bluuebunny/crossref_metadata_2025 huggingface dataset:
A Bibliographic Review of Medicine and Science Research in DanceSport
Authors: Riding McCabe Teri , Wyon Matthew , Ambegaonkar Jatin P , Redding Emma
Published: June 2020

DanceSport is the competitive form of ballroom dancing, and even though it has more participants worldwide than ballet and modern dance, there is less peer-reviewed research. A review was conducted to identify all relevant literature to help researchers and clinicians gain an enhanced
understanding of dancesport. Eight databases were searched, with 34 articles found in topics including participation motives, psychology, exercise physiology, fitness training, injuries and injury prevention, biomechanics, menstrual dysfunction, and substance use. Our results indicate that
researchers have been inconsistently recording and reporting anthropometric and dancesport data; for example, 31 studies separated participants by gender, 21 included the competition classification of dancers, 19 reported which style of dancesport participants competed in, and 13 described
the participants as a dance couple. Common injuries affected the neck, shoulder, spine, knee, lower leg, and foot. Dancesport is in the very heavy to extremely heavy category in energy expenditure (mean heart rate: male 175.2 ± 10.7, female 178.6 ± 8.6 bpm) and utilizes both
aerobic and anaerobic energy systems. Alpha-beta and heart rate variability intervention techniques are reported to successfully enhance performance in dancers. Dancesport participants also appear less likely to smoke cigarettes, but have little knowledge about anti-doping rules. During events,
professionals danced farther (30 m) and faster (0.3 m/sec) than junior dancers. Female competitors were more likely to be eumenorrheic. Dancesport is a physically and mentally demanding competitive sport, but there is a need to standardize measurements in future studies to allow comparison.
Contributions of Muscle Fatigue to a Neuromuscular Neck Injury in Female Ballroom Dancers
Authors: Riding McCabe Teri , Hopkins J Ty , Vehrs Pat , Draper David O
Published: June 2020

OBJECTIVE: To investigate the etiology of a loss-of-control neck injury in international modern (IM) dancesport dancers. A comparison to identify if dancers with neck injury have a greater decrease in median frequency in electromyography (EMG) than non-injured dancers. SUBJECTS: Twenty
female subjects (mean age 21.6 ± 3.0 yrs, height 167.1 ± 4.3 cm, weight 59.1 ± 5.2 kg, mean BMI 21.1 ± 1.2) with minimum 1-year experience in competitive IM dancesport. MEASUREMENTS: EMG activity from the left upper trapezius, left splenius capitius, and right sternocleidomastoid
muscles before and after dancing the five IM dances. Extension, lateral flexion, and neck length were also measured. RESULTS: There was no significant difference in all measurements. CONCLUSIONS: Although we did not find the etiology of this neck injury, this was the first research into this
injury. Future research could study the different IM dances, compare different competition levels, or the amount of force placed on the neck when dancing.
Strategies to Promote Health and Prevent Musculoskeletal Injuries in Students from the High Conservatory of Music of Salamanca, Spain
Authors: Martín López Tomás , Farías Martínez Joaquín
Published: June 2020

Objectives: The present investigation was intended to evaluate the effectiveness of a course on health and the prevention of musculoskeletal injuries in future professional musicians, specifically designed for superior-grade students at the High Conservatory of Music of Salamanca, Spain.
Methods: Students were taught how to evaluate the possible risks associated with the practice of their instruments. They were provided with information about the most frequent medical problems of musicians, warm-up habits, postural hygiene, effective prevention strategies, and different treatment
options for these pathologies. The students were randomly divided into two groups: a control group (n=56) who did not take the course and was evaluated with a questionnaire at the beginning of the academic year and 1 year later, and an experimental group (n=90) who did take the course and
was evaluated with three questionnaires (at the beginning of the course, 6 months later, and 12 months after the start of the course). Results: While the students in the experimental group improved their body awareness by 91% and the frequency of their injuries decreased by 78%, there was
no improvement in the students from the control group at the end of the experiment. Conclusions: The results of our study have demonstrated the effectiveness of this type of course and show that such courses should be included in the academic curriculum of superior conservatories.
Head and Shoulder Functional Changes in Flutists
Authors: Teixeira Ziliane LO , Lã Filipa MB , da Silva Anabela G
Published: June 2020

AIMS: This study aimed at comparing head posture, symmetry of shoulder muscle strength, and posture among developing flutists, professional flutists, and a matched control group of singers. METHODS: Measurements of head and scapular posture and muscle strength were compared between
flutists with ≤10 yrs of practice (developing flutists, n=9), flutists with >10 years of practice (professional flutists, n=9), and singers (n=9). Posture was measured with a goniometer and tape measure; strength was assessed with an isokinetic dynamometer. RESULTS: Significant differences
were found between groups concerning forward head posture only; developing flutists showed a higher forward head posture compared to the other two groups (p<0.05). No significant differences were found for scapular posture or muscle strength. CONCLUSIONS: Developing flutists showed significantly
more forward head posture. This finding supports the need to revise existing music curricula targeting the inclusion of compulsory disciplines on music medicine.
Relationships Between Depression, Anxiety, and Pain in a Group of University Music Students
Authors: Wristen Brenda W , Fountain Sarah E
Published: June 2020

There is emerging interest in studying the incidence of music-related injuries and problems among students. The current study drew on a data set collected from 287 music majors and minors at a large US midwestern university school of music in order to determine if correlations existed
between anxiety and/or depression and the reported presence of physical pain, and to understand the nature of any such relationships. Physical pain symptoms were scored on a scale of 0 (none) to 10 (excruciating) and summed across 21 body regions. Depression and anxiety symptoms were scored
as none (0), mild (1), moderate (2), or severe (3), and each summed across either 13 symptoms for depression or 8 symptoms for anxiety. The potential linear relationship among these variables was evaluated using F-tests (as part of ANOVAs) and linear regression parameter estimation techniques.
The explanatory value of these relationships was evaluated using R2 values. Results indicate a clear positive linear relationship between both depression and pain, and anxiety and pain. However, the presence of depression and/or anxiety symptoms was insufficient to explain variability in pain
scores of these participants.
Abstracts from the Literature, No. 60
Authors: Dawson William J
Published: June 2020

Once again, this column includes topics addressed by more than one recent article. Music aptitude and first-person accounts of vocalists’ health problems lead off the review. Knowing how performers feel and react to their own difficulties adds an important dimension to our understanding
and dealing with the problems they (and we) face. Installment 60.
Worker's Compensation for Musicians
Authors: Lubet Alex , Chimenti Ruth L
Published: June 2020

Kudos to Ruth L. Chimenti et al. and MPPA editor Ralph Manchester for their excellent and complementary contributions to the literature regarding performing arts and worker’s compensation (WC). … Chimenti et al. addressed the issue of why WC is underutilized by professional
orchestral musicians. They conducted a survey whose n = 261, with 243 musicians reporting injuries. The survey (included in the online, but not print version of the article) posits 7 possible reasons for not filing WC claims, plus the option of providing an “other” response. The
authors did a good job choosing possible reasons, since all 7 received significant responses. … I would offer one “other” reason WC claims are not filed. Such claims are often denied and often taken to court.
Development of a Performance Anxiety Scale for Music Students
Authors: Cırakoğlu Okam C , Şentürk Gülce C
Published: June 2020

In the present research, the Performance Anxiety Scale for Music Students (PASMS) was developed in three successive studies. In Study 1, the factor structure of PASMS was explored and three components were found: fear of stage (FES), avoidance (AVD) and symptoms (SMP). The internal
consistency of the subscales of PASMS, which consisted of 27 items, varied between 0.89 and 0.91. The internal consistency for the whole scale was found to be 0.95. The correlations among PASMS and other anxiety-related measures were significant and in the expected direction, indicating that
the scale has convergent validity. The construct validity of the scale was assessed in Study 2 by confirmatory factor analysis. After several revisions, the final tested model achieved acceptable fits. In Study 3, the 14-day test-retest reliability of the final 24-item version of PASMS was
tested and found to be extremely high (0.95). In all three studies, the whole scale and subscale scores of females were significantly higher than for males.
A crise do Coronavírus e o agricultor familiar produtor de hortaliças
Authors: Pedroso Maria Thereza Macedo , Corcioli Graciella , Foguesatto Cristian
Published: June 2020

O objetivo desse estudo foi verificar os principais efeitos imediatos da crise do coronavírus (Covid-19), em particular, sobre a comercialização de hortaliças produzidas em estabelecimentos agropecuários denominados familiares. Para realização desse estudo recorreu-se à revisão bibliográfica e a realização de entrevistas semi-dirigidas. O estudo aponta que a maior diferenciação social entre os produtores decorrente da pandemia tem estreita relação com o canal de comercialização dominante. Verifica-se que os produtores que comercializam para os supermercados, diretamente ou indiretamente, conseguem manter o escoamento de forma mais regular, uma vez que esses estabelecimentos seguem abertos por serem “serviços essenciais”. Mas parte considerável dos agricultores familiares que dependem do funcionamento dos restaurantes e das feiras está em situação de maior vulnerabilidade econômica. Outro importante canal de comercialização para o agricultor familiar são as compras institucionais, em especial, o Programa de Aquisição de Alimentos (PAA) e o Programa Nacional de Alimentação Escolar (PNAE). Para o PAA, a modalidade mais utilizada pelos agricultores familiares é a “Compra com Doação Simultânea”, a qual apresentou decréscimo vertiginoso desde o ano de 2013. O PNAE, por sua vez, diminuiu as aquisições em função da suspensão das aulas em vários municípios. Conclui-se que são dois programas que constituem alternativas concretas para minimizar os impactos causados pela atual crise sobre os agricultores familiares, além de garantir alimentos às pessoas em condições mais vulneráveis.
Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017
Authors: Biribawa Claire , Atuhairwe Joselyn Annet , Bulage Lilian , Okethwangu Denis Othuba , Kwesiga Benon , Ario Alex Riolexus , Zhu Bao-Ping
Published: June 2020

Background: Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated the outbreak to assess the scope, factors facilitating transmission, and recommend control measures.Methods: We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage.Results: We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital pediatric department for non-measles conditions 7-21 days before case-patient’s onset (ORadj=34, 95%CI: 5.1-225). Estimated vaccine effectiveness was 95% (95%CI: 75-99%) and vaccination coverage was 76% (95%CI: 68-82%). During the outbreak, an “isolation” ward was established inside the general pediatric ward where there was mixing of both measles and non-measles patients. Conclusions: This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation ward outside of the building, supplemental vaccination, and vaccinating pediatric patients during measles outbreaks.
Disruption of a primary health care domestic violence and abuse service in two London boroughs: interrupted time series evaluation
Authors: Panovska-Griffiths Jasmina , Sohal Alex Hardip , Martin Peter , Capelas Estela Barbosa , Johnson Medina , Howell Annie , Lewis Natalia , Feder Gene , Griffiths Chris , Eldridge Sandra
Published: June 2020

Background Domestic violence and abuse (DVA) is experienced by about 1/3 of women globally and remains a major health concern worldwide. IRIS (Identification and Referral to Improve Safety of women affected by DVA) is a complex, system-level, training and support programme, designed to improve the primary healthcare response to DVA. Following a successful trial in England, since 2011 IRIS has been implemented in eleven London boroughs. In two boroughs the service was disrupted temporarily. This study evaluates the impact of that service disruption.Methods We used anonymised data on daily referrals received by DVA service providers from general practices in two IRIS implementation boroughs that had service disruption for a period of time (six and three months). In line with previous work we refer to these as boroughs B and C. The primary outcome was the number of daily referrals received by the DVA service provider across each borough over 48 months (March 2013-April 2017) in borough B and 42 months (October 2013-April 2017) in borough C. The data were analysed using interrupted-time series, non-linear regression with sensitivity analyses exploring different regression models. Incidence Rate Ratios (IRRs), 95% confidence intervals and p-values associated with the disruption were reported for each borough.Results A mixed-effects negative binomial regression was the best fit model to the data. In borough B, the disruption, lasted for about six months, reducing the referral rate significantly (p=0.006) by about 70% (95%CI=(23%,87%)). In borough C, the three-month service disruption, also significantly (p=0.005), reduced the referral rate by about 49% (95% CI=(18%,68%)). Conclusions Disrupting the IRIS service substantially reduced the rate of referrals to DVA service providers. Our findings are evidence in favour of continuous funding and staffing of IRIS as a system level programme.
Changes in health inequalities for patients with diabetes among middle-aged and elderly in China from 2011 to 2015
Authors: Cao Guizhen , Cui Zhizhen , Ma Qinghua , Wang Congju , Xu Yong , Sun Hongpeng , Ma Yana
Published: June 2020

Background: The purpose of this paper is to measure income-related health inequality among middle-aged and elderly patients with diabetes in China from 2011 to 2015 and to investigate factors that might be related to this inequality.Methods: The data for this study were obtained from the China Health and Retirement Longitudinal Study that was carried out in 2011, 2013 and 2015. In total, 48519 Chinese middle-aged and elderly population were included (15457 in 2011, 16576 in 2013 and 16486 in 2015). A principal component analysis was performed to measure asset-based economic status. The concentration index was used to measure income-related inequality in patients with diabetes. Additionally, by used generalized linear model, we decomposed the concentration index to identify factors that explained wealth-related inequality in patients with diabetes.Results: The prevalence of self-reported diabetes among middle-aged and elderly Chinese was 5.61%, 7.49% and 8.99% in 2011, 2013 and 2015, respectively. The concentration indices and 95% confidence intervals for diabetes were 0.1359 (0.0525-0.0597), 0.1207 (0.0709-0.0789), 0.1021 (0.0855-0.0942) in 2011, 2013, and 2015, respectively, which are indicative of inequality that favors the rich. The decomposition of the concentration index showed that residence (39.38%), BMI (31.16%), education (7.28%), and region (6.09%) had positive contributions to the measured inequality in diabetes in China in 2015. Age (-29.93%) had a negative contribution to inequality.Conclusion: The findings confirm a health inequality in diabetes that favor the rich. Furthermore, the inequality declined from 2011 to 2015. We suggest that policy and intervention strategies should be developed to alleviate this health inequality, such as narrow the gap between urban and rural areas by improving the urban-rural medical insurance scheme, implementing strategies to enhance hygiene health education, control obesity rate.
Clients’ satisfaction with malaria in pregnancy preventive services in Anambra State, Nigeria
Authors: Obagha Chijioke Emmanuel , Ajayi IkwOluwakpo , Abdullahi Gobir A. , Umeokonkwo Chukwuma David
Published: June 2020

Introduction: Burden of Malaria in pregnancy (MIP) is still high despite availability of proven cost-effective interventions. Considerable progress has been made on improving antenatal attendance but MIP preventive services utilization remains low. Factors responsible for this include dissatisfaction with the services provided. We assessed clients’ satisfaction with preventative services for malaria during pregnancy delivered at antenatal clinics (ANC) in Anambra State Nigeria.Method: We conducted a cross-sectional study among 284 pregnant women attending ANC using a three-stage sampling technique. Pre-tested semi-structured interviewer-administered questionnaire was used to collect information on socio-demographics, knowledge of malaria in pregnancy services and satisfaction with services. Responses to questions on satisfaction was on a 5-point Likert scale. A cut off of ≥75% of composite score was used to classify respondents as satisfied. For knowledge, every correct answer was scored 1 and incorrect 0; ≥75% of the composite score was graded as good knowledge. Chi square and logistic regression were used to test for association between client satisfaction and independent variables. Results: The mean age of participants is 28 years±4.4 years. Overall 62.2% were satisfied with quality of preventive services for malaria during pregnancy. However, 64.8% and 57.8% were dissatisfied with cost of healthcare and interpersonal relationship with the health workers (HWs). Majority of the of respondents (88.73%) had poor knowledge of malaria preventive services during pregnancy. Type of facility (Adjusted odds ratio [aOR] = 2.11; 95%CI: 1.20-3.71) and knowledge (aOR: 0.41; 95%CI: 0.18 – 0.90) were independently associated with satisfaction with interpersonal relationship respectively. Type of facility (aOR: 0.47; 95%CI: 0.27-0.80) and employment status (aOR: 3.07; 95%CI: 1.39 -6.74) were also independently associated with satisfaction with cost of healthcare. Conclusion: A fair proportion of respondents were satisfied with the preventive services for malaria during pregnancy provided even though most were dissatisfied with the cost of assessing care and interpersonal relationship with health workers. Uninterrupted availability of LLIN and IPT at all health facilities, subsidized cost of malaria-related commodities, and incentives for good customer satisfaction ratings may remediate the described barriers to seeking preventative care for malaria during pregnancy
Pre-application of dentin bonding agent prevents discoloration caused by mineral trioxide aggregate
Authors: Choi Yoo-Lim , Jang Young-Eun , Kim Bom Sahn , Kim Jin-Woo , Kim Yemi
Published: June 2020

Background: To evaluate tooth discoloration by newly developed calcium silicate-based materials, and to examine the pre-application of dentin bonding agent (DBA) for preventing discoloration caused by mineral trioxide aggregate (MTA).Methods: The roots of 50 premolars were randomly divided into five groups (n=10) and cavities were prepared from resected root surfaces. MTA was placed in the cavities of teeth belonging to the ProRoot MTA (MTA) and RetroMTA (RMTA) groups. For teeth belonging to the ProRoot + DBA (MTA-B) and RetroMTA + DBA (RMTA-B) groups, DBA was first applied to the cavities prior to the addition of MTA. Teeth in the control group were restored with composite resin only (i.e., without MTA). After 12 weeks, MTA was removed from the MTA and RMTA groups and bleaching agents were applied for 3 additional weeks. Color assessments were recorded at baseline, and 1, 4, and 12 weeks, as well as after bleaching. A one-way ANOVA was performed to assess the differences between the two types of MTAs and color changes following DBA pre-application in each MTA group. A p-value of < 0.05 was considered indicative of statistical significance.Results: Following 12 weeks of MTA treatment, there was a significant difference between the discoloration in the MTA and RMTA groups (p < 0.05). However, no significant difference was observed between the RMTA and RMTA-B groups (p > 0.05). Following bleaching, the color changes (ΔE values) of the MTA group were not significantly different from those of the MTA-B group (p > 0.05). The difference of ΔE between the RMTA group after internal bleaching and the RMTA-B group was also not significant (p > 0.05).Conclusions: RetroMTA caused significantly less discoloration than ProRoot MTA. Pre-application of DBA reduced discoloration caused by ProRoot MTA. MTA discoloration was improved equally well between DBA pre-application and post-bleaching.
Physiological Effects of Different Recruitment Maneuvers in a Pig Model of ARDS
Authors: Xia Feiping , Pan Chun , Wang Lihui , Liu Ling , Liu Songqiao , Guo Fengmei , Yang Yi , Huang Yingzi
Published: June 2020

Background: In acute respiratory distress syndrome (ARDS), lung recruitment maneuvers can recruit collapsed alveoli in gravity-dependent lung regions, improving the homogeneity of ventilation distribution. This study used electrical impedance tomography (EIT) to investigate the physiological effects of different recruitment maneuvers for alveolar recruitment in a pig model of ARDS. Methods: ARDS was induced in ten healthy male pigs with repeated bronchoalveolar lavage until the arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) (P/F ratio) was < 100 mmHg and remained stable for 30 minutes (TARDS). ARDS pigs underwent three sequential recruitment maneuvers, including sustained inflation (SI), increments of positive end-expiratory pressure (PEEP) (IP), and pressure-controlled ventilation (PCV) applied in random order, with 30 mins at a PEEP of 5 cmH2O between maneuvers. Respiratory mechanics, hemodynamics, arterial blood gas, and EIT were recorded at baseline, TARDS, and before and after each recruitment maneuver.Results: In all ten pigs, ARDS was successfully induced with a mean 2.8±1.03L (2800±1032.80ml) bronchoalveolar lavages. PaO2, SO2, P/F, and compliance were significantly improved after recruitment with SI, IP or PCV (all p<0.05), and there were no significant differences between maneuvers. Global inhomogeneity (GI) was significantly decreased after recruitment with SI, IP, or PCV. There were no significant differences in GI before or after recruitment with the different maneuvers. The decrease in GI (ΔGI) was significantly greater after recruitment with IP compared to SI (p=0.023), but there was no significant difference in ΔGI between IP and PCV.Conclusion: SI, IP, and PCV increased oxygenation, and regional and global compliance of the respiratory system, and decreased inhomogeneous gas distribution in ARDS pigs. IP significantly improved inhomogeneity of the lung compared to SI.
Mix Of Destinations And Sedentary Behavior Among Brazilian Adults: A Cross Sectional Study
Authors: Florindo Alex Antonio , Turrel Gavin , Garcia Leandro Martin Totaro , Barbosa Joao João Paulo dos Anjos Souza , Cruz Michele Santos , Failla Marcelo Antunes , Aguiar Breno Souza , Barrozo Ligia Vizeu , Goldbaum Moises
Published: June 2020

Background: Sedentary behavior is influenced by contextual, social and individual factors, including the built environment. However, associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil. Methods: This study uses data from the Sao Paulo Health Survey (n=3,145). Sedentary behavior was assessed by questionnaire using two questions: total sitting time in minutes on a usual weekday; and on a usual weekend day. Mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500m of each participant’s residence. Minutes of sitting time in a typical weekday and weekend day were the outcomes and mix of destinations score in 500m buffers was the exposure variable. Associations between mix of destinations and sitting time were examined using multilevel linear regression: these models accounted for clustering within census tracts and households and adjusted for environmental, sociodemographic, and health-related factors. Results: After adjustment for covariates, mix of destinations was inversely associated with minutes of sitting time on a weekday (β=-8.8, p=0.001) and weekend day (β=-6.1, p=0.022). People who lived in areas with a greater mix of destinations had shorter average sitting times. Conclusion: Greater mix of destinations within 500m of peoples’ residences were inversely associated with sitting time on a typical weekday and weekend day. In Latin American cities like Sao Paulo built environments more favorable for walking may contribute to reducing sedentary behavior and prevent associated chronic disease.
Influenza A virus antagonizes type I and type II interferon responses via SOCS1-dependent ubiquitination and degradation of JAK1
Authors: Du Yinping , Yang Fan , Wang Qiuxia , Xu Nuo , Xie Yizhang , Chen Sujuan , Qin Tao , Peng Da-Xin
Published: June 2020

BACKGROUND: Although influenza A virus (IAV) employs diverse strategies to evade IFN responses by inhibiting the synthesis of IFN, how IAV regulates signaling downstream of IFN is incompletely understood.METHODS: In this study, we used Western blot-based protein analysis coupled with RT-qPCR, overexpression and RNA interference to investigate the regulation of JAK1 by IAV infection.RESULTS: The results indicated that JAK1 was ubiquitinated and degraded, resulting in inhibition of type I and type II IFN responses, demonstrating that IAV antagonizes the IFN-activated JAK/STAT signaling pathway by inducing the degradation of JAK1. Furthermore. IAV infection upregulated the suppressor of cytokine signaling (SOCS) protein SOCS1, and SOCS1 mediated the ubiquitination and degradation of JAK1. CONCLUSION: Collectively, our findings suggest that IAV infection induces SOCS1 expression to promote JAK1 degradation, which in turn inhibits host innate immune responses.
Regret over the delay in childbearing decision negatively associates with life satisfaction among Japanese women and men seeking fertility treatment: a cross-sectional study
Authors: Adachi Tomoko , Endo Masayuki , Ohashi Kazutomo
Published: June 2020

Background: Currently, in developed countries, increasing numbers of women and men are delaying childbearing but begin seeking fertility treatment later in life. Some women undergoing infertility treatment develop negative feelings such as depression associated with low life satisfaction and regret over the delay in childbearing. We therefore examine the association of life satisfaction with regret over the delay in childbearing decision and infertility-related factors among Japanese women and men seeking fertility treatment.Methods: This cross-sectional study included 253 women and 196 men referred to fertility facilities in Japan from July to December 2018. Participants completed a questionnaire on life satisfaction, regret over the delay in childbearing decision, infertility-related factors and sociodemographic characteristics. Life satisfaction was measured using the Satisfaction with Life Scale (SWLS), and the degree of regret over delay in childbearing decision was measured on a 7-point Likert scale. Multiple linear regressions, conducted separately by gender, were used to analyze the association of life satisfaction with regret over the delay in childbearing decision and infertility-related factors.Results: Of the 253 women and 196 men, 102 (40.3%) women and 43 (21.9%) men answered “strongly agree” regarding their regret over the delay in childbearing decision. Among women, life satisfaction was negatively associated with regret (β = -0.155, 95% CI [-0.938, -0.093], p = 0.017), use of assisted reproduction technology (ART) (β = -0.135, 95% CI [-2.977, -0.020], p = 0.047). In contrast, previous live birth was positively associated with life satisfaction (β = 0.134, 95% CI [0.12, 3.739], p = 0.037). In men, we found no significant association of life satisfaction with regret over the delay in childbearing decision and infertility-related factors.Conclusions: Regret over the delay in childbearing decision is negatively associated with life satisfaction among Japanese women seeking fertility treatment. It may be important for women to make better informed decision regarding the timing of childbearing to not regret later in life. Health professionals should address regret over the delay in childbearing decision during fertility treatment and explore ways to spread information on fertility awareness.
HLA-Mismatched GPBSCs infusion therapy in refractory Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis: A observational study from a single center
Authors: Song Yue , Wang Jingshi , Wang Yini , Wang Zhao
Published: June 2020

Background: Hemophagocytic lymphohistiocytosis (HLH) is a severe or even fatal inflammatory state. Epstein–Barr virus (EBV) infection associated HLH (EBV-HLH) is one of the most common secondary HLH and suffers a very poor prognosis. Allo-HSCT is often required for refractory EBV-HLH, but some patients still cannot proceed to the next allo-HSCT due to various factors. This study aimed to observe the efficacy of HLA-mismatched granulocyte colony-stimulating factor (G-CSF) mobilized peripheral blood stem cells (GPBSCs) infusion for refractory EBV-HLH. Methods: A retrospective case-control study of refractory EBV-HLH patients with GPBSCs infusion from HLA-mismatched donors after chemotherapy (as GPBSCs group) and sole chemotherapy (as control group) was performed. Efficacy was evaluated 2 and 4 weeks and all patients were followed up until 1 March 2018.Results: There were 18 cases who accepted infusion between March 2016 and Sep 2017 and 19 were randomly selected from refractory EBV-HLH patients who underwent salvage therapy during the same period for the control group. In GPBSCs group, WBC (p=0.017), Fbg (p=0.040), ferritin (p=0.039) improved significantly after treatment. The overall response rate was 66.7% (CR 22.2%, PR 44.4%). However, there is no significant differences in changes of WBC, HGB, PLT, TG, Fbg, Ferritin, AST, ALT, T-bil between two groups. Only the Fbg level was recovered better in the GPBSCs infusion group (p=0.003). In the GPBSCs group, EBV-DNA decreased significantly after 2 weeks (p=0.001) and 4 weeks (p=0.012) after treatment, and the effect of the decrease was significantly better than that of the chemotherapy alone group in 2 weeks but not 4 weeks (p2w=0.011, p4w=0.145). The median survival time in the infusion group was 20.4 weeks [95%CI 10.9, 29.9], and the median survival time in the control group was 10.8 weeks [95%CI 0-24.34]. In the short-term, the infusion group’s survival rate was better (2-month 88.89% vs. 52.63%, p=0.008; 3-month 83.33% vs. 47.09%, p=0.012), but there was no difference in OS (p=0.287). Conclusions: Infusing GPBSCs combined with chemotherapy is effective, especially in decreasing EBV-DNA, performs better than chemotherapy alone, and improve short term survival rate. GPBSCs infusion is suggested as a bridging treatment method to allo-HSCT.
Prevalence and determinants of virological failure, genetic diversity and drug resistance among people living with HIV in a minority area in China: a population-based study
Authors: Yuan Dan , Liu Meijing , Jia Peng , Li Yiping , Huang Yuling , Ye Li , Api Laze , Chen Maogang , Yao Liang , Wang Zixin , Liu Honglu , Liang Shu , Yang Shujuan
Published: June 2020

Background: Liangshan Yi Autonomous Prefecture is one of the areas that most severely affected by human immunodeficiency virus (HIV) in China, and virological failure on antiretroviral therapy (ART) is serious in this area. Analyses of prevalence and determinants of ART failure, the genetic diversity and drug resistance among people living with HIV (PLWH) helps improve HIV treatment efficiency and prevent HIV transmission.Methods: A total of 5157 PLWH were recruited from 2016 to 2017. The venous blood samples were subjected to RT-PCR, followed by sequencing of the HIV-1 pol gene, targeting the protease and reverse transcriptase fragments. HIV-1 diversity was analyzed using the DNAStar software and drug resistance mutations were analyzed using the Stanford University HIV Drug Resistance Database.Results: A total of 2156 (41.81%) PLWH showed virological failure on ART. Males (ORm=1.25), heterosexual behaviors and drug injection (ORm=1.44) and mother to child transmission routes (ORm=1.58), the clinical stage of AIDS (ORm=1.35), having used illicit drugs and shared the needles (1-4 times: ORm=1.34; more than 5 times: ORm=1.52), having ever replaced ART regimen (ORm=1.48) increased the risk of virological failure among PLWH, while higher education lever (ORm=0.77) and ≥12 months on ART (12~36 months: ORm=0.72; ≥36 months: ORm=0.66) was associated with lower likelihood of virological failure. The data revealed that CRF07_BC (1508, 95.62%) were the most common strains, and the drug-resistant rate was 32.10% among PLWH with virological failure in this area. The high frequencies of drug resistance were found in EFV and NVP of NNRTIs, ABC, FTC and 3TC of NRTIs, and TPV/r in PIs. The most common mutations in NNRTIs, NRTIs and PIs were K103N/KN (64.69%), M184V/MV/I (36.29%) and Q58E/QE (4.93%), respectively.Conclusion: We concluded that surveillance of virological failure, HIV-1 subtypes, and drug resistance to understand HIV-1 epidemiology and guide modification of ART guidelines, and target prevention and control strategies should be formatted to reduce the virological failure and drug resistance to promote viral suppression and prevent HIV-1 transmission.
Assessing the Efficiency of Iran Health System in Making Progress Towards Universal Health Coverage: A Comparative Panel Data Analysis
Authors: Sajadi Haniye Sadat , Goodarzi Zahra , Takian Amirhossein , Mohamadi Efat , Olyaeemanesh Alireza , Lotfi Farhad Hosseinzadeh , Sharafi Hamid , Hekmat Somaye Noori , Jowett Matthew , Majdzadeh Reza
Published: June 2020

Background: Building upon decades of continuous reforms, Iran has been implementing various initiatives to reach universal health coverage (UHC). Improving efficiency is a crucial intermediate policy objective for UHC. Therefore, this article aimed to measure the efficiency and productivity changes of the Iranian health system in making progress towards UHC during 2010-2015 in comparison with 36 selected other upper-middle-income countries.Methods: We used panel data to measure the variations in technical efficiency (TE) and total factor productivity (TFP) through an extended data envelopment analysis (EDEA) and Malmquist productivity index, respectively. General Government Health Expenditure (GGHE) per capita (International dollar) was selected as the input variable. Service coverage of diphtheria, tetanus and pertussis; family planning; antiretroviral therapy; skilled attendants at birth; Tuberculosis treatment success rate; and GGHE as % of Total Health Expenditure (THE) were considered as output variables. The data for each indicator were taken from the Global Health Observatory data repository and World Development Indicator database, for six years (2010-2015). Results: The TE scores of Iran’s health system were 0.75, 0.77, 0.74, 0.74, 0.97, and 0.84 in the period 2010-2015, respectively. TFP improved in 2011 (1.02), 2013 (1.01), and 2014 (1.30, generally). The overall efficiency and TFP increased in 2014. Changes made in CCHE per capita and GGHE/THE attributed to the increase of efficiency. Conclusion: There is a growing demand for efficiency improvements in the health systems to achieve UHC. While there are no defined set of indicators or precise methods to measure health system efficiency, EDEA helped us to draw the picture of health system efficiency in Iran. Our findings highlighted the essential need for targeted and sustained interventions, i.e., allocation of enough proportion of public funds to the health sector, to improve universal financial coverage against health costs aiming to enhance the future performance of Iran’s health system, ultimately. Such tailored interventions may also be useful for settings with similar context to speed up their movement towards improving efficiency, which in turn might lead to more resources to reach UHC. Trial registration: NA
Recruitment, experience, and retention among women with HIV and hazardous drinking enrolled in the WHAT-IF? Study
Authors: Canidate Shantrel , Cook Christa , Varma Deepthi , Carnaby Giselle , Ennis Nicole , Stetten Nichole , Cook Robert
Published: June 2020

Background: Despite efforts by the NIH to enhance the participation of women and minorities in clinical research, women with HIV continue to remain underrepresented in alcohol intervention research. The purpose of this study is to better understand the reasons why women with HIV and hazardous drinking participated in the WHAT-IF? Study and to discuss their experience (positive or negative) in the study.Methods: Convenience and theoretical sampling were used to recruit women with HIV and hazardous drinking to complete qualitative interviews. These women had previously completed a clinical alcohol intervention trial and had consented to be contacted in the future for study-related purposes. The biopsychosocial model was used to frame the interview questions that assessed multiple determinants of drinking behavior and helped explain linkages to broader health constructs.Results: A total of 20 women with HIV and hazardous drinking completed the qualitative interview. Several factors were identified by the women as influential in their decision to participate in the WHAT-IF? study, such as the ability to quit or reduce their drinking to nonhazardous levels (biological), the ability to gain knowledge or a greater understanding of the negative effects of hazardous drinking on HIV disease progression (psychological), and peer pressure and monetary compensation (social). Also, the women identified factors (positive or negative) associated with their clinical trial experience, such as the effects of the study medication on the woman's body (biological), thoughts and feelings toward study procedures (i.e. medication, lab work, study assessments) and the length of the study (psychological), and the interactions with the WHAT-IF? Study staff (social).Conclusion: Recruiting and retaining women with HIV in alcohol intervention research remains a challenge. Findings from this study suggest that women with HIV who are hazardous drinkers may benefit from participating in research studies that could help them to reduce or quit their drinking, increase their knowledge about specific behavior changes, and earn monetary compensation. Also, positive staff interactions may be instrumental in retaining minority women in alcohol intervention research.
Association between diet quality and food waste in Canadian families: a cross-sectional study
Authors: Carroll Nicholas , Wallace Angela , Jewell Kira , Darlington Gerarda , Ma David W.L. , Duncan Alison M. , Parizeau Kate , von Massow Michael , Haines Jess
Published: June 2020

Background : Higher diet quality has been associated with greater amounts of food waste among adults in the United States. This study aims to build on previous work by examining the association between diet quality and food waste, as assessed using detailed waste audits, among a sample of Canadian families. Methods : This cross-sectional study used data from 85 Canadian families with young children. Parent and children diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015), calculated from 3-day food records. Household food waste was measured using detailed waste audits conducted over multiple weeks and these data were used to calculate daily per capita food waste. Linear regression was used to explore the association between parent and child HEI-2015 scores and daily per capita total avoidable and unavoidable food waste, as well as daily per capita avoidable and unavoidable food waste in the following categories: 1) fruits and vegetables, 2) milk, cheese and eggs, 3) meat and fish, 4) breads and cereals, 5) fats and sugars. Results : Parent HEI-2015 scores ranged from 37 to 92 (out of 100) and 81% of parents’ diets scored in the “Needs Improvement (50-80)” category. Parent and child diet quality scores were significantly correlated (r=0.61; P< 0.0001) and 82% of children’s diets scored in the “Needs Improvement” category. On average, households produced 107 grams of avoidable food waste and 52 grams of unavoidable food waste per person per day. Fruits and vegetables were the highest contributor for both avoidable and unavoidable food waste. Both parent and child HEI-2015 scores were not significantly associated with total daily per capita avoidable or unavoidable food waste. However, parent HEI-2015 scores were positively associated with daily per capita avoidable fruit and vegetable waste (Unstandardized β= 1.05; 95%CI: 0.11, 1.99; P = 0.03) and daily per capita unavoidable fruit and vegetable waste (Unstandardized β= 0.60; 95%CI: 0.03, 1.17; P = 0.04), after adjusting for household income. Conclusion : This is the first study to explore the association between diet quality and food waste using detailed waste audits. Future research should explore effective strategies towards improving diet quality while simultaneously reducing food waste, especially of fruits and vegetables.
EFFECT: A randomized phase II study of efficacy and impact on function of two doses of nab-paclitaxel as first-line treatment in older women with advanced breast cancer
Authors: Biganzoli Laura , Cinieri Saverio , Berardi Rossana , Pedersini Rebecca , McCartney Amelia , Minisini Alessandro Marco , Caremoli Elena Rota , Spazzapan Simon , Magnolfi Emanuela , Brunello Antonella , Risi Emanuela , Palumbo Raffaella , Leo Silvana , Colleoni Marco , Donati Sara , De Placido Sabino , Orlando Laura , Pistelli Mirco , Parolin Veronica , Mislang Anna , Becheri Dimitri , Puglisi Fabio , Sanna Giuseppina , Zafarana Elena , Boni Luca , Mottino Giuseppe
Published: June 2020

Background: Limited data are available regarding the use of nab-paclitaxel in older patients with breast cancer. A weekly schedule is recommended, but there is a paucity of evidence regarding the optimal dose. We evaluated the efficacy of two different doses of weekly nab-paclitaxel, with a specific focus on their corresponding impact on patient function, in order to address the lack of data specifically relating to the older population. Methods: EFFECT is an open-label, phase II trial wherein 160 women with advanced breast cancer aged ≥ 65 years were enrolled from 15 institutions within Italy. Patients were randomly assigned 1:1 to receive nab-paclitaxel 100 mg/m2 (Arm A) or 125 mg/m2 (Arm B) on days 1,8,15 on a 28-day cycle, as first-line treatment for advanced disease. The primary endpoint was event-free survival (EFS), wherein an event was defined as disease progression (PD), functional decline (FD) or death. In each arm, the null hypothesis that the median EFS would be ≤7 months was tested against a one-sided alternative according to the Brookmeyer Crowley test. Secondary endpoints included objective response rate (ORR), clinical benefit rate (CBR), progression-free survival (PFS), overall survival (OS), and safety.Results: After a median follow-up of 32.6 months, 140 events were observed in 158 evaluable patients. Median EFS was 8.2 months (90% CI, 5.9-8.9; p=0.188) in Arm A, versus 8.3 months (90% CI, 6.2-9.7; p=0.078) in Arm B. Progression-free survival, overall survival and response rates were similar in both groups. A higher percentage of dose reductions and discontinuations due to adverse events (AEs) was noted in Arm B. The most frequently reported non-hematological AEs were fatigue (grade [G] 2-3 toxicity occurrence in Arm A versus B: 43% and 51%, respectively) and peripheral neuropathy (G2-3 Arm A versus B: 19% and 38%, respectively). Conclusion: Pre-specified outcomes were similar in both treatment arms. However, 100 mg/m2 was significantly better tolerated with fewer neurotoxicity-related events, representing a more feasible dose to be recommended for older patients with advanced disease.Trial registrationEudraCT identifier: 2012-002707-18, registered June 4 2012 - https://www.clinicaltrialsregister.eu/ctr-search/trial/2012-002707-18/IT#E . NIH ClinicalTrials.gov identifier: NCT02783222, registered May 26 2016 – retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02783222