bluuebunny/crossref_metadata_2025 huggingface dataset:
Two-dimensional speckle tracking echocardiography in goats: repeatability, variability, and validation of the technique using an exercise test and an experimentally induced acute ischemic cardiomyopathy.
Authors: Leroux Aurelia A , Moonen Marie , Farnir Frédéric , Deleuze Stefan , Sandersen Charlotte , Amory Hélène
Published: January 2020

Background: Two-dimensional speckle tracking (2DST) technique has been validated in numerous animal species, but neither studies of repeatability nor measurements after exercise or in animals with cardiac disease have been reported in goats. Goats are an attractive candidate for animal models in human cardiology because they are easy to handle and have a body and heart size comparable to that of humans. Therefore, the aim of this study was to validate this technique in goats for further clinical and experimental applications in this species.
Methods: This study was divided into several steps. First, a standardized echocardiographic protocol was performed and 5 cineloops of a right parasternal short-axis view at papillary muscles level were recorded three times at one-day intervals in ten healthy adult unsedated Saanen goats to test repeatability and variability of 2DST measurements. Then, the same measurements were performed immediately before and after a standardized exercise on treadmill in seven of the goats, and at 24h after induction of an experimental ischemic cardiomyopathy in five of the goats, to test the reliability of the technique to assess physiological and pathological changes. Average and regional measurements of radial and circumferential strain and strain rate, radial displacement, rotation and rotation rate were obtained. Comparisons were performed using two-way ANOVA (p<0.05).
Results: Caprine 2DST average measurements have demonstrated a good repeatability with a low to moderate variability for all measurements except for the diastolic peaks of the circumferential strain rate, radial strain rate and rotation rate. Segmental 2DST measurements were less repeatable than average measurements. Time effect of two-way ANOVA was significant for anteroseptal segment diastolic peaks measurements, rotation and rotation rate measurements. Overall variability of segmental measurements was moderate or high. Segmental and average peak values obtained after exercise and after myocardial ischemia were significantly different than curves obtained at baseline.
Conclusions: The results of this study are consistent with those previously described in other animal species and humans. 2DST echocardiography is a valid technique to evaluate physiological and pathological changes in myocardial function in goats, despite the technical limitations observed in this species.
Identification of bacterial pathogens in cultured fish with a custom peptide database constructed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)
Authors: Piamsomboon Patharapol , Jaresitthikunchai Janthima , Hung Tran Quang , Roytrakul Sittiruk , Wongtavatchai Janenuj
Published: January 2020

Background: The majority of infectious diseases of cultured fish is caused by bacteria. Rapid identification of bacterial pathogens is necessary for immediate management. The present study developed a custom Main Spectra Profile (MSP) database and validate the method using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for rapid identification of fish bacterial pathogens. Streptococcus agalactiae, Streptococcus iniae, Aeromonas hydrophila, Aeromonas veronii, and Edwardsiella tarda obtained from diseased fish were used as representative bacterial pathogens in this study. Bacterial peptides were extracted to create a Main Spectra Profile (MSP), and the MSPs of each bacterial species was added into the MALDI Biotyper database. Fifteen additional isolates of each bacterial species were tested to validate the utilized technique.
Results: The MSPs of all field isolates were clearly distinguishable, and the MSPs of the same species were clustered together. The identification methodology was validated with 75 bacterial isolates. The reliability and specificity of the method were determined with MALDI Biotyper log score values and matching results with 16s rDNA sequencing. The species identification using the public MALDI Biotyper library (Bruker MALDI Biotyper) showed unreliable results (log score <2.000) with 42.67% matching result with the reference method. In contrast, accurate identification was obtained when using the custom-made database, giving log score > 2.115, and a 100% matching result.
Conclusion: This study demonstrates an effective identification of fish bacterial pathogens when a complete custom-made MSP database is applied. Further applications require a broad, well-established database to accommodate prudent identification of many fish bacterial pathogens by MALDI-TOF MS.
Women's Experiences of Rectovaginal Fistula: An Ethno- Religious Experience
Authors: Nezhad Fatemeh Touhidi , Jalali Rostam , Karimi Fozieh
Published: January 2020

Background: Obstetric fistulas are one of the most tragic injuries that occur after difficult, prolonged childbirth without timely intervention. These fistulas cause discomfort to patients and result in emotional, social, and even physical suffering. The aim of the present study was to explore the experiences of women with rectovaginal fistula in Kamyaran city, in Kurdestan province, west of Iran. Methods: In a phenomenological study, 16 patients, healthcare personnel and patients' families were investigated. Purposive sampling was performed and Study participants were interviewed in-depth semi-structured interviews. All interviews were audio-recorded, transcribed verbatim (word by word) and analyzed by Colaizzi's method. In order to determine the validity of the study, Lincoln and Guba’s criteria, which include credibility, dependability, transferability, and confirmability, were considered. Results: Five general themes and ten sub-themes emerged after investigating interviews. Themes include religious harassment the sub-theme of being defiled), fail (subthemes of loss and negative attitudes, disrupted sex (the subtheme of sexual dissatisfaction), consequence (three subthemes of sleep disturbance, mental crisis, and isolation), and ultimately panic (three subthemes of humiliation, secrecy, and fear). Conclusion: The rectovaginal fistula is a complex and multifaceted problem with social, individual, familial, religious, and ethnic-environmental dimensions, so there is no simple solution to interact with this problem and there is a need to find a solution, considering the dimensions of the problem and plan for help these patients cope with their disease, and take steps to fully treat it.
Prediction of patients with a tumor proportion score >50% who do not respond to first-line monotherapy with pembrolizumab
Authors: Morita Mitsunori , Tamiya Motohiro , Fujimoto Daichi , Tamiya Akihiro , Suzuki Hidekazu , Hirano Katsuya , Fukuda Yasushi , Yokoyama Toshihide , Kominami Ryota , Kanazu Masaki , Uchida Junji , Hara Satoshi , Yamashita Shuji , Tomioka Hiromi
Published: January 2020

Background: Pembrolizumab is effective as first-line therapy against advanced non-small cell lung cancer (NSCLC) in patients with programmed death ligand-1 (PD-L1) expression levels ≥50%. However, it is not effective in all patients, and the factors predicting responses among this population remain unknown. Methods: We retrospectively analyzed patients with NSCLC and a PD-L1 tumor proportion score (TPS) >50%, who received first-line monotherapy with pembrolizumab from February 1, 2017 to April 30, 2018. The study included 11 hospitals, which participated in the Hanshin Oncology clinical Problem Evaluation group (HOPE). We analyzed the differences between responders and non-responders in terms of age, sex, performance status score, degree of progression, histological type, smoking history, expression of PD-L1, use of steroids prior to treatment, metastasis site, and laboratory data. Results: A total of 205 patients were included in this study. Of those, 108 patients exhibiting complete or partial response were defined as responders. Those exhibiting progressive disease (N=52) were defined as non-responders. In the univariate analysis, Eastern Cooperative Oncology Group performance status score ≥2 (p=0.0832), stage IV disease or recurrence (p=0.0487), PD-L1 TPS 50–89% (p=0.0657), use of steroids prior to the administration of pembrolizumab (p=0.0243), malignant pleural effusion (p=0.0032), and baseline C-reactive protein (CRP) levels >1.0 mg/dL (p=0.0390) were significantly associated with non-response to treatment. In the multivariate analysis, use of steroids prior to the administration of pembrolizumab (odds ratio [OR]: 5.86; 95% confidence interval [CI]: 1.32–31.8; p=0.0200), malignant pleural effusion (OR: 2.68; 95% CI: 1.15–6.35; p=0.0228), and baseline CRP >1.0 mg/dL (OR: 2.17; 95% CI: 1.03–4.68; p=0.0402) were significantly associated with non-response to treatment. Conclusion: In real-world patients with NSCLC and a PD-L1 TPS ≥50%, use of steroids prior to treatment, malignant pleural effusion, and baseline CRP levels >1.0mg/dL reduced the response of first-line monotherapy with pembrolizumab.
Treatment of Distal Clavicle Fractures using a Scorpion Plate and Influence of Timing on Surgical Outcomes: A Retrospective Cohort Study of 105 Cases
Authors: Furuhata Ryogo , Takahashi Masaaki , Hayashi Teppei , Inagawa Miyu , Kono Aki , Matsumura Noboru , Kamata Yusaku , Arino Hiroshi , Morioka Hideo
Published: January 2020

Background Plate fixation is an established method for treating unstable distal clavicle fractures. However, the appropriate timing of surgery for acute distal clavicle fractures remains unclear. The present study aimed to evaluate the clinical outcomes of osteosynthesis using a Scorpion plate and to assess the influence of surgery timing on the surgical outcomes for acute unstable distal clavicle fractures. Methods We retrospectively reviewed 105 patients who underwent fixation for acute unstable distal clavicle fractures (Neer type II and V) using the Scorpion plate between 2008 and 2018. Patients were divided into early (45 patients) and delayed (60 patients) treatment groups based on the timing of the surgical intervention (within or after seven days). The outcomes were postoperative complications (nonunion, peri-implant fracture, plate loosening, plate-related pain, and stiffness). We evaluated the outcomes from X-ray radiographs and clinical notes. Results Among the 105 patients, nonunion, plate loosening, plate-related pain, and stiffness were observed in six patients (5.7%), four patients (3.8%), seven patients (6.7%), and one patient (1.0%), respectively. The nonunion rate was significantly higher in the delayed treatment group than that in the early treatment group (P=0.036). Although the difference was not significant, plate loosening and stiffness were only observed in the delayed treatment group. Conclusion Our results demonstrated that osteosynthesis using Scorpion plates achieved satisfactory surgical outcomes for unstable distal clavicle fractures . In addition, this study suggested that performing surgery within six days after injury is recommended to reduce postoperative complications .
The Development of a Return to Work Intervention Programme for Stroke Survivor (SReTWIP): A Delphi Survey
Authors: Olaoye Olumide Ayoola , Soeker Shaheed Moghammad , Rhoda Anthea
Published: January 2020

Background: Even though clearly defined pathways for vocational re-entry are well recognized for conditions such as mental health, musculoskeletal dysfunction (MSD) and traumatic brain injury (TBI), none has been identified for stroke. There has been a lack of consensus regarding such clear pathways to vocational re-entry and the essential contents of return to work (RTW) interventions for stroke survivors. As part of a larger study aimed to design a RTW programme for stroke survivors, this study describes the concluding process through which Stroke Return to Work Intervention Programme (SReTWIP) was developed.Methods: Experts in the field of neurorehabilitation and vocational rehabilitation (VR) from 6 countries participated in this 3-round Delphi survey via e-mail. Concept mapping was used to triangulate findings from the Delphi with previous phases of the larger study. Content thematic analysis was conducted on qualitative data while descriptive statistic was used to analyze quantitative data.Results: Fifteen experts with a mean age and mean duration of practice of 44.73±9.48 years and 18.26±8.71 years respectively participated in this study. The developed RTW programme (SReTWIP) is a 12 week programme that consisted of four interconnected phases of intervention viz: an assessment phase, clinic-based work and non-work specific intervention phase, a work test placement phase and a client full participation in worker role phase. The experts agreed on a set of implementation strategies that included the use of interdisciplinary team, the tailoring of intervention to meet stroke survivor’s need, as well as the use of case management approach.Conclusion: The SReTWIP is the first step in developing a VR pathway that can ultimately enhance the RTW rates and quick resumption of the worker role of stroke survivors. The stroke survivor can move along the different phases of the SReTWIP after achieving competency in a preceding phase. Future work will include a feasibility study with other key stakeholders involved in RTW such as employers, informal caregivers and stroke survivors before its implementation.
Factors associated with high-risk low-level viremia leading to virologic failure: 16-year retrospective study of a Chinese antiretroviral therapy cohort
Authors: Zhang Tong , Ding Haibo , An Minghui , Wang Xiaonan , Tian Wen , Zhao Bin , Author) Xiaoxu Han(New Corresponding
Published: January 2020

Background: Low level viremia (LLV) often occurs during antiretroviral therapy (ART) against HIV-1. However, whether LLV increases the risk of virologic failure (VF) is controversial because of the non-uniform definitions of LLV and VF. Methods: A long-term first line regimen ART cohort from 2002–2018 from Shenyang, northeast China, was retrospectively studied. All participants were followed up every 3 to 6 months to evaluate the treatment effect. The high-risk LLV subgroups leading to VF (with strict standards) were explored with Cox proportional hazards model and linear mixed-effect model. The association factors of high-risk LLV were further explored using multivariate logistic regression analyses. Results: A total of 2155 HIV-1 infected participants were included; of these, 38.7% showed LLV. Both high level LLV (HLLV) and any other level LLV coupled with high level blip (HLB) showed higher risk of VF (hazards ratios, HRHLLV=5.93, and HRHLB=2.84, p<0.05 respectively). Moreover, HR increased with prolonged duration of LLV. Independent factors associated with high-risk LLV included the zenith baseline viral load (VL) above 6 log copies/ml (aOR=3.49, p=0.002), nadir baseline CD4+T cell counts below 200 cells/mm3 (aOR=1.78, p=0.011), Manchu (aOR=2.03, p=0.003), ART over 60 months (aOR=1.81, p=0.004), AZT+3TC+NVP (aOR=2.26, p<0.001) or DDI-based regimen (aOR=9.96, p=0.002), and subtype B’ infection (aOR=8.22, p=0.001). Conclusions: In case of VF with strict standards, high-risk LLV leading to VF includes VL above 400 copies/ml, occurring at least once. Serious laboratory indicators or advanced stage of infection, long term ART and subtype B’ infection might also predict the occurrence of high-risk LLV.
Transcriptome analysis of postharvest blueberries (Vaccinium corymbosum‘Duke’) in response to cold stress
Authors: Zhang Fan , Ji ShuJuan , Wei BaoDong , Cheng Shunchang , Hao Jia , Wang YaJuan , Wang SiYao , Zhou Qian
Published: January 2020

Background: Blueberry ( Vaccinium spp. ) is a small berry with high economic value. Although cold storage can extend the storage time of blueberry to more than 60 days, it leads to chilling injury (CI) displayed as pedicle pits; and the samples of 0°C-30 days was the critical point of CI. However, little is known about the mechanism and the molecular basis response to cold stress in blueberry have not been explained definitely. Methods: To comprehensively reveal the CI mechanisms in response to cold stress, we performed high-throughput RNA Seq analysis to investigate the gene regulation network in 0d (control) and 30d chilled blueberry. At the same time, the pitting and decay rate, electrolyte leakage (EL), malondialdehyde (MDA) proline content and GSH content were also measured. Results: Two cDNA libraries from 0d (control) and 30d chilled samples were constructed and sequenced, generating a total of 35,060 unigenes with an N50 length of 1,348bp. Of these, 1852 were differentially expressed, with 1,167 upregulated and 685 downregulated. Forty-five cold-induced transcription factor (TF) families containing 1,023 TFs were identified. The DEGs indicated in biological processes such as stress responses; cell wall metabolism; abscisic acid, gibberellin, membrane lipid, energy metabolism, cellular components, and molecular functions were significantly responsed to cold storage. The transcriptional level of 40 DEGs were verified by qRT-PCR. Conclusions: The postharvest cold storage leads serious CI in blueberry, which substantially decreases the quality, storability and consumer acceptance. The MDA content, proline content, EL increased and the GSH content decreased in this chilled process. The biological processes such as stress responses, hormone metabolic processes were significantly affected by CI. Overall, the results obtained here are valuable for preventing CI under cold storage and could help to perfect the lack of the genetic information of non-model plant species.
Management of patients with early stage lung cancer – why do some patients not receive treatment with curative intent?
Authors: Lawrenson Ross , Lao Chunhuan , Brown Leonie , Moosa Lucia , Chepulis Lynne , Keenan Rawiri , Kidd Jacquie , Middleton Karen , Conaglen Paul , de Groot Charles , Aitken Denise , Wong Janice
Published: January 2020

Backgrounds
This study aims to understand the factors that influence whether patients receive potentially curative treatment for early stage lung cancer. A key question was whether indigenous Māori patients were less likely to receive treatment.
Methods
Patients included those diagnosed with early stage lung cancer in 2011-2018 and resident in the New Zealand Midland Cancer Network region. Logistic regression model was used to estimate the odds ratios of having curative surgery/ treatment. The Kaplan Meier method was used to examine the all-cause survival and Cox proportional hazard model was used to estimate the hazard ratio of death.
Results
In total 419/583 (71.9%) of patients with Stage I and II disease were treated with curative intent - 272 (46.7%) patients had curative surgery. Patients not receiving potentially curative treatment were older, were less likely to have non-small cell lung cancer (NSCLC), had poorer lung function and were more likely to have an ECOG performance status of 2+. Current smokers were less likely to be treated with surgery and more likely to receive treatment with radiotherapy and chemotherapy. Those who were treated with surgery had a 2-year survival of 87.8% (95% CI: 83.8%-91.8%) and 5-year survival of 69.6% (95% CI: 63.2%-76.0%). Stereotactic ablative body radiotherapy (SABR) has equivalent effect on survival compared to curative surgery (hazard ratio: 0.77, 95% CI: 0.37-1.61). After adjustment we could find no difference in treatment and survival between Māori and non-Māori.
Conclusions
The majority of patients with stage I and II lung cancer are managed with potentially curative treatment – mainly surgery and increasingly with SABR. The outcomes of those being diagnosed with stage I and II disease and receiving treatment is positive with 70% surviving 5 years.
Pattern and Timing of Diversification in the African Freshwater Fish Genus Distichodus (Characiformes: Distichodontidae)
Authors: Arroyave Jairo , Denton John S. S. , Stiassny Melanie L. J.
Published: January 2020

Background: Distichodus is a clade of tropical freshwater fishes currently comprising 25 named species distributed continent-wide throughout the Nilo-Sudan and most Sub-Saharan drainages. This study investigates the phylogenetic relationships, timing of diversification, and biogeographic history of the genus from a taxonomically comprehensive mutilocus dataset analyzed using Maximum Likelihood and Bayesian methods of phylogenetic inference, coalescence-based species-tree estimation, divergence time estimation, and inference of geographic range evolution.Results: Analyses of comparative DNA sequence data in a phylogenetic context reveal the existence of two major clades of similar species-level diversity and provide support for the monophyletic status of most sampled species. Biogeographic reconstruction on a time-scaled phylogeny suggest that the origins of the genus date back to the late Oligocene and that current geographic distributions are the result of a Congo Basin origin followed by dispersal and range expansion into adjacent ichthyofaunal provinces at different times during the evolutionary history of the group.Conclusions: We present the most comprehensive phylogenetic, chronological, and biogeographic treatment yet conducted for the genus. The few instances of species paraphyly (D. teugelsi, D. fasciolatus) revealed by the resulting phylogenies are likely a consequence of post-divergence introgressive hybridization and/or incomplete lineage sorting due to recent speciation. Historical biogeographic findings are both in agreement and conflict with previous studies of other continent-wide African freshwater fish genera, suggesting a complex scenario for the assemblage of Africa’s continental ichthyofaunal communities.
TeamMate: A longitudinal study of New Zealand working farm dogs. I. Methods, population characteristics and health on enrolment.
Authors: Isaksen Katja Elisabeth , Linney Lori , Williamson Helen , Cave Nick J , Beausoleil Ngaio J , Norman Elizabeth Jane , Cogger Naomi
Published: January 2020

Background
Working farm dogs are invaluable on New Zealand sheep and beef farms. To date no study describing farm dog population and health has included information about incidence of illness and injury, or risk factors affecting health and career duration. This paper describes the methodology and initial results from TeamMate, a longitudinal study that was designed to address this gap. We describe the study population, husbandry practices, and prevalence of clinical abnormalities on enrolment.
Methods
Data about the farms, owners, husbandry practices and dogs were collected on farm at approximately 6-month intervals. All dogs over 18 months old and in full work were enrolled. Dogs were given physical examinations by veterinarians. On examination all abnormalities were noted, regardless of clinical significance.
Results
Six hundred forty-one working farm dogs and 126 owners were enrolled from the South Island of New Zealand. Forty-nine percent of dogs were Heading dogs (314 of 641) and 48% Huntaways (308 of 641). Median age of dogs was four years (range 1.5 – 14) and median body condition score (BCS) was four on a 9-point scale (interquartile range (IQR) 3 – 5). Fifty-four percent of dogs were male (345 of 641), and 6% (41 of 641) were neutered.
Eighty-one percent of owners (102 of 126) fed dogs commercial biscuits and meat sourced on farm. Forty-four percent of dogs (279 of 641) had bedding in their kennel, 14% (55 of 393) had insulated kennels, 69% (442 of 641) had been vaccinated and 33% (213 of 641) were insured.
Clinical abnormalities were found in 74% of dogs (475 of 641). Common abnormalities involved the musculoskeletal system (43%, 273 of 641), skin (including scars and callouses; 42%, 272 of 641), and oral cavity (including worn and broken teeth; 35%, 227 of 641).
Conclusions
Our results expand on those from previous surveys and indicate that musculoskeletal illness and injury, and skin trauma are the most commonly seen clinical abnormalities in working farm dogs. These results will provide a baseline for investigation of incidence and risk factors for illness, injury, retirement and death in New Zealand working farm dogs.
Increased Respiratory Morbidity in Individuals with Interstitial Lung Abnormalities
Authors: Hoyer Nils , Thomsen Laura H. , Wille Mathilde M.W. , Wilcke Torgny , Dirksen Asger , Pedersen Jesper H. , Saghir Zaigham , Ashraf Haseem , Shaker Saher B.
Published: January 2020

Background Interstitial lung abnormalities (ILA) are common in participants of lung cancer screening trials and broad population-based cohorts. They are associated with increased mortality, but less is known about disease specific morbidity and healthcare utilisation in individuals with ILA. Methods We included all participants from the screening arm of the Danish Lung Cancer Screening Trial with available baseline CT scan data (n=1990) in this cohort study. The baseline scan was scored for the presence of ILA and patients were followed for up to 12 years. Data about all hospital admissions, primary healthcare visits and medicine prescriptions were collected from the Danish National Health Registries and used to determine the participants’ disease specific morbidity and healthcare utilisation using Cox proportional hazards models. Results The 332 (16.7%) participants with ILA were more likely to be diagnosed with one of several respiratory diseases, including interstitial lung disease (HR: 4.9, 95% CI: 1.8–13.3, p=0.008), COPD (HR: 1.7, 95% CI: 1.2–2.3, p = 0.01), pneumonia (HR: 2.0, 95% CI: 1.4–2.7, p<0.001), lung cancer (HR: 2.7, 95% CI: 1.8–4.0, p<0.001) and respiratory failure (HR: 1.8, 95% CI: 1.1–3.0, p=0.03) compared with participants without ILA. These findings were confirmed by increased hospital admission rates with these diagnoses and more frequent prescriptions for inhalation medicine and antibiotics in participants with ILA. Conclusions Individuals with ILA are more likely to receive a diagnosis and treatment for several respiratory diseases, including interstitial lung disease, COPD, pneumonia, lung cancer and respiratory failure during long-term follow-up.
The prevalence and correlates of burnout among Chinese preschool teachers
Authors: Li Shen , Li Yibo , Lv Hao , Jiang Rui , Zhao Peng , Zheng Xin , Wang Lili , Li Jie , Mao Fuqiang
Published: January 2020

Background: A series of studies have suggested that teachers are likely to experience professional burnout in various regions around the world. To date, no known research has been conducted to investigate the prevalence and correlates of burnout among preschool teachers in China. Objective: This study examined the level of self-reported burnout and correlates of burnout among Chinese preschool teachers. Methods : A cross-sectional study was conducted among1795 preschool teachers in Tianjin, China, during August 2018- October 2018. The validated Chinese version of the 15-item Maslach Burnout Inventory was used to assess burnout. A self-administered questionnaire collected the sociodemographic factors. The psychological factors were collected by the Chinese version of the 20-item Center for Epidemiologic Studies Depression Scale (CES-D) and the Perceived Stress Scale-14. Results : The prevalence of burnout in Chinese preschool teachers was 53.2% ( 95% CI：51%─56%). Burnout rate was significantly decreased in overweight ( P =0.001, OR=0.58, 95% CI: 0.42-0.79) and obesity ( P =0.048, OR=0.75, 95% CI: 0.56-1.00) teachers compared with teachers with normal weight. The type of school ( P =0.007, OR=1.45, 95% CI: 1.11-1.91), income satisfaction ( P =0.001, OR=0.67, 95% CI: 0.53-0.86), depression ( P <0.001, OR=3.08, 95% CI: 2.34-4.05) and perceived stress ( P <0.001, OR=1.15, 95%CI: 1.13-1.18) were significantly associated with burnout. Conclusions : The prevalence of burnout among preschool teachers in Tianjin, China, is high. Burnout was significantly associated with BMI, the type of school, income satisfaction, depression and perceived stress among Chinese preschool teachers. Keywords: Burnout, Stress, Preschool teachers, Depression
Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses
Authors: Nilsen Per , Seing Ida , Ericsson Carin , Birken Sarah A. , Schildmeijer Kristina
Published: January 2020

Background: Health care organizations are constantly changing as a result of technological advancements, ageing populations, changing disease patterns, new discoveries for the treatment of diseases and political reforms and policy initiatives. Changes can be challenging because they contradict humans’ basic need for a stable environment. The present study poses the question: what characterizes successful organizational changes in health care? The aim was to investigate the characteristics of changes of relevance for the work of health care professionals that they deemed successful.Methods: The study was based on semi-structured interviews with 30 health care professionals: 11 physicians, 12 registered nurses and seven assistant nurses employed in the Swedish health care system. An inductive approach was applied using questions based on the existing literature on organizational change and change responses. The questions concerned the interviewees’ experiences and perceptions of any changes that they considered to have affected their work, regardless of whether these changes were “objectively” large or small changes. The interviewees’ responses were analysed using directed content analysis.Results: The analysis yielded three categories concerning characteristics of successful changes: having the opportunity to influence the change; being prepared for the change; valuing the change. The interviewees emphasized the importance of having the opportunity to influence the organizational changes that are implemented. Changes that were initiated by the professionals themselves were considered the easiest and were rarely resisted. Changes that were clearly communicated to allow for preparation increased the chances for success. The interviewees did not support organizational changes that were perceived to be implemented unexpectedly and/or without prior communication. They conveyed that it was important for them to understand the need for and benefits of organizational changes. They particularly valued and perceived as successful organizational changes with a patient focus, with clear benefits to patients.Conclusions: Organizational changes in health care are more likely to succeed when health care professionals have the opportunity to influence the change, feel prepared for the change and recognize the value of the change, including perceiving the benefit of the change for patients.
Ability of near-infrared spectroscopy and chemometrics to predict the age of mosquitoes reared under different conditions
Authors: Ong Oselyne , Kho Elise , Esperança Pedro , Freebairn Chris , Dowell Floyd , Devine Gregor , Churcher Thomas
Published: January 2020

Background: Practical, field-ready age-grading tools for mosquito vectors of disease are urgently needed because of the impact that daily survival has on vectorial capacity. Previous studies have shown that near-infrared spectroscopy (NIRS), in combination with chemometrics and predictive modeling, can forecast the age of laboratory-reared mosquitoes with moderate to high accuracy. It remains unclear whether the technique has utility for identifying shifts in the age structure of wild-caught mosquitoes. Here we investigate whether models derived from the laboratory strain of mosquitoes can be used to predict the age of mosquitoes grown from pupae collected in the field.
Methods: NIR spectra from adult female Aedes albopictus mosquitoes reared in the laboratory (2, 5, 8, 12 and 15 days old) were compared to spectra from mosquitoes emerging from wild-caught pupae (1, 7 and 14 days old). Different partial least squares (PLS) regression methods trained on spectra from laboratory mosquitoes were evaluated on their ability to predict the age of mosquitoes from more natural environments.
Results: Models trained on spectra from laboratory-reared material were able to predict the age of other laboratory-reared mosquitoes with moderate accuracy and successfully differentiated all day 2 and 15 mosquitoes. Models derived with laboratory mosquitoes could not differentiate between field-derived age groups, with age predictions relatively indistinguishable for day 1-14. Pre-processing of spectral data and improving the PLS regression framework to avoid overfitting can increase accuracy, but predictions of mosquitoes reared in different environments remained poor. Principle component analysis confirms substantial spectral variations between laboratory and field-derived mosquitoes despite both originating from the same island population.
Conclusions: Models trained on laboratory mosquitoes were able to predict ages of laboratory mosquitoes with good sensitivity and specificity though they were unable to predict age of field-derived mosquitoes. This study suggests that laboratory-reared mosquitoes do not capture enough environmental variation to accurately predict the age of the same species reared under different conditions. Further research is needed to explore alternative pre-processing methods and machine learning techniques, and to understand factors that affect absorbance in mosquitoes before field application using NIRS.
Collaboration with community connectors to improve primary care access for hardly reached people: a case comparison of rural Ireland and Australia
Authors: Wallace Carolyn , Farmer Jane , White Carolynne , McCosker Anthony
Published: January 2020

Background: This study presents a way for health services to improve service access for hardly reached people through an exploration of how staff can find and collaborate with citizens (referred to as connectors) who span socio-cultural boundaries in their community. The study explored the local socio-cultural contexts of connectors’ boundary spanning activities and if they are health related; boundary spanning occurring between connectors and health professionals at the interface of health systems and community; and the opportunities and barriers to actively seeking out and collaborating with community connectors to access marginalised and hardly reached people.
Methods: We conducted a qualitative case comparison from rural Ireland and Australia. Following purposive snow-ball sampling techniques to recruit participants, semi-structured interviews were conducted with 34 community informants, 21 healthcare staff and 32 connectors. Transcripts were coded and analysed using an inductive approach to ascertain categories and overall themes.
Results : We found a diverse sample of connectors relating to heterogenous, small and locally distinct groups of hardly reached people. Overall 26 connectors were active at the interface between health services and the community, with variation in how this occurred between cases. The majority (21) described one or more health related activities with hardly reached people. All connectors expressed a willingness to develop a relationship with local health services on issues they identified as relevant. Barriers to collaborations between connectors and health services related to bureaucracy, workload, and burnout.
Conclusions : Collaborating with connectors has potential as one strategy to improve access to health services for hardly reached people. To enact this, health staff need to identify local socio-cultural boundaries and associated connectors, facilitate two-way connections at the boundary between health services and community and enable collaboration by attending to activities in the community, at the interface between health services and community, and within the health system.
Cone Beam Computed Tomography (CBCT) in Periodontal Diseases: A Systematic Review Based on the Efficacy Model
Authors: Assiri Hassan , Dwasaz Ali , Alahmari Ahmad AA , Asiri Zuhair A
Published: January 2020

Objectives The aim of this study was to address the diagnostic efficacy of cone beam computed tomographic (CBCT) imaging in periodontics based on a systematic search and analysis of the literature using the hierarchical efficacy model. Methods A systematic search of the electronic databases such as PubMed, Scopus, Web of Science, and Cochrane was conducted until February 2019 to identify studies addressing the efficacy of CBCT imaging in Periodontics. The identified studies were subjected to pre-identified inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for an appraisal of the literature on a diagnostic imaging modality. Two examiners performed the eligibility and quality assessment of relevant studies, and consensus was reached where disagreement was found.Results The search resulted in 64 studies. Of these, 35 publications were allocated to the relevant level of efficacy and quality assessments wherever applicable. The overall diagnostic accuracy studies showed the risk of bias and applicability concerns in the use of CBCT to be low to moderate. In addition, CBCT is accurate in identifying periodontal defects when compared to other modalities. The studies on the level of patient outcomes agreed that CBCT is a reliable tool for the assessment of the outcomes after the treatment of periodontal defects. Conclusion CBCT was found to be beneficial and accurate in cases of infra-bony defects and furcation involvements.
Playing sport injured is associated with osteoarthritis, joint pain and worse health related quality of life: A cross sectional study
Authors: Bullock Garrett Scott , Collins Gary S , Peirce Nick , Arden Nigel K , Filbay Stephanie R
Published: January 2020

Background: Sports participants are faced with the decision to continue or cease play when injured. The implications of playing sport while injured on joint health and health-related quality of life (HRQoL) has not been investigated. The purpose of this study was to investigate the relationship between having played sport while injured and HRQoL, osteoarthritis, and persistent joint pain; and compare findings in elite and recreational cricketers . Methods: The Cricket Health and Wellbeing Study cohort was used for this study. Inclusion criteria were: age ≥18 years, played ≥1 cricket season. Questionnaire data collected included a history of playing sport injured, SF-8 (physical (PCS) and mental (MCS) component scores), physician-diagnosed osteoarthritis, and persistent joint pain (most days of the last month). Multivariable linear regressions and logistic regressions were performed. Continuous covariates were handled using fractional polynomials. Models were adjusted for age, sex, cricket-seasons played, playing status, joint injury, and orthopaedic surgery. All participants (n=2,233) were included in HRQoL analyses, only participants aged ≥30 years (n=2,071) were included in osteoarthritis/pain analyses. Results: Of the 2,233 current and former cricketers (mean age: 51.7 SD 14.7, played 30 IQR 24 cricket seasons, 60% were current cricketers, 62% played recreationally; median PCS: 51.4 IQR 9.0; MCS: 54.3 IQR 8.6) 1719 (77%) had played sport while injured. People who had played sport injured reported worse adjusted PCS (Effect(95% CI): -1.78(-2.62, -0.93) and MCS (-1.40(-2.25, -0.54), had greater odds of osteoarthritis (adjusted OR(95% CI): 1.86(1.39, 2.51) and persistent joint pain (2.34(1.85, 2.96)), compared to people who had not played sport injured. Similar relationships were observed regarding PCS, osteoarthritis and pain in elite and recreational subgroups. Playing injured was only related to worse MCS scores for elite cricketers (-2.07(-3.52, -0.63)); no relationship was observed in recreational cricketers (-0.70(-1.79, 0.39)). Conclusion: Cricketers that had played sport injured had impaired HRQoL, increased odds of osteoarthritis and persistent joint pain, compared to those who had not played sport injured. Playing sport injured was only related to impaired mental-components of HRQoL in elite cricketers. The long-term impact of playing injured, should be considered when advising athletes on their ability to compete.
Probe-based multiplex qPCR identifies bloodmeal hosts in Anopheles mosquitoes from Papua New Guinea
Authors: Keven John B , Artzberger Georgia , Gillies Mary L. , Mbewe Rex B. , Walker Edward D.
Published: January 2020

Background: Determination of bloodmeal hosts in blood-fed female Anopheles mosquitoes is important for evaluating vectorial capacity of vector populations and assessing effectiveness of vector control measures. Sensitive molecular methods are needed to detect traces of host blood in mosquito samples, to differentiate hosts, and to detect mixed host blood meals. This paper describes a molecular probe-based quantitative PCR for identifying bloodmeal hosts in Anopheles malaria vectors from Papua New Guinea. Methods: TaqMan oligonucleotide probes targeting specific regions of mitochondrial or nuclear DNA of the three primary Anopheles bloodmeal hosts – humans, pigs and dogs – were incorporated into a multiplex, quantitative PCR which was optimized for sensitivity and specificity.Results: Amplification of serially diluted DNA showed that the quantitative PCR detected as low as 10-5 ng/μl of host DNA. Application to field-collected, blood-fed Anopheles showed that the quantitative PCR identified the vertebrate hosts for 335/375 (89%) of mosquitoes whereas only 104/188 (55%) of bloodmeal samples tested in a conventional PCR were identified. Of the 104 blood-fed Anopheles that were positive in both PCR methods, 16 (15.4%) were identified as mixed bloodmeals by the quantitative PCR whereas only 3 (2.9%) were mixed bloodmeals by the conventional PCR. Conclusions: The multiplex quantitative PCR described here is sensitive at detecting low DNA concentration and mixed host DNA in samples and useful for bloodmeal analysis of field mosquitoes, in particular mixed-host bloodmeals.
Analysis of long non-coding RNA expression profiles in vascular endothelial cells with hyperglycemia-induced damage
Authors: Xu Erqin , Hu Xiaolei , Li Xiaoli , Jin Guoxi , Zhuang Langen , Wang Qiong , Pei Xiaoyan
Published: January 2020

Background: Diabetes mellitus is often associated with microvascular and macrovascular lesions, and hyperglycemia-induced vascular endothelial cell damage is a key factor. Methods ： We investigated long non-coding RNAs (lncRNAs) and mRNAs that are affected by hyperglycemia-induced damage using human umbilical vein endothelial cells (HUVECs) as a model. HUVECs were cultured under high (25 mmol/L) or normal (5 mmol/L) glucose conditions for 6 d, and then lncRNAs and protein-coding transcripts were profiled by RNA-seq. Results ： Among 40,379 lncRNAs screened, 214 were upregulated (log2 [fold-change] > 1, FDR < 0.05) and 197 were downregulated (log2 [fold-change] < −1, FDR < 0.05) in response to high-glucose. Furthermore, among 28,431 protein-coding genes screened, 778 were upregulated and 998 were downregulated. A total of 945 lncRNA/mRNA pairs were identified, including 126 differentially expressed lncRNAs predicted to target 201 mRNAs, among which 26 were cis-regulatory interactions. The corresponding lncRNA-mRNA network was composed of 354 lncRNA nodes, 1,167 mRNA nodes and 9,735 edges. Dozens of lncRNAs with high degree may play important roles in high-glucose-induced HUVEC damage, including ENST00000600527, NONHSAT037576.2, NONHSAT135706.2, ENST00000602127, NONHSAT200243.1, NONHSAT217282.1, NONHSAT176260.1, NONHSAT199075.1, NONHSAT067063.2, NONHSAT058417.2. Conclusion ： These observations may provide novel insights into the regulatory molecules and pathways of hyperglycemia-related endothelial dysfunction in diabetes-associated vascular disease.
Establishment of a RESEARCH USE ONLY Condensed-Efficient-Fast (CEF) PITX2 workflow for analysis of PITX2 DNA methylation in small tumor tissue samples 
Authors: Napieralski Rudolf , Schricker Gabriele , Schüren Elisabeth , Perkins Jonathan , Magdolen Viktor , Weichert Wilko , Kiechle Marion , Wilhelm Olaf G.
Published: January 2020

The CE-marked therascreen® PITX2 RGQ PCR Kit (QIAGEN Cat No./ID 873211), a PITX2 DNA methylation assay was introduced to the market in 2018, (hereinafter referred to as the “standard therascreen PITX2 workflow) and represents an in vitro diagnostic to predict outcome to anthracycline-based chemotherapy considered standard-of-care systemic treatment in early breast cancer patients. The Intended Use (IUS) of this kit covers lymph node-positive, estrogen receptor-positive and HER2-negative high-risk breast cancer patients treated in the adjuvant setting with anthracycline-based chemotherapy and requires 400 ng genomic DNA as recommended DNA input extracted from 1-2 x 5 µm Formalin-Fixed-Paraffin-Embedded (FFPE) sections with a minimal total tumor tissue surface area of ≥ 100 mm2. In today’s clinical workflow of early high-risk breast cancer patient therapy, increasing number of patients are treated in the neoadjuvant setting after tumor biopsy with anthracycline-based chemotherapy before tumor resection by surgery. Biopsy material size restriction in this clinical area requires for a predictive marker test to be applicable biopsy specimens with tumor tissue surface area’s in the range of 20-50 mm2. Therefore, a modified PITX2 workflow protocol - the so-called “Condensed Efficient Fast (CEF)” PITX2 workflow – was developed to address this need. The required modifications of the standard therascreen PITX2 workflow is described in the “bisDNA Preparation” section. The “PMR Detection & Analysis” section of the standard therascreen PITX2 workflow remains unchanged. The new CEF PITX2 workflow is for Research Use Only (RUO) and intended to be used by qualified users such as technicians, molecular biologists/clinical chemists, or physicians. The complete CEF PITX2 workflow is optimized for medium sample through-put with highly reliable and robust read-out and can be performed in two working days.