bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational Health Nurses’ Self-Efficacy in Smoking Cessation Interventions: An Integrative Review of the Literature
Authors: Thornberry Amy , Garcia Theresa J. , Peck Jessica , Sefcik Elizabeth
Published: June 2020

Background: Effective smoking cessation interventions (SCIs) are indicated, particularly among the working population, where a higher than expected prevalence of smoking continues. Occupational health nurses’ (OHN) self-efficacy can affect SCI but current scientific literature is limited. The purpose of this integrative literature review was to determine factors that affect OHN self-efficacy and motivation for providing SCI and to guide research needed to enhance SCI programs. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted an integrative literature review. The strategy was an electronic data search of PubMed conducted between 2013 and 2018 and included peer-reviewed manuscripts written in English that addressed self-efficacy and its relationship to SCI. Findings: In total, 15 research articles met the inclusion criteria and two referred specifically to OHNs. Common themes revealed factors which positively and negatively influenced nurses’ self-efficacy, including training, academic preparation, as well as nurse attitudes and personal/social influence. Studies specific to OHNs identify self-efficacy as the most influential factor affecting nurse implementation of SCI. Organizational support and theory-based training are more effective in overcoming personal and social barriers affecting OHN self-efficacy. Conclusion/Application to Practice: The results of this review revealed attitude, innovation, perceived social influence, and self-efficacy were factors for nurses’ intention to implement SCI. Changes in the organizational environment supporting cessation programs and educational development, particularly theory-based training, should be further studied. Our findings suggest that designing programs utilizing these research findings to improve OHN self-efficacy could guide changes in clinical practice for motivating smokers to quit.
Book review: David Longbottom and Alison Lawson (Eds.), Alternative Market Research Methods: Market Sensing
Authors: Eranda B.A. Nuresh
Published: June 2020

David Longbottom and Alison Lawson (Eds.), Alternative Market Research Methods: Market Sensing. London and New York: Routledge, 2017, 312 pp., ISBN: 978-1138843721 (Paperback).
Book review: I.M. Pandey (Ed.), Financial Management, Eleventh Edition
Authors: Peiris Miyuki Shehara , Dewasiri N.J. , Banda Y.K.Weerakoon
Published: June 2020

I.M. Pandey (Ed.), Financial Management, Eleventh Edition. India: Vikas Publishing House, 2015, 946 pp., ISBN: 978-8125937142 (Paperback).
Human Capital: A Key Driver of Consumer Decision-making in Online Promotion (An Application of Grounded Theory in Exploratory Research)
Authors: Sharma Ayushi , Joshi Rakesh Mohan , Wali O. P.
Published: June 2020

This study throws light on the diversity of online sales promotion and deal acquisition with respect to human capital (time cost and efforts cost). This is the non-monetary investment of consumer while making a purchase. The influence of non-monetary cost decides the action towards purchase choice among various product offerings in online space. Findings of the research reveal (a) the different types of consumer: value conscious, price conscious and encounters, (b) different strategies a consumer adopts: track on information, futuristic thinking and formulating deals and (c) source of deal gratification for different goal-oriented consumer behaviour. This study proposes an empirical model validated by data interpretation using grounded theory. It shows how human capital decides approach of consumer to evaluate online sales promotion.
Enhancing citizen engagement in planning through participatory film-making
Authors: Manuel Jen , Vigar Geoff
Published: June 2020

There is a long history of engaging citizens in planning processes, and the intention to involve them actively in planning is a common objective. However, the reality of doing so is rather fraught and much empirical work suggests poor results. Partly in response an increasingly sophisticated toolkit of methods has emerged, and, in recent years, the deployment of various creative and digital technologies has enhanced this toolkit. We report here on case study research that deployed participatory film-making to augment a process of neighbourhood planning. We conclude that such a technology can elicit issues that might be missed in traditional planning processes; provoke key actors to include more citizens in the process by highlighting existing absences in the knowledge base; and, finally, provoke greater deliberation on issues by providing spaces for reflection and debate. We note, however, that while participants in film-making were positive about the experience, such creative methods were side-lined as established forms of technical–rational planning reasserted themselves.
Acute Onset Asymmetric Sensorimotor Paraparesis: Not Always Spinal!
Authors: Gupta Dhananjay , R Pradeep , Mehta Anish , Javali Mahendra , Acharya Purshottam T. , Srinivasa Rangasetty
Published: June 2020

Objective: To report an atypical case of acute onset sensorimotor paraparesis secondary to bilateral cerebral stroke.

Background: Acute onset paraparesis or paraplegia is usually secondary to a spinal cord disease. Central or cerebral causes of paraparesis are rare and include parasagittal and bilateral precentral lesions.

Design/Methods: Case report and literature review.

Results: A 65-year-old man presented with acute onset weakness of both lower limbs, associated with pins and needle sensation. On examination, he was found to have paraparesis (grade 2/5, both legs) and an asymmetric sensory loss in both legs and thighs. Spinal magnetic resonance imaging ruled out any compressive or noncompressive etiology. Magnetic resonance imaging of the brain showed an acute infarction in the bilateral cerebral hemisphere in both the pre- and postcentral gyrus. An angiogram of the brain revealed an aplastic right ACA-A1 with left ACA-A1 feeding bilateral A2. There was distal left ACA-A1 stenosis seen, the probable cause of bilateral stroke in this patient. The patient was treated conservatively and showed symptomatic improvement during the course of stay at the hospital.

Conclusion: This case of acute paraparesis secondary to bilateral cerebral infarction demonstrates the need to always look for a cerebral cause. In patients with cerebral infarction, who present early to a hospital, it may provide a window for thrombolytic or endovascular therapy.
Anthrax Protective Antigen 63 (PA63): Toxic Effects in Neural Cultures and Role in Gulf War Illness (GWI)
Authors: Tsilibary Effie-Photini C , Souto Eric P , Kratzke Marian , James Lisa M , Engdahl Brian E , Georgopoulos Apostolos P
Published: June 2020

Protective antigen (PA) 63 (PA63) is a protein derived from the PA83 component contained in the anthrax vaccine. The anthrax vaccine (“Biothrax”) was administered together with other vaccines to Gulf War veterans, about 35% of whom later developed a multisymptom disease (Gulf War Illness [GWI]), with prominent neurological/cognitive/mood symptoms, among others. The disease has been traditionally attributed to exposures to toxic chemicals during the war but other factors could be involved, including vaccines received. Of these, the anthrax vaccine is the most toxic. Here, we assessed directly the PA63 toxin’s harmful effects on cultured neuroblastoma 2A (N2A) cells with respect to cell spreading, process formation, apoptosis, and integrity of cell membrane, cytoskeleton, and mitochondria. We found that, when added in N2A cultures, PA63 toxin led to decreased cell spreading and cell aggregation, leading to apoptosis. The mechanisms of PA63-induced cell damage included compromised cell membrane permeability indicated by enhanced access of propidium iodide in cells. In addition, signaling pathways leading to organization of N2A cytoskeleton were negatively affected, as both actin and microtubular networks were compromised. Finally, the mitochondrial membrane potential was impaired in specific assays. Altogether, these alterations led to apoptosis as a collective toxic effect of PA63 which was substantially reduced by the concomitant addition of specific antibodies against PA63.
Transplanted stents: a case report
Authors: Kainz Frieda-Maria , Wallner Stephanie , Uyanik-Uenal Keziban , Andreas Martin , Zuckermann Andreas
Published: June 2020

Background

An optimal donor work-up to exclude preexisting conditions is recommended, but urgency and technical equipment in donor centers must be considered. We report a case of two coronary stents present in the donor heart and the related long-term outcome.

Case presentation

A 59-year-old European male patient suffering from dilated cardiomyopathy with severely reduced left ventricular function and presenting with NYHA III underwent cardiac transplantation in 2004. At the one-year follow-up, during routine cardiac catheterization, two stents were found, one in the right coronary artery and one in the circumflex artery, in the patient’s transplanted heart. As no stent implantation was performed since transplantation, these were present prior to transplantation and had been transplanted without causing clinical signs. One of the stents showed in-stent restenosis, and the patient received an additional stent 7 years after transplantation. The other stent still showed a good result, and no further intervention has been required so far. The patient is currently in good clinical condition.

Conclusion

This is the first case report of favorable long-term stented coronary arteries prior to transplantation. This case highlights the importance of the donor work-up and meticulous palpation of the coronary arteries during donor evaluation.
Congenital heart disease diagnosed with echocardiogram in newborns with asymptomatic cardiac murmurs: a systematic review
Authors: Yoon Shin Ae , Hong Woi Hyun , Cho Hwa Jin
Published: June 2020

Background

More than 50% of newborns with congenital heart disease (CHD) are unrecognized at birth; however, the use of echocardiogram (Echo) for diagnosing CHD in newborns with asymptomatic, non-syndromic cardiac murmurs (ANCM), has not been systematically reviewed yet. We aimed to identify the incidence of CHD diagnosed with Echo and systematically review whether Echo should be recommended in this patient group.

Methods

The methodology utilized in this systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Using the MEDLINE, EMBASE, Web of Science, and Cochrane Library databases, we performed a systematic review of publications reporting CHD diagnosed with Echo in newborns with cardiac murmurs. The quality of the included studies was evaluated using the Study Quality Assessment Tools developed by the National Institutes of Health.

Results

Of the 630 studies screened, six cohort studies, four cross-sectional studies, and two case reports were included in this review. The incidence of cardiac murmurs ranged from 0.6–8.6%. Among the 1928 newborns with ANCM, 719 (37.3%) were diagnosed with Echo as having CHD, and ventricular septal defect was the most common congenital malformation. More than 50% of the newborns showed moderate CHD necessitating outpatient cardiology follow-up, and 2.5% had severe CHD requiring immediate interventions, such as cardiac catheterization and heart surgery.

Conclusions

In this systematic review, a high incidence of CHD in newborns with ANCM was detected using Echo. This indicates that the use of Echo for diagnosing CHD in healthy newborns with cardiac murmurs could be helpful in earlier detection of CHD, thereby improving clinical outcomes for newborns with severe CHD.
Women’s experiences of the journey to chronic widespread pain: a qualitative study
Authors: Svensson Miriam , Larsson Ingrid , Aili Katarina
Published: June 2020

Background

Chronic widespread pain (CWP) is a musculoskeletal disorder that affects approximately 10% of the population. It is more common in women than in men. It is important to understand how CWP develops and how it is maintained in order to prevent poor pain prognosis. Long term studies have shown that a mere part improves over time or fluctuates in their CWP condition. Female gender is one of the factors associated with persistence of CWP, suggesting men and women may experience their journey to CWP differently. The aim of the study was to explore women’s experiences of the journey to CWP.

Methods

19 women between 45 and 67 years of age who had not reported CWP in the EPIPAIN survey in 1995, but reported CWP in 2016, participated in the study. Data was collected through individual interviews, where open-ended questions were used to explore the women’s experiences of their pain journey. The interviews were analyzed with a manifest qualitative content analysis.

Results

The women described their journey to CWP in terms of triggering, aggravating, and consolidating factors, from which three different categories emerged. Experiencing that environmental circumstances affect the pain journey refers to factors outside the women’s immediate control, which appeared as unmanageable work-related demands, lack of social support, unfavorable physical environments, and traumatic events. Experiencing that lifestyle affects the pain journey refers to events that are consciously or unconsciously carried out by the women, including different levels of physical efforts and unfavorable behaviors. Experiencing that personal attributes affect the pain journey refers to the women’s characteristics in terms of an anxious state of mind and adverse biological impact.

Conclusions

The women experienced that environmental circumstances, lifestyle, and personal attributes affected their CWP. How these adversities influenced the pain journey varied among the women. These findings show that women are conscious of the complexity of the condition and can describe the broad context of their pain journey. This study confirms the complexity of pain progress and highlights the individual’s awareness of this complexity, which is important to consider when introducing interventions, and when expecting compliance to interventions.
Partial resection of large congenital left ventricular diverticulum in an infant: a case report
Authors: Fang Yibing , An Qi , Yu Tianping , Luo Shuhua
Published: June 2020

Background

Congenital left ventricular diverticulum is a rare cardiac malformation usually requiring total resection.

Case presentation

This report describes an infant presenting with a large apical diverticulum with a wide ventricle connection. Given the vicinity of the left anterior descending coronary artery to the diverticulum and its wide ventricular connection, partial resection was undertaken. The patient remained asymptomatic with good heart function 8 months after surgery. The last follow-up echocardiography did not demonstrate any significant left ventricular outpouching.

Conclusions

We advocate early treatment of left ventricular diverticulum in children given the risk of spontaneous rupture of diverticulum, sudden death, and other serious complications if left untreated. For small patients with a wide connection of diverticulum to ventricle, partial resection is a safe option with favorable short-term outcomes.
Myxoma of the renal pelvis masquerading pelviureteric stenosis: conservative limited resection with renal preservation: case presentation and literature review
Authors: Aldaoud Najla , Hallak Amer , Rousan Liqa A. , Halalsheh Omar , Darayseh Bashar , Al-Abbadi Mousa A.
Published: June 2020

Background

Myxoma is a relatively rare mesenchymal tumor seen mainly in the heart and skin. Renal myxomas in particular are exceptionally rare where only 17 cases were previously reported in the English Language literature. Only 2 of the 17 reported cases were located in the renal sinus/pelvis.

Case presentation

This is a case of an 18-year-old male patient who complained of right, colicky flank pain associated with abdominal pain and discomfort. Imaging findings revealed right kidney hydronephrosis with a provisional diagnosis of pelviureteric junction (PUJ) stenosis. On computed tomography, there was a very faint thin walled mass abutting the calyces, camouflaged within the dilated renal pelvis. During surgery, a polypoid mass was found at the pelviureteric junction, causing the obstruction. Histological examination showed a hypocellular, paucivascular myxoid neoplasm, with few spindle cells displaying serpentine nuclei and inconspicuous nucleoli. The tumor cells expressed immunoreactivity for vimentin, but not for S100, CD34, actin, or desmin. This will qualify as the third case of renal pelvis myxoma.

Conclusion

Myxomas in the renal pelvis/sinus are extremely rare and can present with hydronephrosis and subtle radiological findings mimicking a PUJ stenosis. Being aware of this entity can save the patient unnecessary nephrectomy with possible preservation of the kidney.
Characteristics of aerobic vaginitis among women in Xi’an district: a hospital-based study
Authors: Zhang Taohong , Xue Yan , Yue Ting , Xiong Lili , Wang Xiaowei , Wang Weihong , Liu Ying , An Ruifang
Published: June 2020

Background

Aerobic vaginitis (AV) is a reproductive tract infection that affects health of women. The objective of this study was to analyze the characteristics of simple and mixed AV patients in Xi’an district and provide reference data for the clinical treatment of AV.

Methods

Patients were recruited from the outpatient Department of Obstetrics and Gynecology in the First Affiliated Hospital of Xi’an Jiaotong University from September 2014 to April 2019 in strict accordance with inclusion and exclusion criteria. The study principally examined the vaginal ecosystem, age distribution, levels of functional enzymes, and changes in pH levels in these women. Differences within groups were analyzed.

Results

A total of 284 AV patients were enrolled to investigate the distribution of simple and mixed AV infection. AV infection was found to be mainly simple infection. Simple AV patients were generally aged 50–60 years, while mixed AV patients were mostly aged 30–40 years. In the present study, the density of vaginal bacteria (OR = 13.294, 95% CI = 5.869–30.115, P < 0.01), the type of predominant bacteria (OR = 3.962, 95% CI = 1.785–7.984, P < 0.01) and positive expression of coagulase (OR = 3.789, 95% CI = 1.798–7.984, P < 0.01) were considered risk factors for mixed AV infection.

Conclusions

The epidemiology of simple and mixed AV infection were found to be different, with density of vaginal bacteria (I or IV), species that are predominant and levels of coagulase being risk factors for mixed AV infection.
Antimicrobial resistance of Pasteurella multocida type B isolates associated with acute septicemia in pigs and cattle in Spain
Authors: Cuevas Inmaculada , Carbonero Alfonso , Cano David , García-Bocanegra Ignacio , Amaro Manuel Ángel , Borge Carmen
Published: June 2020

Background

Pasteurella multocidais the etiological agent responsible for several diseases in a wide range of hosts around the world and thus, causes serious economic losses. Acute septicemia associated with capsular type BP. multocidahas recently emerged in Europe and continuous outbreaks of these acute processes have been described in Spain since they were first detected in pigs in 2009 and cattle in 2015. The scarcity of studies on the antimicrobial susceptibility of this capsular type ofP. multocidaand growing concern about the general increase of antimicrobial resistance mean that studies related to the performance of type BP. multocidaagainst antibiotics are necessary to establish accurate treatments and to monitor antimicrobial resistances.

Results

Seventy-six isolates ofP. multocidatype B from pigs and cattle with acute septicemia were tested for susceptibility to 10 different antimicrobials. Bovine isolates were susceptible to all the antibiotics we tested except for lincomycin (94.4% of isolates were resistant). However, the antimicrobials we tested were less effective against swine isolates, of which none were susceptible to lincomycin. Furthermore, 29.3% swine isolates were resistant to tetracycline, 27.6% to penicillin, 20.7% to oxytetracycline, 17.3% to chloramphenicol, 15.5% to gentamicin, and 3.4% to enrofloxacin; no resistance to ceftiofur was detected. No multidrug resistant isolates were detected from cattle, while 25.86% of swine isolates were resistant to three or more antibiotic classes.

Conclusions

In this study, the lower resistance rates and multidrug resistant isolates reported forP. multocidatype B derived from cattle compared to those isolated from pigs may be related to the increased use of antibiotics in the porcine industry in Spain. Lincomycin is not recommended for the treatment of acute septicemia in pigs or cattle, rather, the use of ceftiofur, enrofloxacin, or gentamicin is indicated as an emergency treatment in the early stages of disease; once the susceptibility results are known, the use of tetracyclines, penicillin, or chloramphenicol should be prioritized. The increase in multidrug resistant isolates and antimicrobial resistance rates indicates that more attention should be paid to prevention as well as the responsible use of antibiotics.
The establishment of a rheumatoid arthritis primate model in Macaca fascicularis
Authors: Na Hyun Sik , Lee Seon-yeong , Min Hong Ki , Park Wan-je , Lee Jung-hwan , Cho Ka-hee , Hong Shin-hee , Kim Dae-hoon , Jhun Jooyeon , Choi Jeong-Won , Kim Sung-Min , Kwok Seung-Ki , Cho Mi-La , Park Sung-Hwan
Published: June 2020

Background

Rheumatoid arthritis (RA) is a long-term autoimmune disorder that mostly affects the joints and leads to the destruction of cartilage. An RA model in non-human primates is especially useful because of their close phylogenetic relationship to humans in terms of cross-reactivity to compounds developed using modern drug technologies.

Methods

We used a collagen-induced arthritis (CIA) model in Macaca fascicularis. CIA was induced by the immunization of chicken type II collagen. Swelling was measured as the longitudinal and transverse axes of 16 proximal interphalangeal joints.

Results

A new system for visual evaluation was created, with a perfect score of 16. Individual behavioral analysis was also conducted. Serum was collected once a week after the first immunization. Blood chemistry and inflammatory cytokine parameters were higher in the CIA group than in the wild type group.

Conclusion

In conclusion, we established CIA in M. fascicularis, and the results can be used for drug evaluation models.
Changes in heart morphometric parameters over the course of a monocrotaline-induced pulmonary arterial hypertension rat model
Authors: Hołda Mateusz K. , Szczepanek Elżbieta , Bielawska Joanna , Palka Natalia , Wojtysiak Dorota , Frączek Paulina , Nowakowski Michał , Sowińska Natalia , Arent Zbigniew , Podolec Piotr , Kopeć Grzegorz
Published: June 2020

Background

Aim of this study was to assess changes in cardiac morphometric parameters at different stages of pulmonary arterial hypertension (PAH) using a monocrotaline-induced rat model.

Methods

Four groups were distinguished: I–control, non-PAH (n = 18); II–early PAH (n = 12); III–end-stage PAH (n = 23); and IV–end-stage PAH with myocarditis (n = 7).

Results

Performed over the course of PAH in vivo echocardiography showed significant thickening of the right ventricle free wall (end-diastolic dimension), tricuspid annular plane systolic excursion reduction and decrease in pulmonary artery acceleration time normalized to cycle length. No differences in end-diastolic left ventricle free wall thickness measured in echocardiography was observed between groups. Significant increase of right ventricle and decrease of left ventricle systolic pressure was observed over the development of PAH. Thickening and weight increase (241.2% increase) of the right ventricle free wall and significant dilatation of the right ventricle was observed over the course of PAH (p < 0.001). Reduction in the left ventricle free wall thickness was also observed in end-stage PAH (p < 0.001). Significant trend in the left ventricle free wall weight decrease was observed over the course of PAH (p < 0.001, 24.3% reduction). Calculated right/left ventricle free wall weight ratio gradually increased over PAH stages (p < 0.001). The reduction of left ventricle diameter was observed in rats with end-stage PAH both with and without myocarditis (p < 0.001).

Conclusions

PAH leads to multidimensional changes in morphometric cardiac parameters. Right ventricle morphological and functional failure develop gradually from early stage of PAH, while left ventricle changes develop at the end stages of PAH.
The international X-linked hypophosphataemia (XLH) registry (NCT03193476): rationale for and description of an international, observational study
Authors: Padidela Raja , Nilsson Ola , Makitie Outi , Beck-Nielsen Signe , Ariceta Gema , Schnabel Dirk , Brandi Maria Luisa , Boot Annemieke , Levtchenko Elena , Smyth Michael , Jandhyala Ravi , Mughal Zulf
Published: June 2020

Background

X-linked hypophosphataemia (XLH) is a rare, hereditary, progressive and lifelong phosphate wasting disorder characterised by pathological elevations in fibroblast growth factor (FGF) 23 concentration and activity; XLH has an incidence of approximately 1 in 20–25,000 individuals. Excess FGF23 activity leads to increased phosphate excretion in the kidneys – mediated by downregulation of renal tubular phosphate transporters – and reduced phosphate absorption in the intestines – due to impaired vitamin D activation. This results in impaired bone growth and mineralisation, short and disproportionate stature, leg bowing, musculoskeletal pain, spontaneous dental abscesses, rickets, and osteomalacia. The spectrum of manifestations differs between paediatric and adult patients. Those involved in the treatment of this condition face many challenges, including a lack of robust natural history and demographic data. This multicentre, international, rare-disease patient registry (XLH Registry) was established to address the paucity of data in XLH and to help inform future clinical practice.

Results

The XLH Registry collects standard diagnostic and monitoring practice data, including (where applicable) diagnosis and disease progression history, treatment regimens and family history; the protocol does not mandate any interventions or clinical assessments. The XLH Registry aims to recruit 1200 paediatric and adult patients with XLH over 10 years, and several data analyses and peer-reviewed publications are expected to be generated throughout this period. A post-authorisation safety study for Bburosumab, for which the registry Sponsor is the marketing authorisation holder, will be nested as a sub-study within the XLH Registry via a subsequent protocol amendment.

Conclusion

The data collected within this rare-disease patient registry will be utilised to synthesise real-world evidence to inform the management of XLH, to improve the quality of life and standard of care of patients living with this rare debilitating disease.
Physical activity and disability in patients with noncardiac chest pain: a longitudinal cohort study
Authors: Castonguay Joanne , Turcotte Stéphane , Fleet Richard P , Archambault Patrick M , Dionne Clermont E , Denis Isabelle , Foldes-Busque Guillaume
Published: June 2020

Background

Noncardiac chest pain (NCCP) is one of the leading reasons for emergency department visits and significantly limits patients’ daily functioning. The protective effect of physical activity has been established in a number of pain problems, but its role in the course of NCCP is unknown. This study aimed to document the level of physical activity in patients with NCCP and its association with NCCP-related disability in the 6 months following an emergency department visit.

Methods

In this prospective, longitudinal, cohort study, participants with NCCP were recruited in two emergency departments. They were contacted by telephone for the purpose of conducting a medical and sociodemographic interview, after which a set of questionnaires was sent to them. Participants were contacted again 6 months later for an interview aimed to assess their NCCP-related disability.

Results

The final sample consisted of 279 participants (57.0% females), whose mean age was 54.6 (standard deviation = 15.3) years. Overall, the proportion of participants who were physically active in their leisure time, based on the Actimètre questionnaire criteria, was 22.0%. Being physically active at the first measurement time point was associated with a 38% reduction in the risk of reporting NCCP-related disability in the following 6 months (ρ = .047). This association remained significant after controlling for confounding variables.

Conclusions

Being physically active seems to have a protective effect on the occurrence of NCCP-related disability in the 6 months following an emergency department visit with NCCP. These results point to the importance of further exploring the benefits of physical activity in this population.
The Melanoma Genomics Managing Your Risk Study randomised controlled trial: statistical analysis plan
Authors: Lo Serigne N. , Smit Amelia K. , Espinoza David , Cust Anne E. ,   on behalf of the Managing Your Risk Study Group, Cust Anne E. , Newson Ainsley J. , Morton Rachael L. , Kimlin Michael , Keogh Louise , Law Matthew H. , Kirk Judy , Dobbinson Suzanne J. , Kanetsky Peter A. , Mann Graham J. , Dawkins Hugh , Savard Jacqueline , Dunlop Kate , Trevena Lyndal , Jenkins Mark , Allen Martin , Butow Phyllis , Wordsworth Sarah , Lo Serigne N. , Low Cynthia , Smit Amelia , Espinoza David
Published: June 2020

Background

The Melanoma Genomics Managing Your Risk Study is a randomised controlled trial that aims to evaluate the efficacy of providing information on personal genomic risk of melanoma in reducing ultraviolet radiation (UV) exposure, stratified by traditional risk group (low or high phenotypic risk) in the general population. The primary outcome is objectively measured total daily Standard Erythemal Doses at 12 months. Secondary outcomes include UV exposure at specific time periods, self-reported sun protection and skin-examination behaviours, psychosocial outcomes, and ethical considerations surrounding offering genomic testing at a population level. A within-trial and modelled economic evaluation will be undertaken from an Australian health system perspective to assess the cost-effectiveness of the intervention.

Objective

To publish the pre-determined statistical analysis plan (SAP) before database lock and the start of analysis.

Methods

This SAP describes the data synthesis, analysis principles and statistical procedures for analysing the outcomes from this trial. The SAP was approved after closure of recruitment and before completion of patient follow-up. It outlines the planned primary analyses and a range of subgroup and sensitivity analyses. Health economic outcomes are not included in this plan but will be analysed separately. The SAP will be adhered to for the final data analysis of this trial to avoid potential analysis bias that may arise from knowledge of the outcome data.

Results

This SAP is consistent with best practice and should enable transparent reporting.

Conclusion

This SAP has been developed for the Melanoma Genomics Managing Your Risk Study and will be followed to ensure high-quality standards of internal validity and to minimise analysis bias.

Trial registration

Prospectively registered with the Australian New Zealand Clinical Trials Registry, ID: ACTRN12617000691347. Registered on 15 May 2017.
[18F]FDG uptake of bone marrow on PET/CT for predicting distant recurrence in breast cancer patients after surgical resection
Authors: Lee Jeong Won , Kim Sung Yong , Han Sun Wook , Lee Jong Eun , Lee Hyun Ju , Heo Nam Hun , Lee Sang Mi
Published: June 2020

Background

The objective of this study was to investigate the prognostic value of 2-Deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) uptake of bone marrow (BM) and metabolic parameters of primary tumor on positron emission tomography/computed tomography (PET/CT) for predicting distant recurrence in patients with breast cancer.

Methods

Pretreatment [18F]FDG PET/CT images of 345 breast cancer patients were retrospectively evaluated. Maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of primary breast cancer and bone marrow-to-liver uptake ratio (BLR) on PET/CT were measured. A Cox proportional hazard regression model was used to evaluate the prognostic potential of parameters for predicting recurrence-free survival (RFS) and distant RFS. For Kaplan-Meier analysis, the specific cutoff values pf BLR and TLG were determined by the maximal chi-square method.

Results

The median follow-up duration of the enrolled patients was 48.7 months, and during follow-up, 36 patients (10.4%) experienced the cancer recurrence. BLR was significantly correlated with T stage, serum inflammatory markers, and recurrence pattern (p < 0.05). Patients with high BLR and TLG showed worse RFS and distant RFS than those with low BLR and TLG. On multivariate analysis, BLR was significantly associated with both RFS and distant RFS after adjusting for T stage, estrogen receptor status, and TLG (p = 0.001 for both). Only 0.5% of patients with TLG < 9.64 g and BLR < 0.91 experienced distant recurrence. However, patients with TLG ≥ 9.64 g and BLR ≥ 0.91 had a distant recurrence rate of 40.7%.

Conclusions

BLR on pretreatment [18F]FDG PET/CT were significant predictors for RFS and distant RFS in patients with breast cancer. By combining [18F]FDG uptake of BM and volumetric PET/CT index of breast cancer, the risk of distant recurrence could be stratified.
Trends in and drivers of healthcare expenditure in the English NHS: a retrospective analysis
Authors: Rodriguez Santana Idaira , Aragón María José , Rice Nigel , Mason Anne Rosemary
Published: June 2020

Background

In England, rises in healthcare expenditure consistently outpace growth in both GDP and total public expenditure. To ensure the National Health Service (NHS) remains financially sustainable, relevant data on healthcare expenditure are needed to inform decisions about which services should be delivered, by whom and in which settings.

Methods

We analyse routine data on NHS expenditure in England over 9 years (2008/09 to 2016/17). To quantify the relative contribution of the different care settings to overall healthcare expenditure, we analyse trends in 14 healthcare settings under three broad categories: Hospital Based Care (HBC), Diagnostics and Therapeutics (D&T) and Community Care (CC). We exclude primary care and community mental health services settings due to a lack of consistent data. We employ a set of indices to aggregate diverse outputs and to disentangle growth in healthcare expenditure that is driven by activity from that due to cost pressures. We identify potential drivers of the observed trends from published studies.

Results

Over the 9-year study period, combined NHS expenditure on HBC, D&T and CC rose by 50.2%. Expenditure on HBC rose by 54.1%, corresponding to increases in both activity (29.2%) and cost (15.7%). Rises in expenditure in inpatient (38.5%), outpatient (57.2%), and A&E (59.5%) settings were driven predominately by higher activity. Emergency admissions rose for both short-stay (45.6%) and long-stay cases (26.2%). There was a switch away from inpatient elective care (which fell by 5.1%) and towards day case care (34.8% rise), likely reflecting financial incentives for same-day discharges. Growth in expenditure on D&T (155.2%) was driven by rises in the volume of high cost drugs (270.5%) and chemotherapy (110.2%). Community prescribing grew by 45.2%, with costs falling by 24.4%. Evidence on the relationship between new technologies and healthcare expenditure is mixed, but the fall in drug costs could reflect low generic prices, and the use of health technology assessment or commercial arrangements to inform pricing of new medicines.

Conclusions

Aggregate trends in HCE mask enormous variation across healthcare settings. Understanding variation in activity and cost across settings is an important initial step towards ensuring the long-term sustainability of the NHS.
Impact of Michaelis–Menten type harvesting in a Lotka–Volterra predator–prey system incorporating fear effect
Authors: Lai Liyun , Yu Xiangqin , He Mengxin , Li Zhong
Published: June 2020

We propose and study a Lotka–Volterra predator–prey system incorporating both Michaelis–Menten-type prey harvesting and fear effect. By qualitative analysis of the eigenvalues of the Jacobian matrix we study the stability of equilibrium states. By applying the differential inequality theory we obtain sufficient conditions that ensure the global attractivity of the trivial equilibrium. By applying Dulac criterion we obtain sufficient conditions that ensure the global asymptotic stability of the positive equilibrium. Our study indicates that the catchability coefficient plays a crucial role on the dynamic behavior of the system; for example, the catchability coefficient is the Hopf bifurcation parameter. Furthermore, for our model in which harvesting is of Michaelis–Menten type, the catchability coefficient is within a certain range; increasing the capture rate does not change the final number of prey population, but reduces the predator population. Meanwhile, the fear effect of the prey species has no influence on the dynamic behavior of the system, but it can affect the time when the number of prey species reaches stability. Numeric simulations support our findings.
Modeling the Allee effect and fear effect in predator–prey system incorporating a prey refuge
Authors: Huang Ying , Zhu Zhenliang , Li Zhong
Published: June 2020

In this paper, we consider a predator–prey model with Allee effect, fear effect and prey refuge. By considering the prey refuge as a parameter, we give the threshold condition for the stability of the system, and prove that the system undergoes a supercritical Hopf bifurcation. We show that increasing the prey refuge or Allee effect can make the dynamical behavior of the system more complicated; the fear effect or Allee effect has no influence on the prey density, but can lead to a decrease of the predator population at positive equilibrium.
On monotone nonexpansive mappings in $\operatorname{CAT}_{p}(0)$ spaces
Authors: Shukri Sami
Published: June 2020

In this paper, based on some geometrical properties of $\operatorname{CAT}_{p}(0)$CATp(0) spaces, for $p \geq 2$p≥2, we obtain two fixed point results for monotone multivalued nonexpansive mappings and proximally monotone nonexpansive mappings. Which under some assumptions, reduce to coincide and generalize a fixed point result for monotone nonexpansive mappings. This work is a continuity of the previous work of Ran and Reurings, Nieto and Rodríguez-López done for monotone contraction mappings.
Effects of using inquiry-based learning on EFL students’ critical thinking skills
Authors: Wale Bantalem Derseh , Bishaw Kassie Shifere
Published: June 2020

The aim of this study was to examine the effects of using inquiry-based learning on students’ critical thinking skills. A quasi-experimental design which employed time series design with single group participants was used. A total of 20 EFL undergraduate students who took advanced writing skills course were selected using comprehensive sampling method. Tests, focus group discussion, and student-reflective journal were used to gather data on the students’ critical thinking skills. The participants were given a series of three argumentative essay writing pretests both before and after the intervention, inquiry-based argumentative essay writing instruction. While the quantitative data were analyzed using One-Way Repeated Measures ANOVA, the qualitative data were analyzed through narration. The findings of the study revealed that using inquiry-based argumentative writing instruction enhances students’ critical thinking skills. Therefore, inquiry-based instruction is suggested as a means to improve students’ critical thinking skills because the method enhances students' interpretation, analysis, evaluation, inference, explanation, and self-regulation skills which are the core critical thinking skills.
Aedes mosquito surveillance and the use of a larvicide for vector control in a rural area of the Lao People’s Democratic Republic
Authors: Lamaningao Pheophet , Kanda Seiji , Shimono Takaki , Inthavongsack Somchit , Xaypangna Thonelakhanh , Nishiyama Toshimasa
Published: June 2020

Background

Refillable water containers are commonly used in rural areas of Lao PDR, and they act asAedesmosquito breeding sites.Aedes aegyptiandAe. albopictusmosquitos are transmission vectors for the dengue virus, which causes dengue fever.

Methods

Two isolated rural villages in the central part of Lao PDR were selected as study sites. In the intervention village, domestic water containers were continuously treated with a long-lasting matrix release formulation, containing pyriproxyfen, named SumiLarv®2MR. In the control village, entomological activity was monitored, but no intervention was performed. Baseline data were collected in both villages during the late rainy season (October 2017) then distributed SumiLarv®2MR disks in intervention village. This data was compared with data collected during the intervention periods in the dry season (February 2018), rainy season (July 2018 and 2019), and late rainy season (September 2018) in the region.

Results

Compared with the baseline data (20.24%), the percentage of water containers infested withAe. aegyptilarvae was significantly decreased in the treated village, especially in the rainy seasons in July 2018 (4.11%;P< 0.001) and July 2019 (2.46%;P< 0.001), while the percentage of water containers infested withAe. albopictuslarvae did not decrease significantly in prevalence. No reduction in the frequency ofAedesspecies was seen in the control village. TheAe. albopictusliked to breed in small habitats (the median water volume of its habitats was 5 L and 10 L in the control and treated village, respectively, while the equivalent values forAe. aegyptiwere 30 L and 50 L, respectively).

Conclusion

The treatment of refillable water storage containers in a rural village with SumiLarv®2MR disks led to significant reductions in theAe. aegyptipopulation. However, theAe. albopictuspopulation did not decrease in either the control or treated village. This discrepancy was due to differences in habitat-seeking behaviors and preferred breeding sites such as types of water, water container, and water volume, then led to the differences in results of mosquito prevalence after SumiLarv®2MR disk treatments. The SumiLarv®2MR disk treatment was proven to be effective against the primary dengue-virus vector mosquitoes,Ae. aegypti.
Cultural Self-Definition of Southwest Chieftains during the Ming-Qing Transition
Authors: Hu Siao-chen
Published: June 2020

This article explores how chieftains on the southwest periphery during the Ming-Qing transition conducted long-term plans to formulate cultural and literary heritages that had an affinity with Han Chinese mainstream culture but also retained indigenous qualities. The author demonstrates that the boundaries between Han and non-Han peoples became more negotiable with the enterprising efforts of chieftains to “perform” civilization by way of literary activities. The discussion centers on Rongmei jiyou (My Travel to Rongmei), a travelogue in diary form by early Qing scholar and playwright Gu Cai.
Cold War as Method
Authors: Liu Petrus
Published: June 2020

This essay proposes a reconceptualization of the Cold War as a critical methodology for the study of contemporary Chinese-language cultures and literatures. Arguing that the Cold War is not over but simply transformed, the author redefines it as an enduring “problematic of the present,” an emotional structure that continues to shape the contours of literature, academic discourse, and identity formations in ways of which we are not always fully conscious. Hence the Cold War is best understood as a “cultural palimpsest” where the old dilemma of communism versus anticommunism is rewritten into a contemporary idiom of colonialism versus self-determination. After developing the concept of Cold War as method, the second part of the essay offers a concrete example through a critical reading of Swordsman II, a 1992 martial arts film adapted from Jin Yong's 1967 novel. While the film has generally been analyzed for its representation of (queer) sexuality, the essay shows that it is the Cultural Revolution and its Cold War legacies that explain the emergence of its main character.
Experimentation, Innovation, and Economics
Authors: Kremer Michael
Published: June 2020

The experimental method not only helps identify causal relationships, but also provides economists with a rich sense of context, focuses research on specific practical questions, stimulates collaboration with practitioners and specialists from other fields, and allows for rapid iteration. In this lecture, I present a series of examples illustrating how together these features make the experimental approach a powerful tool for advancing scientific understanding, informing policy, and promoting innovation. I then discuss how institutions can be designed to accelerate innovation and direct it toward the world’s most pressing needs. (JEL B31, C90, I10, O15, O30, O43)
Acquiring Information through Peers
Authors: Herskovic Bernard , Ramos João
Published: June 2020

We develop an endogenous network formation model, in which agents form connections to acquire information. Our model features complementarity in actions as agents care not only about accuracy of their decision-making but also about the actions of other agents. In equilibrium, the information structure is a hierarchical network, and, under weakly convex cost of forming links, the equilibrium network is core-periphery. Although agents are ex ante identical, there is ex post heterogeneity in payoffs and actions. (JEL D83, D85, Z13)
High vaccination coverage, inadequate knowledge and high vector density: Findings from a community-based cross-sectional study on Japanese Encephalitis in Yangon, Myanmar
Authors: Kyaw Pyae Phyo , Shewade Hemant Deepak , Kyaw Nang Thu Thu , Hnin Phyo Khaing , Lin Htar Htar , Kyaw Aye Mon Mon , Mya Mg Mg , Thaung Sein , Maung Maung Yan Naung
Published: June 2020

Background: Japanese encephalitis (JE) is a mosquito-borne disease with high case fatality and no specific treatment. Little is known about the community’s (especially parents/guardians of children) awareness regarding JE and its vaccine in Yangon region, which bears the highest JE burden in Myanmar.

Methods: We conducted a community-based cross-sectional study in Yangon region (2019) to explore the knowledge and perception of parents/guardians of 1-15 year-old children about JE disease, its vaccination and to describe JE vaccine coverage among 1-15 year-old children. We followed multi-stage random sampling (three stages) to select the 600 households with 1-15 year-old children from 30 clusters in nine townships. Analyses were weighted (inverse probability sampling) for the multi-stage sampling design.

Results: Of 600 parents/guardians, 38% exhibited good knowledge of JE, 55% perceived JE as serious in  children younger than 15 years and 59% perceived the vaccine to be effective. Among all the children in the 600 households, the vaccination coverage was 97% (831/855).

Conclusion: In order to reduce JE incidence in the community, focus on an intensified education program is necessary to sustain the high vaccine coverage in the community.
“Who goes there?” Reflections on signs and personhood in Christopher Hutton’s Integrationism and the Self
Authors: Cobley Paul
Published: June 2020

Review of Integrationism and the Self: Reflections on the Legal Personhood of Animals [Series Routledge Advances in Communication and Linguistic Theory] by Christopher Hutton. London: Routledge, 2019, 190 pp.