bluuebunny/crossref_metadata_2025 huggingface dataset:
An exploration of family quality of life in persons with leprosy-, lymphatic filariasis– and podoconiosis-related disabilities and their family members in Ethiopia
Authors: van't Noordende Anna T , Aycheh Moges Wubie , Schippers Alice P
Published: August 2020

Background

Leprosy, podoconiosis and lymphatic filariasis (LF) may adversely affect the social, economic and psychological well-being of persons affected and their families. The objectives of this study were to assess and compare family quality of life of persons affected and their family members, explore the relationship between family quality of life and perceived stigma and activity limitations and explore what factors influence family quality of life.

Methods

A cross-sectional quantitative study was conducted in the Awi zone in Ethiopia. Persons affected and their family members were selected using purposive sampling. Three questionnaires were used: the Beach Center Family Quality of Life (FQOL) scale (range 25–125, with higher scores denoting higher family quality of life), the SARI Stigma Scale (range 0–63, with higher scores denoting higher levels of stigma) and the Screening of Activity Limitation and Safety Awareness (SALSA) scale (range 0–80, with higher scores denoting more activity limitations). Data analysis consisted of simple descriptive analysis and regression analysis.

Results

A total of 95 persons affected and 117 family members were included. The overall mean of the family quality of life score was 71.7. Persons affected had significantly higher mean family quality of life scores than family members on all domains. Female gender, a smaller family size and occupation were associated with lower family quality of life. We found a mean SARI Stigma score of 22.3 and a mean SALSA score of 37.6. There was no association between the FQOL and SARI scores or between the FQOL and SALSA scores.

Conclusions

Family quality of life is an important area to address because neglected tropical diseases often affect the whole family. It is therefore important in order to provide appropriate support for persons affected and their family members. Efforts to improve the quality of life of families in which a family member is affected by leprosy, podoconiosis or LF should give priority to women and families with a smaller family size.
Climate change and dengue fever knowledge, attitudes and practices in Bangladesh: a social media–based cross-sectional survey
Authors: Rahman Md Siddikur , Karamehic-Muratovic Ajlina , Baghbanzadeh Mahdi , Amrin Miftahuzzannat , Zafar Sumaira , Rahman Nadia Nahrin , Shirina Sharifa Umma , Haque Ubydul
Published: August 2020

Background

Bangladesh experienced its worst dengue fever (DF) outbreak in 2019. This study investigated the knowledge, attitudes and practices (KAP) among university students in Bangladesh and significant factors associated with their prevention practices related to climate change and DF.

Methods

A social media–based (Facebook) cross-sectional KAP survey was conducted and secondary data of reported DF cases in 2019 extracted. Logistic regression and spatial analysis were run to examine the data.

Results

Of 1500 respondents, 76% believed that climate change can affect DF transmission. However, participants reported good climate change knowledge (76.7%), attitudes (87.9%) and practices (39.1%). The corresponding figures for DF were knowledge (47.9%), attitudes (80.3%) and practices (25.9%). Good knowledge and attitudes were significantly associated with good climate change adaptation or mitigation practices (p<0.05). Good knowledge, attitudes and previous DF experiences were also found to be significantly associated with good DF prevention practices (p<0.001). There was no significant positive correlation between climate change and DF KAP scores and the number of DF cases.

Conclusions

Findings from this study provide baseline data that can be used to promote educational campaigns and intervention programs focusing on climate change adaptation and mitigation and effective DF prevention strategies among various communities in Bangladesh and similar dengue-endemic countries.
Traffic flow cellular automaton model with bi-directional information in an open boundary condition
Authors: Zheng Liang , He Zhengpeng
Published: August 2020

With Connected Vehicle Technologies being popular, drivers not only perceive downstream traffic information but also get upstream information by routinely checking backward traffic conditions, and the backward-looking frequency or probability is usually affected by prevailing traffic conditions. Meanwhile, the bi-directional perception range of drivers is expected to significantly increase, which results in more informed and coordinated driving behaviours. So, we propose a traffic flow bi-directional CA model with two perception ranges, and perform the numerical simulations with the field data collected from a one-lane highway in Richmond, California, USA as the benchmark data. Numerical results show that the CA model can effectively reproduce the oscillation of relatively congested traffic and the traffic hysteresis phenomenon. When adjusting the backward-looking probability and the perception range, the CA model can well simulate the travel times of all vehicles, and the generation and dissolution of traffic jams under various scenarios.
Discovery and surveillance of viruses from salmon in British Columbia using viral immune-response biomarkers, metatranscriptomics, and high-throughput RT-PCR
Authors: Mordecai Gideon J , Di Cicco Emiliano , Günther Oliver P , Schulze Angela D , Kaukinen Karia H , Li Shaorong , Tabata Amy , Ming Tobi J , Ferguson Hugh W , Suttle Curtis A , Miller Kristina M
Published: August 2020

The emergence of infectious agents poses a continual economic and environmental challenge to aquaculture production, yet the diversity, abundance, and epidemiology of aquatic viruses are poorly characterised. In this study, we applied salmon host transcriptional biomarkers to identify and select fish in a viral disease state, but only those that were negative for known viruses based on RT-PCR screening. These fish were selected for metatranscriptomic sequencing to discover potential viral pathogens of dead and dying farmed Atlantic (Salmo salar) and Chinook (Oncorhynchus tshawytscha) salmon in British Columbia (BC). We found that the application of the biomarker panel increased the probability of discovering viruses in aquaculture populations. We discovered two viruses that have not previously been characterised in Atlantic salmon farms in BC (Atlantic salmon calicivirus and Cutthroat trout virus-2), as well as partially sequenced three putative novel viruses. To determine the epidemiology of the newly discovered or emerging viruses, we conducted high-throughput reverse transcription polymerase chain reaction (RT-PCR) and screened over 9,000 farmed and wild salmon sampled over one decade. Atlantic salmon calicivirus and Cutthroat trout virus-2 were in more than half of the farmed Atlantic salmon we tested. Importantly we detected some of the viruses we first discovered in farmed Atlantic salmon in Chinook salmon, suggesting a broad host range. Finally, we applied in situ hybridisation to determine infection and found differing cell tropism for each virus tested. Our study demonstrates that continual discovery and surveillance of emerging viruses in these ecologically important salmon will be vital for management of both aquaculture and wild resources in the future.
Mechanisms of invasion in glioblastoma
Authors: Chouleur Tiffanie , Tremblay Michel L. , Bikfalvi Andreas
Published: August 2020

Purpose of review

This review provides an overview of recent updates in understanding the mechanisms by which glioblastoma cells interact with their cellular and molecular partners within the microenvironment.

Recent findings

We have now a better knowledge of the cell populations involved in Glioblastoma (GBM) invasion. Recent works discovered the role of new molecular players in GBM invasion, and, most importantly, better models are emerging which better recapitulate GBM invasion.

Invasive properties of glioblastoma make complete surgical resection impossible and highly invasive cells are responsible for tumor recurrence. In this review, we focus on recent updates describing how invasive cells progress in the surrounding tissue along brain structures. We also provide an overview of the current knowledge on key cells and molecular players within the microenvironment that contribute to the invasive process.

Video abstract

http://links.lww.com/COON/A28
Combining poly(ADP-ribose) polymerase inhibitors and immune checkpoint inhibitors in breast cancer: rationale and preliminary clinical results
Authors: Goncalves Anthony , Mezni Essia , Bertucci François
Published: August 2020

Purpose of review

Recently, both immune checkpoint inhibitors and poly(ADP-ribose) polymerase inhibitors have demonstrated clinical benefit in some subsets of HER2-negative breast cancer patients. A biological rationale exists supporting a potential synergism between these compounds, which may further increase their antitumor activity in the clinic.

Recent findings

PARP inhibitors were shown to activate type I interferon pathway, thus eliciting local and general immune response, while inducing programmed cell death-ligand 1 (PD-L1) up-regulation. In addition, the DNA damages created by PARP inhibition may increase tumor mutational burden and neo-antigens, thereby favoring efficacy of immune checkpoint inhibitors. Accordingly, clinical trials combining PARP inhibitors and agents targeting the PD-1/PD-L1 axis have been initiated in breast cancer in both advanced and early stages, enrolling patients with germline BRCA1/2 mutation, homologous recombination deficiency and/or with triple negative phenotype. Preliminary safety and efficacy results are encouraging, but it is still unclear whether the combination adds benefit compared with each therapeutic administered as single agent.

Although a strong rationale exists to support the combination of PARP inhibitors with immune checkpoint inhibitors, future clinical trials will have to demonstrate whether it improves outcome and to identify which patients are the most likely to benefit from.
A Randomized, Split-Body, Placebo-Controlled Trial to Evaluate the Efficacy and Safety of Poly-l-lactic Acid for the Treatment of Upper Knee Skin Laxity
Authors: Kollipara Ramya , Hoss Elika , Boen Monica , Alhaddad Marwan , Fabi Sabrina G.
Published: August 2020

BACKGROUND

Skin laxity of the upper knee and lower thigh is a common complaint among patients.

OBJECTIVE

This is a randomized, double-blinded, split-body, placebo-controlled study to evaluate the safety and efficacy of poly-l-lactic acid (PLLA) for treatment of upper knee skin laxity.

MATERIALS AND METHODS

Twenty female subjects between the ages of 30 and 65 years with upper knee laxity were enrolled. The patients were randomized to receive 3 treatments of PLLA in 1 knee, whereas the other knee received 3 treatments of bacteriostatic water.

RESULTS

Statistically significant improvement as rated on the physician global aesthetic improvement scale was seen at Day 56 after final treatment in the active knee when compared with the placebo knee. This improvement was sustained at Day 84 and Day 168 after final treatment visits. No statistically significant difference was seen between the active and placebo knees on the subject global aesthetic score or the subject satisfaction scale.

CONCLUSION

Based on our study, PLLA may be a safe and effective modality in addressing upper knee skin laxity. Larger studies with longer follow-up times and a validated knee laxity scale are needed to further determine if and how much improvement can be achieved.
Thin, very thin, or ultrathin-strut biodegradable or durable polymer-coated drug-eluting stents
Authors: Buiten Rosaly A. , Zocca Paolo , von Birgelen Clemens
Published: August 2020

Purpose of review

The current article will review recently published clinical studies that evaluate very thin or ultrathin-strut drug-eluting stents (DES), focusing on major randomized clinical trials in broad patient populations.

Recent findings

Multiple randomized trials recently assessed the clinical performance of novel very thin to ultrathin-strut DES. Most randomized trials established noninferiority of the novel device. To date, only one major randomized clinical trial (i.e., BIOFLOW V) showed superiority of an ultrathin-strut biodegradable polymer-coated sirolimus-eluting stent over a very thin-strut durable polymer-coated everolimus-eluting stent in a relatively broad patient population. There are signals that the same ultrathin-strut biodegradable polymer-coated sirolimus-eluting stent may improve clinical outcome in specific patient populations. For example, in the randomized BIOSTEMI trial, 1-year superiority of the ultrathin-strut DES was found in patients presenting with an acute ST-segment elevation myocardial infarction. Yet, substudies of large randomized trials that assessed patients with small-vessel treatment showed equivocal results.

Although two randomized trials showed advantages for ultrathin-strut DES, other clinical trials provided no significant evidence that ultrathin-strut DES improve clinical outcome. The question whether ultrathin-strut DES may reduce the repeat revascularization risk following implantation in small vessels is a matter of further debate and future research.
Ischaemia without obstructive coronary artery disease: the pathophysiology of microvascular dysfunction
Authors: Sinha Aish , Rahman Haseeb , Perera Divaka
Published: August 2020

Purpose of review

Nearly one-third of patients presenting with angina have unobstructed epicardial coronary arteries and evidence of coronary microvascular disease. Up until recently, the pathophysiology of coronary microvascular disease has been poorly understood, resulting in limited effective therapeutic options in these patients. As a result, patients with coronary microvascular disease continue to suffer from a poor quality of life and adverse cardiovascular outcomes.

Recent findings

Recent mechanistic studies have improved our understanding of the pathophysiology underlying coronary microvascular dysfunction; these studies have implicated the nitric oxide and endothelin pathways as the main drivers. The aim of this article is to review our current understanding of the pathophysiology of ischaemia in patients with coronary microvascular disease.

Patients with angina who have coronary microvascular disease, but no obstructive coronary artery disease, are unable to augment their coronary blood flow in response to physiological stress, thereby predisposing them to myocardial ischaemia as a result of supply:demand mismatch in the myocardium. In addition to abnormalities of vascular resistance, perturbations in cardiac–coronary coupling also contribute to ischaemia in these patients. Although impaired flow reserve is the diagnostic hallmark, mechanistic studies have demonstrated that the underlying pathophysiology is heterogeneous. At present, two main endotypes have been identified, which can be readily differentiated on the basis of minimal microvascular resistance. A better understanding of the pathophysiology and mechanisms driving ischaemia in coronary microvascular dysfunction may stimulate the development of individualised therapies that may lead to an improvement in patients’ quality of life and prognosis.
Management of renovascular hypertension
Authors: Textor Stephen C.
Published: August 2020

Purpose of review

Renovascular occlusive disease remains a common cause of resistant and rapidly progressive hypertension. The present review summarizes current practice regarding management of renovascular hypertension (RVH).

Recent findings

Current data using blood oxygen level dependent MR emphasize the tolerance of the kidney to moderate reductions in blood flow and the efficacy of antihypertensive drug therapy for many individuals. Prospective trials have failed to identify benefits of revascularization for moderate disease, either regarding blood pressure or renal function. Antihypertensive drug therapy including renin-angiotensin system blockade is central to management of RVH. Recent and ongoing observational studies report important improvements after revascularization regarding blood pressure, management of refractory or ‘flash’ pulmonary edema, and survival in specific ‘high risk’ clinical populations not included in randomized trials. Research directions underscore the role of adjunctive measures, including mitochondrial protection, therapeutic angiogenesis, and cell-based regenerative repair to protect kidney function in RVH.

Clinicians should recognize the potential for disease progression to threaten renal function with severe and prolonged renal ischemia. Improved patient selection for true resistant hypertension with RVH and ‘high-risk’ clinical manifestations is critical to identify those likely to benefit from renal revascularization.
Adverse events beyond 1 year after percutaneous coronary intervention
Authors: Madhavan Mahesh V. , Stone Gregg W.
Published: August 2020

Purpose of review

To provide a summary and critical appraisal of recent literature pertaining to very late adverse events (>1 year) after revascularization with percutaneous coronary intervention (PCI) with coronary stents.

Recent findings

Recent studies, including an individual patient-level pooled analysis of randomized trials and network meta-analysis have demonstrated that all coronary stents, including contemporary drug-eluting stents (DES), are associated with an ongoing risk of major adverse cardiovascular events related to the stented region beyond the first year after stent implantation, with rates ranging from 2 to 3% per year for at least 4 years. Patients also remain at additional risk for events originating outside the stented segments because of progressive de novo atherosclerotic disease.

Despite improvements in the management of coronary artery disease, patients remain at risk for very late adverse cardiovascular events both arising from the stented regions and other untreated segments of the coronary tree. Further advancements focused on primary prevention, stent design and procedural technique, and secondary prevention will be crucial to reducing rates of very late events and improving symptoms and prognosis of patients after PCI.
Surgical Treatment for SWS Glaucoma: Experience From a Tertiary Referral Pediatric Hospital
Authors: Karaconji Tanya , Ting Eugene R. , Zagora Sophia L. , Ardern-Holmes Simone , Jamieson Robyn V. , Grigg John R.
Published: August 2020

Precis:

Glaucoma associated with Sturge-Weber syndrome (SWS) often requires surgical intervention. Our study shows that trabeculectomy is efficacious in treating this condition.

Purpose:

The purpose of this study was to describe the surgical outcomes of glaucoma associated with SWS in children presenting to the tertiary Paediatric Ophthalmology Department at The Children’s Hospital at Westmead.

Materials and Methods:

A retrospective study of patients with SWS referred to the Department of Ophthalmology at The Children’s Hospital at Westmead between 2003 and 2016 with at least 2 years of follow-up were identified, and information was collected from the clinical notes of all subjects.

Results:

A total of 27 patients with SWS were evaluated for glaucoma in which 8 were excluded due to inadequate follow-up. In total, 19 patients with SWS were included in this study in which glaucoma was diagnosed in 15 patients and 19 eyes, of which 13 eyes required glaucoma surgery. A total of 21 surgical procedures were performed with a median follow-up of 85 months. A primary trabeculotomy was performed in 5 eyes of which 4 required re-do trabeculotomy, and 3 of these eyes underwent a Baerveldt tube (BVT) shunt as a third procedure. One eye with a primary trabeculotomy underwent a BVT as a secondary procedure. A BVT was inserted in a total of 6 eyes in which it was a primary procedure in 2 eyes. Of the 6 eyes undergoing a BVT insertion, 5 achieved success (2 complete and 3 qualified), and 1 failed. One case underwent intraluminal stent removal. Six eyes underwent a primary trabeculectomy and needed no further surgical intervention. In the trabeculectomy group, 4 eyes achieved complete success and 2 eyes achieved qualified success.

Conclusions:

Glaucoma affects a significant proportion of patients with SWS and is associated with the presence of an ipsilateral port-wine stain in most cases. In our study, trabeculectomy was the most efficacious procedure for controlling intraocular pressure and reducing the burden of ongoing treatment in SWS-associated glaucoma.
Opioid Use After Orbital, Eyelid, or Lacrimal Surgery
Authors: Vu Priscilla Q. , Yu Jeffrey J. , Charlson Emily S. , Grob Seanna R. , Kshirsagar Rijul S. , Tao Jeremiah P.
Published: August 2020

Purpose:

Opioids may be indicated to mitigate pain after oculofacial surgery. The opioid crisis prompted attention to how these medications are dispensed and disposed. This study aims to characterize opioid usage and handling of patients undergoing oculofacial plastic surgery.

Methods:

Eighty-nine adult patients were surveyed on their opioid usage after undergoing orbital, lacrimal, or eyelid (including esthetic) surgery at a tertiary oculofacial plastic surgery practice. Each patient was prescribed 10 tablets of hydrocodone/acetaminophen 5 mg/325 mg; one tablet taken orally as needed every 6 hours for pain not relieved by acetaminophen. Subset analysis was performed for type of surgery, age, and gender.

Results:

Patients consumed an average of 3 ± 0.4 tablets. In the subsets, the averages were 2.1 ± 0.5 (n = 38) tablets after eyelid surgery, 1.6 ± 0.6 (n = 24) after lacrimal surgery, and 5.6 ± 0.9 (n = 27) after orbital surgery. Greater opioid usage was observed after orbital versus eyelid surgery (p = 0.0007) and orbital versus lacrimal surgery (p = 0.0005) but not eyelid versus lacrimal surgery (p = 0.8604). Forty-six patients (51.7%) used no opioids. Over half (57.3%; n = 51) filled their prescription. Thirty-three patients (37.1%) had unused medications, of which 21 patients did not properly dispose of their medications. The mean age of patients who used opioids was less than the mean age of those who needed no opioids (p = 0.024). There were no gender differences in opioid usage use versus not (p = 0.62).

Conclusions:

Opioid needs after oculofacial plastic surgeries, especially eyelid and lacrimal, were minimal in this cohort. For most patients, the prescription exceeded needs. Younger age but not gender was associated with opioid use versus not. Most did not properly discard these medications. Quality improvement in both the dispensing and disposal of opioids in oculofacial surgical practice may be warranted.
Anophthalmic Ptosis and the Effects of Enucleation on Upper Eyelid Function
Authors: Custer Philip L. , Maamari Robi N. , Huecker Julia B. , Gordon Mae O.
Published: August 2020

Purpose:

To describe the incidence of anophthalmic ptosis, identify clinical factors associated with its development, and evaluate the effects of enucleation on eyelid mechanics.

Methods:

In this observational cohort study, measurements and photographs were reviewed in 139 patients who underwent enucleation between 2007 and 2016. Patient demographics, pre- and postoperative eyelid measurements, and exophthalmometry were used to assess the incidence of ptosis and effects of surgery on eyelid function.

Results:

Preoperative ptosis was common and more often present in patients with enophthalmos (p = 0.0305) or reactive blepharospasm (p < 0.0001). The incidence of new-onset ptosis and improvement of preexisting ptosis following enucleation were similar (40%). Surgical repair was performed in 7% of patients with ptosis. Contralateral levator function declined with age and was positively correlated with exophthalmometry (p < 0.0001). Anophthalmic levator function was greater with increased anterior projection of the implant (p < 0.0001) and prosthesis (p < 0.0001). Patients with larger implants had improved levator function, with (p = 0.0065) and without (p = 0.0007) the prosthesis. Superior sulcus deepening was associated with decreased levator activity, but not margin-reflex distance.

Conclusions:

Preoperative ptosis was common, and often related to reactive blepharospasm or enophthalmos. Levator function declined with age, and correlated to greater anterior projection of the implant and prosthesis following enucleation. The surgeon can counsel patients regarding the similar likelihood (40%) of preoperative ptosis improving and new ptosis developing after enucleation. The primary factor the surgeon can modify to improve postoperative eyelid function is to maximize implant size, which is associated with greater levator activity.
Substance use and risk of HIV infection among Men who have Sex with Men in India
Authors: Kumar Pradeep , Aridoss Santhakumar , Mathiyazhakan Malathi , Balasubramanian Ganesh , Jaganathasamy Nagaraj , Natesan Manikandan , V.M. Padmapriya , David Joseph K. , Rajan Shobini , Adhikary Rajatashuvra , Arumugam Elangovan
Published: August 2020

HIV prevalence is higher among Men who have Sex with Men (MSM), owing to their unsafe sexual behavior. Further, MSM indulge in behaviors such as consumption of alcohol/oral drugs and/or injecting during/before sex that poses the risk of unsafe behaviors, thereby increasing their vulnerability to HIV. The study aims to analyze the factors associated with HIV infection among the multi-risk MSM using any substances with those MSM who do not use substances.

Community-based cross-sectional survey design using probability-based sampling between October 2014 and November 2015.

For the nation-wide Integrated Biological and Behavioral Surveillance (IBBS), 23,081 MSM were recruited from 4067 hotspots in 108 districts across India. Information on demographics, sexual behaviors, substance use, sexual partners, and awareness on HIV and its management was collected from the consented respondents using computer-assisted personal interview (CAPI) by trained personnel. Blood samples were tested for HIV. Statistical analyses were done, to study the associations between substance use and its influence on high-risk sexual behaviors and HIV infection.

One in 3 MSM (33.88%) in India were substance users, thus exhibiting “multi-risk” (MR) behaviors. Significantly higher HIV prevalence (3.8%, P < .05) was reported among MR-MSM, despite 97.2% of them being aware of HIV. Higher HIV prevalence among MSM exhibiting homosexual behavior for ≤1 year is of specific concern, as this accounts to recent infections and indicates the increased vulnerability of the infection among the new entrants.

Substance-use resulting in high-risk sexual behavior was significantly associated with higher HIV prevalence among MR-MSM. Integrated targeted interventions focusing on safe sex and safe-IDU practices among MR-MSM are required to end the disease transmission.
COVID-19 in hematological malignancy patients
Authors: Chen Can , Weng Qianping , Li Yiwei , Shi Pengfei , Qian Shenxian
Published: August 2020

Background:

COVID-19 is an international outbreak of the respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The diseases themselves, as well as the intensity of chemotherapy, lead to significant immunosuppression, leading hematological malignancy patients susceptible to infections.

Methods:

This protocol will be performed according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines and reported follow the Cochrane Collaboration Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases of PubMed, MEDLINE, Google Scholar, Web of science, Cochrane Library, EMBASE, CNKI, CMB, and Wangfang database from the inception to present will be comprehensively and systematically searched without limitations of language, date, and publication status. Observational, retrospective cohort, prospective case-control, cohort studies, cross-sectional studies, or clinical trials will be included. All assessment of study selection, data extraction, and study quality assessment will be independently performed by 2 reviewers. RevMan V.5.3 program and Stata V.12.0 software will be utilized for the methodological quality assessment and statistical analysis.

Results:

The result of this systematic review will provide evidence for clinicians on the management of COVID-19 patients with hematological malignancy.

Conclusion:

This systematic review will help raise awareness and guide management of COVID-19 patients with hematological malignancy, as well as to improve outcomes in this population.

Ethic and dissemination:

The content of this article does not involve moral approval or ethical review because no individual data will be collected.

PROSPERO registration:

CRD42020187493.
Analgesic effect of pulsed electromagnetic fields for mammaplasty
Authors: Zhang Li , Ding Wei , Ji Yu
Published: August 2020

Background:

Pulsed electromagnetic fields shows some potential in alleviating pain after mammaplasty. This systematic review and meta-analysis is conducted to investigate the analgesic efficacy of pulsed electromagnetic fields for pain control after mammaplasty.

Methods:

The databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases are systematically searched for collecting the randomized controlled trials regarding the impact of pulsed electromagnetic fields on pain intensity after mammaplasty.

Results:

This meta-analysis has included 4 randomized controlled trials. Compared with control group after mammaplasty, pulsed electromagnetic fields results in remarkably reduced pain scores on 1 day (MD = −1.34; 95% confidence interval [CI] = −2.23 to −0.45; P = .003) and 3 days (MD = −1.86; 95% CI = −3.23 to −0.49; P = .008), as well as analgesic consumption (Std. MD = −5.64; 95% CI = −7.26 to −4.02; P < .00001).

Conclusions:

Pulsed electromagnetic fields is associated with substantially reduced pain intensity after mammaplasty.
Effect of a critical thinking intervention on stress management among undergraduates of adult education and extramural studies programs
Authors: Okide Charity Chinelo , Eseadi Chiedu , Ezenwaji Ifeyinwa O. , Ede Moses O. , Igbo Rosemary Ogochukwu , Koledoye Uzoamaka Lucynda , Ekwealor Nwakaego Ebele , Osilike Chioma , Okeke Nkechi Mercy , Igwe Ngozi Justina , Nwachukwu Ruphina U. , Ukanga Lambert Peter , Olajide Mulii Falaremi , Onuorah Anthonia Ekanibe , Ujah Patrick , Ejionueme Lambert K. , Abiogu Godwin C. , Eskay Michael , Ugwuanyi Christian S.
Published: August 2020

Objective:

The objective of this study was to examine the effect of a critical thinking intervention (CTI) on stress management among undergraduates of adult education and extramural studies programs.

Method:

A total of 44 undergraduates were randomly sorted into experimental and waitlist control groups. We used the Perceived Stress Scale for data collection at the pre-test, post-test, and follow-up stages. We used unpaired t and paired t-tests to analyze the data collected. SPSS version 22.0 was used for the data analyses (SPSS Inc., Chicago, IL).

Results:

It was shown that the CTI was effective in reducing the mean stress of the participants compared to the control group both in the post-test (t[42] = −22.453, P < .001) and follow-up periods (t[42] = −34.292, P < .001). There were statistically significant changes in the mean stress of participants in the experimental group from the pre-test to post-test phases (t[23] = 26.30, P = .000, r = .08], and from pre-test to follow-up(t[23] = 37.10, P = .000, r = .30). The mean stress of the participants in the experimental group from post-test to follow-up signified the sustained positive influence of the CTI on the mean stress (t[23] = 2.41, P = .000, r = .46) of the undergraduates.

Conclusion:

This study adds to the literature by showing that a CTI is a valuable strategy for stress reduction in a university environment. Given that the CTI demonstrated the ability to reduce stress among undergraduates enrolled in adult education and extramural studies programs, we hope that similar interventions will be adopted to manage and prevent stress among students in other departments and disciplines.
Impaired immune and coagulation systems may be early risk factors for COVID-19 patients
Authors: Qin Zhi-jun , Liu Lei , Sun Qun , Li Xia , Luo Jian-fei , Liu Jia-sheng , Liu Dan
Published: August 2020

The coronavirus disease 2019 (COVID-19) outbreak has become a global health threat and will likely be one of the greatest global challenges in the near future. The battle between clinicians and the COVID-19 outbreak may be a “protracted war.”

The objective of this study was to investigate the risk factors for in-hospital mortality in patients with COVID-19, so as to provide a reference for the early diagnosis and treatment.

This study retrospectively enrolled 118 patients diagnosed with COVID-19, who were admitted to Eastern District of Renmin Hospital of Wuhan University from February 04, 2020 to March 04, 2020. The demographics and laboratory data were collected and compared between survivors and nonsurvivors. The risk factors of in-hospital mortality were explored by univariable and multivariable logistic regression to construct a clinical prediction model, the prediction efficiency of which was verified by receiver-operating characteristic (ROC) curve.

A total of 118 patients (49 males and 69 females) were included in this study; the results revealed that the following factors associated with in-hospital mortality: older age (odds ratio [OR] 1.175, 95% confidence interval [CI] 1.073–1.287, P = .001), neutrophil count greater than 6.3 × 109 cells/L (OR 7.174, (95% CI 2.295–22.432, P = .001), lymphocytopenia (OR 0.069, 95% CI 0.007–0.722, P = .026), prothrombin time >13 seconds (OR 11.869, 95% CI 1.433–98.278, P = .022), d-dimer >1 mg/L (OR 22.811, 95% CI 2.224–233.910, P = .008) and procalcitonin (PCT) >0.1 ng/mL (OR 23.022, 95% CI 3.108–170.532, P = .002). The area under the ROC curve (AUC) of the above indicators for predicting in-hospital mortality were 0.808 (95% CI 0.715–0.901), 0.809 (95% CI 0.710–0.907), 0.811 (95% CI 0.724–0.898), 0.745 (95% CI 0.643–0.847), 0.872 (95% CI 0.804–0.940), 0.881 (95% CI 0.809–0.953), respectively. The AUC of combined diagnosis of these aforementioned factors were 0.992 (95% CI 0.981–1.000).

In conclusion, older age, increased neutrophil count, prothrombin time, d-dimer, PCT, and decreased lymphocyte count at admission were risk factors associated with in-hospital mortality of COVID-19. The prediction model combined of these factors could improve the early identification of mortality risk in COVID-19 patients.
Prediction of nodal staging in breast cancer patients with 1-2 sentinel nodes in the Z0011 era
Authors: Corsi Fabio , Sorrentino Luca , Albasini Sara , Bossi Daniela , Morasso Carlo , Villani Laura , Truffi Marta
Published: August 2020

The aim of this study was to provide an innovative nomogram to predict the risk of >2 positive nodes in patients fulfilling the Z0011 criteria with 1-2 sentinel lymph nodes (SLNs) only retrieved.

From 2007 to 2017, at the Breast Unit of ICS Maugeri Hospital 271 patients with 1-2 macrometastatic SLNs, fulfilling the Z0011 criteria, underwent axillary dissection and were retrospectively reviewed.

A mean of 1.5 SLNs per patient were identified and retrieved. One hundred eighty-seven (69.0%) had 1-2 positive nodes, and 84 (31.0%) had >2 metastatic nodes. Independent predictors of axillary status were: positive SLNs/retrieved SLNs ratio (odds ratio [OR] 10.95, P = .001), extranodal extension (OR 5.51, P = .0002), and multifocal disease (OR 2.9, P = .003). A nomogram based on these variables was constructed (area under curve after bootstrap = 0.74).

The proposed nomogram might select those patients fulfilling the Z0011 criteria, with 1-2 SLNs harvested, in whom a high axillary tumor burden is expected, aiding to guide adjuvant treatments.
Severe reflux esophagitis and multiple congenital defects
Authors: Ma Jia-Yi , Wang Dan , Li Zhao-Shen , Hu Liang-Hao
Published: August 2020

Introduction:

Gastroesophageal reflux disease is a common and troublesome condition. This paper reports a rare case of gastroesophageal reflux disease caused by ectopic biliary drainage accompanying the absence of a pyloric channel and duodenal bulb in a female patient with multiple underlying malformations.

Patient concerns:

A 24-year-old female presented with acid regurgitation and abdominal pain for one month. She was born two weeks premature and with blindness of the right eye. Cardiac murmur was detected in the physical examination.

Diagnosis:

Gastroendoscopy was performed, and a class D reflux esophagitis and ectopic papilla complicated with the absence of a pyloric channel and duodenal bulb were found. Doppler echocardiography further confirmed the defects of atrial and ventricular septa. Trio-based whole exome sequencing was performed on the proband and her family to find the potential association of multiple variations. However, no putative pathogenic mutations were found.

Interventions:

The patient received proton pump inhibitors and prokinetic treatment and underwent surgical repair of septal defects.

Outcomes:

The symptoms were quickly relieved, and the patient was kept stable upon follow-up.

Conclusion:

The combination of an absent pylorus and ectopic papilla is a rare cause of reflux esophagitis. Unusual gastrointestinal anatomical variations may be accompanied by other malformations. Though no remarkable mutation were detected in this case, sequencing is an efficient technique worth full consideration.
Effect of globalization on global dental caries trend
Authors: Alsuraim Bakr Salem , Han Dong-Hun
Published: August 2020

Risk factors such as smoking and sugar intake threaten the health of human being at an individual national level as well as at a global level. The globalization affect health indirectly through macro and micro-level factors. This study aimed to identify the global trend of dental caries according to countries national income level, and to examine the role of globalization, health services, obesity, and sugar consumption on dental caries. Data for 160 countries were collected for the time period of the 1990s to 2010s. The final sample included 46 countries with complete data (21 high income countries (HIC) and 25 middle and low income countries (MLIC)). The main dependent variable was the mean decayed, missing, and filled teeth (DMFT) index of 12-year-olds as an indicator of dental caries. Globalization was a main independent variable which was measured by economic growth, urbanization and economic freedom. Other independent variables were health services, obesity and sugar consumption. The data were analyzed first using repeated measures analysis of variance to compare dental caries trends in HIC and MLIC. Then, using multiple linear regression and partial least squares structural equation modeling (PLS-SEM), the relationships between globalization, health services, obesity, sugar consumption, and dental caries were examined. The results of PLS-SEM revealed that globalization was associated with lower DMFT in HIC. The global dental caries trend had a declined pattern, but this pattern has been attenuated in MLIC after the new millennium. There is a need for policy change and regulations on sugar trade especially in MLIC to diminish the adverse consequences of globalization, and to improve population dental health.
Prognosis prediction of pancreatic cancer after curative intent surgery using imaging parameters derived from F-18 fluorodeoxyglucose positron emission tomography/computed tomography
Authors: Yoo Min Young , Yoon Yoo-Seok , Suh Min Seok , Cho Jai Young , Han Ho-Seong , Lee Won Woo
Published: August 2020

Imaging parameters including metabolic or textural parameters during F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) are being used for evaluation of malignancy. However, their utility for prognosis prediction has not been thoroughly investigated. Here, we evaluated the prognosis prediction ability of imaging parameters from preoperative FDGPET/CT in operable pancreatic cancer patients.

Sixty pancreatic cancer patients (male:female = 36:24, age = 67.2 ± 10.5 years) who had undergone FDGPET/CT before the curative intent surgery were enrolled. Clinico-pathologic parameters, metabolic parameters from FDGPET/CT; maximal standard uptake value (SUVmax), glucose-incorporated SUVmax (GI-SUVmax), metabolic tumor volume, total-lesion glycolysis, and 53 textural parameters derived from imaging analysis software (MaZda version 4.6) were compared with overall survival.

All the patients underwent curative resection. Mean and standard deviation of overall follow-up duration was 16.12 ± 9.81months. Among them, 39 patients had died at 13.46 ± 8.82 months after operation, whereas 21 patients survived with the follow-up duration of 18.56 ± 9.97 months. In the univariate analysis, Tumor diameter ≥4 cm (P = .003), Preoperative Carbohydrate antigen 19-9 ≥37 U/mL (P = .034), number of metastatic lymph node (P = .048) and GI-SUVmax (P = .004) were significant parameters for decreased overall survival. Among the textural parameters, kurtosis3D (P = .052), and skewness3D (P = .064) were potentially significant predictors in the univariate analysis. However, in multivariate analysis only GI-SUVmax (P = .026) and combined operation (P = .001) were significant independent predictors of overall survival.

The current research result indicates that metabolic parameter (GI-SUVmax) from FDGPET/CT, and combined operation could predict the overall survival of surgically resected pancreatic cancer patients. Other metabolic or textural imaging parameters were not significant predictors for overall survival of localized pancreatic cancer.
Primary central nervous system lymphoma after heart transplantation
Authors: Zhu Fang , Li Qiuhui , Liu Tao , Xiao Yin , Pan Huaxiong , Liu Xinxiu , Wu Gang , Zhang Liling
Published: August 2020

Rationale:

The heart transplantation is the most important treatment for patients with end-stage severe heart disease who failed to conventional therapy. Post-transplant lymphoproliferative disorder is the second most common malignancy in heart transplant recipients. However, primary central nervous system lymphoma (PCNSL) after heart transplantation is an extremely rare condition.

Patients concerns:

This report described a 53-year-old male who was diagnosed as PCNSL 17 months after heart transplantation.

Diagnoses:

The patient was admitted to the local hospital presenting with dizziness, headache, and reduced left-sided power and sensation for 1 week. He had a medical history of heart transplantation because of the dilated cardiomyopathy 17 months ago and had a 17-month history of immunosuppressive therapy with tacrolimus. A computed tomography scan of the brain revealed a bulky mass in the right temporal lobe. The emergency intracranial mass resection and cerebral decompression were performed in our hospital. The histopathology of the brain lesions showed diffuse large B-cell lymphoma. A further 18FDG positron emission tomography-computed tomography scan of the whole body showed no significantly increased metabolic activity in other regions. The final diagnosis of this patient was PCNSL after heart transplantation.

Interventions:

Given the poor health condition, with the patient's consent, the whole brain radiotherapy was performed with supportive care.

Outcomes:

The disease deteriorated rapidly during the period of receiving radiotherapy, and he died within 2 months from the diagnosis.

Lessons:

PCNSL after heart transplantation is an extremely rare phenomenon with extremely poor prognosis. We should pay close attention to the heart recipients, especially when the patients present with neurological symptoms and signs. The available treatment options for PCNS-post-transplant lymphoproliferative disorder include the reduction of immunosuppressive drugs, immune-chemotherapy, operation, radiotherapy. However, individual treatments for heart transplant recipients with PCNSL should be based on the performance status and tolerance to treatment, combined with the doctor's experience and supportive care.
A randomized controlled trial study protocol of modified Mahuang-Fuzi-Xixin decoction in the treatment of patients with mild bronchial asthma during acute exacerbation
Authors: Gan Wenfan , Huang Qun , Wang Maojuan , Wang Jundong , Hui Yuxin , Zhao Keni , Huang Niao , Liao Tingting
Published: August 2020

Introduction:

These years, due to dissatisfaction with western medicine treatments, traditional Chinese medicine (TCM) becomes a main treatment for bronchial asthma patients. Lung and kidney yang deficiency syndrome is a common type of asthma and the Chinese herbal medicine formula modified Mahuang-Fuzi-Xixin (MFX) decoction is prescribed for mild bronchial asthma patients with acute exacerbation syndrome. However, there is not obvious evidence to support the efficacy and safety of modified MFX decoction the efficacy and safety to treat mild bronchial asthma and the mechanism of this disease is still unclear.

Methods:

A double-blind, placebo-controlled, randomized clinical trial was proposed by us. After a 10-day run-in period, 180 eligible objects will be recruited in this study. These subjects will be allocated to the experimental group or control group in a 1:1 ratio. Patients in the experimental group will take modified MFX decoction. At the same time, patients in the control group will receive a matched placebo. The budesonide inhalation powder will be used as a western medicine treatment for both groups. All subjects will receive 14 days of treatment and another 6 months of follow-up. The primary outcome is the mean change in peak expiratory flow rate from the baseline to 14 days in this research. The secondary outcome includes forced expiratory volume in one second, asthma control test score, Asthma Quality of Life Questionnaire score, curative effect of TCM syndrome, and salbutamol dosage. This trial will also explore the association between the change of immunoglobulin E and modified MFX decoction treatment. Any side effects of the treatment will be recorded.

Discussion:

The results of this trial will provide the evidence for the effect of modified MFX decoction in patients with mild bronchial asthma during acute exacerbation. It also will explore the mechanism of this formula in the treatment of bronchial asthma, which will provide another treatment option for patients with mild bronchial asthma.
Effectiveness and safety of massage in the treatment of the congenital muscular torticollis
Authors: Xiao Yuanyi , Chi Zhenhai , Yuan Fuqiang , Zhu Daocheng , Ouyang Xilin , Xu Wei , Li Jun , Luo Zhaona , Chen Rixin , Jiao Lin
Published: August 2020

Background:

Massage has been widely used in the treatment of muscular torticollis in children, but there is no objective and systematic evaluation of the efficacy of various literature, and the efficacy of massage in the treatment of congenital muscular torticollis (CMT) is not clear. The purpose of this study is to evaluate the clinical efficacy and safety of massage in the treatment of muscular torticollis in children.

Methods:

Relevant randomized controlled trials (RCTs) will be searched from the databases of PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, and Chinese Biomedical Literature Database from their inception to May 2020. Two reviewers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool. The RevMan V.5.3 will be used for meta-analysis.

Results:

This study will provide an assessment of the current state of Chinese massage therapy for the congenital muscular torticollis, aiming to show the efficacy and safety of massage treatment.

Conclusion:

This study will provide evidence to judge whether massage is an effective intervention for the third lumbar vertebrae transverse process syndrome.

INPLASY registration number:

INPLASY202070086.