bluuebunny/crossref_metadata_2025 huggingface dataset:
"A Wearable Ring-shaped Inertial System to Identify Action Planning Impairments During Reach-to-grasp Sequences: A Pilot Study"
Authors: Rovini Erika , Galperti Guenda , Manera Valeria , Mancioppi Gianmaria , Fiorini Laura , Gross Auriane , Robert Philippe , Cavallo Filippo
Published: December 2020

Background. The progressive ageing of the population is leading to an increasing of people affected by cognitive decline, included disorders in executive functions (EFs), such as action planning. Current procedures to evaluate cognitive decline are based on neuropsychological tests, but novel methods and approaches start to be investigated. Reach-to-grasp (RG) protocols have shown that intentions can influence the EFs of action planning.Methods. In this work, we proposed a novel ring-shaped wearable inertial device, SensRing, to measure kinematic parameters during RG and after-grasp tasks with different end-goals. The aim is to evaluate whether SensRing can characterize the motor performances of people affected by Mild Neurocognitive Disorder (MND) with impairment in EFs, named dysexecutive MND (d-MND), compared to older healthy subjects (HC). Ten HC and eight d-MND were asked to reach and grasp a can with three different intentions: to drink (DRINK), to place it on a target (PLACE), or to pass it to a partner (PASS). Twenty-one kinematic parameters have been extracted from SensRing inertial data.Results. Several parameters resulted able to differentiate between HC and d-MND, showing that patients generally have longer reaction times, slower peak velocities and longer deceleration phases. Furthermore, d-MND showed fewer differences among conditions, suggesting that impairments in EFs influence their capabilities into modulating the action planning based on the end-goal.Conclusions. Therefore, the system can be proposed for objectifying the clinical assessment of people affected by d-MND by administering an easy quick motor test. Furthermore, the portability, wearability, accuracy, and ease-of use of the system make the SensRing sytem suitable for remote applications at home, including analysis of protocols for neuromotor rehabilitation in patients affected by MND.
Use of Therapeutic Caffeine in Acute Care Post-operative and Critical Care Settings: a Scoping Review
Authors: Bright Matthew , Raman Vignesh , Laupland Kevin B
Published: December 2020

BackgroundCaffeine is the most utilised psychoactive drug worldwide. However, caffeine withdrawal and the therapeutic use of caffeine in intensive care and in the peri-operative period have not been well summarised. Our objective was to conduct a scoping review of caffeine withdrawal and use in the intensive care unit (ICU) and post-operative patients. MethodsPubMed, Embase, CINAHL Complete, Scopus and Web of Science were systematically searched for studies investigating the effects of caffeine withdrawal or administration in ICU patients and in the peri-operative period. Areas of recent systematic review such as pain or post-dural puncture headache were not included in this review. Studies were limited to adults. ResultsOf 2268 articles screened, 26 were included and grouped into two themes of caffeine use in in the peri-operative period and in the ICU. Caffeine withdrawal in the post-operative period increases the incidence of headache, which can be effectively treated prophylactically with peri-operative caffeine. There were no studies investigating caffeine withdrawal or effect on sleep wake cycles, daytime somnolence, or delirium in the intensive care setting. Administration of caffeine results in faster emergence from sedation and anaesthesia, particularly in individuals who are at high risk of post-extubation complications. There has only been one study investigating caffeine administration to facilitate post-anaesthetic emergence in ICU. Caffeine administration appears to be safe in moderate doses in the peri-operative period and in the intensive care setting. ConclusionsAlthough caffeine is widely used, there is a paucity of studies investigating withdrawal or therapeutic effects in patients admitted to ICU and further novel studies are a priority.
Metastasis of Sarcomatoid Malignant Mesothelioma With p16/CDKN2A Deletion Presented as a Subcutaneous Mass in the Back: a Case Report and Review of Literature
Authors: Chen Kai-Bo , Huang Ya-Jing , Huang Yi , Wu Zhi-Wei , Jin Xiao-Li , Zhang Hang , Xiang Xue-Ping , Chen Lin , Chen Li
Published: December 2020

Background: Sarcomatoid malignant mesothelioma (MM) is a rare and aggressive disease, and its diagnosis is challenging.Case presentation: A 60-year-old man was found a recurrent mass in his right back after the initial resection. A chest CT found right pleural thickening, nodular pleural thickening, pleural effusion, mediastinal and right infraclavicular lymph nodes enlargement, which indicated a right pleura MM. Immunohistochemical (IHC) stains of the resected mass showed sarcomatous atypical spindle cells, which were positive for CK 1/3, CK 5/6, WT1, podoplanin and vimentin, and negative for Napsin A, TTF-1 and CDX2, and fluorescent in situ hybridization (FISH) detected homozygous p16/CDKN2A deletion. The association of the chest CT features and the mass assessment confirmed metastatic MM in the subcutaneous layer of the back. Moreover, PET-CT showed multiple metastases in his brain. He developed massive right pleural effusion and chest tightness soon, and the mass kept growing despite of the local and systemic treatments, and he died from pulmonary failure in 3 months.Conclusion: We described an extremely rare subcutaneous metastasis in the back from sarcomatoid MM. And we made the diagnosis by both histological and molecular analysis of the metastatic lesion. MM patients most likely have subcutaneous metastasis on head, they usually develop pleural effusion, chest pain or dyspnea, and their prognosis is very poor because of late diagnosis and insensitivity to current therapies.
Epidemiology, Haematology and Molecular Characterization of Haemoprotozoon and Rickettsial Organisms Causing Infection in Cattle of Jammu Region, North India
Authors: Kaur Rabjot , Yadav Anish , Rafiqi Shafiya Imtiaz , Godara Rajesh , Sudan Vikrant , Chakraborty D , Katoch Rajesh
Published: December 2020

Background: The present study was aimed to establish the prevalence, epidemiology and molecular characterization of major haemoprotozoons (Babesia and Theileria) and rickettsia (Anaplasma) of cattle in Jammu region (North India) using microscopy and Polymerase chain reaction (PCR). Hematology, Microscopy and PCR based prevalence studies were undertaken with 278 blood samples from cattle. Molecular prevalence studies were followed by genetic characterization of the isolates of Babesia, Anaplasma and Theileria spp. based on 18S rRNA, 16S rRNA and Tams1 gene, respectively. The data related to metrology and epidemiological variables like temperature, rainfall, season, age and type of livestock rearing was analyzed and correlated with disease by statistical methods. Results: The study revealed prevalence of Babesia spp., Anaplasma spp. and Theileria spp. to be 14.02%, 23.74% and 1.079% respectively. The metrological and epidemiological variables made inroads for the propagation of vector ticks and occurrence of infection. Haematological alterations predominantly related to haemoglobin, red blood cell count and packed cell volume were evident in diseased animals and collaterally affected the productivity. Further the genetic characterization of Babesia spp. (MN566925.1, MN567603, MN566924.1), Anaplasma spp. (MH733242.1, MN567602.1) and Theileria spp. (MT113479) provided a representative data of the isolates circulating in the region and their proximity with available sequences across the world.Conclusions: Despite holding much significance to the animal sector, comprehensive disease mapping has yet not been undertaken in several parts of India. The present study provides a blue print of disease mapping, epidemiological correlations and genomic diversity of Babesia spp., Anaplasma spp. and Theileria spp circulating in the region.
Colloidal Transport and Deposition Through Dense Vegetation
Authors: Yu Congrong , Duan Peiyi , Yu Zhongbo , Chen Li , Barry D. A. , Sun Yufeng , Li Ying
Published: December 2020

Background
This paper investigates the effectiveness of dense vegetation on removal of colloids, which are important nonpoint source pollutants. In small scale colloid transport experiments, the deposition rate of colloids in dense vegetation is often taken as constant.
Results
This assumption was tested by experiments and modeling aimed at quantifying changes in colloid retention during transport in dense vegetation, in particular how colloid retention changes with travel distance. Flume experiments using a 10-m long dense vegetated strip were conducted under various conditions with combinations of different flow velocities, initial colloid concentrations, solution pH and ionic strength. The advection-dispersion model coupled with first-order deposition kinetics simulated the experimental data satisfactorily.
Conclusions
It showed that the colloid deposition rate decreased with travel distance, with the decline following a power law, and reached steady state after about 10 m. Diffusion and interception processes in colloid filtration theory were sufficient to describe the observed deposition kinetics. The decreasing trend in colloid deposition could be attributed to decreased diffusion along the travel path.
Optimal design and biomechanical simulation analysis of femoral stem based on trabecular bone structure
Authors: Bai Junjun , Feng Yi , Lv Jia , Lv Zhi , Xu Chaojian , Tian Zhi , Wu Zhuangzhuang
Published: December 2020

Background:In orthopaedic clinical treatment, the rigidity mismatch between prosthesis and bone will cause stress shielding phenomenon, affecting bone growth and leading to aseptic loosening and prosthesis failure, and thus a more serious secondary fracture.Purpose:In this paper, the femur stem finite element model of human body standing on one foot and two feet was established, and the biomechanical properties of femur stems with three different structural designs were compared and analyzed, so as to provide theoretical guidance for the structural design and finite element simulation of femur stem.Method: Round-hole femoral stem model and trabecular structural model were established via 3-matic software based on solid femoral stem model. Meshing work was performed by the finite element pre-processing software Hypermesh. The finite element analysis software Abaqus is introduced to analyze the mechanical characteristics of the models for simulating the two different motion conditions of human standing on one foot and on two feet. Results and discussion: The results showed that stress concentration occurred in the femoral neck of all the prostheses with different motion conditions. The stress and displacement values of the three prosthesis models are about twice as much as those of the two-feet models when standing on one foot. The stress and displacement values of the trabecular femoral stem prosthesis were. The stress distribution of femoral stem prosthesis with trabecular bone structure was more uniform, and the force conduction was more obvious, which can effectively reduce the stress shielding effect and was beneficial to the patients’ rehabilitation.
Multi-reference poly-conformational computational methods for de-novo design, optimization, and repositioning of pharmaceutical compounds
Authors: Alexandrov Vadim , Kirpich Alexander , Gankin Yuriy
Published: December 2020

The COVID-19 epidemic, SARS-CoV-2, that began in December of 2019 has drastically altered the aspects of daily life across the global society. Time-effective treatment of those infected has since become a major goal with multiple treatment strategies having been designed to prevent the progression of the disease into severe pneumonia. To date, no drug has been found to be 100% effective against SARS-COV-2, possibly because each candidate drug was targeting only one particular mechanism of action (MoA). Neither proposed up-to-date anti-SARS-COV-2 vaccine are 100% effective. To contribute to the process of finding a more robust small-molecule solution, utilizing several anti-SARS-COV-2 MoAs, a novel framework is presented; where the in silico generated set of virtual library compounds is compared to six known reference drugs: Chloroquine, Favipiravir, Remdesivir, JQ1, Apicidine, and Haloperidol which have been already used for SARS-CoV-2 treatment. The aims were: a) to present a universal search framework for potential candidate compounds based on the comparison of multiple similarities between compounds’ conformers and b) to identify candidate compounds that are simultaneously “close” to each of the six known reference compounds that counteract SARS-CoV-2 via different mechanisms of action.
Characteristics of the Intestinal Microbiota and Metabolism in Infants with Extrauterine Growth Restriction
Authors: Fan Sainan , Zhang Kun , Lv Anping , Ma Yanan , Fang Xiaohui , zhang jinping
Published: December 2020

Objective

Infants with extrauterine growth restriction (EUGR) experience significant postnatal growth restriction in the first week after birth, which indicates a failure of energy absorption. This study aimed to determine the different intestinal microbial species and metabolites between infants with EUGR and those without EUGR.
Methods

A total of 73 infants hospitalized in a neonatal intensive care unit were enrolled and divided into the EUGR group (n = 50) and the non-EUGR group (n = 23). Fecal samples were collected during hospitalization. Bacterial species and their relative abundance were identified with metagenome sequencing. The metabolites in the feces and blood were identified with an LC-MS–based non-targeted metabolome.
Results

The intestinal microbiota of the EUGR group contained less Bacteroides vulgatus, Dorea unclassified, Lachnospiraceae bacterium 1_1_57FAA, and Roseburia unclassified compared to that of the non-EUGR group. More importantly, the intestinal microbiota of the EUGR group contained Streptococcus mitis_oralis_pneumoniae, while that of the non-EUGR group did not. Furthermore, KEGG prediction and a correlation analysis identified that the majority of different microbial species higher in the non-EUGR group were related to metabolism. The results of the non-targeted metabolome revealed that several metabolites in the feces and blood were much higher in either group, some of which were related to the different microbial species.
Conclusions

This study identified several different intestinal microbial species and metabolites in the patients feces and blood, which may provide evidence to identify the biomarkers of infants with EUGR.
Expression levels of plasma exosomal miR-124, miR-125b, miR-133b, miR-130a and miR-125b-1-3p in severe asthma patients and normal individuals with emphasis on inflammatory factors
Authors: Atashbasteh Mostafa , Mortaz Esmaeil , Mahdaviani Seyed Alireza , Jamaati Hamidreza , Allameh Abdolamir
Published: December 2020

BackgroundIdentification of molecular markers, such as miRNAs is promising for the diagnosis of asthma and its clinical phenotypes. The aim of this study was to examine the changes in the expression of selected microRNAs in plasma exosomal fractions severe asthma patients. The expression of the miRNAs was determined in relation to the changes in serum immuno-inflammatory markers.MethodSevere asthma patients (n = 30) and healthy subjects (n = 30) were selected among the individuals referred to the asthma and allergy clinic. Blood was collected from each participant for the estimation of high sensitive C-reactive protein (hs-CRP) and total IgE in serum. The exosomal fraction of plasma was also isolated by ultra-centrifugation and processed for quantitation of miR-124, miR-125b, miR-133b, miR-130a and miR-125b-1-3p expression using quantitative real time-PCR (qRT-PCR).ResultsSerum hs-CRP and total IgE were significantly higher in asthma patients as compared to controls. Expression of miR-124, miR-133b, and miR-130a were down-regulated in asthma patients as compared to controls (p < 0.0001). However, the expression of miR-125b was significantly higher in the patients compared to controls (p < 0.0001). No major changes in miR-125b-1-3p expression was found in the study groups. Data analysis indicated that among the miRNAs, changes in miR-125b in severe asthma patients was highly correlated with the serum levels of hs-CRP and IgE.ConclusionOverexpression of miR-125b that was significantly associated with serum IgE and hs-CRP may suggest that miR-125b is linked to inflammatory reactions in asthma. However, the involvement of miR-124, miR-133b, and miR-130a in asthma complication is ruled out, because they were a poor relationship between these miRNAs and the inflammatory markers.
Short-term Outcomes after Minimally Invasive versus Open Pancreaticoduodenectomy in Elderly Patients: a Propensity Score-matched Analysis
Authors: Yin Shih-min , Liu Yueh-Wei , Liu Yu-Yin , Yong Chee-Chien , Wang Chih-Chi , Li Wei-Feng , Yeh Cheng-Hsi
Published: December 2020

Background:
To date, the evidence on the safety and benefits of minimally invasive pancreatoduodenectomy (MIPD) in elderly patients is still controversy. This study aim to compare the risk and benefit between MIPD and open pancreatoduodenectomy (OPD) in elderly patients.
Methods:
From 2016 to 2020, we retrospective enrolled 26 patients underwent MIPD and other 119 patients underwent OPD. Propensity score matching was applied for old age (≥ 65-year-old) patient analysis. Baseline characteristics, 90-day mortality and short-term surgical outcomes were compared between two groups.
Results:
After 1:2 propensity score matching analysis, elderly patients in MIPD group had significantly poor performance status (P = 0.042) compared to OPD group. Patients receiving MIPD had significantly shorter postoperative hospital stay (POHS) (18 vs. 25 days, P = 0.028), earlier drain removal (16 vs. 21 days, P = 0.012) and smaller delay gastric empty rate (5.9 vs. 32.4% P = 0.036). There was no 90-day mortality (0% vs 11.8%, P = 0.186) and pulmonary complications (0% vs 17.6%, P = 0.075) in MIPD group, and the major complication rate is comparable to OPD group (17.6% vs 29.4%, P = 0.290).
Conclusion:
For elderly patients, MIPD is a feasible and safe option even in patients with inferior preoperative performance status. MIPD might also provide potential advantage for elderly patients in minimizing pulmonary complication and overall mortality over OPD.
Survival Benefit of Intervention Treatment in	Advanced Anaplastic Thyroid Cancer
Authors: KASEMSIRI PORNTHEP , Chaisakgreenon Pimpika , Vatanasapt Patravoot , Laohasiriwong Supawan , Teeramatwanich Watchareeporn , Thongrong Cattleya , Ratanaanekchai Teeraporn , Suetrong Surapol
Published: December 2020

Background

Management of anaplastic thyroid cancer (ATC) is a controversial issue; thus, proper treatment and prognostic factors should be investigated.
Objectives

To compare the survival outcomes of intervention and palliative treatment in ATC patients.
Methods

A hospital-based retrospective study was conducted in a single tertiary university hospital. The medical record charts were retrieved from November 20, 1987 to December 31, 2016. The final follow-up was ended by December 31, 2017. Patients’ demographic data, laboratory data, clinical presentation, and results of treatment modalities were analyzed.
Results

One hundred twenty-one records were analyzed that one-year overall survival rate of 3.5% (median survival time of 77 days); however, there was insufficient data on 16 cases to classify staging and treatment modalities. Therefore 105 ATC patients (37 stage IVa, 39 stage IVb, 29 stage IVc) were included with one-year overall survival rate of 4.0% (median survival time of 82 days). Intervention treatment allowed longer median survival times (p < 0.05) and a better survival rate (p < 0.05). Among the intervention treatment group, post-operative chemoradiation yielded the longest median survival time (187 days) and the longest survival rate (20%) (p < 0.05). At all stages, intervention modality allowed better median survival time, especially in stage IVa (p < 0.05). Unfavorable prognostic factors were adjusted with multiple cox regression model that showed significant factors included age ≥ 65 years (HR of 2.57), palliative treatment (HR of 1.85), and leukocytosis ≥ 10,000/mm3(HR of 2.76).
Conclusions

Intervention treatment provided a better survival outcome in all stages, especially in stage IVa with a significantly better median survival time. Among intervention treatments, postoperative chemoradiation offered the longest survival rate; thus, suggesting this should be considered in ATC patients who have resectable tumors and no poor prognostic factors such as older age and leukocytosis.
Point-of-Care Capillary Blood Creatinine: A Prospective Study In Cardiology and Nephrology Outpatients
Authors: Vilaine Eve , Gabarre Paul , Beauchet Alain , Seidowsky Alexandre , Auzel Olivier , Moreau Marie Hauguel , Dubourg Olivier , Mansencal Nicolas , Essig Marie , Massy Ziad
Published: December 2020

Background: The radiological or interventional use of contrast medium exposes patients to a risk of contrast-induced nephropathy. Pre-existing kidney failure is a major risk factor. Point-of-care capillary (POC) blood creatinine tests are promising; their speed might help to optimize treatment decisions and patient care in these situations. Methods: The objective of the present study was to assess the ability of a new point of care capillary blood creatinine test (Stat Sensor X-press, Nova Biomedical Cooperation, Waltham, MA, USA) to diagnose kidney failure, relative to a standard lab-based plasma creatinine assay. A total of 113 patients 33 women (29.2%) were included. The capillary blood creatinine concentration was significantly correlated with the plasma creatinine concentration in both men (Pearson’s r [95% confidence interval (CI)] = 0.84 [0.75 – 0.89]; p<0.001) and women (Pearson’s r [95%CI] = 0.95 [0.89 – 0.97]; p<0.001). The test’s diagnostic performance was satisfactory, its sensitivity was 70% [35 – 93] in women and 78% [52 – 94] in men, and its specificity was 91% [72 – 99] in woman and 93% [84 – 98] in men. Conclusion: Rapid POC creatinine test is an easy-to-use, accurate tool for detecting kidney failure before a patient is exposed to procedures involving contrast medium.
Genetic investigation of 211 Chinese families expands the mutational and phenotypical spectrum in hereditary retinopathy genes through targeted sequencing technology
Authors: Bai Zhouxian , Xie Yanchuan , Liu Lina , Shao Jingzhi , Liu Yuying , Kong Xiangdong
Published: December 2020

Background: Hereditary retinopathy is a significant cause of blindness worldwide. Despite the discovery of many mutations in various retinopathies, a large part of patients remain undiagnosed genetically. Targeted next generation sequencing of the human genome is a suitable approach for retinopathy molecular diagnosis.Methods: We described a cohort of 211 families from central China with various forms of retinopathy, 95 families of which were investigated using NGS multi-gene panel sequencing as well as the other 116 patients were LHON suspected tested by Sanger sequencing. We validated the candidate variants by PCR-based Sanger sequencing. We have made comprehensive analysis of the cases through sequencing data and ophthalmologic examination information.Results: The potentially causal mutation was identified in majority of the families with retinopathy (57.9% of 95 families) and Leber hereditary optic neuropathy (LHON) (21.6% of 116 families). The identified mutations (68mutations, 37 of which are novel) of the 95 families spanned 31 known disease genes, about half have not been reported relation to hereditary retinopathy. The NGS panel solution provides 45.3% potential diagnostic rate of the retinopathy families and another 12.6% families detect candidate gene mutations with undefined pathogenicity in this study.Conclusion: Our study showed novel mutations and phenotypic aspects of retinopathy, and demonstrated genetic and clinical heterogeneity of the conditions. Our results illustrated the significance of molecular genetic testing for patients with hereditary retinopathy.
Utilising Benefit-Risk Assessments within Clinical Trials – A Protocol for the BRAINS project
Authors: Totton Nikki , Julious Steven , Hughes Dyfrig , Cook Jonathan , Biggs Katie , Coates Lizzie , Cook Andrew , Hewitt Catherine , Day Simon
Published: December 2020

Background: Depending on the treatment to be investigated, a clinical trial could be designed to assess objectives of: superiority; equivalence or non-inferiority. The design of the study is affected by many different elements including: the control treatment, the primary outcome and associated relationships. In some studies, there could be more than one outcome of interest. In these situations, benefit-risk methodologies could be used to assess the outcomes simultaneously and consider the trade-off between the benefits against the risks of a treatment. Benefit-risk is used within the regulatory industry but seldom included within publicly funded clinical trials within the UK. This project aims to gain an expert consensus on how to select the appropriate trial design (e.g. superiority) and when to consider including benefit-risk methods.Methods: The project will consist of four work packages:1. A web-based survey to elicit current experiences and opinions,2. A rapid literature review to assess any current recommendations,3. A two-day consensus workshop to gain agreement on the recommendations,4. Production of a guidance document.Discussion: The aim of the project is to provide a guideline for clinical researchers, grant funding bodies and reviewers for grant bodies for how to select the most appropriate trial design and when it is appropriate to consider using benefit-risk methods. The focus of the guideline will be on publicly funded trials, however, the vision is that the work will be applicable across research settings and we will connect with other organisations and committees as appropriate.
“Having more women humanitarian leaders will help transform the humanitarian system”: Challenges and Opportunities for Women Leaders in Conflict and Humanitarian Health
Authors: Patel Preeti , Meagher Kristen , Achi Nassim El , Ekzayez Abdulkarim , Sullivan Richard , Bowsher Gemma
Published: December 2020

Background: It is estimated that over 40 percent of the half a million humanitarian workers who provide frontline care during emergencies, wars and disasters, are women. Women are at the forefront of improving health for conflict-affected populations through service delivery, education and capacity strengthening, advocacy and research. Women are also disproportionately affected by conflict and humanitarian emergencies. The growing evidence base demonstrating excess female morbidity and mortality reflects the necessity of evaluating the role of women in leadership driving health research, policy and programmatic interventions in conflict-related humanitarian contexts. Despite global commitments to improving gender equality, the issue of women leaders in conflict and humanitarian health has been given little or no attention. The aim of this paper focuses on three domains: importance, barriers and opportunities for women leaders in conflict and humanitarian health. Following thematic analysis of the material collected, we discuss the following themes: barriers of women’s leadership domain at societal level, and organisational level, which is subcategorized into culture and strategy. Building on the available opportunities and initiatives and on inspirational experiences of the limited number of women leaders in this field, recommendations for empowering and supporting women’s leadership in conflict health are presented. Methods: A desk-based literature review of academic and grey sources was conducted followed by thematic analysis.Results: There is very limited evidence on women leaders in conflict and humanitarian health. Some data shows that women have leadership skills that help to support more inclusive solutions which are incredibly important in this sector. However, deeply imbedded discrimination against women at the organisational, cultural, social, financial and political levels is exacerbated in conflict which makes it more challenging for women to progress in such settings.Conclusion: Advocating for women leaders in conflict and health in the humanitarian sector, governmental bodies, academia and the global health community is crucial to increasing effective interventions that adequately address the complexity and diversity of humanitarian crises.
Improvement of Parent’s Awareness, Knowledge, Perception, and Acceptability of HPV Vaccination After a Structured-educational Intervention
Authors: Sitaresmi Mei Neni , Rozanti Nisrina Maulida , Simangunsong Lamria Besty , Wahab Abdul
Published: December 2020

Background: Regardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5 th and 6 th grades (11-13 years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability. Methods: We conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5 th and 6 th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention. Results: A total of 506 parents participated. Before receiving the structured-educational intervention, parents' awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent’s awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p <0.001). HPV vaccine's acceptability increased from 74.3% to 87.4% ( p <0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r=0.32 to 0.53, p <0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine's acceptability with OR 1.90 (95%CI:1.40-2.57) and OR 1.31(95%CI:1.05-1.63), respectively. Conclusions: A structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents’ knowledge, perceptions and HPV vaccine acceptability .
Survey on neutralizing antibodies against Zika virus eighteen months post-outbreak in two southern Thailand communities
Authors: Densathaporn Theerut , Sangthong Rassamee , Sakolnapa Monvaris , Surasombatpattana Smonrapat , Kemapunmanus Marisa , Masrinoul Promsin , Yoksan Sutee , McNeil Edward B , Chongsuvivatwong Virasakdi
Published: December 2020

Background: In 2016 and 2017, Zika virus (ZIKV) infection outbreaks occurred in two communities in southern Thailand. This re-immerging infection can widely spread by mosquito bites and cause serious complications in a central nervous system among children born to infected mothers. Thus, they should be protected. This study aims to (1) To determine the prevalence of neutralizing ZIKV antibodies in the post-outbreak areas among the general population and pregnancy women residing at various distances from the houses of the nearest index patients; (2) To examine the cross-neutralizing capacity of antibodies against ZIKV on other flaviviruses commonly found in the study areas; (3) To identify factors associated with the presence of neutralizing ZIKV antibodies.Methods: The two post-outbreak communities were visited at 18 months after the outbreaks. We enrolled (1) 18 confirmed ZIKV infected (index) cases, (2) sample of 554 neighbors in the outbreak areas who lived at various distances from the index patients’ houses, (3) 190 residents of non-outbreak areas, and (4) all pregnant women regardless of gestational age residing in the study areas (n = 805). All serum specimens underwent the plaque reduction neutralization test (PRNT). Ten randomly selected ZIKV seropositive and ten randomly selected seronegative specimens were tested for dengue virus serotypes 1-4 (DENV1-4) and Japanese encephalitis virus (JEV) antibodies using PRNT90. Serum titer above 1:10 was considered positive. Multiple logistic regression was used to assess factors associated with seropositivity.Results: Out of all 18 index cases, 9 remained seropositive. The seroprevalence (95% CI) in the two outbreak areas were 43.7% (35.9-51.6%) and 29.7% (23.3-36.0%) in general population, and 24.3% (20.1-28.8%) and 12.8% (9.7-16.5%) in pregnant women. Multivariate analysis showed that seropositivity was independent of the distance gradient from the index’s houses. However, being elderly was associated with seropositivity. DENV1-4 and JEV neutralizing antibodies were present in most ZIKV-positive and negative subsamples.Conclusion: Protective herd immunity for ZIKV infection is inadequate, especially among pregnant women in the two post-outbreak areas in southern Thailand.
Shifted Phase of EEG Cross-Frequency Coupling in Individuals with Phelan-McDermid Syndrome
Authors: Mariscal Michael G , Berry-Kravis Elizabeth , Buxbaum Joseph D , Ethridge Lauren E , Filip-Dhima Rajna , Foss-Feig Jennifer H , Kolevzon Alexander , Modi Meera E , Mosconi Matthew W , Nelson Charles A , Powell Craig M , Siper Paige M , Soorya Latha , Thaliath Andrew , Thurm Audrey , Zhang Bo , Sahin Mustafa , Levin April R
Published: December 2020

Background: Phelan-McDermid Syndrome (PMS) is a rare condition caused by deletion or mutation of the SHANK3 gene. Individuals with PMS frequently present with intellectual disability, autism spectrum disorder (ASD), and other neurodevelopmental challenges. Electroencephalography (EEG) can provide a window into network-level function in PMS. Methods: Here, we analyze EEG data collected across multiple sites in individuals with PMS (n = 26) and typically developing individuals (n = 15). We quantify oscillatory power, alpha-gamma phase-amplitude coupling strength, and phase bias, a measure of the phase of cross frequency coupling thought to reflect the balance of feedforward and feedback activity. Results: We find individuals with PMS display increased alpha-gamma phase bias ( U = 3.841, p < 0.0005), predominantly over posterior electrodes. Most individuals with PMS demonstrate positive overall phase bias while most typically developing individuals demonstrate negative overall phase bias. Among individuals with PMS, strength of alpha-gamma phase-amplitude coupling was associated with Sameness, Ritualistic, and Compulsive behaviors as measured by the Repetitive Behavior Scales-Revised (Beta= 0.545, p= 0.011). Conclusions: Increased phase bias suggests potential circuit-level mechanisms underlying phenotype in PMS, offering opportunities for back-translation of findings into animal models and targeting in clinical trials.
A hybrid metaheuristic for Solving Asymmetric Distance-Constrained Vehicle Routing Problem
Authors: Ban Bang Ha , Nguyen Phuong Khanh
Published: December 2020

The Asymmetric Distance-Constrained Vehicle Routing Problem (ADVRP) is an NP-hard problems. In ADVRP problem, each customer is visited once by one vehicle; every tour starts and ends at a depot; and the travelled distance by each vehicle is required to be less than or equal to the given maximum value. The problem is a natural extension of Vehicle Routing Problem case. In our work, we propose a hybrid metaheuristic algorithm combining the Randomized Variable Neighborhood Search (RVNS) and the Tabu Search (TS) to solve the problem. The combination of multiple neighborhoods and tabu mechanism is used for their capacity to escape local optima while exploring the solution space. Furthermore, the intensification and diversification phases are also included to deliver optimized and diversified solutions for the search. Extensive numerical experiments on benchmark instances show that our algorithm can be comparable with the state-of-the-art previous algorithms in terms of solution quality and computation time. In many cases our proposed method is able to improve the best-known solution available from the literature.
Cause analysis and enlightens of hand injury during the COVID-19 outbreak and work resumption period
Authors: Jin Qianjun , Zhou Haiying , Lu Hui
Published: December 2020

Background: In light of the new circumstances caused by the current COVID-19 pandemic, an enhanced knowledge of hand injury patterns may help with prevention in factories as well as the management of related medical conditions.Methods: A sample of 95 patients were admitted to an orthopedics department with an emergent hand injury within half a year of the COVID-19 outbreak. Data were collected between January 23rd, 2020 and July 23rd, 2020. Information was collected regarding demographics, type of injury, location, side of lesions, mechanism of injuries, place where the injuries occurred, surgical management, and outcomes. Results: The number of total emergency visits due to hand injury during the COVID-19 outbreak decreased 37% when compared to the same period in the previous year. At the same time, work resumption injuries increased 40%. In comparison to the corresponding period in the previous year, most injured patients during the COVID-19 outbreak were women (60%) with a mean age of 56.7, while during the work resumption stage, most were men (82.4%) with a mean age of 44.8. The majority of injuries within the resumption period occurred at work (64.7%), significantly more than in the same period in 2019 (37.3%) (P < 0.001). Machine injuries were the most frequent (58.8%). Data show that different degrees of cutting injuries comprised the majority of total cases (82.4%), far more than simple fractures and dislocations, with fingers the most commonly injured body part. The majority of injuries were classified as either minor or moderate (90%) during the outbreak while major (40%) during the resumption of work. The proportion of major injuries during the work resumption stage in this year (40%) have been almost double that of the previous year (pre-pandemic) (21.8%) (P = 0.006).Conclusion: The resumption of work following the COVID-19 outbreak is a time of high risk for hand injuries. The overall number of patients with hand injuries admitted into our department has decreased compared to the corresponding period last year. Workplace injuries, especially machine related ones, increased greatly during the six months after the outbreak of COVID-19. The proportion of major injuries increased by a large margin. Emergency and surgical service providers should be aware of this pattern of hand injuries during this atypical time in order to more effectively prepare and plan services.Level of evidence: Level IV.
Exploring the usability of the COM-B model and Theoretical Domains Framework (TDF) to define the helpers of and hindrances to evidence-based practice in midwifery.
Authors: De Leo Annemarie , BAYES Sara , BLOXSOME Dianne , BUTT Janice
Published: December 2020

Background Despite the advancement of scientific research in the field of maternity care, midwives face challenges translating latest evidence into evidence-based practice (EBP) and express reticence towards leading practice change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to translate latest evidence into everyday practice and consider them in relation to both the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF).Methods This qualitative study formed part of a larger Action Research (AR) project that was designed to improve midwives’ EBP implementation capability. Data were obtained from eight Western Australian midwifery leaders who were employed in either managerial or executive positions within their organisation. Five midwives attended a focus group workshop and three opted for face-to-face interviews. Thematic analysis was used to code the transcribed data and group alike findings into sub-categories, which were collapsed to four major categories and one overarching core finding. These were mapped to a matrix combining the COM-B and TDF to establish the usability of these tools in midwifery contexts. Results Four major categories were developed from the data collected in this study. Three reported the hindrances midwives’ experienced when trying to initiate new EBPs: “For midwives, medical opposition and workplace culture are the biggest challenges”, “Fear can stop change: it’s personal for midwives” and “Midwives are tired of fighting the battle for EBP; they need knowledge and the confidence to bring about practice change.” The other major category highlighted factors midwives’ considered helpers of EBP: “Having stakeholder buy-in and strong midwifery leadership is a huge advantage.” When mapped to the TDF and COM-B, these findings provided valuable insight into the helpers of and hindrances to evidence-based practice in midwifery. Conclusion Midwives are motivated to initiate evidence-based change yet have limited knowledge of implementation processes or the confidence to lead practice change. Factors such as inter-disciplinary buy-in, clear instruction for midwives and support from midwifery leaders were considered beneficial to implementing practice change in clinical areas. The TDF when used in combination with the COM-B was deemed useful to midwives wanting to lead practice change projects in clinical areas.
Dietary Intake, Intestinal Infection, and Safe Drinking Water Among Children with Anemia in Peru: A Cross-Sectional Analysis
Authors: Westgard Christopher M , Orrego-Ferreyros Luis A. , Calderón Liz Franco , Rogers Alexandra M.
Published: December 2020

Anemia is a major public health concern that is present in 41.7% of children under 5 worldwide. The prevalence of anemia in Peru was 43.6% in 2017, a decrease by only 6.8% in 8 years. Despite great efforts made by the government to reduce anemia by distributing free multi-micronutrient supplements and promote the consumption of iron rich foods, progress has been slow. The current study sought to better understand the dietary intake, incidence of intestinal infectious disease, and access to safe drinking water by children with anemia in Peru to help explain why the prevalence remains high. METHODS A cross-sectional analysis was conducted using data from two national surveys that were combined by child ID. Descriptive statistics was analyzed to understand the experience of children with anemia in comparison to child without anemia. Logistic multivariate regression analyses were conducted to test the associations between anemia and dietary intake, intestinal infection, and access to safe drinking water. RESULTS The sample included 586 children between 6 and 35 months. The prevalence of anemia in this population was 53%. The portion of children that consumed sufficient iron to meet the recommendation for their age was 61%. Of the children with anemia, 52% consumed sufficient iron to meet their recommendation, vs. 47% of children without anemia (p<0.001). The children with anemia were more likely to have an intestinal infection in the last year (35% vs. 26%, p=0.057) and less likely to have access to safe drinking water (23% vs. 14%, p=0.02) than those without anemia. The logistic analysis revealed that having an intestinal infection increased the odds of having anemia (OR=1.59, CI 95% [1.01-2.49]), and having access to safe drinking waters decreased the odds of having anemia (OR=0.56, [0.32-0.96]). CONCLUSIONS More than half of the children with anemia in Peru already consume sufficient iron to meet their daily requirement. However, they continue to have anemia, likely due to intestinal infection, such as diarrhea and parasites, and a lack of access to safe drinking water.
Dietary Phenotype and Advanced Glycation End-Products Predict WTC-Obstructive Airways Disease: a Longitudinal Observational Study
Authors: Lam Rachel , Kwon Sophia , Riggs Jessica , Sunseri Maria , Crowley George , Schwartz Theresa , Zeig-Owens Rachel , Colbeth Hilary , Halpren Allison , Liu Mengling , Prezant David J , Nolan Anna
Published: December 2020

BACKGROUND. Diet is a modifier of metabolic syndrome which in turn is associated with World Trade Center Obstructive Airways Disease(WTC-OAD). We have designed this study to 1.assess the dietary phenotype(food types, physical activity, and dietary habits) of the Fire Department of New York(FDNY) WTC-Health Program(WTC-HP) cohort and 2.quantify the association of dietary quality and its advanced glycation end product(AGE) content with the development of WTC-OAD.METHODS. WTC-OAD, defined as developing WTC-Lung Injury(WTC-LI;FEV1<LLN) and/or airway hyperreactivity(AHR;positive methacholine and/or positive bronchodilator response). Rapid Eating and Activity Assessment for Participants-Short Version(REAP-S) deployed on 3/1/2018 in the WTC-HP annual monitoring assessment. Clinical and REAP-S data of consented subjects was extracted(7/17/2019). Diet quality[low-(15-19), moderate-(20-29), and high-(30-39)] and AGE content per REAP-S questionnaire were assessed for association with WTC-OAD. Regression models adjusted for smoking,hyperglycemia,hypertension,age on 9/11,WTC-exposure,BMI and job description. RESULTS. N=9,508 completed the annual questionnaire, while N=4,015 completed REAP-S and had spirometry. WTC-OAD developed in N=921, while N=3,094 never developed WTC-OAD. Low- and moderate-dietary quality, eating more (processed meats,fried foods,sugary drinks), fewer(vegetables,whole-grains),and having a diet abundant in AGEs were significantly associated with WTC-OAD. Smoking was not a significant risk factor of WTC-OAD. CONCLUSIONS. REAP-S was successfully implemented in the FDNY WTC-HP monitoring questionnaire and produced valuable dietary phenotyping. Our observational study has identified low dietary quality and AGE abundant dietary habits as risk factors for pulmonary disease in the context of WTC-exposure. Dietary phenotyping, not only focuses our metabolomic/biomarker profiling but also further informs future dietary interventions that may positively impact particulate matter associated lung disease.