bluuebunny/crossref_metadata_2025 huggingface dataset:
Supercapsular percutaneously-assisted total hip (SuperPath) versus posterolateral total hip arthroplasty in bilateral osteonecrosis of the femoral head: a pilot clinical trial
Authors: Meng Weikun , Huang Zhong , Wang Haoyang , Wang Duan , Luo Zeyu , Bai Yang , Gao Liang , Wang Guanglin , Zhou Zongke
Published: December 2019

Background: The supercapsular percutaneously-assisted total hip arthroplasty (SuperPath) was proposed to be minimally invasive and tissue sparing with possible superior postoperative outcomes to traditional approaches of total hip arthroplasty (THA). Here, we compared the short-term outcomes of staged THA with the SuperPath or through posterolateral approach (PLA) for bilateral osteonecrosis of the femoral head (ONFH).
Methods: Patients with bilateral late-stage ONFH were prospectively recruited from our department from March 2017 to March 2018. Staged bilateral THAs with one side SuperPath and the other side PLA were performed consecutively in the same patients with right and left hips alternating within approaches. The average time interval between the staged THAs was 3 months. Perioperative status (operation time, incision length, intraoperative blood loss, soft tissue damage, and length of hospital stay) and postoperative function (range of motion, pain, and hip function) were recorded and compared between the SuperPath and PLA approaches within 12-month postoperatively.
Results: Four male patients (age, 51.00 ± 4.54; BMI, 21.49 ± 1.73) with bilateral alcohol-induced ONFH (Ficat III/IV) were followed up over 12 months postoperatively. Compared with the PLA, the SuperPath yielded shorter incision length (7.62 vs. 11.12 cm), longer operation time (103.25 vs. 66.50 min), more blood loss (1108.50 vs. 843.50 ml), deficient abduction angle of the acetabular cup (38.75° vs. 44.50°), and inferior early-term hip function (Harris hip score, 72.50 vs. 83.25) at 12-month postoperatively. Soft tissue damage, length of hospital stay, postoperative pain, postoperative range of motion, and 12-month patient satisfaction were comparable between both approaches.
Conclusion: The SuperPath may be a minimally invasive technique but the present study shows less favorable short-term outcomes than PLA for total hip arthroplasty in osteonecrosis of the femoral head. More investigations are required to provide convincing favorable evidences of the SuperPath over other traditional THA approaches.
The last week of life of nursing home residents with advanced dementia: a retrospective study
Authors: Toscani Franco , Finetti Silvia , Giunco Fabrizio , Basso Ines , Rosa Debora , Pettenati Francesca , Bussotti Alessandro , Villani Daniele , Gentile Simona , Boncinelli Lorenzo , Monti Massimo , Spinsanti Sandro , Piazza Massimo , Charrier Lorena , Giulio Paola Di
Published: December 2019

Background: Barriers to palliative care still exist in long term care settings for older people, thus persons with advanced dementia may not receive adequate palliative care in the last days of their life; instead, they may be exposed to aggressive and/or inappropriate treatments. This study aimed to evaluate the clinical interventions and care at end of life in a cohort of Nursing Home (NH) residents with advanced dementia in a large Italian region (Lombardy Region).
Methods: Retrospective study in a convenience sample of 29 NHs. Data were collected from the clinical records of 482 residents with advanced dementia, who had resided in the NH for at least 6 months before death, mainly focusing on the last week of life.
Results: Most residents (97.1%) died in the NH. In the seven days before death, 20% were fed and hydrated by mouth, and 13.4% were tube fed. A median of five, often inappropriate, drugs were prescribed. The acknowledgement of worsening condition in clinical records was recorded for 57% of residents, a median of four days before death. Conclusions: Full implementation of palliative care was not achieved possibly due to the insufficient acknowledgement of the appropriateness of some drugs and interventions, and health professionals’ lack of implementation of end-of-life palliative care decisions. Future studies should focus on how to improve care for NH residents.
Psychological interventions for managing postpartum psychosis: A qualitative analysis of women’s and family members’ experiences and preferences
Authors: Forde Rebecca , Peters Sarah , Wittkowski Anja
Published: December 2019

Background: Postpartum psychosis is a rare, yet severe disorder, in which early identification and immediate intervention are crucial. Despite recommendations for psychological input, little is known about the types of psychological intervention reported to be helpful. The aim of this study was to explore the experiences, needs and preferences for psychological intervention from the perspective of women with postpartum psychosis and from the perspective of family members. Methods: Thirteen women and eight family members, including partners were interviewed. The data from these semi-structured interviews were audio-recorded, transcribed and inductively analysed using thematic analysis. Results: Twelve subthemes were identified and then organised around three main themes: 1) Seeking safety and containment, 2) Recognising and responding to the psychological impact and 3) Planning for the future. These themes highlight the temporal element of recovery from postpartum psychosis, because women’s psychological needs and preferences changed over time. Emphasis was initially placed on ensuring safety, followed by a need to connect, process and adjust to their experiences. Additional needs were reported by women and family when planning for the future, including managing the fear of relapse and help to reach a decision about future pregnancies. Conclusion: The results illustrate a range of areas in which psychological intervention could be delivered to facilitate and enhance recovery. Further research is needed to develop meaningful and effective psychological interventions and to investigate the most appropriate timing for this to be offered.
A maternal GOT1 novel mutation associated with early-onset severe preeclampsia identified by whole-exome sequencing
Authors: Zhang Lin , Cao Zheng , Feng Fan , Xu Ya-Nan , LI LIN , Gao Hong
Published: December 2019

Purpose This study wants to know the genetic cause of preeclampsia (PE) which is a leading cause of maternal and perinatal death, but the underlying molecular mechanisms that cause PE remain poorly understood. Many single nucleotide polymorphisms have been identified by genome-wide association studies and were found to be associated with PE; however, few studies have used whole-exome sequencing (WES) to identify PE mutations. Methods Five patients with severe early-onset preeclampsia (EOPE) were recruited, and WES was performed on each patient. Sanger sequencing was used to confirm the potential causative genetic mutation. Results After a stringent bioinformatics analysis, a rare mutation in the GOT1 gene, c.44C>G:p.P15R, was found in one patient. Bioinformatics analysis showed that the mutation site is highly conserved across several species and was predicted to be a pathogenic mutation according to several online mutational function prediction software packages. Further structural biology homology modeling suggested that P15R would change the electric environment of enzymatic center, and might affect the binding affinity of substrate or product. Conclusion We demonstrated for the first time that the mutation in GOT1 may be associated with EOPE, the results of this study provide researchers and clinicians with a better understanding of the molecular mechanisms that underlie maternal severe EOPE.
Lycopene improves on basic hematological and immunological parameters in diabetes mellitus
Authors: Eze Ejike Daniel , Afodun Adam Moyosore , Kasolo Josephine , Kasozi Keneth Iceland
Published: December 2019

Objective: Diabetes is associated with an upset of hematological and immunological parameters in humans, however information on the effects of Lycopene is scarce. The aim of the study was to gain information on basic changes in hematological parameters as markers for safety since anemia as a complication in diabetic chemotherapy has been reported.
Results: Lycopene had anti-anemic effects and improved on the immune status of diabetic rats and these observations were dose independent. There was a decrease in neutrophil, low neutrophil-lymphocyte ratio and platelet counts and stable albumin, globulin levels. Lycopene could exert its protective effects through a balance of basic hematological physiological variables.
Efficient identification of patients eligible for clinical studies using case-based reasoning on Scottish Health Research Register (SHARE).
Authors: Shi Wen , Kelsey Tom , Sullivan Frank
Published: December 2019

Background: Trials often struggle to achieve their target sample size with only half doing so. Some researchers have turned to Electronic Health Records (EHRs), seeking a more efficient way of recruitment. The Scottish Health Research Register (SHARE) obtained patients’ consent for their EHRs to be used as a searching base from which researchers can find potential participants. However, due to the fact that EHR data is not complete, sufficient or accurate, a database search strategy may not generate the best case-finding result. The current study aims to evaluate the performance of a case-based reasoning method in identifying participants for population-based clinical studies recruiting through SHARE, and assess the difference between its resultant cohort and the original one deriving from searching EHRs.Methods: A case-based reasoning framework was applied to 119 participants in nine projects using two-fold cross-validation, with records from a further 86,292 individuals used for testing. A prediction score for study participation was derived from the diagnosis, procedure, pharmaceutical prescription, and laboratory test results attributes of each participant. Evaluation was conducted by calculating Area Under the ROC Curve and information retrieval metrics for the ranking list of the test set by prediction score. We compared the most likely participants as identified by searching a database to those ranked highest by our model. Results: The average ROCAUC for nine projects was 81% indicating strong predictive ability for these data. However, the derived ranking lists showed lower predictive performance, with only 21% of the persons ranked within top 50 positions being the same as identified by searching databases.Conclusions: Case-based reasoning is may be more effective than a database search strategy for participant identification for clinical studies using population EHRs. The lower performance of ranking lists derived from case-based reasoning means that patients identified as highly suitable for study participation may still not be recruited. This suggests that further study is needed into improvements in the collection and curation of population EHRs such as use of free text data to better define the characteristics of people more likely to be recruited.
Freshwater Viral Metagenome Reveals Novel and Functional Phage-borne Antibiotic Resistance Genes
Authors: Moon Kira , Kang Ilnam , Park Kwang Seung , Jeon Jeong Ho , lee Kihyun , Cha Chang-Jun , Lee Sang Hee , Cho Jang-Cheon
Published: December 2019

BackgroundAntibiotic resistance developed by bacteria is a significant threat to global health. Antibiotic resistance genes (ARGs) spread across different bacterial populations through multiple dissemination routes, including horizontal gene transfer mediated by bacteriophages. ARGs carried by bacteriophages are considered especially threatening due to their prolonged persistence in the environment, fast replication rates, and ability to infect phylogenetically remote bacterial hosts. Several studies employing qPCR and viral metagenomics have shown that viral fraction and viral sequence reads in clinical and environmental samples carry many ARGs. However, only a few ARGs have been found in viral contigs assembled from metagenome reads, with most of these genes lacking effective antibiotic resistance phenotypes. Owing to the wide application of viral metagenomics, nevertheless, different classes of ARGs are being continuously found in viral metagenomes acquired from diverse environments. As such, the presence and functionality of ARGs encoded by bacteriophages remain up for debate.ResultsWe evaluated ARGs excavated from viral contigs recovered from urban surface water viral metagenome data. In virome reads and contigs, diverse ARGs, including polymyxin resistance genes, multidrug efflux proteins, and β-lactamases, were identified. In particular, the novel β-lactamases blaHRV-1 and blaHRVM-1 found in this study had unique sequences, forming distinct clades of Class A and subclass B3 β-lactamases, respectively. Minimum inhibitory concentration analyses for E. coli strains harboring blaHRV-1 and blaHRVM-1 and catalytic kinetics of purified HRV-1 and HRVM-1 showed reduced susceptibility to penicillin, narrow- and extended-spectrum cephalosporins, and carbapenems. These genes were also found in bacterial metagenomes, indicating that they were harbored by actively infecting phages.ConclusionOur results showed that viruses in the environment carry as-yet-unreported functional ARGs, albeit in small quantities. We thereby suggest that environmental bacteriophages could be reservoirs of widely variable, unknown ARGs that could be disseminated via virus-host interactions.
Metal-induced bacterial interactions promote diversity in river-sediment microbiomes
Authors: Cyriaque Valentine , Géron Augustin , Billon Gabriel , Nesme Joseph , Gillan David C. , Sørensen Søren J. , Wattiez Ruddy
Published: December 2019

Background Anthropogenic metal contamination results in long-term environmental selective pressure with unclear impacts on bacterial communities, key players in ecosystem functioning. Since metal contamination poses serious toxicity and bioaccumulation issues, assessing their impact on environmental microbiomes is important to respond to current environmental and health issues. Despite elevated metal concentrations, river sedimentary microbiome near the MetalEurop foundry (France) show unexpected higher diversity compared to upstream control site. In this work, a follow-up of the microbial community assembly during a metal contamination event was performed in microcosms with periodic renewal of the supernatant river water.Results Sediments of the control site were gradually exposed to a mixture of metals (Cd, Cu, Pb and Zn), in order to reach similar concentrations to MetalEurop sediments. Illumina sequencing analysis of 16S rRNA gene amplicons was performed. Metal resistance genes czc A and pbr A, as well as IncP plasmid content were assessed by quantitative PCR. The outcomes of this study support previous in-situ observations showing that metals act as community assembly managers, increasing diversity.Conclusion This work revealed progressive adaptation of the sediment microbiome through the selection of different metal-resistance mechanisms and cross-species interactions involving public good providing bacteria co-occurring with the rest of the community.
Effect of rTMS on Parkinson's Cognitive Deficit: A Systematic Review and Meta-analysis
Authors: Jiang Yi , Guo Zhiwei , McClure Morgan A. , He Lin , mu qiwen
Published: December 2019

Background: To evaluate the effects and optimal parameters of repetitive transcranial magnetic stimulation (rTMS) on cognition improvement of Parkinson's disease (PD) patients with cognitive deficit and to estimate which cognitive function may obtain more benefit from rTMS. Method: The articles dealing with rTMS on cognitive deficit of PD patients were retrieved from the databases until December 2018. Two researchers selected research papers, evaluated their quality, extracted data, and cross-checked them according to the inclusion and exclusion criteria. The standardized mean differences (SMDs) with 95 % confidence interval (CI) of cognitive outcome for different parameters, scales, and cognitive functions were estimated. Results: Fourteen studies involving 163 subjects were included in the study. A significant effect size was observed for the mini-mental state examination (MMSE) global cognitive outcome. Further subtests for different cognitive domains demonstrated prominent effect for the executive function. The significant effect sizes were respectively found with multiple sessions of high-frequency rTMS over frontal cortex, especially with over dorsolateral prefrontal cortex (DLPFC), based on subgroup analysis of the executive function. All of the other cognitive domains including working memory, attention, and language ability did not obtain significant effects. Conclusions: Multiple sessions of high frequency rTMS over the DLPFC may have positive effect on executive function in PD patients with cognitive deficit. Further well designed studies with large sample sizes are needed to verify our results and ascertain the long-term effects of rTMS.
Incidence and predictive factors of diaphragmatic dysfunction in acute stroke.
Authors: Catalá-Ripoll Jose Vicente , Monsalve-Naharro Jose Ángel , Hernández-Fernández Francisco
Published: December 2019

Background: The most characteristic clinical signs of stroke are motor and/or sensory involvement of one hemibody. Respiratory involvement has also been described, which could be related to diaphragmatic dysfunction contralateral to the brain injury. Our objective is to establish the incidence of diaphragmatic dysfunction in ischaemic stroke and analyse the relationship between this and the main prognostic markers. Methods : Patients with supratentorial ischaemic stroke were selected in the first 48 hours of admission for 6 months. Ultrasonography of the diaphragm was performed on each hemithorax to obtain the thickening fraction applying the formula [(inspiratory thickness - expiratory thickness)/expiratory thickness]. Forced breathing was then requested to them and the examination was performed again. Diaphragmatic dysfunction was considered as a thickening fraction lower than 20%. The statistical relationship with the vascular territory involved, the NIHSS scale, the hemiparesis degree and the success of reperfusion techniques were examined. Results : An incidence of diaphragmatic dysfunction of 51.7% was observed on the contralateral side and of 1.7% on the ipsilateral side. A reduction of up to 11.7% was seen in the incidence of dysfunction on the contralateral side upon breathing forcedly. All patients with NIHSS above 6 had diaphragmatic dysfunction on the contralateral side (p < 0.001). They also had lower degrees of muscle strength (p < 0.001). Conclusions : There is a high incidence of diaphragmatic dysfunction in patients with supratentorial ischaemic stroke. An estimation of the diaphragmatic function can be obtained using the thickening fraction.
Identification of E2 strain with improved secretion and immunogenicity against CSFV in piglets
Authors: Xu Huiling , Wang Yanli , Han Guangwei , Fang Weihuan , he fang
Published: December 2019

Background: Outbreaks of CSFV cause significant economic losses in the swine industry. Subunit vaccines present advantages in DIVA immunogenicity and safety. The technology was limited due to the low yield and the high cost with multiple and large doses. Results: A novel E2 sequence (E2ZJ) was identified from an epidemic strain of Zhejiang for outstanding secretion in baculovirus and enhanced immunogenicity. E2 secretion induced with the selected signal peptide, SPZJ, increase at least 50% as compared to any other signal peptides tested. Besides, unique antigenic features were identified in E2ZJ. E2ZJ elicited CSFV antibody at the earlier stage than other E2 types tested in mice. Meantime, higher level of neutralization antibody with E2ZJ was detected than other E2s at the same dosage. Further, in piglets, E2ZJ successfully elicited neutralizing immunity. A single dose of 5 μg of E2ZJ was sufficient to induce protective antibody against CSFV in piglets and provided 100% protection against lethal virus challenge. Conclusions: In this study, with advantages in secretion and immunogenicity over counterparts, SPZJ-E2ZJ is a cost-effective and efficacious vaccine candidate against CSFV. Keywords: Classical swine fever virus; novel signal peptide; SPZJ-E2ZJ; subunit vaccine; protective immunity
High-throughput Sequencing Study of the Effect of Transabdominal Hysterectomy on Intestinal Flora in Patients with Uterine Fibroids
Authors: Wang Wantong , Li Yibing , Wu Qijun , Pan Xin , He Xinhui , ma xiaoxin
Published: December 2019

Background: To investigate the effect of transabdominal hysterectomy on the diversity of the intestinal flora in patients with uterine fibroids. Patients with uterine fibroids were selected from September 2018 to December 2018, in the Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, and stool specimens were collected from patients before and after surgery.Results: High-throughput sequencing of the 16S rRNA gene was used to detect the changes in microbial community structure and diversity, and the effects of total hysterectomy on the intestinal flora were further analyzed. Estrogen levels decreased after trans-abdominal hysterectomy. High-throughput sequencing showed that after abdominal hysterectomy, the abundance and diversity of the intestinal flora decreased. The abundance changes were mainly due to Proteobacteria, where their abundance increased.Conclusions: Trans-abdominal hysterectomy changes the intestinal flora of the body by lowering the level of estrogen in the body, which reduces the diversity and abundance of the intestinal flora.
Immune activation of murine RAW264.7 macrophages by sonicated and alkalized paramylon from Euglena gracilis
Authors: Guo Qingqing , Bi Decheng , Wu Mingcan , Yu Boming , Hu Lang , Liu Chenchen , Gu Liang , Zhu Hui , Lei Anping , Xu Xu , Wang Jiangxin
Published: December 2019

Background: Euglena as a new super health food resource that is rich in the natural polysaccharide paramylon, a linear β-1,3-glucan with various biological activities including activity on the immune system in different cell lines and animals. Despite these reports, the immune regulation mechanism of paramylon is still unclear. Results: We investigate the signaling pathways paramylon impacts in immune macrophages. In RAW264.f:7 macrophages, sonicated and alkalized paramylon oligomers up-regulated inducible nitric oxide synthase (iNOS) and increased secretion of nitric oxide (NO), interleukin (IL)-6 and tumor necrosis factor (TNF)-α, in a concentration-dependent manner. In addition, paramylon activated the nuclear factor-κB(NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways and inhibiting these pathways attenuated the paramylon-induced secretion of the above immune-mediators. Conclusions: These results demonstrate that Euglena gracilis paramylon modulates the immune system via activation of the NF-κB and MAPK signaling pathways and thus has potential therapeutic benefits.
Effectiveness of a health education intervention on the use of long-lasting insecticidal nets for the prevention of malaria in pregnant women of Pakistan: A Quasi-experimental study
Authors: Kumar Ramesh , Farzeen Midhat , Hafeez Assad , Achakzai Baseer Khan , Vankwani Muskan , Lal Manohar , Iqbal Rabia , Somrongthong Ratana
Published: December 2019

Background: Malaria being a pressing public health issue in Pakistan can be prevented if long lasting insecticides are made freely available in the country. However, the success of this prevention strategy depends upon usage of long-lasting insecticide treated nets (LLINs) by community. Hence the focus of present study was to determine the effectiveness of health education on adoption of LLINs among pregnant women living in remote district Tharparkar Sindh Pakistan. Methods: A Quasi-experimental study design with control and intervention group was conducted with 200 pregnant women (100in each group). Women in intervention group were provided with health education sessions on malaria for 12 weeks while those in control group obtained routine information by lady health workers (LHWs). Pre and post intervention assessment was done for use of LLINs; and was statistically analyzed using independent sample t-test, chi-square with p values, and mean scores. Results: Baseline was conducted with 200 pregnant women. Demographic characteristics were similar in both groups except for age, education, income, type of latrine and source of drinking water. After intervention, as compared to baseline, knowledge of participants increased two-fold in intervention group whereas it remained unchanged in control group. Furthermore, statistically significance difference (<0.05) between intervention and control groups on use of LLINs was found with increase in LLINs usage among intervention group. Conclusions: Results proved that health education could be an effective intervention for improving knowledge and usage of LLINs among pregnant women for preventing malaria. Therefore, such educational interventions have a potential to be implemented at scale by incorporating them into routine health sessions provided by health workers to pregnant women so that maternal and child morbidity and mortality due to malaria can be prevented.
Changing the paradigm of cervical cancer prevention through introduction of HPV-testing: evaluation of the implementation process of the Jujuy Demonstration Project in Argentina
Authors: Arrossi Silvina , Paolino Melisa , Laudi Rosa , Thouyaret Laura
Published: December 2019

Background The Jujuy Demonstration Project (JDP) was a four-year implementation project (2011-2014) to develop, implement and evaluate the programmatic components of an HPV-based screening program in Argentina . The aim of this paper is present a qualitative evaluation of the context and implementation process of JDP. Methods We used an adaptation of the Health System Framework (HSF), which includes contextual interconnected factors that are considered key drivers for successful health interventions. We reviewed Secondary Documents, which included program reports, information sheets, power point presentations, and minutes of meetings and management round-tables. We also carried out semi-structured interviews to key informants to explore their views about technology acceptability. Results Key components of JDP implementation process were high level of political support and consensus among stakeholders, the demonstrated effectiveness of the technology and its acceptability by health authorities and providers, funding of tests and diagnosis/treatment services, implementation of an information system for monitoring and evaluation, and the reorganization of the network of screening diagnosis and treatment services. Conclusion This analysis has made explicit the policy context in which the JDP was implemented, and system components that were key for the demonstrated effectiveness of the strategy. Such analyses provide useful insights into core components of HPV-testing implementation that are needed to guarantee its potential effectiveness to reduce cervical cancer incidence and mortality .
Patients' satisfaction factors mining and sentiment analysis of B2C mail-order pharmacy reviews
Authors: Liu Jingfang , Zhou Yingyi , Jiang Xiaoyan , Zhang Wei
Published: December 2019

Background In recent years, mail-order pharmacies have been accepted by increasingly more patients, and the prospects for mail-order pharmacies are optimistic. This article explores the patients’ satisfaction factors addressed in Business to Customer (B2C) mail-order pharmacy reviews and analyzes the sentiments expressed in the reviews. The goal of this work is to help B2C mail-order pharmacy enterprises identify patients’ concerns, continuously improve the health services level. Methods This paper was based on the Latent Dirichlet Allocation (LDA) topic model. From a B2C mail-order pharmacy of integrated e-commerce and a vertical B2C mail-order pharmacy (JD.COM and J1.COM, respectively), 136,630 pieces of over-the-counter (OTC) drug review data posted from January 1, 2015 to December 31, 2018 were selected as samples and used to explore the satisfaction factors of B2C mail-order pharmacy patients regarding the entire drug purchasing process. Then, the sentiments expressed in the drug reviews were analyzed with SnowNLP. Result Categorization of the 12 factors identified by LDA showed that 5 factors were related to logistics; these 5 factors, which also included the most drug reviews, made up 38.5% of the reviews. The number of factors related to drug prices was second, with 3 factors, and reviews of drug prices made up 25.5% of the reviews. Customer service and drug effects each had two related factors, and a smaller percentage of these reviews (13.95%) were related to drug effects. Patients still maintain positive opinions of JD.COM and J1.COM. However, some opinions on logistics and drug prices are expressed.Conclusion The most important task for mail-order pharmacies is to improve logistics. It is better to develop self-built logistics. Both types of B2C mail-order pharmacies can improve patient viscosity by implementing marketing strategies. With regard to customer service, focusing on improving employees' service attitudes is necessary.
Multi-level validation of the German physical activity barriers self-efficacy scale in a sample of female sixth-graders
Authors: Bachner Joachim , Sturm David Joseph , Haug Stephan , Demetriou Yolanda
Published: December 2019

Background The physical activity behaviour of the majority of children and adolescents is insufficient. Self-efficacy is regarded as one of the most important determinants able to enhance physical activity. The purpose of this study is to validate the German version of the physical activity barriers self-efficacy scale by means of a multi-level approach. Factorial validity, internal consistency and criterion validity were examined for the individual and the class level.Methods The final sample comprised 454 female sixth-graders of 33 classes. The original 8-item physical activity barriers self-efficacy scale was translated by a committee approach and pilot tested within the pretest procedure. To examine the factorial validity of the translated scale, a multi-level confirmatory factor analysis was conducted with the lavaan package in R. Internal consistency was estimated with the alpha function of the psych package. Criterion validity was examined by correlating self-efficacy with moderate-to-vigorous physical activity (MVPA) assessed with accelerometers.Results In contrast to previous validation studies, two-dimensional models fit the data better than uni-dimensional models. The best overall fit exhibited a 2x2-model, with two factors both on the individual and the class level (χ2 = 65.13, CFI = .985, TLI = .977, RMSEA = .046, SRMR = .033). The latent factors correlated highly on both levels (r = .87; r = .72). Every item loaded significantly on its respective factor on both levels. Internal consistency for the full scale and the first subscale was good on the individual level and excellent on the class level. For the second subscale, Cronbach’s alpha was low on level 1 and excellent on level 2. Weak relations between self-efficacy values and MVPA were found for level 1, strong associations were found for level 2.Conclusions The validation speaks in favour of a two-dimensional scale measuring not only actual self-efficacy but also support from family and friends. Furthermore, the results argue for the relevance of the multi-level approach which is able to differentiate between self-efficacy on the individual level and collective efficacy on the class level.
A qualitative study on consenting approaches for genomic research in communities with low literacy
Authors: Bukini Daima Athumani , Mbekenga Columba , Nkya Siana , Purvis Lisa , McCurdy Sheryl , Parker Michael , Makani Julie
Published: December 2019

Background: Low literacy of study participants in Sub Saharan Africa has been associated with poor comprehension during consenting process in research participation. The concerns in comprehension are far greater when consenting to participate in genomic studies due to the complexity of the science involved. While efforts are made to explore possibilities of applying genomic technologies in diseases prevalent in Sub Saharan Africa, we ought to develop methods to improve participants’ comprehension for genomic studies. Aim: The aim of this study was to understand different approaches that can be used to seek consent from individuals with low literacy in Sub-Saharan African countries in genomic research to improve comprehension. Methods: Using qualitative study design, we conducted focus-group discussions, in-depth interviews and participant observations as data collection methods. This study was embedded in a hospital based genomic study on Sickle Cell Disease at Muhimbili National Hospital in Tanzania. Thematic content analysis was used to analyse the transcripts and field notes. Results: Findings from this study show that literacy level has little influence on understanding the research details. According to the participants of this study, the methods used to provide information, the language, and time spent with the study participants were the key factors influencing understanding. The availability of group sessions held before individual consent to allow for a detailed questions and answers format was agreed to be the best method to facilitate the comprehension. Conclusion: The quality of the consenting process of participants will be influence by a number of factors. The type of research consented for, where the research will be implemented and who are the potential study participants are amongst the factors that need to be assessed during the consenting. Measures to improve participants’ comprehension need to be developed when consenting participants with low literacy level in genomic studies.
Could the disclosure of individual health results hamper biobanking? Findings from a survey on potential donors screened for depression
Authors: Toccaceli Virgilia , Fagnani Corrado , Gigantesco Antonella , Angelo Picardi , Stazi Maria Antonietta
Published: December 2019

Background: Research based on the use of biological material stored in biobanks together with health information and clinical data may produce new strategies for prevention, early detection, accurate diagnoses, and tailored treatments. A postal survey on the knowledge and attitude towards research biobanking was conducted among a sample of individuals previously recruited in urban primary care services in Rome (Italy), and screened for major depressive disorder (MDD) (SET-DEP project). The present study aims at exploring the attitude of these participants towards the potential future disclosure of individual health results when participating in research biobanking. Methods: The survey was conducted with a validated questionnaire on the knowledge and preferences about donation for research biobanks; self-perceived health was collected and The Satisfaction With Life Scale was administered. Means and percentages were compared across groups by using t test or ANOVA and chi-square test respectively. Results: Out of 416 subjects who underwent the screening for MDD, 51 (12.2%) subjects responded to the mail questionnaire. The large majority of respondents (42 subjects, >82%) declared they would agree to the potential use of their biological samples for biomedical research purposes only if no feedback results regarding health or predisposition to diseases would be given to them. The agreement towards research biobanking was not associated with satisfaction with life (ANOVA: p=0.82) or self-perceived health (chi-square test: p=0.98). Conclusions: It is widely recognized that willingness to donate diminishes when the research scenario raises moral, religious or political concerns. Nevertheless, other emerging concerns, more deeply linked to an individual psychosocial sphere, may also affect research biobanking. Our findings show a prevailing preference opposing the disclosure of individual health results not only among MDD positive screened but also – and even more – among MDD negative screened participants. This suggests that there might be relevant personal factors influencing people’s preferences with respect to the feedback of individual results in the case of psychiatric disorders such as depression. Moreover, these preferences do not seem to depend on the perceived heath status or subjective wellbeing of respondents.
The moral foundations of child health and social policies: A critical interpretive synthesis
Authors: Denburg Avram , Giacomini Mita , Ungar Wendy J. , Abelson Julia
Published: December 2019

Background: Allusions to the uniqueness and value of childhood abound in academic, lay, and policy discourse. However, little clarity exists on the values that should guide child health and social policymaking. We review extant academic literature on the normative dimensions of child health and social policy to provide foundations for the development of child-focused public policies. Methods: We conducted a critical interpretive synthesis of academic literature on the normative dimensions of child health and social policy-making. We employed a social constructivist lens to interpret emergent themes. Political theory on the social construction of target populations served as a bridge between sociologies of childhood and public policy analysis. Results: Our database searches returned 14,658 unique articles; full text review yielded 72 relevant articles. Purposive sampling of relevant literature complemented our electronic searches, adding 51 original articles, for a total of 123 articles. Our analysis of the literature reveals three central themes: potential, rights, and risk. These themes retain relevance in diverse policy domains. A core set of foundational concepts also cuts across disciplines: well-being, participation, and best interests of the child inform debate on the moral and legal dimensions of a gamut of child social policies. Finally, a meta-theme of embedding encompasses the pervasive issue of a child’s place, in the family and in society, at the heart of much social theory and applied analysis on children and childhood. Conclusions: Foundational understanding of the moral language and dominant policy frames applied to children can enrich analyses of social policies for children in a range of sociopolitical contexts. Our proposed schema of values, and allied exploration of their points of consonance and tension, is an important step in efforts to gauge social policy prescriptions not only by measures of outcome but also by evidence of their alignment with social values.
Effect of a nutrition education programme on metabolic risk factor and metabolic syndrome in adults with type 2 diabetes mellitus at a Level 5 Hospital in Kenya: “a randomized controlled trial”
Authors: THUITA-Wambugu ANN Watetu , Kiage Beatrice Nyanchama , Onyango Arnold N , Anselimo Makokha O
Published: December 2019

Background Type 2 diabetes mellitus; a chronic disorder characterized by poor glycemic control, is a life threatening condition of global public health concern which worsens in the presence of metabolic syndrome (MetS) and associated risks. However application of lifestyle intervention may reduce this risk. The aim of the current study was to evaluate the effect of nutrition education programme with inclusion of peer to peer support on MetS and Mets risk factors in type 2 diabetes mellitus patient. Methods This was a randomized controlled trial with two intervention groups and one control. The intervention groups included nutrition education peer to peer support group (NEP) (n=51) and nutrition education group (NE) (n=51) which participated in an eight week (2 h per week) group nutrition education sessions and follow-up sessions for six month. The NEP in addition had a peer to peer support component on weekly basis for the eight weeks of training and monthly support for six months. The control group (C) (n 51) received standard care. Outcomes were assessed at 6 months. An intention-to-treat analysis was conducted using analysis of co-variance (ANCOVA).Results: Differences in MetS were -38.1 and -31.7% (P<0.01) at 6 months in the NEP group as per Harmonized and WHO criteria respectively. Significant improvement was seen in number of participant achieving recommended waist circumference; WC (33.9 %) and high density lipoprotein; HDL (35.2%) in the NEP group and blood pressure; BP (reduction by 39.2 and 31.6) as per harmonized and WHO criteria respectively in the NE group. six month post intervention Statistical mean change was also noted six month post intervention in; weight lost (-6.26kg), BMI (-2.37 kg/m2), waist hip ratio; WHR (-0.03), WC (-14.51 cm) and HDL (+0.34mmol/l in the NEP group and diastolic blood pressure; DBP (-5.17 mmhg) in the NE group. Comparison of the NEP and NE with control showed that NEP and NE had better outcome.Conclusions: Nutrition education with inclusion of peer to peer support was of clinical benefit in reducing metabolic outcomes and MetS in Type 2 diabetes mellitus patient. Optimal goal setting and self-effective training could benefit future nutrition education programmes with peer to peer support component for people with Type 2 Diabetes and at risk of Mets.
The impact of community based prevention on quality of life – the necessity to control for general health trends. The Northern Sweden MONICA Study in 2014
Authors: Spegel Elin , Ek Kristina , Söderberg Stefan , Eliasson Mats
Published: December 2019

Background: The Västerbotten intervention program (VIP), is a public health promotion program in northern Sweden with the aim of preventing cardiovascular disease. Positive effects on risk factors and risk of coronary heart disease have been reported although the evidence is not unequivocal. Since only historical controls have been used, effects from other sources than the program have largely been uncontrolled for and health related quality of life (QoL) has not been evaluated. Aim: By using the neighbouring county of Norrbotten (NB) as the reference population, we compare QoL in Västerbotten (VB) and in NB. Method: The Northern Sweden MONICA survey in 2014 examined a random sample from the two counties. QoL was measured with the EQ-5D-3L. In total, 1112 subjects participated aged 40-74 years, 516 in VB and 594 in NB. Results: Average QoL measured by the EQ-5D-index was 0.798 in VB and 0.811 in NB, a difference of 0.013 (p=0.2, CI -0.009 to 0.036). For subjects aged 45-54 years, the QoL was lower in VB than in NB, a difference of 0.048 (p=0.041; CI 0.002 to 0.0094). In NB, QoL decreased with age, a pattern not seen in VB. Men had higher QoL than women, and university educated had higher QoL than those without university education. EQ-VAS showed similar results. Subjects from NB and from VB did not differ regarding age, gender and level of education. Conclusion: We found similar levels of QoL in VB and in NB.
Suicide among people treated for drug use disorders: a Danish national record-linkage study
Authors: Hesse Morten , Thylstrup Birgitte , Seid Abdu Kedir , Skogen Jens Christoffer
Published: December 2019

Background Substance use disorders are a major risk factor for suicide. However, less is known about specific risk factors for suicide in people with substance use disorders. Methods This population cohort study assessed suicide among people treated for drug use disorders in Denmark 2000-2010, and described risk factors for completed suicide. Data from 27,942 individuals enrolled in treatment were linked to national registers and matched with controls. Competing risk regression was used to identify risk factors of completed suicide. Results There were 163 suicides among patients with a history of drug treatment (0.6% of patients). Increased risk was associated with younger age at enrolment (hazard ratio [HR] = 0.97, 95% CI: 0.95, 0.98), history of psychiatric care (HR=1.96, CI 95%: 1.39, 2.77), opioid use (HR=1.81, 95% CI: 1.23, 2.68) and alcohol use (HR=1.56, 95% CI: 1.09, 2.23). Lower risk was associated with cannabis use (HR=0.69, 95% CI: 0.50, 0.96). The standard mortality ratio was 7.13 for people with drug use disorder without a history of psychiatric care (95% CI: 5.81, 8.44), 13.48 for people with drug use disorder and psychiatric history (95% CI: 9.75, 17.22), and 13.61 for people with psychiatric history only (95% CI: 6.72, 20.50) Conclusions Risk of suicide is increased among people with drug use disorders. Access to treatment for co-morbid mental health problems for people with drug use disorders could potentially reduce risk of suicide.
Elucidation of molecular mechanisms of flower form development in tree peony ( Paeonia suffriticosa ) through comparative transcriptome analysis of floral parts
Authors: Lu Jiuxing , Zheng Yun , Wang Haoning , Wang Zheng , Li Yonghua , Gao Gary , Li Yan
Published: December 2019

Background: Tree peony (Paeonia suffruticasa) is an economically, medicinally ornamentally important woody flowering woody plants in East Asia and is a common also ornamental shrub in Europe and North America. It is well known and prized for their beautiful flowers in many different forms. Samen petalody has been shown to be the most effective way to modify flower forms. However, there is limited information on the molecular mechanisms of stamen petalody and flower form formation in tree peony.Results: In this study, RNA sequencing was used to assemble and annotate the unigenes in the tree peony to identify the critical genes related to flower parts formation and verify the key genes in different flower forms of tree peony cultivar. A total of 76,007 high quality unigenes were assembled and 30,505 were successfully annotated. A total of 1,833 TFs were identified in our study, among them 16 MADS-box genes were found and characterized. Six key genes were selected to verity their functions in stamen petalody. AG and SEP showed high expression level in carpals and sepals separately both in stamen petalody group and non-stamen petalody groups. PI and AP3 showed high expression levels in inter-petals in stamen petalody groups than in staments in non-stamen petalody.Conclusion: Sixteen MADS-box genes were identified for the first time in tree peony through RNA-seq method. We identified six key genes based on their differential expression levels in different flower parts. These six key genes represented all categories in the ABCDE model to verify the functions in stamen petalody. PI and AP3 were verified to likely play important roles in regulating stamen petalody in tree peony. Our study has helped establish the flower development model in tree peony, identified key molecular mechanisms in the development of different flower forms, and provided valuable information in improving genetic diversity of tree peony and many other woody plants.