bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of social problem-solving training on critical thinking and decision making of nursing students
Authors: Ahmady Soleiman , Shahbazi Sara
Published: October 2020

Background

The complex health system and challenging patient care environment require experienced nurses, especially those with high cognitive skills such as problem-solving, decision- making and critical thinking. Therefore, this study investigated the impact of social problem-solving training on nursing students’ critical thinking and decision-making.

Methods

This study was quasi-experimental research and pre-test and post-test design and performed on 40 undergraduate/four-year students of nursing in Borujen Nursing School/Iran that was randomly divided into 2 groups; experimental (n = 20) and control (n = 20). Then, a social problem-solving course was held for the experimental group. A demographic questionnaire, social problem-solving inventory-revised, California critical thinking test, and decision-making questionnaire was used to collect the information. The reliability and validity of all of them were confirmed. Data analysis was performed using SPSS software and independent sampled T-test, paired T-test, square chi, and Pearson correlation coefficient.

Results

The finding indicated that the social problem-solving course positively affected the student’ social problem-solving and decision-making and critical thinking skills after the instructional course in the experimental group (P < 0.05), but this result was not observed in the control group (P > 0.05).

Conclusions

The results showed that structured social problem-solving training could improve cognitive problem-solving, critical thinking, and decision-making skills. Considering this result, nursing education should be presented using new strategies and creative and different ways from traditional education methods. Cognitive skills training should be integrated in the nursing curriculum. Therefore, training cognitive skills such as problem- solving to nursing students is recommended.
Compliance of primary and secondary care public hospitals with standard practices for reprocessing and steam sterilization of reusable medical devices in Nepal: findings from nation-wide multicenter clustered audits
Authors: Panta Gopal , Richardson Ann K. , Shaw Ian C. , Coope Patricia A.
Published: October 2020

Background

Reusable medical devices in healthcare facilities are decontaminated and reprocessed following standard practices before each clinical procedure. Reprocessing of critical medical devices (those used for invasive clinical procedures) comprises several processes including sterilization, which provides the highest level of decontamination. Steam sterilization is the most used sterilization procedure across the globe. Noncompliance with standards addressing reprocessing of medical devices may lead to inadequate sterilization and thus increase the risk of person-to-person or environmental transmission of pathogens in healthcare facilities. We conducted nationwide multicenter clustered audits to understand the compliance of primary- and secondary-care public hospitals in Nepal with the standard practices for medical device reprocessing, including steam sterilization.

Methods

We developed an audit tool to assess compliance of hospitals with the standard practices for medical device reprocessing including steam sterilization. Altogether, 189 medical device reprocessing cycles which included steam sterilization were assessed in 13 primary and secondary care public hospitals in Nepal using the audit tool. Percentage compliance was calculated for each standard practice. Mean percentage compliances were obtained for overall primary and secondary care hospitals and for each hospital type, specific hospital and process involved.

Results

For all primary and secondary care hospitals in Nepal, the mean percentage compliance with the standard practices for medical device reprocessing including steam sterilization was 25.9% (95% CI 21.0–30.8%). The lower the level of care provided by the hospitals, the lower was the mean percentage compliance, and the difference in the means across the hospital types was statistically significant (p < 0.01). The mean percentage compliance of individual hospitals ranged from 14.7 to 46.0%. The hospitals had better compliance with the practices for cleaning of used devices and transport and storage of sterilized devices compared with the practices for other processes of the medical device reprocessing cycle.

Conclusion

The primary and secondary care hospitals in Nepal had poor compliance with the standard practices for steam sterilization and reprocessing of medical devices. Interventions to improve compliance of the hospitals are immediately required to minimize the risks of person-to-person or environmental transmission of pathogens through inadequately reprocessed medical devices.
Developing and implementing a novel mentorship model (4+ 1) for maternal, newborn and child health in Rwanda
Authors: Ngabonzima Anaclet , Kenyon Cynthia , Hategeka Celestin , Utuza Aimee Josephine , Banguti Paulin Ruhato , Luginaah Isaac , F Cechetto David
Published: October 2020

Background

There are a number of factors that may contribute to high mortality and morbidity of women and newborns in low-income countries. These include a shortage of competent health care providers (HCP) and a lack of sufficient continuous professional development (CPD) opportunities. Strengthening the skills and building the capacity of HCP involved in the provision of maternal, newborn and child health (MNCH) is essential to ensure quality care for mothers, newborns and children. To address this challenge in Rwanda, mentorship of HCPs was identified as an approach that could help build capacity, improve the provision of care and accelerate the reduction in maternal and neonatal mortality and morbidity.

In this paper, we describe the development and implementation of a novel mentorship model named Four plus One (4+ 1) for MNCH in Rwanda.

Methods

The mentorship model built on the basis of inter-professional collaboration (IPC) was developed in early 2017 through consultations with different key actors. The design phase included refresher courses in specific skills and training course on mentoring. Field visits were conducted in 10 hospitals from June 2017 to February 2020. Hospital management teams (MT) were involved in the development and implementation of this mentorship model to ensure ownership of the program.

Results

Upon completion of planned visits to each hospital, a total of 218 HCPs were involved in the process. Reports prepared by mentors upon each mentorship visit and compiled by Training Support and Access Model (TSAM) for MNCH’CPD team, highlighted the mothers and newborns who were saved by both mentors and mentees. Also, different logbooks of mentees showed how the capacity of staff was strengthened, thereby suggesting effectiveness of the model. Through different mentorship coordination meetings, the model was much appreciated by the MTs of hospitals, especially the IPC component of the model and confirmed the program ‘effectiveness.

Conclusion

The initiation of a mentorship model built on IPC together with the involvement of the leadership of the hospital may be the cause effect of reduction of specific mortality and improve MNCH in low resource settings even when there are a limited number of specialists in the health facilities.
To what extent do supervised drug consumption services incorporate non-injection routes of administration? A systematic scoping review documenting existing facilities
Authors: Speed Kelsey A. , Gehring Nicole D. , Launier Katherine , O’Brien Daniel , Campbell Sandy , Hyshka Elaine
Published: October 2020

Background

Most of the existing research on supervised consumption services (SCS) is focused on injection drug use. Less is known about the applicability of SCS for people who consume drugs orally, intranasally, or through inhalation. This is problematic because people who use drugs through modes other than injection are also at risk of overdose death and other harm, and experience barriers accessing health and social services. We aimed to describe existing SCS models that accommodate these alternate routes of drug consumption, and synthesize available information on characteristics of program participants.

Methods

We conducted a systematic scoping review of 9 peer-reviewed and 13 grey literature databases on SCS that incorporate non-injection routes of consumption. We screened 22,882 titles, and excluded 22,843 (99.8%) articles. We ultimately included 39 (0.2%) full-text articles; 28 (72%) of these articles explicitly identified SCS that permit alternate routes of consumption and 21 (54%) discussed characteristics of participants who consume drugs through non-injection routes. Data on study characteristics, terms and definitions, and site and program participant characteristics were extracted and double-coded. Extracted data were analyzed using descriptive statistics and narrative synthesis.

Results

Included articles describe 48 SCS that permit non-injection routes of consumption, most of which were located in Germany. The majority of these SCS were legally sanctioned and had models of care that were largely comparable to supervised injection services. Notable differences included physical infrastructure such as ventilated rooms or outdoor areas to accommodate inhalation, and shorter time limits on non-injection drug consumption episodes. Program participants engaging in non-injection forms of consumption were typically men over the age of 30 and structurally vulnerable (e.g., experiencing homelessness or unstable housing).

Conclusions

Extant academic and grey literature indicates that site characteristics and demographics of program participants of SCS that permit non-injection routes of consumption largely reflect those of supervised injection services. Further research on the range of existing SCS that incorporate non-injection routes of consumption is needed to ensure high quality service provision, and improved health outcomes for people who consume drugs via oral, intranasal, and inhalation routes.
Extent and risk factors of psychological violence towards physicians and Standardised Residency Training physicians: a Northern China experience
Authors: Fang Huiying , Wei Lifeng , Mao Jingfu , Jia Haonan , Li Peng , Li Yuze , Fu Yapeng , Zhao Siqi , Liu He , Jiang Kexin , Jiao Mingli , Qiao Hong , Wu Qunhong
Published: October 2020

Purpose

Physicians and Standardised Residency Training physicians (SRTPs) have relatively high exposure to psychological violence. Its adverse effects are far greater than those of physical violence. However, no previous research has paid attention to the problem of psychological violence among them. This study aims to evaluate the extent, characteristics, and risk factors of psychological violence among SRTPs in comparison to physicians, and also to highlight the psychological violence experienced by SRTPs and suggest preventive measures.

Methods

A cross-sectional survey was conducted in northern China. 884 physicians and 537 SRTPs completed a questionnaire which compiled by the ILO, ICN, WHO and PSI in 2003 to measure violence in the workplace. Descriptive statistics and logistic regression analysis were used to analyse results.

Results

The effective response rates of physicians and SRTPs were 63.1%(884/1400) and 86.3%(537/622) respectively. 73.0%(645/884) of physicians and 24.8%(133/537) of SRTPs suffered psychological violence in the past year. Compared to physicians (29/645, 4.5%), SRTPs (42/133, 31.6%) experience more internal violence. Further, after experiencing psychological violence, physicians are willing to talk to family and friends, but SRTPs generally take no action. Shift work was a risk factor for both physicians (OR 1.440, 95% CI 1.014–2.203) and SRTPs (OR 1.851, 95% CI 1.217–2.815) suffering from psychological violence. In contrast, no anxiety symptoms protected physicians (OR 0.406, 95% CI 0.209–0.789) and SRTPs (OR 0.404, 95% CI 0.170–0.959) against psychological violence.

Conclusions

SRTPs and physicians in northern China have a high risk of experiencing psychological violence, and physicians experience more. Meanwhile, there are obvious differences in responses to psychological violence and risk factors between them. Therefore, medical institutions should pay more attention to psychological violence, especially among SRTPs, such as supporting the reporting of psychological violence, strengthening team relationships, and providing psychological comfort and counselling.

Trial registration number (Project Identification Code: HMUIRB20160014), Registered May 10, 2016.
Maternal and newborn care during the COVID-19 pandemic in Kenya: re-contextualising the community midwifery model
Authors: Kimani Rachel Wangari , Maina Rose , Shumba Constance , Shaibu Sheila
Published: October 2020

Peripartum deaths remain significantly high in low- and middle-income countries, including Kenya. The COVID-19 pandemic has disrupted essential services, which could lead to an increase in maternal and neonatal mortality and morbidity. Furthermore, the lockdowns, curfews, and increased risk for contracting COVID-19 may affect how women access health facilities. SARS-CoV-2 is a novel coronavirus that requires a community-centred response, not just hospital-based interventions. In this prolonged health crisis, pregnant women deserve a safe and humanised birth that prioritises the physical and emotional safety of the mother and the baby. There is an urgent need for innovative strategies to prevent the deterioration of maternal and child outcomes in an already strained health system. We propose strengthening community-based midwifery to avoid unnecessary movements, decrease the burden on hospitals, and minimise the risk of COVID-19 infection among women and their newborns.
Profiling pro-neural to mesenchymal transition identifies a lncRNA signature in glioma
Authors: Liang Qingyu , Guan Gefei , Li Xue , Wei Chunmi , Wu Jianqi , Cheng Peng , Wu Anhua , Cheng Wen
Published: October 2020

Background

Molecular classification has laid the framework for exploring glioma biology and treatment strategies. Pro-neural to mesenchymal transition (PMT) of glioma is known to be associated with aggressive phenotypes, unfavorable prognosis, and treatment resistance. Recent studies have highlighted that long non-coding RNAs (lncRNAs) are key mediators in cancer mesenchymal transition. However, the relationship between lncRNAs and PMT in glioma has not been systematically investigated.

Methods

Gene expression profiles from The Cancer Genome Atlas (TCGA), the Chinese Glioma Genome Atlas (CGGA), GSE16011, and Rembrandt with available clinical and genomic information were used for analyses. Bioinformatics methods such as weighted gene co-expression network analysis (WGCNA), gene set enrichment analysis (GSEA), Cox analysis, and least absolute shrinkage and selection operator (LASSO) analysis were performed.

Results

According to PMT scores, we confirmed that PMT status was positively associated with risky behaviors and poor prognosis in glioma. The 149 PMT-related lncRNAs were identified by WGCNA analysis, among which 10 (LINC01057, TP73-AS1, AP000695.4, LINC01503, CRNDE, OSMR-AS1, SNHG18, AC145343.2, RP11-25K21.6, RP11-38L15.2) with significant prognostic value were further screened to construct a PMT-related lncRNA risk signature, which could divide cases into two groups with distinct prognoses. Multivariate Cox regression analyses indicated that the signature was an independent prognostic factor for high-grade glioma. High-risk cases were more likely to be classified as the mesenchymal subtype, which confers enhanced immunosuppressive status by recruiting macrophages, neutrophils, and regulatory T cells. Moreover, six lncRNAs of the signature could act as competing endogenous RNAs to promote PMT in glioblastoma.

Conclusions

We profiled PMT status in glioma and established a PMT-related 10-lncRNA signature for glioma that could independently predict glioma survival and trigger PMT, which enhanced immunosuppression.
Estimation of the basic reproduction number (R0) for the novel coronavirus disease in Sri Lanka
Authors: Dharmaratne Samath , Sudaraka Supun , Abeyagunawardena Ishanya , Manchanayake Kasun , Kothalawala Mahen , Gunathunga Wasantha
Published: October 2020

Background

The basic reproduction number (R0) is the number of cases directly caused by an infected individual throughout his infectious period. R0 is used to determine the ability of a disease to spread within a given population. The reproduction number (R) represents the transmissibility of a disease.

Objectives

We aimed to calculate the R0 of Coronavirus disease-2019 (COVID-19) in Sri Lanka and to describe the variation of R, with its implications to the prevention and control of the disease.

Methods

Data was obtained from daily situation reports of the Epidemiology Unit, Sri Lanka and a compartmental model was used to calculate the R0 using estimated model parameters.
This value was corroborated by using two more methods, the exponential growth rate method and maximum likelihood method to obtain a better estimate for R0. The variation of R was illustrated using a Bayesian statistical inference-based method.

Results

The R0 calculated by the first model was 1.02 [confidence interval (CI) of 0.75–1.29] with a root mean squared error of 7.72. The exponential growth rate method and the maximum likelihood estimation method yielded an R0 of 0.93 (CI of 0.77–1.10) and a R0 of 1.23 (CI of 0.94–1.57) respectively. The variation of R ranged from 0.69 to 2.20.

Conclusion

The estimated R0 for COVID-19 in Sri Lanka, calculated by three different methods, falls between 0.93 and 1.23, and the transmissibility R has reduced, indicating that measures implemented have achieved a good control of disease.
Protective CD8+ T-cell response against Hantaan virus infection induced by immunization with designed linear multi-epitope peptides in HLA-A2.1/Kb transgenic mice
Authors: Ma Ying , Tang Kang , Zhang Yusi , Zhang Chunmei , Cheng Linfeng , Zhang Fanglin , Zhuang Ran , Jin Boquan , Zhang Yun
Published: October 2020

Background

An effective vaccine that prevents disease caused by hantaviruses is a global public health priority, but up to now, no vaccine has been approved for worldwide use. Therefore, novel vaccines with high prophylaxis efficacy are urgently needed.

Methods

Herein, we designed and synthesized Hantaan virus (HTNV) linear multi-epitope peptide consisting of HLA-A*02-restricted HTNV cytotoxic T cell (CTL) epitope and pan HLA-DR-binding epitope (PADRE), and evaluated the immunogenicity, as well as effectiveness, of multi-epitope peptides in HLA-A2.1/Kb transgenic mice with interferon (IFN)-γ enzyme-linked immunospot assay, cytotoxic mediator detection, proliferation assay and HTNV-challenge test.

Results

The results showed that a much higher frequency of specific IFN-γ-secreting CTLs, high levels of granzyme B production, and a strong proliferation capacity of specific CTLs were observed in splenocytes of mice immunized with multi-epitope peptide than in those of a single CTL epitope. Moreover, pre-immunization of multi-epitope peptide could reduce the levels of HTNV RNA loads in the liver, spleen and kidneys of mice, indicating that specific CTL responses induced by multi-epitope peptide could reduce HTNV RNA loads in vivo.

Conclusions

This study may provide an important foundation for the development of novel peptide vaccines for HTNV prophylaxis.
Energy transmission in mechanically ventilated children: a translational study
Authors: Kneyber Martin C. J. , Ilia Stavroula , Koopman Alette A. , van Schelven Patrick , van Dijk Jefta , Burgerhof Johannes G. M. , Markhorst Dick G. , Blokpoel Robert G. T.
Published: October 2020

Background

Recurrent delivery of tidal mechanical energy (ME) inflicts ventilator-induced lung injury (VILI) when stress and strain exceed the limits of tissue tolerance. Mechanical power (MP) is the mathematical description of the ME delivered to the respiratory system over time. It is unknown how ME relates to underlying lung pathology and outcome in mechanically ventilated children. We therefore tested the hypothesis that ME per breath with tidal volume (Vt) normalized to bodyweight correlates with underlying lung pathology and to study the effect of resistance on the ME dissipated to the lung.

Methods

We analyzed routinely collected demographic, physiological, and laboratory data from deeply sedated and/or paralyzed children < 18 years with and without lung injury. Patients were stratified into respiratory system mechanic subgroups according to the Pediatric Mechanical Ventilation Consensus Conference (PEMVECC) definition. The association between MP, ME, lung pathology, and duration of mechanical ventilation as a primary outcome measure was analyzed adjusting for confounding variables and effect modifiers. The effect of endotracheal tube diameter (ETT) and airway resistance on energy dissipation to the lung was analyzed in a bench model with different lung compliance settings.

Results

Data of 312 patients with a median age of 7.8 (1.7–44.2) months was analyzed. Age (p <  0.001), RRp <  0.001), and Vt <  0.001) were independently associated with MPrs. ME but not MP correlated significantly (p <  0.001) better with lung pathology. Competing risk regression analysis adjusting for PRISM III 24 h score and PEMVECC stratification showed that ME on day 1 or day 2 of MV but not MP was independently associated with the duration of mechanical ventilation. About 33% of all energy generated by the ventilator was transferred to the lung and highly dependent on lung compliance and airway resistance but not on endotracheal tube size (ETT) during pressure control (PC) ventilation.

Conclusions

ME better related to underlying lung pathology and patient outcome than MP. The delivery of generated energy to the lung was not dependent on ETT size during PC ventilation. Further studies are needed to identify injurious MErs thresholds in ventilated children.
NMR elucidation of nonproductive binding sites of lignin models with carbohydrate-binding module of cellobiohydrolase I
Authors: Tokunaga Yuki , Nagata Takashi , Kondo Keiko , Katahira Masato , Watanabe Takashi
Published: October 2020

Background

Highly efficient enzymatic saccharification of pretreated lignocellulose is a key step in achieving lignocellulosic biorefinery. Cellobiohydrolase I (Cel7A) secreted by Trichoderma reesei is an industrially used cellulase that possesses carbohydrate-binding module 1 (TrCBM1) at the C-terminal domain. The nonproductive binding of TrCBM1 to lignin significantly decreases the enzymatic saccharification efficiency and increases the cost of biomass conversion because of the additionally required enzymes. Understanding the interaction mechanism between lignin and TrCBM1 is essential for realizing a cost-effective biofuel production; however, the binding sites in lignin have not been clearly elucidated.

Results

Three types of 13C-labeled β-O-4 lignin oligomer models were synthesized and characterized. The 2D 1H–13C heteronuclear single-quantum correlation (HSQC) spectra of the 13C-labeled lignin models confirmed that the three types of the 13C labels were correctly incorporated in the (1) aromatic rings and β positions, (2) α positions, and (3) methoxy groups, respectively. The TrCBM1-binding sites in lignin were analyzed by observing NMR chemical shift perturbations (CSPs) using the synthetic 13C-labeled β-O-4 lignin oligomer models. Obvious CSPs were observed in signals from the aromatic regions in oligomers bound to TrCBM1, whereas perturbations in the signals from aliphatic regions and methoxy groups were insignificant. These findings indicated that hydrophobic interactions and π–π stacking were dominating factors in nonproductive binding. The synthetic lignin models have two configurations whose terminal units were differently aligned and donated C(I) and C(II). The C(I) ring showed remarkable perturbation compared with the C(II), which indicated that the binding of TrCBM1 was markedly affected by the configuration of the lignin models. The long-chain lignin models (degree of polymerization (DP) 4.16–4.70) clearly bound to TrCBM1. The interactions of TrCBM1 with the short-chain lignin models (DP 2.64–3.12) were insignificant, indicating that a DP greater than 4 was necessary for TrCBM1 binding.

Conclusion

The CSP analysis using 13C-labeled β-O-4 lignin oligomer models enabled the identification of the TrCBM1 binding sites in lignins at the atomic level. This specific interaction analysis will provide insights for new molecular designs of cellulase having a controlled affinity to cellulose and lignin for a cost-effective biorefinery process.
COVID-19 with repeated positive test results for SARS-CoV-2 by PCR and then negative test results twice during intensive care: a case report
Authors: Kanamoto Masafumi , Tobe Masaru , Takazawa Tomonori , Saito Shigeru
Published: October 2020

Background

Determining the infectiousness of patients with coronavirus disease 2019 is crucial for patient management. Medical staff usually refer to the results of reverse transcription polymerase chain reaction tests in conjunction with clinical symptoms and computed tomographic images.

Case presentation

We report a case of a 62-year-old Japanese man who twice had positive and negative test results by polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 over 48 days of hospitalization, including in intensive care. His respiratory symptoms and computed tomographic imaging findings consistent with coronavirus disease 2019 improved following initial intensive care, and the result of his polymerase chain reaction test became negative 3 days before discharge from the intensive care unit. However, 4 days after this first negative result, his polymerase chain reaction test result was positive again, and another 4 days later, he had a negative result once more. Eight days after the second polymerase chain reaction negative test result, the patient’s test result again became positive. Finally, his polymerase chain reaction results were negative 43 days after his first hospitalization.

Conclusions

This case emphasizes the importance of repeat polymerase chain reaction testing and diagnosis based on multiple criteria, including clinical symptoms and computed tomographic imaging findings. Clinical staff should consider that a negative result by polymerase chain reaction does not necessarily certify complete coronavirus disease 2019 recovery.
A protocol for a scoping review of equity measurement in mental health care for children and youth
Authors: Gardner William , Nicholls Stuart G. , Reid Graham J. , Hutton Brian , Hamel Candyce , Sikora Lindsey , Salamatmanesh Mina , Duncan Laura , Georgiades Katholiki , Gilliland Jason
Published: October 2020

Background

Mental health (MH) problems are among the most important causes of morbidity and mortality for children and youth. Problems of lack of equity in child and youth MH services (CYMHS)—including, but not limited to, problems in inaccessibility and quality of services—are widespread. Characterizing the nature of equity in CYMHS is an ongoing challenge because the field lacks a consistent approach to conceptualizing equity. We will conduct a scoping review of how equity in MH services for children and youth has been defined, operationalized, and measured. Our objectives are to discover: (1) What conceptual definitions of equity are used by observational studies of CYMHS?; (2) What service characteristics of CYMHS care do indices of equity cover?; (3) What population dimensions have been used to operationalize equity?; (4) What statistical constructs have been used in indices that measure CYMHS equity?; and (5) What were the numerical values of those indices?

Methods

The following databases will be searched: Medline, Embase, PsycINFO, Cochrane Controlled Register of Trials, CINAHL, EconLit, and Sociological Abstracts. Searches will be conducted from the date of inception to the end of the last full calendar year (December 2019). Studies will be included if they include an evaluation of a mental health service for children or youth (defined as those under 19 years of age) and which quantify variation in some aspect of child or youth mental health services (e.g., accessibility, volume, duration, or quality) as a function of socio-demographic and/or geographic variables. Study selection will occur over two stages. Stage one will select articles based on title and abstract using the liberal-accelerated method. Stage two will review the full texts of selected titles. Two reviewers will work independently on full-text reviewing, with each study screened twice using pre-specified eligibility criteria. One reviewer will chart study characteristics and indices to be verified by a second reviewer. Reviewers will resolve full-text screening and data extraction disagreements through discussion. Synthesis of the collected data will focus on compiling and mapping the types and characteristics of the indices used to evaluate MH services equity.

Discussion

The planned, systematic scoping review will survey the literature regarding how equity in MH services for children and youth has been operationalized and help inform future studies of equity in CYMHS.

Systematic review registration

Open Science Foundation ID SYSR-D-19-00371, https://osf.io/58srv/.
Unified integral associated with the generalized V-function
Authors: Chandak S. , Al-Omari S. K. Q. , Suthar D. L.
Published: October 2020

In this paper, we present two new unified integral formulas involving a generalized V-function. Some interesting special cases of the main results are also considered in the form of corollaries. Due to the general nature of the V-function, several results involving different special functions such as the exponential function, the Mittag-Leffler function, the Lommel function, the Struve function, the Wright generalized Bessel function, the Bessel function and the generalized hypergeometric function are obtained by specializing the parameters in the presented formulas. More results are also discussed in detail.
Burden, risk assessment, surveillance and management of SARS-CoV-2 infection in health workers: a scoping review
Authors: Calò Federica , Russo Antonio , Camaioni Clarissa , De Pascalis Stefania , Coppola Nicola
Published: October 2020

Background

Health workers (HWs) are at increased risk for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection and a possible source of nosocomial transmission clusters. Despite the increased risk, the best surveillance strategy and management of exposed HWs are not yet well known. The aim of this review was to summarize and critically analyze the existing evidence related to this topic in order to support public health strategies aimed at protecting HWs in the hospital setting.

Main text

A comprehensive computerized literature research from 1 January 2020 up to 22 May 2020 was made to identify studies analyzing the burden of infection, risk assessment, surveillance and management of HWs exposed to SARS-CoV-2. Among 1623 citation identified using MEDLINE, Embase, Google Scholar and manual search, we included 43 studies, 14 webpages and 5 ongoing trials.

Health workers have a high risk of acquiring infection while caring for coronavirus disease 2019 (COVID-19) patients. In particular, some types exposures and their duration, as well as the inadequate or non-use of personal protective equipment (PPE) are associated with increased infection risk. Strict infection prevention and control procedures (IPC), adequate training programs on the appropriate use of PPE and close monitoring of HWs with symptom surveillance and testing are essential to significantly reduce the risk. At the moment there is not enough evidence to provide precise indications regarding pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).

Conclusions

During the spread of COVID-19 outbreak, numerous published papers investigated the epidemiology, risk assessment and prevention and control of SARS-CoV-2. However, more high-quality studies are needed to provide valid recommendations for better management and for the clinical and microbiological surveillance of healthcare personnel.
Lymphocyte antigen 6 superfamily member D is a marker of urothelial and squamous differentiation: implications for risk stratification of bladder cancer
Authors: Andersson Nina , Ohlsson Johan , Wahlin Sara , Nodin Björn , Boman Karolina , Lundgren Sebastian , Jirström Karin
Published: October 2020

Background

Screening across a multitude of normal and malignant tissues revealed an enhanced expression of lymphocyte antigen 6 superfamily member D (LY6D) in squamous epithelium and urothelium, as well as in malignancies derived therefrom. The aim of this study was to further delineate the protein expression of LY6D in urothelial bladder cancer, with particular attention to its relationship with clinicopathological characteristics and patient outcome.

Methods

Immunohistochemical expression of LY6D was assessed in tissue microarrays with urothelial bladder cancer tumours from three independent patient cohorts; one with transurethral resection of the bladder (TURB) specimens of mixed tumour stages from 110 consecutive cases, one with tumours of mixed stages from 260 incident cases in a population-based cohort, and one with paired TURB specimens, resected tumours and a subset of lymph node metastases from 145 patients with muscle-invasive bladder cancer (MIBC). Chi-square and non-parametric tests were applied to examine associations of LY6D expression with clinicopathological characteristics. Kaplan-Meier and Cox regression analyses were applied to examine 5-year overall survival (OS) and recurrence free survival (RFS) in relation to LY6D expression.

Results

In the two cohorts with mixed stages, positive LY6D expression was denoted in 63 and 64% of the cases, respectively, and found to be significantly higher in low-grade and less invasive tumours. Negative LY6D expression was significantly associated with a reduced 5-year OS, although not independently of established prognostic factors. In the population-based cohort, LY6D expression was higher in tumours with squamous differentiation and lower in other variant histologies compared to pure urothelial tumours, and the association of LY6D expression with survival was somewhat enhanced after exclusion of the former. LY6D expression was generally lower in the MIBC cohort, and even more reduced in resected tumours compared to TURB specimens in patients who had not received neoadjuvant chemotherapy. There were no significant associations between LY6D expression and RFS, neither allover nor in relation to neoadjuvant chemotherapy.

Conclusion

LY6D is a marker of urothelial and squamous differentiation that may add useful diagnostic and prognostic information to better guide the clinical management of bladder cancer, given that the presence of variant histology is taken into account.
Comparative study of elastic properties and mode I fracture energy of carbon nanotube/epoxy and carbon fibre/epoxy laminated composites
Authors: Bora Jyotikalpa , Kirtania Sushen
Published: October 2020

A comparative study of elastic properties and mode I fracture energy has been presented between conventional carbon fibre (CF)/epoxy and advanced carbon nanotube (CNT)/epoxy laminated composite materials. The volume fraction of CNT fibres has been considered as 15%, 30%, and 60% whereas; the volume fraction of CF has been kept constant at 60%. Three stacking sequences of the laminates viz.[0/0/0/0], [0/90/0/90] and [0/30/–30/90] have been considered in the present analysis. Periodic microstructure model has been used to calculate the elastic properties of the laminated composites. It has been observed analytically that the addition of only 15% CNT in epoxy will give almost the same value of longitudinal Young’s modulus as compared to the addition of 60% CF in epoxy. Finite element (FE) analysis of double cantilever beam specimens made from laminated composite has also been performed. It has been observed from FE analysis that the addition of 15% CNT in epoxy will also give almost the same value of mode I fracture energy as compared to the addition of 60% CF in epoxy. The value of mode I fracture energy for [0/0/0/0] laminated composite is two times higher than the other two types of laminated composites.
An antibiotic stewardship program in a surgical ICU of a resource-limited country: financial impact with improved clinical outcomes
Authors: Hussain Kashif , Khan Muhammad Faisal , Ambreen Gul , Raza Syed Shamim , Irfan Seema , Habib Kiren , Zafar Hasnain
Published: October 2020

Background

Antibiotic resistance (ABX-R) is alarming in lower/middle-income countries (LMICs). Nonadherence to antibiotic guidelines and inappropriate prescribing are significant contributing factors to ABX-R. This study determined the clinical and economic impacts of antibiotic stewardship program (ASP) in surgical intensive care units (SICU) of LMIC.

Method

We conducted this pre and post-test analysis in adult SICU of Aga Khan University Hospital, Pakistan, and compared pre-ASP (September–December 2017) and post-ASP data (April–July 2018). January–March 2018 as an implementation/training phase, for designing standard operating procedures and training the team. We enrolled all the patients admitted to adult SICU and prescribed any antibiotic. ASP-team daily reviewed antibiotics prescription for its appropriateness. Through prospective-audit and feedback-mechanism changes were made and recorded. Outcome measures included antibiotic defined daily dose (DDDs)/1000 patient-days, prescription appropriateness, antibiotic duration, readmission, mortality, and cost-effectiveness.

Result

123 and 125 patients were enrolled in pre-ASP and post-ASP periods. DDDs/1000 patient-days of all the antibiotics reduced in the post-ASP period, ceftriaxone, cefazolin, metronidazole, piperacillin/tazobactam, and vancomycin showed statistically significant (p < 0.01) reduction. The duration of all antibiotics use reduced significantly (p < 0.01). Length of SICU stays, mortality, and readmission reduced in the post-ASP period. ID-pharmacist interventions and source-control-documentation were observed in 62% and 50% cases respectively. Guidelines adherence improved significantly (p < 0.01). Net cost saving is 6360US$ yearly, mainly through reduced antibiotics consumption, around US$ 18,000 (PKR 2.8 million) yearly.

Conclusion

ASP implementation with supplemental efforts can improve the appropriateness of antibiotic prescriptions and the optimum duration of use. The approach is cost-effective mainly due to the reduced cost of antibiotics with rational use. Better source-control-documentation may further minimize the ABX-R in SICU.
Gastrointestinal stromal tumor in perforated Meckel’s diverticulum: a case report and literature review
Authors: Hashizume Naoki , Sakamoto Saki , Fukahori Suguru , Ishii Shinji , Saikusa Nobuyuki , Koga Yoshinori , Higashidate Naruki , Tsuruhisa Shiori , Nakahara Hirotomo , Tanaka Yoshiaki , Yagi Minoru
Published: October 2020

Introduction

Gastrointestinal stromal tumor (GIST) is rare neoplasms of the gastrointestinal tract associated with high rates of malignant transformation. GIST has been found largely in the stomach, small bowel, colon and rectum, and esophagus, but about 5% are found in other locations. We herein report a 56-year-old woman with a GIST in perforated Meckel's diverticulum. After encountering this patient, a review of the literature found reports of 18 similar patients.

Case presentation

A 56-year-old woman diagnosed with galactosialidosis (β-galactosidase-neuraminidase deficiency) presented with vomiting. On contrast-enhanced computed tomography, peritonitis due to perforation of the intestine was diagnosed based on the free air and dilated loop of the small bowel. Laparotomy revealed perforation of Meckel’s diverticulitis located 50 cm from the ileocecal valve. Partial resection of the ileum, including the diverticulum, and end-to-end anastomosis of the small intestine were performed. Regarding the pathological findings, the edge of the diverticulum wall consisted of a solid mass measuring 1.0 cm in size, and the tumor cells were spindle-shaped with 1 mitosis present per 50 high-power fields. The diagnosis was established as GIST of the Meckel's diverticulum. The postoperative period was uneventful. Follow-up at two years revealed no evidence of recurrence.

Conclusion

GIST in perforated Meckel's diverticulum is very rare. The potential for the coexistence of GIST or other tumor should be considered in the treatment of perforated Meckel's diverticulum.
Intrahepatic cholangiocarcinoma with clear cell type following laparoscopic curative surgery
Authors: Yamamoto Takuya , Abe Tomoyuki , Oshita Akihiko , Yonehara Shuji , Katamura Yoshio , Matsumoto Nozomu , Kobayashi Tsuyoshi , Nakahara Masahiro , Ohdan Hideki , Noriyuki Toshio
Published: October 2020

Background

Intrahepatic cholangiocarcinoma (ICC) is the second most common malignancy of primary liver cancer. Among the several pathological types of ICC, only five cases of the clear cell type have been reported, including the one presented below. Here we report a unique case of clear cell type ICC following laparoscopic hepatectomy.

Case presentation

A 67-year-old woman had a history of hepatitis B virus. Computed tomography revealed a ring-like enhanced mass 35 mm in diameter at segment 7 in the early phase. The enhancement was prolonged to the late phase through the portal phase, while the shape was irregular. Ethoxybenzy magnetic resonance imaging revealed that the tumor had a low signal intensity on T1-weighted imaging and a high signal intensity on T2-weighted imaging. Diffusion-weighted images identified that the tumor had remarkably high signal intensity. Tumor enhancement was not detected throughout the tumor in the hepatocyte phase. Upon ICC diagnosis, a laparoscopic S7 subsegmentectomy was performed. The patient’s postoperative course was uneventful. An immunohistochemical examination revealed that the cells tested positive for cytokeratin 7 (CK7), CK19, and CD56 and negative for CK20, CD10, α-fetoprotein, thyroid transcription factor-1. At 2 years after surgery, the patient remains alive without recurrence.

Conclusions

Here we presented a case of clear cell ICC that was treated by laparoscopic hepatectomy. Immunological analysis, especially by CD56 and several CK markers, is helpful for diagnosing this disease.
A terminal level analysis of service quality at Nigerian seaports
Authors: Sakyi Daniel , Appiah Christian Kwarteng , Ayesu Enock Kojo , Immurana Mustapha , Baidoo Samuel Tawiah
Published: October 2020

Seaport terminals are major facilitators of international trade. One issue that is very crucial to the performance and survival of seaport terminals is the quality of service provided. However, in order to enhance the quality of service provided at these terminals, it is important to know customers’ expectations and perceptions about service quality. Notwithstanding, very little is known about customers’ expectations and perceptions on the service quality of seaport terminals in Africa. This paper therefore provides a comparative analysis of service quality of Nigerian seaport terminals with the aid of the gap score technique of the service quality (SERVQUAL) model. It is found that generally, all the selected terminals studied have low service quality. With regard to the average gap score per service quality dimension for all the selected terminals, transparency has the best service quality (least gap score) whiles responsiveness has the least service quality (highest gap score). The implication is that, in seaport terminals quest to enhance service quality, more attention should be paid towards enhancing responsiveness by providing prompt services, helping customers and informing them when exactly services will be performed.
Reliance on emotion promotes belief in fake news
Authors: Martel Cameron , Pennycook Gordon , Rand David G.
Published: October 2020

What is the role of emotion in susceptibility to believing fake news? Prior work on the psychology of misinformation has focused primarily on the extent to which reason and deliberation hinder versus help the formation of accurate beliefs. Several studies have suggested that people who engage in more reasoning are less likely to fall for fake news. However, the role of reliance on emotion in belief in fake news remains unclear. To shed light on this issue, we explored the relationship between experiencing specific emotions and believing fake news (Study 1;N = 409). We found that across a wide range of specific emotions, heightened emotionality at the outset of the study was predictive of greater belief in fake (but not real) news posts. Then, in Study 2, we measured and manipulated reliance on emotion versus reason across four experiments (totalN = 3884). We found both correlational and causal evidence that reliance on emotion increases belief in fake news: self-reported use of emotion was positively associated with belief in fake (but not real) news, and inducing reliance on emotion resulted in greater belief in fake (but not real) news stories compared to a control or to inducing reliance on reason. These results shed light on the unique role that emotional processing may play in susceptibility to fake news.
Morphological, thermal, and thermomechanical properties of cellulose nanocrystals reinforced polylactide/poly [(butylene succinate)-co-adipate] blend composite foams
Authors: Motloung Mpho Phillip , Zungu Simphiwe , Ojijo Vincent , Bandyopadhyay Jayita , Ray Suprakas Sinha
Published: October 2020

This study examines the influence of cellulose nanocrystal (CN) particles on the morphological, thermal, and thermo-mechanical properties of polylactide (PLA)/poly [(butylene succinate)-co-adipate] (PBSA) blend foams prepared by casting and particulate leaching method using fructose as porogen particles. The morphological analysis showed an interconnected open-cell structure, with porosity above 80%. The crystallinity of the prepared foams was disrupted by the inclusion of CN particles as observed from XRD analyses, which showed a decrease in PLA crystal peak intensity. With regards to neat blend foam, the onset thermal degradation increased with the addition of CN particles, which also increased the thermal stability at 50% weight loss. Furthermore, CN acted as a reinforcing agent in improving the stiffness of the prepared blend foam. Overall, completely environmentally friendly foams were successfully prepared, as a potential material that can replace the current existing foam materials that pose many environmental concerns. However, there is a need to develop an environmentally friendly processing technique.