bluuebunny/crossref_metadata_2025 huggingface dataset:
A parental educational intervention to facilitate informed consent for pediatric procedural sedation in the emergency department: a parallel group randomized controlled trial
Authors: Lin Yen-Ko , Yeh Yung-Sung , Chen Chao-Wen , Lee Wei-Che , Lin Chia-Ju , Kuo Liang-Chi , Shi Leiyu
Published: May 2020

Background

Obtaining valid parental informed consent for pediatric procedures in the emergency department (ED) is challenging. This study compared a video-assisted informed consent intervention with conventional consent discussion to inform parents about pediatric procedural sedation in the ED.
Methods

A video-assisted informed consent intervention was developed to explain the process, benefits, risks, and alternatives of pediatric procedural sedation. A prospective randomized controlled trial was conducted with a convenience sample of parents of children recommended for procedural sedation for facial laceration in the ED. Intervention group participants watched the video. Control group participants received information from physicians during conventional discussion. Participants completed pre- and post-education knowledge tests and rated their satisfaction with the informed consent process. The primary outcome was efficacy of the video intervention compared with conventional discussion. Secondary outcomes were parental satisfaction and consent refusal. A covariate-controlled multivariable regression model was used to analyze between-group differences in knowledge and satisfaction.
Results

There were 32 participants in the intervention group and 30 in the control group. Mean knowledge scores were higher in the intervention group (91.67 ± [standard deviation] 12.70) than in the control group (73.33 ± 19.86). The intervention group showed significantly greater knowledge score differences (coefficient: 18.931, 95% confidence interval: 11.146–26.716). Intervention group participants showed greater satisfaction than control group participants.
Conclusions

Video-assisted informed consent was superior to conventional discussion for informing parents during an ED informed consent process. Video-assisted informed consent may improve parents’ understanding of pediatric procedural sedation and satisfaction with the informed consent process in the ED. Institutions should develop structured methods and strategies to better inform parents, facilitate treatment decisions, and improve parent satisfaction in the ED.
Trial registration:

The ClinicalTrials.gov Identifier is NCT01850329. Registered 9 May, 2013 - Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/study/NCT01850329
Asperosaponin VI promotes human mesenchymal stem cell differentiation into nucleus pulposus like- cells via up-regulation of ERK1/2 and Smad2/3 signaling pathways.
Authors: Niu Yong-Tao , Xie Lin , Deng Rong-Rong , Zhang Xiao-Yu
Published: May 2020

Background

At present, the regeneration of nucleus pulposus cells is an effective method to prevent intervertebral disc degeneration (IVDD). In this study, we investigated the role of Asperosaponin VI (ASA VI), isolated from a traditional Chinese medicine (TCM), the root of Dipsacus asper Wall, in promoting human mesenchymal stem cell (HMSC) proliferation and differentiation into nucleus pulposus like-cells and explored its possible mechanism of action.
Methods

First, the effects of ASA VI on HMSC vitality and proliferation were determined by the XTT method and EDU staining. Then, HMSCs were cultured with ASA VI. Real-time PCR, immunocytochemistry and immunofluorescence were used to measure the expression of extracellular matrix (ECM) components in nucleus pulposus cells, such as type II collagen(COL2A1), aggrecan, SOX9, KRT19, PAX1 and glycosaminoglycans (GAGs), and Western blot was used to investigate its potential mechanism.
Results

ASA VI could promote HMSC differentiation into nucleus pulposus like-cells, and its optimum concentration was 1 mg/L. The Western blot assays indicated that the possible mechanisms involved upregulating the expression of P-ERK1/2 and P-Smad2/3.
Conclusions

ASA VI can promote HMSC proliferation and differentiation into nucleus pulposus like-cells, which can be used as a potential treatment for IVDD.
Novel Fabrication Method of a Microfluidic Continuous Flow PCR
Authors: Ghalekohneh Sina Jafari , Zand Mahdi Moghimi , Banadaki Mohammad Dehghan , Azad Babak Kamali Doust , MirAhsani Saba
Published: May 2020

In this study, simulation, design, and fabrication of a Micro PCR based on MEMS and LoC are done. The designed PCR has 2 temperature zones. In fact, in this PCR, the second and third stages of the experiment are merged inside one temperature zone. In the first step, a proper design based on genetic studies is considered. Then, to find the location of the heaters, the system is numerically studied via COMSOL Multiphysics. The designed PCR in this study has 2 temperature zones of 95 and 60 centigrade. After that, the heat transfer analysis is validated. The dimensions of the chip are 80 mm in length and width and 7 mm in height. There are 64 channels on the chip which means the PCR has 32 cycles. The length of each microchannel is 33 mm and each temperature cycle is 68 mm. The width of the microchannels is 500 mm and the depth of it is 400 µm (following Mohr et al. study (30)). Different methods for fabrication of the microchannel has been used, which in the end, laser engraving was chosen. Isopropyl Alcohol (IPA) is used for the bonding. Also, the thickness of the cap is considered 2 mm to strengthen the chip. Heater and Peltier (thermoelectric cooler) is used to reach the desired temperatures. The reason to use the Peltier is that the 95 centigrade zone can affect the 60 centigrade zone which increases the temperature at this zone. A PID controller is used to control the temperatures. The main advantage of this research is the very fast, easy, and low-cost method for producing PCR chips. It can be useful in critical situations, such as COVID-19 pandemic conditions where there is an urgent need for PCR chips to diagnose this disease.
Fall prevalence and its influencing factors on quality of life in elderly: a population-based cross sectional study from China
Authors: Ren Jiaojiao , Li Guangyou , Zhang Liju , Zhang Na
Published: May 2020

Background: Fall poses major health problems to the elderly and may potentially lead to various levels of injuries. At present, the sample sizes from most of the epidemiological studies on falls in Chinese elderly are limited and studies on fall risks are not comprehensive. This study is to understand the prevalence of fall and investigate the possible risk factors with fall focusing on the aged 60 years and older in China to shed light on designing interventions targeting this vulnerable population. Methods : Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) based on multistage sampling designs, with participants aged 60 and older. The final sample size is 9692. We performed logistic regression analyses to examine the relationship between fall and its influencing factors. Results : Of the 9692 respondents, 1697 (17.5%) had falls within the last 2 years. Our findings indicated that the participants with disability, chronic condition, age 75 years above, poor health status, sleep duration of≤5h and taking antihypertensive medication were more likely to report falls. A dose response relationship was found between depression, satisfaction with life and risk of fall. Conclusions: After adjusting confounders, our study showed that age, sleep duration, disability, chronic condition, taking antihypertensive medication, self-assessed health status, depression and satisfaction with life were found to be significantly associated with fall in Chinese elderly. Such significant associations emphasize the need for evidence-based prevention and interventions for fall targeting these factors. Future prospective longitudinal study is warranted to investigate the causal relationship between falls and the influencing factors.
Effect of improved cookstove intervention on childhood acute lower respiratory infection in Northwest Ethiopia: Cluster randomized controlled trial
Authors: Adane Mesafint Molla , Alene Getu Degu , Mereta Seid Tiku , Wanyonyi Kristina L
Published: May 2020

BackgroundHousehold air pollution exposure is linked with over 3.5 million premature deaths every year, ranking highest among environmental risk factors globally. Children are uniquely vulnerable and sensitive to the damaging health effects of household air pollution which includes childhood acute lower respiratory infection. The use of improved cookstoves has been widely encouraged to reduce these health burdens. It is, however not clear whether it is possible to prevent household air pollution-related disease burdens with locally made improved cookstoves, and the evidence regarding the health effect of improved cookstove interventions among children still attracts wide debate. Therefore, we investigated the child health effect of improved baking stove intervention compared with the continuation of the customary open burning traditional baking stove.MethodsA cluster randomized controlled trial was conducted to assess the health effect of improved baking stove intervention. A total of 100 clusters were randomly allocated to both arms at a 1:1 ratio, and intervention was delivered to all households allocated into the intervention arm. A total of four follow-up visits were carried out within one year at approximately 3-month intervals immediately after the delivery of the intervention. The intervention effect was estimated using odds ratio as a measure of effect following a Generalized Estimating Equations modeling approach among the intention-to-treat population.ResultsA total of 5508 children were enrolled in the study across 100 randomly selected clusters in both arms, among which data were obtained from a total of 5333 participants for at least one follow-up visit which establishes the intention-to-treat population dataset for analysis. The intervention was not found to have a statistically significant effect on the outcome with an estimated odds ratio of 0.95 (95% CI: 0.89–1.02) compared with the continuation of an open burning traditional baking stove method. Harms: There was no difference in the overall incidence rates of cooking-related burns between arms with an incidence rate ratio of 0.80 (95% CI: 0.53–1.21), and there were no grounds to stop the trial early for adverse events.ConclusionsWe found no evidence that an intervention comprising biomass-fuelled improved baking stove reduced the risk of childhood acute lower respiratory infection compared with the continuation of an open burning traditional baking stove method. Therefore, effective cooking solutions are needed to avert the adverse health effect of household air pollution, particularly, childhood acute lower respiratory infection.
A special acute care surgery model in China: How to improve the efficiency of emergency clinical diagnosis and treatment.
Authors: Xu Dequan , Yin Yue , Hou Limin , Zhou Haoxin
Published: May 2020

Background

There was a fast growth in the number and the formation of ED visits in China during the twenty-first century. As a result, engaging special medical model will be essential to decompressing the ED visits. To do this, it will be important to understand which specific aspects to focus interventions on for the greatest impact.
Methods

To characterize the emergency surgery patients who were seen and discharged from ED. Retrospective cohort study of hospitalized emergency surgery patients currently under the care from specialists presenting to an urban, university affiliated hospital between 01 January 2018 and 1 January 2019. This study will highlight some of the controversies and challenges and key lessons learned.
Results

During the study period there were 231,229 ED visits; 4,100 of these patients were admitted for ACS service. Multivariate analysis identified age ≧ 65 (p = 0.023; odds ratio, OR = 2.66), ACS model (p = 0.000, OR = 0.18), ICU stay (p = 0.000, OR = 118.73) as factors associated with in-hospital mortality. There was a increase in LOS between young and elderly postoperative patients when stratifying patients by age(11.67 ± 9.48 vs 13.95 ± 9.11 p < 0.05). we first came up with this concept of Fast Track Acute Care Surgery.
Conclusions

ED overcrowding is not just an ED problem. ED overcrowding is a systems problem requiring a systematic facility-wide multidisciplinary response. Continuous and high-quality surveillance data across China are needed to estimate the emerging FTACS model which used to deal with ED overcrowding. Trial registration: retrospectively registered
Gender Disparity in Cardiovascular Mortality following Radiation Therapy for Hodgkin's Lymphoma: A Systematic Review
Authors: Khalid Yaser , Fradley Michael , Dasu Neethi , Dasu Kirti , Shah Ankit , Levine Adam
Published: May 2020

Background Radiation-induced coronary artery disease (R-CAD) has become an increasingly recognized phenomenon. Although the clinical relationship between radiation therapy and CAD risk is well known, there is minimal investigation of the gender relationship to radiation-induced CAD events and resulting cardiovascular (CV) mortality. We study the gender variation in the incidence of CV events/mortality related to R-CAD in Hodgkin’s Lymphoma (HL) patients. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used in this systematic review and network meta-analysis. OVID, Cochrane Central Register of Controlled Trials via the Wiley Interface, Web of Science Core Collection, MEDLINE, EMBASE, and Google Scholar were investigated to identify prospective and retrospective observational studies comparing women and men following radiation treatment for Hodgkin's lymphoma. 10 studies were included (4 prospective, 6 retrospective). The primary outcome was incidence of cardiovascular events and mortality. The secondary outcome was all-cause mortality. Meta-regression for age was also performed. Results Of 13,975 patients including 41% females and 59% males, CV events/mortality was noted to be significantly higher in women compared to men (OR 3.74, 95% CI 2.44-5.72, p <0.001). All-cause mortality was also higher in women compared to men (OR 1.94, 95% CI 1.10-3.44, p <0.023). On meta-regression analysis, elderly populations have a higher rate of mortality which was even higher for women than men (coefficient = 0.0458, p=0.0374). Conclusions Women have a higher rate of CAD related CV events/mortality and all-cause mortality compared to men in radiation treated patients. These data highlight the need for increased surveillance to better monitor for CAD in female patients treated with mantle or mediastinal radiation.
Sp1 Induced Long Non-coding Rna Agap2-as1 Promotes Cholangiocarcinoma Proliferation via Silencing of Cdkn1a
Authors: Ji Hao , Wang Juan , Lu Binbin , Li Juan , Zhou Jing , Wang Li , Xu Shufen , Peng Peng , Hu Xuezhen , Keming Wang
Published: May 2020

Background: LncRNA can regulate gene at various levels such as apparent genetics, alternative splicing, and regulation of mRNA degradation.However, the molecular mechanism of LncRNA in cholangiocarcinoma is still unclear.This deserves further exploration.Methods: We investigated the expression of AGAP2-AS1 in 32 CCA tissues and two CCA cell lines. We found a LncRNA AGAP2-AS1 which induced by SP1 has not been reported in cholangiocarcinoma and studied itKnockdown and overexpression were used to investigate the biological role of AGAP2-AS1 in vitro. CHIP and RIP were performed to verify the putative targets of AGAP2-AS1.Results: AGAP2-AS1 was significantly upregulated in 32 CCA tumor tissues.SP1 induced AGAP2-AS1 plays an important role in tumorigenesis.AGAP2-AS1 knockdown significantly inhibited proliferation and caused apoptosis in CCA cells. In addition, we demonstrated that AGAP2-AS1 acts as an oncogene in CCA.Conclusions: We conclude that the long non-coding RNA AGAP2-AS1 plays a role in promoting the proliferation of cholangiocarcinoma.
A Comparative Study on Asperity Peak Modeling Methods
Authors: Zhou Wei , Tang Jin-Yuan , Yi Jun
Published: May 2020

The peak identification scheme based method (three-point definition) and the spectral moments based method (spectral moment approach) are both widely used for asperity peak modeling in tribology. To discover the differences between the two methods, a great number of rough surface profile samples with various statistical distributions are first randomly generated using FFT. Then the distribution parameters of asperity peaks are calculated for the generated samples with both methods. The obtained results are compared and verified by experiment. The variation rules of the differences between the two methods with statistical characteristics of rough surfaces are investigated. To explain for the discovered differences, the assumptions by spectral moment approach that the joint distribution of surface height, slope and curvature is normal and that the height distribution of asperities is Gaussian, are examined. The results show that it is unreasonable to assume a joint normal distribution without inspecting the correlation pattern of [z], [z′] and [z′′], and that the height distribution of asperities is not exactly Gaussian before correlation length of rough surface increases to a certain extent, 20 for instance.
Small/kiddie Cigarette Packaging Size and Its Impact on Smoking: A Systematic Review
Authors: Rifin Halizah Mat , Ling Miaw Yn Jane , Lourdes Tania Gayle Robert , Saminathan Thamil Arasu , Hasani Wan Shakira Rodzlan , Majid Nur Liana Abd , Ahmad Ahzairin , Yusoff Muhammad Fadhli Mohd , Muhamad Nor Asiah
Published: May 2020

Background:Kiddie/small packs contain less than 20 cigarette sticks in a pack.Kiddie packs were introduced by the tobacco industry to support moderation and encourage quit smoking among heavy smokers although this may in turn encourage underage smoking. Smaller packs may suggest lower costs and this may increase affordability among the younger generation. This concern has causedmany countries to ban the sale of single cigarette sticks or kiddie packs. Hence, a systematic review was conducted to identify the impact of kiddie packs on smoking as compared to regular cigarette packaging in the general population.Methods:A database search was conductedin PubMed, EMBASE, CENTRAL, Web of Science and Scopus up to31stJanuary 2020. Other sources namely Google Scholar, as well as Journal of Substance Use and Tobacco Control were also searched.The results were analysed qualitatively, under four groups: initiation of smoking;urge /tendency to buy cigarettes; prevalence of smoking and attempt to reduce cigarette consumption. The methodological quality of all articles that were includedwas determined using a validated 16-item quality assessment tool (QATSDD). The literature search identified 2253 articles, of which20articles had met theinclusion criteria. Discussion:Articles that we reviewed had some evidence that kiddie packs increase the urge/tendency to buy cigarettes and also increase the attempt to reduce cigarette consumption. However, we found no evidence on theimpact of kiddie packs on the initiation of smoking and the prevalence of smoking. The average quality score for all papers was 34.1%.Given the diverse study settings of the articles and despite the challenges of the methodological quality of some papers, this review will provideevidence that kiddie packs increase urge/tendency to buy cigarettes and also increase the attempt to reduce cigarette consumption. However, since most studies were of low quality, further high-quality studies are needed to come to a firm conclusion of the impact of kiddie packs on smoking.Systematic review registration: PROSPEROCRD42018102325
Exploring the Relationship Between Social Cognition Deficits and Neurodegenerative Dementia: Protocol for a Systematic Review
Authors: Setién-Suero Esther , Murillo-García Nancy , Sevilla-Ramos Manuel , Abreu-Fernández Georgelina , Remón-Gallo Diego , Ayesa-Arriola Rosa
Published: May 2020

Background:Due to demographic evolution and the progressive aging of the population, the incidence of dementia has increased worldwide. Many questions about this syndrome have not been resolved yet, such as the relationship between dementia and deficits on social cognition.Therefore, the present review aims to explore this relationship and to establish the possible differential patterns of social cognition deficits in diverse types of neurodegenerative dementias.Methods:The literature searchwas conducted in several electronic databases, including MEDLINE database via Pubmed, Cochrane Library, Lilacs, Web of Science (WoS) and PsycINFO.In order to avoid possible bias during the data extraction, all citations, abstracts information and full-text articles will be independently screen by two reviewers. Themethodological quality of thestudies will be appraised using the Joanna Briggs Institute Critical Evaluation Checklists. All studies published in English or Spanish between October 2009 and October 2019 will be taken into account.Discussion: This systematic review will summarize the evidence provided during the last 10 years regarding the relationship between neurodegenerative dementia and social cognition deficits. This could provide a useful reference to clinicians, since properly defining social cognition profile of each type of neurodegenerative dementia would improve detection and diagnosis, which would undoubtedly guarantee better interventions.Systematic review registration: PROSPERO, ID: 152562
Knockdown of lncRNA FEZF1-AS1 Inhibits metastasis of Osteosarcoma Cells by miR-4456/GALNT10
Authors: Si Zhenxing , Zhou Shifeng , Shen Zilong , Luan Feiyu , yan jinglong
Published: May 2020

Background: Osteosarcoma (OS) is among the malignant tumors with high mortality and low survival, especially in children and adolescents. Research shows that LncRNA FEZ family zinc finger 1 antisense RNA 1 (FEZF1-AS1) enhances osteosarcoma progression. Nevertheless, the function and mechanism of FEZF1-AS1 in metastasis of OS remains unclear.Methods: We used qRT-PCR to assay for the expression of FEZF1-AS1, miR-4456, and GALNT10 in OS tissue specimens and cell lines. We also investigated the progression of OS through metastasis using the wound healing and Transwell assays. Moreover, we used the dual-luciferase reporter test, RIP assays, and western blot to validate whether FEZF1-AS1 serves as a competing endogenous RNA (ceRNA), modulating the expression of GALNT10 through sponging miR-4456 in OS.Results: FEZF1-AS1 was up modulated in OS tissues. Silencing FEZF1-AS1 repressed OS cell migration and invasion. microRNA-4456 (miR-4456) was involved in FEZF1-AS1-induced migration and invasion. miR-4456 was down modulated in OS tissue specimens and cell lines. Functionally, the up modulation of miR-4456 reversed the facilitative influence of FEZF1-AS1 on OS cell infiltration and migration. Mechanically, FEZF1-AS1 interacted with miR-4456 in a reciprocal suppressed manner. Moreover, miR-4456 targets GALNT10 via the Luciferase assay. Besides, the up modulation of GALNT10 reversed the migration and invasion inhibited by FEZF1-AS1 knockdown. Silencing of FEZF1-AS1 inhibits OS cell infiltration and migration through miR-4456 /GALNT10 sponging.Conclusion: Herein, we demonstrated that FEZF1-AS1 is a prospective bio signature of metastasis in OS patients. Mechanistically, we showed that the FEZF1-AS1/miR-4456/GALNT10 axis is a target for novel therapeutic development for OS.
Recurrence pattern and Survival analysis in patients undergoing radiotherapy IMRT technique for medulloblastoma
Authors: Chang Hao , Wang QiMing , Yu ZongYan , Zhang ZiShen , Yu DeQuan , Zhao PinTing , Shao QiuJu , He DongJie
Published: May 2020

Objective The technique of radiotherapy is associated with the recurrence pattern and prognosis of postoperative treatment for medulloblastoma. Our aim was to assess recurrence patterns and survival in patients with medulloblastoma between three-dimensional conformation (3D-CRT) and intensity modulated radiotherapy (IMRT). To analyze the factors affecting the prognosis, such as the use of 3D-CRT or IMRT, the time interval of surgical and radiotherapy, whether there is chemotherapy and chemotherapy regimen.Methods In this study, 36 patients with medulloblastoma were conducted investigating and data were analyzed from May 2009 to September 2017. The median survival of each group was calculated for different clinical stages,pathological types and treatment methods. The PFS and OS for patients curves were derived by Kaplan-Meier estimation, and which were calculated using the Cox proportional hazards model between the IMRT and 3D-CRT treatment groups.Results Up to the follow-up date, 7 of the 9 patients in the 3D-CRT group had recurrence and 9 of the 27 patients in the IMRT group had recurrence. The 2-year and 5-year PFS of the IMRT group were 74.1% and 65.8%, and which of the 3D-CRT group were 55.6% and 22.2%, respectively. The PFS was significantly higher for patients treated with IMRT compared with 3D-CRT (P<0.05). The 2-year overall survival rates of the IMRT group compared with the 3D-CRT group were the same, the 5-year overall survival rate of the IMRT group was higher than that of the 3D-CRT group, however, there was no statistical difference. The PFS and OS for patients with low-risk groups were better than those of the high-risk group (P<0.05). There was no statistical difference between the M2 group and the M3 group in the 2-year and 5-year OS(P>0.05). There was no statistical difference in the chemotherapy-free group, the EP chemotherapy regimen and the temozolomide (TMZ) chemotherapy group in the 2-year and 5-year PFS and OS(P>0.05). The results of multivariate Cox proportional hazards model analysis showed that the residual, recurrence or metastasis before radiotherapy were independent prognostic factors affecting PFS(P<0.05). Radiotherapy mode was negatively correlated, although there was no statistical significance(P=0.061).Conclusions IMRT can reduce the risk of spinal cord recurrence compared with 3D-CRT, especially the low rate of spinal cord recurrence. The development of the technique of radiotherapy was associated with improvements in medulloblastoma prognosis.
Nurses Practice Regarding Post-operative Wound Care And Its Associated Factors Of Hospitalised Patients In Public Hospitals Of Mekelle City, Tigray, Ethiopia, 2018/19.
Authors: tela girmay legass , abebe yohanss tesfay , g/slassie kibrom berhanu , gebrekidan kiros belay
Published: May 2020

Background: Post-operative wound care is a care that applied sterile gauze or bandage to wound to promote healing and protect the wound from further harm after surgical operation is done internally or externally to the involved organs. Post-operative Wound care is a nursing duty that requires excellent skills and knowledge to prevent massive complications such as infection, gangrene and amputation or, in severe cases, even death. Methods: Hospital based cross sectional study design was implemented and the total sample size was 375 nurses working in Ayder Comprehensive Specialized Hospital, Mekelle Hospital and Quiha hospital. Pre-test was done on 10 % of the sample size. Data was collected by observation and face to face interviewing using pre tested checklist and structured questionnaire respectively from March 20, 2019 to May 20, 2019. Simple random sampling was used. Data was coded, entered and analyzed using SPSS version 22.0 for statistical analysis. Binary logistic regression analysis was used to determine the predictor variables to the outcome variables with 95% confidence level at p-value of < 0.25 and finally p-value < 0.05 was described as statically significant. Result: A total of 375 respondents were participated in the study. Among them, 234(62.4%) were women. The overall nursing post-operative wound care practices were poor 258(68.8%). Work experience (AOR=0.47, 95%CI; 0.26-0.86), level of education (AOR=0.03, 95%CI; 0.004-0.25) and lack of materials (AOR=0.29, 95%CI; 0.09-0.89) was found to be associated with nurses post-operative wound care practice. Conclusion and recommendation: Factors such as work experience, educational level and lack of materials were statically significant association with nurses post-operative wound care practice. Highly qualified nurses should be engaged in training of other staff nurses in the tenderized dressing techniques of postoperative wounds.
Online questionnaire, clinical and biomechanical measurements for outcome prediction of plantar heel pain: feasibility for a cohort study
Authors: gulle halime , Birn-Jeffery Aleksandra , Prior Trevor D , Miller Stuart , Morrissey Dylan
Published: May 2020

Background

Plantar heel pain (PHP) accounts for 11-15% of foot symptoms requiring professional care in adults. Recovery is variable, with no robust prognostic guides for sufferers or clinicians. Therefore, we aimed to determine the validity, reliability and feasibility of questionnaire, clinical and biomechanical measures selected to generate a prognostic model in a subsequent cohort study.

Methods

Thirty-six people (19 females & 17 males; 20-63 years) were recruited with equal numbers in each of three groups: people with PHP (PwPHP), other foot pain and healthy controls. Eighteen people performed a questionnaire battery twice in a randomised order to determine online and face to face agreement. The remaining 18 completed the questionnaire battery once, plus clinical and biomechanical measurements. A progressive loading challenge was developed and assessed.

Results

There were no systematic differences between online and face to face administration of questionnaires ( p-values all >.05 ) nor an administration order effect (d =-0.31-0.25). Questionnaire reliability was good or excellent (ICC 2,1_absolute ) (ICC 0.86-0.99), except for two subscales. Full completion of the survey was only 77%, taking 29±14 minutes. Clinically, PwPHP had significantly less ankle dorsiflexion and hip internal rotation compared to healthy controls [mean (±SD) for PHP-OP-H = 14°(±6)-18°(±8)-28°(±10); 43°(±4)- 45°(±9)-57°(±12) respectively; p<.02 for both]. Plantar fascia thickness was significantly higher in PwPHP (3.6(0.4) mm vs 2.9(0.4) mm, p=.01 ) than the other groups. The graded loading challenge led to progressively increasing kinetic foot load.

Conclusion

Online questionnaire administration was valid therefore facilitating large cohort recruitment and being relevant to remote service evaluation and research. The graded loaded challenge increases load progressively and warrants future research. The physical and ultrasound examination revealed expected differences between groups. Clinician and researchers can be confident with these methodological approaches and the cohort study is feasible.
RoadMApp: A feasibility study for a smart travel application to improve maternal health delivery in a low resource setting in Zimbabwe
Authors: Nyati-Jokomo Zibusiso , Dabengwa Israel Mbekezeli , Makacha Liberty , Nyapwere Newton , Dube Yolisa Prudence , Chikoko Laurine , Vidler Marianne , Makanga Prestige Tatenda
Published: May 2020

Background: Travel time and health care financing are key determinants to the provision of quality maternal health care in low resource settings. Despite the availability of pregnancy-related mHealth and smart travel applications, there is a lack of evidence on their usage to travel to health facilities for routine antenatal care and emergencies in low resource settings like Zimbabwe. Little is known about the feasibility of the usage of custom-made mobile technologies that integrate smart travel and mHealth. This paper explores the feasibility of implementing a custom-made geographically enabled mobile technology-based tool (RoadMApp) to counter the negative effects of long travel times and poor financing strategies for maternal care in Kwekwe District, Zimbabwe. Methods: Focus group discussions were conducted with pregnant women, women of childbearing age, men (household heads) and elderly women. Participatory learning approaches with stakeholders (community members) and in-depth interviews with key informants (health care service providers, transport operators) were utilised. In total 193 people took part in the study. The discussion questions centred on travel time, availability of transport, cellular network coverage and perceptions of the RoadMApp application. Data was analysed thematically using Nvivo Pro 12.Results: Most parts of rural Kwekwe have long distances to health facilities and an inefficient road and telecommunications network. Hence, it is hard to predict if RoadMApp will integrate into the lives of the community - especially those in rural areas. Since these issues are pillars of the design of the RoadMApp application, the implementation is likely to be challenging.Conclusion: Communities are keen to embrace the RoadMApp application. However, the feasibility of implementing RoadMApp in Kwekwe District will be challenging due to maternal health care barriers such as poor road network, poor phone network and the high cost of transport. There is, therefore, a need to investigate the social determinants of access to maternity services in order to inform the RoadMApp implementation.
Formyl peptide receptor agonist Ac2-26 alleviates neuroinflammation in a mouse model of pneumococcal meningitis
Authors: Rüger Marvin , Kipp Eugenia , Schubert Nadine , Schröder Nicole , Pufe Thomas , Stope Matthias B , Kipp Markus , Tauber Simone C. , Brandenburg Lars-Ove
Published: May 2020

BackgroundBacterial meningitis is, despite progress in research and the development of new treatment strategies, still a cause of severe neurological disability. The brain is protected from penetrating pathogens by the blood-brain barrier and the innate immune system. The invading pathogens are recognized by pattern recognition receptors including the G-protein coupled formyl peptide receptors (FPRs), which are expressed by immune cells of the central nervous system. FPRs show a broad spectrum of ligands including pro- and anti-inflammatory ones. Here, we investigated the effects of the AnnexinA1 mimetic peptide Ac2-26 in a mouse model of pneumococcal meningitis.MethodsWildtype (WT), Fpr1 and Fpr2-deficient mice were intrathecally infected with Streptococcus pneumoniae D39 (type 2). Subsequently, the different mice groups were treated by intraperitoneal injections of Ac2-26 (1 mg/kg body weight) 2, 8 and 24 hour after the infection. The extent of inflammation was analyzed in various brain regions by means of immunohistochemistry and real-time RT-PCR 30 h after infection.ResultsAc2-26 treated mice showed less severe neutrophil infiltration, paralleled by a reduced induction of pro-inflammatory glia cell responses. While meningitis was ameliorated in Ac2-26-treated Fpr1-deficient mice, this protective effect was not observed in Fpr2-deficient mice.ConclusionsEven with appropriate antimicrobial therapy, mortality during bacterial meningitis is high and so attention has recently focused on adjunctive therapies. Our results suggest that Ac2-26 might be a novel adjunctive therapy for Streptococcus pneumoniae-induced meningitis.* The two last authors contributed equally to this study.
Personality Traits, Risk Perception, and Protective Behaviors during the COVID-19 pandemic
Authors: Mohamed
Published: May 2020

During the 2020 COVID-19 pandemic, people were instructed by health authorities to adopt protective behaviors to avoid infection. One of these behaviors is social distancing, which is influenced by diverse variables. Using data from an online survey with 405 responses, this study performed a multiple regression analysis to explore the effects of personality, risk perception, and personal hygiene practices on social distancing among residents of Qatar. The results showed that conscientiousness, neuroticism, risk perception, and personal hygiene practices predicted social distancing with a moderate effect size. Gender differences were also found in social distancing practices that women reported higher in social distancing practices than men. These results highlighted the importance of these factors in predicting individuals’ protective behaviors during the COVID-19 pandemic.
Grooved Pegboard Test Performance Before and After Cerebral-Spinal Fluid Tap Test in Patients with Normal Pressure Hydrocephalus
Authors: Liu Caiyan , Dong Liling , Mao Chenhui , Li Jie , Huang Xinying , Wei Junji , Hou Bo , Feng Feng , Cui Liying , Gao Jing
Published: May 2020

Background Motor impairment in patients with normal pressure hydrocephalus (NPH) can extend beyond gait and include deficits in upper extremity functions and psychomotor speed. Evaluation of upper extremity function will be helpful for NPH patients who are unable to ambulate (e.g., wheelchair-bound patients) and may not be able to comply with the gait evaluation. Our study aimed to explore the use of the grooved pegboard test to assess responsiveness to the cerebrospinal fluid (CSF) tap test in patients with NPH. Methods Seventy-seven possible NPH patients were enrolled from 2013 to 2018. All patients underwent detailed neuropsychological and walking assessments, CSF tap tests, and brain magnetic resonance imaging. The grooved pegboard test results before and after the CSF tap test were compared and correlated with the other clinical assessments. In diffusion tensor imaging analysis, the fractional anisotropy (FA) and mean diffusivity (MD) values of periventricular white matter were measured by the region of interest method and were correlated with pegboard test performance.Results The grooved pegboard test scores significantly improved after the CSF tap test and correlated with patient walking ability, cognitive function, and functional scores (P < 0.01). The improvement ratios in the complex visual motor speed index (i.e., the grooved pegboard test performance combined with the Symbol-Digit Modalities Test performance) were significantly different between the CSF tap test responder and nonresponder groups. The grooved pegboard test times were significantly correlated with the FA values in right periventricular lesions (P=0.017).Conclusions The performance on the grooved pegboard test was related to lower extremity motor ability and cognitive function. It can be used as an alternative evaluation tool for patients who are unable to ambulate and may not be able to comply with the gait evaluation.
The influence of the Municipal Human Development Index compared to maternal education on infant mortality: a retrospective cohort study in the extreme south of Brazil
Authors: Anele Carolina Ribeiro , Hirakata Vânia Naomi , Goldani Marcelo Zubaran , Silva Clécio Homrich da
Published: May 2020

Background: Infant mortality is considered an important and sensitive health indicator in several countries, especially in underdeveloped and developing countries. Most of the factors influencing infant mortality are interrelated and are the result of social issues. Thus, this study investigated the influence of the Municipal Human Development Index (MHDI) of the residence macro-region compared to maternal education on infant mortality in a capital city in the extreme south of Brazil. Methods: It is a retrospective cohort study with data on births and deaths for the period of 2000-2017. The association between the independent variables and the outcome was done by bivariate analysis through simple Poisson regression. Those with significant association (p<0.001) were used in a multiple Poisson regression for robust variances - adjusted model. Results: The study included 311361 children, of whom 2271 died. Maternal education, individually and jointly analyzed with the MHDI, showed association with the outcome of infant death in the first year of life, particularly for children of mothers with lower maternal education (p<0.001). In relation to other related factors, maternal age; number of Prenatal Care Consultations; gestational age, weight, gender and Apgar Index (5th minute) of the newborn showed association with IM (p<0.001). Conclusions: The lower the HDI classification of the macro-region, the worse were the socioeconomic and demographic conditions, but the results presumably indicated that an individual maternal characteristic supplants the environment in which the family resides as a factor of protection to infant mortality, reinforcing the relevance of maternal education as a social determinant in health.
Chitosan-miRNA Functionalized Microporous Titanium Oxide Surface via A Layer-by-layer Approach with a Sustained Release Profile for Enhanced Osteogenic Activity
Authors: Wu Kaimin , Liu Mengyuan , Li Nan , Zhang Li , Meng Fanhui , Zhao Lingzhou , Liu Min , Zhang Yumei
Published: May 2020

Background: Biofunctionalization of titanium implants for high osteogenic ability holds the hope for advanced implant of promoted osseointegration, especially in the compromised bone condition. In this study, using chitosan-miRNA (CS-miRNA) complex and sodium hyaluronate (HA) as the positively and negatively charged polyelectrolyte, the polyelectrolyte multilayers (PEMs) were fabricated using the layer-by-layer approach on the microarc oxidized (MAO) Ti surface via silane glutaraldehyde coupling. Methods: Dynamic contact angle and scanning electron microscopy were firstly analyzed to monitor the layer accumulation. RiboGreen was used to quantify the miRNA loading and release profile in phosphate-buffered saline. In vitro transfection efficiency and cytotoxicity were investigated after mesenchymal stem cells (MSCs) being seeded on the CS-antimiR-138/HA PEM functionalized microporous Ti surface. The in vitro osteogenic differentiation of MSCs and in vivo osseointegration were also inspected. Results: The surface wettability alternately changed during the formation of PEMs. The CS-miRNA nanoparticles distributed evenly along the MAO surface. The miRNA loading amount increased with the bilayer number increasing. More importantly, a sustained miRNA release of over approximately 2 week was obtained. In vitro transfection revealed that the CS-antimiR-138 nanoparticles were taken up efficiently by the cells and caused significant knockdown of miR-138 without showing significant cytotoxicity. The CS-antimiR-138/HA PEM surface enhanced osteogenic differentiation of MSCs on it in terms of enhanced alkaline phosphatase, collagen product and extracellular matrix mineralization. In the rat model, it led to dramatically enhanced in vivo osseointegration. Conclusions: All these findings demonstrate that novel CS-antimiR-138/HA PEM functionalized microporous Ti implant exhibits sustained release of CS-antimiR-138, and obviously enhances the in vitro osteogenic differentiation of MSCs and dramatically enhanced in vivo osseointegration. This novel miRNA functionalized Ti implant may be used in clinic to allow more effective and robust osseointegration.
Clinical Observation of the Number of Lymphocytes and T Cell Subsets in Patients with COVID-19 at Different Stages
Authors: Bai Jing , Zhou Hui , Dai Bao-sheng
Published: May 2020

To explore the changes of lymphocytes and T cell subsets at different stages in patients with COVID-19. 86 patients with COVID-19 were enrolled, and the dynamic changes of peripheral blood lymphocytes and T cell subsets of CD3+, CD4+, and CD8+ were measured on admission, after treatment for1 week, 2 weeks, and before discharge. There were no significant differences in the number of white blood cells and lymphocytes between admission and 2 weeks after treatment or before discharge in severe patients. The counts of CD3+, CD4+, and CD8+ T cells decreased significantly on admission. After 2 weeks of treatment, the CD3+ counts were significantly higher than that on admission. The CD4+ and CD8+ counts increased significantly after 1 week of treatment, and went up remarkably before discharge compared with that on admission. There was no significant difference in the number of CD3+ cells between the mild group and the control group on admission, but it was significantly lower in the severe group than that in the control group and the mild group. The CD4+ and CD8+ counts decreased significantly in both mild and severe patients on admission, and increased significantly before discharge. At the time of discharge, the CD4+ counts in the severe and mild groups were still significantly lower than in the control group, but there was no significant difference in CD8+ counts among the three groups. The counts of CD3+,CD4+,and CD8+ T cells in the patients with COVID-19 is significantly correlated with the short-term prognosis, and is more sensitive than lymphocytes. In the earliest stage, the numbers of CD4+ and CD8+ cells are more sensitive to early reduction and faster to late recovery.
SUCCESS FACTORS FOR LEAN HEALTHCARE IMPLEMENTATION: AN EXPLORATORY CASE STUDY IN A BRAZILIAN HOSPITAL
Authors: Gohr Cláudia Fabiana , Natália Gomes Cavalcante Cabral  , Luciano Costa Santos
Published: May 2020

This article analyzes the factors required for a successful lean implementation within the context of healthcare operations. For this purpose, a literature review was conducted to identify the success factors of lean implementation in healthcare settings. The paper adopts a case study methodology to investigate how a Brazilian hospital, which intends to be lean, has been prepared to achieve this goal. The studied hospital is in the process of lean implementation and has faced many challenges in this journey. This research analyzed seven success factors: (a) commitment from top management; (b) lean team; (c) strategy alignment; (d) understanding value; (e) training and engagement; (f) assess and control. Despite being in an initial stage of implementation, the hospital demonstrated a partial level of lean readiness. However, it still faces hard challenges in the implementation, especially regarding employees’ engagement. This paper contributes to the literature on lean healthcare implementation and offers recommendations for managers striving to implement lean in their organizations.
Prevalence of latent acidotic stress in dairy cows in the Şanliurfa region
Authors: DİNÇER PELIN FATOŞ POLAT , GÜL YUSUF
Published: May 2020

This study aimed to determine the incidence of latent acidotic stress (LAS), which is an important problem in dairy cow breeding in Turkey, to investigate net acid-base excretion in urine, and to provide veterinary doctors with information about the early diagnosis and treatment of LAS. Two study groups were formed according to the rumen fluid pH values: LAS group (19 cows) with 5.2 < pH < 6.0 (19 cows) and healthy group (81 cows) with 6.0 < pH < 7.2. Blood, urine and ruminal fluid samples were taken after a general clinical examination of the animals. The physical properties of the rumen fluid, methylene blue reduction time, total infusoria number, and volatile fatty acid (VFA) amounts were determined. In addition, examinations of blood gases, urine pH, and net acid-base excretion (NABE) were performed. The general physical examination did not reaveal any statistically significant difference in the body temperature between the LAS group (n = 19) and the control group (n = 81) (p = 0.614), but a significant increase in the heartbeat, respiratory frequency, and the number of rumen movements was observed in the LAS group (p = 0.001). The following findings were observed in the rumen fluid from cows of the LAS group: decreased methylene blue reduction time (p = 0.001), decreased pH (p = 0.001) and infusoria density (p = 0.001), increased sedimentation time (p = 0.001) and total VFA amount (p = 0.001), no flotation. Compared with the healthy cows, the LAS group showed decreased blood pH (p = 0.001) and oxygen pressure (pO2) (p = 0.001), increased carbon dioxide pressure (pCO2), base excess (BE) and bicarbonate (HCO3) values (p = 0.001), and decreased urine pH (p = 0.001) and net acid-base excretion (p = 0.001) values. The incidence of latent acidotic stress in dairy cows in the Sanliurfa region was determined as 19%. In addition, it was concluded that net acid-base excretion values in urine can be used as an auxiliary parameter in the diagnosis of LAS and can be easily applied in the field.