bluuebunny/crossref_metadata_2025 huggingface dataset:
Taxi dancers, Chinese laundrymen, and Peking prisoners: Strangers in the city
Authors: Du Yue
Published: April 2022

This paper points out that the concept of the “marginal man”, derived from Simmel’s concept of the “stranger”, embodies a fusion of formal sociology and American pragmatism in early Chicago School theory. This kind of theoretical fusion gave birth to a research method that focuses on life history and, at the same time, an investigation of the objective “new” and “old” life stages of the individual and the individual’s subjective grasp of the conflict between the new and the old life, which served as the predecessor of the later “career approach” of the Chicago School. In the early 20th century, some Chicago School ethnographers studied three types of urban strangers: “taxi dancers” (female dancers hired to dance with clients), Chinese laundrymen in the US, and prisoners in Peking. These studies revealed profoundly different images of old life–new life conflicts. Taxi dancers were able to “move on” from their old lives, Chinese laundrymen firmly held on to the traditions of their home country and their families in order to cope with the new challenges, and prisoners in Peking had failed to adapt and turned to crime after being uprooted from their old lives. This paper concludes that neither the Chinese laundrymen nor Peking prisoners were able to adapt to the new urban life by “moving on” from their old family and village life. Thus, their paths to modernity differed fundamentally from those of the marginal man. Finally, this paper applies Robert Park’s views on “civilization” to explain these different Chinese and Western individuals’ paths to urban life.
Effects of Alcohol Intoxication on Sexual Decision-Making Among Men Who Have Sex With Men: Alcohol’s Influences on Self-Control Processes
Authors: Maisto Stephen A. , Simons Jeffrey S. , Palfai Tibor P. , Moskal Dezarie , Sheinfil Alan Z. , Tahaney Kelli D.
Published: April 2022

This experiment tested mechanisms linking alcohol intoxication and analogue determinants of condomless anal intercourse (CAI) in a sample of 257 men who have sex with men (MSM). The two mechanisms tested were implicit approach biases toward CAI stimuli and executive working memory. Participants were randomly assigned to three conditions (water control, placebo, or alcohol) and, following beverage administration, completed a working memory task, an approach-avoidance task of sexual versus condom stimuli, and two video role-play vignettes of high-risk sexual scenarios. Sexual arousal and CAI intentions were assessed by self-report, and behavioral skills and risk exposure were derived from participants’ role-play behavior. Estimation of four path models showed that the hypothesized mechanisms were supported for the CAI intention outcome, but the findings for the skills and risk-exposure outcome were mixed. Implications for development and enhancement of HIV prevention interventions are discussed.
Lessons Learned by Novice Nursing Investigators When Developing and Implementing a Research Protocol
Authors: Anderson Jeanette , McNeary-Garvin Antoinette , Morales Dawn
Published: April 2022

Introduction

This lessons learned paper provides recommendations for novice investigators to consider when writing a research protocol; specifically when it involves clinical staff with varying levels of research experience, multiple departments, and is conducted at a non-academic medical center. It further explores each specific lesson with generalizability to help future novice investigators successfully develop and implement their own research study.

Methods

There were several lessons learned during the development and implementation of the research teams’ original study. These lessons include: (1) Conduct feasibility assessments; (2) Assess external factors; (3) Partner with stakeholder(s); (4) Develop tools that promote transparency; (5) Coordinate with Information Technology personnel; and (6) Engage and educate stakeholders.

Conclusion

The aim of this study was to determine if unrestricted oral intake of low fat, low residue foods during labor impacts maternal and neonatal outcomes, with the goal of contributing an adequately powered study to the current literature. Due to the challenges experienced in executing this study, the findings were not able to be generalized. However, the challenges encountered are not specific to the original focus of the researchers’ study. Each of the lessons are generalizable and can be applied to nursing research. As nurses begin to develop clinical research protocols, utilizing the lessons learned in this paper may help ensure successful implementation and completion of their research.
Human Capital Development Challenge: Why Corruption Eradication is a Panacea in Nigeria
Authors: Fagbemi Fisayo , Osinubi Tolulope Temilola , Nzeribe Geraldine Ejiaka , Bankole Taofik Olatunji
Published: April 2022

The study finds empirical evidence regarding the role of corruption in the development of human capital in Nigeria for 1996–2019 period. Using ARDL technique to examine the long-run and short-run relationship between corruption and human capital development, and VECM to assess the causal effects, the analysis involves the inclusion of two corruption indicators (corruption index and control of corruption) as well as two human capital development measures (human capital index and life expectancy at birth). Findings obtained are consistent with efficiency-reducing theory (corruption is harmful), as the empirical evidence indicates that corruption has a significant impact on human capital development, suggesting that the incidence of corruption is a crucial element in the development of human capital. Further evidence reveals that there exists bidirectional causality between corruption and human capital development, implying that both the level of corruption and human capital development are interlinked and mutually inducing. Hence, the entrenched phenomenon of corruption in the country seems to have presaged long-term poor human development. It is therefore suggested that aside existing institutions established to curb corruption, such policy measures, which include addressing factors that incentivise corruption such as inappropriate regulatory frameworks, rent-seeking dispositions, among others, need to be initiated and promoted.
Autophagy of the ER Requires Actin Assembly Driven by the Interaction of ER with Endocytic Pits
Authors: Novick Peter , Liu Dongmei , Ferro-Novick Susan
Published: April 2022

Autophagy of the cortical ER in budding yeast was unexpectedly found to require End3, a component of the endocytic machinery that promotes the assembly of actin at endocytic pits on the plasma membrane. The cortical ER transiently interacts with invaginating endocytic pits through a linkage consisting of VAP proteins, oxysterol binding proteins and type I myosins. These proteins are required for actin assembly and for autophagy of the ER. Assembly of actin at these contact sites may direct the movement of ER away from the cortex towards sites of autophagosome assembly.
Neutrophil Lymphocyte Ratio as a Marker of In-Hospital Deterioration in COVID-19: Observations From a Resource Constraint Setting
Authors: Perera Nilanka , de Silva Ashani , Kumbukage Mahesh , Rambukwella Roshan , Indrakumar Jegarajah
Published: April 2022

Introduction and Objectives:

The study was conducted to assess the association of neutrophil lymphocyte ratio (NLR) in COVID-19 and to identify the cut-off value that predicts mortality, need of respiratory support and admission to high-dependency or intensive care.

Methods:

A retrospective observational study was conducted to collect demographic data, clinical variables, the neutrophil-lymphocyte ratio on-admission and the outcome of confirmed COVID-19 patients admitted to a tertiary care center in Sri Lanka.

Results:

There were 208 patients with a median age of 56 years (IQR 43-67) and 98 (47.1%) males. The median neutrophil count was 4.07 × 103/µL (IQR 2.97-6.79) and the median lymphocyte count was 1.74 × 103/µL (IQR 1.36-4.75). The calculated NLR ranged from 0.12 to 48.28 with a median value of 2.32 (IQR 1.37-4.76). A NLR value >3.6 predicted development of severe disease requiring respiratory support, transfer to a high-dependency or an intensive care unit and/or succumbing to the illness with a sensitivity 80% and specificity 80% (area under the curve 0.8, 95% CI 0.72-0.88, P < .0001). The adjusted odds ratio of NLR > 3.6 on predicting severe disease was 11.1, 95% CI 4.5- 27.0, P < .0001.

Conclusions:

A NLR > 3.6 is a useful variable to be included in risk prediction scores in Sri Lanka.
Understanding Chinese students’ success in the PISA financial literacy: A praxeological analysis of financial numeracy
Authors: Cavalcante Alexandre , Huang Huiyu
Published: April 2022

The goal of this article was to investigate how Chinese mathematics curriculum policies and textbook tasks could help explain the results obtained by Chinese students in the 2012 and 2015 Programme for International Student Assessment (PISA) financial literacy exams. Inspired by the Anthropological Theory of the Didactic, we conducted a praxeological analysis of financial numeracy tasks from middle school textbooks and the PISA. We conceptualized the term financial numeracy as the use, production, and communication of mathematical information in financial situations. The analysis permitted us to contrast the solution to PISA tasks with that of financial tasks from middle school mathematics textbooks. Our results show that, despite the lack of attention to mathematics in the curriculum policies for financial literacy, the mathematics textbooks seem to support the performance of students in the PISA by (a) incorporating more mathematically complex content, (b) tackling equivalent financial concepts, (c) providing students with enough time to consolidate their understanding throughout middle school, and (d) designing pedagogy that revisits these concepts over the years. The implications of this study inform mathematics education research and practice. If we are to incorporate financial literacy in mathematics curricula, this process should be done with intentionality and in connection to multiple mathematical concepts and processes.
ABO blood group type and risk of venous thromboembolism in patients with cancer
Authors: Englisch Cornelia , Moik Florian , Nopp Stephan , Raderer Markus , Pabinger Ingrid , Ay Cihan
Published: April 2022

Venous thromboembolism (VTE) is common in patients with cancer. Although in the general population blood type non-O is associated with increased VTE risk, the impact of ABO blood type on risk of cancer-associated VTE has not been clarified. To determine the influence of ABO blood type on cancer-associated VTE risk, we conducted an analysis within the Vienna Cancer and Thrombosis Study, a prospective cohort study including patients with newly diagnosed or recurrent cancer observed for the primary outcome VTE. Restricted cubic spline analysis was performed and specific time-restricted subdistribution hazard ratios (SHR) were calculated to investigate the association between non-O blood type and VTE over time. One thousand, seven hundred and eight patients were included in the analysis (median follow-up time: 24 months; interquartile range: 10-24), and 151 patients developed VTE (8.8%). During the first 3 months of follow-up, there was no association between non-O blood type and VTE risk (SHR: 1.00; 95% confidence interval [CI]: 0.60-1.67). Thereafter, non-O blood type was associated with a higher VTE risk (SHR: 1.79; 95% CI: 1.12-2.85). Furthermore, non-O blood type was associated with increased VTE risk in patients with intermediate and low thrombotic risk tumor types (SHR: 1.73; 95% CI: 1.09-2.73) but not in very high-risk types (pancreatic, gastroesophageal, and brain cancer; SHR: 0.94; 95% CI: 0.55-1.61). This association was weakened after adjustment for factor VIII. Non-O blood type is a time-dependent predictor of VTE in patients with cancer. It is associated with increased VTE risk beyond 3 months of follow-up and in patients with intermediate- and low-risk tumor types.
A systematic review and functional bioinformatics analysis of genes associated with Crohn’s disease identify more than 120 related genes
Authors: Garza-Hernandez Debora , Sepulveda-Villegas Maricruz , Garcia-Pelaez Jose , Aguirre-Gamboa Raul , Lakatos Peter L. , Estrada Karol , Martinez-Vazquez Manuel , Trevino Victor
Published: April 2022

Background

Crohn’s disease is one of the two categories of inflammatory bowel diseases that affect the gastrointestinal tract. The heritability estimate has been reported to be 0.75. Several genes linked to Crohn’s disease risk have been identified using a plethora of strategies such as linkage-based studies, candidate gene association studies, and lately through genome-wide association studies (GWAS). Nevertheless, to our knowledge, a compendium of all the genes that have been associated with CD is lacking.

Methods

We conducted functional analyses of a gene set generated from a systematic review where genes potentially related to CD found in the literature were analyzed and classified depending on the genetic evidence reported and putative biological function. For this, we retrieved and analyzed 2496 abstracts comprising 1067 human genes plus 22 publications regarding 133 genes from GWAS Catalog. Then, each gene was curated and categorized according to the type of evidence associated with Crohn’s disease.

Results

We identified 126 genes associated with Crohn’s disease risk by specific experiments. Additionally, 71 genes were recognized associated through GWAS alone, 18 to treatment response, 41 to disease complications, and 81 to related diseases. Bioinformatic analysis of the 126 genes supports their importance in Crohn’s disease and highlights genes associated with specific aspects such as symptoms, drugs, and comorbidities. Importantly, most genes were not included in commercial genetic panels suggesting that Crohn’s disease is genetically underdiagnosed.

Conclusions

We identified a total of 126 genes from PubMed and 71 from GWAS that showed evidence of association to diagnosis, 18 to treatment response, and 41 to disease complications in Crohn’s disease. This prioritized gene catalog can be explored athttp://victortrevino.bioinformatics.mx/CrohnDisease.
Identification and comparative analysis of long non-coding RNAs in the brain of fire ant queens in two different reproductive states
Authors: Tsai Cheng-Hung , Lin Tzu-Chieh , Chang Yi-Hsien , Tsai Huai-Kuang , Huang Jia-Hsin
Published: April 2022

Background

Many long non-coding RNAs (lncRNAs) have been extensively identified in higher eukaryotic species. The function of lncRNAs has been reported to play important roles in diverse biological processes, including developmental regulation and behavioral plasticity. However, there are no reports of systematic characterization of long non-coding RNAs in the fire ant Solenopsis invicta.

Results

In this study, we performed a genome-wide analysis of lncRNAs in the brains of S. invicta from RNA-seq. In total, 1,393 novel lncRNA transcripts were identified in the fire ant. In contrast to the annotated lncRNA transcripts having at least two exons, novel lncRNAs are monoexonic transcripts with a shorter length. Besides, the transcriptome from virgin alate and dealate mated queens were analyzed and compared. The results showed 295 differentially expressed mRNA genes (DEGs) and 65 differentially expressed lncRNA genes (DELs) between virgin and mated queens, of which 17 lncRNAs were highly expressed in the virgin alates and 47 lncRNAs were highly expressed in the mated dealates. By identifying the DEL:DEG pairs with a high association in their expression (Spearman’s |rho|> 0.8 and p-value < 0.01), many DELs were co-regulated with DEGs after mating. Furthermore, several remarkable lncRNAs (MSTRG.6523, MSTRG.588, and nc909) that were found to associate with particular coding genes may play important roles in the regulation of brain gene expression in reproductive transition in fire ants.

Conclusion

This study provides the first genome-wide identification of S. invicta lncRNAs in the brains in different reproductive states. It will contribute to a fuller understanding of the transcriptional regulation underpinning reproductive changes.
Mind the gap: covariate constrained randomisation can protect against substantial power loss in parallel cluster randomised trials
Authors: Kristunas Caroline , Grayling Michael , Gray Laura J. , Hemming Karla
Published: April 2022

Background

Cluster randomised trials often randomise a small number of units, putting them at risk of poor balance of covariates across treatment arms. Covariate constrained randomisation aims to reduce this risk by removing the worst balanced allocations from consideration. This is known to provide only a small gain in power over that averaged under simple randomisation and is likely influenced by the number and prognostic effect of the covariates.

We investigated the performance of covariate constrained randomisation in comparison to the worst balanced allocations, and considered the impact on the power of the prognostic effect and number of covariates adjusted for in the analysis.

Methods

Using simulation, we examined the Monte Carlo type I error rate and power of cross-sectional, two-arm parallel cluster-randomised trials with a continuous outcome and four binary cluster-level covariates, using either simple or covariate constrained randomisation. Data were analysed using a small sample corrected linear mixed-effects model, adjusted for some or all of the binary covariates. We varied the number of clusters, intra-cluster correlation, number and prognostic effect of covariates balanced in the randomisation and adjusted in the analysis, and the size of the candidate set from which the allocation was selected. For each scenario, 20,000 simulations were conducted.

Results

When compared to the worst balanced allocations, covariate constrained randomisation with an adjusted analysis provided gains in power of up to 20 percentage points. Even with analysis-based adjustment for those covariates balanced in the randomisation, the type I error rate was not maintained when the intracluster correlation is very small (0.001). Generally, greater power was achieved when more prognostic covariates are restricted in the randomisation and as the size of the candidate set decreases. However, adjustment for weakly prognostic covariates lead to a loss in power of up to 20 percentage points.

Conclusions

When compared to the worst balanced allocations, covariate constrained randomisation provides moderate to substantial improvements in power. However, the prognostic effect of the covariates should be carefully considered when selecting them for inclusion in the randomisation.
Development and evaluation of a novel fast broad-range PCR and sequencing assay (FBR-PCR/S) using dual priming oligonucleotides targeting the ITS/LSU gene regions for rapid diagnosis of invasive fungal diseases: multi-year experience in a large Canadian healthcare zone
Authors: Chow B. , Groeschel M. , Carson J. , Griener T. , Church D. L.
Published: April 2022

Background

This study evaluated the performance of a novel fast broad range PCR and sequencing (FBR-PCR/S) assay for the improved diagnosis of invasive fungal disease (IFD) in high-risk patients in a large Canadian healthcare region.

Methods

A total of 114 clinical specimens (CS) including bronchoalveolar lavages (BALs) were prospectively tested from 107 patients over a 2-year period. Contrived BALs (n = 33) inoculated with known fungi pathogens were also tested to increase diversity. Patient characteristics, fungal stain and culture results were collected from the laboratory information system. Dual-priming oligonucleotide (DPO) primers targeted to the internal transcribed spacer (ITS) (~ 350 bp) and large subunit (LSU) (~ 550 bp) gene regions were used to perform FBR-PCR/S assays on extracted BALs/CS. The performance of the molecular test was evaluated against standard microbiological methods and clinical review for the presence of IFD.

Results

The 107 patients were predominantly male (67, 62.6%) with a mean age of 59 years (range = 0–85 years): 74 (69.2%) patients had at least one underlying comorbidity: 19 (34.5%) had confirmed and 12 (21.8%) had probable IFD. Culture recovered 66 fungal isolates from 55 BALs/CS withCandidaspp. andAspergillusspp. being most common. For BALs, the molecular assay vs. standard methods had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), and efficiency of 88.5% vs.100%, 100% vs. 61.1%, 100% vs. 88.5%, 61.1% vs. 100%, and 90.2% for both. For other CS, the molecular assay had similar performance to standard methods with sensitivity, specificity, PPV, NPV and efficiency of 66.7%, 87.0%, 66.7%, 87.0% and 81.3% for both methods. Both methods also performed similarly, regardless of whether CS stain/microscopy showed yeast/fungal elements. FBR-PCR/S assays results were reported in ~ 8 h compared to fungal cultures that took between 4 and 6 weeks.

Conclusions

Rapid molecular testing compared to standard methods have equivalent diagnostic efficiency but improves clinical utility by reporting a rapid species-level identification the same dayshift (~ 8 h).
Clinical impact of a metagenomic microbial plasma cell-free DNA next-generation sequencing assay on treatment decisions: a single-center retrospective study
Authors: Shishido Akira A. , Noe Myint , Saharia Kapil , Luethy Paul
Published: April 2022

Background

Metagenomic next-generation sequencing of microbial cell-free DNA (mcfDNA) allows for non-invasive pathogen detection from plasma. However, there is little data describing the optimal role for this assay in real-world clinical decision making.

Methods

We performed a single-center retrospective cohort study of adult patients for whom a mcfDNA (Karius©) test was sent between May 2019 and February 2021. Clinical impact was arbitrated after review and discussion of each case.

Results

A total of 80 patients were included. The most common reason for sending the assay was unknown microbiologic diagnosis (78%), followed by avoiding invasive procedures (14%). The test had a positive impact in 34 (43%), a negative impact in 2 (3%), and uncertain or no impact in 44 (55%). A positive impact was observed in solid organ transplant recipients (SOTR, 71.4%, p = 0.003), sepsis (71.4%, p = 0.003), and those receiving antimicrobial agents for less than 7 days prior to mcfDNA testing (i.e., 61.8%, p = 0.004). Positive impact was driven primarily by de-escalation of antimicrobial therapy.

Conclusion

Clinical impact of mcfDNA testing was highest in SOTR, patients with sepsis and patients who had been on antimicrobial therapy for less than 7 days. Positive impact was driven by de-escalation of antimicrobial therapy which may highlight a potential role for mcfDNA in the realm of stewardship.
Transfer learning for medical image classification: a literature review
Authors: Kim Hee E. , Cosa-Linan Alejandro , Santhanam Nandhini , Jannesari Mahboubeh , Maros Mate E. , Ganslandt Thomas
Published: April 2022

Background

Transfer learning (TL) with convolutional neural networks aims to improve performances on a new task by leveraging the knowledge of similar tasks learned in advance. It has made a major contribution to medical image analysis as it overcomes the data scarcity problem as well as it saves time and hardware resources. However, transfer learning has been arbitrarily configured in the majority of studies. This review paper attempts to provide guidance for selecting a model and TL approaches for the medical image classification task.

Methods

425 peer-reviewed articles were retrieved from two databases, PubMed and Web of Science, published in English, up until December 31, 2020. Articles were assessed by two independent reviewers, with the aid of a third reviewer in the case of discrepancies. We followed the PRISMA guidelines for the paper selection and 121 studies were regarded as eligible for the scope of this review. We investigated articles focused on selecting backbone models and TL approaches including feature extractor, feature extractor hybrid, fine-tuning and fine-tuning from scratch.

Results

The majority of studies (n = 57) empirically evaluated multiple models followed by deep models (n = 33) and shallow (n = 24) models. Inception, one of the deep models, was the most employed in literature (n = 26). With respect to the TL, the majority of studies (n = 46) empirically benchmarked multiple approaches to identify the optimal configuration. The rest of the studies applied only a single approach for which feature extractor (n = 38) and fine-tuning from scratch (n = 27) were the two most favored approaches. Only a few studies applied feature extractor hybrid (n = 7) and fine-tuning (n = 3) with pretrained models.

Conclusion

The investigated studies demonstrated the efficacy of transfer learning despite the data scarcity. We encourage data scientists and practitioners to use deep models (e.g. ResNet or Inception) as feature extractors, which can save computational costs and time without degrading the predictive power.
Identification and validation of glomerulotubular crosstalk genes mediating IgA nephropathy by integrated bioinformatics
Authors: Bai Yawen , Li Yajing , Xi Yali , Ma Chunjie
Published: April 2022

Background

IgA nephropathy (IgAN), which has been reported as the most prevalent glomerulonephritis globally, is the major contributor to end-stage renal diseases. This bioinformatics study aimed to explore glomerulotubular crosstalk genes and dysregulated pathways relating to the pathogenesis of IgAN.

Methods

The microarray datasets from the Gene Expression Omnibus (GEO) database were searched. Weighted gene co-expression network analysis (WGCNA) and differentially expressed genes (DEGs) of both glomeruli and tubulointerstitium were conducted individually. The co-expression gene modules of glomeruli and tubulointerstitium were compared via gene function enrichment analysis. Subsequently, the crosstalk co-expression network was constructed via the STRING database and key genes were mined from the crosstalk network. Finally, key genes were validated using another GEO dataset (GSE99340) containing RNA-seq data of IgAN and lupus nephritis, and their potential diagnostic values were shown using receiver operating characteristic (ROC) analysis.

Results

Five hundred eighty-three DEGs and eight modules were identified in glomerular samples, while 272 DEGs and four modules were in tubulointerstitial samples. There were 119 overlapping DEGs between the two groups. Among the distinctive modules, four modules in glomeruli and one module in tubulointerstitium were positively associated with IgAN. While four modules in glomeruli and two modules in tubulointerstitium were negatively associated with IgAN. The top ten key genes screened by CytoHubba were ITGAM, ALB, TYROBP, ITGB2, CYBB, HCK, CSF1R, LAPTM5, FN1, and CTSS. Compared with lupus nephritis, there were significant differences in the expression levels of CYBB, CTSS and TYROBP (P < 0.05), while other key genes showed no significant difference. Meanwhile, CYBB, CTSS, and TYROBP demonstrated possible diagnostic significance.

Conclusions

The crosstalk genes confirmed in this study may provide novel insight into the pathogenesis of IgAN. Immune-related pathways are associated with both glomerular and tubulointerstitial injuries in IgAN. The glomerulotubular crosstalk might perform a role in the pathogenesis of IgAN.
Preparation and consideration for establishment of an isolation maternity unit in a tertiary hospital during COVID-19 pandemic
Authors: He Yingke , Wong Yvonne Wan Yu , Ngeow Alvin Jia Hao , Sim Eileen Yilin , Cherng Benjamin Pei Zhi , Arunachalam Sridhar , Ho Selina Kah Ying , Tan Wei Ching , Mok Un Sam
Published: April 2022

The SARS-CoV-2 pandemic is rapidly evolving and remains a major health challenge worldwide. With an increase in pregnant women with COVID-19 infection, we recognized an urgent need to set up a multidisciplinary taskforce to provide safe and holistic care for this group of women. In this review of practice in a tertiary hospital in Singapore, we discuss the key considerations in setting up an isolation maternity unit and our strategies for peripartum and postpartum care. Through teleconsultation, we involve these women and their families in the discussion of timing and mode of birth, disposition of babies after birth and safety of breastfeeding to enable them to make informed decisions and individualize their care.
Molecular signatures of tumor progression in pancreatic adenocarcinoma identified by energy metabolism characteristics
Authors: Tan Cong , Wang Xin , Wang Xu , Weng Weiwei , Ni Shu-juan , Zhang Meng , Jiang Hesheng , Wang Lei , Huang Dan , Sheng Weiqi , Xu Mi-die
Published: April 2022

Background

In this study, we performed a molecular evaluation of primary pancreatic adenocarcinoma (PAAD) based on the comprehensive analysis of energy metabolism-related gene (EMRG) expression profiles.

Methods

Molecular subtypes were identified by nonnegative matrix clustering of 565 EMRGs. An overall survival (OS) predictive gene signature was developed and internally and externally validated based on three online PAAD datasets. Hub genes were identified in molecular subtypes by weighted gene correlation network analysis (WGCNA) coexpression algorithm analysis and considered as prognostic genes. LASSO cox regression was conducted to establish a robust prognostic gene model, a four-gene signature, which performed better in survival prediction than four previously reported models. In addition, a novel nomogram constructed by combining clinical features and the 4-gene signature showed high-confidence clinical utility. According to gene set enrichment analysis (GSEA), gene sets related to the high-risk group participate in the neuroactive ligand receptor interaction pathway.

Conclusions

In summary, EMRG-based molecular subtypes and prognostic gene models may provide a novel research direction for patient stratification and trials of targeted therapies.
Tumor histology is an independent prognostic factor in locally advanced cervical carcinoma: A retrospective study
Authors: Gallardo-Alvarado Lenny , Cantú-de León David , Ramirez-Morales Rebeca , Santiago-Concha Gabriel , Barquet-Muñoz Salim , Salcedo-Hernandez Rosa , Reyes Cinthya , Perez-Alvarez Sandra , Perez-Montiel Delia , Perez-Plasencia Carlos , Trejo-Duran Elizabeth , Galicia Juan Pablo
Published: April 2022

Background

Even with different histologic origins, squamous cell carcinoma (SCC) and adenocarcinoma (AC) are considered a single entity, and the first-line treatment is the same. Locally advanced disease at the diagnosis of cervical cancer is the most important prognostic factor, the recurrence rate is high, making it necessary to evaluate prognostic factors other than clinical or radiological staging; histology could be one of them but continues to be controversial. The aim of this study was to evaluate tumor histology as a prognostic factor in terms of treatment outcomes, disease-free survival (DFS) and overall survival (OS) in a retrospective cohort of patients with Locally Advanced Cervical Carcinoma (LACC).

Methods

The records of 1291patients with LACC were reviewed, all of them were treated with 45–50 Gy of external beam radiotherapy with concurrent chemotherapy and brachytherapy. A descriptive and comparative analysis was conducted. Treatment response was analyzed by the chi-square test; DFS and OS were calculated for each histology with the Kaplan–Meier method and compared with the log-rank test; and the Cox model was applied for the multivariate analysis.

Results

We included 1291 patients with LACC treated from 2005 to 2014, of which 1154 (89·4%) had SCC and 137 (10·6%) had AC. Complete response to treatment was achieved in 933 (80·8%) patients with SCC and 113 (82·5%) patients with AC. Recurrence of the disease was reported in 29·9% of SCC patients and 31·9% of AC patients. Five-year DFS was 70% for SCC and 62·2% for AC. The five-year OS rates were 74·3% and 60% for SCC and AC, respectively. The mean DFS was 48·8 months for SCC vs 46·10 for AC (p = 0·043), the mean OS was 50·8 for SCC and 47·0 for AC (p = 0·002).

Conclusion

Our findings support the hypothesis that SCC and AC are different clinical entities.

Trial Registration

NCT04537273.
A cross-sectional study on public health nurses' disaster competencies and influencing factors during the COVID-19 pandemic in Korea
Authors: Hong Eunjoo , Jung Aeri , Woo Kyungmi
Published: April 2022

Public health nurses are performing various roles during the COVID-19 pandemic: counseling, surveillance, specimen collection, epidemiological investigation, education, and vaccination. This study investigated their disaster competencies in the context of emerging infectious diseases, and identified their influencing factors based on Deci and Ryan’s self-determination theory. A convenience sample of 242 was selected from public health nurses working in a metropolitan city of South Korea. Data were collected using a structured questionnaire and analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation, and multiple regression analysis using the SPSS Statistics ver. 23.0. Results showed that the significant factors influencing disaster competencies included “willingness to respond to a disaster,” “preventive behavior,” “experience of receiving education on emerging infectious diseases response,” “public health center experience,” “job satisfaction,” and “education.” This regression model explained 33.2% of the variance in disaster competencies. “Willingness to respond to a disaster” was the strongest factor affecting disaster competencies. Based on these results, it is concluded that interventions to improve disaster competencies and psychological well-being of public health nurses are needed. Additionally, strategies such as creating a supportive work environment, deploying experienced nurses primarily on the front line, and reducing the tasks of permanent public health nurses should be implemented.
Towards a better understanding of the psychosocial determinants associated with adults’ use of smokeless tobacco in the Jazan Region of Saudi Arabia: a qualitative study
Authors: Moafa Ibtisam , Crutzen Rik , van den Borne Bart , Jafer Mohammed , Shabi Maan , Al-khaldi Ahmed , Abu-Zawah Ahmed , Al-jabri Hameed , Hedad Ismaeel
Published: April 2022

Background

Most diagnosed oral cancer cases in Saudi Arabia are in the Jazan region. A common type of smokeless tobacco "Shammah" is prevalent in this region. This study aimed to gain an in-depth understanding of the possible psychosocial determinants of Shammah consumption among adult Shammah users in Jazan region.

Methods

A qualitative study was conducted by means of one-on-one interviews among thirty adult Shammah users. Participants were recruited by means of a purposive sampling technique. Data were collected using a semi-structured interview guide utilizing face-to-face and phone-call interviews. Thematic analysis with hybrid approach was used to analyze the dataset.

Results

Twenty-four sub-codes within four overarching themes were generated. Participants revealed uncertainty related to Shammah composition, how to quit knowledge and Shammah prevention/cessation programs. Shammah use identified as a normal phenomenon in society. Its use was frequently reported in participants’ close network but most users faced family and peers’ disapproval. Some users expressed joy, happiness and focused when using Shammah. Others were disgusted or neutral. Many users believed Shammah causes cancer and tears oral tissues. Others believed it relieves toothache or has no effect. Majority of users were confident to quit and recalled some quitting aids. Toothache, craving, drinking tea and chewing Khat (leaves of Catha edulis plant that causes moderate euphoria) perceived to be triggers to use Shammah. Availability of Shammah, withdrawal symptoms, stress, lack of support, seeing others using Shammah, losing part of routine and toothache were barriers to quit.

Conclusions

Shammah use was associated with uncertainty about Shammah composition and quitting knowledge, social acceptability, influence from family/friends, a range of positive and negative attitudinal beliefs toward its use and high quitting efficacy beliefs. Future interventions targeting Shammah should address the acknowledged triggers and barriers in the present study including the dual use of Shammah and Khat.
Psychometric evaluation of a culturally adapted illness perception questionnaire for African Americans with type 2 diabetes
Authors: Shiyanbola Olayinka O. , Rao Deepika , Kuehl Sierra , Bolt Daniel , Ward Earlise , Brown Carolyn
Published: April 2022

Background

Diabetes is burdensome to African Americans, who are twice as likely to be diagnosed, more likely to develop complications and are at a greater risk for death and disability than non-Hispanic whites. Medication adherence interventions are sometimes ineffective for African Americans because their unique illness perceptions are not adequately addressed. The Illness Perception Questionnaire-Revised (IPQ-R) that assesses illness perceptions has shown reliability and validity problems when used with African Americans. Thus, the study objective was to adapt the IPQ-R for African Americans and assess the validity and reliability of the culturally adapted questionnaire.

Methods

The parent study used an exploratory sequential mixed methods design, to explore African Americans’ illness perceptions qualitatively, used the results to adapt the IPQ-R, and tested the culturally adapted IPQ-R items quantitatively. In this paper, a preliminary culturally adapted IPQ-R refined based on the qualitative study, was administered to 170 middle-aged United States-based African Americans with type 2 diabetes in a face-to-face survey. Content, construct, convergent, and predictive validity, including reliability was examined. Pearson and item-total correlations, item analysis, exploratory factor analysis, multiple linear regression analysis, and test-retest were conducted.

Results

A revised culturally adapted IPQ-R was identified with a 9-factor structure and was distinct from the old factor structure of the original IPQ-R. The ‘consequences’ domain from the IPQ-R occurred as two factors (external and internal consequences) while the ‘emotional representations’ domain in the IPQ-R emerged as separate ‘present’ and ‘future’ emotional representation factors. Illness coherence’ was differently conceptualized as ‘illness interpretations’ to capture additional culturally adapted items within this domain. Most items had factor loadings greater than 0.4, with moderate factor score correlations. Necessity and concern beliefs in medicines significantly correlated with domains of the culturally adapted IPQ-R. Pearson’s correlation values were not greater than 0.7, indicating good convergent validity. The culturally adapted IPQ-R significantly predicted medication adherence. None of the correlation values were higher than 0.7 for the test-retest, indicating moderate reliability. Most domains of the culturally adapted IPQ-R had Cronbach’s alpha values higher than 0.7, indicating good internal consistency.

Conclusions

The results provide preliminary support for the validity of the culturally adapted IPQ-R in African Americans with diabetes, showing good construct, convergent and predictive validity, as well as reliability.
The introduction of tobacco excise taxation in the Gulf Cooperation Council Countries: a step in the right direction of advancing public health
Authors: Delipalla Sofia , Koronaiou Konstantina , Al-Lawati Jawad A. , Sayed Mohamed , Alwadey Ali , AlAlawi Ejlal F. , Almutawaa Kholoud , Hussain Amal H. J. , Al-Maidoor Wedad , Al-Farsi Yahya M.
Published: April 2022

Background

The Gulf Cooperation Council (GCC) countries relied, until recently, solely on import duties for tobacco products. The agreement for the introduction of an excise and value added tax (VAT) in 2016 and 2017, respectively, in most GCC countries, was a major breakthrough for public health. There is, however, ample room for improvement.

Methods

The study examines the outcomes of tax reforms, for both public health and public finances, based on the World Health Organization (WHO) recommendations and best practices worldwide. Tax simulations were performed using the WHO TaXSiM model. The study is based on data from Saudi Arabia, the only GCC country for which sufficient data existed.

Results

We recommend a stepwise tax reform, which involves increasing the current ad valorem excise tax rate, phasing out import duties keeping total tax share constant and introducing a minimum excise, and finally switching to a revenue-neutral specific excise. Specific excises must be adjusted for inflation and income increases. If implemented, cigarette tax reform simulations show that the recommended reforms would lead to a higher than 50% increase in cigarette prices, 16% reduction in cigarette sales and almost 50% increase in total cigarette tax revenue. A significant number of cigarette-related deaths would be averted.

Conclusions

The recommended tax reforms are expected to lead to significant improvements in both public health and tobacco tax revenues. Our results provide useful insights that are of relevance to the whole GGC region. The effectiveness of the reforms, however, requires a strong tax and customs administration, including the establishment of a good database to monitor and advance public health.
Efficiency of a novel vertebral body augmentation system (Tektona™) in non-osteoporotic spinal fractures
Authors: Marie-Hardy Laura , Mohsinaly Yann , Pietton Raphaël , Stencel-Allemand Marion , Khalifé Marc , Bonaccorsi Raphaël , Barut Nicolas , Pascal-Moussellard Hugues
Published: April 2022

Background

The restauration of the local kyphosis is crucial to thoracolumbar fractures outcomes. Recently, the Tektona™ (Spine Art) system, constituted by a flexible lamella for corporeal reduction has emerged as a promising solution for osteoporotic fractures. However, no study has yet focused on its results on traumatic fractures.

Methods

A retrospective longitudinal study on prospectively collected data was conducted on 53 patients that had a kyphoplasty by Tektona™, associated or not to percutaneous fixation. The data collected were clinical, surgical and scannographic (measurement of AVH, MVH and PVH (anterior/medium/posterior vertebral height), and RTA (regional traumatic angle) in°), preoperatively, post-operatively and at last follow-up.

Results

Fractures were mainly located at the upper lumbar spine and were AOSpine A3 type for 74%. The mean RTA was 12° in pre-operative, 4° in post-operative (p = 2e− 9), and 8° at the last follow-up (p = 0,01). The mean correction of RTA for the fixation group was − 10 ± 6° versus − 7 ± 4° for the kyphobroplasty alone group (p = 0,006). The mean correction for fractures located at T10-T12 was − 9 ± 3°, − 9 ± 5° for L1, − 8 ± 3° for L2 and − 5 ± 3° for L3-L5 (p = 0,045).

Conclusions

The Tektona® system appears to be efficient for acute thoraco-lumbar fractures, comparable to other available systems, allowing a real intracorporeal reduction work. Its relevance, especially in the long term needs further investigation. The association of a percutaneous fixation allow to obtain a better correction of the RTA but did not seem to prevent the loss of correction at follow-up.
Continuing medical education programs for primary care physicians from remote locations of Vietnam: a needs assessment
Authors: Giang Pham Ngan , Kelly Matthew , Nhung Nguyen Thi Tuyet , Sarma Haribondhu
Published: April 2022

Background

Inadequate attention has been given to ensuring ongoing training to improve knowledge, skills and capacity of primary health care providers in low- and middle-income countries. The Hanoi Medical University, Vietnam is providing training sessions for physicians working in commune health stations (CHSs) in three mountainous, remote northern provinces in 2019. This article aims to assess these physicians’ knowledge of correct medical responses to emergencies in order to assess their training needs.

Methods

We conducted a cross-sectional study amongst doctors posted to CHSs located in 3 mountainous remote provinces of northern Vietnam. We used a self-administered questionnaire that comprised questions on common medical emergencies, maternal and child care, and non-communicable disease management. We performed Chi-square tests to assess the statistical significance of differences in the mean proportions of correct answers for each health care question category, and for differences in mean proportions of correct answers by doctor characteristics.

Results

In total 302 doctors were recruited to the study. More than half of the sample answered 30–50% of the questions correctly, followed by around a third who answered 50–70% correctly. Less than 2% of doctors answered more than 70% correct responses to the entire question set. There were statistically significant differences between question categories, with cardiovascular care questions answered correctly significantly less often than any of the categories (p < 0.00001).

Conclusion

The findings reported here show that the doctors who participated in the study have relatively low knowledge on common emergencies, particularly to answer cardiovascular care questions. The results also support the need for continuing medical education to improve doctors’ knowledge, who are mostly practicing in resource limited remote settings.
Script concordance test acceptability and utility for assessing medical students’ clinical reasoning: a user’s survey and an institutional prospective evaluation of students’ scores
Authors: Kün-Darbois Jean-Daniel , Annweiler Cédric , Lerolle Nicolas , Lebdai Souhil
Published: April 2022

Script Concordance Testing (SCT) is a method for clinical reasoning assessment in the field of health-care training. Our aim was to assess SCT acceptability and utility with a survey and an institutional prospective evaluation of students’ scores.With a user’s online survey, we collected the opinions and satisfaction data of all graduate students and teachers involved in the SCT setting. We performed a prospective analysis comparing the scores obtained with SCT to those obtained with the national standard evaluation modality.

General opinions about SCT were mostly negative. Students tended to express more negative opinions and perceptions. There was a lower proportion of negative responses in the teachers’ satisfaction survey. The proportion of neutral responses was higher for teachers. There was a higher proportion of positive positions towards all questions among teachers. PCC scores significantly increased each year, but SCT scores increased only between the first and second tests. PCC scores were found significantly higher than SCT scores for the second and third tests. Medical students’ and teachers’ global opinion on SCT was negative. At the beginning SCT scores were found quite similar to PCC scores. There was a higher progression for PCC scores through time.