bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Counseling With Cognitive Behavior Approach on Self-esteem and Body Image in Lactating Mothers: Randomized Clinical Trial
Authors: Zamiri-Miandoab Nasrin , Mirghafourvand Mojgan , Nemati Fatemeh , kamalifard mahin
Published: September 2021

BackgroundSelf-esteem and body image are the factors that change during different periods of a women’s life. Some of the women experience low self-esteem and negative body image in pregnancy and postpartum. These two factors along with other factors can reduce the rate of exclusive breastfeeding among women. Cognitive-behavior therapy is one of the psychological approaches that is effective on the betterment of many of the psychological and personality disorders such as body image disorders as well as improvement of self-esteem. The aim of this randomized control trial is to recognize the effects of cognitive-behavior counseling during pregnancy period on self-esteem, body image (primary outcome) and exclusive breastfeeding (secondary outcome).Methodsin this randomized controlled trial, 70 eligible pregnant women referring to health centers of Tabriz- Iran were assigned to two groups of 35 as intervention and control groups using randomized blocking method. For intervention group, 8 sessions of cognitive-behavior therapy based on Cash and Strachan’s body image protocol and Michael Freeʼs for self-esteem were performed.Rosenberg self-esteem scale and multidimensional body self-relation questionnaire (MBSRQ) were completed before intervention, immediately after intervention and 4 weeks after delivery. Likewise, exclusive breastfeeding questionnaire was completed 4 weeks after childbirth. Independent t-test, chi square and repeated measures ANOVA tests were used to analyze the data.ResultsAccording to repeated measures ANOVA test and with controlling baseline score, the mean scores on self-esteem (adjusted mean difference (AMD): 7.18; 95%CI: 4.43 to 9.94; p<0.001) and body image (AMD: 49.74; 95%CI: 70.91 to 28.54; p<0.001) in the intervention group were significantly higher than the control group. 63.6 % of intervention group mothers and 30.3% of control group mothers had exclusive breastfeeding which for the intervention group was significantly higher than the control group based on chi square test (p=0.007). Conclusionscognitive-behavior approach was effective on the improvement of self-esteem and body image and through which might lead to the increase of exclusive breastfeeding among women. Trial register number: Iranian registry clinical trials (IRCT20110524006582N33). Date of registration: 2020-8-19. URL: https://en.irct.ir/trial/43395.
Clinical Characteristics, Risk Factors and Antiviral Treatments of Influenza in Immunosuppressed Inpatients in Beijing During the 2015-2020 Influenza Seasons
Authors: Liu Yafen , Wang Yue , Mai Huan , Chen YuanYuan , Liu Baiyi , Liu YiSi , Ji Ying , Cong Xu , Gao Yan
Published: September 2021

Background
Influenza infection was a vital threat to immunosuppressed patients with longer viral shedding; however, data on these populations in China are still lacking. We analyzed clinical characteristics, risk factors and effects of antiviral therapy in these populations.
Methods
We analyzed 111 immunosuppressed inpatients tested positive for influenza virus using RT-PCR during the 2015–2020 influenza seasons. Univariate analysis and multivariate logistics analysis were used to identify risk factors.
Results
The most common immunosuppression type was malignancies with chemotherapy 87.4% (97/111), then hematopoietic stem cell transplantation 23.4% (26/111). The most common presenting symptom was fever in 92.8% (103/111) patients, then cough 50.6% (44/87). 14.4% (16/111) patients were admitted to ICU and 9.9% (11/111) patients died. Combination and double dose of neuraminidase inhibitors did not significantly reduce the admission to ICU and death. Risk factors for admission to ICU were dyspnea, co-infection with other infections and no antiviral treatment within 48 hours, and presence of dyspnea and altered mental status were independently associated with death through multivariate logistics analysis. Seasonal influenza vaccination in preceding 12 months only took up 2.7% (3/111).
Conclusion
Fever and other classical symptoms of influenza may be absent in immunosuppressed recipients, and conducting influenza virus detection at the first time is a good choice for early diagnosis. Immunosuppressed patients with dyspnea, altered mental status, co-infection with other infections and no antiviral treatment within 48 hours are of note needed, because these people have high-risk to severe cases. Inactivated influenza vaccination should be taken into account in immunosuppressed patients.
Prenatal Exposure to Organophosphate Pesticides and Risk-Taking Behaviors in Early Adulthood
Authors: Sagiv Sharon K. , Rauch Stephen , Kogut Katherine R. , Hyland Carly , Gunier Robert B. , Mora Ana M. , Deardorff Julianna , Eskenazi Brenda
Published: September 2021

Introduction: Previous studies show evidence for associations of prenatal exposure to organophosphate (OP) pesticides with poorer childhood neurodevelopment. As children grow older, poorer cognition and executive function can give rise to risk-taking behaviors, including substance abuse, delinquency, and violent acts. We investigated whether prenatal OP exposure was associated with these risk-taking behaviors in adolescence and young adulthood in a Mexican American cohort. Methods: We measured urinary dialkyl phosphates (DAPs), non-specific metabolites of OPs, in pregnant women recruited in 1999-2000 in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, a birth cohort set in a primarily Latino community living in proximity to agricultural fields in Salinas Valley, California. We followed up children throughout their childhood and adolescence; at the 18-year visit, adolescent youth (n=315) completed a computer-based questionnaire which included questions about substance use, risky sexual activity, risky driving, and delinquency and police encounters. We used multivariable models to estimate associations of prenatal total DAPs with these risk-taking behaviors. Results: The prevalence of risk-taking behaviors in CHAMACOS youth ranged from 8.9% for smoking or vaping nicotine to 70.2% for committing a delinquent act. Associations of total prenatal DAPs (geometric mean=132.4 nmol/L) with risk-taking behavior were generally null and imprecise. Isolated findings included a higher risk for smoking or vaping nicotine within the past 30 days (relative risk [RR] per 10-fold increase in prenatal DAPs = 1.89, 95% CI: 1.00, 3.56) and driving without a license (RR=1.74, 95% CI: 1.25, 2.42). There were no consistent differences by sex or childhood adversity. Discussion: We did not find clear or consistent evidence for associations of prenatal OP exposure with risk-taking behaviors in adolescence/early adulthood in the CHAMACOS population. Our small sample size may have prevented us from detecting potentially subtle associations of OPs with these risk-taking behaviors.
Poland Syndrome Associated with Lung Cancer: A Case Report and Literature Review
Authors: Yao Yuanshan , Gao Wen
Published: September 2021

Background: Poland syndrome is a rare congenital disease consisting a spectrum of defects occupied by unilateral chest wall hypoplasia and ipsilateral hand abnormalities. It is also closely associated with some malignant diseases and some benign diseases, such as breast cancer, lymphoma, recurrent spontaneous pneumothorax, perforating dermatosis, hemangioma, gastric cancer and lung cancer. The low incidence of Poland syndrome has hindered investigators’ attempts to develop randomized prospective trials, so the disease is poorly understood. Now We find out a case of Poland’s syndrome associated with adenocarcinoma of right lung, in which before this article there was only article depicting a case of lung squamous cancer with poland syndrome, this is an interesting topic. To the best of our knowledge, this is the second case of poland syndrome closely related to lung cancer.Case presentation: A 61-year-old man came to the hospital accompanied by intermittent dry cough and hemoptysis that lasted for 2 months. Chest CT revealed showed a large lobulated mass about 5.5cm × 4.0 cm × 3.0 cm in the right lower lung field and the normal right pectoralis major muscle and pectoralis minor were both absent. we diagnosed the patient with stage IIIa lung adenocarcinoma. After two cycles of preoperative platinum-doublet chemotherapy, we have performed a regular right lower lobectomy and lymph node dissection. Until now, after 2.5 years of follow up, he did not relapse.Conclusions: In addition to some other reported types of malignancies, there is increasing evidence that an association between these two clinical entities. Although we do not understand the underlying mechanisms, we assume there exists some common gene pathways that regulate these two clinical entities. Because these patients who got Poland syndrome are susceptibility to different kinds of malignancies, longitudinal epidemiological studies may be needed.
Immune Response and Pathogen Invasion at the Choroid Plexus in the Onset of Cerebral Toxoplasmosis
Authors: Figueiredo Caio Andreeta , Steffen JOhannes , Morton Lorena , Arumugam Sushmita , Liesenfeld OLiver , Deli Maria A , Kröger Andrea , Schüler Thomas , Dunay Ildiko Rita
Published: September 2021

Background: Toxoplasma gondii ( T. gondii ) is a highly successful parasite being able to cross all biological barriers of the body, finally reaching the central nervous system (CNS). Previous studies have highlighted the critical involvement of the blood-brain barrier (BBB) during T. gondii invasion and development of subsequent neuroinflammation. Still, the potential contribution of the choroid plexus (CP), a main structure forming the blood-cerebrospinal fluid (CSF)-barrier (BCSFB) have not been addressed. Methods: To investigate T. gondii invasion and the onset of neuroinflammation, the CP and brain microvessels (BMV) were isolated and analysed for parasite burden. Additionally, immuno-stained brain sections and three dimensional whole mount preparations were evaluated for parasite localization and morphological alterations. Activation of choroidal and brain endothelial cells were characterized by flow cytometry. To evaluate the impact of early immune responses on CP and BMV, expression levels of inflammatory mediators, tight junctions (TJ) and matrix metalloproteinases (MMPs) were quantified. Additionally, FITC-dextran was applied to determine infection-related changes in BCSFB permeability. Finally, the response of primary CP epithelial cells to T. gondii parasites was tested in vitro . Results: Here we revealed that endothelial cells in the CP are initially infected by T. gondii, and become activated prior to BBB endothelial cells indicated by MHCII upregulation. Additionally, CP elicited early local immune response with upregulation of IFN-γ, TNF, IL-6, host-defence factors as well as swift expression of CXCL9 chemokine, when compared to the BMV. Consequently, we uncovered distinct TJ disturbances of claudins, associated with upregulation of MMP-8 and MMP-13 expression in infected CP in vivo , which was confirmed by in vitro infection of primary CP epithelial cells. Notably, we detected early barrier damage and functional loss by increased BCSFB permeability to FITC-dextran in vivo , which was extended over the infection course. Conclusions: Altogether, our data reveal a close interaction between T. gondii infection at the CP and the impairment of the BCSFB function indicating that infection-related neuroinflammation is initiated in the CP.
Lactoferrin Promotes the Autophagy Activity During Osteoblast Formation via BCL2-Beclin1 Signaling
Authors: Ke Dianshan , Wang Xinwen , Lin Yinquan , Wei Shengwang
Published: September 2021

Lactoferrin, as the main component of milk, can maintain osteoblast formation, which is conducive to the prevention and treatment of osteoporosis. Lactoferrin also serves as an autophagy regulator, especially in osteoblasts. This study aimed to explore the significance of autophagy in osteoblast formation regulated by Lactoferrin and the internal mechanism. Our results showed that Lactoferrin enhanced the autophagy activity of primary osteoblasts. Importantly, Lactoferrin inhibited BCL2 expression and the co-immunoprecipitation of BCL2 and Beclin1 in osteoblasts. Moreover, Lactoferrin-promoted autophagy was reversed by BCL2 overexpression or Beclin1 inhibition with spautin-1 in osteoblasts. In conclusion, Lactoferrin can inhibit BCL2 expression in osteoblasts, further enhancing Beclin1-dependent autophagy activation.
Knowledge, Barriers, and Motivators to Cervical Cancer Screening in Rwanda: a Qualitative Study
Authors: Gafaranga Jean Pierre , Manirakiza Felix , Ndagijimana Emmanuel , Ulimubabo Jean Christian , Karenzi David Irenée , Muhawenayo Esperance , Gashugi Phophina , Nyirasebura Dancille , Rugwizangoga Belson
Published: September 2021

Background: Cervical cancer is a global public health problem with marked geographical disparity. There are high morbidity and mortality rates in low- and middle-income countries (LMICs) associated with low screening rates. In 2020, in Rwanda, 3.7 million women aged 15–59 years were at risk of developing cervical cancer. It is the most commonly diagnosed female cancer in Rwanda with an incidence rate of 42 cases per 100,000 women per year. Despite Rwanda being the first African country to vaccinate against human papillomavirus (HPV) with a three-dose regimen, vaccination coverage of nearly 93 % in the target population of girls aged < 15 years, and having an established cervical cancer screening program, recent studies have found low screening rates. Our study sought to determine knowledge, motivators, and barriers to cervical cancer screening.Methods: This was a qualitative phenomenological study conducted in an urban health facility (Muhima district hospital) and a rural health center (Nyagasambu health center) offering cervical screening services in Rwanda. Focus group discussion (FGD) participants were women seeking these services and other women attending the health facility for any reason, as well as female staff working in these health centers. We also interviewed a key informant (KI) from the national organization. FGD and KI interviews were recorded and transcribed, and the data were analyzed using thematic analysis.Results: Thirty women were enrolled in the FGDs, with an average age of 39 years. Many FGD women showed knowledge about cervical cancer existence and prevention methods. However, fear for pain, lack of knowledge about screening, how and where the screening was done, and privacy concerns were recurring subthemes. Key-informant and some FGDs participants have also mentioned a lack of health insurance as a possible barrier for cervical cancer screening.Conclusions: Barriers to the utilization of cervical cancer screening program in Rwanda are related to poor information about cervical cancer and the importance of screening among women, as well non-adherence to medical insurance schemes. Population sensitization through campaign and community outreach activities could have a positive impact on increasing the uptake of cervical cancer screening in Rwanda.
K-Clustering for the Recognition of Moving Entity by Wireless Sensor Networks Using Deep Learning
Authors: R Thiyagarajan , V Balajivijayan , D Rajalakshmi
Published: September 2021

For the detection of the moving entity, a deep learning algorithm is used. To detect the complex type of situations, real-time monitoring of a moving object has to be detected. Using the deep learning method, wireless sensor networks are diagnosed using virtual representation features. Using the k-clustering technique, it achieves the target detection and can determine the positioning. It can determine the characteristics based on the precision. The wireless sensor networks are proposed and analyzed by means of a statistical approach. Statistical way of clustering up of the data detects the precision rate and its positioning state. The positioning method eventually reduces the error which accumulates the efficiency. The main advantages are the robustness and efficiency to improve the performance. These moving targets can be detected with less computational cost. In the field of pervasive computing, the recognition of a moving target can be improvised. The sensor node transmits the information, i.e., communication to nodes. In this paper, the researches focus on wireless sensor data along with a moving entity. This research is mainly used in healthcare and AI-based applications. By using the IoT with wireless sensor networks, the detection of a moving entity can be determined by using the combination of k-clustering algorithms. This deep learning algorithm reduces the time complexity and determines integrity in data.
Contextual and Psychological Factors Influencing Open Defecation Free Status: An Exploratory Qualitative Study in Rural South Western Uganda
Authors: Ntaro Moses , Owokuhaisa Judith , Isunju John Bosco , Mulogo Edgar , Ssempebwa John
Published: September 2021

IntroductionAchieving the Open defecation free (ODF) status remains a major challenge in Uganda, yet it contributes significantly to child health improvement. Literature on social, cultural and behavioral aspects that influence the ODF status in rural Uganda is limited. The study therefore, explored perceived factors influencing the ODF status in rural South Western Uganda.MethodsAn exploratory study employing qualitative techniques and based on deductive analysis between month December 2020 and January 2021 was conducted. Seven Focus Group Discussions (FGDs and three Key Informant Interviews (KIs) were conducted in Kabale District, southwestern Uganda. Focus Group Discussion participants were mothers and fathers having children of two years and below while KIIs included local community leaders and health extension workers. Data was analyzed using a categorization matrix derived from the Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) model which is comprised of contextual and psychological factors. Text was further categorized into high and low statements for attainment of ODF status. Results The contextual factors influencing the Open Defecation Free status behavior included; farming activities far from home, financial constraints, rainy seasons, collapsible soft soils, and alcohol use. Psychological factors influencing ODF status included; perceived health risk for typhoid disease, low perceived severity for lack of ODF components, negative attitude of less value attached to ODF components, and a feeling of time wastage practicing ODF status behavior. The perception that the community has the ability to attain the ODF status was high. Although, the capability to maintain ODF was low when it comes to replacement of ODF component if stolen or destroyed. ConclusionOpen Defecation Free status is influenced by contextual and psychological factors. Therefore, it’s crucial for sanitation promotors to always identify such context specific factors in order to design sanitation and hygiene promotion interventions to address the ODF free status related challenges.
Post-Cardiotomy Pericardial Effusion and Postoperative Atrial Fibrillation Risk
Authors: Kikuchi Yuta , Saijo Yasuaki , Narita Masahiko , Shibagaki Keisuke , Okubo Ryo , Kunioka Shingo , Shirasaka Tomonori , Kamiya Hiroyuki
Published: September 2021

PurposePostoperative atrial fibrillation is a poor prognostic factor that increases mortality rates. We have observed that patients who experienced significant pericardial effusion developed postoperative atrial fibrillation; however, little research has been conducted examining the association between postoperative atrial fibrillation and post-cardiotomy pericardial effusion.MethodsThis retrospective, single-center study included adult patients who underwent cardiovascular surgery via median sternotomy from January 2016 to December 2019. Patients who underwent routine postoperative computed tomography at 7±3 days after surgery (n = 294) were included. Pericardial effusion was measured at its thickest point. Patients were classified into groups with (n = 127) and without (n = 167) postoperative atrial fibrillation, and the association of pericardial effusion with other factors was evaluated. A possible confounder adjusted logistic regression analysis after multiple imputation was performed to obtain odds ratios for postoperative atrial fibrillation using previously published risk factors.ResultsAge, intraoperative bleeding volume, and pericardial effusion size were all significantly higher in the group with postoperative atrial fibrillation. Multivariate logistic regression after multiple imputation revealed that age, intraoperative bleeding volume, and postoperative pericardial effusion were significantly associated with postoperative atrial fibrillation.ConclusionTo our knowledge, this is the first study focusing on the relationship between post-cardiotomy pericardial effusion and postoperative atrial fibrillation. Our findings showed that post-cardiotomy pericardial effusion is associated with postoperative atrial fibrillation. However, causality remains unknown, making further studies mandatory.
Feasibility Study on Topological Optimisation And Additive Manufacturing of An Electric Vehicle Battery Housing
Authors: Yeong Wai Yee , Sing Swee Leong , Aman Bashu
Published: September 2021

Electric vehicles (EVs) are in the incipient stage today and have the capacity to lead the automobile sector in the future. Battery packs of an electric vehicle are held by a large battery housing located at the bottom of the car body. The battery pack contributes significantly to the vehicle’s overall weight. Reduction of the overall weight of the future cars is a designer’s priority today. The aim to reduce weight can be achieved using topological optimisation. The optimised design is complex and therefore requires freeform fabrication. Additive manufacturing (AM) or 3D printing allows the fabrication of complex structures, hence, enables the fabrication of topological optimised parts without compromising on the part performance. In this paper, the topological optimisation of an electric vehicle battery housing is carried out to reduce the weight of the housing. Certain parts of the battery housing are removed and modified to get the final design. The physical, geometric, and performance aspects of the re-designed and original battery housing are compared. Additionally, the feasibility of the fabrication of the re-designed battery housing is discussed through support structures generation and feasibility index. Different AM methods such as powder bed fusion (PBF) and directed energy deposition (DED) are analysed on the basis of advantages and limitations. Finally, a suitable AM technique, selective laser melting (SLM), is chosen to fabricate the topological optimised battery housing.
Clinical Characteristics and Outcome of Primary Brain Abscess: a Retrospective Analysis
Authors: Huang Junying , Wu Haining , Huang Honghong , Wu Weiqi , Wu Bowen , Wang Lingxing
Published: September 2021

Background: Patients with primary brain abscess often present with atypical symptoms, and the outcome is varied. We investigated the demographic, laboratory, and neuroimaging features of patients with brain abscess at our hospital and identified factors associated with their outcome.Methods: We retrospectively collected the data of patients diagnosed with primary brain abscess at our hospital between January 2011 and December 2020. Their clinical characteristics, predisposing factors, laboratory and neuroimaging findings, treatment, and outcome were analyzed. Results: Of the 57 patients diagnosed with primary abscess, 51 (89.47%) were older than 40 years and 42 (73.68%) were male. Only eight patients (14.04%) showed the classical triad of headache, fever, and focal neurological deficit. Fourteen patients (24.56%) had comorbidities, of which diabetes mellitus was the most common. Positive pus cultures were obtained in 46.15% of the patients, and gram-negative enteric bacteria were found in 33.33% of them, with Klebsiella pneumoniae being the most frequently observed. Surgical treatment, most commonly in the form of stereotactic drainage, was received by 54.39% of the patients. Good outcomes were achieved in 75.44% of the patients. Multivariate logistic regression analysis showed that patients with headache were more likely to have a poor outcome (odds ratio 6.010, 95% confidence interval 1.114–32.407, p = 0.037).Conclusions: Male patients and those older than 40 years were more susceptible to brain abscess than female patients and those younger than 40 years, respectively. Only a few patients showed the classical triad of clinical symptoms. Diabetes mellitus was the most common comorbidity. Positive pus culture results were uncommon, with gram-negative enteric bacteria, especially Klebsiella pneumoniae, being the main organisms found. Most patients had a good outcome, and the presence of headache may influence the outcome.
Neoadjuvant Chemotherapy Reduces Adjuvant Radiation Therapy in Patients with Locally Advanced Cervical Cancer
Authors: Huang Yuhui , Chen Lei , Cai Jing , Yang Lu , Sun Si , Zhao Jing , Xiong Zhoufang , Wang Zehua
Published: September 2021

Background: To investigated whether carboplatin-paclitaxel neoadjuvant chemotherapy (NACT) benefits patients with locally advanced cervical cancer (LACC) through avoiding or delaying postoperative radiation.Methods: Patients with International Federation of Gynecology and Obstetrics (FIGO 2009) stage IB2-IIA2 who received carboplatin-paclitaxel chemotherapy followed by radical surgery (NACT group) or received primary radical surgery (PRS group) between 2007 and 2017 at our hospital were included. Their clinicopathological characteristics, treatments and follow-up data were retrospectively collected and analyzed. The clinical outcomes, including adjuvant radiation, progression-free survival (PFS), and overall survival (OS), were compared between the groups.Results: There were 197 and 217 patients included in the NACT group and PRS group, respectively. The baseline characteristics were significantly different between the groups, with more patients with more advanced tumor stages and larger tumor sizes in the NACT group. Postoperative pathology examination revealed lower incidences of deep stromal invasion in the NACT group than in the PRS group. More importantly, the cumulative postoperative radiation rate was significantly lower in the NACT group (P = 0.041), while the differences in 5-year OS and PFS were not statistically significant between the groups.Conclusions: NACT reduces the pathological risk factors and adjuvant radiation without compromising survival in patients with LACC, which may protect younger patients from radiation-related side effects and subsequently improve the quality of life.
Effect of The “Normalized Epidemic Prevention And Control Requirements” On Hospital-Acquired And Community-Acquired Infections In China
Authors: Chen Caiyun , Zhu Ping , Zhang Yongxiang , Liu Bo
Published: September 2021

Background: No studies have yet reported the effect of prevention and control measures, which were implemented to combat COVID-19, on the prevention and control of common HAIs. We aimed to examine the effect of the “Normalized Epidemic Prevention and Control Requirements” (implemented in May 2020) by comparison of hospital-acquired infections (HAIs) and community-acquired infections (CAIs) in China during 2018, 2019, and 2020.Methods: Data of inpatients before and after implementation of new requirements were retrospectively analyzed, including infection rate, use of alcohol-based hand cleaner, anatomical sites of infections, pathogen species, infection by multi-drug-resistant species, use of different antibiotics, and antibiotic use density. Results: The HAI rate was significantly higher in 2020 than in 2018 and 2019 (P<0.05), and the CAI rate was significantly higher in 2019 and 2020 than in 2018 (P<0.001). Lower respiratory tract infections were the most common HAI during all years, with no significant changes over time. Lower respiratory tract infections were also the most common CAI, but were significantly more common in 2018 and 2019 than 2020 (P<0.001). There were no changes in upper respiratory tract infections among HAIs or CAIs. Most HAIs and CAIs were from Gram-negative bacteria, and the percentages of fungal infections were greater in 2019 and 2020 than 2018. MRSA infections were more common in 2020 than in 2018 and 2019 (P<0.05). The utilization rate and usage days of antibiotics decreased over time (P<0.001), the culture rate of microbial specimens before antibiotics usage increased over time (P<0.001), but antibiotic use density remained steady over time. Conclusions: The new prevention and control requirements provided important benefits during the COVID-19 pandemic. However, their effects on HAIs were not obvious.
Nursing Practicum Equity for a Changing Nurse Student Demographic: a Qualitative Study
Authors: Andrew Lesley , Dare Julie , Robinson Ken , Costello Leesa
Published: September 2021

Background:The nursing practicum (clinical practice) is an essential but often highly stressful aspect of the nursing degree. A review of the published literature reveals a strong focus on the stressors that originate within the practicum environment, rather than the student’s life outside the university and practice setting. This article reports on an Australian study, completed before the COVID-19 pandemic, of the university experiences of undergraduate women nurse students with family responsibilities. The findings reveal the importance of factors outside the university on the women students’ practicum experience and their ability to engage and achieve.Methods:The study was qualitative, guided by Gadamer’s hermeneutic philosophy. Twenty-nine women students with family responsibilities (partners and children) were interviewed at two stages of their degree journey. Over 50 hours of data were thematically analysed.Findings:The themes ‘family pressure’ and ‘practicum poverty’ describe the impact of domestic work, family finances and practicum organisation on student stress, wellbeing, achievement, thoughts of attrition, and family tension. These findings are particularly pertinent to Australia and other developed nations where the nurse student demographic continues to age. An interpretation of these findings against the recent impact of COVID-19 on nurse education and women’s life choices reveals the likelihood that these difficulties have intensified for women students with family responsibilities since the pandemic began.Conclusions and Recommendations:Many developed nations, including Australia, are increasingly reliant on older women nurse students to maintain the future graduate nursing workforce. This change in nurse student demographic to the mature-age student requires a revision of the organisation of the nursing practicum. Recommendations to nurse education to improve practicum accessibility for women students who have family responsibilities include the application of a flexible and collaborative approach to practicum organisation and communication. Wider recommendations to Government include a revision of the way the nursing student is financially supported during the practicum. Further research that explores the practicum experience for women nurse students during and following the COVID-19 pandemic is also recommended.
Objective Reduction in Many-Objective Optimization with Social Spider Algorithm for Cloud Detection in Satellite Images
Authors: Gupta Rachana , Nanda Satyasai Jagannath
Published: September 2021

An important difficulty with multi-objective algorithms to analyze many-objective optimization problems (MaOPs) is the visualization of large dimensional Pareto front. This article has alleviated this issue by utilizing objective reduction approach in order to remove non-conflicting objectives from original objective set. The present work proposed formulation of objective reduction technique with multi-objective social spider optimization (MOSSO) algorithm to provide decision regarding conflict objectives and generate approximate Pareto front of non-dominated solutions. A comprehensive analysis of objective reduction approach is carried out with existingmulti-objective methods on many-objective DTLZ and WFG test suite which highlight the superiority of proposed technique. Further, the performance of proposed approach is evaluated on satellite images to detect cloudy region against various types of earth’s surfaces. The performance of proposed approach is compared against existing benchmark many-objective algorithm, NSGA-III in order to evaluate the potential of proposed method in clustering application. It is observed that obtained clustering results using reduced objective set of MOSSO algorithm provides almost equivalent accuracy with results obtained using NSGA-III with many-objective set.
The Impact of the Private Sector Co-Payment Mechanism (PSCM) on the Private Market for ACTs in Nigeria: Results of the 2018 Cross-sectional Outlet and Household Market Surveys.
Authors: Edwards Hannah M. , Sarwar Rubaiyath , Mahmud Parvez , Emmanuel Shekarau , Maxwell Kolawole , Tibenderana James K.
Published: September 2021

BackgroundThe private sector plays a large role in malaria treatment provision in Nigeria. To improve access to, and affordability of, quality-assured artemisinin combination therapies (QA-ACTs) within this sector, the Affordable Medicines Facility - Malaria began operations in 2010 and transitioned to a private sector co-payment mechanism (PSCM) until 2017. To assess the impact of the scheme on the ACT market, cross-sectional household and outlet surveys were conducted in 2018 to coincide with the final stockages of ACTs procured under the PSCM. MethodsAn outlet survey was conducted targeting private pharmacies and Proprietary and Patent Medicine Vendors (PPMVs) across different regions of Nigeria to assess supply-side market factors related to availability and cost of antimalarials, including ACTs subsidised under the PSCM (called green leaf ACTs on account of their green leaf logo) and those not subsidised (non-green leaf ACTs). A concurrent household survey was conducted to determine demand-side factors related to treatment seeking practices, ACT brand preference and purchase decision. Data were compared with previous ACTWatch surveys to consider change over time.ResultsAvailability of ACTs increased significantly over the PSCM period and was almost universal by the time of the 2018 market survey. This increase was seen particularly among PPMVs. While the cost of green leaf ACTs remained relatively stable over time, the cost of non-green leaf ACTs reduced significantly so that by 2018 they had equivalent affordability. Unsubsidised brands were also available in different formulations and dosages, with double-strength ACTs reported as the most frequently purchased dosage type, and child ACTs popular in suspension and dispersible forms (forms not subsidised by the PSCM).ConclusionsThe PSCM had a clear impact on increasing not only the reach of subsidised QA brands, but also of non-subsidised brands. Increased market competition led to innovation from unsubsidised brands and large reductions in costs to make them competitive with subsidised brands. Concerns are drawn from the large market share that non-QA brands have managed to gain as well as the continued market share of oral artemisinin monotherapies. Continued monitoring of the market is recommended, along with improved local capacity for QA-certification and monitoring.
Use of Novel Lab-Assays to Examine the Effect of Pyrethroid-Treated Bed Nets on Blood Feeding Success and Longevity of Highly Insecticide-Resistant Anopheles Gambiae S.I. Mosquitoes.
Authors: Barreaux Priscille , Koella Jacob C. , N’Guessan Raphael , Thomas Matthew B.
Published: September 2021

Background: There is a pressing need to improve understanding of how insecticide resistance affects the functional performance of Insecticide Treated Nets (ITNs). Standard WHO insecticide resistance monitoring assays are designed for resistance surveillance and do not necessarily provide insight into how different frequencies, mechanisms or intensities of resistance affect the ability of ITNs to reduce malaria transmission. Methods: The current study presents some novel laboratory-based assays that attempt to better simulate realistic exposure of mosquitoes to ITNs and to quantify impact of exposure not only on instantaneous mortality, but also blood feeding and longevity, two traits that are central to transmission. The assays evaluated the performance of a standard ITN (Permanet® 2.0), a ‘next generation’ combination ITN that includes a resistance breaking synergist (Permanet® 3.0), and an untreated net (UTN), against field-derived Anopheles gambiae s.l. mosquitoes from Côte d’Ivoire exhibiting 1500-fold pyrethroid resistance. Results: The study revealed that a standard ITN induced negligible instantaneous mortality against the resistant mosquitoes, whereas the resistance breaking net caused high mortality and a reduction in blood feeding. However, the ITNs still impacted long term survival relative to the UTN. The impact on longevity depended on feeding status, with blood-fed mosquitoes living longer than unfed mosquitoes following ITN exposure. The ITNs also reduced the blood feeding success, the time spent on the net, and blood-feeding duration, relative to the untreated net. Conclusion: Thus, while the standard ITN did not have as substantial instantaneous impact as the resistance breaking net, it still had significant impacts on traits important for transmission. These results highlight the benefit of improved bioefficacy assays that allow for realistic exposure and consider sub- or pre-lethal effects to help assess the functional significance of insecticide resistance.
Generative Adversarial Networks Based Cognitive Feedback Analytics System for Integrated Cyber-Physical System and Industrial Iot Networks
Authors: Upreti Kamal , Syed Mohammad Haider , Alam Mohammad Shabbir , Alhudhaif Adi , Shuaib Mohammed , Sharma A K
Published: September 2021

In the modern era of technologies, the internet grows in the advancement of our day-to-day life like automation devices. The devices to set up industries with integrated cyber-physical systems and industrial IoT applications. Generative adversarial networks (GAN) can generate Cognitive feedback analysis with various data for both generator and discriminator in a supervised model. Neural networks are used for artificial intelligence algorithms, but in adversarial networks, feedback analytics is analyzed with the significance of data. The modern age of intelligent manufacturing will indeed be ushered in by Cyber-Physical Production Systems (CPPS). However, because of the connections between the virtual and physical worlds, CPPS would be subject to cross-domain assaults. Against Denial-of-Service (DoS) threats, this paper concentrates on complex performance feedback management of Cyber-Physical Systems (CPS). To begin, a swapping system modelling approach for the complex response feedback CPS is provided by analyzing the distinct effects of DoS assaults on the sensor-controller (S-C) and controller-to-actuator (C-A) channels, accordingly. Given the difference in bandwidth between the dual channels and the accused's energy cap, it is reasonable to conclude that an offender can only jam a single communication stream at a point and also that the possible number of successive DoS attacks is limited. Second, using a packet-based transfer scheme, a nested switching paradigm is built on the foundation of the switching mechanism, considering both the spatial heterogeneity and the temporal durability of DoS attacks. The probability of discriminator gets analyzed feedback data to check whether actual data or fake data is sampled, and it is generated. Cognitive feedback supports genetic algorithms to sample the feedback data in a system for advanced technologies.
Malignancies in Immunoglobulin G4-Related Ophthalmic Disease
Authors: LAI Kenneth K.H. , Li Emmy Y.M. , Chan Regine Y.C. , Wong Kenneth C.W. , Yu Jimmy K.S. , Cheuk W , Hui Y. H. , Cheng Andy C.O. , Chin Joyce K.Y. , Ip S. K. , Chan W. H. , Kwok Jeremy S.W. , Lam W. C. , Io Ida Y. F. , Mak Theresa S.T. , Li Kenneth K.W. , Lam N. M. , Yip Wilson W. K. , Young Alvin L. , Chan Edwin , Ko Callie K.L. , Ko Simon T. C. , Yuen Hunter K.L. , Tham Clement C.Y. , Pang Chi Pui , Chong Kelvin K. L.
Published: September 2021

Purpose: Clinical phenotypes in Immunoglobulin G4-related disease (IgG4-RD) according to the affected organs affected have different risks of malignancies. We attempt to determine the association of malignances with IgG4-related ophthalmic disease (IgG4-ROD). Design: Retrospective cohort study. Methods: Review of medical records, orbital images and histopathology reports in a territory-wide cohort of patients fulfilling the “probable” or “definite” comprehensive diagnostic criteria of IgG4-RD from 2005-2019. Findings: Among 122 patients who had biopsies taken from adnexal lesions including lacrimal glands (n=108), orbital mass (n=30), infiltrated orbital fat (n=10), conjunctiva (n=2) or extraocular muscles (n=3), 16 (13%) developed malignancies over 73±48months’ follow-up. There were 9 cases of ocular adnexal lymphoma (OAL) and 7 extra-orbital malignancies. Compared with the general population, the incidence of OAL was significantly higher (standardized incidence ratios, SIRs=10.0, 95%CI=4.5-17.6) while that of extraorbital malignancy was similar. The SIR was highest within the first year (SIR=46.7, 95%CI=18.5-87.6) when 7 OAL were concomitantly diagnosed. Patients who developed OAL or extra-orbital malignancies were older than other patients when diagnosed of IgG4-ROD (64.9±7.1, 68.3±8.5 versus 55.2±15.0 years, p<0.05). Asymmetric lacrimal gland enlargement (78% versus 13%), lack of frontal (0% versus 12%) or infraorbital nerve enlargement (0% versus 36%)were associated with OAL (all p<0.05). Pre-treatment serum IgG4 level or pattern of extraorbital involvement was similar among patients with or without malignancies. Conclusion: In this biopsy-proven IgG4-ROD cohort, 7% developed OAL which was 10 times higher than the general population. Patients with asymmetric lacrimal gland enlargement or without trigeminal nerves involvement radiologically were associated with OAL.
Applicability of the Linearized Poisson-Boltzmann Theory to Contact Angle problems and Application to the Carbon Dioxide-Brine-Solid Systems
Authors: Amadu Mumuni , Midanoye Adango
Published: September 2021

In colloidal science and bioelectrostatics, the linear Poisson Boltzmann Equation (LPBE) has been used extensively for the calculation of potential and surface charge density. Its fundamental assumption rests on the premises of low surface potential. In the geological sequestration of carbon dioxide in saline aquifers, very low pH conditions coupled with adsorption induced reduction of surface charge density result in low pH conditions that fit into the LPB theory. In this work, the Gouy-Chapman model of the electrical double layer has been employed in addition to the LPBE theory to develop a contact angle model that is a second-degree polynomial in pH. Our model contains the point of zero charge pH of solid surface. To render the model applicable to heterogeneous surfaces, we have further developed a model for the effective value of the point of zero charge pH. The point of zero charge pH model when integrated into our model enabled us to determine the point of zero charge pH of sandstone, quartz and mica using literature based experimental data. In this regard, a literature based thermodynamic model was used to calculate carbon dioxide solubility and pH of aqueous solution. Values of point of zero charge pH determined in this paper agree with reported ones. The novelty of our work stems from the fact that we have used the LPB theory in the context of interfacial science completely different from the classical approach, where the focus is on interparticle electrostatics involving colloidal stabilization.
Evaluation of TP53 Expression and Mutations among Hematological Malignancies Patients in Saudi Arabia
Authors: Alkhatabi Heba , Yasin Elrashed B. , Alserihi Raed , Felimban Raed , Elaimi Aisha , Alharbi Lina , Shaabad Manal , Ahmed Hameeda , Alameer Abdulrahman M , Mathkoor Abdullah Ebraheem , Alqahtani Mohammed
Published: September 2021

Tumor protein 53 (TP53) is the most frequently mutated gene in human cancer which located on the short arm of chromosome 17. In hematological malignancies, the prevalence of TP53 mutations is low compared to other tumors but associated with a complex karyotype, poor prognosis, and poor response to chemotherapy. However, no data on the prevalence and prognostic value of TP53 mutations and the significance of TP53 deletion among hematological malignancies in Saudi patients. The objective of this study was to evaluate the frequency and prognostic significance of TP53 mutations in different hematological malignancies in Jeddah, Saudi Arabia. 20 samples from different hematological malignancies were tested using a next-generation sequencing (NGS) and targeted panel for TP53 deletion using fluorescence in situ hybridization (FISH) and TP53 mutations. Based on the application of the FISH technique, 6 out of 20 patients showed a deletion in TP53 majority of them were Acute lymphoplastic leukemia (ALL), and the deletion was prominent in a child compared to an adult. Furthermore, the result of next-generation sequencing on 10 selected samples showed that 1 out of 10 samples had a heterozygous mutation at codon 175 (exon 5) of the TP53 gene, replacing histidine with arginine (H175R). Also, there were 90 other mutations detected on 13 genes that were sequenced besides TP53. None of the other gene mutations showed any clinical impact or association with TP53 except for two mutations in two different genes; ASXL1 (K1368T) and SETBP1 (V231L). Despite the small size of this study, the identified mutations are considered variants with unknown significance and need further validation and investigation on a larger cohort to determine the pathogenicity of these abnormalities. This study recommends further analysis of genomic mutations, utilizing high throughput technologies, associated with hematological malignancies in Saudi populations.