bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Mindfulness Training Affect Rumination in Women with Breast Cancer?
Authors: Bagherzadeh Razieh , Sohrabinezhad Rezvan , Gharibi Tayebeh , Mehbodi Farkhondeh , Vahedparast Hakimeh
Published: August 2020

Background: Cancers cause not only physical and social impairments but also psychological stress responses such as rumination, which require more attention from researchers as well as clinicians.Aim: This study aimed to investigate the effect of mindfulness training on rumination in women with breast cancer.Method: This randomized controlled trial was performed on 46 women with breast cancer in Bushehr city (2018). Subjects were randomly assigned to two intervention and control groups. The intervention was 8 sessions of group mindfulness training. A rumination questionnaire was administered before the intervention, immediately, and one month after the intervention. The data were analyzed by analytical tests at the 0.05 significance level.Results: There was no significant difference between the rumination scores of the intervention group at the three stages of measurement. For the control group, the mean rumination scores at the posttest and follow-up stages were both significantly higher than the pretest score (P <0.001). Also, the follow-up mean rumination score of the control group was significantly higher than that posttest (P=0.02). Comparison of the two groups where adjusted for baseline, showed a significant difference between the two groups in terms of mean rumination score at the posttest stage (P=0.01) and at the follow-up stage (P<0.001).Conclusion: Subjects in the intervention group were more successful in avoiding increasing rumination than those in the control group, an ability that must be attributed to the effect of mindfulness training. Still, further research is needed to determine whether longer interventions will be able to reduce rumination.Trial registrationTrial registration number: IRCT20090522001930N2 Date: 2018-08-08
Patients’ Perceptions and Satisfaction Regarding Teleconsultations During the COVID-19 Pandemic in Jeddah, Saudi Arabia
Authors: Magadmi Mawadah M , Kamel Fatemah O , Magadmi Rania M
Published: August 2020

Background: The coronavirus disease 2019 (COVID-19) pandemic has resulted in the widespread implementation of teleconsultation. Teleconsultation provides remote communication and reduces the risk of virus transmission. However, patients’ perceptions and satisfaction are relevant to ensuring the quality of the service. Thus, this study aimed to evaluate patients’ perceptions and satisfaction regarding teleconsultations during the COVID-19 pandemic in Jeddah.Methods: This was a cross-sectional study using an electronic questionnaire to assess patients’ perceptions and satisfaction regarding teleconsultations during May 2020. A total of 407 participants were included.Results: Most (38.6%) participants were aged 40 to 59 years, women (73.2%), and had a university education (70.8%). Patients’ perceptions of the effectiveness of teleconsultation ranged from 71.43% to 88.77% and their satisfaction level ranged between 59.40% and 83.96%. Older patients who had favorable outcomes from teleconsultation strongly agreed about the effectiveness of teleconsultation and were more satisfied. Patients with higher education levels who used the service only once were more satisfied with the experience. Moreover, those patients with greater age and educational levels and those who called for emergencies and to request medication refills were more likely to use teleconsultation in the future beyond the COVID-19 pandemic. When asked about reasons for dissatisfaction, 70% of the participants were unhappy with the wait time for a teleconsultation.Conclusions: Most patients were satisfied with the teleconsultations during the COVID-19 pandemic. However, a better understanding of patients’ perceptions and reasons for dissatisfaction are fundamental in the planning and implementation of teleconsultations in Saudi Arabia.
Modeling soil organic carbon as a function of topography and forest characteristics
Authors: Malla Rajesh , Neupane Prem Raj , Köhl Michael
Published: August 2020

BackgroundThe soil organic carbon (SOC), an important carbon pool among the five forest carbon pools, plays a crucial role in global carbon cycling. However, it is affected by various factors like topography and climate. Some studies conducted for smaller areas have shown a dependence of the SOC on altitude, but do not allow a general statement for larger regions. Nepal, which has the world's most dynamic terrain elevation, is ideally suited for studying the dependence of the SOC on altitude. ResultsWe found a significant correlation between SOC and altitude (r=0.81). In our study, altitude alone can explain about 66 percent of the variability of the SOC. On the basis of our data, we developed a model which, with altitude as the only independent variable, can predict around 61 percent of the SOC. Conclusions﻿Only altitude has been found to be a sound predictor of SOC at the national level. Other factors with potential impacts on SOC predictors such as crown cover, slope or basal area have only a minor contribution to the improvement of prediction accuracy of the model.
Identification of Ubiquitin Ligase From Grapevine Ring C3H2C3E3 and Characterization of Drought Resistance Function of VyRCHC114
Authors: Yu Yihe , Yang Shengdi , Bian Lu , Yu Keke , Meng Xiangxuan , Zhang Guohai , Xu Weirong , Yao Wenkong , Guo Dalong
Published: August 2020

Background: RING is one of the largest E3 ubiquitin ligase families and C3H2C3 type is the largest subfamily of RING, playing an important role in plants’ development and growth and their biotic and abiotic stress responses. Results: A total of 143 RING C3H2C3-type genes (RCHCs) were discovered from the grapevine genome and separated into groups (I-XI) according to their phylogenetic analysis, with these genes named according to their positions on chromosomes. Gene replication analysis showed that tandem duplications play a predominant role in the expansion of VyRCHCs family together. Structural analysis showed that most VyRCHCs(67.13%) had no more than 2 introns, while genes clustered together based on phylogenetic trees had similar motifs and evolutionarily conserved structures. Cis-acting element analysis showed the diversity of VyRCHCs regulation. The expression profiles of eight DEGs in RNA-Seq after drought stress were similar to those in qRT-PCR analysis. The in vitro ubiquitin experiment showed that VyRCHC114 had E3 ubiquitin ligase activity, overexpression of VyRCHC114 in Arabidopsis improved drought tolerance, moreover, the transgenic plant survival rate increased by 30%, accompanied by changing of electrolyte leakage, chlorophyll content and the activities of SOD, POD, APX and CAT were changed. AtCOR15a, AtRD29A, AtERD15 and AtP5CS1 were expressed quantitatively, the results showed that they participated in the drought stress response may be regulated by the expression of VyRCHC114.Conclusions: Valuable new information on the evolution of grapevine RCHCs and its relevance for studying the functional characteristics of grapevine VyRCHC114 genes under drought stress emerged from this research.
Role of MADS-box Gene in the Development of Flower Organs in Pineapple of a Typical Collective Fruit
Authors: zhang hongna , Pan Xiaolu , Yi Debao , Lin Wenqiu , Zhang Xiumei
Published: August 2020

Background: MADS-box genes play crucial roles in plant vegetative and reproductive growth, especially in inflorescences, flower, and fruit. Pineapple is a typical collective fruit, and a comprehensive analysis of the MADS-box gene family in the development of floral organs of pineapple is still lacking. Results: In this study, the whole-genome survey and expression profiling of the MADS-box family in pineapple were introduced. Forty-four AcMADS genes were identified in pineapple, 39 of them were located on 18 chromosomes and five genes were distributed in five scaffolds. Twenty-two AcMADS genes were defined as 15 pairs of segmental duplication events. Syntenic analysis showed that pineapple is closely related to monocotyledon plants. Most members of the type II subfamily of AcMADS genes had higher expression levels in floral organs compared with type I subfamily, thereby suggesting that AcMADS of type II may play more crucial roles in the development of floral organs of pineapple. Six AcMADS genes have significant tissue-specificity expression, thereby suggesting that they may participate in the formation of one or more floral organs. Conclusions: Our findings not only benefit to reveal the functional characterization of MADS-box genes in the floral organ development of pineapple but also provide additional information for further understanding the formation and development collective fruit.
The Impact and Response to Climate-Related Disasters in Burkina-Faso
Authors: Zerbo Alexandre , Delgado Rafael Castro , González Pedro Arcos
Published: August 2020

Burkina Faso is a West African Sahelian country with climate-related risks because the disaster risk profile, and drought and floods are the main damaging natural disasters, aggravated by the phenomenon of climate change. An effective design and implementation of disaster reduction management strategies requires an understanding of risk factors and vulnerabilities, but also and an assessment of the strengths and weaknesses of national disaster response systems.In this perspective, a literature review and an analysis of climate information were conducted in order to reveal the risks and vulnerabilities to droughts and floods in the country. This was accompanied by a critical evaluation of the performance of the national prevention and intervention system.Vulnerabilities to drought and floods are exacerbated by the combined effect of climate change and the low performance of the national disaster risk reduction management system. National institutions and frameworks exist for disaster prevention and management, but difficulties persist in implementation due to financial constraints and insufficient human skills. Current trends and estimates suggest that the drawbacks of these natural hazards may be more serious in the future if solutions are not taken to improve early warning forecasts, infrastructure and the implementation of adequate agricultural policies.
The "Glass Lung" - A Lifelike Electromechanical Lung Simulator
Authors: Peuscher Heiko , Dubies Karl , Blechschmidt Ronald , Calzia Enrico , Radermacher Peter
Published: August 2020

Background: This contribution describes the hardware setup, control, andparametrization of an electromechanical test lung intended to perform tests withclinical ventilators.Methods: We use a nonlinear model to imitate the dynamic behavior of a reallung in terms of compliance and resistance. Both passive behavior andspontaneous breathing (weaning) are supported. In automated test sequences,the test lung mimics a variety of physiological and pathological lung conditions,including COVID-19.Results: We present the results obtained with an approved clinical ventilator invarious modes including pressure-controlled and pressure support ventilation.Conclusions: All results are clinically consistent with the values expected fromventilation of a real patient.
Evaluation the energy production potential of aggressively invasive Prosopis juliflora Sw (Fabacea): An emerging threat in the Bundala Ramsar Wetland
Authors: Bandara W.A.R.T.W. , Ranasinghe Oshadi Ruwanthika , Vlosky Richard
Published: August 2020

Prosopis juliflora is an invasive plant species rapidly expanding in the Asian and African continents. Invasion of P. juliflora in Bundala Ramsar Wetland (BRW) in Sri Lanka has created a number of biodiversity and conservation issues. This study was conducted to assess the possibility to utilize this invasive plant as a fuel source for local industries. The moisture content, wood density, ash content, volatile matter, fixed carbon content, biomass/ash ration and calorific value of P. juliflora were measured and compared with Leucaena leucocephala, which is a widely used fuelwood source in Sri Lanka and elsewhere. P. juliflora, performed better than L. leucocephala for most of these parameters. Ash content was comparatively higher in P. juliflora than that of L. leucocephala; however, biomass to ash ratio of P. juliflora was significantly lower (at 0.05 level of significance) than that of L. leucocephala, suggesting its suitability as a fuelwood source. Further, the Fuel Value Index (FVI) of P. juliflora (3,276) was slightly lower than that of L. leucocephala (3,336), a non-significant difference. P. juliflora and L. leucocephala reached Fiber Saturation Point values within drying periods of 24 and 27 days, respectively. According to our estimates of energy properties, 1 Kg of P. juliflora could be used to substitute 0.5 L of diesel and furnace oil as well as 5 kWh (5 units) of electricity. As such, we recommend harvesting P. juliflora from BRW as a potential fuelwood energy source for local industries.
Effectiveness of High-Flow Nasal Cannula on Pulmonary Rehabilitation in Subjects with Chronic Respiratory Failure
Authors: Chihara Yuichi , Tsuboi Tomomasa , Sumi Kensuke , Sato Atsuo
Published: August 2020

Backgrounds: There are no clinical data comparing the effect of exercise training using both high fraction of inspired oxygen (FIO2) and high flow through a high-flow nasal cannula (HFNC) with that of ordinary supplemental oxygen on exercise capacity in subjects with chronic respiratory failure (CRF) receiving long-term oxygen therapy (LTOT). Methods: In this randomized study, 32 patients with CRF receiving LTOT were assigned to undergo 4 weeks of exercise training on a cycle ergometer using an HFNC (flow: 50 L/min) with a FIO2 of 1.0 (HFNC group; n=16) or ordinary supplemental oxygen via a nasal cannula (flow: 6 L/min) (oxygen group; n=16). Before and after 4 weeks of exercise training, a 6-min walking test, constant-load test, and blood sampling were performed. Results: Prior to exercise training, the endurance time of the constant-load exercise test using an HFNC was significantly longer than that reported with prescribed oxygen in daily LTOT (p=0.004) or a 6 L/min nasal cannula (p=0.0003). Following 4 weeks of exercise training, change in the 6-min walking distance was significantly greater in the HFNC versus the oxygen group (55.2±69.6 m vs. —0.5±87.3 m, respectively; p=0.04). The plasma levels of adrenaline, noradrenaline, and serum C-reactive protein were significantly decreased only in the HFNC group, after 4 weeks of exercise training. Conclusions: Despite heterogeneity in the effect among patients, exercise training using both high FIO2 and high flow through an HFNC is a potentially superior exercise training modality for CRF patients receiving LTOT.Clinical Trial Registration ― http://www.clinicaltrials.gov. Unique identifier:　NCT02804243. Registered 13 June 2016.
Storm Surge Hazard Assessment Along the East Coast of India Using Geospatial Techniques
Authors: Prince Harshith C. , Nirmala R. , Mahendra R. S. , Murty P.L. N.
Published: August 2020

The present study is to estimate the inundation extent and depth to estimate the extent of damage using geospatial technique caused due to a storm surge. This is achieved by selecting a worst-case cyclone track (Super Cyclonic Storm) scenario for three Indian states, Andhra Pradesh, Odisha and West Bengal based on the historic data. Over 1300 cyclones are observed to have hit the east coast of India in the past 173 years, which is about an average of more than 7 cyclones per year. Geospatial model results for Orissa cyclone (1999) suggests that over 2,150 km2 of land is submerged due to storm surge. The inundation was observed up to an extent of 45 km inland upright to the shoreline with over 1,100 km2 area submerged 1-2m from ground level. This is the worst cyclone (with peak speed 140 knots) of the country known so far to have caused maximum damage. The storm surge model of Andhra cyclone (1996) suggests that about 450 km2 of area inundated due to storm surge where majority of the area is submerged up to1m of water pile. The most affected place is Mummidavaram. Whereas, the results of storm surge model for the state of West Bengal is carried out using a synthetic track passing through West Bengal coast with wind speed of 155 knots (worst case). The model result shows 5,400 km2 of land submerged up to 1m of water and about 2,700 km2 of area submerged under 1-2m of water. The most affected area is South 24 Parganas and parts of Bangladesh. The results of the current study are useful for the coastal cyclone disaster management in order to make decisions on preparedness and disaster risk reduction. These results can also be used for the coastal future development purposes.
High values of liver stiffness play an important role in stratifying the risk of hepatocellular carcinoma in cirrhotic hepatitis C patients.
Authors: Paranagua-Vezozzo Denise , Reinoso-Pereira Gleicy Luz , Mazo Daniel F. , Nacif Lucas Souto , Moutinho Bruna Damasio , Moutinho Renata , Ono Suzane Kioko , França João Italo Dias , Alves Venâncio Avancini Ferreira , Carrilho Flair José
Published: August 2020

Background: The identification and selection of patients at-risk for HCC is a recognized challenge in outpatient clinical practice. Limited data on risk factors and the impact of HCC on cirrhotic patients stratified by the elasticity imaging technique are still a potential promise. Aim: To evaluate the clinical contribution of liver stiffness measurement by transient elastography, as a risk factor for Hepatocellular Carcinoma (HCC) occurrence in a prospective cohort of (HCV) patients with cirrhosis. Method: A cohort of 99 consecutive HCV patients was included between 2011 and 2016 with baseline liver stiffness equal or above 12 kPa. We evaluated the patients with serum and mechanical liver tests. Kaplan-Meier method with the log-rank test and the use of Cox Univariate and multivariate analysis assessed the association between variables and clinical results. Results: The mean age was 57.8±10.6 years. In a follow-up over a mean of 3.3 years, 20 (20.2%) patients developed HCC, of which 65% were male and 40% had diabetes. The median time to diagnosis of HCC was 2.6 years. In univariate logistic regression analysis, variables associated with HCC occurrence were: lower platelet count (p=0.0446), higher serum alpha-fetoprotein (p=0.0041) and bilirubin (p=0.0008) values, higher MELD score (p=0.0068) and higher liver stiffness measurement (p=0.0354). High LSM evaluated by TE was independently associated with HCC development, and the best cut-off value for HCC risk was > 21.1kPa (HR: 4.7695; 95%CI: 1.0470-21.7274; p=0.0435). Conclusion: High value of liver stiffness relates substantially to the increased risk for HCC in selected patients with HCV cirrhosis.
Metagenomic Analysis of the Gut Microbiome in Psoriasis Reveals Three Subgroups with Distinct Host-Microbe Interactions
Authors: Chang Hsin-Wen , Yan Di , Singh Rasnik , Bui Audrey , Lee Kristina , Truong Alexa , Milush Jeffrey M , Somsouk Ma , Liao Wilson
Published: August 2020

Background

Psoriasis is a chronic, inflammatory skin disease that impacts 2–3% of the global population. Besides skin manifestations, psoriasis patients have increased susceptibility to a number of comorbidities including psoriatic arthritis, cardiovascular disease, and inflammatory bowel disease. To understand the systemic component of psoriasis pathogenesis, we examined the fecal metagenome, host colonic transcriptome, and host peripheral blood immune profiles of psoriasis patients and healthy controls.
Results

Our analysis showed increased functional diversity in the gut microbiome of psoriasis patients. In addition, we identified microbial species that preferentially associate with psoriasis patients and which have been previously found to associate with other autoimmune diseases. Intriguingly, our data reveal new insights about psoriasis disease heterogeneity, as we identified three psoriasis subgroups that have distinct microbial and host features. Finally, integrating microbial and host features revealed host-microbe interactions that are specific to psoriasis or particular psoriasis subgroups.
Conclusion

To our knowledge, this is the first study that provides a comprehensive view of gut microbial function and corresponding host response in psoriasis patients. Our findings provide insight into factors that may affect the development of comorbidities in psoriasis patients and may hold diagnostic potential for early identification of psoriasis patients at risk for these comorbidities.
Understanding and reconciling different approaches for quantifying nitrogen use efficiency in cropping systems
Authors: Quan Zhi , Zhang Xin , Fang Yunting , Davidson Eric
Published: August 2020

Nitrogen use efficiency (NUE) has been widely used in cropping systems to study nitrogen (N) cycles and inform N management on various spatial scales, from a single plant to the globe. Although the number of NUE studies is growing, interpretation of results is unfortunately hindered by widely differing definitions and quantification methods among studies, suggesting a pressing need for harmonization of approaches. Here, we proposed a conceptual framework to understanding the differences and connections among three major approaches for determining NUE, namely, the difference approach, 15N tracer approach, and N balance approach. Using the Chinese cereal cropping system as an example, we demonstrated that the results of those NUE assessments could be very different even for the same cropping system (0.32, 0.24, and 0.52, respectively). Such a difference is attributable largely to the soil legacy effect and could be reduced by extending the observations for a longer term. This study provides the necessary understanding to reconcile NUE values from different approaches and consequently to better inform N management in cropping systems.
Rising and Falling Trends in Incidence Rates of Vulvar and Vaginal Cancers in the United States, 2000-2016
Authors: Yue Yang-yang , Zhou Wei-li , Pei Dong-mei
Published: August 2020

Background: Few studies focus on incidence trends in vulvar and vaginal by histological type, race, age, and region. We aimed to evaluate the temporal incidence trends and survival for the two cancers.Methods: Cases with primary vulvar or vaginal carcinoma from 2000-2016 were identified from the Surveillance, Epidemiology, and End Results 18 registries. Annual percent change (APC) and average APC (AAPC) were calculated to evaluated trends. Relative survival was estimated to compare survival outcomes.Results: Vulvar cancer incidence rates were highest among non-Hispanic whites (20.9 per 1,000,000 person-years) and in the Midwest (27.7), while vaginal cancer rates were highest among non-Hispanic blacks (8.2) and in the South (6.7). Overall, vulvar cancer rate increased 0.4% annually (AAPC, 0.4%; 95% CI, 0.1% to 0.6%), but vaginal cancer rate decreased 1.4% annually (AAPC, -1.4%; 95% CI, -2.0% to -0.5%). The increased vulvar cancer rate was only observed for squamous cell carcinoma (APC, 1.0%), while the decreased vaginal cancer rate was only observed for other malignancies (APC, -1.7%). Vulvar cancer rates increased only among whites (APC, 1.2%), but vaginal cancer rates decreased only among whites (AAPC, -1.3%) and Asians (APC, -2.7%). Vulvar cancer rates increased among patients aged 50-59 (APC, 1.1%), 60-69 (APC, 1.3%), and 70-79 (APC, 1.2%) years, while vaginal cancer rates decreased among patients aged 50-59 (APC, -1.4%) and 80 (APC, -1.4%) years or older. Overall, whites had the highest five-year relative survival for both vulvar (72.22%) and vaginal (49.03%) cancers. Conclusion: There were profound disparities in vulvar and vaginal cancer incidence rates attributable to histological type, race, age, and region. The increased vulvar cancer rates and the declined vaginal cancer rate highlights the importance of further studies to investigate the reason for the disparities.
Geospatial Inequality of Anemia Among Children in Ethiopia
Authors: Endris bilal , Dinant Geert-Jan , Gebreyesus Seifu Hagos , Spigt Mark
Published: August 2020

Background: Anemia remains a severe public health problem among children in Ethiopia. The lack of progress in the trend of anemia infers the failure of national anemia prevention and control programs. If there are considerable geospatial differences in the prevalence of anemia in Ethiopia, targeted approaches, based on the distribution and specific risk factors for that setting are needed to efficiently target health interventions. This study aimed to identify and locate anemia hotspots among children in Ethiopia. Methods: Data analysis was performed using Ethiopia Demographic and Health Survey (EDHS) 2016 Data. Blood specimens for anemia testing were collected from children age 6-59 months. Hemoglobin analyses were placed in a HemoCue photometer and the results were recorded onsite for 9,268 children. The outcome variable anemia was categorized into a dichotomous variable (anemic and not anemic); a child was considered as anemic if the blood-hemoglobin count was less than 11.0 g/dl. We applied Kulldorf’s spatial scan statistics and used SaTScanTM to identify locations and estimate cluster sizes. In addition, we ran LISA (local indicator of spatial association) and the Getis-Ord Gi(d) local statistics to detect and locate hotspots of anemia. We ran multilevel multivariable analysis to identify risk factors for anemia clustering.Result: More than half (57%) of children aged 6-59 months were anemic in Ethiopia. Higher prevalence of anemia was found among children who live in Somali region (83%), in rural area (58%), in the lowest wealth quintile (68%), and among children of mothers’ with no education (59%). We found significant geospatial inequality of anemia among children in Ethiopia. We identified one anemia cluster (hotspot) in the eastern part of Ethiopia. Women anemia, stunting and high fertility were associated with anemia clustering.Conclusion: Anemia clustering was found in the eastern part of Ethiopia. We recommend that policy makers and programmers should especially target this area for accelerated reduction of anemia.
Polarity- and molecular orbital-engineered host materials for stable and efficient blue thermally activated delayed fluorescence
Authors: Ihn Soo-Ghang , Jeong Daun , Kwon Eunsuk , Kim Sangmo , Chung Yeon Sook , Sim Myungsun , Chwae Jun , Koishikawa Yasushi , Jeon Soon Ok , Kim Jong Soo , Kim Joonghyuk , Nam Sungho , Choi Hyeonho , Kim Sunghan
Published: August 2020

To utilize thermally activated delayed fluorescence (TADF) technology for future displays, it is necessary to develop host materials that can harness the full potential of blue TADF emitters. We suggest an elaborative approach for designing host molecules for blue TADF devices with simultaneously improved efficiency and stability. We significantly enhanced the delayed fluorescence quantum yield by engineering the molecular geometry, polarity, and excited-state dipole moment of host molecules based on 3′,5-di(9H-carbazol-9-yl)-[1,1′-biphenyl]-3-carbonitrile. The engineerd hosts stabilized the charge-transfer excited states of TADF emitters, suppressed exciton quenching, and improved the charge balance in the emitting layer. Moreover, because the hosts are phosphine-oxide bond-free molecules, they are photochemically and electrochemically stable compared to bis[2-(diphenylphosphino)phenyl] ether oxide, the most popular high-polarity host. The devices employing the hosts exhibited a two-fold increase in external quantum efficiency and a 37-fold increase in operation lifetime compared to control devices with the same TADF emitter.
Factors Associated with Radiological Hip Joint Involvement in Patients with Ankylosing Spondylitis
Authors: Liu Wei , Song Hui , Man Siliang , Li Hongchao , Dong Peng
Published: August 2020

Background: The associated factors for hip involvement in patients with ankylosing spondylitis (AS) are poorly known. This study was to analyze the clinical data of patients with AS and to explore the potential associated factors of AS-related radiological hip joint.Methods: This was a cross-sectional study of patients diagnosed with AS and treated at the Beijing Jishuitan Hospital between 01/2013 and 12/2019. A BASRI-hip score ≥ 2 was defined as radiological hip joint involvement. Univariable and multivariable logistic regression analyses were performed to analyze the factors associated with radiological hip joint involvement.Results: A total of 350 AS patients were included. Patients with radiological hip joint involvement (BASRI-hip ≥2) accounted for 50.6% (177/350). The proportion of men was 83.7% (293/350). The mean age was 35.0±12.7 years old. The mean duration of the disease was 10.8±8.6 years. The HLA-B27 positive rate was 90.9% (318/350). The multivariable analysis showed that the juvenile onset (OR=4.955, 95%CI: 2.464-9.961, P<0.001), bone mass lower than peers (OR=2.862, 95%CI: 1.593-5.142, P<0.001), BMI <18.5 kg/m2 (OR=2.832, 95%CI: 1.321-6.069, P=0.007), BASFI (OR=1.278, 95%CI: 1.069-1.527, P=0.007), and continuous NSAIDs treatment (OR=0.400, 95%CI: 0.200-0.799, P=0.009) were independently associated with radiological hip joint involvement in patients with AS.Conclusion: AS with radiological hip joint involvement had worse body function and lower bone density. The associated factors with radiological hip joint involvement in AS patients included juvenile-onset, thin body size. The prognosis of patients with AS who received continuous NSAIDs drug treatment might be improved.
Prognosis of Probable Autoimmune Hepatitis Patients in a Retrospective Cohort Study
Authors: Fujita Koji , Oura Kyoko , Tadokoro Tomoko , Morishita Asahiro , Kobara Hideki , Tsutsui Kunihiko , Himoto Takashi , Masaki Tsutomu
Published: August 2020

Background: Autoimmune hepatitis (AIH) is an idiopathic inflammatory liver disease with genetic susceptibility and unknown environmental triggers, which results in failures of physiologic immunotolerance and destruction of the liver tissues. The gold standard for diagnosis is the International Autoimmune Hepatitis Group (IAIHG) scoring system: the disease is classified as definite or probable according to the scores. However, conventional research on probable AIH has focused on the Caucasian population and there is little data pertaining to the Asian population. Therefore, this study aimed to assess and compare the prognosis of Japanese patients with probable and definite AIH. Methods: Patients with probable and definite AIH diagnosed based on IAIHG scores between 1987 and 2018 were enrolled in this retrospective study. Results: Seventy-two patients with definite AIH and 49 patients with probable AIH were evaluated in the study. Univariate analysis revealed age, fibrosis stage 4, and the fibrosis-4 index were prognostic factors for overall survival. Multivariate analysis indicated that age and liver cirrhosis significantly affected the overall survival. When the cut off albumin-bilirubin score was set appropriately, cirrhosis was differentially diagnosed using albumin-bilirubin score with 100% sensitivity and 70.5% specificity. Classification of probable or definite disease did not alter overall survival with statistical significance. Conclusions: Our findings suggest that probable AIH should be managed as definite AIH is managed in Japanese population. The albumin-bilirubin score helps identify liver cirrhosis and is a prognostic biomarker for overall survival.
Medical Professionals Have Higher Risk for Colorectal Adenoma But Lower Risks for Reflux Esophagitis and Atrophic Gastritis: A Propensity Score-Based Analysis
Authors: Qiao Chen , Zhang Min , Li Zhen , Zuo Xiu-Li
Published: August 2020

Background: Previous studies had indicated that medical professionals’ lifestyles were not as healthy as recommended. Whether these lifestyles lead to higher incidences of gastrointestinal diseases is unknown. Objectives: To compare the incidences of gastrointestinal diseases between medical professionals and general populations. Methods: Subjects who underwent endoscopy examination for physical examination in Qilu Hospital from January 2017 to September 2019, were retrospectively reviewed. Propensity score based analysis was used to generate two age- and sex-matched groups, Medical Professional Group and General Population Group. The positive rates of gastrointestinal disorders in two groups, were analyzed by Pearson’s Chi-square test. Subgroup analysis within Medical Professional Group was performed to identify risk factors for medical staffs. Results: 1534 records were enrolled, 791 for gastroscope and 743 for colonoscope. Among upper gastrointestinal diseases, the detection rates of atrophic gastritis and reflux esophagitis showed significant differences, which were 19.8% in Medical Professional Group and 25.9% in General Population Group (p=.04) for atrophic gastritis, 4.0% in Medical Professional Group and 12.6% in General Population Group (p<0.001) for reflux esophagitis. Among the subjects who received colonoscopy, the adenoma detection rate of the Medical Professional Group (17.5%) was statistically distinguished from the General Population Group (11.5%) (p = .02). Conclusion: In a provincial comprehensive hospital in China, medical Professional Group has significantly higher risk for colorectal adenoma, but lower risks for atrophic gastritis and reflux esophagitis.
COVID-19 pandemic and self-reported symptoms of depression, anxiety, and stress among health care workers in Ethiopia
Authors: Jemal kemal , Senbeta Berhanu , Geleta Tinsae Abeya , Awol Mukemil
Published: August 2020

BackgroundThe Coronavirus Diseases 2019 (COVID-19) pandemic has become a major problem in many of the world nations including Ethiopia. Moreover, it is a public health emergency of the community concern and poses a mental health problem to health care workers (HCWs). Therefore, this study aimed to assess the level of self-reporting symptoms of depression, anxiety, and stress during the COVID-19 pandemic among healthcare workers in Ethiopia.MethodsAn institutional-based cross-sectional study was conducted using an online survey from June 25, 2020, to July 25, 2020, in Ethiopia. The data were collected using a self-reported Depression, Anxiety, and Stress Scale (DASS-21). Data were cleaned, coded, and entered using Epi info version 7.5.1 and exported for analyzed to the Social Science package software Version 23 Statistical Package. Moreover, multiple logistic regression analysis was used to identify the associated factors at p-value less than 0.05.ResultsA total of 816 HCWs responded to self-reporting questions. From HCWs who screened positive for depression, anxiety, and stress; 60.3%, 78%, and 33.8% of them had scored moderate to extremely severe symptoms of depression, anxiety, and stress respectively. Females, HCWs who working in Oromiya Specialized Zone, medical laboratory professionals, and HCWs who have working in the COVID-19 treatment isolation department were significantly associated with depression, anxiety, and stress.ConcussionIn this study, health care workers had reported a high prevalence of depression, anxiety, and stress symptoms. Female gender, Oromiya especial zone, medical laboratory professionals, and HCWs who have working in the COVID-19 treatment isolation centers were significantly associated with depression, anxiety, and stress. Psychological intervention for health care workers in central Ethiopia needs special attention.
Effect of Different Types of Modic Changes on Segmental Motion and Disc Degeneration in Cervical Spine
Authors: Zhang Fan , Wang Jin , Xu Haocheng , Lyu Feizhou
Published: August 2020

Background: Few studies have reported the segmental motion characteristics of different types of Modic changes (MCs) in the cervical spine in contrast to the lumbar spine. Considering the close relationship between MCs and disc degeneration (DD), this study is designed to elucidate the relationship of MCs with DD and DD-based angular motion in the cervical spine.Methods: MRI of C2/3~C6/7 from 594 patients were reviewed and those with MCs were selected and evaluated. MCs were defined as type 0, I, II, and III, and the grade of DD was classified from A to E (recorded from 1 to 5 points) as previously reported. DD score of each segment (sDD), total sDD of the entire cervical spine (tDD), and VAS score (neck pain) of each patient with MC were also recorded. Cervical lordosis (CL), C7 slope (C7S), segmental angular motion (sROM) and total angular motion of the entire cervical spine (tROM) were calculated from X-ray images.Results: Totally 135 MC segments were evaluated. In the two groups of DD D and DD E, the sROM of MC I and III segments are smaller than that of MC 0 segments, and the sROM of MC II segments are similar to that of MC 0. In addition, MC I segments present smaller sROM than that of MC II in the group of DD E, and their sROM are larger than that of MC III in the group of DD D. No difference is found in tROM between the patients with MC I, II and III. Our results also show that MC I and III segments are associated with high sDD and tDD scores. Finally, the patients with MC I have larger CL and C7S than those with MC III, and there is no statistical difference in VAS scores of neck pain between the patients with MC I, II and III. Conclusions: In the cervical spine, both MC I and III indicate decreased segmental angular motion and high disc degeneration grade. Cervical MCs may not be a sign of unstable neck pain or an indication for interbody fusion.
A Complex Intervention to Improve Intercultural Communication and Aboriginal Patient Outcomes: Which Components Worked?
Authors: Ralph Anna P , Kerrigan Vicki , Castillon Craig , Mithen Vincent , O'Connor Elise , Hansen Martin , Keilor Natasha , Aitken Robyn , Madrill Gail , Roman Curtis , Cass Alan
Published: August 2020

BackgroundAboriginal language interpreters are under-utilised in healthcare in northern Australia. Self-discharge from hospital is an adverse outcome occurring at high rates among Aboriginal people, with poor communication thought to be a contributor. We previously reported increased Aboriginal interpreter uptake and decreased rates of self-discharge during implementation of a 12-month hospital-based intervention. Interrupted time-series analysis showed sudden increase and up-trending improvement in interpreter use, and a corresponding decrease in self-discharge rates, during a 12-month intervention period (April 2018 - March 2019) compared with a 24-month baseline period (April 2016 – March 2018). This paper aims to explore reasons for these outcomes, and further explore the likelihood of a causal association between study activities and outcomes. MethodsWe used the ‘Template for Intervention Description and Replication’ (TIDieR) as a framework to describe intervention components and evaluate their relative importance. Information on intercurrent activities that may have contaminated study findings was reviewed. The relationship between proportion of hospital separations among Aboriginal people ending in self-discharge and numbers of Aboriginal interpreter bookings made during April 2016-March 2019 was tested using linear regression. ResultsOne full-time Aboriginal Interpreter Coordinator was employed for the intervention period who identified language needs, promoted interpreter use and mentored interpreters. The intervention period start date corresponded with commencement of this role. Three ‘Working with Interpreter’ training sessions were held during the intervention period reaching 83 clinicians, and three medical officers volunteered as champions of interpreter use in hospital practice. Employment of the Aboriginal Interpreter Coordinator was deemed the most important component of the intervention, based on reach compared to the other components and timing of the changes in outcomes. There was an inverse association between interpreter bookings and self-discharge rate among Aboriginal inpatients (p=0.02). This association, the timing of changes and assessment of intercurrent activities at the hospital indicated that the study intervention was likely to be casually related to the measured outcomes. ConclusionsCommunication in healthcare can be improved through targeted strategies, with associated improvements in patient outcomes. Health services with high interpreter needs would benefit from employing an interpreter coordinator.
A Cambodian-Norwegian Competence Building Program in Child Mental Health: A Qualitative Focus-Group Study
Authors: Hafting Marit , Pat Puthy , Aadland Gunn , Fjermestad Krister , Jegannathan Bhoomikumar
Published: August 2020

BackgroundThe prevalence of mental health and neurodevelopmental disorders in young people is high in low- and middle-income counties, such as Cambodia, as risk factors in the perinatal period, malnutrition, infections and adverse childhood experiences can be abundant due to poverty and/or conflict. Collaboration between institutions from high-income countries and institutions in resource-poor settings for professional development can improve service providers’ knowledge and skills, which is key to bridging the gap between service needs and the ability to meet those needs.MethodsA Norwegian team comprised of a pediatrician, a child and adolescent psychiatrist and a child psychologist implemented a participatory program for competence building at Centre for Child and Adolescent Mental Health in Cambodia (Caritas-CCAMH) two weeks per year over a 14-year period. Herein, we explore some aspects of this Cambodian-Norwegian collaboration from the perspective of the Caritas-CCAMH staff with a qualitative approach using thematic analysis of the transcripts from a focus-group interview with 11 staff members at the end of the 14-year period. Results The multidisciplinary team at Caritas-CCAMH described the learning process with the Norwegian team as a “meeting between experts” characterized by collaboration in planning and implementation, which enhanced the contextual relevance of the project. Mixing theory and practice in clinical case discussions with a bio-psycho-social perspective was perceived as the cornerstone of the pedagogical process. Learning by observation and supervision from the Norwegian team led to mastering skills and enhancing self-confidence and job satisfaction. A pedagogical strategy that involved constant reflection back and forth enabled the customization of the content and method of knowledge exchange despite the difference in socio-economic conditions and learning styles that were unfamiliar to the mental health professionals from high-income countries.ConclusionsBuilding knowledge and skills within a dialogic partnership over a significant period of time contributed to learning across cultures. This model of continuity, low-investment and low-intensity collaborative capacity building may enrich the child and adolescent mental health settings in high-, low- and middle-income countries. Furthermore, the model appears feasible for Western professionals who collaborate with institutions for child and adolescent mental health in low- and middle-income countries.
A Cost Analysis of Options for Schistosomiasis Control Mda Programs Targeting Children Aged Five Years and Below in Umkhanyakude District of Kwazulu-natal Province, South Africa
Authors: Ncube Mhlengi Vella , Chimbari Moses John
Published: August 2020

BackgroundSchistosomiasis negatively impacts early childhood development. Inclusion of children aged five years and below in mass drug administration (MDA) programs for controlling schistosomiasis could improve early childhood development in communities where the disease is endemic. We estimated the projected cost of implementing a schistosomiasis control MDA program for children aged five years and below in the uMkhanyakude district of South Africa.MethodWe calculated the cost of implementing a schistosomiasis MDA program targeting children aged five years and below using an economies of scaled based cost function. We further compared different labor composition simulations to determine the most affordable and available human resources to implement the program. We also explored programs to which the MDA program could be integrated; and estimated what the costs for would be. Moreover, we simulated cost-effectiveness and determined the cost drivers for each simulation considered.ResultsA ward-based outreach team (WBOT) for implementing a schistosomiasis MDA program targeting children 5 years old and below was the best labor composition option. The simulations conducted indicated that treating children in batches of 2500 using the WBOT team approach could reduce the cost of treatment by 53% compared to treating the children on batches of 500. Integrating a schistosomiasis MDA targeting children aged 5 years and below with the immunization program was estimated to cost 3% less than integration with the deworming and Vitamin A supplementation program indicating that the former option is more cost-effective. Praziquantel, the drug that is used to treat schistosomiasis contributed 59% of the total cost for such a program.Conclusion.We estimated that US$4.3 million would be needed to implement a cost effective MDA program targeting children 5 years old and blow over 3 years in uMkhanyakude district.
Magnitude and Factors Affecting Virological Treatment Failure among HIV Reactive Adults from Selected Hospitals of North Shoa Zone, Amhara Region, Ethiopia
Authors: Derseh Behailu Tariku , Shewayerga Belay , Dagnaw Abinet , Basha Elyas Admasu
Published: August 2020

Background

Nowadays Human Immuno-deficiency Virus (HIV) is one of the devastating and prevalent viruses affecting the globe without a cure. Highly Active Antiretroviral Therapy (HAART) significantly reduced the morbidity and mortality of patients with HIV infection. Although there is increasing global use of antiretroviral therapy (ART) for the treatment of HIV/AIDs, the global trends in ART failure are growing. In developing countries including Ethiopia, particularly in our study settings, information related to the magnitude and correlates of virological treatment failure is scarce. Thus, this study aimed at assessing the magnitude of virological treatment failure and associated factors among HIV reactive adults at selected hospitals of North Shoa, Amhara Region, Ethiopia.
Methods

a facility-based cross-sectional study was conducted among 498 study participants who started their first-line HAART from August 2005 to December 2018. Data were collected from patients’ charts and face-to-face interviews using a structured questionnaire. The bivariable analysis was executed to select candidate predictor variables at a p-value of less than 0.2. Multivariable logistic regression (forward stepwise, conditional) analysis was used to identify factors associated with virologic failure at a significant level of 5%. Model adequacy check was done by Hosmer and Lemeshow (p = 0.57) and Naglkerke R Square (0.46) was calculated to express the variability of virological failure by predictors.
Result

More than half 290 (58.2%) of the study participants were females. The median age at ART initiation was 40 years with an interquartile range (IQR) of 15 years. The median duration of virologic failure since initiation of treatment was 96 months (IQR) of 72. The magnitude of virological treatment failure was 10.24% (95% CI: 7.57% − 12.91%). Poor ART drug adherence (AOR = 4.54; 95% CI: 2.09, 9.87), CD4 count less than 250 cell/µl (AOR = 24.88; 95% CI: 11.73, 52.81) and Poor Quality of Life (QoL) (AOR = 2.65; 95% CI: 1.12, 6.25) were independent predictors of virologic failure.
Conclusion

The magnitude of Virologic ART treatment failure in this study was relatively high. Poor ART drug adherence, patients’ having lower CD4 count and poorer quality of life were predictors of treatment failure. Thus, an intervention programs that enriches patients’ health-related quality of life should be implemented. Moreover, counseling that supplements the importance of drug adherence and reduction of risks that lower CD4 counts should be given emphasis which in turn helps to prevent first-line ART treatment failure.