bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and enablers for the implementation of clinical practice guidelines in China: a mixed-method study
Authors: Jin Yinghui , Li Zimeng , Han Fei , Huang Di , Huang Qiao , Cao Yue , Weng Hong , Zeng Xian-Tao , Wang Xinghuan , Shang Hong-Cai
Published: September 2019

Objectives

The aim of this study was to explore perspectives and reasoning of medical staff from Class A tertiary hospitals about the factors hindering and facilitating the uptake and use of clinical practice guidelines (CPGs) during medical procedures.

Design

Mixed-method research study to collect and analyse both quantitative and qualitative data.

Setting

Class A tertiary hospitals in China.

Participants

The inclusion criteria for the questionnaire survey and qualitative research were (1) medical practitioners and (2) years of practice: above 5 years in a tertiary hospital.

Methods

Questionnaires were distributed to medical staff in 11 cities to collect quantitative data. Frequency and ranking of barriers and enablers were analysed. Spearman correlations were computed to explore the correlation between years of practice, professional title ranking and educational background with self-reported guideline adherence. Using a constructivist grounded theory method, qualitative data were generated via in-depth face-to-face interviews with Chinese medical practitioners.

Results

A total of 359 medical practitioners were surveyed and 32 medical practitioners interviewed in 11 cities. Higher frequency and higher ranking of barriers all converged on ‘lack of access’, ‘less convenient’, ‘lack of applicability’ and ‘lack of evidence from Chinese sample’. Higher frequency and higher ranking of enablers converged on ‘Short formats presentation’, ‘Utilisation of various media’, ‘Information visualisation’ and ‘Linking to patient electronic medical records’. There were no relationships between characteristics of respondents with self-reported adherence. This research produced a theoretical understanding of the experience of medical practitioners when using guidelines. Themes identified were as follows: existing intrinsic flaws in guidelines, deficient or incomplete system mechanism and being ambiguous.

Conclusion

Our findings provide a comprehensive and culturally sensitive perspective in understanding guideline implementation in China. Strategies addressing those barriers should be further discussed and researched in the future.
Analgesic efficacy and safety of ketamine after total knee or hip arthroplasty: a meta-analysis of randomised placebo-controlled studies
Authors: Xu Bei , Wang Yilun , Zeng Chao , Wei Jie , Li Jiatian , Wu Ziying , He Hongyi , Lei Guanghua , Xie Dongxing , Ding Xiang
Published: September 2019

Objective

To examine the analgesic efficacy and safety of ketamine after total knee or hip arthroplasty.

Design

Systematic review and meta-analysis.

Data sources

PubMed, EMBASE and Cochrane Library from inception to 22 May 2019.

Eligibility criteria for selecting studies

Randomised controlled trials comparing the efficacy and safety of ketamine with placebo for postoperative pain relief in patients undergoing total knee or hip arthroplasty.

Data extraction and synthesis

Data (ie, pain intensity, morphine consumption, gastrointestinal and psychotic adverse effects) were extracted by two reviewers independently. The Cochrane Collaboration’s recommended tool was used to determine the methodological quality of included studies.

Results

A total of 10 studies were included. One of them was rated as low quality. Compared with placebo, intravenous ketamine was effective for pain relief during 0–8-hour (weighted mean difference (WMD) −1.21, 95% CI −1.45 to −0.98, p<0.001; three studies, 149 participants) but not during 8–24-hour postoperative periods, and effective for reduction of cumulative morphine consumption during both 0–24-hour (WMD −17.76, 95% CI −31.25 to −4.27, p=0.01; five studies, 366 participants) and 0–48-hour (WMD −21.79, 95% CI −25.46 to −18.11, p<0.001; four studies, 252 participants) postoperative periods, without increasing risks of gastrointestinal or psychotic adverse effects. The limited data available for intra-articular (WMD −0.49, 95% CI −0.70 to −0.29, p<0.001; two studies, 83 participants) and epidural (WMD −2.10, 95% CI −3.30 to −0.90, p<0.001; one study, 20 participants) ketamine pointed to a significant reduction in pain intensity during 8–24-hour postoperative period.

Conclusions

Intravenous administration of ketamine is effective and safe for postoperative pain relief in patients undergoing total knee or hip arthroplasty. Nevertheless, the analgesic efficacy and safety of ketamine in such patients seem to vary by different administration routes and still warrant further studies to explore.
Study protocol for a randomised controlled trial assessing the clinical and cost-effectiveness of the Journeying through Dementia (JtD) intervention compared to usual care
Authors: Wright Jessica , Foster Alexis , Cooper Cindy , Sprange Kirsty , Walters Stephen , Berry Katherine , Moniz-Cook Esme , Loban Amanda , Young Tracey Anne , Craig Claire , Dening Tom , Lee Ellen , Beresford-Dent Julie , Thompson Benjamin John , Young Emma , Thomas Benjamin David , Mountain Gail
Published: September 2019

Introduction

Services are being encouraged to provide postdiagnostic treatment to those with dementia but the availability of evidence-based interventions following diagnosis has not kept pace with increase in demand. To address this need, the Journeying through Dementia (JtD) intervention was created. A randomised controlled trial (RCT), based on a pilot study, is in progress.

Methods and analysis

The RCT is a pragmatic, two-arm, parallel group trial designed to test the clinical and cost-effectiveness of JtD compared with usual care. Recruitment will be through NHS services, third sector organisations and Join Dementia Research. The sample size is 486 randomised (243 to usual care and 243 to the intervention usual care). Participants can choose to ask a friend or relative (supporter) to become involved in the study. The primary outcome measure for participants is Dementia-Related Quality of Life (DEMQOL), collected at baseline and at 8 months’ postrandomisation. Secondary outcome measures will be collected from participants and supporters at those visits. Participants will also be followed up at 12 months’ postrandomisation with a reduced set of measures. A process evaluation will be conducted through qualitative and fidelity substudies. Analyses will compare the two arms of the trial on an intention to treat as allocated basis. The primary analyses will compare the mean DEMQOL scores of the participants at 8 months between the two study arms. A cost-effectiveness analysis will consider the incremental cost per Quality Adjusted Life Years of the intervention compared with usual care. Qualitative and fidelity substudies will be analysed through framework analysis and fidelity assessment tools respectively.

Ethics and dissemination

REC and HRA approval were obtained. A Data Monitoring and Ethics Committee has been constituted. Dissemination will be via publications, conferences and social media. Intervention materials will be made open access.

Trial registration number

ISRCTN17993825.
A qualitative exploratory study of UK first-time fathers’ experiences, mental health and wellbeing needs during their transition to fatherhood
Authors: Baldwin Sharin , Malone Mary , Sandall Jane , Bick Debra
Published: September 2019

Objectives

To develop an understanding of men’s experiences of first-time fatherhood, their mental health and wellbeing needs.

Design

A qualitative study using semi-structured interviews. Data were analysed using framework analysis.

Setting

Two large National Health Service integrated care trusts covering four London (UK) local authority boroughs.

Participants

First-time fathers with children under 12 months of age were included. Maximum variation sampling was used, with 21 fathers recruited. Ten of these men described their ethnic background as Indian, seven as White British, one as Spanish, one as Black African, one as Black Caribbean and one as Pakistani. Participants’ ages ranged from 20 to over 60 years; completion of full-time education ranged from high school certificate to doctorate level; and annual income ranged from £15 000 to over £61 000. Non-English speaking fathers, those experiencing bereavement following neonatal death, stillbirth, pregnancy loss, sudden infant death, and fathers with existing severe mental illnesses were excluded.

Results

Nine major categories were identified: ‘preparation for fatherhood’, ‘rollercoaster of feelings’, ‘new identity’, ‘challenges and impact’, ‘changed relationship: we’re in a different place’, ‘coping and support’, ‘health professionals and services: experience, provision and support’, ‘barriers to accessing support’, and ‘men’s perceived needs: what fathers want’. Resident (residing with their partner and baby) and non-resident fathers in this study highlighted broadly similar needs, as did fathers for whom English was their first language and those for whom it was not. A key finding of this study relates to men’s own perceived needs and how they would like to be supported during the perinatal period, contributing to the current evidence.

Conclusions

This study provides insight into first-time fathers’ experiences during their transition to fatherhood, with important implications for healthcare policy makers, service providers and professionals for how perinatal and early years services are planned and provided for both new parents.
What are the patient factors that impact on decisions to progress to total knee replacement? A qualitative study involving patients with knee osteoarthritis
Authors: O'Brien Penny , Bunzli Samantha , Ayton Darshini , Dowsey Michelle M , Gunn Jane , Manski-Nankervis Jo-Anne
Published: September 2019

Objectives

General practitioners (GPs) are often the first health professionals to assess patients with osteoarthritis (OA). Despite clinical guideline recommendations for non-surgical intervention as first-line therapies, the most frequent referral from a GP for a person with knee OA is to an orthopaedic surgeon. The aim of our study was to explore patient factors that impact on the decision to progress to total knee replacement (TKR), including the experience of patients in general practice, their perceptions of their condition, and their access and use of community-based allied health interventions.

Design

Qualitative investigation using semi-structured interviews. The Candidacy framework was selected as a lens to examine the factors driving healthcare access. Data were analysed using a thematic analysis approach. Codes identified in the data were mapped to the seven Candidacy domains. Themes corresponding to each domain were described.

Setting

A public hospital in Melbourne, Australia.

Participants

27 patients with knee OA who were on a waiting list to undergo TKR.

Results

Ten themes described factors influencing access and use of non-surgical interventions and decision-making for undergoing TKR: (1) History of knee problems, change in symptoms; (2) Physical and psychosocial functioning (Identification of Candidacy); (3) GP and social networks as information sources, access to care (Navigation); (4) Referral pathways (Permeability of services); (5) Communication of impact (Appearances at health services); (6) GP-Surgeon as the predominant referral pathway (Adjudications); (7) Physical activity as painful; (8) Beliefs about effectiveness of non-surgical interventions (Offers and resistance); (9) Familiarity with local system; and (10) Availability (Operating conditions and local production of Candidacy).

Conclusions

Using the Candidacy framework to analyse patients’ experiences when deciding to progress to TKR highlighted missed opportunities in general practice to orient patients to first try non-surgical interventions. Patients with knee OA also require improved support to navigate allied health services.
Effects of accelerated versus standard care surgery on the risk of acute kidney injury in patients with a hip fracture: a substudy protocol of the hip fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) international randomised controlled trial
Authors: Borges Flavia K , Devereaux P J , Cuerden Meaghan , Bhandari Mohit , Guerra-Farfán Ernesto , Patel Ameen , Sigamani Alben , Umer Masood , Neary John , Tiboni Maria , Tandon Vikas , Ramokgopa Mmampapatla Thomas , Sancheti Parag , John Bobby , Lawendy AbdelRahman , Balaguer-Castro Mariano , Jenkinson Richard , Ślęczka Paweł , Nabi Nur Aamer , Wood Gavin C A , Feibel Robert , McMahon John Stephen , Sigamani Alen , Biccard Bruce M , Landoni Giovanni , Szczeklik Wojciech , Wang Chew Yin , Tomas-Hernandez Jordi , Abraham Valsa , Vincent Jessica , Harvey Valerie , Pettit Shirley , Sontrop Jessica , Garg Amit X
Published: September 2019

Introduction

Inflammation, dehydration, hypotension and bleeding may all contribute to the development of acute kidney injury (AKI). Accelerated surgery after a hip fracture can decrease the exposure time to such contributors and may reduce the risk of AKI.

Methods and analysis

Hip fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) is a multicentre, international, parallel-group randomised controlled trial (RCT). Patients who suffer a hip fracture are randomly allocated to either accelerated medical assessment and surgical repair with a goal of surgery within 6 hours of diagnosis or standard care where a repair typically occurs 24 to 48 hours after diagnosis. The primary outcome of this substudy is the development of AKI within 7 days of randomisation. We anticipate at least 1998 patients will participate in this substudy.

Ethics and dissemination

We obtained ethics approval for additional serum creatinine recordings in consecutive patients enrolled at 70 participating centres. All patients provide consent before randomisation. We anticipate reporting substudy results by 2021.

Trial registration number

NCT02027896; Pre-results.
CDK12 inhibition mediates DNA damage and is synergistic with sorafenib treatment in hepatocellular carcinoma
Authors: Wang Cun , Wang Hui , Lieftink Cor , du Chatinier Aimee , Gao Dongmei , Jin Guangzhi , Jin Haojie , Beijersbergen Roderick L , Qin Wenxin , Bernards René
Published: September 2019

Objectives

Hepatocellular carcinoma (HCC) is one of the most frequent malignancies and a major leading cause of cancer-related deaths worldwide. Several therapeutic options like sorafenib and regorafenib provide only modest survival benefit to patients with HCC. This study aims to identify novel druggable candidate genes for patients with HCC.

Design

A non-biased CRISPR (clustered regularly interspaced short palindromic repeats) loss-of-function genetic screen targeting all known human kinases was performed to identify vulnerabilities of HCC cells. Whole-transcriptome sequencing (RNA-Seq) and bioinformatics analyses were performed to explore the mechanisms of the action of a cyclin-dependent kinase 12 (CDK12) inhibitor in HCC cells. Multiple in vitro and in vivo assays were used to study the synergistic effects of the combination of CDK12 inhibition and sorafenib.

Results

We identify CDK12 as critically required for most HCC cell lines. Suppression of CDK12 using short hairpin RNAs (shRNAs) or its inhibition by the covalent small molecule inhibitor THZ531 leads to robust proliferation inhibition. THZ531 preferentially suppresses the expression of DNA repair-related genes and induces strong DNA damage response in HCC cell lines. The combination of THZ531 and sorafenib shows striking synergy by inducing apoptosis or senescence in HCC cells. The synergy between THZ531 and sorafenib may derive from the notion that THZ531 impairs the adaptive responses of HCC cells induced by sorafenib treatment.

Conclusion

Our data highlight the potential of CDK12 as a drug target for patients with HCC. The striking synergy of THZ531 and sorafenib suggests a potential combination therapy for this difficult to treat cancer.
Energy loss of heavy quarks in the isotropic collisional hot QCD medium
Authors: Jamal M. Yousuf , Chandra Vinod
Published: September 2019

The collisional energy loss of heavy partons (charm and bottom quarks) has been determined within the framework of semi-classical transport theory implying the Bhatnagar–Gross–Krook (BGK) collisional kernel. Hot QCD medium effects have been incorporated while employing a quasi-particle description of the medium in terms of effective gluons, quarks and antiquarks with respective temperature dependent effective fugacities. The momentum dependence of the energy loss for the charm and the bottom quark has been investigated. It is observed that with the increase in momentum of the heavy quarks, the loss increases sharply for the smaller values and reaches saturation later. Furthermore, as compared to the charm quark, the bottom quark loses less energy at a particular momentum and collisional frequency. The energy loss is seen to increase with increasing collisional frequency. We also provide a comparative study of the results obtained using the BGK kernel rather than those using the relaxation time approximation (RTA) kernel and found them to be consistent with each other. The medium effects in all the situations are seen to play a quite significant role.
meso-Tetraphenylporphine as a prochiral solvating agent (pro-CSA): A physicochemical study
Authors: Labuta Jan , Ishihara Shinsuke , Hill Jonathan P.
Published: September 2019

Meso-tetraphenylporphine (TPP) can be used as a prochiral chiral solvating agent (pro-CSA) for NMR detection of enantiomeric excess (ee) of chiral organic acids, in this study 2-phenoxypropionic acid (PPA). The pro-CSA sensing mechanism is unique in that it does not depend on formation of diastereomers. Here we discuss the factors affecting construction of the calibration curves ([Formula: see text] observed linearity between induced chemical shift non-equivalency and ee) including temperature, guest exchange rate and binding strength. We have employed various NMR techniques including variable temperature NMR, titration experiments and analyses of NMR spectral line shapes. It is confirmed that optimization of ee sensing conditions is required for each TPP/acid guest pair. For the TPP/PPA host–guest system, an optimum operating temperature is -32[Formula: see text] C with an acceptable range from -28[Formula: see text] C to -50[Formula: see text] C. The upper bound is due to complete diprotonation of TPP by PPA and the lower bound is due to the limit of PPA guest exchange rate at TPP’s binding site [Formula: see text] s[Formula: see text]. These findings, typical for porphyrin-type diprotonated pro-CSAs, yields valuable insight for design of the next generation of ee sensing molecules.
Seismic imaging of mélanges; Pieniny Klippen Belt case study
Authors: Marzec Paweł , Golonka Jan , Pietsch Kaja , Kasperska Monika , Dec Jerzy , Cichostępski Kamil , Lasocki Stanisław
Published: September 2019

The authors present results of the first high-resolution deep seismic reflection survey in the Pieniny Klippen Belt (PKB) in Poland. This survey sheds new light on the matter of olistostromes and the mélange character of the PKB. The sedimentary mass-transport deposits represented by olistoliths and olistostromes manifest themselves by different petrophysical parameters of rocks (velocity, density and resistivity) and seismic attributes. Seismic attributes are very effective in the interpretation of the geology of complex mélanges. The authors used selected attributes: low-pass filter, energy, energy gradient, dip-steered median filter, Prewitt filter, Laplacian edge enhancing filter and square root of the energy gradient. These attributes emphasize changes of the seismic image inside mélange zones. The distinguished olistoliths are now inside imbricated thrust structures and they are tectonically rearranged. Polygenetic mélanges in the PKB originated as a result of sedimentary and tectonic processes. The PKB in the investigated area forms several north-vergent thrust sheets belonging to the Złatne and Hulina nappes. Both nappes contain large chaotic, non-reflective olistoliths as well as the smaller mainly high-reflective olistoliths. Olistoliths are arranged parallel to the flysch layering and thrusts. The results presented confirm the postulated two olistostrome belts within the PKB structure.

Thematic collection:
This article is part of the Polygenetic mélanges collection available at:
https://www.lyellcollection.org/cc/polygenetic-melanges
A Survey on Mobility-Induced Service Migration in the Fog, Edge, and Related Computing Paradigms
Authors: Rejiba Zeineb , Masip-Bruin Xavier , Marín-Tordera Eva
Published: September 2019

With the advent of fog and edge computing paradigms, computation capabilities have been moved toward the edge of the network to support the requirements of highly demanding services. To ensure that the quality of such services is still met in the event of users’ mobility, migrating services across different computing nodes becomes essential. Several studies have emerged recently to address service migration in different edge-centric research areas, including fog computing, multi-access edge computing (MEC), cloudlets, and vehicular clouds. Since existing surveys in this area focus on either VM migration in general or migration in a single research field (e.g., MEC), the objective of this survey is to bring together studies from different, yet related, edge-centric research fields while capturing the different facets they addressed. More specifically, we examine the diversity characterizing the landscape of migration scenarios at the edge, present an objective-driven taxonomy of the literature, and highlight contributions that rather focused on architectural design and implementation. Finally, we identify a list of gaps and research opportunities based on the observation of the current state of the literature. One such opportunity lies in joining efforts from both networking and computing research communities to facilitate future research in this area.
Automated Expertise Retrieval
Authors: Gonçalves Rodrigo , Dorneles Carina Friedrich
Published: September 2019

Understanding people’s expertise is not a trivial task since it is time-consuming when manually executed. Automated approaches have become a topic of research in recent years in various scientific fields, such as information retrieval, databases, and machine learning. This article carries out a survey on automated expertise retrieval, i.e., finding data linked to a person that describes the person’s expertise, which allows tasks such as profiling or finding people with a certain expertise. A faceted taxonomy is introduced that covers many of the existing approaches and classifies them on the basis of features chosen from studying the state-of-the-art. A list of open issues, with suggestions for future research topics, is introduced as well. It is hoped that our taxonomy and review of related works on expertise retrieval will be useful when analyzing different proposals and will allow a better understanding of existing work and a systematic classification of future work on the topic.
Big Data Analytics for Large-scale Wireless Networks
Authors: Dai Hong-Ning , Wong Raymond Chi-Wing , Wang Hao , Zheng Zibin , Vasilakos Athanasios V.
Published: September 2019

The wide proliferation of various wireless communication systems and wireless devices has led to the arrival of big data era in large-scale wireless networks. Big data of large-scale wireless networks has the key features of wide variety, high volume, real-time velocity, and huge value leading to the unique research challenges that are different from existing computing systems. In this article, we present a survey of the state-of-art big data analytics (BDA) approaches for large-scale wireless networks. In particular, we categorize the life cycle of BDA into four consecutive stages: Data Acquisition, Data Preprocessing, Data Storage, and Data Analytics. We then present a detailed survey of the technical solutions to the challenges in BDA for large-scale wireless networks according to each stage in the life cycle of BDA. Moreover, we discuss the open research issues and outline the future directions in this promising area.
Adaptive Biometric Systems
Authors: Pisani Paulo Henrique , Mhenni Abir , Giot Romain , Cherrier Estelle , Poh Norman , Ferreira de Carvalho André Carlos Ponce de Leon , Rosenberger Christophe , Amara Najoua Essoukri Ben
Published: September 2019

With the widespread of computing and mobile devices, authentication using biometrics has received greater attention. Although biometric systems usually provide good solutions, the recognition performance tends to be affected over time due to changing conditions and aging of biometric data, which results in intra-class variability. Adaptive biometric systems, which adapt the biometric reference over time, have been proposed to deal with such intra-class variability. This article provides the most up-to-date and complete discussion on adaptive biometrics systems we are aware of, including formalization, terminology, sources or variations that motivates the use of adaptation, adaptation strategies, evaluation methodology, and open challenges. This field of research is sometimes referred to as template update.
Video Skimming
Authors: K. Vivekraj V. , Sen Debashis , Raman Balasubramanian
Published: September 2019

Video skimming, also known as dynamic video summarization, generates a temporally abridged version of a given video. Skimming can be achieved by identifying significant components either in uni-modal or multi-modal features extracted from the video. Being dynamic in nature, video skimming, through temporal connectivity, allows better understanding of the video from its summary. Having this obvious advantage, recently, video skimming has drawn the focus of many researchers benefiting from the easy availability of the required computing resources. In this article, we provide a comprehensive survey on video skimming focusing on the substantial amount of literature from the past decade. We present a taxonomy of video skimming approaches and discuss their evolution highlighting key advances. We also provide a study on the components required for the evaluation of a video skimming performance.
Autonomous UAV Cinematography
Authors: Mademlis Ioannis , Nikolaidis Nikos , Tefas Anastasios , Pitas Ioannis , Wagner Tilman , Messina Alberto
Published: September 2019

The emerging field of autonomous UAV cinematography is examined through a tutorial for non-experts, which also presents the required underlying technologies and connections with different UAV application domains. Current industry practices are formalized by presenting a UAV shot-type taxonomy composed of framing shot types, single-UAV camera motion types, and multiple-UAV camera motion types. Visually pleasing combinations of framing shot types and camera motion types are identified, while the presented camera motion types are modeled geometrically and graded into distinct energy consumption classes and required technology complexity levels for autonomous capture. Two specific strategies are prescribed, namely
focal length compensation
and
multidrone compensation
, for partially overcoming a number of issues arising in UAV live outdoor event coverage, deemed as the most complex UAV cinematography scenario. Finally, the shot types compatible with each compensation strategy are explicitly identified. Overall, this tutorial both familiarizes readers coming from different backgrounds with the topic in a structured manner and lays necessary groundwork for future advancements.
Modeling Embedding Dimension Correlations via Convolutional Neural Collaborative Filtering
Authors: Du Xiaoyu , He Xiangnan , Yuan Fajie , Tang Jinhui , Qin Zhiguang , Chua Tat-Seng
Published: September 2019

As the core of recommender systems, collaborative filtering (CF) models the affinity between a user and an item from historical user-item interactions, such as clicks, purchases, and so on. Benefiting from the strong representation power, neural networks have recently revolutionized the recommendation research, setting up a new standard for CF. However, existing neural recommender models do not explicitly consider the correlations among embedding dimensions, making them less effective in modeling the interaction function between users and items. In this work, we emphasize on modeling the correlations among embedding dimensions in neural networks to pursue higher effectiveness for CF. We propose a novel and general neural collaborative filtering framework—namely, ConvNCF, which is featured with two designs: (1) applying outer product on user embedding and item embedding to explicitly model the pairwise correlations between embedding dimensions, and (2) employing convolutional neural network above the outer product to learn the high-order correlations among embedding dimensions. To justify our proposal, we present three instantiations of ConvNCF by using different inputs to represent a user and conduct experiments on two real-world datasets. Extensive results verify the utility of modeling embedding dimension correlations with ConvNCF, which outperforms several competitive CF methods.
Occupational Health and Safety and Turnover Intention in the Ghanaian Power Industry: The Mediating Effect of Organizational Commitment
Authors: Liu Suxia , Gyabeng Emmanuel , Joshua Atteh Sewu Gilbert , Nkrumah Nana Kwame , Dartey Bright
Published: September 2019

This study aimed at investigating the effect of occupational health and safety (OHS) on employee’s turnover intention (TI) with the mediating effect of organizational commitment (OC) in the Ghanaian power industry. Methods. With stratified sampling technique, 350 participants were selected to participate in the study with standardized quantitative questionnaires to measure the variables involved in the study and SmartPLS 3-structural equation modeling technique to analyze the data. Results. The results showed that (1) occupational health and safety and turnover intention are negatively related (β = 0.245, p<0.05); (2) there exists a positive relationship between occupational health and safety and organizational commitment (β = 0.820, p<0.05); (3) organizational commitment and turnover intention are negatively related (β = 0.640, p<0.05); and (4) organizational commitment significantly mediates the relationship between occupational health and safety and turnover intention (indirect effect = −0.53 and direct effect = −0.25, p<0.05). Conclusion. Employees satisfied with the health and safety system of their organization tend to be committed to their organization and have low turnover intention, and vice versa.
Yes-Associated Protein Promotes the Development of Condyloma Acuminatum through EGFR Pathway Activation
Authors: Yang Zhenghui , Xiong Hao , Wei Shanshan , Liu Qingxiu , Gao Yan , Liu Lishi , Hu Zhili , Han Kai , Wang Menglei , Chen Pingjiao , Li Qian , Zeng Kang
Published: September 2019

Objective: Investigate the role of Yes-associated protein (YAP1) in the development of condyloma acuminatum (CA). Methods: We enrolled 30 male patients with CA and 20 healthy individuals as a control group, to compare the YAP1 expression in their tissue samples. Following this, we overexpressed and downregulated YAP1 expression in HaCaT cells to examine the migratory, proliferative, and apoptotic potential of HaCaT cells expressing different levels of YAP1. Results: In the CA patient tissue samples, an increase in YAP1 expression can be observed. In vitro,the overexpression of YAP1 was shown to promote the growth and migration of HaCaT cells and to activate epidermal growth factor receptor (EGFR) pathway-associated proteins, while the downregulation of YAP1 inhibited cell growth and migration of these cells. Conclusions: YAP1 promotes the growth of keratinocytes in CA through the activation of the EGFR pathway, and it may mediate the development of human papilloma virus-associated diseases.
Un caso adulto de neumonía grave y potencialmente mortal causada por una cepa de Mycoplasma pneumoniae resistente a los macrólidos, en Japón: reporte de un caso
Authors: Matsumoto Munehiro , Nagaoka Kentaro , Suzuki Masaru , Konno Satoshi , Takahashi Kei , Takashina Taichi , Ishiguro Nobuhisa , Nishimura Masaharu
Published: September 2019

Antecedentes: Hasta ahora, la prevalencia de infecciones por Mycoplasma pneumoniae (MP) resistente a los macrólidos entre pacientes adultos ha sido baja, y los reportes de neumonía grave por MP debida a una cepa resistente a los macrólidos han sido escasos. En este trabajo describimos un caso raro de neumonía grave y potencialmente mortal en un adulto debido a una cepa de MP resistente a macrólidos, que finalmente se trató con fluoroquinolona y tetraciclina luego de un fracaso terapéutico con macrólido y corticosteroide. Presentación del caso: Una mujer de 39 años, aparentemente saludable, refirió fiebre y tos productiva. Tres días después del inicio de los síntomas se le ingresó en un hospital general local. Al momento de su admisión sus signos vitales eran estables, excepto por una fiebre elevada. Imágenes de rayos X y tomografía computada del pecho de la paciente revelaron una consolidación subtegumentaria en el lóbulo inferior derecho. Se inició tratamiento con ampicilina/sulbactam y azitromicina, con diagnóstico de neumonía adquirida en la comunidad. La fiebre no cedió con el tratamiento y la lesión pulmonar se extendió a todo el lóbulo inferior. Así, se administró prednisolona en pulsos a partir del día 7. Sin embargo, ni los síntomas ni la lesión pulmonar mejoraron, y se le transfirió a nuestro hospital para su examen y tratamiento. En la admisión (día 14 de progresión clínica), el título de hemaglutinación indirecta para MP se elevó hasta 1:2560, y el examen del fluido broncoalveolar dio resultados positivos para el antígeno de micoplasma. Con base en estos hallazgos clínicos, confirmamos un caso de neumonía grave y potencialmente mortal por MP. Puesto que la condición respiratoria de la paciente era extremadamente grave, iniciamos tratamiento con levofloxacina y tetraciclina. Dos días después (día 16 de progresión clínica) se resolvieron la fiebre, el malestar y la hipoxia, y las lesiones pulmonares mejoraron significativamente. Análisis moleculares identificaron el DNA de MP en el fluido broncoalveolar, y se reveló la mutación A2063G en el gen 23S rRNA. Con base en estos resultados y en la progresión clínica, confirmamos que nuestro caso se debió a neumonía grave por MP debido a una cepa resistente a macrólidos. Conclusión: Se requiere mayor sensibilización ante la emergencia de infecciones por MP resistente a los macrólidos en adultos, puesto que la infección puede agravarse a pesar del tratamiento inicial con macrólidos y esteroide, la terapia estándar para MP.
La pandemia de 2009 en México: Experiencia y lecciones sobre políticas nacionales de previsión contra la influenza estacional y epidémica
Authors: Córdova-Villalobos José A. , Macias Alejandro E. , Hernandez-Avila Mauricio , Dominguez-Cherit Guillermo , Lopez-Gatell Hugo , Alpuche-Aranda Celia , Ponce de León-Rosales Samuel
Published: September 2019

La influenza es una enfermedad viral respiratoria capaz de originar epidemias que representan una amenaza para la seguridad mundial. México fue el primer país que notificó a la Organización Mundial de la Salud sobre un brote que habría de convertirse en pandemia, la primera del siglo XXI causada por el virus A(H1N1)2009. Antes de ese evento, México contaba con un plan de previsión nacional que incluía la vacunación estacional, reservas de equipo para protección personal y fármacos antivirales, así como estrategias de comunicación. Durante la epidemia se fortaleció la Red Nacional de Laboratorios de Salud Pública, así como las capacidades de crecimiento de las unidades de cuidados intensivos y el sistema de distribución de medicamentos antivirales. Se puso en marcha una estrategia de comunicación de riesgos para que la población se apegara a las medidas implantadas, como el distanciamiento social (cierre de escuelas y centros de trabajo, y cuarentena en domicilio). Esta revisión describe la experiencia mexicana durante la pandemia de influenza de 2009 y las lecciones aprendidas, que son de utilidad para la preparación contra epidemias futuras.
Primary Pulmonary MALT Lymphoma: A Case Report and Literature Review
Authors: Couto Carlos , Martins Vera , Ribeiro Vicência , Rodrigues Cristina , Nogueira Joana , Oliveira Ana , Vieira Jorge Roldão
Published: September 2019

Background: Primary pulmonary MALT (mucosa-associated lymphoid tissue) lymphoma is a rare entity that imposes a rigorous and demanding diagnostic work-up. Case Report: We present the case of a 74-year-old female non-smoker with a previous healed pulmonary tuberculosis and a history of arterial hypertension and fibromyalgia. She was referred to the pulmonology clinic to investigate a right inferior lobe (RIL) rounded pulmonary opacity (4 × 3.4 cm) identified on a previous thoracic CT scan performed for unrelated reasons. The remaining findings were non-specific and included small calcified mediastinal and hepatic adenopathies and multiple calcified hepatosplenic foci. The 18F-FDG-PET revealed high 18F-FDG uptake at the RIL lesion (SUV 4.7), suspicious for neoplastic involvement. Flexible bronchoscopy and CT-guided transthoracic needle biopsy were non-diagnostic and she was submitted to videothoracoscopy with surgical biopsy. The histological and immunohistochemical examination of the clear margin RIL segmentectomy were in keeping with a MALT lymphoma. Conclusion: The authors present this case to highlight this rare entity, which is particularly challenging to diagnose due to non-specific multimodality imaging features, frequently implying more invasive procedures and surgical biopsy for a final diagnosis.
Investigation of Autoimmune Disease in Children with Chronic Spontaneous Urticaria
Authors: Kosmeri Chrysoula , Siomou Ekaterini , Challa Anna , Tsabouri Sophia
Published: September 2019

Introduction: Chronic spontaneous urticaria (CSU) in childhood affects the quality of life of the patient and may be associated with other autoimmune diseases. The aim of this study was to investigate the association of autoimmune diseases with CSU in children. Methods: In a 3-year period, from 2015 to 2018, forty-nine children were diagnosed with CSU and monitored in the Outpatient Pediatric Allergy Clinic of the University Hospital of Ioannina in Northwestern Greece. The comorbidity with other autoimmune diseases was investigated in this population by autoantibody evaluation. Results: Of the 49 children with CSU, 1 had autoantibodies for celiac disease (CD), which was confirmed by duodenal biopsy via gastroscopy. Four children had high serum levels of anti-thyroid peroxidase antibodies but normal thyroid function. No other specific autoantibodies were detected. Conclusion: The prevalence of autoimmune diseases among our children with CSU was low. Nevertheless, we think it is important to test children with CSU for other autoimmune diseases. CD can be diagnosed in children with CSU even in the absence of other indicative signs.
Enfermedad respiratoria crónica: Telerehabilitación versus rehabilitación pulmonar tradicional
Authors: Posadas-Valay Rodolfo
Published: September 2019

Background: Pulmonary rehabilitation is an effective therapeutic intervention for people with chronic respiratory disease. However, fewer than 5% of eligible individuals receive pulmonary rehabilitation on an annual basis, largely due to limited availability of services and difficulties associated with travel and transport. The Rehabilitation Exercise At Home (REAcH) study is an assessor-blinded, multi-centre, randomised controlled equivalence trial designed to compare the efficacy of home-based telerehabilitation and traditional centre-based pulmonary rehabilitation in people with chronic respiratory disease. Methods: Participants will undertake an 8-week group-based pulmonary rehabilitation program of twice-weekly supervised exercise training, either in-person at a centre-based pulmonary rehabilitation program or remotely from their home via the Internet. Supervised exercise training sessions will include 30 min of aerobic exercise (cycle and/or walking training). Individualised education and self-management training will be delivered. All participants will be prescribed a home exercise program of walking and strengthening activities. Outcomes will be assessed by a blinded assessor at baseline, after completion of the intervention, and 12-months post intervention. The primary outcome is change in dyspnea score as measured by the Chronic Respiratory Questionnaire - dyspnea domain (CRQ-D). Secondary outcomes will evaluate the efficacy of telerehabilitation on 6-min walk distance, endurance cycle time during a constant work rate test, physical activity and quality of life. Adherence to pulmonary rehabilitation between the two models will be compared. A full economic analysis from a societal perspective will be undertaken to determine the cost-effectiveness of telerehabilitation compared to centre-based pulmonary rehabilitation. Discussion: Alternative models of pulmonary rehabilitation are required to improve both equity of access and patient-related outcomes. This trial will establish whether telerehabilitation can achieve equivalent improvement in outcomes compared to traditional centre-based pulmonary rehabilitation. If efficacious and cost-effective, the proposed telerehabilitation model is designed to be rapidly deployed into clinical practice.
Genetic Ablation of TASK-1 (Tandem of P Domains in a Weak Inward Rectifying K
+
Channel–Related Acid-Sensitive K
+
Channel-1) (K
2P
3.1) K
+
Channels Suppresses Atrial Fibrillation and Prevents Electrical Remodeling
Authors: Schmidt Constanze , Wiedmann Felix , Beyersdorf Christoph , Zhao Zhihan , El-Battrawy Ibrahim , Lan Huan , Szabo Gabor , Li Xin , Lang Siegfried , Korkmaz-Icöz Sevil , Rapti Kleopatra , Jungmann Andreas , Ratte Antonius , Müller Oliver J. , Karck Matthias , Seemann Gunnar , Akin Ibrahim , Borggrefe Martin , Zhou Xiao-Bo , Katus Hugo A. , Thomas Dierk
Published: September 2019

Background:

Despite an increasing understanding of atrial fibrillation (AF) pathophysiology, translation into mechanism-based treatment options is lacking. In atrial cardiomyocytes of patients with chronic AF, expression, and function of tandem of P domains in a weak inward rectifying TASK-1 (K
+
channel–related acid-sensitive K
+
channel-1) (K
2P
3.1) atrial-specific 2-pore domain potassium channels is enhanced, resulting in action potential duration shortening. TASK-1 channel inhibition prevents action potential duration shortening to maintain values observed among sinus rhythm subjects. The present preclinical study used a porcine AF model to evaluate the antiarrhythmic efficacy of TASK-1 inhibition by adeno-associated viral anti–TASK-1-siRNA (small interfering RNA) gene transfer.

Methods:

AF was induced in domestic pigs by atrial burst stimulation via implanted pacemakers. Adeno-associated viral vectors carrying anti–TASK-1-siRNA were injected into both atria to suppress TASK-1 channel expression. After the 14-day follow-up period, porcine cardiomyocytes were isolated from right and left atrium, followed by electrophysiological and molecular characterization.

Results:

AF was associated with increased TASK-1 transcript, protein and ion current levels leading to shortened action potential duration in atrial cardiomyocytes compared to sinus rhythm controls, similar to previous findings in humans. Anti–TASK-1 adeno-associated viral application significantly reduced AF burden in comparison to untreated AF pigs. Antiarrhythmic effects of anti–TASK-1-siRNA were associated with reduction of TASK-1 currents and prolongation of action potential durations in atrial cardiomyocytes to sinus rhythm values.

Conclusions

Adeno-associated viral-based anti–TASK-1 gene therapy suppressed AF and corrected cellular electrophysiological remodeling in a porcine model of AF. Suppression of AF through selective reduction of TASK-1 currents represents a new option for antiarrhythmic therapy.
Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe
Authors: Steeds Richard P. , Lutz Matthias , Thambyrajah Jeetendra , Serra Antonio , Schulz Eberhard , Maly Jiri , Aiello Marco , Rudolph Tanja K. , Lloyd Guy , Bortone Alessandro Santo , Hauptmann Karl Eugen , Clerici Alberto , Delle‐Karth Georg , Rieber Johannes , Indolfi Ciro , Mancone Massimo , Belle Loic , Lauten Alexander , Arnold Martin , Bouma Berto J. , Deutsch Cornelia , Kurucova Jana , Thoenes Martin , Bramlage Peter , Frey Norbert , Messika‐Zeitoun David
Published: September 2019

Background

Many patients with severe aortic stenosis are referred late with advanced symptoms or inappropriately denied intervention. The objective was to investigate whether a structured communication to referring physicians (facilitated data relay) might improve the rate and timeliness of intervention.

Methods and Results

A prospective registry of consecutive patients with severe aortic stenosis at 23 centers in 9 European countries with transcatheter as well as surgical aortic valve replacement being available was performed. The study included a 3‐month documentation of the status quo (phase A), a 6‐month intervention phase (implementing facilitated data relay), and a 3‐month documentation of a legacy effect (phase‐B). Two thousand one hundred seventy‐one patients with severe aortic stenoses were enrolled (phase A: 759; intervention: 905; phase‐B: 507). Mean age was 77.9±10.0 years, and 80% were symptomatic, including 52% with severe symptoms. During phase A, intervention was planned in 464/696 (67%), 138 (20%) were assigned to watchful waiting, 8 (1%) to balloon aortic valvuloplasty, 60 (9%) were listed as not for active treatment, and in 26 (4%), no decision was made. Three hundred sixty‐three of 464 (78%) patients received the planned intervention within 3 months. Timeliness of the intervention improved as shown by the higher number of aortic valve replacements performed within 3 months (59% versus 51%,
P
=0.002) and a significant decrease in the time to intervention (36±38 versus 30±33 days,
P
=0.002).

Conclusions

A simple, low‐cost, facilitated data relay improves timeliness of treatment for patients diagnosed with severe aortic stenosis, resulting in a shorter time to transcatheter aortic valve replacement. This effect was mainly driven by a significant improvement in timeliness of intervention in transcatheter aortic valve replacement but not surgical aortic valve replacement.

Clinical Trial Registration

URL
:
https://www.clinicaltrials.gov/
. Unique identifier:
NCT
02241447.
On the taxonomy of two rare freshwater crabs (Decapoda, Brachyura, Chasmocarcinidae and Hymenosomatidae) from Palau, western Pacific
Authors: Ng Peter K. L.
Published: September 2019

The taxonomy of two species of secondary freshwater crabs endemic to Palau is discussed. Males of the chasmocarcinid Australocarcinus palauensis Davie & Guinot, 1996 (Trogloplacinae), previously known only from one female, are reported for the first time and the species is redescribed and figured. This species is closest to A. kanaka Davie & Guinot, 1996, from New Caledonia, but can be distinguished by the form of the carapace, third maxillipeds and gonopods. The rare hymenosomatid Neorhynchoplax inermis (Takeda & Miyake, 1971) (Hymenosomatinae), known only from the original description, is here shown to be distinct from species of Neorhynchoplax Sakai, 1938 s. str., differing in its complete absence of a true rostrum, absence of postocular lobes, the relatively short ischia and meri of the third maxillipeds, unarmed ambulatory dactyli and strongly twisted male first gonopod. The species is redescribed and transferred to a new genus, Insulaplax.