[Clinical effectiveness of Subjective Global Nutritional Assessment in hospitalized children with cerebral palsy].

OBJECTIVE: To investigate the nutritional status of children with cerebral palsy (CP) and the clinical effectiveness of Subjective Global Nutritional Assessment (SGNA) in nutritional assessment of hospitalized children with CP. METHODS: A total of 208 children with CP, aged 1-5 years, who were hospitalized from April to October 2019 were enrolled as subjects. SGNA was used to investigate nutritional status, and the Z-score method recommended by the World Health Organization was used as a reference standard to validate the clinical effectiveness of SGNA. RESULTS: The detection rate of malnutrition in children with CP was 42.3% by SGNA and 39.4% by the Z-score method (P>0.05). The application of SGNA showed high consistency between different evaluators (κ=0.621, P<0.001). With the Z-score method as the reference standard, SGNA had a sensitivity of 80.5%, a specificity of 82.5%, a positive predictive value of 75.0%, and a negative predictive value of 86.7%, and high consistency was observed between the two evaluation methods (κ=0.622, P<0.001). SGNA was moderately consistent with weight-for-age Z-score and height-for-age Z-score (κ=0.495 and 0.478 respectively, P<0.001) and was poorly consistent with weight-for-height Z-score (κ=0.197, P<0.05). CONCLUSIONS: There is a relatively high incidence rate of malnutrition in children with CP. SGNA can be used as a tool to assess the nutritional status of children with CP.

Maximal mid-expiratory flow is a surrogate marker of lung clearance index for assessment of adults with bronchiectasis.

Little is known about the comparative diagnostic value of lung clearance index (LCI) and maximal mid-expiratory flow (MMEF) in bronchiectasis. We compared the diagnostic performance, correlation and concordance with clinical variables, and changes of LCI and MMEF% predicted during bronchiectasis exacerbations (BEs). Patients with stable bronchiectasis underwent history inquiry, chest high-resolution computed tomography (HRCT), multiple-breath nitrogen wash-out test, spirometry and sputum culture. Patients who experienced BEs underwent these measurements during onset of BEs and 1 week following antibiotics therapy. Sensitivity analyses were performed in mild, moderate and severe bronchiectasis. We recruited 110 bronchiectasis patients between March 2014 and September 2015. LCI demonstrated similar diagnostic value with MMEF% predicted in discriminating moderate-to-severe from mild bronchiectasis. LCI negatively correlated with MMEF% predicted. Both parameters had similar concordance in reflecting clinical characteristics of bronchiectasis and correlated significantly with forced expiratory flow in one second, age, HRCT score, Pseudomonas aeruginosa colonization, cystic bronchiectasis, ventilation heterogeneity and bilateral bronchiectasis. In exacerbation cohort (n = 22), changes in LCI and MMEF% predicted were equally minimal during BEs and following antibiotics therapy. In sensitivity analyses, both parameters had similar diagnostic value and correlation with clinical variables. MMEF% predicted is a surrogate of LCI for assessing bronchiectasis severity.

Assessment of a predictive score for pulmonary complications in cancer patients after esophagectomy.

BACKGROUND: Esophagectomy is a very important method for the treatment of resectable esophageal cancer, which carries a high rate of morbidity and mortality. This study was undertaken to assess the predictive score proposed by Ferguson et al for pulmonary complications after esophagectomy for patients with cancer. METHODS: The data of patients who admitted to the intensive care unit after transthoracic esophagectomy at Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College between September 2008 and October 2010 were retrospectively reviewed. RESULTS: Two hundred and seventeen patients were analyzed and 129 (59.4%) of them had postoperative pulmonary complications. Risk scores varied from 0 to 12 in all patients. The risk scores of patients with postoperative pulmonary complications were higher than those of patients without postoperative pulmonary complications (7.27±2.50 vs. 6.82±2.67; P=0.203). There was no significant difference in the incidence of postoperative pulmonary complications as well as in the increase of risk scores (χ (2)=5.477, P=0.242). The area under the curve of predictive score was 0.539±0.040 (95%CI 0.461 to 0.618; P=0.324) in predicting the risk of pulmonary complications in patients after esophagectomy. CONCLUSION: In this study, the predictive power of the risk score proposed by Ferguson et al was poor in discriminating whether there were postoperative pulmonary complications after esophagectomy for cancer patients.

A Facile and Low-Cost Route to Heteroatom Doped Porous Carbon Derived from Broussonetia Papyrifera Bark with Excellent Supercapacitance and CO2 Capture Performance.

In this work, we present a facile and low-cost approach to synthesize heteroatom doped porous carbon via hydrothermal treatment of stem bark of broussonetia papyrifera (BP) as the biomass precursor in diluted sulfuric acid, and following thermal activation by KOH at 800 °C. The morphology, structure and textural property of the prepared porous carbon (PC) are investigated by scanning electron microscopy, transmission electron microscopy, N2 sorption isotherms, and X-ray photoelectron spectroscopy. The porous carbon possesses a high BET surface area of 1759 m(2) g(-1) and an average pore size of 3.11 nm as well as hetero-oxygen (9.09%) and nitrogen (1.7%) doping. Such porous carbon shows outstanding capacitive performances of 416 F g(-1) and 300 F g(-1) in three and two-electrode systems, respectively. As a solid-state adsorbent, the obtained porous carbon has an excellent CO2 adsorption capacity at ambient pressures of up to 6.71 and 4.45 mmol g(-1) at 0 and 25 °C, respectively. The results present one novel precursor-synthesis route for facile large-scale production of high performance porous carbon for a variety of great applications including energy storage and CO2 capture.

Psychometric evaluation of a cultural competency assessment instrument for health professionals.

BACKGROUND: Few valid and reliable measures exist for health care professionals interested in determining their levels of cultural and linguistic competence. OBJECTIVE: To evaluate the measurement properties of the Cultural Competence Health Practitioner Assessment (CCHPA-129). METHODS: The CCHPA-129 is a 129-item web-based instrument, developed by the National Center for Cultural Competence. Responses on the CCHPA -129 were examined using factor analysis; Rasch modeling; and differential item functioning across race, ethnicity, sex, and profession. SUBJECTS: A total of 2504 practitioners, including 1864 nurses (RN/LPN/BSN); 341 clinicians (PA/NP); and 299 physicians (MD/DO), who completed the CCHPA-129 online between 2005 and 2008. RESULTS: Three factors representing domains of Knowledge, Adapting Practice, and Promoting Health for culturally and linguistically diverse populations accounted for 46% of the variance. Among Knowledge factor items, 53% (23/43) fit the Rasch model, item difficulties ranged from -1.01 logits (least difficult) to +1.11 logits (most difficult), separation index (SI) 13.82, and Cronbach's α 0.92. Forty-seven percent (21/44) Adapting Practice factor items fit the model, item difficulties -0.07 to +1.11 logits, SI 11.59, Cronbach's α 0.88; and 58% (23/39). Promoting Health factor items fit the model, item difficulties -1.01 to +1.38 logits, SI 22.64, Cronbach's α 0.92. Early evidence of validity was established by known groups having statistically different scores. CONCLUSIONS: The 67-item CCHPA-67 is psychometrically sound. This shorted instrument can be used to establish associations between practitioners' cultural and linguistic competence and health outcomes as well as to evaluate interventions to increase practitioners' cultural and linguistic competence.

Quantitative assessment of the association between XRCC6 C1310G polymorphism and cancer risk.

X-ray cross-complementing group 6 (XRCC6) plays an important role in the DNA double-strand breaks repair and the maintenance of genomic integrity. XRCC6 C1310G polymorphism may be involved in the development of cancer through increasing genomic damages. However, studies investigating the relationship between XRCC6 C1310G polymorphism and cancer risk yielded contradictory results. To shed some light on these inconsistent findings, a meta-analysis was performed to clarify the effect of XRCC6 C1310G polymorphism on the susceptibility of cancer. A systemic literature search of PubMed, EMBASE, and China National Knowledge Infrastructure databases was conducted from their inception to September 26, 2012. The association between XRCC6 C1310G and cancer risk was assessed by the pooled odds ratio (OR) with 95 % confidence intervals (95 % CI) calculated by meta-analysis. A total of 15 eligible studies (4,642 cancer cases and 6,059 controls) were identified. Overall, there was obvious evidence for an association between XRCC6 C1310G polymorphism and increased risk of cancer under two genetic comparisons (GG vs. CC: fixed-effect OR 1.35, 95 % CI 1.10-1.66, I (2) = 17.0 %; GG vs. CG/CC: fixed-effect OR 1.25, 95 % CI 1.02-1.53, I (2) = 0.0 %). Subgroup analysis indicated that the association was significant in Asians (G vs. C: random-effect OR 1.13, 95 % CI 1.01-1.26, I (2) = 51.3 %; GG vs. CC: fixed-effect OR 1.43, 95 % CI 1.14-1.81, I (2) = 0.0 %; GG vs. CG/CC: fixed-effect OR 1.37, 95 % CI 1.09-1.72, I (2) = 0.0 %), but not in Europeans. Data from the current meta-analysis support the existence of an association between XRCC6 C1310G polymorphism and cancer risk in Asians. Studies with larger sample size are needed to further evaluate the influence of XRCC6 C1310G polymorphism on susceptibility of various cancers.

Women bound to be active: differences in long-term physical activity between completers and noncompleters of a book club intervention.

BACKGROUND: Ideal approaches to increasing long-term physical activity (PA) adherence in women remain unclear. This study used a longitudinal mixed-methods approach to 1) determine the effectiveness of an 8-month book club intervention for increasing PA participation and self-worth, and reducing barriers at 1-year followup; and 2) identify reasons why completers and noncompleters did or did not maintain PA. METHODS: One year after the cessation of Women Bound to be Active (WBA), completers (participated in posttesting; n = 30) and noncompleters (did not participate in posttesting; n = 22) responded to questionnaires and interviews assessing their body mass index (BMI), current PA participation, barriers, and global self-worth. RESULTS: Compared with noncompleters, completers reported decreases in BMI, higher motivation for PA, higher ratio of benefits to barriers, and more consistent PA. Both groups still reported barriers to PA, especially time; however, completers more often reported strategies for overcoming these barriers. Completers more directly discussed the impact of their improved self-worth on their PA participation. CONCLUSIONS: In the future, a greater focus on time management and self-regulation strategies should be emphasized in PA interventions, specifically those that focus on women. This may help to prevent program and long-term PA attrition.

Differential item functioning analysis of the 2003-04 NHANES physical activity questionnaire.

Using differential item functioning (DIF) analyses, this study examined whether there were any DF items in the National Health and Nutrition Examination Survey (NHANES) physical activity (PA) questionnaire. A subset of adult data from the 2003-04 NHANES study (n = 3,083) was used. PA items related to respondents' occupational, transportation, domestic, leisure-time, strength-related, and sedentary activities were analyzed for DIF using Mantel-Haenszel, SIBTEST, and analysis of variance procedures. Some items were identified as DF items, with the majority of those items favoring advantaged social groups. For example, items about domestic activity and moderate-intensity leisure-time activity were DF items favoring non-Hispanic Whites, and persons with higher levels of education (e.g., some college or more) or income (e.g, annual family income [AFI] > $34,999). The vigorous activity item was a DIF item favoring younger adults (ages 20-59 years) and persons with higher levels of education or income. Occupational PA presented DF favoring Hispanics and persons with lower levels of education (e.g., high school or less), and the transportation-related PA item presented DF favoring persons with lower incomes (e.g., AFI $34,999). These findings highlight the importance of conducting DF analysis in PA survey construction and emphasize the need to introduce DIF concepts and methods to PA researchers.

Women bound to be active (years 3 and 4): can a book club help women overcome barriers to physical activity and improve self-worth?

Little progress has been made toward increasing physical activity in women. This study aimed to determine if an 8-month theory-based book club intervention (Women Bound to Be Active) was effective in increasing: (a) self-worth, (b) benefits relative to barriers to physical activity, and (c) physical activity in women (n = 51). Findings suggested a book club was effective for improving: self-worth, the benefits relative to barriers to physical activity, and possibly participation in physical activity. This is an innovative model to help women become more active and learn skills that may enable them to be active on their own long after a physical activity program has ended.

[Assessment of two standards for diagnosis of dental caries in epidemiological survey].

OBJECTIVE: To investigate the difference between the results of using two standards(CPI and No.5 sharp probes) in the diagnosis of clinical dental caries during epidemiological survey. METHODS: The CPI and No. 5 sharp probes were used respectively for the diagnosis of clinical dental caries in the same group of children aged 12 by the two examiners. This group of children were reexamined after 14 days to compare the consistency and the rate of coincidence of the location of teeth and caries average and the prevalence rate of dental caries diagnosed by the two kinds of probes. RESULTS: The difference between the location of teeth with caries examined by the two different standards respectively by the same examiner was not statistically significant. The difference between caries average and the prevalence rate of dental caries examined with the two different standards respectively by the same examiner was also not statistically significant. The difference between the outcomes of the crossover comparison by the two examiners showed no statistical significance. CONCLUSIONS: There was no significant difference between the two diagnostic standards for caries. The outcomes of the diagnosis based on both standards shows a similarity. CPI could replace No. 5 sharp probes due to its convenience in large scale of oral health survey.

Evaluation of protein safety in the context of agricultural biotechnology.

One component of the safety assessment of agricultural products produced through biotechnology is evaluation of the safety of newly expressed proteins. The ILSI International Food Biotechnology Committee has developed a scientifically based two-tiered, weight-of-evidence strategy to assess the safety of novel proteins used in the context of agricultural biotechnology. Recommendations draw upon knowledge of the biological and chemical characteristics of proteins and testing methods for evaluating potential intrinsic hazards of chemicals. Tier I (potential hazard identification) includes an assessment of the biological function or mode of action and intended application of the protein, history of safe use, comparison of the amino acid sequence of the protein to other proteins, as well as the biochemical and physico-chemical properties of the proteins. Studies outlined in Tier II (hazard characterization) are conducted when the results from Tier I are not sufficient to allow a determination of safety (reasonable certainty of no harm) on a case-by-case basis. These studies may include acute and repeated dose toxicology studies and hypothesis-based testing. The application of these guidelines is presented using examples of transgenic proteins applied for agricultural input and output traits in genetically modified crops along with recommendations for future research considerations related to protein safety assessment.

Mapping QTLs with digenic epistasis under multiple environments and predicting heterosis based on QTL effects.

Mixed linear model approach was proposed for mapping QTLs with the digenic epistasis and QTL by environment (QE) interaction as well as additive and dominant effects. Monte Carlo simulations indicated that the proposed method could provide unbiased estimations for both positions and genetic main effects of QTLs, as well as unbiased predictions for QE interaction effects. A method was suggested for predicting heterosis based on individual QTL effects. The immortalized F(2) (IF(2)) population constructed by random mating among RI or DH lines is appropriate for mapping QTLs with epistasis and their QE interaction. Based on the models and methodology proposed, we developed a QTL mapping software, QTLMapper 2.0 on the basis of QTLmapper 1.0, which is suitable for analyzing populations of DH, RIL, F(2) and IF(2). Data of thousand grain weight of IF(2) population with 240 lines derived from elite hybrid rice Shanyou 63 were analyzed as a worked example.

Digestion assays in allergenicity assessment of transgenic proteins.

The food-allergy risk assessment for transgenic proteins expressed in crops is currently based on a weight-of-evidence approach that holistically considers multiple lines of evidence. This approach recognizes that no single test or property is known to distinguish allergens from nonallergens. The stability of a protein to digestion, as predicted by an in vitro simulated gastric fluid assay, currently is used as one element in the risk assessment process. A review of the literature on the use of the simulated gastric fluid assay to predict the allergenic status of proteins suggests that more extensive kinetic studies with well-characterized reference proteins are required before the predictive value of this assay can be adequately judged.