bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Mindfulness-Based Stress Reduction on Resilience of Vulnerable Women at Drop-In Centers in the Southeast of Iran
Authors: Adelian Hamideh , Shahraki Sedigheh Khodabandeh , Miri Sakineh , Farokhzadian Jamileh
Published: March 2021

Background: Vulnerable women such as female sex workers and addicted women are among vulnerable groups affecting the social and mental health of societies. They are prone to psychological problems such as anxiety, stress and reduced resilience due to their lifestyles. Mindfulness-based stress reduction (MBSR) is among interventions that many psychotherapists use to treat stress and anxiety. This study aimed to investigate the effectiveness of MBSR on resilience of the vulnerable women. Methods: The statistical population of this quasi-experimental study consisted of all eligible women referred to the drop-in centers in Kerman in the southeast of Iran. Sixty-three vulnerable women were randomly assigned into two groups of intervention (n=30) and control (n=33). The MBSR intervention was conducted for the intervention group in eight 90-minute sessions. Demographic characteristics questionnaire, and Connor-Davidson resilience scale were used to collect data before and one month after the MBSR intervention.Results: The results showed that the pre-test score of resilience was not significantly different between the intervention (53.40 ± 10.49) and the control (54.5 ± 9.27) groups (t=0.43, p=0.66). The posttest score of resilience in the intervention group (60.66 ± 6.71) was significantly higher than that of the control group (53.88 ± 7.54) (t = 3.58, P = 0.001). Moreover, a comparison of the pretest and posttest scores revealed a significant decrease in resilience of the control group (t=2.81, p=0.009).Conclusion: Since MBSR intervention increased resilience of the vulnerable women, researchers, managers, counselors, community health nurses and psychiatric nurses are suggested to consider such interventions to promote the health of women, especially vulnerable ones.
Organizing Preconception Care for Women Suffering from Chronic Diseases: Patients’ View on the Role of General Practitioners: A Qualitative Study.
Authors: Admiraal Laura , Schonewille Marit , Eugenia Mireina , Schonewille Lydia , Mulders Annemarie , Rosman Ageeth
Published: March 2021

Background: Women suffering from chronic diseases should preferably receive specialized individual preconception care (PCC) by an obstetrician before becoming pregnant. For most chronic diseases it is important that the disease is in remission or under control before conception, aiming for optimal pregnancy outcome. Especially, amongst other considerations, medication use should be monitored for toxicity before starting a pregnancy. Specific case findings followed by a referral to an obstetrician for specialized individual PCC by a general practitioner (GP) could be a solution to improve the uptake of PCC. The aim of this study was to explore patients’ views on PCC organized by general practitioners (GP) for women suffering from a chronic disease.Methods: We recruited participants via a public Facebook message. We asked women suffering from a chronic medical condition, aged 18-42 years, living in the Netherlands and planning to become pregnant to contact the researcher by a personal message. Once contacted, women received additional information about the aim of the study. After reading the study information, women were asked for participation and a digital informed consent was sent. Thereafter, an appointment for a semi-structured interview by telephone, the study intervention, was made. The interviews were audio-taped, transcribed verbatim and member checked. The transcripts were coded and analysed on facilitators and barriers for preconception care by GP’s, using NVivo 10.Results: 45 women replied to the public Facebook message. All women were contacted by the researcher. Finally, 23 women consented to participate in a semi-structured interview by telephone. This resulted in a heterogeneous study population. The participants indicated a range of facilitators and barriers for organizing PCC via the GP. The GP was viewed to be trustworthy, to have knowledge about their medical history and to have a coordinating role but limited knowledge about pregnancy. Patients preferred a referral from the GP to an obstetrician to have a face-to-face preconception consultation together with their medical specialist. Conclusions: According to women suffering from a chronic disease, PCC is ideally given by an obstetrician and medical specialist in a face-to-face consultation whereby the GP has a coordinating role.Trial registration: not applicable.
Seven Tumor-Associated Autoantibodies as a Eerum Biomarker for Primary Screening of Non-Small Cell Lung Cancer
Authors: Tingting Chen , Wei Lu , Ping Chen
Published: March 2021

Objective: Tumor-associated autoantibodies (TAAbs) are produced by the organism in response to peptides at the surface of tumor cells or proteins released by tumors. The purpose of this study is to analyze the expression of TAAbs in different pathological stages and determine their diagnostic value in early non-small cell lung cancer (NSCLC). Methods: We retrospectively analyzed the expression of 7-TAAbs in 216 newly diagnosed NSCLC patients, 202 patients with lung benign diseases and 137 healthy cases. The expression of a panel of 7-TAAbs, including p53, GAGE7, PGP9.5, CAGE, MAGE A1, SOX2, GBU4-5, was measured by ELISA. Results: The serum levels of p53, GAGE7, PGP9.5, CAGE, MAGE A1, SOX2 and GBU4-5 were not statistically significant (P>0.05) in NSCLC, benign and healthy groups. The area under the curve (AUC) of 7-TAAbs were all lower than 0.70. The sensitivity of combined detection was the highest (26.39%), while the specificity was the lowest (88.62%). PGP9.5, SOX2, GAGE7, MAGE A1 and combined detection were significantly different among the three groups (P < 0.05). PGP9.5, GAGE7, MAGE A1 and combined detection were significantly different between the NSCLC and benign groups (P < 0.05). PGP9.5, SOX2, GAGE7 and combined detection were significantly different between the NSCLC and healthy groups (P < 0.05). The positive rate of the combined detection of 7-TAAbs was 44.44% in NSCLC stage IV, while that in the other three stages was less than 30.00%. Conclusions: The sensitivity of 7-TAAbs in early NSCLC was not high, so it cannot be used alone as a screening method for NSCLC. In view of the differences of positive rate between the NSCLC and non- NSCLC groups, 7-TAAbs can be used as a supplementary mean of NSCLC screening.
Ag2Se Nanowire Network as an Effective In-Materio Reservoir Computing Device
Authors: Kotooka Takumi , Lilak Sam , Stieg Adam , Gimzewski James , Sugiyama Naoyuki , Tanaka Yuichiro , Tamukoh Hakaru , Usami Yuki , Tanaka Hirofumi
Published: March 2021

Modern applications of artificial intelligence (AI) are generally algorithmic in nature and implemented using either general-purpose or application-specific hardware systems that have high power requirements. In the present study, physical (in-materio) reservoir computing (RC) implemented in hardware was explored as an alternative to software-based AI. The device, made up of a random, highly interconnected network of nonlinear Ag2Se nanojunctions, demonstrated the requisite characteristics of an in-materio reservoir, including but not limited to nonlinear switching, memory, and higher harmonic generation. As a hardware reservoir, the devices successfully performed waveform generation tasks, where tasks conducted at elevated network temperatures were found to be more stable than those conducted at room temperature. Finally, a comparison of voice classification, with and without the network device, showed that classification performance increased in the presence of the network device.
Healthcare Workers’ Experiences of Working on the Frontline and Views About Support During COVID-19 and Previous Pandemics: A Systematic Review and Qualitative Meta-Synthesis 
Authors: Billings Jo , Ching Brian Chi Fung , Gkofa Vasiliki , Greene Talya , Bloomfield Michael
Published: March 2021

Background: Healthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. Methods: We searched key healthcare databases (Medline, PsychINFO and PubMed), reviewed relevant grey literature, screened pre-print servers and hand searched reference lists of key texts for all published accounts of healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and previous pandemics/epidemics. Final searches took place on September 28, 2020. We conducted a meta-synthesis of all qualitative results to synthesise findings and develop an overarching set of themes and sub-themes which captured the experiences and views of frontline healthcare workers across the studies. Results: This review identified 46 qualitative studies which explored healthcare workers’ experiences and views from pandemics or epidemics including and prior to COVID-19. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Participants across all the studies were deeply concerned about their own and/or others’ physical safety. This was greatest in the early phases of pandemics and exacerbated by inadequate PPE, insufficient resources, and inconsistent information. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. Many experienced stigma. Healthcare workers’ relationships with families, colleagues, organisations, media and the wider public were complicated and nuanced and could be experienced concomitantly as sources of support but also sources of stress. Conclusions: The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of these previous crises, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.
Characterisation of serum protein electrophoresis patterns and C-reactive protein in canine tick-borne diseases
Authors: Asawakarn Sariya , Taweethavonsawat Piyanan
Published: March 2021

Background: Canine tick-borne diseases are important diseases with a worldwide distribution. In Thailand, the most important canine tick-borne diseases are ehrlichiosis, babesiosis and hepatozoonosis. The aim of this study was to determine the serum protein electrophoresis patterns and C-reactive protein levels associated with E. canis, B. canis or H. canis single infections.Results: In dogs infected with E. canis, B. canis and H. canis single infections, the albumin levels and A/G ratios were significantly decreased, whereas β2-globulin levels were increased (P < 0.05). The γ-globulin level was significantly increased in E. canis and H. canis infections (P < 0.05). A monoclonal gammopathy pattern was observed in E. canis and B. canis single infections while β–γ bridging patterns and increased β- and γ-globulin fractions were found in H. canis single infections. The C-reactive protein level was increased in dogs with blood parasite single infections and may be related to the pathogenesis of the infection.Conclusions: Serum protein electrophoresis patterns and C-reactive protein levels can be used to monitor health status and blood parasite problems in infected dogs.
Characterisation of serum protein electrophoresis patterns and C-reactive protein in canine tick-borne diseases
Authors: Asawakarn Sariya , Taweethavonsawat Piyanan
Published: March 2021

Background

Canine tick-borne diseases are important diseases with a worldwide distribution. In Thailand, the most important canine tick-borne diseases are ehrlichiosis, babesiosis and hepatozoonosis. The aim of this study was to determine the serum protein electrophoresis patterns and C-reactive protein levels associated with E. canis, B. canis or H. canis single infections.
Results

In dogs infected with E. canis, B. canis and H. canis single infections, the albumin levels and A/G ratios were significantly decreased, whereas β2-globulin levels were increased (P < 0.05). The γ-globulin level was significantly increased in E. canis and H. canis infections (P < 0.05). A monoclonal gammopathy pattern was observed in E. canis and B. canis single infections while β–γ bridging patterns and increased β- and γ-globulin fractions were found in H. canis single infections. The C-reactive protein level was increased in dogs with blood parasite single infections and may be related to the pathogenesis of the infection.
Conclusions

Serum protein electrophoresis patterns and C-reactive protein levels can be used to monitor health status and blood parasite problems in infected dogs.
Biodecolorization of Azo Dye Mixture (Remazol Brilliant Violet 5r and Reactive Red 120) by Indigenous Bacterial Consortium Obtained From Dye Contaminated Soil
Authors: Rajendran R , Kiruthika S , Saranya P , Mohan Arunkumar , Vaishali C V
Published: March 2021

Discharge of the untreated wastewater containing dyestuff into the surrounding aquatic environment is of significant environmental concern. These dying effluents not only change the color of water bodies but also has many unfavorable conditions and release toxic by-products, which are mutagenic, carcinogenic, and hazardous to different life forms. The present study investigated the biodegradation and removal of dye mixture (Remazol Brilliant violet 5R and Reactive Red 120) using a new bacterial consortium isolated from dye contaminated soil. Among the total 15 isolates screened, the two most efficient bacterial species (SS07 and SS09) were selected and identified as Enterobacter cloacae (MT573884) and Achromobacter pulmonis (MT573885) through biochemical assays and 16S rRNA gene sequencing. The removal efficiency of dye mixture by Enterobacter cloacae and Achromobacter pulmonis at an initial concentration of 100 mg L− 1 was 82.78 and 84.96%, discretely. The bacterial consortium was developed using selected isolates, and the optimum conditions for the removal of dyes were investigated by studying the effects of pH, temperature, carbon and nitrogen sources, dye concentration, and inoculum size. The maximum decolorization efficiency was achieved at pH, 7; temperature, 37°C; dye concentration, 100 ppm; and initial inoculum concentration, 0.5 ml, respectively. Mannitol and Ammonium sulfate was identified as the most suitable carbon and nitrogen sources for better bacterial growth and decolorization. The maximum removal efficiency of 91.3% achieved at the optimal conditions after 72 h of incubation. Decolorization of azo dyestuff by the developed microbial consortia conforms to the zero-order reaction kinetics model. Consortia of Enterobacter cloacae and Achromobacter pulmonis was established as an effective decolorizer for the Remazol Brilliant violet 5R and Reactive Red 120 dye mixture with > 90% color removal.
Use of the Maternal Foetal Triage Index: Addressing the Third Delay in Obstetrics
Authors: Vora Nirzarini Mukul , Maitra Nandita Krishnakant
Published: March 2021

PURPOSE: While several scales have been developed specifically for obstetric triage, the Maternal Foetal Triage Index (MFTI), a five-tier scale designed by Ruhl et al (2015) has been evaluated for women attending the triage area of a tertiary hospital. This study intends to evaluate the effect of MFTI score on third delay and maternal and neonatal outcomes.METHODS: A prospective observational study was conducted over a convenience sample of 1000 subjects who attended the Labour and Delivery Unit of a tertiary care hospital over a period of one year. Assessment included maternal history, baseline vital signs and obstetric examination. The woman was categorised as per the MFTI scale and directed to the appropriate area for further management. Evaluation of the MFTI score was assessed based on predefined maternal and neonatal outcomes within 24h of attendance.RESULTS: A priority wise distribution of subjects based on their clinical diagnosis was found to be statistically significant for anaemia, previous caesarean section, postpartum haemorrhage, miscarriage and hypertensive disorders. Sixty seven percent of the subjects belonged to Priority 3-4 and the mean hospital stay duration varied from 8.26±7.68 days for Priority 1 to 3.82±2.74 days for Priority 4 (p<0.0001). The average time spent in the triage room was 30±17minutes. Maternal and neonatal outcomes were analysed according to priority based on OBICU admissions, mortality, NICU admissions and stillbirths and found to be significant.CONCLUSION: The MFTI scale significantly reduced the third delay, which is crucial in a high-volume, low-resource emergency obstetric setting. This also simplified handover of subjects, improved documentation and decreased time to secondary healthcare provider assessment.
Can Rheumatoid factor and Anti-cyclic citrullinated peptides predict true remission in rheumatoid arthritis patients? Study of relationship between autoantibodies levels and muskuloskelatal ultrasound findings in a sample cohort of Egyptian patients in clinical remission
Authors: Sayed Eman Hassan Al , Amin Doaa Shaker
Published: March 2021

BackgroundTrue remission is the ultimate goal for rheumatoid arthritis (RA) therapy. Our aim was to investigate the relationship between serum levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptides (Anti-CCP) and ultrasonographic (US) findings in Egyptian RA patients in clinical remission.MethodsUsing data from a cross-sectional study on 50 RA patients in clinical remission or low disease activity (LDA) as defined by disease activity score (DAS28-ESR) cutoff points, performed in Alexandria University Hospital; we analyzed statistical relationships and correlations between RF, Anti-CCP) and Gray Scale (GS) and Power Doppler (PD) US using US7 score. US remission was defined as on a GS ≤ 1 and PD = 0. ResultsAmong 34 patients in clinical remission, 61.8% (21) of patients in clinical remission were in ultrasonographic remission, and 38.2% (13) of patients in clinical remission had subclinical ultrasonographic activity. Patients in clinical remission with US remission had significantly higher Anti-CCP (p= 0.006) but not RF (p= 0.086), than those in clinical remission with US subclinical activity. Anti-CCP positively correlated with synovitis score by power Doppler US (PDUS) (rs= 0.553, p= 0.001), and tenosynovitis/paratenonitis score by gray scale US(GSUS) (rs=0.389, p= 0.023).ConclusionWe demonstrated that patients in clinical RA remission with subclinical US activity had higher serum levels of Anti-CCP, but not RF. Such an association should guide further treatment decisions for those patients.
Driving Factors Behind the Social Role of Retail Centers on Recreational Activities 
Authors: Baghaee Sepideh , Nosratabadi Saeed , Aram Farshid , Mosavi Amir
Published: March 2021

Retail centers can be considered as places for interactional and recreational activities and such social roles of retail centers contribute to the popularity of the retail centers. Therefore, the main objective of this study was to identify effective factors encouraging customers to engage with interactional activities and measure how these factors affect customer behavior. Accordingly, two hypotheses were raised illustrating that the travel time (i.e., the time it takes for a customer to reach the retail center) and the variety of shops (in a retail center) increase the percentage of people who spend their leisure time and recreational activities retail centers. Two case studies were conducted in two analogous retail centers, one in Tehran, Iran, and the other in Madrid, Spain. According to the results, there is an interaction between the travel time and the motivation for the presence of people in the retail center. Furthermore, the results revealed that half of both retail center goers who spend more than 10 minutes to reach the retail centers prefer to do leisure activities and browsing than shopping. In other words, the longer it takes a person to get to the center, the more likely he/she is to spend more time in the mall and do more leisure activities. It is also found that there is a significant relationship between the variety of shops in a retail center and the motivation of customers attending a retail center that encourages people to spend their leisure time in retail centers.
Assessing the progress of river restoration in the UK: has ecological condition improved over two decades of intervention?
Authors: Moore Harriet Elizabeth , Mercer Theresa , Pitts Dilkushi de Alwis , Beagley Sam , Naura Marc , Bryden Alex
Published: March 2021

Context: Habitat condition indicates the immediate success of efforts to revegetate degraded river basins as well as longer-term progress towards improving water quality. In the context of the Water Framework Directive, habitat condition in the UK also reflects how well international environmental policy translates into improved river management domestically. Objectives: 1. To assess whether habitat condition in the UK has improved or declined over the past two decades, 2. To assess whether regions identified by the first WFD assessment have improved or declined. Methods: Statistical and spatial analysis of more than 25,000 habitat condition records collated in the River Habitat Survey over the 1990s and 2000s. Computation of an Index of Change demonstrating the improvement or decline of habitat quality in Local Authorities. Comparison of Indices of Change with a sub-sample of 1,727 WFD assessments conducted in 258 Local Authorities. Results: Measures indicate that habitat quality has declined. Riparian quality has improved. 27 regions were identified with the worst declining quality. Condition has declined most substantially in regions that were previously in ‘good’ condition. Conclusion: Priorities for future investment should include improving degraded sites, protecting high quality sites, and increasing monitoring of ‘data poor’ regions. We offer a framework for decision making, including distinguishing the underlying cause of quality decline. Habitat quality decline in the UK mirrors the experience of European nations and points to systemic challenges associated with implementing international water policy in a national context.
Efficacy of Dual Parenteral Artemisinin-Based Combination Therapy for Cerebral Malaria in a Tripple Blinded Randomized Control Trial in Nigerian Children: DUAL PACT TRIAL
Authors: Alao Michael Abel , Orimadegun Adebola Emmanuel , Ibrahim Olayinka Rasheed , Oyenuga Abayomi O , Asinobi Adanze Onyenonachi , Gbadero Daniel Adedosu , Okoye Ifeoma Joy , Nna Emmanuel Okechukwu
Published: March 2021

Background: Evidence exists as to the criticality of the first 24 hours in the management of cerebral malaria. This could serve as a potential safety net for improved outcomes with prompt treatment and utilization of effective therapy. The morbidity and the mortality rate (35%) with the current parenteral monotherapy for the initial treatment of cerebral malaria is unacceptably high. Combination therapy and a shorter course of effective medication have been shown to improve outcomes in human subjects in treatment of other diseases. This study outlines a protocol to conduct a triple blinded randomized control trial on cerebral malaria using dual parenteral medications compared to the current standard of monotherapy.Methods: This is a randomized control triple blinded trial consisting of an intervention and 2 control arms. Eligible and assenting children aged 6 months to 17 years will be recruited from 4 tertiary hospitals by random selection from the list of tertiary hospitals in Nigeria. Subjects will be concealed and allocated in parallel into three arms using random numbers generated from GraphPad Prism (version 9) by a Clinical Pharmacologist who has no link with the investigators, the patients, or the statistician. The parasite load and clearance, fever defervesence, C reactive protein, procalcitonin, blood glucose, electrocardiograms and time to regain consciousness will be monitored. The socio-demographic and clinical details of all patients will be documented. The study will be conducted in line with Declaration of Hesinki 2013. Appropriate statistical tools will be used for data collection and analysis.Discussion:The outcome of this analysis will give insight into the efficacy of dual parenteral antimalaria in the treatment of cerebral malaria among Nigerian children compared with standard of care. The safety profile of this intervention would also be highlighted. This may help inform Physicians on the optimal treatment for cerebral malaria to improve outcomes, prevent development of resistance, recrudescence, treatment failure and stimulate interest of pharmaceutical companies in the development of newer formulations of dual parenteral antimalarial combination therapies. Trial registration: This study was registered in the Pan Africa Clinical Trial Registry (PACTR202102893629864).
Idiopathic Granulomatous Mastitis Presented with Reactive Arthritis and Erythema Nodosum: Case Report from Iraq
Authors: Gorial Faiq I. , J. Farah
Published: March 2021

Idiopathic Granulomatous Mastitis (IGM) is a rare chronic inflammatory disease that involves the development of an inflammatory mass in the breast, which may be difficult to differentiate from malignancy. Few patients have been reported in the literature presenting with arthritis accompanying IGM of breast. Here we report a case of Iraqi patient presented as IGM with reactive arthritis and erythema nodosum.
Intestinal Microbiota Plays Important Effect on Severity of Hand Foot and Mouth Disease in Children
Authors: Shen Chenguang , Xu Yi , Ji Jingkai , Wei Jinli , Jiang Yujin , Yang Yang , Yang Minghui , Huang Huaxin , Zou Rongrong , Fang Chunxiao , Zeng Fansen , Yang Fengxia , Wang Xinfa , Yuan Jing , Li Jianmin , Wang Xianfeng , Yang Huanming , Gong Sitang , Wang Hui , Xia Huimin , Ma Jinmin , Liu yingxia
Published: March 2021

Background. The incidence of hand foot and mouth disease (HFMD) has increased in recent years, making it a very common childhood illness worldwide. The relationship between different enterovirus genotypes and disease severity is not clearly understood. Given that enteroviruses are transmitted through the gastrointestinal tract, we hypothesized that variation in intestinal microorganisms of the host might play a role in the prognosis of HFMD. Methods. We carried out a meta-transcriptomic-wide association study of fecal samples obtained from a cohort of children (254 patients, 227 tested positive for enterovirus, including 16 patient co-infection with 2 kinds of enterovirus) with mild and severe HFMD and healthy controls. Results. We found there was no significant difference in the amount of each virus type between the mild and severe cases. Genes of enterovirus 71 (EV71) and coxsackievirus A (CV-A) from the severe and mild cases did not show significant clustering. Clostridium sp. L2-50 and Bacteroides stercoris ATCC 43183 were enriched in the guts of children with severe HFMD and KEGG enrichment was found between mild and severe cases.Conclusions. Intestinal microorganisms appear to interact with enterovirus to determine the progression of HFMD. Genes of Bacteroides and Clostridium may be used as predictive markers for a more efficient prognosis and intervention. The enrichment of intestinal bacteria genes with functions may facilitate the development of severe symptoms for HFMD patients.
Living with Type 2 Diabetes Mellitus in the Kingdom of Tonga: A Qualitative Investigation of the barriers and enablers to lifestyle management
Authors: Taumoepeau Jennifer , Knight-Agarwal Cathy , Tu'i 'Esiteli , Jani Rati , Osuagwu Levi U , Simmons Professor David
Published: March 2021

Background and Objectives: Despite the increasing prevalence of Type 2 Diabetes Mellitus in the Kingdom of Tonga little is known of the experiences of adults living with this non-communicable disease. This investigation aimed to explore the barriers and enablers to healthy lifestyles in a group of men and women living with type 2 diabetes mellitus residing in this pacific island nation.Methods and Study Design: This qualitative study consisted of three semi-structured focus groups (n = 16) which were conducted at Tonga’s only Public Hospital located in the capital, Nuku’alofa. Discussions were audio recorded, transcribed, cross-checked for consistency and entered into a word processing document for further scrutiny. Data was analysed using Interpretative Phenomenological Analysis. In any phenomenological study the researcher’s objective is to elicit the participant’s views on their lived experiences.Results: Four main themes were identified: (1) Knowledge and Support; (2) Fear and Motivation; 3) Environment; and (4) Faith and Culture.Conclusion: The qualitative findings from this study may assist the future development and dissemination of culturally appropriate lifestyle-related information for men and women living with Type 2 Diabetes Mellitus in the Kingdom Tonga. The need for collaboration between practitioners at the hospital, the church, family members and local traditional healers is important if the lifestyle-related needs and wants of this group of people are to be met.
Investigating the molecular processes behind the cell-specific toxicity response to titanium dioxide nanobelts
Authors: Winckers Laurent Alijda , Willighagen Egon L , Evelo Chris T , Kutmon Martina
Published: March 2021

BackgroundWhereas several engineered nanomaterials are able to incite toxicological effects, the underlying molecular processes are understudied. And the varied physicochemical properties complicate toxicological predictions. Gene expression data allow us to study the cell-specific responses of individual genes, whereas their role in biological processes is harder to interpret. An overrepresentation analysis allows us to identify enriched biological processes and link the experimental data to these, but still prompt broad results which complicates the analysis of detailed toxicological processes. We demonstrated a targeted filtering approach to compare the cell-specific effects of two concentrations of the widely used nanomaterial titanium dioxide (TiO2) -nanobelts.MethodsWe compared public gene expression data generated by Tilton et al. from colon endothelium cells (Caco2), lung endothelium cells (SAE), and monocytic like cells (THP1) after 24-hour exposure to low (10 μg/ml) and high (100 μg/ml) concentrations of TiO2 -nanobelts. We used pathway enrichment analysis of the WikiPathways collection to identify cell and concentration-specific affected pathways. Gene sets from selected Gene Ontology terms (apoptosis, inflammation, DNA damage response and oxidative stress) highlighted pathways with a clear toxicity focus. Finally, pathway-gene networks were created to show the genetic overlap between the altered toxicity-related pathways.ResultsAll cell lines showed more differentially expressed genes after exposure to higher concentration, but our analysis found clear differences in affected molecular processes between the cell lines. Approximately half of the affected pathways are categorized with one of the selected toxicity-related processes. Caco2 cells show resilience to low and high concentrations. SAE cells display some cytotoxic response to the high concentration, while THP1 cells are already strongly affected at a low concentration. The networks show for up- and downregulation for the THP1 cells the most pathways. Additionally, the networks show gene overlap between almost all pathways for all conditions.ConclusionsThe approach allowed us to focus the analysis on affected cytotoxic processes and highlight cell-specific effects. The results showed that Caco2 cells are more resilient to TiO2 -nanobelts exposure compared to SAE cells, while THP1 cells were affected the most. The automated workflow can be easily adapted using other Gene Ontology terms focusing on other biological processes.
Knowledge, Awareness and Associated factors of Telemedicine Services among Health Professionals Working at Amhara Region Referral hospitals, northwest Ethiopia, 2020.
Authors: Assaye Bayou Tilahun , Jemere Adamu Takele , Nigatu Araya Mesfin
Published: March 2021

Background: -Telemedicine is the delivery of healthcare services at a distance. Despite it is an emerging and infancy technology in a developing country, utilizing the technology for delivering healthcare services is low in Ethiopia. To maximize and facilitate Telemedicine adoption it prominently requires information about the knowledge and awareness of telemedicine services among health professionals.Methods: - An institution-based cross-sectional study design was conducted among 423 health professionals working at Amhara Region Referral Hospitals from February 12-March 20/2020. The data were collected using self-administered structured questionnaire. Desk review was done to assure the data quality and then data was entered into EPI INFO version 7 and exported into SPSS version 20 for statistical analysis. Descriptive statistics, bivariable and multivariable logistic regression analysis were done. Odds ratio with 95% confidence interval (95% CI) was used to identify associated factors.Result: About 56% of health professionals had good knowledge and 57.4% had high awareness towards telemedicine services with 411 (97.2%) response rate. Information sharing culture [AOR=3.01, 95% CI: 1.89, 4.80], having IT support staff [AOR=1.87, 95%CI: 1.06, 3.29], internet as information source [AOR=1.80, 95%CI:1.1, 2.94], awareness [AOR=1.35,95% CI: 1.03, 2.40], being male [AOR=1.73,95% CI:1.06, 2.81] were significantly associated with the knowledge of the respondents towards telemedicine services and telemedicine training [AOR= 2.33, 95% CI: 1.15, 4.72] and computer accessibility in their hospitals [AOR= 1.54, 95% CI: 1.01, 2.35] were significantly associated with the awareness of the respondents towards telemedicine services.Conclusion: More than half of the respondents had good knowledge and high awareness of telemedicine services. Information source, having IT support staff, information sharing culture, gender and awareness were significant factors for the knowledge of telemedicine service and telemedicine training and computer access were significant factors of awareness of health professionals towards telemedicine services. Therefore Appropriate and regular awareness creation training of telemedicine systems should be given to the health professional.
A scoping review of global vaccine certificate solutions for COVID-19
Authors: Mithani Salima S. , Bota A. Brianne , Zhu David T. , Wilson Kumanan
Published: March 2021

Background: Globally, measures such as lockdown, quarantining, and physical distancing have been implemented to curb the spread of COVID-19. As the vaccines are now available and reintegration into society is beginning, measures such as vaccine certificates are being implemented around the world.Objective: The objective of the scoping review is to identify the existing digital solutions available globally for COVID-19 vaccine certificates and evaluate them on the basis of purpose and use case, technological architecture, and ethical and legal implications.Methods: We conducted a Google search as well as a search of Embase, Ovid MEDLINE and preprint servers (MedRXIV, BioRXIV). The search terms used were “coronavirus”, “COVID-19”, “SARS COV2”, “immunization passport”, “immunization certificate”, “vaccine certificate”, “vaccination certificate” and “digital”. Articles were included for review if they included any discussion of a digital solution for vaccine certificates and English language. Data was extracted using an electronic data extraction form and included date, location, type of article, source, companies identified, technology used, type of evidence provided, digital architecture, security and privacy measures, and use cases. The articles were categorized based on the following six pre-identified themes: 1) legal, 2) technology, 3) ethics, 4) travel, 5) policy, and 6) science. Results: A total of 70 articles were included in the final analysis. Technology emerged as the most dominant theme, appearing in 58.5% (n=41) articles followed by ethics (n=22, 31%), travel (n=21, 30%), legal concerns (n=10, 14%), public policy (n=9, 13%), and scientific concerns (n=1, 1.5%. Our review identified 8 global solutions that are working towards COVID-19 vaccine certificate, all optimizing blockchain technology. COVID-19 vaccine certificates are being considered in 13 countries and are in place in 3 countries. All the solutions we identified are using blockchain technology.Conclusion: Several countries have implemented or are considering COVID-19 vaccine certificates. Many issues concerning the themes we identified remain to be addressed to facilitate successful implementation.
Decoding the dynamic of poleward shifting climate zones using aqua-planet model simulation
Authors: Yang Hu , Lu Jian , Shi Xiaoxu , Wang Qiang , Lohmann Gerrit
Published: March 2021

Growing evidence implies that the atmospheric and oceanic circulation experiences a systematic poleward shift in a warming climate. However, the complexity of climate system, including the coupling between the ocean and the atmosphere, natural climate variability and land-sea distribution, tends to obfuscate the causal mechanism underlying the circulation shift. Here, using an idealized coupled aqua-planet model, we explore the mechanism of the shifting circulation, by isolating the contributing factors from the direct CO2 forcing, the indirect ocean surface warming, and the wind-stress feedback from the ocean dynamics. We find that, in contrast to direct CO2 forcing, an enhanced subtropical ocean warming plays a leading role in driving the circulation shift. This enhanced subtropical ocean warming emerges from the background Ekman convergence of surface anomalous heat in the absence of the ocean dynamical change. It expands the tropical warm water zone, causes a poleward shift of the meridional temperature gradients, hence forces a corresponding shift in the atmospheric circulation. The shift in the atmospheric circulation in turn drives a shift in the ocean circulation. Our simulations, despite being idealized, capture the main features of observed climate changes, for example, the enhanced subtropical ocean warming, poleward shift of the patterns of near-surface wind, sea level pressure, storm tracks, precipitation and large-scale ocean circulation, implying that increase in greenhouse gas concentrations not only raises the temperature, but can also systematically shift the climate zones poleward.
Impact of relative dose intensity of oxaliplatin in adjuvant therapy among stage III colon cancer patients on early recurrence: a retrospective cohort study
Authors: Żok Jolanta , Bieńkowski Michał , Radecka Barbara , Korniluk Jan , Adamowicz Krzysztof , Duchnowska Renata
Published: March 2021

Background: Oxaliplatin-based therapy with FOLFOX-4 or CAPOX administered over 6 months remains the standard adjuvant treatment for stage III colon cancer (CC) patients. However, many patients experience dose reduction or early termination of chemotherapy due to oxaliplatin toxicity, which may increase the risk of early recurrence. The objective of this study was to analyze the relationship between the relative dose intensity of oxaliplatin (RDI-O) and early recurrence among stage III CC patients.Methods: The study included 365 patients treated at five oncology centers in Poland between 2000 and 2014. Survival analysis was performed using the Kaplan-Meier method. Univariate analysis was performed using the Cox proportional hazard model; multivariate analysis was performed with the stepwise forward approach. For all analyses the α level of 0.05 was employed. Results: The median follow-up was 51.8 months (range 8.2-115.1). Early recurrence <36 months after surgery occurred in 130 patients (37.8%). In this group 51 (39.2%) and 87 (66.9%) of patients were low and high-risk, respectively. Receipt <60% of RDI-O was associated with early recurrence within 18 months after surgery (OR=2.05; 95%CI: 1.18-3.51; p=0.010), especially in low-risk group (HR=1.56 (95%CI: 0.96-2.53), p=0.07). In the multivariate analysis early recurrence was correlated with grade (OR=2.47; 95% CI: 1.25-4.8; p=0.008), pN (OR=2.63; 95% CI: 1.55-4.54; p<0.001), the number of lymph nodes harvested (OR=0.51; 95% CI: 0.29-0.86; p=0.013) and RDI-O (OR=1.91; 95%CI: 1.06-3.39; p=0.028). The early vs. late recurrence negatively correlated with OS regardless of the RDI-O (HR=22.9 (95%CI: 13.9-37.6; p<0.001).Conclusions: RDI-O <60% in adjuvant therapy among stage III CC (especially in low-risk group) increases the risk of early recurrence within 18 months of surgery. Patients with early recurrence showed worse overall survival regardless of the RDI-O.
Prevalence of Peripheral Neuropathic Pain among Adult Diabetic Patients (T2DM) with Peripheral Neuropathy and Quality of Life of the Patients with Peripheral Neuropathic Pain
Authors: Abu-Shennar Jawad Ahmad , Bayraktar Nurhan , Bebis Hatic
Published: March 2021

Aim The aim of the study was to assess the prevalence of diabetic peripheral neuropathic pain (DPNP) among adult patients suffering from type 2 diabetes mellitus (T2DM) with diabetic peripheral neuropathy (DPN) as well as to determine the quality of life of patients with DPNP.Materials and method The study designed in cross-sectional research model was conducted at the Jordanian Ministry of Health in Jordan, Amman during the period from 15 June 2019 to 5 October 2019. A total of 400 adult T2DM patients with DNP were recruited for the study. Data were collected by way of an assessment tool package, including descriptive data (demographics, anthropometric measurements, laboratory measurements, and clinical data), the Douleur Neuropathique4 (DN4) questionnaire, physical exam, Quality of Life Questionnaire (EQ-5D), and Numeric Pain Rating Scale (NRS). To analyze study data descriptive and inferential statistics were used.Results Results of the current study showed that the prevalence of DPNP among adult T2DM patients with DPN was high (47.8%). About half of the participants had mild or moderate pain with the most frequently reported symptoms of tingling and burning. Uncontrolled diabetes was found to be the main predictor of DPNP among patients with DPN. Participants who had DPNP reported having problems in connection with mobility, self-care, routine activities, discomfort, and anxiety or/and depression, and they had a significantly lower quality of life with poorer self-rated health status than those without DPNP. Besides, the effect of pain on their quality of life was found to be significant.Conclusion The study recommends, in accordance with the results, that strategies should be developed for an effective management of painful DPN with an integrated and interdisciplinary approach. Current clinical guideline recommendations should be followed to improve patient care and reduce the burden of the disease.
Quality of Life and Associated Factors Among Women With Obstetric Fistula in Ethiopia
Authors: Matiwos Biruktawit , Tesfaw Getachew , Belete Asmare , Abebaw Dessie , shumet shegaye
Published: March 2021

Background: The physical, emotional and social suffering associated with continuous leakage of urine has a profound impact on women quality of life. The aim of this study was to assess quality of life and associated factors among obstetric fistula patients in Ethiopia, has a significant role for further intervention. Objective: To assess quality of life and associated factors among obstetric fistula patients in Ethiopia, 2017. Methods: In this cross-sectional study, 289 women with obstetric fistula were recruited for interviews, using the systematic random sampling technique. The World Health Organization Quality of Life – Brief (WHOQOL-BREF) Version was used to assess quality of life. The Jacob perceived stigma scale and the Oslo-3 social support instruments were used to assess the factors. We computed simple and multiple linear regression analysis to assess factors associated with quality of life. P-value <0.05 was declared statistically significant.Result: Of 289 women studied, only 12.1% felt satisfied with their general state of health and quality of life. In the physical health domain, the mean quality of life score was 40.78±.78. In the psychological domain, the mean quality of life score was 39.96±.82. In the social and environmental domain, the mean quality of life score was 32.9±.95, 36.45±.8 respectively. Duration of incontinence (unstandard β=-3.8,95% CI(-6.95,-.62), patients coming for surgical procedure (β=-4.4, 95% CI(-7.64,-1.2), poor social support(β= -6.14, 95%CI (-8.8,-3.4), Co-morbid anxiety(β= -4, 95% CI (-7,-1.1) and depression(β=-9.2, 95% CI (-12,-6.4) were negatively associated with physical domain of quality of life. Co-morbid anxiety (β= -11,95% CI (-14.8,-7.3), employment(β= 9.1,95%CI(.5, 17.6), number of children(β= 2.1,95%CI(.8, 3.4), and depression(β= -6.3,95%CI(-9.7,-2.9) were associated with a psychological domain. Duration of incontinence (β=-8.1,95%CI(-12.82,-3.4), poor social support(β= -7.8(-12,-3.6), patients coming for surgical procedure (β= -12,95%CI(-17.4,-6.4) and co-morbid anxiety(β= -9.2,95%CI(-13.8, 4.5) were negatively associated with social domain of quality of life. Number of children present (β=2.4,95%CI(.82, 3.6), and poor social support(β= -5.5,95%CI(-9.5,-1.5) were significantly associated with an environmental domain of quality of life. Conclusion and recommendation: Co-morbid depression and anxiety, poor social support, duration of urine incontinence, employment, number of children, and duration of hospital stay were factors significantly associated with domains of QOL. Treating co-morbid depression and anxiety, strong social support and controlling urine incontinence is necessary to increase women’s domain of quality of life.
Emotional Eating in Adults: the Role of Socio-demographics, Lifestyle Behaviors, and Self-regulation- Findings From a US National Study
Authors: Barak Roni Elran , Shuval Kerem , Li Qing , Oetjen Reid , Drope Jeffrey , Yaroch Amy L. , Fennis Bob M. , Harding Matthew
Published: March 2021

The authors have requested that this preprint be withdrawn due to erroneous posting.
Depressive symptoms in mothers with infants: The quantitative evidence of the association of COVID-19 crisis-related factors in Japan
Authors: Matsushima Midori , Horiguchi Hanna
Published: March 2021

Objective: This study explores the depressive symptoms in postpartum women during the coronavirus disease (COVID-19) crisis in Japan.Methods: An online survey conducted from 31 May to 6 June, 2020 resulted in 3,073 responses obtained from mothers with infants < 12 months. Results: The point prevalence of the Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 9 was 28.66% for primipara and 25.83% for multipara. Logistic regression analysis indicated a negative association between the COVID-19 crisis and EPDS ≥ 9; specifically, decreased social support and financial concern were identified as risk factors. The COVID-19 related experiences significantly increased the score of each factor of EPDS, i.e., anxiety, anhedonia, and depression.Conclusions: During the COVID-19 crisis, the number of mothers who faced depreciation in social support and income had increased. Moreover, spending their perinatal period during the crisis increased the propensity of facing unexpected changes, such as changes of hospitals for delivery, or cancellation of parenting classes. These multiple factors were associated with an elevated risk of depression in postpartum women. In a prolonged crisis, postpartum mental health should be treated carefully with the prevention of infection.