bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconciliation and Indigenous resurgence in the Ontario Far North and Mushkegowuk Cree land use planning processes
Authors: Bowie Ryan
Published: September 2020

The introduction of Ontario’s Far North Initiative in 2008 and resulting Far North Act (2010) set in motion efforts to create land use plans in the northern regions of the Canadian province. Ontario’s approach to reconciling Aboriginal and treaty rights with provincial planning was through a community-based land use planning process, to which Mushkegowuk Council responded with a regional process based on the Omushkegowuk nation. The paper argues that the goals and approach of Mushkegowuk Council were reflective of indigenous resurgence principles, to which Ontario’s community-based planning objectives were a significant obstacle. The paper will closely examine the challenges Mushkegowuk Council faced in their attempt to assert an alternative to Ontario’s Far North planning, and the implications for Mushkegowuk Council and other indigenous communities and organizations involved in land use planning. The paper will conclude with a discussion of how the case study exemplifies the broader difficulties of achieving indigenous driven planning as resurgence necessarily confronts the institutions and ambitions of Settler governments.
Undrained seismic bearing capacity of strip footings horizontally embedded in two-layered slopes
Authors: Wu Gaoqiao , Zhao Minghua , Zhao Heng
Published: September 2020

This study investigated the undrained seismic bearing capacity of strip footings embedded in two-layered slopes by finite element limit analysis (FELA); in particular, a pseudostatic method was specified to seismic loads. Lower bound theory (LB), upper bound theory (UB), and adaptive meshing technique are employed for exploring the effect of the shear strength ratio of top layer and bottom layer, cu1/ cu2; the horizontal embedment depth of footings, b/ B; the footing locations (in bottom layer or top layer); seismic coefficient kh; and the slope gradient β on seismic bearing capacity. Results indicated that the seismic bearing capacity would increase with the growth of horizontal embedment depth of footings. The comparison between the predictions obtained from the proposed method and the existing method was presented, and the failure mechanisms are further summarized.
Comparative genomics of CXCR4MUT and CXCR4WT single cells in Waldenström’s macroglobulinemia
Authors: Jiménez Cristina , Xu Lian , Tsakmaklis Nickolas , Demos Maria G. , Kofides Amanda , Chan Gloria G. , Guerrera Maria Luisa , Chen Jiaji G. , Liu Xia , Munshi Manit , Patterson Christopher J. , Yang Guang , Castillo Jorge J. , Treon Steven P. , Hunter Zachary R.
Published: September 2020

Key Points

Single-cell whole-genome amplification can be used to interrogate the genomic architecture of Waldenström’s macroglobulinemia. The mutational signature of CXCR4MUT cells may be associated with alterations in DNA repairing genes and tumor suppressors.
The impact of fremanezumab on medication overuse in patients with chronic migraine: subgroup analysis of the HALO CM study
Authors: Silberstein Stephen D. , Cohen Joshua M. , Seminerio Michael J. , Yang Ronghua , Ashina Sait , Katsarava Zaza
Published: September 2020

Background

We evaluated the efficacy of fremanezumab, a fully humanized monoclonal antibody that selectively targets calcitonin gene-related peptide, in patients with chronic migraine (CM) with and without medication overuse (MO).

Methods

In a 12-week, phase 3 trial, patients with CM were randomized to fremanezumab quarterly (675 mg/placebo/placebo), monthly (675 mg/225 mg/225 mg), or placebo. Post hoc analyses assessed the impact of fremanezumab in patients with and without MO (monthly use of acute headache medication ≥15 days, migraine-specific acute medication ≥10 days, or combination medication ≥10 days) on efficacy outcomes, including headache days of at least moderate severity (HDs), and six-item Headache Impact Test (HIT-6) and Migraine-Specific Quality of Life (MSQoL) questionnaire scores.

Results

Of 1130 patients enrolled, 587 (51.9%) had baseline MO. Fremanezumab reduced placebo-adjusted least-squares mean (95% confidence interval) monthly HDs (− 2.2 [− 3.1 to − 1.2] and − 2.7 [− 3.7 to − 1.8]; P < 0.0001) in patients with MO and without MO (quarterly − 1.4 [− 2.3 to − 0.5], P = 0.0026; monthly − 1.4 [− 2.3 to − 0.6], P = 0.0017). Significantly more fremanezumab-treated patients had ≥ 50% reduction in HDs versus placebo, regardless of baseline MO (with: quarterly 70/201 [34.8%], monthly 78/198 [39.4%] vs placebo 26/188 [13.8%]; without: quarterly 71/174 [40.8%], monthly 75/177 [42.4%] vs placebo 41/183 [22.4%]). Fremanezumab improved HIT-6 and MSQoL scores. Significantly more fremanezumab-treated patients reverted to no MO (quarterly 111/201 [55.2%], monthly 120/198 [60.6%]) versus placebo (87/188 [46.3%]).

Conclusions

Fremanezumab is effective for prevention of migraine in patients with CM, regardless of MO, and demonstrated a benefit over placebo in reducing MO.

Trial registration

ClinicalTrials.gov NCT02621931 (HALO CM), registered December 12, 2012.
Barriers and facilitators to adherence to walking group exercise in older people living with dementia in the community: a systematic review
Authors: Vseteckova J. , Dadova K. , Gracia R. , Ryan G. , Borgstrom E. , Abington J. , Gopinath M. , Pappas Y.
Published: September 2020

Background & Aims

Evidence suggests that targeted exercise is important for people living with dementia. The aim of this review was to collect and synthesize evidence on the known barriers and facilitators to adherence to walking group exercise of older people living with dementia in the community.

Methods

We have searched appropriate electronic databases between January 1990 until September 2019, in any language. Additionally, we searched trial registries (clinicaltrial.gov and WHO ICTRP) for ongoing studies. We included all study designs. Studies were excluded when participants were either healthy older people or people suffering from dementia but living in residential care. Narrative synthesis was used.

Findings

10 papers met the inclusion criteria. The narrative analysis focused on barriers, facilitators, and adherence. All studies reported on barriers and facilitators. Barriers included: bio-medical reasons (including mental wellbeing and physical ability); relationship dynamics; and socio-economic reasons and environmental issues. Facilitators included: bio-medical benefits & benefits related to physical ability; staff, group relationship dynamics and social aspect of walking group; environmental issues and individual tailoring; and participants perceptions about the walks & the program. Most studies did not provide data about adherence or attendance; where reported, adherence ranged from 47 to 89%.

Conclusions

This systematic review of literature has highlighted known barriers and facilitators to adherence to walking groups type of exercise for people living with dementia in community. Carers’ willingness to engage, their circumstances, perspectives and previous experiences of exercise seem to play a key role in facilitating adherence but there is little research that explores these. Also, the design, location and organisation of walking groups facilitate adherence. This reflects the need for such activities to be part of a wider ‘program of care’, tailored to the needs of the individual, flexible and convenient. Knowledgeable and well-trained instructors or healthcare professionals are recommended as group exercise leaders.
Management of cryptorchidism in adolescent and adult males
Authors: Viljoen J. T. , Zarrabi A. , Van der Merwe A.
Published: September 2020

Background

In developing countries, it is not unusual for patients with undescended testes (UDT) to present in adulthood and the late detection of UDT can be problematic. The limited contribution to fertility and increased potential of malignancy seen in UDT have swayed many authors towards recommending orchidectomy, rather than orchidopexy, for the adult patient presenting with cryptorchidism. With conflicting data, and most guidelines aimed at first world countries with pre-pubertal patients as their focus group, a lot of uncertainty exists regarding the management of adults who present with cryptorchidism. This may result in variation in the approach to management of this patient population.

Methods

A retrospective review was conducted of patients with cryptorchidism, aged 12 years or older at the time of surgery. The following data were retrieved: patient’s age, medical and previous surgical history, clinical features of UDT (laterality, position and size), date of surgery, intra-operative findings and procedure performed. Management decisions were compared to the most recent guidelines.

Results

The mean age of the 106 subjects was 25.4 years. An orchidectomy was performed in a total of 30 (24.2%) of the 124 testicular units. The majority of testes, 91 (73.4%), in this group were preserved. Of these, 43 (47.3%) were older than 18 years of age, 33 (36.2%) were reported as having unilateral UDT with a normal contralateral testis and in 9 (9.8%) of these cases, the preserved testes were described as being atrophic. The majority (59.7%) of UDT in the post-pubertal group (> 18 years) were managed by orchidopexy.

Conclusion

Contrary to the recommended treatment for this group of patients, there was a general tendency towards testicular preservation. The decision on surgical management was made by the attending surgical team. This not only demonstrates variation in the management of UDT, but could also be a reflection of the lack of sufficient guidelines as to the management of the post-pubertal patient presenting with UDT. Further studies, following cryptorchidism through adulthood, are needed to refine guidelines for the optimal management of this group of patients.
Monitoring sustainable development by means of earth observation data and machine learning: a review
Authors: Ferreira Bruno , Iten Muriel , Silva Rui G.
Published: September 2020

This paper presents and explores the different Earth Observation approaches and their contribution to the achievement of United Nations Sustainable Development Goals. A review on the Sustainable Development concept and its goals is presented followed by Earth Observation approaches relevant to this field, giving special attention to the contribution of Machine Learning methods and algorithms as well as their potential and capabilities to support the achievement of Sustainable Development Goals. Overall, it is observed that Earth Observation plays a key role in monitoring the Sustainable Development Goals given its cost-effectiveness pertaining to data acquisition on all scales and information richness. Despite the success of Machine Learning upon Earth Observation data analysis, it is observed that performance is heavily dependent on the ability to extract and synthesise characteristics from data. Hence, a deeper and effective analysis of the available data is required to identify the strongest features and, hence, the key factors pertaining to Sustainable Development. Overall, this research provides a deeper understanding on the relation between Sustainable Development, Earth Observation and Machine Learning, and how these can support the Sustainable Development of countries and the means to find their correlations. In pursuing the Sustainable Development Goals, given the relevance and growing amount of data generated through Earth Observation, it is concluded that there is an increased need for new methods and techniques strongly suggesting the use of new Machine Learning techniques.
Keeping up with the genomes: efficient learning of our increasing knowledge of the tree of life
Authors: Zhao Zhengqiao , Cristian Alexandru , Rosen Gail
Published: September 2020

Background

It is a computational challenge for current metagenomic classifiers to keep up with the pace of training data generated from genome sequencing projects, such as the exponentially-growing NCBI RefSeq bacterial genome database. When new reference sequences are added to training data, statically trained classifiers must be rerun on all data, resulting in a highly inefficient process. The rich literature of “incremental learning” addresses the need to update an existing classifier to accommodate new data without sacrificing much accuracy compared to retraining the classifier with all data.

Results

We demonstrate how classification improves over time by incrementally training a classifier on progressive RefSeq snapshots and testing it on: (a) all known current genomes (as a ground truth set) and (b) a real experimental metagenomic gut sample. We demonstrate that as a classifier model’s knowledge of genomes grows, classification accuracy increases. The proof-of-concept naïve Bayes implementation, when updated yearly, now runs in 1/4thof the non-incremental time with no accuracy loss.

Conclusions

It is evident that classification improves by having the most current knowledge at its disposal. Therefore, it is of utmost importance to make classifiers computationally tractable to keep up with the data deluge. The incremental learning classifier can be efficiently updated without the cost of reprocessing nor the access to the existing database and therefore save storage as well as computation resources.
Fossil-calibrated molecular phylogeny of atlantid heteropods (Gastropoda, Pterotracheoidea)
Authors: Wall-Palmer Deborah , Janssen Arie W. , Goetze Erica , Choo Le Qin , Mekkes Lisette , Peijnenburg Katja T. C. A.
Published: September 2020

Background

The aragonite shelled, planktonic gastropod family Atlantidae (shelled heteropods) is likely to be one of the first groups to be impacted by imminent ocean changes, including ocean warming and ocean acidification. With a fossil record spanning at least 100 Ma, atlantids have experienced and survived global-scale ocean changes and extinction events in the past. However, the diversification patterns and tempo of evolution in this family are largely unknown.

Results

Based on a concatenated maximum likelihood phylogeny of three genes (cytochromecoxidase subunit 1 mitochondrial DNA, 28S and 18S ribosomal rRNA) we show that the three extant genera of the family Atlantidae,Atlanta, ProtatlantaandOxygyrus,form monophyletic groups. The genusAtlantais split into two groups, one exhibiting smaller, well ornamented shells, and the other having larger, less ornamented shells. The fossil record, in combination with a fossil-calibrated phylogeny, suggests that large scale atlantid extinction was accompanied by considerable and rapid diversification over the last 25 Ma, potentially driven by vicariance events.

Conclusions

Now confronted with a rapidly changing modern ocean, the ability of atlantids to survive past global change crises gives some optimism that they may be able to persist through the Anthropocene.
Complete mitochondrial genome of Iniistius trivittatus and unique variation in two observed inserts between rRNA and tRNA genes in wrasses
Authors: Liu Dong , Zhang Yuanyuan , Zhang Ming , Yang Jinquan , Tang Wenqiao
Published: September 2020

Background

The family Labridae made up of 519 species in the world. The functional evolution of the feeding-related jaws leaded to differentiation of species, and the pharyngeal jaw apparatus evolved independently, but evolutionary mechanism still remain unaddressed in wrasses. Mitogenomes data can be used to infer genetic diversification and investigate evolutionary history of wrasses, whereas only eight complete mitogenomes in this family have been sequenced to date. Here, we sequenced the complete mitogenomes of Iniistius trivittatus to investigate genetic differentiation among wrasse species.

Results

We sequenced the complete mitogenomes of I. trivittatus using a novel PCR strategy. The I. trivittatus mitogenomes is 16,820 bp in length and includes 13 protein -coding genes, 2 ribosomal RNA (rRNA) genes, 22 transfer RNA (tRNA) genes, and a control region. Compared to eight known mitochondrial genome, 2 additional noncoding regions (lengths of 121 and 107 bp), or so-called inserts, are found in the intergenic regions 12S rRNA - tRNAVal - 16S rRNA. The presumed origin of the two rare inserts is from tRNA- related retrotransposons. Compared with cytochrome b gene, the two insert sequences are highly conserved at the intraspecies level, but they showed significant variation and low similarity (< 70%) at the interspecies level. The insert events were only observed in I. trivittatus by checking the phylogenetic trees based on the complete mitogenomes of Labrida species. This finding provides evidence that in the mitogenomes, retrotransposon inserts result in intraspecific homoplasmy and interspecific heteroplasmy by natural selection and adaptation to various environments.

Conclusions

This study found additional mitogenome inserts limited in wrasse species. The rRNA genes with inserts might have experienced a selective pressure for adaptation to feeding modes. Such knowledge can enable a better understanding of molecular mechanism underlying morphological evolution in wrasses.
Proteomic and metabolic profile analysis of low-temperature storage responses in Ipomoea batata Lam. tuberous roots
Authors: Cui Peng , Li Yongxin , Cui Chenke , Huo Yanrong , Lu Guoquan , Yang Huqing
Published: September 2020

Background

Sweetpotato (Ipomoea batatasL.) is one of the seven major food crops grown worldwide. Cold stress often can cause protein expression pattern and substance contents variations for tuberous roots of sweetpotato during low-temperature storage. Recently, we developed proteometabolic profiles of the fresh sweetpotatoes (cv. Xinxiang) in an attempt to discern the cold stress-responsive mechanism of tuberous root crops during post-harvest storage.

Results

For roots stored under 4 °C condition, the CI index, REC and MDA content in roots were significantly higher than them at control temperature (13 °C). The activities of SOD, CAT, APX, O2.-producing rate, proline and especially soluble sugar contents were also significantly increased. Most of the differentially expressed proteins (DEPs) were implicated in pathways related to metabolic pathway, especially phenylpropanoids and followed by starch and sucrose metabolism. L-ascorbate peroxidase 3 and catalase were down-regulated during low temperature storage. α-amylase, sucrose synthase and fructokinase were significantly up-regulated in starch and sucrose metabolism, while β-glucosidase, glucose-1-phosphate adenylyl-transferase and starch synthase were opposite. Furthermore, metabolome profiling revealed that glucosinolate biosynthesis, tropane, piperidine and pyridine alkaloid biosynthesis as well as protein digestion and absorption played a leading role in metabolic pathways of roots. Leucine, tryptophan, tyrosine, isoleucine and valine were all significantly up-regulated in glucosinolate biosynthesis.

Conclusions

Our proteomic and metabolic profile analysis of sweetpotatoes stored at low temperature reveal that the antioxidant enzymes activities, proline and especially soluble sugar content were significantly increased. Most of the DEPs were implicated in phenylpropanoids and followed by starch and sucrose metabolism. The discrepancy between proteomic (L-ascorbate peroxidase 3 and catalase) and biochemical (CAT/APX activity) data may be explained by higher H2O2levels and increased ascorbate redox states, which enhanced the CAT/APX activity indirectly. Glucosinolate biosynthesis played a leading role in metabolic pathways. Leucine, tryptophan, tyrosine, isoleucine and valine were all significantly up-regulated in glucosinolate biosynthesis.
Infantile fever-triggered acute liver failure caused by novel neuroblastoma amplified sequence mutations: a case report
Authors: Li Weiran , Zhu Yu , Guo Qin , Wan Chaomin
Published: September 2020

Background

Infantile liver failure syndrome-2 (ILFS2) is caused by neuroblastoma amplified sequence (NBAS) mutation. The disease is characterized by recurrent episodes of acute liver failure (ALF) or by liver crisis triggered by recurrent episodes of fever and complete recovery.

Case presentation

Here, we describe the case of a Chinese girl with typical clinical manifestation of ILFS2 without exhibition of extrahepatic involvement. The patient harbored novel compound heterozygous mutations in the NBAS region (c.3386C > T (p.Ser1129Phe), c.1A > C (p.Met1Leu) and c.875G > A (p.Gly292Glu)), mutations which have not been previously reported. After administration of antipyretics and intravenous glucose and electrolyte administration, the patient recovered fully.

Conclusion

Through the present study, we recommend that ILFS2 should be taken into consideration during the differential diagnosis of children with recurrent, fever-triggered ALF. While the definitive diagnosis of ILFS2 remains dependent on genetic sequencing and discovery of NBAS, early antipyretic treatment is recommended to prevent liver crisis.
The metagenomic next-generation sequencing in diagnosing central nervous system angiostrongyliasis: a case report
Authors: Feng Li , Zhang Aiwu , Que Jiali , Zhou Hongyan , Wang Haiyan , Guan Yuanlin , Shen Cunzhou , Sun Xunsha , Lai Rong , Peng Fuhua , Feng Huiyu , Chen Ling
Published: September 2020

Backgrounds

The incidence of angiostrongyliasis is increasing in recent decades due to the expanding endemic areas all over the world. Clinicians face tremendous challenge of diagnosing angiostrongyliasis because of the lack of awareness of the disease and less effective definitive laboratory tests.

Case presentation

A 27-year-old man initially manifested skin itching, emesis, myalgia and quadriparesis. With progressive weakness of four limbs and elevated protein in the cerebrospinal fluid (CSF), he was diagnosed as Guillain-Barré syndrome and treated with intravenous methylprednisolone and immunoglobulin. However, the patient deteriorated with hyperpyrexia, headache and then persistent coma. The routine tests for Angiostrongylus cantonensis (A. cantonensis) with both the CSF and the serum were all negative. In contrast, the metagenomic next-generation sequencing (mNGS) was applied with the serum sample and the CSF sample in the middle phase. The central nervous system (CNS) angiostrongyliasis was diagnosed by mNGS with the mid-phase CSF, but not the mid-phase serum. At the same time, the CSF analysis revealed eosinophils ratio up to 67%. The discovery of A. cantonensis was confirmed by PCR with CSF later. Unfortunately, the patient died of severe angiostrongyliasis. During his hospitalization, mNGS was carried out repeatedly after definitive diagnosis and targeted treatment. The DNA strictly map reads number of A. cantonensis detected by mNGS was positively correlated with the CSF opening pressure and clinical manifestations.

Conclusions

The case of A. cantonensis infection highlights the benefit of mNGS as a target-free identification in disclosing the rare CNS angiostrongyliasis in the unusual season, while solid evidence from routine clinical testing was absent. The appropriate sample of mNGS should be chosen according to the life cycle of A. cantonensis. Besides, given the fact that the DNA reads number of A. cantonensis fluctuated with CSF opening pressure and clinical manifestations, whether mNGS could be applied as a marker of effectiveness of treatment is worth further exploration.
Identification of missense and synonymous variants in Iranian patients suffering from autosomal dominant polycystic kidney disease
Authors: Khadangi Fatemeh , Torkamanzehi Adam , Kerachian Mohammad Amin
Published: September 2020

Background

Autosomal dominant polycystic kidney disease (ADPKD), the predominant type of inherited kidney disorder, occurs due to PKD1 and PKD2 gene mutations. ADPKD diagnosis is made primarily by kidney imaging. However, molecular genetic analysis is required to confirm the diagnosis. It is critical to perform a molecular genetic analysis when the imaging diagnosis is uncertain, particularly in simplex cases (i.e. a single occurrence in a family), in people with remarkably mild symptoms, or in individuals with atypical presentations. The main aim of this study is to determine the frequency of PKD1 gene mutations in Iranian patients with ADPKD diagnosis.

Methods

Genomic DNA was extracted from blood samples from 22 ADPKD patients, who were referred to the Qaem Hospital in Mashhad, Iran. By using appropriate primers, 16 end exons of PKD1 gene that are regional hotspots, were replicated with PCR. Then, PCR products were subjected to DNA directional Sanger sequencing.

Results

The DNA sequencing in the patients has shown that exons 35, 36 and 37 were non- polymorphic, and that most mutations had occurred in exons 44 and 45. In two patients, an exon-intron boundary mutation had occurred in intron 44. Most of the variants were missense and synonymous types.

Conclusion

In the present study, we have shown the occurrence of nine novel missense or synonymous variants in PKD1 gene. These data could contribute to an improved diagnostic and genetic counseling in clinical settings.
Caesarean section rates in women in the Republic of Ireland who chose to attend their obstetrician privately: a retrospective observational study
Authors: Turner Michael J. , Reynolds Ciara M. E. , McMahon Léan E. , O’Malley Eimer G. , O’Connell Michael P. , Sheehan Sharon R.
Published: September 2020

Background

Caesarean section (CS) rates are increasing and there are wide variations in rates internationally and nationally. There is evidence that women who attend their obstetrician privately have a higher incidence of CS than those who attend publicly. The purpose of this observational study was to further investigate why CS rates may be higher in women who chose to attend their obstetrician privately.

Methods

This study analysed data collected as part of the clinical records by midwives at the woman’s first antenatal appointment in a large European maternity hospital. All women who delivered between the years 2009 and 2017 were included. Data were analysed both cross-sectionally and longitudinally.

Results

Overall, 73,266 women had a singleton pregnancy and 1830 had a multiple pregnancy. Of the packages of maternity care, 75.2% chose public, 10.8% chose semiprivate and 14.0% chose private. During the study, 11,991 women attended the hospital for their first and second pregnancies. Overall, women who attended privately were older and had higher proportions of infertility treatment and history of miscarriage (all p < 0.001) compared to those publicly-funded. Private patients were more likely to have a history of infertility, a history of miscarriage, a multiple pregnancy and to be ≥35 yrs. They had lower rates of obesity, smoking and illicit drug use in pregnancy (all p < 0.001). In women who chose private care, the overall rate of CS was higher compared to women choosing publicly-funded (42.7% vs 25.3%, p < 0.001) The increase was due to an increase in elective rather than emergency CS. The increase in elective CS fell after adjustment for clinical risks. In the longitudinal analysis, 89.7% chose the same package second time around. Women who changed from public to private care for the second pregnancy were more likely to have had a previous emergency CS or admission to the Neonatal Unit.

Conclusions

This study suggests that the increased CS rate in women privately insured may be attributed, in part, to the fact that women who can afford health insurance choose continuity of care from a senior obstetrician because they are risk adverse and wish to have the option of an elective CS.
Lived experience research as a resource for recovery: a mixed methods study
Authors: Honey Anne , Boydell Katherine M. , Coniglio Francesca , Do Trang Thuy , Dunn Leonie , Gill Katherine , Glover Helen , Hines Monique , Scanlan Justin Newton , Tooth Barbara
Published: September 2020

Background

Lived experience research is conducted by people who have experience of mental health issues and is therefore better placed than more traditional research to illuminate participants’ experiences. Findings that focus on identifying enablers of recovery from a lived experience perspective have the potential to assist people in their recovery process. However, this lived experience research is often difficult to find, access and interpret. We co-produced user-friendly and engaging resources to disseminate findings from six lived experience research studies. This paper seeks to answer the research questions: a) Did exposure to lived experience research increase hopefulness for participants?; and b) How else did interacting with lived experience research resources influence participants’ lives?

Methods

Thirty-eight participants were introduced to four resources of their choosing by peer workers over a four-week period. The helpfulness of resources was evaluated using mixed methods, including a quasi-experimental analysis of change in hope, an anonymous survey and in-depth interviews.

Results

Findings indicated that the resources promoted hope, but that increases in hopefulness may not be seen immediately. Other impacts include that the resources: encouraged helpful activities; provided a positive experience; increased valued knowledge; encouraged people to reflect on their journey and think constructively about mental health issues; helped people to feel less alone; and assisted people to explain their situation to others.

Conclusions

The research suggests the potential usefulness of lived experience research resources, presented in user-friendly formats, in the lives of people who experience mental health issues and implies a need to nurture this type of research.
Bayesian frailty modeling of correlated survival data with application to under-five mortality
Authors: Alotaibi Refah M. , Rezk Hoda Ragab , Guure Chris
Published: September 2020

Background

There is high rate of under-five mortality in West Africa with little effort made to study determinants that significantly increase or decrease its risk across the West African sub-region. This is important since it will help in the design of effective intervention programs for each country or the entire region. The overall objective of this research evaluates the determinants of under-five mortality prior to the end of the 2015 Millennium Development Goals, to guide West African countries implement strategies that will aid them achieve the Sustainable Development Goal 3 by 2030.

Method

This study used the Demographic and Health Survey (DHS) data from twelve (12) out of the eighteen West African countries; Ghana, Benin, Cote d’ Ivoire, Guinea, Liberia, Mali, Niger, Nigeria, Sierra Leone, Burkina Faso, Gambia and Togo. Data were extracted from the children and women of reproductive age files as provided in the DHS report. The response or outcome variable of interest is under-five mortality rate. A Bayesian exponential, Weibull and Gompertz regression models via a gamma shared frailty model were used for the analysis. The deviance information criteria and Bayes factors were used to discriminate between models. These analyses were carried out using Stata version 15 software.

Results

The study recorded 101 (95% CI: 98.6–103.5) deaths per 1000 live births occurring among the twelve countries. Burkina Faso (124.4), Cote D’lvoire (110.1), Guinea (116.4), Nigeria (120.6) and Niger (118.3) recorded the highest child under-5 mortality rate. Gambia (48.1), Ghana (60.1) and Benin (70.4) recorded the least unde-5 mortality rate per 1000 livebirths. Multiple birth children were about two times more likely to die compared to singleton birth, in all except Gambia, Nigeria and Sierra Leone. We observed significantly higher hazard rates for male compared to female children in the combined data analysis (HR: 1.14, 95% CI: [1.10–1.18]). The country specific analysis in Benin, Cote D’lvoire, Guinea, Liberia, Mali and Nigeria showed higher under-5 mortality hazard rates among male children compared to female children whilst Niger was the only country to report significantly lower hazard rate of males compared to females.

Conclusion

There is still quite a substantial amount of work to be done in order to meet the Sustainable Development Goal 3 in 2030 in West Africa. There exist variant differences among some of the countries with respect to mortality rates and determinants which require different interventions and policy decisions.
Social networks, health and identity: exploring culturally embedded masculinity with the Pakistani community, West Midlands, UK
Authors: Kokab Farina , Greenfield Sheila , Lindenmeyer Antje , Sidhu Manbinder , Tait Lynda , Gill Paramjit
Published: September 2020

Background

Migrants from South Asia living in developed countries have an increased risk for developing cardiovascular disease (CVD), with limited research into underlying social causes.

Methods

We used social capital as an interpretive lens to undertake analysis of exploratory qualitative interviews with three generations of at-risk migrant Pakistani men from the West Midlands, UK. Perceptions of social networks, trust, and cultural norms associated with access to healthcare (support and information) were the primary area of exploration.

Results

Findings highlighted the role of social networks within religious or community spaces embedded as part of ethnic enclaves. Local Mosques and gyms remained key social spaces, where culturally specific gender differences played out within the context of a diaspora community, defined ways in which individuals navigated their social spheres and influenced members of their family and community on health and social behaviours.

Conclusions

There are generational and age-based differences in how members use locations to access and develop social support for particular lifestyle choices. The pursuit of a healthier lifestyle varies across the diverse migrant community, determined by social hierarchies and socio-cultural factors. Living close to similar others can limit exposure to novel lifestyle choices and efforts need to be made to promote wider integration between communities and variety of locations catering to health and lifestyle.
Ethnicity classification systems for public health surveys: experiences from HIV behavioural surveillance among men who have sex with men
Authors: Lachowsky Nathan J. , Saxton Peter J.W. , Dickson Nigel P. , Hughes Anthony J. , Jones Rhys G. , Clark Terryann C. , Ho Elsie , Summerlee Alastair J.S. , Dewey Cate E.
Published: September 2020

Background

Race and ethnicity classification systems have considerable implications for public health, including the potential to reveal or mask inequities. Given increasing “super-diversity” and multiple racial/ethnic identities in many global settings, especially among younger generations, different ethnicity classification systems can underrepresent population heterogeneity and can misallocate and render invisible Indigenous people and ethnic minorities. We investigated three ethnicity classification methods and their relationship to sample size, socio-demographics and sexual health indicators.

Methods

We examined data from New Zealand’s HIV behavioural surveillance programme for men who have sex with men (MSM) in 2006, 2008, 2011, and 2014. Participation was voluntary, anonymous and self-completed; recruitment was via community venues and online. Ethnicity allowed for multiple responses; we investigated three methods of dealing with these: Prioritisation, Single/Combination, and Total Response. Major ethnic groups included Asian, European, indigenous Māori, and Pacific. For each classification method, statistically significant associations with ethnicity for demographic and eight sexual health indicators were assessed using multivariable logistic regression.

Results

Overall, 10,525 MSM provided ethnicity data. Classification methods produced different sample sizes, and there were ethnic disparities for every sexual health indicator. In multivariable analysis, when compared with European MSM, ethnic differences were inconsistent across classification systems for two of the eight sexual health outcomes: Māori MSM were less likely to report regular partner condomless anal intercourse using Prioritisation or Total Response but not Single/Combination, and Pacific MSM were more likely to report an STI diagnosis when using Total Response but not Prioritisation or Single/Combination.

Conclusions

Different classification approaches alter sample sizes and identification of health inequities. Future research should strive for equal explanatory power of Indigenous and ethnic minority groups and examine additional measures such as socially-assigned ethnicity and experiences of discrimination and racism. These findings have broad implications for surveillance and research that is used to inform public health responses.
Kimura’s disease mimicking thoracic spine dumbbell neurogenic tumor: a case report and literature review
Authors: Bi Siwei , Gu Jun , Hu Chenggong
Published: September 2020

Background

Kimura’s disease is a rare, benign chronic inflammatory disease of unknown etiology that mostly affects Asians. The disease typically presents as subcutaneous masses in the head or neck region that are predominantly found in the preauricular and submandibular areas.

Case presentation

A 7-year-old boy presenting with paralysis of both lower extremities and a thoracic spine dumbbell mass was initially diagnosed with a neurogenic tumor, but the pathological and laboratory examinations confirmed the diagnosis of Kimura’s disease. The paralysis symptom disappeared rapidly, but the patient had developed a recurrent mass in the cervical vertebral canal at the 9-month follow-up.

Conclusion

To our knowledge, no prior published literature has revealed Kimura’s disease cases that mimic dumbbell neurogenic tumors. Here, we report such a case of Kimura’s disease for the first time and provide a brief review of the literature.
How breast cancer treatments affect the quality of life of women with non-metastatic breast cancer one year after surgical treatment: a cross-sectional study in Greece
Authors: Yfantis Aris , Sarafis Pavlos , Moisoglou Ioannis , Tolia Maria , Intas George , Tiniakou Ioanna , Zografos Konstantinos , Zografos George , Constantinou Marianna , Nikolentzos Athanasios , Kontos Michalis
Published: September 2020

Background

The continuously increasing survivorship of female breast cancer makes the monitoring and improvement of patients’ quality of life ever so important. While globally there is a growing body of research on health-related quality of life 1 year after surgical treatment for non-metastatic breast cancer, up-to-date information regarding Greek patients is scarce.

Objective

To measure the level of QoL of non-metastatic BC survivors in Greece 1 year after surgery.

Methods

A sample of 200 female breast cancer survivors aged 18 to 75, who followed up as outpatients in five public hospitals were included in this cross-sectional study. All recruited patients agreed to participate in the study (100% response rate). Quality of life data were collected through the EORTC QLQ-C30 as well as BR23 questionnaires.

Results

Cronbach’s alpha for all scales of the two questionnaires was from 0.551 to 0.936 indicating very good reliability. According to the Multiple Linear Regression, older patients showed a lower future perspective (p = .031), with those living in rural areas, which was associated with more financial difficulties (p = .001). Women with tertiary education and those who had been hospitalized in a university hospital recorded better on global health status (p = .003 and .000 respectively). Patients who underwent chemotherapy reported better scores in the emotional function sub-scale (p = .025). Women with reconstruction and at least one complication appeared to have significantly better scores in future perspective and social function (p = .005, .002 respectively).

Conclusions

Breast cancer survivors were found to have an overall good quality of life, functioning/symptoms scores and were satisfied with the provided care.
Informed self-assessment versus preceptor evaluation: a comparative study of pediatric procedural skills acquisition of fifth year medical students
Authors: Elhadi Muhammed , Ahmed Hazem , Khaled Ala , Almahmoudi Wejdan K. , Atllah Samah S. , Elhadi Ahmed , Esahli Hamida
Published: September 2020

Background

Simulation training is widely used in medical education as students rarely perform clinical procedures, and confidence can influence practitioners’ ability to perform procedures. Thus, this study assessed students’ perceptions and experiences of a pediatric skills program and compared their informed self-assessment with their preceptor-evaluated performance competency for several pediatric clinical procedures.

Methods

A total of 65 final-year medical students attended a weeklong pediatric skills training course by the University of Tripoli that used a manikin and various clinical scenarios to simulate real-life cases. Participants completed questionnaires self-assessing their performance skills, while examiners evaluated each students’ competency on five procedural skills (lumbar puncture, nasogastric tube insertion, umbilical vein catheterization, intraosseous access, and suprapubic aspiration) using an objective structured clinical examination (OSCE) model. Differences between agreement levels in question responses were evaluated through a nonparametric chi-square test for a goodness of test fit, and the relationship between confidence levels and the OSCE scores for each procedure was assessed using Spearman’s rank-order correlation.

Results

All participants completed the informed self-assessment questionnaire and OSCE stations. The frequency differences in agreement levels in students’ questionnaire responses were statistically significant. No significant differences were found between students’ self-assessment and preceptors’ evaluation scores. For each procedure’s passing score rate, umbilical vein catheterization had the highest passing rate (78.5%) and nasogastric tube placement the lowest (56.9%). The mean performance scores were above passing for all procedures. The Wilcoxon signed-rank test revealed no significant differences between participants’ self-assessment and their preceptor-evaluated competency; students correctly perceived and assessed their ability to perform each procedure.

Conclusions

High competence in several life-saving procedures was demonstrated among final-year medical students. The need for consistent and timely feedback, methods to increase medical students’ confidence, and further development and improvement of competency-based assessments are also highlighted.
Has teaching about intellectual disability healthcare in Australian medical schools improved? A 20-year comparison of curricula audits
Authors: Trollor Julian N. , Eagleson Claire , Ruffell Beth , Tracy Jane , Torr Jennifer J. , Durvasula Seeta , Iacono Teresa , Cvejic Rachael C. , Lennox Nicholas
Published: September 2020

Background

People with intellectual disability (ID) have multiple and complex health needs, more frequent healthcare episodes, and experience poorer health outcomes. Research conducted two decades ago showed that medical professionals were lacking in the knowledge and skills required to address the complex needs of this patient group. The aim of the current study was to determine whether Australian undergraduate medical schools that offer ID health education content had changed the amount and nature of such teaching over this period.

Methods

Identical or equivalent questionnaire items were compared across eight Australian medical schools that participated in curricula audits conducted in 1995 (referred to as T1) and 2013/14 (T2). The audits were of the nature of the ID content, methods used to teach it, and who taught it.

Results

There was no significant difference in the number of hours of compulsory ID content offered to medical students at T2 (total = 158.3 h; median = 2.8 h per ID unit) compared with T1 (total = 171 h; median = 2.5 h). At T2 compared with T1, units with ID content taught in the area of general practice had increased (2 units; 3.6% to 7 units; 16.3%), while decreases were seen in paediatrics (22 units; 40.0% to 10 units; 23.3%) and psychiatry (10 units; 18.2% to 4 units; 9.3%). The number of schools using problem- and/or enquiry-based learning rose to six at T2 from one at T1. Inclusive teaching practices (people with ID develop or deliver content) in compulsory/elective units had increased at T2 (10 units; 23.3%) compared with T1 (6 units; 10.9%), but direct clinical contact with people with ID had decreased (29 units; 52.7% to 11 units; 25.6%).

Conclusions

Overall, little progress has been made to address the gaps in ID education for medical students identified from an audit conducted in 1995. Renewal of ID content in medical curricula is indicated as a key element in efforts to improve workforce capacity in this area and reduce barriers to care, with the aim of reversing the poor health outcomes currently seen for this group.
Structural coercion in the context of community engagement in global health research conducted in a low resource setting in Africa
Authors: Nyirenda Deborah , Sariola Salla , Kingori Patricia , Squire Bertie , Bandawe Chiwoza , Parker Michael , Desmond Nicola
Published: September 2020

Background

While community engagement is increasingly promoted in global health research to improve ethical research practice, it can sometimes coerce participation and thereby compromise ethical research. This paper seeks to discuss some of the ethical issues arising from community engagement in a low resource setting.

Methods

A qualitative study design focusing on the engagement activities of three biomedical research projects as ethnographic case studies was used to gain in-depth understanding of community engagement as experienced by multiple stakeholders in Malawi. Data was collected through participant observation, 43 In-depth interviews and 17 focus group discussions with community leaders, research staff, community members and research participants. Thematic analysis was used to analyse and interpret the findings.

Results

The results showed that structural coercion arose due to an interplay of factors pertaining to social-economic context, study design and power relations among research stakeholders. The involvement of community leaders, government stakeholders, and power inequalities among research stakeholders affected some participants’ ability to make autonomous decisions about research participation. These results have been presented under the themes of perception of research as development, research participants’ motivation to access individual benefits, the power of vernacular translations to influence research participation, and coercive power of leaders.

Conclusion

The study identified ethical issues in community engagement practices pertaining to structural coercion. We conclude that community engagement alone did not address underlying structural inequalities to ensure adequate protection of communities. These results raise important questions on how to balance between engaging communities to improve research participation and ensure that informed consent is voluntarily given.