DESIGN: This is a secondary analysis of a multicenter, retrospective, cohort study. Data on epidemiology, ventilation, therapies, and outcomes were collected and analyzed. Patients were classified into two mutually exclusive groups (extrapulmonary pediatric acute respiratory distress syndrome and pulmonary pediatric acute respiratory distress syndrome) based on etiologies. Primary outcome was PICU mortality. Cox proportional hazard regression was used to identify risk factors for mortality.
SETTING: Ten multidisciplinary PICUs in Asia.
PATIENTS: Mechanically ventilated children meeting the Pediatric Acute Lung Injury Consensus Conference criteria for pediatric acute respiratory distress syndrome between 2009 and 2015.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Forty-one of 307 patients (13.4%) and 266 of 307 patients (86.6%) were classified into extrapulmonary pediatric acute respiratory distress syndrome and pulmonary pediatric acute respiratory distress syndrome groups, respectively. The most common causes for extrapulmonary pediatric acute respiratory distress syndrome and pulmonary pediatric acute respiratory distress syndrome were sepsis (82.9%) and pneumonia (91.7%), respectively. Children with extrapulmonary pediatric acute respiratory distress syndrome were older, had higher admission severity scores, and had a greater proportion of organ dysfunction compared with pulmonary pediatric acute respiratory distress syndrome group. Patients in the extrapulmonary pediatric acute respiratory distress syndrome group had higher mortality (48.8% vs 24.8%; p = 0.002) and reduced ventilator-free days (median 2.0 d [interquartile range 0.0-18.0 d] vs 19.0 d [0.5-24.0 d]; p = 0.001) compared with the pulmonary pediatric acute respiratory distress syndrome group. After adjusting for site, severity of illness, comorbidities, multiple organ dysfunction, and severity of acute respiratory distress syndrome, extrapulmonary pediatric acute respiratory distress syndrome etiology was not associated with mortality (adjusted hazard ratio, 1.56 [95% CI, 0.90-2.71]).
CONCLUSIONS: Patients with extrapulmonary pediatric acute respiratory distress syndrome were sicker and had poorer clinical outcomes. However, after adjusting for confounders, it was not an independent risk factor for mortality.
METHODS: Adults from the general-population (n = 392) completed online measures of Type D personality (DS14) and insomnia severity.
RESULTS: Individuals with the Type D personality trait reported significantly greater symptoms of insomnia relative to Non-Type Ds. Moreover, insomnia-symptoms were independently related to negative affectivity (NA) and social inhibition (SI) and the Type D interaction (i.e. synergistic product of SI and NA). Linear regression analysis determined that NA but not SI significantly predicted insomnia symptoms after controlling for age and sex. However, after accounting for the Type D interaction, negative affectivity remained the only significant predictor of insomnia-symptoms.
CONCLUSIONS: The Type D personality type appears to be related to insomnia-symptoms, both as a categorical and dimensional construct. These outcomes support prior research evidencing that whilst Type D personality is related to poor sleep in adolescents, NA appears to be the main contributor.
METHODS: A cross-sectional study was conducted among Malaysian manufacturing workers, aged 40-65 years old. They completed a self-administered questionnaire on sociodemographics, lifestyle and family history, and the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Waist circumference, blood pressure, fasting blood sugar, triglycerides and high-density lipoprotein levels were measured. Baron and Kenny's method, Sobel test and multiple mediation models with bootstrapping were used to determine whether the PSQI global score or its components mediated the association between night-shift work and MetS.
RESULTS: Of the 494 participants, 177 (36%) worked night shift and 51% were men. The prevalence of MetS was 37%. Night-shift work was independently associated with a twofold increase in the risk of MetS (adjusted OR: 1.92, 95% CI 1.24 to 2.97). However, the association between night-shift work and MetS did not appear to be modified by sex. Night-shift workers also reported significantly poorer sleep quality, longer sleep latency, shorter sleep duration, sleep disturbances and daytime dysfunction. Robust mediation analysis nonetheless showed that neither PSQI global score nor its components mediated the association between night-shift work and MetS.
CONCLUSION: Early screening and management of MetS and the development of programmes to improve sleep quality should be carried out among night-shift workers. Future research should investigate other modifiable mediators linking night-shift work and MetS.
METHODS: The English version of the PACIC questionnaire is a 20-item scale measuring five key components, which are patient activation, decision support, goal setting, problem solving and follow-up care. The PACIC underwent forward - backward translation and cross cultural adaptation process to produce the PACIC-Malay version (PACIC-M). Reliability was tested using internal consistencies and test-retest reliability analyses, while construct validity was tested using the exploratory factor analysis (EFA).
RESULTS: The content of PACIC-M and the original version were conceptually equivalent. Overall, the internal consistency by Cronbach's α was .94 and the intra-class correlation coefficient was .93. One item was deleted (item 1) when the factor loading was
METHODS: iPC clones were generated from two colorectal cancer (CRC) cell lines by retroviral transduction of the Yamanaka factors. The iPC clones obtained were characterized by morphology, expression of pluripotency markers and the ability to undergo in vitro tri-lineage differentiation. Genome-wide miRNA profiles of the iPC cells were obtained by microarray analysis and bioinformatics interrogation. Gene expression was done by real-time RT-PCR and immuno-staining; MET/EMT protein levels were determined by western blot analysis.
RESULTS: The CRC-iPC cells showed embryonic stem cell-like features and tri-lineage differentiation abilities. The spontaneously-differentiated post-iPC cells obtained were highly similar to the parental CRC cells. However, down-regulated pluripotency gene expression and failure to form teratoma indicated that the CRC-iPC cells had only attained partial pluripotency. The CRC-iPC cells shared similarities in the genome-wide miRNA expression profiles of both cancer and pluripotent embryonic stem cells. One hundred and two differentially-expressed miRNAs were identified in the CRC-iPC cells, which were predicted by bioinformatics analysis be closely involved in regulating cellular pluripotency and the expression of the MET/EMT genes, possibly via the phosphatidylinositol-3 kinases-protein kinase B (PI3K-Akt) and transforming growth factor beta (TGF-β) signaling pathways. Irregular and inconsistent expression patterns of the EMT vimentin and Snai1 and MET E-cadherin and occludin proteins were observed in the four CRC-iPC clones analyzed, which suggested an epithelial/mesenchymal hybrid phenotype in the partially reprogrammed CRC cells. MET/EMT gene expression was also generally reversed on re-differentiation, also suggesting epigenetic regulation.
CONCLUSIONS: Our data support the elite model for cancer cell-reprogramming in which only a selected subset of cancer may be fully reprogrammed; partial cancer cell reprogramming may also elicit an epithelial-mesenchymal mixed phenotype, and highlight opportunities and challenges in cancer cell-reprogramming.
MATERIALS AND METHODS: A total of 47 patients with 88 IPS e.max Press single crowns were examined at the Faculty of Dentistry, University of Malaya, using modified United States Public Health Service evaluation criteria (USPHS). These 88 crowned teeth included 19 vital and 69 nonvital teeth that were restored with different post and core materials. The periodontal status was compared using the plaque index (PI), gingival recession (GR), modified papillary bleeding index (MPBI) and probing pocket depth (PPD) between the crowned teeth and contralateral control (sound) teeth.
RESULTS: About 96.6% of the crowns exhibited satisfactory clinical performance. The mean survival rate at three years was 97.7%, and 100% at two years with a low incidence of fractures. There were no staitistically significant differences in the mean gingival recession (p = 0.182) and mean plaque scores (p = 0.102) between crowned and control teeth. The crowned teeth had higher mean MPBI (p = 0.000) and PPD (p = 0.051) compared to the contralateral sound teeth. Periodontal response in relation to subgingival crown margins, was statistically significantly lower regarding pocket depths (p = 0.01) and bleeding on probing (p = 0.00).
CONCLUSION: IPS e.max Press crowns exhibited satisfactory clinical performance with high survival rate. No dentinal sensitivity was recorded. Plaque retention and gingival recession were similar to contralateral control teeth. Poor periodontal health was related to the subgingival crown margins.
MATERIALS AND METHODS: Fifty-six pregnant women attending the Antenatal Clinic, UMMC for their first antenatal check-up consented and were recruited for this study: 28 subjects with diseased periodontium (test group) and 28 subjects with healthy periodontium (control). The test group underwent nonsurgical periodontal therapy and the control group was given oral hygiene education. Periodontal parameters and CRP levels were evaluated at baseline and 6 weeks. Pregnancy outcome data were recorded from the Antenatal Clinic, UMMC.
RESULTS: Plasma CRP levels in the test group were statistically significantly elevated compared to the control group (8.55 ± 5.28 mg/l vs 5.66 ± 2.91 mg/l). After nonsurgical periodontal therapy, a statistically significant reduction in the CRP level in the test group (2.06 mg/l) along with statistically significant improvement in periodontal status in both groups was observed. The mean birth weight for infants of both groups showed no statistically significant difference.
CONCLUSIONS: Plasma CRP levels in pregnant women with diseased periodontium were statistically significantly reduced after nonsurgical periodontal therapy. However, no association between CRP levels and adverse pregnancy outcome was observed.