bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing Accuracy and Durability Effects of Jigsaw Versus Input Flood Tasks on the Recognition of Regular Past Tense /-ed/
Authors: Rahimi Soheil , Ahmadian Moussa , Amerian Majid , Dowlatabadi Hamid Reza
Published: May 2020

This study investigated the effects of input flood tasks, as focused tasks, and Jigsaw tasks, as unfocused tasks, on promoting Iranian English as Foreign Language (EFL) learners’ recognition of regular past tense /-ed/ in terms of accuracy and durability. Accordingly, using a quasi-experimental study, two intact university classes including 62 participants were randomly designated to experimental and comparison groups. The participants were homogenized regarding their language and grammar proficiency levels. The experimental group was instructed through input flood tasks and the comparison group through Jigsaw tasks. Analysis of covariance (ANCOVA) analysis showed that although both groups’ mean accuracy scores were improved on the immediate posttest, the experimental group outscored the comparison group. However, the results of the delayed posttest demonstrated that whereas the comparison group maintained their accuracy level over time, the experimental group’s accuracy mean score dropped. It can be postulated that input flood tasks may promote learners’ recognition accuracy of second language forms immediately, but this effect may gradually diminish. Hence, it can be tentatively concluded that Jigsaw tasks result in more durable gains than input flood tasks. The findings imply that when the goal of grammar instruction is to achieve durable effects, unfocused tasks should be integrated with focused tasks in the syllabus.
Dynamics of Emotional Intelligence and Empowerment: The Perspectives of Middle Managers
Authors: Udod Sonia A. , Hammond-Collins Karon , Jenkins Megan
Published: May 2020

This study examines employee perspectives of leader behavior to better understand how these perspectives influence and shape employee work experiences. Creating empowering work environments in today’s workplace is an ongoing challenge for leaders and managers. Research has shown that leaders who work to build interpersonal relationships with workplace subordinates are using emotional intelligence (EI) to lead individuals to work more effectively, and thereby increase overall job satisfaction. We employed a qualitative descriptive design using in-depth interviews to elicit and explore managers’ perceptions of their leader’s behaviors and their own sense of empowerment in the workplace. We present the findings within two major categories: perception of leader’s behavior and feelings of empowerment. This study adds to the body of evidence that demonstrates how the use of leadership skills that focus on the EI construct is necessary to build relationships and empower employees, thus creating conditions for creativity in the workplace.
Repairing Police Psychological Safety: The Role of Career Adaptability, Feedback Environment, and Goal-Self Concordance Based on the Conservation of Resources Theory
Authors: Gong Zhenxing , Yang Jie , Gilal Faheem Gul , Van Swol Lyn M. , Yin Kui
Published: May 2020

The purpose of this study is to investigate the role of career adaptability, feedback environment, and goal-self concordance in improving police psychological safety. Questionnaires with integral and regular answers were collected from 295 police officers from four provinces in China. The police officers completed a questionnaire that included items measuring goal-self concordance, supervisor feedback environment, psychological safety, and demographics. In a separate questionnaire, each supervisor rated the subordinate’s career adaptability. Career adaptability indirectly influences psychological safety through the feedback environment. Career adaptability has a greater influence on improving psychological safety for police officers with lower goal-self concordance than for individuals with higher goal-self concordance. Police officers with lower goal-self concordance must care about their future work roles, control their personal professional activities, make education and career choices based on curiosity, and be confident in their own careers to improve their psychological safety.
Which Elements Matter? Constructing Word Cards for English Vocabulary Growth
Authors: Reynolds Barry Lee , Wu Wei-Hua , Shih Ying-Chun
Published: May 2020

An English reading class of 10th graders ( N = 50) was asked to self-construct English word cards for unknown vocabulary incidentally encountered when completing textbook readings. The students were assigned this task to determine what linguistic and nonlinguistic elements they would self-select to include on the cards and whether the appearance of those particular self-selected elements affect English vocabulary growth. Learners’ second language (L2) vocabulary size was assessed before and after the investigation, and learners’ self-constructed word cards were subjected to qualitative analysis uncovering additional “elements” included on the cards that were not suggested by the classroom teacher. Among the uncovered “element” themes (i.e., Formulaic Language, Word Formation, Additional Language Features, Creativity, Misunderstanding, and Carelessness), Word Formation was found to correlate significantly with L2 vocabulary growth. A multiple regression model accounted for 15.8% of the variance in vocabulary growth of which word formation explained the most variance, yielding a medium effect. A critical discussion of findings is provided in connection with previous literature to elucidate the feasibility of incorporating word card construction into L2 classroom instruction while also providing teachers suggestions on implementing a word card construction component into their classes.
Faith Effect and Voice on Early Marriage in a Nigerian State
Authors: Amzat Jimoh
Published: May 2020

The rate of early marriage is 87% in northwest Nigeria, although it is 56% in Kaduna. One major issue is that early marriage is often rationalized as a religious norm. This study explores the role of faith leaders in advancing the cause of adolescent girls regarding the timing of marriage in Kaduna state. This qualitative study took place in three local government areas: Chikun (Mixed Christians and Muslims), Makarfi (majority Muslims), and Zangon-Kataf (majority Christians) were purposively selected to have a variety of mixed religious contexts. Using purposive sampling methods, the researcher conducted 24 focus group discussions with adolescent girls, 24 in-depth interviews with faith leaders, and 12 key informant interviews with other stakeholders. The study used a framework method for analyzing qualitative data. The study found that faith leaders play essential roles in rationalizing or discouraging early marriage through preaching and other activities. The study identifies three categories of faith leaders concerning early marriage. Some are proactive, discoursing about it. The second category is the passive faith leaders, somehow indifferent but has never preached against or in favor of early marriage. The last set consists of faith leaders promoting early marriage—who think early marriage is still beneficial. The study recommends that considering the social position of faith leaders and critical role in sanctioning marital unions, they could be considered as a vital link in efforts to curtail early marriage.
An Investigation of the Iranian EFL Learners’ Perceptions Towards the Most Common Writing Problems
Authors: Derakhshan Ali , Karimian Shirejini Roghayeh
Published: May 2020

Inasmuch as the fact that writing is a cognitively demanding task and as a step toward overcoming some of the barriers English as a Foreign Language (EFL) learners face during writing performance, this study attempted to investigate Iranian EFL learners’ perceptions toward the most common writing difficulties. To this end, 120 Iranian EFL learners from Golestan University, Iran, filled out a reliable and validated questionnaire. The results of the questionnaire and the semi-structured interviews ( N = 24) revealed that most of the participants agreed that for teaching grammar and punctuation, they should be embedded in a context and be integrated with the four skills. They also believed that teachers should use punctuation appropriately in their writings themselves and teach them to students explicitly. Besides, it was believed that through using mnemonics, students can better learn words spelling. The results of the interviews revealed grammar, spelling, punctuation, choice of words, organization, and familiarity with genres and rhetorical structures, negative transfer from Persian to English, and idiomatic expressions and collocations are the other factors that make the writing task difficult. Based on the students’ perceptions, the findings of this study can inform English language teachers to teach grammar, punctuation, and spelling by contextualizing them in an appropriate context, and they offer some practical implications for teachers, learners, material developers, and curriculum designers in this regard.
Violent Videogames, Telepresence, Presumed Influence, and Support for Taking Restrictive and Protective Actions
Authors: Liu Xudong , Lo Ven-hwei , Wei Ran
Published: May 2020

This study examines the perceived impact of violent videogames from an influence of presumed influence perspective. The role of perceived telepresence and the amount of time spent playing violent videogames in influencing people’s beliefs about the effects of such games were hypothesized and tested. Results of data collected from a random sample of 528 respondents in China showed that playing violent videogames was significantly related to perceived telepresence. Furthermore, perceived telepresence was found to be the strongest predictor of the presumed influence of violent videogames on others. Finally, the presumed influence of violent videogames was positively correlated with the intention to take actions to protect others from the harms of such games.
The Effect of Play-Based Math Activities on Different Areas of Development in Children 48 to 60 Months of Age
Authors: Taner Derman Meral , Şahin Zeteroğlu Elvan , Ergişi Birgül Arzu
Published: May 2020

There are previous studies in the literature conducted on the effect of play-based math activities on the mathematical skills, language, and cognitive development of preschool children. However, the number of studies conducted to determine the effect of play-based math activities on different areas of development in preschool children was too few. The purpose of this study is to investigate the effect of play-based math activities on different developmental areas (personal-social, fine motor, language, and gross motor development) of children 48 to 60 months of age. The pretest/posttest quasi-experimental research design with control and experimental groups was employed in this study. The research group of this study is composed of 45 children 22 of whom (10 girls and 12 boys) were in the experimental group and 23 (10 girls and 13 boys) in the control group. Denver II Developmental Screening Test was used as the data collection tool. As a result, it was determined that there was a significant difference between the subscales and pretest-posttest total scores concerning personal-social, fine motor, and language areas in the experimental group, while there was no statistically significant difference in the gross motor subscale. In addition, it was observed that there was statistically no significant difference between pretest–posttest scores concerning personal-social, fine motor, language, gross motor subscales and total scores of the control group. The result revealed that play-based math activities have a positive effect on personal-social, fine motor, language, and gross motor developments of children. Further studies can be planned to investigate the effects of play-based mathematics education integrated with different activities where children can have fun and be physically active on children’s developmental areas.
Management of nonunion of humeral medial condyle fracture: A case series and review of the literature
Authors: Su Huang-Chia , Chou Shih-Hsiang , Ho Hsin-Yi , Lu Cheng-Chang , Tien Yin-Chun , Shih Chia-Lung , Liu Zi-Miao , Shen Po-Chih , Huang Peng-Ju
Published: May 2020

Pediatric humeral medial condyle fracture (HMCF) is a rare condition and is difficult to detect, especially in young children. The management of late presentation of HMCF is challenging and lacks consensus. Herein, we reported four cases of HMCF nonunion received open reduction and internal fixation (ORIF) or supracondyle osteotomy from our institution. In addition, 12 cases of ORIF and 4 cases of osteotomy reported in the previous studies were also reviewed. The HMCF nonunion can heal after ORIF, but the indication and the optimal techniques need to be clarified. Supracondylar osteotomy alone is an effective and safe treatment option to improve the functional and cosmetic outcomes of HMCF nonunion.
Knowledge, Attitudes and Practices Regarding Oral Health and Oral Care Among Nursing Staff at a Mental Health Hospital in Taif, Saudi Arabia: A Questionnaire-based Study
Authors: Ashour Amal Adnan
Published: May 2020

Background and Aim:

Nurses are the principal oral healthcare providers for hospitalized patients. The purpose of this study was to assess the knowledge, attitudes, and practices of nurses at a mental health hospital in Saudi Arabia regarding oral health care of the hospitalized patients.

Materials and Methods:

A cross-sectional survey design was used in which 247 nursing staff completed a questionnaire that collected sociodemographic information, knowledge, and practices regarding oral health maintenance of patients and their attitudes toward oral health care of psychiatric patients. The chi-square and Kruskal-Wallis H tests were used to examine group differences.

Results:

A total of 247 (136 males and 111 females) nursing staff were involved in the survey with the mean age of 26 ± 32 years. Results showed significant gender differences in knowledge and practices, but no gender differences in attitudes. Male nurses were more likely to look at teeth and gums for signs of a healthy mouth (male = 97.8%, female = 95.5%, P = .04), used toothpaste to clean the patient’s teeth (male = 52.9%, female = 50.5%, P = .03), and believed that HIV/AIDS patients are at risk of developing oral health problems (male = 50.7%, female = 43.2%, P = .04). Nurses had more knowledge than nurse technicians regarding gum disease and dental abscesses ( P = .0001). Nursing staff with over five years of experience were more likely to agree about the need for the oral health care of hospitalized patients.

Conclusion:

The results emphasize the need for training of healthcare workers about the importance of oral health and considering oral health care as a patient’s rights rather than privilege.
Dentists’ Decision to Conduct CRA in Adult Patients in Turkey: A Questionnaire-based Survey
Authors: Akgül Sinem , Yıkılgan İhsan , Ömürlü Hüma
Published: May 2020

Aim:

The concept of minimal intervention in dentistry is one of the most important stages of the preventive dentistry, and caries risk assessment (CRA) is an application that needs to be primarily evaluated in order to perform minimal intervention approaches. This study was aimed to evaluate the awareness of CRA and whether CRA is included in daily practice by dentists in Turkey.

Materials and Methods:

This study used a questionnaire survey. A survey was prepared and sent to the dentists who were registered with the Turkish Dental Association via e-mail. A total of 790 dentists returned and 95 respondents were excluded. All the registered dentists filled and returned their survey. Descriptive and logistic regression analyses were performed (n = 695).

Results:

A total of 86.9 percent dentists who took the survey said that they performed CRA in daily practice. “Lack of time” was specified as the most important factor by the respondents who did not perform CRA in daily practice (61.5%). Current oral hygiene status (96.4%) and the presence of one or more active caries lesions (74.5%) were considered the most important risk factors for not performing CRA. Results of multiple logistic regression analysis showed that clinical experience, number of patients treated per day, and type of practice were mostly associated with whether or not performing CRA ( P = .012, .018, and .035, respectively).

Conclusions:

It can be concluded that most of the dentists are aware of the importance of conducting CRA and, with differences in the factors considered, CRA is required in their daily practice in Turkey. The concept of minimal intervention in dentistry is one of the most important stages of preventive dentistry, and CRA is an application that needs to be primarily evaluated in order to perform minimal intervention approaches.
Salivary sIgA and PRAP-1 Protein in Relation to Dental Caries: A Comparative Study
Authors: Al-ani Aseel , MacDonald Douglas A. , Ahmad Maha
Published: May 2020

Aim:

Certain individuals are more prone to dental caries than others are. Caries risk may be related in the secretion of certain defensive salivary proteins including secretory IgA (sIgA) and proline-rich acidic protein (PRAP-1). In this study, we investigated the relationship between PRAP-1 and sIgA leading to the susceptibility of development of dental caries in adults and explored the differences in the levels of sIgA and PRAP-1 between men and women.

Materials and Methods:

Unstimulated saliva samples were collected from 28 patients with high caries risk and 32 control subjects with low caries risk according to caries management by risk assessment guidelines. sIgA and PRAP-1 levels in clarified saliva samples were measured using the enzyme-linked immunosorbent assay.

Results:

According to our results, sIgA and PRAP-1 levels did not demonstrate statistically significant differences as a function of caries risk or gender, even when potential confounding variables such as age and numbers of teeth were taken into consideration. Estimates of effect size, however, revealed small- to medium-sized effects and suggest that significant results may have been found if larger sample sizes were used.

Conclusion:

The results of this study indicate that caries risk and salivary levels of sIgA and PRAP-1 do not appear to be significantly associated. Statistically significant findings could emerge if the sample size was larger.
Correction to: Obituary for Tamara Grummt
Authors: Braunbeck Thomas , Erdinger Lothar , Frimmel Fritz H. , Hollert Henner , Knasmüller Siegfried , DeMarini David M. , Plewa Michael J. , Richardson Susan D. , Triebskorn Rita , de Aragão Umbuzeiro Gisela , White Paul A.
Published: May 2020

An amendment to this paper has been published and can be accessed via the original article.
Intron and gene size expansion during nervous system evolution
Authors: McCoy Matthew J. , Fire Andrew Z.
Published: May 2020

Background

The evolutionary radiation of animals was accompanied by extensive expansion of gene and genome sizes, increased isoform diversity, and complexity of regulation.

Results

Here we show that the longest genes are enriched for expression in neuronal tissues of diverse vertebrates and of invertebrates. Additionally, we show that neuronal gene size expansion occurred predominantly through net gains in intron size, with a positional bias toward the 5′ end of each gene.

Conclusions

We find that intron and gene size expansion is a feature of many genes whose expression is enriched in nervous systems. We speculate that unique attributes of neurons may subject neuronal genes to evolutionary forces favoring net size expansion. This process could be associated with tissue-specific constraints on gene function and/or the evolution of increasingly complex gene regulation in nervous systems.
Similar responses to EQ-5D-3L by two elicitation methods: visual analogue scale and time trade-off
Authors: Wang Xiuying , Zhuo Lin , Ma Yifei , Cai Ting , Must Aviva , Xu Ling , Zhuo Lang
Published: May 2020

Background

Health-related quality of life (HRQoL) is often measured using EQ-5D-3L by the elicitation methods of visual analogue scale (VAS) and time trade-off (TTO). Although many countries have constructed both national VAS and TTO value sets, the fact that VAS and TTO value sets produces different values bewilders researchers and policymakers. The aim of this study is to explore certain conditions which could yield similar value sets using VAS and TTO.

Methods

A homogeneous sample of medical school students was selected to value 18 hypothetical health states using VAS and TTO methods. The 18 hypothetical health states were produced by orthogonal design (L18, 2*3^7). The range of rescaled values was transformed into − 1 ~ 0 ~ 1. The investigations via different methods were carried out by computer-assisted personal interviewing with a wash-time interval of 72 h. Value sets for VAS and TTO were constructed using general least square regression models. Independent variables were composed of 10 dummy variables from 5 dimensions and including or omitting both constant and N3 terms.

Results

Three hundred thirteen medical students participated. The mean age was 21.03 ± 0.44 years and 56.2% were female. The four regression models (for each method with and without constant and N3 terms) were all statistically significant (P < 0.05) with high goodness-of-fit (Adj.R2 > 0.94 and MAE < 0.033). Differences between the coefficients of the 10 dummy variables corresponding to each model were all less than 0.059. Pearson correlation coefficients between observed means and predicted values exceeded 0.981. Fitted curves of VAS and TTO largely coincided.

Conclusions

VAS and TTO can generate similar responses under certain conditions, suggesting that the two valuation methods could be equivalent intrinsically. The VAS method appears a more valid approach for valuation in the general population due to its greater simplicity and feasibility.
It takes two to tango: carers’ reflections on their participation and the participation of people with dementia in the James Lind Alliance process
Authors: Nygaard Agnete , Halvorsrud Liv , Bye Asta , Bergland Astrid
Published: May 2020

Background

Worldwide, patient and public involvement (PPI) in health research has grown steadily in recent decades. The James Lind Alliance (JLA) is one approach to PPI that brings patients, carers and clinicians together to identify priorities for future research in a Priority Setting Partnership (PSP). Our study aim was to describe the reflections of informal carers of people with dementia on the possibility of participating in the JLA’s PSP process, for both themselves and the recipients of their care. In addition, we wanted to explore barriers to and facilitators of their participation.

Methods

We conducted four focus groups with 36 carers of people with dementia. Thematic analysis was applied to analyse the data.

Results

An overarching theme emerged from the participants’ reflections: “Creating empowering teams where all voices are heard”. The overarching theme incorporates the participants’ suggestions about the importance of equivalence in power, mutual agreement with and understanding of the goals, adequate support, openness about each partner’s tasks and the bonds needed between the partners to sustain the enterprise, and expectations of positive outcomes. From the overarching theme, two main themes emerged: “Interaction of human factors, the PSP process and the environment” and “The power of position and knowledge”. The overall results indicated that carers are willing to participate in PSP processes and that they thought it important for people with dementia to participate in PSP processes as well, even if some might need extra support to do so. The carers also identified the need for research topics that influence their everyday lives, policy development and healthcare services.

Conclusions

Both carers and the people with dementia for whom they care are able to contribute to the PSP process when given sufficient support. The involvement of these groups is important for setting healthcare research agendas, developing research projects that increase awareness and knowledge about their circumstances and improving health professionals’, researchers’ and policymakers’ understanding of and insight into their unique situations.
Acute kidney injury after nephrectomy: a new nomogram to predict postoperative renal function
Authors: Xu Lingyu , Li Chenyu , Zhao Long , Zhou Bin , Luo Congjuan , Man Xiaofei , Luan Hong , Che Lin , Wang Yanfei , Xu Yan
Published: May 2020

Background

We aimed to develop a nomogram based on preprocedural features for early prediction of acute kidney injury (AKI) and to assess the prognosis in patients after radical and partial nephrectomy.

Methods

The study included a development cohort of 1111 patients who were treated between June 2012 and June 2017 and an additional validation cohort of 356 patients who were treated between July 2017 and June 2018. Stepwise regression and logistic regression analyses were used to evaluate the association between predictors and AKI. Incorporating all independent predictors, a nomogram for postoperative AKI was developed and externally validated. Patients were followed up for 5 years to assess renal function, acute kidney disease (AKD), chronic kidney disease (CKD), hospital readmission and mortality were key prognosis we focused on.

Results

After multivariate logistic regression, radical nephrectomy (odds ratio (OR) = 3.57, p < 0.001), aspirin (OR = 1.79, p = 0.008), systolic blood pressure (OR = 1.41, p = 0.004), triglyceride (OR = 1.26, p = 0.024), and alkaline phosphatase (OR = 1.75, p = 0.034) were independent risk factors for postoperative AKI, while albumin (OR = 0.72, p = 0.031) was a protective factor for postoperative AKI. Patients with a higher estimated glomerular filtration rate (eGFR) (60–90 ml/min/1.73 m2, OR = 0.41, p = 0.004; ≥ 90 ml/min/1.73 m2, OR = 0.37, p < 0.001) were less prone to AKI than those with a lower eGFR (< 15 ml/min/1.73 m2). These predictors were all included in the final nomogram. The area under the receiver operating characteristics curve for the model were 0.77 (p < 0.001) in the development cohort and 0.72 (p < 0.001) in the validation cohort. The incidence of AKD and CKD were 27.12 and 18.64% in AKI group, which were much higher than those in no AKI group (p < 0.001).

Conclusions

The nomogram had excellent predictive ability and might have significant clinical implications for the early detection of AKI in patients undergoing nephrectomy.
Perinatal outcomes of babies delivered by second-stage Caesarean section versus vacuum extraction in a resource-poor setting, Nigeria – a retrospective analysis
Authors: Eze Paul , Lawani Lucky Osaheni , Chikezie Raphael Ugochukwu , Ukaegbe Chukwuemeka Ikechi , Iyoke Chukwuemeka Anthony
Published: May 2020

Background

To evaluate the perinatal status of neonates delivered by assisted vaginal delivery (AVD) versus second-stage caesarean birth (CS).

Methods

A 5-year retrospective study was conducted in a tertiary hospital. Data was analyzed with IBM SPSS® version 25.0 statistical software using descriptive/inferential statistics.

Results

A total of 559 births met the inclusion criteria; AVD (211; 37.7%) and second-stage CS (348; 62.3%). Over 80% of the women were aged 20–34 years: 185 (87.7%) for the AVD group, and 301 (86.5%) for the second-stage CS group. More than half of the women were parous: 106 (50.2%) for the AVD group, and 184 (52.9%) for the second-stage CS group. The commonest indication for intervention in both groups is delayed second stage: 178 (84.4%) in the AVD group, and 239 (68.9%) in the second-stage CS group. There was a statistically significant difference in decision to delivery interval (DDI) between both groups: 197 (93.4%) women in the AVD group had DDI of less than 30 min and 21 women (6.0%) in the CS group had a DDI of less than 30 min (p <  0.001). During the DDI, there were 3 (1.4%) intra-uterine foetal deaths (IUFD) in the AVD and 19 (5.5%) in the CS group (p = 0.023). After adjusting for co-variates, there were statistically significant differences between the AVD and CS groups in the foetal death during DDI (p = 0.029) and perinatal deaths (p = 0.040); but no statistically significant differences in severe perinatal outcomes (p = 0.811), APGAR scores at 5th minutes (p = 0.355), and admission into the NICU (p = 0.946). After adjusting for co-variates, use of AVD was significantly associated with the level of experience of the care provider, with resident (junior) doctors less likely to opt for AVD than CS (aOR = 0.45, 95% CI: 0.29–0.70).

Conclusion

Second-stage CS when compared with AVD was not associated with improved perinatal outcomes. AVD is a practical option for reducing the rising Caesarean delivery rates without compromising the clinical status of the newborn.
Journey of vulnerability: a mixed-methods study to understand intrapartum transfers in Tanzania and Zambia
Authors: Lavender Tina , Bedwell Carol , Blaikie Kieran , Danna Valentina Actis , Sutton Chris , Kasengele Chowa Tembo , Wakasiaka Sabina , Vwalika Bellington , Laisser Rose
Published: May 2020

Background

Timely intrapartum referral between facilities is pivotal in reducing maternal/neonatal mortality and morbidity but is distressing to women, resource-intensive and likely to cause delays in care provision. We explored the complexities around referrals to gain understanding of the characteristics, experiences and outcomes of those being transferred.

Methods

We used a mixed-method parallel convergent design, in Tanzania and Zambia. Quantitative data were collected from a consecutive, retrospective case-note review (target, n = 2000); intrapartum transfers and stillbirths were the outcomes of interest. A grounded theory approach was adopted for the qualitative element; data were collected from semi-structured interviews (n = 85) with women, partners and health providers. Observations (n = 33) of transfer were also conducted. Quantitative data were analysed descriptively, followed by binary logistic regression models, with multiple imputation for missing data. Qualitative data were analysed using Strauss’s constant comparative approach.

Results

Intrapartum transfer rates were 11% (111/998; 2 unknown) in Tanzania and 37% (373/996; 1 unknown) in Zambia. Main reasons for transfer were prolonged/obstructed labour and pre-eclampsia/eclampsia. Women most likely to be transferred were from Zambia (as opposed to Tanzania), HIV positive, attended antenatal clinic < 4 times and living > 30 min away from the referral hospital. Differences were observed between countries. Of those transferred, delays in care were common and an increase in poor outcomes was observed. Qualitative findings identified three categories: social threats to successful transfer, barriers to timely intrapartum care and reparative interventions which were linked to a core category: journey of vulnerability.

Conclusion

Although intrapartum transfers are inevitable, modifiable factors exist with the potential to improve the experience and outcomes for women. Effective transfers rely on adequate resources, effective transport infrastructures, social support and appropriate decision-making. However, women’s (and families) vulnerability can be reduced by empathic communication, timely assessment and a positive birth outcome; this can improve women’s resilience and influence positive decision-making, for the index and future pregnancy.
PPFIA1 expression associates with poor response to endocrine treatment in luminal breast cancer
Authors: Alfarsi Lutfi H. , El Ansari Rokaya , Craze Madeleine L. , Masisi Brendah K. , Ellis Ian O. , Rakha Emad A. , Green Andrew R.
Published: May 2020

Background

PPFIA1 is an important regulator of cell migration and invasion, regulating focal adhesion signalling and disassembly. PPFIA1 is frequently amplified in breast cancer, and recent functional studies indicate that PPFIA1 is an important promoter of migration and invasion in breast cancer. This study aims to evaluate the utility of PPFIA1 expression in the luminal breast cancer as a prognostic marker to predict the response to endocrine therapy.

Methods

Large, well-characterised cohorts of primary luminal breast cancer patients with long-term follow-up was assessed for the clinical impact of PPFIA1 expression at the transcriptomic and proteomic levels. Prognostic significance of PPFIA1 and its relationship with clinical outcome and benefit of endocrine therapy were analysed. In addition, its association with other related-genes was analysed.

Results

There was significant association between PPFIA1 expression and a member of the liprin family that involves in cell invasion (PPFIBPI), and the cell cycle regulator (CCND1), whereas a negative association was observed with the tumour suppressor gene (CD82). Patients with high PPFIA1 expression were associated with high risk of recurrence, distant metastasis and death from breast cancer (P < 0.05). Importantly, high PPFIA1 expression predicted relapse in a subset of patients who were subject to endocrine treatment alone, and was an independent prognostic marker of unfavourable outcome in these patients (P < 0.05).

Conclusions

These findings support the proposed role for PPFIA1 as a regulator of cell migration in breast cancer and provides definitive evidence for the clinical utility of PPFIA1 expression in patients with luminal breast cancer. Most importantly, our data suggests that PPFIA1 might be a potential predictive marker for poor benefit from endocrine therapy.
CDX2 expression and perioperative patient serum affects the adhesion properties of cultured colon cancer cells
Authors: Davidsen Johanne , Jessen Stine Bull , Watt Sara Kehlet , Larsen Sylvester , Dahlgaard Katja , Kirkegaard Tove , Gögenur Ismail , Troelsen Jesper T.
Published: May 2020

Background

Colon cancer is one of the most commonly diagnosed types of cancer with surgical resection of the tumor being the primary choice of treatment. However, the surgical stress response induced during treatment may be related to a higher risk of recurrence. The aim of this study was to examine the effect of surgery on adhesion of cultured colon cancer cells with or without expression of the tumour suppressor CDX2.

Method

We enrolled 30 patients undergoing elective, curatively intended laparoscopic surgery for colon cancer in this study. Blood samples were drawn 1 day prior to surgery and 24 h after surgery. The samples of pre- and postoperative serum was applied to wild type colon cancer LS174T cells and CDX2 inducible LS174T cells and adhesion was measured with Real-Time Cell-Analysis iCELLigence using electrical impedance as a readout to monitor changes in the cellular adhesion.

Results

Adhesion abilities of wild type LS174T cells seeded in postoperative serum was significantly increased compared to cells seeded in preoperative serum. When seeding the CDX2 inducible LS174T cells without CDX2 expression in pre- and postoperative serum, no significant difference in adhesion was found. However, when inducing CDX2 expression in these cells, the adhesion abilities in pre- and postoperative serum resembled those of the LS174T wild type cell line.

Conclusions

We found that the adhesion of colon cancer cells was significantly increased in postoperative versus preoperative serum, and that CDX2 expression affected the adhesive ability of cancer cells. The results of this study may help to elucidate the pro-metastatic mechanisms in the perioperative phase and the role of CDX2 in colon cancer metastasis.
An epidemiological investigation of food allergy among children aged 3 to 6 in an urban area of Wenzhou, China
Authors: Dai Huan , Wang Fangmin , Wang Like , Wan Jinyi , Xiang Qiangwei , Zhang Hui , Zhao Wei , Zhang Weixi
Published: May 2020

Background

The prevalence of food allergy (FA) has increased worldwide. In China, the prevalence of FA in infants and school-aged children is well known, but the prevalence in preschool children is unknown.

Methods

A total of 4151 preschool children aged 3 to 6 years in urban Wenzhou, China, were recruited for this cross-sectional study. Their parents completed a preliminary screening questionnaire, and a detailed FA questionnaire was given to parents whose children had suspected FA according to the preliminary screening. According to the results of the detailed FA questionnaires, some children underwent a skin prick test (SPT) and specific IgE (sIgE) measurement. Children with abnormal SPT and/or sIgE results who did not meet the diagnostic criteria and those with negative SPT and sIgE results whose histories strongly supported FA underwent an oral food challenge (OFC).

Results

Of the 4151 children’s parents who completed the surveys, 534 (12.86%) indicated a positive medical history of FA. Among the 40 children who underwent an OFC, 24 were positive. According to SPT and sIgE measurements, 11 children were diagnosed with FA. The prevalence of FA was at least 0.84%; children who dropped out during the study were considered FA-negative. Among the 35 children with FA, the most common allergic manifestation was skin symptoms. The most common allergic foods were egg, fish and shrimp.

Conclusions

The parent-reported rate of FA in preschool children in urban Wenzhou was 12.86%. The prevalence of FA was at least 0.84%. Among all cases, the most common allergic food was eggs, and the most common allergic manifestation was skin symptoms.

Trial registration

NCT03974555, registered on 30 May 2019 (www.clinicaltrials.gov).
Gaps and challenges: WHO treatment recommendations for tobacco cessation and management of substance use disorders in people with severe mental illness
Authors: Das-Munshi Jayati , Semrau Maya , Barbui Corrado , Chowdhary Neerja , Gronholm Petra C. , Kolappa Kavitha , Krupchanka Dzmitry , Dua Tarun , Thornicroft Graham
Published: May 2020

Background

People with severe mental disorders (SMD) experience premature mortality mostly from preventable physical causes. The World Health Organization (WHO) have recently produced guidelines on the management of physical health conditions in SMD. This paper presents the evidence which led to the recommendations for tobacco cessation and management of substance use disorders in SMD.

Methods

Scoping reviews informed 2 PICO (Population Intervention, Comparator, Outcome) questions relating to tobacco cessation and management of substance use disorders in SMD. Systematic searches led to the identification of systematic reviews with relevant evidence to address these questions. Retrieved evidence was assessed using GRADE methodology, informing the development of guidelines.

Results

One thousand four hundred thirty-four records were identified through systematic searches for SMD and tobacco cessation, of which 4 reviews were included in GRADE tables and 18 reviews in narrative synthesis. For SMD and substance use disorders, 4268 records were identified, of which 4 studies from reviews were included in GRADE tables and 16 studies in narrative synthesis.

People with SMD who use tobacco should be offered combined pharmacological (Varenicline, Bupropion or Nicotine Replacement Therapy) and non-pharmacological interventions such as tailored directive and supportive behavioural interventions. For people with SMD and substance use disorders (drug and/or alcohol), interventions should be considered in accordance with WHO mhGAP guidelines. Prescribers should note potential drug-drug interactions. Recommendation were conditional and based on low/very low certainty of evidence with a scarcity of evidence from low- and middle-income settings.

Conclusions

These guidelines mark an important step towards addressing premature mortality in people with SMD. The dearth of high-quality evidence and evidence from LMIC settings must inform the future research agenda.

Guidelines: https://www.who.int/mental_health/evidence/guidelines_physical_health_and_severe_mental_disorders/en

https://www.who.int/publications-detail/mhgap-intervention-guide%2D%2D-version-2.0
A social cost-benefit analysis of meat taxation and a fruit and vegetables subsidy for a healthy and sustainable food consumption in the Netherlands
Authors: Broeks Marlin J. , Biesbroek Sander , Over Eelco A. B. , van Gils Paul F. , Toxopeus Ido , Beukers Marja H. , Temme Elisabeth H. M.
Published: May 2020

Background

Implementation of food taxes or subsidies may promote healthier and a more sustainable diet in a society. This study estimates the effects of a tax (15% or 30%) on meat and a subsidy (10%) on fruit and vegetables (F&V) consumption in the Netherlands using a social cost-benefit analysis with a 30-year time horizon.

Methods

Calculations with the representative Dutch National Food Consumption Survey (2012–2014) served as the reference. Price elasticities were applied to calculate changes in consumption and consumer surplus. Future food consumption and health effects were estimated using the DYNAMO-HIA model and environmental impacts were estimated using Life Cycle Analysis. The time horizon of all calculations is 30 year. All effects were monetarized and discounted to 2018 euros.

Results

Over 30-years, a 15% or 30% meat tax or 10% F&V subsidy could result in reduced healthcare costs, increased quality of life, and higher productivity levels. Benefits to the environment of a meat tax are an estimated €3400 million or €6300 million in the 15% or 30% scenario respectively, whereas the increased F&V consumption could result in €100 million costs for the environment. While consumers benefit from a subsidy, a consumer surplus of €10,000 million, the tax scenarios demonstrate large experienced costs of respectively €21,000 and €41,000 million. Overall, a 15% or 30% price increase in meat could lead to a net benefit for society between €3100–7400 million or €4100–12,300 million over 30 years respectively. A 10% F&V subsidy could lead to a net benefit to society of €1800–3300 million. Sensitivity analyses did not change the main findings.

Conclusions

The studied meat taxes and F&V subsidy showed net total welfare benefits for the Dutch society over a 30-year time horizon.
Factors associated with good health among older persons who received a preventive home visit: a cross-sectional study
Authors: Nivestam Anna , Westergren Albert , Petersson Pia , Haak Maria
Published: May 2020

Background

The ageing population is increasing worldwide, and this trend is bringing challenges both for the older person and for society. In order to meet the challenges a comprehensive approach is needed involving both health promotion and risk prevention. The preventive home visit is a public health intervention used around the world with the purpose of promoting health and preventing risk among older persons. However, most preventive home visits are focused on questions asking about risks. In order to strengthen the health promotion perspective during the preventive home visits, factors associated with good health need to be identified. The aim of this study was therefore to determine which factors were associated with good self-rated health among older persons who received preventive home visit.

Methods

This was a register study with a cross-sectional design, including older persons (≥75 years old), living in their own homes, and that had received preventive home visit. Data were collected during a period of 9 months, in two municipalities in the south of Sweden. A questionnaire covered mental, physical and lifestyle factors were used at home visit. Binary logistic regression was used to analyse the data.

Results

In total, 619 older persons were included in the study; 55.4% were women, and the mean age was 80.6 years (standard deviation 2.2 years). The following items were significantly associated with good health (after adjustment for age and gender): being able to do things that make one feel valuable, having no physical problems affecting participation in social activities, not feeling sad, not having reduced energy, and not having impaired endurance.

Conclusions

The main conclusion of this study is that questions focusing on risks could be seen from a health promotion perspective and could thus be turned into assets with a positive impact on older persons’ health. Furthermore, the mental and physical factors identified in the results as associated with good health have implications for the person’s ability to feel valuable and participate in social activities. The results suggest that issues regarding both health promotion as well as risk prevention must be brought up during the preventive home visit.
Does age alone negatively predict the outcome of sacral neuromodulation? A single-centre retrospective observational study
Authors: Schönburg Sandra , Bukethal Tobias , Fornara Paolo
Published: May 2020

Background

For patients over the age of 70 years, sacral neuromodulation (SNM) is often not considered a potential therapeutic option. We therefore report on our results from performing SNM in elderly patients ≥70 years.

Methods

Between 01/09 and 12/18, a total of 95 patients with refractory overactive bladder (OAB) or chronic non-obstructive urinary retention underwent SNM testing at our department. In the overall sample, 20 patients were aged 70 years or older (21%, group B), and 75 patients were under 70 years old (79%, group A). The mean follow-up period was 50.2 ± 36.2 months. Pre-, peri- and postoperative parameters were compared between the two groups. Statistical analysis was carried out with SPSS 25.0 (p < 0.05).

Results

The mean patient age was 53 ± 16 (17–76) years. The indications for SNM testing were OAB and retention in 51 and 49% of patients, respectively. A total of 56 patients (59%) [8 patients (40%) in group B, 48 patients (64%) in group A] had more than 50% improvement in the context of the test (stage 1), such that a permanent neuromodulator (stage 2) was implanted. A total of 14 patients, all under 70 years old except for one older female, needed to undergo revision due to defects or infection. Overall, the success rate was 58.3% for OAB and 59.6% for urinary retention. The success rates and complications in our patient group were independent of age and geriatric assessment.

Conclusion

SNM can also be successfully implemented in older patients.