bluuebunny/crossref_metadata_2025 huggingface dataset:
Depression, anxiety, and burnout among medical students and residents of a medical school in Nepal: a cross-sectional study
Authors: Pokhrel Nishan Babu , Khadayat Ramesh , Tulachan Pratikchya
Published: June 2020

Background

Medical students and residents were found to have suffered from depression, anxiety, and burnout in various studies. However, these entities have not been adequately explored in the context of Nepal. We proposed to determine the prevalence of depression, anxiety, burnout, their associated factors, and identify their predictors in a sample of medical students and residents in a Nepalese medical school.

Methods

It was a cross-sectional study with 651 medical students and residents chosen at random between December 2018 and February 2019. The validated Nepali version of Hospital Anxiety and Depression Scale, the Copenhagen Burnout Inventory, and Medical Students’ Stressor Questionnaire were used to assess depression, anxiety, burnout, and stressors respectively. We used univariate and multivariable logistic regression analyses to identify the correlation of predictor variables with depression, anxiety, and burnout.

Results

The overall prevalence of burnout (48.8%; 95% CI 44.9–52.7) and anxiety (45.3%; 95% CI 41.4–49.2) was more than that of depression (31%; 95% CI 27.5–34.7). Burnout and depression were more prevalent in residents than in medical students (burnout: 64.5% vs 37.6%,P-value < 0.0001; depression: 33.7% vs 29.1%,P-value 0.21). Whereas, medical students were found more anxious than residents (46.3% versus 43.96%,P-value 0.55). Academic related stressors caused high-grade stress to participants. Multivariable model for depression significantly showed anxiety, personal burnout, and work-related burnout as risk enhancing correlates; satisfaction with academic performance as a protective correlate. Similarly, the multivariate model for anxiety significantly identified female gender, depression, personal burnout, teaching and learning related stressors, and past history of mental illness as risk enhancing correlates; being satisfied with academic performance, getting adequate sleep, and being a second-year resident as protective correlates. The logistic model for burnout significantly showed being a first-year resident, depression, anxiety, and drive and desire related stressors as positive predictors. None of the variables were identified as significant negative predictors of burnout.

Conclusions

A high prevalence of depression, anxiety, and burnout was seen among medical students and residents. Most of them were stressed with academic-related factors. A strong correlation between teaching and learning-related stressors with depression and anxiety may be a call for an efficient and more student-friendly curriculum.
Suicidal ideation among Lebanese adolescents: scale validation, prevalence and correlates
Authors: Chahine Melissa , Salameh Pascale , Haddad Chadia , Sacre Hala , Soufia Michel , Akel Marwan , Obeid Sahar , Hallit Rabih , Hallit Souheil
Published: June 2020

Background

In addition to the unstable political situation, Lebanon had experienced a cycle of wars, local armed conflicts, terrorist attacks, and crises (lack of clean water, recurrent power failure, and waste mismanagement, in addition to the growing number of unemployed people, as the number of Syrian refugees has dramatically increased, and led to competition for jobs with locals. All these factors make the Lebanese population prone to mental disorders, particularly suicide, without clear management policies. This study aims to validate the Columbia-Suicide Severity Rating Scale (CSSRS), and determine the prevalence of suicidal ideation and associated factors among a Lebanese nationally representative sample of adolescents from 9th to 12th grades.

Methods

Participants were 1810 adolescents who enrolled in this cross-sectional study (January–May 2019), using a proportionate random sample of schools from all Lebanese Mohafazat. The Columbia-Suicide Severity Rating Scale was used to screen for suicidal ideation.

Results

The results showed that 28.9% had some type of suicidal ideation [95% CI 26.7–31.1%]. The CSSRS items converged on a one-factor solution, accounting for a total of 85.40% of the variance (αCronbach = 0.966). Higher psychological abuse (Beta = 0.041), child physical abuse (Beta = 0.030), alcohol dependence (Beta = 0.062), social fear (Beta = 0.028), victimization/bullying score (Beta = 0.028), impulsivity (Beta = 0.028) and internet addiction (Beta = 0.010) scores were significantly associated with higher suicidal ideation. Same applies to adolescents whose parents are separated compared to living together (Beta = 0.992) and in females compared to males (0.311). On another hand, a higher age (Beta = − 0.182) was significantly associated with lower suicidal ideation.

Conclusion

This study provides insights about suicidal ideation among Lebanese adolescents and related risk factors, such as child psychological and physical abuse, alcohol use disorders, social fear, bullying and victimization, impulsivity, and internet addiction.
What are the sociodemographic and gender determinants of non-fatal self-harm in older adult users and non-users of antidepressants? A national population-based study
Authors: Hedna Khedidja , Fastbom Johan , Skoog Ingmar , Hensing Gunnel , Waern Margda
Published: June 2020

Background

Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors associated with non-fatal SH, in older adults with and without antidepressant therapy.

Methods

We used national longitudinal register data from a total cohort of all Swedish residents aged ≥75 years between 2006 and 2014 (N = 1,413,806). Using personal identity numbers, we linked individuals’ data from numerous national registers. We identified all those with at least one episode of non-fatal self-harm (regardless of level of intent to die) and matched 50 controls to each case. A nested case–control design was used to investigate sociodemographic factors associated with non-fatal SH in the total cohort and among antidepressant users and non-users. Risk factors were analysed in adjusted conditional logistic regression models for the entire cohort and by gender.

Results

In all, 2242 individuals had at least one episode of a non-fatal SH (980 men and 1262 women). Being unmarried was a risk factor for non-fatal SH in men but not in women. Among users of antidepressants, higher non-fatal SH risk was observed in those born outside the Nordic countries (IRR: 1.44; 95% CI: 1.11–1.86), whereas in AD non-users increased risk was seen in those from Nordic countries other than Sweden (IRR: 1.58; 95% CI: 1.08–2.29). Antidepressant users with higher education had an increased risk of non-fatal SH (IRR: 1.34; 95% CI: 1.12–1.61), in both men and women.

Conclusions

Foreign country of birth was associated with increased risk for non-fatal SH in older adults with and without AD therapies. Being married was a protective factor for non-fatal SH in men. The complex association between sociodemographic factors and use of antidepressants in the occurrence of self-harm in older men and women indicates the need for multifaceted tailored preventive strategies including healthcare and social services alike.
Social inequalities in traditional and emerging screen devices among Portuguese children: a cross-sectional study
Authors: Rodrigues Daniela , Gama Augusta , Machado-Rodrigues Aristides M. , Nogueira Helena , Silva Maria-Raquel G. , Rosado-Marques Vítor , Padez Cristina
Published: June 2020

Background

Children are often exposed to too much screen time but few studies have explored the use of old and new digital media among young children. This study assesses screen time, including traditional and mobile devices, in pre-school and elementary school-aged children, according to their gender, age, and socioeconomic position (SEP).

Methods

A total of 8430 children (3 to 10 years; 50.8% boys) from the north, center and south-central Portugal were included in the present study. Data was collected by a parental questionnaire during 2016/2017. Children’s screen time (by media device, weekdays and at the weekend; calculated by mean minutes per day) were reported by parents. Analysis were carried to compare screen time by children’s age, gender and family SEP (classified using father’s educational degree).

Results

Daily screen time was high both in children aged 3 to 5 and 6 to 10 years – 154 min/day (95% CI: 149.51–158.91) and 200.79 min/day (95% CI: 197.08–204.50), respectively – and the majority of children, independently of their gender, exceed the recommended 2 h/day of screen viewing. Children are still primarily engaging in screen time through television but the use of mobile devices, particularly tablets, were already high among 3 year-old children and increased with age. SEP was a negative predictor of screen time in the linear regression analysis, including after adjustment.

Conclusions

Considering the negative health impacts of excessive screen time, recognizing subgroups at risk of excessive screen time and identifying how each device is used according to age is fundamental to enable appropriate future interventions. The screen time in children aged 3–10 years is longer than the recommended, particularly among boys and in those children from lower SEP. Parents and policymakers should have in mind that children spend most of their screen time watching television but mobile devices are becoming extremely popular starting at a young age.
A comparative impact evaluation of two human resource models for community-based active tuberculosis case finding in Ho Chi Minh City, Viet Nam
Authors: Vo Luan Nguyen Quang , Forse Rachel Jeanette , Codlin Andrew James , Vu Thanh Nguyen , Le Giang Truong , Do Giang Chau , Van Truong Vinh , Dang Ha Minh , Nguyen Lan Huu , Nguyen Hoa Binh , Nguyen Nhung Viet , Levy Jens , Squire Bertie , Lonnroth Knut , Caws Maxine
Published: June 2020

Background

To achieve the WHO End TB Strategy targets, it is necessary to detect and treat more people with active TB early. Scale–up of active case finding (ACF) may be one strategy to achieve that goal. Given human resource constraints in the health systems of most high TB burden countries, volunteer community health workers (CHW) have been widely used to economically scale up TB ACF. However, more evidence is needed on the most cost-effective compensation models for these CHWs and their potential impact on case finding to inform optimal scale-up policies.

Methods

We conducted a two-year, controlled intervention study in 12 districts of Ho Chi Minh City, Viet Nam. We engaged CHWs as salaried employees (3 districts) or incentivized volunteers (3 districts) to conduct ACF among contacts of people with TB and urban priority groups. Eligible persons were asked to attend health services for radiographic screening and rapid molecular diagnosis or smear microscopy. Individuals diagnosed with TB were linked to appropriate care. Six districts providing routine NTP care served as control area. We evaluated additional cases notified and conducted comparative interrupted time series (ITS) analyses to assess the impact of ACF by human resource model on TB case notifications.

Results

We verbally screened 321,020 persons in the community, of whom 70,439 were eligible for testing and 1138 of them started TB treatment. ACF activities resulted in a + 15.9% [95% CI: + 15.0%, + 16.7%] rise in All Forms TB notifications in the intervention areas compared to control areas. The ITS analyses detected significant positive post-intervention trend differences in All Forms TB notification rates between the intervention and control areas (p = 0.001), as well as between the employee and volunteer human resource models (p = 0.021).

Conclusions

Both salaried and volunteer CHW human resource models demonstrated additionality in case notifications compared to routine case finding by the government TB program. The salaried employee CHW model achieved a greater impact on notifications and should be prioritized for scale-up, given sufficient resources.
Understanding mobility and sexual risk behaviour among women in fishing communities of Lake Victoria in East Africa: a qualitative study
Authors: Kwena Zachary , Nakamanya Sarah , Nanyonjo Gertrude , Okello Elialilia , Fast Pat , Ssetaala Ali , Oketch Bertha , Price Matt , Kapiga Saidi , Bukusi Elizabeth , Seeley Janet ,   the LVCHR, Grosskurth Heiner , Kamali Anatoli , Kaleebu Pontiano , Kibengo Freddie Mukasa , Kidega William , De Bont Jan
Published: June 2020

Background

HIV-prevalence and incidence is high in many fishing communities around Lake Victoria in East Africa. In these settings, mobility among women is high and may contribute to increased risk of HIV infection and poor access to effective prevention and treatment services. Understanding the nature and patterns of this mobility is important for the design of interventions. We conducted an exploratory study to understand the nature and patterns of women’s mobility to inform the design of HIV intervention trials in fishing communities of Lake Victoria.

Methods

This was a cross-sectional formative qualitative study conducted in six purposively selected fishing communities in Kenya, Tanzania and Uganda. Potential participants were screened for eligibility on age (18+ years) and having stayed in the fishing community for more than 6 months. We collected data using introductory and focus group discussions, and in-depth interviews with key informants. Data focused on: history and patterns of mobility, migration in and out of fishing communities and the relationship between mobility and HIV infection. Since the interviews and discussions were not audio-recorded, detailed notes were taken and written up into full scripts for analysis. We conducted a thematic analysis using constant comparison analysis.

Results

Participants reported that women in fishing communities were highly mobile for work-related activities. Overall, we categorized mobility as travels over long and short distances or periods depending on the kind of livelihood activity women were involved in. Participants reported that women often travelled to new places, away from familiar contacts and far from healthcare access. Some women were reported to engage in high risk sexual behaviour and disengaging from HIV care. However, participants reported that women often returned to the fishing communities they considered home, or followed a seasonal pattern of work, which would facilitate contact with service providers.

Conclusion

Women exhibited circular and seasonal mobility patterns over varying distances and duration away from their home communities. These mobility patterns may limit women’s access to trial/health services and put them at risk of HIV-infection. Interventions should be tailored to take into account mobility patterns of seasonal work observed in this study.
The serious full-length forearm injury - a case report and literature review
Authors: Wang Jun
Published: June 2020

Background

Among upper limb injuries, carpal bone fractures and dislocation, Essex-Lopresti injury, and the terrible triad injury of the elbow are serious and relatively rare injuries. These injuries require surgical intervention. The surgical method is difficult, and the treatment effect is poor. These injuries have not been described in the same limb in the literature.

Case presentation

A 21-year-old male patient fell from a height in our institution and sustained multiple injuries, including carpal bone fracture-dislocation, Essex-Lopresti injury, and the terrible triad injury of the elbow of his right upper limb. After 2 surgeries and rehabilitation, he returned to work. We reviewed available reviews and related literature on serious upper-limb damage.

Conclusions

Full-length forearm injury is very rarely encountered, and the management of such fractures is difficult. Radial head replacement with a metal prosthesis, reconstructed the IOM with Tightrope, and fixed the DRUJ with a K-wire pin is appropriate treatment.
Pattern and outcome of perforated peptic ulcer disease patient in four teaching hospitals in Addis Ababa, Ethiopia: a prospective cohort multicenter study
Authors: Bupicha Jatani Arero , Gebresellassie Hailu Wondimu , Alemayehu Abebe
Published: June 2020

Background

Perforated peptic ulcer disease is a surgical emergency with a high morbidity and mortality. The socio-demographic characteristic and the factors associated with morbidity and mortality seems to differ between the developed and developing world. This is the first a prospective cohort study in Ethiopia designed to analyze pattern and outcome of patients with perforated peptic ulcer disease in four teaching hospitals affiliated with SOM, CHS of Addis Ababa University.

Method

This is a prospective cohort study of patients operated for perforated peptic ulcer disease from June 1, 2018 to May 31, 2019 in four teaching hospital affiliated to department of surgery of SOM, CHS of Addis Ababa university.

Result

A total of 97 patients were operated in a year. 86.6% were males with a male to female ratio of 6.5:1. The age group 21–30 were most affected constituting 42.3% of all patients. Mean age is 31.9, Median of 27, age ranges from 16 to 76. Alcohol use (45.4%) and previous history of ulcer disease (75.3%) were the most prevalent risk factors.33% were smokers. Abdominal was present in all and most presented within 48 h (79.4%). 85.6% had pneumo = peritoneum in an x-ray at presentation. Size of the perforation is 10 mm or less in 81.3%. 91(93.8%) had anterior first part duodenum perforation. Repair with pedicled omental patch was done in 65 (67.1%) patients. Age, duration of presentation, hypotension at presentation, size of perforation, degree of peritoneal contamination were found to be the significant factors for morbidity and mortality. Major morbidities were observed in 16 (16.5%) and mortality occurred in 3 (3.1%) patients.

Conclusion

Perforation of peptic ulcer disease here occurs in the young. Age, duration of presentation, hypotension at presentation, size of perforation, degree of peritoneal contamination were found to be the significant factors for morbidity and mortality. Morbidity and mortality rate of 16.5 and 3.1% observed here are quite acceptable.
What occupational therapists’ say about their competencies’ enactment, maintenance and development in practice? A two-phase mixed methods study
Authors: Rochette Annie , Brousseau Martine , Vachon Brigitte , Engels Cynthia , Amari Fatima , Thomas Aliki
Published: June 2020

Background

Understanding how professional competencies are actually enacted in clinical practice can help university programs better prepare their graduates. The study aimed to describe 1) the perceived competency level of occupational therapists holding an entry-to-practice master’s degree 2) the factors perceived as impacting the enactment of competencies; and 3) the strategies used to maintain and further develop level of competency in the seven practice roles: expert in enabling occupation, communicator, collaborator, practice manager, change agent, scholarly practitioner and professional.

Methods

Descriptive two-phase mixed methods sequential design. The quantitative phase consisted of an online survey sent to all occupational therapists holding an entry-to-practice master’s degree in Quebec, Canada (n = 1196), followed by focus group discussions with a subset of participants. Analysis used descriptive statistics and the Framework Approach for content analysis of focus group data. Competencies were theoretically anchored into the Profile of Occupational Therapist Practice in Canada (an equivalent to CanMEDS framework) and we used the Theoretical Domain Framework to collect and describe perceived factors and strategies.

Results

Response rate to Phase 1 was 26.5% (n = 317/1196). The communicator, collaborator and professional roles were perceived as highly solicited in practice, valued and were rated more frequently at a higher competency level as compared to the other four roles (expert, manager, change agent and scholar roles). Focus group participants (n = 16) mentioned that both individual and organisational factors influence enactment of competencies. Consulting colleagues was the preferred strategy to support the scholar role, often described as foundational for the development of expertise.

Conclusion

This descriptive study provides valuable information as to how the seven roles are enacted in practice. Though the scholar role is highly valued by clinicians and organizations, insufficient time is allotted to searching for evidence and reflection in practice. Strategies emerging from the results are mainly directed toward this role with an emphasis on using of peers as a source of evidence. Future studies could explore how contextual factors influence the enactment of competencies across different professions as well as how these evolve over time.
Knowledge, attitudes and practices of faculty on mentorship: an exploratory interpretivist study at a sub-Saharan African medical school
Authors: Mubuuke Aloysius G. , Mbalinda Scovia N. , Munabi Ian G. , Kateete David , Opoka Robert B. , Kiguli Sarah
Published: June 2020

Background

Mentorship has become a routine part of undergraduate training in health professions education. Although many health professions training institutions have successfully incorporated faculty-student mentorship in their formal training, many others especially in Sub-Saharan Africa have not fully embraced this. Institutionalized mentorship programmes are effective methods of enhancing student learning experiences. Faculty, who are the mentors have an active role to play in driving the mentorship agenda and ensure that students benefit from this important activity. The aim of this study was to explore the knowledge, attitudes and practices of faculty about student mentorship at Makerere University College of Health Sciences.

Methods

It was an exploratory qualitative study using interviewer-administered semi-structured questionnaires. The study participants included faculty at Makerere University College of Health Sciences. Thematic analysis was used to analyse the data using pre-determined themes.

Results

Four themes were identified: 1) Knowledge of mentorship, 2) Attitude towards mentorship, 3) Practice of mentorship and 4) Improving the mentorship process. Majority of the faculty reported being less knowledgeable on mentorship regardless of seniority. The level of knowledge seemed to influence the practice of mentorship. Despite the observed knowledge gap, all faculty demonstrated a positive attitude to participate in mentoring.

Conclusion

Faculty demonstrated a positive attitude towards mentorship despite the knowledge gap of mentorship identified. Continuous faculty development in mentorship as well as using peer mentorship were identified as key in sustaining the mentorship programme.
Is there a relationship between moral competencies and the formation of professional identity among nursing students?
Authors: Haghighat Sahar , Borhani Fariba , Ranjbar Hadi
Published: June 2020

Background

Moral competencies are essential for nursing work. Professional identity is a set of values and beliefs that a person has about her/his job, which includes moral values as well. The development of moral competencies and formation of professional identity in nursing students occurs mainly during their college years. The aim of this study was to investigate the relationship between moral competencies and the formation of professional identity among nursing students.

Methods

This study was designed as a descriptive-correlational study. The study population was consisted of nursing students who were enrolled in nursing schools at the time of the study. Two hundred and twenty-one nursing students completed the study tools. The research tools were a demographic questionnaire, Moral Development Scale for Professionals (MDSP), and Professional Identity Scale for Nursing Students (PISNS).

Results

The mean (SD) of MDSP and PISNS scores was 45.69 ± 5.90 and 55.61 ± 12.75, respectively. There was a significant statistical relationship between MSDP and PISNS scores (p < 0.05). A significant equation was found (f (2, 218) = 16.68,p < 0.001) with an R2 of 0.113. The MSDP scores increased 0.136 for each score of PISNS, and married students had 2.452 scores higher than single students.

Conclusions

The positive correlation between the formation of professional identity and development of morality in nursing students indicates that by strengthening students’ professional values, their moral competencies may develop positively.
The utilization of social networking sites, their perceived benefits and their potential for improving the study habits of nursing students in five countries
Authors: Valdez Glenn Ford D. , Cayaban Arcalyd Rose R. , Al-Fayyadh Sadeq , Korkmaz Mehmet , Obeid Samira , Sanchez Cheryl Lyn A. , Ajzoon Muna B. , Fouly Howieda , Cruz Jonas P.
Published: June 2020

Background

The abundance of easy and accessible information and the rapid development of social networking sites (SNSs) have proven that the world is small and within reach. The great implication of this interconnectivity is attributable to the change in the learning and sharing environment, which for the most part is something that classrooms are lacking. Considering the potential implications of SNSs in nursing education reveals the benefits of SNSs in allowing students to communicate and interact with a wider audience and beyond the classroom. The aim of this study is to identify the extent of SNS utilization, the perceived benefits of SNSs and the potential of SNSs for improving the study habits of nursing students in five countries (Israel, Iraq, Oman, the Philippines and Turkey).

Methods

This study is a quantitative cross-sectional study that determined the relationship between the utilization of SNSs, the perceived benefits of SNSs, and the potential of SNSs for improving the study habits of nursing students in the five participating countries (Israel, Iraq, Oman, the Philippines, and Turkey). This paper is based on carefully analysing the survey responses of a sample of 1137 students from an online hosting site. The online instrument focuses on the extent of the utilization and benefits of SNSs according to their accessibility, usability, efficiency and reliability.

Results

Based on the Pearson correlation coefficient (r) our findings, reveal a significant positive correlation between the extent of a possible improvement in study habits and the extent of SNS utilization in terms of the four domains, namely, accessibility (r = 0.246), usability (r = 0.377), reliability (r = 0.287) and efficiency (r = 0.387).

Conclusion

It can be concluded that there is a significant positive correlation between students’ study habits and the extent of SNS utilization, meaning that the more students devote themselves to their study habits, the higher the level of SNS utilization. The use of SNSs by nursing students has positive and negative implications, and there is greater potential for further improving approaches to nursing education through the adaptation of curricula based on the proper utilization of SNSs.
A mutation that blocks integrin α4β7 activation prevents adaptive immune-mediated colitis without increasing susceptibility to innate colitis
Authors: Zhang Hailong , Zheng Yajuan , Pan Youdong , Lin Changdong , Wang Shihui , Yan Zhanjun , Lu Ling , Ge Gaoxiang , Li Jinsong , Zeng Yi Arial , Chen Jianfeng
Published: June 2020

Background

β7integrins are responsible for the efficient recruitment of lymphocytes from the blood and their retention in gut-associated lymphoid tissues. Integrin α4β7binds MAdCAM-1, mediating rolling adhesion of lymphocytes on blood vessel walls when inactive and firm adhesion when activated, thereby controlling two critical steps of lymphocyte homing to the gut. By contrast, integrin αEβ7mediates the adhesion of lymphocytes to gut epithelial cells by interacting with E-cadherin. Integrin β7blocking antibodies have shown efficacy in clinical management of inflammatory bowel disease (IBD); however, fully blocking β7function leads to the depletion of colonic regulatory T (Treg) cells and exacerbates dextran sulfate sodium (DSS)-induced colitis by evoking aberrant innate immunity, implying its potential adverse effect for IBD management. Thus, a better therapeutic strategy targeting integrin β7is required to avoid this adverse effect.

Results

Herein, we inhibited integrin α4β7activation in vivo by creating mice that carry in their integrin β7gene a mutation (F185A) which from structural studies is known to lock α4β7in its resting state. Lymphocytes from β7-F185A knock-in (KI) mice expressed α4β7integrins that could not be activated by chemokines and showed significantly impaired homing to the gut. The β7-F185A mutation did not inhibit αEβ7activation, but led to the depletion of αEβ7+lymphocytes in the spleen and a significantly reduced population of αEβ7+lymphocytes in the gut of KI mice. β7-F185A KI mice were resistant to T cell transfer-induced chronic colitis, but did not show an increased susceptibility to DSS-induced innate colitis, the adverse effect of fully blocking β7function.

Conclusions

Our findings demonstrate that specific inhibition of integrin α4β7activation is a potentially better strategy than fully blocking α4β7function for IBD treatment.
Stance and weight distribution after tibial plateau leveling osteotomy in forelimb and hind limb amputee dogs
Authors: Ben-Amotz Ron , Dycus David , Levine David , Arruda Andréia Gonçalves , Fagan Nicholas , Marcellin-Little Denis
Published: June 2020

Background

Little is known about the weight distribution to the remaining limbs for amputee dogs that undergo orthopedic surgery.

The objective of the paper was to describe stance and weight distribution after tibial plateau leveling osteotomy (TPLO) in forelimb and in hind limb amputees (AmpTPLO) and to compare them to four-legged TPLO patients (4LTPLO) and amputees without TPLO (Amp). Weight bearing distribution at a stance was compared between groups. Joint angles of forelimb and hind limb joints in a sagittal plane, hind limb orientation in a frontal plane, and pelvic orientation in a transverse plane (pelvic tilt) were measured and compared between groups.

Results

Joint angles, hind limb abduction, and pelvic tilt of AmpTPLO and Amp did not differ statistically. Mean weight bearing in the operated hind limb was higher for AmpTPLO than 4LTPLO. Mean weight bearing for thoracic limbs of AmpTPLO and 4LTPLO did not differ statistically. Weight bearing of the hind limb of AmpTPLO and Amp did not differ statistically.

Conclusions

The position of the center of mass and posture of AmpTPLO and Amp does not differ. The weight distribution and posture of Amp is not impacted negatively by TPLO.
Occurrence of Trichophyton verrucosum in cattle in the Ningxia Hui autonomous region, China
Authors: Guo Yanan , Ge Song , Luo Haifeng , Rehman Atif , Li Yong , He Shenghu
Published: June 2020

Background

Ningxia Hui Autonomous Region is an important cattle breeding area in China, and cattle breeding bases are located in this area. In Ningxia, dermatophytes have not been paid attention to, so dermatophytosis is becoming more and more serious. For effective control measures, it is important to determine the disease prevalence and isolate and identify the pathogenic microorganism.

Results

The study showed the prevalence of dermatophytes was 15.35% (74/482). The prevalence in calf was higher than adult cattle (p < 0.05). The morbidity was the highest in winter compared with autumn (p < 0.0001), summer (p < 0.05) and spring (p < 0.0001). The prevalence in Guyuan was the highest compared with Yinchuan (p < 0.05) and Shizuishan (p < 0.05). The incidence of lesions on the face, head, neck, trunk and whole body was 20.43, 38.71, 20.43, 10.75 and 9.68%, respectively. From all samples, the isolation rate of Trichophyton was highest (61.1%). The phylogenetic tree constructed showed that the 11 pathogenic fungi were on the same branch as Trichophyton verrucosum.

Conclusions

This study reports, for the first time, the presence of Trichophyton verrucosum in cattle in Ningxia and showed that the incidence of dermatophytosis is related to different regions, ages and seasons. A better knowledge of the prevalence of dermatophytosis of cattle may allow the adoption of more efficient control measures and prophylaxis.
Associations of (pre)diabetes with right ventricular and atrial structure and function: the Maastricht Study
Authors: Linssen Pauline B. C. , Veugen Marja G. J. , Henry Ronald M. A. , van der Kallen Carla J. H. , Kroon Abraham A. , Schram Miranda T. , Brunner-La Rocca Hans-Peter , Stehouwer Coen D. A.
Published: June 2020

Backgrounds

The role of right ventricular (RV) and atrial (RA) structure and function, in the increased heart failure risk in (pre)diabetes is incompletely understood. The purpose of this study is to investigate the associations between (pre)diabetes and RV and RA structure and function, and whether these are mediated by left ventricular (LV) alterations or pulmonary pressure.

Methods

Participants of the Maastricht Study; a population-based cohort study (426 normal glucose metabolism (NGM), 142 prediabetes, 224 diabetes), underwent two-dimensional and tissue Doppler echocardiography. Multiple linear regression analyses with pairwise comparisons of (pre)diabetes versus NGM, adjusted for cardiovascular risk factors, and mediation analyses were used.

Results

In general, differences were small. Nevertheless, in individuals with prediabetes and diabetes compared to NGM; RA volume index was lower (both p < 0.01, ptrend < 0.01), RV diameter was lower (both p < 0.01, ptrend < 0.01) and RV length was significantly smaller in diabetes (p = 0.67 and p = 0.03 respectively, ptrend = 0.04), TDI S′RV was lower (p = 0.08 and p < 0.01 respectively, ptrend < 0.01), TDI E′RV was lower (p = 0.01 and p = 0.02 respectively, ptrend = 0.01) and TDI A′RV was lower (p < 0.01 and p = 0.07 respectively, ptrend = 0.04). Only the differences in RA volume index (7.8%) and RV diameter (6.2%) were mediated by the maximum tricuspid gradient, but no other LV structure and function measurements.

Conclusions

(Pre)diabetes is associated with structural RA and RV changes, and impaired RV systolic and diastolic function, independent of cardiovascular risk factors. These associations were largely not mediated by indices of LV structure, LV function or pulmonary pressure. This suggests that (pre)diabetes affects RA and RV structure and function due to direct myocardial involvement.
TRIM2 directly deubiquitinates and stabilizes Snail1 protein, mediating proliferation and metastasis of lung adenocarcinoma
Authors: Lin Zhaoxian , Lin Xing , Zhu Lihuan , Huang Jianyuan , Huang Yangyun
Published: June 2020

Background

Lung adenocarcinoma has surpassed lung squamous cell carcinoma as the most common type of non-small cell lung cancer. In this study, we had tested the biological role of TRIM2 in lung adenocarcinoma.

Methods

TRIM2 abundance in clinical tissues and six cell lines were examined with quantitative real-time PCR test (qRT-PCR) and western blot. TRIM2 overexpression treated H322 cells and TRIM2 knockdown treated A549 cells were used to study cell proliferation, migration, colony formation, invasion, and the expression of epithelial mesenchymal transformation (EMT) biomarkers. Moreover, ubiquitination related Snail1 degradation were studied with qRT-PCR and western blot. The relationships between TRIM2 and Snail1 were investigated with western blot, co-immunoprecipitation, migration, and invasion.

Results

TRIM2 was highly expressed in lung adenocarcinoma tissues. TRIM2 overexpression and knockdown treatments could affect cell proliferation, colony formation, migration, invasion, and the expression of EMT associated biomarkers. Moreover, TRIM2 can regulate the ubiquitination related Snail1 degradation. In addition, TRIM2 can regulate Snail1 degradation in lung adenocarcinoma via ubiquitination pathway. TRIM2 could promote the proliferation, migration, and invasion of lung adenocarcinoma. Meanwhile, TRIM2 can deubiquitinate and stabilize Snail1 protein, which play important role in the function of lung adenocarcinoma.

Conclusion

A high TRIM2 expression could be detected in lung adenocarcinoma tissues and cells. TRIM2 could aggravate cell proliferation, invasion, and migration in colorectal cancer by regulating Snail1 ubiquitylation degradation. Our results could provide detailed information for further studies in lung adenocarcinoma.
Photo-responsive degradable hollow mesoporous organosilica nanoplatforms for drug delivery
Authors: Fan Jie , Zhang Zhipeng , Wang Yaru , Lin Shiting , Yang Shun
Published: June 2020

Background

Stimulus-responsive degradable mesoporous organosilica nanoparticles (MONs) have shown great promise as drug carriers via enhancing the efficiency of drug delivery and accelerating the degradation of nanocarriers. However, it remains a great challenge to develop novel light-enabled spatial and temporal degradable MONs with both superior responsiveness for efficient anti-cancer drug delivery and safe exocytosis.

Results

We report a novel photo-responsive degradable hollow mesoporous organosilica nanoplatform (HMONs@GOQD). The platform is based on organosilica nanoparticles (HMONs) containing singlet oxygen (1O2)-responsive bridged organoalkoxysilanes and wrapped graphene oxide quantum dots (GOQDs). The unique hollow mesoporous structure of the HMONs guarantees an excellent drug loading and release profile. During light irradiation, 1O2 produced by the GOQDs leads to the degradation of the organosilica nanoparticles, resulting in enhanced local drug release.

Conclusions

We carried out in vitro and in vivo experiments using DOX as a model drug; DOX-HMONs@GOQDs exhibited high biocompatibility, accelerated degradation, and superior therapeutic efficacy during light irradiation, indicating a promising platform for clinical cancer therapy.
Motivations, facilitators and barriers to accessing hepatitis C treatment among people who inject drugs in two South African cities
Authors: Versfeld Anna , McBride Angela , Scheibe Andrew , Spearman C. Wendy
Published: June 2020

Background

Treatment of hepatitis C (HCV) among people who inject drugs (PWID) is a critical component of efforts to eliminate viral hepatitis. A recent study found high HCV prevalence among PWID in two cities, Pretoria (84%) and Cape Town (44%). Very few (< 5%) HCV-infected individuals attended follow-up appointments. This sub-study explores differences between stated desire for cure and appointment attendance in light of perceived facilitators and barriers to HCV treatment and care access among PWID.

Method

Two sets of semi-structured interviews were implemented in a group of HCV-infected participants opportunistically sampled and recruited at harm reduction service sites. Initial interviews, conducted before the planned hospital appointment date, asked participants (N = 17, 9 in Pretoria and 8 in Cape Town) about past experiences of healthcare provision, plans to attend their referral appointment and perceived barriers and facilitators to seeking hepatitis treatment. Second interviews (n = 9, 4 in Pretoria, 5 in Cape Town), conducted after the planned referral appointment date, asked about appointment attendance and treatment experience. Trained social scientists with experience with PWID conducted the interviews which were recorded in detailed written notes. Data was thematically analysed in NVivo 11.

Results

Despite routine experiences of being stigmatised by the healthcare system in the past, most participants (n = 16, 94%) indicated a desire to attend their appointments. Attendance motivators included the desire to be cured, fear of dying and the wish to assist the research project. Perceived barriers to appointment attendance included fear of again experiencing stigmatisation and concerns about waiting periods and drug withdrawal. Perceived facilitators included the knowledge they would be treated quickly, and with respect and access to opioid substitution therapy. In the end, very few participants (n = 5) went to their appointment. Actual barriers to attendance included lack of finances, lack of urgency and forgetting and fatalism about dying.

Conclusions

South Africa can learn from other countries implementing HCV treatment for PWID. Successful linkage to care will require accessible, sensitive services where waiting time is limited. Psychosocial support prior to initiating referrals that focuses on building and maintaining a sense of self-worth and emphasising that delayed treatment hampers health outcomes is needed.
Mapping analysis to predict EQ-5D-5 L utility values based on the Oxford Hip Score (OHS) and Oxford Knee Score (OKS) questionnaires in the Spanish population suffering from lower limb osteoarthritis
Authors: Martín-Fernández Jesús , Morey-Montalvo Mariel , Tomás-García Nuria , Martín-Ramos Elena , Muñoz-García Juan Carlos , Polentinos-Castro Elena , Rodríguez-Martínez Gemma , Arenaza Juan Carlos , García-Pérez Lidia , Magdalena-Armas Laura , Bilbao Amaia
Published: June 2020

Background

The EQ-5D-5 L is a quality-of-life questionnaire based on individuals’ preferences that is widely employed for cost-effectiveness analysis. Given the current demand for mapping algorithms to directly assign “utilities”, this study aimed to generate different mapping models for predicting EQ-5D-5 L utility values based on scores of the Oxford Hip Score (OHS) and Oxford Knee Score (OKS) questionnaires provided by patients suffering from hip and knee osteoarthritis (OA), respectively, and to assess the predictive capability of these functions.

Methods

This was a prospective, observational study. Following the criteria of the American Rheumatism Association, 361 patients with hip OA and 397 with knee OA from three regions in Spain were included. Health-related quality of life (HRQoL) was assessed through the EQ-5D-5 L general questionnaire and the OHS and OKS specifically for lower limb OA.

Based on the scores on the OHS and OKS questionnaires, EQ-5D-5 L utilities were estimated using 4 models: ordinary least squares (OLS), Tobit, generalized linear model (GLM), and beta regression (Breg).

The models were validated on the same patients after 6 months: the mean absolute error (MAE) and mean squared error (MSE) with their 95% confidence intervals (CI), mean values of standard errors (SE), intraclass correlation coefficients (ICC), and Bland-Altman plots were obtained.

Results

The lowest MAEs were obtained using GLM and Breg models, with values of 0.1103 (0.0993–0.1214) and 0.1229 (0.1102–0.1335) for hip OA, and values of 0.1127 (0.1014–0.1239) and 0.1141 (0.1031–0.1251) for knee OA. MSE values were also lower using GLM and Breg. ICCs between predicted and observed values were around or over the 0.8 cut-off point. Bland-Altman plots showed an acceptable correlation, but precision was lower for subjects with worse HRQoL, which was also evident when comparing MAEs of the bottom and top halves of the utilities scale. Predictive equations for utilities based on OHS/OKS scores were proposed.

Conclusions

The OHS and OKS scores allow for estimating EQ-5D-5 L utility indexes for patients with hip and knee OA, respectively, with adequate validity and precision. GLM and Breg produce the best predictions. The predictive power of proposed equations is more consistent for subjects in better health condition.
Assessing the governance of the health policy-making process using a new governance tool: the case of Lebanon
Authors: Hamra Rasha , Siddiqi Sameen , Carmel Emma , Ammar Walid
Published: June 2020

Background

In the international agenda, it has become common to assert that the assessment of health system governance using a practical tool is crucial. This approach can help us better understand how health systems are being steered as well as to identify gaps in the decision-making process and their causes. The authors developed a new assessment tool, the Health Policymaking Governance Guidance Tool (HP-GGT), that was designed to be conceptually sound and practical. This tool enables policy-makers and stakeholders to systematically review and assess health system governance at policy-making level. This article presents first use of the HP-GGT in Lebanon, together with generated results, recommendations, and discusses how these results improve governance practices when initiating new health policy formulation processes.

Methods

The HP-GGT, which is a multidimensional structured tool, was used retrospectively to assess and review the process used to develop a new mental health strategy; this process was compared against consensus-based good governance principles, focusing on participation, transparency, accountability, information and responsiveness. The assessment was conducted through face-to-face interviews with 11 key informants who were involved in the development of the strategy.

Results

The HP-GGT enabled policy-makers to reflect on their governance practices when developing a mental health strategy and was able to identify key areas of strengths and weaknesses using good governance practice checklists given by the questions. The insights generated from the assessment equipped the national policy-makers with a better understanding of the practice and meaning of policy-making governance. Identifying weaknesses to be addressed in future attempts to develop other national health policies helped in this regard. Using the tool also increased awareness of alternative good practices among policy-makers and stakeholders.

Conclusions

Assessing a health policy formulation process from a governance perspective is essential for improved policy-making. The HP-GGT was able to provide a general overview and an in-depth assessment of a policy formulation process related to governance issues according to international good practices that should be applied while formulating health policies in any field. The HP-GGT was found to be a practical tool that was useful for policy-makers when used in Lebanon and awaits applications in other low- and middle-income countries to further show its validity and utility.
Workplace-based health research training: a qualitative study of perceived needs in a rural setting
Authors: Schmidt David , Reyment Jill , Webster Emma , Kirby Sue , Lyle David
Published: June 2020

Background

The calls for increased numbers of researchers in rural health are growing. To meet this demand, training is needed. If training is to be effective, the value placed on research, the organisational need for research training and key targets for research skill development within a rural health organisation must be understood.

Methods

This qualitative study was underpinned by a critical realist perspective that allowed exploration of the organisational, cultural and structural contexts of research training and of the ability of individuals to act within these contexts. Individual interviews with purposively selected key informants from the organisation’s board, executive and facility management (n = 7) and two focus groups with a convenience sample of frontline health workers with interests in research (total n = 11) were held. Data were analysed using NVivo software and thematic analysis.

Results

The themes emerging from this study were the fragmentation of research activity, a need for systems that support research and collaboration for expertise.

Conclusions

This study has identified an overreliance on individual activity leading to a fragmented approach to research. There is a need for supportive structures, coordination and workplace leadership to overcome a longstanding culture that views research as out of the rural scope of practice. Identifying research training targets, partnering for educational expertise and planning for long-term sustainability are necessary steps toward increasing research activity in the longer term.