bluuebunny/crossref_metadata_2025 huggingface dataset:
Reforming medical education admission and training in low- and middle-income countries: who gets admitted and why it matters
Authors: Tumlinson Katherine , Jaff Dilshad , Stilwell Barbara , Onyango Dickens Otieno , Leonard Kenneth L.
Published: December 2019

Recent studies reveal public-sector healthcare providers in low- and middle-income countries (LMICs) are frequently absent from work, solicit informal payments for service delivery, and engage in disrespectful or abusive treatment of patients. While extrinsic factors may foster and facilitate these negative practices, it is not often feasible to alter the external environment in low-resource settings. In contrast, healthcare professionals with strong intrinsic motivation and a desire to serve the needs of their community are less likely to engage in these negative behaviors and may draw upon internal incentives to deliver a high quality of care. Reforming medical education admission and training practices in LMICs is one promising strategy for increasing the prevalence of medical professionals with strong intrinsic motivation.
Understanding mistreatment during institutional delivery in Northeast Nigeria: a mixed-method study
Authors: Umar Nasir , Wickremasinghe Deepthi , Hill Zelee , Usman Umar Adamu , Marchant Tanya
Published: December 2019

Background

Improving quality of care including the clinical aspects and the experience of care has been advocated for improved coverage and better childbirth outcomes.

Objective

This study aimed to explore the quality of care relating to the prevalence and manifestations of mistreatment during institutional birth in Gombe State, northeast Nigeria, an area of low institutional delivery coverage.

Methods

The frequency of dimensions of mistreatment experienced by women delivering in 10 health facilities of Gombe State were quantitatively captured during exit interviews with 342 women in July–August 2017. Manifestations of mistreatment were qualitatively explored through in-depth interviews and focus groups with 63 women living in communities with high and low coverage of institutional deliveries.

Results

The quantitative data showed that at least one dimension of mistreatment was reported by 66% (95% confidence interval (CI) 45–82%) of women exiting a health facility after delivery. Mistreatment related to health system conditions and constraints were reported in 50% (95% CI 31–70%) of deliveries. In the qualitative data women expressed frustration at being urged to deliver at the health facility only to be physically or verbally mistreated, blamed for poor birth outcomes, discriminated against because of their background, left to deliver without assistance or with inadequate support, travelling long distances to the facility only to find staff unavailable, or being charged unjustified amount of money for delivery.

Conclusions

Mistreatment during institutional delivery in Gombe State is highly prevalent and predominantly relates to mistreatment arising from both health system constraints as well as health worker behaviours, limiting efforts to increase coverage of institutional delivery. To address mistreatment during institutional births, strategies that emphasise a broader health systems approach, tackle multiple causes, integrate a detailed understanding of the local context and have buy-in from grassroots-level stakeholders are recommended.
MLC parameters from static fields to VMAT plans: an evaluation in a RT-dedicated MC environment (PRIMO)
Authors: Paganini Lucia , Reggiori Giacomo , Stravato Antonella , Palumbo Valentina , Mancosu Pietro , Lobefalo Francesca , Gaudino Anna , Fogliata Antonella , Scorsetti Marta , Tomatis Stefano
Published: December 2019

Background

PRIMO is a graphical environment based on PENELOPE Monte Carlo (MC) simulation of radiotherapy beams able to compute dose distribution in patients, from plans with different techniques. The dosimetric characteristics of an HD-120 MLC (Varian), simulated using PRIMO, were here compared with measurements, and also with Acuros calculations (in the Eclipse treatment planning system, Varian).

Materials and methods

A 10 MV FFF beam from a Varian EDGE linac equipped with the HD-120 MLC was used for this work. Initially, the linac head was simulated inside PRIMO, and validated against measurements in a water phantom. Then, a series of different MLC patterns were established to assess the MLC dosimetric characteristics. Those tests included: i) static fields: output factors from MLC shaped fields (2 × 2 to 10 × 10 cm2), alternate open and closed leaf pattern, MLC transmitted dose; ii) dynamic fields: dosimetric leaf gap (DLG) evaluated with sweeping gaps, tongue and groove (TG) effect assessed with profiles across alternate open and closed leaves moving across the field. The doses in the different tests were simulated in PRIMO and then compared with EBT3 film measurements in solid water phantom, as well as with Acuros calculations. Finally, MC in PRIMO and Acuros were compared in some clinical cases, summarizing the clinical complexity in view of a possible use of PRIMO as an independent dose calculation check.

Results

Static output factor MLC tests showed an agreement between MC calculated and measured OF of 0.5%. The dynamic tests presented DLG values of 0.033 ± 0.003 cm and 0.032 ± 0.006 cm for MC and measurements, respectively. Regarding the TG tests, a general agreement between the dose distributions of 1–2% was achieved, except for the extreme patterns (very small gaps/field sizes and high TG effect) were the agreement was about 4–5%. The analysis of the clinical cases, the Gamma agreement between MC in PRIMO and Acuros dose calculation in Eclipse was of 99.5 ± 0.2% for 3%/2 mm criteria of dose difference/distance to agreement.

Conclusions

MC simulations in the PRIMO environment were in agreement with measurements for the HD-120 MLC in a 10 MV FFF beam from a Varian EDGE linac. This result allowed to consistently compare clinical cases, showing the possible use of PRIMO as an independent dose calculation check tool.
Right atrial and SVC infiltrating mass-the entity of infiltrating lipoma
Authors: Shah Owais A. , Badran Abdul , Kaarne Markku , Velissaris Theodore
Published: December 2019

Background

Cardiac lipomas are rare benign primary cardiac tumours primarily composed of mature adipocytes. They are usually well defined, encapsulated masses, but rarely demonstrate malignant characteristics by infiltrating the myocardium. This causes diagnostic uncertainty as it becomes a priority to rule out primary malignant cardiac tumours such as sarcoma which often carry a poor prognosis.

Case Report

A 61 year old female presenting with chest pain was found to have an infiltrating right atrial hypertrophic mass. Mutli-disciplinary team (MDT) discussions along with the presence of symptoms and likelihood of malignancy led to the recommendations for surgery.

Intraoperatively this involved the right pulmonary veins and superior vena cava (SVC). The mass was resected with good margins and reconstruction of the right atrium, pulmonary veins and SVC was done using porcine pericardial patch. The patient made a good postoperative recovery and was discharged home in sinus rhythm with no significant valvular lesions. This was further confirmed at 6 month follow up. Final histology was that of infiltrating lipoma.

Conclusions

In this rare case of infiltrating cardiac lipoma in a relatively young patient, the diagnostic uncertainty despite multimodal imaging meant surgery was indicated due to the high suspicion of cancer. Even in benign cases, fatty infiltration can lead to conduction defects and embolisation. Technical difficulties in sectioning these specimens is caused by intra-tumour variability and current recommendations are for excision biopsy, for best characterisation.

The management of these patients requires an MDT with Cardiac surgery being a safe approach providing definitive management.
Epidemiological study and genetic characterization of inherited muscle diseases in a northern Spanish region
Authors: Pagola-Lorz Inmaculada , Vicente Esther , Ibáñez Berta , Torné Laura , Elizalde-Beiras Itsaso , Garcia-Solaesa Virginia , García Fermín , Delfrade Josu , Jericó Ivonne
Published: December 2019

Background

Inherited muscle diseases are a group of rare heterogeneous muscle conditions with great impact on quality of life, for which variable prevalence has previously been reported, probably due to case selection bias. The aim of this study is to estimate the overall and selective prevalence rates of inherited muscle diseases in a northern Spanish region and to describe their demographic and genetic features. Retrospective identification of patients with inherited muscle diseases between 2000 and 2015 from multiple data sources. Demographic and molecular data were registered.

Results

On January 1, 2016, the overall prevalence of inherited muscle diseases was 59.00/ 100,000 inhabitants (CI 95%; 53.35–65.26). Prevalence was significantly greater in men (67.33/100,000) in comparison to women (50.80/100,000) (p = 0.006). The highest value was seen in the age range between 45 and 54 (91.32/100,000) years. Myotonic dystrophy type 1 was the most common condition (35.90/100,000), followed by facioscapulohumeral muscular dystrophy (5.15/100,000) and limb-girdle muscular dystrophy type 2A (2.5/100,000).

Conclusions

Prevalence of inherited muscle diseases in Navarre is high in comparison with the data reported for other geographical regions. Standard procedures and analyses of multiple data sources are needed for epidemiological studies of this heterogeneous group of diseases.
Different forms of informal coercion in psychiatry: a qualitative study
Authors: Pelto-Piri Veikko , Kjellin Lars , Hylén Ulrika , Valenti Emanuele , Priebe Stefan
Published: December 2019

Objectives

The objective of the study was to investigate how mental health professionals describe and reflect upon different forms of informal coercion.

Results

In a deductive qualitative content analysis of focus group interviews, several examples of persuasion, interpersonal leverage, inducements, and threats were found. Persuasion was sometimes described as being more like a negotiation. Some participants worried about that the use of interpersonal leverage and inducements risked to pass into blackmail in some situations. In a following inductive analysis, three more categories of informal coercion was found: cheating, using a disciplinary style and referring to rules and routines. Participants also described situations of coercion from other stakeholders: relatives and other authorities than psychiatry. The results indicate that informal coercion includes forms that are not obviously arranged in a hierarchy, and that its use is complex with a variety of pathways between different forms before treatment is accepted by the patient or compulsion is imposed.
Changes in DNA methylation from pre- to post-adolescence are associated with pubertal exposures
Authors: Han Luhang , Zhang Hongmei , Kaushal Akhilesh , Rezwan Faisal I. , Kadalayil Latha , Karmaus Wilfried , Henderson A. John , Relton Caroline L. , Ring Susan , Arshad S. Hasan , Ewart Susan L. , Holloway John W.
Published: December 2019

Background

Adolescence is a period characterized by major biological development, which may be associated with changes in DNA methylation (DNA-M). However, it is unknown to what extent DNA-M varies from pre- to post-adolescence, whether the pattern of changes is different between females and males, and how adolescence-related factors are associated with changes in DNA-M.

Methods

Genome-scale DNA-M at ages 10 and 18 years in whole blood of 325 subjects (n= 140 females) in the Isle of Wight (IOW) birth cohort was analyzed using Illumina Infinium arrays (450K and EPIC). Linear mixed models were used to examine DNA-M changes between pre- and post-adolescence and whether the changes were gender-specific. Adolescence-related factors and environmental exposure factors were assessed on their association with DNA-M changes. Replication of findings was attempted in the comparable Avon Longitudinal Study of Parents and Children (ALSPAC) cohort.

Results

In the IOW cohort, after controlling for technical variation and cell compositions at both pre- and post-adolescence, 15,532 cytosine–phosphate–guanine (CpG) sites (of 400,825 CpGs, 3.88%) showed statistically significant DNA-M changes from pre-adolescence to post-adolescence invariant to gender (false discovery rate (FDR) = 0.05). Of these 15,532 CpGs, 10,212 CpGs (66%) were replicated in the ALSPAC cohort. Pathway analysis using Ingenuity Pathway Analysis (IPA) identified significant biological pathways related to growth and development of the reproductive system, emphasizing the importance of this period of transition on epigenetic state of genes. In addition, in IOW, we identified 1179 CpGs with gender-specific DNA-M changes. In the IOW cohort, body mass index (BMI) at age 10 years, age of growth spurt, nonsteroidal drugs use, and current smoking status showed statistically significant associations with DNA-M changes at 15 CpGs on 14 genes such as theAHRRgene. For BMI at age 10 years, the association was gender-specific. Findings on current smoking status were replicated in the ALSPAC cohort.

Conclusion

Adolescent transition is associated with changes in DNA-M at more than 15K CpGs. Identified pathways emphasize the importance of this period of transition on epigenetic state of genes relevant to cell growth and immune system development.
Complications of hepatic echinococcosis: multimodality imaging approach
Authors: Greco Silvia , Cannella Roberto , Giambelluca Dario , Pecoraro Giusy , Battaglia Emanuele , Midiri Massimo , Brancatelli Giuseppe , Vernuccio Federica
Published: December 2019

Hydatid disease is a worldwide zoonosis endemic in many countries. Liver echinococcosis accounts for 60–75% of cases and may be responsible for a wide spectrum of complications in about one third of patients. Some of these complications are potentially life-threatening and require prompt diagnosis and urgent intervention. In this article, we present our experience with common and uncommon complications of hepatic hydatid cysts which include rupture, bacterial superinfection, and mass effect-related complications. Specifically, the aim of this review is to provide key imaging features and diagnostic clues to guide the imaging diagnosis using a multimodality imaging approach, including ultrasound (US), computed tomography (CT), magnetic resonance (MR), and endoscopic retrograde cholangiopancreatography (ERCP).
Signaling pathways involved in colorectal cancer progression
Authors: Koveitypour Zahra , Panahi Farnoush , Vakilian Mehrdad , Peymani Maryam , Seyed Forootan Farzad , Nasr Esfahani Mohammad Hossein , Ghaedi Kamran
Published: December 2019

Colorectal cancer (CRC) is the fourth leading cause of the worldwide cancer mortality. Different molecular mechanisms have been attributed to the development and progress of CRC. In this review, we will focus on the mitogen-activated protein kinase (MAPK) cascades downstream of the epidermal growth factor receptor (EGFR), Notch, PI3K/AKT pathway, transforming growth factor-β (TGF-β), and Wnt signaling pathways. Various mutations in the components of these signaling pathways have been linked to the development of CRC. Accordingly, numerous efforts have been carried out to target the signaling pathways to develop novel therapeutic approaches. Herein, we review the signaling pathways involved in the incidence and progression of CRC, and the strategies for the therapy targeting components of signaling pathways in CRC.
Data compression in ViSAR sensor networks using non-linear adaptive weighting
Authors: Khosravi Mohammad R. , Samadi Sadegh
Published: December 2019

Nowadays, industrial video synthetic aperture radars (ViSARs) are widely used for aerial remote sensing and surveillance systems in smart cities. A main challenge of a group of networked ViSAR sensors in an IoT-based environment is low bandwidth of wireless links for communicating big video data. In this research, we propose a non-linear statistical estimator for adaptive reconstruction of compressed ViSAR data. Our proposed reconstruction filter is based on an adaptively generated non-linear weight mask of spatial observations. It can strongly outperform several conventional and well-known reconstruction filters for three different video samples.
Weight loss interventions for Hispanic women in the USA: a protocol for a systematic review
Authors: Morrill Kristin E. , Lopez-Pentecost Melissa , Ballesteros Guadalupe , Pfander Jeanne L. , Hingle Melanie D. , Klimentidis Yann C. , Thomson Cynthia A. , Garcia David O.
Published: December 2019

Background

In the U.S., Hispanic women experience a disproportionate rate of obesity and obesity-related chronic diseases. At the same time, Hispanic women remain considerably underrepresented in behavioral weight loss interventions. The purpose of this review is to systematically evaluate the evidence related to the effectiveness of weight loss interventions among Hispanic women in the U.S. This review will identify elements of successful weight loss interventions as well as areas for future research.

Methods/Design

The following databases will be searched to identify all relevant articles (from inception onwards): PubMed, Embase, Scopus, Web of Science (Science Citation Index and Social Sciences Citation Index), PsycINFO, CINAHL, Chicano Database, SPORTDiscus, CAB Abstracts, and Google Scholar. We will include randomized controlled trials and quasi-experimental studies of adult women (> 18 years) from Hispanic/Latino background living in the United States. Eligible interventions will target weight-related behaviors (including diet, physical activity, behavior modification and/or their combinations). The review’s primary outcome will be weight change (expressed as change in lbs/kg or body mass index (BMI) (kg/m2)). Three reviewers will independently screen and select data and two will extract data. The methodological quality (or risk of bias) of individual studies will be appraised using the Effective Public Health Practice Project Quality Assessment Tool. A narrative synthesis will describe quality and content of the evidence.

Discussion

The aim of this systematic review is to critically examine existing weight loss interventions for Hispanic women in the U.S. and provide quality evidence for the effectiveness of these interventions on weight loss. Further, this review seeks to identify characteristics of effective interventions and suggest future directions for research efforts targeting weight loss in this population. This review will inform the development of future weight loss interventions for this population.

Systematic review registration

PROSPERO CRD42019119094
Quality of life and well-being from the perspective of patients on opioid agonist maintenance treatment: study protocol for a systematic review of qualitative research and a scoping review of measures
Authors: Solà Ivan , Trujols Joan , Ribalta Elisa , Alcaraz Saul , Robleda Gemma , Selva Olid Clara , Pérez de los Cobos José
Published: December 2019

Background

Opioid agonist maintenance treatment (OAMT) is a first-line treatment for heroin dependence, but its effectiveness has been assessed primarily through clinical outcomes with a limited attention to patient perspectives. Despite the increased use of patient reported outcome measures their patient-centeredness is highly questionable. This is the protocol of a systematic review of qualitative research on how OAMT users construct the meaning of their quality of life and well-being and a scoping review of instruments that measure these domains.

Methods

We will conduct a systematic review of qualitative research exploring the views of quality of life of patients on OAMT (registration number CRD42018086490). According pre-specified eligibility criteria, we will include studies from a comprehensive search of bibliographical databases from their inception. We will extract data from included studies and assess their risk of bias with the CASP appraisal criteria, and will implement a thematic analysis to generate a set of interpretative analytical themes ascertaining their confidence using the CERQual approach. We will implement similar methods to conduct a scoping review to assess to what extent the existing measures of these domains were focused on user’s views, assessing their validity using the COSMIN methodology, and summarizing their characteristics and level of patient centeredness.

Conclusion

The findings from the reviews will contribute to obtain a genuine understanding of the perspective from users on OAMT regarding their perception of well-being and quality of life and will likely lead to greater patient centeredness when assessing such variables, which in turn may contribute to a more patient-centered care.
A best proximity point theorem for special generalized proximal β-quasi contractive mappings
Authors: Ayari M. Iadh , Jaradat M. M. M. , Mustafa Z.
Published: December 2019

In this paper, we obtain some best proximity point results for a new class of non-self mappings $T:A \longrightarrow B$T:A⟶B called special generalized proximal β-quasi contractive. Our result is illustrated by an example. Several consequences are derived.
Clinicopathologic characterization and abnormal autophagy of CSF1R-related leukoencephalopathy
Authors: Tian Wo-Tu , Zhan Fei-Xia , Liu Qing , Luan Xing-Hua , Zhang Chao , Shang Liang , Zhang Ben-Yan , Pan Si-Jian , Miao Fei , Hu Jiong , Zhong Ping , Liu Shi-Hua , Zhu Ze-Yu , Zhou Hai-Yan , Sun Suya , Liu Xiao-Li , Huang Xiao-Jun , Jiang Jing-Wen , Ma Jian-Fang , Wang Ying , Chen Shu-Fen , Tang Hui-Dong , Chen Sheng-Di , Cao Li
Published: December 2019

Background

CSF1R-related leukoencephalopathy, also known as hereditary diffuse leukoencephalopathy with spheroids (HDLS), is a rare white-matter encephalopathy characterized by motor and neuropsychiatric symptoms due to colony-stimulating factor 1 receptor (CSF1R) gene mutation. Few of CSF1R mutations have been functionally testified and the pathogenesis remains unknown.

Methods

In order to investigate clinical and pathological characteristics of patients with CSF1R-related leukoencephalopathy and explore the potential impact of CSF1R mutations, we analyzed clinical manifestations of 15 patients from 10 unrelated families and performed brain biopsy in 2 cases. Next generation sequencing was conducted for 10 probands to confirm the diagnosis. Sanger sequencing, segregation analysis and phenotypic reevaluation were utilized to substantiate findings. Functional examination of identified mutations was further explored.

Results

Clinical and neuroimaging characteristics were summarized. The average age at onset was 35.9 ± 6.4 years (range 24–46 years old). Younger age of onset was observed in female than male (34.2 vs. 39.2 years). The most common initial symptoms were speech dysfunction, cognitive decline and parkinsonian symptoms. One patient also had marked peripheral neuropathy. Brain biopsy of two cases showed typical pathological changes, including myelin loss, axonal spheroids, phosphorylated neurofilament and activated macrophages. Electron microscopy disclosed increased mitochondrial vacuolation and disorganized neurofilaments in ballooned axons. A total of 7 pathogenic variants (4 novel, 3 documented) were identified with autophosphorylation deficiency, among which c.2342C > T remained partial function of autophosphorylation. Western blotting disclosed the significantly lower level of c.2026C > T (p.R676*) than wild type. The level of microtubule associated protein 1 light chain 3-II (LC3-II), a classical marker of autophagy, was significantly lower in mutants expressed cells than wild type group by western blotting and immunofluorescence staining.

Conclusions

Our findings support the loss-of-function and haploinsufficiency hypothesis in pathogenesis. Autophagy abnormality may play a role in the disease. Repairing or promoting the phosphorylation level of mutant CSF1R may shed light on therapeutic targets in the future. However, whether peripheral polyneuropathy potentially belongs to CSF1R-related spectrum deserves further study with longer follow-up and more patients enrolled.

Trial registration

ChiCTR, ChiCTR1800015295. Registered 21 March 2018.
Effects of dietary menthol-rich bioactive lipid compounds on zootechnical traits, blood variables and gastrointestinal function in growing sheep
Authors: Patra Amlan K. , Geiger Sebastian , Schrapers Katharina T. , Braun Hannah-Sophie , Gehlen Heidrun , Starke Alexander , Pieper Robert , Cieslak Adam , Szumacher-Strabel Malgorzata , Aschenbach Jörg R.
Published: December 2019

Background

The present study aimed at investigating the influence of 90% menthol-containing plant bioactive lipid compounds (PBLC, essential oils) on growth performance, blood haematological and biochemical profile, and nutrient absorption in sheep. Twenty-four growing Suffolk sheep were allotted into three dietary treatments: Control (without PBLC), lower dose of PBLC (PBLC-L; 80 mg/d) and higher dose of PBLC (PBLC-H; 160 mg/d). Sheep in all groups were fed meadow hay ad libitum plus 600 g/d of concentrate pellets for 28 d.

Results

Average daily gain was not affected by treatment. Feeding of PBLC increased hay and total feed intake per kg body weight (P < 0.05). Counts of total leucocytes, lymphocytes and monocytes were not different among treatments. However, neutrophil count decreased (P < 0.05) in PBLC-H with a similar trend in PBLC-L (P < 0.10). Concentrations of glucose, bilirubin, triglycerides, cholesterol, urea and magnesium in serum were not different among sheep fed different doses of PBLC. However, serum calcium concentration tended to increase in PBLC-H (P < 0.10) and serum concentrations of aspartate & asparagine (P < 0.01) and glutamate & glutamine (P < 0.05) increased linearly with increasing PBLC dose. In ruminal epithelia isolated from the rumen after killing, baseline conductance (Gt; P < 0.05) and short-circuit current (Isc; P < 0.01) increased in both PBLC groups. Ruminal uptakes of glucose and methionine in the presence of Na+ were not affected by the dietary PBLC supplementation. In the absence of Na+, however, glucose and methionine uptakes increased (P < 0.05) in PBLC-H. In the jejunum, Isc tended to increase in PBLC-H (P < 0.10), but baseline Gt was not affected. Intestinal uptakes of glucose and methionine were not influenced by PBLC in the presence or absence of Na+.

Conclusion

The results suggest that menthol-rich PBLC increase feed intake, and passive ion and nutrient transport, the latter specifically in the rumen. They also increased serum concentrations of urea precursor amino acids and tended to increase serum calcium concentrations. Future studies will have to show whether some of these findings might be commonly linked to a stimulation of transient receptor potential (TRP) channels in the gastrointestinal tract.
Identity, stigma, and HIV risk among transgender women: a qualitative study in Jiangsu Province, China
Authors: Yan Zi-Han , Lin Jessica , Xiao Wen-Jing , Lin Keh-Ming , McFarland Willi , Yan Hong-Jing , Wilson Erin
Published: December 2019

Background

Transgender women have multiple disparities globally, including social rejection and stigma, HIV infection and untreated mental health problems. However, few data on transgender women are available in China. Therefore, this study aimed to explore transgender women’s experiences on gender identity, disclosure, discrimination, transgender-specific medical care, and perceptions of HIV and sexually transmitted infections (STI) risk in China.

Methods

A qualitative study was conducted in Nanjing and Suzhou city, China in 2018. Key informant interviews (n = 14) and focus group discussions (n = 2) with diverse transgender women were implemented. Text was transcribed and translated, and Dedoose™ software was used for coding, analysis and interpretation by the research team.

Results

Chinese transgender women share experiences with transgender women worldwide, including a long and challenging identity search, stigma and discrimination, poor access to trans-specific services and unmet needs for mental health care. Features unique to them include terms used for self-identification, culturally-shaped expectations for reproduction, and ideals of placing the familial and societal welfare over personal fulfillment. Social networks of this population appear sparse, scattered, and underground. Familial rejection was experienced by nearly all respondents. Perceptions of HIV and STI risk and history of HIV testing were notably low.

Conclusions

Transgender women in China face high social rejection and discrimination along with unmet need for various types of healthcare. Scaling up transgender-specific services including gender-affirming medical care, mental health care and HIV/STI prevention are warranted to address the social, medical and mental health of transgender women in China.
The role of need satisfaction for solo self-employed individuals’ vs. employer entrepreneurs’ affective commitment towards their own businesses
Authors: Schummer Steffen E. , Otto Kathleen , Hünefeld Lena , Kottwitz Maria U.
Published: December 2019

Persistence in self-employment is crucial for entrepreneurial activities to generate long-term economic benefits. Consequently, this research examined the commitment of the self-employed towards their business as an important determinant of persistence. However, this research treats the self-employed as one entity. Yet we assume that especially for the research on commitment the differentiation of the self-employed into solo self-employed individuals (self-employed individuals without employees) and employer entrepreneurs (self-employed individuals with employees) provides seminal insights. Thus, this study examined differences in affective commitment to (emotional attachment to and identification with) one’s business and its antecedents between these self-employment forms. We used data of German solo self-employed individuals (n = 117) and employer entrepreneurs (n = 103) from the European Working Condition Survey (EWCS 2010). A simple t test revealed that the solo self-employed individuals report lower levels of affective commitment to their business than employer entrepreneurs. Moreover, regression analyses revealed that satisfaction of the needs for autonomy and competence was more strongly related to affective commitment for the solo self-employed than that for employer entrepreneurs, whereas satisfaction of the need for relatedness was more weakly related among the solo self-employed than that the employer entrepreneurs. These results suggest that solo self-employed individuals and employer entrepreneurs not only differ in affective commitment to their businesses but also in their antecedents. Implications for research on motivational processes of the self-employed and for fostering persistence in self-employment are discussed.
Social capital and entrepreneurial intention: empirical evidence from rural community of Pakistan
Authors: Ali Amjad , Yousuf Sania
Published: December 2019

Understanding the antecedents of the entrepreneurial intentions is vital in development of entrepreneurship in a region. Entrepreneurship is considered as one of the important elements of local economic development which can be used to address the issues of poverty and scarcity of livelihood opportunities in rural areas of the world. This study investigates the influence of social capital on entrepreneurial intentions in rural area of Pakistan. For this purpose, a representative sample of 325 respondents has been selected from rural community in Gilgit-Baltistan. The constructed model has been estimated using the partial least square method and the results show that social capital has significant positive impact on entrepreneurial intentions by forming perceived desirability, perceived self-efficacy, and perceived social norms towards entrepreneurship. This study recommends rural community of Pakistan should be given awareness about the potential of entrepreneurship opportunities and such awareness programs have unique advantages to various segments of rural community. Women, unemployed individuals, and younger generations in particular may get the maximum benefits as people in mountainous regions have already limited earning options. In such a case, developing entrepreneurial intentions of the mountain community in Gilgit-Baltistan leads to understandings of benefits of initiating their own ventures, get economic advantages, and contribute to households’ income.
Effects of different nose types on class II treatments for female patients
Authors: Cankaya Ozkan Semih , Celebi Fatih , Bicakci Ali Altug
Published: December 2019

Background

The aim of this study was to evaluate the effect of different nose types on the perception of facial aesthetics following camouflage treatment and orthognathic surgery for skeletal class II female patients.

Methods

A pre-treatment profile photograph of a skeletal class II adult patient was selected from the department archive. Two constructed photographs were created to represent orthognathic surgery and camouflage treatments with the aid of computer software. A total of 18 constructed images was composed using three profiles (pre-treatment, post-camouflage, and post-orthognathic surgery) and six nose types. These photographs were shown to the three groups (orthodontists, plastic surgeons, and lay people), and they were asked to assign an attractiveness score to each photo ranging from 0 to 100, with 0 indicating the least attractive and 100 indicating the most attractive.

Results

For the convex nose profiles, anterior movement of the mandible obtained by orthognathic surgery did not result in a significant change in the scores given by the lay people. When surgical or camouflage treatment was not implemented and, instead, just rhinoplasty was performed for these profiles, there was a significant increase in the aesthetic scores given by all groups. For the straight nose profiles, orthognathic surgery increased the attractiveness scores given by all groups. Furthermore, for all the profiles, extraction treatment did not affect the aesthetic scores given by any of the groups (P > 0.05).

Conclusions

The lay people perceived that having a convex-bridged nose was a bigger problem than having a retrognathic profile. Overall, in terms of skeletal and dental orthodontic treatments, nose shape should be considered during the treatment planning process.
Severely imbalanced Big Data challenges: investigating data sampling approaches
Authors: Hasanin Tawfiq , Khoshgoftaar Taghi M. , Leevy Joffrey L. , Bauder Richard A.
Published: December 2019

Severe class imbalance between majority and minority classes in Big Data can bias the predictive performance of Machine Learning algorithms toward the majority (negative) class. Where the minority (positive) class holds greater value than the majority (negative) class and the occurrence of false negatives incurs a greater penalty than false positives, the bias may lead to adverse consequences. Our paper incorporates two case studies, each utilizing three learners, six sampling approaches, two performance metrics, and five sampled distribution ratios, to uniquely investigate the effect of severe class imbalance on Big Data analytics. The learners (Gradient-Boosted Trees, Logistic Regression, Random Forest) were implemented within the Apache Spark framework. The first case study is based on a Medicare fraud detection dataset. The second case study, unlike the first, includes training data from one source (SlowlorisBig Dataset) and test data from a separate source (POST dataset). Results from the Medicare case study are not conclusive regarding the best sampling approach using Area Under the Receiver Operating Characteristic Curve and Geometric Mean performance metrics. However, it should be noted that the Random Undersampling approach performs adequately in the first case study. For the SlowlorisBig case study, Random Undersampling convincingly outperforms the other five sampling approaches (Random Oversampling, Synthetic Minority Over-sampling TEchnique, SMOTE-borderline1 , SMOTE-borderline2 , ADAptive SYNthetic) when measuring performance with Area Under the Receiver Operating Characteristic Curve and Geometric Mean metrics. Based on its classification performance in both case studies, Random Undersampling is the best choice as it results in models with a significantly smaller number of samples, thus reducing computational burden and training time.
Microbial quality of poultry meat in an ISO 22000:2005 certified poultry processing plant of Kathmandu valley
Authors: Maharjan Samita , Rayamajhee Binod , Chhetri Vijay Singh , Sherchan Samendra P. , Panta Om Prakash , Karki Tika Bahadur
Published: December 2019

Poultry meat can be contaminated by different types of microorganisms during processing in processing plant. The microbiological quality of chicken carcasses and along with processing steps and environmental condition was analyzed in this study in an ISO 22000:2005 certified poultry processing plant of Kathmandu. Standard plate count method was applied for the enumeration and detection of total mesophilic bacteria, total coliform, total faecal coliform, Staphylococcus load along with selected pathogens like Salmonella spp., S. aureus, Escherichia coli, Clostridium perfringens, and Listeria spp. in chicken meat at four processing step (evisceration, final washing, frozen and market). It was observed that the level of microbial load decreased with subsequent processing phases in poultry processing plant where high level of bacteria were reduced during final washing and frozen phase. After processing poultry meat in an ISO 22000:2005 certified meat processing plant, total aerobic mesophilic count, total coliform count, total faecal coliform count, total Staphylococcus count were decreased from 6.92 to 4.45 log CFU/g, 3.49 to 2.19 log CFU/g, 2.41 to nil log CFU/g, and 3..43 to 1.99 log CFU/g respectively. Pathogenic bacteria like Salmonella spp., C. perfringens, and Listeria spp. were absent in chicken meat at the fourth processing step. Prevalence of E. coli was reduced from 37.4% to 10.2%, whereas S. aureus was decreased from 18.57% to 17.1%. It was concluded that the final washing and freezing steps were the Critical Control Point (CCP) to control microbial hazards in poultry processing phase.
Change in diaphragm and intercostal muscle thickness in mechanically ventilated patients: a prospective observational ultrasonography study
Authors: Nakanishi Nobuto , Oto Jun , Ueno Yoshitoyo , Nakataki Emiko , Itagaki Taiga , Nishimura Masaji
Published: December 2019

Background

Diaphragm atrophy is observed in mechanically ventilated patients. However, the atrophy is not investigated in other respiratory muscles. Therefore, we conducted a two-center prospective observational study to evaluate changes in diaphragm and intercostal muscle thickness in mechanically ventilated patients.

Methods

Consecutive adult patients who were expected to be mechanically ventilated longer than 48 h in the ICU were enrolled. Diaphragm and intercostal muscle thickness were measured on days 1, 3, 5, and 7 with ultrasonography. The primary outcome was the direction of change in muscle thickness, and the secondary outcomes were the relationship of changes in muscle thickness with patient characteristics.

Results

Eighty patients (54 males and 26 females; mean age, 68 ± 14 years) were enrolled. Diaphragm muscle thickness decreased, increased, and remained unchanged in 50 (63%), 15 (19%), and 15 (19%) patients, respectively. Intercostal muscle thickness decreased, increased, and remained unchanged in 48 (60%), 15 (19%), and 17 (21%) patients, respectively. Decreased diaphragm or intercostal muscle thickness was associated with prolonged mechanical ventilation (median difference (MD), 3 days; 95% CI (confidence interval), 1–7 and MD, 3 days; 95% CI, 1–7, respectively) and length of ICU stay (MD, 3 days; 95% CI, 1–7 and MD, 3 days; 95% CI, 1–7, respectively) compared with the unchanged group. After adjusting for sex, age, and APACHE II score, they were still associated with prolonged mechanical ventilation (hazard ratio (HR), 4.19; 95% CI, 2.14–7.93 and HR, 2.87; 95% CI, 1.53–5.21, respectively) and length of ICU stay (HR, 3.44; 95% CI, 1.77–6.45 and HR, 2.58; 95% CI, 1.39–4.63, respectively) compared with the unchanged group.

Conclusions

Decreased diaphragm and intercostal muscle thickness were frequently seen in patients under mechanical ventilation. They were associated with prolonged mechanical ventilation and length of ICU stay.

Trial registration

UMIN000031316. Registered on 15 February 2018
An exploratory study of CT-guided percutaneous radiofrequency ablation for stage I thymoma
Authors: Dong Jun , Yuan Shaofei , Chang Boyang , Huang Jinsheng , Geng Xiaojing , Cai Xiuyu , Hu Pili , Zhang Bei , Xia Liangping , Wu Peihong
Published: December 2019

Background

Thymoma is a rare tumor that originates from thymic epithelial cells and is usually associated with myasthenia gravis. Radiofrequency ablation (RFA) is a minimally invasive and curative treatment for other tumors, but RFA has not been used for the early treatment of thymoma.

Methods

The current study included 13 patients with stage I thymoma who were not candidates for surgical resection or video-assisted thoracoscopic surgery (VATS). All patients underwent first-line CT-guided percutaneous RFA. The feasibility and therapeutic effects of the intervention were thoroughly documented.

Results

All tumors were completely ablated (13 / 13, 100%). During follow-up (median 80.5 months, range, 64.6–116.9 months), only 1 of the 13 patients had recurrence of thymoma (1 / 13, 7.7%) at 35.5 months after the initial ablation. There were no surgery-related deaths after RFA treatment. The most common complications were fever (13 / 13, 100%) and pain (13 / 13, 100%). There was only one patient who occurred severe puncture-related bleeding during the procedure that needed blood transfusion and intravascular embolization of the punctured-injured vessel.

Conclusion

CT-guided percutaneous RFA for treatment of stage I thymoma is associated with minor trauma, few complications and good treatment outcomes.
Characterization, dietary habits and nutritional intake of omnivorous, lacto-ovo vegetarian and vegan runners – a pilot study
Authors: Nebl Josefine , Schuchardt Jan Philipp , Wasserfurth Paulina , Haufe Sven , Eigendorf Julian , Tegtbur Uwe , Hahn Andreas
Published: December 2019

Background

The number of people preferring plant-based nutrition is growing continuously in the western world. Vegetarianism and veganism are also becoming increasingly popular among individuals participating in sport. However, whether recreationally active vegetarian and vegan populations can meet their nutritional needs is not clear.

Methods

The purpose of this cross-sectional study was to compare the nutrient intake of omnivorous (OMN, n = 27), lacto-ovo vegetarian (LOV, n = 25) and vegan (VEG, n = 27) recreational runners (two to five training sessions per week) with intake recommendations of the German, Austrian and Swiss Nutrition Societies (Deutsche, Österreichische und Schweizerische Gesellschaften für Ernährung, D-A-CH) for the general population. Lifestyle factors and supplement intake were examined via questionnaires; dietary habits and nutrient intake were determined based on 3-day dietary records.

Results

More than half of each group did not reach the recommended energy intake (OMN: 10.4, 8.70–12.1; LOV: 9.67, 8.55–10.8; VEG: 10.2, 9.12–11.3 MJ). Carbohydrate intake was slightly below the recommendations of > 50 EN% in OMN (46.7, 43.6–49.8 EN%), while LOV (49.4, 45.5–53.3 EN%) and VEG (55.2, 51.4–59.0 EN%) consumed adequate amounts (p = 0.003). The recommended protein intake of 0.8 g/kg body weight (D-A-CH) was exceeded in all three groups (OMN: 1.50, 1.27–1.66; LOV: 1.34, 1.09–1.56; VEG: 1.25; 1.07–1.42 g/kg BW; p = 0.047). Only VEG (26.3, 22.7–29.8 EN%) did not achieve the recommended fat intake of 30 EN%. The supply of micronutrients, such as vitamin D and cobalamin, was dependent on supplement intake. Additionally, female OMN and LOV achieved the recommended daily intake of 15 mg iron only after supplementation, while VEG consumed adequate amounts solely via food.

Conclusion

All three groups were sufficiently supplied with most nutrients despite the exceptions mentioned above. The VEG group even showed advantages in nutrient intake (e.g. carbohydrates, fiber and iron) in comparison to the other groups. However, the demand for energy and several macro- and micronutrients might be higher for athletes. Thus, it is also necessary to analyze the endogenous status of nutrients to evaluate the influence of a vegetarian and vegan diet on the nutrient supply of athletes.

Trial registration

German Clinical Trial Register (DRKS00012377), registered on April 28, 2017.
Evaluation of forecasting methods from selected stock market returns
Authors: Mallikarjuna M. , Rao R. Prabhakara
Published: December 2019

Forecasting stock market returns is one of the most effective tools for risk management and portfolio diversification. There are several forecasting techniques in the literature for obtaining accurate forecasts for investment decision making. Numerous empirical studies have employed such methods to investigate the returns of different individual stock indices. However, there have been very few studies of groups of stock markets or indices. The findings of previous studies indicate that there is no single method that can be applied uniformly to all markets. In this context, this study aimed to examine the predictive performance of linear, nonlinear, artificial intelligence, frequency domain, and hybrid models to find an appropriate model to forecast the stock returns of developed, emerging, and frontier markets. We considered the daily stock market returns of selected indices from developed, emerging, and frontier markets for the period 2000–2018 to evaluate the predictive performance of the above models. The results showed that no single model out of the five models could be applied uniformly to all markets. However, traditional linear and nonlinear models outperformed artificial intelligence and frequency domain models in providing accurate forecasts.
Strategies to prevent anthracycline-induced cardiotoxicity in cancer survivors
Authors: Bansal Neha , Adams M. Jacob , Ganatra Sarju , Colan Steven D. , Aggarwal Sanjeev , Steiner Rudolf , Amdani Shahnawaz , Lipshultz Emma R. , Lipshultz Steven E.
Published: December 2019

Cancer diagnostics and therapies have improved steadily over the last few decades, markedly increasing life expectancy for patients at all ages. However, conventional and newer anti-neoplastic therapies can cause short- and long-term cardiotoxicity. The clinical implications of this cardiotoxicity become more important with the increasing use of cardiotoxic drugs. The implications are especially serious among patients predisposed to adverse cardiac effects, such as youth, the elderly, those with cardiovascular comorbidities, and those receiving additional chemotherapies or thoracic radiation. However, the optimal strategy for preventing and managing chemotherapy-induced cardiotoxicity remains unknown. The routine use of neurohormonal antagonists for cardioprotection is not currently justified, given the marginal benefits and associated adverse events, particularly with long-term use. The only United States Food and Drug Administration and European Medicines Agency approved treatment for preventing anthracycline-related cardiomyopathy is dexrazoxane. We advocate administering dexrazoxane during cancer treatment to limit the cardiotoxic effects of anthracycline chemotherapy.