bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effectiveness of Therapeutic Physical Exercise in Patients with Amyotrophic Lateral Sclerosis in Relation to the Alsfrs-R Functionality Scale: A Systematic Review
Authors: Ortega-Hombrados Laura , Molina-Torres Guadalupe , Galán-Mercant Alejandro , Sánchez- Guerrero Eduardo , González-Sánchez Manuel , Ruiz-Muñoz María
Published: November 2020

What do you want to do ?New mailCopyBackground: to analyze the changes that a therapeutic physical exercise program is capable of causing in the functionality of patients suffering from ALS and in addition, to analyze the respiratory capacity. Methods: a systematic review of the PubMed, SCOPUS, Cochrane, SciELO, PEDro, CINAHL and MEDline databases is carried out. The information was filtered using the following MeSH terms: "Amyotrophic lateral sclerosis", "Physical Therapy", "Physical and Rehabilitation Medicine". Clinical trials published in the last 5 years were included in which one of the interventions was therapeutic physical exercise in patients with ALS, which included the ALSFRS-R as a result variable. Results: 10 clinical trials with a total of 421 patients were analyzed, of which 183 underwent rehabilitation with physical exercise and were part of the case group; the rest belong to the control group and their treatment was mostly passive. The observed trend is of a decrease of approximately 6 points in the ALSFRS-R scale at 6 months in the case groups; however, no behavior pattern was met in the controls. Conclusions: Therapeutic physical exercise could contribute to slow down the deterioration of the musculature of people with ALS, thus facilitating the performance of their daily activities.
Recombinant Protein Vaccines, a Proven Approach Against Coronavirus Pandemics
Authors: Pollet Jeroen , Chen Wen-Hsiang , Strych Ulrich
Published: November 2020

With the COVID-19 pandemic now ongoing for close to a year, people all over the world are still waiting for a vaccine to become available. The initial focus of accelerated global research and development efforts to bring a vaccine to market as soon as possible was on novel platform technologies that promised speed but had limited history in the clinic. In contrast, recombinant protein vaccines, with numerous examples in the clinic for many years, missed out on the early wave of investments from government and industry. Emerging data are now surfacing suggesting that recombinant protein vaccines indeed might offer an advantage or complement to the nucleic acid or viral vector vaccines that will likely reach the clinic faster. Here, we summarize the current public information on the nature and on the development status of recombinant subunit antigens and adjuvants targeting SARS-CoV-2 infections.
The Role of Prison Inmates’ Socio-Economic Characteristics on Rehabilitation Outcomes
Authors: Ondigo Queenter , Rono Henry
Published: November 2020

Studies continue to report minimal (or negligible) institutional rehabilitation outcomes among the prison inmates serving various offences; particularly in developing countries. Reports indicate that the rate of recidivism and re-conviction is even more acute in some of the regions, particularly Sub-Sahara Africa. The study examined rehabilitation outcomes of the prison inmates and the role of the socio-economic characteristics on those rehabilitation outcomes. The study employed Life course perspective and socio-economic vulnerability theory to identify phases of life typically associated with socio-economic vulnerabilities. The specific objectives of the study were 1) to identify rehabilitation outcomes of the prison inmates; 2) to examine their socio-economic characteristics; and 3) to examine the role (influence) of those characteristics on rehabilitation outcomes in respect to prerelease readiness to lawful livelihoods and community environment. The study was carried-out within three (3) selected correction institutions in Nairobi, Kenya, through a survey design. A sample of 286 subjects was used. Data was collected through key informants, focused group discussions (FGDs) and survey questionnaire. Results indicated that rehabilitation outcomes were substantially limited or inadequate in most of the indicators including compliance to institutional rules, participation of inmates in the design of their respective rehabilitation plans, access to apprenticeship, access to productive activities, exposure to employment experience, opportunity to engage with prospective employers, and opportunity to visit the family with a view to maintain support. Study results indicated that characteristics of the inmates had substantial influence on the rehabilitation outcomes. The study concluded that life course and socio-economic characteristics of the inmates needed to be taken into account in the institutional rehabilitation for the purposes of sustained rehabilitation outcomes.
LA CONSTRUCCIÓN DE LA IDENTIDAD FEMENINA EN LA LITERATURA CLÁSICA ESPAÑOLA DEL S. XV AL S. XVII
Authors: Souviron Begoña
Published: November 2020

Las mujeres levantan su voz en la ficción literaria. Son mujeres desplazadas, a menudo disfrazadas o con hábitos, las que asumen la defensa de sus libertades en el amor o reivindican su derecho a la educación. Muchas veces las mujeres amenazan el orden impuesto y son perseguidas, violadas o vendidas por sus propios padres o tutores. Otras ingresan en el convento y hacen votos para construir desde dentro su identidad. Todas ellas encuentran un espacio de realización personal y representación en la literatura. En nuestro trabajo dedicamos especial atención al testimonio de Aldonza, la protagonista de la obra de Francisco Delicado, La lozana andaluza, y a otras protagonistas de la novela del Siglo de Oro, así como a las voces de Teresa de Cartagena, Teresa de Jesús y sor Juana Inés de la cruz.
GEORG HEYM, DIECINUEVE VENTANAS A SU POESÍA
Authors: Riesco Chueca Pascual
Published: November 2020

Estas líneas proponen un recorrido por la producción poética de Georg Heym, figura iniciática del Expresionismo alemán. El objeto de la selección realizada es mostrar la diversidad de fuentes que nutren al autor, y que someten su obra a un delicado pulso entre herencia e innovación. La cuidada métrica resiste la presión de una temática rebosante de obsesión y presagio. Una cultura potente y suicida, la de la Alemania de anteguerras, desborda por boca del autor en una alocución donde creación y destrucción conviven en misterioso e íntimo connubio.
Biografías ilustradas y construcción del canon autorial (entre España y Europa): de Pacheco a Sedano
Authors: Ruiz Pérez Pedro
Published: November 2020

En torno a dos obras españolas destacadas, el Libro de retratos (1599-1644) de Pacheco y el Parnaso español (1768-1778) de López de Sedano, se plantea la consideración genérica de la hibridación de biografías y retratos con una muestra textual antológica, los antecedentes de su aplicación a los escritores, su dimensión europea y su función en los procesos de institucionalización de la literatura y de construcción de la subjetividad autorial.
Abu 'Uthmán 'Amr ben Bahr (Al-Yáhiz), Elogio y diatriba de cortesanas y efebos, edición y traducción del árabe de Pedro Buendía e Ignacio Gutiérrez de Terán
Authors: Bonhome-Pulido Lourdes
Published: November 2020

Reseña de Libro
La urbanización de la pobreza: de la acumulación originaria a la crisis habitacional en Ibiza
Authors: Vives-Miró Sònia , Rullan Salamanca Onofre
Published: November 2020

A partir de la teoría del desarrollo geográfico desigual y analizando el espacio ibicenco desde la trialéctica lefebvriana, el artículo presenta un nuevo relato sobre la transformación del territorio ibicenco desde el período preturístico hasta convertirse en un destino líder del turismo hedonista. Un proceso que ha convertido la ciudad de Ibiza en la ciudad más cara de España y la ha sometido a una profunda crisis habitacional. En el texto se interpreta la vivienda como uno de los principales ejes que ha facilitado esta transformación: desde la acumulación originaria que propició el interés por la vida autárquica insular y su arquitectura vernácula hasta la emergencia y expansión como destino de clubbers y de la oferta de alquiler turístico, todo ello como desencadenante de los actuales procesos de desposesión de vivienda. El artículo pretende generar una discusión sobre la urbanización de la pobreza como fenómeno que integra inherentemente los procesos de mercantilización, financiarización y desposesión de vivienda en una lógica urbana que puede ser conceptualizada como productora de desigualdad espacial.
Factors Influencing Palliative Care Utilisation Among Patients With Cancer In Kwazulu-Natal, South Africa: A Cross-Sectional Study
Authors: Dlamini Minenhle S. , Hlongwana Khumbulani W. , Dlamini Siyabonga B. , Ginindza Themba G.
Published: November 2020

Background: Cancer remains a public health challenge in low-and-middle income countries (LMICs). Over 30% of those in need of palliative care (PC) worldwide suffer from cancer and 80% of patients with cancer in LMICs are diagnosed at advanced stages, by which time they can only benefit from PC services. The aim of this study was to determine factors influencing PC utilisation among patients with cancer in KwaZulu-Natal (KZN). Methods: A study was conducted among patients who had been diagnosed with different cancers and attending Inkosi Albert Luthuli Central Hospital, Addington Hospital, Pietermaritzburg Grey’s hospital, Msunduzi Hospice and Chatsworth Hospice, using cross-sectional mixed methods. A systematic random sampling technique was used to select the participants. Semi-structured questionnaires were administered to a total of 394 patients with cancer. The questionnaire included two open-ended questions and 59 closed-ended questions. Data from open-ended questions were manually coded and converted into themes, while the closed ended-questions were entered into the REDCap (v.8.11.7) and exported to Stata for analysis. Results: The mean (+SD) age of the 394 participants was 51.89 (+14.67) years and about 22.9% were within the 41–50 years age-group. The majority of participants were females (77.7%) and were unmarried (60.6%). Most of the participants’ racial classification was black (81.5%) and 64.5% had primary education. More than four-fifths (82.7%) were unemployed, 55.8% lived in urban areas and 24.6% had cervical cancer. The analysis of the two open-ended questions incorporated into the questionnaire revealed five major barriers preventing cancer patients from seeking PC services. These themes included lack of cancer knowledge, pursuit of alternative treatment options and long waiting periods at healthcare institutions. In addition, stigma and discrimination, lack of screening and diagnostic equipment and socio-economic barriers, contributed to the underutilisation of PC services by patients with cancer. Participants recommended that cancer awareness campaigns, healthcare services and continuous professional development (CPD) be improved.Conclusion: Cancer patients in low-to middle-income countries, such as South Africa, are still facing barriers to pursuing PC. Better education of the public could contribute to increased knowledge and awareness on cancer and PC services. Utilisation of PC could be maximised, thereby providing a better quality of life for the sufferers and their families until the end of life’s journey. The study also provides information that can be used to strengthen and/or to develop PC guidelines for addressing PC issues.
Stretchable Supercapacitor at -30 oC
Authors: Jin Xuting , Song Li , Yang Hongsheng , Dai Chunlong , xiao Yukun , Zhang Xinqun , Han Yuyang , Bai Congcong , Lu Bing , Liu Qianwen , Zhang Jiatao , Zhang Zhipan , Qu Liangti
Published: November 2020

At relatively low temperature (e.g, -30 oC), most flexible supercapacitors that work well at room temperature will lose their stretchability due to the poor cold intolerance of conventional electrolytes and the absence of intrinsically stretchable electrodes. Herein, an anti-freezing and highly stretchable supercapacitor (AF-SSC) was fabricated for the first time by one-step in-situ growth of polyaniline onto an organohydrogel polyelectrolyte from cross-linked polyacrylamide networks soaked by ethylene glycol/water/H2SO4. As no extra stretchable substrates (e.g. elastic fiber, polydimethylsiloxane, rubber, etc.) or predefining stretchable structures (e.g. helical, spring, wrinkle, honeycombed structures etc.) are needed in such a design, the prepared AF-SSC shows a high mechanical stretchability of 200% under -30 oC and can be repeatedly stretched for 100 cycles without significant capacitance loss. Besides, an impressive capacitance retention of 73.1% at -30 oC is achieved when the current density increases by 20 times, which is much higher than those of stretchable supercapacitors based on pseudocapacitive materials that operated at room temperature. Furthermore, the device shows an ultralong lifespan with 91.7% capacitance retention after 100000 cycles at -30 oC, outperforming all stretchable supercapacitors reported previously. With other merits of high compressibility, strong adhesion, good processability and excellent anti-drying ability, the current device is an ideal power source to drive multi-functional electronic components in real-life scenarios.
Is Muscle Weakness a Risk Factor of the Development of Rotator Cuff Tendinopathy – A Systematic Review
Authors: Kwan Cheuk-Kin , Ko Man-Chi , Fu Sai-Chuen , Ling Samuel Ka-Kin , Leong Hio-Teng , Oh Joo-Han , Yung Patrick Shu-Hang
Published: November 2020

BackgroundUnderlying muscle weakness may explain the inconsistency in the development of rotator cuff tendinopathy in population with similar activity levels. This systematic review aims to assess existing prospective studies to evaluate whether muscle weakness is a risk factor to the development of rotator cuff tendinopathy. MethodsA systematic search was performed using the PRISMA guidelines. Prospective studies measuring muscle strength or stiffness and the incidence of rotator cuff tendinopathy will be included. Quality assessment was performed with the Newcastle-Ottawa Quality Assessment Scale. ResultsThe search yielded 6 studies, with a total of 523 trained overhead athletes followed up for 1 season. External and internal rotation strength was described as protective factors for the development of rotator cuff tendinopathy, with an odds ratio of 0.940 (p < 0.05) and 0.946 (p < 0.01) respectively for each N/m increased in force generated. Limited range of motion of <106o for shoulder external rotation was also described as a risk factor with an odds ratio of 1.12 (p < 0.001).Imbalance between external and internal rotation strength was reported as a risk factor for shoulder injuries in 2 studies, with a relative risk of 2.57 (p < 0.05) reported in 1 of them. Supraspinatus weakness was also reported as a risk factor for shoulder injuries in 1 study, with no odds ratio or relative risk provided. Due to insufficient data, combination into a meta-analysis was not possible. ConclusionsLimited evidence support that weakness of the external rotators, weakness in the internal rotators, and limited range of motion in external rotation are risk factors to the development of rotator cuff tendinopathy. Very limited evidence support that imbalance in external rotator and internal rotator strength, and supraspinatus weakness are risk factors for rotator cuff tendinopathies. Future cohort studies may improve on existing evidence with investigations on more muscle groups, a longer follow-up time, clearly documented injury history, and a stringent diagnosis to rotator cuff tendinopathy.
A Novel Reconstruction Device for Osteonecrotic Femoral Head Efficacy Evaluation: A Randomized-controlled Feasibility Trial
Authors: Jiang Ching-Chuan , Chiang Hongsen , Hsieh Chang-Hsun , Tsai Chia-Jung , Kuo Yu-Feng
Published: November 2020

BackgroundNumerous surgical treatments to preserve hip replacements have several controversies and none of these procedures are universally accepted nor have compelling evidence for osteonecrosis of the femoral head (ONFH). With developing a novel approach osteonecrotic device surgical procedure to support the regeneration of necrotic bone and articular cartilage in vivo, this will be the first randomized-controlled feasibility study to determine its safety in ONFH patients in comparison to the core decompression surgical procedure.MethodA total of 20 patients were enrolled and randomized; 10 in the osteonecrotic device group and 10 in the core decompression group. After their baseline data has been collected and their surgical procedure has been completed, the following postoperative data are then continued to 6 weeks, 3 months, 6 months, one year, and two years’ before the start of their surgery. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS) were collected. ResultsAll surgical procedures were performed uneventfully with no perioperative complications. Immediate pain relief in twenty patients of both groups were observed from WOMAC and VAS, however, the osteonecrotic device group had significantly lower scores throughout all periods of the follow up overall.ConclusionOsteonecrotic device procedure is a safe surgical procedure that can provide a minimally invasive endoscopic approach for direct visual examination to the lesion site. Trial registrationClinicaltrials.gov, NCT04103944. Registered 26 September 2019 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04103944
The Association between Poor Glycemic Control in Diabetes Mellitus and Progression of COVID-19
Authors: Estedlal AliReza , Jeddi Marjan , Heydari Seyed Taghi , Dabbaghmanesh Mohammad Hossein
Published: November 2020

Background: Coronavirus disease 2019 (COVID-19) is a newly recognized disease whose rapid spread has resulted in a global pandemic. In this resepct, there are several comorbidities presumed to be associated with presentation of complications in COVID-19 such as diabetes mellitus (DM), hypertension (HTN), and cardiovascular diseases (CVDs). Therefore, this study aimed to explore whether DM was a risk factor influencing presentation, progression, and prognosis of COVID-19 or not.Methods: A total number of 447 patients with confirmed COVID-19 were selected from two centers for COVID-19 in the city of Shiraz, south-central Iran, from February 20 to April 29, 2020. Then, demographic data, medical history, signs and symptoms, laboratory test results, as well as chest computed tomography (CT) scan reports were collected and analyzed.Results: This study revealed that older age, HTN, and CVDs could be mostly seen in diabetic patients with COVID-19. In addition, such patients had prolonged hospital stay, lower oxygen (O2) saturation, and abnormal laboratory test results such as higher white blood cell (WBC) count, lower lymphocyte count, elevated serum tumor markers such as aspartate aminotransferase (AST), and abnormal kidney function.Conclusion: DM is an important risk factor for adverse endpoints in patients with COVID-19. In diabetic patients, proper consideration of clinical characteristics is thus of utmost importance. In addition, special clinical insight for disease prevention, good glycemic control during hospitalization, and efforts to develop a vaccine can help improve disease outcomes in this population.
Which Factors Are Associated With Positive Resection Margin in Pancreatic Ductal Adenocarcinoma for Different Surgical Procedures? Results Based on a Standard Pathological Evaluation System-retrospective Cohort Study 
Authors: Li Bo , Guo Shiwei , Shi Xiaohan , Ni Chenming , Gao Suizhi , Li Gang , Ni Canrong , Jiang Hui , Lau Wan Yee , Jin G
Published: November 2020

Background/Objectives: The present study identified the independent risk factors of R1 resection in pancreaticoduodenectomy (PD) and distal pancreatosplenectomy (DP) for patients with pancreatic ductal adenocarcinoma (PDAC).Methods：Consecutive patients who were operated from December 2017 to 2018 with curative intent were analyzed retrospectively. A standardized pathological examination with digital whole-mount slide images (DWMSIs) was utilized for the resection margin status. R1 was defined as microscopic tumor infiltration within 1 mm to the resection margin. The potential risk factors of R1 resection for PD and DP were analyzed separately by univariate and multivariate logistic regression analyses. Results：For the 240 patients who underwent PD, and the 142 patients who underwent DP, the R1 resection rates were 30.8% and 35.6 %, respectively. Univariate analysis on risk factors of R1 resection for PD were tumor location, absence of tumor necrosis, N staging, TNM staging, and surgical type of PD; while those for DP were nerve invasion, T staging, and TNM staging. Multivariate logistic regression analysis showed that the risk factors of R1 resection for PD were tumor location (neck vs. head; uncinate process vs. head) and N staging, while those for DP were T staging .Conclusions：The location of tumor in the neck and uncinate process, and N1/2 staging were independent risk factors of R1 resection for PD; while those for DP were T3/4 staging.
Timing of Onset of Symptom for COVID-19 from Publicly Reported Confirmed Cases in Uganda
Authors: Ario Alex Riolexus , Mirembe Bernadette Basuta , Biribawa Claire , Bulage Lilian , Kadobera Daniel , Kyobe Henry Bosa , Kiwanuka Noah , Wamala Robert
Published: November 2020

Background: The incubation period for COVID-19, which is the time from exposure to symptom onset, is on average five to six days but reach 14 days. The question is, the timing of onset of various signs and symptoms of COVID-19 along the period amongst cases in Uganda is not known. Methodology: We utilized administrative data of publicly reported real-time RT-PCR laboratory COVID-19 confirmed cases in Uganda to investigate the timing of symptom onset, from 21-Marto 4-Sep-2020. Since timing of COVID-19 symptom onset is highly likely to be an interval rather than a point estimate, we generated three tertile categories of the period – 1st, 2nd, and 3rd tertiles denoting symptom presentation within 3, 4-6 and at least 7-days respectively. All signs and symptoms reported in the database were considered. We did not make any inferences about asymptomatic infection with SARS-COV-2. We analysed using frequency distributions, Chi-square test and Multinomial Logistic Regression; and controlled for age and sex.Results: We analysed a total of 420 symptomatic case-patients. The case-patients were predominantly male, 72.0% (304/420), median age of 33 years, IQR=26-41. The common symptoms of SARS-CoV-2 were: cough (47.6%), running nose (46.2%), fever (27.4%), headache (26.4%) and sore throat (20.5%). We utilized only 293 COVID-19 symptomatic cases that had clinical symptom onset date recorded for analysis of the timing of symptom onset. Most case-patients, 37.5% (109/293) - presented symptom within 3-days after laboratory confirmation, 31.4% (92/293) had symptoms in the 2nd and another 31.4% (92/293) in 3rd tertile, denoting 4-6 days and at-least 7 days after exposure, respectively. Running nose (RRR =0.45, 95% CI 0.24 - 0.84) and chest pain (RRR = 0.64, 95% CI 0.09 – 0.72) were less likely to occur in the 1st tertile and 2nd tertile rather than in the 3rd tertile. Case-patients aged ≥20yrs were less likely to have symptoms in the 1st and 2nd tertile compared to ≤20 years (p < 0.05). Conclusion: Our study provides empirical evidence for epidemiological characterization of cases by signs and symptoms along the incubation period among case-patients. This complements the current proposals for the length of active monitoring of persons exposed to SARS-CoV-2.
Use of Prophylactic Indomethacin in Preterm Infants: A Systematic Review and Meta-analysis
Authors: matary Abdulrahman Al
Published: November 2020

BackgroundProphylactic indomethacin has been widely used as an effective intervention for reducing mortalities and morbidities in preterm infants including the cardiopulmonary and neurodevelopmental morbidities as intraventricular hemorrhage (IVH), but many studies have reported contraindicated outcomes of its significance. Therefore, we aim to systematically review and meta-analyze the data of prophylactic indomethacin on preterm infants. MethodsOur systematic search included the following databases: Pubmed, Google Scholar, Scopus, Web of Science, The New York Academy of Medicine (NYAM), Virtual health library (VHL), and the System for Information on Grey Literature in Europe (SIGLE) to include studies that assessed the use of prophylactic indomethacin in preterm infants until August 12, 2020. ResultsThe final list of our included studies is comprised of 22 randomized trials and cohort studies. Our analysis of observational data showed that intubation in the delivery room/first day (74%), bronchopulmonary dysplasia (BPD) (33.2%), and patent ductus arteriosus (PDA) (32.2%) were the most prevalent outcomes in infants that received prophylactic indomethacin. Among all the studies outcomes, the only significant favorable outcome was lowering the rate of PDA (P< 0.001) while no significance was recorded with BPD, pulmonary hemorrhage, neurodevelopmental delays (IVH), mortality, length of hospital stays, and time spent on ventilators outcomes (P = 0.106, 0.123, 0.460, 0.340, 0.625, and 0.732, respectively). Moreover, necrotizing enterocolitis was significantly increased when applying prophylactic indomethacin in these infants (P< 0.001). Conclusion﻿The use of prophylactic indomethacin in preterm infants should be generally discouraged due to its neutral effect on most of the mortality and morbidity outcomes and the significant occurrence of its adverse events despite the positive effect on ductal closure.
Urinary CXCL10 is Associated with Acute Kidney Injury and Sepsis, and Predicts Mortality in Critically Ill Children
Authors: Huang Hui , Zhou Huiting , Wang Wenwen , Dai Xiaomei , Li Wenjing , Chen Jiao , Bai Zhenjiang , Pan Jian , Li Xiaozhong , Wang Jian , Li Yanhong
Published: November 2020

Background: Acute kidney injury (AKI) biomarkers are often susceptible to confounding factors, limiting their utility as a specific biomarker, in the prediction of AKI, especially in heterogeneous population. The urinary CXC motif chemokine 10 (uCXCL10), as an inflammatory mediator, has been proposed to be a biomarker for AKI in a specific setting. Whether uCXCL10 is associated with AKI and predicts AKI in critically ill patients remains unclear. The aims of the study were to investigate clinical variables potentially associated with uCXCL10 levels and determine the associations of uCXCL10 with AKI, sepsis and PICU mortality in critically ill children, as well as its predictive values of aforementioned issues. Methods: Urinary CXCL10 levels were serially measured in a heterogeneous group of children during the first week after pediatric intensive care unit (PICU) admission. AKI diagnosis was based on the criteria of Kidney Disease: Improving Global Outcomes with serum creatinine and urine output. Sepsis was diagnosed according to surviving sepsis campaign international guidelines for children. Mortality was defined as all-cause death occurring during the PICU stay.Results: Among 342 critically ill children, 52 (15.2%) developed AKI during the first week after PICU admission, and 132 (38.6%) were diagnosed as sepsis and 30 (12.3%) died during PICU stay. Both the initial and peak values of uCXCL10 remained independently associated with AKI with adjusted odds ratios (AORs) of 1.791 (P = 0.010) and 2.002 (P = 0.002), sepsis with AORs of 1.679 (P = 0.003) and 1.752 (P = 0.002), septic AKI with AORs of 3.281 (P <0.001) and 3.172 (P <0.001), and PICU mortality with AORs of 2.779 (P = 0.001) and 3.965 (P <0.001), respectively. The AUCs of the initial uCXCL10 for predicting AKI, sepsis, septic AKI, and PICU mortality were 0.63 (0.53-0.72), 0.62 (0.56-0.68), 0.75 (0.64-0.87), and 0.77 (0.68-0.86), respectively. The AUCs for prediction by using peak uCXCL10 were as follows: AKI 0.65 (0.56-0.75), sepsis 0.63 (0.57-0.69), septic AKI 0.76 (0.65-0.87), and PICU mortality 0.84 (0.76-0.91).Conclusions: Urinary CXCL10 is independently associated with AKI and sepsis, and may be a potential indicator of septic AKI and PICU mortality in critically ill children.
Do We have Arguments in Decision Making: Conservative or Surgical Treatment in Painful Degenerative Large Rotator Cuff Tears?
Authors: Vincent Karl , Gagey Olivier , Leboeuf-Yde Charlotte
Published: November 2020

Background and Hypotheses: The contemporary research literature indicates that there is no significant clinical difference in terms of improvement of pain and functional disability between surgical repair and rehabilitation treatment for degenerative rotator cuff tears. It could be hypothesized that rehabilitation, which is cheaper and causes few complications, is preferable for smaller lesions, whereas surgical repair might be needed for the larger lesions. The purpose of our review was to assess whether the size of the tear, particularly the large or massive, plays a major role in terms of long-term clinical results for rehabilitation compared to surgical repair.Method: We searched the literature on PubMed, Embase, PEDro, and Cochrane Library database up to March 2020 for randomized controlled clinical trials that compared long term results for surgical vs. rehabilitation concerning large or massive degenerative rotator cuff tears. A systematic, critical review process was planned using a slightly modified SIGN checklist. The review methodology followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and was submitted to PROSPERO and registered under the number CRD42020146161.Results: We found no randomized clinical trials that had dealt with this subject.Conclusion: There is no evidence that would help to choose between surgical repair or rehabilitation in case of large or massive rotator cuff degenerative tears. The reason for this is probably that large tears may be relatively painless since they often occur after retirement and therefore are relatively rarely seen in clinical practice. To obtain enough study subjects, it would therefore be necessary to study this question in multicenter randomized clinical trials.
Characterizing Common Challenges Faced by Parental Caregivers of Children With Type 1 Diabetes Mellitus in Mainland China: A Qualitative Study
Authors: Tong Huijuan , Qiu Feng , Fan Ling
Published: November 2020

Background: Parental caregiver psychology affects outcomes of children with Type 1 Diabetes Mellitus (T1DM). Objectives: To qualitatively examine perceptions of commo n challenges among parental caregivers of children with T1DM (T1DM Parental Caregivers). Methods: 45-60 minutes semi structured interviews were conducted with T1DM Parental Caregivers at Shengjing Hospital, China Medical University form January 2018 to Jun e 2019. Interview recordings were transcribed and coded in NVivo 11.0 to observe emergent themes. Results: Content analysis revealed 5 common themes with 14 subthemes, including persistent psychological stress (catastrophic emotions, emotional distress, a nd altered self efficacy), family function change (altered family life patterns and changes in parental role/function), challenges in daily management (technical challenges, emotional regulation, parent child conflict, and transition of care autonomy from parent to child), financial burden (cost burden of treatment and altered family economics), and lack of social support (social activity limitations and insufficient support systems). All were highly saturated across interview data. Conclusions: Young children with T1DM rely on parental caregivers for disease management and to one day become capable of autonomous self management as they age. However, both the period of emotional disturbance during initial diagnosis, psychological stresses of long term care giving, and conflict emerging from transition for parental to child responsibility for care can cause psychological effects detrimental to parental caregivers and T1DM children. This work provides compelling evidence for the role of assessment and intervention in parental caregiver psychological and emotional wellbeing in diabetes care, as well as the need for improved social and school support for children with T1DM in China. school support for children with T1DM in China.
Medicine Knowledge and Purchasing Behaviour in a South African Township: Lessons Learnt From a Pilot Study on Awareness of Substandard and Falsified Medical Products
Authors: Liu Rui , Lundin Susanne , Gosa Thumakele , Muller Elmi , Khambule Paul Roviss , Smith Anja
Published: November 2020

Background: Substandard and falsified (SF) medical products are available in informal as well as formal markets globally. South Africa has a large formal, regulated pharmaceutical sector but there has been limited attention to the existence of SF medical products and the risks posed to people in need of medication. Little is known about individuals’ medicine consumption behaviour, especially from a social sciences perspective. This study presents findings on knowledge and awareness of medicine risks amongst residents in a lower-income community in Khayamnandi in the Western Cape province of South Africa. We also reflect on challenges and lessons learnt from the data collection process.Results:Quantitative and qualitative data, using a mixed-methods approach, were collected from 41 adult (≥18 years) respondents through a survey and audio-recorded discussions around the survey questions. Comparison of the two types of data through bricolage and mixed-methods revealed inconsistencies in responses. We argue that multi-disciplinary research using a mixed-methods approach, including reflexivity regarding empirical observations, not only provides a broader knowledge, but that it also brings insights into the complex processes and ambivalent statements collected from research participants. In addition, research participants were not always open about their health-seeking behaviour and provider choices due to concerns about potential conflict of interests among different types of medical care providers in the local community. Conclusions:This is one of the few studies focusing on demand-side attitudes with regards to medicine purchasing behaviour and the potential risks this behaviour holds for the use of SF medical products in South Africa. Multi-disciplinary research using a mixed-methods approach can bring insights into the complex processes and ambivalent statements collected from research participants.
Treatment Seeking Behavior for COVID-19 Symptoms and Its Related Factors Among Northern Iranian Population: A Cross-sectional Study
Authors: Joukar Farahnaz , Asgharnezhad Mehrnaz , Naghipour Mohammadreza , Mansour-Ghanaei Fariborz , Maroufizadeh Saman , Yeganeh Sara , Nargessi Dorrin Aghajani , Zohrehvandi Behzad
Published: November 2020

Background: This study was conducted to investigate the treatment seeking behavior for COVID-19 symptoms among northern Iranian population and its related factors.Methods: This hospital-based cross-sectional study was conducted to investigate the treatment seeking behavior for COVID-19 symptoms and its related factors in 602 confirmed COVID-19 cases for a period of 2 months between March and May 2020 in Guilan at the onset of the corona epidemic in Iran. Results: Professional treatment-seeking was observed in 18.6% of patients and most of patient reported home remedies (50.3%) and self-medication (31.1%) as first reaction to COVID-19 symptoms. The multivariate logistic regression analyses revealed that patients with breathing difficulties symptom and history of respiratory disease had greater odds professional treatment of seeking respectively (adjusted odds ratio (OR) =1.6, P=0.03, (OR) =3.3, P =0.001). Conclusions: Roughly half of symptomatic COVID-19 patient reported home remedies as first treatment-seeking behaviors and only breathing difficulties symptom and past history of respiratory disease were identified as an independent predictor of professional treatment–seeking. However, we found no more professional treatment -seeking behaviors among elderly, diabetic, hypertensive and obese patients, while there were at risk of severe illness and death from COVID-19 infections. Thus, behavior change interventions in population with underling disease (including diabetes, hypertension and obesity) and older age is crucial to improve professional treatment -seeking behaviors.
A Comparison of Dental Education Between University of Toronto and Zhejiang University During COVID-19 Pandemic
Authors: Zhao Juan , Zhao Xiaomin , Zhou Na , Wang Sijie , Ye Guanchen , Wang Jin , Wang Yiru , Ye Hengni , Xie Zhijian
Published: November 2020

Background: To compare the contingency modifications to the dental education between the University of Toronto Faculty of Dentistry and the Zhejiang University School of Stomatology during COVID-19 pandemic, and to share experiences in keeping the dental academic continuity, resuming practicing activities and preparing the faculty and students for a new normality. Three approaches were adopted to collect information and data: online interviews and email-contact with the instructors and the deans, a small-scale online survey of dental students, and official online announcements of various authorities. Results: The two universities shared similarity in changing trends, while differed in details. The delivery of lectures, seminars and exams was transitioned from in-person mode to online mode and has proceeded effectively and efficiently. The pre-clinical lab training and clinical rotation were the most retarded parts and will not be resumed until the settle-down of the pandemic. Research activities have been kept on at the best possible level. Since the Zhejiang University reopened the campus in May 2020, clinical activities and research works were in recovery with a cautiously-planned and gradual phased approach. Conclusion: Both universities have been trying their best to meet the academic needs of students while protect their health, and to keep alert to the real time epidemic situation in preparation for resumption. Dental institutions could take the COVID-19 pandemic as an opportunity to armor dental students with infection control measures prior to their reengagement into clinical practice. There is a need of a new normality for global dental education that spans time and space.
Secondary Infection in Severe and Critical COVID-19 Patients in China: A Multicenter Retrospective Study
Authors: Sang Ling , Xi Yin , Lin Zhimin , Pan Ying , Song Bin , Li Chang-an , Zheng Xia , Zhong Ming , Jiang Li , Pan Chun , Zhang Wei , Lv Zheng , Xia Jiaan , Chen Nanshan , Wu Wenjuan , Xu Yonghao , Chen Sibei , Liu Dongdong , Liang Weibo , Liu Xuesong , Liu Xiaoqing , Li Shiyue , Zhong Nanshan , Ye Dan , Xu Yuanda , Zhang Nuofu , Zhang Dingyu , Li Yimin
Published: November 2020

Background. Since 2020 COVID-19 pandemic became an emergent public sanitary incident. The epidemiology data and the impact on prognosis of secondary infection in severe and critical COVID-19 patients in China remained largely unclear.Methods. We retrospectively reviewed medical records of all adult patients with laboratory-confirmed COVID-19 who were admitted to ICUs from January 18th 2020 to April 26th 2020 at two hospitals in Wuhan, China and one hospital in Guangzhou, China. We measured the frequency of bacteria and fungi cultured from respiratory tract, blood and other body fluid specimens. The risk factors for and impact of secondary infection on clinical outcomes were also assessed. Results. Secondary infections were very common (86.6%) when patients were admitted to ICU for >72 hours. The majority of infections were respiratory, with the most common organisms being Klebsiella pneumoniae (24.5%), Acinetobacter baumannii (21.8%), Stenotrophomonas maltophilia (9.9%), Candida albicans (6.8%), and Pseudomonas spp. (4.8%). Furthermore, the proportions of multidrug resistant (MDR) bacteria and carbapenem resistant Enterobacteriaceae (CRE) were high. We also found that age ≥60 years and mechanical ventilation ≥13days independently increased the likelihood of secondary infection. Finally, patients with positive cultures had reduced ventilator free days in 28 days and patients with CRE and/or MDR bacteria positivity showed lower 28 day survival rate.Conclusions. In a retrospective cohort of severe and critical COVID-19 patients admitted to ICUs in China, the prevalence of secondary infection was high, especially with CRE and MDR bacteria, resulting in poor clinical outcomes.
A Clustering Based Image Segmentation Procedure to Automatically Detect Grains in Polycrystalline Materials
Authors: Alagić Dženana , Pilz Jürgen
Published: November 2020

The physical and mechanical properties of a polycrystalline material depend on its microstructure characteristics such as the size and morphology of grains. In practice, different imaging methods are used to visualize the grain structure of such materials. To analyze microstructural changes in case of applied stress and to predict its performance in a given application, the quantitative information about the grain structure must be taken into account. In this work, an effcient and reproducible algorithm, which automatically detects grains in different types of microstructure images, is proposed. Due to the diversity between the analyzed images and a limited number of labeled data, a clustering patch-based approach is followed. The algorithm aims to distinguish between patches in homogeneous grain areas and those lying on grain boundaries through Gaussian Mixture Modeling. The identified groups of grain patches are used to create the seed image for a Seeded Region Growing algorithm, enabling nally a pixelwise image segmentation.
Vaccine Research in COVID-19: A Living Scoping Review Protocol
Authors: Li Jieyun , Feng Lufang , Zhao Haitong , Yang Kehu , Lu Cuncun
Published: November 2020

Background: Coronavirus disease 2019 (COVID-19) has become a global public problem and a pandemic event. Since the epidemic outbreak, deaths and cumulative confirmed positive cases have continued rising rapidly worldwide. Vaccines are regarded as one of the most effective means of preventing and controlling an epidemic. With the spread of COVID-19, a large number amount of literature on vaccines has been published recently. There is a pressing need to map the research activities of COVID-19 vaccines.Methods: Following Arksey and O’Malley’s framework and Joanna Briggs Institute (JBI) methodological guidance, a scoping review is proposed to summarize the extent/breadth, range, and nature of evidence in research related to COVID-19 vaccines. Based on the research questions we have developed by ours, a comprehensive search will be performed in Cochrane Library, Embase, PubMed, Web of Science, CNKI, CBM, VIP, and WanFang databases by two independent reviewers. According to our predefined inclusion criteria, pairs of reviewers will independently assess the eligibility of identified studies from the databases. Following literature selection, pairs of reviewers will extract relevant information related to our research questions. The methodological quality and reporting quality of key evidence types (i.e., randomized controlled trials, systematic reviews and meta-analyses) will be evaluated using commonly used tools, if possible. Qualitative synthesis and descriptive statistics will be used to summarize and present the results. In addition, new or updated meta-analysis will be conducted to pool the data available in included primary studies where possible. To track the trends in COVID-19 vaccines research, we plan to update our results every 2~3 months. Preparation of this scoping review protocol referred to PRISMA-P checklist, and the reporting of the following full-text will be using PRISMA-ScR guidelines.Discussion: We believe the results of this scoping review on COVID-19 vaccine will contribute to provide foundational knowledge, and have significant value for the research and practice of COVID-19 vaccines. The findings will also allow us to identify research gaps on this topic and help to guide the future research of COVID-19 vaccines well.
Optimal Endometrial Preparation Protocols for Frozen-thawed Embryo Transfer Cycles by Maternal Age
Authors: Zheng Qizhen , Zhang Hongzhan , Xu Shiru , Xiao Shan , Wang Xuejin , Mo Meilan , Zeng Yong
Published: November 2020

Background: It is paramount to consider the appropriate preparation of the endometrium to receive the transferred embryos as the amount of frozen embryo transfer (FET) cycles is increasing worldwide. However, there remains lack of evidence about what is the most optimal protocol of endometrial preparation regarding pregnancy outcomes in different subgroup of infertile women. This retrospective cohort study was aim to explore the best endometrial preparation protocols among different maternal age groups.Methods: A total of 16870 FET cycles were categorized into three groups based on endometrial preparation protocols: Natural cycle (NC n=3893), artificial cycles (AC, n=11459) and AC with pretreatment with GnRH-a (AC+GnRH-a, n=1518). Logistic regression was performed to investigate the independent effect of endometrial preparation protocols on IVF pregnancy outcomes. Subgroup analyses were conducted to evaluate the most optimal endometrial preparation protocols for different maternal age groups.Results: In overall populations, after controlling for potential confounders, the incidence of live birth (NC as reference; AC: adjusted odds ratio (aOR) =0.840, 95%CI 0.774-0.912; AC+GnRHa: aOR=0.907, 95%CI 0.795-1.034) in NC was significantly higher than that of AC, while comparable to that of AC+GnRH-a. The early miscarriage rate (AC: aOR=1.413, 95%CI 1.220-1.638; AC+GnRHa: aOR=1.537, 95%CI 1.232-1.919) was significantly lower in NC compared to either AC group. In younger women, the live birth rates (AC: aOR=0.894, 95%CI 0.799-1.001; AC+GnRHa: aOR=1.111, 95%CI 0.923-1.337) were comparable between the three groups, with a slightly higher in AC+GnRH-a. Early miscarriage rate was only significantly lower in NC compared to that of AC without GnRH-a (aOR=1.452, 95%CI 1.159-1.820). While in older women, the incidence of live birth (AC: aOR=0.811, 95%CI 0.718-0.916; AC+GnRHa: aOR=0.760, 95%CI 0.626-0.923) was significantly higher, and early miscarriage (AC: aOR=1.358, 95%CI 1.114-1.655; AC+GnRHa: aOR=1.717, 95%CI 1.279-2.305) was significantly lower in NC compared to those of two AC groups.Conclusions: NC protocol is associated with lower early miscarriage late in overall IVF population. There is a mild favor of AC+GnRH-a in younger women, while the priority of NC is remarkable in older women. Maternal age should be a considerable factor when determine endometrial preparation method for FET.
Expression of Serum Cytokines Profile in Neonatal Sepsis
Authors: Kuang Mengjiao , Chen Suipeng , Huang Shirui , Gong Binbin , Lin Suzhen , Wang Huiyan , Wang Guiye , Tao Hongqun , Yu Jian , Yang Zuqin , Jiang Minghua , Xie Qipeng
Published: November 2020

BackgroundSepsis remains a major cause of neonatal death, but its underlying pathological mechanisms are poorly understood. Methods To characterize the serum cytokine/chemokine profile in neonates with sepsis, we enrolled 40 full-term neonates with sepsis and 19 neonates without infection as controls. Forty cytokines/chemokines in serum were analyzed using the Luminex Bead Immunoassay System. Serum IL-17 was measured using an enzyme-linked immunosorbent assay. ResultsOur results showed that serum IL-6, IL-8, TNF-α, IL-1β, MIF, CXCL13, CXCL1, CXCL2, CXCL5, CXCL6, CXCL16, CCL27, CCL2, CCL8, CCL3, CCL20, CCL23, CCL27, and CX3CL1 levels were significantly increased in neonates with sepsis compared to those in the control group (all p<0.05). The levels of serum CXCL6, CXCL1, IL-6, CXCL10, CXCL11, CCL20, and IL-17 were higher in late-onset sepsis (LOS) than in early-onset sepsis (EOS) (all p<0.05). Conversely, serum IL-16, CXCL16, and CCL22 were lower in LOS than in EOS (all p<0.05). The levels of CX3CL1, CXCL2, CCL8, and TNF-α were all positively correlated with SOFA scores. ConclusionOur findings revealed that excessive pro-inflammatory cytokines might be involved in neonatal sepsis. In addition, chemokines significantly increased the recruitment of immune cells after infection to participate in the anti-infection defense of neonates, but this could lead to damage.