Tag: pubmed

Orthop Surg. 2021 Sep 3. doi: 10.1111/os.13030. Online ahead of print.

ABSTRACT

OBJECTIVE: To clarify the morphological, biochemical, and biomechanical effects of peracetic acid-ethanol sterilization processing to human hamstring tendon allografts for different time periods.

METHODS: Thirty-two fresh-frozen human hamstring tendon allografts obtained from an allograft supplier were prepared and incubated in peracetic acid-ethanol solution (PES) containing 1% v/v peracetic acid and 24% v/v ethanol. Specimens were randomly classified into four groups according to the PES processing time (untreated as the control group, 30 min as the PES30 group, 120 min as the PES120 group, and 240 min as the PES240group). Light microscopy with hematoxylin-eosin and toluidine blue were performed, along with transmission electron microscopy (TEM) to measure the collagen fibril diameters and their distributions, from which the collagen fibril index (CFI) and mass average diameter (MAD) were calculated. The thermal stability and collagen denaturation were analyzed by differential scanning calorimetry (DSC) and collagen denaturation test by α-chymotrypsin. Cyclic loading and failure testing were applied on five tendons from each group, from which the cyclic creep strain, elastic modulus, maximum stress, maximum strain, and strain energy density were calculated.

RESULTS: Tendons in the control, PES30, PES120 groups showed similar regularly aligned collagen fibers in light microscopy images, while the images from the PES240 group revealed relatively disordered and heterogeneous collagen bundles with larger interfiber spaces. TEM analysis showed that the mean diameter (F = 3.09, P = 0.04) was lower in the PES120 group (87.15 ± 4.76 nm) than it was in the control group (99.39 ± 9.19 nm) but not statistically (P = 0.05). Moreover, the CFI value in the PES30 group (65.37 ± 4.14%) was the lowest among groups (all P ≤ 0.01), while no variance existed in density and MAD among groups (F = 2.09, P = 0.13, and F = 0.27, P = 0.85, respectively). The onset temperature (H = 8.74, P = 0.03) and peak temperature (H = 9.97, P = 0.02) were decreased in the PES30 group compared to the control group (P = 0.02 and P = 0.01, respectively), but there were no differences in enthalpy of denaturation among groups (F = 2.20, P = 0.17). The collagen denaturation test revealed lower hydroxyproline concentrations in PES-treated specimens with no statistical differences among groups (H = 8.86, P = 0.07). The maximum stress showed variance (F = 10.52, P < 0.01) that it was higher in PES30 group (68.29 ± 10.86 MPa) compared to the PES120 and the PES240 group, while it was lower in the PES120 group (19.40 ± 4.94 MPa) compared to the control and the PES30 group (all P < 0.05). The strain energy density (F = 7.34, P < 0.01) was over 4 times higher in the PES30 group (7.39 ± 2.51 MPa) than it was in the PES120 group (1.56 ± 0.64 MPa, P < 0.01).

CONCLUSION: PES treatment for 30 min has no adverse effect on the properties of human hamstring tendon allografts, longer processing time could not promise better properties preservation.

PMID:34477308 | DOI:10.1111/os.13030

J Magn Reson Imaging. 2021 Sep 3. doi: 10.1002/jmri.27903. Online ahead of print.

ABSTRACT

BACKGROUND: Levodopa is the most-commonly used therapy for Parkinson’s Disease (PD). Imaging findings show increased cerebral blood flow (CBF) response to levodopa, but the artery morphological change is less studied.

PURPOSE: To investigate the effect of levodopa on cerebral arteries and CBF.

STUDY TYPE: Prospective.

POPULATION: 57 PD patients (56 ± 10 years, 26 males) and 17 age-matched healthy controls (AMC, 57 ± 9 years, 9 males) were scanned at baseline (OFF). Patients were rescanned 50 minutes after taking levodopa (ON).

FIELD STRENGTH AND SEQUENCE: 3 T; Simultaneous noncontrast angiography intraplaque imaging (SNAP) based on turbo field echo; Pseudo-continuous arterial spin labeling (PCASL) based on echo-planner imaging.

ASSESSMENT: The Unified Parkinson’s Disease Rating Scale (UPDRS-III) was used to assess the disease severity. Length and radius of arteries were measured from SNAP images. CBF was calculated from PCASL images globally and regionally.

STATISTICAL TESTS: Mann Whitney U tests were conducted in comparing PD vs. AMC. Wilcoxon matched-pairs signed rank tests were used in comparing OFF vs. ON, and the more-affected vs. the less-affected hemisphere in PD. Linear regressions were performed to test the correlations of neuroimaging findings with behavioral changes. Significance threshold was P < 0.05 with Bonferroni correction.

RESULTS: PD patients were identified with significantly lower CBF (PD OFF Mean = 40.15 ± 5.99, AMC Mean = 43.48 ± 6.21 mL/100 g/min) and shortened total artery length (PD OFF Mean = 5851.07 ± 1393.45, AMC Mean = 7479.16 ± 1335.93 mm). Levodopa elevated CBF of PD brains (PD ON Mean = 41.48 ± 6.32 mL/100 g/min) and expanded radius of proximal arteries. Artery radius change significantly correlated with CBF change in corresponding territories (r = 0.559 for Internal Carotid Arteries, r = 0.448 for Basilar Artery, and r = 0.464 for Middle Cerebral Artery M1). Global CBF significantly related to UPDRS-III (r = -0.391) post-levodopa.

DATA CONCLUSION: Levodopa can increase CBF by dilating proximal arteries.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY STAGE: 4.

PMID:34477268 | DOI:10.1002/jmri.27903

Obes Rev. 2021 Sep 3:e13318. doi: 10.1111/obr.13318. Online ahead of print.

ABSTRACT

High risk of bias associated with missing outcome data (MOD) in meta-analyses (MAs) of the effects of lifestyle interventions during pregnancy on postpartum weight retention (PPWR) casts doubt on whether such interventions can be relied upon as truly effective. This systematic overview of three MAs (19 RCTs), each with high MOD rates in the subset of RCTs included, examined how MOD were addressed in the estimation of summary intervention effects. All MAs reported beneficial and statistically significant intervention effects estimated based on complete case analyses, deemed valid if MOD was missing at random (MAR). Therefore, we conducted sensitivity analyses using pattern mixture models and informative missingness parameters (describing how the outcome in the missing participants may be related to the outcome in the completers), to ascertain the robustness of the estimates to reasonable deviations from the MAR assumption. In plausible scenarios where the response in intervention group participants with versus without MOD was worse (by just 0.5 kg), effect estimates were attenuated in all MAs and no longer statistically significant in two MAs. Statistical significance was retained when all 19 RCTs identified across MAs were examined together in a broader meta-analysis: -0.63 kg (95%CI -0.17, -0.08), but the clinical relevancy of effects of this magnitude remains unclear.

PMID:34477276 | DOI:10.1111/obr.13318

J Card Surg. 2021 Sep 3. doi: 10.1111/jocs.15976. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the effect of music therapy on infants who underwent mechanical ventilation after cardiac surgery.

METHODS: A prospective randomized controlled study was conducted in a provincial hospital in southeast China. The subjects were randomly divided into the music therapy (MT) group and the control group. Both groups were given standardized sedation treatment and routine nursing. Infants in the MT group received 60 min of MT three times a day. The sedation medication, Richmond sedation agitation scale (RASS) score, incidence of delirium, mechanical ventilation duration, length of cardiac intensive care unit (CICU) stay, restraint belt use time, and successful ventilation withdrawal rate were collected.

RESULTS: Infants in the control group had a higher total amount of on-demand midazolam (p = .039). Infants in the MT group had a significantly lower incidence of delirium, shorter mechanical ventilation duration, and restraint band use time (p = .047, p = .046, and p = .038, respectively). Although infants in the MT group had a higher success rate of ventilation withdrawal, lower RASS scores, and shorter ICU stay, the difference was not statistically significant (p = .427, p = .585, and p = .068, respectively).

CONCLUSION: MT in the ICU can reduce the use of on-demand sedative drugs, shorten mechanical ventilation, and reduce the occurrence of delirium in infants who underwent mechanical ventilation after cardiac surgery. MT is a safe and reliable treatment and worthy of clinical application.

PMID:34477246 | DOI:10.1111/jocs.15976

Disasters. 2021 Sep 3. doi: 10.1111/disa.12508. Online ahead of print.

ABSTRACT

Freetown is confronted with health-related risks that are compounded by rapid unplanned urbanisation and weak capacities of local government institutions. Addressing such community health risks implies a shared responsibility between government and non-state actors. In low-income communities, the role of Community-Based Organisations (CBOs) in combatting health disasters is well-recognized. Yet, empirical evidence about how CBOs have drawn on their networks and coordinated community-level strategies in responding to the Covid-19 pandemic is scant. Based on a qualitative study in two informal settlements in Freetown, this paper draws on actor-network theory to understand how CBOs problematize Covid-19 as a health risk, interact with other actors and the tensions that arise within these actor networks. The study findings show that community vulnerabilities and past experiences with health disasters such as Ebola informed CBOs’ perception of Covid-19 as communal emergency. In response, CBOs coordinated sensitization and mobilization programs by relying on a network of internal and external actors to support Covid-19 risk reduction strategies. Nonetheless, misunderstandings among actors caused tensions in the actor- network. The study suggests that creating new channels for knowledge exchange and building on CBO capacity can help strengthen actor networks in communities and combat current and future health disasters. This article is protected by copyright. All rights reserved.

PMID:34477244 | DOI:10.1111/disa.12508

Histol Histopathol. 2021 Sep 3:18371. doi: 10.14670/HH-18-371. Online ahead of print.

ABSTRACT

Perilipin-2, a lipid droplet (LD) coating protein, has been found to be involved in cancer progression. However, its role in hepatoblastoma (HB) is undefined. We collected 87 HB samples and the corresponding clinical data. Immunohistochemistry (IHC) staining was performed to detect perilipin-2 and the association of the perilipin-2 expression with clinical characteristics and prognosis was analyzed. The expression of perilipin-2 was increased in fetal HB components in comparison to embryonal HB components. The predominant staining pattern was vesicular in fetal HB cells, while it was granular in embryonal HB cells. Furthermore, strong expression of perilipin-2 was associated with the histopathological type of fetal predominant HB. Although event-free survival (EFS) did not differ to a statistically significant extent between the strong and weak expression groups in a univariate survival analysis, a multivariate survival analysis revealed that EFS was significantly improved in the strong perilipin-2 expression group. In conclusion, perilipin-2 is differentially expressed in HB and the strong expression of perilipin-2 predicts a better prognosis.

PMID:34477212 | DOI:10.14670/HH-18-371

Br J Dermatol. 2021 Sep 3. doi: 10.1111/bjd.20689. Online ahead of print.

ABSTRACT

BACKGROUND: In children, psoriasis can be challenging to diagnose. Difficulties arise from differences in the clinical presentation compared to adults.

OBJECTIVES: To test the diagnostic accuracy of previously agreed consensus criteria and develop a shortlist of best predictive diagnostic criteria for childhood psoriasis.

METHODS: A case-control diagnostic accuracy study in 12 UK dermatology departments (2017-2019) assessed 18 clinical criteria using blinded trained investigators. Children (<18 years) with dermatologist diagnosed psoriasis (cases n=160) or a different scaly inflammatory rash (controls n=170) were recruited. The best predictive criteria were identified using backward logistic regression and internal validation was conducted using bootstrapping.

RESULTS: The sensitivity of the consensus agreed criteria and consensus scoring algorithm was 84.4%, specificity was 65.1% and area under the curve (AUC) 0.75. Seven diagnostic criteria which performed best were: i) scale and erythema in the scalp involving the hairline; ii) scaly erythema inside the external auditory meatus; iii) persistent well-demarcated erythematous rash anywhere on the body; iv) scaly erythematous plaques on the extensor surfaces of the elbows and/or knees; v) persistent erythema in the umbilicus; vi) well demarcated erythematous rash in the napkin area involving the crural folds; vii) family history of psoriasis. Sensitivity of the best predictive model was 76.8%, specificity 72.7% and AUC 0.84. The c-statistic optimism adjusted shrinkage factor was 0.012.

CONCLUSIONS: This study provides examination and history-based data on the clinical features of psoriasis in children and proposes seven diagnostic criteria with good discriminatory ability in secondary care patients. External validation is now needed.

PMID:34477218 | DOI:10.1111/bjd.20689

Rev Esp Salud Publica. 2021 Sep 3;95:e202109123.

ABSTRACT

OBJECTIVE: Research has uncovered a global pandemic of physical inactivity and schools have been signaled as possible “agents” to modify these negative scores, since all children spend many hours a day there. The aim was to evaluate if it is possible to increase the physical activity levels of a whole school using a multifactorial, self-regulated intervention program during recess.

METHODS: A cross-sectional study was conducted involving all the students (N=50) of a rural public school located in northern Spain (grades 1-6). The study followed an ABA case study research design (changes in the experimentation conditions and data collection after each one: week 1 no intervention, weeks 2-3 intervention, week 4 no intervention) and mixed quantitative-qualitative methodology which included the use of accelerometers (each participant wore one during the whole school day and the school week), field notes (researcher) and focus groups (teachers). Normality tests, descriptive and inferential statistics (ANOVAs) were conducted in the quantitative data obtained, while thematic content and constant comparison analyses in the qualitative data.

RESULTS: Quantitative results showed that there was a significant increase to 67.15 ± 13.95 minutes/day of moderate-to-vigorous physical activity (MVPA) in week 2. Boys reached significantly higher scores than girls: 72.1 ± 12.12. Unfortunately, these scores went back to almost normal in the second week of implementation of the program (58.21 ± 12.88; boys= 62.75 ± 10.86). From the joined analysis of the researcher field notes and the teachers’ focus groups 4 themes emerged: intensity change, dominance change, interactions change and self-regulation.

CONCLUSIONS: It is possible to increase the physical activity levels of a whole school with a multifactorial, self-regulated program, but it is necessary to acknowledge that novelty “wears out” to avoid losing efficacy with time.

PMID:34477180

Rev Esc Enferm USP. 2021 Sep 1;55:e20200428. doi: 10.1590/1980-220X-REEUSP-2020-0428. eCollection 2021.

ABSTRACT

OBJECTIVE: To identify knowledge, skills, and attitudes on Evidence-Based Practice of nursing students in the School of Nursing of Universidade de São Paulo and to explore the relationship between knowledge, skills, and attitudes and associated variables.

METHOD: This is an exploratory, descriptive, analytical study conducted with 125 nursing undergraduate students. The data were obtained through application of the Evidence-Based Practice Questionnaire.

RESULTS: The mean score for the questionnaire was 4.73 (SD = 0.79), with a higher score in the Attitudes domain. There was a significant statistical correlation between questionnaire score and course year (p < 0.001).

CONCLUSION: There is a gap in the knowledge and skills associated to Evidence-Based Practice among nursing students. Effective strategies for teaching this subject in the nursing undergraduate course must be developed.

PMID:34477197 | DOI:10.1590/1980-220X-REEUSP-2020-0428

Medicine (Baltimore). 2021 Sep 3;100(35):e27165. doi: 10.1097/MD.0000000000027165.

ABSTRACT

BACKGROUND: The mechanism of cryptogenic stroke (CS) in patients with atrial septal abnormalities remains unclear, and the increased incidence of atrial vulnerability may be one of the reasons. We performed this meta-analysis to clarify the association between atrial septal abnormalities and atrial vulnerability, and to provide evidence-based basis for the prevention and mechanism of CS.

METHODS: We systematically searched for studies on the association between atrial septal abnormalities and atrial vulnerability, and pooled available data on types of atrial septal abnormalities, types of atrial vulnerability, and methods of atrial vulnerability detection. The primary endpoints were the occurrence of atrial arrhythmias or P wave abnormalities. Random-effects models were used to calculate odds ratios (OR) and 95% confidence intervals (CI).

RESULTS: Twelve case-control studies were eligible. Compared with the control group, patients with atrial septal abnormalities had a higher risk of atrial vulnerability (OR: 1.93; 95% CI: 1.13-3.30, P = .02). Data based on stroke patients showed that the group with atrial septal abnormalities had a higher risk of atrial vulnerability than the control group (OR: 2.00; 95% CI: 1.13-3.53, P = .02). However, there was no significant difference in the incidence of atrial vulnerability between the 2 groups of nonstroke patients. Subgroup analysis showed that although atrial septal abnormality increased the risk of atrial vulnerability in the subgroup of atrial septal aneurysm (OR: 1.68; 95% CI: 0.47-5.95, P = .42), the subgroup of atrial fibrillation (AF)/atrial fluster (OR: 1.81; 95% CI: 0.94-3.46, P = .07) and the subgroup of subcutaneous recording system (OR: 1.33; 95% CI: 0.68-2.61, P = .41), the difference was not statistically significant.

CONCLUSIONS: Atrial septal abnormalities can increase the risk of atrial vulnerability, and atrial arrhythmia caused by atrial septal abnormalities may be one of the mechanisms of CS.

PMID:34477173 | DOI:10.1097/MD.0000000000027165