Intervention strategies for white noise alleviating procedural pain in newborns: A systematic review.

AIMS AND OBJECTIVE: To systematically evaluate the current intervention strategies of white noise alleviating procedural pain in newborns. METHODS: This review was conducted following the PRISMA guideline. Seventeen databases National Guideline Clearinghouse, up to date, Clinical Evidence, BMJ best practice, Cochrane library, OVID, PubMed, Medline, EMBASE, Web of Science, CHINHAL, Medlive, China Biology Medicine disc, Chinese Clinical Trial Registry, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data Knowledge Service Platform were employed, and the studies about pain-relieving with white noise in newborns published before June 2022 was included. Quality of studies was evaluated by using the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: 18 studies were included, with sample sizes ranging from 32-296 cases. Intervention indices included duration, distance, volume, music type and outcome measure. Duration varies from study to study, from 5 min before to 5 min after the procedures. The distance was controlled at 10-60 cm, volume was controlled at 45-60 dB and music type was selected from Orhan Osman's album "Kolic" in most studies. Outcome measures included physiological indicators, neurophysiological indicators, behavioural indicators and pain score. Differences in duration leading to different white noise effects was found, but no studies have shown whether there is an effect of different volume, distance or music type. CONCLUSIONS: Based on this review, we recommend the following intervention strategies: the duration is set from 1 min before to 3 min after the procedures, the distance is decided according to the actual clinical situation, the volume is controlled at 45-55 dB (55 dB is optimal), the music type is selected to simulate intrauterine sounds, and outcome measures can choose physiological indicators, neurophysiological indictors, behavioural indicators and pain score depending on specific department and population. It is important to further explore the best intervention strategies. RELEVANCE TO CLINICAL PRACTICE: In addition to providing a set of intervention strategies, this review could be used as evidence for relieving procedural pain in newborns. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. Data were obtained from others' literature.

Spatial Heterogeneity and Influencing Factors of HFRS Epidemics in Rural and Urban Areas: A Study in Guanzhong Plain of Shaanxi Province, China.

Objective: The Guanzhong Plain of Shaanxi Province is a severely afflicted hemorrhagic fever with renal syndrome (HFRS) epidemic area, while HFRS prevalence has decreased in most epidemic areas in China. Little information is available regarding the leading fine-scale influencing factors in this highly HFRS-concentrated area and the roles of natural environmental and socioeconomic factors. To investigate this, two regions in the Guanzhong Plain, that is, the Chang'an District and Hu County, with similar geographical environments, different levels of economic development, and high epidemic prevalence, were chosen as representative areas of the HFRS epidemic. Methods: Maximum entropy models were constructed based on HFRS cases and fine-scale influencing factors, including meteorological, natural environmental, and socioeconomic factors, from 2014 to 2016. Results: More than 95% of the HFRS cases in the study area were located in the northern plains, which has an altitude of less than 800 m, with topography contributed 84.1% of the impact on the spatial differentiation of the HFRS epidemic. In the northern plains, precipitation and population density jointly affected the spatial differentiation of the HFRS epidemic, with contribution rates of 60.7% and 28.0%, respectively. By comparing the influencing factors of the northern plains of Chang'an District and Hu County, we found that precipitation and the normalized difference vegetation index (NDVI) dominated the HFRS epidemic in the relatively developed Chang'an District, while land-use type, temperature, precipitation and population density dominated the HFRS epidemic in the relatively undeveloped Hu County. Conclusion: Topography was the primary key factor for HFRS prevalence in the Chang'an District and Hu County, and the spatial differentiation of HFRS was dominated by precipitation and population density in the northern plains. Compared with the influencing factors of the relatively developed Chang'an District, the developing Hu County was more affected by socioeconomic factors. When formulating targeted HFRS epidemic prevention and control strategies in the targeted areas, it is crucial to consider the local economic development state and combine natural environmental factors, including the meteorological environment and vegetation coverage.

Exploration of interventions to enhance return-to-work for cancer patients: A scoping review.

OBJECTIVE: With the increasing incidence and earlier onset of cancer, more and more cancer patients are facing the problems of return-to-work. This review is to explore the types, contents, and results of return-to-work interventions for cancer patients. METHODS: This scoping review followed Arksey and O'Malley's framework and PRISMA-ScR List. Three Chinese databases and five English databases were searched from the establishment of databases to 31 March, 2021. Article selection and data extraction were conducted by two researchers. RESULTS: Thirty-two studies and 1916 cancer patients with mainly breast and gastrointestinal cancer were included. According to the contents, interventions could be divided into four types: (1) physical interventions (n = 6), including high-intensity exercise, low-to-moderate intensity exercise, yoga, and upper limb functional training, (2) psychological interventions (n = 2), including early active individualized psychosocial support and mindfulness-based recovery, (3) vocational interventions (n = 14), including making work plans, educational leaflets, vocational consultations, electronic health intervention, and interventions targeting at employers, (4) multidisciplinary interventions (n = 10), including any combination of above interventions. Physical exercises, making working plans, vocational consultations, educational leaflets, two combinations of vocational and physical interventions were validated to have positive results in enhancing cancer patients' return-to-work. CONCLUSIONS: Return-to-work interventions for cancer patients are diversified and can be divided into physical, psychological, vocational, and multidisciplinary interventions. Medical staffs can utilize physical exercises, making working plans, vocational consultation, educational leaflets, combinations of vocational and physical interventions to enhance cancer patients' return-to-work. Other interventions still need to be developed and validated.

Quantitative response of cell growth and Tuber polysaccharides biosynthesis by medicinal mushroom Chinese truffle Tuber sinense to metal ion in culture medium.

During the submerged fermentation of medicinal mushroom Chinese truffle Tuber sinense, there was no significant effect of metal ion on the cell growth and the production of intracellular polysaccharides, while metal ion and its concentration significantly affected the production of extracellular polysaccharides (EPS). By using the approach of "one-variable-at-a-time", 50 mM Mg2+ was identified to be the most favorable for EPS production, and the next was 10 mM K+. A mathematical model, constructed by response surface methodology combination with full factorial design, was applied to study the synergic effect of Mg2+ and K+. EPS production reached its peak value of 5.86 g/L under their optimal combination of 30 mM Mg2+ and 5 mM K+ predicted by the model, which was higher by 130.7% compared with the basal fermentation medium without metal ion. The validation experiment showed the experimental values agreed with the predicted values well. EPS production obtained in this work was the highest reported in the culture of T. sinense.

[Study on clinical and biological characteristics of childhood acute leukemia with MLL gene rearrangements].

OBJECTIVE: To study the clinical and laboratory features of childhood acute leukemia (AL) with MLL gene rearrangements. METHODS: Sixteen of 298 cases of childhood AL with MLL rearrangements were studied by using MLL dual-color FISH, multiplex RT-PCR with 13 pairs of primers in combination with R banding karyotype analysis and cell immunophenotyping by flow cytometry. RESULTS: Sixteen cases of childhood AL with MLL rearrangements accounted for 5.4% of 298 AL patients, and 56.3% of infant ALs. Among 106 cases analyzed by multiplex RT-PCR, MLL gene rearrangements were found in 11 cases, including MLL/AF4 fusion gene in 2, MLL/AF6 fusion gene in 1, MLL/AF6 and MLL/ELL combined with MLL/ AFX or HOX11 in one case each, MLL/AF9 in 2, MLL/AF10 in 1, MLL/ELL in 2. MLL partial tandem duplication in 1 and activated HOX11 in 1. In 27 cases assayed by FISH, 9 cases (36.0%) were demonstrated MLL gene rearrangements. In 16 patients with MLL gene rearrangements, 14 (87.5%) exhibited clonal chromosome abnormalities involved chromosome 11 in 11 cases: being t(4;11) in 2, t(6;11), t(8;11), t(7;8;11), t(9;11) in each trisomy 11 in 2 and 11q--in 3 cases. Among these 16 patients, 11 were B-ALL, and 5 AML-M5, 3 of the latter were CD7+ and CD2+. Of these 16 patients, 8 received chemotherapy and 7 of them achieved complete remission, while the other 8 patients gave up treatment. CONCLUSION: Multiplex RT-PCR combined with FISH provided a more accurate and sensitive method for detection of MLL gene rearrangements. Finding out MLL gene rearrangement is of most importance in guiding therapy and predicting prognosis in childhood AL.

[Detection of fusion genes resulting from chromosome abnormalities in childhood acute lymphoblastic leukemia].

OBJECTIVE: To detect the expression of the fusion genes resulting from chromosome abnormalities in childhood acute lymphoblastic leukemia(ALL) and its conformity to WHO classification. METHODS: Sixty-two children with ALL were investigated. The expression of fusion genes was determined by multiplex reverse transcription-polymerase chain reaction (RT-PCR), karyotyping (R band) and immunophenotyping (by flow cytometry) were also performed. RESULTS: Of the 62 patients, 23(37.1%) were found to carry 13 different fusion genes. The patients with immunophenotype of Pre-B-ALL were found to carry: TEL/AML1(3 cases); E2A/PBX1, E2A/HLF, TLS/ERG, MLL/AF4, MLL/AF9, MLL/AF10, MLL/AFX-MLL/AF6-MLL/ELL, MLL/AF6-MLL/ELL, dupMLL (one case for each); and HOX11 (6 cases). The patients with immunophenotype of Pre-T-ALL were found to carry: TAL1D (4 cases, one is also found to have HOX11 expression); and HOX11 (2 cases). The multiplex RT-PCR in combination with chromosome analysis revealed genetic abnormalities in 69.4%(43/62) of childhood ALL. CONCLUSION: Multiplex RT-PCR combined with chromosome analysis and immunophenotyping can provide reliable and helpful information for the diagnosis, therapy evaluation and prognosis prediction in childhood ALL, which may also serve as a basis on which to implement the criteria of WHO classification.

[A combined assay of multiplex RT-PCR and karyotypic analysis in childhood acute lymphoblastic leukemia].

OBJECTIVE: To study the value of combination assay of multiplex RT-PCR and karyotypic analysis in the diagnosis and classification of childhood acute lymphoblastic leukemia (ALL). METHODS: Fifty cases of childhood ALL patients were studied by multiplex RT-PCR in combination with R or G banding karyotype analysis. RESULTS: Of the 50 childhood ALL patients, 18 (36.0%) carried 11 types of fusion genes including E2A/PBX1, TEL/AML1, TLS/ERG, MLL/AF4, MLL/AF9, MLL/AF10, MLL/AFX, MLL/AF6, MLL/ELL, TAL1D, and HOX11, revealed by multiplex RT-PCR, and in 48 cases, 24 (57.1%) had chromosome abnormalities. Among the latter, numeral chromosome abnormalities and chromosome deletions accounted for 75.0% (18/24), while translocations 25.0% (6/24). The multiplex RT-PCR in combination with chromosome analysis could detect genetic abnormalities in 70% (35/50) of childhood ALL. CONCLUSIONS: Multiplex RT-PCR combined with chromosome analysis can enhance the detection rate of genetic abnormalities in childhood ALL. It provides reliable evidence for the diagnosis, classification and prognosis.

[Clinical and laboratory studies on childhood acute leukemia with 11q23 abnormalities].

OBJECTIVE: To investigate the interrelations among morphology, immunology, cytogenetics and clinical outcome in childhood acute leukemia with 11q23 abnormalities. METHODS: Eighteen patients with 11q23 abnormalities, from 320 childhood acute leukemia patients, were retrospectively analysed for cell morphology, flow cytometry, immunophenotyping, R-banding karyotype as well as clinical features and prognosis. Twenty cases of childhood AL with normal karyotype during the same period were used as control. RESULTS: The incidence of 11q23 abnormalities in our childhood acute leukemia patients was 5.63% including 14 acute lymphoblastic leukemia (ALL) and 4 acute myeloid leukemia (AML). Of 16 cases immunophenotypically tested, 13 expressed lymphoid antigens and 3 CD(34) and other myeloid antigens. Karyotype analysis disclosed the following abnormalities: t(4; 11)(q21; q23) in 6 cases, t(10; 11)(p13; q23) in 3, t(11; 19)(q23; p13) in one and del(11)(q23) in 6. The complete remission rate for these patients with 11q23 abnormalities was comparable to that of the control (72.2% vs 80.0%, P > 0.05), while the mortality rate in the former was significantly higher than that in the latter (61.1% vs 25.0%, P < 0.05). CONCLUSIONS: 11q23 abnormalities were mainly seen in childhood ALL and acute monocytic leukemia with unique prognostic features.