bluuebunny/crossref_metadata_2025 huggingface dataset:
Public–Nonprofit Collaboration in Homeless Services: Are Nonprofit-Led Networks More Effective in Winning Federal Funding?
Authors: Valero Jesus N. , Lee David , Jang Hee Soun
Published: August 2020

Does nonprofit leadership have an impact on the performance of collaborative networks? This article examines the degree to which nonprofit-led networks and other governance characteristics matter in explaining the performance of network achieving federal funding. Specifically, we hypothesize that networks led by nonprofit organizations may achieve more funding and project awards than those led by government organizations. Using data from a national survey of local homeless service networks, we find that contrary to the hypothesized expectations, networks led by nonprofits are less successful in federal funding and project award than networks led by government organizations.
The Effects of School Police Officers on Victimization, Delinquency, and Fear of Crime: Focusing on Korean Youth
Authors: Han Sungil , Connell Nadine M.
Published: August 2020

As a response to rising concerns about school violence, the Korean National Police Agency began recruiting specialized police officers, called Korean School Police Officers (KSPOs), in hopes that they would reduce in school behavioral and delinquency problems. The current study provides insight into the effects of crime prevention activities in Korean schools, using the 2014 Korean Youth Victimization Survey to advance the knowledge about the role of the KSPOs and their potential impact on delinquency reduction. Results indicate that the presence of KSPOs did not have any significant association with criminal victimization or fear of victimization. In some cases, the presence of KSPOs is associated with higher property crime by students. Implications of these findings for understanding KSPOs and their roles in preventing school crime and improving school environments are discussed. In addition, we discuss how lessons learned from the U.S. may influence future advancements in KSPO approaches and vice versa.
A First (and Disturbing) Look at the Relationship Between the Opioid Epidemic and Elder Abuse: Insights of Human Service Professionals
Authors: Roberto Karen A. , Teaster Pamela B. , Lindberg Brian W. , Blancato Robert
Published: August 2020

This study explored the relationship between the opioid epidemic and elder abuse. Twenty professionals from four states with working knowledge of elder abuse cases participated in focus groups. Thematic analysis revealed four themes characterizing the relationship between opioid misuse and elder abuse: (a) Opioid-Related Elder Abuse i s an Escalating Problem; (b) Vulnerable Older Adults a re Prisoners in Their Own Home; (c) Health Care Professionals Perpetrate Opioid-Related Elder Abuse; and (d) Older Adults Abuse and Deal Opiates. In addition, all participants noted the lack of reliable, retrievable data to address cases of elder abuse when opioids are involved. Findings lay the groundwork for further research to understand the breadth and depth of the opioid-elder abuse relationship that can ultimately be used to develop prevention and intervention strategies and policies to address this hidden but widespread concern.
Can a Nursing Home Psychotropic Reduction Project be Successfully Implemented in Assisted Living?
Authors: Abrahamson Kathleen , Davila Heather , Kirk Laura , Garavito German Alarcon , Mueller Christine
Published: August 2020

The objective of this study was to compare implementation of a psychotropic medication reduction project across two types of residential long-term care settings: nursing homes (NH) and assisted living (AL) facilities. Fifteen NHs and 14 AL facilities from within a single corporate chain participated in the psychotropic medication reduction project. Using a comparative case study approach, we conducted in-person and telephone interviews with 62 staff members from participating NH and AL facilities to investigate the experience of project implementation. Project implementation within the more institutional NH model produced dramatic changes in residents’ lives and medication use. Conversely, changes made in the AL environment appeared to have less impact on resident medication use and resident-centric narratives, and AL staff identified numerous barriers to implementation. Identifying methods to monitor processes and outcomes of care without increasing the regulatory burden of AL facilities may increase transferability of quality improvement efforts across settings.
“Almost Equal”: Confronting Norms and Normality in Experiencing Visual Disability
Authors: Porkertová Hana
Published: August 2020

This article examines the everyday experience of visually disabled people with norms and normality and confronts it with three approaches discussed in disability studies: (i) the medical model, (ii) the social model, and (iii) critical disability studies. The most available model to the people in the study, as well as the most widespread approach in Czech society, is the medical model. However, the text shows that although other approaches are rather marginal, their logic is present in the everyday experience of the communication partners in the research. They can espouse the rigid, medical model, while, at the same time, confronting the construction of norms that both the social model and critical disability studies defy. This finding reveals both the normative and subversive character of disability, manifested in visually impaired experience.
Identification of Functional, Social, and Health Needs of Older Residents in Nonurban Settings: A Community Risk Assessment
Authors: Weaver Raven H. , Burley Mason
Published: August 2020

Objectives: We examined functional, social, and health needs and service delivery gaps among a geographically expansive and economically diverse population of older adults to identify service priorities. Methods: We conducted analyses based on 1280 respondents aged 60 years and older surveyed for an 8-county needs assessment. Results: We identified three distinct risk profiles using two-step cluster analysis. ANOVA and chi-square analyses revealed significant differences between risk profiles on a range of health and social service needs. Discussion: Identifying high-risk residents can support community providers’ efforts to help older adults age in place. Community-based organizations are well-positioned to respond early to social determinants of health needs. Targeting services and supports that reduce risk, extend independence, and prevent avoidable adverse healthcare situations to improve health and achieve health equity among historically underserved and hard-to-reach populations and prioritizing low-cost community interventions can reduce the need for high-cost interventions (e.g., emergency care and hospitalizations).
Experimental study of vibration characteristics of 110 kV oil-immersed transformer
Authors: Li Xiang , Mo Juan , Ma Yuchao , Lu Ling
Published: August 2020

As the voltage level and capacity of power transformer continue to rise, this results in its increasingly prominent vibration and noise problems. In this article, we study the vibration characteristics of the 110-kV oil-immersed transformer by means of experiments. Under different no-load voltages and short-circuit currents, the vibration signals in different positions and directions of the transformer are monitored respectively, and the vibration laws are analyzed. First, the vibration law of transformers is closely related to the operating conditions of transformers, which directly affects the frequency components of transformer vibration and the amplitude corresponding to different frequencies; second, it is found that the vibration law of transformers facing different directions will change under different operating conditions; and third, it summarizes the vibration of transformers in different positions under different operating conditions. These results can not only be used as the experimental basis for the theoretical research on large-scale transformer noise but also provides experimental support for the research on vibration reduction and noise reduction methods of large-scale transformer in engineering.
The Depression Prevention Initiative: Trauma as a Moderator of Prevention Outcomes
Authors: Sbrilli Marissa D. , Jones Jason D. , Kanine Rebecca M. , Gallop Robert , Young Jami F.
Published: August 2020

Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) is an evidence-based indicated depression prevention program that has been shown to reduce depression symptoms. Research is needed to identify moderators of IPT-AST’s effects. Although trauma history has emerged as a moderator of depression treatment outcomes, the impact of trauma on short- and long-term outcomes in the context of preventive interventions for adolescent depression is unknown. This study examines the impact of trauma on prevention outcomes in a school-based randomized controlled trial (RCT) in which 186 adolescents (mean age = 14.01 years, SD = 1.22; 67% female) were randomly assigned to IPT-AST delivered by research staff or to group counseling (GC) provided by school counselors. Trauma history significantly moderated intervention outcomes during the active phase of the intervention but not during long-term follow-up. During the active phase, youth in IPT-AST with low or no trauma exposure experienced significantly greater reductions in depression symptoms than youth in GC with low or no trauma exposure, but there were no significant differences in rates of change between the two interventions for youth with high or any trauma exposure. These findings highlight the importance of assessing trauma and investigating whether these interventions can be tailored or supplemented to enhance the effects for youth with trauma exposure.
Medical Cannabis and Psychiatric Disorders: Implications for Psychiatric Nurses
Authors: Groh Carla J.
Published: August 2020

Objective:

Cannabis use for medical condition has significantly increased over the past 20 years with 33 states and the District of Columbia passing laws legalizing medical cannabis. Five qualifying psychiatric disorders have been identified. The objective of this review article is to present a brief history of medical cannabis, the evidence for the qualifying psychiatric conditions, and to discuss the implications for psychiatric nurses.

Method:

A review of the literature on the five qualifying psychiatric disorders was conducted. Databases searched included CINAHL, PubMed, Cochrane Library, MedLine Plus, and EMBASE. Keywords were cannabis, medical cannabis, delta-9-tetrahydrocannabinaol, cannabidiol, and psychiatric disorders.

Results:

The evidence that medical cannabis or cannabinoids is an effective treatment for the qualifying psychiatric disorders (e.g., posttraumatic stress disorder, agitation in Alzheimer’s disease and other dementias, Tourette’s syndrome, anxiety, and obsessive-compulsive disorder) is too weak and of low quality to recommend as an intervention at this time. A discussion of the implications of these findings for psychiatric nurses is offered based on the published guidelines by the American Nurses Association and National Council of State Boards of Nursing.

Conclusion:

There is a significant gap between evidence supporting the effectiveness of medical cannabis for psychiatric disorders and patient interest and use of cannabis for such conditions as well as other psychiatric symptoms. There are tremendous opportunities for psychiatric nurses to make an impact both clinically and be conducting research in this emerging field. We need to educate ourselves and our patients about the benefits and risks of medical cannabis and to help patients make informed decisions about their health care.
Discussion on the conformal mapping of a half-plane onto a unit disk in anisotropic elasticity and related applications
Authors: Dai Ming , Hua Jian
Published: August 2020

The conformal mapping, which transforms a half-plane into a unit disk, has been used widely in studies involving an isotropic elastic half-plane under anti-plane shear or plane deformation. However, very little attention has been paid to the possibility of utilizing this mapping in the study of an anisotropic elastic half-plane under the same deformation. In this paper, we discuss a general case of an arbitrarily located anisotropic elastic half-plane that corresponds to several affine counterparts (resulting from corresponding complex variable formalism). We show that this mapping is indeed applicable to each of the affine half-planes if and only if the key parameters in the mapping satisfy simple geometrical conditions. In addition, we introduce the application of this mapping with the corresponding geometrical conditions to the related study of anisotropic thin films under two-dimensional deformation.
Phonological working memory and non-verbal complex working memory as predictors of future English outcomes in young ELLs
Authors: White Michelle J
Published: August 2020

Aim of the study:

The aim of this longitudinal study was twofold: first, to determine whether the relationship between working memory measures and language performance in young English language learners (ELL) remains constant over the year. The second aim was to determine if performance on working memory tasks predicts future performance on language measures.

Methodology:

The participants were 27 ELLs between the ages of 5 and 6 years who were in their first year of formal schooling and attended the same mid-low socioeconomic status school in South Africa. The participants were tested three times throughout the year on tasks of working memory and an English assessment battery.

Data analysis and results:

Mixed effects models and multiple linear regression were used to address the aims of the study. The first aim of the study showed that there are significant correlations between all working memory measures and all language measures in varying strengths across the year. The second research aim further elaborated on this by showing that both phonological working memory and non-verbal complex working memory are implicated in the acquisition of syntax, semantics and pragmatics at different points throughout the year.

Implications and originality:

Language acquisition in ELLs is not a stand-alone process and working memory measures may be able to predict future language outcomes. This could indicate that working memory measures may be used as an indicator for who may need language intervention, at a time when the ELL only has limited English proficiency and limited English exposure. This research is the first of its kind to originate from Africa, with a sample from low socioeconomic, culturally and linguistically diverse circumstances who are exposed to English consistently for the first time and are tested with working memory tasks with less strong language components.
Migrant platformed subjectivity: Rethinking the mediation of transnational affective economies via digital connectivity services
Authors: Cabalquinto Earvin Charles , Wood-Bradley Guy
Published: August 2020

This article investigates how commercial and government-based sectors in the Philippines deploy emotive mechanisms to promote the importance of connectivity services in addressing the affective and transnational needs of overseas Filipinos. By combining a walkthrough method with critical discourse analysis, the study compares and contrasts the interface, operating model and mode of governance of three selected case studies in the Philippines: Western Union, LBC Express Inc. and BaLinkBayan. The findings reveal that the emotionalising techniques of connectivity services construct what we call ‘platformed migrant subjectivity’. This conception articulates migrants as economic subjects and valued clientele within the commercial infrastructures and operations of an online platform. In sum, this article takes a nuanced approach to examine how commercial and government institutions utilise online platforms in mobilising emotional, transnational and digital transactions, which may redefine a migrant’s subjectivity, mobility and citizenship in a digital era.
Transnational togetherness through Rela: Chinese queer women’s practices for maintaining ties with the homeland
Authors: Li Haili
Published: August 2020

In the context of global migration, diaspora’s use of digital media to maintain transnational connections has become a focus of intense research. By deploying the walkthrough method and semi-structured in-depth interviews, this study explores the transnational practices of Chinese queer women living in Australia for maintaining digital connections with queer women communities in China through Rela, a Chinese lesbian social app. Rela live streaming is innovatively used by Chinese queer women in Australia to maintain diverse transnational relationships, including friendships with streamers and viewers, and romantic relationships with their partners. Rela groups have also become vital spaces through which diasporic Chinese queer women connect with the Rela queer women community. Nevertheless, although the use of Rela diversifies Chinese queer women’s diasporic life and helps them gain a sense of belonging, it reduces their participation in local queer activities and limits their interactions with queer women communities in Australia.
Regimes of visibility and the affective affordances of Twitter
Authors: Geboers Marloes Annette , Van De Wiele Chad Thomas
Published: August 2020

Online social networks produce a visuality that reflects the attention economy governing this space. What is seen becomes elevated into prominence by networked publics that ‘perform’ affective expressions within platform affordances. We mapped Twitter images of refugees in two language spaces – English and Arabic. Using automated analysis and qualitative visual analysis, we found similar images circulating both spaces. However, photographs generating higher retweet counts were distinct. This highlights the impact of affective affordances of Twitter – in this case retweeting – on regimes of visibility in disparate spheres. Representations of refugees in the English language space were characterized by personalized, positive imagery, emphasizing solidarity for refugees contributing to their host country or stipulating innocence. Resonating images in the Arabic space were less personalized and depicted a more localized visuality of life in refugee camps, with an emphasis on living conditions in refugee camps and the efforts of aid organizations.
Intersectionality: A challenge for cultural studies in the 2020s
Authors: Guimarães Corrêa Laura
Published: August 2020

In this article I argue that the intersectional paradigm is a necessary tool to approach culture in the new decade, drawing mainly on the scholarship of Black feminism. I also argue that cultural studies can benefit from drawing attention to production – be it in popular culture or in academia – that comes from the margins, that is, from individuals who face interlocked oppressions and who experience life from the standpoint of an outsider-within, a familiar stranger with an oppositional gaze. Different perspectives tend to bring decentralized, broader knowledge and inventive possibilities for academic research and societal change.
Damage assessment of carbon fibre reinforced plastic using acoustic emission technique: experimental and numerical approach
Authors: Barile Claudia , Casavola Caterina , Pappalettera Giovanni , Paramsamy Kannan Vimalathithan
Published: August 2020

In this research work, the acoustic emission results obtained from testing double cantilever beam specimens with carbon fibre reinforced plastic laminates are analysed. The acoustic emission descriptors such as amplitude, frequency centroid, counts, duration and risetime are clustered using k-means++ algorithm. An unconventional and innovative way of using the acoustic emission descriptors, after the clustering, is introduced. This method can favourably be used for relating the different damage progression modes in fibre reinforced plastics. Apart from this, the cumulative acoustic energy is used for predicting the crack length of the specimens. The predicted crack length is almost identical to the actual crack length opening recorded in each specimen. Finally, analytical and finite element models are used for validating the experimental results under the mode I delamination. The finite element studies are carried out using cohesive zone modelling in Comsol Multiphysics® platform.
Self-Reported Sexual Behavioral Similarities and Differences Among Young Men Who Have Sex With Men With Childhood Sexual Abuse Histories: A Qualitative Exploratory Study
Authors: Emetu Roberta E. , Yarber William L. , Sherwood-Laughlin Catherine M. , Brandt Alexis S.
Published: August 2020

Young men who have sex with men (YMSM) have the highest burden of sexually transmitted infections (STIs), including HIV. Childhood sexual abuse (CSA) is a risk factor for high-risk sexual behavior and STI acquisition. Studies that have explored sexual behavior based on the type of reported sexual abuse are limited. This study aimed to further understand current sexual behaviors and perceptions among YMSM that have experienced different types of CSA. Sixteen YMSM who were survivors of CSA were interviewed utilizing a phenomenological conceptual framework and methodology. Thematic findings were divided into two parts. Part I gave an overview of the entire sample, and themes were as follows: unprotected oral sex used to evaluate penile abnormalities, trust promoting unprotected sex, and alcohol and other drugs not cited as the reason for casual sex. Part II demonstrated the differences among those with a history of CSA involving non-penile–anal intercourse and those with a history of CSA involving penile–anal intercourse. The major themes in Part II were that victims of CSA involving penile–anal intercourse reported the following: a hypersexual self-definition, an STI diagnosis and noncondom use history, and a third sexual partner during sexual activity. Based on the findings, early life experiences such as CSA should be considered when developing preventative sexual health strategies and individuals who experienced penetrative sexual abuse may have different needs which should be further explored.
“You Can’t Ignore the Rat”: Nonhuman Animals in Boundary Work
Authors: McCumber Andrew
Published: August 2020

This article demonstrates how human–animal interactions are uniquely important to the negotiation of group identity and its boundaries. I use ethnographic, interview, and archival historical data to examine Alberta, Canada’s province-wide rat control program and its decades-old claim to ‘rat-free’ status. Using an approach to culture as systems of shared meaning, I investigate the significance of this institutional rat control effort and why being ‘rat-free’ is a meaningful distinction in Alberta. I argue that this rat control program is one element of an overarching project of border policing and ‘boundary work’ that continually works to define the limits of Albertan collective identity. Rat control contributes to this project both by clarifying the actual geographic borders of the province and by narratively constructing a notion of Albertan identity. This analysis provides useful and widely applicable insight into the unique capacity of animals to participate in boundary work, owing to their dual identities as cultural objects and elements of the biophysical landscape, which makes them instrumental in negotiating both spatial and symbolic boundaries.
Association between metal cobalt exposure and the risk of congenital heart defect occurrence in offspring: a multi-hospital case-control study
Authors: Zhang Nannan , Yang Shuihua , Yang Jiaxiang , Deng Ying , Li Shengli , Li Nana , Chen Xinlin , Yu Ping , Liu Zhen , Zhu Jun
Published: August 2020

Background

Many studies have investigated heavy metal exposure could increase the occurrence of congenital heart defects (CHDs). However, there are limited data regarding the relationship between cobalt exposure and CHD occurrence in offspring. The aim of this study was to analyze the association between cobalt exposure in mothers and the risk of CHDs in offspring.

Materials and methods

In order to explore the association between cobalt exposure and occurrence of congenital heart defect (CHD), a case-control study with 490 controls and 399 cases with CHDs in China were developed. The concentrations of cobalt in hair of pregnant woman and fetal placental tissue were measured and processed by a logistic regression analysis to explore the relationship between cobalt exposure and risk of CHDs.

Results

The median concentration of hair cobalt in the control and case group was 0.023 ng/mg and 0.033 ng/mg (aOR, 1.837; 95% CI, 1.468–2.299; P < 0.001), respectively. And the median (5–95% range) fetal placental cobalt concentrations were 19.350 ng/g and 42.500 ng/g (aOR, 2.924; 95% CI, 2.211–3.868; P < 0.001) in the control and case groups, respectively. Significant differences in the middle level of cobalt in hair were found in the different CHD subtypes, including septal defects, conotruncal defects, right ventricular outflow tract obstruction, and left ventricular outflow tract obstruction (P < 0.001). Dramatically, different cobalt concentrations in fetal placental tissue were found in all subtypes of cases with CHDs (P < 0.01).

Conclusions

The finding suggested that the occurrence of CHDs may be associated with cobalt exposure.
A genome-wide analysis of copy number variation in Murciano-Granadina goats
Authors: Guan Dailu , Martínez Amparo , Castelló Anna , Landi Vincenzo , Luigi-Sierra María Gracia , Fernández-Álvarez Javier , Cabrera Betlem , Delgado Juan Vicente , Such Xavier , Jordana Jordi , Amills Marcel
Published: August 2020

Background

In this work, our aim was to generate a map of the copy number variations (CNV) segregating in a population of Murciano-Granadina goats, the most important dairy breed in Spain, and to ascertain the main biological functions of the genes that map to copy number variable regions.

Results

Using a dataset that comprised 1036 Murciano-Granadina goats genotyped with the Goat SNP50 BeadChip, we were able to detect 4617 and 7750 autosomal CNV with the PennCNV and QuantiSNP software, respectively. By applying the EnsembleCNV algorithm, these CNV were assembled into 1461 CNV regions (CNVR), of which 486 (33.3% of the total CNVR count) were consistently called by PennCNV and QuantiSNP and used in subsequent analyses. In this set of 486 CNVR, we identified 78 gain, 353 loss and 55 gain/loss events. The total length of all the CNVR (95.69 Mb) represented 3.9% of the goat autosomal genome (2466.19 Mb), whereas their size ranged from 2.0 kb to 11.1 Mb, with an average size of 196.89 kb. Functional annotation of the genes that overlapped with the CNVR revealed an enrichment of pathways related with olfactory transduction (fold-enrichment = 2.33, q-value = 1.61 × 10−10), ABC transporters (fold-enrichment = 5.27, q-value = 4.27 × 10−04) and bile secretion (fold-enrichment = 3.90, q-value = 5.70 × 10−03).

Conclusions

A previous study reported that the average number of CNVR per goat breed was ~ 20 (978 CNVR/50 breeds), which is much smaller than the number we found here (486 CNVR). We attribute this difference to the fact that the previous study included multiple caprine breeds that were represented by small to moderate numbers of individuals. Given the low frequencies of CNV (in our study, the average frequency of CNV is 1.44%), such a design would probably underestimate the levels of the diversity of CNV at the within-breed level. We also observed that functions related with sensory perception, metabolism and embryo development are overrepresented in the set of genes that overlapped with CNV, and that these loci often belong to large multigene families with tens, hundreds or thousands of paralogous members, a feature that could favor the occurrence of duplications or deletions by non-allelic homologous recombination.
Mid-Cenozoic climate change, extinction, and faunal turnover in Madagascar, and their bearing on the evolution of lemurs
Authors: Godfrey Laurie R. , Samonds Karen E. , Baldwin Justin W. , Sutherland Michael R. , Kamilar Jason M. , Allfisher Kristen L.
Published: August 2020

Background

Was there a mid-Cenozoic vertebrate extinction and recovery event in Madagascar and, if so, what are its implications for the evolution of lemurs? The near lack of an early and mid-Cenozoic fossil record on Madagascar has inhibited direct testing of any such hypotheses. We compare the terrestrial vertebrate fauna of Madagascar in the Holocene to that of early Cenozoic continental Africa to shed light on the probability of a major mid-Cenozoic lemur extinction event, followed by an “adaptive radiation” or recovery. We also use multiple analytic approaches to test competing models of lemur diversification and the null hypothesis that no unusual mid-Cenozoic extinction of lemurs occurred.

Results

Comparisons of the terrestrial vertebrate faunas of the early Cenozoic on continental Africa and Holocene on Madagascar support the inference that Madagascar suffered a major mid-Cenozoic extinction event. Evolutionary modeling offers some corroboration, although the level of support varies by phylogeny and model used. Using the lemur phylogeny and divergence dates generated by Kistler and colleagues, RPANDA and TESS offer moderate support for the occurrence of unusual extinction at or near the Eocene-Oligocene (E-O) boundary (34 Ma). TreePar, operating under the condition of obligate mass extinction, found peak diversification at 31 Ma, and low probability of survival of prior lineages. Extinction at the E-O boundary received greater support than other candidate extinctions or the null hypothesis of no major extinction. Using the lemur phylogeny and divergence dates generated by Herrera & Dàvalos, evidence for large-scale extinction diminishes and its most likely timing shifts to before 40 Ma, which fails to conform to global expectations.

Conclusions

While support for large-scale mid-Cenozoic lemur extinction on Madagascar based on phylogenetic modeling is inconclusive, the African fossil record does provide indirect support. Furthermore, a major extinction and recovery of lemuriforms during the Eocene-Oligocene transition (EOT) would coincide with other major vertebrate extinctions in North America, Europe, and Africa. It would suggest that Madagascar’s lemurs were impacted by the climate shift from “greenhouse” to “ice-house” conditions that occurred at that time. This could, in turn, help to explain some of the peculiar characteristics of the lemuriform clade.
Discussing proton pump inhibitor deprescribing: the views of Danish GPs and older patients
Authors: Thompson Wade , Nissen Malene , Haastrup Peter , Le Jette Videbæk , Lundby Carina , Nielsen Jesper Bo , Jarbøl Dorte Ejg
Published: August 2020

Background

Deprescribing of proton pump inhibitors (PPIs) can be considered in situations where the drug may no longer be necessary; however, this requires a careful discussion between patients and healthcare providers, often general practitioners (GPs). The aim of our study was to explore how GPs discuss PPI deprescribing with patients and compare that to how older patients would like to discuss this decision.

Methods

We conducted a qualitative study using semi-structured interviews with GPs (n = 11) and patients aged ≥65 years who were taking PPIs (n = 4). Analysis of interviews was based on systematic text condensation.

Results

We identified four main themes: (1) Reasons PPI deprescribing comes up, (2) Considering PPI deprescribing, (3) Discussion topics, and (4) Incorporating patient preferences into PPI deprescribing decisions. We found that PPI deprescribing often comes up during consultations for other problems or due to concern about medication burden in general. GPs discussed topics related to symptom control, such as the possibility of rebound symptoms, the need to taper PPIs, and what to do if symptoms returned. This aligned with what patients felt was important to discuss. Some GPs routinely incorporated patient preferences into decisions, whereas others did not.

Conclusion

When discussing PPI deprescribing, the GPs in our study generally focused on topics related to symptom control. There was variability in how and if patient preferences were discussed. Greater focus may be needed on developing mechanisms to elicit and incorporate patient preferences into PPI deprescribing decisions. Future research could also explore more systematic approaches to reassess ongoing PPI use in an effort to curb unnecessary long-term use of PPIs.
Education level as a predictor of survival in patients with multiple myeloma
Authors: Xu Limei , Wang Xiuju , Pan Xueyi , Wang Xiaotao , Wang Qing , Wu Bingyi , Cai Jiahui , Zhao Ying , Chen Lijuan , Li Wuping , Li Juan
Published: August 2020

Background

Disparities in multiple myeloma (MM) prognosis based on sociodemographic factors may exist. We investigated whether education level at diagnosis influenced Chinese MM patient outcomes.

Methods

We performed a multicenter retrospective analysis of data from 773 MM patients across 9 centers in China from 2006 to 2019. Sociodemographic and clinical factors at diagnosis and treatment regimens were recorded, and univariate and multivariate analyses were performed.

Results

Overall, 69.2% of patients had low education levels. Patients with low education levels differed from those with high education levels in that they were more likely to be older, and a higher proportion lived in rural areas, were unemployed, had lower annual incomes and lacked insurance. Additionally, compared to patients with high education levels, patients with low education levels had a higher proportion of international staging system (ISS) stage III classification and elevated lactate dehydrogenase (LDH) levels and underwent transplantation less often. Patients with high education levels had a median progression-free survival (PFS) of 67.50 (95% confidence interval (CI): 51.66–83.39) months, which was better than that of patients with low education levels (30.60 months, 95% CI: 27.38–33.82, p < 0.001). Similarly, patients with high education levels had a median overall survival (OS) of 122.27 (95% CI: 117.05–127.49) months, which was also better than that of patients with low education levels (58.83 months, 95% CI: 48.87–62.79, p < 0.001). In the multivariable analysis, patients with high education levels had lower relapse rates and higher survival rates than did those with low education level in terms of PFS and OS (hazard ratio (HR) = 0.50 [95% CI: 0.34–0.72], p < 0.001; HR = 0.32 [0.19–0.56], p < 0.001, respectively).

Conclusions

Low education levels may independently predict poor survival in MM patients in China.
Demographic, behavioral, and cardiovascular disease risk factors in the Saudi population: results from the Prospective Urban Rural Epidemiology study (PURE-Saudi)
Authors: Alhabib Khalid F. , Batais Mohammed A. , Almigbal Turky H. , Alshamiri Mostafa Q. , Altaradi Hani , Rangarajan Sumathy , Yusuf Salim
Published: August 2020

Background

Cardiovascular disease (CVD) is the major cause of death in Saudi Arabia. We aimed to assess associated demographic, behavioral, and CVD risk factors as part of the Prospective Urban Rural Epidemiology (PURE) study.

Methods

PURE is a global cohort study of adults ages 35–70 years in 20 countries. PURE-Saudi study participants were recruited from 19 urban and 6 rural communities randomly selected from the Central province (Riyadh and Alkharj) between February 2012 and January 2015. Data were stratified by age, sex, and urban vs rural and summarized as means and standard deviations for continuous variables and as numbers and percentages for categorical variables. Proportions and means were compared between men and women, among age groups, and between urban and rural areas, using Chi-square test and t-tests, respectively.

Results

The PURE-Saudi study enrolled 2047 participants (mean age, 46.5 ± 9.12 years; 43.1% women; 24.5% rural). Overall, 69.4% had low physical activity, 49.6% obesity, 34.4% unhealthy diet, 32.1% dyslipidemia, 30.3% hypertension, and 25.1% diabetes. In addition, 12.2% were current smokers, 15.4% self-reported feeling sad, 16.9% had a history of periods of stress, 6.8% had permanent stress, 1% had a history of stroke, 0.6% had heart failure, and 2.5% had coronary heart disease (CHD). Compared to women, men were more likely to be current smokers and have diabetes and a history of CHD. Women were more likely to be obese, have central obesity, self-report sadness, experience stress, feel permanent stress, and have low education. Compared to participants in urban areas, those in rural areas had higher rates of diabetes, obesity, and hypertension, and lower rates of unhealthy diet, self-reported sadness, stress (several periods), and permanent stress. Compared to middle-aged and older individuals, younger participants more commonly reported an unhealthy diet, permanent stress, and feeling sad.

Conclusion

These results of the PURE-Saudi study revealed a high prevalence of unhealthy lifestyle and CVD risk factors in the adult Saudi population, with higher rates in rural vs urban areas. National public awareness programs and multi-faceted healthcare policy changes are urgently needed to reduce the future burden of CVD risk and mortality.
An evaluation of posterior cruciate ligament reconstruction surgery
Authors: Razi Mohammad , Ghaffari Saman , Askari Alireza , Arasteh Peyman , Ziabari Elaheh Ziaei , Dadgostar Haleh
Published: August 2020

Background

The nature of posterior cruciate ligament (PCL) injuries and the scarcity of data on this issue have made reports on clinical and epidemiological features of PCL injuries valuable. We aimed to report our experiences with PCL injuries in our region.

Methods

Any patient who referred with a diagnosis of PCL rupture from 2004 to 2018 to our center, was included in this report. We evaluated pre- and postoperative outcomes and compared patients with isolated and combined (multi-ligament) PCL injuries.

Results

Overall, 55 patients were included in our study. Majority of patients were men (87.2%). Mean age of patients was 28.12 ± 8.53 years old.

Average follow-up period was 28.83 ± 20.62 months and mean duration between trauma and surgery was 27.8 ± 38.0 months. Most common cause of PCL injury was traffic accidents (70.9%) followed by sports injuries (5.5%). Majority of patients (69.1%) had combined PCL injuries.

Majority of patients underwent single tibial-double femoral tunnel reconstruction (56.4%), followed by single tibial-single femoral tunnel (34.5%) reconstruction. Allografts were used in 60% of patient. Average Cincinnati knee rating scale (CKRC) was 35.87 ± 11.4, which improved significantly after PCL reconstruction (79.45 ± 11.90, p <  0.001). Full range of motion only existed in 29.1% of patient prior to surgery, which improved after surgery (92.7%, p <  0.001).

Three patients had postoperative arthrofibrosis and motion stiffness, 1 had deep vein thrombosis and 3 patients had infections.

Those with isolated PCL injuries had higher pre-operative CKRS (42.05 ± 8.96 vs. 33.10 ± 11.45, p = 0.006) and lower pre-operative posterior drawer test (2.76 ± 0.43 vs. 3.1 ± 0.6, p = 0.042) compared to those with combined injuries.

Conclusion

Today with advances in surgical techniques, considering treatment of collateral ligament injuries, use of stronger allografts and more secure fixation methods, better rehabilitation programs and early range of motion, results of reconstruction of the PCL has become very promising. Accordingly we recommend surgical treatment even for isolated PCL tears, with the goal to prevent functional deficit and to prevent degenerative arthritis.
Feasibility testing of a community dialogue approach for promoting the uptake of family planning and contraceptive services in Zambia
Authors: Munakampe Margarate Nzala , Nkole Theresa , Silumbwe Adam , Zulu Joseph Mumba , Cordero Joanna Paula , Steyn Petrus S.
Published: August 2020

Background

Community dialogues have been used in participatory approaches in various health prevention and awareness programs, including family planning interventions, to increase understanding and alignment of particular issues from different peoples’ perspectives. The main objective of this paper is to document the feasibility of a community dialogue approach, which aimed to promote dialogue between healthcare providers and community members. The feasibility testing was part of formative-phase research needed to design an intervention, with the ultimate goal of increasing the uptake of family planning and contraception. The community dialogue intervention generated discussions on key approaches to improve family planning and contraception provision and uptake.

Methods

Key stages of the community dialogue were undertaken, with representation from healthcare providers and community members. Participants included frontline and managerial health care providers, community health workers, family planning and contraception users, the youth, other stakeholders from the education sector, and civil society. How the dialogue was implemented (operational feasibility) as well as the cultural feasibility of the community dialogue content was evaluated through participant observations during the dialogue, using a standardised feasibility testing tick-list, and through focus group discussions with the stakeholders who participated in the community dialogue.

Results

Overall, 21 of the 30 invited participants attended the meeting- 70% attendance. The approach facilitated discussions on how quality care could be achieved in family planning and contraception provision, guided by the ground rules that were agreed upon by the different stakeholders. A need for more time for the discussion was noted. Participants also noted the need for more balanced representation from adolescents as well as other family planning stakeholders, such as community members, especially in comparison to healthcare providers. Some participants were not comfortable with the language used. Young people felt older participants used complicated terminologies while community members felt the health care providers outnumbered them, in terms of representation.

Conclusion

Generally, the community dialogue was well received by the community members and the healthcare providers, as was observed from the sentiments expressed by both categories. Some key considerations for refining the approach included soliciting maximum participation from otherwise marginalized groups like the youth would provide stronger representation.
Identification of Newcastle disease virus subgenotype VII.2 in wild birds in Turkey
Authors: Turan Nuri , Ozsemir Cemal , Yilmaz Aysun , Cizmecigil Utku Y. , Aydin Ozge , Bamac Ozge Erdogan , Gurel Aydin , Kutukcu Ahmet , Ozsemir Kubra , Tali H. Emre , Tali Besim H. , Yilmaz Semaha G. , Yaramanoglu Mehmetcan , Tekelioğlu B. Kaan , Ozsoy Serhat , Richt Juergen A. , Iqbal Munir , Yilmaz Huseyin
Published: August 2020

Background

Newcastle disease viruses (NDVs) can spread across continents via migratory birds. Hence, we investigated the frequency of NDV in both non-migratory and birds migrating on the Black Sea-Mediterranean flyway, in Istanbul, Turkey. Birds were trapped using nets placed around the Kucukcekmece lake Avcilar, Istanbul, in spring seasons of 2016 and 2018. In total, 297 birds belonging to 42 different species were trapped, categorized according to species and sex, and flocked oropharyngeal swabs were collected. In addition, flocked swabs were also collected from 115 mallards caught by hunters around Edirne and from 207 birds which had been treated in the Veterinary Faculty of Istanbul university-Cerrahpasa. Tissue samples were taken from dead wild birds brought by public to Veterinary Faculty. A total of 619 flocked oropharyngeal swabs were pooled into 206 samples. RNA was extracted from swabs and tissue samples. Real-time RT-PCR prob. assay was used to detect NDV-RNA in samples.

Results

There was no amplification in real time RT-PCR in samples taken from wild birds caught by traps. However, amplification of NDV-F gene was observed in oropharyngeal swabs taken from 2 waterfowls (Common Moorhen and Mallard), and in tissue samples taken from 2 little owls and 1 common kestrel. Sequencing and phylogenetic analyses of these 5 samples for NDV-F gene showed great similarity with NDV subgenotype VII.2 viruses. Analysis also showed that there is a high similarity with the F gene sequences previously reported from Turkey in 2012 and as well as the sequences from neighbouring countries Bulgaria and Georgia and geographically close country such as Pakistan. Although the strains found in this study are closely related, there is a relatively small degree of molecular divergence within 543 bp of F gene of the Turkish NDV isolate and strains detected in Israel, Pakistan, Iran, United Arab Emirates and Belgium.

Conclusions

Our findings revealed the presence of subgenotype VII.2 of NDVs in wild birds in north west of Turkey and demonstrated some degree of molecular evolution when compared to the earlier NDV-VII.2 isolate in Turkey.
Bioinformatics analysis combined with experiments to explore potential prognostic factors for pancreatic cancer
Authors: Ke Mu-jing , Ji Lian-dong , Li Yi-xiong
Published: August 2020

Background

Pancreatic cancer is a common malignant tumor of the digestive tract. It has a high degree of malignancy and poor prognosis. Finding effective molecular markers has great significance for pancreatic cancer diagnosis and treatment. This study aimed to investigate DLGAP5 expression in pancreatic cancer and explore the possible mechanisms and clinical value of DLGAP5 in tumorigenesis and tumor development.

Methods

Differentially expressed genes were screened using the Gene Expression Omnibus (GEO) data set GSE16515. Gene Ontology (GO)-based functional analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways enrichment analysis were performed on the corresponding proteins of the above genes using the Database for Annotation, Visualization, and Integrated Discovery (DAVID). The Kaplan–Meier Plotter database was used to analyze the relationship between differentially expressed genes and pancreatic cancer prognosis. The most prognostic gene, DLGAP5, was screened out, and the Oncomine and gene expression profiling interactive analysis (GEPIA) databases were used to analyze its expression in pancreatic cancer and other cancer tissues. The Cancer Genome Atlas (TCGA) database was used to analyze the overall survival of DLGAP5. Gene set enrichment analysis (GSEA) was performed to explore its possible molecular mechanisms in pancreatic cancer. Furthermore, the biological behavior of DLGAP5 in pancreatic cancer was verified by cell function experiments.

Results

A total of 201 significant upregulated differentially expressed genes and 79 downregulated genes were selected. The biological processes with significant enrichment of differential genes included cell adhesion, apoptosis, wound healing, leukocyte migration, angiogenesis. Pathways were mainly enriched in tumor-related signaling pathways such as cancer pathways, the extracellular matrix-receptor interaction pathway, and the p53 signaling pathway. DLGAP5 was significantly expressed in pancreatic cancer, and its expression level had a significant effect on patients’ survival time and progression-free survival. GSEA results indicated that DLGAP5 had significantly enriched into signaling pathways such as the cell cycle, the p53 signaling pathway, and oocyte meiosis. The experimental results showed that when we knocked down the expression of DLGAP5 in pancreatic cancer cells, their proliferation ability was significantly inhibited, and their invasion and migration ability significantly decreased.

Conclusions

DLGAP5 can be used as a prognostic indicator for pancreatic cancer and affect the occurrence and development of pancreatic cancer.