bluuebunny/crossref_metadata_2025 huggingface dataset:
Taking charge: Characterizing the rapid development of self-regulation through intensive training
Authors: Mrazek Alissa J , Mrazek Michael D , Maul Andrew , Mrazek Kaita L , Schooler Jonathan W
Published: March 2020

Self-regulation is widely considered as a relatively stable trait, and the extent to which it can be improved through training is unknown. This randomized controlled investigation found dramatic and enduring increases in self-regulation among college students, as measured by experience sampling, nightly journaling, and questionnaires. Participants encountered stable levels of temptations throughout the intervention but became better at resisting them over time. Increases in self-regulation were accompanied by improvements across a diversity of additional outcomes like mood, stress, focus, mindfulness, emotional regulation, and life satisfaction. Collectively, this points to higher levels of plasticity in self-regulation and wellbeing than is widely assumed.
Mindfulness-Based Interventions in Recurrent Ovarian Cancer: A Mixed-Methods Feasibility Study
Authors: Arden-Close Emily , Mitchell Felicity , Davies Gail , Bell Lauren , Fogg Carole , Tarrant Ruth , Gibbs Roslyn , Yeoh Chit Cheng
Published: March 2020

A recurrence of cancer is a traumatic and stressful experience, and a number of approaches have been proposed to manage or treat the associated psychological distress. Meditative techniques such as mindfulness may be able to improve an individual’s ability to cope with stressful life events such as cancer diagnosis or treatment. This single-arm mixed-methods study primarily aimed to determine the feasibility of using a mindfulness-based intervention in managing psychosocial distress in recurrent ovarian cancer. Twenty-eight participants took part in a mindfulness-based program, involving six group sessions, each lasting 1.5 hours and delivered at weekly intervals. The study found that the mindfulness-based intervention was acceptable to women with recurrent ovarian cancer and feasible to deliver within a standard cancer care pathway in a UK hospital setting. The results suggested a positive impact on symptoms of depression and anxiety, but further study is needed to explore the effectiveness of the intervention.
Biphasic Dose–Response Induced by PCB150 and PCB180 in HeLa Cells and Potential Molecular Mechanisms
Authors: Zehra Ainy , Hashmi Muhammad Zaffar , Khan Abdul Majid , Malik Tariq , Abbas Zaigham
Published: March 2020

The polychlorinated biphenyls (PCBs) are persistent and their dose-dependent toxicities studies are not well-established. In this study, cytotoxic and genotoxic effects of PCB150 and PCB180 in HeLa cells were studied. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay indicated that the cell proliferation was stimulated at low doses (10−3 and 10−2 µg/mL for 12, 24, 48, and 72 hours) and inhibited at high doses (10 and 15 µg/mL for 24, 48, and 72 hours) for both PCBs. Increase in reactive oxygen species formation was observed in the HeLa cells in a time- and dose-dependent manner. Malondialdehyde and superoxide dismutase showed increased levels at high concentrations of PCBs over the time. Glutathione peroxidase expression was downregulated after PCBs exposure, suggested that both PCB congeners may attributable to cytotoxicity. Comet assay elicited a significant increase in genotoxicity at high concentrations of PCBs as compared to low concentrations indicating genotoxic effects. PCB150 and PCB180 showed decrease in the activity of extracellular signal–regulated kinase 1/2 and c-Jun N-terminal kinase at high concentrations after 12 and 48 hours. These findings may contribute to understanding the mechanism of PCBs-induced toxicity, thereby improving the risk assessment of toxic compounds in humans.
Analysis of structure strength for direct current high-speed switch based on flexible body theory
Authors: Li Mei , Gong Peng , Wu Yifei , Wu Yi
Published: March 2020

The Thomson coil actuator has an important application prospect in direct current high-speed switch due to its short respond time and fast operation speed. However, the large electromagnetic impact force during the opening process may bring the stress deformation of movable components and thus cause damage to the mechanism. Therefore, the dynamic stress and strain evaluation of the moving parts is very important for the design and optimization of direct current high-speed switch. In this article, a novel method of structure strength analysis based on the flexible body theory is established for direct current high-speed switch. The electromagnetic and buffer forces in the rapid opening process are calculated, and then the stress and strain distribution of the key components are obtained. Finally, the strain test circuit of the key components is built. By comparing the simulation and experimental results of dynamic strain, the validity of the established simulation model is verified.
Monitoring and managing medication adherence in community pharmacies in Quebec, Canada
Authors: Fénélon-Dimanche Rébecca , Guénette Line , Yousif Alia , Lalonde Geneviève , Beauchesne Marie-France , Collin Johanne , Blais Lucie
Published: March 2020

Background:

Community pharmacists have direct access to prescription refill information and regularly interact with their patients. Therefore, they are in a unique position to promote optimal medication use.

Objectives:

To describe how community pharmacists in Quebec, Canada, identify nonadherent patients, monitor medication use and promote optimal medication adherence.

Methods:

An invitation to complete a web-based survey was published online through different platforms, including a Facebook pharmacists’ group, an electronic newsletter, a pharmacy network forum and e-mail. The survey included questions on participant characteristics, methods used by pharmacists to identify nonadherent patients and monitor medication use and interventions they used to promote medication adherence.

Results:

In total, 342 community pharmacists completed the survey. The participants were mainly women (71.6%), staff pharmacists (56.7%) and aged 30 to 39 years (34.2%). The most common method to identify nonadherent patients was to check gaps between prescription refills (98.8%). The most common intervention to promote adherence was patient counselling (82.5%). The most common barriers to identifying nonadherent patients were lack of time (73.1%) and lack of prescription information (65.8%), whereas the most common barriers to intervening were anticipation of a negative reaction from their patients (91.2%) and lack of time (64%).

Conclusion:

Lack of time and lack of prescription information are frequent challenges encountered by community pharmacists regarding effective monitoring and management of patients with poor medication adherence. Pharmacists could benefit from electronic tools based on prescription refills that would provide quick and easily interpretable information on their patients’ medication adherence. Can Pharm J (Ott) 2020;153:xx-xx.
Reactivation of hepatitis B virus infection in rheumatic diseases: risk and management considerations
Authors: Koutsianas Christos , Thomas Konstantinos , Vassilopoulos Dimitrios
Published: March 2020

In patients with rheumatic diseases undergoing immunosuppressive treatment, hepatitis B virus reactivation (HBVr) has been long recognized as a major treatment-related adverse event with substantial morbidity and mortality. Because HBVr is easily preventable with appropriate screening and monitoring strategies, and, when indicated, prophylactic antiviral treatment, awareness of this complication is of the utmost importance, especially in the era of biologic treatments. As a condition, it continues to be topical, in view of the emergence of novel classes of immunosuppressive drugs (i.e. Janus kinase inhibitors) acquiring licenses for a variety of rheumatic diseases. The class-specific risk of these agents for HBVr has not yet been determined. Moreover, ambiguity still exists for the management of patients planned to be treated with traditional agents, such as cyclophosphamide and glucocorticoids, particularly in the setting of resolved HBV infection. Clinicians in the field of rheumatic diseases should be tailoring their practice according to the host’s profile and treatment-specific risk for HBVr. In this review, the authors attempt to critically review the existing literature and provide practical advice on these issues.
Evidence-Based Design in Hospital Renovation Projects: A Study of Design Implementation for User Controls
Authors: Bingham Evan , Whitaker David , Christofferson Jay , Weidman Justin
Published: March 2020

Purpose:

The purpose of this article was to investigate and report the implementation of evidence-based design (EBD) principles relating to user controls into hospital renovation projects.

Background:

Progress requires the application of the most recent knowledge and technology. When it comes to the design and construction of healthcare facilities, the latest knowledge comes in the form of EBD research. EBD is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes. The desired outcomes of EBD recommendations include improvements to enhance user control. User control factors include the individual control over bed position, air temperature, lights, sound, and natural light.

Method:

A list of recommendations from existing EBD literature related to user controls was compiled. Construction documents from 30 recent healthcare facility renovation projects across the United States were obtained and analyzed. Implementation levels for the EBD categories of user controls were reported.

Results:

The findings indicate relatively extensive industry use of EBD principles relating to user control of temperature, lights, and natural lighting.

Conclusions:

The findings indicate that EBD recommendations related to user controls are being adopted in practice at consistently high levels. These findings also reveal that there are still areas of potential improvement which could inform those who influence or determine building design, codes, standards, and guidelines. The results are helpful to owners, designers, and contractors by providing a glimpse into how well the industry is recognizing and implementing known best practices. The findings likewise introduce new opportunities for further research which could lead to additional improvement in the healthcare facilities of the future.
Paranormal Tourism: Market Study of a Novel and Interactive Approach to Space Activation and Monetization
Authors: Houran James , Hill Sharon A. , Haynes Everett D. , Bielski Ursula A.
Published: March 2020

We review the premise, popularity, and profitability of paranormal tourism, which involves visits to any setting or locale for the explicit purpose of encountering apparent supernatural phenomena for leisure, investigation, services, products, or conventions. This niche sector can offer an inherently engaging conceptual framework for seasonal or year-round space activation and monetization by businesses situated in specific settings or cities. On a broader level, the niche also illustrates how tourism–hospitality brands and operations can navigate and even capitalize on three paradigm shifts that have disrupted contemporary markets, that is, the mobilities, performative, and creative turns. This assertion is underscored with a case analysis of a historic site that successfully leveraged paranormal themes as part of its space reactivation and rebranding. Finally, our market study suggests that the success factors of paranormal tourism might indicate a fourth paradigm shift across the wider tourism–hospitality industry, whereby the experience economy is transforming to an enchantment economy.
Surgical Approach to Orbital Floor Fractures: Comparing Complication Rates Between Subciliary and Subconjunctival Approaches
Authors: Bronstein Joel A. , Bruce William J. , Bakhos Fadi , Ishaq Dalia , Joyce Cara J. , Cimino Victor
Published: March 2020

Background:

There are multiple approaches to repairing orbital floor fractures. This study compares the postoperative complications of the subciliary and transconjunctival approaches.

Methods:

The electronic medical records from 2 hospitals were screened for CPT codes associated with orbital floor reconstruction. A total of 184 patients were identified and included in the study. Patient characteristics and complications were compared by surgical approach.

Results:

Of the 184 patients, 82 (44.6%) were in the subciliary group and 102 (55.4%) were in the transconjunctival group. The overall postoperative complication rate was 25.5%. The most common of these were diplopia (11.4%), corneal injury (7.1%), proptosis (5.4%), and enopthalmos (4.9%). The complication rate was not statistically significant between the 2 groups.

Conclusion:

Subciliary and transconjunctival approaches to orbital floor repair are equally safe. This study is limited by a smaller sample size, and a larger study will likely be necessary to fully address this question.
Incorporating Mindfulness Into Occupational Stress Management Programming for Nursing Staff
Authors: Sos Tammy , Melton Bridget
Published: March 2020

Nurses are often at risk of burnout due to the effects of occupational stress. Implementing mindfulness wellness programming, that is easy to access and incorporate into the workday, can be effective in reducing occupational stress.
Sleep quality and endometriosis: A group comparison study
Authors: Davie Stacey , Hamilton Yasu , Webb Lachlan , Amoako Akwasi A
Published: March 2020

Introduction:

Endometriosis affects around 10% of women of reproductive age with symptoms of pelvic pain, dysmenorrhoea, dyspareunia, dyschezia, and infertility. Current research highlights a possible relationship between endometriosis and poor sleep quality. The aim of this study was to assess the relationship between sleep quality and endometriosis. Outcomes measured included sleep quality and quality of life and pain score.

Methods:

Thirty women with a histological diagnosis of endometriosis and 30 control patients completed an online questionnaire that assessed sleep quality (Pittsburgh Sleep Quality Index) and quality of life (WHO-QOL-BREF). Pain scores within the endometriosis group were evaluated using a visual analogue scale.

Results:

Women with endometriosis had significantly poorer sleep quality (80% vs 50%, p = 0.015) and lower quality of life scores when compared to the control group. Within the endometriosis group, there were trends between poor sleep, a reduced quality of life, and higher pain scores; however, these did not reach statistical significance.

Discussion:

Sleep quality and quality of life were significantly reduced in women with endometriosis when compared to controls.
Does Early Functional Mobilization Affect Long-Term Outcomes After an Achilles Tendon Rupture? A Randomized Clinical Trial
Authors: Aufwerber Susanna , Heijne Annette , Edman Gunnar , Silbernagel Karin Grävare , Ackermann Paul W.
Published: March 2020

Background:

Functional deficits and health-related impairments are common after an Achilles tendon rupture (ATR). Rehabilitation protocols vary greatly, and few studies have allowed loading in combination with ankle motion immediately after surgery (ie, early functional mobilization [EFM]). It is unclear whether EFM may counteract the negative impact of ankle immobilization after an ATR.

Purpose:

The primary aim of this study was to assess the efficacy of EFM compared with standard treatment (ie, 2 weeks of unloading in a plaster cast followed by 4 weeks of weightbearing in an orthosis) regarding patient-reported and functional outcomes in patients with an ATR after acute operative repair. The secondary aim was to explore whether the occurrence of deep venous thrombosis (DVT) during the 2 postoperative treatments affected outcomes.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

A total of 135 patients who underwent ATR repair, randomized to either EFM, including immediate postoperative loading and ankle motion, or standard treatment, were evaluated with functional tests and 5 self-administered outcome questionnaires at 6 and 12 months postoperatively.

Results:

At 6 months, the EFM group scored higher on the RAND 36-Item Health Survey (RAND-36) questionnaire subscales of general health and vitality ( P < .05) compared with the control group. No significant differences between the groups were found on disease-specific questionnaires (Achilles tendon Total Rupture Score [ATRS] and Foot and Ankle Outcome Score [FAOS]). At 12 months, no significant differences on any of the patient-reported outcome measures or the functional heel-rise test were seen between the groups. The RAND-36 subscale of general health, however, exhibited higher values in the EFM group (82.6 ± 16.9) than the control group (77.1 ± 17.0) ( P = .051) at 12 months after the injury. Patients sustaining DVT postoperatively had lower self-reported outcomes on the ATRS, FAOS, and RAND-36 questionnaires at 6 and 12 months compared with patients not having sustained DVT (all P < .05).

Conclusion:

This study demonstrated that an accelerated postoperative protocol with immediate loading and ankle motion resulted in better general health and vitality at 6 months. However, there were no differences between the groups in the recovery of heel-rise function. Future studies should focus on the means to reduce the risk of DVT to improve patient outcomes after ATR.

Registration:

NCT02318472 (ClinicalTrials.gov identifier).
Decolonial and Transnational Feminist Solidarity: Promoting Ethically Sustainable Social Change with Women in Rural Nepalese Communities
Authors: Mikkonen Enni
Published: March 2020

This article addresses the complexities and dynamics of promoting social change with marginalised communities in the Global South. It builds empirically on a social work ethnographic study about the change process(es) and development of women’s social position in rural Nepalese communities. The research results suggest that the tools to promote ethically sustainable social change are based on decolonial and transnational feminist solidarity and its different, overlapping forms: solidarity through dialogue, alliance and exchange. The study argues that international social work and community development need to strengthen the approaches that recognise and deconstruct white and economic power dominance within their research, theory and practice. The research produces knowledge on a context-sensitive transnational solidarity praxis, which contributes to the discussion on social justice and ethicality in international development and social work paradigms.
Unrecognized Cardiovascular Abnormalities Detected Through a Community Cardiovascular Screening Program
Authors: Bierig S. Michelle , Arnold Anita , Einbinder Lynne C. , Armbrecht Eric , Burroughs Thomas
Published: March 2020

Objective:

Self-referral community cardiovascular screening programs (CCSPs) have a potential to reduce outcome events through early detection of disease. This study evaluated the characteristics of a population that could predict a positive test.

Materials and Methods:

Participants who completed a cardiovascular screening protocol were compared. The screening protocol included a blood pressure (BP), Doppler ankle brachial index (ABI) testing, a limited carotid sonogram, a limited aortic sonogram, electrocardiogram (ECG), and limited transthoracic echocardiogram (TTE).

Results:

Screenings were performed on 205 participants (58% female, 68 ± 9 years of age). Sixty-seven (34%) participants were abnormal in at least one of the following screening tests: ABI (2%), carotid sonogram (6%), aortic sonogram (3%), ECG (11%), and TTE (22%). Although 60.5% of the participants reported recent symptoms, there were no differences in normal or abnormal results of participants presenting with or without symptoms ( P = .06). Income was not a predictor of abnormal test results (odds ratio, 0.76; 95% confidence interval, 0.55–0.97; P = .19). Multivariate analysis demonstrated, when controlling for age greater than 75 years, that participants taking BP medication was the only variable that predicted a positive test result.

Conclusion:

One-third of patient results were abnormal, regardless of symptoms or lack thereof, suggestive of subclinical disease. Further large-scale studies would demonstrate the role of CCSPs in risk stratifying participants.
Impact of socioeconomic status on participation and outcomes in the Salford Lung Studies
Authors: Jones Rupert , Nicholls Andy , Browning Dominy , Diar Bakerly Nawar , Woodcock Ashley , Vestbo Jørgen , Leather David A. , Jacques Loretta , Lay-Flurrie James , Svedsater Henrik , Collier Susan
Published: March 2020

COPD and asthma prevalence is associated with socioeconomic status (or “deprivation”), yet deprivation is rarely considered in typical large-scale efficacy randomised controlled trials that recruit highly selected patient populations. In thispost hocanalysis of the Salford Lung Studies in COPD and asthma (two 12-month, open-label, effectiveness randomised controlled trials conducted in UK primary care), we evaluated the impact of patient deprivation on clinical outcomes with initiating fluticasone furoate/vilanterolversuscontinuing usual care.

Patients were categorised into deprivation quintiles based on postcode and a countrywide database of indices of deprivation, and trial outcomes by quintile were assessed.

52% of patients in the COPD study were included in the most deprived quintile, contrasting with 20% in the asthma study. Greater deprivation was associated with higher rates of primary/secondary healthcare contacts and costs. However, the treatment effect of fluticasone furoate/vilanterolversususual care for primary (COPD: moderate/severe exacerbations; asthma: Asthma Control Test responders at week 24) and secondary/other (healthcare consumption, adherence, treatment modifications, study withdrawals, exacerbations, serious adverse events) outcomes was similar across deprivation quintiles.

Our findings support the recruitment of participants from all socioeconomic strata to allow assessment of data generalisability to routine clinical practice.
Endothelial dysfunction and myocardial injury after major emergency abdominal surgery: a prospective cohort study
Authors: Ekeloef Sarah , Oreskov Jakob Ohm , Falkenberg Andreas , Burcharth Jakob , Schou-Pedersen Anne Marie V. , Lykkesfeldt Jens , Gögenur Ismail
Published: March 2020

Background

Preoperative endothelial dysfunction is a predictor of myocardial injury and major adverse cardiac events. Non-cardiac surgery is known to induce acute endothelial changes. The aim of this explorative cohort study was to assess the extent of systemic endothelial dysfunction after major emergency abdominal surgery and the potential association with postoperative myocardial injury.

Methods

Patients undergoing major emergency abdominal surgery were included in this prospective cohort study. The primary outcome was the change in endothelial function expressed as the reactive hyperemia index from 4-24 h after surgery until postoperative day 3–5. The reactive hyperemia index was assessed by non-invasive digital pulse tonometry. Secondary outcomes included changes in biomarkers of nitric oxide metabolism and bioavailability. All assessments were performed at the two separate time points in the postoperative period. Clinical outcomes included myocardial injury within the third postoperative day and major adverse cardiovascular events within 30 days of surgery.

Results

Between October 2016 and June 2017, 83 patients were included. The first assessment of the endothelial function, 4–24 h, was performed 15.8 (SD 6.9) hours after surgery and the second assessment, postoperative day 3–5, was performed 83.7 (SD 19.8) hours after surgery. The reactive hyperemia index was suppressed early after surgery and did not increase significantly; 1.64 (95% CI 1.52–177) at 4–24 h after surgery vs. 1.75 (95% CI 1.63–1.89) at postoperative day 3–5, p = 0.34. The L-arginine/ADMA ratio, expressing the nitric oxide production, was reduced in the perioperative period and correlated significantly with the reactive hyperemia index. A total of 16 patients (19.3%) had a major adverse cardiovascular event, of which 11 patients (13.3%) had myocardial injury. The L-arginine/ADMA ratio was significantly decreased at 4–24 h after surgery in patients suffering myocardial injury.

Conclusion

This explorative pathophysiological study showed that acute systemic endothelial dysfunction was present early after major emergency abdominal surgery and remained unchanged until day 3–5 after the procedure. Early postoperative disturbances in the nitric oxide bioavailability might add to the pathogenesis of myocardial injury. This pathophysiological link should be confirmed in larger studies.

Trial registration

clinicaltrials.gov no. NCT03010969.
Dietary patterns in the healthy oldest old in the healthy aging study and the Canadian longitudinal study of aging: a cohort study
Authors: Gu Qianqian , Sable Carly M. , Brooks-Wilson Angela , Murphy Rachel A.
Published: March 2020

Background

Very few people live to eighty-five years and older (the ‘oldest old’), and even fewer live to this age without developing chronic diseases. It is important to understand the relationship, if any, of modifiable factors such as diet on healthy aging. However, there are few studies of diet among healthy oldest old, especially in North American populations. We aimed to characterize dietary patterns among ‘super-seniors’ (SS) within the Canadian Healthy Aging Study.

Methods

122 SS aged 85 years or older and free of cancer, cardiovascular or pulmonary disease, dementia and diabetes were recruited. Comparisons were made to 12,626 participants aged 65–86 in the Canadian Longitudinal Study of Aging who completed the same 36-item food frequency questionnaire that queried consumption over the prior 12 months of nutrients and foods thought to be important for aging. Dietary patterns were identified with principal component analysis. The odds of being a SS were determined for quartiles of each dietary pattern with logistic regression.

Results

Two dietary patterns were identified; a western diet characterized by french fries, red meat, processed meat and a nutrient-rich diet which included fruits, vegetables, whole grains, nuts and seeds among other healthy food choices. Higher scores for both dietary patterns were associated with increased odds of being a SS, however, only the western dietary pattern remained associated with adjustment for covariates (Quartile 4: OR = 3.21, 95% CI 1.91–5.51).

Conclusions

Our finding adds to the limited evidence on dietary intake among the healthiest oldest old but it is unclear whether assocations reflect generational differences between groups or possible contributions to longevity.
Potential long-term impact of “On The Move” group-exercise program on falls and healthcare utilization in older adults: an exploratory analysis of a randomized controlled trial
Authors: Coyle Peter C. , Perera Subashan , Albert Steven M. , Freburger Janet K. , VanSwearingen Jessie M. , Brach Jennifer S.
Published: March 2020

Background

Wellness program participation may reduce the risk of falling, emergency department-use, and hospitalization among older adults. “On the Move” (OTM), a community-based group exercise program focused on the timing and coordination of walking, improved mobility in older adults, but its impact on falls, emergency department-use, and hospitalizations remains unclear. The aim of this preliminary study was to investigate the potential long-term effects that OTM may have on downstream, tertiary outcomes.

Methods

We conducted a secondary analysis of a cluster-randomized, single-blind intervention trial, which compared two community-based, group exercise programs: OTM and a seated exercise program on strength, endurance, and flexibility (i.e. ‘usual-care’). Program classes met for 50 min/session, 2 sessions/week, for 12 weeks. Older adults (≥65 years), with the ability to ambulate independently at ≥0.60 m/s were recruited. Self-reported incidence of falls, emergency department visitation, and hospitalization were assessed using automated monthly phone calls for the year following intervention completion. Participants with ≥1 completed phone call were included in the analyses. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated (reference = usual-care).

Results

Participants (n = 248) were similar on baseline characteristics and number of monthly phone calls completed. Participants in the seated exercise program attended an average of 2.9 more classes (p = .017). Of note, all results were not statistically significant (i.e. 95% CI overlapped a null value of 1.0). However, point estimates suggest OTM participation resulted in a decreased incidence rate of hospitalization compared to usual-care (IRR = 0.88; 95% CI = 0.59–1.32), and the estimates strengthened when controlling for between-group differences in attendance (adjusted IRR = 0.82; 95% CI = 0.56–1.21). Falls and emergency department visit incidence rates were initially greater for OTM participants, but decreased after controlling for attendance (adjusted IRR = 1.08; 95% CI = 0.72–1.62 and adjusted IRR = 0.96; 95% CI = 0.55–1.66, respectively).

Conclusion

Compared to a community-based seated group exercise program, participation in OTM may result in a reduced risk of hospitalization. When OTM is adhered to, the risk for falling and hospitalizations are attenuated. However, definitive conclusions cannot be made. Nevertheless, it appears that a larger randomized trial, designed to specifically evaluate the impact of OTM on these downstream health outcomes is warranted.

Trial registration

Clinical trials.gov (NCT01986647; prospectively registered on November 18, 2013).
Effect of a pedometer-based walking intervention on body composition in patients with ESRD: a randomized controlled trial
Authors: Sheshadri Anoop , Kittiskulnam Piyawan , Lai Jennifer C. , Johansen Kirsten L.
Published: March 2020

Background

A randomized trial of a pedometer-based intervention with weekly activity goals led to a modest increase in step count among dialysis patients. In a secondary analysis, we investigated the effect of this intervention on body composition.

Methods

Sixty dialysis patients were randomized to standard care or a 6-month program consisting of 3 months of pedometers and weekly step count targets and 3 months of post-intervention follow-up. We obtained bioelectrical impedance spectroscopy (BIS) data on 54 of these patients (28 control, 26 intervention) and used linear mixed-modeling (adjusted for sex and dialysis modality) to estimate differences in change in total-body muscle mass (TBMM) adjusted for height2, fat mass (kg), and body mass index (BMI) (kg/m2) between control and intervention groups.

Results

The median age of participants was 57.5 years (53–66), and 76% were men. At baseline, there was no significant difference between groups in age, BMI, race, or body composition, but there were more men in the intervention group. After 3 months, patients in the intervention group increased their average daily steps by 2414 (95% CI 1047, 3782) more than controls (p < 0.001), but there were no significant differences in body composition. However, at 6 months, participants in the intervention had a significantly greater increase from baseline in TBMM of 0.7 kg/m2 (95% CI 0.3, 1.13), decrease in fat mass (− 4.3 kg [95% CI -7.1, − 1.5]) and decrease in BMI (− 1.0 kg/m2 [95% CI -1.8, − 0.2]) relative to controls. In post-hoc analysis, each increase of 1000 steps from 0 to 3 months was associated with a 0.3 kg decrease in fat mass (95% CI 0.05, 0.5) from 0 to 6 months, but there was no dose-response relationship with TBMM/ht2 or BMI.

Conclusion

A pedometer-based intervention resulted in greater decreases in fat mass with relative preservation of muscle mass, leading to a greater decrease in BMI over time compared with patients not in the intervention. These differences were driven as much by worsening in the control group as by improvement in the intervention group. Step counts had a dose-response relationship with decrease in fat mass.

Trial registration

ClinicalTrials.gov (NCT02623348). 02 December 2015.
Determinants of early postnatal care attendance: analysis of the 2016 Uganda demographic and health survey
Authors: Ndugga Patricia , Namiyonga Noor Kassim , Sebuwufu Deogratious
Published: March 2020

Background

The first 2 days after childbirth present the highest risk of dying for a mother. Providing postnatal care within the first 2 days after childbirth can help avert maternal mortality because it allows early detection of problems that could result in adverse maternal health outcomes. Unfortunately, knowledge of the uptake of early postnatal care (EPNC), which is imperative for informing policies aimed at reducing maternal mortality, remains low in Uganda. Therefore, the purpose of this study is to investigate the determinants of early postnatal care attendance among Ugandan women.

Methods

This study was based on nationally representative data from the 2016 Uganda Demographic and Health Survey. The study sample comprised 5471 women (age 15–49) who delivered a child in the 2 years preceding the survey. We used logistic regression to identify factors associated with use of early postnatal care.

Results

Our findings showed that 50% of mothers used EPNC services for their most recent delivery in the 2 years preceding the survey. Women’s residence, education level, religion, wealth status, marital status, occupation, antenatal care attendance, place of delivery, birth order, perceived accessibility of health facilities, and access to mass media messages were associated with greater use of EPNC. The percentage of women receiving EPNC was much higher among women who delivered at a health facility, either a public facility (63%) or private facility (65%), versus only 9% among women who delivered at home. Multivariate analysis showed that delivery at a health facility was the most important determinant of early postnatal care attendance.

Conclusions

To increase mothers’ use of EPNC services and improve maternal survival in Uganda, programs could promote and strengthen health facility delivery and ensure that EPNC services are provided to all women before discharge. Even so, the fact that only about two-thirds of women who delivered at a health facility received early postpartum care shows substantial room for improvement. Interventions should target women who deliver at home, women who attend fewer than four antenatal care visits, and women with a primary education.
Correction to: Increased MiR-221 expression in hepatocellular carcinoma tissues and its role in enhancing cell growth and inhibiting apoptosis in vitro
Authors: Rong Minhua , Chen Gang , Dang Yiwu
Published: March 2020

Following publication of the original article [1], the authors reported that they had misspelt the name of a cell line and supplied the incorrect Fig. 7 for publication.
Nordic treatment practices survey and consensus for treatment of eyelid sebaceous carcinoma
Authors: Leivo Tiina , Sarmela Johanna , Enckell-Aaltonen Maria , Dafgård Kopp Eva , Schmitt Caroline , Toft Peter B. , Sigurdsson Haraldur , Uusitalo Marita
Published: March 2020

Background

The purpose was to describe the Nordic treatment practices and to reach a Nordic consensus for the treatment of sebaceous eyelid carcinoma.

Methods

The treatment practices data was collected by a questionnaire with 37 questions to the Nordic oculoplastic surgeons and analyzed. A PubMed MEDLINE database search was done to gather data on the published treatment practices and recommendations. A working group that consisted of in minimum one senior consultant from each leading Nordic University Eye Hospital was assigned. A structured interactive method was used to establish the consensus.

Results

Twenty-four doctors responded to the questionnaire. 23/24 (96%) of the respondents took a biopsy before surgery. Regional lymph node scanning was routinely done by 14/23 (61%) and a systemic screening of a metastatic disease by 13/23 (57%). 6/22 (27%) never took conjunctival mapping biopsies and 12/23 (52%) never screened for Muir- Torre. Respondents used Mohs surgery, frozen section or multi-stage excision with delayed closure, and 5–6 mm was the mostly preferred margin. Sentinel lymph node biopsy was a possible option for 9/22 (41%) and cryotherapy and Mitomycin C for 6/22 (27%) respondents. 50% of respondents considered radiation as a treatment option. 15/16 (94%) respondents always followed-up their patients, most for 5 years. Two thirds scanned regional lymph nodes during the follow-up. Consensus was reached for 18 statements representing three domains: preoperative work-up, treatment and follow-up.

Conclusion

Treatment practices differ in between the five Nordic countries which have similar public health care systems. In the article the authors present a Nordic consensus for the treatment of eyelid sebaceous carcinoma.
Morphologic and biochemical changes in the retina and sclera induced by form deprivation high myopia in guinea pigs
Authors: Zi Yingxin , Deng Yu , Zhao Jingru , Ji Meiqi , Qin Yali , Deng Tingting , Jin Ming
Published: March 2020

Background

To study the morphologic and biochemical changes in the retina and sclera induced by form deprivation high myopia (FDHM) in guinea pigs and explore the possible mechanisms of FDHM formation.

Methods

Forty 3-week-old guinea pigs were randomized into the blank control (Group I, 20 cases) and model groups (20 cases). In the model group, the right eyes of the guinea pigs were sutured for 8 weeks to induce FDHM (Group II) and the left eyes were considered a self-control group (Group III). The refractive errors were measured with retinoscopy. The anterior chamber depth (AC), lens thickness (L), vitreous chamber depth (V) and axial length (AL) were measured using ultrasonometry A. Retinal and scleral morphology and ultrastructural features were observed with light and electron microscopy. The malondialdehyde (MDA) content and superoxide dismutase (SOD) activity in the retina and sclera were detected with a chemical colorimetric assay.

Results

After 8 weeks of stitching, the refractive errors of Group II changed from (+ 3.59 ± 0.33) D to (− 7.96 ± 0.55) D, and these values were significantly higher than those of Group I (+ 0.89 ± 0.32) D and Group III (− 0.55 ± 0.49) D (P < 0.05). The vitreous chamber depth (4.12 ± 0.13) mm and axial length (8.93 ± 0.22) mm of Group II were significantly longer than those of Group I [(3.71 ± 0.23) mm and (7.95 ± 0.37) mm, respectively] and Group III [(3.93 ± 0.04) mm and (8.01 ± 0.15) mm, respectively] (P < 0.05). With the prolongation of form deprivation (FD), the retina and scleral tissues showed thinning, the ganglion cell and inner and outer nuclear layers of the retina became decreased, and the arrangement was disordered. In Group II, the SOD activity was significantly lower than that in Group I and Group III; the MDA content was significantly higher than that in Group I and Group III. The differences were statistically significant (P < 0.05).

Conclusions

These findings suggested that in the FDHM guinea pigs model, the refractive errors, the vitreous chamber depth, and axial length increased significantly with prolongation of monocular FD time, and morphological structural changes in the retina and sclera were observed. Oxygen free radicals might participate in the formation of FDHM.
Application of protection motivation theory to clinical trial enrolment for pediatric chronic conditions
Authors: Brooks Stephanie P. , Bubela Tania
Published: March 2020

Background

Parents of children living with chronic but manageable conditions hope for improved therapies or cures, including Advanced Therapy Medicinal Products (ATMPs). Multiple pediatric clinical trials for ATMPs are underway, but the risk profile of ATMPs for chronic conditions is largely unknown and likely different than for terminal pediatric illnesses. Applying Protection Motivation Theory modified to the context of pediatric ATMP clinical trial enrollment, our study analyses information needs of parents of children living with chronic manageable conditions: Type 1 Diabetes (T1D) or Inherited Retinal Diseases (IRD).

Methods

We conducted semi-structured interviews with 15 parents of children living with T1D and 14 parents of children living with an IRD about: a) family background and the diagnostic experience; b) awareness of gene and stem cell therapy research and clinical trials for T1D and IRD; c) information sources on trials and responses to that information; d) attitudes to trial participation, including internationally; e) understanding of trial purpose and process; and f) any experiences with trial participation. We then discussed a pediatric ATMP clinical trial information sheet, which we developed with experts. We applied directed qualitative content analysis, based on PMT, to examine the information preferences of parents in deciding whether to enrol their children in stem cell or gene therapy clinical trials.

Results

Parents balanced trial risks against their child’s ability to cope with the chronic condition. The better the child’s ability to cope with vision impairment or insulin management, the less likely parents were to assume trial risks. Conversely, if the child struggled with his/her vision loss, parents were more likely to be interested in trial participation, but only if the risks were low and likelihood for potential benefit was high.

Conclusions

Fear of adverse events as part of threat appraisal was the predominant consideration for parents in considering whether to enroll their child living with a manageable, chronic condition in a pediatric clinical trial of an ATMP. This consideration outweighed potential benefits and severity of their child’s condition. Parents called for available safety data and fulsome communication processes that would enable them to make informed decisions about clinical trial enrolment on behalf of their children.
Comparison of consumer knowledge about Campylobacter, Salmonella and Toxoplasma and their transmissibility via meat: results of a consumer study in Germany
Authors: Henke K. A. , Alter T. , Doherr M. G. , Merle R.
Published: March 2020

Background

Campylobacteris the most commonly reported causative agent of foodborne bacterial infection in Germany, and contaminated chicken meat is an important source of this zoonotic agent. The aim of this study was to determine the knowledge of consumers in Germany aboutCampylobacter, Salmonella and Toxoplasmaand their transmissibility via meat. In addition, we investigated the level of knowledge between selected consumer groups and whether the results coincided with those of international studies.

Methods

We conducted a cross-sectional survey of 1008 consumers in Germany via an online panel to record, analyse and evaluate the state of knowledge aboutCampylobacter, SalmonellaandToxoplasma. The participants were selected according to age, gender and federal states to be representative of the German population.

Results

Overall, 68.3% of the respondents had never heard ofCampylobacter, 20.2% had heard ofCampylobacterbut did not know how to protect themselves, and only 11.5% knew how to protect themselves fromCampylobacterinfections. Slightly more than half (52.2%) of the respondents who had at least heard ofCampylobacterknew thatCampylobacterwas transmissible via meat. Knowledge increased significantly with age. Participants over 60 years old knew aboutCampylobacteralmost three times as often as the 16- to 19-year-old comparison group (OR = 2.982). Consumers who had at least a secondary school certificate were almost twice as likely to know aboutCampylobacteras those who had no school certificate or a lower secondary school certificate (OR = 1.899). Participants who were not actors in the food chain were significantly less frequently informed aboutCampylobacterthan were those who were actors in the food chain. Consumer knowledge ofToxoplasmawas better than that ofCampylobacter. Consumers have the most knowledge aboutSalmonella.

Conclusions

Consumers in Germany are predominantly poorly informed aboutCampylobacterand the transmission route via meat. General knowledge ofToxoplasmais better than that ofCampylobacter. Among the three pathogens, consumers are best informed aboutSalmonella. This finding highlights the importance of making existing information materials more accessible to consumers in the future to increase their knowledge, with the objective of reducing the incidence ofCampylobacterinfections.
Cross-cultural translation, adaptation and validation of a Japanese version of the functional index for hand osteoarthritis (J-FIHOA)
Authors: Nakagawa Yasunobu , Kurimoto Shigeru , Maheu Emmanuel , Matsui Yuichiro , Kanno Yuri , Menuki Kunitaka , Hayashi Masanori , Nemoto Tetsuya , Nishizuka Takanobu , Tatebe Masahiro , Yamamoto Michiro , Iwatsuki Katsuyuki , Dreiser Renée Liliane , Hirata Hitoshi
Published: March 2020

Background

Hand osteoarthritis (OA) has a wide spectrum of clinical presentations and physical function is one of the core domains where patients suffer. The Functional Index for Hand Osteoarthritis (FIHOA) is a leading assessment tool for hand OA-related functional impairment. Our objective was to make a Japanese version of FIHOA (J-FIHOA) and validate it among Japanese hand OA patients.

Methods

Forward and backward translation processes were completed to create a culturally adapted J-FIHOA. A prospective, observational multicenter study was undertaken for the validation process. Seventeen collaborating hospitals recruited Japanese hand OA patients who met the American College of Rheumatology criteria. A medical record review and responses to the following patient-rated questionnaires were collected: J-FIHOA, Hand20, Health Assessment Questionnaire (HAQ), numerical rating scale for pain (NRS pain) and Short Form 36 Health Survey (SF-36). We explored the structure of J-FIHOA using factor analysis. Cronbach’s alpha coefficients and item-total correlations were calculated. Correlations between J-FIHOA and other questionnaires were evaluated for construct validity. Participants in clinically stable conditions repeated J-FIHOA at a one- to two-week interval to assess test-retest reliability. To evaluate responsiveness, symptomatic patients who started new pharmacological treatments had a 1-month follow-up visit and completed the questionnaires twice. Effect size (ES) and standardized response mean (SRM) were calculated with pre- and post-treatment data sets. We assessed responsiveness, comparing ES and SRM of J-FIHOA with other questionnaires (construct approach).

Results

A total of 210 patients participated. J-FIHOA had unidimensional structure. Cronbach’s alphas (0.914 among females and 0.929 among males) and item-total correlations (range, 0.508 to 0.881) revealed high internal consistency. Hand20, which measures upper extremity disability, was strongly correlated with J-FIHOA (r = 0.82) while the mental and role-social components of SF-36 showed no correlations (r = − 0.24 and − 0.26, respectively). Intraclass correlation coefficient for test-retest reliability was 0.83 and satisfactory. J-FIHOA showed the highest ES and SRM (− 0.68 and − 0.62, respectively) among all questionnaires, except for NRS pain.

Conclusions

Our results showed J-FIHOA had good measurement properties to assess physical function in Japanese hand OA patients both for ambulatory follow-up in clinical practice, and clinical research and therapeutic trials.