bluuebunny/crossref_metadata_2025 huggingface dataset:
Vaccination status and prevalence of hepatitis B virus infection among health-care workers in a tertiary health institution, Enugu State, Nigeria
Authors: Orji Chinonyelu Jennie , Chime Onyinye Hope , Ndibuagu Edmund Onyemaechi
Published: May 2020

Background:

Hepatitis B virus (HBV) infection is a major global health concern. The prevalence among health-care workers (HCWs) is about 13% in Nigeria. Although the vaccine has been found to be effective in preventing infection in 90–95% of recipients, its uptake among HCW is low. The objective of this study was to determine the prevalence and vaccination status of HCW in a tertiary health facility in Southeast Nigeria.

Methods:

The study was conducted at Enugu State University Teaching Hospital (ESUTH) to mark the 2018 World Hepatitis Day. The HCWs were sensitised through handbills, posters, memo to the different departments and an awareness walk. HCWs who presented voluntarily were screened. Data were collected using a pro forma and analysed.

Results:

Out of the 1720 staff at ESUTH, 241 (14.0%) were screened; 33.2% were classified as clinical staff, 43.9% worked in clinical departments and 25.3% and 6.6% had been previously screened and vaccinated, respectively. Only 2.1% were positive for hepatitis B surface antigen. Previous screening for hepatitis B, working in clinical departments and being a core clinical health worker were factors that were significantly associated with previous vaccination status. Positive predictors included previous screening and working in clinical departments.

Conclusion/Recommendation:

This study revealed low HBV screening and vaccination uptake among HCWs in Enugu state University Teaching hospital, and also low disease prevalence. Though the prevalence of HBV infection was low, organising more awareness-raising activities in the facility will improve prevention and further reduce prevalence.
Unique case of inverted papilloma of septum with nasopharyngeal carcinoma: Is it a metachronous tumour?
Authors: Flach Susanne , Ferguson Aaron SJ , White Sharon , White Paul S , Manickavasagam Jaiganesh
Published: May 2020

Inverted papilloma is a rare and benign tumour. It affects the nasal cavity and paranasal sinuses, has a high rate of recurrence and is associated with malignant transformation. Only few cases of a poorly differentiated carcinoma arising from inverted papilloma have been reported, none of which in the nasopharynx. We report a case of a 37-year-old female, who presented originally in 2012 with inverted papilloma of the nasal septum which was surgically resected. Nasopharyngeal biopsy from 2014 was reported as carcinoma in situ and treated with local endoscopic resection. Three years later she presented with a solitary lesion of the right Eustachian tube opening, confirmed as invasive poorly differentiated carcinoma. Imaging revealed T4 N2b M0 malignancy with skull base and prevertebral space invasion, likely extension into right temporal lobe and malignant adenopathy. Although rare, malignant transformation of inverted papilloma in unusual places should be considered during workup and monitoring of patients.
Use of a new cold plasma tool for psoriasis treatment: A case report
Authors: Gareri Clarice , Bennardo Luigi , De Masi Gianluca
Published: May 2020

Cold atmospheric plasma sources are emerging as new potent tools in different fields of medicine, from oncology to dermatology. Psoriasis is a chronic inflammatory disease characterized by the presence of itchy red plaque on skin, known as psoriatic plaques. In this case report, we evaluate the effectiveness of a cold atmospheric plasma treatment on a psoriatic plaque on the hand of a 20-year-old woman. Two quick applications of the procedure led to a complete disappearance of the cutaneous lesion in 14 days. The results of this case show a potential application of this new technique in the dermatological field, as palmo-plantar psoriasis is usually resistant to traditional treatments. A clinical trial would be necessary in order to evaluate the real effectiveness of this plasma.
Rehabilitative and assistive wearable mechatronic upper-limb devices: A review
Authors: Desplenter Tyler , Zhou Yue , Edmonds Brandon PR , Lidka Myles , Goldman Allison , Trejos Ana Luisa
Published: May 2020

Recently, there has been a trend toward assistive mechatronic devices that are wearable. These devices provide the ability to assist without tethering the user to a specific location. However, there are characteristics of these devices that are limiting their ability to perform motion tasks and the adoption rate of these devices into clinical settings. The objective of this research is to perform a review of the existing wearable assistive devices that are used to assist with musculoskeletal and neurological disorders affecting the upper limb. A review of the existing literature was conducted on devices that are wearable, assistive, and mechatronic, and that provide motion assistance to the upper limb. Five areas were examined, including sensors, actuators, control techniques, computer systems, and intended applications. Fifty-three devices were reviewed that either assist with musculoskeletal disorders or suppress tremor. The general trends found in this review show a lack of requirements, device details, and standardization of reporting and evaluation. Two areas to accelerate the evolution of these devices were identified, including the standardization of research, clinical, and engineering details, and the promotion of multidisciplinary culture. Adoption of these devices into their intended application domains relies on the continued efforts of the community.
Review of the effects of soft robotic gloves for activity-based rehabilitation in individuals with reduced hand function and manual dexterity following a neurological event
Authors: Proulx Camille E , Beaulac Myrka , David Mélissa , Deguire Catryne , Haché Catherine , Klug Florian , Kupnik Mario , Higgins Johanne , Gagnon Dany H.
Published: May 2020

Despite limited scientific evidence, there is an increasing interest in soft robotic gloves to optimize hand- and finger-related functional abilities following a neurological event. This review maps evidence on the effects and effectiveness of soft robotic gloves for hand rehabilitation and, whenever possible, patients’ satisfaction. A systematized search of the literature was conducted using keywords structured around three areas: technology attributes, anatomy, and rehabilitation. A total of 272 titles, abstracts, and keywords were initially retrieved, and data were extracted out of 13 articles. Six articles investigated the effects of wearing a soft robotic glove and eight studied the effect or effectiveness of an intervention with it. Some statistically significant and meaningful beneficial effects were confirmed with the 29 outcome measures used. Finally, 11 articles also confirmed users’ satisfaction with regard to the soft robotic glove, while some articles also noticed an increased engagement in the rehabilitation program with this technology. Despite the heterogeneity across studies, soft robotic gloves stand out as a safe and promising technology to improve hand- and finger-related dexterity and functional performance. However, strengthened evidence of the effects or effectiveness of such devices is needed before their transition from laboratory to clinical practice.
The Dynamics of Political Incivility on Twitter
Authors: Theocharis Yannis , Barberá Pablo , Fazekas Zoltán , Popa Sebastian Adrian
Published: May 2020

Online incivility and harassment in political communication have become an important topic of concern among politicians, journalists, and academics. This study provides a descriptive account of uncivil interactions between citizens and politicians on Twitter. We develop a conceptual framework for understanding the dynamics of incivility at three distinct levels: macro (temporal), meso (contextual), and micro (individual). Using longitudinal data from the Twitter communication mentioning Members of Congress in the United States across a time span of over a year and relying on supervised machine learning methods and topic models, we offer new insights about the prevalence and dynamics of incivility toward legislators. We find that uncivil tweets represent consistently around 18% of all tweets mentioning legislators, but with spikes that correspond to controversial policy debates and political events. Although we find evidence of coordinated attacks, our analysis reveals that the use of uncivil language is common to a large number of users.
Contextual Correlates of Risky Sexual Behavior Among Migrant and Non-Migrant Men in Nigeria
Authors: Ajaero Chukwuedozie K. , Onuh Juliana C. , Amoo Emmanuel O. , Adewoyin Yemi
Published: May 2020

This study compared risky sexual behavior (RSB) between migrant and non-migrant Nigerian men, and investigated the individual and community factors of RSB between the two groups. Data for the study were from the 2012 National HIV/AIDS and Reproductive Health Survey in Nigeria. It comprised 15,346 male respondents aged 15 to 64 years and made up of 7,158 non-migrants and 8,188 migrants. The data were analyzed using descriptive statistics, chi-square test, and multilevel binary logistic regression. More non-migrants (37.69%) than migrants (28.43%) were engaged in RSB. RSB among migrants showed significant differences in all explanatory variables except for place of residence and religion. Among non-migrants, significant differences existed between RSB and all the explanatory variables except for awareness of family planning and sexually transmitted diseases. The regression null model showed lower odds of RSB for migrants and non-migrants. In the full model, the intercepts increased odds of RSB for migrants (odds ratio [OR] = 8.55) and non-migrants (OR = 9.21). Variables which increased odds of RSB by migrants included employment status, religion, and place of residence. Education, employment status, wealth index, and place of residence were found to increase the odds of engaging in RSB among non-migrants. The study therefore concludes that social contexts matter for engagement in RSB.
Prevalence of Goiter and Associated Factors Among Adolescents in Gazgibla District, Northeast Ethiopia
Authors: Gebremichael Gebremedhin , Demena Melake , Egata Gudina , Gebremichael Berhe
Published: May 2020

Background

Although goiter is a major public health problem in Ethiopia and affects a large number of people, there was little evidence among adolescents particularly in Northern Ethiopia. This study was, therefore, aimed at investigating the prevalence of goiter and associated factors among adolescents in Gazgibla District, Northeast Ethiopia.

Methods

A community-based cross-sectional study was conducted among 596 adolescents from August 5–30, 2019. Data were collected using a structured questionnaire. Adolescents were assessed for goiter based on World Health Organization criteria. The level of iodine in household salt samples was tested using rapid test kit. Data were entered into EpiData version 3.1 and exported into Statistical Package for the Social Sciences version 22.0 for statistical analysis. Multivariable logistic regression analysis was done to control for all possible confounders and to identify predictors of goiter. Odds ratio along with 95% confidence interval (CI) was estimated to measure the strength of the association. Level of statistical significance was declared at P ≤ .05.

Results

The prevalence of goiter among adolescents was 42.5% (95% CI: 38.4%, 46.7%). Being a female (adjusted odds ratio [AOR] = 1.83, 95% CI: 1.18, 2.85), family history of goiter (AOR = 3.63, 95% CI: 2.31, 5.69), cabbage consumption at least once per week (AOR = 4.6, 95% CI: 2.42, 8.74), not consuming meat at all (AOR = 2.5, 95% CI: 1.17, 5.32), not consuming milk at all (AOR = 2.19, 95% CI: 1.19, 4.03), and inadequate iodine level of household salt (AOR = 7.05, 95% CI: 3.83, 12.97) were significantly associated with the development of goiter among adolescents.

Conclusions

The prevalence of goiter was very high in the study area. Therefore, the health sector of the district should invest efforts on improving the community’s awareness through disseminating key messages about iodized salt and iodine-rich foods.
Suture anchor stabilization of symptomatic accessory navicular in adolescents: Clinical and radiographic outcomes
Authors: Kakihana Masataka , Tochigi Yuki , Yamazaki Takayuki , Ohashi Masanori , Ozeki Satoru
Published: May 2020

Background:

Screw fixation used in modified Kidner procedures to treat persistent symptomatic accessory navicular in adult cases is often challenging in adolescent cases with a small accessory fragment. The present study aimed to document the clinical effect of a suture anchor stabilization technique applicable to such cases where osteosynthesis is considered an ideal outcome.

Methods:

Consecutive clinical cases who received this surgical treatment from 2009 to 2016 were retrospectively reviewed. The focus of interest included radiographic union of the accessory bone, changes in symptoms evaluated using a validated clinical outcome scale introduced by the Japanese Society for Surgery of the Foot, and changes in the medial arch bony alignment measured in lateral weight-bearing plain radiographs.

Results:

Twenty-two feet in 15 individuals (11 females and 4 males, age at surgery 10–16 years) were identified. In 14 feet (64%), radiographic bone union was confirmed within 8 weeks postoperatively. At the final follow-up ranging 12–51 months postoperation, the clinical scores have significantly improved ( p < 0.001) to 96 ± 5.71 (mean ± standard deviation, range 87–100), from 54 preoperatively. Radiographic measurements revealed significant postoperative increase of the sagittal talar tilt angle ( p < 0.001, increment 4 ± 3°, range 0–11) and the talo-first metatarsal angle ( p < 0.001, increment 5 ± 4°, range 0–12). No significant changes were identified in the calcaneal pitch angle, first metatarsal tilt angle, calcaneo-navicular angle, and the navicular height.

Conclusion:

Despite the modest bone union rate, the clinical outcomes suggest distinct symptom-relieving effect, at least in the short- to midterm, while the radiographic measurements suggest positive biomechanical effects. The present suture-anchor stabilization concept appears to be a promising treatment option for persistent symptomatic accessory navicular in adolescent cases.
Strengthening Perceptions of Ethical Competence Among Nursing Students and Graduates
Authors: Obeid Samira , Man Michal
Published: May 2020

Introduction

Ethical competence is part of all health-care professionals’ general competence. It relates to moral issues and is based on the professionals’ knowledge, skills, and attitudes for coping with ethical dilemmas. Ethics education aims to increase nursing students’ and nursing graduates’ ethical self-confidence. Previous research has found many gaps in ethical education content and poor understanding of how these gaps affect graduates.

Objectives

This study aims to evaluate an advanced education workshop held in the nursing department in Max Stern Yezreel Valley College aimed at strengthening the self-perceptions of ethical competence, to address the above gap, by raising students’ self-efficacy when coping with ethical dilemmas.

Methods

The effectiveness of the workshop for nursing students was evaluated using the Generalized Self-Efficacy Scale and at three points in time: before the workshop, after the workshop, and after graduation.

Results

Statistically significant differences were found in overall self-efficacy: before the workshop (mean of 2.42), after the workshop (mean of 2.13), and for graduates (mean of 1.58) with p < .000 on a scale ranging from 1 to 5 (1 indicating high self-efficacy). Mean scores for students’ evaluation after the workshop and for graduates were 7.8 and 7.25, respectively, on a scale ranging from 1 to 10, where 10 indicates high self-efficacy. Graduates presented a high mean score regarding their ability to cope with ethical dilemmas when compared with other nurses working with them (mean of 7.4, on a scale ranging from 1 to 10).

Conclusion

Levels of self-efficacy with regard to coping with ethical dilemmas increased over time, suggesting that the workshop strengthened the self-perception of ethical competence for nursing students and graduates.
Soil chemical evaluation and power plant ash impact on chemical properties of Salix alba L. (Fam. Salicaceae): The impact of bioaccumulation
Authors: Bajraktari Demush , Petrovska Biljana Bauer , Zeneli Lulzim , Dimitrovska Aneta , Kavrakovski Zoran
Published: May 2020

Plants grown under contaminated conditions exhibit differences in metal absorption, accumulation, and transportation, and these differences are seen in different plant parts. Metal content in the soil and bark samples collected next to the Sitnica river, which passes through the industrial area of thermal power plants in Kosovo, was measured by inductively coupled plasma optical emission spectrometry. The total metal concentration in willow bark collected from the polluted area of Obilic, Kosovo, ranged 5260–22,280 mg/kg for calcium (Ca), 840–1680 mg/kg for magnesium (Mg), 66.79–910.75 mg/kg for iron (Fe), 5.09–28.66 mg/kg for copper (Cu), 56.39–140.94 mg/kg for zinc (Zn), 19.68–392.75 mg/kg for manganese (Mn), 6.49–10.09 mg/kg for nickel (Ni), 0.10–4.49 mg/kg for cadmium (Cd), 0.85–1.89 mg/kg for chromium (Cr), and 67.79–94.77 mg/kg for aluminum (Al).

Data analysis indicated that correlation between trace elements in the soil and willow bark samples varied with the highest observed in Ni(s)/Zn(p) and Fe(s)/Ca(p) followed by Fe(s)/Mg(p), Al(s)/Ca(p), Cr(s)/Mg(p), Cr(s)/Cu(p), Ni(s)/Ni(p), Cu(s)/Ca(p), and Cu(s)/Zn(p). Correlations among trace elements within willow bark samples varied. The correlation between Cr and Al concentration was the highest, followed by that between Ni and Al. A significantly strong correlation was observed between Al and Fe, Ni and Cr, Cr and Fe, Ni and Fe, and Ca and Mg. The highest transfer factor was established in Zn, followed by Cu > Ni > Cr > Al > Fe.
Polygenic chamosite from a hydrothermalized oolitic ironstone (Saint-Aubin-des-Châteaux, Armorican Massif, France): crystal chemistry, visible–near-infrared spectroscopy (red variety) and geochemical significance
Authors: Moëlo Yves , Fritsch Emmanuel , Gloaguen Eric , Rouer Olivier
Published: May 2020

Several generations of chamosite, including a red variety, occur in the Ordovician hydrothermalized oolitic ironstone from Saint-Aubin-des-Châteaux (Armorican Massif, France). Their chemical re-examination indicates a low Mg content (0.925 < Fe/(Fe + Mg) < 0.954), but a significant variation inIVAl. Minor vanadium is present at up to 1.1 wt.% oxide. Variations inIVAl, the vanadium content and the colour of chamosite are related to the hydrothermal reworking of the ironstone. Taking into account other published data, the ideal composition of chamosite is (Fe5–xAl1+x)(Si3–xAl1+x)O10(OH)8, with 0.2 <x< 0.8 (0.2: equilibrium with quartz; 0.8: SiO2deficit). The red chamosite (IIbpolytype) has a mean composition of (Fe3.87Mg0.23Mn0.01□0.07Al1.74V0.07)(Si2.33Al1.67)O10(OH)8. This chamosite is strongly pleochroic, from pale yellow (E|| (001)) to deep orange red (E⊥ (001)). Visible–near-infrared absorbance spectra show a specific absorption band centred at ~550 nm forE⊥ (001), due to a proposed new variety of Fe/V intervalence charge-transfer mechanism in the octahedral sheet, possibly Fe2+– V4+→ Fe3+– V3+. While the formation of green chamosite varieties is controlled by reducing conditions due to the presence of organic matter as a buffer, that of red chamosite would indicate locally a weak increase offO2related to oxidizing hydrothermal solutions.
Pain rates in general population for the period 1991–2015 and 10-years prediction: results from a multi-continent age-period-cohort analysis
Authors: Guido Davide , Leonardi Matilde , Mellor-Marsá Blanca , Moneta Maria V. , Sanchez-Niubo Albert , Tyrovolas Stefanos , Giné-Vázquez Iago , Haro Josep M. , Chatterji Somnath , Bobak Martin , Ayuso-Mateos Jose L. , Arndt Holger , Koupil Ilona , Bickenbach Jerome , Koskinen Seppo , Tobiasz-Adamczyk Beata , Panagiotakos Demosthenes , Raggi Alberto
Published: May 2020

Background

Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people. The aims of this study are to evaluate the temporal variations of pain rates among general populations for the period 1991–2015 and to project 10-year pain rates.

Methods

We used the harmonized dataset of ATHLOS project, which included 660,028 valid observations in the period 1990–2015 and we applied Bayesian age–period–cohort modeling to perform projections up to 2025. The harmonized Pain variable covers the content “self-reported pain experienced at the time of the interview”, with a dichotomous (yes or no) modality.

Results

Pain rates were higher among females, older subjects, in recent periods, and among observations referred to cohorts of subjects born between the 20s and the 60s. The 10-year projections indicate a noteworthy increase in pain rates in both genders and particularly among subjects aged 66 or over, for whom a 10–20% increase in pain rate is foreseen; among females only, a 10–15% increase in pain rates is foreseen for those aged 36–50.

Conclusions

Projected increase in pain rates will require specific interventions by health and welfare systems, as pain is responsible for limited quality of subjective well-being, reduced employment rates and hampered work performance. Worksite and lifestyle interventions will therefore be needed to limit the impact of projected higher pain rates.
Computational strategies for the preconditioned conjugate gradient method applied to ssSNPBLUP, with an application to a multivariate maternal model
Authors: Vandenplas Jeremie , Eding Herwin , Bosmans Maarten , Calus Mario P. L.
Published: May 2020

Background

The single-step single nucleotide polymorphism best linear unbiased prediction (ssSNPBLUP) is one of the single-step evaluations that enable a simultaneous analysis of phenotypic and pedigree information of genotyped and non-genotyped animals with a large number of genotypes. The aim of this study was to develop and illustrate several computational strategies to efficiently solve different ssSNPBLUP systems with a large number of genotypes on current computers.

Results

The different developed strategies were based on simplified computations of some terms of the preconditioner, and on splitting the coefficient matrix of the different ssSNPBLUP systems into multiple parts to perform its multiplication by a vector more efficiently. Some matrices were computed explicitly and stored in memory (e.g. the inverse of the pedigree relationship matrix), or were stored using a compressed form (e.g. the Plink 1 binary form for the genotype matrix), to permit the use of efficient parallel procedures while limiting the required amount of memory. The developed strategies were tested on a bivariate genetic evaluation for livability of calves for the Netherlands and the Flemish region in Belgium. There were 29,885,286 animals in the pedigree, 25,184,654 calf records, and 131,189 genotyped animals. The ssSNPBLUP system required around 18 GB Random Access Memory and 12 h to be solved with the most performing implementation.

Conclusions

Based on our proposed approaches and results, we showed that ssSNPBLUP provides a feasible approach in terms of memory and time requirements to estimate genomic breeding values using current computers.
Discovery of thermophilic Bacillales using reduced-representation genotyping for identification
Authors: Talamantes-Becerra Berenice , Carling Jason , Kilian Andrzej , Georges Arthur
Published: May 2020

Background

This study demonstrates the use of reduced-representation genotyping to provide preliminary identifications for thermophilic bacterial isolates. The approach combines restriction enzyme digestion and PCR with next-generation sequencing to provide thousands of short-read sequences from across the bacterial genomes. Isolates were obtained from compost, hot water systems, and artesian bores of the Great Artesian Basin. Genomic DNA was double-digested with two combinations of restriction enzymes followed by PCR amplification, using a commercial provider of DArTseq™, Diversity Arrays Technology Pty Ltd. (Canberra, Australia). The resulting fragments which formed a reduced-representation of approximately 2.3% of the genome were sequenced. The sequence tags obtained were aligned against all available RefSeq bacterial genome assemblies by BLASTn to identify the nearest reference genome.

Results

Based on the preliminary identifications, a total of 99 bacterial isolates were identified to species level, from which 8 isolates were selected for whole-genome sequencing to assess the identification results. Novel species and strains were discovered within this set of isolates. The preliminary identifications obtained by reduced-representation genotyping, as well as identifications obtained by BLASTn alignment of the 16S rRNA gene sequence, were compared with those derived from the whole-genome sequence data, using the same RefSeq sequence database for the three methods. Identifications obtained with reduced-representation sequencing agreed with the identifications provided by whole-genome sequencing in 100% of cases. The identifications produced by BLASTn alignment of 16S rRNA gene sequence to the same database differed from those provided by whole-genome sequencing in 37.5% of cases, and produced ambiguous identifications in 50% of cases.

Conclusions

Previously, this method has been successfully demonstrated for use in bacterial identification for medical microbiology. This study demonstrates the first successful use of DArTseq™ for preliminary identification of thermophilic bacterial isolates, providing results in complete agreement with those obtained from whole-genome sequencing of the same isolates. The growing database of bacterial genome sequences provides an excellent resource for alignment of reduced-representation sequence data for identification purposes, and as the available sequenced genomes continue to grow, the technique will become more effective.
Resuscitation with macromolecular superoxide dismutase/catalase mimetic polynitroxylated PEGylated hemoglobin offers neuroprotection in guinea pigs after traumatic brain injury combined with hemorrhage shock
Authors: Seno Soichiro , Wang Jun , Cao Suyi , Saraswati Manda , Park Sharon , Simoni Jan , Ma Li , Soltys Bohdan , Hsia Carleton J. C. , Koehler Raymond C. , Robertson Courtney L.
Published: May 2020

Background

Polynitroxylated PEGylated hemoglobin (PNPH, aka SanFlow) possesses superoxide dismutase/catalase mimetic activities that may directly protect the brain from oxidative stress. Stabilization of PNPH with bound carbon monoxide prevents methemoglobin formation during storage and permits it to serve as a carbon monoxide donor. We determined whether small volume transfusion of hyperoncotic PNPH is neuroprotective in a polytrauma model of traumatic brain injury (TBI) plus hemorrhagic shock. Guinea pigs were used because, like humans, they do not synthesize their own ascorbic acid, which is important in reducing methemoglobin.

Results

TBI was produced by controlled cortical impact and was followed by 20 mL/kg hemorrhage to a mean arterial pressure (MAP) of 40 mmHg. At 90 min, animals were resuscitated with 20 mL/kg lactated Ringer’s solution or 10 mL/kg PNPH. Resuscitation with PNPH significantly augmented the early recovery of MAP after hemorrhagic shock by 10–18 mmHg; whole blood methemoglobin was only 1% higher and carboxyhemoglobin was 2% higher. At 9 days of recovery, unbiased stereology analysis revealed that, compared to animals resuscitated with lactated Ringer’s solution, those treated with PNPH had significantly more viable neurons in the hippocampus CA1 + 2 region (59 ± 10% versus 87 ± 18% of sham and naïve mean value) and in the dentate gyrus (70 ± 21% versus 96 ± 24%; n = 12 per group).

Conclusion

PNPH may serve as a small-volume resuscitation fluid for polytrauma involving TBI and hemorrhagic shock. The neuroprotection afforded by PNPH seen in other species was sustained in a species without endogenous ascorbic acid synthesis, thereby supporting potential translatability for human use.
Molecular characteristics of Clostridium difficile in children with acute gastroenteritis from Zhejiang
Authors: Shuai Huiqun , Bian Qiao , Luo Yun , Zhou Xiaohong , Song Xiaojun , Ye Julian , Huang Qinghong , Peng Zhaoyang , Wu Jun , Jiang Jianmin , Jin Dazhi
Published: May 2020

Background

Clostridium difficile infection (CDI) has an increasing pediatric prevalence worldwide. However, molecular characteristics of C. difficile in Chinese children with acute gastroenteritis have not been reported.

Methods

A five-year cross-sectional study was conducted in a tertiary children’s hospital in Zhejiang. Consecutive stool specimens from outpatient children with acute gastroenteritis were cultured for C. difficile, and isolates then were analyzed for toxin genes, multi-locus sequence type and antimicrobial resistance. Diarrhea-related viruses were detected, and demographic data were collected.

Results

A total of 115 CDI cases (14.3%), and 69 co-infected cases with both viruses and toxigenic C. difficile, were found in the 804 stool samples. The 186 C. difficile isolates included 6 of toxin A-positive/toxin B-positive/binary toxin-positive (A+B+CDT+), 139 of A+B+CDT−, 3 of A−B+CDT+, 36 of A−B+CDT− and 2 of A−B−CDT−. Sequence types 26 (17.7%), 35 (11.3%), 39 (12.4%), 54 (16.7%), and 152 (11.3%) were major genotypes with significant differences among different antimicrobial resistances (Fisher's exact test, P < 0.001). The A−B+ isolates had significantly higher resistance, compared to erythromycin, rifampin, moxifloxacin, and gatifloxacin, than that of the A+B+ (χ2 = 7.78 to 29.26, P < 0.01). The positive CDI rate in infants (16.2%) was significantly higher than that of children over 1 year old (10.8%) (χ2 = 4.39, P = 0.036).

Conclusions

CDI has been revealed as a major cause of acute gastroenteritis in children with various genotypes. The role of toxigenic C. difficile and risk factors of CDI should be emphatically considered in subsequent diarrhea surveillance in children from China.
Evaluation of microstructural changes in spinal cord of patients with degenerative cervical myelopathy by diffusion kurtosis imaging and investigate the correlation with JOA score
Authors: Liu Zhuohang , Bian Bingyang , Wang Gang , Tian Cheukying , Lv Zhenshan , Shao Zhiqing , Li Dan
Published: May 2020

Background

To explore the feasibility of the metrics of diffusion kurtosis imaging (DKI) for investigations of the microstructural changes of spinal cord injury in patients with degenerative cervical myelopathy (DCM) and the correlation between Japan Orthopaedic Association (JOA) scores and DKI metrics.

Methods

Fifty-seven patients with DCM and 38 healthy volunteers underwent 3.0 T magnetic resonance (MR) imaging with routine MRI sequences and DKI from echo-planar imaging sequence. Based on the JOA score, DCM patients were divided into four subgroups. DKI metrics of the DCM group and control group were obtained and compared, separately for the white matter (WM) and the gray matter (GM).

Results

The FA values in WM were significantly lower (P = 0.020) in the DCM group than in the control group. The MK values in GM were lower (P = 0.011) in the DCM group than in the control group. The MD values in WM were significantly higher (P = 0.010) in the DCM group than in the control group. In GM, the JOA score was positively correlated with the MK values (r = 0.768, P < 0.05). In the WM, the JOA score was positively correlated with the FA values (r = 0.612, P < 0.05).

Conclusion

DKI provides quantitive evaluation to the characters of microstructure of the spinal cord damage in patients with DCM compared to conventional MR. MK values can reflect microstructural abnormalities of gray matter of the cervical spinal cord and provide more information beyond that obtained with routine diffusion metrics. In addition, MK values of GM and FA values of WM may as a be highly sensitive biomarker for the degree of cervical spinal cord damage.
Kayser–Fleischer ring with keratoconus: a coincidence? A case report
Authors: Hu Peike , Lin Lin , Wu Zhiyi , Jin Xiuming , Ni Hailong
Published: May 2020

Background

It is rare for hepatolenticular degeneration [Wilson’s disease (WD)] to occur along with keratoconus (KC). In our report, a teenager was diagnosed with WD because of the discovery of Kayser–Fleischer (KF) ring in the cornea, and concomitant KC was found.

Case presentation

A 19-year-old male was diagnosed with KC due to a rapid decline in visual acuity within a short period of time. Ocular examination revealed the presence of ring-shaped, dense, brown sediment at the Descemet membrane of the bilateral limbus cornea, exhibiting characteristics similar to those of KF ring. Then, the patient was referred to the Department of Neurology and diagnosed with asymptomatic WD. During the next 5 years of follow-up, the patient has worn RGP lenses, routinely taken drugs that inhibit copper absorption and promote copper excretion, and maintained a low-copper diet. He has never exhibited obvious systemic symptoms associated with WD, such as neurological, mental, or hepatic dysfunction, and the color of the KF ring has grown obviously lighter. Moreover, the morphology of the cornea has stabilized.

Conclusion

Only one report of WD combined with KC was found in the literature. So far, there is no evidence of a correlation between the occurrence of the two diseases. However, a low-copper diet and active copper-reducing therapy may have played a role in stabilizing the patient’s condition in this case.
Depression, anxiety and associated factors among housemaids working in Addis Ababa Ethiopia
Authors: Ejigu Alem K. , Seraj Zahra R. , Gebrelibanos Mahlet W. , Jilcha Tolesa F. , Bezabih Yodit H.
Published: May 2020

Background

Housemaids are part of women with low socioeconomic status and most of them are migrant from rural to central part of Ethiopia, less educated, either with poor, separated, single or divorced family and/or dead parents. Housemaid may experience problems like depression and anxiety more than other groups of women. Therefore, the aim of this study was to assess the magnitude and determinants of those problems among housemaids.

Objective

To assess the magnitude and determinants of depression & anxiety among housemaids in Addis Ababa; Ethiopia; 2018.

Methods

Community based cross-sectional study was conducted from May 1 to August 30, 2018 among housemaids working in Addis Ababa, Ethiopia. Multistage sampling technique was applied with a total of 826 samples. Quantitative data was employed by using structured questionnaires. The collected data was coded, entered in to Epi-Info version 7 and analyzed by using SPSS version 20. Descriptive, analytical statistical procedures; bivariate and multivariate binary logistic regressions with odds ratios and 95% confidence interval was employed. The statistical significance was declared at p value < 0.05.

Results

This study enrolled 862 participants with response rate 99.5%, 99.5% refers to the number of people who actually completed the interview. The result showed prevalence of depression and anxiety among housemaids 27.5% and 32.3% respectively. Among all participants 44.6% (95% CI= 41.0 – 47.9) have mild, 18.5% (95% CI= 15.7 – 21.2) have moderate and 6.1% (95% CI= 4.5 – 7.8) have severe form of comorbid anxiety with depression. Depression (44.9%) and anxiety (41.9%) found more prevalent among the age group 16 to 20. In this study history of parental divorce, participant’s divorce, physical violence and sexual violence are positively associated. Other factors; being less educated and living with relatives; were associated negatively.

Conclusion

The prevalence of Depression and Anxiety is found high among housemaid; its prevalence is more among age group 16 to 20 than other age groups. Violence, participant’s divorce, history of parental divorce and contraceptive use has positively associated with depression and anxiety.
The neighborhood food environment modifies the effect of the 2009 WIC food package change on childhood obesity in Los Angeles County, California
Authors: Anderson Christopher E. , Crespi Catherine M. , Wang May C. , Whaley Shannon E. , Chaparro M. Pia
Published: May 2020

Background

Food packages provided by the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were revised in 2009 to better align them with the Dietary Guidelines for Americans. This study was conducted to evaluate whether the effect of the food package change on childhood obesity varied by the food environment in the neighborhoods where WIC-participating children live.

Methods

Administrative data from participating children in Los Angeles County, California (2003–2016) were merged with geocoded food vendor information by neighborhood of residence. Obesity risk at age 4 was compared between children receiving old (2003–2009) and new (2010–2016) WIC food packages using sex-stratified Poisson regression models, with interaction terms between WIC package and neighborhood density (number per square mile) of healthy and unhealthy food outlets.

Results

The new food package was associated with a significant decrease in obesity risk. Among boys, the new food package was associated with 8 to 18% lower obesity risk at all healthy and unhealthy food outlet densities, and the association was not modified by neighborhood food outlet density. Among girls, the association of the new food package with obesity risk was protective in neighborhoods with high healthy and low unhealthy food outlet densities, and adverse in neighborhoods with high unhealthy and low healthy food outlet densities. The effect of the new food package among girls was modified by unhealthy food outlet density, with significantly smaller (p-value = 0.004) decreases in obesity risk observed in neighborhoods with higher unhealthy food outlet density.

Conclusions

The impact of the food package change was modified by the neighborhood food environment among girls only. Future policy changes should incorporate consideration of ways to mitigate potentially inequitable geographic distribution of the health benefits of policy changes.
Risk perception and behavior in Egyptian adolescent pesticide applicators: an intervention study
Authors: Rohlman Diane S. , Davis Jonathan W. , Ismail Ahmed , Abdel Rasoul Gaafar M. , Hendy Olfat , Olson James R. , Bonner Matthew R.
Published: May 2020

Background

Adolescents are engaged in agricultural work, including pesticide application, around the world. Adolescent pesticide applicators are more likely to be exposed to pesticides than their adult counterparts because of their application practice and hygiene habits surrounding pesticide use. There is a need for low-cost interventions to reduce pesticide exposure. We evaluated a theoretically-based educational intervention to change perceptions about the risk of pesticide use and hygiene habits during and after pesticide application for adolescent and young adult pesticide applicators in Egypt.

Methods

Young adult and adolescent male pesticide applicators were given a one-hour educational intervention to inform them about the risk of pesticide use and how to reduce pesticide exposure. The median age of participants was 18 years old. Changes in perceived susceptibility and effectiveness were measured with a survey pre and post-intervention (n = 119) on the same day. The same survey (n = 95) was given 8-months post-intervention to identify sustained effects. Observational checklists of pesticide application practice were also completed during application seasons before and after the intervention.

Results

There was an increase in the proportion of individuals who viewed pesticides as being a long-term health risk (74.7% pre-intervention to 97.9% post-intervention, McNemar testp < 0.001). This change remained significant when surveyed at the 8-month follow-up (90.5%,p < 0.001). There was also a sustained improvement regarding participants’ views of proper hygiene practice surrounding pesticide application. Applicators were observed wearing goggles, shoes, and masks more frequently post-intervention.

Conclusion

This theoretically-based intervention is an example of a low-cost solution that can improve adolescents’ and young adults’ practices regarding pesticide application and personal hygiene practices during and after pesticide application. The intervention can be applied in other countries with similar safety culture surrounding pesticide application.
The effect of health education on knowledge and behavior toward respiratory infectious diseases among students in Gansu, China: a quasi-natural experiment
Authors: Wang Manli , Fang Haiqing
Published: May 2020

Background

The respiratory infectious diseases (RID) threaten the health and life quality of school students. However, previous related studies were insufficient in research design and method applied. This study aimed to evaluate the effect of health education on the knowledge and behavior of students toward RID through difference-in-difference (DID) analysis in Gansu, China.

Methods

In 2015–2016, a one-year health education program in Gansu, China was conducted. The intervention group contained 1064 students before and 1001 students after the health education (2015 and 2016, respectively). The control group contained 1018 and 1001 students, respectively. The health education, including playing promotional cartoons, developing lectures, giving out handbook copies and making hand copy and blackboard newspapers, and publicity columns on RID, were conducted monthly from 2015 to 2016 in intervention group. The data were collected before and after the health education program with a questionnaire on the students’ knowledge and preventive behaviors regarding RID. The ×2 and t tests were performed to compare the accuracy rate and scores for RID knowledge and behavior of the two groups. DID estimation was conducted to evaluate the effect of health education on RID knowledge and behavior while controlling the non- equilibrium variables.

Results

After the health education program, the accuracy rate and scores of most items in the intervention group were significantly higher than those in the control group (P < 0.05) except for item k9 “What methods can prevent flu?”. The DID results wherein the demographics- age, nationality, and household register were controlled showed that health education significantly improved the accuracy rate of RID knowledge by 5.2–63.9% for most items, although the accuracy rates of items k2 “What’s the transmission way of the mumps?” and k9 were significantly decreased by 36.8 and 12.0%. The health education significantly improved the score of knowledge by 155.2% (P < 0.001) and the accuracy rate of all items of RID behavior by 2.9–51.5% except for item b3 “If you have phlegm, how do you usually deal with it?”. In addition, the health education also significantly improved the score of behavior toward RID of the sampled students by 138.2% (P < 0.001).

Conclusion

The results of this study show that health education seemed to increase the RID knowledge and behavior of students. It is recommended that the health education should be enhanced and popularized in schools of China, and RID transmission routes and prevention methods should attract more attention.
Ethical issues and practical barriers in internet-based suicide prevention research: a review and investigator survey
Authors: Bailey Eleanor , Mühlmann Charlotte , Rice Simon , Nedeljkovic Maja , Alvarez-Jimenez Mario , Sander Lasse , Calear Alison L. , Batterham Philip J. , Robinson Jo
Published: May 2020

Background

People who are at elevated risk of suicide stand to benefit from internet-based interventions; however, research in this area is likely impacted by a range of ethical and practical challenges. The aim of this study was to examine the ethical issues and practical barriers associated with clinical studies of internet-based interventions for suicide prevention.

Method

This was a mixed-methods study involving two phases. First, a systematic search was conducted to identify studies evaluating internet-based interventions for people at risk of suicide, and information pertaining to safety protocols and exclusion criteria was extracted. Second, investigators on the included studies were invited to complete an online survey comprising open-ended and forced-choice responses. Quantitative and qualitative methods were used to analyse the data.

Results

The literature search identified 18 eligible studies, of which three excluded participants based on severity of suicide risk. Half of the 15 suicide researchers who participated in the survey had experienced problems obtaining ethics approval, and none had encountered adverse events attributed to their intervention. Survey respondents noted the difficulty of managing risk in online environments and the limitations associated with implementing safety protocols, although some also reported increased confidence resulting from the ethical review process. Respondents recommended researchers pursue a collaborative relationship with their research ethics committees.

Conclusion

There is a balance to be achieved between the need to minimise the risk of adverse events whilst also ensuring interventions are being validated on populations who may be most likely to use and benefit from them (i.e., those who prefer anonymity). Further research is required to obtain the views of research ethics committees and research participants on these issues. Dialogue between researchers and ethics committees is necessary to address the need to ensure safety while also advancing the timely development of effective interventions in this critical area.
Examining the translational success of an initiative to accelerate the assessment of chest pain for patients in an Australian emergency department: a pre-post study
Authors: Greenslade Jaimi H. , Ho Ariel , Hawkins Tracey , Parsonage William , Crilly Julia , Cullen Louise
Published: May 2020

Background

The Improved assessment of chest pain trial (IMPACT) protocol is an accelerated strategy for the risk stratification and management of patients presenting to the emergency department (ED) with chest pain. This study sought to describe the adoption, sustainability and health services implications of implementing the IMPACT protocol.

Methods

This was a study of adult patients in a large Australian tertiary hospital who had serial troponin testing commenced within the ED. Data from two periods were utilized; the pre-implementation period (8th April 2012 to 5th April 2014) and the post-implementation period (6th April 2014 to 2nd April 2016). The primary outcome was the proportion of patients undergoing accelerated care. Secondary endpoints were ED assessment time, hospital length of stay, and costs. Data were compared in the pre- and post-implementation periods.

Results

The proportion of patients receiving accelerated care increased from 3% in the pre- to 34% in the post-intervention period. This increase occurred rapidly after implementation of IMPACT and was sustained over a 2-year period. For patients with troponin concentrations <99th percentile, the mean ED assessment time reduced from 12.3 h in the pre- to 10.1 h in the post-implementation period. Mean hospital length of stay was similar in the pre- and post-implementation periods (82.4 and 80.9 h). The average cost of chest pain assessment reduced from $3520 pre implementation to $3204 post implementation; a $316 reduction per patient.

Conclusions

The IMPACT protocol was rapidly adopted and utilised after implementation into standard care. The initial increase in the proportion of patients undergoing accelerated assessment, followed by a plateau towards the end of the study period indicate adoption and sustainability of the IMPACT protocol over a two-year period. Modest reductions in length of stay and cost were seen after implementation. Given the large number of patients investigated for chest pain, such reductions may have substantial impact on the overall healthcare system.