bluuebunny/crossref_metadata_2025 huggingface dataset:
Construction and validation of a scale for assessing arteriovenous fistulas
Authors: Bulbul Elif , Enc Nuray
Published: June 2020

Aim:

This methodological study was conducted to develop a reliable instrument for the assessment of the arteriovenous fistula in patients under hemodialysis therapy. The purpose of the scale is to evaluate risk of developing arteriovenous fistula complications in patients receiving hemodialysis treatment.

Methods:

An item pool was created in accordance with data obtained from our literature review and expert opinions. Validity of the scale was evaluated using construct and content validity analyses. Cronbach’s alpha coefficient, test–retest, and split-half reliability were used to assess reliability.

Results:

The final 3-point Likert-type Arteriovenous Fistula Assessment Scale developed in this study consists of 18 items in three subdimensions: arteriovenous fistula flow, stenosis and ischemia, and needle entry site. The scale-level Content Validity Ratio was 0.90. Explanatory factor analysis revealed a three-factor structure with factor loadings of 0.622–0.800, 0.361–0.891, and 0.431–0.954, respectively, explaining 55.51% of the total variance. The Cronbach’s alpha values for the subdimensions were 0.72, 0.71, and 0.83, respectively, and 0.82 for the scale overall.

Conclusion:

The Arteriovenous Fistula Assessment Scale is a valid and reliable instrument that can be used to monitor arteriovenous fistulas in hemodialysis patients.
Datafied corporate political activity: Updating corporate advocacy for a digital era
Authors: Murray John , Flyverbom Mikkel
Published: June 2020

Digital transformations have significant consequences for organizational attempts to shape their environments. Our focus is on how corporate political activity evolves in ways that require us to pay more attention to how information gets structured in digital spaces, and on how information ecosystems operate and shape strategic communication activities in organizational settings. We outline these digital transformations, offer a focus on corporate political activity as informational and develop a typology of datafied corporate political activity techniques to illustrate how the workings of digital spaces shape political issues more concretely. This serves to highlight the necessity of extending the focus of informational corporate political activity beyond the contents of overt and direct messages to include the more covert and subtle forms of influence made possible through the strategic structuring of information itself. This also contributes to our understanding of the political significance of corporate political activity, which is less about influencing political issues by composing appealing messages and distributing them to relevant audiences, and more about influencing political issues by organizing digital information and feeding algorithms. We suggest that such datastructures and algorithmic forms of sorting will become as important as message contents, and that datafied advocacy will become a central component of corporate political activity and other organizational activities.
How do self-brand connections affect ad responses among South Korean consumers? The roles of reference groups and message construals
Authors: Kim Dong Hoo , Sung Yoon Hi , Lee So Young , Yoo Chan Yun
Published: June 2020

This research explored how self-brand connections (SBCs) influence consumers’ ad responses in South Korea where collectivistic cultures, especially in-group orientations, are highly valued. Synthesizing social identity and construal level theories, Study 1 found that individuals tended to feel proximal to the brand that is perceived to be highly consistent with their in-groups. Furthermore, individuals’ SBCs were found to mediate such a relationship between in-group orientations and psychological distance to the brand. Expanding to the advertising context, Study 2 investigated the interactive effect of SBCs and ad messages construals. The results demonstrated that ads featuring low-construal messages evoked more favorable attitudes toward and purchase intentions of brands with weak SBCs, whereas no such matching effect was found for brands with strong SBCs.
Three-dimensional multi-patch isogeometric analysis of composite laminates with a discontinuous Galerkin approach
Authors: Obohat M Amin , Tahvilian Ehsan , Yildizdag M Erden , Ergin Ahmet
Published: June 2020

In this study, a three-dimensional discontinuous Galerkin isogeometric analysis framework is presented for the analysis of composite laminates. Non-uniform rational B-splines are employed as basis functions for both geometric and computational implementations. From a practical point of view, modeling with multiple non-uniform rational B-spline patches is required in many different applications due to the complexity of computational domains. Then, a special numerical technique is necessary to couple different non-uniform rational B-spline patches to carry out the isogeometric analysis. In this study, therefore, one of the discontinuous Galerkin methods, namely, symmetric interior penalty Galerkin formulation is utilized to deal with multi-patch isogeometric analysis applications. In order to show the applicability of the proposed framework, composite laminates under sinusoidally distributed load with different stacking sequences are studied in the numerical examples. The predicted results are compared with those obtained by the three-dimensional elasticity solutions and various numerical models available in the literature.
Using Mixed Methods to Uncover Inclusive Leader Behaviors: A Promising Approach for Improving Employee and Organizational Outcomes
Authors: Brimhall Kim C. , Palinkas Lawrence
Published: June 2020

Although inclusion is a promising approach for enhancing workplace outcomes, limited studies have examined how leaders create inclusive workplaces. The purpose of this study was to investigate whether transformational leadership (TFL) fosters a climate for inclusion. Mixed methods were used to triangulate quantitative and qualitative data from participants in an urban hospital. Data revealed that some TFL characteristics were helpful in fostering inclusion, whereas other TFL characteristics were not, thereby only partially supporting TFL as an inclusive leadership approach. New insights are uncovered around more and less inclusive leader behaviors, providing a foundation for future research in building inclusive leadership theory.
Identification of Key Genes and Pathways Associated With Irradiation in Breast Cancer Tissue and Breast Cancer Cell Lines
Authors: Zhu Changchun , Ge Chang , He Junbo , Zhang Xueying , Feng Guoxing , Fan Saijun
Published: June 2020

Radiotherapy is mainly a traditional treatment for breast cancer; however, the key genes and pathways in breast cancer associated with irradiation are not clear. In this study, we aimed to explore the messenger RNA expression changes between preradiation and postradiation breast cancer. The gene expression data set (GSE59733) was downloaded from Gene Expression Omnibus database. According to |log2FC (fold change) | ≥ 1 and with false discovery rate adjusted P value <.05, differentially expressed genes (DEGs) were screened and annotated by R programming software. The protein–protein interaction (PPI) network was conducted through STRING database, and subnetworks and hub genes were extracted by plug-in in Cytoscape. A total of 82 DEGs (74 upregulated and 8 downregulated genes) were identified. These DEGs mainly enriched in an intrinsic apoptotic signaling pathway and G-protein-coupled receptor binding. What’s more, tumor necrosis factor signaling pathway and interleukin 17 signaling pathway abnormally activated in postradiation tumor samples. Two characteristic subnetworks and 3 hub genes ( FOS, CCL2, and CXCL12) were strongly distinguished in PPI network. Moreover, the expression level of the hub genes was confirmed in irradiated MCF-7 cell and SUM-159 cell using quantitative real-time polymerase chain reaction assay. These findings imply that these hub genes may play momentous function in breast cancer to irradiation.
International expansion of the Accrediting Council on Education in Journalism and Mass Communications (ACEJMC) curricular evaluation program
Authors: Blom Robin , Bowe Brian J , Davenport Lucinda
Published: June 2020

Eight journalism educational programs outside the United States are certified by the U.S.-based Accrediting Council on Education in Journalism and Mass Communications. A survey of journalism undergraduate program directors in the United States indicated that many respondents see opportunities for expanding this voluntary curriculum evaluation and endorsement as a way of spreading U.S. values, in particular to countries lacking press freedoms. However, other respondents worry about the cultural imperialism of imposing U.S. cultural norms and practices on those in other countries. And, some directors questioned the ability to apply standards equitably across all programs, in countries with different political and cultural environments. The results indicated a lack of consensus and the need for a thorough discussion about Accrediting Council on Education in Journalism and Mass Communication’s role in promoting journalism education and practice around the globe and what forms that education should take.
Combination therapy of gefitinib and miR-30a-5p may overcome acquired drug resistance through regulating the PI3K/AKT pathway in non-small cell lung cancer
Authors: Wang Fengfeng , Meng Fei , Wong Sze Chuen Cesar , Cho William C.S. , Yang Sijun , Chan Lawrence W.C.
Published: June 2020

Background:

Non-small cell lung cancer (NSCLC) patients with an epidermal growth factor receptor (EGFR) mutation often initially respond to EGFR tyrosine kinase inhibitor (EGFR-TKI) treatment but may acquire drug resistance due to multiple factors. MicroRNAs are a class of small noncoding and endogenous RNA molecules that may play a role in overcoming the resistance.

Materials and methods:

In this study, we explored and validated, through in vitro experiments and in vivo models, the ability of a combination treatment of EGFR-TKI, namely gefitinib, and a microRNA mimic, miR-30a-5p, to overcome drug resistance through regulation of the insulin-like growth factor receptor-1 (IGF1R) and hepatocyte growth factor receptor signaling pathways, which all converge on phosphatidylinositol 3 kinase (PI3K), in NSCLC. First, we examined the hypothesized mechanisms of drug resistance in H1650, H1650-acquired gefitinib-resistance (H1650GR), H1975, and H460 cell lines. Next, we investigated a potential combination treatment approach to overcome acquired drug resistance in the H1650GR cell line and an H1650GR cell implanted mouse model.

Results:

Dual inhibitors of EGFR and IGF1R significantly lowered the expression levels of phosphorylated protein kinase B (p-AKT) and phosphorylated mitogen-activated protein kinase (p-ERK) compared with the control group in all cell lines. With the ability to repress PI3K expression, miR-30a-5p mimics induced cell apoptosis, and inhibited cell invasion and migration in the treated H1650GR cell line.

Conclusion:

Gefitinib, combined with miR-30a-5p mimics, effectively suppressed the growth of H1650GR-induced tumor in xenografts. Hence, a combination therapy of gefitinib and miR-30a-5p may play a critical role in overcoming acquired resistance to EGFR-TKIs. The reviews of this paper are available via the supplemental material section.
Framing the Youth-Led Movement for Gun Violence Prevention: How News Coverage Impacts Efficacy in Generation Z, Millennials, and Gen X
Authors: Haenschen Katherine , Tedesco John C.
Published: June 2020

The American youth-led movement for gun violence prevention (YMGVP) that emerged after the 2018 shooting at Marjory Stoneman Douglas High School in Parkland, Florida, has received tremendous media attention. To assess the potential effect of this coverage on readers’ efficacy, we conduct a two-wave population-based survey experiment on members of Generation Z, the Millennial generation, and Generation X that frames the movement as a success or failure in terms of achieving its political goals. Results show that emphasis framing impacts readers’ perceptions of the movement’s likely success in line with the manipulation. Furthermore, framing the YMGVP as unsuccessful suppresses readers’ own external and collective efficacy regardless of generation. Subjects’ support for gun control moderates the effect of treatment, such that individuals low in support express a decline in internal and information efficacy when presented with the success framing. Thus, we extend the effects of news framing beyond attitudes toward the subjects of reporting to readers’ own perceptions of themselves as capable of political action.
The successful use of therapeutic plasma exchange for severe COVID-19 acute respiratory distress syndrome with multiple organ failure
Authors: Keith Philip , Day Matthew , Choe Carol , Perkins Linda , Moyer Lou , Hays Erin , French Marshall , Hewitt Kristi , Gravel Gretchen , Guffey Amanda , Scott L Keith
Published: June 2020

The COVID-19 pandemic has brought about an urgent need for effective treatment, while conserving vital resources such as intensive care unit beds and ventilators. Antivirals, convalescent plasma, and biologics have been used with mixed results. The profound “cytokine storm” induced endotheliopathy and microthrombotic disease in patients with COVID-19 may lead to acute respiratory distress syndrome, sepsis, and multi-organ failure. We present a case of SARS-COV2 pneumonia with septic shock and multi-organ failure that demonstrated significant clinical improvement after therapeutic plasma exchange. A 65-year-old female with multiple comorbidities presented with progressive dyspnea and dry cough. She was found to be COVID-19 positive with pneumonia, and developed progressive hypoxemia and shock requiring vasopressors, cardioversion, and non-invasive positive pressure ventilation. Given her worsening sepsis with multi-organ failure, she underwent therapeutic plasma exchange with rapid clinical improvement. Her case supports the theory that plasma exchange may help abate the “cytokine storm” induced endotheliopathy and microthrombosis associated with COVID-19. Further studies are needed to identify markers of this pathway and the potential role of plasma exchange in these critically ill patients.
Long-term oncological outcomes for radiofrequency ablation of small renal masses
Authors: Steen Benjamin , Curry David , Pahuja Ajay , Loan Willy , Thwaini Ali
Published: June 2020

Objective:

To describe oncology outcomes and complications with radiofrequency ablation (RFA) for T1 renal cell carcinoma in a centre with 14 years of experience.

Method:

Retrospective study of 95 consecutive patients from 2005 to 2013 who underwent RFA. Those with metastatic disease at time of treatment, incomplete follow up, proven benign pathology, genetic underlying genetic pre-disposition were excluded. 48 patients with 49 tumours met the inclusion criteria. Data was collected on demographics oncological outcomes and complications. Primary outcome measures were disease free survival and cancer specific survival at five and eight years.

Results:

Median follow up was 83 months. We demonstrate an 87% 5-year disease free survival (DFS) and 70% eight-year DFS. Mean time to progression was 45 months. Cancer specific survival was demonstrated as 97.9% at five years and 93.6% at eight years – all cancer-related deaths had an initial tumour of > 3 cm diameter. 42.9% of the recurrences occurred beyond five years The median time to progression for secondary failure was 50.7 months. One Clavien-Dindo Grade 2 complication was encountered in the series.

Outcome:

RFA produces comparable long-term oncological outcomes to other modalities for T1 tumours with a low complication rate. Follow up should be considered beyond five years as a significant proportion of the recurrences (42.9%) in this study occurred beyond this point. Level of evidence: 4
The standard for the management of male urethral strictures in the UK: a consensus document
Authors: Bugeja Simon , Payne Stephen R. , Eardley Ian , Mundy Anthony R.
Published: June 2020

Objective:

The aim of this study was to establish an evidence-based best clinical practice consensus for the management of urethral stricture disease in the UK.

Methods:

A systematic review of optimal management of urethral stricture generated a base document which was endorsed by the British Association of Urological Surgeons (BAUS) section of Andrology and Genito-Urinary Reconstructive Surgeons (AGUS). A two-round electronic mail modified Delphi survey of 43 consultant reconstructive urologists, members of the British Association of Genito-Urinary Reconstructive Surgeons (BAGURS), was then performed. The panel’s views about the base document was sought in seven domains: definition, diagnosis, investigation, conservative, endoscopic and reconstructive treatments, and follow up. Responses were collated and used to modify the base to achieve a consensus statement.

Results:

In round one of the Delphi process four panel members commented on the base document and seven in round two. Consensus was thereby reached on 38 statements regarding definition (one), diagnosis (three), investigation (two), conservative/endoscopic (five) and reconstructive (24) treatments and follow up (three) for the management of urethral stricture disease.

Conclusion:

This consensus statement will help standardise care, provide guidance on the management of urethral stricture disease, and assist in clinical decision-making for healthcare professionals of all grades.
Postsecondary Education Programs on College Campuses Supporting Adults With Intellectual and Developmental Disabilities in the Literature: A Scoping Review
Authors: Whirley Mary L. , Gilson Carly B. , Gushanas Christina M.
Published: June 2020

Postsecondary education (PSE) programs for young adults with intellectual and developmental disabilities (IDDs) have increased steadily since the passage of the Higher Education Opportunity Act. The purpose of this scoping review was to explore a decade of research pertaining to PSE programs for students with IDDs on college campuses. Online databases were examined. Hand searches were completed to identify studies released from 2008 to 2018 about PSE programs offered on college campuses. Sixty-eight studies met inclusion criteria: 43 peer-reviewed articles across 26 interdisciplinary journals and 25 dissertations across 20 universities. This review identified an increasing trend in research on PSE programs on college campuses. Suggestions for future research and implications for stakeholders were discussed.
Rapid Perceptual Learning: A Potential Source of Individual Differences in Speech Perception Under Adverse Conditions?
Authors: Rotman Tali , Lavie Limor , Banai Karen
Published: June 2020

Challenging listening situations (e.g., when speech is rapid or noisy) result in substantial individual differences in speech perception. We propose that rapid auditory perceptual learning is one of the factors contributing to those individual differences. To explore this proposal, we assessed rapid perceptual learning of time-compressed speech in young adults with normal hearing and in older adults with age-related hearing loss. We also assessed the contribution of this learning as well as that of hearing and cognition (vocabulary, working memory, and selective attention) to the recognition of natural-fast speech (NFS; both groups) and speech in noise (younger adults). In young adults, rapid learning and vocabulary were significant predictors of NFS and speech in noise recognition. In older adults, hearing thresholds, vocabulary, and rapid learning were significant predictors of NFS recognition. In both groups, models that included learning fitted the speech data better than models that did not include learning. Therefore, under adverse conditions, rapid learning may be one of the skills listeners could employ to support speech recognition.
Combination dose-escalated hydroxyurea and transfusion: an approach to conserve blood during the COVID-19 pandemic
Authors: Nickel Robert Sheppard , Margulies Stefanie , Frazer Brittany , Luban Naomi L. C. , Webb Jennifer
Published: June 2020

Nickel et al describe a single-arm trial using dose-escalated hydroxyurea and regular transfusions to prevent complications of sickle cell anemia. Preliminary results suggest that a reduction in volume of red cell requirements may be achievable.
Fulvic acid ameliorates drought stress-induced damage in tea plants by regulating the ascorbate metabolism and flavonoids biosynthesis
Authors: Sun Jianhao , Qiu Chen , Ding Yiqian , Wang Yu , Sun Litao , Fan Kai , Gai Zhongshuai , Dong Guoqiang , Wang Jiguo , Li Xinghui , Song Lubin , Ding Zhaotang
Published: June 2020

Background

Fulvic acid (FA) is a kind of plant growth regulator, which can promote plant growth, play an important role in fighting against drought, improve plant stress resistance, increase production and improve quality. However, the function of FA in tea plants during drought stress remain largely unknown.

Results

Here, we examined the effects of 0.1 g/L FA on genes and metabolites in tea plants at different periods of drought stress using transcriptomics and metabolomics profiles. Totally, 30,702 genes and 892 metabolites were identified. Compared with controlled groups, 604 and 3331 differentially expressed metabolite genes (DEGs) were found in FA-treated tea plants at 4 days and 8 days under drought stress, respectively; 54 and 125 differentially expressed metabolites (DEMs) were also found at two time points, respectively. Bioinformatics analysis showed that DEGs and DEMs participated in diverse biological processes such as ascorbate metabolism (GME, AO, ALDH and L-ascorbate), glutathione metabolism (GST, G6PDH, glutathione reduced form and CYS-GYL), and flavonoids biosynthesis (C4H, CHS, F3’5’H, F3H, kaempferol, quercetin and myricetin). Moreover, the results of co-expression analysis showed that the interactions of identified DEGs and DEMs diversely involved in ascorbate metabolism, glutathione metabolism, and flavonoids biosynthesis, indicating that FA may be involved in the regulation of these processes during drought stress.

Conclusion

The results indicated that FA enhanced the drought tolerance of tea plants by (i) enhancement of the ascorbate metabolism, (ii) improvement of the glutathione metabolism, as well as (iii) promotion of the flavonoids biosynthesis that significantly improved the antioxidant defense of tea plants during drought stress. This study not only confirmed the main strategies of FA to protect tea plants from drought stress, but also deepened the understanding of the complex molecular mechanism of FA to deal with tea plants to better avoid drought damage.
Acute encephalopathy with elevated CSF inflammatory markers as the initial presentation of COVID-19
Authors: Farhadian Shelli , Glick Laura R. , Vogels Chantal B. F. , Thomas Jared , Chiarella Jennifer , Casanovas-Massana Arnau , Zhou Jing , Odio Camila , Vijayakumar Pavithra , Geng Bertie , Fournier John , Bermejo Santos , Fauver Joseph R. , Alpert Tara , Wyllie Anne L. , Turcotte Cynthia , Steinle Matthew , Paczkowski Patrick , Dela Cruz Charles , Wilen Craig , Ko Albert I. , MacKay Sean , Grubaugh Nathan D. , Spudich Serena , Barakat Lydia Aoun
Published: June 2020

Background

COVID-19 is caused by the severe acute respiratory syndrome virus SARS-CoV-2. It is widely recognized as a respiratory pathogen, but neurologic complications can be the presenting manifestation in a subset of infected patients.

Case presentation

We describe a 78-year old immunocompromised woman who presented with altered mental status after witnessed seizure-like activity at home. She was found to have SARS-CoV-2 infection and associated neuroinflammation. In this case, we undertake the first detailed analysis of cerebrospinal fluid (CSF) cytokines during COVID-19 infection and find a unique pattern of inflammation in CSF, but no evidence of viral neuroinvasion.

Conclusion

Our findings suggest that neurologic symptoms such as encephalopathy and seizures may be the initial presentation of COVID-19. Central nervous system inflammation may associate with neurologic manifestations of disease.
Factors obstetricians, family physicians and midwives consider when counselling women about a trial of labour after caesarean and planned repeat caesarean: a qualitative descriptive study
Authors: Kurtz Landy Christine , Sword Wendy , Kathnelson Jackie Cramp , McDonald Sarah , Biringer Anne , Heaman Maureen , Angle Pam
Published: June 2020

Background

Repeat caesarean sections (CSs) are major contributors to the high rate of CS in Canada and globally. Women’s decisions to have a planned repeat CS (PRCS) or a trial of labour after CS (TOLAC) are influenced by their maternity care providers. This study explored factors maternity care providers consider when counselling pregnant women with a previous CS, eligible for a TOLAC, about delivery method.

Methods

A qualitative descriptive design was implemented. Semi-structured, one-to-one in-depth telephone interviews were conducted with 39 maternity care providers in Ontario, Canada. Participants were recruited at 2 maternity care conferences and with the use of snowball sampling. Interviews were audio recorded and transcribed verbatim. Data were uploaded into the data management software, NVIVO 10.0 and analyzed using qualitative content analysis.

Results

Participants consisted of 12 obstetricians, 13 family physicians and 14 midwives. Emergent themes, reflecting the factors maternity care providers considered when counselling on mode of delivery, were organized under the categories clinical/patient factors, health system factors and provider preferences. Maternity care providers considered clinical/patient factors, including women’s choice … with conditions, their assessment of women’s chances of a successful TOLAC, their perception of women’s risk tolerance, women’s preferred delivery method, and their perception of women’s beliefs and attitudes about childbirth. Additionally, providers considered health system factors which included colleague support for TOLAC and time needed to mount an emergency CS. Finally, provider factors emerged as considerations when counselling. They included provider preference for PRCS or TOLAC, provider scope of practice, financial incentives and convenience related to PRCS, past experiences with TOLAC and PRCS and providers’ perspectives on risk of TOLAC.

Conclusion

The findings highlight the multiplicity of factors maternity care providers consider when counselling women. Effectively addressing clinical, health care system and personal factors that influence counselling may help decrease non-medically indicated PRCS.
Improving the mental wellbeing of Arabic speaking refugees: an evaluation of a mental health promotion program
Authors: Slewa-Younan Shameran , McKenzie Molly , Thomson Russell , Smith Mitchell , Mohammad Yaser , Mond Jonathan
Published: June 2020

Background

Refugee populations have particularly high rates of mental health problems, including Posttraumatic Stress Disorder (PTSD) and depression. However, uptake of mental health care may be low even when severe depression and PTSD symptoms are present in individuals following resettlement. This is likely due, at least in part, to cultural influences on refugees’ knowledge and beliefs about mental health problems and their treatment. We sought to provide preliminary evidence for the effectiveness of a culturally tailored mental health promotion program for Arabic-speaking refugees.

Methods

A total of 33 Arabic-speaking refugees resettled in South Western Sydney were recruited and completed intervention which consisted of weekly three-hour sessions for 4 weeks delivered in Arabic. Key aspects of mental health literacy, help-seeking intentions and levels of general psychological distress were assessed, by means of a self-report survey, pre-intervention, (immediately) post-intervention and 3 months following intervention.

Results

Of the 33 participants that completed the intervention, 31 completed the immediate post-intervention survey and 29 completed the 3 months follow-up survey. Improvements in most aspects of mental health literacy assessed were found immediately post-intervention and at follow-up, although only changes relating to stigmatising attitudes were statistically significant. Additionally, a statistically significant decrease in participants’ levels of general psychological distress was observed immediately following the intervention, and this decrease was sustained at follow-up.

Conclusion

While further research employing a more rigorous study design and larger sample size will be needed, results of this initial trial suggest that a culturally tailored mental health promotion program targeting key aspects of mental health literacy can improve the mental health of Arabic-speaking refugees resettled in a Western nation.
Illness prevalence rate in Tibet, China: data from the 2018 National Health Service Survey
Authors: Deng Rendan , Labasangzhu  , Zhaxideji  , Wang Guihua , Hong Peiwei , Li Jiaqi , Li Qiwen , Wan Yang , Xiong Hai
Published: June 2020

Background

Tibet is located in the high-altitude area of Southwest China, where the health level is influenced by specific factors such as the natural environment and living habits. However, there has been little research that has focused on Tibetan health conditions. The two-week prevalence rate is an important indicator of the health level of residents. The purpose of this study was to understand the health status of the residents and the health service needs in Tibet.

Methods

The two-week prevalence rate was calculated using data from a population of 10,493 individuals aged 15 and above that was obtained from the 2018 Sixth National Health Service Survey of Tibet. We initially analysed the types and associated factors of two-week illnesses in Tibetan. The influencing factors for the two-week prevalence rate in Tibet were determined by multivariate logistic regression analysis. Subsequently, we assessed the severity of two-week illnesses by calculating the average days of the duration of the disease, the days of being bedridden and the days of being off work.

Results

The two-week illness prevalence rate was 20.1% in Tibet. Digestive system diseases were frequent, and hypertension was the most common disease. According to the multivariate logistic regression analysis, the two-week prevalence rate was associated with gender, age, residence, marital status, and employment status. In addition, the severity of two-week illnesses differed among the residents.

Conclusion

This study identified that health service needs have increased in Tibet and that the health status of the local residents needs to be improved. Moreover, hypertension has become a major health hazard for the residents and should be considered in the utilization of health services.
Coverage of tuberculosis and diabetes mellitus screening among household contacts of tuberculosis patients: a household-based cross-sectional survey from Southern Thailand
Authors: Oo Myo Minn , Tassanakijpanich Nattaporn , Phyu Moe Hnin , Safira Nanda , Kandel Shashi , Chumchuen Kemmapon , Zhang Li Mei , Kyu Hnin Aye , Sriwannawit Porraporn , Bilmumad Bintinee , Cao Li , Guo Yingwu , Sukmanee Jarawee , Cuong Vu Manh , Chongsuvivatwong Virasakdi , McNeil Edward B.
Published: June 2020

Background

The comorbid presence of tuberculosis and diabetes mellitus has become an increasingly important public health threat to the prevention and control of both diseases. Thus, household contact investigation may serve a dual purpose of screening for both tuberculosis and diabetes mellitus among household contacts. We therefore aimed to evaluate the coverage of screening for tuberculosis and diabetes mellitus among household contacts of tuberculosis index cases and to determine predictors of tuberculosis screening.

Methods

A household-based survey was conducted in February 2019 in Muang district of Phatthalung Province, Thailand where 95 index tuberculosis patients were newly diagnosed with pulmonary or pleural tuberculosis between October 2017 and September 2018. Household contacts of the index patients were interviewed using a structured questionnaire to ascertain their past-year history of tuberculosis screening and, if appropriate, diabetes mellitus screening. For children, the household head or an adult household member was interviewed as a proxy. Coverage of tuberculosis screening at the household level was regarded as households having all contacts screened for tuberculosis. Logistic regression and mixed-effects logistic regression models were used to determine predictors of tuberculosis screening at the household and individual levels, respectively, with the strengths of association presented as adjusted odds ratios (AOR) and 95% confidence intervals (CI).

Results

Of 61 responding households (64%), complete coverage of tuberculosis screening at the household level was 34.4% and among the 174 household contacts was 46.6%. About 20% of contacts did not receive any recommendation for tuberculosis screening. Households were more likely to have all members screened for tuberculosis if they were advised to be screened by a healthcare professional rather than someone else. At the individual level, contacts aged ≥35 years (AOR: 30.6, 95% CI: 2.0–466.0), being an employee (AOR: 0.1, 95% CI: 0.0–0.8) and those who had lived more than 5 years in the same household (AOR: 0.1, 95% CI: 0.0–0.8) were independent predictors for tuberculosis screening. Coverage of diabetes mellitus screening was 80.6% with lack of awareness being the main reason for not being screened.

Conclusions

Compared to diabetes screening, the coverage of tuberculosis screening was low. A better strategy to improve coverage of tuberculosis contact screening is needed.
The association of healthy lifestyle behaviors with mental health indicators among adolescents of different family affluence in Belgium
Authors: Maenhout L. , Peuters C. , Cardon G. , Compernolle S. , Crombez G. , DeSmet A.
Published: June 2020

Background

Healthy lifestyles may contribute to better mental health, which is particularly important in adolescence, an age at which half of all mental health problems first occur. This association may be even more relevant in adolescents of low family affluence, who show more mental health problems, as well as more unhealthy lifestyles. This study investigated healthy lifestyle behaviors, namely sufficient sleep and physical activity, daily breakfast intake, low levels of alcohol use or smoking, in relation to mental health and symptoms of mental health problems (feelings of depression, anxiety, stress and self-esteem) among adolescents from different family affluence. Furthermore, the moderating role of family affluence was examined in those relations.

Methods

Adolescents aged 12-18y were recruited via a random sample of schools in Flanders, Belgium. A total of 1037 adolescents participated (mean age = 15.2, 49.8% female). Independent samples t-tests, Mann Whitney U-tests and χ2-tests determined the differences in healthy lifestyle behaviors and mental health indicators between adolescents of low-medium and high family affluence. Regression analyses assessed the association between healthy lifestyles and mental health outcomes and the moderating role of family affluence.

Results

All healthy lifestyle behaviors were associated with at least one mental health outcome, with the exception of alcohol consumption. Adolescents from low-medium family affluence had lower levels of physical activity, less often took breakfast, had lower levels of alcohol consumption and reported lower self-esteem than adolescents from high family affluence. The results showed no moderating effect of family affluence for the association between healthy lifestyle and mental health.

Conclusion

These findings support the value of integrating healthy lifestyle behaviors in interventions for mental health promotion, for both youth of low-medium and high family affluence.
Early warning score validation methodologies and performance metrics: a systematic review
Authors: Fang Andrew Hao Sen , Lim Wan Tin , Balakrishnan Tharmmambal
Published: June 2020

Background

Early warning scores (EWS) have been developed as clinical prognostication tools to identify acutely deteriorating patients. In the past few years, there has been a proliferation of studies that describe the development and validation of novel machine learning-based EWS. Systematic reviews of published studies which focus on evaluating performance of both well-established and novel EWS have shown conflicting conclusions. A possible reason is the heterogeneity in validation methods applied. In this review, we aim to examine the methodologies and metrics used in studies which perform EWS validation.

Methods

A systematic review of all eligible studies from the MEDLINE database and other sources, was performed. Studies were eligible if they performed validation on at least one EWS and reported associations between EWS scores and inpatient mortality, intensive care unit (ICU) transfers, or cardiac arrest (CA) of adults. Two reviewers independently did a full-text review and performed data abstraction by using standardized data-worksheet based on the TRIPOD (Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) checklist. Meta-analysis was not performed due to heterogeneity.

Results

The key differences in validation methodologies identified were (1) validation dataset used, (2) outcomes of interest, (3) case definition, time of EWS use and aggregation methods, and (4) handling of missing values. In terms of case definition, among the 48 eligible studies, 34 used the patient episode case definition while 12 used the observation set case definition, and 2 did the validation using both case definitions. Of those that used the patient episode case definition, 18 studies validated the EWS at a single point of time, mostly using the first recorded observation. The review also found more than 10 different performance metrics reported among the studies.

Conclusions

Methodologies and performance metrics used in studies performing validation on EWS were heterogeneous hence making it difficult to interpret and compare EWS performance. Standardizing EWS validation methodology and reporting can potentially address this issue.
Cerebrospinal fluid and plasma biomarkers in individuals at risk for genetic prion disease
Authors: Vallabh Sonia M. , Minikel Eric Vallabh , Williams Victoria J. , Carlyle Becky C. , McManus Alison J. , Wennick Chase D. , Bolling Anna , Trombetta Bianca A. , Urick David , Nobuhara Chloe K. , Gerber Jessica , Duddy Holly , Lachmann Ingolf , Stehmann Christiane , Collins Steven J. , Blennow Kaj , Zetterberg Henrik , Arnold Steven E.
Published: June 2020

Background

Prion disease is neurodegenerative disease that is typically fatal within months of first symptoms. Clinical trials in this rapidly declining symptomatic patient population have proven challenging. Individuals at high lifetime risk for genetic prion disease can be identified decades before symptom onset and provide an opportunity for early therapeutic intervention. However, randomizing pre-symptomatic carriers to a clinical endpoint is not numerically feasible. We therefore launched a cohort study in pre-symptomatic genetic prion disease mutation carriers and controls with the goal of evaluating biomarker endpoints that may enable informative trials in this population.

Methods

We collected cerebrospinal fluid (CSF) and blood from pre-symptomatic individuals with prion protein gene (PRNP) mutations (N = 27) and matched controls (N = 16), in a cohort study at Massachusetts General Hospital. We quantified total prion protein (PrP) and real-time quaking-induced conversion (RT-QuIC) prion seeding activity in CSF and neuronal damage markers total tau (T-tau) and neurofilament light chain (NfL) in CSF and plasma. We compared these markers cross-sectionally, evaluated short-term test-retest reliability over 2–4 months, and conducted a pilot longitudinal study over 10–20 months.

Results

CSF PrP levels were stable on test-retest with a mean coefficient of variation of 7% for both over 2–4 months in N = 29 participants and over 10–20 months in N = 10 participants. RT-QuIC was negative in 22/23 mutation carriers. The sole individual with positive RT-QuIC seeding activity at two study visits had steady CSF PrP levels and slightly increased tau and NfL concentrations compared with the others, though still within the normal range, and remained asymptomatic 1 year later. T-tau and NfL showed no significant differences between mutation carriers and controls in either CSF or plasma.

Conclusions

CSF PrP will be interpretable as a pharmacodynamic readout for PrP-lowering therapeutics in pre-symptomatic individuals and may serve as an informative surrogate biomarker in this population. In contrast, markers of prion seeding activity and neuronal damage do not reliably cross-sectionally distinguish mutation carriers from controls. Thus, as PrP-lowering therapeutics for prion disease advance, “secondary prevention” based on prodromal pathology may prove challenging; instead, “primary prevention” trials appear to offer a tractable paradigm for trials in pre-symptomatic individuals.
A novel chalcone derivative suppresses melanoma cell growth through targeting Fyn/Stat3 pathway
Authors: Tang Ling , Long Jing , Li Keke , Zhang Xu , Chen Xiang , Peng Cong
Published: June 2020

Background

Fyn has been documented to have oncogenic features in multiple tumors, which might be a potential therapeutic target, however, few studies on the function role of Fyn and its specific inhibitors in melanoma.

Methods

We investigated the impacts of Fyn and its inhibitor Lj-1-60 on melanoma through bioinformatics analysis, western blot, cell viability, cell cycle and apoptosis and xenograft tumor model as well as immunohistochemical staining. Pull-down and in vitro kinase assay were used to demonstrate Lj-1-60 targeting Fyn. Transcriptome sequencing and RT-PCR were adopted to confirm the potential mechanisms of Lj-1-60 in melanoma.

Results

Our findings showed that Fyn was overexpressed in melanoma cells and knocked down of Fyn suppressed the proliferation of melanoma cells. To identify the potential inhibitors of Fyn, our in-house library including total of 111,277 chemicals was conducted to vitro screening, among those compounds, 83 inhibitors were further detected to explore the effect on melanoma cells growth and discovered a novel chalcone derivative Lj-1-60 that exhibited low cellular toxicity and high anti-tumor efficacy. Lj-1-60 directly was associated with Fyn and inhibited the Fyn kinase activity with Stat3 as substrate. What’s more, Lj-1-60 suppressed the proliferation of melanoma in vitro and in vivo through inducing cell cycle arrest and apoptosis. Moreover, the activation of Stat3 had also been abrogated both in Lj-1-60 treated melanoma cells or Fyn knocked down cells.

Conclusion

Our study revealed a novel Fyn inhibitor that could significantly suppress melanoma growth, which is a promising potential inhibitor for melanoma treatment.
Potential risks in sentinel lymph node biopsy for cervical cancer: a single-institution pilot study
Authors: Tu Hua , Wan Ting , Zhang Xinke , Gu Haifeng , Feng Yanling , Huang He , Liu Jihong
Published: June 2020

Background

Sentinel lymph node (SLN) biopsy is an attractive technique that is widely performed in many oncological surgeries. However, the potential risks in SLN biopsy for cervical cancer remains largely unclear.

Methods

Seventy-five patients with histologically confirmed cervical cancer were enrolled between May 2014 and June 2016. SLN biopsies were performed followed by pelvic lymphadenectomies and all resected nodes were labeled according to their anatomic areas. Only bilateral detections of SLNs were considered successful. Patients’ clinicopathologic feature, performance of SLN detection, and distributions of lymph node metastases were analyzed.

Results

Of the 75 enrolled patients, at least one SLN was detected in 69 (92.0%), including 33 in bilateral and 36 in unilateral. SLNs were most detected in the obturator area (52 of 69 patients, 75.4%) and 26 (37.7%) patients presented SLNs in more than one area of hemipelvis. Lymphovascular invasion was found to be the only factor that adversely influenced SLN detection, while the tumor diameter, growth type, histological grade, deep stromal invasion, and neoadjuvant chemotherapy showed no significant impacts. Patients with lymphovascular invasion showed a significantly higher rate to have unsuccessful detection (90.9% versus 41.5%, P < 0.001) and lymph node metastasis (40.9% versus 3.8%, P < 0.001) compared with those without. Nodal metastases were confirmed in 11 patients, of whom 9 (81.8%) had lymphovascular invasion and 7 (63.6%) had non-SLN metastasis. The most frequently involved SLNs were obturator nodes (9/11, 81.8%). In addition, the parametrial nodes also have a high rate to be positive (4/11, 36.4%), although they were relatively less identified as SLNs. Besides, 3 patients showed metastases in the laterals without SLN detected.

Conclusions

In cervical cancer, lymphovascular invasion is a significant factor for unsuccessful SLN detection. The risk of having undetected metastasis is high when SLN is positive; therefore, further lymphadenectomy may be necessary for these patients.
Explaining the experience of prenatal care and investigating the association between psychological factors with self-care in pregnant women during COVID-19 pandemic: a mixed method study protocol
Authors: Masjoudi Marzieh , Aslani Armin , Khazaeian Somayyeh , Fathnezhad-Kazemi Azita
Published: June 2020

Background

Coronavirus disease 2019 (COVID-19) is a novel global public health emergency. Prenatal care (PNC) providing institutes should identify the needs and demands of pregnant women by optimizing the means of PNC services during the COVID-19 pandemic. The present study aims to: a) explain prenatal care experiences; b) assess the factors affecting self-care, and c) present a prenatal care guideline and Strategies to improve the PNC.

Methods

This mixed-methods study with a sequential explanatory design consists of three phases. The first phase is a qualitative study exploring the prenatal care experiences among pregnant women. In this phase, the subjects will be selected through purposive sampling; moreover, in-depth individual interviewing will be used for data collection. Finally, the conventional content analysis approach will be employed for data analysis. The second phase is quantitative and will be used as a cross-sectional approach for assessing the association between psychological factors of self-care. In this regard, a multistage cluster sampling method will be used to select 215 subjects who will be visited in health care centers of Tabriz, Iran. The third phase will be focusing on developing a prenatal care guideline and Strategies, using the qualitative and quantitative results of the previous phases, a review of the related literature, and the nominal group technique will be performed among experts.

Discussion

The present research is the first study to investigate the prenatal care experiences and factors influencing self-care among pregnant women during COVID-19 pandemic. For the purposes of the study, a mixed-methods approach will be used which aims to develop strategies for improving health care services. It is hoped that the strategy proposed in the current study could lead to improvements in this regard.

Ethical code

IR.TBZMED.REC.1399.003.