Participation profiles in domestic life and peer relations as experienced by adolescents with and without impairments and long-term health conditions

Purpose: To investigate how individual and environmental factors relate to self-reported participation profiles in adolescents with and without impairments or long-term health conditions. Methods: A person-oriented approach (hierarchical cluster analysis) was used to identify cluster groups of individuals sharing participation patterns in the outcome variables frequency perceived importance in domestic life and peer relations. Cluster groups were compared using one-way analysis of variance (ANOVA). Results: A nine-cluster solution was chosen. All clusters included adolescents with impairment and long-term health conditions. Perceived importance of peer relations was more important than frequent attendance in domestic-life activities. Frequency of participation in dialogues and family interaction patterns seemed to affect the participation profiles more than factors related to body functions. Conclusion: Type of impairment or long-term health condition is a weaker determinant of membership in clusters depicting frequency and perceived importance in domestic life or peer relations than dialogue and family environment.     

Perfect- and typical-use effectiveness of the Dot fertility app over 13 cycles: results from a prospective contraceptive effectiveness trial

Objective: Dynamic Optimal Timing (Dot) is a smartphone application (app) that estimates the menstrual cycle fertile window based on the user’s menstrual period start dates. Dot uses machine learning to adapt to cycles over time and informs users of ‘low’ and ‘high’ fertility days. We investigated Dot’s effectiveness, calculating perfect- and typical-use failure rates.

Methods: This prospective, 13 cycle observational study (ClinicalTrials.gov NCT02833922) followed 718 women who were using Dot to prevent pregnancy. Participants contributed 6616 cycles between February 2017 and October 2018, providing data on menstrual period start dates, daily sexual activity and prospective intent to prevent pregnancy. We determined pregnancy through participant-administered urine pregnancy tests and/or written or verbal confirmation. We calculated perfect- and typical-use failure rates using multi-censoring, single-decrement life-table analysis, and conducted sensitivity, attrition and survival analyses.

Results: The perfect-use failure rate was calculated to be 1.0% (95% confidence interval [CI]: 0.9%, 2.9%) and the typical-use failure rate was 5.0% (95% CI: 3.4%, 6.6%) for women aged 18–39 (n?=?718). Survival analyses identified no significant differences among age or racial/ethnic groups or women in different types of relationships. Attrition analyses revealed no significant sociodemographic differences, except in age, between women completing 13 cycles and those exiting the study earlier.

Conclusion: Dot’s effectiveness is within the range of other user-initiated contraceptive methods.     

Attenuation Coefficient Estimation of Normal Placentas

Attenuation coefficient estimation has the potential to be a useful tool for placental tissue characterization. A current challenge is the presence of inhomogeneities in biological tissue that result in a large variance in the attenuation coefficient estimate (ACE), restricting its clinical utility. In this work, we propose a new Attenuation Estimation Region Of Interest (AEROI) selection method for computing the ACE based on the (i) envelope signal-to-noise ratio deviation and (ii) coefficient of variation of the transmit pulse bandwidth. The method was first validated on a tissue-mimicking phantom, for which an 18%–21% reduction in the standard deviation of ACE and a 14%–24% reduction in the ACE error, expressed as a percentage of reported ACE, were obtained. A study on 59 post-delivery clinically normal placentas was then performed. The proposed AEROI selection method reduced the intra-subject standard deviation of ACE from 0.72 to 0.39 dB/cm/MHz. The measured ACE of 59 placentas was 0.77 ± 0.37 dB/cm/MHz, which establishes a baseline for future studies on placental tissue characterization.     

Quantitative analysis of facial soft tissue perfusion during hypotensive anesthesia using laser-assisted indocyanine green fluorescence angiography

The aim of this study was to quantitatively evaluate the efficacy of induced hypotensive anesthesia in decreasing facial soft tissue perfusion during orthognathic surgery using laser-assisted indocyanine green fluorescence angiography. This retrospective study involved the evaluation of 16 patients who underwent orthognathic surgery. Data collection included facial tissue perfusion of the bilateral cheeks and chin at normotension and with pharmacologically induced hypotensive anesthesia. There were statistically significant differences in the facial tissue perfusion at normal and depressed levels of blood pressure (P < 0.001). This study used an objective measure to demonstrate the long-standing belief that hypotensive anesthesia is efficacious in reducing tissue perfusion in the surgical field. The data suggest that pharmacologically depressing the level of mean arterial pressure by 18% may result in a 41–52% decrease in facial soft tissue perfusion. This study reports a novel method of quantitative analysis.     

不同体位支气管镜检查的麻醉中气道通畅性的随机对照研究

目的对坐位及仰卧位支气管镜检查麻醉中气道通畅性进行研究。方法选取48例行不插管全麻下支气管镜检查的患者随机分为两组。其中24例行坐位下支气管镜检查,24例行仰卧位支气管镜检查,观察两组患者检查过程中气道的通畅性及生命体征变化。结果坐位支气管镜检查过程中到达隆突的平均时间更短,气道通畅性更好。外周血氧饱和度(Sp O2)降低、平均动脉压(MAP)升高和烦躁的发生率明显低于仰卧位。结论支气管镜检查麻醉可减轻患者不适感与恐惧感,但传统的仰卧位气管镜检查时麻醉可引起舌后坠,咽喉部塌陷、软腭和声带相关的重力可能造成上呼吸道的阻塞,不但给检查带来不便,同时也增加了相应的气道相关性风险及血流动力学不稳定,而坐位支气管镜检查可以通过保证气道通畅性,维持更为稳定的血流动力学状态,使该体位在支气管镜麻醉镇静中的应用更安全,更方便。     

Proparacaine-Induced Mydriasis During Strabismus Surgery

Aim: To evaluate the mydriatic effect of proparacaine hydrochloride (PH) in children undergoing strabismus surgery under general anesthesia (GA). Methods: This was a pilot, prospective, non-randomized, self-controlled interventional study. Nine children with esotropia or exotropia undergoing horizontal muscle squint surgery under GA at a tertiary eye care center were included. The six Group 1 patients underwent both eye surgeries, while the three Group 2 patients underwent single eye surgery. PH was instilled in one eye of Group 1 patients and both eyes of Group 2 patients. Change in pupil diameter (PD) was analyzed as the main outcome measure. Results: Mean age of the patients was 4.67 ± 2.64 years. In the study eyes, mean average baseline PD was 1.59 ± 0.40 mm (range: 1.06–2.37), while postoperative average PD was 3.99 ± 1.34 mm (range: 1.79–6.02). The mean baseline PC had increased from 5.51 ± 1.09 mm to 12.6 ± 3.58 mm at the end of the surgery. PD and PC increased in all of the study eyes while no change in PD or PC was seen in the control eyes of either of the groups. The dilated pupil was skewed horizontally towards the muscle being operated upon in all of the study eyes. Conclusions: PH has a mydriatic effect of its own. It penetrates through the bare sclera and leads on to skewed dilation of the pupil. Surgeons should consider this effect while judging pupil alignment at the end of the surgery.     

替加环素单药及与5种抗菌药物联用对耐碳青霉烯类鲍曼不动杆菌的体外抑菌及生物膜清除作用研究#br#

目的 评价替加环素单用及与其他5种临床常用抗菌药物分别联合使用，对耐碳青霉烯类鲍曼不动杆菌(carbapenems-resistant Acinetobacter baumannii, CRAB)的体外抑菌及生物膜清除作用。方法 微量肉汤稀释法测定替加环素、阿米卡星、美罗培南、环丙沙星、黏菌素和舒巴坦对42株CRAB的最低抑菌浓度(minimal inhibititory concentration, MIC)和最低生物被膜清除浓度(minimal biofilm eradication concentration, MBEC)。棋盘稀释法测定替加环素分别联用阿米卡星、美罗培南、环丙沙星、黏菌素和舒巴坦对42株CRAB的MIC值和MBEC值，并计算分级抑菌浓度指数(fractional inhibitory concentration index, FICI)和分级生物膜清除浓度指数(fractional eradication concentration index, FECI)。结果 替加环素与5种抗菌药物分别联用后，对CRAB的抑菌作用和生物被膜清除作用表现为协同或无关，均未发现拮抗现象。其中替加环素与阿米卡星联用后具有较高的协同抑菌率(47.6%, 20/42)，而替加环素与环丙沙星联用后则具有较高的生物膜协同清除率(30.9%, 13/42)。结论 与单药相比，替加环素与5种药物分别联用，对CRAB的体外抑菌及生物膜清除作用具有一定的增强效果。