bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance evaluation of conductive tracks in fabricating e-textiles by lock-stitch embroidery
Authors: Zheng Yan , Jin Lu , Qi Jing , Liu Zekun , Xu Lulu , Hayes Steven , Gill Simeon , Li Yi
Published: July 2020

Lock-stitch embroidery has been the centre of much interest as a versatile and precise method of producing conductive tracks in the fabrication of wearable electronic devices. However, improper fabrication parameter settings could result in the nonconformity of the conductive tracks and damage the conductive coating of the conductive yarns. In this study, we evaluate the appearance quality, dimensional stability and electrical resistance of conductive tracks by taking into account the embroidering speed (ES), stitch length (SL), needle thread pre-tension (NTP) and embroidering direction (ED). The conductive tracks are embroidered onto knitted fabric in different directions with silver-coated polyamide yarn as the needle thread. The results show that stitching the conductive tracks in the wale direction results in a more uniform stitch lines in comparison to the other directions. To resolve the problem of floated stitches, it is recommended that an SL of 4 mm and a higher NTP are used. The percentage of shrinkage in the wale direction is lower than in the course direction. The electrical resistance of the conductive tracks increases with a higher ES and shorter SL. It is also found that a thicker yarn is more sensitive to the NTP and some of the silver coating is rubbed off with an NTP of 50 gf. We also carry out an overlay plot analysis, through which we predict and validate the optimal embroidery parameters that balance appearance quality and electrical resistance. The technique parameters in this study can be used to embroider conductive tracks for smart clothing.
A Novel Universal Endovascular Robot for Peripheral Arterial Stent–Assisted Angioplasty: Initial Experimental Results
Authors: Lu Qingsheng , Shen Yu , Xia Shibo , Chen Bing , Wang Kundong
Published: July 2020

Background:

The bottleneck of the development of endovascular interventional robot is that it cannot fully adapt to commercialized endovascular devices, such as guidewires, catheters, and stents, and cannot complete the entire procedure of endovascular treatment, for instance, stent implantation. The purpose of this study is to evaluate whether the novel universal endovascular interventional robot can adapt to different commercialized endovascular devices and accomplish the entire procedure of endovascular treatment of peripheral vascular disease.

Methods and Material:

The novel universal endovascular interventional robot consists of 2 components: a master surgeon console and a robotic platform with 4 manipulators. An adult pig was served as the experimental animal. Bilateral iliac artery stent implantation was performed on the pig by the endovascular interventional robot using commercialized guidewires, catheters, and stent delivery systems.

Results:

The novel universal endovascular interventional robot can adapt to commercialized endovascular devices, and most interventional procedures, such as insertion, withdrawal, and rotating, can be done through remote control. By coordinating multiple manipulators, complex actions such as superselection, crossing action, or implantation of self-expanding bare stent can be realized. The entire procedure took about 50 minutes, and the total exposure time of the surgeon was less than 1 minute. Postoperative angiography showed that the position of the stent grafts was accurate. The procedure was stable without any stent or surgical-related complications.

Conclusion:

The novel universal endovascular interventional robot can realize peripheral arterial stent-assisted angioplasty with commercialized devices. Through the design improvement, the problem related to stent implantation is solved, and the remote operation is realized throughout the endovascular procedure.
Factors influencing instructional leadership capacity in Baku, Azerbaijan
Authors: Sindhvad Swetal , Mikayilova Ulviyya , Kazimzade Elmina
Published: July 2020

Azerbaijan has introduced significant reforms to improve school leadership in public schools. Responsibilities were redefined to prioritize teacher supervision and engagement with school governance structures to ensure school improvement and accountability measures. The purpose of this study was to provide insight into contextual factors predicting the extent of principals’ sense of self-efficacy, or capacity, for instructional leadership in public schools in the capital city of Baku. Findings suggest that any increment in outcome expectancy for teacher supervision, mentorship, and training is likely to increase Baku principals’ intentions to perform those instructional leadership practices. However, time on instructional leadership is the key contextual factor influencing outcome expectancy. Findings also point to the importance of time spent on stakeholder engagement and school management tasks such as providing classroom resources, which are interrelated to instructional leadership tasks. Policy reforms for instructional leadership in Azerbaijan need to consider the interrelations between school leadership functions.
A Comparison of Sphenoid Sinus Osteoneogenesis in Aspirin-Exacerbated Respiratory Disease
Authors: Malfitano Madison J. , Santarelli Griffin D. , Gelpi Mark , Brown William C. , Stepp Wesley H. , Hernandez Stephen , Kimple Adam J. , Thorp Brian D. , Zanation Adam M. , Ebert Charles S.
Published: July 2020

Background

Aspirin-exacerbated respiratory disease (AERD) is characterized by excessive leukotriene production, diffuse polyp burden and osteitic bone changes. These bony changes have not been previously characterized.

Objective

The aim of this radiographic study is to characterize the bony changes noted on computed tomography (CT) scans of the sphenoid sinus in patients with AERD compared to other diseased sinonasal inflammatory states and non-diseased controls.

Methods

A retrospective review of 43 patients with clinically confirmed AERD were included and compared to 22 non-diseased, 9 allergic fungal sinusitis, and 43 chronic rhinosinusitis controls (23 without polyps and 18 with polyps). Comparative measurements were performed using fine-cut CT scans. Sites of comparison were the intersinus septum, the left and right lateral sphenoid wall, the roof, and left and right floor of the sphenoid sinus. Standardized measurements were averaged by two separate rhinologists.

Results

Patients with AERD had an average statistically significant increase in bone thickness compared to healthy and diseased controls in nearly every site with the most pronounced changes in the intersinus septum (p < 0.05).

Conclusion

Patients with AERD have significantly increased thickness of the sphenoid bone compared to control groups with the most pronounced difference in the intersinus septum. These findings may help clinicians increase suspicion for a diagnosis of AERD who clinically have diffuse nasal polyposis.
Foregone Opportunities and Choosing Not to Act: Replications of Inaction Inertia Effect
Authors: Chen Jieying , Hui Long Sang , Yu Teresa , Feldman Gilad , Zeng Shiyuan , Ching Tze Lam , Ng Chi Ho , Wu Kwok Wai , Yuen Chung Man , Lau Tsz Ki , Cheng Bo Ley , Ng Ka Wai
Published: July 2020

Inaction inertia is the phenomenon that forgoing an initial attractive opportunity decreases the likelihood of taking a subsequent opportunity that is less attractive, even when the subsequent opportunity still offers positive value. We conducted three preregistered replications of Tykocinski et al.’s Experiments 1 and 2’s four scenarios in four samples ( N = 1,555). We found consistent findings across samples, with the inaction inertia effect dependent on the scenario used. Strongest support was for the car scenario ( d = −0.57 to −0.68) and the ski scenario ( d = −0.18 to −0.67), with mixed findings for the fitness scenario (large-small: d = −0.62; control contrasts: opposite to predictions) and weak to no effects for the flyer scenario ( d = −0.14 to 0.02). We conclude that context is important in studying inaction inertia, recommend the car and ski scenarios for follow-up research on inaction inertia, and discuss implications for future research.
In a Representative Sample Grit Has a Negligible Effect on Educational and Economic Success Compared to Intelligence
Authors: Zisman Chen , Ganzach Yoav
Published: July 2020

We compare the relative contribution of grit and intelligence to educational and job-market success in a representative sample of the American population. We find that, in terms of Δ R 2, intelligence contributes 48–90 times more than grit to educational success and 13 times more to job-market success. Conscientiousness also contributes to success more than grit but only twice as much. We show that the reason our results differ from those of previous studies which showed that grit has a stronger effect on success is that these previous studies used nonrepresentative samples that were range restricted on intelligence. Our findings suggest that although grit has some effect on success, it is negligible compared to intelligence and perhaps also to other traditional predictors of success.
To screen or not to screen women for Group B Streptococcus (Streptococcus agalactiae) to prevent early onset sepsis in newborns: recent advances in the unresolved debate
Authors: Rao Guduru Gopal , Khanna Priya
Published: July 2020

Streptococcus agalactiae, also known as Group B streptococcus (GBS) is the commonest cause of early onset sepsis in newborns in developed high-income countries. Intrapartum antimicrobial (antibiotic) prophylaxis (IAP) is recognized to be highly effective in preventing early onset Group B sepsis (EOGBS) in newborns. The key controversy is about the strategy that should be used to identify mothers who should receive IAP. There are two strategies that are followed in developed countries: screening-based or risk-factor-based identification of women requiring IAP. The debate regarding which of the two approaches is better has intensified in the recent years with concerns about antimicrobial resistance, effect on newborn’s microbiome and other adverse effects. In this review, we have discussed some of the key research papers published in the period 2015–2019 that have addressed the relative merits and disadvantages of screening versus risk-factor-based identification of women requiring IAP. Although screening-based IAP appears to be more efficacious than risk-based IAP, IAP-based prevention has several limitations including ineffectiveness in prevention of late-onset GBS infection in babies, premature and still births, impact of IAP on neonatal microbiota, emergence of antimicrobial resistance and difficulties in implementing IAP-based strategies in middle and low income countries. Alternative strategies, principally maternal immunization against GBS would circumvent use of IAP. However, no licensed vaccines are currently available for use.
Life at a Stop Sign: Narrative Plots of the Transition to Adulthood During Unemployment Among South African Graduates
Authors: van Lill Rinet , Bakker Therese Maria
Published: July 2020

Compared to older cohorts, emerging adults are more susceptible to unemployment as they enter the labor market. In the context of increasing higher education access, an unstable economic climate is leaving a growing number of South African graduates unemployed. After the exploration that is typically part of higher education, unemployment could influence emerging adult graduates’ ability to make adult commitments. The aim of the current study was to gain both a detailed and a holistic perception of the developmental impact of unemployment during the transition to adulthood. A sample of 12 participants were recruited to partake in individual interviews. A narrative analysis revealed six common plotlines of progression and regression as the participants approached the goals they had set to achieve as adults. The findings illustrate the inability to accomplish adult commitments as a contributing factor in explaining the decrease in subjective well-being associated with unemployment specific to emerging adults.
“Do Not Ignore Musculoskeletal Pain”—Initial Presentation of a Rare Malignant Disease: Case Report and Literature Review
Authors: Patel Ishan , Akoluk Arda , Upadhyaya Vandan , Makadia Shraddhadevi , Douedi Steven , Farooq Taliya , Flynn Daniel , Levitt Michael , Hossain Mohammad A.
Published: July 2020

Gray zone lymphoma, also known as B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, is a rare malignancy with overlapping features of both diffuse large B-cell lymphoma and classical Hodgkin lymphoma. Most commonly mediastinal involvement is seen. Extranodal involvement is rare. In this case report, we present the case of a 59-year-old male who presented with stress-related left shoulder pain, ultimately diagnosed with gray zone lymphoma. The patient was treated with etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin-rituximab (EPOCH-R) regimen followed by consolidation radiotherapy resulting in complete response. We are highlighting this case as rare and atypical presentation of a rare disease.
Lateral entorhinal cortex lesions impair both egocentric and allocentric object–place associations
Authors: Kuruvilla Maneesh V. , Wilson David I. G. , Ainge James A.
Published: July 2020

During navigation, landmark processing is critical either for generating an allocentric-based cognitive map or in facilitating egocentric-based strategies. Increasing evidence from manipulation and single-unit recording studies has highlighted the role of the entorhinal cortex in processing landmarks. In particular, the lateral (LEC) and medial (MEC) sub-regions of the entorhinal cortex have been shown to attend to proximal and distal landmarks, respectively. Recent studies have identified a further dissociation in cue processing between the LEC and MEC based on spatial frames of reference. Neurons in the LEC preferentially encode egocentric cues while those in the MEC encode allocentric cues. In this study, we assessed the impact of disrupting the LEC on landmark-based spatial memory in both egocentric and allocentric reference frames. Animals that received excitotoxic lesions of the LEC were significantly impaired, relative to controls, on both egocentric and allocentric versions of an object–place association task. Notably, LEC lesioned animals performed at chance on the egocentric version but above chance on the allocentric version. There was no significant difference in performance between the two groups on an object recognition and spatial T-maze task. Taken together, these results indicate that the LEC plays a role in feature integration more broadly and in specifically processing spatial information within an egocentric reference frame.
Blown films with balanced in-plane properties from polypropylene-clay nanocomposites though silane coupling
Authors: Ren Weijie , Jayaraman Krishnamurthy
Published: July 2020

Layered silicates present interaction sites at both faces and edges of the nanolayers and silane coupling agents that locate at both sites lead to polymer nanocomposites with superior melt strength and properties. This work’s objective was (a) to investigate the effectiveness of solvent-free, vapor phase, silane treatment of the nanolayers for formulating masterbatches and (b) to compare the mechanical properties of 1 mil thick blown films from polypropylene copolymer nanocomposites with such coupling, to films from the neat polypropylene. The nanocomposite blown film tensile modulus and tensile strength improved along both the draw direction and the transverse direction. In addition, their elongation to failure was close to 500% along both directions, in contrast to values of 500% along MD and 170% along TD for the neat PP copolymer. These trends may be understood in terms of the crystalline lamellar orientation distribution in the films. FESEM images revealed that cross-hatched lamellae were absent from the unfilled PP blown film and were pervasive in the nanocomposite blown film. The nanolayers were oriented in the film plane with the longer dimension largely along the MD. The lower extent of lamellar orientation around nanolayers may be attributed to the strong reduction in the polymer chain mobility attached to the nanolayers.
PFBNet: a priori-fused boosting method for gene regulatory network inference
Authors: Che Dandan , Guo Shun , Jiang Qingshan , Chen Lifei
Published: July 2020

Background

Inferring gene regulatory networks (GRNs) from gene expression data remains a challenge in system biology. In past decade, numerous methods have been developed for the inference of GRNs. It remains a challenge due to the fact that the data is noisy and high dimensional, and there exists a large number of potential interactions.

Results

We present a novel method, namely priori-fused boosting network inference method (PFBNet), to infer GRNs from time-series expression data by using the non-linear model of Boosting and the prior information (e.g., the knockout data) fusion scheme. Specifically, PFBNet first calculates the confidences of the regulation relationships using the boosting-based model, where the information about the accumulation impact of the gene expressions at previous time points is taken into account. Then, a newly defined strategy is applied to fuse the information from the prior data by elevating the confidences of the regulation relationships from the corresponding regulators.

Conclusions

The experiments on the benchmark datasets from DREAM challenge as well as the E.coli datasets show that PFBNet achieves significantly better performance than other state-of-the-art methods (Jump3, GEINE3-lag, HiDi, iRafNet and BiXGBoost).
Seamless integration of image and molecular analysis for spatial transcriptomics workflows
Authors: Bergenstråhle Joseph , Larsson Ludvig , Lundeberg Joakim
Published: July 2020

Background

Recent advancements in in situ gene expression technologies constitute a new and rapidly evolving field of transcriptomics. With the recent launch of the 10x Genomics Visium platform, such methods have started to become widely adopted. The experimental protocol is conducted on individual tissue sections collected from a larger tissue sample. The two-dimensional nature of this data requires multiple consecutive sections to be collected from the sample in order to construct a comprehensive three-dimensional map of the tissue. However, there is currently no software available that lets the user process the images, align stacked experiments, and finally visualize them together in 3D to create a holistic view of the tissue.

Results

We have developed an R package named STUtility that takes 10x Genomics Visium data as input and provides features to perform standardized data transformations, alignment of multiple tissue sections, regional annotation, and visualizations of the combined data in a 3D model framework.

Conclusions

STUtility lets the user process, analyze and visualize multiple samples of spatially resolved RNA sequencing and image data from the 10x Genomics Visium platform. The package builds on the Seurat framework and uses familiar APIs and well-proven analysis methods. An introduction to the software package is available at https://ludvigla.github.io/STUtility_web_site/.
Intestinal parasites co-infection among tuberculosis patients in Ethiopia: a systematic review and meta-analysis
Authors: Alemu Ayinalem , Bitew Zebenay Workneh , Worku Teshager
Published: July 2020

Background

Tuberculosis and intestinal parasites are mostly affecting poor people. They are in a vicious since one is the risk factor for the other. However, the comprehensive report on the burden and co-incidence of intestinal parasites and tuberculosis in Ethiopia is scant. This systematic review and meta-analysis aimed to provide abridge conclusive evidence on the intestinal parasite-tuberculosis co-infection in Ethiopia.

Methods

A total of 414 articles published in English were searched from both electronic databases (CINAHL, DOAJ, Embase, Emcare, Medline, ProQuest, and PubMed, Science Direct, and Web of Science) and other sources. The qualities of the included studies were assessed using the Joanna Briggs Institute Critical Appraisal tools and the publication bias was measured using the funnel plot and Eggers regression test. Comprehensive meta-analysis (CMA) Version 3.3.07 and Review Manager software were used to estimate pooled prevalence and associations of intestinal parasites and tuberculosis infection.

Results

Eleven articles with a total of 3158 tuberculosis patients included in the analysis based on the eligibility criteria. The estimated pooled prevalence of intestinal parasites co-infection was 33% (95% CI: 23.3, 44.3) using the random-effects model. The most common intestinal parasites wereAscaris lumbricoides10.5% (95% CI: 6.0, 17.5),Hookworm9.5% (95% CI: 6.10, 14.4),Giardia lamblia5.7% (95% CI: 2.90, 10.9) andStrongyloides sterocoralis5.6% (95% CI: 3.3, 9.5). The odds of intestinal parasites infection was higher among tuberculosis patients compared to tuberculosis free individuals (OR = 1.76; 95% CI: 1.17, 2.63). A significant difference was observed among TB patients for infection with intestinal helminths (OR = 2.01; 95% CI: 1.07, 3.80) but not for intestinal protozoans when compared with their counterparts. The odds of multiple parasitic infections was higher among tuberculosis patients (OR = 2.59, 95% CI: 1.90, 3.55) compared to tuberculosis free individuals. However, intestinal parasites co-infection was not associated withHIVstatus among tuberculosis patients (OR = 0.97; 95% CI: 0.71, 1.32).

Conclusion

One-third of tuberculosis patients are co-infected with one or more intestinal parasites, and they are more likely to be infected with intestinal helminths and multiple intestinal parasitic infections compared to TB free individuals. We recommend routine screening of tuberculosis patients for intestinal parasites. The effect of mass deworming on tuberculosis incidence would be important to be considered in future researches.

Trial registration

Registered on PROSPERO with reference number ID:CRD42019135350.
Real-world adherence to, and persistence with, once- and twice-daily oral disease-modifying drugs in patients with multiple sclerosis: a systematic review and meta-analysis
Authors: Nicholas Jacqueline A. , Edwards Natalie C. , Edwards Roger A. , Dellarole Anna , Grosso Megan , Phillips Amy L.
Published: July 2020

Background

Nonadherence to disease-modifying drugs (DMDs) for multiple sclerosis (MS) is associated with poorer clinical outcomes, including higher rates of relapse and disease progression, and higher medical resource use. A systematic review and quantification of adherence and persistence with oral DMDs would help clarify the extent of nonadherence and nonpersistence in patients with MS to help prescribers make informed treatment plans and optimize patient care.

The objectives were to: 1) conduct a systematic literature review to assess the availability and variability of oral DMD adherence and/or persistence rates across ‘real-world’ data sources; and 2) conduct meta-analyses of the rates of adherence and persistence for once- and twice-daily oral DMDs in patients with MS using real-world data.

Methods

A systematic review of studies published between January 2010 and April 2018 in the PubMed database was performed. Only studies assessing once- and twice-daily oral DMDs were available for inclusion in the analysis. Study quality was evaluated using a modified version of the Newcastle-Ottawa Scale, a tool for assessing quality of observational studies. The random effects model evaluated pooled summary estimates of nonadherence.

Results

From 510 abstracts, 31 studies comprising 16,398 patients with MS treated with daily oral DMDs were included. Overall 1-year mean medication possession ratio (MPR; n = 4 studies) was 83.3% (95% confidence interval [CI] 74.5–92.1%) and proportion of days covered (PDC; n = 4 studies) was 76.5% (95% CI 72.0–81.1%). Pooled 1-year MPR ≥80% adherence (n = 6) was 78.5% (95% CI 63.5–88.5%) and PDC ≥80% (n = 5 studies) was 71.8% (95% CI 59.1–81.9%). Pooled 1-year discontinuation (n = 20) was 25.4% (95% CI 21.6–29.7%).

Conclusions

Approximately one in five patients with MS do not adhere to, and one in four discontinue, daily oral DMDs before 1 year. Opportunities to improve adherence and ultimately patient outcomes, such as patient education, medication support/reminders, simplified dosing regimens, and reducing administration or monitoring requirements, remain. Implementation of efforts to improve adherence are essential to improving care of patients with MS.
Differentiation of arterial and venous neurovascular conflicts estimates the clinical outcome after microvascular decompression in trigeminal neuralgia
Authors: Müller Sebastian , Khadhraoui Eya , Khanafer Ali , Psychogios Marios , Rohde Veit , Tanrikulu Levent
Published: July 2020

Background

Balanced Steady State Free Precession (b-SSFP) sequences and the newly developed Fast-Spin-Echo (FSE)-sequences enable an optimized visualization of neurovascular compression (NVC) in patients with trigeminal neuralgia (TN). Arterial conflicts are mostly associated with a favorable outcome of microvascular decompression (MVD) compared to venous conflicts. An additional Time-of-Flight (TOF) angiography provides the differentiation between offending arteries and veins and a precise counselling of the patient concerning postoperative pain relief. The goal of this study was to analyze the reliability and impact of the combination of highly-resoluted MRI techniques on the correct prediction of the vessel type and the estimation of postoperative outcome of microvascular decompression (MVD).

Methods

In total, 48 patients (m/f: 32/16) underwent MVD for TN. All the preoperative imaging data (T2: b-SFFP and FSE, MRA: TOF) were compared to the intraoperative microsurgical findings during MVD. b-SFFP was available in 14 patients, FSE in 34 patients and an additional TOF sequence was available in 38 patients (9 times in combination with b-SSFP, 29 times in combination with FSE). The patients were categorized into four subgroups: 1) NVC negative, 2) venous NVC, 3) arterial NVC, 4) combined arterial and venous NVC. The preoperative MRI findings were compared to the intraoperative morphological findings. Postoperative pain relief was quantified by the Barrow Neurological Institute pain score.

Results

Twenty-five purely arterial NVC, 9 purely venous NVC and 5 combined arterial and venous NVC were detected by MRI. In 9 cases NVC was absent on MRI. Overall, the MRI findings correctly predicted the intraoperative findings in 91.7% of the 48 patients. The percentage of correct prediction increased from 80 to 94.7%, when TOF angiography was adjoined.

Conclusion

The visualization of the trigeminal nerve using sequences such as b-SSFP or FSE in combination with TOF angiography enables an optimized delineation of arterial and venous neurovascular conflicts and may allow a more reliable differentiation between veins and arteries, resulting in superior prediction of postoperative pain relief compared to T2 imaging data alone.
Pregnant women’s attitudes and decision-making regarding prenatal Down syndrome screening and diagnosis: scale development and validation
Authors: Huang Wei-Hsiang , Shih Shu-Fang , Lin Chen-Li , Liu Chieh-Hsing
Published: July 2020

Background

Down syndrome is a common chromosomal abnormality and prenatal screening can inform parents of the risk of their baby having Down syndrome. Little research has examined how decisions regarding both Down syndrome screening as well as diagnosis are made among women who are currently pregnant and how their decisions are influenced by their social contexts, specifically family and social media, using mixed methods. The study was to test the validity and reliability of a scale that measures pregnant women’s attitudes and decision-making concerning prenatal Down syndrome screening and diagnosis in urban areas of Taiwan.

Methods

We developed an item pool based on a literature review and in-depth interviews with 30 pregnant women recruited at two district hospitals in urban areas. The item pool was reviewed by a panel of experts and then administered to 300 women who had been pregnant for less than 24 weeks and had not received the Down syndrome screening tests. We used item analysis and exploratory factor analysis to validate the scale and test its reliability.

Results

The initial item pool had 54 items. After the expert review, three items were deleted. After the item analysis, 16 additional items were deleted. Exploratory factor analysis of the remaining items revealed four factors labeled – “Attitudes towards Down syndrome and Screening Tests,” “Important others’ Attitudes towards Down Syndrome,” “Influence of Important Others on Decision-Making,” and “Influence of Social Media on Decision-Making” – and 16 of the remaining items had satisfactory loadings on those factors, explaining 72.0% of the total variance. The Cronbach’s α values of the dimensions ranged between 0.75 and 0.90, demonstrating satisfactory internal reliability.

Conclusions

The scale has satisfactory validity and reliability, and can be used to understand pregnant women’s attitudes and decision-making regarding Down syndrome screening and diagnosis, and to help design tailored consultations for pregnant women in clinical settings.
Development and validation of a predictive model for estimating EGFR mutation probabilities in patients with non-squamous non-small cell lung cancer in New Zealand
Authors: Aye Phyu Sin , Tin Tin Sandar , McKeage Mark James , Khwaounjoo Prashannata , Cavadino Alana , Elwood J. Mark
Published: July 2020

Background

Targeted treatment with Epidermal Growth Factor Receptor (EGFR) tyrosine kinase inhibitors (TKIs) is superior to systemic chemotherapy in non-small cell lung cancer (NSCLC) patients with EGFR gene mutations. Detection of EGFR mutations is a challenge in many patients due to the lack of suitable tumour specimens for molecular testing or for other reasons. EGFR mutations are more common in female, Asian and never smoking NSCLC patients.

Methods

Patients were from a population-based retrospective cohort of 3556 patients diagnosed with non-squamous non-small cell lung cancer in northern New Zealand between 1 Feb 2010 and 31 July 2017. A total of 1694 patients were tested for EGFR mutations, of which information on 1665 patients was available for model development and validation. A multivariable logistic regression model was developed based on 1176 tested patients, and validated in 489 tested patients. Among 1862 patients not tested for EGFR mutations, 129 patients were treated with EGFR-TKIs. Their EGFR mutation probabilities were calculated using the model, and their duration of benefit and overall survival from the start of EGFR-TKI were compared among the three predicted probability groups: < 0.2, 0.2–0.6, and > 0.6.

Results

The model has three predictors: sex, ethnicity and smoking status, and is presented as a nomogram to calculate EGFR mutation probabilities. The model performed well in the validation group (AUC = 0.75). The probability cut-point of 0.2 corresponds 68% sensitivity and 78% specificity. The model predictions were related to outcome in a group of TKI-treated patients with no biopsy testing available (n = 129); in subgroups with predicted probabilities of < 0.2, 0.2–0.6, and > 0.6, median overall survival times from starting EGFR-TKI were 4.0, 5.5 and 18.3 months (p = 0.02); and median times remaining on EGFR-TKI treatment were 2.0, 4.2, and 14.0 months, respectively (p < 0.001).

Conclusion

Our model may assist clinical decision making for patients in whom tissue-based mutation testing is difficult or as a supplement to mutation testing.
The effects of cognitive behavioural therapy on depression and quality of life in patients with maintenance haemodialysis: a systematic review
Authors: Ling Chen , Evans Debra , Zhang Yunfang , Luo Jianying , Hu Yanping , Ouyang Yuxia , Tang Jiamin , Kuang Ziqiao
Published: July 2020

Background

Depression is highly prevalent among Haemodialysis (HD) patients and is known to results in a series of adverse outcomes and poor quality of life (QoL). Although cognitive behavioural therapy (CBT) has been shown to improve depressive symptoms and QoL in other chronic illness, there is uncertainty in terms of the effectiveness of CBT in HD patients with depression or depressive symptoms.

Methods

All randomised controlled trials relevant to the topic were retrieved from the following databases: CINHAL, MEDLINE, PubMed, PsycINFO and CENTRAL. The grey literature, specific journals, reference lists of included studies and trials registers website were also searched. Data was extracted or calculated from included studies that had measured depression and quality of life using valid and reliable tools –this included mean differences or standardised mean differences and 95% confidence intervals. The Cochrane risk of bias tool was used to identify the methodological quality of the included studies.

Results

Six RCTs were included with varying methodological quality. Meta-analysis was undertaken for 3 studies that employed the CBT versus usual care. All studies showed that the depressive symptoms significantly improved after the CBT. Furthermore, CBT was more effective than usual care (MD = − 5.28, 95%CI − 7.9 to − 2.65, P = 0.37) and counselling (MD = − 2.39, 95%CI − 3.49 to − 1.29), while less effective than sertraline (MD = 2.2, 95%CI 0.43 to 3.97) in alleviating depressive symptoms. Additionally, the CBT seems to have a beneficial effect in improving QoL when compared with usual care, while no significant difference was found in QoL score when compared CBT with sertraline.

Conclusions

CBT may improve depressive symptoms and QoL in HD patients with comorbid depressive symptoms. However, more rigorous studies are needed in this field due to the small quantity and varied methodological quality in the identified studies.
The role of the Stop Transmission of Polio (STOP) program in developing countries: the experience of Kenya
Authors: Tesfaye Brook , K. Makam Jeevan , Sergon Kibet , Onuekwusi Iheoma , Muitherero Charles , Sowe Alieu
Published: July 2020

Background

In 1988, the 41st World Health Assembly (WHA) marked the launch of the Global Polio Eradication Initiative (GPEI) for the eradication of polio. A key component of the GPEI has been the development and deployment of a skilled workforce to implement eradication activities. In 1989, the Stop Transmission of Polio (STOP) was initiated to address skilled human resource gaps and strengthen poliovirus surveillance. This paper describes the role of the STOP 52 team in technical capacity building and health system strengthening in the implementation of polio eradication strategies in Kenya following the outbreak of Circulating Vaccine-derived Poliovirus type 2 (cVDPV2).

Methods

Overview of the STOP program, deployment, and the modality of support are described. Descriptive analysis was conducted using data collected by the STOP 52 team during integrated supportive supervisory visits conducted from July 2018 to September 2019. Analyses were carried out using Epi-Info statistical software (Version 7.0) and maps were developed using Quantum Geographic Information System (Q-GIS) (version 3.12.0).

Results

The STOP 52 team supportively supervised 870 health facilities on Expanded Program on Immunization (EPI), and Acute Flaccid Paralysis (AFP) and other Vaccine-Preventable Diseases (VPDs) surveillance in 16 (34.1%) of the 47 counties during the study period. AFP surveillance was conducted in all health facilities supervised leading to the detection and investigation of 11 unreported AFP cases. The STOP 52 team, as part of the outbreak response, provided technical support to five successive rounds of polio Supplementary Immunization Activities (SIAs) conducted during the study period. Moreover, in addressing programmatic data needs, the STOP 52 Data Manager played a valuable role in enhancing the quality and use of data for evidence-based planning and decision-making. The STOP 52 team contributed to the development of operational plans, guidelines and training manuals, and participated in the delivery of various Training of Trainers (TOT) and On-the-Job Training (OJT) on EPI, AFP and other VPDs surveillance including data management.

Conclusion

The STOP 52 team has contributed to polio eradication efforts in Kenya by enhancing AFP and other VPDs surveillance, supporting polio SIAs, strengthening EPI, use of quality EPI, AFP and other VPDs data, and capacity building of Frontline Health Workers (FLWs). The use of Open Data Kit (ODK) technology during supportive supervision, and AFP and other VPDs surveillance was found to be advantageous. A national STOP program should be modeled to produce a homegrown workforce to ensure the availability of more sustainable technical support for polio eradication efforts in Kenya and possibly other polio-affected countries.
Applying equity-centered principles in an interprofessional global health course: a mixed methods study
Authors: Stallwood Lisa , Adu Prince A. , Tairyan Kate , Astle Barbara , Yassi Annalee
Published: July 2020

Background

Medical students, practitioners and other health professionals are commonly unprepared to address the many complex issues that emerge while conducting research in the Global South. As a response to identified deficiencies in global health education, a hybrid online/face-to-face multi-institutional credit course was developed based on the equity-centered principles advanced by the Canadian Coalition for Global Health Research (CCGHR), namely Authentic partnering, Inclusion, Shared benefits, Commitment to the future, Responsiveness to causes of inequities, and Humility. This study aimed to analyze the extent to which the course was effective in fortifying attitudes consistent with the CCGHR principles; identify successes and challenges; and assess how a course such as this can fill an identified gap.

Methods

This interprofessional course was offered to 25 graduate and postgraduate students in various health professions and public health. Faculty were drawn from medicine, public health, nursing and social sciences from four universities in Western Canada. A pre-post retrospective survey, key informant interviews and participant observation were used to gather data for this study.

Results

Findings showed that student attitudes regarding global health research and practice significantly evolved towards views consistent with the principles articulated. The multiple instructors and hybrid course format created both opportunities and challenges; the interprofessional nature of the cohort was considered a strong asset, as was the fact that many students came from the Global South. Some students suggested that the course could be further strengthened by concretely partnering with institutions in the Global South rather than offered solely to learners registered in universities in the Global North.

Conclusions

While weaknesses were identified, results support the conclusion that a course focused on the CCGHR principles could be useful in preparing the next generation of global health researchers and practitioners to mitigate historical limitations in this field. Longitudinal follow-up is warranted to provide more definitive conclusions.
Inequalities in caesarean section in Burundi: evidence from the Burundi Demographic and Health Surveys (2010–2016)
Authors: Yaya Sanni , Zegeye Betregiorgis , Idriss-Wheeler Dina , Shibre Gebretsadik
Published: July 2020

Background

Despite caesarean section (CS) being a lifesaving intervention, there is a noticeable gap in providing this service, when necessary, between different population groups within a country. In Burundi, there is little information about CS coverage inequality and the change in provision of this service over time. Using a high-quality equity analysis approach, we aimed to document both magnitude and change of inequality in CS coverage in Burundi over 7 years to investigate disparities.

Methods

For this study, data were extracted from the 2010 and 2016 Burundi Demographic and Health Surveys (BDHS) and analyzed through the recently updated Health Equity Assessment Toolkit (HEAT) of the World Health Organization. CS delivery was disaggregated by four equity stratifiers, namely education, wealth, residence and sub-national region. For each equity stratifier, relative and absolute summary measures were calculated. We built a 95% uncertainty interval around the point estimate to determine statistical significance.

Main findings

Disparity in CS was present in both survey years and increased over time. The disparity systematically favored wealthy women (SII = 10.53, 95% UI; 8.97, 12.10), women who were more educated (PAR = 8.89, 95% UI; 8.51, 9.26), women living in urban areas (D = 12.32, 95% UI; 9.00, 15.63) and some regions such as Bujumbura (PAR = 11.27, 95% UI; 10.52, 12.02).

Conclusions

Burundi had not recorded any progress in ensuring equity regarding CS coverage between 2010 and 2016. It is important to launch interventions that promote justified use of CS among all subpopulations and discourage overuse among high income, more educated women and urban dwellers.
FAM20B-catalyzed glycosaminoglycans control murine tooth number by restricting FGFR2b signaling
Authors: Wu Jingyi , Tian Ye , Han Lu , Liu Chao , Sun Tianyu , Li Ling , Yu Yanlei , Lamichhane Bikash , D’Souza Rena N. , Millar Sarah E. , Krumlauf Robb , Ornitz David M. , Feng Jian Q. , Klein Ophir , Zhao Hu , Zhang Fuming , Linhardt Robert J. , Wang Xiaofang
Published: July 2020

Background

The formation of supernumerary teeth is an excellent model for studying the molecular mechanisms that control stem/progenitor cell homeostasis needed to generate a renewable source of replacement cells and tissues. Although multiple growth factors and transcriptional factors have been associated with supernumerary tooth formation, the regulatory inputs of extracellular matrix in this regenerative process remains poorly understood.

Results

In this study, we present evidence that disrupting glycosaminoglycans (GAGs) in the dental epithelium of mice by inactivating FAM20B, a xylose kinase essential for GAG assembly, leads to supernumerary tooth formation in a pattern reminiscent of replacement teeth. The dental epithelial GAGs confine murine tooth number by restricting the homeostasis of Sox2(+) dental epithelial stem/progenitor cells in a non-autonomous manner. FAM20B-catalyzed GAGs regulate the cell fate of dental lamina by restricting FGFR2b signaling at the initial stage of tooth development to maintain a subtle balance between the renewal and differentiation of Sox2(+) cells. At the later cap stage, WNT signaling functions as a relay cue to facilitate the supernumerary tooth formation.

Conclusions

The novel mechanism we have characterized through which GAGs control the tooth number in mice may also be more broadly relevant for potentiating signaling interactions in other tissues during development and tissue homeostasis.
Seropositivity and associated intrinsic and extrinsic factors for Rift Valley fever virus occurrence in pastoral herds of Nigeria: a cross sectional survey
Authors: Alhaji Nma Bida , Aminu Jibrin , Lawan Mohammed Kabiru , Babalobi Olutayo Olajide , Ghali-Mohammed Ibrahim , Odetokun Ismail Ayoade
Published: July 2020

Background

Rift Valley fever (RVF) is a vector-borne emerging zoonotic disease of animals and humans, characterized by socioeconomic losses to livestock farmers and global public health threat. The study determined RVFV seroprevalence in cattle, assessed pastoralists’ knowledge about RVF, and factors that influence its occurrence in pastoral cattle herds of Nigeria. A cross-sectional study was conducted in pastoral herds of North-central Nigeria from 2017 to 2018. Data were collected using serology and questionnaire tools. Descriptive statistics were used to analyze the obtained data. Categorical variables were presented as proportions and their associations determined by Chi-square tests. Associations of risk factors were analyzed by univariable and multivariable logistic regressions analyses at 95% confidence level.

Results

The overall IgM seropositivity of RVFV in pastoral cattle herds was 5.6%. This was higher in nomadic herds (7.4%) than in agro-pastoral herds (3.8%). All animal demographic characteristics of age, sex and breeds were not significantly (p > 0.05) associated with RVFV occurrence in pastoral herds. All the 403 pastoralists selected participated in the study, with the majorities of them being male, married and have no formal education. Majority of the pastoralists had low knowledge levels about zoonotic RVFV infection. All identified socio-ecological factors significantly (p < 0.05) influenced RVFV occurrence in herds. Mosquitoes availability in cattle environment (OR = 7.81; 95% CI: 4.85, 12.37), presence of rivers and streams at grazing fields (OR = 10.80; 95% CI: 6.77, 17.34), high rainfall (OR = 4.30; 95% CI: 2.74, 6.59), irrigated rice fields (OR = 5.14; 95% CI: 3.21, 7.79), bushy vegetation (OR = 6.11; 95% CI: 3.96, 9.43), animal movement (OR = 2.2; 95% CI: 1.45, 3.25), and seasons (OR = 2.34; 95% CI: 1.55, 3.51) were more likely to influenced RVFV occurrence in cattle herds.

Conclusions

Results of this study had illustrated recent circulation of RVFV in pastoral cattle herds in Nigeria and needs urgent interventions. The surveyed pastoralists had low knowledge level about RVF while the socio-ecological factors significantly influenced RVFV occurrence in herds. To address these gaps, pastoralists should be educated on clinical manifestations and modes of transmission of the disease in animals and humans, and mitigation measures. Adequate knowledge about RVF epidemiology will assure food security and public health.
The sputum microbiome is distinct between COPD and health, independent of smoking history
Authors: Haldar Koirobi , George Leena , Wang Zhang , Mistry Vijay , Ramsheh Mohammadali Yavari , Free Robert C. , John Catherine , Reeve Nicola F. , Miller Bruce E. , Tal-Singer Ruth , Webb Adam J. , Brookes Anthony J. , Tobin Martin D. , Singh Dave , Donaldson Gavin C. , Wedzicha Jadwiga A. , Brown James R. , Barer Michael R. , Brightling Christopher E.
Published: July 2020

Background

Airway bacterial dysbiosis is a feature of chronic obstructive pulmonary disease (COPD). However, there is limited comparative data of the lung microbiome between healthy smokers, non-smokers and COPD.

Methods

We compared the 16S rRNA gene-based sputum microbiome generated from pair-ended Illumina sequencing of 124 healthy subjects (28 smokers and 96 non-smokers with normal lung function), with single stable samples from 218 COPD subjects collected from three UK clinical centres as part of the COPDMAP consortium.

Results

In healthy subjects Firmicutes, Bacteroidetes and Actinobacteria were the major phyla constituting 88% of the total reads, and Streptococcus, Veillonella, Prevotella, Actinomyces and Rothia were the dominant genera. Haemophilus formed only 3% of the healthy microbiome. In contrast, Proteobacteria was the most dominant phylum accounting for 50% of the microbiome in COPD subjects, with Haemophilus and Moraxella at genus level contributing 25 and 3% respectively. There were no differences in the microbiome profile within healthy and COPD subgroups when stratified based on smoking history. Principal coordinate analysis on operational taxonomic units showed two distinct clusters, representative of healthy and COPD subjects (PERMANOVA, p = 0·001).

Conclusion

The healthy and COPD sputum microbiomes are distinct and independent of smoking history. Our results underline the important role for Gammaproteobacteria in COPD.