Candida parapsilosis associated with cervical necrotizing fasciitis and descending mediastinitis

published_or_final_versio

Dynamic Random Effects Models for Times between Repeated Events

We consider recurrent event data when the duration or gap times between successive event occurrences are of intrinsic interest. Subject heterogeneity not attributed to observed covariates is usually handled by random effects which result in an exchangeable correlation structure for the gap times of a subject. Recently, efforts have been put into relaxing this restriction to allow non-exchangeable correlation. Here we consider dynamic models where random effects can vary stochastically over the gap times. We extend the traditional Gaussian variance components models and evaluate a previously proposed proportional hazards model through a simulation study and some examples. Besides, semiparametric estimation of the proportional hazards models is considered. Both models are easily used. The Gaussian models are easily interpreted in terms of the variance structure. On the other hand, the proportional hazards models would be more appropriate in the context of survival analysis, particularly in the interpretation of the regression parameters. They can be sensitive to the choice of model for random effects but not to the choice of the baseline hazard function.postprin

The Prevalence and Risk Factors of Paternal Depression from the Antenatal to the Postpartum period and the Relationships between Antenatal and Postpartum Depression among Fathers in Hong Kong

Introduction. Despite the fact that maternal perinatal mental health problems have been extensively studied and addressed to be a significant health problem, the literature on paternal perinatal mental health problems is relatively scarce. The present study aims at determining the prevalence of paternal perinatal depression and identifying the risk factors and the relationship between antenatal and postpartum depression. Methodology. 622 expectant fathers were recruited from regional maternal clinics. The expectant fathers were assessed using standardized and validated psychological instruments on 3 time points including early pregnancy, late pregnancy, and six weeks postpartum. Results. Results showed that a significant proportion of expectant fathers manifested depressive symptoms during the perinatal period. Paternal antenatal depression could significantly predict higher level of paternal postpartum depression. Psychosocial risk factors were consistently associated with paternal depression in different time points. Conclusions. The present study points to the need for greater research and clinical attention to paternal depression given that it is a highly prevalent problem and could be detrimental to their spouse and children development. The present findings contribute to theoretical basis of the prevalence and risk factors of paternal perinatal depression and have implications of the design of effective identification, prevention, and interventions of these clinical problems.published_or_final_versio

The association between back pain and trunk posture of workers in a special school for the severe handicaps

<p>Abstract</p> <p>Background</p> <p>The present study aims to determine the time spent in different static trunk postures during a typical working day of workers in a special school for the severe handicaps.</p> <p>Methods</p> <p>Eighteen workers with low back pain (LBP) and fifteen asymptomatic workers were recruited. A cross-sectional design was employed to study the time spent in different static trunk postures which was recorded by a biaxial accelerometer attached to the T₁₂level of the back of the subjects.</p> <p>Results</p> <p>The results of ANCOVA revealed that subjects with LBP spent significantly longer percentage of time in static trunk posture when compared to normal (p < 0.05). It was also shown that they spent significantly longer time in trunk flexion for more than 10° (p < 0.0125).</p> <p>Conclusion</p> <p>An innovative method has been developed for continuous tracking of spinal posture, and this has potential for widespread applications in the workplace. The findings of the present investigation suggest that teachers in special schools are at increased risk of getting LBP. In order to minimise such risk, frequent postural change and awareness of work posture are recommended.</p

Magnetic ordering at the edges of graphitic fragments: Magnetic tail interactions between the edge-localized states

To understand the formation mechanism of magnetic moments at the edges of graphitic fragments, we carry out first-principles density-functional calculations for the electronic and magnetic structures of graphitic fragments with various spin and geometric configurations. We find that interedge and interlayer interactions between the localized moments can be explained in terms of interactions between the magnetic tails of the edge-localized states. In addition, the dihydrogenated edge states as well as Fe ad-atoms at the edge are studied in regard to the magnetic order and proximity effects.open28621

Feasibility and potentials of online support for stress management among secondary school teachers

Teachers' work-related stress is a widespread problem. Few studies have used online communications to provide support to teachers, and these were mainly focused on novice teachers. Here, we performed an exploratory study to examine whether the use of online forums by secondary school teachers in Hong Kong could provide social support to manage work-related stress. Following 7 days of forum use, content analysis and post-intervention evaluations were carried out to examine the anonymous communications of 75 secondary school teachers who participated in one of five online discussion forums. Consensus on the coding and categorization of the data was reached among three experienced researchers in qualitative analyses. The online forums were well received by the participants. Most participants reported that they received support from the forum and considered it useful for stress management. These results suggest that online support can be used for stress management among secondary school teachers. Further studies on using online approaches as stress management tools are warranted. Copyright © 2010 John Wiley & Sons, Ltd.preprin

Assessment of median nerve mobility by ultrasound dynamic imaging in carpal tunnel syndrome diagnosis

2013 Joint UffC, EFTF and PFM SymposiumCarpal tunnel syndrome (CTS) is a common entrapment neuropathy. Nerve conduction studies (NCS) have been used as a standard for CTS diagnosis. Complementing NCS, ultrasound imaging provides anatomic information on pathologic changes of the median nerve, such as the reduced median nerve mobility. Motion of median nerve is dependent on mechanical characteristics, and body movements. The purpose of this study was therefore to measure transverse sliding patterns of the median nerve during fingers flexion and extension in ultrasound B-mode images for distinguishing healthy from CTS subjects, and to investigate any correlation between NCS severity and median nerve motion. Transverse ultrasound images were acquired from 19 normal, 15 mild, and 10 severe CTS subjects confirmed by NCS. In two-second acquisition, their fingers were initially in natural position; the median nerve was then moved toward the ulnar side and radius side in fingers flexion and extension, respectively. The displacements of the median nerve were calculated by the multilevel block-matching pyramid algorithm and averaged. All the average displacements at different acquisition times were then accumulated to obtain cumulative displacements, which were curve-fitted by polynomial function. To differentiate the normal from CTS cases, the R-squared, curvature, and amplitude of the fitted curves were computed, to evaluate the goodness, variation, and maximum value of the fit, respectively. Compared to the CTS patients, the normal subjects had higher R-square, curvature, and amplitude estimates. The three parameters were then inputted to a fuzzy c-means algorithm to classify normal cases and CTS ones. The diagnostic efficiency had an accuracy of 93.2%, a specificity of 100%, and a sensitivity of 88%. Further study includes measuring mechanical strain and stress at different neural sites to provide elasticity of the median nerve. © 2013 IEEE.published_or_final_versio

Antenatal anxiety in the first trimester: Risk factors and effects on anxiety and depression in the third trimester and 6-week postpartum

Objective: Anxiety is common among pregnant women. However, research attention in the area of reproductive mental health has mainly focused on postpartum depression in past decades. Given adverse outcomes of antenatal anxiety, there is an urgent need to fill the research gaps. The objectives of the present study were to determine the prevalence of antenatal anxiety symptoms and examine the risk factors and effects of anxiety symptoms in early pregnancy on anxiety and depressive symptoms in later pregnancy and early postpartum period. Methodology: A prospective longitudinal design with quantitative approach was adopted. A consecutive sample of 1470 Chinese pregnant women from hospitals in Hong Kong was invited to participate in the study and was assessed using standardized instruments on 3 time points including first and third trimesters of pregnancy and 6-week postpartum. Results: The results showed that 17.7% of pregnant women manifested anxiety symptoms in the first trimester of pregnancy. Single mothers, younger mothers, mothers who smoked before pregnancy and mothers who received low education level reported significantly higher levels of anxiety symptoms in the first trimester. Unwanted pregnancy, low self esteem, low marital satisfaction and perceived low social support were significant psychosocial risk factors for anxiety symptoms in the first trimester. Anxiety symptoms in the first trimester were independent predictors for anxiety symptoms in the third trimester ( QUOTE β = 0.26, t = 5.74, p < 0.001), however anxiety symptoms in the first trimester no longer significantly predicted anxiety and depressive symptoms in 6 weeks postpartum after adjusting for the effects of potential confounders. Discussions: The present study points to the need for greater research and clinical attention to antenatal anxiety given that antenatal anxiety is a prevalent problem and has serious impacts on maternal well-being. Such findings also contribute to the understanding of maternal anxiety and have implications for the design of effective identification, prevention and treatment of these significant clinical problemspublished_or_final_versio