bluuebunny/crossref_metadata_2025 huggingface dataset:
The Moral Registers of Banqueting in Contemporary China
Authors: Oxfeld Ellen
Published: March 2020

Chinese feasting encompasses everything from life-cycle celebrations to the indulgences of corrupt officials. Although woven into the commodity economy, banqueting also creates and solidifies social relationships, providing a space where different moral economies converge. This article explores the moral economies that intersect in Chinese banqueting as well as the differing moral registers people use to understand it. Proper form in banqueting is essential to being a cultured person and all banqueting gathers meaning through analogy to the commensal sharing at the heart of the family and ritual economy. Lavish official banqueting may be condemned in popular and state discourse as corrupt; yet officials may claim banqueting is necessary work that creates social connections which help their localities. Banquet inflation among ordinary people is also subject to contradictory moral evaluations. While the recent crackdown on official corruption stigmatises banquet indulgence, it may reinforce ordinary people’s desire to utilise banquets as one of their only tools to influence those with relatively more power.
Autonomous Artificial Intelligence in Diabetic Retinopathy: From Algorithm to Clinical Application
Authors: Channa Roomasa , Wolf Risa , Abramoff Michael D.
Published: March 2020

Artificial intelligence (AI)-based algorithms are rapidly entering the health care field and have the potential to improve patient care. Our article focuses on the use of autonomous AI algorithms (ie, algorithms that can make clinical decisions without human oversight) in diagnostic imaging. In this article, we have used the example of diabetic retinopathy screening to highlight some important aspects to be considered by developers, policymakers, and end users when bringing autonomous AI algorithms into clinical practice. We have divided these aspects into (1) following the principles of safety, efficacy, and equity in all phases of development and implementation of the algorithm; (2) regulatory processes involving medical records, medical liability, and patient privacy; (3) cost and billing; and (4) the role of health care providers.
Populist Attitudes and Selective Exposure to Online News: A Cross-Country Analysis Combining Web Tracking and Surveys
Authors: Stier Sebastian , Kirkizh Nora , Froio Caterina , Schroeder Ralph
Published: March 2020

Research has shown that citizens with populist attitudes evaluate the news media more negatively, and there is also suggestive evidence that they rely less on established news sources like the legacy press. However, due to data limitations, there is still no solid evidence whether populist citizens have skewed news diets in the contemporary high-choice digital media environment. In this paper, we rely on the selective exposure framework and investigate the relationship between populist attitudes and the consumption of various types of online news. To test our theoretical assumptions, we link 150 million Web site visits by 7,729 Internet users in France, Germany, Italy, Spain, the United Kingdom, and the United States to their responses in an online survey. This design allows us to measure media exposure more precisely than previous studies while linking these data to demographic attributes and political attitudes of participants. The results show that populist attitudes leave pronounced marks in people’s news diets, but the evidence is heterogeneous and highly contingent on the supply side of a country’s media system. Most importantly, citizens with populist attitudes visit less Web sites from the legacy press, while consuming more hyperpartisan news. Despite these tendencies, the Web tracking data show that populist citizens still primarily get their news from established sources. We discuss the implications of these results for the current state of public spheres in democracies.
Patient Race and Insurance Status Do Not Impact the Treatment of Simple Mandibular Fractures
Authors: Xu Thomas Q. , Wiegmann Aaron L. , Jarazcewski Taylor J. , Ritz Ethan M. , Santos Carlos A. Q. , Dorafshar Amir H.
Published: March 2020

Introduction:

Health-care disparities have been reported throughout medical literature for decades. While blatant explicit bias is not prevalent, a substantial body of research has been published suggesting that systemic biases related to sex, race, income, and insurance status likely exist. To our knowledge, no study has assessed the impact of patient race and insurance status on clinical decision-making in facial fracture repair in the United States. Thus, the objective of this project was to assess if race and insurance status impacted whether patients obtained open or closed treatment of simple mandibular fractures.

Methods:

Patients who had either open or closed treatment of mandibular fractures were extracted from the 2012 and 2013 National Inpatient Sample and analyzed. Patients who had a length of stay longer than 3 days or died during their inpatient stay were excluded. These exclusion criteria were used to control for patients with polytrauma as well as complicated fractures. Univariate analysis was undertaken to elucidate different variable associations with the type of reduction performed. All covariates were then entered into a multivariable logistic regression model to test the variables simultaneously.

Results:

Patients with simple condylar, alveolar border, and closed mandibular fractures were more likely to undergo closed reduction (CR) on univariate analysis, as were patients with female gender and a fall mechanism ( P value < .05). African Americans, Hispanics, and patients without insurance were more likely to undergo open reduction on univariate analysis ( P value < .05). Multivariate analysis demonstrated that patients with simple condylar, subcondylar, alveolar border, or closed mandibular fractures were more likely to undergo a CR, as were patients with female gender and a firearm or fall mechanism ( P < .05). However, neither race nor insurance status demonstrated a statistically significant association with closed or open reduction.

Conclusion:

Anatomic location and mechanism of injury were the variables found to be significantly associated with patients undergoing open reduction versus CR of simple mandibular fractures—not race or insurance status.
The Impact of Music and Noise-Cancellation on Sedation Requirements During Total Knee Replacement: A Randomized Controlled Trial
Authors: Tran Bryant W. , Nowrouz Maliha Y. , Dhillon Sabrina K. , Xie Katherine K. , Breslin Kathryn M. , Golladay Gregory J.
Published: March 2020

Background:

Music has emerged as a well-received medical intervention. Patients may be uncomfortable during total joint replacement, which can result in high sedation requirements. These requirements place elderly patients at risk for delirium. This study compares the effect of noise-cancellation versus music medicine on sedation requirements, pain, and opioid consumption during elective total knee replacement.

Methods:

This prospective, double-blinded, randomized clinical trial was conducted at Virginia Commonwealth University Medical Center between July 2018 and July 2019. All participants underwent primary total knee arthroplasty with a combined spinal-epidural as their primary anesthetic and received noise-cancelling, wireless headphones. Patients in the control group received the noise-cancellation feature only, while patients in the experimental group were permitted to listen to music of their choice. Patients signaled a request for sedation by squeezing a noise-making rubber hippopotamus toy. The primary outcomes included whether sedation was requested by the participant, the number of sedation demand doses requested, and the amount of propofol sedation administered during the procedure. Secondary outcomes included postoperative pain scores, total opioid consumption, and time to first opioid request.

Results:

Seventy-one percent (n = 36) of patients agreed to participate in the study. Forty-four percent of participants in the noise-cancellation group and 19% of participants in the music group requested sedation ( P = .25). The median propofol consumption was not different between groups (0 [0-6.7] µg/kg/min vs 0 [0-0] µg/kg/min, P = .101 for noise cancellation vs music, respectively). Pain scores and opioid consumption were not different between groups.

Discussion:

To date, this is the first study to use Bluetooth communication, noise-cancellation, and an Internet-based music streaming service to determine whether this technology has an impact on outcomes during major orthopedic surgery.

Conclusion:

As an isolated intervention, the benefits of music in a complex operating room environment may be overstated. However, music integration with noise-reduction technology and patient-controlled sedation may lead to a safer and more satisfying anesthetic. More research is needed to determine the nonpharmacologic interventions that will produce positive outcomes for the geriatric population.
Post-Graduation Impact of a Program Planning Service-Learning Project
Authors: Risisky Deb , Goldson Tess , DeMezzo Robert
Published: March 2020

Research has shown that service-learning can increase student-learning outcomes across various disciplines. Service-learning opportunities have been steadily increasing in college settings, especially in health-related fields. This evaluation of an undergraduate public health course at a mid-size, public university in New England sought to understand the impact of service-learning on material retention, internships, and post-graduation public health careers. A 25-item questionnaire was emailed to students who took the course between the Fall 2010 and Spring 2016 semesters with 75 completed (33.3% completion rate). More than half of the respondents noted that their participation in a service-learning project positively affected their internship experience, their first post-graduation job, and their overall career, while also helping them retain the course material after graduation. Open-ended responses provided insight to the qualitative responses. Respondents noted that in addition to having the understanding and ability to put on programs in their community, they also had more confidence in their abilities. The opportunity to practice public speaking skills as well as work collaboratively in group settings, were both noted as essential skills needed to succeed in the public health workforce. It was concluded the project had a positive impact on student’s learning and retention in planning, implementing, and evaluating an actual health promotion program as well as how they were able to use those skills in their careers.
Use of the Highly Biocompatible Au Nanocages@PEG Nanoparticles as a New Contrast Agent for In Vivo Computed Tomography Scan Imaging
Authors: Gao Yan , Kang Jian , Lei Zhen , Li Yankun , Mei Xifan , Wang Guannan
Published: March 2020

In recent years, contrast agents have been widely used in imaging technology to improve quality. Nanoparticles have better in vivo detection capability than conventional molecular scale contrast agents. In this study, a new type of Au nanocages@PEG nanoparticles (AuNC@PEGs) with a strong X-ray absorption coefficient was synthesized as a contrast agent for computed tomography (CT) scan imaging. Results showed that AuNC@PEGs had good aqueous dispensation, low cytotoxicity, and strong X-ray absorption ability. Furthermore, in vivo studies have shown that the synthesized AuNC@PEGs have an evident contrast enhancement, long circulation time in the blood, and negligible toxicity in vivo. Therefore, the synthesized functionalized AuNC@PEGs in this study have great potential for clinical application in CT scan imaging.
The Cost-Effective Preparation of Green Fluorescent Carbon Dots for Bioimaging and Enhanced Intracellular Drug Delivery
Authors: Sun Yuqing , Zheng Shaohui , Liu Long , Kong Ying , Zhang Aiwei , Xu Kai , Han Cuiping
Published: March 2020

Doxorubicin entrapped carbon dots (DOX-CDs) were prepared for bioimaging and enhanced intracellular drug delivery. The CDs were synthesized via the hydrothermal method using citrate and urea under 200 °C for 1 h. Then, DOX was successfully conjugated on the CDs via physicochemical interactions. The DOX-CDs exhibited good crystal structure, remarkable aqueous stability, excellent photoluminescence property, and a high quantum yield of 93%. The fluorescent images revealed that the DOX-CDs could be readily taken up by the cancer cells for cell labeling. Furthermore, endo-lysosomal pH-assisted DOX release behavior was observed from DOX-CDs, and the cytotoxicity of DOX-CDs was confirmed by the MTS assay against H0-8910 ovarian cancer cells. In addition, the CDs indicated bright fluorescent signal in the animal imaging test and demonstrated low toxicity after administration for 7 and 21 days. Therefore, the prepared CDs could be a promising imaging probe for biomedical imaging and intracellular drug delivery.
Evolution of PHAS loci in the young spike of Allohexaploid wheat
Authors: Zhang Rongzhi , Huang Siyuan , Li Shiming , Song Guoqi , Li Yulian , Li Wei , Li Jihu , Gao Jie , Gu Tiantian , Li Dandan , Zhang Shujuan , Li Genying
Published: March 2020

Background

PhasiRNAs (phased secondary siRNAs) play important regulatory roles in the development processes and biotic or abiotic stresses in plants. Some of phasiRNAs involve in the reproductive development in grasses, which include two categories, 21-nt (nucleotide) and 24-nt phasiRNAs. They are triggered by miR2118 and miR2275 respectively, in premeiotic and meiotic anthers of rice, maize and other grass species. Wheat (Triticum aestivum) with three closely related subgenomes (subA, subB and subD), is a model of allopolyploid in plants. Knowledge about the role of phasiRNAs in the inflorescence development of wheat is absent until now, and the evolution ofPHASloci in polyploid plants is also unavailable.

Results

Using 261 small RNA expression datasets from various tissues, a batch ofPHAS(phasiRNA precursors) loci were identified in the young spike of wheat, most of which were regulated by miR2118 and miR2275 in their target site regions. Dissection ofPHASand their trigger miRNAs among the diploid (AA and DD), tetraploid (AABB) and hexaploid (AABBDD) genomes ofTriticumindicated that distribution ofPHASloci were dominant randomly in local chromosomes, while miR2118 was dominant only in the subB genome. The diversity ofPHASloci in the three subgenomes of wheat and their progenitor genomes (AA, DD and AABB) suggested that they originated or diverged at least before the occurrence of the tetraploid AABB genome. The positive correlation between thePHASloci or the trigger miRNAs and the ploidy of genome indicated the expansion of genome was the major drive force for the increase ofPHASloci and their trigger miRNAs inTriticum. In addition, the expression profiles of thePHAStranscripts suggested they responded to abiotic stresses such as cold stress in wheat.

Conclusions

Altogether, non-coding phasiRNAs are conserved transcriptional regulators that display quick plasticity inTriticumgenome. They may be involved in reproductive development and abiotic stress in wheat. It could be referred to molecular research on male reproductive development inTriticum.
Biofilm forming properties of quinolone resistant Escherichia coli from the broiler production chain and their dynamics in mixed biofilms
Authors: Nesse Live L. , Osland Ane Mohr , Mo Solveig S. , Sekse Camilla , Slettemeås Jannice S. , Bruvoll Anna Eline E. , Urdahl Anne Margrete , Vestby Lene K.
Published: March 2020

Background

Quinolone resistant Escherichia coli (QREC) have been found in samples from Norwegian broiler chicken, despite quinolones not being administered to poultry in Norway. Biofilm production may be one factor contributing to the observed persistence in the broiler production chain. In the present study, 158 QREC strains from chicken caecal and retail meat samples were screened for biofilm production in microtiter plates, biofilm morphotype on Congo Red (CR) agar plates and phylotype by multiplex PCR. Furthermore, the dynamics in mixed biofilms with strains of different morphotypes were studied on glass slides and on CR agar plates.

Results

All strains but one produced biofilm in microtiter plates and/or on CR agar plates at room temperature. There were no differences between strains from chicken caecum and chicken retail meat in the mean amount of biofilm produced in microtiter plates. Furthermore, no differences in biofilm production were observed between phylotypes. However, significant differences in biofilm production were found between biofilm morphotypes. The morphotype RDAR (red dry and rough, which has both curli and cellulose in the matrix, was displayed by 70% of the strains. Mean biofilm production by these strains were significantly higher than by strains with the morphotypes PDAR (pink dry and rough) with only cellulose or BDAR (brown dry and rough) with only curli. Interestingly, the two latter morphotypes produced biofilms with the morphotype RDAR when grown together. None of the strains achieved significantly higher numbers of colony forming units (cfu) in mixed biofilms than in single strain biofilms on glass slides.

Conclusions

The results indicate that QREC can form biofilm reservoirs on both inert and organic surfaces in production environments, as well as on meat. This may contribute to persistence and dissemination of the strains. Strains with both curli and cellulose in the biofilm matrix were significantly better biofilm formers than strains lacking one of these components. However, strains with only one of the components could compensate for this by producing mixed biofilms with strains having the other component, and thereby most likely enhance their probabilities of persistence in the production environment.
αβ-Dehydrocurvularin isolated from the fungus Aspergillus welwitschiae effectively inhibited the behaviour and development of the root-knot nematode Meloidogyne graminicola in rice roots
Authors: Xiang Chao , Liu Ying , Liu Shi-Ming , Huang Ya-Fei , Kong Ling-An , Peng Huan , Liu Mao-Yan , Liu Jing , Peng De-Liang , Huang Wen-Kun
Published: March 2020

Background

The root-knot nematode Meloidogyne graminicola has become a serious threat to rice production as a result of the cultivation changes from transplanting to direct seeding. The nematicidal activity of Aspergillus welwitschiae have been investigated in vitro, and the disease control efficacy of the active compound has been evaluated under greenhouse and field conditions.

Results

The active compound αβ-dehydrocurvularin (αβ-DC), isolated by nematicidal assay-directed fractionation, showed significant nematicidal activity against M. graminicola, with a median lethal concentration (LC50) value of 122.2 μg mL− 1. αβ-DC effectively decreased the attraction of rice roots to nematodes and the infection of nematodes and also suppressed the development of nematodes under greenhouse conditions. Moreover, αβ-DC efficiently reduced the root gall index under field conditions.

Conclusions

To our knowledge, this is the first report to describe the nematicidal activity of αβ-DC against M. graminicola. The results obtained under greenhouse and field conditions provide a basis for developing commercial formulations from αβ-DC to control M. graminicola in the future.
The iTRAQ-based chloroplast proteomic analysis of Triticum aestivum L. leaves subjected to drought stress and 5-aminolevulinic acid alleviation reveals several proteins involved in the protection of photosynthesis
Authors: Wang Yuexia , Li Xiaoyan , Liu Nana , Wei Shimei , Wang Jianan , Qin Fujun , Suo Biao
Published: March 2020

Backgrounds

The perturbance of chloroplast proteins is a major cause of photosynthesis inhibition under drought stress. The exogenous application of 5-aminolevulinic acid (ALA) mitigates the damage caused by drought stress, protecting plant growth and development, but the regulatory mechanism behind this process remains obscure.

Results

Wheat seedlings were drought treated, and the iTRAQ-based proteomic approach was employed to assess the difference in chloroplast protein content caused by exogenous ALA. A total of 9499 peptides, which could be classified into 2442 protein groups, were identified with ≤0.01 FDR. Moreover, the contents of 87 chloroplast proteins was changed by drought stress alone compared to that of the drought-free control, while the contents of 469 was changed by exogenous ALA application under drought stress compared to that of drought stress alone. The Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis results suggested that the ALA pretreatment adjusted some biological pathways, such as metabolic pathways and pathways involved in photosynthesis and ribosomes, to enhance the drought resistance of chloroplasts. Furthermore, the drought-promoted H2O2 accumulation and O2− production in chloroplasts were alleviated by the exogenous pretreatment of ALA, while peroxidase (POD) and glutathione peroxidase (GPX) activities were upregulated, which agreed with the chloroplast proteomic data. We suggested that ALA promoted reactive oxygen species (ROS) scavenging in chloroplasts by regulating enzymatic processes.

Conclusions

Our results from chloroplast proteomics extend the understanding of the mechanisms employed by exogenous ALA to defend against drought stress in wheat.
Genome-wide analysis of RopGEF gene family to identify genes contributing to pollen tube growth in rice (Oryza sativa)
Authors: Kim Eui-Jung , Park Sung-Wook , Hong Woo-Jong , Silva Jeniffer , Liang Wanqi , Zhang Dabing , Jung Ki-Hong , Kim Yu-Jin
Published: March 2020

Background

In plants, the key roles played by RopGEF-mediated ROP signaling in diverse processes, including polar tip growth, have been identified. Despite their important roles in reproduction, a comprehensive analysis of RopGEF members has not yet been performed in rice (Oryza sativa). To determine whether RopGEF regulators are involved in rice pollen tube growth, we performed genome-wide analysis of this family in rice.

Results

Phylogenomic and meta-expression analysis of eleven RopGEFs in rice showed that four genes were preferentially expressed in mature pollen. These four genes contain the plant-specific Rop nucleotide exchanger (PRONE) domain and possible phosphorylated residues, suggesting a conserved role in polar tip growth with Arabidopsis thaliana. In subcellular localization analysis of the four RopGEFs through tobacco (Nicotiana benthamiana) infiltration, four proteins were predominantly identified in plasma membrane. Moreover, double mutants of RopGEF2/8 exhibited reduced pollen germination, causing partial male sterility. These genes possess unique cis-acting elements in their promoters compared with the other RopGEF genes.

Conclusions

In this study, four RopGEF genes were identified as pollen-specific gene in eleven members of rice, and the expression pattern, promoter analysis, and evolutionary relationship of the RopGEF family were studied compared with Arabidopsis. Our study indicated that four RopGEF genes might function during pollen germination in distinct subcellular localization. Our study could provide valuable information on the functional study of RopGEF in rice.
Transcriptome and metabolite analyses provide insights into zigzag-shaped stem formation in tea plants (Camellia sinensis)
Authors: Cao Hongli , Wang Feiquan , Lin Hongzheng , Ye Yijun , Zheng Yucheng , Li Jiamin , Hao Zhilong , Ye Naixing , Yue Chuan
Published: March 2020

Background

Shoot orientation is important for plant architecture formation, and zigzag-shaped shoots are a special trait found in many plants. Zigzag-shaped shoots have been selected and thoroughly studied in Arabidopsis; however, the regulatory mechanism underlying zigzag-shaped shoot development in other plants, especially woody plants, is largely unknown.

Results

In this study, tea plants with zigzag-shaped shoots, namely, Qiqu (QQ) and Lianyuanqiqu (LYQQ), were investigated and compared with the erect-shoot tea plant Meizhan (MZ) in an attempt to reveal the regulation of zigzag-shaped shoot formation. Tissue section observation showed that the cell arrangement and shape of zigzag-shaped stems were aberrant compared with those of normal shoots. Moreover, a total of 2175 differentially expressed genes (DEGs) were identified from the zigzag-shaped shoots of the tea plants QQ and LYQQ compared to the shoots of MZ using transcriptome sequencing, and the DEGs involved in the “Plant-pathogen interaction”, “Phenylpropanoid biosynthesis”, “Flavonoid biosynthesis” and “Linoleic acid metabolism” pathways were significantly enriched. Additionally, the DEGs associated with cell expansion, vesicular trafficking, phytohormones, and transcription factors were identified and analysed. Metabolomic analysis showed that 13 metabolites overlapped and were significantly changed in the shoots of QQ and LYQQ compared to MZ.

Conclusions

Our results suggest that zigzag-shaped shoot formation might be associated with the gravitropism response and polar auxin transport in tea plants. This study provides a valuable foundation for further understanding the regulation of plant architecture formation and for the cultivation and application of horticultural plants in the future.
Agreement of claims-based methods for identifying sepsis with clinical criteria in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort
Authors: Donnelly John P. , Dai Yuling , Colantonio Lisandro D. , Zhao Hong , Safford Monika M. , Baddley John W. , Muntner Paul , Wang Henry E.
Published: March 2020

Background

Claims-based algorithms are commonly used to identify sepsis in health services research because the laboratory features required to define clinical criteria may not be available in administrative data.

Methods

We evaluated claims-based sepsis algorithms among adults in the US aged ≥65 years with Medicare health insurance enrolled in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Suspected infections from baseline (2003–2007) through December 31, 2012 were analyzed. Two claims-based algorithms were evaluated: (1) infection plus organ dysfunction diagnoses or sepsis diagnoses (Medicare-Implicit/Explicit) and (2) Centers for Medicare and Medicaid Services Severe Sepsis/Septic Shock Measure diagnoses (Medicare-CMS). Three classifications based on clinical criteria were used as standards for comparison: (1) the sepsis-related organ failure assessment (SOFA) score (REGARDS-SOFA), (2) “quick” SOFA (REGARDS-qSOFA), and (3) Centers for Disease Control and Prevention electronic health record criteria (REGARDS-EHR).

Results

There were 2217 suspected infections among 9522 participants included in the current study. The total number of suspected infections classified as sepsis was 468 for Medicare-Implicit/Explicit, 249 for Medicare-CMS, 541 for REGARDS-SOFA, 185 for REGARDS-qSOFA, and 331 for REGARDS-EHR. The overall agreement between Medicare-Implicit/Explicit and REGARDS-SOFA, REGARDS-qSOFA, and REGARDS-EHR was 77, 79, and 81%, respectively, sensitivity was 46, 53, and 57%, and specificity was 87, 82, and 85%. Comparing Medicare-CMS and REGARDS-SOFA, REGARDS-qSOFA, and REGARDS-EHR, agreement was 77, 87, and 85%, respectively, sensitivity was 27, 41, and 36%, and specificity was 94, 92, and 93%. Events meeting the REGARDS-SOFA classification had a lower 90-day mortality rate (140.7 per 100 person-years) compared with the Medicare-CMS (296.1 per 100 person-years), REGARDS-qSOFA (238.6 per 100 person-years), Medicare-Implicit/Explicit (219.4 per 100 person-years), and REGARDS-EHR classifications (201.8 per 100 person-years).

Conclusion

Claims-based sepsis algorithms have high agreement and specificity but low sensitivity when compared with clinical criteria. Both claims-based algorithms identified a patient population with similar 90-day mortality rates as compared with classifications based on qSOFA and EHR criteria but higher mortality relative to SOFA criteria.
Knowledge and attitudes regarding elder abuse in the community, Eastern Province Saudi Arabia
Authors: Almakki Zahra E. , Alshehri Shaher Z. , Abdel Wahab Moataza M.
Published: March 2020

Background

The population of old people is increasing world-wide. Along with the increase in their population, an increase in the cases of elder abuse is expected. This study identifies the knowledge of elder abuse and attitudes towards it among the adult attendees of Al Qatif primary health care centers (PHCCs) in Saudi Arabia.

Methods

In this cross-sectional study, 430 participants at PHCCs, in Al Qatif, in the kingdom of Saudi Arabia completed a questionnaire concerning their knowledge of elder abuse and their attitudes toward the subjects of such abuse.

Results

A total of 430 subjects participated in the study. The mean age of the respondents was 35.6 years. Participants included both caregivers (n = 93) and non-caregivers (n = 337). The overwhelming majority of respondents 97% stated that it is their individual responsibility to report elder abuse and neglect if they witness any. Similarly, (91.8%) of the participants agreed that elder abuse and neglect is a criminal act and they have the responsibility to prevent such abuse and neglect. Also, (90.7%) were aware of financial abuse, and (93.5%) believed that using swear words can be considered abuse, as it is not part of their culture. The majority of them (90.5%) agreed that occasional manhandling of the older people is violence/abuse.

Conclusion

Most of the participants regarded abuse and neglect of the older people as a serious problem and considered it their responsibility to intervene when they encountered it. Further efforts are required to explore the factors associated with elder abuse to utilize that knowledge in the development of effective interventions to prevent such abuse.
Are older people putting themselves at risk when using their walking frames?
Authors: Thies Sibylle Brunhilde , Bates Alex , Costamagna Eleonora , Kenney Laurence , Granat Malcolm , Webb Jo , Howard Dave , Baker Rose , Dawes Helen
Published: March 2020

Background

Walking aids are issued to older adults to prevent falls, however, paradoxically their use has been identified as a risk factor for falling. To prevent falls, walking aids must be used in a stable manner, but it remains unknown to what extent associated clinical guidance is adhered to at home, and whether following guidance facilitates a stable walking pattern.

It was the aim of this study to investigate adherence to guidance on walking frame use, and to quantify user stability whilst using walking frames. Additionally, we explored the views of users and healthcare professionals on walking aid use, and regarding the instrumented walking frames (‘Smart Walkers’) utilized in this study.

Methods

This observational study used Smart Walkers and pressure-sensing insoles to investigate usage patterns of 17 older people in their home environment; corresponding video captured contextual information. Additionally, stability when following, or not, clinical guidance was quantified for a subset of users during walking in an Activities of Daily Living Flat and in a gait laboratory. Two focus groups (users, healthcare professionals) shared their experiences with walking aids and provided feedback on the Smart Walkers.

Results

Incorrect use was observed for 16% of single support periods and for 29% of dual support periods, and was associated with environmental constraints and a specific frame design feature. Incorrect use was associated with reduced stability. Participants and healthcare professionals perceived the Smart Walker technology positively.

Conclusions

Clinical guidance cannot easily be adhered to and self-selected strategies reduce stability, hence are placing the user at risk. Current guidance needs to be improved to address environmental constraints whilst facilitating stable walking. The research is highly relevant considering the rising number of walking aid users, their increased falls-risk, and the costs of falls.
ADL recovery trajectory after discharge and its predictors among baseline-independent older inpatients
Authors: Li Xiuyue , Zheng Tingting , Guan Yaqi , Li Hui , Zhu Kexin , Shen Lu , Yin Zhiqin
Published: March 2020

Background

Among the previous studies about the ADL recovery and its predictors, the researches and resources used to study and protect the baseline-independent older patients from being permanently ADL-dependent was few. We aimed to describe the level of activities of daily living (ADL) at discharge and ADL change within 6 months after discharge in older patients who were ADL-independent before admission but became dependent because of acute illness, and to identify the predictors of early rehabilitation,so as to provide the basis to early intervention.

Methods

Stratified cluster sampling was used to recruit 520 hospitalised older patients who were ADL-independent from departments of internal medicine at two tertiary hospitals from August 2017 to May 2018. Demographics, clinical data, and ADL status at 1, 3, and 6 months after discharge were collected. Data were analysed using descriptive statistics, Student’s t-test, Pearson’s chi-square test,Spearman’s correlation analysis, binary logistic regression analysis, and receiver operating characteristic (ROC) curve analysis.

Results

There were 403 out of 520 patients completing the 6-month follow-up, and 229 (56.8%) regained independence at 6 months after discharge. There was an overall increasing trend in ADL with time. The recovery rate was the highest within the first month after discharge, gradually declined after 1 month, and changed less obviously from 3 to 6 months after discharge (p < 0.001). ADL score at discharge (OR = 1.034,p < 0.001), age (OR = 0.269,p = 0.001), post-discharge residence (OR = 0.390,p < 0.05), and cognition status at discharge (OR = 1.685,p < 0.05) were predictors of ADL recovery. The area under the curve of the four predictors combined was 0.763 (p < 0.001).

Conclusion

Studying ADL recovery rate and its predicting indicators of the baseline independent inpatients at different time points provide a theoretical reference for the formulation of nursing plans and allocation of care resources.
Spatial distribution and determinants of an optimal ANC visit among pregnant women in Ethiopia: further analysis of 2016 Ethiopia demographic health survey
Authors: Tessema Zemenu Tadesse , Animut Yaregal
Published: March 2020

Background

Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing. Antenatal care coverage is improving in Africa since over two-thirds of pregnant women have at least one ANC contact. However, to realize the complete life-saving potential that ANC guarantees for mothers and babies, at least four visits providing essential evidence-based interventions are required.. Therefore, this study was conducted to identify determinants of an optimal ANC visit and its spatial distribution in Ethiopia.

Methods

This study is a secondary data analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS). A total of 8025 women who had a live birth in the five years preceding the survey were included in this study. STATA 14 software and ArcGIS10.7 software were used for analysis. The generalized estimating equation (GEE) model was fitted to identify factors associated with an optimal ANC visit. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between explanatory and outcome variables.

Results

This study revealed that rural residence (AOR = 0.59, 95%CI: 0.45–0.77),male partners educational status [secondary school (AOR = 1.33, 95%CI: 1.05–1.67)], distance to the health institutions [not a big problem (AOR = 1.21, 95%CI: 1.04–1.39)], community-level literacy (AOR = 1.07, 95%CI: 1.03–1.12), and community level service utilization (AOR = 2.67,95%CI:2.21–3.24) were significantly associated with optimal ANC visits. From the spatial analysis result, an Optimal ANC visit was observed in Addis Ababa, Tigray, Harari, and Dire Dawa regions whereas areas with no optimal ANC visit were Afar, Amhara, Oromia Benishangul, SNNP, and Somalia regions.

Conclusion

Living in peripheral regions of the country and in rural areas, lower educational status of male partners and distance to health institutions were prohibiting factors for an adequate number of visits. In this study, community-level literacy and community level service utilizations were were also affect womens’ ANC utilization which implies community-level interventions should be considered for improving antenatal care utilization and better health outcomes. The government should give special attention to the regions like Afar, Amhara, Oromia, Benishangul, SNNP, and Somalia which had low optimal ANC visits.
Adherence to iron-folic acid supplementation among pregnant women in Ethiopia: a systematic review and meta-analysis
Authors: Sendeku Fikadu Waltengus , Azeze Getnet Gedefaw , Fenta Selamawit Lake
Published: March 2020

Background

Despite the supplementation of iron-folic acid is the recommended strategy during the antenatal period; iron deficiency anemia is the commonest hematologic complication during pregnancy. Therefore, this systematic review and meta-analysis aimed to assess the level of adherence to iron-folic acid supplementation and its associated factors among pregnant women in Ethiopia.

Methods

Systematic review and meta-analysis guideline was followed for this study. Different online databases were used for the review: PubMed, HINARI, EMBASE, Google Scholar and African Journals Online. Different searching terms were applied based on the adapted PICO principles to achieve and access all the essential articles. The data were entered and analyzed using Microsoft Excel and Stata 11 software respectively.

Results

Fifteen studies were included in this systematic review and meta-analysis with a total of 5808 pregnant women. The overall pooled prevalence of adherence to iron-folic acid supplementation among pregnant women in Ethiopia was 41.38% (95% CI: 33.09, 49.67). Having secondary and above educational status of the women (AOR:2.68,95%CI:1.25, 5.74), having an early registration of antenatal care follow-up (≤16 weeks) (AOR:2.54,95%CI:1.99, 3.24), having anemia complication during current pregnancy (AOR:3.01,95%CI:1.88, 4.81), having good knowledge of iron-folic acid supplementation (AOR: 2.96, 95%CI:1.76, 4.99), having four times or more antenatal care follow up (AOR:3.66, 95%CI:2.81, 4.77), getting health education about benefit of iron and folic acid (AOR:2.62,95%CI:1.46,4.72), and having good knowledge about anemia (AOR:2.99,95%CI:2.32, 3.85) were associated risk factors for adherence to iron-folic acid supplementation.

Conclusion

The overall pooled prevalence adherence of IFAS among pregnant women was lower than the WHO recommendations. Educational status, early registration of ANC, anemia in the current pregnancy, good knowledge of IFAS, number of ANC visits, good knowledge of anemia and receiving health education about the benefit of IFAS were factors associated with the adherence of IFAS among pregnant women in Ethiopia. This finding is important to design strategic policies and to prevent anemia and congenital anomaly resulted from inadequate intake of iron and folic acid.
“INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes”
Authors: Fernández-Alba Juan Jesús , Soto Pazos Estefanía , Moreno Cortés Rocío , Vilar Sánchez Ángel , González Macías Carmen , Castillo Lara María , Moreno Corral Luis , Sainz Bueno José Antonio
Published: March 2020

Background

Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polyhydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to assess for fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers.

Methods

This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. The nutritional status of newborns was assessed using the ponderal index. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios.

Results

Two hundred thirty-one pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWTH21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st. (RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%).

Conclusions

In pregnant women with DMG, the ability of customized fetal growth curves to identify newborns with alterations in nutritional status appears to exceed that of INTERGROWTH21st.
Association of CYP2A6 gene deletion with cancers in Japanese elderly: an autopsy study
Authors: Abudushataer Maidina , Sato Noriko , Mieno Makiko , Sawabe Motoji , Muramatsu Masaaki , Arai Tomio
Published: March 2020

Background

CYP2A6 is an enzyme involved in oxidation of a number of environmental chemicals, including nicotine, pro-carcinogenic nitrosamines and polycyclic aromatic hydrocarbons (PAHs). The whole gene deletion of CYP2A6 (CYP2A6*4) is prevalent in East Asian population. Whether or not CYP2A6*4 associates with cancer is still controversial.

Methods

We undertook an association study to determine whether deletion of CYP2A6 gene associates with total cancer and major cancer types employing data of consecutive autopsy cases registered in the Japanese single-nucleotide polymorphisms for geriatric research (JG-SNP) database. The presence of cancer were inspected at the time of autopsy and pathologically confirmed. Genotyping for CYP2A6 wild type (W) and deletion (D) was done by allele specific RT-PCR method.

Results

Among 1373 subjects, 826 subjects (60.2%) were cancer positive and 547 subjects (39.8%) were cancer negative. The genotype frequency in the whole study group for WW, WD and DD were 65.0, 30.6 and 4.4%, respectively, which obeyed the Hardy-Weinberg equilibrium (p = 0.20). Total cancer presence, as well as major cancers including gastric, lung, colorectal, and blood cancers did not show any positive association with CYP2A6 deletion. When male and female were separately analyzed, CYP2A6 deletion associated with decreased gastric cancer risk in female (OR = 0.49, 95%CI: 0.25–0.95, p = 0.021, after adjustment for age, smoking and drinking). When smoker and non-smoker were separately analyzed, CYP2A6 deletion associated with decreased total cancer in female nonsmokers (OR = 0.67, 95%CI: 0.45–0.99, p = 0.041 after adjustment). On the other hand, CYP2A6 deletion associated increase blood cancers in smokers (OR = 2.05, 95%CI: 1.19–3.53, p = 0.01 after adjustment).

Conclusion

The CYP2A6 deletion may not grossly affect total cancer. It may associate with individual cancers in sex and smoking dependent manner. Further studies with larger sample size are warranted to confirm our results.
Risk factors for aspiration pneumonia during concurrent chemoradiotherapy or bio-radiotherapy for head and neck cancer
Authors: Shirasu Hiromichi , Yokota Tomoya , Hamauchi Satoshi , Onozawa Yusuke , Ogawa Hirofumi , Onoe Tsuyoshi , Onitsuka Tetsuro , Yurikusa Takashi , Mori Keita , Yasui Hirofumi
Published: March 2020

Background

Aspiration pneumonia is one of the most important side effects of chemoradiotherapy (CRT) and bio-radiotherapy (BRT) in patients with head and neck cancer (HNC). Aspiration pneumonia can lead to cancer-related mortality in HNC patients. However, the relationship between aspiration pneumonia occurring during CRT or BRT for HNC and treatment outcomes in HNC patients is not well characterized. In this study, we assessed the influence of aspiration pneumonia on treatment outcomes and sought to identify the clinical risk factors for aspiration pneumonia during definitive CRT and BRT in HNC patients.

Methods

We retrospectively assessed the data pertaining to patients with locally advanced HNC who received definitive CRT or BRT at the Shizuoka Cancer Center between August 2006 and December 2016.

Results

Among the 374 HNC patients who received CRT or BRT, 95 (25.4%) developed aspiration pneumonia during treatment. Aspiration pneumonia was significantly associated with therapeutic response to CRT or BRT (multivariate adjusted odds ratio for complete response, 0.52, p = 0.020) and poor overall survival (multivariate adjusted hazard ratio for overall survival, 1.58, p = 0.024). The multivariate analyses identified four independent factors for aspiration pneumonia: poor oral hygiene, high N-classification, hypoalbuminemia before treatment, and inpatient treatment.

Conclusions

Aspiration pneumonia occurring during CRT or BRT has a detrimental effect on the therapeutic response and survival of HNC patients. Careful attention should be paid to these risk factors for aspiration pneumonia in HNC patients undergoing CRT or BRT.
Optical quality after posterior chamber Phakic implantation of an intraocular Lens with a central hole (V4c implantable Collamer Lens) under different lighting conditions
Authors: He Tianrui , Zhu Yi , Zhou Jibo
Published: March 2020

Background

The current study compared optical quality before and after implantation of a posterior chamber phakic intraocular lens with a central hole [V4c implantable collamer lens (ICL)] under bright and dark lighting conditions by means of the Optical Quality Analysis System™ (OQAS; Visiometrics, Terrassa, Spain).

Methods

This prospective study involved 91 eyes of 46 consecutive high myopia patients (15 males and 31 females, average spherical equivalent − 10.50 ± 0.33D) undergoing implantation of a V4c ICL. The modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scattering index (OSI), and predicted visual acuities (PVAs; 100, 20, and 9%), under different lighting conditions, were measured before and 1 week, 1 month, and 3 months after surgery.

Results

All optical parameters showed significant improvements, at all time points, under dark condition after surgery. We observed no significant changes in PVA 9% at 1 week (mean value 0.539,P = 0.12) or 1 month after surgery (mean value 0.573,P = 0.08) under bright condition; but all other postoperative parameters improved significantly. Comparing the two lighting conditions, the OSI decreased more under dark conditions at 1 week (P = 0.02), 1 month (P = 0.004), and 3 months (P = 0.002), but there was no significant difference in any other parameter. In addition, patients were divided into super high myopia (group S, spherical equivalent greater than − 10 D) and high myopia (group H, spherical equivalent from − 6 D to − 10 D), the group S improved significantly more than group H in all parameters, under both bright and dark conditions.

Conclusions

V4c ICL implantation improved optical quality under both bright and dark lighting conditions, and had a better ability to reduce the extent of scattering in the dark. Furthermore, group S achieved greater improvement in visual quality, which should be considered by physicians before surgery.