Évaluation de BabelMeSH en français

BabelMeSH is a multilingual search tool for Medline/PubMed. It is intended for users whose primary language is not English. The languages currently supported are: Arabic, Chinese, French, German, Italian, Japanese, Korean, Portuguese, Russian, Spanish and Swedish. The goal of this work is to evaluate the usability and effectiveness of the French version. This study consisted of two parts: (1) evaluation of translation of French keywords by BabelMeSH, (2) user feedback. We used two sets of keywords: a list of authors’ keywords in medical journals published in French and a list of terms derived from Web server logs submitted by French-speaking users to search BabelMeSH. English translations by the authors were compared with those translated by BabelMeSH. The accuracy of translation of user submitted terms was evaluated. An online questionnaire using the 5-point Likert scale was used to evaluate user opinion on the usefulness of BabelMeSH. One hundred and seventy-four author keywords and 179 user keywords in French were randomly selected to search Medline/PubMed via BabelMeSH. With the author-generated keywords, BabelMeSH exactly matched (word-for-word) the authors’ translations for 69 terms; translations were accurate (similar concept) for 69 keywords; multiple suggestions were given for 19, one of which was the same as the authors’ translation or considered accurate. Partial matches (compound words) were found for 22 keywords. BabelMeSH translations were incorrect for 21 terms. For user search terms, 135 translations and suggestions were considered accurate, 15 partially accurate, 21 were incorrect. Of the eight with multiple suggestions, only one was accurate. Six responses were received from the online questionnaire. The average ratings (5: agree, 1: disagree) for the following statements were: (1) that BabelMeSH was useful: 4.3; (2) the overall quality of citations retrieved was excellent: 4.3; and (3) that they would continue to use BabelMeSH: 4.6. All declared that they had previously searched Medline in English and all, except one, stated that they would recommend it to others. BabelMeSH is an alternative resource for researchers whose native language is other than English. Limited user feedback and the results of an objective evaluation seem to indicate that it could be a useful addition to multilanguage search tools for Medline/PubMed. However, at the time we conducted this study, the development of BabelMeSH was not finished. Therefore, it might be necessary to evaluate BabelMeSH French version in future.     

Validation of the Diagnostic Interview for Genetic Studies (DIGS) in Colombia

An interview tool, Diagnostic Interview for Genetic Studies (DIGS 3.0), was translated into Spanish for application in studies of psychiatric disorders in Colombia. Two Spanish translations of the original English version of DIGS were prepared and back-translated into English. A review committee verified the linguistic and cultural equivalence of the translations. The evaluator and test-retest reliability were assessed calculating Cohen's kappa for samples of 65 and 91 patients respectively. DIGS proved valid in both appearance and content. The confidence interval (C.I.) was excellent for schizophrenia (kappa = 0.81, C.I. 95% = 0.68-0.93), bipolar disorder (kappa = 0.87, C.I. 95% = 0.75-0.99), major depressive disorder (kappa = 0.86, C.I. 95% = 0.70-1.00), and for a normal diagnosis (kappa = 0.65, C.I. 95% = 0.41-0.89); it was good for other psychiatric diagnosis (kappa = 0.65, C.I. 95% = 0.41-0.89) and poor for schizoaffective disorder (kappa = 0.37, C.I. 95% = -0.02-0.76). Test-retest reliability was excellent for all diagnoses (kappa > 0.8), except for "other psychiatric diagnoses" (kappa = 0.64, C.I. 95% = 0.31-0.96). The Spanish translation of the DIGS was comprehensible, with face and content validity, and good test-retest and evaluator reliability. This translation will be a useful tool for genetic studies of psychiatric disorders in Latin America, particularly where schizophrenia and affective disorders are involved.     

Adherence with tobramycin inhaled solution and health care utilization

Background

To produce a conceptually equivalent Arabic version to the original Self-Administered Chronic Respiratory Disease Questionnaire with standardized dyspnea domain (CRQ-SAS) and to assess its reliability.

Methods

The study was carried out in two stages: stage I which was the translation of the CRQ-SAS questionnaire from the English to the Arabic language, and stage II which represented the test-retest reliability for patients receiving usual care for COPD who were not yet admitted to the pulmonary rehabilitation program.

Results

Forty five patients with stable COPD were enrolled in this study. Strong test-retest reliability was found for the four domains of the CRQ-SAS, with the intra-class correlation coefficient of 0.97 for each of the domains. The association between most parameters and the four domains of CRQ-SAS were not found to be statistically significant, as measured by Pearson correlation. The number of exacerbations was negatively correlated with the dyspnea domain (correlation = -0.36, p-value = 0.02). The disease duration was negatively correlated with the domain fatigue (correlation = -0.35, p-value = 0.02). The correlation between FEV1/FVC ratio and emotion domain was -0.30 (p-value = 0.05). The mastery domain was negatively correlated with FEV1/FVC ratio with a correlation of -0.27 with borderline statistical significance (p-value = 0.07).

Conclusion

The Arabic translation of the CRQ-SAS was found to be reliable to assess the quality of life among patients with COPD.     

Validation of the German Version of the Social Functioning Scale (SFS) for Schizophrenia

Deficits in social functioning are a core symptom of schizophrenia and an important criterion for evaluating the success of treatment. However, there is little agreement regarding its measurement. A common, often cited instrument for assessing self-reported social functioning is the Social Functioning Scale (SFS). The study aimed to investigate the reliability and validity of the German translation. 101 patients suffering from schizophrenia (SZ) and 101 matched controls (C) (60 male / 41 female, 35.8 years in both groups) completed the German version. In addition, demographic, clinical, and functional data were collected. Internal consistency was investigated calculating Cronbach’s alpha for SFS full scale (α: .81) and all subscales (α: .59-.88). Significant bivariate correlation coefficients were found between all subscales as well as between all subscales and full scale (p <.01). For the total sample, principal component analysis gave evidence to prefer a single-factor solution (eigenvalue ≥ 1) accounting for 48.5 % of the variance. For the subsamples, a two-component solution (SZ; 57.0 %) and a three-component solution (C; 65.6 %) fitted best, respectively. For SZ and C, significant associations were found between SFS and external criteria. The main factor “group” emerged as being significant. C showed higher values on both subscales and full scale. The sensitivity of the SFS was examined using discriminant analysis. 86.5% of the participants could be categorized correctly to their actual group. The German translation of the SFS turned out to be a reliable and valid questionnaire comparable to the original English version. This is in line with Spanish and Norwegian translations of the SFS. Concluding, the German version of the SFS is well suited to become a useful and practicable instrument for the assessment of social functioning in both clinical practice and research. It accomplishes commonly used external assessment scales.     

Arabic version of the Geriatric Oral Health Assessment Index

Objectives: The purpose of this study was to translate the original English version of the Geriatric Oral Health Assessment Index (GOHAI) into an Arabic version, and to test the validity and reliability of the translated instrument (GOHAI‐Ar) for use among the elderly in Saudi Arabia. Methods: The 12‐item GOHAI was translated into Arabic using the back‐translation technique and performing a preliminary test to determine the comprehensibility and readability of the Arabic language version. A total of 156 elderly patients answered the questionnaire, and underwent a clinical examination by one calibrated dentist. Information on subjects’ socio‐demographic background and oral health conditions was collected. Convergent validity was evaluated by identifying the associations between perceived oral health status, general health status, perceived need for dental care and GOHAI‐Ar scores. Discriminant validity was examined by comparing the GOHAI‐Ar scores and six oral health parameters. Internal consistency was measured by Cronbach’s alpha. Test–retest reliability was assessed by intra‐class correlation coefficient (ICC) and weighted kappa. Factor structure of GOHAI‐Ar was evaluated using principal component factor analysis. Results: The mean GOHAI‐Ar was 32.1 (SD 12.2; range 11–59). Mean GOHAI‐Ar scores were higher for the elderly who rated their oral and general health as good. Subjects with perceived dental treatment needs had a lower mean GOHAI‐Ar score than those without any such needs. The caries experience, number of missing teeth, OHI‐S score, number of pathologically mobile teeth and number of oral lesions were negatively correlated with the GOHAI‐Ar score. The Cronbach’s alpha (0.93) indicated a high degree of internal consistency and homogeneity between items. The ICC for GOHAI‐Ar was 0.95, the weighted kappa coefficient for individual items varied between 0.42 and 0.71, and the correlation coefficients for the 12 items were above 0.70. Factor analysis didn’t support the expected dimensions of the index, and only one factor was found at eigenvalue greater than 1. Conclusions: The findings suggest an excellent reliability and validity of GOHAI‐Ar. Further research is needed to assess the value of this instrument in oral health‐related quality of life studies in Arabic elderly population.     

The European General Practice Research Network Presents the Translations of Its Comprehensive Definition of Multimorbidity in Family Medicine in Ten European Languages

Background

Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review.

Objective

To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research.

Method

Forward translation of the EGPRN’s definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teams to ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached

Results

229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved.

Conclusion

A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care.     

Factor Analysis of the Caregiver Quality of Life Index-Cancer (CQOLC) Scale for Chinese Cancer Caregivers: A Preliminary Reliability and Validity Study of the CQOLC-Chinese Version

The English version of the Caregiver Quality of Life Index-Cancer (CQOLC) was translated into simplified Chinese (CQOLC-C), following cultural translation, back-translation and pretest steps. Three hundred and sixty one cancer caregivers participated in this study. Cronbach’s alpha was used to assess CQOLC-C reliability. Exploratory factor analyses (EFA) was used to generate two models of the measure’s factor structure, and confirmatory factor analyses (CFA) were used to test each model, such that the best model to explain the latent structure of the CQOLC-C was identified. EFA using different factor extraction methods yielded two models including four and eight factors. According to the CFA results, model 2 was better fit for the original study data, based on the RMSEA criterion [0.058(90% CI = 0.051-0.065)], χ² (531) = 853.92, p < 0.0001; CFI (0.96), NNFI (0.96), IFI (0.97), and NFI (0.92). We also examined the effect of removing three items on the CQOLC-C factor structure and discuss the resulting differences from other versions. These results indicate that the CQOLC-C’s factor structure does not fully fit the original theorized model. This study provides preliminary support for further use of the CQOLC-C. However, the present work provides only partial support for the relevance and construct validity of the scale for Chinese caregivers.     

Serum Glycine Is Associated with Regional Body Fat and Insulin Resistance in Functionally-Limited Older Adults

Background

Metabolic profiling may provide insight into biologic mechanisms related to age-related increases in regional adiposity and insulin resistance.

Objectives

The objectives of the current study were to characterize the association between mid-thigh intermuscular and subcutaneous adipose tissue (IMAT, SCAT, respectively) and, abdominal adiposity with the serum metabolite profile, to identify significant metabolites as further associated with the homeostasis model assessment of insulin resistance (HOMA-IR), and, to develop a HOMA-IR associated metabolite predictor set representative of regional adiposity, in 73 functionally-limited (short physical performance battery ≤10; SPPB) older adults (age range, 70–85 y).

Methods

Fasting levels of 181 total metabolites, including amino acids, fatty acids and acylcarnitines were measured with use of an untargeted mass spectrometry-based metabolomic approach. Multivariable-adjusted linear regression was used in all analyses.

Results

Thirty-two, seven and one metabolite(s) were found to be associated with IMAT, abdominal adiposity and, SCAT, respectively, including the amino acid glycine, which was positively associated with SCAT and, negatively associated with both IMAT and abdominal adiposity. Glycine and four metabolites found to be significantly associated with regional adiposity were additionally associated with HOMA-IR. Separate stepwise regression models identified glycine as a HOMA-IR associated marker of both IMAT (model R² = 0.51, p<0.0001) and abdominal adiposity (model R² = 0.41, p<0.0001).

Conclusion

Our findings for a positive association between glycine with SCAT but, a negative association between glycine with IMAT and abdominal adiposity supports the hypothesis that SCAT metabolic processes are different from that found in other fat depots. In addition, because of the significant associations found between glycine with HOMA-IR, IMAT, SCAT and abdominal adiposity, our results suggest glycine as a serum biomarker of both insulin sensitivity and regional fat mass in functionally-limited older adults.     

Hypersensitivity of trunk biomechanical model predictions to errors in image-based kinematics when using fully displacement-control techniques

Recent advances in medical imaging techniques have allowed pure displacement-control trunk models to estimate spinal loads with no need to calculate muscle forces. Sensitivity of these models to the errors in post-imaging evaluation of displacements (reported to be ∼0.4–0.9° and 0.2–0.3 mm in vertebral displacements) has not yet been investigated. A Monte Carlo analysis was therefore used to assess the sensitivity of results in both musculoskeletal (MS) and passive finite element (FE) spine models to errors in measured displacements. Six static activities in upright standing, flexed, and extended postures were initially simulated using a force-control hybrid MS-FE model. Computed vertebral displacements were subsequently used to drive two distinct fully displacement-control MS and FE models. Effects of alterations in the reference vertebral displacements (at 3 error levels with SD (standard deviation) = 0.1, 0.2, and 0.3 mm in input translations together with, respectively, 0.2, 0.4, and 0.6° in input rotations) were investigated on the model predictions. Results indicated that outputs of both models had substantial task-dependent sensitivities to errors in the measured vertebral translations. For instance, L5-S1 intradiscal pressures (IDPs) were considerably affected (SD values reaching 1.05 MPa) and axial compression and shear forces even reversed directions as translation errors increased to 0.3 mm. Outputs were however generally much less sensitive to errors in measured vertebral rotations. Accounting for the accuracies in image-based kinematics measurements, therefore, it is concluded that the current measured vertebral translation errors at and beyond 0.1 mm are too large to drive biomechanical models of the spine.     

Evidencias psicométricas de una versión breve de la Coping Humor Scale en adultos mayores peruanos

IntroductionHumour plays an important role in promoting successful and healthy aging. However, its scientific study is still limited, partly due to the absence of validated tools for use in Latin America. The objective of this study was to translate the 5-item Coping with Humor Scale (CHS-5) from English to Spanish and examine the evidence of reliability and validity based on the internal, convergent, and discriminant structure of the Peruvian version of the scale.Materials and methodThe participants were 236 elderly Peruvian adults (78.4% A confirmatory factor analysis, analysis of correlation (r), and reliability (α, Cronbach's alpha and ω, omega) was performed.ResultsThe one-dimensional model presented an adequate fit of the data (χ² = 7.72, df =5, P=.17, χ² / df = 1.54, GFI = 0.988, CFI = 0.996, NFI = 0.988, RMSEA =0. 048 [95% CI; 0.000-0.111]; and SRMR = 0.016). The reliability indexes were adequate (α= 0.86 [95% CI: 0.82-0.89] and ω = 0.89 [95% CI: 0.87-0.91]). A positive correlation was observed between the mean score of CHS-5 and satisfaction with life, and was negative with depression.ConclusionsThe CHS-5 has excellent psychometric properties, being a measure that provides valid and reliable interpretations to be used in elderly Peruvians with depression.     

Determination of 3-(5-cyclopropyl-1,2,4-oxadiazol-3-yl)-5-(1-methylethyl)imidazo[1,5-a]quinoxalin-4(5H)-one in serum by high-performance liquid chromatography

A high-performance liquid chromatographic assay with solid-phase extraction (SPE) for the rapid and sensitive quantitation of 3-(5-cyclopropyl-1,2,4-oxadiazol-3-yl)-5-(1-methylethyl)imidazo[1,5-a]quinoxalin-4(5H)-one (I, U-78875) in serum is described. The validation results indicated that the present method had excellent intra- and inter-assay precision (≤ 9.5%, mean ± S.D. = 3.9±3.0%, n = 25) and accuracy (≤ 10.0%, mean ± S.D. = 3.0 ± 2.9%, n = 25), as well as improved sensitivity (2 ng/ml, using a 100-μl injection). Each chromatographic run is only 10 min and the organic solvent for the extraction of I and internal standard (U-82217) from serum was only 300 μl. The application results obtained from the SPE method were in good agreement with the advanced automated sample preparation method.     

Psychological distress,resettlement stress,and lower school engagement among Arabic-speaking refugee parents in Sydney,Australia: A cross-sectional cohort study

BackgroundSchools play a key role in supporting the well-being and resettlement of refugee children, and parental engagement with the school may be a critical factor in the process. Many resettlement countries have policies in place to support refugee parents’ engagement with their children’s school. However, the impact of these programs lacks systematic evaluation. This study first aimed to validate self-report measures of parental school engagement developed specifically for the refugee context, and second, to identify parent characteristics associated with school engagement, so as to help tailor support to families most in need.Methods and findingsThe report utilises 2016 baseline data of a cohort study of 233 Arabic-speaking parents (77% response rate) of 10- to 12-year-old schoolchildren from refugee backgrounds across 5 schools in Sydney, Australia. Most participants were born in Iraq (81%) or Syria (11%), and only 25% spoke English well to very well. Participants’ mean age was 40 years old, and 83% were female. Confirmatory factor analyses were run on provisional item sets identified from a literature review and separate qualitative study. The findings informed the development of 4 self-report tools assessing parent engagement with the school and school community, school belonging, and quality of the relationship with the schools’ bilingual cultural broker. Cronbach alpha and Pearson correlations with an established Teacher–Home Communication subscale demonstrated adequate reliability (α = 0.67 to 0.80) and construct and convergent validity of the measures (p < 0.01), respectively.Parent characteristics were entered into respective least absolute shrinkage and selection operator (LASSO) regression analyses. The degree of parents’ psychological distress (as measured by the Kessler10 self-report instrument) and postmigration living difficulties (PLMDs) were each associated with lower school engagement and belonging, whereas less time lived in Australia, lower education levels, and an unemployed status were associated with higher ratings in relationship quality with the schools’ cultural broker. Study limitations include the cross-sectional design and the modest amount of variance (8% to 22%) accounted for by the regression models.ConclusionsThe study offers preliminary refugee-specific measures of parental school engagement. It is expected they will provide a resource for evaluating efforts to support the integration of refugee families into schools. The findings support the need for initiatives that identify and support parents with school-attending children from refugee backgrounds who are experiencing psychological distress or resettlement stressors. At the school level, the findings suggest that cultural brokers may be effective in targeting newly arrived families.

Jess Baker and co-workers study engagement of Arabic-speaking refugees with their children’s schools in Australia.     

Maintenance of myoglobin concentration in human skeletal muscle after heavy resistance training

The aim of this study was to determine the effects of 8 weeks of resistance training (RT) on the myoglobin concentration ([Mb]) in human skeletal muscle, and to compare the change in the [Mb] in two different RT protocols. The two types of protocol used were interval RT (IRT) of moderate to low intensity with a high number of repetitions and a short recovery time, and repetition RT (RRT) of high intensity with a low number of repetitions and a long recovery time. A group of 11 healthy male adults voluntarily participated in this study and were divided into IRT (n = 6) and RRT (n = 5) groups. Both training protocols were carried out twice a week for 8 weeks. At the completion of the training period, the one-repetition maximal force values and isometric force were increased significantly in all the subjects, by about 38.8% and 26.0%, respectively (P < 0.01). The muscle fibre composition was unchanged by the 8 weeks of training. The muscle fibre cross-sectional areas were increased significantly by both types of training in all fibre types (I, IIa and IIb, mean + 16.1 %, P < 0.05). The [Mb] showed no significant changes at the completion of the training [IRT from 4.63 (SD 0.63) to 4.48 (SD 0.72), RRT from 4.47 (SD 0.75) to 4.24 (SD 0.80) mg x g(-1) wet tissue] despite a significant decrease in citrate synthase activity [IRT from 5.27 (SD 1.45) to 4.49 (SD 1.48), RRT from 5.33 (SD 2.09) to 4.85 (SD 1.87) micromol x min(-1) x g(-1) wet tissue; P < 0.05] observed after both protocols. These results suggested that myoglobin and mitochondria enzymes were regulated by different mechanisms in response to either type of RT. Moreover, the maintained [Mb] in hypertrophied muscle should preserve oxygen transport from capillaries to mitochondria even when diffusion distance is increased.     

The German Version of the Gaze Anxiety Rating Scale (GARS): Reliability and Validity

Objective

Fear of eye gaze and avoidance of eye contact are core features of social anxiety disorders (SAD). To measure self-reported fear and avoidance of eye gaze, the Gaze Anxiety Rating Scale (GARS) has been developed and validated in recent years in its English version. The main objectives of the present study were to psychometrically evaluate the German translation of the GARS concerning its reliability, factorial structure, and validity.

Methods

Three samples of participants were enrolled in the study. (1) A non-patient sample (n = 353) completed the GARS and a set of trait questionnaires to assess internal consistency, test-retest reliability, factorial structure, and concurrent and divergent validity. (2) A sample of patients with SAD (n = 33) was compared to a healthy control group (n = 30) regarding their scores on the GARS and the trait measures.

Results

The German GARS fear and avoidance scales exhibited excellent internal consistency and high stability over 2 and 4 months, as did the original version. The English version’s factorial structure was replicated, yielding two categories of situations: (1) everyday situations and (2) situations involving high evaluative threat. GARS fear and avoidance displayed convergent validity with trait measures of social anxiety and were markedly higher in patients with GSAD than in healthy controls. Fear and avoidance of eye contact in situations involving high levels of evaluative threat related more closely to social anxiety than to gaze anxiety in everyday situations.

Conclusions

The German version of the GARS has demonstrated reliability and validity similar to the original version, and is thus well suited to capture fear and avoidance of eye contact in different social situations as a valid self-report measure of social anxiety and related disorders in the social domain for use in both clinical practice and research.     

Questions of Methodology in Aristotle’s Zoology: A Medieval Perspective

During the Middle Ages Aristotle’s treatises were accessible to intellectuals via translations and commentaries. Among his works on natural philosophy, the zoological books received relatively little scholarly attention, though several medieval commentators carefully studied Aristotle’s investigations of the animal kingdom. Averroes completed in 1169 a commentary on an Arabic translation of Aristotle’s Parts of Animals and Generation of Animals. In 1323 Gersonides completed his supercommentary on a Hebrew translation of Averroes’ commentary. This article examines how these two medieval commentators interpret the first book of Aristotle’s Parts of Animals, at the center of which stand methodological questions regarding the study of animals. Aristotle’s discussion of classification is presented by Averroes and Gersonides in light of an epistemological debate concerning the requisite method for scientific inquiries and discoveries. Sense perception is contrasted with rational reasoning, and ultimately a combined method is proposed, sense perception maintaining supremacy. These commentators outline a clear link between the systematic arrangement of animal species as offered by Aristotle, and his subsequent logical demonstrations which, according to them, form the core of biological investigations.     

Predicting mean ribosome load for 5’UTR of any length using deep learning

The 5’ untranslated region plays a key role in regulating mRNA translation and consequently protein abundance. Therefore, accurate modeling of 5’UTR regulatory sequences shall provide insights into translational control mechanisms and help interpret genetic variants. Recently, a model was trained on a massively parallel reporter assay to predict mean ribosome load (MRL)—a proxy for translation rate—directly from 5’UTR sequence with a high degree of accuracy. However, this model is restricted to sequence lengths investigated in the reporter assay and therefore cannot be applied to the majority of human sequences without a substantial loss of information. Here, we introduced frame pooling, a novel neural network operation that enabled the development of an MRL prediction model for 5’UTRs of any length. Our model shows state-of-the-art performance on fixed length randomized sequences, while offering better generalization performance on longer sequences and on a variety of translation-related genome-wide datasets. Variant interpretation is demonstrated on a 5’UTR variant of the gene HBB associated with beta-thalassemia. Frame pooling could find applications in other bioinformatics predictive tasks. Moreover, our model, released open source, could help pinpoint pathogenic genetic variants.     

Factors associated with in-hospital mortality of adult tetanus patients–a multicenter study from Bangladesh

BackgroundTetanus, a vaccine-preventable disease, is still occurring in the elderly population of low- and middle-income countries with a high case-fatality rate. The objective of the study was to elucidate the factors associated with in-hospital mortality of tetanus in Bangladesh.MethodsThis prospective observational study, conducted in two specialized infectious disease hospitals, conveniently selected adult tetanus patients (≥18 years) for inclusion. Data were collected through a preformed structured questionnaire. Kaplan Meier survival analysis and univariate and multivariable Cox regression analysis were carried out to assess factors associated with in-hospital mortality among patients. All analysis was done using Stata (version 16) and SPSS (version 26).ResultsA total of 61 tetanus cases were included, and the overall in-hospital mortality rate was 34.4% (n = 21). Patients had an average age of 46.49 ±15.65 years (SD), and the majority were male (96.7%), farmers (57.4%), and came from rural areas (93.4%). Survival analysis revealed that the probability of death was significantly higher among patients having an age of ≥ 40 years, incubation time of ≤12 days, onset time of ≤ 4 days, and having complication(s). However, on multivariable Cox regression analysis, age (adjusted hazard ratio [aHR] 4.03, 95% Confidence Interval [CI] 1.07–15.17, p = 0.039) and onset time (≤4 days) (aHR 3.33; 95% CI 1.05–10.57, p = 0.041) came as significant predictors of in-hospital mortality after adjusting for incubation period and complications.ConclusionOlder age and short onset time are the two most important determinants of in-hospital mortality of tetanus patients. Hence, these patients require enhanced emphasis and care.     

Direction-dependent neck and trunk postural reactions during sitting

Postural reactions in healthy individuals in the seated position have previously been described and have been shown to depend on the direction of the perturbation; however the neck response following forward and backward translations has not been compared. The overall objective of the present study was to compare neck and trunk kinematic, kinetic and electromyographic (EMG) stabilization patterns of seated healthy individuals to forward and backward translations. Ten healthy individuals, seated on a chair fixed onto a movable platform, were exposed to forward and backward translations (distance = 0.15 m, peak acceleration = 1.2 m/s²). The head and trunk kinematics as well as the EMG activity of 16 neck and trunk muscles were recorded. Neck and trunk angular displacements were computed in the sagittal plane. The centers of mass (COMs) of the head (HEAD), upper thorax (UPTX), lower thorax (LOWTX) and abdomen (ABDO) segments were also computed. Moments of force at the C7-T1 and L5-S1 levels were calculated using a top-down, inverse dynamics approach. Forward translations provoked greater overall COM peak displacements. The first peak of moment of force was also reached earlier following forward translations which may have played a role in preventing the trunk from leaning backwards. These responses can be explained by the higher postural threat imposed by a forward translation.