bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlates, facilitators and barriers of physical activity among primary care patients with prediabetes in Singapore – a mixed methods approach
Authors: Lim Raymond Boon Tar , Wee Wei Keong , For Wei Chek , Ananthanarayanan Jayalakshmy Aarthi , Soh Ying Hua , Goh Lynette Mei Lim , Tham Dede Kam Tyng , Wong Mee Lian
Published: January 2020

Background

Primary care patients with prediabetes is a priority group in the clinical, organisational and policy contexts. Engaging in regular physical activity is crucial to prevent diabetes for this group. The objectives of the study were to assess factors associated with meeting the recommendation of at least 150 min of moderate/vigorous physical activity weekly, and to explore facilitators and barriers related to the behaviour among primary care patients with prediabetes in Singapore.

Methods

This was a mixed methods study, consisting of a cross-sectional survey involving 433 participants from 8 polyclinics, and in-depth interviews with 48 of them. Adjusted prevalence ratios (aPR) were obtained by mixed effects Poisson regression model. The socio-ecological model (SEM) was applied, and thematic analysis performed.

Results

The prevalence of meeting the recommendation was 65.8%. This was positively associated with being male (aPR 1.21, 95%CI 1.09–1.34), living in 4–5 room public housing (aPR 1.19, 95%CI 1.07–1.31), living in executive flat/private housing (aPR 1.26, 95%CI 1.06–1.50), having family members/friends to exercise with (aPR 1.57, 95%CI 1.38–1.78); and negatively associated with a personal history of osteoarthritis (aPR 0.75, 95%CI 0.59–0.96), as well as time spent sitting or reclining daily (aPR 0.96, 95%CI 0.94–0.98). The recurrent themes for not meeting the recommendation included lacking companionship from family members/friends, medical conditions hindering physical activity (particularly osteoarthritis), lacking knowledge/skills to exercise properly, “no time” to exercise and barriers pertaining to exercise facilities in the neighbourhood. The recurrent themes for meeting the recommendation included family/peer influence, health/well-being concerns and education by healthcare professionals.

Conclusions

Much more remains to be done to promote physical activity among primary care patients with prediabetes in Singapore. Participants reported facilitators and barriers to physical activity at different levels of the SEM. Apart from the individual and interpersonal levels, practitioners and policy makers need to work together to address the organisational, community and policy barriers to physical activity.
Work-family balance and the subjective well-being of rural women in Sichuan, China
Authors: Shui Yue , Xu Dingde , Liu Yi , Liu Shaoquan
Published: January 2020

Background

Due to the great burden of family and the conflicts among family, society and career roles resulting from migrant working, rural women suffer more conflicts between work and family and need more social attention. Previous studies of the conflicts between family and work mainly focus on the group of career women, and there is a lack of the research on the conflicts between work and family of rural women, which needs to be systematically and further studied.

Methods

This study used a sample survey of 380 rural women in rural areas of Sichuan Province to measure rural women’s cognition of work-family, coordination and handling of conflicts, post-conflict choices, and subjective well-being; the study constructs an ordered multi-class logistic regression model to explore the impact of work-family conflict on the subjective well-being of rural women in rural regions.

Results

The study result shows that: (1) The level of subjective well-being of rural women is generally high, and 70% of women feel satisfied or very satisfied. (2) The factor which impacts the subjective well-being among rural women most is work-interfering-with-family conflict, followed by work-family balance and confidence in conflict coordination.

Conclusion

This study can enhance our understanding of rural women in rural areas, and provide a reference for formulating policies to improve people’s life satisfaction.
Advanced practice nurses in primary care in Switzerland: an analysis of interprofessional collaboration
Authors: Josi Renata , Bianchi Monica , Brandt Sophie Karoline
Published: January 2020

Background

The increase in the number of chronically ill patients due to ageing is calling existing models of primary care (PC) into question. New care models have recently been implemented in Swiss PC and involve interprofessional teams. This paper aimed to investigate the practice of interprofessional collaboration between advanced practice nurses, registered nurses, and medical practice assistants within new models of PC in Switzerland using the National Interprofessional Competency Framework.

Methods

An ethnographic design comprising semi-structured interviews and non-participant observations was conducted. Sixteen interviews were conducted with care providers at their PC practice. Interviewees included four advanced practice nurses, two registered nurses, six medical practice assistants, and four general practitioners. Nine other health professionals were subsequently observed in their practice. Interviews and observations were conducted by the first author from February to April 2019.

Results

Our analysis of interview and observational data confirmed that role clarification, team functioning, collaborative leadership, interprofessional conflict resolution, patient-centered care, and interprofessional communication have a significant influence on the interprofessional collaboration among health professionals in Swiss PC. Among these domains, role clarification and team functioning were the most frequently raised issues. Both were found to have the potential to negatively influence and, therefore, hinder efficient interprofessional collaboration within PC.

Conclusion

From the analysis, it emerged that role clarification is crucial for effective interprofessional collaboration within new care delivery models in the Swiss PC context. Our study results may inform international health policymakers and practitioners about six important domains of interprofessional care when implementing new care models. Practical experience with new models of care involving advanced practice nurses and medical practice assistants may also influence the regulation of the scope of practice of these health professionals in Switzerland.
Evolutionary superscaffolding and chromosome anchoring to improve Anopheles genome assemblies
Authors: Waterhouse Robert M. , Aganezov Sergey , Anselmetti Yoann , Lee Jiyoung , Ruzzante Livio , Reijnders Maarten J. M. F. , Feron Romain , Bérard Sèverine , George Phillip , Hahn Matthew W. , Howell Paul I. , Kamali Maryam , Koren Sergey , Lawson Daniel , Maslen Gareth , Peery Ashley , Phillippy Adam M. , Sharakhova Maria V. , Tannier Eric , Unger Maria F. , Zhang Simo V. , Alekseyev Max A. , Besansky Nora J. , Chauve Cedric , Emrich Scott J. , Sharakhov Igor V.
Published: January 2020

Background

New sequencing technologies have lowered financial barriers to whole genome sequencing, but resulting assemblies are often fragmented and far from ‘finished’. Updating multi-scaffold drafts to chromosome-level status can be achieved through experimental mapping or re-sequencing efforts. Avoiding the costs associated with such approaches, comparative genomic analysis of gene order conservation (synteny) to predict scaffold neighbours (adjacencies) offers a potentially useful complementary method for improving draft assemblies.

Results

We evaluated and employed 3 gene synteny-based methods applied to 21 Anopheles mosquito assemblies to produce consensus sets of scaffold adjacencies. For subsets of the assemblies, we integrated these with additional supporting data to confirm and complement the synteny-based adjacencies: 6 with physical mapping data that anchor scaffolds to chromosome locations, 13 with paired-end RNA sequencing (RNAseq) data, and 3 with new assemblies based on re-scaffolding or long-read data. Our combined analyses produced 20 new superscaffolded assemblies with improved contiguities: 7 for which assignments of non-anchored scaffolds to chromosome arms span more than 75% of the assemblies, and a further 7 with chromosome anchoring including an 88% anchored Anopheles arabiensis assembly and, respectively, 73% and 84% anchored assemblies with comprehensively updated cytogenetic photomaps for Anopheles funestus and Anopheles stephensi.

Conclusions

Experimental data from probe mapping, RNAseq, or long-read technologies, where available, all contribute to successful upgrading of draft assemblies. Our evaluations show that gene synteny-based computational methods represent a valuable alternative or complementary approach. Our improved Anopheles reference assemblies highlight the utility of applying comparative genomics approaches to improve community genomic resources.
Therapeutic effect of subcutaneous injection of low dose recombinant human granulocyte-macrophage colony-stimulating factor on pulmonary alveolar proteinosis
Authors: Zhang Fen , Weng Dong , Su Yiliang , Yin Chengsheng , Shen Li , Zhang Yuan , Zhou Ying , Li Qiuhong , Hu Yang , Li Huiping
Published: January 2020

Objective

To observe the efficacy of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) for pulmonary alveolar proteinosis (PAP).

Materials and methods

A total of 55 patients with PAP were screened at Shanghai Pulmonary Hospital between May 2014 and May 2018. Among these, 42 were diagnosed with idiopathic PAP, 24 were included in this study, 20 were treated for 6 months, and 17 were followed up for additional 6 months. All patients received a subcutaneous injection of 75μg/d GM-CSF qd for 1 month. The therapeutic dose was adjusted according to the changes in the lesions of chest CT. If the lesions were absorbed, subcutaneous injections of 75μg/d GM- CSF qd and 75μg/d GM-CSF qod were given for 2 and 3 months, otherwise, the dose was increased to 150μg/d GM-CSF qd and 150μg/d qod for 2 and 3 months, respectively. All cases were treated once a day in the first 3 months and once every other day in the last 3 months. The total course of treatment was 6 months. After withdrawal, the patients were followed up for another 6 months. The deadline of follow up was September 30, 2019.

Results

Twenty patients completed the treatment and efficacy evaluation. One patient was completely cured, 16 cases improved, three cases were noneffective. After 1-month evaluation, 12 patients received an increased dose (150μg) from the second month of treatment. Seventeen patients completed the 12-month follow-up, among which fourteen improved. CT showed the lesions were slightly increased in three cases. Economic burden was the following: RMB 7324–15,190 Yuan were required for the 6-month treatment course, which is significantly lower compared to other treatment methods.

Conclusion

Subcutaneous injection of rhGM-CSF at low dose (75μg-150μg /d) is effective treatment for patients with idiopathic PAP.

Trial registration

NCT01983657. Registered 16 April 2013.
Breaking the selectivity-uptake trade-off of photoimmunoconjugates with nanoliposomal irinotecan for synergistic multi-tier cancer targeting
Authors: Liang Barry J. , Pigula Michael , Baglo Yan , Najafali Daniel , Hasan Tayyaba , Huang Huang-Chiao
Published: January 2020

Background

Photoimmunotherapy involves targeted delivery of photosensitizers via an antibody conjugate (i.e., photoimmunoconjugate, PIC) followed by light activation for selective tumor killing. The trade-off between PIC selectivity and PIC uptake is a major drawback limiting the efficacy of photoimmunotherapy. Despite ample evidence showing that photoimmunotherapy is most effective when combined with chemotherapy, the design of nanocarriers to co-deliver PICs and chemotherapy drugs remains an unmet need. To overcome these challenges, we developed a novel photoimmunoconjugate-nanoliposome (PIC-Nal) comprising of three clinically used agents: anti-epidermal growth factor receptor (anti-EGFR) monoclonal antibody cetuximab (Cet), benzoporphyrin derivative (BPD) photosensitizer, and irinotecan (IRI) chemotherapy.

Results

The BPD photosensitizers were first tethered to Cet at a molar ratio of 6:1 using carbodiimide chemistry to form PICs. Conjugation of PICs onto nanoliposome irinotecan (Nal–IRI) was facilitated by copper-free click chemistry, which resulted in monodispersed PIC–Nal–IRI with an average size of 158.8 ± 15.6 nm. PIC–Nal–IRI is highly selective against EGFR-overexpressing epithelial ovarian cancer cells with 2- to 6-fold less accumulation in low EGFR expressing cells. Successful coupling of PIC onto Nal–IRI enhanced PIC uptake and photoimmunotherapy efficacy by up to 30% in OVCAR-5 cells. Furthermore, PIC–Nal–IRI synergistically reduced cancer viability via a unique three-way mechanism (i.e., EGFR downregulation, mitochondrial depolarization, and DNA damage).

Conclusion

It is increasingly evident that the most effective therapies for cancer will involve combination treatments that target multiple non-overlapping pathways while minimizing side effects. Nanotechnology combined with photochemistry provides a unique opportunity to simultaneously deliver and activate multiple drugs that target all major regions of a cancer cell—plasma membrane, cytoplasm, and nucleus. PIC–Nal–IRI offers a promising strategy to overcome the selectivity-uptake trade-off, improve photoimmunotherapy efficacy, and enable multi-tier cancer targeting. Controllable drug compartmentalization, easy surface modification, and high clinical relevance collectively make PIC–Nal–IRI extremely valuable and merits further investigations in living animals.
Nanoantibiotics containing membrane-active human cathelicidin LL-37 or synthetic ceragenins attached to the surface of magnetic nanoparticles as novel and innovative therapeutic tools: current status and potential future applications
Authors: Wnorowska Urszula , Fiedoruk Krzysztof , Piktel Ewelina , Prasad Suhanya V. , Sulik Magdalena , Janion Marianna , Daniluk Tamara , Savage Paul B. , Bucki Robert
Published: January 2020

Nanotechnology-based therapeutic approaches have attracted attention of scientists, in particular due to the special features of nanomaterials, such as adequate biocompatibility, ability to improve therapeutic efficiency of incorporated drugs and to limit their adverse effects. Among a variety of reported nanomaterials for biomedical applications, metal and metal oxide-based nanoparticles offer unique physicochemical properties allowing their use in combination with conventional antimicrobials and as magnetic field-controlled drug delivery nanocarriers. An ever-growing number of studies demonstrate that by combining magnetic nanoparticles with membrane-active, natural human cathelicidin-derived LL-37 peptide, and its synthetic mimics such as ceragenins, innovative nanoagents might be developed. Between others, they demonstrate high clinical potential as antimicrobial, anti-cancer, immunomodulatory and regenerative agents. Due to continuous research, knowledge on pleiotropic character of natural antibacterial peptides and their mimics is growing, and it is justifying to stay that the therapeutic potential of nanosystems containing membrane active compounds has not been exhausted yet.
Developing item banks to measure three important domains of health-related quality of life (HRQOL) in Singapore
Authors: Uy Elenore Judy B. , Xiao Lynn Yun Shan , Xin Xiaohui , Yeo Joanna Peck Tiang , Pua Yong Hao , Lee Geok Ling , Kwan Yu Heng , Teo Edmund Pek Siang , Vaingankar Janhavi Ajit , Subramaniam Mythily , Chan Mei Fen , Kumar Nisha , Ang Alcey Li Chang , Bautista Dianne Carrol , Cheung Yin Bun , Thumboo Julian
Published: January 2020

Objectives

To develop separate item banks for three health domains of health-related quality of life (HRQOL) ranked as important by Singaporeans – physical functioning, social relationships, and positive mindset.

Methods

We adapted the Patient Reported Outcomes Measurement Information System Qualitative Item Review protocol, with input and endorsement from laymen and experts from various relevant fields. Items were generated from 3 sources: 1) thematic analysis of focus groups and in-depth interviews for framework (n = 134 participants) and item(n = 52 participants) development, 2) instruments identified from a literature search (PubMed) of studies that developed or validated a HRQOL instrument among adults in Singapore, 3) a priori identified instruments of particular relevance. Items from these three sources were “binned” and “winnowed” by two independent reviewers, blinded to the source of the items, who harmonized their selections to generate a list of candidate items (each item representing a subdomain). Panels with lay and expert representation, convened separately for each domain, reviewed the face and content validity of these candidate items and provided inputs for item revision. The revised items were further refined in cognitive interviews.

Results

Items from our qualitative studies (51 physical functioning, 44 social relationships, and 38 positive mindset), the literature review (36 instruments from 161 citations), and three a priori identified instruments, underwent binning, winnowing, expert panel review, and cognitive interview. This resulted in 160 candidate items (61 physical functioning, 51 social relationships, and 48 positive mindset).

Conclusions

We developed item banks for three important health domains in Singapore using inputs from potential end-users and the published literature. The next steps are to calibrate the item banks, develop computerized adaptive tests (CATs) using the calibrated items, and evaluate the validity of test scores when these item banks are administered adaptively.
Implementation analysis of patient reported outcomes (PROs) in oncological routine care: an observational study protocol
Authors: Görlach Mirja Gianna , Schrage Theresa , Bokemeyer Carsten , Kröger Nicolaus , Müller Volkmar , Petersen Cordula , Betz Christian Stephan , Krüll Andreas , Schulz Holger , Bleich Christiane
Published: January 2020

Background

The successful implementation of patient-reported outcomes (PROs) in clinical routine faces many challenges, first and foremost the lack of consideration thereof in the patient care process. The aim of this study will be to first identify relevant barriers and facilitators and then design suitable implementation strategies which will be evaluated to improve the effectiveness of a PRO measure assessment in inpatient and outpatient cancer routine care.

Methods

During the preparation phase, interviews with oncological patients (N = 28) and medical staff (N = 4) as well as focus groups with medical staff (N = 18) across five different departments caring for cancer patients were conducted. On the basis of these, qualitative content analysis revealed relevant barriers and facilitators for implementation of PROs in cancer care. Subsequently, implementation strategies and a model of implementation were developed. In the study phase, implementation strategies will be evaluated based on nine different implementation outcomes in five different oncological clinics. Evaluation of the implementation process will take place during three months in each clinic and data will be conducted pre, while and post implementation of the PRO measure. Therefore a sample size of 60 participants of whom 30 staff members and 30 participants will be questioned using existing and newly developed implementation outcome evaluation instruments.

Discussion

Key to improving the effectiveness of PRO assessment in the time-critical clinical environment is the utilization of easy-to-use, electronic PRO questionnaires directly linked to patients’ records thereby improving consideration of PROs in patient care. In order to validate the effectiveness of this implementation process further, an evaluation parallel to implementation following an observational study design with a mixed-methods approach will be conducted. This study could contribute to the development of adequate evaluation processes of implementation of PROs to foster sustainable integration of PRO measures into routine cancer care.

Trial registration

This study was registered at Open Science Framework (https://osf.io/y7xce/).
Development and validation of a nomogram for preoperative prediction of lymph node metastasis in early gastric cancer
Authors: Yin Xiao-Yi , Pang Tao , Liu Yu , Cui Hang-Tian , Luo Tian-Hang , Lu Zheng-Mao , Xue Xu-Chao , Fang Guo-En
Published: January 2020

Background

The status of lymph nodes in early gastric cancer is critical to make further clinical treatment decision, but the prediction of lymph node metastasis remains difficult before operation. This study aimed to develop a nomogram that contained preoperative factors to predict lymph node metastasis in early gastric cancer patients.

Methods

This study analyzed the clinicopathologic features of 823 early gastric cancer patients who underwent gastrectomy retrospectively, among which 596 patients were recruited in the training cohort and 227 patients in the independent validation cohort. Significant risk factors in univariate analysis were further identified to be independent variables in multivariable logistic regression analysis, which were then incorporated in and presented with a nomogram. And internal and external validation curves were plotted to evaluate the discrimination of the nomogram.

Results

Totally, six independent predictors, including the tumor size, macroscopic features, histology differentiation, P53, carbohydrate antigen 19-9, and computed tomography-reported lymph node status, were enrolled in the nomogram. Both the internal validation in the training cohort and the external validation in the validation cohort showed the nomogram had good discriminations, with a C-index of 0.82 (95%CI, 0.78 to 0.86) and 0.77 (95%CI, 0.60 to 0.94) respectively.

Conclusions

Our study developed a new nomogram which contained the most common and significant preoperative risk factors for lymph node metastasis in patients with early gastric cancer. The nomogram can identify early gastric cancer patients with the high probability of lymph node metastasis and help clinicians make more appropriate decisions in clinical practice.
Reweighting national survey data for small area behaviour estimates: modelling alcohol consumption in Local Authorities in England
Authors: Pryce Robert , Angus Colin , Holmes John , Gillespie Duncan , Buykx Penny , Meier Petra , Hickman Matt , de Vocht Frank , Brennan Alan
Published: January 2020

Background

There are likely to be differences in alcohol consumption levels and patterns across local areas within a country, yet survey data is often collected at the national or sub-national/regional level and is not representative for small geographic areas.

Methods

This paper presents a method for reweighting national survey data—the Health Survey for England—by combining survey and routine data to produce simulated locally representative survey data and provide statistics of alcohol consumption for each Local Authority in England.

Results

We find a 2-fold difference in estimated mean alcohol consumption between the lightest and heaviest drinking Local Authorities, a 4.5-fold difference in abstention rates, and a 3.5-fold difference in harmful drinking. The method compares well to direct estimates from the data at regional level.

Conclusions

The results have important policy implications in itself, but the reweighted data can also be used to model local policy effects. This method can also be used for other public health small area estimation where locally representative data are not available.
Globalization of national surgical, obstetric and anesthesia plans: the critical link between health policy and action in global surgery
Authors: Truché Paul , Shoman Haitham , Reddy Ché L. , Jumbam Desmond T. , Ashby Joanna , Mazhiqi Adelina , Wurdeman Taylor , Ameh Emmanuel A. , Smith Martin , Lugazia Edwin , Makasa Emmanuel , Park Kee B. , Meara John G.
Published: January 2020

Efforts from the developed world to improve surgical, anesthesia and obstetric care in low- and middle-income countries have evolved from a primarily volunteer mission trip model to a sustainable health system strengthening approach as private and public stakeholders recognize the enormous health toll and financial burden of surgical disease. The National Surgical, Obstetric and Anesthesia Plan (NSOAP) has been developed as a policy strategy for countries to address, in part, the health burden of diseases amenable to surgical care, but these plans have not developed in isolation. The NSOAP has become a phenomenon of globalization as a broad range of partners – individuals and institutions – help in both NSOAP formulation, implementation and financing. As the nexus between policy and action in the field of global surgery, the NSOAP reflects a special commitment by state actors to make progress on global goals such as Universal Health Coverage and the United Nations Sustainable Development Goals. This requires a continued global commitment involving genuine partnerships that embrace the collective strengths of both national and global actors to deliver sustained, safe and affordable high-quality surgical care for all poor, rural and marginalized people.
Microarray expression studies on bone marrow of patients with Shwachman-Diamond syndrome in relation to deletion of the long arm of chromosome 20, other chromosome anomalies or normal karyotype
Authors: Khan Abdul Waheed , Minelli Antonella , Frattini Annalisa , Montalbano Giuseppe , Bogni Alessia , Fabbri Marco , Porta Giovanni , Acquati Francesco , Pinto Rita Maria , Bergami Elena , Mura Rossella , Pegoraro Anna , Cesaro Simone , Cipolli Marco , Zecca Marco , Danesino Cesare , Locatelli Franco , Maserati Emanuela , Pasquali Francesco , Valli Roberto
Published: January 2020

Background

Clonal chromosome changes are often found in the bone marrow (BM) of patients with Shwachman-Diamond syndrome (SDS). The most frequent ones include an isochromosome of the long arm of chromosome 7, i (7)(q10), and an interstitial deletion of the long arm of chromosome 20, del (20)(q). These two imbalances are mechanisms of somatic genetic rescue. The literature offers few expression studies on SDS.

Results

We report the expression analysis of bone marrow (BM) cells of patients with SDS in relation to normal karyotype or to the presence of clonal chromosome anomalies: del (20)(q) (five cases), i (7)(q10) (one case), and other anomalies (two cases). The study was performed using the microarray technique considering the whole transcriptome (WT) and three gene subsets selected as relevant in BM functions. The expression patterns of nine healthy controls and SDS patients with or without chromosome anomalies in the bone marrow showed clear differences.

Conclusions

There is a significant difference between gene expression in the BM of SDS patients and healthy subjects, both at the WT level and in the selected gene sets. The deletion del (20)(q), with the EIF6 gene consistently lost, even in patients with the smallest losses of material, changes the transcription pattern: a low proportion of abnormal cells led to a pattern similar to SDS patients without acquired anomalies, whereas a high proportion yields a pattern similar to healthy subjects. Hence, the benign prognostic value of del (20)(q). The case of i (7)(q10) showed a transcription pattern similar to healthy subjects, paralleling the positive prognostic role of this anomaly as well.
0.9% saline versus Plasma-Lyte as initial fluid in children with diabetic ketoacidosis (SPinK trial): a double-blind randomized controlled trial
Authors: Williams Vijai , Jayashree Muralidharan , Nallasamy Karthi , Dayal Devi , Rawat Amit
Published: January 2020

Background

Acute kidney injury (AKI) is an important complication encountered during the course of diabetic ketoacidosis (DKA). Plasma-Lyte with lower chloride concentration than saline has been shown to be associated with reduced incidence of AKI in adults with septic shock. No study has compared this in DKA.

Methods

This double-blind, parallel-arm, investigator-initiated, randomized controlled trial compared 0.9% saline with Plasma-Lyte-A as initial fluid in pediatric DKA. The study was done in a tertiary care, teaching, and referral hospital in India in children (> 1 month–12 years) with DKA as defined by ISPAD. Children with cerebral edema or known chronic kidney/liver disease or who had received pre-referral fluids and/or insulin were excluded. Sixty-six children were randomized to receive either Plasma-Lyte (n = 34) or 0.9% saline (n = 32).

Main outcomes

Primary outcome was incidence of new or progressive AKI, defined as a composite outcome of change in creatinine (defined by KDIGO), estimated creatinine clearance (defined by p-RIFLE), and NGAL levels. The secondary outcomes were resolution of AKI, time to resolution of DKA (pH > 7.3, bicarbonate> 15 mEq/L & normal sensorium), change in chloride, pH and bicarbonate levels, proportion of in-hospital all-cause mortality, need for renal replacement therapy (RRT), and length of ICU and hospital stay.

Results

Baseline characteristics were similar in both groups. The incidence of new or progressive AKI was similar in both [Plasma-Lyte 13 (38.2%) versus 0.9% saline 15 (46.9%); adjusted OR 1.22; 95% CI 0.43–3.43, p = 0.70]. The median (IQR) time to resolution of DKA in Plasma-Lyte-A and 0.9% saline were 14.5 (12 to 20) and 16 (8 to 20) h respectively. Time to resolution of AKI was similar in both [Plasma-Lyte 22.1 versus 0.9% saline 18.8 h (adjusted HR 1.72; 95% CI 0.83–3.57; p = 0.14)]. Length of hospital stay was also similar in both [Plasma-Lyte 9 (8 to 12) versus 0.9% saline 10 (8.25 to 11) days; p = 0.39].

Conclusions

The incidence of new or progressive AKI and resolution of AKI were similar in both groups. Plasma-Lyte-A was similar to 0.9% Saline in time to resolution of DKA, need for RRT, mortality, and lengths of PICU and hospital stay.

Trial registration

Clinical trial registry of India, CTRI/2018/05/014042 (ctri.nic.in) (Retrospectively registered).
Reducing violent discipline by teachers using Interaction Competencies with Children for Teachers (ICC-T): study protocol for a matched cluster randomized controlled trial in Tanzanian public primary schools
Authors: Masath Faustine Bwire , Hermenau Katharin , Nkuba Mabula , Hecker Tobias
Published: January 2020

Background

Despite the existing national and international plans of action to end violent discipline strategies used by teachers in schools, they still prevail in Tanzanian schools. This underlines the need to implement school-based interventions that aim at reducing violent discipline by teachers. In this study, we will evaluate the feasibility and effectiveness of the preventative intervention Interaction Competencies with Children – for Teachers (ICC-T) in Tanzanian primary schools. Following its success in secondary schools, we hypothesize that the intervention will reduce teachers’ positive attitudes towards and their use of violent discipline at school.

Methods/design

The study will be conducted in six randomly selected regions in Tanzania. We have already randomly selected two schools in each region (12 in total) that fulfill our inclusion criteria. From each region, one school will be randomly assigned to the intervention and the other to the monitoring group (no intervention). Eighty students between the ages of 9 to 12 years (N = 960) and 20 teachers from each school (N = 240) will be included in the trial. We will collect data directly before the intervention (t1) and 6 months after the intervention (t2) both at intervention and monitoring schools. Using guided questionnaire assessments, we will measure violence by teachers using students’ reports on their exposure to and teachers’ reports on their use of violence using the Conflict Tactics Scale. Furthermore, we will assess teachers’ positive attitudes towards violent discipline using a modified version of the Conflict Tactic Scale. The feasibility of the intervention will be evaluated using purpose-built measures assessing the demand, applicability, acceptability, and integration of core elements into daily work in the participating schools.

Discussion

The proposed study will allow us to test the feasibility and effectiveness of an intervention aiming to reduce positive attitudes towards and the use of violent discipline by teachers in school settings. With the reduction of violent discipline by teachers, this study contributes to national and international efforts towards ending violence against children as well as the attainment of the United Nations’ Sustainable Development Goals that also aim to prevent all types of maltreatment of children.

Trial registration

ClinicalTrials.gov, NCT03893851. Registered on 28 March 2019.
A trial protocol for the effectiveness of digital interventions for preventing depression in adolescents: The Future Proofing Study
Authors: Werner-Seidler Aliza , Huckvale Kit , Larsen Mark E. , Calear Alison L. , Maston Kate , Johnston Lara , Torok Michelle , O’Dea Bridianne , Batterham Philip J. , Schweizer Susanne , Skinner S. Rachel , Steinbeck Katharine , Ratcliffe Julie , Oei Ju-Lee , Patton George , Wong Iana , Beames Joanne , Wong Quincy J. J. , Lingam Raghu , Boydell Katherine , Salmon Allison M. , Cockayne Nicole , Mackinnon Andrew , Christensen Helen
Published: January 2020

Background

Depression frequently first emerges during adolescence, and one in five young people will experience an episode of depression by the age of 18 years. Despite advances in treatment, there has been limited progress in addressing the burden at a population level. Accordingly, there has been growing interest in prevention approaches as an additional pathway to address depression. Depression can be prevented using evidence-based psychological programmes. However, barriers to implementing and accessing these programmes remain, typically reflecting a requirement for delivery by clinical experts and high associated delivery costs. Digital technologies, specifically smartphones, are now considered a key strategy to overcome the barriers inhibiting access to mental health programmes. The Future Proofing Study is a large-scale school-based trial investigating whether cognitive behaviour therapies (CBT) delivered by smartphone application can prevent depression.

Methods

A randomised controlled trial targeting up to 10,000 Year 8 Australian secondary school students will be conducted. In Stage I, schools will be randomised at the cluster level either to receive the CBT intervention app (SPARX) or to a non-active control group comparator. The primary outcome will be symptoms of depression, and secondary outcomes include psychological distress, anxiety and insomnia. At the 12-month follow-up, participants in the intervention arm with elevated depressive symptoms will participate in an individual-level randomised controlled trial (Stage II) and be randomised to receive a second CBT app which targets sleep difficulties (Sleep Ninja) or a control condition. Assessments will occur post intervention (both trial stages) and at 6, 12, 24, 36, 48 and 60 months post baseline. Primary analyses will use an intention-to-treat approach and compare changes in symptoms from baseline to follow-up relative to the control group using mixed-effect models.

Discussion

This is the first trial testing the effectiveness of smartphone apps delivered to school students to prevent depression at scale. Results from this trial will provide much-needed insight into the feasibility of this approach. They stand to inform policy and commission decisions concerning if and how such programmes should be deployed in school-based settings in Australia and beyond.

Trial registration

Australian and New Zealand Clinical Trial Registry, ACTRN12619000855123. Registered on 31 May 2019.

Clinical Trial Notification Scheme (CTN), CT-2019-CTN-02110-1-v1. Registered on 30 June 2019.
Pre-operative anxiolysis in children through a combined pharmacological therapy with hydroxyzine and a non-pharmacological distraction technique with a clown (SONRISA): study protocol for randomised double-blind clinical trial
Authors: Aleo Luján Esther , Lopez-Picado Amanda , Rivas Ana , Joyanes Abancens Belén , Rodríguez Rojo Marina Laura , Fernández García Patricia , Soto Beauregard Carmen , Rodríguez Alarcón Jaime , González Perrino Carlos , San Pedro de Urquiza Borja , Arias Eva , Rodriguez Diamelis , Esteban Polonio Carmen , Torrejón Maria José
Published: January 2020

Background

Surgery can generate significant stress and anxiety in up to 70% of the paediatric population. There are several pharmacological and non-pharmacological strategies to reduce pre-operative anxiety in children, however, they have several side effects and the available information about them is contradictory. The role of clowns and hydroxyzine in the management of anxiety is controversial, with some studies supporting and others contraindicating both strategies.

Methods

We propose a randomised double-blind, controlled clinical trial that will evaluate the effectiveness of both interventions (hydroxyzine and clowns), alone or in combination, to reduce pre-operative anxiety (using the modified Yale scale of preoperative anxiety) in children aged 2–16 years undergoing outpatient surgery (n = 188).

Subjects will be randomised into two groups – (1) standard procedure (parental accompaniment) combined with placebo or (2) standard procedure combined with preoperative hydroxyzine. After randomisation, they will be divided by chance into two further groups, depending on the presence of clowns on the patient’s surgery day. Control of pre-operative anxiety will be determined in the four groups by a modified Yale scale of preoperative anxiety and cortisol levels. Compliance of children during induction of anaesthesia, time until anaesthesia recovery, presence of postoperative delirium and use of analgesia until discharge will be also assessed. For additional information, the children, parents and healthcare professionals involved in the study will complete a satisfaction survey.

Conclusions

This study aims to gather evidence on which of these four therapeutic options achieves the highest reduction of pre-operative anxiety with the best safety profile to allow paediatricians and anaesthesiologists to use the most effective and safe option for their patients.

Trial registration

ClinicalTrials.gov identifier:NCT03324828. Registered 21 September 2017.
Drug-induced hepatotoxicity among TB/HIV co-infected patients in a referral hospital, Ethiopia
Authors: Zeleke Abebe , Misiker Bethelihem , Yesuf Teshager Aklilu
Published: January 2020

Objectives

Anti-tuberculosis drug-induced hepatotoxicity is a common serious adverse drug reaction. This study intended to determine the prevalence and associated factors of drug-induced hepatotoxicity among tuberculosis and human immunodeficiency virus co-infected patients in Dessie referral hospital northeast Ethiopia.

Results

In this cross-sectional study 84 patients were enrolled retrospectively. Data from September 1/2015 to August 30/2018 were extracted from March 1/2019 to April 1/2019. Association between dependent and independent variables was determined using the odds ratio and a P value of < 0.05 was considered as statistical significance. Out of 84 patients, 17 patients developed drug-induced hepatotoxicity which makes the prevalence of drug-induced hepatotoxicity 20.2%. The result revealed that the presence of disseminated or extrapulmonary tuberculosis [(AOR: 7.728, 95% CI (1.516–39.404)] and/or body mass index less than 18.5 kg/m2 [(AOR = 5.593, 95% CI (1.180–26.519)] were a risk factor for drug-induced hepatotoxicity. Tuberculosis and human immunodeficiency virus co-infected patients with extra- pulmonary tuberculosis and/or body mass index less than 18.5 kg/m2 should be closely followed and supervised for the development of hepatotoxicity.
Exploring the decoy effect to guide tobacco treatment choice: a randomized experiment
Authors: Rogers Erin S. , Vargas Elizabeth A. , Voigt Elizabeth
Published: January 2020

Objectives

Guidelines recommend that smokers participate in four or more counseling sessions when trying to quit, but smokers rarely engage in multiple sessions. The “decoy effect” is a cognitive bias that can cause consumer preferences for a “target” product to change when presented with a similar but inferior product (a “decoy”). This study tested the use of a decoy to guide smokers’ selection of a target number of counseling sessions. During an online survey, adult tobacco users (N = 93) were randomized to one of two groups that determined the answer choices they saw in response to a question assessing their interest in multi-session cessation counseling. Group A choose between two sessions or a “target” of five sessions. Group B was given a third “decoy” option of seven sessions. Binary logistic regression was used to compare groups on the proportion of participants selecting the “target.”

Results

Among 90 participants with complete data, a decoy effect was not found. There was no significant difference between groups in the proportion of participants selecting the target of five sessions (47% in Group B vs. 53% in Group A; aOR = 0.76, 95%CI 0.48–1.19).

Trial Registration This study was retrospectively registered at clinicaltrials.gov on December 13, 2019 (NCT04200157)
Cluster of differentiation 8 and programmed cell death ligand 1 expression in triple-negative breast cancer combined with autosomal dominant polycystic kidney disease and tuberous sclerosis complex: a case report
Authors: Gonda Kenji , Akama Takanori , Nakamura Takayuki , Hashimoto Eiko , Kyoya Naomi , Rokkaku Yuichi , Maejima Yuko , Horita Shoichiro , Tachibana Kazunoshin , Abe Noriko , Ohtake Tohru , Shimomura Kenju , Kono Koji , Saji Shigehira , Takenoshita Seiichi , Higashihara Eiji
Published: January 2020

Background

Autosomal dominant polycystic kidney disease is defined as an inherited disorder characterized by renal cyst formation due to mutations in the PKD1 or PKD2 gene, whereas tuberous sclerosis complex is an autosomal dominant neurocutaneous syndrome caused by mutation or deletion of the TSC2 gene. A TSC2/PKD1 contiguous gene syndrome, which is caused by a chromosomal mutation that disrupts both the TSC2 and PKD1 genes, has been identified in patients with tuberous sclerosis complex and severe early-onset autosomal dominant polycystic kidney disease. The tumor tissue of patients with breast cancer with contiguous gene syndrome has a high mutation burden and produces several neoantigens. A diffuse positive immunohistochemistry staining for cluster of differentiation 8+ in the T cells of breast cancer tissue is consistent with neoantigen production due to high mutation burden.

Case presentation

A 61-year-old Japanese woman who had been undergoing dialysis for 23 years because of end-stage renal failure secondary to autosomal dominant polycystic kidney disease was diagnosed as having triple-negative breast cancer and underwent mastectomy in 2015. She had a history of epilepsy and skin hamartoma. Her grandmother, mother, two aunts, four cousins, and one brother were also on dialysis for autosomal dominant polycystic kidney disease. Her brother had epilepsy and a brain nodule. Another brother had a syndrome of kidney failure, intellectual disability, and diabetes mellitus, which seemed to be caused by mutation in the CREBBP gene. Immunohistochemistry of our patient’s breast tissue showed cluster of differentiation 8 and programmed cell death ligand 1 positivity.

Conclusions

Programmed cell death ligand 1 checkpoint therapy may be effective for recurrence of triple-negative breast cancer in a patient with autosomal dominant polycystic kidney disease and tuberous sclerosis complex.
A new load balancing strategy by task allocation in edge computing based on intermediary nodes
Authors: Li Guangshun , Yao Yonghui , Wu Junhua , Liu Xiaoxiao , Sheng Xiaofei , Lin Qingyan
Published: January 2020

The latency of cloud computing is high for the reason that it is far from terminal users. Edge computing can transfer computing from the center to the network edge. However, the problem of load balancing among different edge nodes still needs to be solved. In this paper, we propose a load balancing strategy by task allocation in edge computing based on intermediary nodes. The intermediary node is used to monitor the global information to obtain the real-time attributes of the edge nodes and complete the classification evaluation. First, edge nodes can be classified to three categories (light-load, normal-load, and heavy-load), according to their inherent attributes and real-time attributes. Then, we propose a task assignment model and allocate new tasks to the relatively lightest load node. Experiments show that our method can balance load among edge nodes and reduce the completion time of tasks.
A note on the boundedness of sublinear operators on grand variable Herz spaces
Authors: Nafis Hammad , Rafeiro Humberto , Zaighum Muhammad Asad
Published: January 2020

In this paper, we introduce grand variable Herz type spaces using discrete grand spaces and prove the boundedness of sublinear operators on these spaces.
On weighted Atangana–Baleanu fractional operators
Authors: Al-Refai Mohammed
Published: January 2020

In this paper, we define the weighted Atangana–Baleanu fractional operators of Caputo sense. We obtain the solution of a related linear fractional differential equation in a closed form, and use the result to define the weighted Atangana–Baleanu fractional integral. We then express the weighted Atangana–Baleanu fractional derivative in a convergent series of Riemann–Liouville fractional integrals, and establish commutative results of the weighted Atangana–Baleanu fractional operators.
Developing an online hate classifier for multiple social media platforms
Authors: Salminen Joni , Hopf Maximilian , Chowdhury Shammur A. , Jung Soon-gyo , Almerekhi Hind , Jansen Bernard J.
Published: January 2020

The proliferation of social media enables people to express their opinions widely online. However, at the same time, this has resulted in the emergence of conflict and hate, making online environments uninviting for users. Although researchers have found that hate is a problem across multiple platforms, there is a lack of models for online hate detection using multi-platform data. To address this research gap, we collect a total of 197,566 comments from four platforms: YouTube, Reddit, Wikipedia, and Twitter, with 80% of the comments labeled as non-hateful and the remaining 20% labeled as hateful. We then experiment with several classification algorithms (Logistic Regression, Naïve Bayes, Support Vector Machines, XGBoost, and Neural Networks) and feature representations (Bag-of-Words, TF-IDF, Word2Vec, BERT, and their combination). While all the models significantly outperform the keyword-based baseline classifier, XGBoost using all features performs the best (F1 = 0.92). Feature importance analysis indicates that BERT features are the most impactful for the predictions. Findings support the generalizability of the best model, as the platform-specific results from Twitter and Wikipedia are comparable to their respective source papers. We make our code publicly available for application in real software systems as well as for further development by online hate researchers.