Cross-sectional Observational Study Research Articles

Physical functional capacity assessment in children with chronic kidney disease: A cross sectional observational study.

Chronic kidney disease (CKD) leads to reduced muscle mass and strength in children resulting in a decrease in functional capacity. The objectives of this cross-sectional observational study were to evaluate and compare the functional capacity and muscle strength in children with CKD stage I - V (group A), on dialysis (stage VD) (group B), and kidney transplant recipients (KTR) (group C) in Indian children. 60 children, 20 each in groups A, B, and C were enrolled. Children who could not do the tests and transplant recipients within 6 months of transplantation were excluded. Functional capacity and muscle strength were assessed by 6-minute walk distance (SMWD), timed floor-to-stand test (TFTS), and hand grip strength (HGS). The mean age of the group was 12.54 ± 2.96 years. Among groups A, B, and C, the SMWD in meters (465.90 ± 68.85, 381.45 ± 50.88, 509.05 ± 43.37), TFTS in seconds (9.93 ± 1.77, 10.36 ± 1.30, and 7.68 ± 0.76), and HGS in kg were (12.7 ± 3.85, 10.4 ± 3.02, 19.75 ± 4.45), respectively (p &lt; 0.001). Group C had the best physical functional capacity. The SMWD and HGS had a moderate positive correlation (r = 0.658, 0.658, respectively), and TFTS had a negative correlation (r = -0.605) with estimated glomerular filtration rate (eGFR). The mean HGS and TFTS were different between groups A, C, and B, C (p < 0.05) and not between A and B. The SMWT was however different between A, B, and C (p < 0.001). Muscle strength and functional capacity were most impaired in Indian children on hemodialysis and best preserved in KTR.

Enlightenment on Knee Flexors Strength Loss in Cases of Posterior Knee Pain After Anterior Cruciate Ligament Reconstruction.

The persistence and the recurrence of posterior medial knee pain (PKP) after anterior cruciate ligament reconstruction (ACLR) using hamstring tendon graft are often overlooked during rehabilitation. Cross-sectional observational study. The study aimed (1)to evaluate the prevalence of these types of PKP before 4months post-ACLR, (2)to measure their consequences on the knee flexors strength, and (3)to evaluate the role of the type of ACLR. From a cohort of patients operated on with hamstring tendon procedures, the persistent and the recurrent PKP were sought at 4months post-ACLR. The evolution of isokinetic muscle strength recovery in PKP subjects was compared with those of nonpainful subjects. The functional deficit was measured at 6/7months post-ACLR by a hop test. Three hundred seventeen subjects (25.8 [6.0]y) were included. At 4months post-ACLR, 2 populations were identified based on the recurrent onset of PKP (PKP+, n = 40) or the absence of knee pain (PKP-, n = 277). The prevalence of PKP was 8.3%. At the fourth month post-ACLR, the PKP+ group had a higher flexor strength deficit compared with the PKP- group (limb symmetry index at 60°/s: 67.2% [12.4%] vs 84.3% [12.6%]; P < .05). At 6/7months, the loss of strength persisted (limb symmetry index at 60°/s: 82.3% [13.4%] vs 87.7% [12.8%]; P < .05). The hop test deficit was comparable, and no difference was shown according to the type of graft. Persistent and recurrent PKP during the rehabilitation period were not uncommon and were associated with a worsening of flexors strength loss on the ACLR side.

Time In Tight Range in children and adolescents with type 1 diabetes: A cross-sectional observational single centre study evaluating efficacy of new advanced technologies.

Early and tight glycaemic control is crucial to prevent long-term complications of Type 1 Diabetes (T1D). The aim of our study was to compare glucose metrics, including Time In Tight Range (TITR), in a real-world setting. We performed a single-centre cross-sectional study in 534 children and adolescents with T1D. Participants were divided into four groups (multiple daily injections+real-time Continuous glucose monitoring (CGM), multiple daily injections+intermittently scanned CGM, sensor augmented pump (SAP), and Advanced Hybrid Closed-Loop (AHCL). Demographical and clinical data were collected and analysed. The group with AHCL showed significantly higher Time In Range (TIR) (71.31%±10.88) than SAP (57.82%±14.98; p<0.001), MDI+rtCGM (54.56%±17.04; p<0.001) and MDI+isCGM (52.17%±19.36; p<0.001) groups with a lower Time Above Range (p<0.001). The group with AHCL also showed lower Time Below Range than MDI+isCGM and SAP groups (p<0.01). The overall TITR was 37%±14 with 19% of participants who reached a TITR ≥50% with a mean TIR of 81%. AHCL had significantly higher TITR (45.46%±11.77) than SAP (36.25%±13.53; p<0.001), MDI+rtCGM (34.03%±13.89; p<0.001) and MDI+isCGM (33.37%±15.84; p<0.001) groups with a lower Coefficient of Variation (p<0.001). Our study indicates that AHCL ensures a better glycaemic control with an improvement in both TIR and TITR, along with a reduction in CV. Implementation of automated insulin delivery systems should be considered in the treatment of children and adolescents with T1D.

Racial and ethnic diversity in academic nursing leadership: A cross-sectional analysis

Background/PurposeTo characterize the representation of racial and ethnic minoritized faculty in leadership positions at the top 50 National Institutes of Health-ranked academic nursing institutions. MethodsWe conducted a cross-sectional observational study to characterize the racial/ethnic composition of academic leaders, including those in diversity, equity, and inclusion (DEI) positions from September 2020 to December 2020. DiscussionAmong the 409 leaders, the sample was predominantly composed of females (86.6%), White leaders (80.9%), affiliated with public institutions (75.1%), and in the southern region (42.1%). Exactly 13.6% were from minoritized groups. Minoritized leaders were less likely to hold dean and higher executive positions than their nonminoritized counterparts (p < .002). DEI leadership positions were mostly concentrated in lower executive positions (e.g., director) and primarily consisted of minoritized leaders (>60%). ConclusionUnderrepresentation of racial and ethnic minoritized individuals in academic nursing leadership persists, necessitating structural interventions within nursing academia to promote inclusivity. Achieving this goal requires a concerted investment in diversifying academic nursing leadership and ensuring positions that minoritized leaders are in, hold weight.

Assessment the Incidence of Inferior Wall Myocardial Infarction, its Association with Right Ventricular Infarction and Function and its Clinical Outcome

Introduction: Myocardial infarction is one of the most common diagnoses in hospitalized patients. Myocardial infarction was previously thought to be a disease of mainly the left ventricle. Right ventricular infarction was just a pathological entity. Myocardial infarction may go undetected or may lead to catastrophic events leading to sudden cardiac death or causing severe hemodynamic derangements. Objective: To find out the Assessment the incidence of Inferior Wall Myocardial Infarction, its association with right ventricular infarction and function and its clinical outcome. Methods: The hospital based observational cross-sectional study was contacted at Department of Cardiology, Mymensingh Medical College Hospital, Bangladesh from 1st January 2022 to 30th January 2024. Conducted in intensive care unit, on an in-patient basis, consist of 50 cases of inferior wall MI. In patients with RVMI, the hospital death is high and major complications are greater. Right ventricular infarction leads to hemodynamic instability, atrio-ventricular conduction blocks, and in-hospital mortality in patients with inferior wall myocardial infarction. Results: Out of the total 150 cases of acute MI were included. The incidence of IMI among all the cases of AMI was 33.3%. In our study group of IMI RVI incidence was 30%. So, the incidence of RVI in all cases of AMI was 10%. There is a significant association between IWMI and RVMI and RVMI is seen in about 20% of cases and most common complication encountered was hypotension followed by complete heart block. The mean age of participants was 58.33 and maximum number of patients was in the age group of 40-60 (43%) and consists of 80% males and 20% females. Among them 51.4% was hypertensive, 22.8% were diabetic, 74.3% smokers, 11.42% were alcoholics. In this study 58.33% of patients with RVMI and 2% of patients without RVMI were presented with hypotension at the time of admission. Complete heart block seen in 13.33% of IWMI patients and Hypotension seen in 20% IWMI patients RVMI group. Right ventricular myocardial infarction seen in 20% of IWMI cases and TR is seen 66% of patients of IWMI with RVMI and 4% of patients of IWMI without RVMI. Conclusion: The incidence of mortality and complications can be reduced only when we are fully aware of the diagnosis and the complications that can occur in RVI. So, in all cases of IMI, RVI should be looked for by using simple and specific investigation like RPLs of ECG. Involvement of the right ventricle in inferior wall myocardial infarction significantly affects the mortality and morbidity and complications.

Early Detection of 5 Neurodevelopmental Disorders of Children and Prevention of Postnatal Depression With a Mobile Health App: Observational Cross-Sectional Study.

Delay in the diagnosis of neurodevelopmental disorders (NDDs) in toddlers and postnatal depression (PND) is a major public health issue. In both cases, early intervention is crucial but too rarely implemented in practice. Our goal was to determine if a dedicated mobile app can improve screening of 5 NDDs (autism spectrum disorder [ASD], language delay, dyspraxia, dyslexia, and attention-deficit/hyperactivity disorder [ADHD]) and reduce PND incidence. We performed an observational, cross-sectional, data-based study in a population of young parents in France with at least 1 child aged <10 years at the time of inclusion and regularly using Malo, an "all-in-one" multidomain digital health record electronic patient-reported outcome (PRO) app for smartphones. We included the first 50,000 users matching the criteria and agreeing to participate between May 1, 2022, and February 8, 2024. Parents received periodic questionnaires assessing skills in neurodevelopment domains via the app. Mothers accessed a support program to prevent PND and were requested to answer regular PND questionnaires. When any PROs matched predefined criteria, an in-app recommendation was sent to book an appointment with a family physician or pediatrician. The main outcomes were the median age of the infant at the time of notification for possible NDD and the incidence of PND detection after childbirth. One secondary outcome was the relevance of the NDD notification by consultation as assessed by health professionals. Among 55,618 children median age 4 months (IQR 9), 439 (0.8%) had at least 1 disorder for which consultation was critically necessary. The median ages of notification for probable ASD, language delay, dyspraxia, dyslexia, and ADHD were 32.5 (IQR 12.8), 16 (IQR 13), 36 (IQR 22.5), 80 (IQR 5), and 61 (IQR 15.5) months, respectively. The rate of probable ADHD, ASD, dyslexia, language delay, and dyspraxia in the population of children of the age included between the detection limits of each alert was 1.48%, 0.21%, 1.52%, 0.91%, and 0.37%, respectively. Sensitivity of alert notifications for suspected NDDs as assessed by the physicians was 78.6% and specificity was 98.2%. Among 8243 mothers who completed a PND questionnaire, highly probable PND was detected in 938 (11.4%), corresponding to a reduction of -31% versus our previous study without a support program. Suspected PND was detected a median 96 days (IQR 86) after childbirth. Among 130 users who filled in the satisfaction survey, 99.2% (129/130) found the app easy to use and 70% (91/130) reported that the app improved follow-up of their child. The app was rated 4.8/5 on Apple's App Store. Algorithm-based early alerts suggesting NDDs were highly specific with good sensitivity as assessed by real-life practitioners. Early detection of 5 NDDs and PNDs was efficient and led to a possible 31% reduction in PND incidence. ClinicalTrials.gov NCT06301087; https://www.clinicaltrials.gov/study/NCT06301087.

Comparative study of tramadol and nalbuphine as an adjuvant to ropivacaine in supraclavicular block: A cross sectional observational study

Brachial plexus block via supraclavicular approach performed with the help of ultrasound assistance, is a promising anaesthetic alternative for upper limb surgery, when compared with general anaesthesia. It provides good surgical anaesthesia and better post-operative analgesia. We compared the anaesthetic and analgesic efficacy of two additives, nalbuphine and tramadol with 0.375% ropivacaine.A double-blind, cross-sectional study, performed prospectively on 82 patients who were randomly assigned into Group N (41) and Group T (41). Patients were posted for surgical procedure of upper limb under supraclavicular brachial plexus block. Group N received inj. Ropivacaine 0.375% 25 ml plus 1ml (10 mg) of Nalbuphine plus 1ml of normal saline. Patients in Group T received inj. Ropivacaine 0.375% 25 ml with Inj. Tramadol 2 ml (100 mg). Total volume was 27 ml in both groups. Duration of postoperative analgesia was the primary outcome of our study. The secondary outcomes were the sensory and motor block characteristics (onset and duration), change in hemodynamic parameters and side effects.A statistically significant difference was noted in the duration of postoperative analgesia [Group N: 648.27 (± 124.69) minutes, Group T: 514.73 (± 43.15) minutes; P &amp;#60;0.001]. In terms of onset of both sensory and motor block no statistically significant difference was noted. A significant difference was noted in duration of sensory block (Group N: 545.85 ± 118.13 min; Group T: 416.71 ± 50.43 min; P &amp;#60;0.001). The mean duration of motor block was 482.93 ± 120.07 min in nalbuphine group and 356.59 ± 43.74 min in tramadol group; P &amp;#60;0.001.Nalbuphine 10mg is a better adjuvant to 0.375% ropivacaine when compared with tramadol 100 mg. It prolongs the duration of sensory block and motor block and increases the duration of analgesia postoperatively.

AI-driven discovery of blood xenobiotic biomarkers in neovascular age-related macular degeneration using iterative random forests.

To investigate the xenobiotic profiles of patients with neovascular age-related macular degeneration (nAMD) undergoing anti-vascular endothelial growth factor (anti-VEGF) intravitreal therapy (IVT) to identify biomarkers indicative of clinical phenotypes through advanced AI methodologies. In this cross-sectional observational study, we analyzed 156 peripheral blood xenobiotic features in a cohort of 46 nAMD patients stratified by choroidal neovascularization (CNV) control under anti-VEGF IVT. We employed Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) for measurement and leveraged an AI-driven iterative Random Forests (iRF) approach for robust pattern recognition and feature selection, aligning molecular profiles with clinical phenotypes. AI-augmented iRF models effectively refined the metabolite spectrum by discarding non-predictive elements. Perfluorooctanesulfonate (PFOS) and Ethyl β-glucopyranoside were identified as significant biomarkers through this process, associated with various clinically relevant phenotypes. Unlike single metabolite classes, drug metabolites were distinctly correlated with subretinal fluid presence. This study underscores the enhanced capability of AI, particularly iRF, in dissecting complex metabolomic data to elucidate the xenobiotic landscape of nAMD and environmental impact on the disease. The preliminary biomarkers discovered offer promising directions for personalized treatment strategies, although further validation in broader cohorts is essential for clinical application.

Gut microbiota composition in recurrent acute otitis media: a cross-sectional observational study.

Recurrent acute otitis media (rAOM) poses a significant challenge in children aged 1 to 6 years, characterized by frequent and treatment-resistant ear infections. While existing studies predominantly focus on alterations in the nasopharyngeal microbiome associated with rAOM, our research explores the understudied association with the gut microbiome.In this cross-sectional observational prospective study, we enrolled 35 children aged 1 to 6 years during the 2021/2022 cold season. The test group comprised children with rAOM (n = 16), and the control group consisted of generally healthy children (n = 19). Samples (stool and nasopharyngeal swabs) were collected in late spring to ensure an antibiotic-free period. Detailed metadata was gathered through a questionnaire examining factors potentially influencing microbiota. Microbiota composition was assessed through amplicon sequencing of the V3-V4 region of the 16S rRNA gene. Our findings revealed limited alterations in gut microbiota composition among children with rAOM compared to healthy controls. Six bacterial taxa (Veillonella, Lachnospiraceae, Ruminococcaceae, Lachnospiraceae, Bacteroides and Blautia) were differentially represented with weak statistical significance. However, several bacterial taxa displayed correlations with multiple consecutive infections, with Turicibacter showing the most significant association. Additionally, day care centre attendance emerged as a potent gut microbiota modifier, independent of rAOM. Although our study identified limited differences in gut microbiota composition between children with rAOM and healthy controls, the observed correlations between the number of infections and specific bacterial taxa suggest a potential link between rAOM and the gut microbiota, warranting further investigation.

Relationship between benzene concentration, MDA levels and kidney function in car painting workshops in Surabaya: A cross-sectional observational study

Background Car painting workers are at risk because of the use of solvents containing benzene as the main ingredient in the car painting process. One of the clinical effects of systemic benzene is kidney disorders. Therefore, the purpose of this study is to analyze the relationship between benzene and Risk Quotient (RQ) benzene concentrations with Malondialdehyde (MDA), Blood Urea Nitrogen (BUN), and creatinine levels in workers exposed to benzene in car painting workshops in Surabaya. Methods This study used an observational design with a cross-sectional method conducted at two car paint workshops in Surabaya. The study population was all workers exposed to benzene in the two car paint workshops, aged between 20-65 years in 2019. The sample was taken using an accidental sampling method, involving 30 respondents. Inclusion criteria included workers exposed to benzene and willing to participate, while exclusion criteria included workers with a liver or kidney disease history. The variables studied included benzene concentration, benzene RQ (benzene metabolite), malondialdehyde (MDA) levels as a marker of oxidative stress, and indicators of kidney function (BUN and creatinine levels). Data were analyzed using descriptive and bivariate analysis with Pearson correlation test. Results There was no significant relationship between concentrations, RQ benzene, and MDA levels in workers in painting in Surabaya (p&gt; 0.05). There was no significant relationship between benzene concentration, BUN levels, and creatinine levels in paint workers in Surabaya (p&gt; 0.05). There was no significant relationship between benzene RQ and BUN and creatinine levels in paint workers in Surabaya (p&gt; 0.05). Conclusions This study's results indicate that benzene's effects do not lead to impaired kidney function. The benzene RQ variable in this study did not become a determining factor in BUN and creatinine levels in workers.

Burnout during the COVID-19 pandemic among nurses in Taiwan: the parental role effect on burnout

BackgroundDuring the COVID-19 pandemic, medical workers were concerned about the care of their children or family members and the impact of being separated from them. This increased stress could harm the relationship between nurses and patients. This study assessed how medical workers’ parental role may affect burnout during such a high-stress period.MethodsThis cross-sectional observational study was carried out in 2021 during the COVID-19 pandemic. The client burnout (CB) scale of the Copenhagen Burnout Inventory, the Nordic Musculoskeletal Questionnaire, and a demographic questionnaire were used. Statistical methods such as the t-test, one-way ANOVA, and univariable/multiple linear regression were applied.ResultsA total of 612 nurses were included in this study. The likely risk factors of CB were identified and the parenthood effect was found to be associated with reduced CB. The parental role and leisure activity with family and friends on CB were found to have an impact. Engaging in leisure activity with family and playing the role of a parent diligently will help relieve nurses’ burnout from frequent contact with patients and their families, thus lowering the risk of clinical burnout.ConclusionThe parental role, family/friends relationships, and a complex work environment associated with nurses’ burnout during the COVID-19 pandemic. This finding allows us to re-examine the importance of family life and parent–child relationships in high-stress work environments.

Correlation Between Coronal Position Sequence of Lumbar and WOMAC Score in Knee Osteoarthritis (KOA) in Standard Standing Position.

Sagittal sequences of the spine have been shown to correlate with knee osteoarthritis (KOA), but coronal sequences and KOA have never been studied before. The study required patients to use a standard standing posture and aimed to explore the relationship between coronal position of lumbar spine and WOMAC score in KOA. This is a cross-sectional observational study. Data on a total of 268 patients with KOA were collected. Patients were photographed in a standard standing position and lumbar-sacrum offset distance (L-SOD) and lumbar-knee offset distance (ΔL-KOD) were calculated. Patients were then divided into different groups according to different critical values and differences were compared. In the L-SOD of L1-3, WOMAC function (P = 0.021, P = 0.032, P = 0.001) and total score (P = 0.039, P = 0.034, P < 0.001) were different. In the L-SOD of L3-4, WOMAC pain score were different (P = 0.001, P = 0.032). At a cutoff of 13mm, ΔL-KOD of L1-2 showed significant differences in pain part (P = 0.025, P = 0.039) and total score (P = 0.036, P = 0.050). There were significant differences in pain (P = 0.023, P = 0.027, P = 0.022), function (P = 0.048, P = 0.038, P = 0.047), and total score (P = 0.030, P = 0.027, P = 0.029) of L3-5. In the 18-mm cutoff group, only L1 and L2have differences in the pain part (P = 0.050, P = 0.038). Coronal balance of the lumbar spine is associated with knee pain and function. The pelvis plays an important role in maintaining the coronal balance. Both the lumbar spine and the knee joint should be considered when developing the surgical strategy.

Self-Reported Functional Vision in USH2A-Associated Retinal Degeneration as Measured by the Michigan Retinal Degeneration Questionnaire.

The purpose of this study was to evaluate self-reported functional vision (FV) and the impact of vision loss in patients with USH2A-associated retinal degeneration using a patient-reported outcome (PRO) measure, the Michigan Retinal Degeneration Questionnaire (MRDQ), to correlate MRDQ scores with well-established visual function measurements. An observational cross-sectional study (n = 93) of participants who had Usher Syndrome Type 2 (USH2, n = 55) or autosomal recessive non-syndromic retinitis pigmentosa (ARRP; n = 38) associated with biallelic variants in the USH2A gene. The study protocol was approved by all ethics boards and informed consent was obtained from each participant. Participants completed the MRDQ at the 48-month study follow-up visit. Disease duration was self-reported by participants. One-way ANOVA was used to compare subgroups (clinical diagnosis, age, disease duration, and full-field stimulus threshold [FST] Blue-Red mediation) on mean scores per domain. Spearman correlation coefficients were used to assess associations between MRDQ domains and visual/retinal function assessments. Of the study sample, 58% were female participants and the median disease duration was 13years. MRDQ domains were sensitive to differences between subgroups of clinical diagnosis, age, disease duration, and FST Blue-Red mediation. MRDQ domains correlated with static perimetry, microperimetry, full-field stimulus testing, and best-corrected visual acuity (BCVA). Self-reported FV measured by the MRDQ, when applied to USH2 and ARRP participants, had good distributional characteristics and correlated well with visual function tests. MRDQ adds a new dimension of understanding on vision-related functioning and establishes this PRO tool as an informative measure in evaluating USH2A outcomes.

Troponin I levels in systemic sclerosis patients with myocardial involvement

Objectives: Troponin I has been suggested as a more specific diagnostic biomarker for myocardial involvement in systemic sclerosis than the frequently used troponin T. The aim of this study is to evaluate the additive value of troponin I to detect myocardial involvement in systemic sclerosis. To this end, we evaluated the association between troponin I levels and myocardial involvement in systemic sclerosis patients. Methods: A cross-sectional observational study was performed, including 20 healthy controls and four groups of each 20 systemic sclerosis patients from the Leiden Combined Care in Systemic Sclerosis cohort: (1) patients with myocardial involvement, (2) patients with myositis, (3) patients with elevated troponin T and creatine kinase levels but without organ involvement, and (4) patients without any signs of organ involvement. Troponin I levels were measured using enzyme-linked immunosorbent assay. Troponin I levels were compared between the different groups using the Mann–Whitney U and Kruskal–Wallis tests. Results: The mean age of the 80 included patients was 56 years; 61% of the study population was female. Troponin I levels were not significantly different between patients with and without myocardial involvement (2.7 (0.5–15.3) vs 1.2 (0.1–6.6) ng/L; p = 0.117). Systemic sclerosis patients were more often positive for troponin I than healthy controls (70.0% vs 30.0%; p = 0.001). Conclusion: Elevated troponin I was not of additional value to diagnose myocardial involvement in systemic sclerosis patients.

Analysis of Risk Factors for Dengue Hemorrhagic Fever in Children: An Observational Study in Batang Regency, Indonesia

Dengue hemorrhagic fever (DHF) is a significant public health problem in Indonesia, including in Batang Regency. This study aims to analyze the risk factors associated with the incidence of dengue fever in children in Batang Regency, Indonesia. A cross-sectional observational study was conducted on 258 child subjects in Batang Regency. Data was collected through structured interviews with parents or guardians, direct observation of the home environment, and laboratory tests to confirm the diagnosis of dengue fever. Data analysis included univariate, bivariate (Chi-square test), and multivariate (logistic regression) analyses to identify independent risk factors. Univariate analysis showed a relationship between the incidence of dengue fever and age, gender, parental education, parental occupation, residential density, presence of mosquito larvae in water reservoirs, habit of hanging clothes, history of mosquito bites, and nutritional status. Bivariate analysis identified several statistically significant risk factors, including high residential density (OR=2.87; 95% CI: 1.65-5.01), presence of mosquito larvae (OR=3.21; 95% CI: 1.89-5.45), habit of hanging clothes (OR=2.87; 95%CI:1.32-5.21), and history of mosquito bites (OR=2.54; 95%CI: 1.48 -4.36). Multivariate analysis confirmed that high residential density and the presence of mosquito larvae were independent predictors of dengue incidence. High residential density and the presence of mosquito larvae in the home environment are the main risk factors for the incidence of dengue fever in children in Batang Regency. Public health interventions that focus on vector control and improving environmental sanitation are critical to reducing the dengue burden in this area.

Motivational impact, self-reported fear, avoidance, and harm perception of shoulder movements pictures in people with chronic shoulder pain

Objectives (1) to represent in pictures a group of items from the International Classification of Functioning (ICF) that represent daily situations; (2) to compare valence and arousal evoked by these pictures between chronic shoulder pain and pain-free control groups and assess self-reports of fear, avoidance, and harm perception. Methods This is a cross-sectional observational study and approved by Research Ethics Committee. Selected pictures representing items from the ICF were judged by members of the general public using an online form. We used the set of International Affective Picture System and the Self-Assessment Manikin to compare valence and arousal between groups. The chronic shoulder pain group answered questions regarding self-reports of fear, avoidance, and harm perception. Results The protocol consisted of 58 pictures. A repeated measures ANOVA for valence revealed a main effect of group, F(1, 9)=24.81;p < 0.005, and no effect on the arousal, F(1,9)=2.00;p < 0.190. The shoulder pain group judged shoulder pictures more aversive. The picture that represents the movement of carrying on shoulder presented the highest medians of self-reports of fear, avoidance, and harm perception 10(8-10). Conclusion The pictures represent daily activities that correspond to the items from the ICF. The valence of the shoulder pictures was different between the groups, shoulder pictures were considered more aversive for the group with chronic shoulder pain. The responses of avoidance, fear, and harm perception showed higher median in the carrying on shoulders, hip, and back picture.

Iron status is associated with tibial structure and vitamin D metabolites in healthy young men

The influence of iron on collagen synthesis and vitamin D metabolism has implications for bone health. This cross-sectional observational study investigated associations between markers of iron status and tibial structure, vitamin D metabolites, and circulating biochemical markers of bone metabolism in young healthy men. A total of 343 male British Army recruits participated (age 22 ± 3 y, height 1.77 ± 0.06 m, body mass 75.5 ± 10.1 kg). Circulating biochemical markers of iron status, vitamin D metabolites, and bone metabolism, and tibial structure and density by high-resolution peripheral quantitative computed tomography scans (HRpQCT) were measured in participants during week 1 of basic military training. Associations between markers of iron status and HRpQCT outcomes, bone metabolism, and vitamin D metabolites were tested, controlling for age, height, lean body mass, and childhood exercise volume. Higher ferritin was associated with higher total, trabecular, and cortical volumetric bone mineral density, trabecular volume, cortical area and thickness, stiffness, and failure load (all p ≤ 0.037). Higher soluble transferrin receptor (sTfR) was associated with lower trabecular number, and higher trabecular thickness and separation, cortical thickness, and cortical pore diameter (all p ≤ 0.033). Higher haemoglobin was associated with higher cortical thickness (p = 0.043). Higher ferritin was associated with lower βCTX, PINP, total 25(OH)D, and total 24,25(OH)2D, and higher 1,25(OH)2D:24,25(OH)2D ratio (all p ≤ 0.029). Higher sTfR was associated with higher PINP, total 25(OH)D, and total 24,25(OH)2D (all p ≤ 0.025). The greater density, size, and strength of the tibia, and lower circulating concentrations of markers of bone resorption and formation with better iron stores (higher ferritin) are likely as a result of the direct role of iron in collagen synthesis.

An investigation on nurses’ competencies and practices regarding enteral tube medication administration: a cross-sectional study

Background: understanding how healthcare professionals correctly administer medications through enteral routes is necessary to reduce patient morbidity and mortality. The study’s objective is to evaluate nurses’ competencies and management methods in administering oral medications to hospitalized patients who have enteral feeding tubes. Materials and Methods: an observational cross-sectional study involving nurses employed at the University Hospital for at least six months. A survey consisting of 16 questions related to medication dilution, pharmaceutical form management, and enteral medication administration techniques was administered. Results: a total of 218 nurses were recruited, with a mean age of 30.95 years (SD 6.15), of whom 132 (60.5%) were female, and 173 (78.9%) held a bachelor’s degree. Approximately half of the responses (49.3%) were incorrect. Conclusions: nurses should improve their knowledge regarding enteral medication administration. Nurses are responsible for pharmacological management, and their level of knowledge directly impacts the health and safety of these patients. Therefore, specific training addressing the identified gaps would be appropriate.

Smile esthetics in different vertical skeletal patterns in an Egyptian sample (a cross sectional observational study)

Smile esthetics in different vertical skeletal patterns in an Egyptian sample (a cross sectional observational study)

Microbiological Evaluation of Commercial Hand Sanitisers Available in Pakistan Using European Standard and Membrane Filtration Method.

To evaluate the antibacterial efficacy of various commercially available alcohol-based hand sanitisers (ABHS) using European standard (EN 1500) method and perform ABHS testing with membrane filtration method. A Cross-sectional observational study. Place and Duration of the Study:Quality Control Section of the Microbiology Laboratory, The Aga Khan University Hospital, Karachi, Pakistan, from February to April 2023. Efficacy of 14 commercially and widely accessible hand sanitisers was defined as reducing micro-organism growth. It was determined using the EN 1500 European standard test and membrane filtration method. Majority (92.8%) ABHS showed a significant bacterial reduction except one ABHS tested with the EN 1500 method. Only six ABHS products were tested through the membrane filtration method because high viscosity of hand sanitisers was causing damage to filter membranes. Continued vigilance in evaluating hand sanitiser's efficacy through robust testing methods is essential to ensure public health and prevent the dissemination of misleading products that may compromise hand hygiene practices. Hand sanitisers, European standard, Membrane filtration method, Antibacterial efficacy.