bluuebunny/crossref_metadata_2025 huggingface dataset:
Female clients’ gender preferences for frontline health workers who provide maternal, newborn and child health (MNCH) services at primary health care level in Nigeria
Authors: Okereke Ekechi , Unumeri Godwin , Akinola Akinwumi , Eluwa George , Adebajo Sylvia
Published: January 2020

Background
In Nigeria, anecdotes abound that female clients, particularly within northern Nigeria, have gender-based preferences for frontline health workers (FLHWs) who provide healthcare services. This may adversely affect uptake of maternal newborn and child health services, especially at primary healthcare level in Nigeria, where a huge proportion of the Nigerian population and rural community members in particular, access healthcare services. This study explored female clients’ gender preferences for frontline health workers who provide maternal, newborn and child healthcare (MNCH) services at primary healthcare level in Nigeria.
Methods
The study adopted a cross-sectional quantitative design with 256 female clients’ exit interviews from 66 randomly selected primary health facilities within two States - Bauchi (northern Nigeria) and Cross-River (southern Nigeria). Data was collected using Personal Digital Assistants and data analysis was done using SPSS software. Descriptive analysis was carried out using percentage frequency distribution tables. Bivariate analysis was also carried out to examine possible relationships between key characteristic variables and the gender preferences of female clients involved in the study.
Results
Out of 256 women who accessed maternal, newborn and child health services within the sampled health facilities, 44.1% stated preference for female FLHWs, 2.3% preferred male FLHWs while 53.5% were indifferent about the gender of the health worker. However only 26.6% of female clients were attended to by male FLHWs. Bivariate analyses suggest a relationship between a female client’s health worker gender preference and her pregnancy status, the specific reason for which a female client visits a primary healthcare facility, a female client’s location in Nigeria as well as the gender of the health worker(s) working within the primary healthcare facility which she visits to access maternal, newborn and child health services.
Conclusions
The study findings suggest that female clients at primary healthcare level in Nigeria possibly have gender preferences for the frontline health workers who provide services to them. There should be sustained advocacy and increased efforts at community engagement to promote the acceptability of healthcare services from male frontline health workers in order to have a significant impact on the uptake of MNCH services, particularly within northern Nigeria.
Efficacy of ultrasound-guided rectus sheath block, butorphanol for single-incision laparoscopic cholecystectomy: A prospective, randomized, clinical trial
Authors: Fu Huimin , Zhong Chaochao , Gao Yongtao , Xu Xingguo
Published: January 2020

Background: Whether rectus sheath block (RSB) combined with butorphanol can relieve incisional pain and visceral pain in patients undergoing single-incision laparoscopic cholecystectomy (SILC) remains unknown. The goal of this study was to assess the efficacy of ultrasound-guided bilateral RSB, and butorphanol for postoperative analgesia in patients undergoing SILC.Methods: All patients who met the criteria were randomly divided into four groups: group I, (n=29) patient-controlled intravenous analgesia (PCIA) (sufentanil 1 µg/ml); group II, (n=29) PCIA (butorphanol 0. 08 µg/ml); group III, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (sufentanil 1 µg/ml); and group IV, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (butorphanol 0.08 µg/ml). General anesthesia in all groups, It's noteworthy that we only use general anesthesia, not ultrasound-guided RSB in group I and II. The primary outcome were numeric rating scale (NRS) scores (0-10) of incisional pain and visceral pain. Secondary outcomes were the dose of butorphanol and sufentanil, the number of PCIA presses, the length of hospital stay and the incidence of postoperative adverse events.
Results: Both the rest and cough incisional pain scores were lower during the first 2, 6 and 12 h in group Ⅲ than in group Ⅰ (P＜0.05). Similarly, scores in group Ⅳ were significantly lower than those in group II (P＜0.05). The NRS scores for visceral pain were lower in group II at 2, 6 and 12 h after surgery than in group I (P＜0.05) and lower in group IV than in group Ⅲ (P＜0.05). Patients in group I needed more butorphanol as a rescue analgesic for pain relief than did those in group III, and patients in group IV needed less butorphanol as a rescue analgesic for pain relief than did those in group II. From the above pairwise comparisons, it is clear that groups III and IV had lower NRS scores. Overall, ultrasound-guided RSB combined with PCIA (butorphanol 0. 08 µg/ml) performed the best.
Conclusions: Ultrasound-guided RSB combined with butorphanol can provide sufficient pain treatment after SILC than can general anaesthesia combined with sufentanil.
A Pilot Evaluation of Magnetic Resonance Imaging Characteristics Seen With Primary Soft Tissue Giant Cell Tumor in 2 patients
Authors: Zhang Lina , Kang Jianyun , Zhang Kai , Liu Ailian , Wang Huali , Liu Tieli
Published: January 2020

Background: Primary soft tissue giant cell tumor (GCT-ST) is a rare tumor with low malignant potential . Here we reported two cases of patients with soft tissue giant cell tumor in the limb, including their clinical and imaging findings (conventional Magnetic resonance imaging (MRI) and Diffusion-weighted imaging (DWI)).
Methods: This retrospective study included two pathology-confirmed GCT-ST patients. Plain MRI, dynamic contrast enhancement MRI (DCE-MRI), and DWI were performed with a 3.0T whole-body MR scanner before surgery. The following characteristics of lesion were recorded: signal intensity on T 1 FSPGR and T 2 WI, morphology, maximum lesion size, time-intensity curve (TIC) on DCE-MRI, and apparent diffusion coefficient (ADC) value from DWI.
Results: The maximum lesion size ranged from 4.0 cm to 6.0 cm. Signal intensities of all lesions were heterogeneous on T 1 FSPGR and T 2 WI. Nodular enhancements were observed for all lesions with either oval or irregular shapes on MRI. All lesion margins were blurred, and internal enhancements were heterogeneous on DCE-MRI. TIC appeared with a slow increase in type. Lesions on DWI (b=500s/mm 2 ) were hyperintense with a higher mean ADC value of 2.19×10 −3 mm 2 /s compared to surrounding normal soft tissue (1.03×10 −3 mm 2 /s).
Conclusions: MRI features of these two GCT-STs include heterogeneous signal intensity within the lesion on T 2 WI and T 1 FSPGR, nodular enhancement with blurred margins, either oval or irregular shapes, and a slow increase enhancement of TIC on DCE-MRI. DWI may be a useful tool for differentiating benign soft tissue mass from giant cell-rich soft tissue neoplasms or malignant tumors. However, these findings need to be confirmed using a higher sample study.
Interference of functional dual-tasks on gait in untrained people with Parkinson’s disease and healthy controls: cross-sectional study
Authors: Valenzuela Constanza San Martín , Dueñas-Moscardó Lirios , López-Pascual Juan , Serra-Añó Pilar , Miguel José Manuel Tomás
Published: January 2020

Background: In Parkinson’s disease (PD) population, performing secondary tasks while walking further deteriorates gait and restrict mobility in functional contexts of daily life. This study (1) analyzed the interference of functional cognitive and motor secondary task on untrained people with PD and (2) compared their walking with healthy subjects.
Methods : Forty people with PD (aged 66.72 [7.5] years, Hoehn and Yahr stage I-II-III on-medication) composed the PD group (PDG) and 43 participants (aged 66.60 [8.75] years) formed the group of healthy counterparts (HG). Gait was evaluated through spatiotemporal, kinematic and kinetic outcomes in five conditions: single task (ST) and visual, verbal, auditory and motor dual-task (DT).
Results : The performance of both groups was higher in the ST than verbal, auditory and motor DT conditions (p < .05). A similar gait pattern was observed between ST and visual DT during velocity, cadence and vertical forces in PDG and HG. In addition, PDG exhibited a better double support time, ankle range, midstance and braking forces in the visual DT than the verbal and motor DT (p < .05). PDG participants had a significantly lower performance than the HG in all the variables analyzed except for the maximum hip extension in the stance phase (p>0.05). Conclusions : In untrained participants with PD, verbal and motor secondary tasks affect gait significantly, while auditory and visual tasks interfere to a lesser extent. Untrained patients with PD have a poorer gait performance than their healthy counterparts, but in different grades according to the analyzed variables.
Trial registration : The data in this paper are part of a single-blind, randomized, controlled trial and correspond to the evaluations performed before a physical rehabilitation program, retrospectively registered with number at clinicaltrial.gov NCT04038866 .
A multi-institutional and cross-sectional study on empathy in Chinese medical students: Differences by student cadre or not, future career preference, and father's education status
Authors: Yi Kangqi , Kang Mingyi , Li Dongju , Wang Zhipeng , Bai Jinsong , Xu Huiming , MA Shulan
Published: January 2020

Background
The aims of this study were to examine the factor structure of the Chinese version of the Jefferson Scale of Empathy for medical students (JSE-S) and investigate differences in empathy scores among Chinese medical students according to gender, student cadre or not, future career preference, and parents’ education.
Methods
Medical students from three universities completed an online questionnaire containing the JSE-S. Exploratory factor analysis was conducted to determine the factor structure, and group comparisons of empathy scores were examined via t -tests and analysis of variance.
Results
Four factors emerged from the factor analysis: “perspective taking,” “compassionate care,” “standing in the patient’s shoes,” and an uninterpretable factor. The results indicated that students who were female, held positions as student cadres, preferred to become a doctor, and whose fathers had a high school education or below tended to have more empathy.
Conclusions
Overall, the findings provide information on the dimensions of empathy applicable to Chinese medical students and confirm the factors found in the original measure.The dimensions have implications for developing empathy among medical students throughout the world. Educators can use the information to design interventions to foster empathy among students in the context of medical education reform in many countries, including China.
The Functional Outcomes and Complications of Different Reconstruction Methods for Giant Cell Tumor of the Distal Radius: Comparison of Osteoarticular Allograft and Three-Dimensional-Printed Prosthesis
Authors: Wang Yitian , Min Li , Lu Minxun , Zhou Yong , Wang Jie , Zhang Yuqi , Yu Xinzhu , Tang Fan , Luo Yi , Duan Hong , tu chongqi
Published: January 2020

Background: En bloc excision has been increasingly used for the management of giant cell tumors(GCTs) in the distal radius. An osteoarticular allograft has been used extensively for decades, and custom-made prosthesis reconstruction has been more recently applied. We aimed to compare the clinical outcomes of the two procedures.

Methods: We retrospectively analyzed 30 patients with Campanacci III or recurrent GCTs of the distal radius for follow-up at a mean of 33.2 months. In total, 15 underwent osteoarticular allograft reconstruction (allograft group) and 15 received cementless three-dimensional(3D)-printed prosthesis reconstruction (prosthesis group) between March 18, 2013, and May 20, 2018. All patients underwent by clinical and radiological examinations, including pre- and postoperative active range of motion (ROM) of the wrist, VAS score, grip strength, degenerative change of wrist, Mayo wrist score and Musculoskeletal Tumor Society (MSTS) score. Complications were evaluated using the Henderson classification.

Results: Both groups showed significantly increased ROM, grip strength, Mayo score and MSTS score postoperatively. Furthermore, the extension, flexion, MSTS, and Mayo score were significantly higher in the prosthesis group. There was no significant difference in grip strength and VAS between the groups. In allograft group, one patient had a late infection one had resorption of allograft without allograft bone fracture. and four had wrist subluxation. All patients had degenerative changes (mean 9 months). In the prosthesis group, three patients developed wrist subluxation, three had separation of the distal radioulnar joint, and none of the patients developed wrist degeneration.

Conclusions: Our study compared the objective functional outcomes and complications of two reconstructive methods for Campanacci III or recurrent GCT in the distal radius. 3D-printed prosthesis replacement can partially preserve wrist function better than allograft reconstruction in the short-term. During the design of 3D-printed prosthesis, preoperative morphological assessment of the affected proximal row carpal is helpful to control postoperative dislocation. After allograft reconstruction, wrist degeneration, which has been demonstrated in all patients, severely influence their wrist function. Therefore, compared to allograft reconstruction, 3D-printed prosthesis reconstruction has irreplaceable advantages at early-stage application, especially in wrist function, however, further studied with a larger number of cases and longer follow-up.
Comparative evaluation of epidural bupivacaine alone and bupivacaine combined with magnesium sulfate in providing postoperative analgesia: a meta-analysis of randomized controlled trials
Authors: Li Li-Qin , Zhang Hou-Zhong , Fang Mei-Dan , Wang Cong , Lu Hong-Liu , Wang Li-Xue , Xu Hong-Yu
Published: January 2020

Background The comparative efficacy of epidural bupivacaine alone and bupivacaine combined with magnesium sulfate in providing postoperative analgesia remains controversial.Methods We searched Mediline (OvidSP), EMBASE (OvidSP) and Cochrane Central Register of Controlled Trials (CENTRAL) to identify trials that compared epidural bupivacaine and magnesium sulfate combination (intervention) with bupivacaine alone (control). Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework was used to assess the quality of evidence.Results Eleven studies fulfilled our inclusion criteria after screening. We found that epidural bupivacaine combined with magnesium sulfate could prolong the time for first rescue analgesics (SMD 4.96; 95% CI [2.75, 7.17], P<0.00001, I 2 = 98%), reduce the number of patients who need rescue analgesics (RR 0.38; 95% CI [0.20, 0.74], P = 0.004, I 2 = 75%) and requirement for rescue analgesics (SMD -2.65; 95% CI [-4.23, -1.06], P=0.001, I 2 = 96%).Conclusions Magnesium suifate as an adjuvant of epidural bupivacaine improved postoperative analgesia. However, we rated the quality of evidence to be very low because of high heterogeneity, imprecise of results and small sample sizes. Furthermore, further large high-quality trials are still needed to confirm the effects of magnesium sulfate on postoperative analgesia.
Adenovirus Virus Expressing Myostatin- Somatostatin Fusing Gene Promote the Growth Rate of the Mice
Authors: Wang Xinglong , Xu Gaoxiao , Zhang Ning , Chen Xingfa , Yu Dongling
Published: January 2020

Background Myostatin (MSTN) and somatostatin (SST) are all involved in regulation the growth of the animals. Animals immunized with these proteins induce the related immune response, which could neutralize the normal inhibitory effects of these two proteins. Here, a recombinant adenovirus expressing MSTN-SST was constructed and used to deliver these two antigen to mice, so as to check the immunize efficacy of these proteins delivered in this way. Results The adenovirus expression fusing protein MSTN-SST was successfully rescued on HEK293A cell as adenovirus related cell pathological change were observed after transfection with the adenovirus genome harboring MSTN-SST gene. The expression of MSTN-SST were confirmed using western blotting and indirect immunofluorescence. Immunization with the recombinant adenovirus once or twice were successfully induce immune response against MSTN-SST and resulted in an improved growth rate and muscle mass. In addition, a booster immunization leaded a better results shown as higher antibody response and mice growth rate. Conclusions Accordingly, adenovirus can be used as a vector for deliver myostatin and somatostatin gene to increase animal growth rate and muscle mass .
Precision implementation of early ambulation in elderly patients underwent off-pump coronary artery bypass graft surgery: a randomized controlled clinical trial
Authors: Cui Zhaomei , Li Na , Fan Yiou , Zhuang Xin , Liu Jing , Zhang Jie , Tan Qi
Published: January 2020

Background Though early ambulation (EA) is associated with improved outcomes for post-operative patients, precision initiative on EA for elderly patients has rarely been reported. The aim of this study is to determine the safety and effectiveness of precision implementation of EA in elderly patients underwent off-pump coronary artery bypass graft (OPCABG) surgery. Methods We conducted a single-center, randomized and controlled clinical trial involving elderly patients(≥60 years) in who EA support was implemented after OPCABG surgery. Patients were randomly assigned to precision early ambulation (PEA) group or routine ambulation (Control) group. Innovatively referring age-predicted maximal heart rate (APMHR) and VO 2max was the highlight of PEA. The primary end-point was the postoperative length of stay in hospital (PLOS). The secondary end-point included 90-day mortality, laboratory test, length of stay in ICU, the incidence of multiple organ complications as well as post-traumatic stress disorder (PTSD). Results There were 178 patients were enrolled, with 89 patients assigned to receive PEA and 89 to receive control procedure. By intent-to-treat analysis, during PEA program, participants performed a much longer distance of ambulation on the third day ( P =0.000). Mild-to-moderate physical activity in PEA group ameliorates PLOS ( P =0.031), Time of first bowel ( P =0.000) and partial pressure O 2 ( P g =0.001). Additionally, patients in PEA group showed significantly lower incidence of PTSD than those in Control group ( P =0.000). Conclusion APMHR and VO 2max are valuable for target intensity and exercise formula. PEA after OPCAPG surgery is safe and reliable for elderly patients, which not only reduces the hospital stay but also improves patients’ postoperative functional status.
Tracing foot-and-mouth disease virus phylogeographical patterns and transmission dynamics.
Authors: Jara Manuel , Frias-De-Diego Alba , Dellicour Simon , Baele Guy , Machado Gustavo
Published: January 2020

Background Foot-and-mouth disease virus (FMDV) has proven its potential to propagate across local and international borders on numerous occasions, but yet details about the directionality of the spread along with the role of the different host in transmission remain unexplored. To elucidate FMDV global spread characteristics, we studied the spatiotemporal phylodynamics of serotypes O, A, Asia1, SAT1, SAT2, and SAT3, based on more than 50 years of phylogenetic and epidemiological information. Results Our results revealed phylogeographic patterns, dispersal rates, and the role of host species in the dispersal and maintenance of virus circulation. Contrary to previous studies, our results showed that three serotypes were monophyletic (O, A, and Asia1), while all SATs serotypes did not evidence a defined common ancestor. Root state posterior probability (RSPP) analysis suggested Belgium as the country of origin for serotype O (RSPP= 0.27). India was the ancestral country for serotypes A (RSPP= 0.28), and Asia-1 (RSPP= 0.34), while Uganda appeared as the most likely origin country of all SAT serotypes (RSPP> 0.45). Furthermore, we identified the key centers of dispersal of the virus, being China, India and Uganda the most important ones. Bayes factor analysis revealed cattle as the major source of the virus for most of the serotypes (RSPP> 0.63), where the most important host-species transition route for serotypes O, A, and Asia1 was from cattle Bos taurus to swine Sus scrofa domesticus (BF>500), while, for SAT serotypes was from B. taurus to African buffalo Syncerus caffer. Conclusions This study provides significant insights into the spatiotemporal dynamics of the global circulation of FMDV serotypes, by characterizing the viral routes of spread at serotype level, especially uncovering the importance of host species for each serotype in the evolution and spread of FMDV which further improve future decisions for more efficient control and eradication.
WITHDRAWN: Outcomes in patients with early stage uterine clear cell carcinoma treated with chemotherapy and radiotherapy: A systematic review and meta-analysis
Authors: Yin Xia , Cheng Jie , Zhang Yi , Chua Chee Wai , Zhou Cheng , Zhuang Guanglei , Di Wen , Corsi Daniel J.
Published: January 2020

Background : Uterine clear cell carcinoma (UCCC) is a rare histological type of endometrial cancer with poor prognosis and high risk of tumor relapse. Although adjuvant chemotherapy (CT) and/or radiotherapy (RT) are often recommended for early stage UCCC patients, the effectiveness of these treatment strategies remains unclear. Methods : Systematic review and meta-analysis were applied to evaluate treatment-related outcomes of stage I-II UCCC patients. Search strategy was applied using electronic databases until June 1st, 2019. Inclusion criteria were retrospective, observational and prospective studies that reported outcome of UCCC patients receiving adjuvant therapy. Clinical endpoints like overall survival (OS) and progression-free survival (PFS) were evaluated. Data were extracted by two independent reviewers and a meta-analysis was performed. Results : 13 articles with a total of 3967 patients were analyzed. Overall, adjuvant CT after surgery could improve 5 year-OS significantly compared to patients without CT (odds ratio 0.75, 95% confidence interval [CI] 0.58-0.96; p=0.02). In comparison, RT could also improve OS in UCCC patients of early stage (odds ratio 0.58, 95% CI 0.44-0.77; p=0.0002) compared to the patients without RT, especially in US and Europe patients. Lastly, when comparing the patients undergoing both CT and RT with those receiving CT or RT alone, no further improvement in OS was observed (odds ratio 1.12, 95% CI 0.63-1.99; P=0.70). Conclusions : Either CT or RT after surgery could improve the OS of early stage of UCCC patients. However, combinatorial CT and RT treatment did not improve the OS compared with CT or RT treatment alone.
Juvenile diet quality and intensity of sexual conflict in the mite Sancassania berlesei
Authors: Łukasiewicz Aleksandra
Published: January 2020

Background: Differing evolutionary interests of males and females may result in sexual conflict, whereby traits or behaviours that are beneficial for male reproductive success (e.g., traits related to male-male competition) are costly for females. Since sexual conflict plays an important role in areas such as speciation, population persistence or evolution of life history traits, understanding what factors modulate the intensity of sexual conflict is important. This study aims to examine juvenile diet quality as one of the underestimated ecological factors that may affect the intensity of sexual conflict via individual conditions. I used food manipulation during the development of the mite Sancassania berlesei to investigate the effects on male reproductive behaviour and competitiveness, male-induced harm to female fitness and female resistance to this harm.Results: Males that were exposed to low-quality food started mating later than the control males, and number of their mating attempts were decreased compared to those of control males. Moreover, males from the low-quality diet treatment sired fewer offspring in a competitive situation than males from the control treatment. However, the fitness of females exposed to males reared on a poor diet did not differ from that of females mated with control males. Furthermore, female diet quality did not alter their resistance to male-induced harm.Conclusion: Overall, diet quality manipulation affected male reproductive behaviour and mating success. However, I found no evidence that the intensity of sexual conflict in S. berlesei depends on male or female conditions. Investigating a broad range of environmental factors will provide a better understanding of sexual conflict dynamics and its feedback into associated evolutionary mechanisms.
Ocular biometry and power of intra ocular lens among cataract patients in rural Eastern Ethiopia
Authors: KASSA MANDEFRO SINTAYEHU , GESSESSE GIRUM W
Published: January 2020

Background : The main objective of the study was to report on the main parameters of ocular biometry and Intra ocular lens power of patients attending a cataract surgical program in Eastern Ethiopia. Methods : The study was a cross sectional study on 765 eyes which were legible for cataract surgery during a mass eye camp conducted from April 04 to April 10, 2018 at Bisidimo Hospital,Eastern Ethiopia.Ocular biometric parameters such as axial length (AL), anterior chamber depth (ACD), mean corneal curvature (MCC) were measured using automated keratorefractometer(Retinomax) and Sonomed A - Scan. Analysis of variance and multivariate analysis were done to determine association of ocular biometry components with socio demography of the study subjects. Results : A total of 765 eyes were enrolled in this study. The mean corneal curvature and the mean anterior chamber depth were found to be 7.61 mm and 2.88mm respectively. The mean axial length was estimated to be 22.98 mm. The mean refractive power of Intra ocular lenses was calculated to be 19.34D. The mean axial length in females was shorter than that of males by 0.24 and this was statistically significant ( P - value = 0.01). Under multiple linear regression model gender had a statistically significant impact on the axial length. The mean Anterior chamber depth in males was also larger than that of females by nearly 0.1 and this was statistically significant (P - value = 0.001). Under multiple linear regression model both age and gender had a statistically significant impact on the anterior chamber depth. There was no a statistically significant difference on the mean Intra ocular lens power required for male and female patients.Conclusion : This study is the first of its kind to provide a larger population based normative data on the most important parameters of ocular biometry in Ethiopia.The female sex was a strong predictor of small axial length and shallow anterior chamber. Increasing age had no effect on the axial length but was found to be a stronger predictor of shallow anterior chamber. Key words : Axial length, Anterior chamber depth, Corneal curvature, Intra ocular lens.
Knowledge, Attitude, and Practice (KAP) of Diabetes and Diabetic Retinopathy among Patients with Diabetes in Riyadh City.
Authors: Al-Yahya Abdulrahman Abdullah , Almizel Abdulrahman , Alsulaiman Alwaleed Mohammad , barri Abdulrahman Mohammed , aladel fadwa
Published: January 2020

Objective To identify the knowledge, attitude, practice (KAP) of diabetes and diabetic retinopathy among Saudi patients with diabetes in Riyadh Saudi Arabia.Methods A cross sectional study that was conducted in 50 randomly selected primary care centers and two university hospitals, involving diabetic patients that are 18 years and older during May 2018 and December 2018 in Riyadh, Saudi Arabia, using a validated KAP-45 questionnaire to assess the KAP levels of diabetes and diabetic retinopathy.Results A total of 313 participants were enrolled in the study. Most of them 168(59.8%) were males and 38(12.3%) were illiterate and 141(45.4%) had at least a bachelor's degree. Most of them had a family history of DM and long standing history of DM The average knowledge score for diabetes was good and was suboptimal for diabetic retinopathy. While the attitude scores for both diabetes and diabetic retinopathy were suboptimal. Meanwhile the average practice score for diabetes was good and was low for diabetic retinopathy.Conclusions Findings observed in our study stress on the importance of improving education and awareness as it’s the key for controlling the disease and reducing its complications.
Willingness-to-pay for spectacles studies: a scoping review of rationales and methodologies
Authors: Graham Christine , Chan Ving Fai
Published: January 2020

Background The global recognition of uncorrected refractive error as the main cause of vision impairment has increasingly demand for affordable, available and accessible refraction and spectacle dispensing services. Willingness to pay (WTP) for spectacles studies afford context-specific planning for integration of these services into eye care service delivery. The aim of this scoping review was to identify the rationales and the range of methods used when conducting WTP for spectacles studies. Methods We undertook this scoping review, using a search from EBSCO (host), Medline, PubMed, SCOPUS, Google Scholar and ProQuest databases. We also searched Google and eyecare organisation’s websites for grey literature. We analysed the articles using the scoping review methodological framework proposed by Arskey and Marley. Results The search identified 237 from and only 14 were eligible. 79% (n=11) were published articles and 21% (n=3) were grey literature. All studies were from developing countries. Most of the studies reported rationales with a few that were vague. The majority of the studies used survey-based techniques, where the limitation and strengths were reported. Conclusion The scoping review highlighted the knowledge gap in reporting the WTP for spectacles methodologies that need to be considered in reporting future research. Keywords: Willingness to pay, spectacles, eyeglasses
Clinical effect of conbercept on improving diabetic macular ischemia by OCT angiography
Authors: Zhu Ziyi , Liang Youling , Yan Bin , Meng Zhishang , Long Kejun , Zhang Yiwei , Luo Jing
Published: January 2020

Purpose Varying degrees of macular ischemia generally occur in diabetic retinopathy (DR). This study aims to evaluate the effect of conbercept with 3+ pro re nata (PRN) on macular perfusion status in patients with diabetic macular edema (DME) and quantitatively assess changes in foveal avascular zone (FAZ) areas and capillary density in macular regions by applying OCT angiography (OCTA). Methods Fifty patients were divided into ischemic (n=31) and non-ischemic (n=19) groups according to the presence of ischemia on OCTA at baseline. All patients received interval injection of 0.5mg of conbercept with 3+ PRN principle. The FAZ areas and macular vessel density measured using OCTA were evaluated at baseline, 3 months, and 6 months after treatment in both groups. Results At months 3 and 6, the FAZ area in the ischemic group changed from 0.510±0.171mm 2 to 0.441±0.158mm 2 then to 0.427±0.153mm 2 (p=0.003, p=0.296); in the non-ischemic group, it remained stable (p=0.269, p=0.926). The superficial vessel density changed from 41.1%±4.1% to 42.5%±4.7% then to 42.6%±4.6% (p=0.043, p=0.812), and the deep vessel density changed from 40.7%±4.4% to 42.3%±3.6% then to 42.3%±4.7% (p=0.072, p=0.961) in the ischemic group. In the non-ischemic group, the superficial vessel density changed from 44.8%±3.2% to 46.0%±3.5% then to 45.7%±3.3% (p=0.108, p=0.666), whereas the deep vessel density changed from 43.6%±3.6% to 43.8%±3.2% then to 43.5%±4.5% (p=0.882, p=0.736). Reperfusion in macular nonperfusion areas was observed. Conclusion Anti–vascular endothelial growth factor treatment may have a positive effect on macular perfusion status, improve macular ischemia, and promote reperfusion appearance in patients with DME. Furthermore, OCTA had advantages in quantifying and calculating blood flow index in the study of macular perfusion status.
Metallic nanoparticles and ions accelerate the uptake of extracellular antibiotic resistance genes through transformation
Authors: Guo Jianhua , Zhang Shuai , Lu Ji , Wang Yue , Verstraete Willy , Yuan Zhiguo
Published: January 2020

Background: Antibiotic resistance genes (ARGs), heavy metal ions and nanoparticles (NPs) are emerging and ubiquitous contaminants in the environment. However, little is known about whether heavy metal-based NPs or ions could facilitate the dissemination of ARGs through natural transformation. This study evaluated the contributions of heavy metal-based NPs (Ag NPs, CuO NPs and ZnO NPs) and their ion forms (Ag + , Cu 2+ and Zn 2+ ) to the transformation of extracellular ARGs in Acinetobacter baylyi ADP1. Results: We found that these commonly-used NPs and ions from environmentally relevant concentrations can significantly promote the natural transformation frequency of ARGs by a factor of 11.0-folds, which is comparable to the effects of antibiotics. The enhanced transformation by Ag NPs, CuO NPs, Ag + and Cu 2+ was primarily associated with reactive oxygen species (ROS) over-production and cell membrane damage, which was also evident from up-regulations of both transcription and translation of ROS and outer membrane-related genes. Additionally, transmission electron microscope imaging revealed the roughened cell membrane after Ag NPs, CuO NPs, Ag + and Cu 2+ exposure. ZnO NPs and Zn 2+ might increase the natural transformation rate by stimulating the stress response and ATP synthesis. All tested NPs and ions resulted in up-regulating the competence and SOS response-associated genes. Conclusions: Our results demonstrate that Ag, CuO and ZnO-based NPs/ions from environmental concentrations could promote the natural transformation of plasmid-encoded ARGs into naturally competent A. baylyi . Our findings provide insights into the contributions of heavy metals and NPs to the spread of antibiotic resistance.
Oral manifestations in premature infants. A systematic review
Authors: Couto Lara Vivero , Pozo Elena Planells del , Escobar José Ignacio Salmerón , López Jorge Molina , Ruiz-Extremera Ángela , Pozo Paloma Planells del
Published: January 2020

Background Preterm delivery, defined as delivery occurring before a gestational age of 37 weeks, represents 6-10% of all births in developed countries. Preterm infants are characterized by a short prenatal development period and are at an increased risk of systemic disorders as a result of their immaturity. Few studies have analyzed oral alterations among preterm infants. This systematic review examines the orofacial characteristics most commonly found among preterm infants versus infants born at term and evaluates their repercussions upon oral health and quality of life.Methods The search was limited to articles published in English or Spanish that compared orofacial characteristics of preterm infants versus infants born at term. Their methodological quality was assessed based on the guidelines of the Joanna Briggs Institute (JBI).Results Most of the studies found the prevalence of structural enamel defects of the primary dentition to be greater among preterm infants. Other disorders such as structural enamel defects of the permanent dentition, caries, malocclusions or alterations in dental composition, size and development also appeared to be more frequent among preterm infants, though the supporting evidence was weak.Conclusions Further studies are needed, analyzing the association between preterm delivery and certain orofacial disorders such as caries, malocclusions and dental anomalies.
Comparative study between Fenton and Intergrowth 21 charts in a sample of Lebanese premature babies
Authors: Samarani Marie , Restom Gianna , Mardini Joelle , Fares Georges Abi , Hallit Souheil , Khalife Marie-Claude Fadous
Published: January 2020

Background: Different charts are used to assess premature growth. The Fenton chart, based on prenatal growth, was used in in the intensive care unit of the Notre Dame des Secours University Hospital to assess premature newborns’ development. Intergrowth21 is a new multidisciplinary, multiethnic growth chart better adapted to premature growth. Our objective was to compare both charts Fenton and Intergrowth21 in order to implement Intergrowth in our unit.Methods: We analyzed 318 files of premature babies born who were admitted to the NICU from 2010 till 2017. Anthropometric data (weight, height and head circumference) converted to percentiles was filled on both charts from birth till 1 month of age.Results: The results of the linear regression taking the weight at birth as the dependent variable, showed that the Fenton scale (R2=0.391) would predict the weight at birth better than the Intergrowth 21 scale (R2=0.257). The same applies for the height at birth and cranial perimeter at birth when taken as dependent variables. When considering the weight and height at 2 weeks, the results showed that the Intergrowth 21 scale would predict those variables better than the Fenton scale, with higher R2 values higher in favor of the Intergrowth 21 scale for both weight (0.384 vs 0.311) and height (0.650 vs 0.585). At 4 weeks, the results showed that the Fenton scale would predict weight (R2=0.655 vs 0.631) and height (R2=0.710 vs 0.643) better than the Intergrowth 21 scale. The results obtained are adjusted over the newborns’ sociodemographic and clinical factors.Conclusion:The results of our study are controversial where the Fenton growth charts are superior to Intergrowth 21 before two weeks of age and at 4 weeks, whereas Intergrowth 21 charts showed higher percentiles for weight and height than Fenton charts at 2 two weeks of age. Further studies following a different design, such as a clinical trial or a prospective study, and conducted in multiple centers should be considered to enroll a more representative Lebanese sample of children and be able to extrapolate our results to the national level.
A behavioral economic intervention to increase psychiatrist adherence to tobacco treatment guidelines: a provider-randomized study protocol
Authors: Rogers Erin , Wysota Christina , Prochaska Judith J. , Tenner Craig , Dognin Joanna , Wang Binhuan , Sherman Scott E.
Published: January 2020

BackgroundPeople with a psychiatric diagnosis smoke at high rates, yet are rarely treated for tobacco use. Health care systems often use a ‘no treatment’ default for tobacco, such that providers must actively choose (opt-in) to treat their patients who express interest in quitting. Default bias theory suggests that opt-in systems may reinforce the status quo to not treat tobacco use in psychiatry. We aim to conduct a pilot study testing an opt-out system for implementing a 3A’s (ask, advise, assist) tobacco treatment model in outpatient psychiatry.MethodsWe will use a mixed-methods, cluster-randomized study design. We will implement a tobacco use clinical reminder for outpatient psychiatrists at the VA New York Harbor Healthcare System. Psychiatrists (N = 20) will be randomized 1:1 to one of two groups: (1) Opt-In Treatment Approach: Psychiatrists will receive a reminder that encourages them to offer cessation medications and referral to cessation counseling; or (2) Opt-Out Treatment Approach: Psychiatrists will receive a clinical reminder that includes a standing cessation medication order and a referral to cessation counseling that will automatically generate unless the provider cancels. Prior to implementation of the reminders, we will hold a 1-hour training on tobacco treatment for psychiatrists in both arms. We will use VA administrative data to calculate the study’s primary outcomes: 1) the percent of smokers prescribed a cessation medication and 2) the percent of smokers referred to counseling. During the intervention period, we will also conduct post-visit surveys with a cluster sample of 400 patients (20 per psychiatrist) to assess psychiatrist fidelity to the 3 A’s approach and patient perceptions of the opt-out system. At six months, we will survey the clustered patient sample again to evaluate the study’s secondary outcomes: 1) patient use of cessation treatment in the prior 6 months and 2) self-reported 7-day abstinence at 6 months. At the end of the intervention period, we will conduct semi-structured interviews with 12-14 psychiatrists asking about their perceptions of the opt-out approach. DiscussionThis study will produce important data on the potential of opt-out systems to overcome barriers in implementing tobacco use treatment in outpatient psychiatry.
Correlation between clinical risk factors and tracheal intubation difficulty in infants with Pierre-Robin syndrome: A systematic review
Authors: Liu Yanli , Wang Jiashuo , Zhong Shan
Published: January 2020

Background: Difficult tracheal intubation is a problem commonly encountered by anesthesiologists in the clinic. Methods: In this retrospective study, case-level clinical data and computed tomography images of 96 infants with Pierre-Robin syndrome were included in the analysis. First, computed tomography images were labeled by a clinically experienced physician. Then color space conversion, binarization, contour acquisition, and area calculation processing were performed on the annotated files. Finally, we calculated the correlation coefficient between the seven clinical factors and tracheal intubation difficulty, and the difference in each risk factor under tracheal intubation difficulty. Results: The absolute value of the correlation coefficient between throat area and tracheal intubation difficulty is 0.54, and the difference of throat area under tracheal intubation difficulty is significant. Body surface area, weight and gender also show significant difference under tracheal intubation difficulty. Conclusions: There is a significant correlation between throat area and tracheal intubation difficulty in infants with Pierre-Robin syndrome. Body surface area, weight and gender may have an impact on tracheal intubation difficulty in infants with Pierre-Robin syndrome.
Identification of ‘Haryejosaeng’ mandarin by multiplex SNP genotyping
Authors: Jin Seong-Beom , Kim Ho Bang , Park Suk Man , Kim Min Ju , Kang Seok-Beom , Yang Gyeong-Rok , Yun Su-Hyun
Published: January 2020

BackgroundMost of the satsuma mandarin (Citrus unshiu Marc.) cultivars grown on Jeju Island farms, Korea, are difficult to improve through hybridization because of polyembryony and male sterility. Therefore, their improvement has mostly been based on the selection of nucellar embryo and bud mutation. These cultivars are supplied to breeders and farms at the seedling stage, which renders their identification based only on morphological traits. In addition, because these seedlings originate from nucellar embryo and bud mutation selection, they are genetically very similar. Therefore, the present study was carried out to develop markers that can specifically and rapidly distinguish ‘Haryejosaeng,’ which is generally supplied to breeders, from other satsuma mandarin cultivars that are planted on farms.ResultsPolymerase chain reaction (PCR) was performed to distinguish ‘Haryejosaeng’ from other 8 cultivars (‘Haryejosaeng’- breeder’s stock, ‘Miyagawa wase,’ ‘Okitsu wase,’ ‘Yura wase,’ ‘Miyamoto wase,’ ‘Ueno wase,’ ‘Yonezawa wase,’ and ‘Nichinan 1 gou’) using 6 single nucleotide polymorphism (SNP) markers specific for ‘Haryejosaeng’ and one SNP primer pair, which was used as the negative control. Using a multiplex PCR, SNP markers P1 (HL-SNP-SCAF_2-23997586-F and HL-SNP-SCAF_2-23997586-R), P2 (HL-SNP-SCAF_2-36059523-F and HL-SNP-SCAF_2-36059523-R), and P5 (HL-SNP-SCAF_9-30793978-F and HL-SNP-SCAF_9-30793978-R) simultaneously yielded 165, 150, and 526 bp amplicons, respectively, for Haryejosaeng only. The SNP markers were further validated by high-resolution melting analysis. The multiplex PCR based on P1/P5 and P2/P5 was also used to identify ‘Haryejosaeng’ on a farm growing 17 different cultivars of satsuma mandarin.ConclusionsWe developed specific molecular markers for accurate identification of ‘Haryejosaeng,’ which can be performed by multiplex PCR to save time and cost associated with the supply of ‘Haryejosaeng’ to farms.
Continuous inflorescence removal changes parameters, lignin and saponin a content and alters the transcriptome of root of Bupleurum chinense DC
Authors: Wang Hui , Zhang Gaixia , Gao Zhihui , Sui Chun , Wei Jianhe
Published: January 2020

BackgroundBupleurum chinense DC. is an important traditional medicinal plant, and its root as the only medicinal part named Radix Bupleuri is used widely for the treatments of influenza, fever, inflammation, etc. in China, Japan and Korea. As a bulk herb, this herbal medicine occupies a comparatively big market share and is widely cultivated. However, because of the vigorous flowering and fruiting, the root growth is influenced seriously. ResultsWe assessed the effect of the continuous inflorescence removal (CIR) on improving the yield and quality of Radix Bupleuri. The results showed that the taproot length, root head diameter, and lateral root numbers were significantly elevated by CIR. We also found an average 1.71-fold increase in root biomass, and the lower lignin and higher saponin a content were detected in roots of CIR-treated plants. Based on a comparative transcriptome analysis, 172, 243, 1974 and 3024 differentially expressed genes (DEGs) were respectively identified in the CIR-treated roots. Gene Ontology and KEGG pathway functional annotation analysis of the DEGs showed that multiple genes were involved sugars metabolism pathway, lignin and terpenoids biosynthesis pathway, and the plant hormones signal transduction pathway. In addition, 295 genes encoding transcription factors (TFs), including members of the ERF, MYB-related, bHLH, NAC, MYB, AUX/IAA and bZIP families etc, were identified as CIR responsive. ConclusionThe CIR treatment could improve the yield, quality and market value of B. chinense DC. medicine, and the first transcriptome profile of CIR-treated roots of B. chinense DC. provides a series of clues of the molecular mechanisms of these phenotype changes induced by CIR.
Comparison of the clinical efficacy of Wiltse paraspinal approach and O-arm navigation for the treatment of thoracolumbar fractures
Authors: Lu Yingjie , Zhu Tianfeng , Shen Xu , Fang Yuepeng , Lu Dongdong , Zhou Liyu , Zhu Xuesong , Gan Minfeng
Published: January 2020

Background To evaluate the clinical efficacy of Wiltse paraspinal approach and percutaneous pedicle screw placement under O-arm navigation for the treatment of thoracolumbar fracture.Methods We enrolled a total of 54 patients with neurologically intact thoracolumbar fracture that received minimally invasive technology. Among these, 28 cases were treated with pedicle screw fixation through Wiltse paraspinal approach (WPSF), and another 26 cases were received percutaneous pedicle screws fixation under O-arm navigation (OPSF). The statistical methods were used to performing a detailed comparison of clinical outcomes, radiologic findings and complications between the two groups at pre-op, post-op and last follow-up.Results There were no significant differences between the two groups among intraoperative bleeding, length of incision, postoperative hospitalization times and accuracy rate of pedicle screw placement (p>0.05). Visual analog scale (VAS) scores, Oswestry disability in­dex (ODI) scores, local Cobb angle (LCA), vertebral wedge angle (VWA) and R value were obviously improved after surgery, though no clear discrepancy between the groups at each time point (p>0.05). However, the OPSF group had longer operation time and higher surgical expenditure than the WPSF group (p<0.05).Conclusions Both WPSF and OPSF were safe and effective for the treatment of thoracolumbar fracture. Although the two groups showed favorable clinical and radiologic outcomes till the final follow-up, we recommended the minimally invasive technology of WPSF considering the lower duration of surgery and medical costs. A randomized controlled study of high-quality and large sample required to prove our findings in the future.