bluuebunny/crossref_metadata_2025 huggingface dataset:
Mapping Evidence on Global Perceptions of Environmental Sustainability amidst the COVID-19 Pandemic: A Systematic Review Protocol
Authors: ANSU-MENSAH PETER , Ansu-Mensah Monica , Kuupiel Desmond
Published: January 2021

Background: Identifying and addressing research gaps on environmental sustainability in this striving time of COVID-19, it is imperative to ensure proper waste management disposal, efficient use of energy as well as judicious use of transport in order to achieve the SDGs 2030.Aim: The proposed scoping review is aimed at mapping evidence on global perceptions of environmental sustainability amidst COVID-19 pandemic. Methods: The proposed study will be guided by the enhanced version of Arksey and O’Malley’s scoping review framework, and Levac et al. 2010 recommendations together with the 2015 Joanna Briggs Institute guidelines. A comprehensive keywords search for relevant studies presenting evidence of environmental sustainability during COVID-19 pandemic will be conducted with the following databases: SCOPUS, Google Scholar, EBSCOhost, and PubMed. Literature from university repositories and international organization such as the World Health Organization (WHO) and government websites relevant to the proposed study will also be retrieved. The proposed review will use the Preferred Reporting Items for Systematic Reviews and Meta-analysis: Extension for Scoping Review (PRISMA-ScR) to present the results of the study. For data extraction in a content thematic manner of analysis, NVivo version 11 software package will be used. A mixed methods appraisal tool (MMAT) version 2018 will be employed to appraise the quality of all the included studies. Discussion: We are hopeful that the results of the proposed study will inform future research and unveil evidence-based information to report potential environmental sustainability issues that may arise in this new phase of COVID-19 pandemic. It also anticipated that the proposed study will enable policy and regulatory bodies to implement new strategies to achieve the SDGs inclusive of COVID-19 pandemic.
Can Universities be a Platform for Climate Mitigation? Exploring the Impacts of Carbon Pricing in the University Setting
Authors: Lee Suyeon , Lee Seyeon
Published: January 2021

Climate Change is one of the most important threats in the world today and it is driven by the human-induced build-up of greenhouse gases (GHG) in the atmosphere. Despite worldwide policy efforts from the Kyoto Protocol to the Paris Agreement, global emissions of GHG have continued to steadily increase over the past decade. Against this backdrop, many higher education institutions (HEIs) around the world began to engage in sustainable practices implementing green initiatives on their campuses. Using the waste disposal and the associated GHG emissions data from the academic community, this study describes how HEIs can assume a leadership role in climate mitigation through the implementation of a carbon pricing initiative. Specifically, this study estimates the economic costs of carbon emissions from waste and conceptualizes how revenues generated from carbon pricing can be rechanneled to support carbon reduction efforts in HEIs. By this approach, HEIs not only create incentives for campus users such as students and employees to choose cleaner options but also be able to understand their own carbon footprint and adjust strategy accordingly. While carbon pricing has long been regarded as an alternative approach to tackle carbon pollution, it has not been much discussed in the area of waste management. In this regard, this study attempted to fill this research gap by finding emission reduction potentials in waste management using carbon pricing as a mechanism.
Burn the Base to Get the Polyp Erased: A Novel Technique to Reduce Post-EMR Recurrence
Authors: Levenick John Maynard , Groff Adnrew J , Manzo Carl , Lester Courtney , Maranki Jennifer L
Published: January 2021

Background and Aims: Endoscopic mucosal resection (EMR) has become the standard for removing large colon polyps but has a 10-30% recurrence rate using standard techniques. Data shows improved recurrence rates with focal therapy of the edge of the resection base using cautery. We examine a novel technique, hybrid APC assisted EMR, which treats both the edge and the base with cautery to assess its effect on local recurrence. Methods: We reviewed all EMRs of polyps >2cm by a single endoscopist with six month follow-up from May 2018-November 2019 using both standard EMR as well as hybrid APC assisted EMR to assess local recurrence as well complications. Results: 48 patients with 59 polyps removed by EMR had full six month follow up with a mean age of 66.1 years of age, 45% were female. 30 polyps were removed by hybrid APC assisted EMR and 29 removed with standard EMR. Overall, 0 (0%) polyps in the h-APC arm had local recurrence while 6 (20.7%) in the standard group had histological proven local recurrence (p=0.01). Post-resection bleeding occurred in 6 patients, 2 in the hAPC arm and 4 in the standard arm (p=0.41). Conclusions: Hybrid APC assisted EMR was superior to conventional EMR for local recurrence after removal of large colon polyps and trended towards a less post-EMR bleeds.
Validation of a Novel Cutoff Point for the Fibrosis-4 Index Modified by Age in Patients with Fatty Liver Diseases
Authors: Fujii Hideki , Fukumoto Shinya , Enomoto Masaru , Uchida-Kobayashi Sawako , Kimura Tatsuo , Tamori Akihiro , Nadatani Yuji , Takashima Shingo , Nishimoto Naoki , Kawada Norifumi
Published: January 2021

Background/purpose: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new concept that better expresses the pathogenesis of nonalcoholic fatty liver disease (NAFLD). Although the Fibrosis-4 Index (FIB-4) can easily predict the degree of liver fibrosis, its diagnostic ability, especially in the elderly, requires validation. This study aimed to validate the diagnostic ability of revised cutoff points for FIB-4 in patients with MAFLD and NAFLD.Methods: This cross-sectional study included participants who underwent a health check-up from 2014 to 2019. The proportion and number of low, indeterminate, and high cutoff group between the conventional and revised cutoff points for FIB-4 were compared. The diagnostic ability of these points was compared using the aspartate aminotransferase (AST) to platelet ratio index (APRI) as a standard.Results: Of 21,801 participants, 5,559 (25.5%) had MAFLD and 4,463 (20.5%) had NAFLD. Using revised cutoff points, the proportion of the indeterminate group dropped from 46% to 15% in the MAFLD and 43% to 14% in the NAFLD group. Approximately 60% of patients with MAFLD and NAFLD from the indeterminate group with conventional FIB-4 moved to the low group with a revised FIB-4. Even after age adjustment, the APRI significantly increased for each FIB-4 category and the area under the receiver operating characteristic curve with a diagnosis of APRI ≥ 1.0 increased in both the MAFLD and NAFLD groups.Conclusions: Using cutoff points for the FIB-4 modified by age, the proportion of the indeterminate group dropped and the diagnostic ability increased for both MAFLD and NAFLD.
Identification of Key Genes and Pathways in Ulcerative Colitis Through Bioinformatics Analysis
Authors: Liu Mingdi , Li Fa Ping , Jian Yong Ping , Yang Ge , Zhang Dan , Wang Yi Shu , Xu Zhi Xiang
Published: January 2021

Background Ulcerative colitis (UC) is a chronic inflammatory disease whose therapy remains largely uncertain due to the lack of etiological understanding. It is also a higher risk factor for colon cancer. Aims This study was designed to identify key genes correlated with intestinal epithelial repair and their associated signaling pathways in the pathogenesis and malignant transformation of UC.Methods With an online database pubmed2ensemble, correlative genes were identified to be associated with both UC and its self-healing, and then were imported in Cytoscape for enrichment analysis. A protein-protein interaction network containing was established, and the most significant gene modules and top ten hub genes were selected for further enrichment analysis. Then, potential drugs that target the corresponding genes were identified with online tool in DGIdb. A map which reflected the links among genes, drugs, and their associated pathways was constructed. Finally, we searched the TCGA database and CPTAC database for testing the gene expression of identified UC-associated genes in colon cancer.Results We identified FN1, GRB2, EGF, CXCL8, VEGFA, STAT3, IL6, IL4, IL10, TNF, CSF2, IL13, IL1A, CCL2, ICAM1 and IL18 had closest associations with the function of epithelial function in UC patients, based on functional enrichment analysis. Besides, 11 of them were validated in colon cancer. Conclusions The corresponding signaling pathways that are altered in UC, which provide a new clue for understanding the mechanism underlying the UC pathogenesis and malignant transformation. Key signals in the process and their target drugs might serve as new treatment strategy for UC.
Ileostomy or Ileal Pouch-anal Anastomosis for Ulcerative Colitis: Patient Participation and Decisional Needs.
Authors: Cohan Jessica N. , Ozanne Elissa M. , Hofer Rebecca K. , Kelly Yvonne M. , Kata Anna , Larsen Craig , Finlayson Emily
Published: January 2021

Background: Up to 30% of patients with ulcerative colitis will undergo surgery resulting in an ileal pouch-anal anastomosis (IPAA) or permanent end ileostomy (EI). We aimed to understand how patients decide between these two options. Methods: We performed semi-structured interviews with ulcerative colitis patients who underwent surgery. Areas of questioning included the degree to which patients participated in decision-making, challenges experienced, and suggestions for improving the decision-making process. We analyzed the data using a directed content and thematic approach. Results: We interviewed 16 patients ranging in age from 28-68 years. Nine were male, 10 underwent IPAA, and 6 underwent EI. When it came to participation in decision-making, 11 patients felt independently responsible for decision-making, 3 shared decision-making with the surgeon, and 2 experienced surgeon-led decision-making. Themes regarding challenges during decision-making included lack of support from family, lack of time to discuss options with the surgeon, and the overwhelming complexity of the decision. Themes for ways to improve decision-making included the need for additional information, the desire for peer education, and earlier consultation with a surgeon. Only 3 patients were content with the information used to decide about surgery. Conclusions: Patients with ulcerative colitis who need surgery largely experience independence when deciding between IPAA and EI, but struggle with inadequate educational information and social support. Patients may benefit from early access to surgeons and peer guidance to enhance independence in decision-making. Preoperative educational materials describing surgical complications and postoperative lifestyle could improve decision-making and facilitate discussions with loved ones.
An Innovative Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Spinal Stenosis with Degenerative Instability: a prospective cohort study
Authors: Yin Peng , Ding Yi , Zhou Lijin , Xu Chunyang , Zhang Liming , Gao Haifeng , Yang Jincai , Hai Yong
Published: January 2021

Lumbar spinal stenosis (LSS) is most common lumbar degenerative diseases for people with low back pain. Endoscopic lumbar fusion technique was considered as a promising treatment for LSS with degenerative instability. The objective of this study was to compared the clinical effects for the treatment of Lumbar spinal stenosis (LSS) with degenerative instability between the innovative percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) technique and posterior lumbar interbody fusion (PLIF) technique. Between April 2019 and December 2019, 40 patients with single-segment LSS were prospectively included in our study. Visual Analogue Scale (VAS) on lumbar and leg pain (VAS-LBP, VAS-LP), Oswestry Disability Index (ODI), serum Creatine Kinase (CK), the maximal cross-sectional area of multifidus muscle (Max-CSA) and the peak intensity of Sulphur hexafluoride microbubble contrast agent (PI) around the surgical incision by contrast-enhanced ultrasonography were evaluated preoperatively, post-operatively and at regular follow-up. All patients were followed up. The VAS-LBP, VAS-LP, ODI after operation were improved significantly compared to these data before operation in all the patients (P < 0.05). The VAS-LBP at 1 weeks, 3 months after operation in PE-TLIF group were significantly lower than these in PLIF group (P < 0.05). The injury degree of multifidus muscle evaluated by MAX-CSA and PI was significantly less in PE-TLIF group after operation(P < 0.05). There was no significant difference on the complication rate between these two groups (P > 0.05). Our results presented PE-TLIF technique could obtain comparable effective outcomes as conventional PLIF for the treatment of LSS with degenerative instability. The Patients with PE-TLIF had less muscle injury, less pain and quicker postoperative rehabilitation. (A multicenter non-randomized controlled study for percutaneous endoscope transforaminal lumbar interbody fusion (PE-TLIF) and traditional open surgery for the treatment of degenerative diseases of the lumbar spine;2019/4/13; http://www.chictr.org.cn/showproj.aspx?proj=38002; ChiCTR1900022492)
Predictive biomarkers of ICU and mechanical ventilation duration in critically-ill COVID19 patients
Authors: Taleb Sara , Yassine Hadi A , Benslimane Fatiha A , Smatti Maria , Schuchardt Sven , Albagha Omar , Al-Thani Asmaa A , Hssain Ali Ait , Diboun Ilhame , Elrayess Mohamed A
Published: January 2021

Background: Detection of early metabolic changes in critically-ill COVID-19 patients under invasive mechanical ventilation (IMV) at the intensive care unit (ICU) could predict recovery patterns and help in disease management. Methods: Targeted metabolomics of serum samples from 39 COVID-19 patients under IMV in ICU was performed within 48 hours of intubation and a week later. A generalized linear model (GLM) was used to identify, at both time points, metabolites and clinical traits that predict the length of stay (LOS) at ICU (short ≤14 days /long >14 days) as well as the duration under IMV. All models were initially trained on a set of randomly selected individuals and validated on the remaining individuals in the cohort. Further validation in recently published Metabolomics data of COVID-19 severity was performed. Results: A model based on hypoxanthine and betaine measured at first time point was best at predicting whether a patient is likely to experience a short or long stay at ICU (AUC=0.92). A further model based on kynurenine, 3-methylhistidine, Ornithine, p-Cresol sulfate and C24.0 sphingomyelin, measured one-week later, accurately predicted the duration of IMV (Pearson correlation=0.94). Both predictive models outperformed APACHE II scores and differentiated COVID-19 severity in published data. Conclusion: This study has identified specific metabolites that can predict in advance LOS and IMV, which could help in the management of COVID-19 cases at ICU.
Impact of Dietary Intervention on Undernourished Farm Women
Authors: K Geetha , Yankanchi Geetha M , Das Lipi , Hiremath Nethravathi , Yatnatti Shilpa , Sajjan Jyothi T
Published: January 2021

Background

Women are vulnerable group for under nutrition, due to various physiological states in the life cycle. Especially in developing countries, despite the fact that women are predominantly the food producers for the nation, majority of them are anaemic, malnourished and have health problems due to insufficient nutrient intake. Hence, a study was undertaken to develop a energy dense food product from regionally available food ingredients and to test its efficacy on farm women in improving nutritional status.
Methods

A traditional food product ‘laddu’ was developed from combination of millet, cereal, legume, oil seeds, fats and sugars by application of simple processing techniques. The developed product was further subjected for nutritional evaluation and dietary intervention on farm women up to 120 days. Impact was studied on anthropometric measurements and nutrient intake of subjects.
Results

Findings indicated that, the product contained 516 kcal of energy per 100 gm. The protein, fat, total dietary fiber, iron and calcium content of the product was 9.80 g, 31.60 g, 3.90 g, 2.47 mg and 159.60 mg respectively. Majority of the subjects belonged to lower middle socio-economic group with marginal land holding. Mean body weight of rural farm women increased significantly from 40.67 ± 3.29 to 43.29 ± 4.51 kg and corresponding increase in BMI was also observed from 17.43 ± 0.49 to 18.75 ± 1.26 (kg/ m2). The initial protein, fat and energy intake in experimental group was 31.99 ± 3.01 g, 23.46 ± 4.52 g and 1288 kcal respectively which was increased significantly for all the nutrients after intervention.
Conclusion

In the present scenario, providing nutrition security through development and popularization of nutri- dense food products from regionally available food ingredients among the vulnerable sections of the society is of vital importance.
Resilience of Health Systems in Conflict Affected Governorates of Iraq, 2014-2018
Authors: Ibrahim Shaimaa , Al-Dahir Sara , Al-Mulla Taha , Lami Faris , Hossain SM Moazzem , Baqui Abdullah , Burnham Gilbert
Published: January 2021

ObjectivesThe objective of this study was to assess the resilience of health services in four governorates affected by conflict from 2014-2018, and to convey recommendations.MethodsHealth managers from Al Anbar, Ninawa, Salah-al-din, and Kirkuk governorates assessed resilience factors of Primary Health Care services affected by the 2014-2017 ISIS insurgency. Additional information was gathered from key informants and a health facility Unicef survey. Three specific aspects were examined: 1) meeting health needs in the immediate crisis response, 2) adaptation of services, 3) restructuring and recovery measures. Data from and MoH/UNICEF national health facility survey were 2017-2019 analyzed for functionality.FindingsThere were many common themes across the four governorates, with local variations.1. Absorption. The shock to the public sector health services by the invasion by ISIS caught the in the four governorates unprepared, with limited abilities to continue to provide services. Pharmacies and private clinics sometimes withstood the initial shock better. 2. Adaptation. After the initial shock, many health facilities adapted by focused on urgent needs for injury and communicable disease care. In most locations, maternal, neonatal, and child health (MNCH) preventive and promotive services stopped. Ill persons would sometimes consult health workers in their houses at night for security reasons. 3. Restructuring or transformative activities. In most areas, health services restructuring was continuing in 2020. Some heavily damaged facilities are still functioning below pre-crisis level, with reduced service availability. Rebuilding lost community trust in the public sector is proving difficult, though in some communities, trust remained strong.ConclusionHealth services generally had little preparation and limited resilience to the ISIS influx. Governorates are, in places, still restructuring services after the liberation from ISIS in 2017. Disaster planning was identified by all participants as a missing component, as managers anticipated future emergencies.
The Potential Molecular Mechanism of Autologous Adipose Tissue Grafting in Treating Keloid Patients: a Case-control Study
Authors: Zhou Jiong , Shen Ji-Yang , Tao Li-En , Chen Huan
Published: January 2021

Background: Keloids represent the dysregulation of cutaneous wound healing caused by aberrant fibroblast activities. Adipose-derived stem cells have been recognized as a promising treatment for keloids. However, their molecular mechanisms have not been fully elucidated. Methods: Skin biopsies were obtained from 10 keloid patients and 9 healthy volunteers. Fibroblasts isolated from all samples were divided into 2 groups, one co-cultured with adipose-derived stem cells, the other growing independently. Between each group, we compared the wound healing rate, fibroblasts’ survival rate, apoptosis rates, mRNA expressions and protein level of Col-1, Col-3, CTGF, P-4-HB. Results: In our research, no significant differences between normal fibroblasts and keloid fibroblasts in terms of wound-healing rate, survival rate, or apoptosis rate were found at the baseline. Adipose-derived stem cells strongly suppressed keloid fibroblasts’ proliferative and invasive behavior, but negatively regulated keloid fibroblast apoptosis. The further measurement of key components in keloid formation showed that adipose-derived stem cells upregulated Col-3 and CTGF levels in normal fibroblasts but downregulated protein expression of CTGF and P-4-HB in keloid fibroblasts. Conclusions: Adipose-derived stem cells had the potential to serve as a promising alternative for keloid treatment.
Exosomal miR-100-5p Inhibits Osteogenesis of BMSCs and Angiogenesis of VECs By Suppressing BMPR2/Smad1/5/9 Signaling Pathway
Authors: Yang Wu , Zhu Weiwen , Yang Yunfei , Guo Minkang , Qian Husun , Jiang Weiqian , Chen Yu , Lian Chengjie , Xu Zijie , Bai Haobo , Chen Tingmei , Zhang Jian
Published: January 2021

Background: Non-traumatic osteonecrosis of the femoral head (NONFH) is a common, progressive, and refractory orthopedic disease. We aimed to figure out whether exosomal miRNA from necrotic bone tissues of the non-traumatic osteonecrosis of the femoral head (NONFH) patients are involved in the pathogenesis of NONFH and reveal the underlying mechanisms.Methods: RT-PCR and western blotting were used to detect the expression of osteogenic, adipogenic and angiogenic markers. ALP staining and Alizarin red s (ARS) staining were used to evaluate osteogenic differentiation of BMSCs. Oil red staining was conducted to test the adipocyte deposition. Tube formation assay was used to study angiogenesis of vascular endothelial cells (VECs). HE staining and IHC staining were used to detect the effect of NONFH-exosomes in vivo. MicroRNA sequencing was conducted to find potential regulators in NONFH-exosomes.Results: The NONFH-exosomes can lead to NONFH-like impairment on BMSCs, HUVECs and rats. MiR-100-5p was upregulated in NONFH-exosomes and could inhibit osteogenesis of BMSCs and angiogenesis of HUVECs by targeting BMPR2.Conclusion: The NONFH-exosomal miR-100-5p can lead to NONFH-like damage by targeting BMPR2 and suppressing BMPR2/SMAD1/5/9 signaling pathway, which may be involved in the pathomechanism of non-traumatic osteonecrosis of the femoral head (NONFH).
Genetic Effects on Longitudinal Cognitive Decline During the Early Stages of Alzheimer's Disease
Authors: Kumar Atul , Shoai Maryam , Palmqvist Sebastian , Stomrud Erik , Hardy John , Mattsson-Carlgren Niklas , Hansson Oskar
Published: January 2021

Background

Cognitive decline in early-stage Alzheimer’s disease (AD) may depend on genetic variability.
Methods

In the Swedish BioFINDER study, we used polygenic scores (PGS) (for AD, intelligence and educational attainment), and genetic variants (in a genome-wide association study [GWAS]) to predict longitudinal cognitive change (measured by MMSE) over a mean of 4.2 years. We included 555 β-amyloid (Aβ) negative cognitively unimpaired (CU) individuals, 206 Aβ-positive CU (preclinical AD), 110 Aβ-negative mild cognitive impairment (MCI) patients, and 146 Aβ-positive MCI patients (prodromal AD).
Results

Polygenic scores for AD (in Aβ-positive individuals) and intelligence (independent of Aβ-status) were associated with cognitive decline. Eight genes were associated with cognitive decline in GWAS (3 independent of Aβ-status).
Conclusions

AD risk genes may influence cognitive decline in early AD, while genes related to intelligence may modulate cognitive decline irrespective of disease. Therapies targeting the implicated biological pathways may modulate the clinical course of AD.
Prevalence of high HDL-Cholesterol and its Associated Factors Among Childbearing Age Tunisian women: A Cross-Sectional Study
Authors: Cherifa Fatma Ben , Ati Jalila El , Doggui Radhouene , Hellal Fayçal , Ati-Hellal Myriam El
Published: January 2021

Background: The protective role of high HDL-C against cardiovascular risk has been questioned recently. Due to the increasing trend of CVD in Tunisia, this study aimed to determine the prevalence of high HDL-C and its associated factors in childbearing age Tunisian women. Methods: A cross-sectional survey was conducted among a subsample of 1689 women, aged 20 to 49 y in the Great Tunis region. Data on socio-demographic and lifestyle factors were collected by a questionnaire. Overall adiposity was assessed by BMI. All biological variables were assayed in blood samples coated with EDTA by enzymatic methods. Stata software (2015) was used for data management and statistical analysis. Results: High HDL-C values were recorded in 26.6% of selected women. After adjustment for all socio-demographic and lifestyle factors, age, hypertension and smoking were negatively associated with high HDL-C levels while family history of cancer was positively associated with high HDL-C in women. Conclusions: Additional investigation on the relationship between high HDL-C and cancer risk should be performed due to controversial results.
The Effectiveness of a Men-only Supportive Expressive Therapy Group Intervention for Psychosocial Health Outcomes in Gastrointestinal Cancer Patients: A 6-month longitudinal study
Authors: Oberoi Devesh , Martopullo Celestina , Bultz Barry D. , Carlson Linda Ellen
Published: January 2021

Background: An increasing number of gastrointestinal cancer (GI) patients suffer from the side effects of cancer treatment that can affect their psychosocial health outcomes such as mood states and quality of life. Despite its demonstrated usefulness in female cancer patients, the Supportive Expressive Group Therapy (SEGT) has not been tested in male cancer patients. The current study sought to examine the longitudinal effects of a professionally-led, men-only supportive-expressive group therapy (SEGT) on mood states, coping, and quality of life (QoL) in male GI cancer patients. Methods: Male GI cancer patients (n=31), at different stages of cancer treatment, were recruited from an ongoing men-only biweekly GI cancer SEGT. Data were collected at baseline (before or near the beginning of group attendance) and at three months and six months follow-up. All outcomes were patient-reported and included demographic data as well as the validated questionnaires: Profile of Mood States (POMS) for mood states, Functional Assessment of Cancer Therapy-General (FACT-G) for QoL, and Ways of Coping-cancer version (WOC) for coping. Linear mixed models were used to examine the change in the outcomes over time. Effect sizes were estimated using Cohen’s d. Results: The Anxiety (p=.04; d=0.70), Depression (p=.03; d=0.93) and Anger (p=.04; d=1.28) subscales of the POMS decreased between baseline and six months. Participants also reported improvements in coping through Distancing (distancing oneself from negative thoughts, being more accepting of the situation, and looking for positives) of the WOC (p=.04; d=0.4) between baseline and six months. There was no change in any of the FACT subscales (QoL) over time. Conclusions: This is the first study to investigate the effects of a SEGT intervention in male cancer patients. Participation in the intervention was associated with improved mood states and coping in male GI cancer patients; however, there was no change in measures of QoL.
Why secondary school geography students perform poorly in external examinations
Authors: Eze Emmanuel
Published: January 2021

The perpetual decline of students’ performance in external geography examinations necessitated this enquiry to identify causes of failure reported by examiners. This study, therefore, adopted a qualitative approach to analyze West African Examination Council (WAEC) chief examiners’ reports from 2008 to 2018 to extract vital information on why Nigerian students perform poorly in geography, using the grounded theory methodology and RQDA for data analyses. Poor map work, inadequate preparation and scanty explanation of points were identified. Ideal geography teachers ought to be multiplied in schools, with the utilization of relevant instructional resources and student-centered teaching strategies for improvements.
Initial CT blend sign is not associated with poor outcome in patients following stereotactic minimally invasive surgery
Authors: Yang Xu , Zhu Yan , Zhang Linshan , Wang Likun , Mao Yuanhong , Li Yinghui , Luo Jingbiao , Wu Guofeng
Published: January 2021

Background: The initial computed tomography (CT) blend sign has been used as an imaging marker to predict haematoma expansion and poor outcomes in patients with a small volume intracerebral haemorrhage (ICH). However, the relationship between the blend sign and outcomes remains elusive. The present study aimed to retrospectively measure the impact of initial CT blend signs on short-term outcomes in patients with hypertensive ICH who underwent stereotactic minimally invasive surgery (sMIS). Methods: We enrolled 242 patients with spontaneous ICH. Based on the initial CT features, the patients were assigned to a blend sign group (91 patients) or a nonblend sign (control) group (151 patients). The NIHSS, GCS and mRS were used to measure the effects of sMIS. The rates of severe pulmonary infection and cardiac complications were also compared between the two groups. Results: No significant differences in NIHSS and GCS scores were observed between the two groups. The proportion of patients with good outcomes during follow-up was not different between the two groups. The rate of rehaemorrhaging increased in the blend sign group. No significant differences in severe pulmonary infections and cardiac complications were noted between the two groups. Conclusions: The initial CT blend sign was not associated with poor outcomes in patients with hypertensive ICH who underwent sMIS. ICH patients with CT blend signs should undergo sMIS if they are suitable candidates for surgery.
Self-esteem, Social Support and Coping Strategies of left-behind Children in Rural China, and the Intermediary Role of Subjective Support：a cross-sectional survey
Authors: Cui Shu , Cheng Fangshuo , Zhang Ling , Zhang Chao , Yuan Qiuyu , Huang Cui , Zhang Kai , Zhou Xiaoqin
Published: January 2021

Background: Negative coping strategies and behavioral problems are common among Chinese left-behind children, which are related to a variety of negative consequences. At this stage of development, the relevant factors of coping strategies need to be further studied, in which social support and self-esteem are worthy of our attention. The aim of this study is to detected the current situation of self-esteem, social support, and coping styles of left-behind children (LBC) in rural China and the relationship between the three.Methods: 322 children from 3 schools in China participated in this study, including 236 LBC and 86 non-left-behind children (NLBC) to assess self-esteem, social support and coping strategies.Results: The LBC group had lower self-esteem score and lower total social support (subjective support, objective support and support-seeking behavior) than the NLBC group. In terms of coping strategies, the LBC group was lower than the NLBC group in problem-solving and rationalization. The self-esteem score in LBC was significant positive associated with the subjective support score, objective support score, problem-solving and help-seeking score. In addition, self-esteem has significant mediating effect between subjective support and problem-solving, subjective support and help-seeking, respectively.Conclusions: The finding indicate that Chinese LBC’s self-esteem and social support need to be improved. Given the significant correlativity between self-esteem, subjective support and coping strategy, it is necessary to promote Chinese LBC’s self-esteem and social support, especially subjective support.
The climate change mitigation effects of daily active travel in cities
Authors: Brand Christian , Dons Evi , Anaya-Boig Esther , Avila-Palencia Ione , Clark Anna , Nazelle Audrey de , Gascon Mireia , Gaupp-Berghausen Mailin , Gerike Regine , Gotschi Thomas , Iacorossi Francesco , Kahlmeier Sonja , Laeremans Michelle , Nieuwenhuijsen Mark , Mendoza Juan Orjuela , Racioppi Francesca , Raser Elisabeth , Rueda David Rojas , Standaert Arnout , Stigell Erik , Sulikova Simona , Wegener Sandra , Panis Luc Int
Published: January 2021

Active travel (walking or cycling for transport) is considered the most sustainable form of personal transport. Yet its net effects on mobility-related CO2 emissions are complex and under-researched. Here we collected travel activity data in seven European cities and derived life cycle CO2 emissions across modes and purposes. Daily mobility-related life cycle CO2 emissions were 3.2 kgCO2 per person, with car travel contributing 70% and cycling 1%. Cyclists had 84% lower life cycle CO2 emissions than non-cyclists. Life cycle CO2 emissions decreased by -14% per additional cycling trip and decreased by -62% for each avoided car trip. An average person who ‘shifted travel modes’ from car to bike decreased life cycle CO2 emissions by 3.2 kgCO2/day. Promoting active travel should be a cornerstone of strategies to meet net zero carbon targets, particularly in urban areas, while also improving public health and quality of urban life.
Favored location of a stabilizing screw for syndesmotic diastasis: Recommendation based on clinical and theoretical considerations
Authors: Wu Chi-Chuan , Yeh Wen-Ling , Lee Po-Cheng , Chou Ying-Chao , Hsu Yung-Heng , Yu Yi-Hsun
Published: January 2021

BackgroundAnkle injuries are common; however, simultaneous malleolar fractures and syndesmotic diastasis (SD) are relatively fewer. There is no consensus about the optimal technique for syndesmotic stabilization. We hypothesized that the optimal location of stabilization should be at the syndesmosis based on theoretical consideration. The aim of this study was to compare the various locations of a stabilizing screw and determinate the preferable location from clinical and theoretical viewpoints. Patients and MethodsOver a 10-year period, we retrospectively studied 63 consecutive adult patients with combined injuries. The malleolar fractures were internally stabilized with screws and plates, and stress tests were performed to re-confirm syndesmotic instability. The diastatic syndesmosis was stabilized with cortical screws under image intensifier guidance. In the present study, we enrolled patients with only one syndesmotic screw (55 patients) and divided them into the trans-syndesmotic (TR) or the supra-syndesmotic (SU) group. Clinical and functional outcomes between the two groups were compared. The favored location was determined based on the data analysis.ResultsWe followed 48 patients for at least one year (average, 1.8 years; range, 1.0-7.0 years). The TR group included 31 patients and the SU group included 17 patients. None of the clinical and functional comparisons were statistically significant (p > 0.05).ConclusionAlthough statistical comparison showed no significant differences, TR screw insertion has biomechanical and biological merits. The study’s failure to show clear advantages of TR screw insertion for clinical and functional outcomes can be attributed to the small sample size and early screw removal. Clinically, TR insertion of a screw with late removal (> 3 months) might be a better choice.Level of evidence: Therapy/Prevention, III, retrospective cohort study.
Hidden Bedside Rationing in the Netherlands: a Cross-Sectional Survey among Physicians in Internal Medicine
Authors: de Ruijter Ursula , Lingsma Hester , Bax Willem , Legemaate Johan
Published: January 2021

Background Healthcare rationing can be defined as withholding beneficial care for cost reasons. One form in particular, hidden bedside rationing, is problematic because it may result in conflicting loyalties for physicians, unfair inequality among patients and illegitimate distribution of resources. Our aim is to establish whether bedside rationing occurs in the Netherlands, whether it qualifies as hidden and what physician characteristics are associated with its practice.Methods Cross-sectional online questionnaire on knowledge of -, experience with -, and opinion on rationing among physicians in internal medicine within the Dutch healthcare system. Multivariable ordinal logistic regression was used to explore relations between hidden bedside rationing and physician characteristics.Results The survey was distributed among 1139 physicians across 11 hospitals with a response rate of 18% (n=203). Most participants (n=129; 64%) had experience prescribing a cheaper course of treatment while a more effective but more expensive alternative was available, suggesting bedside rationing. Subsequently, 32 (24%) participants never disclosed this decision to their patient, qualifying it as hidden. The majority of participants (n=153; 75%) rarely discussed treatment cost. Employment at an academic hospital was independently associated with more bedside rationing (OR=17 95%CI 6.1-48). Furthermore, residents were more likely to disclose rationing to their patients than internists (OR=3.2, 95%CI 2.1-4.7), while salaried physicians were less likely to do so than physicians in private practice (OR=0.5, 95%CI 0.4-0.8).Conclusion Hidden bedside rationing occurs in the Netherlands: patient choice is on occasion limited with costs as rationale and this is not always disclosed. To what extent distribution of healthcare should include bedside rationing in the Netherlands, or any other country, remains up for debate.
Visualization of clinical teaching citations using social network analysis
Authors: Hazrati Hakimeh , Bigdeli Shoaleh , Arabshahi Seyed Kamran Soltani , Gavgani Vahideh Zarea , Vahed Nafiseh
Published: January 2021

BackgroundAnalyzing the previous research literature in the filed of clinical teaching has potential to show the trend and future direction of this field. This study aimed to visualize the co-authorship networks and scientific map of research outputs of clinical teaching and medical education by Social Network Analysis (SNA).Methods We Identified 1229 publications on clinical teaching through a systematic search strategy in the Scopus (Elsevier), Web of Science (Clarivate Analytics) and Medline (NCBI/NLM) through PubMed from the year 1980 to 2018.The Ravar PreMap, Netdraw, UCINet and VOSviewer software were used for data visualization and analysis. ResultsBased on the findings of study the network of clinical teaching was weak in term of cohesion and the density in the co-authorship networks of authors (clustering coefficient (CC): 0.749, density: 0.0238) and collaboration of countries (CC: 0.655, density: 0.176). In regard to centrality measures; the most influential authors in the co-authorship network was Rosenbaum ME, from the USA (0.048). More, the USA, the UK, Canada, Australia and the Netherlands have central role in collaboration countries network and has the vertex co-authorship with other that participated in publishing articles in clinical teaching. Analysis of background and affiliation of authors showed that co-authorship between clinical researchers in medicine filed is weak. Nineteen subject clusters were identified in the clinical teaching research network, seven of which were related to the expected competencies of clinical teaching and three related to clinical teaching skills.Conclusions In order to improve the cohesion of the authorship network of clinical teaching, it is essential to improve research collaboration and co-authorship between new researchers and those who have better closeness or geodisk path with others, especially those with the clinical background. To reach to a dense and powerful topology in the knowledge network of this field encouraging policies to be made for international and national collaboration between clinicians and clinical teaching specialists. In addition, humanitarian and clinical reasoning need to be considered in clinical teaching as of new direction in the field from thematic aspects.
The Supportive Supervisory Scale: Psychometric Properties in Chinese Health Care Aides Samples
Authors: Tian Li , Li Haixia , Dong Bei , Xie Congyan , Wang Hong , Lin Lu
Published: January 2021

Objective: To sinicize the Supportive Supervisory Scale (SSS) and analyze the psychometric properties of the Chinese version of SSS (SSS-C).Methods: The SSS (the original English version) was firstly sinicized and adjusted, then its psychometric properties were examined in 300 health care aides from four long-term care (LTC) facilities. SPSS 22.0 was used to process the data and calculate the reliability and validity. Results The 15-item SSS-C had satisfactory internal consistency (Cronbach’s α coefficient=0.852), split half reliability (Spearman-Brown coefficient=0.834) and test-retest reliability (Pearson correlation coefficient=0.784), and three factors were extracted. If the four items with their communality <0.4 were deleted, the remaining 11 items could explain 55.654% of the total variance. The discriminant validity of the SSS-C varied significantly between sites.Conclusions The Chinese version of SSS can be used to effectively measure the supervisory support of the nurses within the LTC settings.
How Well Do Documented Goals-of-Care Discussions for Patients with Stage IV Cancer Reflect Communication Best Practices?
Authors: Ernecoff Natalie C. , Wessell Kathryn L. , Wood William A. , Winzelberg Gary S. , Collichio Frances A. , Hanson Laura C.
Published: January 2021

Background: Written clinical communication regarding patients’ disease understanding and values may facilitate goal-concordant care, yet little is known about electronic health record (EHR) goals-of-care documentation. We sought to (1) describe frequency of communication best practices in EHR-documented goals-of-care discussions, and (2) assess whether templated notes improve quality of documentation.Methods: We abstracted all EHR-documented goals-of-care discussions for hospitalized patients with Stage IV cancer from admission to 60-days follow-up. Goals-of-care documentation was operationalized to include discussion of: (a) prognosis and/or illness understanding; and (b) goals and/or treatment options. Investigators qualitatively coded text based on conceptual frameworks for communication best practices, including decision making documentation, and noted if a health system template was used. Results: Among 206 of 492 (42%) patients with documented goals-of-care discussions, clinicians frequently communicated cancer progression or incurability (89%), but rarely addressed prognosis for life expectancy (22%). Goals and values were documented for 83%, and a treatment decision for 82% of patients. Treatment preferences were assessed for 98% of patients; options discussed included cancer treatment (62%), hospice (62%), resuscitation (51%), or intensive care (38%). Clinicians made a treatment recommendation for 40% of patients. Attention to emotional and spiritual concerns was uncommon (15%). Use of a template increased documentation of patient goals and values (80% vs. 61%, p<0.01), but did not enhance other communication best practices.Conclusion: Insights from the study can be used to guide future training and research to study and improve the quality of written communication about goal of care, and its impact on goal-concordant care.
Polyparasitism with Schistosoma haematobium,Plasmodium and soil-transmitted helminths in school-aged children in Muyuka-Cameroon following implementation of control measures: a cross sectional study
Authors: Sumbele Irene Ule Ngole , Otia Ofon Vitalis , Bopda Orelien Sylvain Mtopi , Ebai Calvin Bisong , Kimbi Helen KuoKuo , Nkuo-Akenji Theresa
Published: January 2021

Background: Despite the ubiquity of polyparasitism, its health impacts have been inadequately studied. The aim of this study was to determine the prevalence and determinants of polyparasitism with Schistosoma haematobium, Plasmodium and soil-transmitted helminths (STH) following sustained control measures, as well as evaluate the outcomes and clinical correlates of infection in school-aged children (SAC) living in the schistosomiasis endemic focus of Muyuka-Cameroon.Methods: In a cross-sectional study, urine, blood and stool samples were each collected from SAC (4–14 years) selected at random between March to June 2015. Microhaematuria in urine was detected using reagent strip and S. haematobium ova by filtration/microscopy methods. Plasmodium was detected using Giemsa-stained blood films and complete blood count was obtained using an auto-haematology analyser. STH in stool was detected by the Kato-Katz method. Categorical and continuous variables were compared as required, Kappa value estimated and the adjusted odds ratio (aOR) in the multivariate analysis was used to evaluate association of the risk factors with infection.Results: Out of the 638 SAC examined, single infection was prevalent in 33.4% while polyparasitism was 19.9%. Prevalence of S. haematobium + Plasmodium was 7.8%; S. haematobium + STH was 0.8%; Plasmodium + STH was 0.8%; while S. haematobium + Plasmodium + STH was 0.9%. Higher preponderance of S. haematobium + Plasmodium infection occurred in females, those from Likoko, did not use potable water, practiced bathing in stream and carried out open defecation than their equivalents. However, being female (aOR =2.38, P = 0.009) was the only significant risk factor identified. Anaemia was a common morbidity (74.3%) with a slight agreement with microscopy in predicting S. haematobium and Plasmodium infections. The sensitivity and specificity of haematuria (13.0%) in predicting S. haematobium infection was 46.5% and 100% with a moderate agreement with microscopy. Co-infection with S. haematobium and malaria parasite was significantly associated with 3-fold odds of history of fever in the last three days.Conclusions: Polyparasitism is a public health problem in Muyuka with females most at risk. Anaemia prevalence is exacerbated in co- and triple-infections and together with a history of fever are of value in predicting polyparasitism.
Measurement and Prediction of Short-Range Path Loss between 27 and 40 GHz in University Campus Scenarios
Authors: Ramos Glaucio , Vargas Carlos , Mello Luiz , Pereira Paulo , Vieira Robson , Gonçalves Sandro , Rego Cássio
Published: January 2021

In this paper, we present the results of short-range path loss measurement in the microwave and millimetre wave bands, at frequencies between 27 and 40 GHz, obtained in a campaign inside a university campus in Rio de Janeiro, Brazil. Existing empirical path loss prediction models, including the alpha-beta-gamma (ABG) model and the close-in free space reference distance with frequency-dependent path loss exponent (CIF) model, are tested against the measured data, and an improved prediction method that includes the path loss dependence on the height diﬀerence between transmitter and receiver is proposed. The main contribution of this paper is the use of the Fuzzy technique to perform path loss predictions for short links in the millimetre wave range, from 27 to 40 GHz, providing lower errors when compared to the traditional ABG and CIF models. However, it should be noted that the Fuzzy technique uses a set of equations to perform the prediction and the attenuation coeﬃcient is not explicit as in the classical models. Also, a non-negligible correlation between the diﬀerence in height between transmitter and receiver positions and the path loss in such short links (i.e., the path inclination) has been observed and requires further investigation. If conﬁrmed, it could provide an additional parameter to improve the accuracy of the traditional ABG model.