bluuebunny/crossref_metadata_2025 huggingface dataset:
Bayesian Network Models with Decision Tree Analysis for Management of Childhood Malaria in Malawi
Authors: Taneja Sanya B. , Douglas Gerald P. , Cooper Gregory F. , Michaels Marian G. , Druzdzel Marek J. , Visweswaran Shyam
Published: August 2020

Background: Malaria is a major cause of death in children under five years old in low- and middle-income countries such as Malawi. Accurate diagnosis and management of malaria can help reduce the global burden of childhood morbidity and mortality. Trained healthcare workers in rural health centers manage malaria with limited supplies of malarial diagnostic tests and drugs for treatment. A clinical decision support system that integrates predictive models to provide an accurate prediction of malaria based on clinical features could aid healthcare worker in judicious use of testing and treatment. We developed Bayesian network (BN) models to predict the probability of malaria from clinical features and an illustrative decision tree to model the decision to use or not use a malaria rapid diagnostic test (mRDT).Methods: We developed two BN models from data that were collected in a national survey of outpatient encounters of children in Malawi. The target diagnosis is taken as the result of mRDT. The first BN model was created manually with expert knowledge, and the second model was derived using an automated method followed by modifications guided by expert knowledge. The performance of the BN models was compared to other statistical models on a range of performance metrics. We developed a decision tree that integrates predictions from these predictive models with the costs of mRDT and a course of recommended treatment. Results: Compared to the logistic regression and random forest models, the BN models had similar accuracy of 64% but had higher sensitivity at the cost of lower specificity at the default threshold. Sensitivity analysis of the decision tree showed that at low (below 0.04) and high (above 0.4) probabilities of malaria in a child, the preferred decision that minimizes expected costs is not to perform mRDT.Conclusion: In resource-constrained settings, judicious use of mRDT is important. Predictive models in combination with decision analysis can provide personalized guidance on when to use mRDT in the management of childhood malaria. BN models can be efficiently derived from data to support such clinical decision making.
Associations of poor oral health with frailty and physical functioning in the oldest old: results from two studies in England and Japan
Authors: Albani Viviana , Nishio Kennsuke , Ito Tomoka , Kotronia Eftychia , Moynihan Paula , Robinson Louise , Hanratty Barbara , Kingston Andrew , Abe Yukiko , Takayama Michiyo , Iinuma Toshimitsu , Arai Yasumichi , Ramsay Sheena E
Published: August 2020

Background: Very few studies have examined the relationship of oral health with physical functioning and frailty in the oldest old (>85 years). We examined the association of poor oral health with markers of disability, physical function and frailty in studies of oldest old in England and Japan.Methods: The Newcastle 85+ Study in England (n=853) and the Tokyo Oldest Old Survey on Total Health (TOOTH; n=542) comprise random samples of people aged >85 years. Oral health markers included tooth loss, dryness of mouth, and self-reported difficulty eating due to dental problems. Physical functioning was based on grip strength and gait speed; disability was assessed as mobility limitations. Frailty was ascertained using the Fried frailty phenotype. Cross-sectional analyses were undertaken using logistic regression.Results: In the Newcastle 85+ Study, dry mouth symptoms, difficulty swallowing, difficulty eating, and tooth loss were associated with increased risks of mobility limitations after adjustment for gender, socioeconomic position, behavioural factors and co-morbidities [odds ratios (95%CIs) were 1.76 (1.26-2.46); 2.52 (1.56-4.08); 2.89 (1.52-5.50); 2.59 (1.44-4.65) respectively]. Similar results were observed for slow gait speed. Difficulty eating was associated with weak grip strength and frailty on full adjustment. In the TOOTH Study, difficulty eating was associated with increased risks of frailty, mobility limitations and slow gait speed; and complete tooth loss was associated with increased risk of frailty.Conclusion: Different markers of poor oral health are independently associated with worse physical functioning and frailty in the oldest old age groups. Research to understand the underlying pathways is needed.
PSMA PET Before and After Initial Long Term Androgen Deprivation in Patients With Newly Diagnosed Prostate Cancer
Authors: Hoberück Sebastian , Löck Steffen , Winzer Robert , Zöphel Klaus , Froehner Michael , Fedders Dieter , Kotzerke Jörg , Hölscher Tobias
Published: August 2020

Purpose: The study aimed to evaluate the effect of androgen deprivation therapy (ADT) on PSMA imaging and its correlation to the PSA concentration comparing qualitative and quantitative parameters: SUVmax, SUVmean, PSMA-derived tumor volume (PSMA-TV), total lesion PSMA (TL-PSMA) and metabolic imaging (mi)PSMA score. Methods: Retrospective analysis of 19 therapy-naïve and oligometastatic prostate cancer patients (median age 73 years) who underwent either 68Ga-PSMA-11-PET/CT or -PET/MRI before initiation (T1) of as well as during ADT (T2). The median duration of ADT was 156 days (range: 61-289 days). All lesions were analyzed using several qualitative and quantitative PET parameters.Results: During long term ADT occurred a relevant decrease of lesion count and PSMA expression. A total of 104 PSMA-positive lesions (21 intraprostatic, 54 lymphonodal, 29 osseous) were visually detected at each of the two points, while at T2 two new bone lesions were detected in one patient. All analyzed PET parameters, which correlated strongly with each other. During ADT, all patients experienced a decrease of their PSA level (median: 29.1 before vs. 0.69 after; p<0.001). The PSA level at T2 correlates modestly with the decrease of PSMA expression and its derived volumes.Conclusion: Post ADT scans detected less PSMA-positive lesions with overall lower PSMA expression, regardless of primary tumor site or metastatic sites. None of the PET parameters has proven to be superior, as they all correlated modestly with the PSA value at T2. Thus, the simply acquirable miPSMA score seems to be the most suitable for evaluating the effect of ADT on PSMA expression.
The Transverse Diameter of Right Common Femoral Vein by Ultrasound in the Supine Position for Predicting Post-spinal Hypotension During Cesarean Delivery
Authors: Yao Shi-Fa , Zhao Yan-Hong , Zheng Jing , Qian Jie-Yan , Zhang Chen , Xu Zifeng , Xu Tao
Published: August 2020

Background: Post-spinal anesthesia hypotension during cesarean delivery is caused by decreased systemic vascular resistance due to the blockage of autonomic nerves, which is further worsened by aortocaval compression by the gravid uterus. The aim of this study was to assess whether peak velocities and diameters of the abdominal aorta (AA) and inferior vena cava (IVC) below the xiphoid or the right common femoral artery (RCFA) and right common femoral vein (RCFV) in the inguinal region, as measured on ultrasound, could reflect the degree of aortocaval compression and further identify parturients at risk of post-spinal hypotension.Methods: After ultrasound measurement of peak velocities and anteroposterior diameters of the AA, and IVC and peak velocities and transverse diameters of the RCFA and RCFV before anesthesia, 56 parturients undergoing elective cesarean section with spinal anesthesia were enrolled in this study. Multinomial logistic regression analysis was used to identify the risk factors for post-spinal hypotension during cesarean delivery. Receiver operating characteristic curves were used to test the abilities of the identified parameters to predict post-spinal hypotension, and the areas under the curve and the optimum cut-off values for the predictive parameters were calculated. Results: The transverse diameter of the RCFV was a risk factor for post-spinal hypotension (odds ratio = 2.022, 95% confidence interval [CI] 1.261–3.243). The area under the receiver operating characteristics curve for the prediction of post-spinal hypotension was 0.759 (0.628–0.890; P = 0.001). A transverse diameter of the RCFV longer than 12.2 mm could predict post-spinal hypotension during cesarean delivery. Conclusions: We demonstrated a higher transverse RCFV diameter was associated with hypotension and it could effectively predict parturients at risk of hypotension before anesthesia. Trial Registration: This study was registered at http://www.chictr.org.cn on 16, May, 2018. No. ChiCTR1800016163
Bathing and Toileting Difficulty of Chinese Older Adults: The Role of Environment
Authors: Liu Changxi , Fong Joelle H. , Hoh Jasmon W. T. , Wu Hailin , Dong Yunsheng , Gu Danan , Qiushi Feng
Published: August 2020

Background: For older adults, difficulties in bathing and toileting are often the most prevalent in the index of Activities of daily living (ADL). Few studies, however, have investigated how the built environment and other environmental factors affect bathing and toileting in later life. This study aims to fill this gap. Method: The data are from the 2014 Thousand-Village Survey (TVS), a national survey of Chinese rural residents of old age. The sample consists of 10,689 subjects, 55 years or older, from 536 villages across all provinces of China. The multinomial logistic regressions were applied to examine how difficulty in bathing and toileting was related to environmental factors such as geographic location, community amenity, and built environment of bathing and toileting. Results: Older adults living in the southern regions of China had lesser difficulty in bathing and toileting than those living in Northern China, controlling on other confounders. Better community conditions also reduced the likelihood of having such disabilities. Persons who bathed indoors without shower facilities, in public facility, and outdoors were significantly more likely to have bathing disability than those who showered indoors. Rural older adults who used pedestal pan and indoor bucket for toileting were more likely to have toileting disability than those who used indoor squatting facilities. Conclusion: Environmental factors are strongly associated with functional disability among older adults, but the relationship is not unidirectional. Having a showering facility could reduce difficulties of bathing for rural Chinese. Very frail older persons may actively choose to change their environmental settings to suit their needs, for instance, by using a pedestal pan or bucket for toileting as an alternative to squatting. There is an urgent need to promote the use of showering facilities and pedestal pans for toileting in rural China.
An assessment of the potential miscalibration of cardiovascular disease risk predictions caused by a secular trend in cardiovascular disease in England
Authors: Pate Alexander , Staa Tjeerd van , Emsley Richard
Published: August 2020

Background
A downwards secular trend in the incidence of cardiovascular disease (CVD) in England was identified through previous work and the literature. Risk prediction models for primary prevention of CVD do not model this secular trend, this could result in over prediction of risk for individuals in the present day. We evaluate the effects of modelling this secular trend, and also assess whether it is driven by an increase in statin use during follow up.
Methods
We derived a cohort of patients (1998–2015) eligible for cardiovascular risk prediction from the Clinical Practice Research Datalink with linked hospitalisation and mortality records (N = 3,855,660). Patients were split into development and validation cohort based on their cohort entry date (before/after 2010). The calibration of a CVD risk prediction model developed in the development cohort was tested in the validation cohort. The calibration was also assessed after modelling the secular trend. Finally, the presence of the secular trend was evaluated under a marginal structural model framework, where the effect of statin treatment during follow up is adjusted for.
Results
Substantial over prediction of risks in the validation cohort was found when not modelling the secular trend. This miscalibration could be minimised if one was to explicitly model the secular trend. The secular trend was still present under the marginal structural model framework, indicating increasing statin use during follow up is not the cause.
Conclusions
Inclusion of the secular trend into the model substantially changed the CVD risk predictions. Models that are being used in clinical practice in the UK do not model secular trend and may thus overestimate the risks, possibly leading to patients being treated unnecessarily.
Squamanitaceae and Three New Species of Squamanita Parasitic on Amanita Basidiomes
Authors: Liu Jian-Wei , Ge Zai-Wei , Horak Egon , Vizzini Alfredo , Halling Roy. E. , Pan Chunlei , Yang Zhu L.
Published: August 2020

The systematic position of the enigmatic genus Squamanita (Agaricales, Basidiomycota) is largely unknown. Together with Cystoderma and Phaeolepiota, they were categorized as belonging in the tribe Cystodermateae. In this study, with newly generated sequences of the type species of the genus Squamanita, namely S. schreieri, and sequences of a few species of Cystodermateae, the phylogeny of this “tribe” is reinvestigated with a concatenated (28S-5.8S-18S) dataset. Our study reveals that Squamanita and Phaeolepiota-Cystoderma are indeed sister groups with moderate statistic support (MLBS/PP = 80/1), and Squamanita is a monophyletic clade with highly statistic support (MLBS/PP = 92/1). The family name Squamanitaceae is resurrected and emended to accommodate the three genera. Meanwhile, another concatenated (ITS-28S-18S) dataset is used to investigate the phylogenetic relationship and species delimitation in Squamanita. Our data indicated that “S. umbonata” from North America, Europe, East Asia, and Central America harbors a complex of species, and species of Squamanita can parasitize species of Amanita, besides other fungal species. Squamanita mira parasitizes A. kitamagotake (A. sect. Caesareae), while S. orientalis and S. sororcula are parasites of species belonging to the A. sepiacea complex (A. sect. Validae). “Squamanita umbonata” from Italy occurs on A. excelsa (A. sect. Validae). Three new species of Squamanita from East Asia, viz. S. mira, S. orientalis and S. sororcula are documented with morphological, multi-genes phylogenetic, ecological data, line drawings, and photographs and compared with similar species.
Metabolic syndrome and 5-year incident hyperuricemia among older Chinese adults: a community-based cohort study
Authors: Liu Jing-Hong , Ma Qing-Hua , Xu Yong , Chen Xing , Pan Chen-Wei
Published: August 2020

Background
There was a lack of studies focusing on older adults about the longitudinal association between metabolic syndrome (MetS) and hyperuricemia (HUA). We aimed to assess the association of baseline MetS and incident HUA among older Chinese adults, with a special focus on the associations between different combinations of MetS components and HUA.
Methods
Data of 3,247 Chinese adults aged 60 years or older included in a community-based longitudinal cohort study were analyzed. Anthropometric examinations and collection of blood sample were conducted both at baseline and follow-up. HUA was defined as 7 mg/dl or above for men and 6 mg/dl or greater for women. MetS was assessed based on the National Cholesterol Education Program-Adult Treatment Panel Ⅲ, and older adults with presence of at least three of MetS components were considered as having MetS.
Results
MetS and its components including high blood pressure (BP), high body mass index, diabetes mellitus and high triglycerides were significantly related to incident HUA. The association between high BP and incident HUA is strongest among the five MetS components. Among all combinations of MetS components, the group consisting of diabetes mellitus, high BP and high triglycerides had the highest odds for incident HUA (OR = 13.07, 95%CI = 4.95–34.54).
Conclusions
MetS and its components except for low high-density lipoprotein cholesterol could increase the risk of HUA among community-dwelling older adults and high BP may be the most important determinant.
Oncological Outcomes of Laparoscopic Versus Open Gastrectomy After Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer: A Retrospective Multicenter Study
Authors: Khaled Islam , Soliman Hany , Faisal Mohamed , Saad Ihab
Published: August 2020

Background: Oncological outcomes of laparoscopic gastrectomy (LG) and open gastrectomy (OG) following neo-adjuvant chemotherapy were investigated in few studies. Our purpose was to evaluate the oncological outcomes of LG and OG after neoadjuvant chemotherapy for patients with locally advanced GC to determine its safety and feasibility.Methods: We conducted a retrospective chart review for all patients who underwent either OG (n = 43) or LG (n = 41). The neoadjuvant treatment regimen consisted of capecitabine plus oxaliplatin for 3 cycles, which was then repeated for 5 cycles 6 to 12 weeks after the operation.Results: The hospital stay length and intraoperative blood loss the LG group were significantly lower than in the OG group. The in-hospital mortality rate and the 3-year survival rate for patients in the OG group were comparable to that of patients in the LG group (4.6% vs 9.7%; 58.1% vs 68.3%, respectively). Similar trends were observed regarding the 3-year recurrence rate and metastasis. The mean survival time was 52.9 months (95% confidence interval [CI], 44.2–61.6) in the OG group compared with 43.3 (95% CI, 36.6–49.8) in the LG group. Likewise, the mean disease-free survival was 56.1 months (95% CI, 46.36–65.8) in the LG group compared with 50.9 months (95% CI, 44.6–57.2) in the OG group.Conclusion: Compared to OG, LG is a feasible and safe alternative for patients receiving neoadjuvant chemotherapy with locally advanced GC.
Clinical diagnosis in paediatric patients at urban primary health care facilities in southern Malawi: a longitudinal observational study
Authors: Gondwe Mtisunge Joshua , Henrion Marc YR , O’Byrne Thomasena , Masesa Clemens , Lufesi Norman , Dube Queen , Majamanda Maureen D , Makwero Martha , Lalloo David G , Desmond Nicola
Published: August 2020

Background: Despite health centres being the first point of contact of care, there are challenges faced in providing care to patients at this level. In Malawi, service provision barriers reported at this level included long waiting times, high numbers of patients and erratic consultation systems which lead to mis-diagnosis and delayed referrals. Proper case management at this level of care is critical to prevent severe disease and deaths in children.Objective: Adopting ETAT to improve ability to identify severe illness in children at primary health centre (PHC) level through comparison with secondary level diagnoses.Methods: We implemented ETAT mHealth algorithm at eight urban PHCs in Blantyre, Malawi between April 2017 and September 2018. Health workers and support staff were trained in mHealth ETAT. Stabilisation rooms were established and equipped with emergency equipment. All PHCs used an electronic tracking system to triage and track sick children on referral to secondary care, facilitated by a unique barcode. Support staff at PHC triaged sick children using ETAT Emergency (E), Priority (P) and Queue (Q) symptoms and clinician gave clinical diagnosis. The secondary level diagnosis was considered as a gold standard. We used statistical computing software R (v3.5.1) and used exact 95% binomial confidence intervals when estimating diagnosis agreement proportions.Results: Eight-five percentage of all cases where assigned to E (9.0%) and P (75.5%) groups. Pneumonia was the most common PHC level diagnosis across all three triage groups (E,P,Q). The PHC level diagnosis of trauma was the most commonly confirmed diagnosis at secondary level facility (85.0%) , while a PHC diagnosis of pneumonia was least likely to be confirmed at secondary level (39.56%). The secondary level diagnosis least likely to have been identified at PHC level was bronchiolitis 3 (5.2%). The majority of bronchiolitis cases (n = 50; (86.2%) were classified as pneumonia at the PHC level facility.Conclusions Implementing a sustainable and consistent ETAT approach with stabilisation and treatment capacity at PHC level reinforce staff capacity to diagnose and has the potential to reduce other health system costs through fewer, timely and appropriate referrals.
Diagnostic Accuracy of Physical Examination for Detecting Pelvic Fractures Among Blunt Trauma Patients: A Systematic Review and Meta-Analysis
Authors: Okada Yohei , Nishioka Norihiro , Ohtsuru Shigeru , Tsujimoto Yasushi
Published: August 2020

Background: Pelvic fractures are common among blunt trauma patients, and timely and accurate diagnosis can improve patient outcomes. However, it remains unclear whether physical examinations are sufficient in this context. This study aims to perform a systematic review and meta-analysis of studies on the diagnostic accuracy and clinical utility of physical examination for pelvic fracture among blunt trauma patients.Methods: Studies were identified using the MEDLINE, EMBASE, and CENTRAL databases starting from the creation of the database to January 2020. A total of 20 studies (49,043 patients with 8,300 cases [16.9%] of pelvic fracture) were included in the quality assessment and meta-analysis. Two investigators extracted the data and evaluated the risk of bias in each study. The meta-analysis involved a hierarchical summary receiver operating curve (ROC) model to calculate the diagnostic accuracy of the physical exam. Subgroup analysis assessed the extent of between-study heterogeneity. Clinical utility was assessed using decision curve analysis.Results: The median prevalence of pelvic fracture was 10.5% (interquartile range: 5.1–16.5). The pooled sensitivity (and corresponding 95% confidence interval) of the hierarchical summary ROC parameters was 0.859 (0.761–0.952) at a given specificity of 0.920, which was the median value among the included studies. Subgroup analysis revealed that the pooled sensitivity among patients with a Glasgow Coma Scale score ≥ 13 was 0.933 (0.847–0.998) at a given specificity of 0.920. The corresponding value for patients with scores ≤ 13 was 0.761 (0.560–0.932). For threshold probability < 0.01 with 10%–15% prevalence, the net benefit of imaging tests was higher than that of physical examination. Conclusion: Imaging tests should be performed in all trauma patients regardless of findings from physical examination or patients’ levels of consciousness. However, the clinical role of physical examination should be considered given the prevalence and threshold probability in each setting.
Perceptions and prevention practices on malaria among the indigenous Orang Asli community in Kelantan, Peninsular Malaysia
Authors: Munajat Mohd Bakhtiar , Rahim Mohd Amirul Fitri A. , Wahid Wathiqah , Rakna Mohd Ikhwan Mukmin Seri , Divis Paul C. S. , Chuangchaiya Sriwipa , Lubis Inke Nadia D. , Osman Emelia , Kasri Muhd Rafiq Mohd , Id Zulkarnain Md
Published: August 2020

Background
Malaysia is on track towards malaria elimination. However, several cases of malaria still occur in the country. Contributing factors and communal aspects have noteworthy effects on any malaria elimination activities. Thus, assessing the community’s knowledge, attitudes and practices (KAP) towards malaria is essential. This study was performed to evaluate KAP regarding malaria among the indigenous people (i.e. Orang Asli) in Peninsular Malaysia.
Methods
A household-based cross-sectional study was conducted in five remote villages (clusters) of Orang Asli located in the State of Kelantan, a central region of the country. Communities aged 6 years and above were interviewed. Demographic, socio-economic and KAP data on malaria were collected using a structured questionnaire and analysed using descriptive statistics.
Results
Overall, 536 individuals from 208 households were interviewed. Household indoor residual spraying (IRS) coverage and bednet ownership were 100% and 89.2%, respectively. A majority of respondents used mosquito bed nets every night (95.1%), but only 50.2% aware of bednets were use to prevent malaria. Nevertheless, almost all of the respondents (97.9%) were aware that malaria is transmitted by mosquitoes. Regarding practice for managing malaria, the most common practice adopted by the respondents was seeking treatment at the health facilities (70.9%), followed by self-purchase of medication from a local shop (12.7%), seeking treatment from a traditional healer (10.5%) and self-healing (5.9%). Concerning potential zoonotic malaria, about half of the respondents (47.2%) reported seeing monkeys from their house and 20.1% reported entering nearby forests within the last six months.
Conclusion
We conclude that most populations living in the villages have an acceptable level of knowledge and awareness about malaria. However, positive attitudes and practices with respect to managing malaria require marked improvement.
Exploring the mRNA Expression Level of RELN in Peripheral Blood of Schizophrenia Patients Before and After Antipsychotic Treatment
Authors: Yin Jiajun , Lu Yana , Yu Shui , Dai Zhanzhan , Zhang Fuquan , Yuan Jianmin
Published: August 2020

Background: The Reelin (RELN) gene encodes the protein reelin, which is a large extracellular matrix glycoprotein that plays a key role in brain development. Additionally, this protein may be involved in memory formation, neurotransmission, and synaptic plasticity, which have been shown to be disrupted in schizophrenia (SCZ). A decreasing trend in the expression of RELN mRNA in the brain and peripheral blood of SCZ patients has been observed. There is a need to determine whether changes in RELN mRNA expression in SCZ patients are the result of long-term antipsychotic treatment rather than the etiological characteristics of schizophrenia. The expression levels of RELN mRNA in the peripheral blood of 48 healthy controls and 30 SCZ patients before and after 12-weeks of treatment were measured using quantitative real-time PCR. Results: The expression levels of RELN mRNA in the SCZ group were significantly lower than that of healthy controls; however, after 12-weeks of antipsychotic treatment, RELN mRNA levels were significantly increased in the SCZ group.Conclusion: The up-regulation of RELN mRNA expression was concurrent with the improvement of symptoms in SCZ patients after antipsychotic treatment, suggesting that the changes in RELN mRNA expression were related to the effect of the antipsychotic treatment.
Psychometric Properties of the Contextual Body Image Questionnaire for Athletes: A Replication and Extension Study in Female Collegiate Athletes
Authors: Stewart Tiffany , Kilpela Lisa , Wesley Nicole , Baule Kate , Thompson Ronald , Sherman Roberta , Becker Carolyn
Published: August 2020

Background: Although the link between body dissatisfaction and eating disorder (ED) pathology is well-stablished in general female samples, less is known about correlates of contextual body image (CBI) among female athletes. CBI refers to female athletes experiencing body image concerns in two distinct contexts: sport and daily life (de Bruin et al., 2011). The Contextual Body Image Questionnaire for Athletes (CBIQA) measures four factors of body image (Appearance, Thin-Fat Self-Evaluation, Thin-Fat Others’ Evaluation, and Muscularity) in both contexts. This study sought to A) investigate the psychometric properties of the CBIQA, B) examine the prospective relation of CBI with ED pathology and negative affect among female collegiate athletes, and C) the degree to which CBI prospectively predicts ED pathology and negative affect in female collegiate athletes. Method: Using self-report data collected from a multi-site parent trial, we first examined the psychometric properties of the CBIQA by conducting a confirmatory factor analysis. We assessed construct validity via cross-sectional bivariate correlation analyses with thin-ideal internalization, negative affect, and ED pathology. Lastly, using data collected at Time 1 and 6 months later (Time 2), we investigated the degree to which CBI prospectively predicted ED pathology and negative affect.Results: Results from the CFA largely confirmed de Bruin et al.’s (2011) original factor analysis. Two CBIQA factors (Thin-Fat Self and Appearance) in both contexts correlated with ED pathology and negative affect. Thin-Fat Others also correlated with ED pathology in both domains and negative affect in the sport domain. The Muscularity domain was predominantly orthogonal with other measures. CBIQA factors were uncorrelated with thin-ideal internalization. Finally, when controlling for BMI and Time 1 scores, daily life and sport appearance concerns predicted ED pathology, whereas perceived evaluation of thin-fat by others in the sport context predicted negative affect 6 months later. Conclusions: Results support the psychometric validity of the CBIQA and suggest that this measure appears to capture variance discrete from thin-ideal internalization. The Muscularity factor largely was not related to other outcomes. Further, specific elements of perceived self- and other-evaluation in both contexts is relevant to risk for ED pathology and negative affect. Future research could examine the impact of dual body image between seasons and after transitioning out of sport.Clinical trials registration: NCT01735994
Unconventional reconciliation path for quantum mechanics and general relativity
Authors: Yuguru Samuel
Published: August 2020

Physics in general is successfully governed by quantum mechanics at the microscale and principles of relativity at the macroscale. Any attempts to unify them using conventional methods have somewhat remained elusive for nearly a century up to the present stage. Here in this study, a classical gedanken experiment of an electron-wave diffraction of a single slit is intuitively examined for its quantized states. A unidirectional monopole field as quanta of the electric field is pictorially conceptualized. Its application towards quantum mechanics and general relativity in consistent with existing knowledge in physics paves an alternative path towards their reconciliation process by assuming a multiverse at a hierarchy of scales. Such an outcome provides an approximate intuitive guide to pursue physics in general from alternative perspectives using conventional methods.
Learner satisfaction, engagement and performances in an online module: Implications for institutional e-learning policy
Authors: Banoor Rajabalee Yousra , Issack Santally Mohammad
Published: August 2020

There has been much debate on the issue of whether online learning was better than traditional education and vice-versa over the past decade. Over time, the concept of blended learning became quite the norm, especially within traditional universities who could no longer turn a blind eye to the educational revolution brought about by information and communication technologies. While the pace of technology integration in universities generally varies in pace, the world has recently experienced a massive uptake, albeit in an unplanned and mostly disorganized manner, of e-learning technologies due to the Covid-19 pandemic. Researchers have emphasized on the quality of online courses from a perspective of learner achievement in terms of student satisfaction, engagement and performances. In this paper, we analyze student feedback and report the findings of a study of the relationships between student satisfaction and their engagement in an online course with their overall performances. The module was offered online to 844 university students in the first year across different disciplines, namely Engineering, Science, Humanities, Management and Agriculture. It was assessed mainly through continuous assessments and was designed using a learning-by-doing pedagogical approach. The focus was on the acquisition of new skills and competencies, and their application in authentic mini-projects throughout the module. Student feedback was coded and analyzed both from a quantitative and qualitative perspective. The association between satisfaction and engagement was significant and positively correlated. On the other hand, there was a weak but positive and significant correlation between satisfaction or engagement with their overall performances. We further observed that students were generally very satisfied with the learning design philosophy, irrespective of their performance levels. Students, however, reported issues related to lack of tutor support and experiencing technical difficulties across groups. The findings raise important implications for institutional e-learning policy making. The factors that are important relate to the object of such policies, learning design models, personalized support, distributed virtual learning through synchronous interaction, and learning analytics.
Map the Apps: a rapid review of digital approaches to support the engagement of older adults in strength and balance exercises
Authors: McGarrigle Lisa , Boulton Elisabeth , Todd Chris
Published: August 2020

Background: Exercise interventions, particularly those targeting strength and balance, are effective in preventing falls in older people. Activity levels are generally below recommended levels and reduce with age. There is concern that exercise levels may be further reduced in the context of the COVID-19 pandemic. Digital approaches may offer a means for older people to engage in strength and balance exercises independently in their own homes. The objective of this review was to identify and evaluate existing apps and websites to support independent engagement in strength and balance exercises by older people.Methods: We conducted a rapid review of apps and websites, following PRISMA guidelines. We searched for available apps in the Android and iOS app stores, and performed a database search (MEDLINE and EMBASE) for apps in development. We searched for websites using the Google search engine. Apps and websites were evaluated in terms of existing evidence for effectiveness, use of behaviour change techniques (BCTs), and quality. Results: We evaluated 13 apps and 24 websites on the basis of our selection criteria. Considering the evidence-base, quality and BCT scores, four apps and six websites are recommended for use by older people who wish to engage in exercise independently in their own homes. No apps or websites have been to RCT evaluation at the time of review.Conclusions: Apps and websites have the potential to provide a convenient, cost-effective, and accessible means for many older adults to engage in strength and balance training and reduce falls risk.
Epidemiology of pediatric uveitis and associated systemic diseases
Authors: Shin Yoonkyeom , Kang Ji-Man , Lee Junwon , Lee Christopher Seungkyu , Lee Sung Chul , Ahn Jong Gyun
Published: August 2020

Background: The early detection of uveitis associated with systemic inflammatory disease in children is important for proper treatment and prognosis. However, the diagnosis may be delayed because of difficulties in childhood examinations and early minor systemic symptoms. The objective of our study was to identify the pattern of childhood uveitis and investigate the frequency and clinical features of rheumatic diseases in pediatric patients with uveitis. Methods: This retrospective observational study reviewed the medical records of children (age ≤18 years) with uveitis at a Korean tertiary hospital between January 2005 and December 2018. Data collected included the age at onset of uveitis, sex, anatomic location of ocular inflammation, comorbid disease (including systemic inflammatory disease), ocular complications, relevant laboratory data, and treatment. Fisher’s exact test was used to compare categorical variables and the Mann–Whitney U test was used to compare continuous variables. A p-value of <0.05 was considered statistically significant. Results: A total of 155 pediatric patients with uveitis were included in this study. The median age at diagnosis was 13.0 years (interquartile range, 9.5–16.0 years). The male-to-female ratio was 1.09. The process was unilateral in 51.6% of children. Anterior uveitis, panuveitis, intermediate uveitis, and posterior uveitis represented 51.6%, 26.5%, 6.5%, and 1.9% of the cases, respectively. Idiopathic uveitis (65.2%) was the most frequent type of uveitis. Systemic rheumatic disease associations were responsible for 28.4% of the cases, among which juvenile idiopathic arthritis (JIA) was the most frequent cause (14.8%). Human leukocyte antigen (HLA)-B27 and antinuclear antibody (ANA) positive rates were significantly higher in patients with JIA than in those with idiopathic uveitis (p=0.006 and p=0.007, respectively). Conclusions: Approximately one-third of children with uveitis in Korea have a systemic rheumatic disease, of which JIA accounts for the majority of cases. HLA-B27 and ANA can be useful screening tools in children with JIA-associated uveitis.
Mass-production and Distribution of Medical Face Shields Using Additive Manufacturing and Injection Molding Process for Healthcare System Support During COVID-19 Pandemic in Brazil
Authors: Kunkel Maria Elizete , Vasques Mayra Torres , Perfeito João Aléssio Juliano , Zambrana Nataly Rabelo Mina , Bina Tainara dos Santos , Passoni Laura Helena de Melo , Ribeiro Thamires Verri , Rodrigues Sandra Maria Sousa , Castro Renato Ortolani Marcondes de , Ota Natacha Harumi
Published: August 2020

Face shields have been adopted worldwide as personal protective equipment for healthcare professionals during the COVID-19 pandemic. This device provides a transparent facial physical barrier reducing the exposure to aerosol particles. The fused deposition modeling (FDM) is the most applied process of additive manufacturing due to its usability and low-cost. The injection molding (IM) is the fastest process for mass production. This study is the first to perform a qualitative comparison between the use of FDM and IM processes for mass production and rapid distribution of face shields in a pandemic. The design of the face shield and tests were conducted in prototyping cycles based on requirements of medical, Brazilian standards, manufacturing, and production. The FDM face shields manufacturing was carried out by a volunteer network, and the IM manufacturing was carried out by companies. The volunteers produced 35,000 medical face shields through the FDM process with daily delivery to several hospitals. A total of 80,000 face shields was produced by the IM process and delivered to remote Brazilian regions. The mass production of 115,000 face shields protected health professionals from public hospitals in all states of Brazil. In a pandemic, both FDM and IM processes are suitable for mass production of face shields. Once a committed network of volunteers is formed in strategic regions, the FDM process promotes a fast daily production. The IM process is the best option for large scale production of face shields and delivery to remote areas where access to 3D printing is reduced.
Relative impacts of climate change and land cover change on streamflow using SWAT in the Clackamas River Watershed, USA
Authors: Chen Junjie , Chang Heejun
Published: August 2020

To understand the spatial–temporal pattern of climate and land cover (CLC) change effects on hydrology, we used three land cover change (LCC) coupled scenarios to estimate the changes in streamflow metrics in the Clackamas River Watershed in Oregon for the 2050s (2040–2069) and the 2080s (2070–2099). Coupled scenarios, which were split into individual and combined simulations such as climate change (CC), LCC, CLC change, and daily streamflow were simulated in the Soil and Water Assessment Tool. The interannual variability of streamflow was higher in the lower urbanized area than the upper forested region. The watershed runoff was projected to be more sensitive to CC than LCC. Under the CLC scenario, the top 10% peak flow and the 7-day low flow are expected to increase (2–19%) and decrease (+9 to −20 cm s), respectively, in both future periods. The center timing of runoff in the year is projected to shift 2–3 weeks earlier in response to warming temperature and more winter precipitation falling as rain. High streamflow variability in our findings suggests that uncertainties can stem from both climate models and hydrologic model parameters, calling for more adaptive water resource management in the watershed.
Simulating rainfall runoff and assessing low impact development (LID) facilities in sponge airport
Authors: Peng Jing , Zhong Xiang , Yu Lei , Wang Qianqian
Published: August 2020

The appearance of extreme weather causes frequent airport flooding, which has a serious impact on the normal operation of an airport. In this study, three simulation scenarios are set in order to study the effect of low impact development (LID) facilities (green roof and vegetative swale) on the water depth of overflow junctions and total inflow to the study area outlet in an airport at different rainfall return periods (2 a, 5 a, 20 a and 50 a). Vegetative swale has better reduction effect on water depth of overflow junctions than has green roof. The reduction rate of vegetative swale is about 25–52% at different rainfall return periods, but the effect of green roof is not obvious. For the double peak rainstorm, the reduction effect on the water depth of overflow junctions after setting vegetative swale for the first rain peak is better than that for the second rain peak. Under the condition of 2 a, 5 a, and 20 a, the total inflow reduction rates of study area outlet after applied green roof and vegetative swale are 16.85%, 20% and 22.17% respectively, and the effect is poor (only 2.26%) at low-frequency return period (50 a). This study can provide theoretical guidance for the design of LID facilities of a sponge airport.
Pieces of the Complex Puzzle of Cancer Cell Energy Metabolism: An Overview of Energy Metabolism and Alternatives for Targeted Cancer Therapy
Authors: Ghasemishahrestani Zeinab , Melo Mattos Larissa Maura , Tilli Tatiana Martins , Santos André Luis Souza dos , Pereira Marcos Dias
Published: August 2020

Over the past decades, several advances in cancer cell biology have led to relevant details about a phenomenon called the ‘Warburg effect’. Currently, it has been accepted that the Warburg effect is not compatible with all cancer cells, and thus the process of aerobic glycolysis is now challenged by the knowledge of a large number of cells presenting mitochondrial function. The energy metabolism of cancer cells is focused on the bioenergetic and biosynthetic pathways in order to meet the requirements of rapid proliferation. Changes in the metabolism of carbohydrates, amino acids and lipids have already been reported for cancer cells and this might play an important role in cancer progression. To the best of our knowledge, these changes are mainly attributed to genetic reprogramming which leads to the transformation of a healthy into a cancerous cell. Indeed, several enzymes that are highly relevant for cellular energy are targets of oncogenes (e.g. PI3K, HIF1, and Myc) and tumor suppressor proteins (e.g. p53). As a consequence of extensive studies on cancer cell metabolism, some new therapeutic strategies have appeared that aim to interrupt the aberrant metabolism, in addition to influencing genetic reprogramming in cancer cells. In this review, we present an overview of cancer cell metabolism (carbohydrate, amino acid, and lipid), and also describe oncogenes and tumor suppressors that directly affect the metabolism. We also discuss some of the potential therapeutic candidates which have been designed to target and disrupt the main driving forces associated with cancer cell metabolism and proliferation.
Development of Emulgel Delivery of Mupirocin for Treatment of Skin Infection
Authors: Jagdale Swati C. , Kothekar Payal V.
Published: August 2020

Aim::

To design controlled release topical delivery of mupirocin for the treatment
of skin infection.

Background::

Mupirocin is an antibacterial drug. Mupirocin works to kill the bacteria,
which include strains of Staphylococcus aureus and Streptococcus pyogenes. It is also used
for the treatment of inflammation of a hair follicle. The half-life of mupirocin is only 20-40
min. It has very slight solubility in water. Patent literature had shown work on ointment, antibiotic
composition, nasal and topical composition. Emulgel is a duel control release system
for the topical delivery of hydrophobic drugs.

Objective::

The objective was to formulate emulgel with controlled delivery of mupirocin
using Sepineo P 600.

Methods::

Soya oil, tween 80 and polyethylene glycol 400 (Oil:Surfactant:Cosurfactant)
were used for emulsion formulation. Emulgel was optimized by 32 factorial design. Sepineo
P 600 and hydroxy propyl methyl cellulose K4M were used as independent variables. Drug
excipient compatibility analysis was carried out by FTIR, UV and DSC spectra. Emulgel
was evaluated for its physical characterization, in vitro release, ex vivo release, antimicrobial
and anti-inflammatory study.

Results::

DSC, UV and FTIR analysis confirmed drug excipient compatibility. FE SEM
showed a size range between 228-255 nm. Zeta potential was found to be -25.1 mV, which
showed good stability of the emulsion. Design expert software showed F2 as an optimized
batch. Release studies indicated that the controlled release of drugs forms Sepineo P 600 gel
due to its higher gelling capacity. Batch F2 showed comparable results with marketed formulation
against Staphylococcus aureus. For batch F2, 40 μg/ml was the minimal inhibitory
concentration.

Conclusion::

Antimicrobial and anti-inflammatory study proved successful development of
stably controlled release mupirocin emulgel.
A Network Pharmacology Approach to Reveal the Underlying Mechanisms of Zuogui Yin in the Treatment of Male Infertility
Authors: Zhao Qi , Dai Hengheng , Wang Jisheng , Yan Fei , Jang Guejin , Ma Jianxiong , Wang Bin , Li Haisong
Published: August 2020

Background and Aim:

Traditional Chinese medicine (TCM), as a complementary and
alternative therapy, has played increasingly important roles in clinical treatment and disease prevention.
Zuogui Yin (ZGY) is one of the well-known TCM prescriptions used for the treatment of
male infertility. To fully reveal the potential mechanisms underlying the therapeutic effects of
ZGY on male infertility, a network pharmacology approach was conducted at the molecular level.

Methods:

Network pharmacology approach was used in this study, which mainly included active
compound screening, target prediction, gene enrichment analysis, and network analysis.

Results:

The network analysis successfully identified 148 potential active ingredients of ZGY and
155 predicted targets that were associated with male infertility. ZGY might play a role in the treatment
of male infertility by regulating ten hub targets (VEGFA, CASP3, TNF, AKT1, EGF, EGFR,
IL-6, MAPK1, TP53, and PTGS2) and six pathways (TNF signaling pathway, PI3K-Akt signaling
pathway, FoxO signaling pathway, Toll-like receptor signaling pathway, VEGF signaling pathway,
and MAPK signaling pathway).

Conclusion:

: This study explored the pharmacological activity and molecular mechanisms of ZGY
against male infertility from a holistic perspective. The underlying molecular mechanisms were
closely related to the intervention of oxidative stress and apoptosis with CASP3, TP53, AKT1, and
MAPK1 being possible targets.