bluuebunny/crossref_metadata_2025 huggingface dataset:
Individual and age differences in block-by-block dynamics of category learning strategies
Authors: Gouravajhala Reshma , Wahlheim Christopher N , McDaniel Mark A
Published: November 2019

The present experiment examined individual and age differences in the dynamics of category learning strategies. Participants learned categories determined by a disjunctive rule with relational features through a feedback training procedure. During training, participants responded to strategy probes following each block to provide online assessment of the extent to which rule- and exemplar-based strategies were used throughout the training period. We introduced this measure as an alternative to model-based approaches to assessing individual differences in strategy use during training. Following training, participants classified ambiguous transfer objects that were assumed to distinguish between earlier use of rule- and exemplar-based learning strategies. We included this measure to obtain a relatively objective index of strategy use during training. Next, participants provided global ratings of their use of rule- and exemplar-based strategies during training. Results showed that strategy preferences expressed on the final training block predicted categorisation of ambiguous transfer objects better than global strategy reports. In addition, we utilised the block-by-block strategy reports to investigate the dynamics of learners’ strategy preferences over the course of training. The findings revealed greater fluidity in strategy preferences for both younger and older adults than has been previously documented in the category learning literature. The novel block-by-block strategy reports in conjunction with the transfer-based approach allowed for a more nuanced examination of individual and age differences in strategy use and categorisation performance.
The effects of encoding instruction and opportunity on the recollection of behaviourally relevant events
Authors: Broitman Adam Wood , Swallow Khena Marie
Published: November 2019

How does attending to a brief, behaviourally relevant stimulus affect episodic memory encoding? In the attentional boost effect, increasing attention to a brief target in a detection task boosts memory for items that are presented at the same time (relative to distractor-paired items). Although the memory advantage for target-paired items is well established, the effects of attending to targets on other aspects of episodic memory encoding are unclear. This study examined the effects of target detection and goal-directed attention on memory for task-irrelevant information from a single event, focusing on the contributions of recollection and familiarity during recognition. In Experiment 1, participants viewed a series of briefly presented faces as they performed a detection task on unrelated squares, pressing the space bar only when the square was a target colour (e.g., blue) rather than a distractor colour (e.g., orange). Half of the participants were told to memorise the faces, and half were told to ignore them. Results indicated that both recollection and familiarity were greater for target-paired faces than for distractor-paired faces, regardless of whether the faces were intentionally encoded. Experiment 2 examined whether these effects are present for single events, replicating the recollection benefit when encoding time is sufficient. Attending to behaviourally relevant targets appears to facilitate both intentional and incidental memory for the background item and the context in which it occurred, boosting subsequent recollection as well as familiarity.
Augmented reality as a form of digital technology in early childhood education
Authors: Madanipour Parian , Cohrssen Caroline
Published: November 2019

The incorporation of digital technologies is explicitly addressed in the Early Years Learning Framework for Australia. The use of augmented reality (AR) technology, as one form of digital technology, is increasingly embedded in digital applications because it allows individuals to interact with real and virtual objects. A significant body of research has reported the benefits afforded by the use of AR technology in schools and higher education settings. However, little is known about the contribution of AR technology to teaching practice and child learning outcomes in the preschool years. Here, we present a summary of the limited research that has explored the use of AR in preschool curricula and argue for the need for further research to explore the contribution of AR to high-quality pedagogical practice.
Targeted Treatment Protocol in Patellofemoral Pain: Does Treatment Designed According to Subgroups Improve Clinical Outcomes in Patients Unresponsive to Multimodal Treatment?
Authors: Yosmaoğlu Hayri Baran , Selfe James , Sonmezer Emel , Sahin İlknur Ezgi , Duygu Senay Çerezci , Acar Ozkoslu Manolya , Richards Jim , Janssen Jessica
Published: November 2019

Background:

Targeted intervention for subgroups is a promising approach for the management of patellofemoral pain.

Hypothesis:

Treatment designed according to subgroups will improve clinical outcomes in patients unresponsive to multimodal treatment.

Study Design:

Prospective crossover intervention.

Level of Evidence:

Level 3.

Methods:

Patients with patellofemoral pain (PFP; n = 61; mean age, 27 ± 9 years) were enrolled. Patients with PFP received standard multimodal treatment 3 times a week for 6 weeks. Patients not responding to multimodal treatment were then classified into 1 of 3 subgroups (strong, weak and tight, and weak and pronated foot) using 6 simple clinical tests. They were subsequently administered 6 further weeks of targeted intervention, designed according to subgroup characteristics. Visual analog scale (VAS), perception of recovery scale (PRS), 5-Level European Quality 5 Dimensions (EQ-5D-5L), and self-reported version of the Leeds Assessment of Neuropathic Symptoms and Signs scale (S-LANSS) were used to assess pain, knee function, and quality of life before and after the interventions.

Results:

In total, 34% (n = 21) of patients demonstrated recovery after multimodal treatment. However, over 70% (n = 29/40) of nonresponders demonstrated recovery after targeted treatment. The VAS, PRS, S-LANSS, and EQ-5D-5L scores improved significantly after targeted intervention compared with after multimodal treatment ( P < 0.001). The VAS score at rest was significantly lower in the “weak and pronated foot” and the “weak and tight” subgroups ( P = 0.011 and P = 0.008, respectively). Posttreatment pain intensity on activity was significantly lower in the “strong” subgroup ( P = 0.006).

Conclusion:

Targeted treatment designed according to subgroup characteristics improves clinical outcomes in patients unresponsive to multimodal treatment.

Clinical Relevance:

Targeted intervention could be easily implemented after 6 simple clinical assessment tests to subgroup patients into 1 of 3 subgroups (strong, weak and tight, and weak and pronated foot). Targeted interventions applied according to the characteristics of these subgroups have more beneficial treatment effects than a current multimodal treatment program.
I’m the Operator With My Pocket Vibrator: Collective Intimate Relations on Chaturbate
Authors: Martins Eduardo E. B.
Published: November 2019

This article focuses on the use of a remote-controlled vibrator on Chaturbate, a sexually explicit webcam platform. Looking at the complex arrangement formed by so-called human and nonhuman counterparts in networked settings, I analyze an intimate moment hosted by the selected erotic platform, observing how a sex toy that can be controlled by distance modulates the affective underpinnings of such “vibrant” assemblage and participates in this carnal activity by heightening and clustering different groupings of bodies to create an orgasmic moment. Drawing on Actor–Network Theory and theories of affect, I focus on the sociotechnical affordances that constitute this sexual setting and describe the movement of actants as they throb to develop senses of intimacy and presence in the unfurling event, thus showing how a great number of players, from varied scopes of intelligibility, participate jointly to develop visceral affect and body friction even though they do not share the same spatial frame.
What Works for Managing Chronic Pain: An Appreciative Inquiry Qualitative Analysis
Authors: Holtrop Jodi Summers , Fisher Mary , Martinez Doreen E. , Simpson Matthew , Awadallah Nida S. , Nease Donald E. , Zittleman Linda , Westfall John M.
Published: November 2019

Background: Chronic pain is a prevalent and dynamic condition for both patients and providers. Learning how patients with chronic pain successfully manage their pain may prove helpful in guiding health care providers in their treatment of other patients with chronic pain. This research sought to identify successful strategies for managing chronic pain from interviews with individuals experiencing chronic pain who were able to do “most of what they want on most days.” Methods: Qualitative, descriptive study. Patients were from metro Denver, Colorado, USA and were recruited from community and health care settings. Appreciative inquiry (AI) was used as an approach to elicit stories of successful pain management. We conducted one-on-one, in person interviews using a semistructured interview guide. Analysis was completed using a grounded hermeneutic editing approach. Results: Twenty-four interviews were completed representing a range of adult ages, genders, race/ethnicities, and underlying reasons for chronic pain. Consistent themes were found in that all patients had developed multiple strategies for ongoing pain management and prevention, as well as a mental approach embedded with elements of positive beliefs and determination. Friends, family, support group members, and health care providers were key in support and ongoing management. Although 10 patients regularly used opioid pain medications, none were dependent, and all stated an active desire to avoid these medications. Conclusions: Successful chronic pain management seems possible as displayed from the patient narratives but requires persistence through individual trial and error. Recommendations for health care provider teams are made to apply these findings to assist patients with chronic pain.
Examining the Utility of a Novel Neurologic Test in Patients With Obstructive Sleep Apnea: A Pilot Study
Authors: Grover Michael L. , Grover Lori Latowski , Mookadam Martina , Mi Lanyu , Chang Yu-Hui , Parish James
Published: November 2019

Purpose: To test the association between participant King-Devick Test (KDT) times and obstructive sleep apnea (OSA) severity and evaluate for improvement after continuous positive airway pressure (CPAP) treatment. Methods: Study dates January 30 to July 31, 2018. Patients were referred for initial evaluation of sleep disordered breathing concerns. OSA severities were defined by Apnea Hypopnea Index (AHI) results, with ≥15 considered at least moderate OSA. The KDT is an objective physical measure of brain function. We estimated correlation between KDT time and AHI and compared mean KDT time between patients with and without moderate OSA. For the OSA subgroup, we evaluated for potential improvement in KDT after CPAP. Results: We enrolled 60 participants, of whom 35 (58.3%) had OSA with an AHI ≥15. Initial analyses noted no significant KDT time differences between patients based on OSA severity. However, after excluding 3 participants who had baseline neurologic illness, adjusted analyses demonstrated that mean KDT time was significantly prolonged for patients with moderate or greater OSA (AHI ≥15) as compared to those with mild or no sleep apnea (AHI <15); 63.4 seconds (95% CI 58.9-67.8) versus 55.7 seconds (95% CI 50.2-61.1), P = .03. CPAP-treated subjects demonstrated significantly improved KDT test times; 63.5 seconds mean pretreatment versus 55.6 posttreatment; −6.6 seconds mean difference, 95%CI (−12.0, −1.13), P = .02. Conclusion: Neurologic abnormalities in patients with OSA are potentially demonstrable utilizing this objective physical measure. Significant improvement is achieved in patients after CPAP treatment.
Lacrimal Sac Malignant Melanoma in 15 Japanese Patients: Case Report and Literature Review
Authors: Matsuo Toshihiko , Tanaka Takehiro , Yamasaki Osamu
Published: November 2019

Background. Primary malignant melanoma of the lacrimal sac is rare. A patient with lacrimal sac melanoma was presented, and 14 Japanese patients with lacrimal sac melanoma in the literature were reviewed. Case Presentation. A 78-year-old Japanese man was presented with painless swelling of the lacrimal sac on the left side. Dacryocystectomy revealed diffuse infiltration with large epithelioid cells, sometimes with pigments, which were positive for cocktail mix of antibodies to tyrosinase, melan A (MART-1), and HMB45, leading to pathological diagnosis of melanoma. One month later, positron emission tomography (PET) revealed 2 high-uptake sites (SUVmax = 10.29 and 15.38) at the levels of medial canthus and nasolacrimal duct, but no abnormal uptake in the other site of the body. The lesion had the BRAF V600E mutation. He began to take daily oral dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor), leading to no abnormal uptake on PET in half a year. He had stable disease in good physical status with small and weak uptake sites of lymph nodes on PET 1 year later. Results. In the review of 15 Japanese patients, including this patient, local recurrence was noted in 4 patients, regional lymph node metastasis only in 3, distant metastasis in 6, and no metastasis in 6. Five patients died within 2 years and the others were alive in short follow-up periods. Conclusions. Chemotherapy was the standard for local recurrence or metastasis. Emerging molecular target drugs, as shown in the present patient, would change the strategy for management of lacrimal sac melanoma.
Risk Factors for Revision Anterior Cruciate Ligament Reconstruction and Frequency With Which Patients Change Surgeons
Authors: Sutherland Kirsty , Clatworthy Mark , Chang Kevin , Rahardja Richard , Young Simon W.
Published: November 2019

Background:

Revision surgery is a known complication after anterior cruciate ligament (ACL) reconstruction (ACLR), but the proportion of patients who seek a different surgeon for their revision procedure is unknown.

Purpose:

To determine the rate and risk factors for revision ACLR in New Zealand and to find the proportion of patients undergoing revision ACLR who see a different surgeon compared with their primary procedure as well as the factors that may influence this decision.

Study Design:

Case series; Level of evidence, 4.

Methods:

Data from New Zealand’s single government insurer, the Accident Compensation Corporation (ACC), were analyzed. All primary ACLR procedures performed between January 1, 2009, and December 31, 2014 were evaluated, and revision ACLR procedures performed between January 1, 2009, and December 31, 2016, were evaluated to allow for a minimum 2-year follow-up period. Cases undergoing subsequent revision were divided into those with the same or a different surgeon compared with the primary procedure. Risk factors for revision and change of surgeons were assessed, including age, sex, time from injury to surgery, time between primary and revision procedures, surgeon volume, and ethnicity.

Results:

A total of 15,212 primary ACLR procedures were recorded in 14,926 patients. The mean patient age was 29.2 years, and 61% were male patients. There were 676 subsequent revision procedures and 510 contralateral procedures during the study period, resulting in a 5-year survival rate of 95.5% for the ACL graft and 96.5% for the contralateral ACL. Risk factors for revision surgery included male sex, age <20 years, and <1 year from injury to surgery. Of the revision procedures, 44.5% (n = 301) were performed by a different surgeon compared with primary ACLR. For primary ACLR procedures performed by low-volume surgeons, 75.0% of patients requiring revision ACLR changed surgeons, compared with 21.5% for high-volume surgeons (≤10 vs >50 primary ACLR/y; hazard ratio, 10.70 [95% CI, 6.01-19.05]; P < .001). Other factors associated with change of surgeons included older age, longer time between primary and revision surgery, and Asian and Maori ethnicities.

Conclusion:

A significant proportion of patients change surgeons when requiring revision ACLR. In the absence of formal follow-up systems such as registries, surgeons, particularly those with a low volume of ACLRs, may underestimate their personal revision rate.
Active surveillance of adverse events following immunization (AEFI): a prospective 3-year vaccine safety study
Authors: Sebastian Juny , Gurumurthy Parthasarathi , Ravi Mandyam Dhati , Ramesh Madhan
Published: November 2019

Background:

Vaccines used in national immunization programs are considered safe and effective but immunization safety has become as important as the efficacy of vaccination programs. The objective of the study was to detect adverse events following immunization (AEFIs) to all vaccines administered to a pediatric population in India.

Methods:

The prospective active vaccine safety surveillance study enrolled eligible children in the age group 0–5 years receiving vaccination from the immunization center at JSS Hospital, Mysuru. Study participants were monitored at the site for 30 min following vaccination and a telephonic survey was made after 8 days to identify all AEFIs. Causality assessment of the AEFIs were done using a new algorithm developed by the safety and vigilance department of the World Health Organization.

Results:

The incidence of reported AEFIs was 13.7%. The most frequently reported AEFI was fever ( n = 3095, 93.2%) with an incidence of 109.7 per 1000 doses of vaccine administered, followed by persistent crying ( n = 69, 2.4 per 1000 doses of vaccine) and diarrhea ( n = 57, 2.0 per 1000 doses of vaccine). The majorly implicated vaccine for AEFIs was Pentavac® followed by BCG. Consistent causal association to immunization was observed in 93.4% of cases.

Conclusions:

A high incidence rate of AEFI was observed in our study population when compared with previous published studies. AEFI surveillance studies help to detect changes in the frequency of adverse events, which may be an alert to consider vaccine quality or identify a specific risk among the local population.
HDAC11 deficiency disrupts oncogene-induced hematopoiesis in myeloproliferative neoplasms
Authors: Yue Lanzhu , Sharma Vasundhara , Horvat Nathan P. , Akuffo Afua A. , Beatty Matthew S. , Murdun Cem , Colin Christelle , Billington Julia M. R. , Goodheart William E. , Sahakian Eva , Zhang Ling , Powers John J. , Amin Narmin E. , Lambert-Showers Que T. , Darville Lancia N. , Pinilla-Ibarz Javier , Reuther Gary W. , Wright Kenneth L. , Conti Chiara , Lee Jennifer Y. , Zheng Xiaozhang , Ng Pui Yee , Martin Matthew W. , Marshall C. Gary , Koomen John M. , Levine Ross L. , Verma Amit , Grimes H. Leighton , Sotomayor Eduardo M. , Shao Zonghong , Epling-Burnette Pearlie K.
Published: November 2019

Protein acetylation is an important contributor to cancer initiation. Histone deacetylase 6 (HDAC6) controls JAK2 translation and protein stability and has been implicated in JAK2-driven diseases best exemplified by myeloproliferative neoplasms (MPNs). By using novel classes of highly selective HDAC inhibitors and genetically deficient mouse models, we discovered that HDAC11 rather than HDAC6 is necessary for the proliferation and survival of oncogenic JAK2-driven MPN cells and patient samples. Notably, HDAC11 is variably expressed in primitive stem cells and is expressed largely upon lineage commitment. Although Hdac11is dispensable for normal homeostatic hematopoietic stem and progenitor cell differentiation based on chimeric bone marrow reconstitution, Hdac11 deficiency significantly reduced the abnormal megakaryocyte population, improved splenic architecture, reduced fibrosis, and increased survival in the MPLW515L-MPN mouse model during primary and secondary transplantation. Therefore, inhibitors of HDAC11 are an attractive therapy for treating patients with MPN. Although JAK2 inhibitor therapy provides substantial clinical benefit in MPN patients, the identification of alternative therapeutic targets is needed to reverse MPN pathogenesis and control malignant hematopoiesis. This study establishes HDAC11 as a unique type of target molecule that has therapeutic potential in MPN.
Triage and flow management in sepsis
Authors: Pires Hudson Henrique Gomes , Neves Fábio Fernandes , Pazin-Filho Antonio
Published: November 2019

Background

Sepsis is a major public health problem, with a growing incidence and mortality rates still close to 30% in severe cases. The speed and adequacy of the treatment administered in the first hours of sepsis, particularly access to intensive care, are important to reduce mortality. This study compared the triage strategies and intensive care rationing between septic patients and patients with other indications of intensive care. This study included all patients with signs for intensive care, enrolled in the intensive care management system of a Brazilian tertiary public emergency hospital, from January 1, 2010, to December 31, 2016. The intensivist periodically evaluated the requests, prioritizing them according to a semi-quantitative scale. Demographic data, Charlson Comorbidity Index (CCI), Sequential Organ Failure Assessment (SOFA), and quick SOFA (qSOFA), as well as surgical interventions, were used as possible confounding factors in the construction of incremental logistic regression models for prioritization and admission to intensive care outcomes.

Results

The study analyzed 9195 ICU requests; septic patients accounted for 1076 cases (11.7%), 293 (27.2%) of which were regarded as priority 1. Priority 1 septic patients were more frequently hospitalized in the ICU than nonseptic patients (52.2% vs. 34.9%,p <  0.01). Septic patients waited longer for the vacancy, with a median delay time of 43.9 h (interquartile range 18.2–108.0), whereas nonseptic patients waited 32.5 h (interquartile range 11.5–75.8)—p <  0.01. Overall mortality was significantly higher in the septic group than in the group of patients with other indications for intensive care (72.3% vs. 39.8%,p <  0.01). This trend became more evident after the multivariate analysis, and the mortality odds ratio was almost three times higher in septic patients (2.7, 2.3–3.1).

Conclusion

Septic patients had a lower priority for ICU admission and longer waiting times for an ICU vacancy than patients with other critical conditions. Overall, this implied a 2.7-fold increased risk of mortality in septic patients.
Genome-wide identification and transcriptome profiling reveal that E3 ubiquitin ligase genes relevant to ethylene, auxin and abscisic acid are differentially expressed in the fruits of melting flesh and stony hard peach varieties
Authors: Tan Bin , Lian Xiaodong , Cheng Jun , Zeng Wenfang , Zheng Xianbo , Wang Wei , Ye Xia , Li Jidong , Li Zhiqian , Zhang Langlang , Feng Jiancan
Published: November 2019

Background

Ubiquitin ligases (E3) are the enzymes in the ubiquitin/26S proteasome pathway responsible for targeting proteins to the degradation pathway and play major roles in multiple biological activities. However, the E3 family and their functions are yet to be identified in the fruit of peach.

Results

In this study, genome-wide identification, classification and characterization of the E3 ligase genes within the genome of peach (Prunus persica) was carried out. In total, 765 E3 (PpE3) ligase genes were identified in the peach genome. The PpE3 ligase genes were divided into eight subfamilies according to the presence of known functional domains. The RBX subfamily was not detected in peach. The PpE3 ligase genes were not randomly distributed among the 8 chromosomes, with a greater concentration on the longer chromosomes. The primary mode of gene duplication of the PpE3 ligase genes was dispersed gene duplication (DSD). Four subgroups of the BTB subfamily never characterized before were newly identified in peach, namely BTBAND, BTBBL, BTBP and BTBAN. The expression patterns of the identified E3 ligase genes in two peach varieties that display different types of fruit softening (melting flesh, MF, and stony hard, SH) were analyzed at 4 different stages of ripening using Illumina technology. Among the 765 PpE3 ligase genes, 515 (67.3%) were expressed (FPKM > 1) in the fruit of either MF or SH during fruit ripening. In same-stage comparisons, 231 differentially expressed genes (DEGs) were identified between the two peach cultivars. The number of DEGs in each subfamily varied. Most DEGs were members of the BTB, F-box, U-box and RING subfamilies. PpE3 ligase genes predicted to be involved in ethylene, auxin, or ABA synthesis or signaling and DNA methylation were differentially regulated. Eight PpE3 ligase genes with possible roles in peach flesh texture and fruit ripening were discussed.

Conclusions

The results of this study provide useful information for further understanding the functional roles of the ubiquitin ligase genes in peach. The findings also provide the first clues that E3 ligase genes may function in the regulation of peach ripening.
Pancreatitis in pre-adolescent children: a 10 year experience in the pediatric emergency department
Authors: Randall Melanie M. , McDaniels Sarah , Kyle Kristina , Michael Meina , Giacopuzzi Julia , Brown Lance A.
Published: November 2019

Background

The diagnosis of pediatric pancreatitis has been increasing over the last 15 years but the etiology of this is uncertain. The population of pre-adolescent patients with pancreatitis in the emergency department has not been specifically described. Our objective was to determine the characteristics of these patients to illuminate this population and disease in order to better identify them and avoid a delay in diagnosis and treatment.

Methods

This was a retrospective descriptive study of consecutive pediatric patients under the age of 13 years between 2006 and 2016 who presented to our pediatric emergency department with a diagnosis of atraumatic pancreatitis. Patient characteristics, lab and imaging results, identified etiology of pancreatitis, and recurrence rates were recorded and evaluated.

Results

There were 139 visits, of which 85 were for a first episode of acute pancreatitis, and 54 were patients with an episode of recurrent pancreatitis. The median age for all visits was 8 years (IQ range 5–11). Of the acute cases, 26% had uncertain or undetermined etiologies of which half were thought to likely be viral related; 20% had systemic inflammatory or autoimmune diseases; 19% were associated with medications, with the most common being valproic acid; 16% were cholelithiasis-related; and 15% were found to have a genetic, congenital or structural etiology. No patients had elevated triglycerides. Those with cholelithiasis and genetic or structural defects were found to have a higher recurrence rate than those with other etiologies. There were only four patients diagnosed with chronic pancreatitis.

Conclusions

The etiology of pancreatitis in pre-adolescent children has a different distribution than in adolescents and adults, with gallstone disease less frequent and concurrent contributing illness more common. Patients on pancreatitis-causing medications or with known genetic risk or structural pancreatic problems should be tested for pancreatitis if presenting with concerning symptoms. Hypertriglyceridemia and chronic pancreatitis with evidence of pancreatic exocrine insufficiency is uncommon in this population.
Mixing mixed-mode designs in a national health interview survey: a pilot study to assess the impact on the self-administered questionnaire non-response
Authors: Braekman Elise , Drieskens Sabine , Charafeddine Rana , Demarest Stefaan , Berete Finaba , Gisle Lydia , Tafforeau Jean , Van der Heyden Johan , Van Hal Guido
Published: November 2019

Background

Many population health surveys consist of a mixed-mode design that includes a face-to-face (F2F) interview followed by a paper-and-pencil (P&P) self-administered questionnaire (SAQ) for the sensitive topics. In order to alleviate the burden of a supplementary P&P questioning after the interview, a mixed-mode SAQ design including a web and P&P option was tested for the Belgian health interview survey.

Methods

A pilot study (n = 266, age 15+) was organized using a mixed-mode SAQ design following the F2F interview. Respondents were invited to complete a web SAQ either immediately after the interview or at a later time. The P&P option was offered in case respondents refused or had previously declared having no computer access, no internet connection or no recent usage of computers. The unit response rate for the web SAQ and the overall unit response rate for the SAQ independent of the mode were evaluated. A logistic regression analysis was conducted to explore the association of socio-demographic characteristics and interviewer effects with the completed SAQ mode. Furthermore, a logistic regression analysis assessed the differential user-friendliness of the SAQ modes. Finally, a logistic multilevel model was used to evaluate the item non-response in the two SAQ modes while controlling for respondents’ characteristics.

Results

Of the eligible F2F respondents in this study, 76% (107/140) agreed to complete the web SAQ. Yet among those, only 78.5% (84/107) actually did. At the end, the overall (web and P&P) SAQ unit response rate reached 73.5%. In this study older people were less likely to complete the web SAQ. Indications for an interviewer effect were observed as regard the number of web respondents, P&P respondents and respondents who refused to complete the SAQ. The web SAQ scored better in terms of user-friendliness and presented higher item response than the P&P SAQ.

Conclusions

The web SAQ performed better regarding user-friendliness and item response than the P&P SAQ but the overall SAQ unit response rate was low. Therefore, future research is recommended to further assess which type of SAQ design implemented after a F2F interview is the most beneficial to obtain high unit and item response rates.
Safety and effectiveness of granulocyte and monocyte adsorptive apheresis in patients with inflammatory bowel disease in special situations: a multicentre cohort study
Authors: Motoya Satoshi , Tanaka Hiroki , Shibuya Tomoyoshi , Osada Taro , Yamamoto Takayuki , Hongo Hitoshi , Mizuno Chiemi , Saito Daisuke , Aoyama Nobuo , Kobayashi Toshihisa , Ito Hiroaki , Tanida Satoshi , Nojima Masanori , Kokuma Seiichiro , Hosoi Eiji
Published: November 2019

Background

The available information on granulocyte and monocyte adsorptive apheresis (GMA) in patients with inflammatory bowel disease (IBD) under special situations remains unclear. We conducted a retrospective, multicentre cohort study to evaluate the safety and effectiveness of GMA in patients with IBD under special situations.

Methods

This study included patients with ulcerative colitis (UC) or Crohn’s disease who had at least one special situation feature and who had received GMA between November 2013 and March 2017. The incidence of adverse events (AEs) was compared in relation to the special situation, and patient background factors related to an AE were identified. For patients with UC, clinical remission was defined as a partial Mayo score of ≤2.

Results

A total of 437 patients were included in this study. The incidence of AEs among the elderly patients (11.2%) was similar in all patients (11.4%), whereas the incidences of AEs in patients on multiple immunosuppressant medications (15.2%), patients with anaemia (18.1%) and paediatric/adolescent patients (18.9%) were higher than that in all patients (11.4%). In multivariate analysis, anaemia and concomitant immunosuppressant medications were independently associated with the incidence of AEs. Clinical remission was achieved in 46.4% of the patients with UC.

Conclusions

The incidence of AEs in the elderly patients was not higher than that in all patients, whereas the incidence of AE was higher in patients with anaemia and those on multiple immunosuppressant medications than that in all patients. GMA is a safe treatment option in elderly patients with IBD.
An inventory of collaborative medication reviews for older adults - evolution of practices
Authors: Kiiski A. , Airaksinen M. , Mäntylä A. , Desselle S. , Kumpusalo-Vauhkonen A. , Järvensivu T. , Pohjanoksa-Mäntylä M.
Published: November 2019

Background

Collaborative medication review (CMR) practices for older adults are evolving in many countries. Development has been under way in Finland for over a decade, but no inventory of evolved practices has been conducted. The aim of this study was to identify and describe CMR practices in Finland after 10 years of developement.

Methods

An inventory of CMR practices was conducted using a snowballing approach and an open call in the Finnish Medicines Agency’s website in 2015. Data were quantitatively analysed using descriptive statistics and qualitatively by inductive thematic content analysis. Clyne et al’s medication review typology was applied for evaluating comprehensiveness of the practices.

Results

In total, 43 practices were identified, of which 22 (51%) were designed for older adults in primary care. The majority (n = 30, 70%) of the practices were clinical CMRs, with 18 (42%) of them being in routine use. A checklist with criteria was used in 19 (44%) of the practices to identify patients with polypharmacy (n = 6), falls (n = 5), and renal dysfunction (n = 5) as the most common criteria for CMR. Patients were involved in 32 (74%) of the practices, mostly as a source of information via interview (n = 27, 63%). A medication care plan was discussed with the patient in 17 practices (40%), and it was established systematically as usual care to all or selected patient groups in 11 (26%) of the practices. All or selected patients’ medication lists were reconciled in 15 practices (35%). Nearly half of the practices (n = 19, 44%) lacked explicit methods for following up effects of medication changes. When reported, the effects were followed up as a routine control (n = 9, 21%) or in a follow-up appointment (n = 6, 14%).

Conclusions

Different MRs in varying settings were available and in routine use, the majority being comprehensive CMRs designed for primary outpatient care and for older adults. Even though practices might benefit from national standardization, flexibility in their customization according to context, medical and patient needs, and available resources is important.
Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in Canada
Authors:   The Canadian Observational Cohort (CANOC) Collaboration, Rana Urvi , Driedger Matt , Sereda Paul , Pan Shenyi , Ding Erin , Wong Alex , Walmsley Sharon , Klein Marina , Kelly Deborah , Loutfy Mona , Thomas Rejean , Sanche Stephen , Kroch Abigail , Machouf Nima , Roy-Gagnon Marie-Helene , Hogg Robert , Cooper Curtis L.
Published: November 2019

Background

Hepatitis B (HBV) and Human Immunodeficiency Virus (HIV) share common risk factors for exposure. Co-infected patients have an increased liver-related mortality risk and may have accelerated HIV progression. The epidemiology and demographic characteristics of HIV-HBV co-infection in Canada remain poorly defined. We compared the demographic and clinical characteristics and factors associated with advanced hepatic fibrosis between HIV and HIV-HBV co-infected patients.

Methods

A retrospective cohort analysis was conducted using data from the Canadian Observational Cohort (CANOC) Collaboration, including eight sites from British Columbia, Quebec, and Ontario. Eligible participants were HIV-infected patients who initiated combination ARV between January 1, 2000 and December 14, 2014. Demographic and clinical characteristics were compared between HIV-HBV co-infected and HIV-infected groups using chi-square or Fisher exact tests for categorical variables, and Wilcoxon’s Rank Sum test for continuous variables. Liver fibrosis was estimated by the AST to Platelet Ratio Index (APRI).

Results

HBV status and APRI values were available for 2419 cohort participants. 199 (8%) were HBV co-infected. Compared to HIV-infected participants, HIV-HBV co-infected participants were more likely to use injection drugs (28% vs. 21%,p = 0.03) and be HCV-positive (31%, vs. 23%,p = 0.02). HIV-HBV co-infected participants had lower baseline CD4 T cell counts (188 cells/mm3, IQR: 120–360) compared to 235 cells/mm3in HIV-infected participants (IQR: 85–294) (p = 0.0002) and higher baseline median APRI scores (0.50 vs. 0.37,p < 0.0001). This difference in APRI was no longer clinically significant at follow-up (0.32 vs. 0.30,p = 0.03). HIV-HBV co-infected participants had a higher mortality rate compared to HIV-infected participants (11% vs. 7%,p = 0.02).

Conclusion

The prevalence, demographic and clinical characteristics of the HIV-HBV co-infected population in Canada is described. HIV-HBV co-infected patients have higher mortality, more advanced CD4 T cell depletion, and liver fibrosis that improves in conjunction with ARV therapy. The high prevalence of unknown HBV status demonstrates a need for increased screening among HIV-infected patients in Canada.
Fatal deep venous thrombosis and pulmonary embolism secondary to melioidosis in China: case report and literature review
Authors: Wu Hua , Huang Dongliang , Wu Biao , Pan Mengjie , Lu Binghuai
Published: November 2019

Background

Burkholderia pseudomallei is a gram-negative bacterium and the causative pathogen of melioidosis, which manifests a variety ranges of infection symptoms. However, deep venous thrombosis (DVT) and pulmonary embolism (PE) secondary to bacteremic melioidosis are rarely documented in the literature. Herein, we reported a fatal case of melioidosis combined with DVT and PE.

Case presentation

A 54-year-old male construction worker and farmer with a history of diabetes was febrile, painful in left thigh, swelling in left lower limb, with chest tightness and shortness of breath for 4 days. He was later diagnosed as DVT of left lower extremity and PE. The culture of his blood, sputum and bone marrow samples grew B. pseudomallei. The subject was administrated with antibiotics (levofloxacin, cefoperazone/tazobactam, and imipenem) according to antimicrobial susceptibility testing and low molecular heparin for venous thrombosis. However, even after appropriate treatment, the patient deteriorated rapidly, and died 2 weeks after admission.

Conclusions

This study enhanced awareness of the risk of B. pseudomallei bloodstream infection in those with diabetes. If a patient has predisposing factors of melioidosis, when DVT is suspected, active investigation and multiple therapeutic interventions should be implemented immediately to reduce mortality rate.
Malaria parasite prevalence and Haematological parameters in HIV seropositive patients attending the regional hospital Limbe, Cameroon: a hospital-based cross-sectional study
Authors: Sandie Sorelle Mekachie , Sumbele Irene Ule Ngole , Tasah Martin Mih , Kimbi Helen Kuokuo
Published: November 2019

Background

Malaria and the human immunodeficiency virus (HIV) infection constitute public health problems in Cameroon including the South West Region (SWR). This study determined the prevalence of malaria parasites and haematological abnormalities in HIV positive patients in Limbe, Cameroon from April–July 2014.

Methods

The study was cross-sectional and involved 411 participants who were administered structured questionnaires to record socio-demographic and clinical data. Three hundred and nine (309) HIV positive patients and one hundred and two (102) HIV negative individuals were examined clinically and venous blood collected for malaria parasite detection, HIV infection diagnosis and full blood count analysis.

Results

Overall malaria parasite prevalence was 14.1% (58/411). This prevalence was significantly higher (P <  0.001) in the HIV negative participants (33.3%, 34/102) compared to the HIV positive patients (7.8%, 24/309). Amongst HIV positive participants, malaria parasite prevalence was significantly higher in female patients (P = 0.003), febrile patients (P <  0.001), anaemic patients (P = 0.015) and in patients who were not on antiretroviral treatment (ART) (P = 0.03) when compared with their respective counterparts. Among the HIV negative group, though not significant, malaria parasite prevalence was higher in females, febrile and anaemic patients when compared with their respective counterparts. Overall anaemia prevalence was 52.1% (214/309) and was significantly higher (P = 0.004) in HIV positive patients (56%, 173) than in HIV negative participants (40.2%, 41). Malaria/HIV co-infected patients had a significantly lower mean value of Hb (P = 0.002), RBC (P = 0.002) and Hct (P = 0.001) when compared with HIV-infected patients.

Conclusion

HIV negative participants had a higher prevalence of malaria parasites than their HIV positive counterparts. Anaemia prevalence was higher in HIV positive patients than in HIV negative participants. Malaria/HIV co-infected patients presented with more red blood cell abnormalities than HIV-infected patients.
Associated factors and their individual contributions to caesarean delivery among married women in Bangladesh: analysis of Bangladesh demographic and health survey data
Authors: Hasan Farhana , Alam Md. Mesbahul , Hossain Md. Golam
Published: November 2019

Background

Caesarean section (CS) delivery has a significant effect on maternal and neonatal health especially in a developing country like Bangladesh. The aim of the study was to determine the risk factors and their individual contribution to CS delivery among Bangladeshi married women in reproductive age.

Methods

The cross sectional secondary data was used in this study. Data was extracted from Bangladesh Demographic and Health Survey (BDHS), 2014 dataset. BDHS-2014 collected data from all over Bangladesh. Stepwise logistic regression analysis and population attributable fractions (PAF) were utilized in this study.

Results

A total number of 4422 married Bangladeshi women having at least one child (age ≤ 5 years) were considered in this study. The prevalence of CS delivery among Bangladeshi women was 23.94%. The stepwise logistic regression model showed that location (division), type of residence, education of respondent and her husband, working status, age at first birth, number of children, wealth index and baby’s birth weight were most important predictors of CS delivery among Bangladeshi mothers. PAF demonstrated that overweight or obese women had highest contribution (23.36%) among the risk factors of CS delivery, followed by age at first birth (age >  20 years) (18.97%), highest wealth quintile (17.39%), higher education (15.93%), living in urban environment (14.39%), having lower number of ever born children (1–2 children) (13.58%), living in Dhaka division (12.11%), delivering large size of child at birth (11.13%) and housewife (6.55%).

Conclusions

In the present study, we have identified the important risk factors and their individual contribution to CS delivery in Bangladesh. Consequently, these factors can be considered for reducing the rate of CS delivery in Bangladesh.
Change in smoking cessation stage over 1 year in patients with schizophrenia: a follow up study in Japan
Authors: Higuchi Yuji , Fujiwara Masaki , Nakaya Naoki , Fujimori Maiko , Hayashibara Chinatsu , So Ryuhei , Shinkawa Ikuta , Sato Kojiro , Yada Yuji , Kodama Masafumi , Takenaka Hiroshi , Kishi Yoshiki , Kakeda Kyoko , Uchitomi Yosuke , Yamada Norihito , Inagaki Masatoshi
Published: November 2019

Background

We performed a follow up study about willingness and behaviors to quit smoking among smokers with schizophrenia in Japan.

Methods

Participants were outpatients with schizophrenia aged 20–69 years who had been visiting the hospital for ≥1 year as of April 1, 2016, and had visited the hospital more than once in the previous 6 months. A baseline survey on smoking behaviors including current smoking status and smoking cessation stage, was administered in 420 participants that were randomly extracted from a patient pool (n = 680) in 2016, and a follow-up survey was administered in 2017. We calculated the distribution and change in smoking cessation stage, number of smokers and nonsmokers after 1 year, and quitting rate from a naturalistic 1-year smoking-cessation follow up.

Results

The number of baseline respondents was 350; 113 current smokers and 68 former smokers. Among the 113 current smokers, 104 (92.0%) were followed for 1 year, 79 (70.0%) were interested in smoking cessation, and only 7 had received smoking cessation treatments at baseline. Among the tracked 104 participants, only 6 (5.8%) stopped smoking after 1 year. Among the 25 participants who had intentions to quit smoking within 6 months at baseline, 6 (24.0%) maintained their intention to quit smoking for 1 year, and 16 (64.0%) did not maintain their intention to quit smoking.

Conclusions

Our findings showed that many smokers with schizophrenia were interested in quitting smoking, but few patients received treatment and actually quit smoking. Timely intervention, including the option to receive smoking cessation treatment, is necessary for those patients with schizophrenia who smoke.

Trial registration

UMIN Clinical Trials Registry (UMIN000023874, registered on August 31, 2016).
A review of the impact of financing mechanisms on maternal health care in Australia
Authors: Fox Haylee , Topp Stephanie M. , Callander Emily , Lindsay Daniel
Published: November 2019

Background

The World Health Organization states there are three interrelated domains that are fundamental to achieving and maintaining universal access to care - raising sufficient funds for health care, reducing financial barriers to access by pooling funds in a way that prevents out-of-pocket costs, and allocating funds in a way that promotes quality, efficiency and equity. In Australia, a comprehensive account of the mechanisms for financing the health system have not been synthesised elsewhere. Therefore, to understand how the maternal health system is financed, this review aims to examine the mechanisms for funding, pooling and purchasing maternal health care and the influence these financing mechanisms have on the delivery of maternal health services in Australia.

Methods

We conducted a scoping review and interpretative synthesis of the financing mechanisms and their impact on Australia’s maternal health system. Due to the nature of the study question, the review had a major focus on grey literature. The search was undertaken in three stages including; searching (1) Google search engine (2) targeted websites and (3) academic databases. Executive summaries and table of contents were screened for grey literature documents and Titles and Abstracts were screened for journal articles. Screening of publications’ full-text followed. Data relating to either funding, pooling, or purchasing of maternal health care were extracted for synthesis.

Results

A total of 69 manuscripts were included in the synthesis, with 52 of those from the Google search engine and targeted website (grey literature) search. A total of 17 articles we included in the synthesis from the database search.

Conclusion

Our study provides a critical review of the mechanisms by which revenues are raised, funds are pooled and their impact on the way health care services are purchased for mothers and babies in Australia. Australia’s maternal health system is financed via both public and private sources, which consequentially creates a two-tiered system. Mothers who can afford private health insurance – typically wealthier, urban and non-First Nations women - therefore receive additional benefits of private care, which further exacerbates inequity between these groups of mothers and babies. The increasing out of pocket costs associated with obstetric care may create a financial burden for women to access necessary care or it may cause them to skip care altogether if the costs are too great.