Hubattle7466

This study aimed to determine if having an overweight or obese range body mass index (BMI) at time of beginning school is associated with increased fracture incidence in childhood. A dynamic cohort was created from children presenting for routine preschool primary care screening, collected in the Information System for Research in Primary Care (SIDIAP) platform in Catalonia, Spain. Data were collected from 296 primary care centers representing 74% of the regional pediatric population. A total of 466,997 children (48.6% female) with a validated weight and height measurement within routine health care screening at age 4 years (±6 months) between 2006 and 2013 were included, and followed up to the age of 15, migration out of region, death, or until December 31, 2016. BMI was calculated at age 4 years and classified using WHO growth tables, and fractures were identified using previously validated ICD10 codes in electronic primary care records, divided by anatomical location. Actuarial lifetables were used to calcormal weight. © 2020 American Society for Bone and Mineral Research.CLINICAL RELEVANCE The effects of orthokeratology (Ortho-K) on myopic eyes was examined, providing confidence to optometrists applying Ortho-K to high myopic and anisometropic children. BACKGROUND Ortho-K slows the progression of low to moderate myopia. The effectiveness of Ortho-K in Chinese children with fellow moderate and high myopic eyes was determined. METHODS This retrospective study included female (n = 35) and male (n = 30) children with moderate myopia in one eye (spherical equivalent refractive (SER) error ≤ -3.00 D, but > -6.00 D) and high myopia in the contralateral eye (SER error ≤ -6.00 D). Three age groups were included 7-10 years (n = 18), 11-12 years (n = 21), and 13-15 years (n = 26). Baseline refraction and axial lengths were measured before fitting Ortho-K lenses worn nightly for at least eight hours, and after one year. RESULTS Axial length increased 0.14 ± 0.13 mm (mean ± standard deviation) and 0.13 ± 0.16 mm in the moderate and high myopic groups respectively (p = 0.78). For females, axial elongation in the moderate and high myopic groups was 0.10 and 0.08 mm respectively. For males, it was 0.19 mm in both groups. Axial elongation in 7-10-year-old children with moderate and high myopic eyes was 0.24 ± 0.14 and 0.21 ± 0.15 mm respectively. In 11-12-year-old children, it was 0.12 mm in both myopic groups. In 13-15-year-old children, it was 0.09 mm in both groups. In moderate myopic eyes, axial elongation in the youngest group was greater than the other two age groups (p  less then  0.01). In high myopic eyes, there were no differences among the age groups (p = 0.06). CONCLUSIONS Ortho-K was equally effective in reducing myopic progression in moderate and in contralateral high myopic eyes. Axial elongation was greater for males than females. For both sexes, it decreased at the same rate with increasing age, regardless of difference in myopia. © 2020 Optometry Australia.BACKGROUND Time to successful reperfusion is a critical prognostic factor for acute ischaemic stroke. Mechanical thrombectomy has become the gold standard treatment for emergent large vessel occlusion stroke. The timely delivery of this highly specialized procedure to patients outside of metropolitan centres presents a dilemma of inequity, with limited workflow data hindering benchmarking and service optimisation. AIM We sought to analyse key stroke treatment time parameters from a primary stroke centre existing in a regional centre within a hub-and-spoke delivery model in Victoria, Australia. METHODS Retrospective cohort study of patients transferred from a regional primary stroke centre to a metropolitan comprehensive stroke centre for mechanical thrombectomy between July 2016 and December 2018. Time workflow analysis was conducted from symptom onset to primary stroke centre departure. Exarafenib inhibitor RESULTS 55 patients were included in this study with an average age of 70.2 years. Median National Institutes of Health Stroke Scale score on admission was 13 (IQR 7-17). Median pre-hospital time was 68 min (IQR, 56-137) and median door-in-door-out time was 120.5 min (IQR, 98-150), constituting 36.1% and 63.9% of total median time from symptom onset to PSC departure (188.5 min) respectively. There were no significant differences across observed cohort characteristics under linear regression analysis. CONCLUSION Protracted pre-hospital and primary stroke centre workflow times can delay effective treatment for patients with acute ischaemic stroke in regional areas. A systems-level approach to streamlining processes in these key areas is required to bridge this inequity in best practice care. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.The management of pathogen detection using a rapid and cost-effective method presents a major challenge to the biological safety of the world. The field of pathogen detection is nascent and therefore, faces a dynamic set of challenges as the field evolves. Visceral leishmaniasis (VL), or kala-azar is the most severe form of leishmaniasis. Delay to the accurate diagnosis and treatment is likely to lead to fatality. The reliable, fast and sensitive detection is closely linked to safe and effective treatment of Leishmania spp. Despite several routine and old method for sensitive and specificity detection of Leishmania spp, there is highly demand for developing modern and powerfully system. In this study a novel ultra-sensitive DNA-based biosensor was prepared for detection of Leishmania spp. For the first time, the specific and thiolated sequences of the Leishmania spp genome (5'-SH-[CH2 ]6 ATCTCGTAAGCAGATCGCTGTGTCAC-3') were recognized by electrochemical methods. Also, selectivity of the proposed bioassay was examined by three sequences that were mismatched in 1, 2, and 3 nucleotides. The linear range (10-6 to 10-21 M) and limit of detection (LLOQ = 1 ZM) obtained are remarkable in this study. Also, simple and cost-effective construction of genosensors was another advantage of the proposal DNA-based assay. The experimental results promise a fast and simple method in detection of kala-azar patients with huge potential of the nanocomposite-based probe for development of ideal biosensors. © 2020 John Wiley & Sons Ltd.Graphdiyne (GDY) as a new carbon allotrope, possessing both sp- and sp 2- hybridized carbon atoms, has attracted extensive attention due to great application potentials in various fields. To realize fundamental understanding of the intrinsic properties of GDY, the controllable synthesis of ultrathin and high crystalline GDY is necessary and challenging. We reported herein a confined interfacial synthesis strategy towards high crystalline ultrathin GDY at water/oil/organogel interface with greatly improved control over GDY structures. The morphology and chemical composition of GDY was characterized accordingly. After loading with Au, the as-prepared hydrophobic Au/GDY system showed excellent performances in nitrogen reduction reaction (NRR), reaching highest yield of 4.15 μg·cm -2 ·h -1 with FE achieving 1.95% . © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.This study aimed to evaluate normal features of the heart and lower respiratory tract in toco toucans by means of radiography and helical computed tomography (CT) scanner. Fifteen healthy adult toco toucans (Ramphastos toco), 10 females and 5 males, average body mass of 650 g were studied. CT examination as well as right lateral and ventrodorsal radiographic examinations of the coelomic cavity were performed under chemical restraint. Heart, lungs, air sacs, trachea and syrinx were analysed. The mean values of heart length, heart width and thoracic cavity in radiographs were, respectively, 23.76 mm, 25.94 mm and 48.87 mm. In both X-rays and CT scans, the lung parenchyma had honeycomb-like pattern. The topographic areas of the anterior and posterior air sacs were visualized as dark and air-filled spaces in X-rays. On CT evaluation, the air sacs occupied a larger area in the coelomic cavity compared to X-ray. In the lateral radiographic view, the cervical part of the trachea was positioned more ventrally in the transition from cervical to thoracic regions showing a V-shaped appearance. In all CT planes was visible division of the trachea into the right and left main bronchi at the level of 3rd thoracic vertebra. The syrinx was difficult to visualize in X-rays, but on CT it was easily identified in axial slice. In conclusion, the normal features of toco toucan's heart and lower respiratory tract that were determined on X-rays and CT scans are useful to compare with sick toco toucans, as well as other bird species. © 2020 Blackwell Verlag GmbH.OBJECTIVE As a malignant tumor with high mortality, lung cancer (LC) often causes great trauma to patients, and a series of negative emotions and a heavy psychological burden accompanies poor prognosis. Whether or not to inform the patients of their condition has always been a controversial topic in the medical community. This retrospective cohort study investigated the association between early informed diagnosis and survival time in patients with LC. METHODS A total of 29 825 patients with LC were enrolled between October 2002 and December 2016. The potential factors influencing LC survival were registered, including knowing their cancer diagnosis status, age, gender, pathological type, clinical stage, surgical history, hospital grade, and patient occupation. All participants were followed up every 6 months until June 2017. RESULTS In June 2017, 23.1% of the participants still survived. Their median survival time (MST) was 11.20 months (95% confidence interval [CI], 10.98-11.43). Generally, patients that knew their cancer diagnosis had longer MST than those who did not (18.33 months vs 8.77 months, P  less then  .001). By stratified analysis, patients that knew their cancer diagnosis had longer survival time in each subgroup (P  less then  .001, all subgroups). Cox regression analysis showed that knowing their cancer diagnosis was an independent influencing factor for survival in patients with LC (hazard ratio, 0.826; 95% CI, 0.802-0.851; P  less then  .001). CONCLUSIONS Knowing their cancer diagnosis contributed to longer survival time in patients with LC, providing clear evidence that medical staff and patients' families should fully disclose cancer diagnoses to patients. © 2020 John Wiley & Sons, Ltd.BACKGROUND Data relating to the association between inflammatory bowel disease (IBD) and pregnancy outcomes are lacking in Korea. AIMS To determine the incidence rates of pregnancy outcomes in women with IBD. METHODS A nationwide population study was performed using the Korean National Health Insurance claims database. A total of 2058 women with IBD consisting of ulcerative colitis (UC, n = 1469) and Crohn's disease (CD, n = 589) were pregnant between 2007 and 2016. We compared their incidence of pregnancy outcomes with 20 580 age-matched controls without IBD. We also stratified the patients into those with quiescent to mild and moderate to severe IBD and compared the outcomes between them. RESULTS The pregnancy rate of women with IBD was lower than that of women without (25.7% vs 32.3%, P  less then  0.001). Caesarean section (46.5% vs 38.8%, odds ratio [OR] 1.43, 95% confidence interval [CI] 1.17-1.75), and intrauterine growth retardation (IUGR) (3.0% vs 1.0%, OR 2.89, 95% CI 1.59-5.26) were increased in CD patients than the controls.