bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between splenectomy and portal hypertension in the development of pulmonary hypertension
Authors: Huang Li , Li Wen , Yang Tao , Xiong Changming , Ni Xinhai , Gu Qing , He Jianguo
Published: November 2019

Both portal hypertension and splenectomy are risk factors for pulmonary hypertension. However, the interactions between portal hypertension and splenectomy in the development of pulmonary hypertension remain unclear. Twelve newly diagnosed pulmonary hypertension patients with a previous history of splenectomy induced by portal hypertension were recruited between November 2008 and May 2017. We compared their clinical features, hemodynamics, and prognosis with idiopathic pulmonary arterial hypertension patients, who were matched by cardiac index, mean pulmonary arterial pressure, and pulmonary vascular resistance. We also compared the clinical characteristics of portal hypertension‐post‐splenectomy‐pulmonary hypertension patients with eight portopulmonary hypertension patients. Compared with the matched idiopathic pulmonary arterial hypertension patients, the portal hypertension‐post‐splenectomy‐pulmonary hypertension patients showed significantly wider red blood cell distribution width (16.7 ± 2.8% versus 13.3 ± 1.7%, p = 0.004), higher total bilirubin concentration (31.0 ± 13.8 µmol/l versus 18.9 ± 10.0 µmol/l, p = 0.010), and higher lactate dehydrogenase concentration (321.5 ± 41.2 IU/l versus 229.2 ± 69.4 IU/l, p = 0.001). Kaplan–Meier survival analyses showed that the portal hypertension‐post‐splenectomy‐pulmonary hypertension patients tended to have poorer prognosis than the matched idiopathic pulmonary arterial hypertension patients (log‐rank test: p = 0.010). Compared with the portal hypertension‐post‐splenectomy‐pulmonary hypertension patients, the portopulmonary hypertension cohort appeared to exhibit poorer clinical conditions, including significantly lower mixed venous oxygen saturation (62.9 ± 8.0% versus 73.9 ± 6.5%, p = 0.004) and a significantly higher proportion of pericardial effusion (75.0% versus 8.3%, p = 0.004), even though the two cohorts showed similar hemodynamics. The mean intervals from diagnosis of portal hypertension to pulmonary hypertension in portopulmonary hypertension patients were significantly shorter than the intervals from splenectomy to diagnosis of pulmonary hypertension in portal hypertension‐post‐splenectomy‐pulmonary hypertension patients (5.5 ± 5.2 years versus 13.1 ± 5.9 years, p = 0.008). Splenectomy might be involved in the initiation and development of pulmonary hypertension in patients with portal hypertension, although the precise mechanisms involved remain unknown. Portal hypertension‐post‐splenectomy‐pulmonary hypertension patients might have poorer prognosis even with mild hemodynamics.
Higher plasma fibroblast growth factor 23 levels are associated with a higher risk profile in pulmonary arterial hypertension
Authors: Bouzina Habib , Hesselstrand Roger , Rådegran Göran
Published: November 2019

Metabolic abnormalities are proposed to contribute to pulmonary arterial as well as right ventricular remodelling in pulmonary arterial hypertension. Among the proposed abnormalities are altered glucose and lipid processing, mitochondrial malfunction, oxidative stress as well as vitamin D and iron abnormalities. In the present study, we investigated 11 metabolic plasma biomarkers, with the hypothesis that metabolic proteins may mirror disease severity in pulmonary arterial hypertension. Using proximity extension assays, plasma metabolic biomarkers were measured in 48 pulmonary arterial hypertension patients at diagnosis and, in 33 of them, at an early treatment follow‐up, as well as in 16 healthy controls. Among the studied metabolic biomarkers, plasma fibroblast growth factor‐23 (p < 0.001), fibroblast growth factor‐21 (p < 0.001), fatty acid binding protein 4 (p < 0.001) and lectin‐like oxidised low‐density lipoprotein receptor 1 (p < 0.001) were increased and paraoxonase‐3 was decreased (p < 0.001) in pulmonary arterial hypertension at diagnosis versus controls. Fibroblast growth factor‐23 showed the strongest correlations to studied clinical parameters and was therefore selected for further analyses. Fibroblast growth factor‐23 correlated specifically to mean right atrial pressure (r = 0.67, p < 0.001), six‐min walking distance (r = −0.66, p < 0.001), NT‐proBNP (r = 0.64, p < 0.001), venous oxygen saturation (r = −0.61, p < 0.001), cardiac index (r = −0.39, p < 0.007) and pulmonary vascular resistance (r = 0.37, p < 0.01). Fibroblast growth factor‐23 correlated moreover to ESC/ERS (r = 0.72, p < 0.001) and the REVEAL risk score (r = 0.61, p < 0.001). Comparing early treatment follow‐up with baseline, fibroblast growth factor‐23 decreased (p < 0.02), with changes in fibroblast growth factor‐23 correlating to changes in six‐min walking distance (r = −0.56, p < 0.003), venous oxygen saturation (r = −0.46, p < 0.01), pulmonary vascular resistance (r = 0.43, p < 0.02), mean right atrial pressure (r = 0.38, p < 0.04) and cardiac index (r = −0.39, p < 0.04). Elevated plasma fibroblast growth factor‐23 levels at pulmonary arterial hypertension diagnosis were associated with worse haemodynamics and a higher risk profile, and were decreased after the administration of pulmonary arterial hypertension‐specific treatment.
A quasi-experimental investigation of college students’ ratings of two physical activity mobile apps with varied behavior change technique quantity
Authors: Davis Ashlee , Ellis Rebecca
Published: November 2019

Background

An assessment of how users rate physical activity apps of varying behavior change technique content is necessary to understand if users recognize differences in an app’s ability to promote physical activity.

Objective

The purpose of this study was to compare user ratings of an app with a lower behavior change technique count to an app with a higher behavior change technique count.

Method

Participants were randomly assigned to interact with either the high behavior change technique app or the low behavior change technique app using an iPad. Participants then completed a Mobile App Rating questionnaire.

Results

The final sample included 83 participants with an average age of 22.66 years (SD = 2.13; range = 20–29). Independent t-tests revealed significant group differences for perceived impact, t(81) = 5.27, p < .001, g = 1.15, 95% confidence interval (0.69, 1.62); engagement, t(81) = 6.71, p < .001, g = 1.15, 95% confidence interval (1.02, 1.87); aesthetics, t(81) = 4.29, p < .001, g = 1.15, 95% confidence interval (0.50, 1.38); and subjective quality, t(81) = 6.46, p < .001, g = 1.15, 95% confidence interval (0.75, 1.42), with participants from the high behavior change technique group scoring these qualities more positively than participants from the low behavior change technique group.

Conclusion

App users rated a physical activity app with higher behavior change technique content more favorably on aesthetics, engagement, subjective quality, and perceived impact than those with reduced behavior change technique content. Additional research is needed to understand how these perceptions influence users during the app selection process, as well as the efficacy of apps for promoting physical activity behavior change.
The Lourdes Pilgrimage: A hidden treasure to incorporate spiritual care into nursing education
Authors: Beauvais Audrey , Goncalves Susan , Barr Emily , Di Yeso Jaclyn , Berardino Gail T
Published: November 2019

Nurses are expected to provide spiritual care to patients. Even though standards provided by accreditation organizations, national nursing organizations, and the national RN licensure examination outline the expectation that nurses are to offer spiritual care to patients, the provision of spiritual care is often limited owing to time constraints and a lack of education. This article shares how the Lourdes Pilgrimage is offered to Fairfield University nursing students to provide an experiential learning opportunity to promote the understanding of spiritual care. Achievement of spiritual outcomes through the Lourdes Pilgrimage experience are assessed through reflective writings, debriefing sessions with the sponsor, faculty, and priests, as well as oral and visual presentations to the student body.
Pupillometry as an Objective Measure of Sustained Attention in Young and Older Listeners
Authors: Zhao Sijia , Bury Gabriela , Milne Alice , Chait Maria
Published: November 2019

The ability to sustain attention on a task-relevant sound source while avoiding distraction from concurrent sounds is fundamental to listening in crowded environments. We aimed to (a) devise an experimental paradigm with which this aspect of listening can be isolated and (b) evaluate the applicability of pupillometry as an objective measure of sustained attention in young and older populations. We designed a paradigm that continuously measured behavioral responses and pupillometry during 25-s trials. Stimuli contained a number of concurrent, spectrally distinct tone streams. On each trial, participants detected gaps in one of the streams while resisting distraction from the others. Behavior demonstrated increasing difficulty with time-on-task and with number/proximity of distractor streams. In young listeners ( N = 20; aged 18 to 35 years), pupil diameter (on the group and individual level) was dynamically modulated by instantaneous task difficulty: Periods where behavioral performance revealed a strain on sustained attention were accompanied by increased pupil diameter. Only trials on which participants performed successfully were included in the pupillometry analysis so that the observed effects reflect task demands as opposed to failure to attend. In line with existing reports, we observed global changes to pupil dynamics in the older group ( N = 19; aged 63 to 79 years) including decreased pupil diameter, limited dilation range, and reduced temporal variability. However, despite these changes, older listeners showed similar effects of attentive tracking to those observed in the young listeners. Overall, our results demonstrate that pupillometry can be a reliable and time-sensitive measure of attentive tracking over long durations in both young and (with caveats) older listeners.
Thrombotic microangiopathy in dasatinib-treated patients with chronic myeloid leukemia
Authors: Koshida Takeo , Wu Sylvia , Suzuki Hitoshi , Wanchoo Rimda , Bijol Vanesa , Tomita Shigeki , Suzuki Yusuke , Jhaveri Kenar D
Published: November 2019

Dasatinib is the second-generation tyrosine kinase inhibitor used in the treatment of chronic myeloid leukemia. Proteinuria has been reported with this agent. We describe two kidney biopsy–proven cases of dasatinib-induced thrombotic microangiopathy that responded to stoppage of dasatinib and using an alternate tyrosine kinase inhibitor. Certain specific tyrosine kinase inhibitors lead to endothelial injury and renal-limited thrombotic microangiopathy. Hematologists and nephrologists need to be familiar with this off-target effect of dasatinib.
Adsorption of Cadmium Ions from an Aqueous Solution on a Highly Stable Dopamine-Modified Magnetic Nano-Adsorbent
Authors: Lei Ting , Li Sheng-Jian , Jiang Fang , Ren Zi-Xuan , Wang Li-Lian , Yang Xiang-Jun , Tang Li-Hong , Wang Shi-Xiong
Published: November 2019

Magnetic nanomaterials were functionalized with dopamine hydrochloride as the functional reagent to afford a core–shell-type Fe3O4 modified with polydopamine (Fe3O4@PDA) composite, which was used for the adsorption of cadmium ions from an aqueous solution. In addition, the effects of environmental factors on the adsorption capacity were investigated. Furthermore, the adsorption kinetics, isotherm, and thermodynamics of the adsorbents were discussed. Results revealed that the adsorption of cadmium by Fe3O4@PDA reaches equilibrium within 120 min, and kinetic fitting data are consistent with the pseudo-second-order kinetics (R2 > 0.999). The adsorption isotherm of Cd2+ on Fe3O4@PDA was in agreement with the Freundlich model, with the maximum adsorption capacity of 21.58 mg/g. The thermodynamic parameters revealed that adsorption is inherently endothermic and spontaneous. Results obtained from the adsorption–desorption cycles revealed that Fe3O4@PDA exhibits ultra-high adsorption stability and reusability. Furthermore, the adsorbents were easily separated from water under an enhanced external magnetic field after adsorption due to the introduction of an iron-based core. Hence, this study demonstrates a promising magnetic nano-adsorbent for the effective removal of cadmium from cadmium-containing wastewater.

Graphical Abstract
AMON: annotation of metabolite origins via networks to integrate microbiome and metabolome data
Authors: Shaffer M. , Thurimella K. , Quinn K. , Doenges K. , Zhang X. , Bokatzian S. , Reisdorph N. , Lozupone C. A.
Published: November 2019

Background

Untargeted metabolomics of host-associated samples has yielded insights into mechanisms by which microbes modulate health. However, data interpretation is challenged by the complexity of origins of the small molecules measured, which can come from the host, microbes that live within the host, or from other exposures such as diet or the environment.

Results

We address this challenge through development of AMON: Annotation of Metabolite Origins via Networks. AMON is an open-source bioinformatics application that can be used to annotate which compounds in the metabolome could have been produced by bacteria present or the host, to evaluate pathway enrichment of host verses microbial metabolites, and to visualize which compounds may have been produced by host versus microbial enzymes in KEGG pathway maps.

Conclusions

AMON empowers researchers to predict origins of metabolites via genomic information and to visualize potential host:microbe interplay. Additionally, the evaluation of enrichment of pathway metabolites of host versus microbial origin gives insight into the metabolic functionality that a microbial community adds to a host:microbe system. Through integrated analysis of microbiome and metabolome data, mechanistic relationships between microbial communities and host phenotypes can be better understood.
Transcriptome profiling of resistance response to Meloidogyne chitwoodi introgressed from wild species Solanum bulbocastanum into cultivated potato
Authors: Bali Sapinder , Vining Kelly , Gleason Cynthia , Majtahedi Hassan , Brown Charles R. , Sathuvalli Vidyasagar
Published: November 2019

Background

Meloidogyne chitwoodi commonly known as Columbia root-knot nematode or CRKN is one of the most devastating pests of potato in the Pacific Northwest of the United States of America. In addition to the roots, it infects potato tubers causing internal as well as external defects, thereby reducing the market value of the crop. Commercial potato varieties with CRKN resistance are currently unavailable. Race specific resistance to CRKN has been introgressed from the wild, diploid potato species Solanum bulbocastanum into the tetraploid advanced selection PA99N82–4 but there is limited knowledge about the nature of its resistance mechanism. In the present study, we performed histological and differential gene expression profiling to understand the mode of action of introgressed CRKN resistance in PA99N82–4 in comparison to the CRKN susceptible variety Russet Burbank.

Results

Histological studies revealed that the nematode juveniles successfully infect both resistant and susceptible root tissue by 48 h post inoculation, but the host resistance response restricts nematode feeding site formation in PA99N82–4. Differential gene expression analysis shows that 1268, 1261, 1102 and 2753 genes were up-regulated in PA99N82–4 at 48 h, 7 days, 14 days and 21 days post inoculation respectively, of which 61 genes were common across all the time points. These genes mapped to plant-pathogen interaction, plant hormonal signaling, antioxidant activity and cell wall re-enforcement pathways annotated for potato.

Conclusion

The introgressed nematode resistance in PA99N82–4 is in the form of both pattern-triggered immune response and effector-triggered immune response, which is mediated by accumulation of reactive oxygen species and hypersensitive response (HR). Salicylic acid is playing a major role in the HR. Polyamines and suberin (a component of the Casperian strip in roots) also play an important role in mediating the resistance response. The present study provides the first ever comprehensive insights into transcriptional changes among M. chitwoodi resistant and susceptible potato genotypes after nematode inoculation. The knowledge generated in the present study has implications in breeding for CRKN resistance in potato.
Quantile function modeling with application to salinity tolerance analysis of plant data
Authors: Agarwal Gaurav , Saade Stephanie , Shahid Mohammad , Tester Mark , Sun Ying
Published: November 2019

Background

In plant science, the study of salinity tolerance is crucial to improving plant growth and productivity under saline conditions. Since quantile regression is a more robust, comprehensive and flexible method of statistical analysis than the commonly used mean regression methods, we applied a set of quantile analysis methods to barley field data. We use univariate and bivariate quantile analysis methods to study the effect of plant traits on yield and salinity tolerance at different quantiles.

Results

We evaluate the performance of barley accessions under fresh and saline water using quantile regression with covariates such as flowering time, ear number per plant, and grain number per ear. We identify the traits affecting the accessions with high yields, such as late flowering time has a negative impact on yield. Salinity tolerance indices evaluate plant performance under saline conditions relative to control conditions, so we identify the traits affecting the accessions with high values of indices using quantile regression. It was observed that an increase in ear number per plant and grain number per ear in saline conditions increases the salinity tolerance of plants. In the case of grain number per ear, the rate of increase being higher for plants with high yield than plants with average yield. Bivariate quantile analysis methods were used to link the salinity tolerance index with plant traits, and it was observed that the index remains stable for earlier flowering times but declines as the flowering time decreases.

Conclusions

This analysis has revealed new dimensions of plant responses to salinity that could be relevant to salinity tolerance. Use of univariate quantile analyses for quantifying yield under both conditions facilitates the identification of traits affecting salinity tolerance and is more informative than mean regression. The bivariate quantile analyses allow linking plant traits to salinity tolerance index directly by predicting the joint distribution of yield and it also allows a nonlinear relationship between the yield and plant traits.
Predictors of Epstein-Barr virus serostatus in young people in England
Authors: Winter Joanne R. , Taylor Graham S. , Thomas Olivia G. , Jackson Charlotte , Lewis Joanna E. A. , Stagg Helen R.
Published: November 2019

Background

Epstein-Barr virus (EBV) is an important human pathogen which causes lifelong infection of > 90% people globally and is linked to infectious mononucleosis (arising from infection in the later teenage years) and several types of cancer. Vaccines against EBV are in development. In order to determine the most cost-effective public health strategy for vaccine deployment, setting-specific data on the age at EBV acquisition and risk factors for early infection are required. Such data are also important to inform mathematical models of EBV transmission that can determine the required target product profile of vaccine characteristics. We thus aimed to examine risk factors for EBV infection in young people in England, in order to improve our understanding of EBV epidemiology and guide future vaccination strategies.

Methods

The Health Survey for England (HSE) is an annual, cross-sectional representative survey of households in England during which data are collected via questionnaires and blood samples. We randomly selected individuals who participated in the HSE 2002, aiming for 25 participants of each sex in each single year age group from 11 to 24 years. Stored samples were tested for EBV and cytomegalovirus (CMV) antibodies. We undertook descriptive and regression analyses of EBV seroprevalence and risk factors for infection.

Results

Demographic data and serostatus were available for 732 individuals. EBV seroprevalence was strongly associated with age, increasing from 60.4% in 11–14 year olds throughout adolescence (68.6% in 15–18 year olds) and stabilising by early adulthood (93.0% in those aged 22–24 years). In univariable and multivariable logistic regression models, ethnicity was associated with serostatus (adjusted odds ratio for seropositivity among individuals of other ethnicity versus white individuals 2.33 [95% confidence interval 1.13–4.78]). Smoking was less strongly associated with EBV seropositivity.

Conclusions

By the age of 11 years, EBV infection is present in over half the population, although age is not the only factor associated with serostatus. Knowledge of the distribution of infection in the UK population is critical for determining future vaccination policies, e.g. comparing general versus selectively targeted vaccination strategies.
Automatic labeling of the fanning and curving shape of Meyer’s loop for epilepsy surgery: an atlas extracted from high-definition fiber tractography
Authors: Shan Yong-Zhi , Wang Zhen-Ming , Fan Xiao-Tong , Zhang Hua-Qiang , Ren Lian-Kun , Wei Peng-Hu , Zhao Guo-Guang
Published: November 2019

Background

Visual field defects caused by injury to Meyer’s loop (ML) are common in patients undergoing anterior temporal lobectomy during epilepsy surgery. Evaluation of the anatomical shapes of the curving, fanning and sharp angles of ML to guide surgeries is important but still challenging for diffusion tensor imaging. We present an advanced diffusion data-based ML atlas and labeling protocol to reproduce anatomical features in individuals within a short time.

Methods

Thirty Massachusetts General Hospital-Human Connectome Project (MGH-HCP) diffusion datasets (ultra-high magnetic gradient & 512 directions) were warped to standard space. The resulting fibers were projected together to create an atlas. The anatomical features and the tractography correspondence rates were evaluated in 30 MGH-HCP individuals and local diffusion spectrum imaging data (eight healthy subjects and six hippocampal sclerosis patients).

Results

In the atlas, features of curves, sharp angles and fanning shapes were adequately reproduced. The distances from the anterior tip of the temporal lobe to the anterior ridge of Meyer’s loop were 23.1 mm and 26.41 mm on the left and right sides, respectively. The upper and lower divisions of the ML were revealed to be twisting. Eighty-eight labeled sides were achieved, and the correspondence rates were 87.44% ± 6.92, 80.81 ± 10.62 and 72.83% ± 14.03% for MGH-HCP individuals, DSI-healthy individuals and DSI-patients, respectively.

Conclusion

Atlas-labeled ML is comparable to high angular resolution tractography in healthy or hippocampal sclerosis patients. Therefore, rapid identification of the ML location with a single modality of T1 is practical. This protocol would facilitate functional studies and visual field protection during neurosurgery.
Effect of short-term orthokeratology lens or ordinary frame glasses wear on corneal thickness, corneal endothelial cells and vision correction in adolescents with low to moderate myopia
Authors: Yuan Shuyi , Zhang Shuxian , Jiang Yanglin , Li Lihua
Published: November 2019

Background

We aimed to investigate the effect of short-term orthokeratology lens or frame glasses wear on corneal thickness, corneal endothelial cells and vision correction in adolescents with low to moderate myopia.

Methods

Data of 100 adolescents with low to moderate myopia were retrospectively analyzed. The patients were assigned into two groups. The experimental group were treated with night-wear orthokeratology lens, and control group were treated with ordinary frame glasses. Follow up was carried out at the 3rd, 6th and 12th months of treatment. The naked-eye vision, diopter, corneal curvature, intraocular pressure, axial length, endothelial cell count and central corneal thickness were examined. Complications within 12 months were observed, and corneal fluorescein staining was graded.

Results

The naked-eye vision of the experimental group was significantly higher than that of the control group at the 3rd, 6th and 12th months, while the diopter of the experimental group was significantly lower than that of the control group at these time points. The corneal curvature of the experimental group was significantly decreased when comparing with that of the control group at the above 3 time points. The increase of axial length in the experimental group was significantly less than that in the control group at the 6th and 12th months.

Conclusions

Short-term orthokeratology lens wear can effectively improve the naked-eye vision in adolescents with low to moderate myopia without significant impact on the central corneal thickness and corneal endothelial cells. It is a relatively safe method to correct myopia.
Associated factors of modern contraceptive use among women infected with human immunodeficiency virus in Enemay District, Northwest Ethiopia: a facility-based cross-sectional study
Authors: Kebede Yibeltal Bimrew , Geremew Tesfahun Taddege , Mehretie Yohannes , Abejie Ayenew Negesse , Bewket Liknaw , Dellie Endalkachew
Published: November 2019

Background

The prevention of unplanned pregnancy among women infected with human immunodeficiency virus (HIV) is critical for the prevention of mother-to-child transmission (PMTCT) of HIV. Of the prevention strategies, deployment of modern contraceptives is principal one. However, there were limited facts on utilization of modern contraceptives and associated factors among HIV infected women, in particular of resource-limited settings in Ethiopia. Hence, we aimed to quantify the proportion of modern contraceptive utilization and the possible related factors among women infected HIV.

Methods

A facility-based cross-sectional study was conducted on randomly selected 632 women infected with HIV from 05 February to 25 March 2018. Data on their treatment, socio-economic, and demographic background were collected through a structured interviewer administered questionnaire. Binary logistic regression model was fitted to identify the associated factors of modern contraceptive use among women infected with HIV.

Result

We found 61.4% (95% CI, 57.6–65.2) were using modern contraceptives. Greater than four family size (AOR:2.17; 95%CI: 1.31–3.59), family planning counseling service (AOR: 2.37; 95% CI: 1.44–3.91), discussing contraceptive issues with sexual partner (AOR: 1.76; 95% CI: 1.12–2.77), history of giving birth (s) (AOR:2.21; 95%CI:1.20–4.05) and World Health Organization (WHO) clinical stage III or IV (AOR: 3.59; 95%CI: 1.37, 9.44) were positively associated with modern contraceptives use, whereas, older age (AOR: 0.45; 95% CI: 0.24–0.81) and being widowed (AOR: 0.34; 95% CI: 0.14–0.83), abridged the chances of modern contraceptives use.

Conclusion

The prevalence of modern contraceptive use among women infected with HIV is low. Higher family size, counseling on contraceptives, discussing contraceptives issues with partner, history of giving births and WHO clinical stage III/IV were positively related with contraceptives use, whereas, older age and being widowed abridged the chances of contraceptives use among HIV infected women. Therefore, our findings support calls for the district health office and the antiretroviral treatment clinics of the resource-limited settings to work more on family planning counseling services and promoting more dialogues with sexual partners on modern contraceptives use.
Feeding practices and risk factors for chronic infant undernutrition among refugees and migrants along the Thailand-Myanmar border: a mixed-methods study
Authors: Hashmi A. H. , Nyein P. B. , Pilaseng K. , Paw M. K. , Darakamon M. C. , Min A. M. , Charunwatthana P. , Nosten F. , McGready R. , Carrara V. I.
Published: November 2019

Background

This study aims to provide a comprehensive understanding of maternal risk factors, infant risk factors and maternal infant feeding practices among refugees and migrants along the Thailand-Myanmar border.

Methods

This study employed a mixed-methods approach with two components: (1) cross-sectional survey (n = 390) and (2) focus group discussions (n = 63). Participants were chosen from one of three clinics providing antenatal and delivery services for Karen and Burman refugees and migrants along the border. Participants were pregnant women and mother-infant dyads.

Results

Refugee and migrant mothers demonstrated high rates of suboptimal breastfeeding and low rates of minimum dietary diversity and acceptable diet. Multivariable regression models showed infant stunting (AOR: 2.08, 95% CI: 1.12, 3.84,p = 0.020) and underweight (AOR: 2.26, 95% CI: 1.17, 4.36,p = 0.015) to have increased odds among migrants, while each 5 cm increase in maternal height had decreased odds of stunting (AOR: 0.50, 95% CI: 0.38, 0.66,p < 0.001) and underweight (AOR: 0.64, 95% CI: 0.48, 0.85,p = 0.002). In addition, small-for-gestational-age adjusted for length of gestation, infant age and gender increased odds of infant’s stunting (AOR: 3.42, 95% CI: 1.88, 6.22, p < 0.001) and underweight (AOR: 4.44, 95% CI: 2.36, 8.34,p < 0.001). Using the Integrated Behavioural Model, focus group discussions explained the cross-sectional findings in characterising attitudes, perceived norms, and personal agency as they relate to maternal nutrition, infant malnutrition, and infant feeding practices.

Conclusions

Inadequate infant feeding practices are widespread in refugee and migrant communities along the Thailand-Myanmar border. Risk factors particular to maternal nutrition and infant birth should be considered for future programming to reduce the burden of chronic malnutrition in infants.
Variations of health check attendance in later life: results from a British birth cohort study
Authors: Wilson Rebecca , Kuh Diana , Stafford Mai
Published: November 2019

Background

Older adults are advised to attend a number of preventive health checks to preserve health and identify risk factors for disease. Previous research has identified a number of health and social factors, labelled as predisposing, enabling and need factors, using Andersen’s Behavioural Model of Health Service Use, that are associated with health care utilisation. We aimed to assess associations between factors from childhood and adulthood, and health check attendance in later life in a British birth cohort study.

Methods

For 2370 study members from the MRC National Survey of Health and Development (NSHD), health check attendance was assessed at age 68. Study members were asked if they: attended blood pressure and cholesterol checks, had their eyes tested, received the influenza vaccine, attended colon cancer screening and dental checks. Health and social factors from childhood and adulthood were used in binomial regression models to test associations with health check attendance in men and women.

Results

Health check attendance was high; 41% reported attending all six health checks within the recommended time frame. In multivariable models, being a non-smoker and having more health conditions in adulthood were associated with greater health check attendance in men and women. In women, childhood socioeconomic advantage, being more physically active in midlife and previously attending screening procedures, and in men, greater self-organisation in adolescence and being married were associated with attending more health checks in later life, following adjustments for childhood and adulthood factors.

Conclusions

A number of predisposing, enabling and need factors from childhood and adulthood were found to be associated with health check attendance at age 68, demonstrating the relevance of applying a life course perspective to Andersen’s model in investigating health check attendance in later life. Health related factors were found to be stronger correlates of health check attendance than socioeconomic factors.
Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing: a retrospective cohort study
Authors: Cui Yiliang , Hua Xingyi , Schmidutz Florian , Zhou Jian , Yin Zongsheng , Yan Shuang G.
Published: November 2019

Background

Tibial shaft fractures are routinely managed with intramedullary nailing (IMN). An increasingly accepted technique is the suprapatellar (SP) approach. The purpose of this study was to compare the clinical and functional outcomes of knee joint after tibia IMN through an suprapatellar (SP) or traditional infrapatellar (IP) approach.

Methods

Retrospective analysis was performed in patients with tibial shaft fractures that were treated with IMN through a SP or IP approach between 01/01/2014 and 31/12/2016. The clinical and functional outcomes of the knee were assessed with the Hospital for Special Surgery (HSS) Knee Score. Secondary outcomes included the operation time and intraoperative blood loss.

Results

A total of 50 patients/fractures (26 IP and 24 SP) with a minimum follow-up of 15 months were evaluated. All fractures were OTA 42. No significant differences were found between the two groups in age, gender, side of fractures, operation time, intra-operative blood loss, and follow-up time. No significant difference was seen in HSS score (P = 0.62) between them. Sub analysis of all the HSS components scores revealed no significant differences between pain (P = 0.57), the stand and walk (P = 0.54), the need for walking stick (P = 0.60) and extension lag (P = 0.60). The other HSS components showed full scores (IP 10 vs. SP 10) in both approaches, including muscle force, flexion deformity and stability components. The range of motion (ROM) component score was superior in the IP group (P = 0.04) suggesting a higher ROM.

Conclusions

Both SP and IP approach results in equivalent overall HSS knee scores. However, for the HSS component, the IP approach was superior to SP approach regarding the ROM.
LC-MSMS based screening of emerging pollutant degradation by different peroxidases
Authors: Almaqdi Khadega A. , Morsi Rana , Alhayuti Bahia , Alharthi Farah , Ashraf S. Salman
Published: November 2019

Background

The presence of a wide range of bioactive organic pollutants in wastewater and municipal water sources is raising concerns about their potential effects on humans. Not surprisingly, various approaches are being explored that can efficiently degrade these persistent organic pollutants. Use of peroxidases has recently been recognized as a novel remediation approach that may have potential advantages over conventional degradation techniques. However, testing the abilities of different peroxidases to degrade diverse emerging pollutants is tedious and cumbersome.

Results

In the present study, we present a rapid and robust approach to easily test the degradability of 21 different emerging pollutants by five different peroxidases (soybean peroxidase, chloroperoxidase, lactoperoxidase, manganese peroxidase, and horseradish peroxidase) using an LC-MSMS approach. Furthermore, this approach was also used to examine the role of a redox mediator in these enzymatic degradation assays. Our results show that some of the organic pollutants can be easily degraded by all five of the peroxidases tested, whereas others are only degraded by a specific peroxidase (or when a redox mediator was present) and there are some that are completely resistant to degradation by any of the peroxidases tested (even in the presence of a redox mediator). The degradation of furosemide and trimethoprim by soybean peroxidase and chloroperoxidase, respectively, was investigated in detail by examining the transformation products generated during their degradation. Some of the products generated during enzymatic breakdown of these pollutants have been previously reported by others, however, we report many new transformation products.

Conclusions

LC-MSMS approaches, like the one described here, can be used to rapidly evaluate the potential of different peroxidases (and redox requirements) to be used as bioremediation agents. Our preliminary result shows peroxidases hold tremendous potential for being used in a final wastewater treatment step.
Development of a national medical leadership competency framework: the Dutch approach
Authors: Keijser Wouter A. , Handgraaf Henricus J. M. , Isfordink Liz M. , Janmaat Vincent T. , Vergroesen Pieter-Paul A. , Verkade Julia M. J. S. , Wieringa Sietse , Wilderom Celeste P. M.
Published: November 2019

Background

The concept of medical leadership (ML) can enhance physicians’ inclusion in efforts for higher quality healthcare. Despite ML’s spiking popularity, only a few countries have built a national taxonomy to facilitate ML competency education and training. In this paper we discuss the development of the Dutch ML competency framework with two objectives: to account for the framework’s making and to complement to known approaches of developing such frameworks.

Methods

We designed a research approach and analyzed data from multiple sources based on Grounded Theory. Facilitated by the Royal Dutch Medical Association, a group of 14 volunteer researchers met over a period of 2.5 years to perform: 1) literature review; 2) individual interviews; 3) focus groups; 4) online surveys; 5) international framework comparison; and 6) comprehensive data synthesis.

Results

The developmental processes that led to the framework provided a taxonomic depiction of ML in Dutch perspective. It can be seen as a canonical ‘knowledge artefact’ created by a community of practice and comprises of a contemporary definition of ML and 12 domains, each entailing four distinct ML competencies.

Conclusions

This paper demonstrates how a new language for ML can be created in a healthcare system. The success of our approach to capture insights, expectations and demands relating leadership by Dutch physicians depended on close involvement of the Dutch national medical associations and a nationally active community of practice; voluntary work of diverse researchers and medical practitioners and an appropriate research design that used multiple methods and strategies to circumvent reverberation of established opinions and conventionalisms.

Implications

The experiences reported here may provide inspiration and guidance for those anticipating similar work in other countries to develop a tailored approach to create a ML framework.
A mixed methods process evaluation of a person-centred falls prevention program
Authors: Morris Rebecca L. , Hill Keith D. , Ackerman Ilana N. , Ayton Darshini , Arendts Glenn , Brand Caroline , Cameron Peter , Etherton-Beer Christopher D. , Flicker Leon , Hill Anne-Marie , Hunter Peter , Lowthian Judy A. , Morello Renata , Nyman Samuel R. , Redfern Julie , Smit De Villiers , Barker Anna L.
Published: November 2019

Background

RESPOND is a telephone-based falls prevention program for older people who present to a hospital emergency department (ED) with a fall. A randomised controlled trial (RCT) found RESPOND to be effective at reducing the rate of falls and fractures, compared with usual care, but not fall injuries or hospitalisations. This process evaluation aimed to determine whether RESPOND was implemented as planned, and identify implementation barriers and facilitators.

Methods

A mixed-methods evaluation was conducted alongside the RCT. Evaluation participants were the RESPOND intervention group (n = 263) and the clinicians delivering RESPOND (n = 7). Evaluation data were collected from participant recruitment and intervention records, hospital administrative records, audio-recordings of intervention sessions, and participant questionnaires. The Rochester Participatory Decision-Making Scale (RPAD) was used to evaluate person-centredness (score range 0 (worst) - 9 (best)). Process factors were compared with pre-specified criteria to determine implementation fidelity. Six focus groups were held with participants (n = 41), and interviews were conducted with RESPOND clinicians (n = 6). Quantitative data were analysed descriptively and qualitative data thematically. Barriers and facilitators to implementation were mapped to the ‘Capability, Opportunity, Motivation – Behaviour’ (COM-B) behaviour change framework.

Results

RESPOND was implemented at a lower dose than the planned 10 h over 6 months, with a median (IQR) of 2.9 h (2.1, 4). The majority (76%) of participants received their first intervention session within 1 month of hospital discharge with a median (IQR) of 18 (12, 30) days. Clinicians delivered the program in a person-centred manner with a median (IQR) RPAD score of 7 (6.5, 7.5) and 87% of questionnaire respondents were satisfied with the program. The reports from participants and clinicians suggested that implementation was facilitated by the use of positive and personally relevant health messages. Complex health and social issues were the main barriers to implementation.

Conclusions

RESPOND, which was previously shown to reduce falls and fractures in the main trial analysis, was found to be delivered in a timely and person-centred manner, at a substantially lower dose, using fewer resource than anticipated.

Trial registration

This study was registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12614000336684 (27 March 2014).
Schmallenberg virus neutralising antibody responses in sheep
Authors: Jones Scott , Eden Laura , McKay Heather , Bollard Nicola , Dunham Stephen , Davies Peers , Tarlinton Rachael
Published: November 2019

Background

Schmallenberg virus (SBV) is a midge borne virus of cattle and sheep. Infection is typically asymptomatic in adult sheep but fetal infection during pregnancy can result in abortion, stillbirth, neurological disorders and malformations of variable severity in newborn animals. It was first identified in Germany and the Netherlands in 2011 and then circulated throughout Europe in 2012 and 2013. Circulation in subsequent years was low or non-existent until summer and autumn 2016, leading to an increased incidence of deformed newborn lambs and calves in 2016–17. This study reports SBV circulation in October 2016 within a group of 24 ewes and 13 rams. The ewes were monitored at 3 times points over an 11 week period (September to December 2016).

Results

Most ewes displayed an increase in SBV VNT with antibody titre increases greater in older, previously exposed ewes. Two ewes had SBV RNA detectable by RT-qPCR, one on 30/09/16 and one on 04/11/16. Of these ewes, one had detectable serum SBV RNA (indicating viraemia) despite pre-existing antibody. The rams had been previously vaccinated with a commercial inactivated SBV vaccine, they showed minimal neutralising antibody titres against SBV 8 months post-vaccination and all displayed increased titre in October 2016.

Conclusion

This data suggests that SBV circulated for a minimum period of 5 weeks in September to October 2016 in central England. Ewes previously exposed to virus showed an enhanced antibody response compared to naïve animals. Pre-existing antibody titre did not prevent re-infection in at least one animal, implying immunity to SBV upon natural exposure may not be life-long. In addition, data suggests that immunity provided by killed adjuvanted SBV vaccines only provides short term protection (< 8 months) from virus.
Mitochondrial DNA methylation and copy number predict body composition in a young female population
Authors: Bordoni Laura , Smerilli Vanessa , Nasuti Cinzia , Gabbianelli Rosita
Published: November 2019

Background

Since both genomic and environmental factors are involved in obesity etiology, several studies about the influence of adiposity on both nuclear DNA and mitochondrial DNA methylation patterns have been carried out. Nevertheless, few evidences exploring the usage of buccal swab samples to study mitochondrial DNA epigenetics can be found in literature.

Methods

In this study, mitochondrial DNA from buccal swabs collected from a young Caucasian population (n = 69) have been used to examine potential correlation between mitochondrial DNA copy number and methylation with body composition (BMI, WHtR and bioimpedance measurements).

Results

A negative correlation between mitochondrial DNA copy number and BMI was measured in females (p = 0.028), but not in males. The mean percentage of D-loop methylation is significantly higher in overweight than in lean female subjects (p = 0.003), and a specific CpG located in the D-loop shows per se an association with impaired body composition (p = 0.004). Body composition impairment is predicted by a combined variable including mtDNA copy number and the D-loop methylation (AUC = 0.785; p = 0.009).

Conclusions

This study corroborates the hypothesis that mitochondrial DNA carries relevant information about body composition. However, wider investigations able to validate the usage of mtDNA methylation from buccal swabs as a biomarker are warranted.
Public–private partnerships for universal health coverage? The future of “free health” in Sri Lanka
Authors: Kumar Ramya
Published: November 2019

Sri Lanka reports impressive health indicators compared to its peers in the South Asian region. Maternal and infant mortality are relatively low, and several intractable communicable diseases have been eliminated. The publicly financed and delivered “free” healthcare system has been critical to these health achievements. Placing the country’s healthcare system in historical context, this commentary analyses the contradictions and political tensions surrounding Sri Lanka’s 2018 Universal Health Coverage (UHC) policy, with attention to the Ministry of Health’s plans for public–private partnerships (PPP). As economic exigencies and private interests increasingly erode the 1951 “Free Health” policy, this commentary calls for a re-envisioning of UHC that can meet people’s aspirations for health and social justice.