bluuebunny/crossref_metadata_2025 huggingface dataset:
Avoiding Difficult Conversations in the Australian Health Sector
Authors: King Christine , Edlington Tanya , Williams Brett
Published: July 2020

Background

Health professionals avoiding difficult conversations with each other can lead to serious negative consequences for patients. Clinical supervisors are in the unique position of interacting both with students as well as colleagues and peers. This study explores the avoidance of difficult conversations from the perspective of clinical supervisors in order to better understand why health professionals avoid difficult conversations.

Objective

This study aimed to identify the reasons why difficult conversations are avoided between health-care professionals and to gain deeper insight into the phenomenon of avoiding difficult conversations in general.

Methods

Convergent interviewing was used with 20 clinical supervisors to explore the following question: Why do you think that people in your workplace avoid difficult conversations?

Results

Major reasons for avoiding difficult conversations included the fear of negative consequences, a general distaste for confrontation, and a lack of confidence in their skills to have such conversations. Additional factors included individual qualities such as personality type and communication style, available time, size of the workplace, and a range of perceived cultural barriers standing in the way of having difficult conversations.

Conclusion

There is a need to encourage clinical supervisors and other health professionals to embrace difficult conversations to reduce adverse events and enhance patient outcomes. This requires additional training and educational opportunities to enhance knowledge, skills, and confidence to plan and engage in difficult conversations. Some types of difficult conversations require more skills than others.
Policy framing and crisis narratives around food safety in Vietnam
Authors: Béné Christophe , Kawarazuka Nozomi , Pham Huong , Haan Stef de , Tuyen Huynh , Thi Duong Thanh , Dang Chien
Published: July 2020

While progress has been made recently in understanding food systems per se, much less is known about policies around those food systems. In this paper, we aim at understanding the food system policy context with the specific objective to look at policy dynamics—defined as the way policy agendas are identified, justified, and framed by decision-makers, and how they interact. Vietnam is used as a case study. Primary data were generated through face-to-face interviews complemented by an online survey. A policy framing approach was used to structure the research. The analysis reveals how the policy agenda is considered by many actors to be only partially evidence-based and highlights the extent to which the state government remains the most powerful actor in the setting of that agenda. The research also reveals the diffusion of the food safety crisis narrative beyond its original technical domain into a larger number of policy framings related to other issues of food systems, thus making it de facto the “center of gravity” of the current agenda on food systems in Vietnam. Yet, a comparison with data from other countries challenges this narrative, and reveals instead how the (legitimate) public concern about food safety is being instrumentalized by certain groups of actors to advance their own agenda. The implication of this “distorted” framing is the risk for the decision-makers to “overfocus” their attention on this short-term issue and lose sight of some other longer-term structural trends such as the emergence of obesity in Vietnamese urban population.
Elastomeric respirators are safer and more sustainable alternatives to disposable N95 masks during the coronavirus outbreak
Authors: Chiang James , Hanna Andrew , Lebowitz David , Ganti Latha
Published: July 2020

Background

In this paper, the authors review the safety and practicality of elastomeric respirators for protecting themselves and others from the novel coronavirus or COVID-19. They also describe the safe donning and doffing procedures for this protective gear.

Main text

Due to the shortage of personal protective equipment (PPE), the CDC has recommended ways to conserve disposable N95 masks, including re-use and extended use, and reserving N95 masks for aerosol-generating procedures. However, these were never made to be re-used.

Although the modes of transmission of COVID-19 are not fully understood, based on what we know about severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), droplets and aerosolized droplets contribute to the spread of this virus. More evidence from Wuhan, China, has demonstrated that COVID-19 viral particles are aerosolized and found in higher concentrations in rooms where PPE is being removed. Thus, it is best for all healthcare providers to have full aerosol protection.

Conclusion

Given the shortage of PPE for aerosols, it is logical to utilize reusable elastomeric respirators with filter efficiency of 95% or higher. A single elastomeric respirator may replace hundreds to thousands of new disposable N95 masks.
Enhancer prediction in the human genome by probabilistic modelling of the chromatin feature patterns
Authors: Osmala Maria , Lähdesmäki Harri
Published: July 2020

Background

The binding sites of transcription factors (TFs) and the localisation of histone modifications in the human genome can be quantified by the chromatin immunoprecipitation assay coupled with next-generation sequencing (ChIP-seq). The resulting chromatin feature data has been successfully adopted for genome-wide enhancer identification by several unsupervised and supervised machine learning methods. However, the current methods predict different numbers and different sets of enhancers for the same cell type and do not utilise the pattern of the ChIP-seq coverage profiles efficiently.

Results

In this work, we propose a PRobabilistic Enhancer PRedictIoN Tool (PREPRINT) that assumes characteristic coverage patterns of chromatin features at enhancers and employs a statistical model to account for their variability. PREPRINT defines probabilistic distance measures to quantify the similarity of the genomic query regions and the characteristic coverage patterns. The probabilistic scores of the enhancer and non-enhancer samples are utilised to train a kernel-based classifier. The performance of the method is demonstrated on ENCODE data for two cell lines. The predicted enhancers are computationally validated based on the transcriptional regulatory protein binding sites and compared to the predictions obtained by state-of-the-art methods.

Conclusion

PREPRINT performs favorably to the state-of-the-art methods, especially when requiring the methods to predict a larger set of enhancers. PREPRINT generalises successfully to data from cell type not utilised for training, and often the PREPRINT performs better than the previous methods. The PREPRINT enhancers are less sensitive to the choice of prediction threshold. PREPRINT identifies biologically validated enhancers not predicted by the competing methods. The enhancers predicted by PREPRINT can aid the genome interpretation in functional genomics and clinical studies.
Performance evaluation of lossy quality compression algorithms for RNA-seq data
Authors: Yu Rongshan , Yang Wenxian , Wang Shun
Published: July 2020

Background

Recent advancements in high-throughput sequencing technologies have generated an unprecedented amount of genomic data that must be stored, processed, and transmitted over the network for sharing. Lossy genomic data compression, especially of the base quality values of sequencing data, is emerging as an efficient way to handle this challenge due to its superior compression performance compared to lossless compression methods. Many lossy compression algorithms have been developed for and evaluated using DNA sequencing data. However, whether these algorithms can be used on RNA sequencing (RNA-seq) data remains unclear.

Results

In this study, we evaluated the impacts of lossy quality value compression on common RNA-seq data analysis pipelines including expression quantification, transcriptome assembly, and short variants detection using RNA-seq data from different species and sequencing platforms. Our study shows that lossy quality value compression could effectively improve RNA-seq data compression. In some cases, lossy algorithms achieved up to 1.2-3 times further reduction on the overall RNA-seq data size compared to existing lossless algorithms. However, lossy quality value compression could affect the results of some RNA-seq data processing pipelines, and hence its impacts to RNA-seq studies cannot be ignored in some cases. Pipelines using HISAT2 for alignment were most significantly affected by lossy quality value compression, while the effects of lossy compression on pipelines that do not depend on quality values, e.g., STAR-based expression quantification and transcriptome assembly pipelines, were not observed. Moreover, regardless of using either STAR or HISAT2 as the aligner, variant detection results were affected by lossy quality value compression, albeit to a lesser extent when STAR-based pipeline was used. Our results also show that the impacts of lossy quality value compression depend on the compression algorithms being used and the compression levels if the algorithm supports setting of multiple compression levels.

Conclusions

Lossy quality value compression can be incorporated into existing RNA-seq analysis pipelines to alleviate the data storage and transmission burdens. However, care should be taken on the selection of compression tools and levels based on the requirements of the downstream analysis pipelines to avoid introducing undesirable adverse effects on the analysis results.
Differential contribution of p300 and CBP to regulatory element acetylation in mESCs
Authors: Martire Sara , Nguyen Jennifer , Sundaresan Aishwarya , Banaszynski Laura A.
Published: July 2020

Background

The transcription coactivators CREB binding protein (CBP) and p300 are highly homologous acetyltransferases that mediate histone 3 lysine 27 acetylation (H3K27ac) at regulatory elements such as enhancers and promoters. Although in most cases, CBP and p300 are considered to be functionally identical, both proteins are indispensable for development and there is evidence of tissue-specific nonredundancy. However, characterization of chromatin and transcription states regulated by each protein is lacking.

Results

In this study we analyze the individual contribution of p300 and CBP to the H3K27ac landscape, chromatin accessibility, and transcription in mouse embryonic stem cells (mESC). We demonstrate that p300 is the predominant H3K27 acetyltransferase in mESCs and that loss of acetylation in p300KD mESCs is more pronounced at enhancers compared to promoters. While loss of either CBP or p300 has little effect on the open state of chromatin, we observe that distinct gene sets are transcriptionally dysregulated upon depletion of p300 or CBP. Transcriptional dysregulation is generally correlated with dysregulation of promoter acetylation upon depletion of p300 (but not CBP) and appears to be relatively independent of dysregulated enhancer acetylation. Interestingly, both our transcriptional and genomic analyses demonstrate that targets of the p53 pathway are stabilized upon depletion of p300, suggesting an unappreciated view of the relationship between p300 and p53 in mESCs.

Conclusions

This genomic study sheds light on distinct functions of two important transcriptional regulators in the context of a developmentally relevant cell type. Given the links to both developmental disorders and cancer, we believe that our study may promote new ways of thinking about how these proteins function in settings that lead to disease.
DNA methylation and its effects on gene expression during primary to secondary growth in poplar stems
Authors: Zhang Yang , Liu Cong , Cheng He , Tian Shuanghui , Liu Yingying , Wang Shuang , Zhang Huaxin , Saqib Muhammad , Wei Hairong , Wei Zhigang
Published: July 2020

Background

As an important epigenetic mark, 5-methylcytosine (5mC) methylation is involved in many DNA-dependent biological processes and plays a role during development and differentiation of multicellular organisms. However, there is still a lack of knowledge about the dynamic aspects and the roles of global 5mC methylation in wood formation in tree trunks. In this study, we not only scrutinized single-base resolution methylomes of primary stems (PS), transitional stems (TS), and secondary stems (SS) of Populus trichocarpa using a high-throughput bisulfite sequencing technique, but also analyzed the effects of 5mC methylation on the expression of genes involved in wood formation.

Results

The overall average percentages of CG, CHG, and CHH methylation in poplar stems were ~ 53.6%, ~ 37.7%, and ~ 8.5%, respectively, and the differences of 5mC in genome-wide CG/CHG/CHH contexts among PS, TS, and SS were statistically significant (p < 0.05). The evident differences in CG, CHG, and CHH methylation contexts among 2 kb proximal promoters, gene bodies, and 2 kb downstream regions were observed among PS, TS, and SS. Further analysis revealed a perceptible global correlation between 5mC methylation levels of gene bodies and transcript levels but failed to reveal a correlation between 5mC methylation levels of proximal promoter regions and transcript levels. We identified 653 and 858 DMGs and 4978 and 4780 DEGs in PS vs TS and TS vs SS comparisons, respectively. Only 113 genes of 653 DMGs and 4978 DEGs, and 114 genes of 858 DMGs and 4780 DEG were common. Counterparts of some of these common genes in other species, including Arabidopsis thaliana, are known to be involved in secondary cell wall biosynthesis and hormone signaling. This indicates that methylation may directly modulate wood formation genes and indirectly attune hormone signaling genes, which in turn impact wood formation.

Conclusions

DNA methylation only marginally affects pathway genes or regulators involved in wood formation, suggesting that further studies of wood formation should lean towards the indirect effects of methylation. The information and data we provide here will be instrumental for understanding the roles of methylation in wood formation in tree species.
First description of antimicrobial resistance in carbapenem-susceptible Klebsiella pneumoniae after imipenem treatment, driven by outer membrane remodeling
Authors: Tian Xuebin , Wang Qiongdan , Perlaza-Jiménez Laura , Zheng Xiangkuo , Zhao Yajie , Dhanasekaran Vijay , Fang Renchi , Li Jiahui , Wang Chong , Liu Haiyang , Lithgow Trevor , Cao Jianming , Zhou Tieli
Published: July 2020

Background

The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a looming threat to human health. Although there are numerous studies regarding porin alteration in association with the production of ESBLs and/or AmpC β-lactamase, a systematic study on the treatment-emergence of porins alteration in antibiotic resistance does not yet exist. The aim of this study was to investigate the underlying mechanism of resistance of K. pneumoniae during carbapenem treatment.

Results

Here, we report three strains (FK-2624, FK-2723 and FK-2820) isolated from one patient before and after imipenem treatment during hospitalization. Antibiotic susceptibility testing indicated that that the first isolate, FK-2624, was susceptible to almost all tested antimicrobials, being resistant only to fosfomycin. The subsequent isolates FK-2723 and FK-2820 were multidrug resistant (MDR). After imipenem therapy, FK-2820 was found to be carbapenem-resistant. PCR and Genome Sequencing analysis indicated that oqxA, and fosA5, were identified in all three strains. In addition, FK-2624 also harbored blaSHV-187 and blaTEM-116. The blaSHV-187 and blaTEM-116 genes were not detected in FK-2723 and FK-2820. blaDHA-1, qnrB4, aac (6′)-IIc, and blaSHV-12, EreA2, CatA2, SulI, and tetD, were identified in both FK-2723 and FK-2820. Moreover, the genes blaDHA-1, qnrB4, aac (6′)-IIc were co-harbored on a plasmid. Of the virulence factors found in this study, ybtA, ICEKp6, mrkD, entB, iroN, rmpA2–6, wzi16 and capsular serotype K57 were found in the three isolates. The results of pairwise comparisons, multi-locus sequencing typing (MLST) and pulsed-field gel electrophoresis (PFGE) revealed high homology among the isolates. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) results showed that isolate FK-2820 lacked OmpK36, with genome sequence data validating that there was a premature stop codon in the ompK36 gene and real-time RT-PCR suggesting high turnover of the ompK36 non-sense transcript in FK-2820, with the steady-state mRNA level 0.007 relative to the initial isolate.

Conclusion

This study in China highlight that the alteration of outer membrane porins due to the 14-day use of imipenem play a potential role in leading to clinical presentation of carbapenem-resistance. This is the first description of increased resistance developing from a carbapenem-susceptible K. pneumoniae with imipenem treatment driven by outer membrane remodeling.
Examining the relationship between maternal body size, gestational glucose tolerance status, mode of delivery and ethnicity on human milk microbiota at three months post-partum
Authors: LeMay-Nedjelski Lauren , Butcher James , Ley Sylvia H. , Asbury Michelle R. , Hanley Anthony J. , Kiss Alex , Unger Sharon , Copeland Julia K. , Wang Pauline W. , Zinman Bernard , Stintzi Alain , O’Connor Deborah L.
Published: July 2020

Background

Few studies have examined how maternal body mass index (BMI), mode of delivery and ethnicity affect the microbial composition of human milk and none have examined associations with maternal metabolic status. Given the high prevalence of maternal adiposity and impaired glucose metabolism, we systematically investigated the associations between these maternal factors in women ≥20 years and milk microbial composition and predicted functionality by V4-16S ribosomal RNA gene sequencing (NCT01405547; https://clinicaltrials.gov/ct2/show/NCT01405547). Demographic data, weight, height, and a 3-h oral glucose tolerance test were gathered at 30 (95% CI: 25–33) weeks gestation, and milk samples were collected at 3 months post-partum (n = 113).

Results

Multivariable linear regression analyses demonstrated no significant associations between maternal characteristics (maternal BMI [pre-pregnancy, 3 months post-partum], glucose tolerance, mode of delivery and ethnicity) and milk microbiota alpha-diversity; however, pre-pregnancy BMI was associated with human milk microbiota beta-diversity (Bray-Curtis R2 = 0.037). Women with a pre-pregnancy BMI > 30 kg/m2 (obese) had a greater incidence of Bacteroidetes (incidence rate ratio [IRR]: 3.70 [95% CI: 1.61–8.48]) and a reduced incidence of Proteobacteria (0.62 [0.43–0.90]) in their milk, compared to women with an overweight BMI (25.0–29.9 kg/m2) as assessed by multivariable Poisson regression. An increased incidence of Gemella was observed among mothers with gestational diabetes who had an overweight BMI versus healthy range BMI (5.96 [1.85–19.21]). An increased incidence of Gemella was also observed among mothers with impaired glucose tolerance with an obese BMI versus mothers with a healthy range BMI (4.04 [1.63–10.01]). An increased incidence of Brevundimonas (16.70 [5.99–46.57]) was found in the milk of women who underwent an unscheduled C-section versus vaginal delivery. Lastly, functional gene inference demonstrated that pre-pregnancy obesity was associated with an increased abundance of genes encoding for the biosynthesis of secondary metabolites pathway in milk (coefficient = 0.0024, PFDR < 0.1).

Conclusions

Human milk has a diverse microbiota of which its diversity and differential abundance appear associated with maternal BMI, glucose tolerance status, mode of delivery, and ethnicity. Further research is warranted to determine whether this variability in the milk microbiota impacts colonization of the infant gut.
Effects of awake caudal anesthesia on mean arterial blood pressure in very low birthweight infants
Authors: Fideler Frank , Walker Michael , Grasshoff Christian
Published: July 2020

Background

Intraoperative blood pressure is a relevant variable for postoperative outcome in infants undergoing surgical procedures. It is therefore important to know whether the type of anesthesia has an impact on intraoperative blood pressure management in very low birth weight infants. Here, we retrospectively analyzed intraoperative blood pressure in very low birthweight infants receiving either awake caudal anesthesia without sedation, or caudal block in combination with general anesthesia, both for open inguinal hernia repair.

Methods

Ethical approval was provided by the University of Tuebingen Ethical Committee on 05/29/2018 with the project number 403/2018BO2. Patient records of infants admitted by the neonatologist (median age at birth 31.1 ± 3.5 weeks, median weight at birth 1240 ± 521 g) which were scheduled for inguinal hernia repair were retrospectively evaluated for the course of mean arterial blood pressure and perioperative interventions to stabilize blood pressure. A total of 42 patients were included, 16 patients (11 boys, 5 girls) received awake caudal anesthesia, 26 patients (22 boys, 4 girls) a combination of general anesthesia and caudal block.

Results

Approximately 3% of the measured mean arterial blood pressure values in the caudal anesthesia group were below a critical margin of 35 mmHg, in contrast to 47% in the combined anesthesia group (p < 0.001). Patients in the latter group showed a significantly larger drop of mean arterial blood pressure below 35 mmHg (4.7 ± 2.7 mmHg vs. 1.9 ± 1.6 mmHg; p < 0.005) and a significantly longer time of mean arterial blood pressure below 35 mmHg (25.6 ± 26.0 min vs. 0.9 ± 2.3 min; p < 0.001), although they received more volume and vasopressor boluses for stabilization (27 ± 14.8 ml vs. 10 ± 4.1 ml; p < 0.01 and 0.15 ± 0.06 ml vs. 0 ml of cafedrine/theoadrenaline; p < 0.001).

Conclusions

The study indicates that the use of caudal block as stand alone procedure for inguinal hernia repair in very low birthweight infants might be advantageous in preventing critical blood pressure drops compared to a combination of caudal block with general anesthesia.
A graphical approach to assess the goodness-of-fit of random-effects linear models when the goal is to measure individual benefits of medical treatments in severely ill patients
Authors: Wang Zhiwen , Diaz Francisco J.
Published: July 2020

Background

Two-dimensional personalized medicine (2-PM) models are tools for measuring individual benefits of medical treatments for chronic diseases which have potential applications in personalized medicine. These models assume normality for the distribution of random effects. It is necessary to examine the appropriateness of this assumption. Here, we propose a graphical approach to assessing the goodness-of-fit of 2-PM models with continuous responses.

Methods

We propose benefit quantile-quantile (BQQ) plots which compare the empirical quantiles of individual benefits from a patient sample predicted through an empirical Bayes (EB) approach versus the quantiles of the theoretical distribution of individual benefits derived from the assumption of normality for the random effects. We examine the performance of the approach by conducting a simulation study that compared 2-PM models with non-normal distributions for the random effects versus models with comparable normal distributions. Cramer-von Mises discrepancies were used to quantify the performance of the approach. The approach was illustrated with data from a clinical trial of imipramine for patients with depression.

Results

Simulations showed that BQQ plots were able to capture deviations from the normality assumption for the random effects and did not show any asymmetric deviations from they = xline when the random effects were normally distributed. For the depression data, the points of the BQQ plot were scattered around closely to they = xline, without presenting any asymmetric deviations. This implied the adequacy of the normality assumption for the random effects and the goodness-of-fit of the 2-PM model for the imipramine data.

Conclusion

BQQ plots are sensitive to violations of the normality assumption for the random effects, suggesting that the approach is a useful tool for examining the goodness-of-fit of random-effects linear models when the goal is to measure individual treatment benefits.
A phase IV randomised, open-label pilot study to evaluate switching from protease-inhibitor based regimen to Bictegravir/Emtricitabine/Tenofovir Alafenamide single tablet regimen in Integrase inhibitor-naïve, virologically suppressed HIV-1 infected adults harbouring drug resistance mutations (PIBIK study): study protocol for a randomised trial
Authors: Iwuji Collins C. , Churchill Duncan , Bremner Stephen , Perry Nicky , To Ye , Lambert Debbie , Bruce Chloe , Waters Laura , Orkin Chloe , Geretti Anna Maria
Published: July 2020

Background

Currently recommended boosted protease-inhibitor (bPI) regimens may be associated with increased risk of cardiovascular or chronic kidney diseases; in addition, boosted regimens are particularly associated with drug-drug interactions. Since both cardiovascular and renal disease, and polypharmacy, are common in ageing people with HIV, there is a need for alternative efficacious regimens. bPI-based regimens are often the treatment of choice for individuals with pre-treatment or treatment-acquired resistance but it is plausible that carefully selected HIV-positive individuals with drug resistance, who are virologically suppressed on their current bPI regimen, could maintain virological efficacy when switched to bictegravir, emtricitabine and tenofovir alafenamide (B/F/TAF) fixed dose combination (FDC).

Methods/design

A phase IV, investigator-initiated, multicentre, open label pilot, randomised two-arm study to assess the safety and efficacy of switching from bPI regimen to B/F/TAF single tablet regimen in integrase inhibitor-naïve, virologically suppressed adults with HIV-1 infection harbouring drug resistance mutations. Eligible individuals will either continue on their bPI regimen or switch to B/F/TAF FDC. After 24 weeks, all participants in the bPI arm will be switched to B/F/TAF and followed for a further 24 weeks and all participants will be followed for 48 weeks. The primary efficacy endpoint is the proportion of participants with HIV-1 RNA < 50 copies/mL at week 24 using pure virologic response whilst the secondary efficacy endpoint is the proportion of participants with HIV-1 RNA < 50 copies/mL at Week 48. Other secondary outcome measures include between arm comparisons of drug resistance at virological failure, safety and tolerability and patient-reported outcome measures.

Discussion

We aim to provide preliminary evidence of the efficacy of switching to B/F/TAF in patients with virological suppression on a bPI-based regimen who harbour select drug resistance mutations.

Trial registration

ISRCTN 44453201, registered 19 June 2019 and EudraCT 2018–004732-30.
A pooled analysis of the LAMP assay for the detection of Neisseria meningitidis
Authors: Fan Shu-Jin , Tan Hong-Kun , Xu Yu-Cheng , Chen Yuan-Zhi , Xie Tian-Ao , Pan Zhi-Yong , Ouyang Shi , Li Qin , Li Xiao-yan , Li Zhen-Xing , Guo Xu-Guang
Published: July 2020

Background

Neisseria meningitidis is a major cause of bacterial meningitis, and these infections are associated with a high mortality rate. Rapid and reliable diagnosis of bacterial meningitis is critical in clinical practice. However, this disease often occurs in economically depressed areas, so an inexpensive, easy to use, and accurate technology is needed. We performed a pooled-analysis to assess the potential of the recently developed loop-mediated isothermal amplification (LAMP) assay for detection of meningococcus.

Methods

Pubmed, Embase, and Web of Science were searched to identify original studies that used the LAMP assay to detect meningococcus. After pooling of data, the sensitivity and specificity were calculated, a summary receiver operating characteristic (SROC) curve was determined, and the area under the SROC curve was computed to determine diagnostic accuracy. Publication bias was assessed using Deek’s funnel plot.

Results

We examined 14 studies within 6 publications. The LAMP assay had high sensitivity (94%) and specificity (100%) in the detection of meningococcus in all studies. The area under the SROC curve (0.980) indicated high overall accuracy of the LAMP assay. There was no evidence of publication bias.

Discussion

The LAMP assay has accuracy comparable to bacterial culture and PCR for detection of meningococcus, but is less expensive and easier to use. We suggest the adoption of the LAMP assay to detect meningococcus, especially in economically depressed areas.
Basic epidemiological parameter values from data of real-world in mega-cities: the characteristics of COVID-19 in Beijing, China
Authors: Wang Xiaoli , Pan Yang , Zhang Daitao , Chen Lijuan , Jia Lei , Li Xinyu , Yang Peng , Wang Quanyi , Macintyre C. Raina
Published: July 2020

Background

With the spread of SARS-CoV-2 worldwide, understanding the basic epidemiological parameter values of COVID-19 from real-world data in mega-cities is essential for disease prevention and control.

Methods

To investigate the epidemiological parameters in SARS-CoV-2 infected cases in Beijing, we studied all confirmed cases and close contacts in Beijing from Jan 1st to Apr 3rd 2020. The epidemiological and virological characteristics of SARS-CoV-2 were analyzed.

Results

A total of 602 cases were positive for SARS-CoV-2, including 585 confirmed patients and 17 asymptomatic infections. The imported cases were mainly from Wuhan initially and then from abroad. Among 585 confirmed case-patients, the median age was 39 years old. The mean incubation period was 6.3 days. The secondary attack rate among households was higher than social contacts (15.6 vs 4.6%). The secondary attack rate of healthcare workers (HCWs) was higher than non-HCWs’ (7.3 vs 4.2%). The basic reproduction number was 2.0, and the average serial interval was 7.6 days. No significant genetic variant was identified.

Conclusions

The transmissibility of SARS-CoV-2 was relatively high, especially among households and from HCWs, which draws specific public health attention. So far, no evidence of widespread circulation of SARS-CoV-2 in communities in Beijing was found.
Surgical outcomes of three different weakening procedures of inferior oblique muscle in the treatment of unilateral superior oblique palsy
Authors: Farid Mohamed F. , Anany Mohamed , Abdelshafy Marwa
Published: July 2020

Background

To compare surgical outcomes and complications of three inferior oblique weakening procedures; Inferior Oblique Myectomy (IOM), Inferior Oblique combined Resection-Anterior Transposition (IORAT) and Inferior Oblique Anterior Transposition (IOAT) in the management of unilateral Superior Oblique (SO) palsy.

Methods

Retrospective review of medical records of all patients with unilateral SO palsy who underwent one of the aforementioned IO weakening procedures at Benha University hospital was performed. Patients were excluded if surgery was bilateral or combined with other vertical muscle surgery. Primary outcome parameters were improvement of Hypertropia (HT) in primary gaze, side gazes, on alternate head turn, Inferior Oblique Overaction (IOOA), Superior Oblique Underaction (SOUA), correction of head tilt and postoperative complications.

Results

The review reveals a total of 65 patients with unilateral SO palsy; 54 congenital and 11 acquired, who met the study criteria and were classified into 3 groups; IOM group (24cases), IORAT group (19cases) and IOAT group (22cases). Compared with IOM, both IORAT and IOAT induced significant correction of HT in primary position, ipsilateral gaze, contralateral head tilt and IOOA. IORAT was significantly more effective than IOAT in correction of HT in ipsilateral gaze and contralateral head tilt while there was no statistical difference between the three groups in correction of HT in ipsilateral gaze, contralateral head tilt and SOUA. Postoperative Anti-elevation was significantly recorded following IORAT (6 cases, 31%) than IOAT (3 cases, 13%) and IOM (one cases, 4%).

Conclusions

The IORAT and IOAT were more superior to IOM in correction of IOOA and HT in the primary position and some other gaze positions. However, superiority of IORAT over the other two procedures should be weighed against its significant association with postoperative underaction of IO muscle and anti-elevation syndrome.
Cognitive performance in children and adolescents at high-risk for obsessive-compulsive disorder
Authors: Bernardes Elisa Teixeira , Saraiva Leonardo Cardoso , e Souza Marina de Marco , Hoexter Marcelo Queiroz , Chacon Priscila , Requena Guaraci , Miguel Euripedes Constantino , Shavitt Roseli Gedanke , Polanczyk Guilherme Vanoni , Cappi Carolina , Batistuzzo Marcelo Camargo
Published: July 2020

Background

Cognitive performance has been studied in adults with obsessive-compulsive symptoms (OCS) and in adult relatives of patients with obsessive-compulsive disorder (OCD) Meanwhile, few studies have been conducted with children under the same conditions. This study compared the neurocognitive domains previously associated with dysfunction in OCD, especially visuoconstructive ability, visuospatial memory, executive functions, and intelligence, in children and adolescents at high risk (HR) for OCD (n = 18) and non-OCD controls (NOC) (n = 31).

Methods

For the HR group, we considered the first-degree relatives of patients with OCD that present OCS, but do not meet diagnostic criteria for OCD. Psychiatric diagnosis was assessed by experienced clinicians using the Structured Clinical Interview for DSM-IV and OCS severity was measured by the Yale-Brown Obsessive-Compulsive Scale. Neurocognitive assessment was performed with a comprehensive neuropsychological battery. Performance on the cognitive domains was compared between groups using Multivariate Analysis of Variance, whereas performance on the neuropsychological variables was compared between groups using independent t-tests in a cognitive subdomain analysis.

Results

The cognitive domain analysis revealed a trend towards significance for impairments in the motor and processing speed domain (p = 0.019; F = 3.12) in the HR group. Moreover, the cognitive subdomain analysis identified a statistically significant underperformance in spatial working memory in the HR group when compared to the NOC group (p = 0.005; t = − 2.94), and a trend towards significance for impairments in non-verbal memory and visuoconstructive tasks in the HR group.

Conclusions

Our results suggest impairments in spatial working memory and motor and processing speed in a non-clinical sample of HR participants. Considering the preliminary nature of our findings, further studies investigating these neurocognitive domains as potential predictors of pediatric OCD are warranted.
Temporal cross-correlations between air pollutants and outpatient visits for respiratory and circulatory system diseases in Fuzhou, China
Authors: Jiang Yu , Chen Jiedong , Wu Chuancheng , Lin Xin , Zhou Quan , Ji Shumi , Yang Shuangfeng , Zhang Xiaoyang , Liu Baoying
Published: July 2020

Background

Previous studies have suggested that there is an association between air pollutants and circulatory and respiratory diseases; however, relatively few have analyzed the association between air pollutants and outpatient visits based on the mortality, hospitalization rates, etc., especially in areas with relatively good air quality. Therefore, we conducted this study to research the association between air pollutants and outpatient visits in Fuzhou, China.

Methods

We used a generalized linear Poisson model to study the association between air pollution and outpatient visits for respiratory and circulatory diseases from 2016 to 2018 in Fuzhou, China.

Results

In the single pollutant model, nitrogen dioxide (NO2) had a significant effect. For lag day 0 to lag day 5, the effect decreased with every 10 μg/L increase in NO2. The daily maximum 8-h mean ozone (O3-8h) and upper respiratory outpatient visits were positively associated during the cold period [lag2, excess risk (ER) (95% confidence interval (CI)): 1.68% (0.44–2.94%)], while O3-8h and respiratory disease were positively associated during the warm period [lag5, ER (95% CI): 1.10% (0.11–2.10%) and lag4, ER (95% CI): 1.02% (0.032–2.02%)]. Similarly, particulate matter (PM) with an average aerodynamic diameter of less than 10 μm (PM10) and lower respiratory diseases were positively associated during the warm period [lag0, ER (95% CI): 1.68% (0.44–2.94%)]. When the concentration of O3-8h was higher than 100 μg/L, there was a positive effect on circulatory [lag5, ER (95% CI): 2.83% (0.65–5.06%)], respiratory [lag5, ER (95% CI): 2.47% (0.85–4.11%)] and upper respiratory [lag5, ER (95% CI): 3.06% (1.38–4.77%)] outpatient visits. The variation in O3-8h changed slightly when we adjusted for other air pollutants, and after adjusting for O3-8h, the ERs of the other air pollutants changed slightly. After adjusting for PM with an average aerodynamic diameter of less than 2.5 μm (PM2.5), the ERs of the other air pollutants increased, and after adjusting for NO2, the ER of PM decreased.

Conclusion

Exposure to ambient NO2, O3, PM2.5 and PM10 was associated with an increase in respiratory and circulatory system-related outpatient visits in Fuzhou, China.
Cumulative, high-stress calls impacting adverse events among law enforcement and the public
Authors: Jetelina Katelyn K. , Beauchamp Alaina M. , Reingle Gonzalez Jennifer M. , Molsberry Rebecca J. , Bishopp Stephen A. , Lee Simon Craddock
Published: July 2020

Background

The unpredictable, and sometimes dangerous, nature of the occupation exposes officers to both acute and chronic stress over law enforcement officers’ (LEO)  tenure. The purpose of this study is two-fold: 1) Describe multi-level characteristics that define high-stress calls for service for LEO; and 2) Characterize factors that impact cumulative stress over the course of a LEO’s shift.

Methods

Qualitative data were collected from 28 LEOs at three law enforcement agencies in the Dallas-Fort Worth areas from April 2019 to February 2020. Focus group data were iteratively coded by four coders using inductive and deductive thematic identification.

Results

Five multi-level factors influenced officer stress: 1) officer characteristics (e.g. military experience; gender); 2) civilian behavior (e.g. resistance, displaying a weapon); 3) supervisor factors (micromanagement); 4) environmental factors (e.g. time of year); and, 5) situational factors (e.g. audience present; complexity of calls). Four themes that characterized cumulative stress: 1) cyclical risk; 2) accelerators; 3) decelerators; and 4) experience of an adverse event.

Conclusions

LEOs become susceptible to adverse events (e.g. injury, excessive use of force) after repeated exposure to high-stress calls for service. Ongoing exposures to stress continue to occur throughout the shift. Our long-term goal is to interrupt this repetitive, cumulative process by restricting the number of consecutive high-risk, high-intensity calls an officer is permitted to respond to.
Factors contributing to educational differences in obesity among women: evidence from South Korea
Authors: Chung Woojin , Lim Seungji
Published: July 2020

Background

Obesity is more prevalent among less-educated women than highly-educated women around the world. However, little is known about the factors which cause this difference in obesity, and almost nothing is known about how the individual factors which explain differences in education among women alone contribute to obesity. In this study, we identified the factors which help explain the relationship between education and obesity in women, and quantified their separate contributions to obesity.

Methods

We analyzed information on 14,577 women aged 25 years or over using datasets from the Korea National Health and Nutrition Examination Survey (2010–2014). We divided the women into two education groups: women who had, at most, finished high school (less-educated women), and women who had college degrees and beyond (highly-educated women). Using an extended Oaxaca-Blinder method, we decomposed the difference in obesity prevalence between the two education groups into the contributions (%) due to two effects: composition effect and association effect.

Results

Obesity was more than twice as prevalent among the less-educated women (34.3%) than it was among the highly-educated women (16.0%). The composition effect—contribution of differences in the distribution of observed characteristics compared to that of the difference in obesity prevalence between the two education groups—was 38.2%. The association effect—contributions of differences in the estimated coefficients of characteristics compared to that of the difference in obesity prevalence between the two education groups—was 55.8%, of which lifestyle factors were the most important contributor (43.6%). Of the separate contributions of each factor, the association effect of the factor related to women’s stress exhibited the largest contribution (23.0%).

Conclusion

We suggest that to effectively mitigate the high prevalence of obesity among less-educated women, it may be necessary to help low-educated women who do not feel stressful develop strategies to combat their higher risk of obesity. We also suggest the need to conduct decomposition studies in countries which show significant relationships between education and obesity among women, and to create targeted policies to reduce this population’s overall risk of obesity.
Insights from qualitative research on NAFLD awareness with a cohort of T2DM patients: time to go public with insulin resistance?
Authors: Alemany-Pagès Mireia , Moura-Ramos Mariana , Araújo Sara , Macedo Maria Paula , Ribeiro Rogério T. , do Ó Dulce , Ramalho-Santos João , Azul Anabela Marisa
Published: July 2020

Background

It is estimated that around 70% of Type 2 Diabetes Mellitus patients (T2DM) have Non-Alcoholic Fatty Liver Disease (NAFLD). Awareness and education are amongst the major shortcomings of the public health response to the increasing threat of NAFLD. Characterizing the specific NAFLD-related information needs of particular high-risk metabolic communities, for instance, T2DM patients, might aid in the development of evidence-based health promotion strategies, ultimately promoting NAFLD-awareness, treatment adherence and therapeutic success rates.

Methods

Semi-structured interviews with T2DM patients were conducted to gain insight into their awareness of NAFLD, including its relationship with insulin resistance and T2DM.

Results

Awareness of NAFLD as a disease entity, as well as its progression to end-stage liver disease or its relationship with other metabolic conditions, including insulin resistance and T2DM was low. Surveillance behaviours were also suboptimal and perceptions on the self-management knowledge and praxis regarding lifestyle intervention components of T2DM treatment seemed detached from those of NAFLD.

Conclusions

Our findings could inform the integration of NAFLD-related content in T2DM health promotion strategies. Rising awareness on NAFLD progression and its relationship with T2DM using culturally and community-relevant constructs might facilitate the development of primary and secondary prevention programmes to promote the adherence to lifestyle interventions by influencing NAFLD threat perceptions.
Job stress and interpersonal relationships cross country evidence from the EU15: a correlation analysis
Authors: Nappo Nunzia
Published: July 2020

Background

The aim of the study is to analyse the association between job stress and interpersonal relationships on and outside of the job in Europe. The main assumption of the paper is that since social relations at various levels enhance individual well-being, they may counteract stress created by an unfavourable work environment.

Methods

The econometric analysis, based on a standard ordered probit model, employs data taken from the Sixth European Working Conditions Survey carried out in 2015 and released in 2017.

Results

The results show significant correlations between interpersonal contacts on and outside of the job and job stress. Help and support provided by one’s manager decreases the probability of being stressed at work, while receiving help and support from co-workers is likely to increase the probability of job stress occurrence. However, maintaining cooperation and getting on well with colleagues decrease the probability of experiencing stress, confirming the positive and gratifying features of contact with co-workers reported by the literature.

Conclusions

While we were not able to establish the direction of causality between job stress and interpersonal relationships (a limitation of this paper), the present work contributes new evidence to the literature on occupational stress. Our results show that interpersonal relationships on and outside of the job can be considered valuable resources that, when available to an individual, are useful for managing stress created by workplace stressors.
Correlation between percutaneous transthoracic needle biopsy and recurrence in stage I lung cancer: a systematic review and meta-analysis
Authors: Li Haichao , Chen Rong , Zhao Jian
Published: July 2020

Background

To systematically evaluate the correlation between percutaneous transthoracic needle biopsy (PTNB) and recurrence in stage I lung cancer.

Methods

The databases of PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and China Biology Medicine disc were retrieved to collect relevant literatures about the correlation between PTNB and recurrence in stage I lung cancer. The retrieval time was limited from the time of their database establishment to April 30/2020.Screened the literature, extracted the data and assessed the quality of studies included. Then the meta-analysis was performed by using Stata l6.0 software.

Results

A total of 8 cohort studies involving 2760 lung cancer patients were included. The results of meta-analysis showed that PTNB did not increase the risk of total recurrence and pleural recurrence in the patients with stage I lung cancer. The result of subgroup analysis is according to the tumor location. For stage I lung cancer, PTNB will increase the risk of pleural recurrence in patients with sub-pleural lesions but not in those without sub-pleural lesions.

Conclusions

To stage I lung cancer, PTNB is not associated with the total recurrence and pleural recurrence but PTNB will increase the risk of pleural recurrence in patients with sub-pleural lesions.