bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of diagnosed cases of eye rhinosporidiosis in a public hospital of Maranhão, Northeast Brazil
Authors: Almeida Francílio Araújo , Teixeira-Junior Antonio Augusto Lima , Pinho Jaqueline Diniz , Costa Elaine Fiod , Silva Gyl Eanes Barros
Published: November 2019

Background

Oculosporidiosis (ocular rhinosporidiosis) accounts for 15% of cases of rhinosporidiosis, which is a chronic granulomatous disease and is endemic in India and Sri Lanka. In Brazil, the climatic and hydrographic similarities to these endemic areas and the presence of riverside populations contributes to an increase in the incidence of rhinosporidiosis particularly in the State of Maranhão. This study, therefore, aimed to identify the number of diagnosed cases of oculosporidiosis and describe its the clinical epidemiology, laboratory, histopathology, and therapeutic characteristics.

Methods

The study is descriptive, observational, and cross-sectional, and reports the prevalence and clinical epidemiological characteristics of oculosporidiosis in the State of Maranhão, Brazil. A retrospective analysis of the paper and electronic records for a period from 1999 to 2017 was conducted in the University Hospital of Federal University of Maranhão (HU-UFMA), located in the northeastern region of Brazil.

Results

Thirty patients were diagnosed with rhinosporidiosis, eight of them had oculosporidiosis and seven of these met the criteria to be included in the study. Of the cases (23.3% of all 30), five were men (71.4%) and two women (28.5%), with an average age of 16.4 ± 15.6 years. In terms of race, four patients (57.1%) declared themselves white and three (42.9%) as brown. The north of the state, the mesoregion, had the most diagnosed cases accounting for 57.1% of the total. Left eye was the most affected site, reported in six patients (85.7%), while the conjunctiva was affected in all patients. Rhinosporidiosis and papilloma were the predominant diagnostic hypotheses (28.5 and 28.5%, respectively), followed by chronic scleritis, granuloma, and chalazion (14.25, 14.25, and 14.25%, respectively). All these cases were treated with lesion excision, and only two patients (28.5%) progressed with recurrence.

Conclusion

It was verified that there was a male predominance, with only one eye reported as an infected site, with no bilateral involvement. The younger age group (between 1 and 2 years of age) was more affected by oculosporidiosis, and histopathological examination was necessary for a conclusive diagnosis.
A research tool for measuring non-participation of older people in research on digital health
Authors: Poli Arianna , Kelfve Susanne , Motel-Klingebiel Andreas
Published: November 2019

Background

Healthcare services are being increasingly digitalised in European countries. However, in studies evaluating digital health technology, some people are less likely to participate than others, e.g. those who are older, those with a lower level of education and those with poorer digital skills. Such non-participation in research – deriving from the processes of non-recruitment of targeted individuals and self-selection – can be a driver of old-age exclusion from new digital health technologies. We aim to introduce, discuss and test an instrument to measure non-participation in digital health studies, in particular, the process of self-selection.

Methods

Based on a review of the relevant literature, we designed an instrument – the NPART survey questionnaire – for the analysis of self-selection, covering five thematic areas: socioeconomic factors, self-rated health and subjective overall quality of life, social participation, time resources, and digital skills and use of technology. The instrument was piloted on 70 older study persons in Sweden, approached during the recruitment process for a trial study.

Results

Results indicated that participants, as compared to decliners, were on average slightly younger and more educated, and reported better memory, higher social participation, and higher familiarity with and greater use of digital technologies. Overall, the survey questionnaire was able to discriminate between participants and decliners on the key aspects investigated, along the lines of the relevant literature.

Conclusions

The NPART survey questionnaire can be applied to characterise non-participation in digital health research, in particular, the process of self-selection. It helps to identify underrepresented groups and their needs. Data generated from such an investigation, combined with hospital registry data on non-recruitment, allows for the implementation of improved sampling strategies, e.g. focused recruitment of underrepresented groups, and for the post hoc adjustment of results generated from biased samples, e.g. weighting procedures.
Improved hemodynamics and cardiopulmonary function in patients with inoperable chronic thromboembolic pulmonary hypertension after balloon pulmonary angioplasty
Authors: Jin Qi , Luo Qin , Yang Tao , Zeng Qixian , Yu Xue , Yan Lu , Zhang Yi , Zhao Qing , Ma Xiuping , An Chenhong , Xiong Changming , Zhao Zhihui , Liu Zhihong
Published: November 2019

Background

Balloon pulmonary angioplasty (BPA) has been demonstrated to improve cardiac function and exercise capacity in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH), but its instant impact on cardiopulmonary function has seldom been evaluated. This study aims to determine the safety and efficacy of BPA and its immediate and lasting effects on cardiopulmonary function among CTEPH patients.

Methods

From May 2018 to January 2019, patients with inoperable CTEPH who underwent BPA sessions were consecutively enrolled. Hemodynamics were measured by right heart catheterization, selective pulmonary angiography and BPA were successively conducted. Hemodynamic variables, WHO functional class (WHO-FC), 6-min walk distance (6MWD) and serum NT-proBNP were evaluated before and after BPA sessions during hospitalization. Pulmonary function testing (PFT) and cardiopulmonary exercise testing (CPET) were performed within 1–3 days pre and post BPA to evaluate the effect of BPA on cardiopulmonary function.

Results

Twenty-five patients with inoperable CTEPH who underwent a total of forty BPA sessions were consecutively enrolled. A total of 183 segmental or subsegmental vessels (4.6 ± 1.9 vessels per session) in 137 segments (3.4 ± 1.6 segments per session) were dilated. No procedure-related complications occurred. Instant hemodynamics, WHO-FC, 6MWD and NT-proBNP were all significantly improved after a single BPA session. Significant improvement in cardiopulmonary function was also evident as assessed by PFT indexes (forced vital capacity, forced expiratory volume in the first second, maximal voluntary ventilation) and CPET parameters (peak work rate, peak VO2, oxygen uptake efficiency slope). Further analysis among ten CTEPH patients receiving multiple BPA sessions (2–4 sessions) indicated BPA resulted in lasting improvements in hemodynamics and cardiopulmonary function.

Conclusions

BPA, a safe and effective approach, can bring instant improvements after a single session and lasting benefits after multiple sessions to hemodynamics and cardiopulmonary function for patients with inoperable CTEPH.
The effectiveness of the “SMG” model for health-promoting lifestyles among empty nesters: a community intervention trial
Authors: Zhang Chichen , Zheng Xiao , Zhu Ruifang , Hou Lihong , Yang Xiaozhao Yousef , Lu Jiao , Jiang Feng , Yang Tingzhong
Published: November 2019

Background

With the disintegration of the extended family in recent years, the empty-nest phenomenon is increasingly common in China and the health of empty nesters is attracting more attention. Lifestyles, accounting for 53% in determining death, play a vital role in improving the health of individuals. However, it was rarely studied in promoting the health of empty nesters. In this study, we proposed a “SMG” model in empty nesters, including the self-management, mutual management, and group management, to implement health-promoting lifestyles interventions among empty nesters to provide an effective means to improve their lifestyles and health.

Methods

We conducted a prospective intervention on 350 empty nesters in three communities located in Taiyuan, China. One hundred sixty-seven empty nesters were randomly assigned to the intervention group with SMG-based health-promoting lifestyles interventions used for 7-months, and 183 were randomly assigned to the control group with no measures imposed. The Health-Promoting Lifestyle Profile (HPLP-C) was used to rate the lifestyles of empty nesters. Generalized estimation model was used to analyze the differences between the intervention and control groups over time, adjusted for education and employment.

Results

After 7 months of health-promoting lifestyles intervention, HPLP-C score and each dimension score in the intervention group all increase from baseline. There were significant differences after intervention associated with time and group interaction effects in aspects of HPLP-C (mean score = 8.838, 95%CI:6.369–11.306), self-realization (mean score = 1.443, 95%CI:0.352–2.534), Health responsibility (mean score = 1.492, 95%CI:0.477–2.508), physical activity (mean score = 1.031, 95%CI:0.572–1.491), nutrition (mean = 0.827, 95%CI:0.177–1.476), interpersonal relations (mean = 2.917, 95%CI:2.365–3.469) and stress management (mean score = 0.729, 95%CI:0.131–1.327). And education is contributing to the effect of the health-promoting lifestyle intervention (Estimate:8.833, p < 0.001).

Conclusions

SMG-based health-promoting lifestyles intervention in empty nesters effectively improved the lifestyles of empty nesters, and the outcome was affected by education. Lifestyle change requires ongoing intervention, and community service centres must be involved in implementing the “SMG” model to provide ongoing support and improve the effect of interventions among empty nesters.

Trial registration

Chinese Clinical Trial ChiCTR1800015884. Registration date: 26–04-2018. Retrospectively registered.
Access to public transportation and health facilities offering long-acting reversible contraceptives among residents of formal and informal settlements in two cities in Kenya
Authors: Escamilla Veronica , Calhoun Lisa , Odero Norbert , Speizer Ilene S.
Published: November 2019

Background

Despite improved health facility access relative to rural areas, distance and transportation remain barriers in some urban areas. Using household and facility data linked to residential and transportation geographic information we describe availability of health facilities offering long-acting reversible contraceptive (LARC) methods and measure access via matatus (privately owned mid-size vehicles providing public transport) in urban Kenya.

Methods

Study data were collected by the Measurement, Learning and Evaluation (MLE) Project. Location information for clusters (2010) representative of city-level population were used to identify formal and informal settlement residents. We measured straight-line distances between clusters and facilities that participated in facility audits (2014) and offered LARCs. In Kisumu, we created a geographic database of matatu routes using Google Earth. In Nairobi, matatu route data were publicly available via the Digital Matatus Project. We measured straight-line distance between clusters and matatu stops on ‘direct’ routes (matatu routes with stop(s) ≤1 km from health facility offering LARCs). Facility and matatu access were compared by settlement status using descriptive statistics. We then used client exit interview data from a subset of facilities in Nairobi (N = 56) and Kisumu (N = 37) Kenya (2014) to examine the frequency of matatu use for facility visits.

Results

There were 141 (Informal = 71; Formal = 70) study clusters in Nairoibi and 73 (Informal = 37; Formal = 36) in Kisumu. On average, residential clusters in both cities were located ≤1 km from a facility offering LARCs and ≤ 1 km from approximately three or more matatu stops on direct routes regardless of settlement status. Client exit interview data in Nairobi (N = 1602) and Kisumu (N = 1158) suggest that about 25% of women use matatus to visit health facilities. On average, women who utilized matatus travelled 30 min to the facility, with 5% travelling more than 1 hour. Matatu use increased with greater household wealth.

Conclusions

Overall, formal and informal settlement clusters were within walking distance of a facility offering LARCs, and multiple matatu stops were accessible to get to further away facilities. This level of access will be beneficial as efforts to increase LARC use expand, but the role of wealth and transportation costs on access should be considered, especially among urban poor.
Interaction between position sense and force control in bimanual tasks
Authors: Ballardini Giulia , Ponassi Valentina , Galofaro Elisa , Carlini Giorgio , Marini Francesca , Pellegrino Laura , Morasso Pietro , Casadio Maura
Published: November 2019

Background

Several daily living activities require people to coordinate the motion and the force produced by both arms, using their position sense and sense of effort. However, to date, the interaction in bimanual tasks has not been extensively investigated.

Methods

We focused on bimanual tasks where subjects were required:

(Experiment 1) to move their hands until reaching the same position – equal hand position implied identical arm configurations in joint space - under different loading conditions;

(Experiment 2) to produce the same amount of isometric force by pushing upward, with their hands placed in symmetric or asymmetric positions.

The arm motions and forces required for accomplishing these tasks were in the vertical direction. We enrolled a healthy population of 20 subjects for Experiment 1 and 25 for Experiment 2. Our primary outcome was the systematic difference between the two hands at the end of each trial in terms of position for Experiment 1 and force for Experiment 2. In both experiments using repeated measure ANOVA we evaluated the effect of each specific condition, namely loading in the former case and hand configuration in the latter.

Results

In the first experiment, the difference between the hands’ positions was greater when they were concurrently loaded with different weights. Conversely, in the second experiment, when subjects were asked to exert equal forces with both arms, the systematic difference between left and right force was not influenced by symmetric or asymmetric arm configurations, but by the position of the left hand, regardless of the right hand position. The performance was better when the left hand was in the higher position.

Conclusions

The experiments report the reciprocal interaction between position sense and sense of effort inbimanual tasks performed by healthy subjects. Apart for the intrinsic interest for a better understanding of basic sensorimotor processes, the results are also relevant to clinical applications, for defining functional evaluation and rehabilitative protocols for people with neurological diseases or conditions that impair the ability to sense and control concurrently position and force.
Outcome of the modified Dunn procedure in severe chronic or acute on chronic slipped capital femoral epiphysis
Authors: Ebert Nicola , Rupprecht Martin , Stuecker Ralf , Breyer Sandra , Stiel Norbert , Priemel Matthias H. , Spiro Alexander S.
Published: November 2019

Background

In recent years, the modified Dunn osteotomy has gained popularity to treat slipped capital femoral epiphysis (SCFE) with various complication rates. Most studies included patients with different severities. This study aimed to determine (1) the radiological and clinical outcome, (2) the health-related quality of life, and (3) the incidence of avascular necrosis of the femoral head (AVN) in patients with severe chronic or acute on chronic SCFE treated by the modified Dunn procedure.

Methods

Out of 150 patients with SCFE treated at our institution between 2001 and 2014, 15 patients (mean age 12.9 years (range 11.8–15)) were treated by the modified Dunn procedure. Eight SCFE were chronic and 7 acute on chronic. All slips were severe with a mean Southwick slip angle (SSA) of 67° (range 60–80). Radiographic and clinical outcomes were measured. Mean time of follow-up was 3.8 years (range 1–10).

Results

Anatomical reduction was achieved in all cases. Good radiological results according to the Stulberg Classification (grade 1 + 2) and the Sphericity Deviation Score (< 30) were found in 9 out of 13 patients at the last follow-up. Clinical and functional outcome analysis revealed good results in 8 out of 10 patients (Harris Hip Score > 80). The quality of life measured by the Nottingham Health Profile (NHP) was described good in 10 out of 10 patients. Four out of 15 patients developed an AVN.

Conclusions

The modified Dunn procedure has a great potential to restore proximal femur geometry in severe chronic or acute on chronic SCFE. It should be considered only if there is no other possibility to restore proximal femur geometry, as is the case in severe slips, due to the risk of AVN.
The discriminatory power of visceral adipose tissue area vs anthropometric measures as a diagnostic marker for metabolic syndrome in South African women
Authors: Davidson Florence E. , Matsha Tandi E. , Erasmus Rajiv T. , Kengne Andre Pascal , Goedecke Julia H.
Published: November 2019

Background

A number of studies have shown central adiposity, in particular visceral adipose tissue (VAT) accumulation to be a hallmark of metabolic syndrome (MetS). In clinical practice, waist circumference (WC) is used as a proxy for VAT.

Aim

To compare the ability of dual energy x-ray absorptiometry (DXA)-derived VAT area and anthropometric measures of adiposity for diagnosing MetS in a sample of high risk South African women.

Methods

MetS was quantified using the Joint Interim Statement (JIS) criteria. Fasting glucose, insulin and lipid profile were measured in 204 post-menopausal women. Anthropometry measures included body mass index (BMI), WC, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and a body shape index (ABSI). The area under the curve (AUC) was used to assess their performance in detecting any two components of MetS (excluding WC). Optimal WC and VAT area cut-points were derived to compare their performance for diagnosing MetS and to compare to internationally recognised cut-points.

Results

The highest AUC for the prediction of MetS was recorded for VAT, followed by WHtR and WC (AUC, 0.767, 0.747 and 0.738 respectively), but these did not differ significantly (all p ≥ 0.192). In contrast, VAT was significantly better than BMI (p = 0.028), hip (p = 0.0004) and ABSI (p < 0.0001). The optimal WC (94.4 cm) and VAT area (174 cm2based on the Youden’s index method and 175.50 cm2based on the CTL approach) cut-points performed similarly in detecting MetS.

Conclusion

DXA-derived VAT and WC had the same overall performance in discriminating the presence of any 2 MetS components in high risk South African women. These findings support the current recommendations of using WC rather than VAT for MetS risk screening, as it is cheap, accessible and easy to measure.
Prediction of mortality in adult patients with sepsis using six biomarkers: a systematic review and meta-analysis
Authors: Pregernig Andreas , Müller Mattia , Held Ulrike , Beck-Schimmer Beatrice
Published: November 2019

Background

Angiopoietin-1 (Ang-1) and 2 (Ang-2), high mobility group box 1 (HMGB1), soluble receptor for advanced glycation endproducts (sRAGE), soluble triggering receptor expressed on myeloid cells 1 (sTREM1), and soluble urokinase-type plasminogen activator receptor (suPAR) have shown promising results for predicting all-cause mortality in critical care patients. The aim of our systematic review and meta-analysis was to assess the prognostic value of these biomarkers for mortality in adult patients with sepsis.

Methods

A systematic literature search of the MEDLINE, PubMed, EMBASE, and Cochrane Library databases, for articles in English published from 01.01.1990 onwards, was conducted. The systematic review focused exclusively on observational studies of adult patients with sepsis, any randomized trials were excluded. For the meta-analysis, only studies which provide biomarker concentrations within 24 h of admission in sepsis survivors and nonsurvivors were included. Results are presented as pooled mean differences (MD) between nonsurvivors and survivors with 95% confidence interval for each of the six biomarkers. Studies not included in the quantitative analysis were narratively summarized. The risk of bias was assessed in all included studies using the Quality in Prognosis Studies (QUIPS) tool.

Results

The systematic literature search retrieved 2285 articles. In total, we included 44 studies in the qualitative analysis, of which 28 were included in the meta-analysis. The pooled mean differences in biomarker concentration (nonsurvivors − survivors), measured at onset of sepsis, are listed as follows: (1) Ang-1: − 2.9 ng/ml (95% CI − 4.1 to − 1.7, p < 0.01); (2) Ang-2: 4.9 ng/ml (95% CI 2.6 to 7.1, p < 0.01); (3) HMGB1: 1.2 ng/ml (95% CI 0.0 to 2.4, p = 0.05); (4) sRAGE: 1003 pg/ml (95% CI 628 to 1377, p < 0.01); (5) sTREM-1: 87 pg/ml (95% CI 2 to 171, p = 0.04); (6) suPAR: 5.2 ng/ml (95% CI 4.5 to 6.0, p < 0.01).

Conclusions

Ang-1, Ang-2, and suPAR provide beneficial prognostic information about mortality in adult patients with sepsis. The further development of standardized assays and the assessment of their performance when included in panels with other biomarkers may be recommended.

Trial registration This study was recorded on PROSPERO, prospective register of systematic reviews, under the registration ID: CRD42018081226
The alternate direction iterative methods for generalized saddle point systems
Authors: Luo Shuanghua , Cui Angang , Zhang Cheng-yi
Published: November 2019

The paper studies two splitting forms of generalized saddle point matrix to derive two alternate direction iterative schemes for generalized saddle point systems. Some convergence results are established for these two alternate direction iterative methods. Meanwhile, a numerical example is given to show that the proposed alternate direction iterative methods are much more effective and efficient than the existing one.
Microbial communities of the house fly Musca domestica vary with geographical location and habitat
Authors: Park Rahel , Dzialo Maria C. , Spaepen Stijn , Nsabimana Donat , Gielens Kim , Devriese Herman , Crauwels Sam , Tito Raul Y. , Raes Jeroen , Lievens Bart , Verstrepen Kevin J.
Published: November 2019

House flies (Musca domestica) are widespread, synanthropic filth flies commonly found on decaying matter, garbage, and feces as well as human food. They have been shown to vector microbes, including clinically relevant pathogens. Previous studies have demonstrated that house flies carry a complex and variable prokaryotic microbiota, but the main drivers underlying this variability and the influence of habitat on the microbiota remain understudied. Moreover, the differences between the external and internal microbiota and the eukaryotic components have not been examined. To obtain a comprehensive view of the fly microbiota and its environmental drivers, we sampled over 400 flies from two geographically distinct countries (Belgium and Rwanda) and three different environments—farms, homes, and hospitals. Both the internal as well as external microbiota of the house flies were studied, using amplicon sequencing targeting both bacteria and fungi. Results show that the house fly’s internal bacterial community is very diverse yet relatively consistent across geographic location and habitat, dominated by genera Staphylococcus and Weissella. The external bacterial community, however, varies with geographic location and habitat. The fly fungal microbiota carries a distinct signature correlating with the country of sampling, with order Capnodiales and genus Wallemia dominating Belgian flies and genus Cladosporium dominating Rwandan fly samples. Together, our results reveal an intricate country-specific pattern for fungal communities, a relatively stable internal bacterial microbiota and a variable external bacterial microbiota that depends on geographical location and habitat. These findings suggest that vectoring of a wide spectrum of environmental microbes occurs principally through the external fly body surface, while the internal microbiome is likely more limited by fly physiology.
Molecular characterization of cytidine monophospho-N-acetylneuraminic acid hydroxylase (CMAH) associated with the erythrocyte antigens in dogs
Authors: Uno Yumiko , Kawakami Shota , Ochiai Kazuhiko , Omi Toshinori
Published: November 2019

Background

N-glycolylneuraminic acid (Neu5Gc) is synthesized from its precursor N-acetylneuraminic acid (Neu5Ac) by cytidine-5′-monophospho-N acetylneuraminic acid hydroxylase (CMAH), which is encoded by theCMAHgene. Most mammals have both Neu5Gc and Neu5Ac, but humans and ferrets have only Neu5Ac because of loss-of-function mutations. Dogs and cats are polymorphic for Neu5Gc and Neu5Ac expression like cats, in which theCMAHgene is responsible for the AB Blood group system. Although theCMAHgene has been characterized in many species, not much is known about it in dogs. In this study, we cloned the dogCMAHcDNA, and performed mRNA expression analysis of this gene in several organs. We also identified single nucleotide polymorphisms (SNPs) in theCMAHgene.

Results

We cloned the 1737-bp open reading frame of the dogCMAHgene. This gene consists of at least 14 coding exons and codes for a polypeptide of 578 amino acids and is located on chromosome 35. The amino acid identities of dogCMAHwith the corresponding sequences from cat, pig, chimpanzee, mouse, and rat were high (89 to 93%). RT-PCR analysis showed that the dogCMAHcDNA was expressed in various tissues. We identified four exonic SNPs (three synonymous and one non-synonymous), 11 intronic SNPs, and an indel in 11 dog breeds by analyzing the nucleotide sequences of the 14 exons, including the coding region ofCMAH.In the genotype of the non-synonymous SNP, c.554 A > G (p.Lys185Arg), in a total of 285 dogs of seven different breeds, the allele G was widely distributed, and the allele A was the most frequent in the Shiba dogs. The dogs expressing Neu5Ac did not carry the loss-of-function deletion ofCMAHfound in humans and ferrets, and it remains unclear whether the point mutations influence the expression of Neu5Ac.

Conclusions

We characterized the canineCMAHgene at the molecular level for the first time. The results obtained in this study provide essential information that will help in understanding the molecular roles of theCMAHgene in canine erythrocyte antigens.
A case of portal venous gas after obstructive transverse colon cancer surgery
Authors: Furutani Yuichiro , Hiranuma Chikashi , Hattori Masakazu , Doden Kenji , Hashizume Yasuo
Published: November 2019

Background

Portal venous gas has traditionally been considered an inevitable harbinger of death due to its association with bowel necrosis. Recently, an increasing number of cases of portal venous gas have been reported in patients with various clinical conditions and without bowel necrosis. We herein report the case of a patient in whom portal venous gas developed after transverse colon cancer surgery.

Case presentation

A 69-year-old man who had transverse colon cancer underwent insertion of a transanal ileus tube for decompression. Transverse colon resection was performed on the 11th day after the insertion of the transanal ileus tube. The patient had a high fever on the 6th day after the operation. Computed tomography showed portal venous gas over the entire area of the liver and pneumatosis intestinalis in the wall of the ascending colon. There were no signs of anastomotic leakage or bowel necrosis, so we decided to use conservative therapy with fasting and antibiotics. The portal venous gas disappeared on the 19th day after the operation. The patient was discharged in good condition on the 29th day after the operation.

Conclusions

Conservative treatment for portal venous gas is reasonable for patients without signs of anastomotic leakage or bowel necrosis. However, it is important to carefully observe patients with portal venous gas during conservative treatment because portal venous gas may be life-threatening.
Developing interventions to improve health: a systematic mapping review of international practice between 2015 and 2016
Authors: Croot Liz , O’Cathain Alicia , Sworn Katie , Yardley Lucy , Turner Katrina , Duncan Edward , Hoddinott Pat
Published: November 2019

Background

Researchers publish the processes they use to develop interventions to improve health. Reflecting on this endeavour may help future developers to improve their practice.

Methods

Our aim was to collate, describe, and analyse the actions developers take when developing complex interventions to improve health. We carried out a systematic mapping review of empirical research studies that report the development of complex interventions to improve health. A search was undertaken of five databases over 2015–2016 using the term ‘intervention dev*’. Eighty-seven journal articles reporting the process of intervention development were identified. A purposive subset of 30 articles, using a range of published approaches to developing interventions, was selected for in-depth analysis using principles of realist synthesis to identify the actions of intervention development and rationales underpinning those actions.

Results

The 87 articles were from the USA (39/87), the UK (32/87), continental Europe (6/87), and the rest of the world (10/87). These mainly took a pragmatic self-selected approach (n = 43); a theory- and evidence-based approach, e.g. Intervention Mapping, Behaviour Change Wheel (n = 22); or a partnership approach, e.g. community-based participatory research, co-design (n = 10). Ten actions of intervention development were identified from the subset of 30 articles, including identifying a need for an intervention, selecting the intervention development approach to follow, considering the needs of the target population, reviewing published evidence, involving stakeholders, drawing or generating theory, and designing and refining the intervention. Rationales for these actions were that they would produce more engaging, acceptable, feasible, and effective interventions.

Conclusions

Developers take a variety of approaches to the international endeavour of complex intervention development. We have identified and described a set of actions taken within this endeavour regardless of whether developers follow a published approach or not. Future developers can use these actions and the rationales that underpin them to help them make decisions about the process of intervention development.

Trial registration

PROSPERO, CRD42017080545.
Using a Reconciliation Module Leads to Large Gains in Evolution Acceptance
Authors: Lindsay John , Arok Adhieu , Bybee Seth M. , Cho Walter , Cordero April Maskiewicz , Ferguson Daniel G. , Galante Leontine L. , Gill Richard , Mann Mark , Peck Steven L. , Shively Cassidy L. , Stark Michael R. , Stowers Joshua A. , Tenneson Michael , Tolman Ethan R. , Wayment Thomas , Jensen Jamie L.
Published: November 2019

Too many students reject the theory of evolution because they view it as incompatible with their religious beliefs. Some have argued that abandoning religious belief is the only way to help religious individuals accept evolution. Conversely, our data support that highlighting faith/evolution compatibility is an effective means to increase student acceptance. We surveyed students enrolled in entry-level biology courses at four religiously affiliated institutions. At each university, teachers gave students a presentation that demonstrated potential compatibility between evolution and faith within the teachings of each university’s respective religious affiliation. Students were asked to evaluate their own beliefs about evolution both before and after this instruction. After instruction at each university, students showed significant gains in evolution acceptance without abandoning their religious beliefs. These results demonstrate that giving religious students the opportunity to reconcile their religious beliefs with the theory of evolution under the influence of intentional instruction on the compatibility of belief and evolution can lead to increased evolution acceptance among religious students.
Effects of inhibiting mTOR with rapamycin on behavior, development, neuromuscular physiology, and cardiac function in larval Drosophila
Authors: Potter Samuel , Sifers Jacob , Yocom Emily , Blümich Sandra L. E. , Potter Rachel , Nadolski Jeremy , Harrison Douglas A. , Cooper Robin L.
Published: November 2019

Rapamycin and other mTOR inhibitors are being heralded as possible treatments for many human ailments. It is currently being utilized clinically as an immunomodulator after transplantation procedures and treatment for certain forms of cancer, but it has numerous potential clinical indications. Some studies have shown profound effects on life cycle and muscle physiology, but these issues have not been addressed in an organism undergoing developmental processes. This paper fills this void by examining the effect of mTOR inhibition by rapamycin on several different qualities of larval Drosophila. Various dosages of the compound were fed to second instar larvae. These larvae were monitored for pupae formation to elucidate possible life cycle effects, and a delay to pupation was quantified. Behavioral deficits were documented in rapamycin treated larvae. Electrophysiological measurements were taken to discern changes in muscle physiology and synaptic signaling (i.e., resting membrane potential, amplitude of excitatory post-synaptic potentials, synaptic facilitation). Pupation delay and effects on behavior which are likely due to synaptic alterations within the CNS were discovered in rapamycin-fed larvae. These results allow for several conclusions as to how mTOR inhibition by rapamycin affects a developing organism. This could eventually allow for a more informed decision when using rapamycin and other mTOR inhibitors to treat human diseases, especially in children and adolescents to account for known side effects.
Loss of the E2 SUMO-conjugating enzyme Ube2i in oocytes during ovarian folliculogenesis causes infertility in mice
Authors: Rodriguez Amanda , Briley Shawn M. , Patton Bethany K. , Tripurani Swamy K. , Rajapakshe Kimal , Coarfa Cristian , Rajkovic Aleksander , Andrieux Alexandra , Dejean Anne , Pangas Stephanie A.
Published: November 2019

The number and quality of oocytes within the ovarian reserve largely determines fertility and reproductive lifespan in mammals. An oocyte-specific transcription factor cascade controls oocyte development, and some of these transcription factors, such as newborn ovary homeobox gene (NOBOX), are candidate genes for primary ovarian insufficiency in women. Transcription factors are frequently modified by the post-translational modification SUMOylation, but it is not known whether SUMOylation is required for function of the oocyte-specific transcription factors or if SUMOylation is required in oocytes during their development within the ovarian follicle. To test this, the sole E2 SUMO-conjugating enzyme, Ube2i, was ablated in mouse oocytes beginning in primordial follicles. Loss of oocyte Ube2i resulted in female infertility with major defects in stability of the primordial follicle pool, ovarian folliculogenesis, ovulation and meiosis. Transcriptomic profiling of ovaries suggests that loss of oocyte Ube2i caused defects in both oocyte- and granulosa cell-expressed genes, including NOBOX and some of its known target genes. Together, these studies show that SUMOylation is required in the mammalian oocyte during folliculogenesis for both oocyte development and communication with ovarian somatic cells.
Tunnel-tube and Fourier methods for measuring three-dimensional medium reaction force in burrowing animals
Authors: Moore Crisp L. , Barnes C. J. , Lee D. V.
Published: November 2019

Subterranean digging behaviors provide opportunities for protection, access to prey, and predator avoidance for a diverse array of vertebrates, yet studies of the biomechanics of burrowing have been limited by the technical challenges of measuring kinetics and kinematics of animals moving within a medium. We describe a new system called a ‘tunnel-tube’ for measuring 3D reaction forces during burrowing, which is composed of two, separately instrumented plastic tubes — an ‘entry tube’ with no medium in series with a ‘digging tube’ filled with medium. Mean reaction forces are measured for a digging bout and Fourier analysis is used to quantify the amplitude of oscillatory digging force as a function of frequency. In sample data from pocket gophers digging in artificial and natural media, the mean ground reaction force is constant, whereas Fourier analysis resolves a reduced amplitude of oscillatory force in the artificial medium with lower compaction strength.
Fascial Hydrodissection for Chronic Hamstring Injury
Authors: Courseault Jacques , Kessler Eric , Moran Alexandra , Labbe Andre
Published: November 2019

Hamstring muscle injuries (HMI) are common among athletes. HMI can take many months to years to resolve. Often, athletes do not report complete resolution with typical conservative therapy. We present several cases of athletes who presented with chronic hamstring injuries that resolved immediately after being treated with an ultrasound-guided fascial hydrodissection procedure. Following the procedure and graded rehabilitation protocol, athletes reported resolution of pain and tightness in addition to increased performance and a quicker return to play.
A new tool to assess understanding of Down syndrome screening information presented by midwives
Authors: John Sophie , Kirk Maggie , Tonkin Emma , Stuart-Hamilton Ian
Published: November 2019

Aim

To identify factors that could influence women's understanding of Down syndrome (DS) screening information presented by midwives.

Methods

Current literature was scrutinised. Components that could influence women's understanding were identified and a new framework was developed and refined. Measures were selected and developed to create a tool to assess the framework.

Findings

A new framework and assessment tool, measuring understanding of screening information and communication (MUSIC), was developed to assess women's understanding of DS screening information, their cognitive status and the midwives' communicative style.

Conclusion

This framework is the first of its kind, encompassing both women's cognitive status and midwife communication as an influence on women's understanding. Applying the framework and tool could inform midwifery practice by providing an insight into whether, to what extent and how, cognitive status influences understanding of DS screening information, the importance of tailoring information to each woman and highlighting areas of communication that are most effective.
How do risk management principles fit in with the reality of clinical midwifery?
Authors: Roberts Evette Sebastien
Published: November 2019

Background

Risk assessment and management has become a key focus in midwifery practice, in light of failings in maternity care. Whilst studies have explored risk management within healthcare, it has not looked at its impact on normal midwifery practice.

Aim

To review the literature exploring how risk management principles fit with clinical midwifery.

Methods

A literature search was undertaken electronically as well as a search by hand. Nine papers were identified as suitable for the literature review. Data was extracted and used to inform the themes.

Findings

Three themes were identified: midwives being with women; midwives and normality, and increased sensitivity to risk; and organisational risk technologies and blame.

Conclusion

There is a mismatch between clinical midwifery culture and risk management. Risk categorisation and increasing risk surveillance clearly have an impact on midwifery practice. However, more research is needed to explore how midwives navigate around these systems.
Current Policy Challenges in Genomic Medicine
Authors: Klein Roger D
Published: November 2019

BACKGROUND

Molecular genetic testing has raised a variety of policy issues, ranging from privacy to reimbursement. Recently, payment policies have become of paramount importance as Medicare implemented the first significant change to test pricing since 1984 and announced a broad national coverage policy for the use of next-generation sequencing (NGS) in cancer patients that contains significant restrictions. Regulatory and oversight concerns have been important topics for discussion as the US Food and Drug Administration (FDA), Congress, and stakeholders have focused on new approaches to regulation of laboratory-developed tests (LDTs). Patents on gene sequences and relationships between genetic variants and clinical phenotypes have been points of contention since the field's inception. Two Supreme Court cases invalidated patents on gene sequences and biological relationships, ushering in the era of NGS and precision medicine. However, a recent legislative proposal threatens to reverse these gains and restore gene patents as barriers to progress in genetic and genomic testing and the implementation of genomic medicine.

CONTENT

This review discusses current issues in payment policy, laboratory oversight, and gene patenting and their potential impacts on genetic and genomic testing.

Coverage and reimbursement policies present serious challenges to genetic and genomic testing. The potential for FDA regulation of LDTs looms as a significant threat to diagnostic innovation, patient access, and the viability of molecular genetic testing laboratories. Changes in patent law could cause gene patents to reemerge as barriers to the advancement of genomic medicine.
Conflicting priorities: The dichotomous roles of leadership and management at TVET colleges
Authors: Roberts Catherine , Frick Liezel
Published: November 2019

The notions of leadership and management in the technical and vocational education and training(TVET) sector have become blurred in South Africa. The growing need for responsive and flexibleleadership in the TVET sector has resulted in challenges that can only be overcome with therelevant leadership knowledge and skills. Our findings suggest that the demands of leadershipand management have created conflicting priorities for leaders at the TVET colleges. Leadershipdevelopment in the TVET sector may be one way of addressing these issues. Yet, in South Africa,there are no strategically planned, custom-designed leadership development programmes forleaders in public TVET colleges. A curriculum framework for leadership development should beinformed by these conflicting priorities in order to reprioritise the focus of TVET leaders in SouthAfrica on their core business: that of vocational education. This article reports on current andfuture TVET leaders’ perceptions of how the notions of leadership and management influencetheir practice.
Revitalising technical and vocational education and training in Africa: Issues outstanding
Authors: Afeti George
Published: November 2019

One of the stark realities of Africa today is the crisis of youth unemployment. Every year,about 10–12 million poorly skilled young people exiting the various levels of the educationsystem enter the labour market (AfDB & OECD, 2012), where they end up in insecure andsometimes hazardous employment with no prospect of further education or training. Evengraduates of higher education institutions are not spared the frustration of seeking and notimmediately finding a job. In countries such as Zambia and Ethiopia, young graduates maytake up to five years after training before finding a job in the formal sector (ILO, 2013). InGhana, it is estimated that the economy needs to create 300 000 new jobs per year to absorbthe growing number of unemployed (Honorati & Johansson de Silva, 2016). In Tanzania,approximately 800 000 people enter the labour market each year (ILO, 2012), in contrast tothe absorptive capacity of the public sector of only 40 000.
What’s in it for me? Barriers to participation in adult learning in small communities of western Canada
Authors: Roberts Gotta Cari-Ann
Published: November 2019

This article examines educators’ and policymakers’ efforts at addressing barriers and supporting adult students’ access to, and success in, small communities in western Canada. Research indicates that, despite the provision of financial support and flexible and varied delivery modes, and a focus on meeting learner needs, adult learner participation rates in Canada are currently lower than those in other countries. Government policies and programmes are aimed at employability: they currently focus on trade and vocational training programmes that meet the needs of the job market. This single-minded approach of funding programmes that meet economic needs promotes the ideal that the primary purpose of education is the financial gain that comes from securing employment, or better employment, as a result of one’s studies – this as opposed to recognising the role adult education can play in fostering social justice. What is argued here is that, in order to increase participation in adult education, one does not necessarily need greater resources but rather a shift in cultural values – a shift from valuing education solely as a means to employment towards valuing it as a means of individual and community development. Greater numbers of people must see the value of adult learning and recognise the ways that it can contribute to equity and social justice in their lives and communities. This article calls for research that will delve deeply into the barriers to participation in adult education in the wider context of our society. I hope that Canadian students, educators and policymakers will create room for social justice and equity alongside their employment-focused approach to adult learning, and that nations with an emerging discourse will revisit the implications of considering adult education as being solely aimed at employability.
Heads found in Vessels in the Maďarovce-Věteřov-Böheimkirchen Cultural Complex. What Can They Tell Us?
Authors: Jelínek Pavol
Published: November 2019

The author of the present article applies cognitive science theories to archaeology, and more specifically to the findings of human skulls deposited in ceramic vessels from the time of settlement of the Maďarovce-Vetěrov culture. This ritual expression is explained in the comparison with the postmortal manipulations from burial sites from the viewpoint of the theory on religious ideas and their retention in memory and Harvey Whitehouse’s theory on modes of religiosity.
The Belt and Road Initiative: The Cornerstone of the New-Fangled Financial Institutionalism Led by China
Authors: Galán Enrique Martínez , Leandro Francisco José
Published: November 2019

The debate about the benefits and the risks brought both to People’s Republic of China and to the other participant countries by the Belt and Road Initiative (BRI) has been gaining momentum in the academic and in the political landscapes. We argue that the BRI is the main pillar of the new financial institutionalism proposed by China to redefine the current global financial architecture and that, consequently, the initiative needs to be considered in that context. This paper (i) reviews the timeline that led to this Chinese-led new financial institutionalism, (ii) proposes two theoretical frameworks to define the concept of multilateral financial statecraft and of new financial institutionalism led by China, and (iii) enumerates the main differences and similarities observed between this new financial institutionalism and the one dominated by the Bretton Woods-related institutions that gradually emerged after World War II, such as the International Bank for Reconstruction and Development, the Marshall Plan, and the Asian Development Bank.