[Experimental] List of manuscripts available for review volunteers
Background. Work related accidents are common and may lead to permanent physical disability or death. Besides specific injury related challenges these workers face numerous socioeconomic stresses. These stresses are associated with cortical reorganization that may result in cognitive problems. The purpose of this study was to evaluate the stress level and attention in adults with work related physical disabilities.
Methods. Morning salivary cortisol was used as a stress marker while the event-related potential during the performance of the auditory oddball paradigm was conducted to investigate the attentive ability to sound stimuli. Eighteen injured workers (IW) and ten unaffected healthy workers (CW) were recruited for this study with half being men and the other half women (aged 21 to 55). Behavioral performance measures including reaction time (RT), accuracy rate, and commission error as well as the latency and amplitude of P300 wave over the central (Cz), centroparietal (CPz), and parietal (Pz) electrode sites were used to compare the two groups.
Results. This study demonstrated significantly higher salivary cortisol levels, longer RT, less accuracy to respond to the target during the auditory oddball paradigm in the IW group as compared to CW group. In addition, a significant prolongation of the peak latency of auditory P300 wave over Cz, CPz, and Pz electrodes was also detected in IW group.
Discussion. The increased cortisol levels found in the IW group reflect the alteration of the basal hypothalamic-pituitary-adrenal axis as a result of the stresses of living with a physical disability. Delayed RT and the decreased in accuracy together with changing in peak latencies of auditory P300 wave indicate the impairment of attention networks in IW.
Conclusion. Our study revealed that the workers with permanent physical disabilities exhibit the higher level of stress and attention deficits as compared to their uninjuried peers.
Background: Sampling bias, like survey participants’ nonresponse, needs to be adequately addressed in the analysis of sampling designs to get representative population estimates. Often survey weights will be calibrated on specific covariates related to the probability of selection and nonresponse, to get unbiased population estimates. Such calibrated survey (CS) weights are usually constructed for valid cross-sectional results and not for additional longitudinal analyses. For example, when the outcome of interest is time to death, and sampling selection is related to time to death and censoring, given other covariates, the sampling design is informative. Then, unweighted or CS weighted regression analyses may be biased. In 2010, Switzerland changed from a decennial full census to a yearly register-based and survey-based census system. In the present study, we investigated the potential bias in mortality analysis due to an informative sampling design using census-linked survey data.
Methods: We analysed more than 6.5 million individuals aged 15 years or older from registry-based census data from years 2010 to 2013, linked with mortality records up to end of 2014. Out of this population, approximately 3.5% were aimed to be sampled from the Swiss Federal Statistical Office (SFSO) in a stratified yearly micro census. The SFSO calculated CS weights to enable representative population estimates from the micro census. We additionally constructed inverse probability (IP) weights where we used survival information in addition to the known sampling design and nonresponse covariates from the SFSO. We compared CS and IP weighted mortality rates (MR) and life expectancy (LE) with estimates from the true underlying population. Additionally, we performed simulation studies under different sampling and nonresponse scenarios.
Results: We found that individuals who died in 2011, had a 0.67 [95% CI (0.64, 0.70)] times lower odds of participating in the 2010 micro census, using a multivariable logistic regression model with covariates age, gender, nationality, civil status, region and survival information. IP weighted MR were comparable to estimates from the total population, whereas CS weighted MR underestimated the population MR in general. The IP weighted LE estimates at age 30 years for men were 50.9 years (95% CI, 50.2 to 51.6 years), whereas the CS weighted overestimated LE by 2.5 years. Our results from the simulation study confirmed that IP weighted models are comparable to true underlying population estimates.
Conclusion: Mortality analyses based on the new Swiss survey-based census may be biased, caused by an informative sampling design, where an unmeasured risk factor is related to mortality and non-response of the survey. We conclude that mortality analyses based on census-linked survey data have to be carefully conducted - and if possible – validated by register information to allow for an unbiased interpretation and generalisation.
Background. E-health technology applications are essential tools of modern information technology that improve quality of healthcare delivery in hospitals of both developed and developing countries. However, despite its positive benefits, studies indicate that the rate of the e-health adoption in some developing countries is either low or underutilized. This is due in part, to barriers such as resistance from healthcare professionals, poor infrastructure, and low technical expertise among others.
Objective. The aim of this study is to investigate, identify and analyze the underlying factors that affect healthcare professionals decision to adopt and use e-health technology applications in developing countries, with particular reference to hospitals in Nigeria.
Methods. The study used quantitative method in the form of close-ended questionnaire to collect data from a sample of 465 healthcare professionals randomly selected from 15 hospitals in Nigeria. We used variables of modified Technology Acceptance Model (TAM) as dependent variables and external factors as independent variables. The collected data was then analyzed using SPSS statistical analysis such as frequency test, reliability analysis, and correlation coefficient analysis.
Results. The results obtained, which correspond with findings from other researches published, indicate that perceived usefulness, belief, as well as attitude of healthcare professionals have significant influence on their willingness to adopt and use the e-health technology applications. Other strategic factors identified include low literacy level and experience in using the e-health technology applications, lack of motivation, poor organizational and management policies.
Conclusion. The study contributes to the literature by pin-pointing significant areas its findings can positively affect or be useful, such as serving as guide to healthcare policy decision makers in Nigeria and other developing countries to understand their areas of priorities and weaknesses when planning for e-health technology adoption and implementation.
Background: Kawasaki disease (KD) is an immune-mediated systemic vasculitis and infection plays an important role in the pathophysiology of KD. The susceptibility to infectious disease in patients with KD remains largely unclear. This study aimed to investigate the risk of respiratory tract infection (RTI)-related hospitalizations in children with KD.
Methods: Data from Taiwanese National Health Insurance Research Database was analyzed. Children with KD were selected as KD group and age- and sex-matched non-KD patients were selected as control group with 1:1 ratio. Both cohorts were tracked for 1 year to investigate the incidences of RTI-related hospitalizations. Cox regression hazard model was used to adjust for confounding factors and calculate the adjusted hazard ratio (aHR).
Results: Between January 1996 and December 2012, 13,760 patients with KD were identified as KD group and 13,709 patients were enrolled as control group. An obviously reduced risk of RTI-related hospitalizations was observed in KD patients (aHR: 0.53, 95% confidence interval: 0.49-0.57). The decreased risk persisted through the 1-year follow-up period with a peak protection in 3-6 months (aHR: 0.46, 95% confidence interval: 0.40-0.53).
Conclusions: KD patients had approximately half reduction of risk for RTI-related hospitalizations. The protective effects persisted for at least 1 year. Further studies are warranted to elucidate the entire mechanism and investigate the influences of intravenous immunoglobulin.
Background: Patellofemoral pain is often reported as a diffuse pain at the front of the knee during knee-loading activities. A patient’s description of pain location and distribution is commonly drawn on paper by clinicians, which is difficult to quantify, report and compare within and between patients. One way of overcoming these potential limitations is to have the patient draw their pain regions using digital platforms, such as personal computer tablets.
Objective: To assess the validity of using computer tablets to acquire a patient’s knee pain drawings as compared to paper based records in patients with patellofemoral pain.
Methods: Patients (N=35) completed knee pain drawings on identical images (size and color) of the knee as displayed on paper and a computer tablet. Pain area expressed as pixel density, was calculated as a percentage of the total drawable area for paper and digital records. Bland-Altman plots, Pearson’s correlation coefficients and one-sample tests were used in data analysis.
Results: No significant difference in pain area was found between the paper and digital records of mapping pain area (mean difference (95%CI; p) = 0.002% (-0.159 to 0.157; P=0.98)). A strong linear correlation (R2=0.870) was found for pain area and the limits of agreement show less than ±1% difference between paper and digital drawings.
Conclusion: Pain drawings as acquired using paper and computer tablet are equivalent in terms of total area of reported knee pain. The advantages of digital recording platforms, such as, quantification and reporting of pain area, could be realized in both research and clinical settings.
Objective: To translate the Perceived Stress Questionnaire (PSQ) into Chinese, validate its reliability and validity in nursing students and investigate the perceived stress level of nursing students.
Method: Forward- and back-translation combined with expert assessment and cross-cultural adaptations were used to construct the Chinese version of the Perceived Stress Questionnaire (C-PSQ). This research adopted a stratified sampling method among 1519 nursing students in 30 classes of Ningbo College of Health Sciences to assess the reliability and validity of the C-PSQ.
Results: The C-PSQ retained all 30 items of the original scale. Principal component analysis extracted five factors that explained 52.136% of the total variance. The S-CVI/Ave was 0.913. The results of the confirmatory factor analysis were as follows: χ 2 /df=4.376, RMR=0.023, GFI=0.921, AGFI=0.907,CFI=0.921, PNFI=0.832, and PGFI=0.782. The scale’s Cronbach’s α was 0.922 CI (0.916, 0.928), and Cronbach’s α of each dimension was 0.899 CI (0.891, 0.907), 0.821 CI (0.807, 0.835), 0.688 CI (0.661, 0.713), 0.703 CI (0.678, 0.726) and 0.523 CI (0.472, 0.570). The correlation coefficient between the first and second test, the first and third test, and the second and third test was 0.725 CI (0.514, 0.878), 0.787 CI (0.607, 0.890), and 0.731 CI (0.506, 0.897), respectively. The average score of perceived stress in nursing students was 0.399±0.138. Different demographic factors were significantly associated with the perceived stress of nursing students.
Discussion:The C-PSQ has good reliability and validity, which means that the scale can be used as a universal tool for psychosomatic studies. The perceived stress of nursing students was relatively high. Further studies are needed.
Background: Autoimmune thyroid disease (AITD), which is characterized by an increased presence of thyroid autoantibodies (TAbs), such as antibodies against thyroid peroxidase (TPOAbs) and antibodies against thyroglobulin (TgAbs), has been reported to be associated with rheumatoid arthritis (RA) because AITD and RA both involve autoimmunity. However, few data are available on the incidence of TAbs in Chinese RA patients, and studies on the association between TAbs and joint damage as well as synovitis in RA patients remain sparse. Here, we aimed to evaluate the incidence of TAbs in a consecutive Chinese RA cohort and to investigate whether the elevated presence of TAbs is associated with joint damage and synovitis in RA patients.
Methods: A total of 125 hospitalized RA patients were consecutively recruited. Clinical data and available synovial tissues were collected at baseline, and TAbs and thyroid function were detected by chemiluminescent immunoassay. Patients who tested positive for TPOAbs or TgAbs were classified as the TAbs-positive group, and patients who tested positive for neither TPOAbs nor TgAbs were recruited as the TAbs-negative group. Disease activity was assessed using DAS28-ESR (the disease activity score in 28 joints and including the erythrocyte sedimentation rate). X-ray assessment of the hand/wrist was performed according to the Sharp/van der Heijde-modified Sharp score (mTSS), and patients with an mTSS score > 10 were defined as having radiographic joint damage (RJD). Serial tissue sections were stained immunohistochemically for CD3, CD15, CD20, CD34, CD38, and CD68, and synovitis were assessed according to Krenn’s synovitis score.
Results: A total of 44 (35%) patients were positive for either TPOAbs or TgAbs. Importantly, there was a significantly greater percentage of patients with RJD in the TAbs-positive group versus the TAbs-negative group (68% vs. 42%, p = 0.005). Compared with the TAbs-negative group, significantly more CD38-positive plasma cells infiltrated the TAbs-positive synovium, and a higher percentage of patients with high-grade synovitis were observed in the TAbs-positive group (5/8, 63% vs. 5/14, 36%). Moreover, RF positivity and disease activity indicators, including TJC28, DAS28-ESR, and CDAI, were significantly higher in the TAbs-positive group (all p < 0.05). Adjusted logistic regression analysis revealed that positive TAbs (OR 2.999, 95% CI 1.301-6.913; p=0.010) and disease duration (OR 1.013, 95% CI 1.006-1.019; p < 0.001) were independently associated with RJD, and an odds ratio of 2.845 (95% CI 1.062-7.622) was found for RJD in women with positive TAbs (n=37) compared with those without TAbs (n = 59) (p = 0.038).
Conclusion: Our data showed that joint destruction was amplified in RA patients with an elevated presence of TAbs, which supports the importance and necessity of TAbs and thyroid function screening and monitoring in RA patient management in clinical practice.
Society is increasingly demanding a more sustainable management of agro-ecosystems in a context of climate change and an ever growing global population. The fate of crop residues is one of the important management aspects under debate, since it represents an unneglectable quantity of organic matter which can be kept in or removed from the system. The topic of residue management is not new, but the need for conclusions linked to local pedo-climatic conditions has become apparent with an increasing amount of studies showing a diversity of conclusions. This study specifically focusses on temperate climate and loamy soil using a 8-year data set.
We compared four contrasting residue management strategies differing in the amount of crop residues returned to the soil (incorporation vs. exportation of residues) and in the type of tillage (reduced tillage (10 cm depth) vs. conventional tillage (ploughing at 25 cm depth)) in a field experiment between 2008 and 2016. We assessed the impact of the crop residue management on crop production (six crops – winter wheat, faba bean and maize), soil organic carbon content, nitrogen, phosphorus and potassium soil content and uptake by the crops.
We observed a limited effect of the residue management strategy on crop productivity. The main differences came from the type of tillage and less from the restitution or removal of residues. All years and crops combined, conventional tillage resulted in a yield advantage of 3.4% as compared to reduced tillage, which can be partly explained by a lower germination rate under reduced tillage, especially during drier years. On average, only small differences were observed for total organic carbon (TOC) content of the soil, but reduced tillage resulted in a very clear stratification of TOC and also of P and K content as compared to conventional tillage. We observed no effect of residue management on the NO3- content, since the effect of fertilization dominated the effect of residue management. The relatively low differences between the management strategies are probably due to the fact that the experiment is rather young (<10y). The experiment should be followed up in the future to observe whether more consistent changes in soil quality are present on the long term. In order to assess the full impact of crop residue management on the agro-ecosystem functioning, there is a range of additional variables to quantify: soil fauna, greenhouse gas emissions, economical aspects of the technical itinerary, …
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