bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of undesirable treatment outcome of severe acute malnutrition inpatient children in Addis Ababa, Ethiopia: a retrospective cohort study
Authors: Negussie Absalat Serawit , Tadesse Amare Worku
Published: April 2020

Background: Globally, in 2018, malnutrition contributes to 45% of all child deaths. These early child deaths are due to conditions that could be prevented or treated with access to simple and affordable interventions. Hence, this study intends to provide a quantitative example of factors associated with undesirable treatment outcomes of severe acute malnutrition (SAM). Methods: We studied a retrospective cohort of 304 children aged 6-59 months with complicated SAM admitted to Yekatit 12 teaching hospital from 2013- 2016 . We extracted data from hospital records on nutritional status, socio-demographic factors and medical conditions during admission. The analysis was carried out with SPSS version 20.The Kaplan-Meier estimator was employed to analyze the recovery rate of the children undergoing treatment for SAM and Cox regression was used to adjust for confounding effects of other variables. Result: From overall of 304 under-five children with SAM, 133 (51.4%) were males and 126 (48.6%) were females. Marasmus was the most common type of severe acute malnutrition 132(51%). The recovery, death and defaulter rate were 70.4%, 12.2% and 8.2% respectively. The main predictors of undesirable outcome were found to be presence of HIV antibody (AHR=3.208; 95% CI: [1.045-9.846]) and sepsis (AHR= 7.677, 95% CI: [2.320-25.404])Conclusion: The study revealed that the overall treatment outcomes were below the SPHERE standard recommendation and the main predictors of death in children receiving in-patient treatment for SAM were HIV and sepsis. Intervention to reduce death should focus cases with comorbidities especially HIV and sepsis.
Chronic patients’ satisfaction and priorities regarding medical care, information and services and quality of life: a French online patient community survey
Authors: Adé Apolline , Debroucker Frédérique , Delporte Laura , De Monclin Cécile , Fayet Emmanuel , LEGENDRE Pierre , Radoszycki Lise , Chekroun Michael
Published: April 2020

Background: The French healthcare system is evolving to meet the challenges of an aging population, the growing prevalence of chronic diseases, the development of new technologies and the increasing involvement of patients in the management of their disease. The aim of this study is to assess the satisfaction and priorities of chronic patients regarding medical care, information and services and their quality of life.Methods: A cross-sectional study was conducted from February to March 2018 via the French Carenity platform. Adult patients enrolled in type 1 diabetes, heart failure or obesity communities were invited to answer an online questionnaire. A numeric scale from 0 (meaning not satisfied) to 5 was used to evaluate patients’ satisfaction. Patients’ priorities were assessed using a ranking question. Patients’ satisfaction and priorities have been combined in a matrix to identify patients’ expectations.Results: 67 respondents of each condition answered a questionnaire. The most important and least satisfactory items about medical care are availability and active listening from healthcare providers, as well as access to coordinated and multidisciplinary care. Regarding information and services, respondents mostly expect connected medical devices, in addition to lifestyle and dietary measures. As for the quality of life, respondents fear that their chronic condition will keep impacting their daily mood and ability to do physical activities.Conclusions: This study shows that chronic patients want to be more actively involved in their care pathway. Patient training and therapeutic patient education programs could help them manage their chronic conditions within a patient-centred healthcare system.
Lactic acid level as an outcome predictor in pediatric patients with intussusception in the emergency department
Authors: Lee Jeong-Yong , Byun Young-Hoon , Park Jun-Sung , Lee Jong Seung , Ryu Jeong-Min , Choi Seung Jun
Published: April 2020

Background: Intussusception decreases blood flow to the bowel, and tissue hypoperfusion results in increased lactic acid levels. We aimed to determine whether lactic acid levels are associated with pediatric intussusception outcomes. Methods: The electronic medical records of our emergency department pediatric patients diagnosed with intussusception, between January 2015 and October 2018, were reviewed. An outcome was considered poor when intussusception recurred within 48 hours of reduction or when surgical reduction was required due to air enema failure. Results: A total of 249 patients were included in the study, including 39 who experienced intussusception recurrence and 11 who required surgical reductions; hence, 50 patients were included in the poor outcome group. The poor and good outcome groups showed significant differences in their respective blood gas analyses for pH (7.39 vs. 7.41, P = .001), lactic acid (1.70 vs. 1.30 mmol/L, P < .001), and bicarbonate (20.70 vs. 21.80 mmol/L, P = .036). Multivariable logistic regression analyses showed that pH and lactic acid levels were the two factors significantly associated with poor outcomes. When the lactic acid level cutoff values were ≥1.5, ≥2.0, ≥2.5, and ≥3.0 mmol/L, the positive predictive values for poor outcomes were 30.0%, 34.6%, 50.0%, and 88.9%, respectively. Conclusion: Lactic acid levels affect outcomes in pediatric patients with intussusception; higher lactic acid levels are associated with higher positive predictive values for poor outcomes.
Theoretically designed interventions for colorectal cancer prevention: A Case of the Health Belief Model
Authors: Rakhshanderou Sakineh , Ghaffari Mohtasham , Safari-Moradabadi Ali , Maghsoudloo Maryam
Published: April 2020

Background: According to the WHO, most chronic diseases, including cancer, can be prevented by identifying their risk factors such as unhealthy diet, smoking and physical inactivity. This study examined the effectiveness of educational interventions on colorectal cancer prevention-nutritional behaviors in staff and based on HBM. Methods: In this interventional study, 110 employees of Shahid Beheshti University of Medical Sciences were randomly divided into two groups (intervention and control) with cluster sampling. The data gathering tool was a researcher-made questionnaire containing two parts of 10-dimensional information and health belief model constructs. The educational intervention was conducted for one month and in four sessions in the form of classroom lecture, pamphlet, educational text messages via mobile phones and educational pamphlets through the office automation system. Two groups were evaluated in two stages, pre-test and post-test. Data were analyzed using SPSS-18 software, analysis of Covariance (ANCOVA) and independent t-test (intergroup comparisons).Results: Two groups were evaluated for variables such as age, sex, education level and family history of colorectal cancer, and there was no significant differences between the two groups (P<0.05). After the two months since intervention, except for the mean score of perceived barriers, which was not significant after intervention, the mean scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived self-efficacy, behavioral intention, and preventive behaviors were significantly increased after the intervention in the intervention group compared to the control group (P> 0.05).Conclusion: Implementation of educational intervention based on health belief model was effective for the personnel, and can enhance the preventative nutritional behaviors related to colorectal cancer.
Gender difference in the association between education and schizophrenia in Chinese adults
Authors: Luo Yanan , Pang Lihua , Zhao Yihao , Guo Chao , Zhang Lei , Zheng Xiaoying
Published: April 2020

Background: Improving education level was evidenced to decrease the risk of schizophrenia, but whether this strength of education role depends on gender is not. This study aimed to investigate whether there was gender difference in the association between education and schizophrenia in Chinese adults. Methods: Data were obtained from the Second China National Sample Survey on Disability in 2006, including 1,909,205 participants aged 18 years or older. Schizophrenia was ascertained according to the International Statistical Classification of Diseases, Tenth Revision. Logistics regression models were fitted to examine the combined effect of gender and education on schizophrenia. Results: The lifetime prevalence of schizophrenia in female groups was higher than in male groups, with 0.44% (95% CI : 0.42%- 0.45%) and 0.36% (95% CI : 0.35%- 0.37%), respectively. Compared with schizophrenia male patients, more females with schizophrenia experienced severe or extreme difficulty in understanding and communicating. However, more males with schizophrenia suffered from severe or extreme difficulty in the function of daily activities. The combined effect of education and schizophrenia was statistically significant, indicating that, as the level of education increased, schizophrenia risk of females decreased faster than the risk of males. Conclusions: This study showed that additional years of education associated with lower risk of schizophrenia, and this association was stronger in females than in males. As education elevated, the risk of schizophrenia decreased more for women than for men. The findings indicate that improving education level may have an effect on reducing the gender disparities in mental health of China. Actions to prevent schizophrenia and address its gender disparities will require attention to the improving educational opportunities.
Arsenic trioxide ameliorates experimental autoimmune encephalomyelitis in C57BL/6 mice by inducing CD4+ T cell apoptosis
Authors: An Ke , Xue Mengjiao , Zhong Jiaying , Yu Shengnan , Lan Tianshu , Qi Zhongquan , Xia Junjie
Published: April 2020

Background: Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system characterized by severe white matter demyelination. Because of its complex pathogenesis, there is no definite cure for MS. Experimental autoimmune encephalomyelitis (EAE) is an ideal animal model for the study of MS. Arsenic trioxide (ATO) is an ancient Chinese medicine used for its therapeutic properties with several autoimmune diseases. It is also used to inhibit acute immune rejection due to its anti-inflammatory and immunosuppressive properties. However, it is unclear whether ATO has a therapeutic effect on EAE, and the underlying mechanisms have not yet been clearly elucidated. In this study, we attempted to assess whether ATO could be used to ameliorate EAE in mice.Methods: ATO (0.5 mg/kg/day) was administered intraperitoneally to EAE mice 10 days post-immunization for 8 days. On day 22 post-immunization, the spinal cord, spleen, and blood were collected to analyze demyelination, inflammation, microglia activation, and the proportion of CD4+ T cells. In vitro, for mechanistic studies, CD4+ T cells were sorted from the spleen of naïve C57BL/6 mice and treated with ATO and then used for an apoptosis assay, JC-1 staining, imaging under a transmission electron microscope, and western blotting.Results: ATO delayed the onset of EAE and alleviated the severity of EAE in mice. Treatment with ATO also attenuated demyelination, alleviated inflammation, reduced microglia activation and decreased the expression levels of IL-2, IFN-γ, IL-1β, IL-6, and TNF-α in EAE mice. Moreover, the number and proportion of CD4+ T cells in the spinal cord, spleen, and peripheral blood were reduced in ATO-treated EAE mice. Finally, ATO induced CD4+ T cell apoptosis via the mitochondrial pathway both in vitro and in vivo. Additionally, the administration of ATO had no adverse effect on the heart, liver, or kidney function, nor did it induce apoptosis in the spinal cord.Conclusions: Overall, our findings indicated that ATO plays a protective role in the initiation and progression of EAE and has the potential to be a novel drug in the treatment of MS.
Prevalence of acute kidney injury and use of renal replacement therapy in intensive care unit patients in Indonesia
Authors: Jonny Jonny , Hasyim Moch , Angelia Vedora , Jahya Ayu Nursantisuryani , Hilman Lydia Permata , Kusumaningrum Venna Febrian , Srisa Nattachai
Published: April 2020

Background : Currently, there is limited epidemiology data on acute kidney injury (AKI) from Southeast Asia, especially from Indonesia which is one of the biggest countries in Southeast Asia. Therefore, we assessed the prevalence of AKI and the utilization of renal replacement therapy (RRT) in Indonesia. Methods : Demographic and clinical data were collected from 952 ICU participants. The participants were categorized into AKI and non-AKI groups. The participants were further classified according to the 3 different stages of AKI as per the Kidney Disease Improving Global Outcome (KDIGO) criteria. We then assessed the Acute Physiology and Chronic Health Evaluation (APACHE) II score of AKI and non-AKI participants. RRT modalities were listed according to the number of times the procedures were carried out. Results : Overall incidence of AKI was 43%. The participants were divided into three groups based on the AKI stages: 18.5 % had stage 1, 33% had stage 2, and 48.5 % had stage 3. The use of mechanical ventilation was higher among the participants with AKI compared to the non-AKI participants. Also, AKI participants had higher average APACHE score compared to the non-AKI participants (16.5 vs 9.9). Among the AKI participants, 24.6% required RRT. The most common RRT modalities were intermittent hemodialysis (69.4%), followed by slow low-efficiency dialysis (22.1%), continuous renal replacement therapy (4.2%), and peritoneal dialysis (1.1%). Conclusions : This study showed that AKI is a common problem in the Indonesian ICU and had a high mortality rate. We strongly believe that identification of the risk factors associated with AKI will help us to develop a predictability score for AKI so we can prevent and improve AKI outcome in the future.
Measurement of three-dimensional changes in lip vermilion in adult female patients after orthodontic extraction: a preliminary study
Authors: Shen Linhui , Xie Tian-yi , Jiang Ruo-ping , Chen Gui , Xu Tian-min , Han Bing
Published: April 2020

Background

The objective of this study was to evaluate three-dimensional (3D) morphological changes in the lip vermilion in adult females after orthodontic treatment for four-premolar extraction in patients with dentoalveolar protrusion using a structured light-based scanner.
Methods

Forty-two female subjects with protruding lips were recruited as the treatment group; these patients underwent extraction of the four first premolars (PM1) without mini-implants for anchorage control. A total of twenty female subjects were enrolled in the non-treatment group; these patients did not require orthodontic treatment. Six facial landmarks (Ls, Ll, R.Cu, L.Cu, R.Ch, L.Ch), three linear measurements (vermilion height, cupid’s bow width, mouth width), and three area measurements (upper, lower, and total vermilion area along the 3D surface of the lip vermilion) were measured using 3D facial scans. Superimposed color maps and spectra were constructed for visual analysis of morphological changes in the lip vermilion for qualitative evaluation. The spacial deviations of the three volumetric measurements (upper, lower, and total vermilion) were constructed for quantitative analysis.
Results

Vermilion height and cupid’s bow width decreased significantly and no significant change in mouth width was observed after extraction. The lower vermilion and total vermilion surface areas decreased significantly after orthodontic treatment in the extraction group, but the upper vermilion remained unchanged. Significant retractions were observed in vermilion volumetric measurements in the extraction group.
Conclusions

This study established a method to objectively and quantitatively compare the lip vermilion. Extraction of the four first premolars in adult females produced significant retraction in the lip vermilion. Morphological variation in the vermilion was different between the upper vermilion and the lower vermilion.
Potential metabolic monitoring indicators of suicide attempts in first episode and drug naive young patients with major depressive disorder:a cross-sectional study
Authors: Zhao Ke , Zhou Siyao , Shi Xiang , Chen Jianjun , Zhang Yaoyao , Fan Kaili , Zhang Xiangyang , Wang Wei , Tang Wei
Published: April 2020

Backgrounds: Major depressive disorder is an ordinary mental disorder, suicide and physical health deterioration are two major sequelae. Some studies indicate that metabolic levels are associated with suicide attempt. Previous studies have focused on the relationship between suicide attempts and metabolism in elderly patients with MDD, while ignore the young people. The aim of this study is to find the potential relationship between suicide attempts and metabolism in young MDD patients to find a promising way to effectively prevent and ultimately reduce suicide in young MDD patients.Methods: Cross-sectional design was employed in the study.740 patients aged between 18 and 45 years old with MDD had been consecutively recruited in this study, 128 of whom had suicide attempts. Their serum samples which used to monitor fasting blood glucose, serum lipids as well as socio-demographic characteristics were collected. Besides, some clinical scales were also employed to measure symptoms of anxiety, depression and other conditions.Results: This study indicated that compared with non-suicide attempters, suicide attempters in young patients with MDD showed higher levels of FBG, TC, LDL-C (all p <0.05) and lower levels of HDL-C(p<0.001). Further logistic regression analysis suggested that suicide attempts were associated with increased FBG with an odd ratio (OR) of 1.832, decreased HDL-C with an OR of 1.891 and obvious anxiety with an OR of 4.103.Conclusions: suicide attempts in young patients with MDD may be predicted by metabolic levels in the future. And our findings suggested that the level of FBG and HDL-C can be promising biomarkers to predict the occurrence of this event.
Oral PrEP: Is it only a pill to be swallowed: a qualitative study among female sex workers in India
Authors: Sahay Seema , Verma Archana , Shewale Suhas , Dhayarkar Sampada , Bijeshkumar Athokpam , Angolkar Mubashir , Subramanian Thilakavathi , Chandhiok Nomita
Published: April 2020

Background Empowering female sex workers (FSWs) through women controlled HIV prevention option has been in focus globally. The success of targeted interventions among FSWs indicates that this population could become an important and feasible target for oral PrEP (Pre Exposure Prophylaxis). A qualitative study was conducted to study FSWs’ willingness to use oral PrEP in India.Methods In-depth interviews (n=39) and two focus group discussions (n=14) were conducted at 3 high HIV prevalence urban and rural sites in India among FSWs. Key informant interviews (n=34) were conducted with a bisexual man, 6 brothel keepers and 27 Health Care Providers (HCPs). The study explored issues around willingness to use oral PrEP. The study was approved by the respective institutional ethics committee of the study sites. Thematic analysis using the grounded theory approach was used to analyze the data in N-VIVO version 8.0. Results FSWs were willing to use daily oral PrEP and hoped to use it as an alternative to the male condom. One of the emerging themes showed that the situations of condom-less sex over which FSWs had no control. This made them desire oral PrEP which was easy to use and geared to provide independence, financial gains, and privacy. HCP initiated oral PrEP was not acceptable. However, HCPs pointed out safety monitoring needs. For FSWs, safety concerns pertained to their own physical/ aesthetic attributes and reproductive system in a major way. Adherence emerged as a challenge because of: 1) FSWs’ prevalent habit and need of alcohol use; 2) their notion of daily dosing being too mundane; 3) Stigma because Oral PrEP is ARV based. Alcohol use and dread of repetitive dose bring forth the need for long-acting oral PrEP. Conclusion Oral PrEP is acceptable among FSWs; it should be rolled out alongside strong messages on STI protection given the perceptions of FSWs that oral PrEP might replace condoms. Education about ARV-based oral PrEP needs to be spelled to prevent stigma. Adherence counseling should take cognizance of FSWs’ lifestyle, specifically making oral PrEP less of a mundane task.
Is body mass index associated with irregular menstruation: A questionnaire study?
Authors: Tang Yunhui , Chen Yan , Feng Hua , Zhu Chen , Tong Mancy , Chen Qi
Published: April 2020

Background: Irregular menstrual cycles including the length of cycles and menses, and heavy menstrual blood loss are linked to many gynaecological diseases. Obesity has been reported to be associated with irregular menstrual cycles. However, to date, most studies investigating this association are focused on adolescence or university students. Whether this association is also seen in adult women, especially women who had a history of birth has not been fully investigated. Methods: Questionnaire data were collected from 1012 women aged 17 to 53 years. Data on age, weight and height, gravida, the length of menstrual cycles and menses, and the number of pads used during menses were collected. Factors associated with menstrual cycle according to BMI categories were analysed.Results: There were no differences in the length of menstrual cycles and menses in women of different body mass index (BMI) groups. However, there was a significant difference in menstrual blood loss in women of different BMI categories. The odds ratio of having heavy menstrual blood loss in obese women was 2.28 (95%CL: 1.244, 4.193), compared to women with normal weight, while there was no difference in the odds ratio of having heavy menstrual blood loss in overweight, compared to normal weight, women. In contrast, the odds ratio of having heavy menstrual blood loss in underweight women was 0.4034 (95%CL: 0.224, 0.725), compared to women with normal weight. Conclusion: Although BMI was not correlated with the length of menstrual cycle and menses, BMI is positively associated with menstrual blood loss. Our data suggest that BMI influences menstrual blood loss in women of reproductive age and weight control is important in women’s reproductive years.
Breast Cancer Screening Beliefs Questionnaire: Psychometric Properties of the Persian Version
Authors: Sharifnia Hamid , Behmanesh Fereshteh , Kwok Cannas , Firouzbakht Mojgan , Ebadi Abbas , Nikpour Maryam
Published: April 2020

Backgrand Cancer-related personal beliefs, attitudes, and knowledge can significantly determine cancer screening behaviors. Valid and reliable instruments are needed to assess such beliefs, attitudes, and knowledge. This study aimed to translate Breast Cancer Screening Beliefs Questionnaire into Persian and evaluate its psychometric properties among Iranian women.Methods In this methodological study, the twelve-item Breast Cancer Screening Beliefs Questionnaire was translated into Persian and filled out by 1256 Iranian women. Sampling was purposively done from June 2017 to March 2018. Face, content, convergent, and discriminant validity were evaluated and exploratory and confirmatory factor analyses were performed for construct validity evaluation. Reliability was also evaluated through calculating Cronbach’s alpha, McDonald’s omega, Average inter-item correlation, and test-retest intraclass correlation coefficient and finally, composite reliability was estimated.Results Three factors were extracted in factor analysis which included screening attitude, screening knowledge and perception, and screening practice. These factors explained 55.71% of the total variance of breast cancer screening beliefs. This three-factor model was confirmed in confirmatory factor analysis based on model fit indices (PCFI = 0.703, PNFI = 0.697, CMIN/DF = 2.127, RMSEA = 0.30, GFI = 0.980, AGFI = 0.998, and CFI = 0.991). Convergent and discriminant validity were also confirmed. Composite reliability and test-retest intraclass correlation coefficient were more than 0.7.Conclusion With a three-factor structure, the Persian Breast Cancer Screening Beliefs Questionnaire has acceptable validity and reliability and hence, can be used to evaluate Iranian women’s breast cancer screening beliefs.
Diet and exercise as a management strategy for symptoms of polycystic ovary syndrome (PCOS): the views of women in the community with PCOS.
Authors: Arentz Susan , Smith Caroline A , Abbott Jason , Bensoussan Alan
Published: April 2020

Background The international clinical practice guidelines for PCOS emphasize diet and exercise as first-line management of clinical signs and symptoms. This study aimed to describe the patterns, perceptions and experiences of lifestyle interventions for women in the community with PCOS. Method An electronic survey of 493 members of two PCOS consumer support groups described women’s types and patterns of diet and exercise, experiences and perceptions of effectiveness. Women were recruited from the Polycystic Ovary Association of Australia (POSAA) and from the Facebook group, PCOS University Research Group. Associations between participants perceptions of effectiveness, and diet types and exercise patterns were assessed using logistic regression. Response bias for the POSAA group was assessed with a continuum of resistance model. Results 91% of POSAA members aged 16-50 years responded to the survey. Nearly all women reported adjusting their dietary and exercise practices with the aim to improve their health and/or PCOS (82% and 73% respectively), however less than 13% reported achievement of health goals (12.2% and 8.1% respectively). Low carbohydrate, high protein diets, and vigorous activity were associated with self-perceived effectiveness (r.0.16, p<0.01; r.0.15 p<0.01 and r.0.2 p<0.01 respectively). Barriers for lifestyle interventions included psychosocial factors. Response bias was not assessed for the Facebook group, however self-reported PCOS aligned with prevalence of clinical phenotypes and suggests results are generalizable to clinical populations of women with PCOS, who are responsible for self-directing and administering lifestyle interventions to manage their PCOS.Conclusions Perceptions of effectiveness for lifestyle interventions by women with PCOS may be complicated by a lack of rigorous evidence. The strength of recommendations in clinical practice guidelines may be enhanced by clinical trials investigating flexible and feasible lifestyle interventions for women in the community with PCOS.
DDoS Attack Detection Method under Deep Learning in the Context of SDN-OpenFlow
Authors: Ke Gang , Chen Ruey-Shun , Chen Y.C. , Xiong Naixue , Tian Yuan , Al-Nabhan Najla
Published: April 2020

The authors have removed this preprint from Research Square.
Metabolic profiling of CSF from people suffering from Sporadic and LRRK2 Parkinson’s disease: a pilot study.
Authors: Yilmaz Ali , Ugur Zafer , Ustun Ilyas , Bahado-Singh Ray O. , Maddens Michael , Aasly Jan O. , Graham Stewart F.
Published: April 2020

Background: CSF from unique groups of Parkinson’s disease (PD) patients were biochemically profiled to identify previously unreported metabolic pathways linked to PD pathogenesis and novel biochemical biomarkers of the disease were characterized. Methods: Utilizing both 1H NMR and DI-LC-MS/MS we quantitatively profiled CSF from patients with sporadic PD (n=20), those who are genetically predisposed (LRRK2) to the disease (n=20) and compared them with age,- and gender-matched controls (n=20). Further, we systematically evaluated the utility of several machine learning techniques for the diagnosis of PD.Results: 1H NMR and mass spectrometry-based metabolomics, in combination with bioinformatic analyses, provided useful information highlighting previously unreported biochemical pathways and CSF based biomarkers associated with both sporadic PD (sPD) and LRRK2 PD. Results of this metabolomics study further support our group’s previous findings identifying Bile Acid metabolism as one of the major aberrant biochemical pathways in PD patients.Conclusion: This study demonstrates that a combination of two complimentary techniques can provide a much more holistic view of the CSF metabolome and by association, the brain metabolome. Future studies for the prediction of those at risk of developing PD should investigate the clinical utility of these CSF based biomarkers in more accessible biomatrices. Further, it is essential that we determine if the biochemical pathways highlighted here are recapitulated in the brain of PD patients with the aim of identifying potential therapeutic targets.
Interaction Between Coping Strategies Among Infertile Couples and Women’s Psychological Symptoms
Authors: Kazemi Ashraf , Torabi Marjan , Abdishahshahani Mahshid
Published: April 2020

Background Social problems and suffering from treatment process for infertile couples requires the couples use coping strategies for balancing the infertility crisis. According to the close interactions of the couples with each other, the objective of the study was assess of interrelationships between coping strategies of the infertile couples under assisted reproductive treatment and women’s psychological symptoms.Method This cross sectional research was done on 212 infertile couples undergoing assisted reproductive treatment. The using level of coping strategies, the stress, anxiety and depression levels were evaluated by using valid questionnaire. The relations between the coping strategies of the couples with each other, and also women’s stress, anxiety and depression levels were evaluated.Results The results showed the relationship between using the coping strategies by men, except understanding emotion, maintaining optimism strategies, and the coping strategies by women showed a significant relation. The results showed that the stress, anxiety and depression levels of women were positively related to the using of self-focused rumination and other blame strategies.Conclusion The couples’ coping strategies toward infertility are interacted and psychological symptoms in women’s are affected by their partners’ coping strategies and using of self-focused rumination and other blame strategies by men may effect on partners’ psychological health.
Feasibility of sentinel lymph node detection by near-infrared endoscopy in squamous cell carcinoma of the oral cavity: a pilot study
Authors: Sievert Matti , Goncalves Miguel , Eckstein Markus , Iro Heinrich , Koch Michael
Published: April 2020

Background

Near-Infrared (NIR) fluorescence imaging is a novel technique for intraoperative sentinel lymph node (SLN) identification. It has demonstrated promising results in several surgical specialties. The study aims to evaluate the feasibility of identifying the SLN by indocyanine green (ICG) enhanced NIR endoscopy in squamous cell carcinoma of the oral cavity (OCSCC).
Methods

Five patients with (cT1-3N0) OCSCC were included. We injected 1–1.25 ml of ICG (5 mg/ml) at four to five points around the primary. After the elevation of a platysma flap and posterior retraction of the sternocleidomastoid muscle, fluorescence images were taken with the IMAGE1 S™ NIR/ICG system to define the SLN(s). We sampled fluorescence marked SLN(s) stratified to lymph node levels, followed by level-specified elective neck dissection.
Results

The detection of at least one uni- or bilateral SLN (range 1–4) was possible in every case. The fluorescence signal occurred, on average, 4.8 ± 2.6 minutes after injection. There was no case of neck metastasis in SLN (0/13) and non-SLN (0/189). No adverse reactions to ICG occurred.
Conclusions

Our first results are confirming the concept of SLN concerning OCSCC after the application of real-time NIR fluorescence endoscopy. However, this has to be verified by more extended studies.
Association of Smoking Behavior Among Chinese Expectant Fathers and Smoking Abstinence After Their Partner Becomes Pregnant: A Cross-Sectional Study
Authors: Xia Wei , Li William Ho Cheung , Cai Wenzhi , Song Peige , Ho Laurie Long Kwan , Cheung Ankie Tan , Luo Yuanhui , Zeng Chunxian , He Li , Gao Chao , Ho Ka Yan
Published: April 2020

Background Exposure to secondhand smoke during pregnancy can cause pregnancy complications and adverse birth outcomes. About 40% of Chinese expectant fathers are smokers and they rarely attempt to quit smoking. There is a paucity of effective smoking cessation services targeting this population. In this study, we assessed the smoking behavior of Chinese expectant fathers and examined its association with smoking abstinence after their partner became pregnant, which is an essential prerequisite for designing effective smoking cessation interventions.Methods We conducted a cross-sectional survey in the obstetrics and gynecology clinic of three tertiary hospitals in China. Expectant fathers who smoked at least one cigarette per day for 1 month within the past 12 months were invited to participate in this study. The participants were asked to complete a structured questionnaire that assessed their smoking behaviors before and after their partner became pregnant.Results From December 2017 to March 2018, we recruited a total of 466 eligible expectant fathers, among whom 323 (69.3%) were identified as current smokers and 143 (30.7%) were ex-smokers. Using lasso regression, 19 features were selected from among 27 independent variables. The results of the selected multivariable logistic regression model showed that knowledge about the health hazards of smoking among smokers (odds ratio (OR) 1.39; 95% confidence interval (CI) 1.24 to 1.58; p < 0.001), knowledge about the health hazards of SHS among pregnant women (OR 1.46; 95% CI 1.09 to 1.97; p < 0.001), knowledge about harm to the fetus and newborn (OR 1.58; 95% CI 1.25 to 2.03; p < 0.001), and being a first-time expectant father (OR 2.08; 95% CI 1.02 to 3.85; p = 0.046) were significantly positively associated with smoking abstinence among expectant fathers after their partner became pregnant. Significantly negative associations were found for severe dysfunctionality in terms of family support (OR 0.48; 95% CI 0.24 to 0.95; p = 0.036) and smoking only outside the home (OR 0.81; 95% CI 0.26 to 0.98; p < 0.001).Conclusions In this study, we identified several factors associated with smoking abstinence among expectant fathers after their partner became pregnant. These findings can guide the development of effective interventions targeting expectant fathers, to help them quit smoking.
Energy-efficient hierarchical routing in wireless sensor networks based on Fog Computing
Authors: Abidoye Ademola , Kabaso Boniface
Published: April 2020

Wireless sensor networks (WSNs) have been recognized as one of the most essential technologies of the 21st century. The applications of WSNs are rapidly increasing in almost every sector because they can be deployed in areas where cable and power supply are difficult to use. In the literature, different methods have been proposed to minimize energy consumption of sensor nodes so as to prolong WSNs utilization. In this article, we propose an efficient routing protocol for data transmission in WSNs; it is called Energy-Efficient Hierarchical routing protocol for wireless sensor networks based on Fog Computing (EEHFC). Fog computing is integrated into the proposed scheme due to its capability to optimize the limited power source of WSNs and its ability to scale up to the requirements of the Internet of Things applications. In addition, we propose an improved ant colony optimization (ACO) algorithm that can be used to construct optimal path for efficient data transmission for sensor nodes. The performance of the proposed scheme is evaluated in comparison with P-SEP, EDCF, and RABACO schemes. The results of the simulations show that the proposed approach can minimize sensor nodes’ energy consumption, data packet losses and extends the network lifetime.
The Upper Bound of Multi-source DOA Information in Sensor Array and Its Application in Performance Evaluation
Authors: Tu Weilin , Xu Dazhuan , Zhou Ying , Shi Chao
Published: April 2020

Direction of arrival (DOA) estimation has been discussed extensively in the array signal processing field. In this paper, we focus on the DOA information which is defined as the mutual information between the DOA and the received signal with complex additive white Gaussian noise. A theoretical expression of DOA information with multiple sources is presented in the uniform linear array. Specially, the upper bound of DOA information for sparse sources with high SNR is derived and compared with the information of single source. Moreover, the relationship between Cramer-Rao bound and the upper bound of DOA information is given. Finally, the paper investigate the performance evaluation of estimation based on the DOA information. We define the entropy error (EE) as a new performance evaluation index and find that EE is better than mean square error. Moreover, the lower bound of the EE can be regarded as the Generalized Cramer-Rao bound considering the sources' order in multi-source scenario.
Higher inflammation and cerebral white matter injury associated cognitive deficit in asthmatic patients with depression
Authors: Lu Yue , Zhou Shu , Fan Cunxiu , Shang Yan , Xiaoying Bi
Published: April 2020

Background
Depression is a common co-morbidity in asthma, worsening asthma control and impairing patient’s quality of life. Previous studies have reported a higher risk of cognitive deficit in depression. However, few research has focused on the cognitive status of asthmatic patients with depression. Evidence showed that inflammation may play an important role in both asthma and depression. Moreover, cerebral white matter injury, which could be induced by inflammation, has been associated with depression. The present study aimed to assess the cognitive function and explore the potential mechanism in patients with asthma, depression and comorbidity.
Methods
We admitted four groups: Asthma comorbid Depression group (A + D, n = 26), Depression group (D, n = 25), Asthma group (A, n = 33) and Normal controls (N, n = 28). Cognitive function was assessed by Montreal Cognitive Assessment (MoCA). Various inflammatory cytokines were measured, including interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-mobility group box 1(HMGB1) and Netrin-1. Cerebral white matter injury was assessed by serum myelin basic protein (MBP) and myelin oligodendrocyte glycoprotein (MOG), and their correlations with cognitive performance were calculated.
Results
A + D group showed the highest incidence of cognitive deficit with specific affected cognitive domain. Compared to N group, serum levels of IL-6, HMGB1, Netrin-1, MBP and MOG were significantly elevated in A + D group. MOG level was negatively correlated with MoCA score.
Conclusion
Patients with comorbid condition presented more definite, severe cognitive deficit and higher level of inflammatory cytokines. Cerebral white matter injury may account for the cognitive deficit in these patients and MOG could be a potential biomarker of this process.
Phenotypic and genotypic evaluation of antibiotic resistance and molecular characterization of Streptococcus species isolated from hospital cockroaches
Authors: Chehelgerdi Mohammad , Ranjbar Reza
Published: April 2020

Background

The present investigation aimed to assess the antibiotic resistance properties and distribution of virulence factors in the Streptococcus spp. isolated from hospital cockroaches.
Methods

Six-hundred and sixty cockroach samples were collected. Cockroaches were vigorously washed with normal saline, and the achieved saline was used for bacterial culture. Isolated Streptococcus spp. were subjected to disk diffusion as well as PCR amplification of virulence factors and antibiotic resistance genes.
Results

Prevalence of S. pyogenes, S. agalactiae and S. pneumonia was 4.82%, 1.66% and 6.96%, respectively. The highest prevalence of S. pyogenes, S. agalactiae and S. pneumonia were found in oriental (5.71%), oriental (2.85%) and American (7.71%) cockroaches, respectively. Cfb (53.93%), cyl (52.8%), scaa (51.68%) and glna (50.56%) were the most commonly detected streptococcal virulence factors. Pbp2b (71.91%), pbp2 × (58.42%), mefA (46.06%), ermB (46.06%) and tetM (46.06%) were the most commonly detected antibiotic resistance genes. Streptococcal spp. exhibited the highest prevalence of resistance against tetracycline (80.89%), trimethoprim (65.16%), and penicillin (56.17%).
Conclusion

To the best of our knowledge, this is the first prevalence report of virulence factors and antibiotic resistance genes in the Streptococcal spp. isolated from American, German and oriental hospital cockroaches. Findings recommended a certain role for cockroaches in the transmission of nosocomial infections and particularly those caused by virulent and resistant Streptococcus spp. in the hospital environment.
Online health information seeking behaviours of parents of children undergoing surgery in a pediatric hospital in Rome, Italy: a survey
Authors: Russo Luisa , Campagna Ilaria , Ferretti Beatrice , Pandolfi Elisabetta , Atti Marta Luisa Ciofi Degli , Piga Simone , Jackson Sally , Rizzo Caterina , Gesualdo Francesco , Tozzi Alberto Eugenio
Published: April 2020

Background
People increasingly search online for health information. Particularly, parents of patients often use the Internet as a source for health information. We conducted a survey to investigate the online searching behavior of parents of patients < 18 years, admitted for surgery in an Italian pediatric hospital.
Methods
The cross-sectional survey was nested in a prospective cohort study on surgical procedures. Parents of patients undergoing surgical procedures at Bambino Gesù Children's Hospital, Rome, Italy, were enrolled and contacted by phone after the procedure. We recorded socio-demographic data, sex, length of stay following surgery, proximity of residence to the hospital, use of the internet to search for information on the surgery before and after the intervention and effect of information found online.
Results
The majority (91%) of parents of children undergoing surgical intervention used the internet. Of these, 74.3% of parents searched for information before surgery, and 26.1% searched for information after. Most parents searched for information on the care provider’s website. Two thirds of parents reported that information found online had increased their understanding of the child’s condition. Multivariate analyses indicated that families living far from the hospital (> 43 km) were more likely to search for health information (OR 2.3; 95% CI 1.34–4.00), as were families of patients undergoing a major surgery (OR = 2.1; 95% CI 1.04–4.11).
Conclusions
Parents of children undergoing surgery often search online for information on their child’s intervention, in particular those whose child is scheduled for a major surgery and those living far from the hospital. A survey like the present one allows to understand parents’ information needs, to better guide them in online information seeking and to better tailor information provided on the care provider’s website.
Feasibility and acceptability of financial incentives and peer-led life skills training for improving adherence to antiretroviral therapy among adolescents living with HIV in Rwanda: A pilot study
Authors: Osman Majdi , Niyonsenga Simon Pierre , Sharma Manasi , Hope Rebecca , Milroy Shannon , Levine Jordan , Kusi Caroline , Chan Tiffany , Ngamije Patient , Kabayiza Bernard , Manzi Olivier , Ribakare Muhayimpundu , Ntawunga Laurence Isaaya , Nkurikyamfuma Jean-Luc , Habumugisha Lameck , Remera Eric , Nsanzimana Sabin
Published: April 2020

Background

The Human Immunodeficiency Virus (HIV) is the leading cause of death among adolescents in sub-Saharan Africa. Despite the long-term benefits of antiretroviral therapy (ART), adherence remains low among adolescents due to challenges related to cost, acquisition, and treatment regimen. Sub-optimal adherence to ART is associated with the development of viral resistance, treatment failure, and increased morbidity and mortality. Financial incentives and life skills training interventions have shown early promise in motivating protective behaviors, however, gaps still remain around effective and innovative ways to motivate adolescents to stay in HIV care. In partnership with youth, we developed an intervention to address their social and financial pressures in order to promote adherence.
Methods

A human-centered design approach was utilized to engage adolescents in the initial design of the intervention. Through random sampling, 72 adolescents ages 12–19 were then recruited from two clinics in Rwanda for the pilot study. Adolescents participated in three monthly peer-led life skills trainings at clinics and received financial incentives via mobile money upon clinic attendance and demonstration of suppressed viral load. Semi-structured interviews were then conducted with adolescents, healthcare workers, and caregivers to understand their experiences with the intervention.
Results

Participants responded favorably to the intervention because of the psychosocial, financial, and health benefits it provided. Caregivers felt that adolescents’ moods, attitudes, and overall well-being improved over time. Adolescents used funds to purchase school supplies and save for investments, thus mitigating their financial burdens. Additionally, we learned that logistical challenges such as SIM card registration and mobile phone access must be considered for scale-up of the intervention.
Conclusions

To our knowledge, this is the first intervention designed in partnership with youth in sub-Saharan Africa aimed at removing financial barriers to ART adherence. The findings suggest that involving youth in the design of programs, providing them with financial incentives, and training them to use and invest their money wisely has a positive effect on them and their families. Thus, to improve adherence to ART and retention in care among HIV-positive youth, it is critical to address their socioeconomic and psychosocial needs.