bluuebunny/crossref_metadata_2025 huggingface dataset:
An investigation of Stenotrophomonas maltophilia-positive culture caused by fiberoptic bronchoscope contamination
Authors: Liu Bende , Tong Shenglan
Published: December 2019

Background

Stenotrophomonas maltophilia (SMA) is present in hospital environments and has been one of the pathogens that cause nosocomial contamination and infections. To investigate the occurrence of Stenotrophomonas maltophilia (SMA) in bronchoscope lavage fluid (BALF) among 25 cases treated in the Division of Infection and to trace the contamination source and transmission route.

Methods

25 cases of SMA positive BALF occurring from May 11 to August 10, 2018 were tested for drug sensitivity. Environmental hygiene conditions were investigated to identify the source of contamination and the route of transmission.

Results

BALF associated SMA was in all cases sensitive to minocycline, levofloxacin and chloramphenicol and resistant to ceftazidime and imipenem. 92.3% of samples were sensitivity to compound sulfamethoxazole. Investigation of environmental hygiene parameters revealed SMA growing on the inner wall of the fiberoptic bronchoscope as a likely source of contamination.

Conclusion

Incomplete cleaning and sterilization of the fiberoptic bronchoscope led to SMA nosocomial contamination. Strict sterilization procedures are required to prevent and control nosocomial contamination.
Factors affecting HIV counselling and testing among Ethiopian women aged 15–49
Authors: Erena Asfaw Negero , Shen Guanxin , Lei Ping
Published: December 2019

Background

HIV voluntary counseling and testing (VCT) is a crucial gateway to all strategies related to care, prevention and treatment of human immunodeficiency virus (HIV) infection. Nevertheless, utilization of voluntary counselling and testing (VCT) service among adults is very low in Ethiopia. The objective of this study is to identify determinants associated with VCT utilization among adult women aged 15–49 in Ethiopia.

Methods

A cross–sectional study was conducted based on data taken from the Ethiopian Demographic Health Survey (EDHS) 2016. Using cluster sampling, 14,369 women aged 15–49 years were selected from all the nine administrative regions and two city administrations. Logistic regression was used to analyze factors associated with HIV VCT utilization.

Results

Overall prevalence of ever tested for HIV was 53% (95% CI, 52, 54). Aged 20–44, ever married, being at higher socio economic position (SEP) and having risky sexual behavior were factors which are positively associated with VCT utilization. Being Muslims in urban and protestants in rural were factors significantly and negatively associated with VCT utilization. Those who had stigmatizing attitude both in urban and rural and who had comprehensive knowledge in rural were less likely to utilize VCT service.

Conclusion

VCT utilization among women in Ethiopia is demonstrating better improvement in recent years. However, stigmatizing attitude continued to be among the major factors, which are negatively affecting VCT uptake among women in Ethiopia. Concerted efforts should be made by all stakeholders to mitigate stigma, improve socio economic inequities and increase awareness on the benefit of VCT in controlling HIV in the society. In this aspect, the role of religious leader, schools, health extension workers and community leaders should not be undermined.
Correction to: Analysis of cardiac monitoring and safety data in patients initiating fingolimod treatment in the home or in clinic
Authors: Brown Brandon , Weiss Jamie L. , Kolodny Scott , Meng Xiangyi , Williams Ian M. , Osborne John A.
Published: December 2019

Following publication of the original article [1], the authors reported a mistake regarding the year found in the paragraph of the Background section.
Chinese version of narcolepsy severity scale: a validation study
Authors: Ouyang Hui , Han Fang , Zheng Qiwen , Zhang Jun
Published: December 2019

Background

The narcolepsy severity scale (NSS) was developed to measure the severity and consequences of symptoms in patients with narcolepsy. The scale has been validated in France, though no other studies have further validated this instrument. The current study aimed to present psychometric properties and describe the score distribution of the Chinese-NSS.

Methods

One hundred twenty-two patients with narcolepsy (41 females and 81 males; mean age 26.14 ± 15.40 years) participated in the study. All patients completed the Chinese-NSS. Cronbach’s α, item-total score correlations, exploratory factor analysis (EFA), and correlations between NSS total scores and clinical or sleep parameters were then calculated.

Results

EFA yielded a three-factor model. Internal consistency was acceptable (Cronbach’sα = 0.799). The NSS total score had significant correlations with the Epworth sleepiness score (0.447), pediatric daytime sleepiness scale (0.318), the insomnia severity index (0.592), Beck depression inventory (0.593), EurQol five dimensions-utility (0.457), EurQol five dimensions -VAS (− 0.323), the sleep disturbance scale for children (0.440), the children depression inventory (0.553), and the pediatric quality of life inventory (0.555) total scores, demonstrating acceptable convergence as predicted.

Conclusions

The current study is the first validation study of the narcolepsy severity scale in an Asian population. The findings validated the Chinese-narcolepsy severity scale in a Chinese population with acceptable psychometric properties. There are minor differences between our results and those of the original study due to cultural differences.
Understanding side effects of therapy for myasthenia gravis and their impact on daily life
Authors: Bacci Elizabeth Dansie , Coyne Karin S. , Poon Jiat-Ling , Harris Linda , Boscoe Audra N.
Published: December 2019

Background

Myasthenia gravis is a chronic, autoimmune, neuromuscular junction disorder characterized by skeletal muscle weakness. Current therapies for myasthenia gravis are associated with significant side effects. The objective of this study was to characterize the side effects, and associated health-related quality of life and treatment impacts, of traditional myasthenia gravis treatments.

Methods

This study had two phases; a Phase 1 interview and a 2-part web-based survey in Phase 2 that included brainstorming (Step 1) and rating (Step 2) exercises using group concept mapping. In Phase 1, all 14 participants reported experiencing side effects from myasthenia gravis treatments which had significant impacts on daily life. In Phase 2, 246 participants contributed to Step 1; 158 returned for Step 2.

Results

The brainstorming exercise produced 874 statements about side effects and their impact, which were reduced to 35 side effects and 23 impact-on-daily life statements. When rating these statements on severity, frequency, and tolerability, blood clots, infections/decreased immunity, weight gain, and diarrhea were the least tolerable and most severely rated. The most frequent and severe impacts were sleep interference and reduced physical and social activities.

Conclusions

Based on these findings, there appears to be a need for better and more tolerable treatments for myasthenia gravis patients.
Clinical value of vestibular-evoked myogenic potential tests in patients with sudden sensorineural hearing loss
Authors: Wang Yuan , Gu Shun-Tong , Bao Xiao-Lin , Guo Jia-Liang
Published: December 2019

Background

This study aims to investigate the clinical value of two kinds of vestibular-evoked myogenic potentials in patients with sudden sensorineural hearing loss (SSNHL).

Methods

A total of 82 patients were divided into two groups: vertigo group and non-vertigo group. All patients underwent examinations for pure tone hearing thresholds, middle ear analysis, the videonystagmography, caloric tests, and vestibular-evoked myogenic potentials elicited from the sternocleidomastoid and extraocular muscle. In addition, 30 healthy subjects were selected as the control group.

Results

For the 30 healthy subjects, the average latency of p13 and n23 of the cervical vestibular evoked myogenic potentials (cVEMPs) were 13.13 ± 2.89 ms and 23.51 ± 3.25 ms, respectively, and the bilateral amplitude asymmetry rate ranged within 0.05–0.31. The average latency of n10 of the ocular vestibular evoked myogenic potentials (oVEMPs) was 10.13 ± 0.48 ms. The average amplitude of the n10-p15-wave was 5.58 ± 0.65 μV. Among the 35 vertigo patients with SSNHL, 27 patients had normal cVEMP and oVEMP examination results, five patients had abnormal oVEMP examination results, and five patients had abnormal cVEMP examination results. The latency and amplifier of oVEMPs and cVEMPs were within the normal range in 47 SSNHL patients without vertigo. The chi-square value was 5.647, theP-value was equal to 0.017, and the difference was statistically significant at a confidence interval of 95%.

Conclusions

OVEMPs and cVEMPs can be used evaluate the vestibular nerve function of SSNHL patients with vertigo.
Mapping the trajectories for women and their babies from births planned at home, in a birth centre or in a hospital in New South Wales, Australia, between 2000 and 2012
Authors: Scarf Vanessa L. , Viney Rosalie , Yu Serena , Foureur Maralyn , Rossiter Chris , Dahlen Hannah , Thornton Charlene , Cheah Seong Leang , Homer Caroline S. E.
Published: December 2019

Background

In New South Wales (NSW) Australia, women at low risk of complications can choose from three birth settings: home, birth centre and hospital. Between 2000 and 2012, around 6.4% of pregnant women planned to give birth in a birth centre (6%) or at home (0.4%) and 93.6% of women planned to birth in a hospital. A proportion of the woman in the home and birth centre groups transferred to hospital. However, their pathways or trajectories are largely unknown.

Aim

The aim was to map the trajectories and interventions experienced by women and their babies from births planned at home, in a birth centre or in a hospital over a 13-year period in NSW.

Methods

Using population-based linked datasets from NSW, women at low risk of complications, with singleton pregnancies, gestation 37–41 completed weeks and spontaneous onset of labour were included. We used a decision tree framework to depict the trajectories of these women and estimate the probabilities of the following: giving birth in their planned setting; being transferred; requiring interventions and neonatal admission to higher level hospital care. The trajectories were analysed by parity.

Results

Over a 13-year period, 23% of nulliparous and 0.8% of multiparous women planning a home birth were transferred to hospital. In the birth centre group, 34% of nulliparae and 12% of multiparas were transferred to a hospital. Normal vaginal birth rates were higher in multiparous women compared to nulliparous women in all settings. Neonatal admission to SCN/NICU was highest in the planned hospital group for nulliparous women (10.1%), 7.1% for nulliparous women planning a birth centre birth and 5.1% of nulliparous women planning a homebirth. Multiparas had lower admissions to SCN/NICU for all thee settings (hospital 6.3%, BC 3.6%, home 1.6%, respectively).

Conclusions

Women who plan to give birth at home or in a birth centre have high rates of vaginal birth, even when transferred to hospital. Evidence on the trajectories of women who choose to give birth at home or in birth centres will assist the planning, costing and expansion of models of care in NSW.
Men’s knowledge and involvement on obstetric danger signs, birth preparedness and complication readiness in Burayu town, Oromia region, Ethiopia
Authors: Gize Addisu , Eyassu Alemtsehay , Nigatu Balkachew , Eshete Mekonen , Wendwessen Nebiyou
Published: December 2019

Background

Men’s involvement in obstetrics care is an important strategy in reducing preventable maternal morbidity and mortality. This is particularly important in developing countries where men often make decision on financial, health and other family issues. Hence, the objective of this study was to assess men’s knowledge and involvement in obstetric danger signs; birth preparedness and complication readiness in Burayu town administration, Oromia, Ethiopia.

Methods

A community based cross-sectional study was conducted in Burayu town administration, Oromia Region from May 2016 to July 2016. Multistage with systematic random sampling techniques were employed. Bivariate and multivariate logistic regression analyses were performed using SPSS version 20. P-value less than 0.05 were taken as a cutoff point to declare significant association.

Result

A total of 523 men were involved in the study. The mean and ± SD age of the study participant was 36.6 ± 7 years. Majority of the participants were Orthodox religion followers and, employees of private organization, regarding residency majority were residing in urban setting.

Pregnancy related vaginal bleeding was the most familiar danger sign recognized by the study participants which was 342(65.4%).

From the total, 441(84.3%) of men were highly involved in preparation of arranging for postpartum cultural food expenses, 345(66.0%) for clean clothes both for the baby and mother; and 71–76% participants were involved in availing transport money for antenatal, delivery and postnatal care. The study revealed that educational status of men, monthly income, knowledge of pregnancy danger sign, delivery and post-delivery care, and knowledge of birth preparedness and complication readiness (BP/CR) were significantly associated with men’s involvement in BP/CR.

Conclusion

Majority of participants had knowledge on obstetric danger sign. Men showed low interest to donate blood to their wives during antenatal, delivery and postpartum care. There is a need continued awareness creation on danger sings as well as birth preparedness.
Factors associated with neonatal near-miss in selected hospitals of Gamo and Gofa zones, southern Ethiopia: nested case-control study
Authors: Mersha Abera , Bante Agegnehu , Shibiru Shitaye
Published: December 2019

Background

To scale up a comprehensive way of implementation to reduce neonatal mortality evaluation of factors for neonatal near-miss cases is very important. Certain studies were done in assessing near-miss cases, but they failed in identifying the proximate factors affecting profoundly. So, this study is to fill those gaps in the aforementioned studies, in assessing the factors affecting neonatal near-miss cases.

Methods

A nested case-control study was conducted in selected three Hospitals of Gamo and Gofa Zones, Southern Ethiopia from April 5, 2018, to March 5, 2019. The structured standard tool was used to identify neonatal near-miss cases. Data were entered into Epi data version 3.1 and exported to Stata version 15 for analysis. A conditional logistic regression model was used to identify factors associated with near-miss cases. The goodness of fit was tested by a log-likelihood ratio (LR). In this study P-value < 0.05 was considered to declare a result as a statistically significant association.

Results

In this study 121 neonatal near-miss cases, and 363 controls were involved. The identified factors that affect neonatal near-miss were multiparty (AOR = 3.81, 95%CI: 1.72, 8.42), antenatal care follow up (AOR = 0.02, 95%CI: 0.01, 0.05), premature rupture of membrane (AOR = 3.40, 95%CI: 1.53, 7.55), non-vertex presentation (AOR = 2.83, 95%CI: 1.44, 5.58), and cesarean delivery (AOR = 4.89, 95%CI: 2.34, 10.24).

Conclusions

Those identified factors are better should be intervened. Strengthening antenatal care services by providing appropriate information for the mother and counseling about the consequences of multiparty and providing information on family planning. There is a need to identify, screen and critical follow high-risk mothers and give immediate and appropriate intervention as early as possible.
Causes of death in patients with locally advanced head and neck cancer treated with radiotherapy and systemic therapy
Authors: Zapata I. , Alvarez M. , Hidalgo R. , Pajares B. , Garcia-Anaya M. J. , Toledo M. D. , Trigo J. M. , Lupiañez-Perez Y. , Medina J. A. , Jaime Gomez-Millan J.
Published: December 2019

Background

To investigate the incidence of non-cancer mortalities and prognostic factors associated with competitive causes of death in a homogeneous cohort of patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment.

Methods

This study included 284 patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment between 2005 and 2017. The cumulative incidence of death associated with tumour, second tumours, treatment, side effects and comorbidity was calculated. A Fine and Gray regression model was used to investigate factors associated with cancer and competitive mortality.

Results

The cumulative incidence of tumoral death at 5 and 10 years were 35 and 47% respectively, whereas the cumulative incidence of competitive mortality were 10 and 12% respectively. In the multivariate analysis, age and comorbidity were independent factors for non-cancer mortality. Patients with a high risk of non-cancer mortality presented a cumulative incidence of 17.3% at 5 years and 18.4% at 10 years.

Conclusions

This study demonstrated a high incidence of competing mortality in older patients with comorbidities. Non-cancer deaths should be considered when selecting patients for combination therapies and in the study design ofclinical trials.
Mesenchymal stem cells promote glioma neovascularization in vivo by fusing with cancer stem cells
Authors: Sun Chao , Dai Xingliang , Zhao Dongliang , Wang Haiyang , Rong Xiaoci , Huang Qiang , Lan Qing
Published: December 2019

Background and objective

Tumor angiogenesis is vital for tumor growth. Recent evidence indicated that bone marrow-derived mesenchymal stem cells (BMSCs) can migrate to tumor sites and exert critical effects on tumor growth through direct and/or indirect interactions with tumor cells. However, the effect of BMSCs on tumor neovascularization has not been fully elucidated. This study aimed to investigate whether fusion cells from glioma stem cells and BMSCs participated in angiogenesis.

Methods

SU3-RFP cells were injected into the right caudate nucleus of NC-C57Bl/6 J-GFP nude mice, and the RFP+/GFP+ cells were isolated and named fusion cells. The angiogenic effects of SU3-RFP, BMSCs and fusion cells were compared in vivo and in vitro.

Results

Fusion cells showed elevated levels of CD31, CD34 and VE-Cadherin (markers of VEC) as compared to SU3-RFP and BMSCs. The MVD-CD31 in RFP+/GFP+ cell xenograft tumor was significantly greater as compared to that in SU3-RFP xenograft tumor. In addition, the expression of CD133 and stem cell markers Nanog, Oct4 and Sox2 were increased in fusion cells as compared to the parental cells. Fusion cells exhibited enhanced angiogenic effect as compared to parental glioma cells in vivo and in vitro, which may be related to their stem cell properties.

Conclusion

Fusion cells exhibited enhanced angiogenic effect as compared to parental glioma cells in vivo and in vitro, which may be related to their stem cell properties. Hence, cell fusion may contribute to glioma angiogenesis.
Non-destructive, label free identification of cell cycle phase in cancer cells by multispectral microscopy of autofluorescence
Authors: Campbell Jared M. , Habibalahi Abbas , Mahbub Saabah , Gosnell Martin , Anwer Ayad G. , Paton Sharon , Gronthos Stan , Goldys Ewa
Published: December 2019

Background

Cell cycle analysis is important for cancer research. However, available methodologies have drawbacks including limited categorisation and reliance on fixation, staining or transformation. Multispectral analysis of endogenous cell autofluorescence has been shown to be sensitive to changes in cell status and could be applied to the discrimination of cell cycle without these steps.

Methods

Cells from the MIA-PaCa-2, PANC-1, and HeLa cell lines were plated on gridded dishes and imaged using a multispectral fluorescence microscope. They were then stained for proliferating cell nuclear antigen (PCNA) and DNA intensity as a reference standard for their cell cycle position (G1, S, G2, M). The multispectral data was split into training and testing datasets and models were generated to discriminate between G1, S, and G2 + M phase cells. A standard decision tree classification approach was taken, and a two-step system was generated for each line.

Results

Across cancer cell lines accuracy ranged from 68.3% (MIA-PaCa-2) to 73.3% (HeLa) for distinguishing G1 from S and G2 + M, and 69.0% (MIA-PaCa-2) to 78.0% (PANC1) for distinguishing S from G2 + M. Unmixing the multispectral data showed that the autofluorophores NADH, FAD, and PPIX had significant differences between phases. Similarly, the redox ratio and the ratio of protein bound to free NADH were significantly affected.

Conclusions

These results demonstrate that multispectral microscopy could be used for the non-destructive, label free discrimination of cell cycle phase in cancer cells. They provide novel information on the mechanisms of cell-cycle progression and control, and have practical implications for oncology research.
Focused screening reveals functional effects of microRNAs differentially expressed in colorectal cancer
Authors: Sastre Danuta , Baiochi João , de Souza Lima Ildercilio Mota , Canto de Souza Felipe , Corveloni Amanda Cristina , Thomé Carolina Hassib , Faça Vitor Marcel , Schiavinato Josiane Lilian dos Santos , Covas Dimas Tadeu , Panepucci Rodrigo Alexandre
Published: December 2019

Background

Colorectal cancer (CRC) is still a leading cause of death worldwide. Recent studies have pointed to an important role of microRNAs in carcinogenesis. Several microRNAs are described as aberrantly expressed in CRC tissues and in the serum of patients. However, functional outcomes of microRNA aberrant expression still need to be explored at the cellular level. Here, we aimed to investigate the effects of microRNAs aberrantly expressed in CRC samples in the proliferation and cell death of a CRC cell line.

Methods

We transfected 31 microRNA mimics into HCT116 cells. Total number of live propidium iodide negative (PI-) and dead (PI+) cells were measured 4 days post-transfection by using a high content screening (HCS) approach. HCS was further used to evaluate apoptosis (via Annexin V and PI staining), and to discern between intrinsic and extrinsic apoptotic pathways, by detecting cleaved Caspase 9 and 8, respectively. To reveal mRNA targets and potentially involved mechanisms, we performed microarray gene expression and functional pathway enrichment analysis. Quantitative PCR and western blot were used to validate potential mRNA targets.

Results

Twenty microRNAs altered the proliferation of HCT116 cells in comparison to control. miR-22-3p, miR-24-3p, and miR-101-3p significantly repressed cell proliferation and induced cell death. Interestingly, all anti-proliferative microRNAs in our study had been previously described as poorly expressed in the CRC samples. Predicted miR-101-3p targets that were also downregulated by in our microarray were enriched for genes associated with Wnt and cancer pathways, including MCL-1, a member of the BCL-2 family, involved in apoptosis. Interestingly, miR-101-3p preferentially downregulated the long anti-apoptotic MCL-1 L isoform, and reduced cell survival specifically by activating the intrinsic apoptosis pathway. Moreover, miR-101-3p also downregulated IL6ST, STAT3A/B, and MYC mRNA levels, genes associated with stemness properties of CRC cells.

Conclusions

microRNAs upregulated in CRC tend to induce proliferation in vitro, whereas microRNAs poorly expressed in CRC halt proliferation and induce cell death. We provide novel evidence linking preferential inhibition of the anti-apoptotic MCL-1 L isoform by miR-101-3p and consequent activation of the intrinsic apoptotic pathway as potential mechanisms for its antitumoral activity, likely due to the inhibition of the IL-6/JAK/STAT signaling pathway.
Risk factors for glial cell proliferation after idiopathic macular hole repair with internal limiting membrane flap
Authors: Liu Yuyan , Wu Changlong , Wang Ying , Dong Yi , Liang Dongqing , Xiao Bo , Han Quanhong , Chu Yanhua
Published: December 2019

Background

To study the influencing factors for different healing patterns of patients with idiopathic macular holes (IMH) after vitrectomy surgery performed with the internal limiting membrane (ILM) flap technique.

Methods

This study was a retrospective, consecutive, observational case series study. We recruited 52 IMH patients who underwent vitrectomy with the ILM flap technique. The participants were divided into 2 groups: group A (25 patients), without significant glial cell proliferation in the macular area on postoperative optical coherence tomography (OCT); and group B (27 patients), with significant glial cell proliferation. The postoperative visual acuity (VA), external limiting membrane (ELM) and ellipsoid zone (EZ) recovery characteristics were compared between the two groups.

Results

There were statistically significant differences in minimum linear diameter (MLD) of the macular hole and postoperative VA (p = 0.02, 2.81 E-4 respectively) between the two groups. Compared with patients in group A, patients in group B had poorer VA and EZ recovery in the first 12 months after surgery, and a longer ELM recovery period. The OCT results showed that patients in group B had more extensive ILM filling in the macular area after surgery than patients in group A.

Conclusion

The presence of aberrant glial cell proliferation was related to a larger MLD of the IMH, and the filling approach for the ILM during the operation was related to the postoperative healing pattern and vision acuity.
Macular hole surgery recovery with and without face-down posturing: a meta-analysis of randomized controlled trials
Authors: Ye Ting , Yu Ji-guo , Liao Lin , Liu Lan , Xia Ting , Yang Lei-lei
Published: December 2019

Background

After pars plana vitrectomy with internal limiting membrane (ILM) peeling and gas tamponade, patients are often required to remain in a face-down position (FDP) to allow the gas bubble to push against the macular hole (MH) to promote hole closure. However, this position may be uncomfortable and inconvenient for the elderly and those with medical comorbidities; it may also lead to certain postoperative complications. Hence, this study aimed to evaluate and compare the effect of postoperative FDP and non-face-down position (nFDP) on the closure rate of MHs following MH surgery.

Methods

Randomized controlled trials (RCTs) were selected through an electronic search of the Cochrane Library, Pubmed, and Embase databases. Trial eligibility and risk of bias were assessed according to Cochrane review methods. The primary measures included overall MH closure rate and subgroup analysis based on MH size. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Statistical analysis was performed using RevMan 5.0 software and Stata software 15.0.

Results

Five RCTs composed of a total of 183 eyes in the FDP group and 175 eyes in the nFDP group were included in this meta-analysis. Statistical meta-analysis revealed that the overall MH closure rate in the FDP group was significantly higher than that in the nFDP group (OR = 2.27, 95% CI: 1.02 to 5.05, P = 0.04). For MH sizes smaller than 400 μm, the subgroup meta-analysis indicated that the closure rate of the FDP group was not significantly higher than that of the nFDP group (OR = 1.32, 95% CI: 0.39 to 4.49, P = 0.66). However, when MH size was larger than 400 μm, there was a significantly higher closure rate in the FDP group (OR = 2.95, 95% CI: 1.10 to 7.94, P = 0.03).

Conclusions

Our results provide evidence that a face-down postoperative position seems to be unnecessary when MHs are smaller than 400 μm but may be highly recommended for MHs larger than 400 μm. Further RCTs with large sample sizes are warranted to validate these findings in future.
Gross motor developmental dysfunctional outcomes in infantile and toddler pediatric intensive care unit survivors
Authors: Yang Chun-Feng , Xue Yang , Feng Jun-Yan , Jia Fei-Yong , Zhang Yu , Li Yu-Mei
Published: December 2019

Background

Increasing studies have focused on motor function/dysfunction in PICU survivors; however, most studies have focused on adults and older children. This study investigated gross motor developmental function outcomes in infantile and toddler pediatric intensive care unit (PICU) survivors and the factors associated with gross motor developmental functions.

Methods

This observational study was conducted in the PICU of the First Hospital of Jilin University between January 2019 and March 2019. Thirty-five eligible patients were divided into the dysfunctional (n = 24) or non-dysfunctional (n = 11) group according to the results of the Peabody Developmental Motor Scales, Second Edition (PDMS-2). Baseline gross motor function for all participants before PICU admission was measured via the Age and Stages Questionnaires, Third Edition (ASQ-3). The PDMS-2 was used to evaluate gross motor development function before PICU discharge.

Results

The gross motor developmental dysfunction incidence was 68.6%. Linear correlation analysis showed that the gross motor quotient (GMQ) was positively correlated with the pediatric critical illness score (PCIS, r = 0.621, P < 0.001), and negatively correlated with length of PICU stay (r = − 0.556, P = 0.001), days sedated (r = − 0.602, P < 0.001), days on invasive mechanical ventilation (IMV; r = − 0.686, P < 0.001), and days on continuous renal replacement therapy (CRRT; r = − 0.538, P = 0.001). Linear regression analysis showed that IMV days (β = − 0.736, P = 0.001), sepsis (β = − 18.111, P = 0.003) and PCIS (β = 0.550, P = 0.021) were independent risk factors for gross motor developmental dysfunction.

Conclusions

Gross motor developmental dysfunction in infantile and toddler PICU survivors is more common and may be exacerbated by experiences associated with longer IMV days and increasing illness severity combined with sepsis.

Trial registration

The trial ‘Early rehabilitation intervention for critically ill children’ has been registered at http://www.chictr.org.cn/showproj.aspx?proj=23132. Registration number: ChiCTR1800020196.
High level of pattern glare in major depressive disorder
Authors: Qi Xiongwei , Fan Huanhuan , Yang Xiao , Chen Yayun , Deng Wei , Guo Wanjun , Wang Qiang , Chen Eric , Li Tao , Ma Xiaohong
Published: December 2019

Background

Visual deficits have been reported in abundance by recent studies on major depressive disorder. Pattern glare manifests as visual distortions, such as the symptoms of headache, glare, eyestrain, illusions of shapes, colors, and motion when viewing repetitive striped patterns, of which some can be observed in major depressive disorder. Inspired by what mentioned, the present study aims to explore whether there exists association between pattern glare and major depressive disorder and further attempts to explore possible clinical diagnostic value of pattern glare in major depressive disorder.

Methods

Twenty-four patients diagnosed with major depressive disorder (MDDs group) were compared with 30 age-, gender- and education level-matched healthy control subjects (HCs group) on their visual stress with black-and-white gratings of different spatial frequencies-0.3 (low-SF), 2.3 (mid-SF), and 9.4 (high-SF) cycles per degree (c/deg)-which was named pattern glare test. The MDDs group divided into first episode medication-free group (fMDD) and recurrent medicated group (rMDD), comparisons of pattern glare scores (PGS) were performed within the MDDs group. We used Pearson and Spearman analysis to explore the relationship between some clinical indexes and pattern glare scores. ROC (receiver operating characteristic) curve was used to evaluate whether pattern glare test was able to discriminate patients and healthy controls.

Results

The mid-SF pattern glare score significantly elevated in patients with major depressive disorder compared to control subjects. No differences of pattern glare scores were found between fMDD and rMDD. A significant negative correlation between mid-high difference and age in HCs group was found. There were no correlations between other variables and pattern glare scores. The mid-SF score has limited value in the diagnosis of major depressive disorder.

Conclusions

We observed an increased level of pattern glare in patients with major depressive disorder, reflecting the existence of cortical hyper-excitability in major depressive disorder. The mid-SF score may have a value in understanding cortical excitability in major depressive disorder.
A cross-sectional study of mother-child agreement on PTSD symptoms in a south Indian post-tsunami sample
Authors: Exenberger Silvia , Riedl David , Rangaramanujam Kumuthavalli , Amirtharaj Vijai , Juen Florian
Published: December 2019

Background

Few studies examine caregiver-child agreement on posttraumatic stress disorder (PTSD) symptoms in non-Western cultures. The present study investigated mother-child agreement for PTSD symptoms in a South Indian sample, which was affected by the Indian Ocean Tsunami in 2004.

Methods

Data was collected four years post-disaster. In total, 80 mothers rated PTSD symptoms for their 164 children and gave information about their own trauma symptoms. In addition, the children aged 8 to 17 reported about their own PTSD symptoms.

Results

Results showed that mother-child agreement on posttraumatic stress symptoms was poor, and a child’s age, gender and living situation (fishing village vs. family-based out-of-home care) did not positively influence this concordance. Moreover, mothers’ own posttraumatic symptoms were strongly related to maternal reports of the child’s PTSD symptoms. Multivariate analyses showed that mothers’ PTSD symptoms were the only significant predictor for discrepancies in the rating of the child’s PTSD symptoms. That means, if mothers reported clinically relevant PTSD symptoms, the likelihood for disagreement on the child’s PTSD ratings more than doubled. Neither age, nor gender nor the living situation had an influence on children’s self-rated posttraumatic stress reactions.

Conclusions

In general, long-term monitoring of posttraumatic stress symptoms of mothers and children should be planned by relief actions as recovery processes are decelerated through lacking resources in developing countries such as India. Specifically, the assessment of mothers’ trauma symptoms is inevitable because the mothers’ own responses to disaster highly influence their assessment of their children’s symptoms. Mother-child agreement is discussed against the background of socio-cultural aspects.
Current prevalence pattern of tobacco smoking in Nigeria: a systematic review and meta-analysis
Authors: Adeloye Davies , Auta Asa , Fawibe Ademola , Gadanya Muktar , Ezeigwe Nnenna , Mpazanje Rex G. , Dewan Mary T. , Omoyele Chiamaka , Alemu Wondimagegnehu , Harhay Michael O. , Adewole Isaac F.
Published: December 2019

Background

National smoking cessation strategies in Nigeria are hindered by lack of up-to-date epidemiologic data. We aimed to estimate prevalence of tobacco smoking in Nigeria to guide relevant interventions.

Methods

We conducted systematic search of publicly available evidence from 1990 through 2018. A random-effects meta-analysis and meta-regression epidemiologic model were employed to determine prevalence and number of smokers in Nigeria in 1995 and 2015.

Results

Across 64 studies (n = 54,755), the pooled crude prevalence of current smokers in Nigeria was 10.4% (9.0–11.7) and 17.7% (15.2–20.2) for ever smokers. This was higher among men compared to women in both groups. There was considerable variation across geopolitical zones, ranging from 5.4% (North-west) to 32.1% (North-east) for current smokers, and 10.5% (South-east) to 43.6% (North-east) for ever smokers. Urban and rural dwellers had relatively similar rates of current smokers (10.7 and 9.1%), and ever smokers (18.1 and 17.0%). Estimated median age at initiation of smoking was 16.8 years (IQR: 13.5–18.0). From 1995 to 2015, we estimated an increase in number of current smokers from 8 to 11 million (or a decline from 13 to 10.6% of the population). The pooled mean cigarettes consumption per person per day was 10.1 (6.1–14.2), accounting for 110 million cigarettes per day and over 40 billion cigarettes consumed in Nigeria in 2015.

Conclusions

While the prevalence of smokers may be declining in Nigeria, one out of ten Nigerians still smokes daily. There is need for comprehensive measures and strict anti-tobacco laws targeting tobacco production and marketing.
Cluster randomised controlled trial of behavioural intervention program: a study protocol for control of hypertension among teachers in schools in Kerala (CHATS-K), India
Authors: Mini G. K. , Sarma P. S. , Thankappan K. R.
Published: December 2019

Background

Control of blood pressure among hypertensives is a major challenge around the world. Interventions for improving hypertension control in India are very limited. This paper describes the protocol for a cluster randomized controlled trial of efficacy of behavioural intervention on control of hypertension among school teachers in Kerala.

Methods

A total of 92 schools are randomised to intervention and control group in Kerala. A baseline survey was conducted in all schools to assess the prevalence of hypertension and its risk factors among school teachers in Thiruvananthapuram district of Kerala state, India. Teachers in both sets of schools will receive a leaflet containing details on the importance of controlling hypertension. With the objective of improving control of hypertension, the intervention schools will additionally receive self-management education and behavioural intervention programs delivered by trained intervention managers along with measurement of weight, waist circumference and blood pressure. This intervention program will be developed based on the findings of the baseline survey and selected components of successful models of hypertension control from previous research done in similar settings. The intervention will be given for 3 months after which a post-survey will be conducted among teachers of both control and intervention schools. The primary outcome is change in control of hypertension and secondary outcome is the change in behavioural risk factors of hypertension both in the control and intervention groups.

Discussion

This is the first comprehensive study looking at the efficacy of behavioural intervention on hypertension control among school teachers in Kerala, India. This study is likely to provide an upper estimate of behavioural intervention on hypertension control since teachers are reported to have one of the highest compliance rates of behavioural intervention.

Trial registration

This trial was prospectively registered with the Clinical Trials Registry of India [CTRI/2018/01/011402] on 18 January 2018.
Pattern of physical exercise practice among university students in the Kingdom of Saudi Arabia (before beginning and during college): a cross-sectional study
Authors: Alkhateeb Sarah Ahmed , Alkhameesi Najwa Fahad , Lamfon Ghadeer Nazeh , Khawandanh Shahad Zuhair , Kurdi Lujain Khalid , Faran Murooj Yaseen , Khoja Alya Abdullah , Bukhari Lujain Muhammed , Aljahdali Hadeel Rajeh , Ashour Nuha Abdullah , Bagasi Hessan Turki , Delli Raghdah Adel , Khoja Ohood Abdullah , Safdar Osama Yousof
Published: December 2019

Background

Transition to college is characterized by change, ambiguity, and adjustment compared to the previous lifestyle before entering college. Our study aimed was to determine the pattern of students’ physical exercise practices in the Kingdom of Saudi Arabia in the period before and during college attendance.

Methods

A cross-sectional study was conducted among university students from fifteen universities in the Kingdom of Saudi Arabia on August 2017. The data were collected using an electronic questionnaire that was modified from questionnaires used in previous studies. Statistical analysis and data entry was performed with SPSS version 21. This study was approved by the Research Ethics Committee at King Abdulaziz University.

Results

417 college students completed the questionnaire and 77.2% were female. Slightly more than half of the participants (55.9%) were from King Abdulaziz University, and 59.7% were from healthcare specialties from different institutions. The mean age of the participants was 21.80 years old (SD = 2.75). The pattern of practicing physical exercise showed a significant decrease after enrollment in college (p = 0.000). The most common reason for not practicing exercise was time restrictions, accounting for 18.5% of all the reasons, while the most common reason for practicing exercise was to improve body shape, accounting for 48% of all the reasons.

Conclusions

Our research found that there was a significant decrease in doing regular exercise during one’s college years in comparison to the school years prior to college. To address the decrease in physical exercise, we recommend organizing and promoting more awareness campaigns and providing suitable sports facilities and infrastructure.
Loading capacity of dynamic knee spacers: a comparison between hand-moulded and COPAL spacers
Authors: Chong Sook-Yee , Shen Lu , Frantz Sandra
Published: December 2019

Background

The two-stage revision protocol represents the current gold standard for treating infected total knee replacement implants. Allowing early mobility with weight-bearing between staged procedures will enable early restoration to knee function. So, the mechanical performance of knee spacers is a key issue. Commercially available moulds are often used as they are easy to prepare and produce smoother surfaces of the articulating parts. However, they are costly, and only for single use. A cost-effective alternative is the surgeon-made hand-moulded spacers. In this study, we wanted to determine how the hand-moulded spacers will compare biomechanically with the commercially available COPAL spacers.

Methods

Seven cadaveric knees were implanted with knee spacers fabricated using COPAL knee moulds. The same surgeon implanted eight cadaveric knees with hand-moulded spacers. In the first test protocol, an axial load was applied at 200 mm/min till failure. In the second test protocol, the knees were cyclically loaded in five steps of 1000 cycles each from 30-400 N, 30-600 N, 30-800 N, 30-1000 N, 30-1200 N at 1.5 Hz.

Results

COPAL knee spacers demonstrated a maximum load and mean stiffness of 5202 (± 486.9) N and 1098 (± 201.5) N/mm respectively. The hand-moulded knee spacers demonstrated a mean stiffness of 4509 (± 1092.6) N and 1008.7 (± 275.4) N/mm respectively. The maximum axial displacement was 1.19 ± 0.57 mm and 0.89 ± 0.30 mm for specimens implanted with COPAL knee spacers and hand-moulded spacers respectively. The differences between COPAL and hand-moulded knee spacers were not statistically different.

Conclusions

Our study demonstrated that dynamic knee spacers may be able to withstand more than the touch-down load permitted in previous studies, and this may allow more weight-bearing during ambulation. Previous studies have demonstrated that hand-moulded knee spacers have similar advantages to commercially available dynamic spacers with respect to mobility, pain, bone loss, and reinfection rate. Given that ambulation with weight-bearing up to 1200 N is permitted during rehabilitation, it may be more cost-effective to fabricate hand-moulded spacers in revision total knee arthroplasty.
A conceptual model of barriers and facilitators to primary clinical teams requesting pediatric palliative care consultation based upon a narrative review
Authors: Walter Jennifer K. , Hill Douglas L. , DiDomenico Concetta , Parikh Shefali , Feudtner Chris
Published: December 2019

Background

Despite evidence that referral to pediatric palliative care reduces suffering and improves quality of life for patients and families, many clinicians delay referral until the end of life. The purpose of this article is to provide a conceptual model for why clinical teams delay discussing palliative care with parents.

Discussion

Building on a prior model of parent regoaling and relevant research literature, we argue for a conceptual model of the challenges and facilitators a clinical team might face in shifting from a restorative-focused treatment plan to a plan that includes palliative aspects, resulting in a subspecialty palliative care referral.

Like patients and families, clinicians and clinical teams may recognize that a seriously ill patient would benefit from palliative care and shift from a restorative mindset to a palliative approach. We call this transition “clinician regoaling”. Clinicians may experience inhibitors and facilitators to this transition at both the individual and team level which influence the clinicians’ willingness to consult subspecialty palliative care. The 8 inhibitors to team level regoaling include: 1) team challenges due to hierarchy, 2) avoidance of criticizing colleagues, 3) structural communication challenges, 4) group norms in favor of restorative goals, 5) diffusion of responsibility, 6) inhibited expression of sorrow, 7) lack of social support, 8) reinforcement of labeling and conflict. The 6 facilitators of team regoaling include: 1) processes to build a shared mental model, 2) mutual trust to encourage dissent, 3) anticipating conflict and team problem solving, 4) processes for reevaluation of goals, 5) sharing serious news as a team, 6) team flexibility.

Conclusions

Recognizing potential team level inhibitors to transitioning to palliative care can help clinicians develop strategies for making the transition more effectively when appropriate.
Predictive factors of success at the French National Ranking Examination (NRE): a retrospective study of the student performance from a French medical school
Authors: Lhuaire Martin , Dramé Moustapha , Hivelin Mikael , Levasseur Thomas , Maestraggi Quentin , Hunsinger Vincent , Abrahams Peter , Lantieri Laurent , Sommacale Daniele
Published: December 2019

Background

The national ranking examination (NRE) marks the end of the second cycle (6th university year) of French medical studies and ranks students allowing them to choose their specialty and city of residency. We studied the potential predictive factors of success at the 2015 NRE by students attending a French School of Medicine.

Methods

From March 2016 to March 2017, a retrospective study of factors associated with the 2015 NRE success was conducted and enrolled 242 students who attended their sixth year at the school of medicine of Reims. Demographic and academic data collected by a home-made survey was studied using univariate and then multivariate analysis by generalized linear regression with a threshold of p <  0.05 deemed significant.

Results

The factors independently associated with a better ranking at the NRE were the motivation for the preparation of the NRE (gain of 3327 ± 527 places, p <  0.0001); to have participated in the NRE white test organized by la Revue du Praticien in November 2014 (gain of 869 ± 426 places, p <  0.04), to have participated in the NRE white test organized by la conférence Hippocrate in March 2015 (+ 613 places ±297, p <  0.04). The factors independently associated with poor NRE ranking were repeating the first year (loss of 1410 places ±286, p <  0.0001), repeating a year during university course (loss of 1092 places ±385, p <  0.005), attendance of hospital internships in 6th year (loss of 706 places ±298, p <  0.02).

Conclusions

The student motivation and their white tests completion were significantly associated with success at the NRE. Conversely, repeating a university year during their course and attendance of 6th year hospital internships were associated with a lower ranking.