic wheeze was frequent in HDM negative group (96.7%). There is a statistically significant difference between studied cases classified according to sensitivity to HDM regarding level of asthma control (50.0% were uncontrolled among cases sensitive to HDM and 56.7% of cases non-sensitive to HDM were controlled (p = 0.001*). Severity according to treatment results was significantly higher among cases sensitive to HDM (26.7% of cases sensitive to HDM versus 3.3% of cases non-sensitive to HDM), p = 0.017.

Conclusions

HDM sensitization is associated mainly with cough asthma phenotype and allergic rhinitis in our studied cases. HDM sensitization increases asthma severity and decreases the ability to control asthma symptoms.

Trial registration

ClinicalTrial.gov, NCT04958616.
A Prospective Study of Early-pregnancy Thyroid Markers, Lipid Species, and Risk of Gestational Diabetes Mellitus
Authors: Wang Yi , Sun Fengjiang , Wu Ping , Huang Yichao , Ye Yi , Yang Xue , Yuan Jiaying , Liu Yan , Zeng Huayan , Wen Ying , Qi Xiaorong , Yang Chun-Xia , Wang Yixin , Liu Gang , Chen Da , Li Liangzhong , Pan Xiong-Fei , Pan An
Published: August 2021

Context

While the associations between thyroid markers and gestational diabetes mellitus (GDM) have been extensively studied, the results are inconclusive and the mechanisms remain unclear.

Objective

We aimed to investigate the prospective associations of thyroid markers in early gestation with GDM risk, and examine the mediating effects through lipid species.

Methods

This study included 6068 pregnant women from the Tongji-Shuangliu Birth Cohort. Maternal serum thyroid markers (free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody) were measured before 15 weeks. Deiodinase activity was assessed by fT3/fT4 ratio. Plasma lipidome were quantified in a subset of 883 participants.

Results

Mean age of the participants was 26.6 ± 3.7 years, and mean gestational age was 10.3 ± 2.0 weeks. Higher levels of fT4 were associated with a decreased risk of GDM (OR = 0.73 comparing the extreme quartiles; 95% CI 0.54, 0.98, Ptrend = .043), while higher fT3/fT4 ratio was associated with an increased risk of GDM (OR = 1.43 comparing the extreme quartiles; 95% CI 1.06, 1.93, Ptrend = .010) after adjusting for potential confounders. Multiple linear regression suggested that fT3/fT4 ratio was positively associated with alkylphosphatidylcholine 36:1, phosphatidylethanolamine plasmalogen 38:6, diacylglyceride 18:0/18:1, sphingomyelin 34:1, and phosphatidylcholine 40:7 (false discovery rate [FDR] adjusted P < .05). Mediation analysis indicated 67.9% of the association between fT3/fT4 ratio and GDM might be mediated through the composite effect of these lipids.

Conclusion

Lower concentration of serum fT4 or higher fT3/fT4 ratio in early pregnancy was associated with an increased risk of GDM. The association of fT3/fT4 ratio with GDM was largely mediated by specific lipid species.
Ketogenic diet in therapy of bipolar affective disorder - case report and literature review
Authors: Chmiel Ireneusz
Published: August 2021

Choroba afektywna dwubiegunowa (ChAD) jest zaburzeniem psychicznym, o przewlekłym przebiegu, cechującym się fluktuacją nastrojów, pojawianiem się naprzemiennie depresji oraz stanów maniakalnych lub hipomaniakalnych. Niestety u części pacjentów postepowanie farmakologiczne nie przynosi satysfakcjonujących efektów, a pewna ich grupa prezentuje oporność na leczenie. Wobec tego poszukuję się innych sposobów leczenia, w tym zmiany diety. Najbardziej obiecującym modelem żywienia jest dieta ketogenna. W zaprezentowanym przypadku mężczyzny, dzięki wprowadzeniu diety ketogennej osiągnięto pełną remisję choroby, zmniejszono dawki lamotryginy oraz całkowicie wykluczono kwetiapinę. Wcześniej zarówno w monoterapii lamotryginą jak i leczeniu skojarzonym z kwetiapiną nie osiągnięto stanu eutymii. Działanie diety może być związane m.in. z wpływem na kanały jonowe i zwiększeniem kwasowości krwi (podobnie do stabilizatorów nastroju), wzrostem stężenia kwasu gamma-aminomasłowego (GABA), modulacją receptorów GABAA oraz blokadą receptorów AMPA przez średniołańcuchowe kwasy tłuszczowe. Dieta ketogenna wpływa na przemiany glutaminianu oraz metabolizm komórki nerwowej, która wykorzystuje ciała ketonowe jako źródła energii. Ketoza może również pobudzać biogenezę mitochondriów, usprawniać metabolizm mózgowy, działać neuroprotekcyjnie, a także zwiększać syntezę glutationu oraz zmniejszać stres oksydacyjny. Potrzeba jednak dobrze zaplanowanych badań, z uwzględnieniem odpowiedniej grupy reprezentatywnej, celem zweryfikowania potencjalnych korzyści i zagrożeń związanych z wprowadzeniem diety ketogennej u chorych z ChAD.
The Relationship Between Soil-transmitted Helminth Infections and Clean and Healthy Living Behavior
Authors: Zuchaliya Anifa Chofsoh , Sari Yulia , Setyawan Sigit , Mashuri Yusuf Ari
Published: August 2021

Background: Soil-transmitted Helminth (STH) are nematodes that can infect humans through direct contact with soil due to poor hygiene behavior. School-age children are the most susceptible to the infection. The clinical symptoms of STH infection are usually asymptomatic. However, it can affect the quality of life of the infected. This study aims to analyze the relationship between STH infection with clean and healthy living behavior; Method: This study takes the form of analytic observational research with a cross-sectional approach. The sampling technique used was the total sampling method with subjects of 132 students of Sekolah Dasar (SD) 1 Talakbroto, SD 1 Kedunglengkong, and SD Wates, Simo, Boyolali. The data were obtained from the results of the students' clean and healthy living behavior questionnaire and the examination of stool samples using the Kato Katz technique. Data were presented in a categorical form and analyzed using the chi-square method.; Results: There were 15 students (11%) infected by STH from 132 subjects studied. Based on the chi-square test, the p-value of STH infection and clean and healthy living behavior was 0.043 (p<0,05); Conclusion: There is a significant relationship between STH infection with clean and healthy living behavior.
The Effects of Occupational Modality Therapy on the Independence Level of the Elderly
Authors: Apriani Miftah , Wulandari Ria
Published: August 2021

Background: Independence in elderlies is the ability to carry out daily activities. The Activity of Daily Living (ADL) is a form of measuring a person's ability to perform ADL independently so that information on elderly morbidity can be analyzed. Occupational therapy is the art and science of supporting interactions in everyday life through work (occupation) that enables people to do work that promotes health and well-being and enables a just and inclusive society, encouraging everyone to optimize their potential in the workplace from everyday life. This study aims to identify the independence level of elderlies before and after occupational modality therapy. Methods: The method employed in this study was a quasi-experimental technique design using a pretest-posttest control group design. Results: The results of the study showed a p-value of 0.00, indicating that occupational modality therapy affected the level of independence of the elderlies who were given treatment with a change of independence level from 13.50 to 16.95. Meanwhile, in the control group where the respondents were not given occupational modality therapy, there was no significant difference before and after the final observation. Conclusion: The elderlies who were given treatment became more independent in carrying out their daily activities compared to those who were not given treatment in the control group.
The Behaviour of Health Faculty Students Responding to Hoaxes Related Covid-19 on Social Media
Authors: Haikal Haikal , Pramitasari Ratih , Yanuar Alvin Maulana Firza , Rahma Nis Syifa’ur
Published: August 2021

Background: Hoax is still a problem in the era of information disclosure and technological advances currently. News or information containing hoax related to Covid-19 affects the handling effort of the Covid-19 pandemic. This research aimed to describe the behavior of health faculty students in responding to the hoaxes associated with Covid-19 on social media. Method: This research was a descriptive study. The sampling technique used was random sampling. The samples were 384 students who were required to complete the questionnaire. The statistical test used was descriptive statistical analysis. Results: The results obtained in this study were that respondents considered Facebook as the most widely used social media for spreading hoaxes (68%). Respondents thought that cross-checking the accuracy and validity of information is a step that should be performed when receiving hoax news (85%). Respondents stated that they dug up information through official government websites regarding the handling of Covid-19 to check the statement's truth (65%). Some respondents did not cross-check the news or information related to Covid-19 due to the assumption that someone else had done it. Conclusion: Most respondents have cross-checked news or information about Covid-19. Extracting information through official government websites on handling Covid-19 has also been taken to check the accuracy and validity of the statement.
The Relationship Between Husband Support and Behavior of Pregnant Teenagers to Face Pregnancy During the Covid-19 Pandemic in Gombong, Kebumen, Indonesia
Authors: Rahmadhani Wulan , Suyanto Jipri , Soe Than Kyaw , Mutoharoh Siti
Published: August 2021

Background: Age influences pregnancy and childbirth. Pregnant women aged less than 20 years old or pregnant adolescents are not physically and mentally ready to cope with pregnancy or childbirth. The husband's support highly determines the health status of the mother. This research aimed to determine the relationship between husband support and the behavior of pregnant adolescents to face pregnancy during the COVID-19 pandemic in the Gombong District, Kebumen Regency. Methods: This study used a cross-sectional approach. The population was all pregnant women aged less than 20 years in the Gombong District, Kebumen Regency. It used a saturated sampling technique involving 256 people. Data were analyzed using univariate and bivariate analysis to answer the percentage and the Chi-Square test to answer the research hypothesis. Results: The study showed that 130 (50.8%) husbands did not support the mothers, and 126 (49.2%) husbands supported the mothers. The result also showed that 116 (45.3%) of the pregnant women showed positive behavior, while140 (54.7%) pregnant women showed negative behavior. The chi-square test found a p-value of 0.005, which proved a significant relationship between the husband's support and the behavior of pregnant adolescents to overcome pregnancy during the covid-19 pandemic. Conclusion: Pregnant teenagers with husband support will prepare for pregnancy and childbirth programs more maturely to ensure the safety of both mother and fetus.
Perceived caregiving preparedness and quality of life among Indonesian family caregivers of patients with life-limiting illness
Authors: Rochmawati Erna , Prawitasari Yuli
Published: August 2021

Background:

Family caregivers play an important role in palliative care. However, family caregivers often report that they felt insufficiently prepared to become a caregiver. This lack of preparedness may lead to a decline in the caregiver's quality of life (QoL), and they may not be able to provide sufficient palliative care to their family member.

Aims:

To investigate the preparedness of family members to become caregivers alongside their QoL.

Method:

A correlational cross-sectional study design was used. A sample of 104 family caregivers completed a World Health Organization Quality of Life Brief to assess the QoL of participants. The Caregiving Inventory (CGI) was used to assess how prepared family members felt to become care-givers, and the CGI also included questions related to the patient's socio-demographic status and illness. Correlation analysis was used to address the research questions. Caregivers were caring for a family member with a life-limiting illness in a suburban district of Indonesia.

Findings:

The 104 family caregivers had a relatively low score for both QoL and caregiving preparedness. A caregiver feeling more prepared was associated with a higher QoL. The study also found a positive correlation (r value, between 0.236–0.481) between perceived caregiving preparedness, including its factors, and domains of QoL.

Conclusion:

A person's preparedness to become a caregiver is significantly associated with all QoL domains: physical, psychological, social and environmental. Family members can be better prepared to become a caregiver with training and information about personal care and symptom management.
You're hired: apprenticeships and the new scheme
Authors: Bernstein Adam
Published: August 2021

Lord Sugar and Donald Trump popularised the term ‘apprentice’ and the phrase ‘you're fired!’, but there is much more to the concept. Implemented well, with willing candidates, apprenticeships are a great entrée into the worlds of learning and work. Adam Bernstein explains.
External Fixator as a Saviour in the Management of Aneurysmal Bone Cyst with Physeal Extension in Pathological Fracture of the Proximal Femur: A Case Report with a Review of Literature
Authors: Kushwaha Sudhir S , Lal Atil Kumar , Kumar Nitish , Bharti Ajay
Published: August 2021

Introduction: Aneurysmal bone cysts (ABC’s) are expansile, tumour-like vascular lesion. They are more commonly seen in the metaphyseal region of long bones. They are benign lesion although malignant transformation has been reported. Usually presents in the first three decades of life. Common presentation is pain, swelling, or fracture. Proximal femur with ABC’s is a rare entity and with physeal extension is even sparse.
Case Report: A 13- year-. old female presented in the orthopaedic emergency with complaints of pain in the right hip region following a trivial fall. Following trauma, the patient was unable to stand or walk. On examination, there was tenderness in Scarpa’s triangle, straight leg raise test was not possible and limb was in external rotation. Plain radiography revealed an inter-trochanteric fracture with cystic lesion in the proximal femur extending till until epiphysis. MRI of the proximal femur showed an air fluid level with septations and soft- tissue oedema suggestive of aneurysmal bone cyst ABC’s. The patient was managed by intra-lesional curettage with fibular strut grafting along with cancellous bone graft and fixation by Uni-planar external fixator.
Conclusion: Pathological Fractures fractures of proximal femur management is are a challenge for an orthopaedic surgeon due to its location and biomechanical factors. Treatment of proximal femur ABC’s should be case dependent. In our opinion, aneursymal bone cyst of the proximal femur with physeal extension can be managed by external fixation along with extensive curettage and bone graft.
Keywords: Aneurysmal bone cyst, proximal femur, external fixation
Long-term Results of the Thrust Plate Prosthesis, 21-year Follow-up: A Case Report and Literature Review
Authors: Elbardesy Hany , Gul Rehan
Published: August 2021

Introduction: The thrust plate prosthesis (TPP) is a type of cementless hip replacement. Aimed to preserve femoral diaphyseal bone, it was favored by some orthopedic surgeons in younger patients as they could potentially undergo multiple revision arthroplasties during their lifetime. Of particular note, the preserved diaphyseal bone allows for the implantation of a subsequent primary total hip arthroplasty (THA).
Case Report: We reported on a 64-year-old male patient who underwent thrust plate prosthesis (TPP) implantation 21 years ago (1999) for the treatment of primary osteoarthritis (OA) of the right hip joint. At 21-year follow-up, he had not developed any post-operative complications, and he reported a SF12 score of 32 and Oxford hip score of 47/48.
Conclusion: TPP proved to be successful clinically and radiologically, especially in the young patient. It loads directly to the cortex of the proximal femoral metaphysis as in a native hip joint. It is a bone preserving prosthesis which allows for good bone stock in the case of revision surgery that was a victim of commercial considerations.
Keywords: Thrust plate prosthesis, thrust plate prosthesis, arthroplasty.