bluuebunny/crossref_metadata_2025 huggingface dataset:
Intensity of pyrethroid resistance in Anopheles gambiae before and after a mass distribution of insecticide-treated nets in Kinshasa and in 11 provinces of the Democratic Republic of Congo
Authors: Wat’senga Francis , Agossa Fiacre , Manzambi Emile Z. , Illombe Gillon , Mapangulu Tania , Muyembe Tamfum , Clark Tiffany , Niang Mame , Ntoya Ferdinand , Sadou Aboubacar , Plucinski Mateusz , Li Yikun , Messenger Louisa A. , Fornadel Christen , Oxborough Richard M. , Irish Seth R.
Published: April 2020

Background: Between 2011 and 2018, an estimated 134.8 million pyrethroid-treated long-lasting insecticidal nets (LLINs) were distributed nationwide in the Democratic Republic of Congo (DRC) for malaria control. Pyrethroid resistance has developed in DRC in recent years, but the intensity of resistance and impact on LLIN efficacy was not known. Therefore, the intensity of resistance of Anopheles gambiae sensu lato (s.l.) to permethrin and deltamethrin was monitored before and after a mass distribution of LLINs in Kinshasa in December 2016, and in 7 sites across the country in 2017 and 11 sites in 2018.Methods: In Kinshasa, CDC bottle bioassays using 1, 2, 5, and 10 times the diagnostic dose of permethrin and deltamethrin were conducted using An. gambiae s.l. collected as larvae and reared to adults. Bioassays were conducted in four sites in Kinshasa province six months before a mass distribution of deltamethrin-treated ITNs and then two, six, and ten months after the distribution. One site in neighbouring Kongo Central province was used as a control (no mass campaign of ITN distribution during the study). Nationwide intensity assays were conducted in six sites in 2017 using CDC bottle bioassays and in 11 sites in 2018 using WHO intensity assays. A sub-sample of An. gambiae s.l. was tested by PCR to determine species composition and frequency of kdr-1014F and 1014S alleles. Results: In June 2016, before LLIN distribution, permethrin resistance intensity was high in Kinshasa; the mean mortality rate was 43% at the 5× concentration and 73% at the 10× concentration. Bioassays at 3 time points after LLIN distribution showed considerable variation by site and time and there was no consistent evidence for an increase in pyrethroid resistance intensity compared to the neighbouring control site. Tests of An. gambiae s.l. in 7 sites across the country in 2017 and 11 sites in 2018 showed all populations were resistant to the diagnostic doses of 3 pyrethroids. In 2018, the intensity of resistance varied by site, but was generally moderate for all three pyrethroids, with survivors at ×5 the diagnostic dose. Anopheles gambiae sensu stricto (s.s.) was the most common species identified across 11 sites in DRC, but in Kinshasa, An. gambiae s.s. (91%) and Anopheles coluzzii (8%) were sympatric.Conclusions: Moderate or high intensity pyrethroid resistance was detected nationwide in DRC and is a serious threat to sustained malaria control with pyrethroid LLINs. Next generation nets (PBO nets or bi-treated nets) should be considered for mass distribution.
Circular RNA hsa_circ_102209 promotes the growth and metastasis of colorectal cancer through miR-761-mediated Ras and Rab interactor 1 signaling
Authors: LI CHI , Zhou Hong
Published: April 2020

Background: The levels of hsa_circ_102209 in colorectal cancer (CRC) specimens and cells, as well as its effects on CRC cells were investigated. Methods: The expression of hsa_circ_102209 in CRC and paired non-cancerous samples, human CRC and normal colonic epithelial cells were examined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Cells with hsa_circ_102209 knockdown were established using lentiviral vectors. Cell proliferative ability was evaluated using CCK-8 assay; cell migration and invasion were assessed by wound healing and Transwell assay. Cell cycle arrest and apoptosis were determined; apoptosis and EMT markers were examined using RT-qPCR and western blotting. Tumour development and levels of associated proteins were determined in hsa_circ_102209 knockdown mice. Results: Our results revealed that expression of hsa_circ_102209 was remarkably increased in CRC tissues, where the levels of miR-761 were notably reduced (p<0.05). Additionally, the levels of hsa_circ_102209 was associated with histology grade and occurrence of liver metastasis in CRC patients, and the expression of hsa_circ_102209 and miR-761 were negatively correlated (p<0.05). Moreover, hsa_circ_102209 was upregulated in CRC cells compared with normal colonic epithelial cells. Knockdown of hsa_circ_102209 notably inhibited the proliferation, migration, invasion and EMT of CRC cells (p<0.05), whereas enhanced cell cycle arrest at G0/G1 phase and apoptosis (p<0.05). Furthermore, miR-761/Ras and Rab interactor 1 (RIN1) axis was the putative target of hsa_circ_102209 in CRC and involved in hsa_circ_102209-modulated growth and metastasis in CRC cells (p<0.05). Knockdown of hsa_circ_102209 also remarkably suppressed tumor growth in vivo (p<0.05). Conclusions: our data revealed that the expression of hsa_circ_102209 was elevated in CRC samples and cells. Furthermore, hsa_circ_102209 could promote the progression of CRC through miR-761/RIN1 axis. More importantly, hsa_circ_102209/miR-761/RIN1 signaling may be a novel therapeutic target for the treatment of CRC patients.
Health Literacy and its Effect on Chronic Disease Prevention: Evidences from China’s Data
Authors: Liu Lefan , Qian Xujun , Chen Zhuo , He Tianfeng
Published: April 2020

Background Improving health literacy is an important public health goal in many countries. Although many studies have suggested that low health literacy has adverse effects on an individual’s health outcomes, confounding factors are often not accounted. This paper examines the interplay between health literacy and chronic disease prevention. Methodology A population-based sample of 8194 participants aged 15-69 years old in Ningbo were used from China’s 2017 National Health Literacy Surveillance Data. We use multivariate regression analysis to disentangle the relationship between health literacy and chronic disease occurrence. Results We find the association between health literacy and the occurrence of the first chronic condition is attenuated after we adjust the results for age and education. This might arise because having one or more chronic conditions is associated with better knowledge about chronic diseases and thus improve health literacy on chronic disease prevention. More importantly, we find health literacy is associated with a reduction in the occurrence of a new chronic condition. However, this protective effect is only found among urban residents, suggesting health literacy might be a key factor explaining the rural-urban disparity in health outcomes. Conclusion Our findings highlight the important role of health literacy in reducing occurrence of comorbidities rather than preventing the first chronic condition. Moreover, family support could help improve health literacy and result in beneficial effects on health.
Trends and determinants of HIV transmission among men who inject drugs in the Pokhara Valley, Nepal: Analysis of cross-sectional studies
Authors: Hogan Sam , Page Andrew , Ogbo Felix , Dixit Sameer , Rajbhandari Rajesh Man , Rawal Bir , Deuba Keshab
Published: April 2020

Background HIV is a major public health issue around the world, especially in developing countries. Although the overall prevalence of HIV in Nepal is relatively low and the country itself is considered low risk, there are specific sub-populations where the prevalence is far higher than the national average. One of these sub-groups is male injection drug users (IDUs). In order to understand the reasons for the differences in prevalence, a series of socio-demographic, behavioural and knowledge-based risk factors need to be assessed. Methods The study used a series of 7 cross-sectional survey datasets, collected between 2003 and 2017 (N=2,235) to investigate trends in HIV prevalence among male IDUs by key socio-demographic and behavioural and knowledge-based risk factors. A series of logistic regression models were conducted to investigate the association between study factors and HIV in the Pokhara valley, Nepal. Results Overall HIV prevalence has decreased from the levels seen in 2003 (22.0%) and 2005 (21.7%), with the lowest prevalence recorded in 2015 (2.6%), however prevalence has increased in the most recent period (4.9%). A lower risk of HIV was associated with younger age (less than or equal to 24 years compared to greater than 24 years, OR = 0.17, 95% CI = 0.10, 0.31), not being married (OR = 0.51, 95% CI = 0.33, 0.80) and shorter duration of drug use (less than or equal to 4 years compared to greater than 4 years, OR = 0.16, 95% CI = 0.09, 0.29). A higher risk of HIV was associated with low (compared to secondary or higher) education level (OR = 2.76, 95% CI = 1.75, 4.36), a lack of addiction treatment (OR = 2.59, 95% CI = 1.64, 4.08), and recent use of unsterilized injection equipment (OR = 2.22, 95% CI = 1.20, 4.11). Conclusion Although knowledge of HIV is high among male IDUs, the prevalence of individuals who possess comprehensive knowledge and the number of individuals who have received treatment for drug addiction has decreased. This may indicate that addiction treatment and HIV education programs need to be strengthened.
Host DNA contents in fecal metagenomics as a biomarker for intestinal diseases and effective treatment
Authors: Jiang Puzi , Lai Senying , Wu Sicheng , Zhao Xing-Ming , Chen Wei-Hua
Published: April 2020

Background: Compromised intestinal barrier (CIB) has been associated with many enteropathies, including colorectal cancer (CRC) and inflammatory bowel disease (IBD). We hypothesized that CIB could lead to increased host-derived contents including epithelial cells into the gut, change its physio-metabolic properties, and globally alter microbial community and metabolic capacities. Results: Consistently, we found host DNA contents (HDCs), calculated as the percentage of metagenomic sequencing reads mapped to the host genome, were significantly elevated in patients of CRC and Crohn’s disease (CD). Consistent with our hypothesis, we found that HDC correlated with microbial- and metabolic-biomarkers of these diseases, contributed significantly to machine-learning models for patient stratification and was consequently ranked as a top contributor. CD patients with treatment could partially reverse the changes of many CD-signature species over time, with reduced HDC and fecal calprotectin (FCP) levels. Strikingly, HDC showed stronger correlations with the reversing changes of the CD-related species than FCP, and contributed greatly in classifying treatment responses, suggesting that it was also a biomarker for effective treatment. Conclusions: Together, we revealed that association between HDCs and gut dysbiosis, and identified HDC as a novel biomarker from fecal metagenomics for diagnosis and effective treatment of intestinal diseases; our results also suggested that host-derived contents may have greater impact on gut microbiota than previously anticipated.
Clinical characteristics of Coronavirus Disease 2019 in Hangzhou, China: the combination of lopinavir/ritonavir, interferon, and arbidol may be a well choice for antiviral therapy in common cases
Authors: Yu Jianhua , Wang Meihua , Zhou Kexing , Zhang Siquan , Xiang Bo , Zhang Yan , Chen Zuhua , Huang Jinsong , Cai Zhaobin , Liu Shourong , Yan Dingyan , Yang Zongxing
Published: April 2020

Background

Since December 2019, when Coronavirus Disease 2019 (COVID-19) emerged in Wuhan, China, it is currently causing outbreaks in many countries worldwide. No specific therapeutics have yet been proven effective for the treatment of COVID-19.
Methods

A retrospective, single-center case series study was conducted in a designated hospital for special treatment of COVID-19 in Hangzhou, China. Clinical characteristics of COVID-19 patients were described and compared between the common and severe groups. Multiple linear regression and sensitivity analysis was conducted to evaluate the antiviral effects of the 3-drug combination therapy (lopinavir/ritonavir, interferon, and arbidol).
Results

One hundred and ten confirmed COVID-19 patients were enrolled, including 99 common cases and 11 severe cases. The mean age was 43.1 years and 54.5% were female. Severe patients might be older (P < 0.01), and have more coexisting disorders (P < 0.01), lower levels of lymphocyte counts (P = 0.016), blood sodium (P = 0.039) and chloride (P < 0.01), and higher levels of C reactive protein and procalcitonin (both P < 0.01). Multiple linear regression and sensitivity analysis indicated that both in Model 1 and Model 2, after adjusted by confounding factors, significant associations between completing the 3-drug combination antiviral therapy (vs. incompleting) and a shorter hospital staying time could be seen (B = -5.970, 95% CI, -9.222, -2.718, P < 0.01, in Model 1; and B = -5.948, 95% CI, -10.622, -1.274, P = 0.014, in Model 2).
Conclusions

Severe patients might be older and have more comorbidities. The combination of lopinavir/ritonavir, interferon, and arbidol may be a well choice for antiviral therapy, especially in adult common cases.
Efficacy of Isolated Bacteriophage Against Biofilm Embedded Colistin-Resistant Acinetobacter baumannii
Authors: Ebrahimi Saeedeh , Sisakhtpour Behnam , Mirzaei Arezoo , Karbasizadeh Vajihe , Moghim Sharareh
Published: April 2020

Objective: Acinetobacter baumannii is responsible for most nosocomial infections in hospitals. It has the ability to form biofilms and has a high degree of antibiotic resistance. Colistin is one of the last therapeutic options for the treatment of Multi Drug Resistance infections. Recently, strains of this pathogen resistance to the colistin were reported increasingly. Therefore, alternative antibacterial methods such as phage therapy are being researched. Results: From 15 MDR A. baumannii clinical isolates, 26.6% were resistant to colistin, 80% were able to produce strong biofilm, and 20% produce weak biofilm. The isolated lytic phage (IsfAB78) was able to reduce the biofilm by up to 87%. Since most of the MDR colistin-resistant strains produce biofilm, and MDR A. baumannii infections are difficult to treat, development of phage therapy could be an alternative in the future. Phage IsfAB78 is a good candidate for this purpose.
Improving linkage to care of hepatitis C: Evaluation of GeneXpert® HCV Viral Load Point-of-Care Assay in Indonesia
Authors: Thedja Meta Dewi , Wibowo Dhita Prabasari , El-Khobar Korri Elvanita , Ie Susan Irawati , Turyadi Turyadi , Setiawan Lyana , Murti Ignatia Sinta , Muljono David Handojo
Published: April 2020

Background: Lack of simple, rapid, and reliable point-of-care (POC) test hampers large-scale diagnosis and treatment of hepatitis C virus (HCV) infection and pose a challenge for its elimination as a public health threat. This study aimed to evaluate Cepheid Xpert® HCV Viral Load performance in comparison to Roche Cobas® TaqMan® HCV Test using HCV-samples with various genotypes in Indonesia.Methods: Viral load (VL) quantification was performed on 243 anti-HCV positive patients’ samples using both Xpert and Roche HCV tests, followed by HCV genotyping by reverse hybridization. Strength of relationship between the assays was measured by Pearson correlation coefficient, while level of agreement was analyzed by Deming regression and Bland-Altman plot analysis using log10-transformed VL values.Results: Quantifiable VL was detected in 180/243 (74.1%), with Xpert sensitivity of 100% (95% CI 0.98, 1.00) and specificity of 98.41% (95% CI 0.91, 0.99), while HCV genotypes were determined in 172/180 (95.6%) samples. There was a very good correlation between both assays (r = 0.97, P < 0.001), overall and per genotype, with good concordance by Deming regression and mean difference of −0.25 log10 IU/mL (95% CI −0.33, −0.18) by Bland-Altman plot analysis.Conclusion: Good performance of Xpert HCV Viral Load test was demonstrated as a POC platform for HCV diagnosis and treatment decision, which would be beneficial for decentralized service in resource-limited areas.
Spatio-Temporal Characteristics and its determinants of Hand, Food and Mouth Diseases in Shaanxi province, China: a county level analysis
Authors: Ding Li , Zhang Ning , Zhu Bin , Liu Jinlin , Wang Xue , Liu Feng , Mao Ying
Published: April 2020

Background: Hand-foot-mouth disease (HFMD) is one of the common intestinal infectious diseases worldwide, which caused a huge economic and disease burden in many counties. In China, the Chinese Center for Disease Control and Prevention included the HFMD into the Class C reported infectious diseases. The average annual growth rate of HFMD is 16.43%. Shaanxi is a special region which across three temperature zones. Hence, in this study, the spatial-temporal analysis of Shaanxi would reveal the characteristics of distribution of HFMD and explore the related determinants of HFMD.Methods: The county-level and municipal data of Shaanxi province from 2009 to 2018 were applied to research the spatio-temporal characteristics of HFMD and its meteorological determinants. Time series analysis and spatial autocorrelation analysis were applied to analyze the spatial-temporal characteristics of HFMD. This study used spatial econometric panel models to explore the relationship between HFMD and meteorological factors.Results: The incidence rate of HFMD displayed no long-term changing pattern from temporal perspective. The high incidence rate of HFMD were observed from June to September, which is the season with a climate characterized by heavy rain, high temperature, and high humidity. The high spot is mainly located in central region in Shaanxi. The Low-low clusters were mainly found in Northern Shaanxi. As for the meteorological factors analyzed in this study, the waterfall, temperature and humidity in one specific and surrounding region is positive association with incidence rate of HFMD in specific region.Conclusion: The results could be applied by government and general public to take effective measures to prevent diseases. The region-targeted policies could be enacted and implemented in the future. The local government needs take responsible for the health management of immigration and mobile population. The citizen should cultivate good living habits such as hand-washing habit and the eating habit.
Enzymatic Activity And Brine Shrimp Lethality Of Venom From The Large Brown Spitting Cobra (Naja Ashei) And Its Neutralization By Antivenom
Authors: Okumu Mitchel Otieno , Mbaria James Mucunu , Gikunju Joseph Kangangi , Mbuthia Paul Gichohi , Madadi Vincent Odongo , Ochola Francis Okumu
Published: April 2020

Objective There has been little focus on the enzymatic and lethal activities of Naja ashei venom and their neutralization by antivenom. This study aimed to determine the snake venom phospholipase A2/svPLA2 activity and brine shrimp lethality of N. ashei venom and their neutralization by two antivenoms (I and II). The venom of other snakes in East Africa including the puff adder (Bitis arietans), green mamba (Dendroaspis angusticeps), black mamba (Dendroaspis polylepis), Egyptian cobra (Naja haje), red spitting cobra (Naja pallida), and the Eastern forest cobra (Naja subfulva) were used for comparison. Results: N. subfulva venom had the highest svPLA2 activity while D. angusticeps venom had the least activity. N. subfulva venom was the most toxic in the 24-hour brine shrimp lethality assay (BSLA), while N. ashei venom was the most toxic in the 48 and 72-hour assays. N. haje venom was the least toxic in all assays. One ml of antivenom I neutralized 0.075 µg of svPLA2 in N. ashei venom compared to 0.051 µg by antivenom II. Antivenom I was ineffective in neutralizing N .ashei venom-induced lethality but 1 ml of antivenom II neutralized 0.21 mg of N. ashei venom.
Perspectives of Scientists on Disseminating Research Findings to Non-Research Audiences
Authors: McNeal Demetria , Glasgow Russell E. , Brownson Ross C. , Matlock Daniel D. , Peterson Pamela N. , Daugherty Stacie L. , Knoepke Christopher E.
Published: April 2020

Background
Little is known about practices used to disseminate findings to non- research audiences. This study describes the perspectives, experience and activities of dissemination & implementation (D&I) researchers around disseminating their research findings.
Methods
The study explored D&I researchers’ experiences and recommendations for assessment of dissemination activities to non-research audiences. Existing list serves were used to recruit scientist. Respondents were asked three open ended questions on an Internet survey regarding 1) how their dissemination activities are evaluated, 2) how they would recommend changing the system to recognize dissemination activities and 3) how they could improve their own dissemination of their work.
Results
Surveys were completed by 159 scientists reporting some training, funding, and/or publication history in D&I. Three themes emerged across each of the three open ended questions. Question 1 on evaluation generated the themes of: 1a) promotional review; 1b) funding requirements; and 1c) absence of evaluation of dissemination activities. Question 2 on recommended changes generated the themes of: 2a) dissemination as a distinct component of research; 2b) requirement of dissemination plan; and 2c) dissemination metrics. Question 3 on personal changes to improve dissemination generated the themes of: 3a) allocation of resources for dissemination activities; 3b) utilization of non-traditional (or alternative) dissemination mediums; and 3c) identify and address issues of priority for stakeholders.
Conclusions
The findings revealed the different types of issues D&I researchers encounter when disseminating findings to non-academic audiences and their suggestions to improve the process. Future research should consider key requirements which determine academic promotion and grant funding as an opportunity to expand dissemination efforts.
Social support and harm reduction activities in a peer led pilot study with respondent driven sampling and community based participatory action research
Authors: Elkhalifa Sulaf , Jozaghi Ehsan , Marsh Samona , Thomson Erica , Gregg Delilah , Buxton Jane , Jolly Ann
Published: April 2020

Background: People who smoke drugs (PWSD) are at high risk of both infectious disease and overdose. Harm reduction activities organised by their peers in the community can reduce risk by providing education; safer smoking supplies, and facilitate access to other services. Peers also provide a network of people who provide social support to PWSD which may reinforce harm reducing behaviours. We evaluated the numbers of supportive network members and the relationships between received support and participants’ harm reducing activities.Methods: Initial participant-researchers with past or current lived drug use experience were employed from communities in Abbotsford and Vancouver to interview ten friends from their social networks who use illegal drugs mainly through smoking. Contacts completed a questionnaire about people in their own harm reduction networks, and their relationships with each other. We categorised social support into informational, emotional and tangible aspects, and harm reduction into being trained in the use of, or carrying naloxone; assisting peers with overdoses, using brass screens to smoke, obtaining pipes from service organisations and being trained in CPR.Results: Fifteen initial participant-researchers interviewed 149 participants who provided information on up to 10 people who were friends or contacts and the relationships between them. People who smoked drugs in public were 1.46 (95% CI;1.13-1.78) more likely to assist peers with possible overdoses if they received tangible support; women who received tangible support were 1.24(95% CI;1.02-1.45) more likely to carry, and be trained in the use of naloxone. There was no relationship between number of supportive network members and harm reduction behaviours.Conclusions: In this pilot study, PWSD who received tangible support were more likely to assist peers in possible overdoses and be trained in the use of and/or carry naloxone, than those who did not receive tangible support. Future work on the social relationships of PWSD may prove valuable in the search for credible and effective interventions.
Prevalence of heavy episodic drinking and associated factors among adults residing in Arba Minch health and demographic surveillance site: a cross-sectional study
Authors: Gutema Befikadu Tariku , Chuka Adefris , Ayele Gistane , Tariku Eshetu Zerhun , Aschalew Zeleke , Baharu Alazar , Degefa Nega , Gurara Mekdes Kondale
Published: April 2020

Background: Alcohol consumption is associated with different types of illness, particularly heavy episodic drinking considerably increases the risk of non- communicable diseases burden. The aim of the study was to assess the prevalence of heavy episodic drinking and associated factors in Arba Minch Health and Demographic Surveillance Site (HDSS).Methods: A community-based cross-sectional study was conducted in 2017 among adult residents of Arba Minch HDSS. Using Arba Minch HDSS database, 3368 individuals were selected by simple random sampling techniques. From WHO STEPS instruments, step one was applied for this study. Variables with a p-value of less than 0.25 for bivariate analysis entered into a multivariable logistic regression model to outline the independent predictors of the heavy episodic drinking. To assess the presence of an association between dependent and independent variables, a p-value of less than 0.05 was considered.Results: The prevalence of heavy episodic drinking was 13.7% (95% CI: 12.6–14.9). The study has shown that heavy episodic drinking was significantly associated with occupation (daily laborer [AOR=0.53; 95% C.I: 0.31–0.91] and housewives [AOR=0.64; 95% C.I: 0.45–0.90] compared with farmers), wealth index (2nd quintiles [AOR =0.56; 95% C.I: 0.41–0.75) and 3rd quintiles [AOR = 0.68; 95% C.I: 0.48–0.96] compared with 1st quintiles), climatic zone (midland [AOR=1.74;95% CI: 1.08–2.82), highland [AOR=1.72;95% CI: 1.05–2.81] compared with lowland) and physical activity level (high physical activity [AOR= 1.59, 95% CI: 1.19 – 2.12] compared with low physical activity). In addition, tobacco use [AOR=4.29;95% CI: 3.39–5.44], and khat use [AOR=4.48; 95% CI: 2.56–8.17) were also associated with heavy episodic drinking among the study participants. Conclusions: More than one in ten adults reported heavy episodic drinking in the study area. Intervention programs that aim to prevent heavy episodic drinking should be designed appropriately for individuals from lower wealth status, and for highlander.
The scope of a weekly infection control team rounding in an acute-care teaching hospital: a pilot study
Authors: Jeong Yeon Su , Kim Jin Hwa , Lee Seungju , Lee So Young , Oh Sun Mi , Lee Eun Jung , Kim Tae Hyong , Park Se Yoon
Published: April 2020

Activities of infection control and prevention are diverse and complicated. Regular and well-organized inspection of infection control is essential element of infection control program. The aim of study was to identify strong points and limitations of weekly infection control rounding (ICTR) in an acute care hospital. We conducted infection control rounding weekly to improve the compliance of infection control in the real field at a 734-bed academic hospital in Republic of Korea between January, 18, 2018 to December, 26, 2018. We investigated the functional coverage of a weekly ICTR. The result of the rounding are categorized well maintained, improvement is needed, long-term support such as space or manpower is needed, not applicable and could not observed. ICTR visited median 7 times [interquartile range (IQR) 6–7 times] per department. When visiting a department, ICTR observed median 16 practices (IQR 12–22). There were 7452 results of practices. Of those results, 75% were monitored properly, 22% were not applicable, and 4% were difficult-to-observe. Among applicable practice results, the most common practices that were difficult to observe were strategies to prevent catheter-related surgical site infections and pneumonia, injection safety practices, and strategies to prevent occupationally-acquired infections. The ICTR was able to maintain regular visits to each department; however, additional observation is necessary to eliminate blind spots.* These authors contributed equally
Nurse Professionalism Scale: Development and Psychometric Evaluation
Authors: Braganca Ana Vaz De , Nirmala R.
Published: April 2020

Background

Professionalism is a key trait connecting the nurse and patient, and Code of Professional Conduct, a professional legitimacy in considering nursing as a profession and an essential tool that facilitates nurse practice. This study aims to develop Nurse Professionalism Scale using the Code of Professional Conduct for Nurses in India and test the psychometric properties.
Methods

A sample of 1054 registered nurses working in various work areas at different levels and sectors of health care was selected using stratified random sampling. Data were collected through self-report from registered nurses and multi-source feedback from their supervisors and colleagues. A total of 830 self-reported data sets, 687 supervisor and 747 colleague responses were received. Following data cleaning, complete sets of 644 self-supervisor-colleague responses were used for analysis using exploratory factor analysis in SPSS version 25 and confirmatory factor analysis in AMOS 22.
Results

Reliability estimate for internal consistency of the 38 item scale was .910 (self report), .951 (supervisor feedback) and .952 (colleague feedback). Exploratory factor analysis using self-reports extracted five factors with 22 items at Eigen values > 1. Items with communalities ≥ .4 and factor loadings ≥ .5 were retained. Five factors explained total cumulative variance extracted at 51 percent and KMO value of .893 indicated sample adequacy. Bartlett Test of Sphericity was significant (χ2 = 3318, df = 231, p < .000). The factors are labelled with reference to the original code and higher factor loading. CFA using supervisors feedback (CMIN/DF = 2.938; GFI = .926, TLI = .927; CFI = .939 and RMSEA = .055) and colleagues feedback (CMIN/DF = 3.165; GFI = .921, TLI = .908; CFI = .923 and RMSEA = .058) yielded acceptable model fit indices confirming the psychometric properties.
Conclusions

The scale can be used as a tool to evaluate professionalism among nurses across different settings. Multisource feedback from stakeholders can also be considered as an effective method of gathering data on this construct.
Glycerol-based formulations increases ovulation rate in sheep similarly to eCG but red blood cell indices may be affected
Authors: Porcu Cristian , Sotgiu Francesca Daniela , Pasciu Valeria , Cappai Maria Grazia , Fernández Alicia Barbero- , Gonzalez-Bulnes Antonio , Dattena Maria , Gallus Marilia , Molle Giovanni , Berlinguer Fiametta
Published: April 2020

Background: The objective of this study was to investigate the metabolic and osmotic effects of different doses of glycerol or a glycerol – propylene glycol mixture in Sarda sheep with the aim to identify those able to beneficially modify ewe’s metabolic status without harmful changes in red blood cell (RBC) indices. Thereafter, the selected doses were tested for their effects on ewe’s ovarian activity during an induced follicular phase and compared to the effects of a hormonal treatment with equine chorionic gonadotrophin (eCG). Results: Glycerol was administered alone (G groups: 90% glycerol and 10% water; % v/v) or in combination with propylene glycol (M groups: 70% glycerol, 20% propylene glycol, 10% water; % v/v). Treatments were formulated to provide 100%, 75%, 50% and 25% of the amount of energy supplied in previous experiments. Obtained results showed that the formulations G75 and M75 (22.5% and 18.2% on DM basis, respectively) induce metabolic changes comparable to those induced by M100. The latter dose has been already evaluated for its effects on sheep metabolism and reproductive performance. However, with these high doses, plasma osmolality increased significantly, and RBC indices showed significant alterations. The low dose groups (G25 and M25, 8.6% and 6.9% on DM basis, respectively) did not show any alterations in plasma osmolality and RBC indices, but the metabolic milieu differed markedly from that of M100. Between the medium dose groups, M50 (12.9% on DM basis) showed a more comparable milieu to M100 than G50 (15.9% on DM basis) and no RBC alterations. Therefore, M75, G75 and M50 doses were tested for their effect on ovarian functions and proved to be equally effective as eCG. Conclusion: The results of the present study evidenced an alteration of RBC indices, and possibly of their functions, as a side effect of glycerol administration at high doses in the diet of ewes. Therefore, protocols foreseeing the administration of glycerol should be tested for their effects on RBC indices and functions. In general terms, the medium dose of the glucogenic mixture (12.9% of dietary DM on offer) should be preferred.
Examining Relationship between Occupational Acid Exposure and Oral Health in Workplace
Authors: Chen Wei-Liang , Chen Yuan-Yuei , Wu Wei-Te , Lai Ching-Huang , Sun Yu-Shan , Wang Chung-Ching
Published: April 2020

Objectives: Acid mist can suspend in the air and enter the body via skin contact, the respiratory tract, or even oral intake, which pose various health hazards. Previous studies have shown that occupational exposure to acid mist or acidic solutions is a major risk factor for oral diseases. However, the findings are inconsistent and do not consider individual factors and lifestyles that may cause the same oral diseases. Therefore, we conducted a comprehensive oral health survey and collected detail information to confirm the effect of acidic solution exposure on worker’s oral health. Methods: The study selected enterprises in the metal surface treatment or electroplating industries in Taiwan that employed 300 or more employees and were willing to participate in this survey. Each enrolled subject underwent a questionnaire and comprehensive teeth and oral mucosa examination by a team of qualified and uniformed trained dentists. Oral clinical mirrors and community periodontal index (CPI)-type millimetric probe clinical data were collected according to the World Health Organization (WHO) dental caries diagnostic criteria. In this cross-sectional study, a total of 309 subjects participated was surveyed. Results: The results showed that acid exposure was correlated with soft oral tissue injury rather than hard oral tissue in our survey. Besides, halitosis and age were positive associated with periodontal disease and use of dental floss reduced the risk of periodontal disease. After correcting for major factors, such as age, sex, smoking, drinking, and chewing areca, acid exposure was still statistically related to periodontal disease in LA (loss of attachment) index by 3.27-fold (p = 0.00, CI 1.69 - 6.34). Conclusion: This study showed that occupational acid exposure during acidic solution work was an independent risk factor for periodontal disease. It is important to strengthen occupational hazard control, educate workers on oral disease and related factors, and raise the awareness of oral hygiene.
Associations between family functioning, acculturative stress, and sugar-sweetened beverage consumption in the Hispanic Community Children's Health Study/Study of Latino Youth
Authors: Figueroa Roger , Isasi Carmen R , Perreira Krista M , McClain Amanda , Gallo Linda C , Sotres Daniela , Delamater Alan M , Daviglus Martha , Horn Linda Van , Mattei Josiemer
Published: April 2020

Background. Maintaining a bond with one’s family as well coping with stress while acculturating to the US may protect Hispanic/Latino youth from increased sugar-sweetened beverages (SSB) consumption. This study aims to examine associations between acculturative stress, family functioning, and SSB consumption by acculturation status among U.S. Hispanic/Latino youth. Methods. With data on 1,465 youth 8-16y (49.6% females) participating in the Hispanic Community Children's Health Study/Study of Latino Youth, we classified youths into four acculturation groups – assimilated, integrated, marginalized/separated, and unclassified. SSB consumption was assessed through two 24-hour diet recalls and defined as intake frequency of soda, fruit juice, sweetened soft and fruit drinks. Multi-group path regression models were used to test associations of Hispanic/Latino youth’ acculturative stress and family functioning with SSB consumption, as well as the moderating role of acculturation status. Results. When controlling for age, sex, and study site, acculturative stress (β = -0.13, p = 0.01) was inversely associated with SSB, and poor family functioning (β = 0.11, p = 0.07) was only marginally associated with SSB consumption among youth classified as assimilated but not among youth classified as integrated, marginalized/separated, or unclassified. Conclusions. A socio-ecological perspective that incorporates the role of key acculturation-related factors across multiple levels may aid efforts to identify mechanisms that influence the relationship between acculturation status and diet among Hispanic/Latino youth and their families.
Maternal age influence in human colostrum fat composition
Authors: Morceli Glilciane , Moraes Lucas Lima de , Campos Letícia Aguiar de , Polettini Jossimara , Saeki Erika Kushikawa , Keller Rogéria , Ferrari Denise Vasconcelos de Jesus
Published: April 2020

Introduction: Colostrum is the first milk secretion produced and contains the nutrients necessary for the development of the neonate. Objectives: To compare the chemical level of colostrum fats from adolescent nursing mothers and those of advanced maternal age and to describe their gestational characteristics. Methods: A prospective cross-sectional study, including 98 nursing adolescent mothers (up to 24 years of age) and 33 nursing mothers of advanced maternal age (over 35) attending the Maternity Hospital of Presidente Prudente. Colostrum samples were obtained through manual extraction between 48 and 72 hours postpartum. The determination of fats and calories was performed by means of the Creamatocrit technique. Statistical analysis was performed using the Student's t-test or Mann-Whitney test. Results: The mean age of the nursing mothers of advanced maternal age was 37 years, statistically higher than that of the adolescent mothers with a mean age of 20 years. In total, 66.3% of the adolescent nursing mothers were primiparous and 66.7% of the mothers of advanced maternal age underwent a cesarean delivery. Gestational BMI was statistically higher in the women of advanced maternal age (31.3±5.6 vs 26.06±3.6). Although the colostrum fat and cream composition was significantly higher in nursing mothers of advanced maternal age, the number of calories was similar between the groups. Conclusion: Advanced maternal age influenced gestational BMI and the biochemical composition of colostrum and its components.
Relationship between time-varying status of reflux esophagitis and Helicobacter pylori and progression to long-segment Barrett’s esophagus: time-dependent Cox proportional-hazards analysis
Authors: Usui Genki , Shinozaki Tomohiro , Jinno Toyohisa , Fujibayashi Kazutoshi , Morikawa Teppei , Gunji Toshiaki , Matsuhashi Nobuyuki
Published: April 2020

Background:
Reflux esophagitis (RE) and absence of Helicobacter pylori (non-H. pylori) are considered to be associated with the progression to long-segment Barrett’s esophagus (LSBE). However, it is difficult to assess this association because RE and H. pylori status can change during follow-up. Additionally, the association between H. pylori eradication and LSBE remains unclear.
Methods:
A total of 11,493 asymptomatic Japanese subjects who underwent medical check-ups and were endoscopically diagnosed with short-segment Barrett’s esophagus (SSBE) between May 2006 and December 2015 were enrolled. The hazards of progression to LSBE were compared between time-varying RE and H. pylori infection/eradication by time-dependent multivariable Cox proportional hazards models.
Results
A total of 7,637 subjects who underwent additional medical check-ups after being diagnosed with endoscopic SSBE were analyzed. Subjects with RE and without current/past H. pylori infection were strongly associated with a higher rate of progression to LSBE (adjusted hazard ratio [HR]: 7.17, 95% confidence interval [CI]: 2.48–20.73, p < 0.001 for RE and non-H. pylori vs. non-RE and H. pylori groups). Subjects with H. pylori had a lower rate of progression to LSBE (adjusted HR: 0.48, 95% CI: 0.22–1.07, p = 0.07 for H. pylori vs. non-H. pylori). Hazards of progression to LSBE were still lower in the H. pylori eradication group than that of the non-H. pylori group (adjusted HR: 0.51, 95% CI: 0.18–1.46, p = 0.21).
Conclusions
RE and non-H. pylori were associated with the progression to LSBE, considering the changes in exposures. H. pylori eradication may not increase the rate of progression to LSBE.
Is precariousness the blind spot of prevention and treatment of the use of psychoactive substances?
Authors: Chossegros Philippe , Nino Fiorant Di
Published: April 2020

Background and aims: Prevalence of the use of psychoactive substances is high in precarious populations. Yet the influence of precariousness on the trajectory of drug users (DUs) has rarely been studied. For the first time, we conducted such a study with a representative group of DUs.Methods: We combined a recruitment through a respondent driven sampling (RDS) with a 250 items questionnaire. The answers of our sample of 327 UDs were studied according to a precariousness score (PS).Results: The prevalence of precariousness ranged from low PS 48.9 %, average PS 30.9 % to high PS 20.2 %. Access to health services at the time of our survey concerned 61.8 % of DUs. Its prevalence was lower among DUs with the highest precariousness score (Low PS 72.5 %, Average PS 61.4 %, High PS 36.4 %) with an Odds ratio of 5.01 (CI95% 2.52-9.97; p<0.0001) between low and high PS for a continuous follow-up. A higher dropout rate was also observed among the highest PS (p<0.0001).Despite differences in their socio-economic characteristics, DUs represented a homogeneous community with respect to their use of drugs. The more precarious DUs were younger, had an earlier age of initiation of injection, of experimentation of cannabis, alcohol, heroin as well as diverted opioid substitution treatments (OST). They had a more frequent and durable use of alcohol. Precariousness was also associated with lower educational levels, less contacts with one’s parents, less search for information on the Internet for drugs and GPs for health and more housing and social rights as plans for the future.Conclusion: In France, despite the fact that specialized care is free of charge, the lower access to for the most precarious DUs and their higher drop-out rates suggest that it is not adapted to their demand, which is more oriented towards socio-economic problems than towards drug use or harm reduction. This observation is all the more important as it concerns the youngest users. Our data suggest that precariousness influences the course of drug addiction from its onset. Lack of consideration of this population limits the ability to develop effective health policies.
Early Detection of Sepsis Using Artificial Intelligence: A Scoping Review Protocol
Authors: Pepic Ivana , Feldt Robert , Ljungström Lars , Torkar Richard , Dalevi Daniel , Söderholm Hanna Maurin , Andersson Lars-Magnus , Axelson-Fisk Marina , Bohm Katarina , Sjöqvist Bengt Arne , Candefjord Stefan
Published: April 2020

Background: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. To decrease the high case fatality rates and morbidity for sepsis and septic shock, there is a need to increase the accuracy of early detection of suspected sepsis in prehospital and emergency department settings. This may be achieved by developing risk prediction decision support systems based on artificial intelligence. Methods: The overall aim of this scoping review is to summarize the literature on existing methods for early detection of sepsis using artificial intelligence. The review will be performed using the framework formulated by Arksey and O’Malley and further developed by Levac and colleagues. To identify primary studies and reviews that are suitable to answer our research questions, a comprehensive literature collection will be compiled by searching several sources. Databases/web search engines that will be used are PubMed, Web of Science, Scopus, IEEE Xplore, Google Scholar, Cochrane Library and ACM Digital Library. Furthermore, clinical studies that have completed patient recruitment and reported results found in the database ClinicalTrials.gov will be considered. The term artificial intelligence is viewed broadly and a wide range of machine learning and mathematical models suitable as base for decision support will be evaluated. Two members of the team will test the framework on a sample of included studies to ensure that the coding framework is suitable and can be consistently applied. Analysis of collected data will provide a descriptive summary and thematic analysis. The reported results will convey knowledge about the state of current research and innovation for using artificial intelligence to detect sepsis in early phases of the medical care chain. Ethics and dissemination: The methodology used here is based on the use of publicly available information and does not need ethical approval. It aims at aiding further research towards digital solutions for disease detection and health innovation. Results will be extracted into a review report for submission to a peer-reviewed scientific journal. Results will be shared with relevant local and national authorities and disseminated in additional appropriate formats such as conferences, lectures, and press releases.
Trends in global research on Sanitation: A 30-year perspective from 1990 to 2019
Authors: huang li , zhou mi
Published: April 2020

Background
Sanitation issues have aroused widespread concern around the world, and scholars began research in this area as early as the 1920s. After decades of development, there is a great amount of research on this topic, and the body of research continues to grow rapidly.
Methods
Based on the Web of Science Core Collection databases from 1990–2019, this paper applies the bibliometric method to analyze the research characteristics and developments of scientific publications about sanitation. Visualized knowledge mapping is employed to investigate development status, scientific collaboration, involved disciplines, research hotspots and emerging trends of this field.
Results
The breadth and depth of sanitation studies has improved significantly as the number of related publications increases rapidly in the 21st century. The strength of developed countries is greater than that of developing countries; the comprehensive strength of the United States ranks first in the field, followed by England and Switzerland. This field is a highly interdisciplinary field that covers a wide range of interests, and institutional collaboration is increasing in this field. Keyword clustering analysis shows that the main research topics in the domain of sanitation could be summarized as: (a) drinking water; (b) sustainability; (c) biofilm; (d) epidemiology; and (e) WaSH. Meanwhile, keyword bursts analysis showed that the new research hotspots and research frontiers mainly concentrated on: (a) Sustainable development of sanitation services adapting to climate change; (b) Main determinants affecting child malnutrition; (c) Multinational research and model innovation; and (d) Evaluations on various aspects of performance.
Conclusions
Through in-depth analysis of sanitation research, this paper provides a better understanding of trends that have emerged over the past 30 years, and can serve as a reference for future research.