bluuebunny/crossref_metadata_2025 huggingface dataset:
Outlier Analysis to Improve the Performance of an Incident Duration Estimation and Incident Management System
Authors: Won Minsu
Published: May 2020

Traffic incidents, as non-recurrent events, are one of the major causes of congestion in the transportation network. To mitigate the impacts of such incidents and to recover the performance of transportation systems as safely and quickly as possible, most responsible agencies over the past decades have implemented various traffic incident management systems, and an incident duration prediction model is one of the key components to estimate the impact of time-varying incidents on the network. Many studies have been undertaken to develop a robust prediction model of incident duration, but they have struggled to provide a reliable and accurate estimation result because of various data and modeling issues, such as a highly skewed distribution, complex correlations, heteroscedasticity, many outliers, and so forth. This study proposes an outlier analysis process for estimating the outlier-ness of each detected incident and utilizing such outlier information to improve accuracy of prediction of incident duration estimation and detect any system deficiency. An ensemble modeling technique and various outlier detection methodologies have been used to estimate the outlier-ness, and a hybrid association rule mining method has been applied to classify the detected outliers as anomalies or noises. Lastly, through the model evaluation and application example in this study, we can conclude that the proposed outlier analysis process can improve the accuracy of incident duration estimation and detect the potential system deficiencies associated with incident response, data recording, resource management, and so forth.
Psychometric Properties of the Subjective Wellbeing Assessment Scale—French Version (SWBAS-18F): A Study With Young Refugees and Internally Displaced People in Nigerien Refugee Camps
Authors: Veronese Guido , Pepe Alessandro
Published: May 2020

The aim of our research was to identify an easy-to-administer instrument for evaluating wellbeing in an at-risk population of young internal displaced people and young refugees in sub-Saharan Africa ( N = 462). To this end, we adapted the French-language 17-item version of the Subjective Wellbeing Assessment Scale (SWBAS—French version) and evaluated its factor structure, using a combination of exploratory factor analysis and confirmatory factor analysis. We observed five underlying factors (positive functioning, negative functioning, human insecurity, school domain, and social domain) and 17 items. Participants’ scores on the positive functioning, negative functioning, and social domain subscales were associated with their levels of psychological distress, and the statistical outcomes provided support for practical adoption of the instrument. The SWBAS-17F may, therefore, represent user-friendly instruments that practitioners might use alongside adaptations of more traditional diagnostic tools to obtain a complete and holistic assessment of refugees, asylum seekers, and internally displaced people.
Can financial rewards complement altruism to raise deceased organ donation rates?
Authors: Rasiah Rajah , Naghavi Navaz , Mubarik Muhammad Shujaat , Nia Hamid Sharif
Published: May 2020

Background:

Organ supply–demand in developing countries worldwide has continued to widen. Hence, using a large survey (n ¼ 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates.

Methods:

Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs.

Ethical considerations:

The study was approved by the University of Malaya ethics committee.

Results:

The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate.

Conclusion:

Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach.
Bearing fault diagnosis using deep learning techniques coupled with handcrafted feature extraction: A comparative study
Authors: Alabsi Mohammed , Liao Yabin , Nabulsi Ala-Addin
Published: May 2020

Deep learning has seen tremendous growth over the past decade. It has set new performance limits for a wide range of applications, including computer vision, speech recognition, and machinery health monitoring. With the abundance of instrumentation data and the availability of high computational power, deep learning continues to prove itself as an efficient tool for the extraction of micropatterns from machinery big data repositories. This study presents a comparative study for feature extraction capabilities using stacked autoencoders considering the use of expert domain knowledge. Case Western Reserve University bearing dataset was used for the study, and a classifier was trained and tested to extract and visualize features from 12 different failure classes. Based on the raw data preprocessing, four different deep neural network structures were studied. Results indicated that integrating domain knowledge with deep learning techniques improved feature extraction capabilities and reduced the deep neural networks size and computational requirements without the need for exhaustive deep neural networks architecture tuning and modification.
Marked Elevation in Serum Procalcitonin Levels Do Not Correlate With Severity of Disease or Mortality in Hospitalized Patients: A Retrospective Study
Authors: Durrance Richard J , Ullah Tofura , Patel Harsh , Martinez Grace , Cervellione Kelly , Zafonte Veronica B , Gafoor Khalid , Bagheri Farshad
Published: May 2020

Background:

Bacteremia and sepsis are significant contributors to the morbidity, mortality, and economic burden of health care systems worldwide. Procalcitonin has been identified as a potentially useful marker of disease and severity in sepsis. However, the assumption that greater procalcitonin levels correlate with greater burden of disease has not been adequately studied.

Methods:

A retrospective chart review of adult patients admitted to an urban teaching hospital with suspected sepsis was undertaken to test the association of elevated procalcitonin (>30 ng/mL) with other markers of sepsis (lactic acid, white blood cell count, percent bands), severity of disease (Sequential Organ Failure Assessment [SOFA] and Acute Physiology and Chronic Health Evaluation–II [APACHE II] scores), and mortality.

Results:

In total, 168 patients were identified over 18 months (42% ward, 11% Stepdown, 44% medical intensive care unit [MICU], 2% surgical intensive care unit (STICU), 1% gynecology [GYN]). The Spearman correlation analysis showed that serum procalcitonin level did not correlate with SOFA ( P = .238) or APACHE II ( P = .918) scores on admission, and did not correlate with survival (Kruskal-Wallis test, P = .937). However, higher serum procalcitonin levels were associated with patients who had positive blood cultures (Kruskal-Wallis test, P = .0016 for Gram-positive and P = .0007 for Gram-negative bacteria). Lactic acid levels on admission strongly correlated with SOFA APACHE II (the Spearman correlation, P < .0001 for both) and mortality ( P = .0001 for both).

Conclusions:

Higher serum procalcitonin levels above 30 ng/mL failed to correlate with indicators of sepsis, severity of disease (SOFA and APACHE II scores), and mortality but were associated with positive blood cultures. Lactic acid levels did show correlation to both severity of disease and mortality. Serum procalcitonin levels >30 ng/mL do not appear to correlate with the severity of disease in a sample of patients with markedly elevated initial procalcitonin levels.
Tribological analyses of a new optimized gearbox biodegradable lubricant blended with reduced graphene oxide nanoparticles
Authors: Bhaumik Shubrajit , Kamaraj M , Paleu Viorel
Published: May 2020

The current work aims to develop a biodegradable lubricant by adding different volume percentages of cashew nut shell liquid (CNSL) in neat castor oil (NCO) and investigating its possibility as replacement to non-biodegradable mineral oil (commercial mineral oil) in industrial applications. The blend exhibiting better tribological properties was additived with different weight percentages of reduced graphene oxide (r-GO) nano-platelets and further tribological tests were performed. The performance of 40%CNSL+NCO was 45.8% better than commercial mineral oil, and with the addition of the 0.5% r-GO in the blend, the performance was improved by 61.7% than the commercial mineral oil. Finally, the novel biodegradable mixture blended with nanoparticles was employed as a lubricant in a gearbox, proving the superiority of the biodegradable lubricant over the commercial mineral oil.
An approach to predicting indoor radon concentration based on depressurisation measurements
Authors: McGrath James A , Byrne Miriam A
Published: May 2020

Exposure to radon is recognised as the second-leading cause of lung cancer after tobacco smoke. The passive measurements typically take up to three months to be representative of the annual radon concentration. A recently developed approach depressurises a dwelling to heighten the convective radon flux determining radon entry rate coefficients. The current study characterises the ventilation status, air tightness and eight selected hourly air change rates measurements, of a sample of naturally ventilated dwellings in Ireland. The household averaged air change rate ranged from 0.28 to 1.87 h−1 and airtightness measurements ranged from 4.830 to 9.423 m3 h−1 m−2 @ 50 Pa, depending on the building characteristics. The experimentally obtained values were used to parameterise a computational model for these selected dwellings and to predict radon concentrations. The radon entry rate power laws ranged from 0.18ΔP0.97 to 1.28ΔP1.18 Bq s−1. Probabilistic functions were generated based on the experimental data and predicted radon concentrations were within one standard deviation of the experimentally measured values in three out of four cases. The data generated can be used in modelling simulations to predict indoor radon concentrations based on local meteorological conditions, building characteristics, ventilation guidelines and energy-retrofit measurements.
Pattern of injuries and management of adolescent trauma in a combined adult and paediatric major trauma centre in United Kingdom
Authors: Anwar Fahim , Mee Harry , Allanson Judith , Mendis Elly , Hamilton Colin
Published: May 2020

Background

Major trauma is a leading cause of death and disability in 16–18-year olds in the UK. Since the launch of major trauma centres (MTCs) in 2012 in UK, survival rates have improved on the whole. The aim of this study was to look at the pathways of 16–18-year olds through one MTC and patterns of rehabilitation provision.

Material and methods

A retrospective case notes review of all trauma patients aged between 16 and 18 years admitted to one MTC between October 2012 and May 2018.

Results

One hundred forty-seven young people were identified. 67.3% were male with a mean age of 17.1 years. Motor vehicle accidents were the most common cause of injury (59.2%). Thirty-nine percent had a Glasgow Coma Scale at scene >13. Sixty-three percent were admitted to an adult intensive care unit (ICU), 5.4% to paediatric ICU and 31.3% directly to a ward. Admissions to rehabilitation ward came through adult services with no commissioned equivalent in those admitted to paediatrics. Mean length of stay was 18.1 days. 75.5% of patients were discharged home from the MTC.

Discussion

The majority of young people were admitted on to adult wards and were able to access commissioned services. However, such services do not provide for the specialist needs of young people, with no access to schooling or parent’s accommodation. Those who were admitted to children’s services missed out on commissioned rehabilitation pathways.

Conclusion

Young people of transition age often fall between services. For the first time, we illustrate injury patterns and the fragmented services seen in this vulnerable patient group.
The coverage method of unmanned aerial vehicle mounted base station sensor network based on relative distance
Authors: Zhao Taifei , Wang Hua , Ma Qianwen
Published: May 2020

The unmanned aerial vehicle features with high flexibility and easy deployment. It could be used as an air base station and provide fast communication services for the ground users. It plays an important role in some special occasions such as natural disasters, emergency communications and temporary large-scale activities. A single unmanned aerial vehicle equipped with base station has limited range of services, but a multiple unmanned aerial vehicle equipped with base station network can serve a wider range of users. The research goal of unmanned aerial vehicle equipped with base station network coverage control is to maximize the network coverage under the condition of maintaining the service quality. In view of the low dynamic coverage ratio of unmanned aerial vehicle equipped with base station network, this article proposes a relative distance–based unmanned aerial vehicle equipped with base station deployment method. The unmanned aerial vehicle realizes on-demand coverage and maintains a stable network topology under the influence of three relative distances by sensing the uncovered area of the ground, the neighbouring unmanned aerial vehicles and the location of the coverage boundary or obstacles. In addition, the algorithm is also adapted to a variety of scenarios. The simulation results show that the coverage of the proposed algorithm is 22.4% higher than that of random deployment, and it is 9.9%, 4.7% and 2.1% higher than similar virtual force-oriented node, circular binary segmentation and hybrid local virtual force algorithms.
Similarity analysis of dam behavior characterized by multi-monitoring points based on Cloud model
Authors: Li Hanman , Li Ziyang , Ma Fuheng , Liu Chengdong
Published: May 2020

The availability of massive amount of dam safety monitoring data can make it difficult to analyze and characterize dam behavior. This article describes the use of the Cloud model to transform quantitative monitoring data into qualitative information. Each monitoring point returning dam safety data is regarded as a cloud drop, and parameters such as the expectation, entropy, and hyper-entropy of the monitoring data are obtained through a backward cloud generator to represent the operational state of the dam. The monitoring points are then treated as vectors, and the cloud similarity is calculated using the cosine value of the angle between them. The cloud similarity coefficient is then determined to characterize the similarity of dam behavior. Experimental analysis shows that the process of identifying cloud parameters has a good effect on the discovery of abnormal monitoring values regarding dam safety and demonstrates the feasibility of characterizing the dam behavior. Clustering analysis is applied to the similarity coefficients to further achieve the hierarchical management of dam monitoring points.
The study of transcarotid artery revascularization under local versus general anesthesia with results from the Society for Vascular Surgery Vascular Quality Initiative
Authors: Mukherjee Dipankar , Collins Devon T , Liu Chang , Ha Neul , Jim Jeffrey
Published: May 2020

Objective

The primary purpose of this study was to examine any potential difference in clinical outcomes between transcarotid artery revascularization performed under local anesthesia compared with general anesthesia by utilizing a large national database.

Methods

The primary outcome of the study was a composite endpoint of postoperative in-hospital stroke, myocardial infarction and mortality following transcarotid artery revascularization for the index procedure. Secondary outcomes included a composite outcome of postoperative in-hospital stroke, transient ischemic attack, myocardial infarction and mortality along with several subsets of its components and each individual component, flow reversal time (min), radiation dose (GY/cm2), contrast volume utilized (mL), total procedure time (min), extended total length of stay (>1 day) and extended postoperative length of stay (>1 day). Statistical analyses employed both descriptive measures to characterize the study population and analytic measures such as multivariable mixed-effect linear and logistic regressions using both unmatched and propensity-score matched cohorts.

Results

A total of 2609 patients undergoing transcarotid artery revascularization between the years 2016 and 2018 in the US were identified, with 82.3% performed under general anesthesia and 17.7% under local anesthesia. The primary composite outcome was observed in 2.3% of general anesthesia patients versus 2.6% of local anesthesia patients ( p = 0.808). The rate of postoperative transient ischemic attack and/or myocardial infarction was 1.6% with general anesthesia versus 1.1% with local anesthesia ( p = 0.511). For adjusted regression analysis, general anesthesia and local anesthesia were comparable in terms of primary outcome (OR: 0.72; 95% CI: 0.27–1.93, p = 0.515). As for the secondary outcomes, no significant differences were found except for contrast, where the results demonstrated significantly less need for contrast with procedures performed under general anesthesia (coefficient: 4.94; 95% CI: 1.34–8.54, p = 0.007). A trend towards significance was observed for lower rate of postoperative transient ischemic attack and/or myocardial infarction (OR: 0.33; 95% CI: 0.09–1.18, p = 0.088) and lower flow reversal time under local anesthesia (coefficient: –0.94: 95% CI: –2.1–0.22, p = 0.111).

Conclusions

Excellent outcomes from transcarotid artery revascularization for carotid stenosis were observed in the VQI database between the years 2016 and 2018, under both local anesthesia and general anesthesia. The data demonstrate the choice of anesthesia for transcarotid artery revascularization does not appear to have any effect on clinical outcomes. Surgical teams should perform transcarotid artery revascularization under the anesthesia type they are most comfortable with.
Where is Boris Johnson? When and why it matters that leaders show up in a crisis
Authors: Tomkins Leah
Published: May 2020

Now, more than at any time in our recent history, we will be judged by our capacity for compassion. (Rishi Sunak, UK Chancellor of the Exchequer, 20 March 2020). 1

In this piece, I draw on an ethics of care and compassion to address a question that has been asked almost daily in UK politics over the past weeks and months, namely: Where is Boris Johnson? Johnson is a leader with a long-standing reputation for being selective about whether and when he shows up. On 16 March 2020, as the severity of the coronavirus finally seemed to register, Johnson agreed to start holding daily press briefings, bringing his previous track-record and apparent instinct for no-shows into sharp relief. Criticism was understandably stilled during his hospitalisation for the virus, but it was not long after his discharge from hospital before the question of his absences came back into focus, with renewed concern about his non-attendance at key COBRA meetings and his decision to go on holiday in mid-February as the virus had been taking hold. 2 Through the prism of the psychoanalytic caring leader, I reflect on some of the explanations for, and implications of, his absences, arguing that they do not always have the same function or effect. Some absences may be politically astute, as a way of promoting an anti-establishment message and/or reassuring his constituents of their own competence and efficacy. Other absences are decidedly risky, because they send a message that he does not care. In times of crisis, the scales of separation versus proximity – absence versus presence – tip differently to normal, and leaders who appear not to care risk triggering especially powerful anxieties about betrayal and abandonment. When it is impossible for us to be care free, leaders must avoid being perceived or experienced as care less.
Men’s Help-Seeking for Depression: Attitudinal and Structural Barriers in Symptomatic Men
Authors: Rice Simon M. , Oliffe John L. , Kealy David , Seidler Zac E. , Ogrodniczuk John S.
Published: May 2020

Objective: Men with depression are known to have significant challenges with health service engagement. The current study sought to better understand attitudinal and structural mental health care barriers among those men identified as symptomatic for symptoms of major depression. Design: Cross-sectional study with data provided by Canadian men via a nationally representative online survey. Outcomes examined depression, suicide risk, and barriers to mental health services. Participants: A total of 117 men (mean age = 42.36 years) reporting symptoms of major depression consistent with moderate severity as identified by the Patient Health Questionnaire–Depression Module (PHQ-9). Results: In all, 51.3% of the sample reported previously receiving counselling or psychotherapy for mental health concerns. The majority (63.2%) reported past 2-week suicide or self-harm ideation; however, only a small proportion (8.5%) were currently engaged with professional mental health support. Logistic regression indicated that men’s attitudinal barriers to mental health help-seeking had a greater predictive effect than structural barriers (33% vs 0% of items, respectively). In particular, lower likelihood of help-seeking was associated with men’s reluctance to disclose mood-related symptoms to their physician/family doctor (adjusted odds ratio [AOR] = 0.37), a tendency for self-reliance and solving one’s own problems (AOR = 0.34), and uncertainly about the process of psychotherapy (AOR = 0.29). Conclusion: Gender-transformative approaches to primary health care may be key to improving men’s rates of disclosure and increasing detection for depression and suicide risk.
Epidemiologic Assessment of Concussions in an NCAA Division I Women’s Soccer Team
Authors: Weber Alexander E. , Trasolini Nicholas A. , Bolia Ioanna K. , Rosario Santano , Prodromo John P. , Hill Catherine , Romano Russ , Liu Charles Y. , Tibone James E. , Gamradt Seth C.
Published: May 2020

Background:

Among collegiate sports, ice hockey and wrestling have been reported to have the highest rates of concussion injury. Recent literature has shown that among all sports, female soccer players had the highest rate of concussion injury at the high school level. Sport-specific analysis will increase our knowledge of epidemiologic characteristics of this serious injury in young soccer players, where “heading” is commonly involved during participation.

Hypothesis:

Heading during soccer will be associated with increased frequency of concussion injury in collegiate female players compared with other mechanisms of injury, and concussion injury mechanism and rates will differ by setting of injury (practice or match) and player position.

Study Design:

Descriptive epidemiologic study.

Methods:

This was a retrospective review and epidemiologic analysis of all concussions documented from a single National Collegiate Athletic Association (NCAA) Division I female collegiate soccer team between 2004 and 2017. A total of 381 participants were reviewed, and concussion injury mechanism, setting (practice or match), player position, and number of games and practices missed due to injury were analyzed.

Results:

Overall, 25 concussions in 22 players from the 2004 to 2017 seasons were identified, for an annual rate of 1.79 concussions per year. Collisions (36%) followed by headers (20%) were the most common mechanisms. Forwards sustained the most concussions (32%). Injuries were more common in games (56%) than practice (40%). Of note, the most common cause of concussion during practice was headers (40%). Of the concussions documented, 20 (91%) were the player’s first concussion. On average, each concussion resulted in a player missing 3.96 games and 12.46 practices.

Conclusion:

Our results demonstrate that concussion rates in female NCAA soccer players vary by position and occur with different frequencies and mechanisms in practice and games. Interventions for concussion avoidance should aim to limit exposure to high-risk activity, including player-to-player contact in games and headers in practice. Although gameplay and collisions can be unpredictable and difficult to control, practice settings can be modified in an attempt to decrease risk.
Facilitators and barriers to improved cookstove adoption: a community-based cross-sectional study in Northwest Ethiopia
Authors: Adane Mesafint Molla , Alene Getu Degu , Mereta Seid Tiku , Wanyonyi Kristina Lutomya
Published: May 2020

Background

Among the environmental risk factors, household air pollution exposure from traditional cooking practices is one of the biggest killers globally, which mainly impacts developing countries where many families rely on traditional cooking practices. Although improved cookstove adoption is central to tackle this public health issue, the efforts to disseminate cookstove technologies have faced challenges, and the adoption rates are reported to be very low in many developing countries including Ethiopia. Therefore, this study aimed to determine the magnitude and identify potential factors that may act as facilitators or barriers to adoption from users’ point of view.

Methods

As part of the wider stove trial project, a cross-sectional study was conducted among a total of 5830 households under randomly selected clusters. The required data were collected through face-to-face interviews, and a backward stepwise logistic regression analysis technique was applied to evaluate the effect of potential predictor variables on adoption using adjusted odds ratio (AOR) as measures of effect.

Results

The prevalence of adoption was found to be 12.3% (95% CI 11.5–13.2), and households headed by females (AOR 1.96; 95% CI 1.24–3.10), private house ownership (AOR 4.58; 95% CI 3.89–6.19), separate cooking location (AOR 1.84; 95% CI 1.49–2.78), fuel purchasing (AOR 2.13; 95% CI 1.64–2.76), health benefit (AOR 1.76; 95% CI 1.15–2.70), optimistic social interaction (AOR 1.81; 95% CI 1.46–2.26), traditional suitability (AOR 1.58; 95% CI 1.28–1.95), stove use demonstration experience (AOR 2.47; 95% CI 1.98–3.07), cheap price (AOR 2.48; 95% CI 1.91–3.21), availability (AOR 1.81; 95% CI 1.5–1, 2.17), fuel-saving benefit (AOR 1.63; 95% CI 1.18–2.24), and more durable stove (AOR 1.71; 95% CI 1.30–2.26) of cookstove played a significant role as facilitators to adoption. In addition, lower educational level of head (AOR 0.31; 95% CI 0.23–0.42) and fuel processing requirement (AOR 0.55; 95% CI 0.44–0.70) of cookstove were found to be barriers for adoption.

Conclusions

Extremely lower improved cookstove adoption was observed due to household- and setting-related, cookstove technology-related, user knowledge- and perception-related, and financial- and market development-related factors. Therefore, to gain successful adoption, implementers and policymakers should consider those important factors in the implementation of clean cooking solutions to the community.
Role of phasiRNAs from two distinct phasing frames of GhMYB2 loci in cis- gene regulation in the cotton genome
Authors: Zhao Ting , Tao Xiaoyuan , Li Menglin , Gao Mengtao , Chen Jiedan , Zhou Na , Mei Gaofu , Fang Lei , Ding Linyun , Zhou Baoliang , Zhang Tianzhen , Guan Xueying
Published: May 2020

Background

Phased small interfering RNA (phasiRNA) is primarily derived from the 22-nt miRNA targeting loci. GhMYB2, a gene with potential roles in cotton fiber cell fate determination, is a target gene of miR828 and miR858 in the generation of phasiRNAs.

Results

In the presented work, through the evaluation of phasing scores and phasiRNA distribution pattern, we found that phasiRNAs from GhMYB2 were derived from the 3′ cleavage fragments of 22-nt miR828 and 21-nt miR858 respectively. These two miRNA targeting sites initiated two phasing frames on transcripts of one locus. By means of RNA ligase-mediated rapid amplification of cDNA ends (RLM-RACE), we further demonstrated that phasiRNAs derived from the two phasing frames played a role in cis-regulation of GhMYB2. The phasiRNAs derived from GhMYB2 were expressed in the somatic tissues, especially in anther and hypocotyl. We further employed our previous small RNA sequencing data as well as the degradome data of cotton fiber bearing ovules, anthers, hypocotyls and embryogenic calli tissues published in public databases, to validate the expression, phasing pattern and functions of phasiRNAs.

Conclusions

The presenting research provide insights of the molecular mechanism of phasiRNAs in regulation of GhMYB2 loci.
Patient information, communication and competence empowerment in oncology (PIKKO) – evaluation of a supportive care intervention for overall oncological patients. Study protocol of a non-randomized controlled trial
Authors: Schneider Nico , Bäcker Anna , Brenk-Franz Katja , Keinki Christian , Hübner Jutta , Brandt Florian , von der Winkel Geraldine , Hager Lutz , Strauss Bernhard , Altmann Uwe
Published: May 2020

Background

Cancer patients have to undergo a difficult medical therapy and are also confronted with various psychological, social and economic problems. Support is available from many providers, but patients often gain no access to it. Accordingly, there is a need for a single point of contact that can provide advice, information and assistance. In the state of Saarland, Germany, a supportive new consulting and information path (PIKKO) for all types of cancer is currently evaluated by the German Cancer Society, the Cancer Society of the Saarland, three statutory health insurances and the Jena University Hospital. PIKKO is designed to improve quality of life, self-efficacy, health literacy and patient satisfaction and to reduce psychological distress, related health care costs and the days of inability to work. This methodical work presents the process and analysis planning of this evaluation.

Methods

The study population includes all cancer types, both new and existing diseases. PIKKO (with patient navigator, oncological knowledge database, specialized oncological counseling) is evaluated within a controlled, non-randomized, comparative, multicenter, longitudinal design. In addition to patient surveys, data from statutory health insurances and utilization data from the web database are collected, and interviews with patient navigators and doctors are carried out. Patients are assigned to a control (usual care) or an intervention group (u. c. + PIKKO). Primary outcome is the health related quality of life (SF-12) six months after baseline. Secondary outcomes are self-efficacy (GSE), psychological distress such as depression (PHQ-9) or anxiety (GAD-7), health literacy (HLS-EU-Q47) and patient satisfaction in health care (Qualiskope-A). Furthermore, the time course of direct costs of medical care (e.g. work disability days) and usage data of the intervention modules are analyzed. Among other statistical procedures, we use t-tests, univariate tests and growth curve models.

Discussion

If PIKKO proves to be effective, recommendations can be made to health organizations, which should lead to the concept being rolled out throughout Germany and included into oncological guidelines. We expect PIKKO to be a useful addition to usual cancer care, helping to improve the quality of life of cancer patients and reduce healthcare costs.

Trial registration

This study was retrospectively registered in the German Clinical Trial Register under DRKS00016703 (21.02.2019, the reason for the delay was the prioritization of the study management in the first year to establish the new approach into practice). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016703
Molecular prevalence of intestinal parasites infections in children with diarrhea in Franceville, Southeast of Gabon
Authors: Oyegue-Liabagui Sandrine Lydie , Ndjangangoye Nal Kennedy , Kouna Lady Charlene , Lekolo Gwladys Mirlande , Mounioko Franck , Kwedi Nolna Sylvie , Lekana-Douki Jean Bernard
Published: May 2020

Background

Pediatric diarrhea caused by a range of pathogens, including intestinal parasites, is one of main causes of death among children under 5 years of age. The distribution of these parasitic infections overlaps in many environmental, socioeconomic and epidemiological settings. Their distribution and prevalence varies from region to region. In the current study, we assess the prevalence of intestinal parasites among pediatric patients with syndromic diarrheal disease living in Franceville, Gabon.

Methods

A cross-sectional study conducted in the Amissa Bongo Regional Hospital and Chinese-Gabonese Friendship Hospital in Franceville, between November 2016 and August 2017, enrolled a total of 100 diarrheic children between 0 and 180 months of age. Parasite detection in stool samples was performed using molecular diagnostic by PCR. Difference in means were tested by Student’s t test and ANOVA while principal component analysis was used to determine the correlation between parasite distributions and age groups.

Results

The overall prevalence of intestinal parasite infection was 61% (61/100). Hymenolepis sp and Cryptosporidium hominis/parvum were the most common parasites (31 and 19%, respectively), followed by Encephalitozoon intestinalis (15%), Trichuris trichiura (4%), Dientamoeba fragilis (4%), and Enterocytozoon bieneusi (2%). The polyparasitism rate was 19.7%, with 83.3% double and 16.7% triple infections. Protozoan infections (66.7%) were more prevalent than helminths infections (33.3%). Seasonal association of the circulation of intestinal parasite was statistically significant (p = 0.03). Correlations between different parasites was also observed.

Conclusion

The prevalence of intestinal parasitic infections is highest in diarrheic pediatric children. The prevalence of parasitic infections indicates that protozoa and helminths are the most common parasites in the Franceville environment. This study reinforces the importance of routine examination of diarrheic stool samples for the diagnostic of intestinal parasites. Further analyses are required to better understand the local epidemiology and risk factors associated with the transmission of intestinal parasites in Franceville, Gabon.

Keyswords

diarrhea, children, intestinal parasitic infections, molecular diagnostic, Franceville, Gabon.
Factors affecting infant mortality in the general population: evidence from the 2016 Ethiopian demographic and health survey (EDHS); a multilevel analysis
Authors: Baraki Adhanom Gebreegziabher , Akalu Temesgen Yihunie , Wolde Haileab Fekadu , Lakew Ayenew Molla , Gonete Kedir Abdela
Published: May 2020

Background

Infant mortality is one of the leading public health problems globally; the problem is even more staggering in low-income countries. In Ethiopia seven in ten child deaths occurred during infancy in 2016. Even though the problem is devastating, updated information about the major determinants of infant mortality which is done on a countrywide representative sample is lacking. Therefore, this study was aimed to identify factors affecting infant mortality among the general population of Ethiopia, 2016.

Methods

A Community-based cross-sectional study was conducted in all regions of Ethiopia from January 18 to June 27, 2016. A total of 10,641 live births were included in the analysis. Data were analyzed and reported with both descriptive and analytic statistics. Bivariable and multivariable multilevel logistic regression models were fitted by accounting correlation of individuals within a cluster. Adjusted odds ratio (AOR) with 95% confidence interval was reported to show the strength of the association and its significance.

Results

A total of 10,641 live-births from the Ethiopian demographic and health survey (EDHS) data were included in the analysis. Being male infant (AOR = 1.51; 1.25, 1.82), Multiple birth (AOR = 5.49; 95% CI, 3.88–7.78), Preterm (AOR = 8.47; 95% CI 5.71, 12.57), rural residents (AOR = 1.76; 95% CI; 1.16, 2.67), from Somali region (AOR = 2.07; 1.29, 3.33), Harari (AOR = 2.14; 1.22, 3.75) and Diredawa (AOR = 1.91; 1.04, 3.51) were found to be statistically significantly associated with infant mortality.

Conclusion

The study has assessed the determinants of infant mortality based on EDHS data. Sex of the child, multiple births, prematurity, and residence were notably associated with infant mortality. The risk of infant mortality has also shown differences across different regions. Since infant mortality is still major public health problem interventions shall be done giving more attention to infants who were delivered multiple and who are preterm.
The mediating effect of dietary patterns on the association between mother’s education level and the physical aggression of five-year-old children: a population-based cohort study
Authors: Wu Wen-Chi , Lin Ching-I , Li Yi-Fan , Chang Ling-Yin , Chiang Tung-liang
Published: May 2020

Background

Relatively few studies have investigated the effects of diet on behavior problems among preschoolers, particularly, physical aggression. In addition, children raised by poorly educated mothers usually have a higher probability of developing negative outcomes. Additionally, highly educated mothers have a higher probability of providing more healthy foods for their children. Thus, mothers providing healthy foods might mitigate children’s behavior problems. The study aims to examine whether preschoolers’ dietary pattern, as a manipulable factor, mediates the association between maternal education level and physical aggression.

Methods

Data came from the Taiwan Birth Cohort Study (TBCS), a nationally representative population-based cohort study, which included 18,513 five-year-old Taiwanese children. Mothers and primary caregivers reported the information on preschoolers’ physical aggression and food consumption at age 5 and maternal education level at age 6 months. Two dietary patterns, namely a healthy diet and a high-fat-sugar-salt (HFSS) diet, were retrieved by exploratory factor analysis. Mediation hypotheses were tested by a series of multiple regression models conducted using the PROCESS macro of SAS 9.4. All models were adjusted for children’s sex, parental marital status, household income, mental distress at age 5 and children’s physical aggression at age 3.

Results

Maternal education positively linked to healthy dietary patterns (B = 0.014, p = 0.002) which was negatively associated with preschoolers’ physical aggression (B = -0.096, p = 0.013), and it is negatively related to the HFSS dietary pattern (B = -0.042, p = 0.002) which was directly positively associated with preschoolers’ physical aggression (B = 0.123, p = 0.008). The association between maternal education and preschoolers’ physical aggression was partially mediated by preschoolers’ healthy (B = -0.001, p < .001) and HFSS (B = -0.005, p = <.001) dietary patterns, respectively. The R-square of the mediation model is 0.178.

Conclusions

Preschoolers’ dietary patterns directly associate with their physical aggression. In addition, mothers with poor education may provide less healthy foods and more unhealthy foods to their children, which may increase the level of physical aggression. The results imply partial mediating effects of dietary patterns between maternal education and physical aggression. It is suggested that a parent-based nutritional education program focusing on healthy meal preparation for poor educated mothers might be beneficial for preschoolers’ healthy development.
The PAPHIO study protocol: a randomised controlled trial with a 2 x 2 crossover design of physical activity adherence, psychological health and immunological outcomes in breast cancer survivors
Authors: Pudkasam Supa , Pitcher Meron , Fisher Melanie , O’Connor Anne , Chinlumprasert Nanthaphan , Stojanovska Lily , Polman Remco , Apostolopoulos Vasso
Published: May 2020

Background

The PAPHIO study; a randomized controlled trial with 2X2 crossover design will implement a self-directed physical activity program in which participants will engage in self-monitoring and receive motivational interviewing to enhance physical activity adherence. The study aims to determine the effects of 24 weeks self-directed activity combined with motivational interviewing (MI) on (i) psychological health, (ii) quality of life (QoL) and (iii) immune function in female breast cancer survivors.

Methods

The study will recruit 64 female breast cancer survivors within 3 years of diagnosis and at least 6 months post primary treatments at Western Health Sunshine Hospital, Melbourne, Australia. They will be randomly allocated to immediate intervention (IIG group) or delayed intervention groups (DIG group) in a 1:1 ratio. All participants will be given a wearable device (Fitbit Alta HR) and undertake self-directed physical activity for 24 weeks and will receive MI for 12 weeks (IIG; during week 0 to week 12 and DIG; during week 13 to week 24). Participants’ daily step count and the changes of immune cell functionality will be assessed at the beginning (week 1: T1), week 12 (T2) and week 24 (T3) of the program. Physical activity adherence will be assessed at T2 and T3. Participants will also complete four questionnaires assessing exercise self-regulation (BREQ2), exercise barrier and task self-efficacy, mental health (DASS-21) and QoL (FACT-B) at three time points (T1 to T3). Linear-mixed models will be used to assess the relationship between physical activity volume by step counting and mental health (DASS-21), QoL (FACT-B), immune biomarkers, self-regulation (BREQ2) and self-efficacy at T1, T2 and T3;between 2 groups.

Discussion

We expect this physical activity intervention to be acceptable and beneficial to the participants in terms of psychological and immunological well-being with the potential outcomes to be implemented more widely at relatively low cost to these or other patient populations.

Trial registration

Australian New Zealand Clinical trials Registry- ACTRN12619001271190. Prospectively registered on 13 September 2019.
Tuberculosis treatment outcomes among prisoners and general population in Zomba, Malawi
Authors: Singano Victor , Kip Esther , Ching’ani Wilson , Chiwaula Lawrence
Published: May 2020

Background

TB remains a major global health problem. It is particularly prevalent in prisons in sub-Saharan Africa due to overcrowding, malnutrition, high HIV prevalence and insufficient medical services. Prisoners have experienced worse TB treatment outcomes than the general population. The researchers investigated the TB treatment outcomes and predictors of unsuccessful treatment outcomesamong prisoners and the general population in Zomba, Malawi.

Methods

We retrospectively reviewed TB registers of prisoners and the general population diagnosed with TB from January 2011 to December 2016 at Zomba Maximum Central Prison and Zomba Central Hospital, Malawi. The study used routinely collected data extracted from national, standardized TB treatment monitoring tools. Successful treatment outcome was classified as the total for cured and completed treatment while unsuccessful treatment outcome was classified as the total of deaths and treatment failures. We used descriptive statistics to compare the demographics and TB treatment parameters among prisoners and non – prisoners and computed multivariate analysis to predict the independent factors of unsuccessful treatment outcomes.

Results

Of 1652 registered cases, 27% were prisoners (all males) and 72% were non-prisoners (58% males). The median age was 35 years (IQR: 29–42); 76% were Pulmonary TB cases (78% among prisoners vs 75% among general population); 83% were new TB cases (77% among prisoners vs 86% among general population); and 65% were HIV positive (50% among prisoners vs 71% among general population). Regarding treatment outcome, 1472 (89%) were cured and/or completed treatment (93% among prisoners vs 88% among general population), 2(0.2%) were treatment failures, 122 (8%) died (5% among prisoners vs 8% among general population) and 55 (3%) were not evaluated (1% among prisoners vs 4% among general population). Unsuccessful TB treatment outcomes were associated with age greater than 35 years (aOR = 0.68: 95% C.I: 0.58–0.80), Extra-Pulmonary TB (aOR = 1.69: 95% C.I: 1.08–2.63) andHIV positive status (aOR = 0.63: 95% C.I: 0.42–0.94).

Conclusion

Maximum prisons provide a stable population that can be easily monitored throughout the course of TB treatment. Good TB treatment outcomes which are comparable to the general population can be achieved among Malawian prisoners despite the challenging prison conditions.
Long-term sickness absence in a working population: development and validation of a risk prediction model in a large Dutch prospective cohort
Authors: van der Burg Lennart R. A. , van Kuijk Sander M. J. , ter Wee Marieke M. , Heymans Martijn W. , de Rijk Angelique E. , Geuskens Goedele A. , Ottenheijm Ramon P. G. , Dinant Geert-Jan , Boonen Annelies
Published: May 2020

Background

Societal expenditures on work-disability benefits is high in most Western countries. As a precursor of long-term work restrictions, long-term sickness absence (LTSA) is under continuous attention of policy makers. Different healthcare professionals can play a role in identification of persons at risk of LTSA but are not well trained. A risk prediction model can support risk stratification to initiate preventative interventions. Unfortunately, current models lack generalizability or do not include a comprehensive set of potential predictors for LTSA. This study is set out to develop and validate a multivariable risk prediction model for LTSA in the coming year in a working population aged 45–64 years.

Methods

Data from 11,221 working persons included in the prospective Study on Transitions in Employment, Ability and Motivation (STREAM) conducted in the Netherlands were used to develop a multivariable risk prediction model for LTSA lasting ≥28 accumulated working days in the coming year. Missing data were imputed using multiple imputation. A full statistical model including 27 pre-selected predictors was reduced to a practical model using backward stepwise elimination in a logistic regression analysis across all imputed datasets. Predictive performance of the final model was evaluated using the Area Under the Curve (AUC), calibration plots and the Hosmer-Lemeshow (H&L) test. External validation was performed in a second cohort of 5604 newly recruited working persons.

Results

Eleven variables in the final model predicted LTSA: older age, female gender, lower level of education, poor self-rated physical health, low weekly physical activity, high self-rated physical job load, knowledge and skills not matching the job, high number of major life events in the previous year, poor self-rated work ability, high number of sickness absence days in the previous year and being self-employed. The model showed good discrimination (AUC 0.76 (interquartile range 0.75–0.76)) and good calibration in the external validation cohort (H&L test: p = 0.41).

Conclusions

This multivariable risk prediction model distinguishes well between older workers with high- and low-risk for LTSA in the coming year. Being easy to administer, it can support healthcare professionals in determining which persons should be targeted for tailored preventative interventions.