bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of season and post-fire on habitat preferences of the endangered Swayne’s hartebeest (Alcelaphus buselaphus swaynei) in Maze National Park, Ethiopia
Authors: Tamrat Misganaw , Atickem Anagaw , Tsegaye Diress , Evangelista Paul , Bekele Afework , Stenseth Nils Christian
Published: January 2020

Background: The availability of preferred habitats determines the spatial and temporal distribution of herbivores in savanna ecosystems. Understanding habitat preference of a targeted wildlife species is crucial for developing effective conservation strategies. Habitat preference of large grazers in connection to grass height and post-fire effect has been debated for the last century. Here, we examined the effects of season, grass height and burning on the habitat preference on Swayne’s hartebeest ( Alcelaphus buselaphus swaynei ) in Maze National Park. Data for seasonal habitat selection were collected using both direct observation along established transect lines and pellet counting using permanently established plots. Every month, we measured grass height commonly preferred by Swayne’s hartebeest in grassland habitat. Starting from the first week of burning, we recorded the abundance of Swayne’s hartebeest in both burned and unburned grassland patches. Results: From detected pellets, 94.3% were recorded in the grassland habitat indicating that other habitat types are less used despite their extensive cover > 50% of the Park. During wet and early dry seasons, Swayne’s hartebeest exclusively preferred grassland habitat. We found that 85.2% (n=1,079) and 85.3% (n=593) of individuals observed in areas with a grass height below 30 cm during wet and early-dry seasons, respectively; while 70.9% (n=2,288) preferred grass height below 30 cm during the dry season. The density of Swayne’s hartebeest in burned grassland area was higher than unburned grassland areas up to 150 days since burning. However, in unburned grassland areas, the density was initially low but showed increasing trend for consecutive days, reaching similar density with burned areas after 150 days since burning. Conclusion: Swayne’s hartebeest exclusively preferred grassland habitat, particularly during wet and early-dry seasons, shortest available grass height in all seasons and were attracted to burned grassland areas. Our results suggested that fire played an important role in maintaining habitat quality in grassland, and that management should continue using controlled burning as a tool for the conservation of Swayne’s hartebeest. However, we remain cautious of our findings given the paucity of information regarding other confounding factors and the absence of long-term data on fire disturbance.
Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners
Authors: Erisman Jetske Charlotte , de Sabbata Kevin , Zuiderent-Jerak Teun , Syurina Elena V
Published: January 2020

Background Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of all children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. They use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making, and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are needed in healthcare. This study aims to understand how Dutch CYHC-practitioners perceive the role of intuition in their work and in relation to evidence-based medicine, in the case of child abuse. Methods A sequential exploratory mixed-methods design: in-depth semi-structured interviews with CYHC-practitioners focused on perceptions on intuition, which were followed by a survey amongst CYHC-professionals on the recognition and use of the concept. Results The majority of CYHC-practitioners and professionals recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition: 1) to sense that something is off, 2) to differentiate between ‘normal’ and ‘abnormal’, 3) to assess risks, 4) to weigh secondary information and 5) to communicate with parents. At the same time, they warn for its dangers as it may lead to tunnel vision and false accusations. Their ways of working with intuition show parallels to the practices that evidence-based guidelines try to support. Conclusion Intuition is experienced as an integral part of the work of CYHC-practitioners. It is stated to be particularly useful in the case of child abuse, which is inherently complex as signs and evidence of abuse are hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. As there is a lack of guidance on how to practice intuition, there is a need for support through guidelines.
Assessing Quality of Newborn Care at District Facilities in Malawi
Authors: Kawaza Kondwani , Kinshella Mai-Lei Woo , Hiwa Tamanda , Njirammadzi Jenala , Banda Mwai , Vidler Marianne , Newberry Laura , Nyondo-Mipando Alinane Linda , Dube Queen , Molyneux Elizabeth , Goldfarb David M.
Published: January 2020

Background: Malawi is celebrated as one of the few countries in sub-Saharan Africa to meet the Millennium Development Goal of reducing under-5 mortality by two-thirds between 1990 and 2015. However, within this age range neonatal mortality rates are the slowest to decline, even though rates of facility births are increasing. Examining the quality of neonatal care at district-level facilities where most deliveries occur is warranted. Objective: The objective of this paper is to evaluate the quality of neonatal care in three district hospitals and one primary health centre in southern Malawi as well as to report the limitations and lessons learned on using the WHO integrated quality of care assessment tool. Methodology: These facility assessments were part of the “Integrating a neonatal healthcare package for Malawi” project, a part of the Innovating for Maternal and Child Health in Africa (IMCHA) initiative. The WHO integrated quality of care assessment tool was used to assess quality of care and availability and quantity of supplies and resources. The modules on infrastructure, neonatal care and labour and delivery were included. Facility assessments were administered in November 2017 and aspects of care were scored on a Likert scale from one to five (a score of 5 indicating compliance with WHO standards of care; one as lowest indicating inadequate care). Results: The continuum of labour, delivery and neonatal care were assessed to identify areas that required improvements to meet standards of care. Critical areas for improvements included infection control (mean score 2.9), equipment, supplies and setup for newborn care in the labor ward (2.3), in the surgical theater (3.3), and nursery (3.4 nursery facilities, 3.0 supplies and equipment), as well as for management of sick newborns (3.2), monitoring and follow-up (3.6). Only one of the 12 domains, laboratory, met the standards of care with only minor improvements needed (4.0). Conclusion: The WHO integrated quality of care assessment tool is a validated tool that can shed light on the complex quality of care challenges faced by district-level health facilities. The results reveal that the quality of care needs improvement, particularly for sick and vulnerable newborns.
Risk factors for HIV infection among married couples in Rakai, Uganda: A cross-sectional study
Authors: Nabukenya Anne M. , Nambuusi Aminah , Matovu Joseph KB
Published: January 2020

Background: Although married couples can be at an elevated risk of HIV infection, few studies have explored the risk factors for HIV infection at the couple-level. We explored the risk factors for HIV infection among married couples in settings with differing HIV prevalence levels in Rakai, Uganda.
Methods: This was a cross-sectional study conducted among 664 heterosexual couples living in three HIV prevalence strata (low: 9-11.2%; medium: 11.4-20% or high HIV prevalence: 21-43%) in Rakai District, south-western Uganda, between November 2013 and February 2014. Data were collected on socio-demographic and behavioural characteristics from all consenting adults and aggregated to allow for couple-level analyses. We conducted bivariate and multivariable Logistic regression to assess the factors that were independently associated with HIV infection among married couples. Data were analysed using STATA statistical software (version 14.1).
Results: Of the 664 couples, 6.4% (n=42) were in HIV-discordant relationships; 5.8% (n=39) were in concordant HIV-positive relationships while 87.8% (n=583) were in concordant HIV-negative relationships. At the bivariate analysis, we found that residing in a high HIV prevalence stratum, reporting extra-marital relations, age difference between partners and number of previous marriages were significantly associated with being part of an HIV infected couple. After adjusting for potential cofounders, living in a high HIV prevalence stratum (Adjusted OR [AOR] =2.31, 95% CI: 1.52, 3.52), being in a third or higher order relationship (AOR=3.80, 95% CI: 2.30, 6.28), and engagement in extra-marital relations (AOR= 1.75; 95% CI: 1.19, 2.59) were associated with couple HIV infection. Individuals that had stayed together for six or more years had 28% odds of being part of an HIV infected couple (AOR = 0.28; 95%CI: 0.18, 0.43).
Conclusion: Living in a high HIV prevalence stratum, engagement in extra-marital relations and having a higher number of previous marriages were significant risk factors for HIV infection among married couples. Long marital duration was associated with reduced risk of HIV infection. Interventions that increase marital stability and those that promote pre-marital couples’ HIV testing before marital formation, particularly among previously married individuals, can reduce HIV transmission risk among married couples in this setting.
Serum osteocalcin may serve as a predictor for the mortality in FOP patients aged ≤18 years at diagnosis
Authors: She Dunmin , Li Ran , Fang Ping , Zong Guannan , Xue Ying , Zhang Keqin
Published: January 2020

Background Fibrodysplasia ossificans progressive (FOP) is an ultra-rare genetic disorder characterized by extraskeletal heterotopic ossification. It is well recognized that FOP can lead to a devastating condition of disability. However, the mortality rate of FOP patients in China and risk factors for mortality are still largely unclear.
Methods We conducted a retrospective research on a cohort of 65 cases of FOP patients in China from 2008 to 2018. We reviewed medical records of these FOP patients to retrieve information such as date of birth/death, gender, clinical features, genotypes and biochemical parameters and analyze the correlation of these parameters with the mortality.
Results 92.3% (60/65 cases) patients were classic FOP patients, 3.1% (2/65 cases) were FOP-plus and 4.6% (3/65 cases) were FOP variants. 9 cases of this cohort were dead during the ten-year period, and the overall mortality rate was 13.8%. c.617G>A mutation was confirmed in all non-survivors. In FOP patients≤18 years at diagnosis, non-survivors demonstrated significantly lower blood osteocalcin and alkaline phosphatase levels compared with survivors ( P <0.05), and spearman correlation and logistic regression analysis indicated that serum osteocalcin and alkaline phosphatase levels were negatively correlated with the mortality. Furthermore, the receiver-operating characteristic curve analysis showed serum osteocalcin had the largest area under the curve of 0.855 among four biochemical parameters, and serum osteocalcin < 65.9 ng/ml displayed a good capacity to discriminate the non-survivors from survivors in FOP patients aged 18 years and younger at diagnosis.
Conclusions Our findings showed that the mortality rate of FOP was 13.8% in China. Serum osteocalcin may serve as a clinical predictor for the mortality in FOP patients aged ≤18 years at diagnosis in China.
【 Key words 】Fibrodysplasia ossificans progressive (FOP); mortality; risk factors; osteocalcin
Does long-term recreational gymnastics prevent injurious falls in older women? A prospective 20-year follow-up
Authors: Uusi-Rasi Kirsti , Karinkanta Saija , Kannus Pekka , Tokola Kari , Sievänen Harri
Published: January 2020

Background : Exercise interventions focused on balance and strength training have been shown to be effective for falls prevention. The aim of this 20-year register-based follow-up was to examine whether long-term participation in recreational female gymnastics is associated with a lower risk of medically-attended injurious falls. Methods : Health care register data of 187 women (103 recreational gymnasts and 84 sedentary controls) from the original cohort of 243 women were assessed. The mean age (sd) at baseline was 62.8 (5.4) years and the mean follow-up time was 19.4 (2.7) years (range from 5.6 to 21.0 years). Injurious falls were scrutinized from medical records. An injurious fall was defined as an event in which falling was mentioned as a reason for making contact with the health-care professionals. Negative binomial regression was used to estimate incidence rate ratios (IRR) for injurious falls, and Cox-regression models for calculating hazard ratios (HR) for injured fallers with the control group as reference. Results Recreational gymnasts had about 30% less injurious falls compared to controls, the mean IRR (95% CI) being 0.71 (0.51 to 0.96). Regarding injured fallers, the HR was 0.73 (0.52 to 1.02) favoring the recreational gymnasts. There were no statistically significant between-group differences for fractures. Conclusion s: Long-term recreational gymnastics appears to reduce the risk of injurious falls in old age.
A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admission and bed days in people nearing the end of their life: Much innovation but limited supporting evidence
Authors: Taylor Ros , Ellis Jonathan , Gao Wei , Searle Liz , Heaps Kate , Davies Robert , Hawksworth Claire , Garcia-Perez Angela , Colclough Giles , Walker Steven , Wee Bee
Published: January 2020

Objectives
Hospitalisation during the last weeks of life when there is no medical need or desire to be there is distressing and expensive. This study sought palliative care initiatives which may avoid or shorten hospital stay at the end of life and analysed their success in terms reducing bed days.
Methods
Part 1 included a search of literature in PubMed and Google Scholar between 2013 and 2018, an examination of governmental and organisational publications plus discussions with external and co-author experts regarding other sources. This initial sweep sought to identify and categorise relevant palliative care initiatives. In Part 2, we looked for publications providing data on hospital admissions and bed days for each category.
Results
A total of 1252 abstracts were reviewed, resulting in ten broad classes being identified. Further screening revealed 50 relevant publications describing a range of multi-component initiatives. Studies were generally small and retrospective. Most researchers claim their service delivered benefits. In descending frequency, benefits identified were support in the community, integrated care, out-of-hours telephone advice, care home education and telemedicine. Nurses and hospices were central to many initiatives. Barriers and factors underpinning success were rarely addressed.
Conclusions
A wide range of initiatives have been introduced to improve end-of-life experiences. Formal evidence supporting their effectiveness in reducing inappropriate/non-beneficial hospital bed days was generally limited or absent.
Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention
Authors: Lin Kai-Yang , Chen Han-Chuan , Jiang Hui , Wang Sun-Ying , Chen Hong-mei , Wu Zhi-Yong , Jiang Feng , Guo Yan-Song , ZHU PENG-LI
Published: January 2020

Background DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI.Methods We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure.Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005).Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.
The behavioural and neuropathologic sexual dimorphism and absence of MIP-3α in tau P301S mouse model of Alzheimer’s disease
Authors: Sun Yao , Guo Yongqing , Feng Xuejian , Jia Meng , Ai Ning , Dong Yue , Zheng Yayuan , Fu Lu , Yu Bin , Zhang Haihong , Wu Jiaxin , Yu Xianghui , Wu Hui , Kong Wei
Published: January 2020

Background : Tau hyper-phosphorylation has been considered a major contributor to neurodegeneration in Alzheimer’s disease (AD) and related tauopathies, and has gained prominence in therapeutic development for AD. To elucidate the pathogenic mechanisms underlying AD and evaluate therapeutic approaches targeting tau, numerous transgenic mouse models that recapitulate critical AD-like pathology have been developed. Tau P301S transgenic mice is one of the most widely used mouse models in AD research. Extensive studies have demonstrated that sex significantly influences AD pathology, behavioral status and therapeutic outcomes, suggesting that studies using mouse models of AD must consider sex- and age-related differences in neuropathology, behavior, and plasma content. Method : We systematically investigated differences in tau P301S transgenic mice (PS19 line) and wildtype littermates of different sex behavioral performance, tau neuropathology and biomarkers in plasma and brain. Results : Male P301S transgenic mice exhibited significant changes in weight loss, survival rate, clasping, kyphosis, composite phenotype assessment, nest building performance, tau phosphorylation at Ser202/Thr205 and astrocyte activation compared to that of wild type littermates. In contrast, female P301S transgenic mice were only sensitive in the Morris Water Maze and open field test. In addition, we characterized the absence of macrophage-inflammatory protein (MIP-3α) and the upregulation of interferon (IFN)-γ, interleukin (IL)-5, and IL-6 in the plasma of P301S transgenic mice, which can be served as potential plasma biomarkers in P301S Tg mice. Male P301S transgenic mice expressed more monokine induced by IFN-γ (MIG), tumor necrosis factor-α (TNF-α), IL-10 and IL-13 than those of female P301S mice. Conclusion : Our findings highlight sexual dimorphism in the behavior, neuropathology, and plasma proteins in tau P301S transgenic AD mice, indicating that the use of male P301S transgenic mice may be more suitable for assessing anti-phosphorylated tau therapeutic strategies for AD and related tauopathies, and the MIP-3α may be a new potential plasma biomarker.
Vaccination accelerates hepatic erythroblastosis induced by blood-stage malaria
Authors: Delic Denis , Wunderlich Frank , Al-Quraishy Saleh , Abdel-Baki Abdel-Azeem S. , Dkhil Mohamed A. , Araúzo-Bravo Marcos J.
Published: January 2020

Background Vaccination induces survival of otherwise lethal blood-stage infections of the experimental malaria Plasmodium chabaudi . Blood-stage malaria induces extramedullary erythropoiesis in the liver. This study investigates how vaccination affects the course of malaria-induced expression of erythrocytic genes in the liver. Methods Female Balb/c mice were vaccinated at week 3 and week 1 before challenging with 10 6 P. chabaudi- parasitized erythrocytes. The non-infectious vaccine consisted of erythrocyte ghosts isolated from P. chabaudi -infected erythrocytes. Gene expression microarrays and quantitative real-time PCR were used to compare mRNA expression of different erythrocytic genes in the liver of vaccination-protected and non-protected mice during infections on days 0, 1, 4, 8, and 11 p.i. . Results Global transcriptomics analyses reveal vaccination-induced modifications of malaria-induced increases in hepatic gene expression on days 4 and 11 p.i.. On these days, vaccination also alters hepatic expression of the erythropoiesis-involved genes Ermap, Kel, Rhd , Rhag , Slc4a1, Gypa, Add2, Ank1, Epb4.1, Epb4.2, Epb4.9, Spta1, Sptb, Tmod1 , Ahsp, Acyp1 , Gata1, Gfi1b, Tal1, Klf1, Epor , and Cldn13 . In vaccination-protected mice, expression of these genes, except Epb4.1 , is significantly higher on day 4 p.i. than in un-protected non-vaccinated mice, reaches maximal expression at peak parasitaemia on day 8 p.i., and is slowed down or even decreased towards the end of crisis phase on day 11 p.i.. After day 1 p.i., Epor expression takes about the same course as that of the other erythroid genes. Hepatic expression of Epo, however, is delayed in both vaccinated and non-vaccinated mice for the first 4 days p.i. and is maximal at significantly higher levels in vaccinated mice on day 8 p.i. , before declining towards the end of crisis phase on day 11 p.i. . Conclusion The present data indicate that vaccination accelerates malaria-induced erythroblastosis in the liver for 1-2 days. This may contribute to earlier replenishment of peripheral red blood cells by liver-derived reticulocytes, which may favour final survival of otherwise lethal blood-stage malaria, since reticulocytes are not preferred as host cells by P. chabaudi .
Lessons learned, challenges and outlooks for decision-making after a decade of experience monitoring the impact of Indoor Residual Spraying in Benin, West Africa
Authors: Akogbéto Martin C , Dagnon Fortuné , Aikpon Rock , Osse Razaki , Salako Albert , Ahogni Idelphonse , Akinro Bruno , Sominahouin André , Sidick Aboubakar , Tokponnon Filémon , Padonou Germain Gil
Published: January 2020

Background Since 2008, Indoor Residual Spraying (IRS) has been performed in Benin in 19 districts, including 4 in southern Benin, 9 in Atacora, and 8 in Atacora, Alibori and Donga in northern Benin. However, Benin still struggles with questions about IRS cost benefit and epidemiological impact. We discussed lessons learned and challenges from 10 years of IRS in Benin to be shared with the stakeholders involved in vector control implementation for decisions making. Methods We have assessed entomological parameters in IRS communes since 2008. In all IRS intervention communes, decreases in Human Biting Rate (HBR) of An. gambiae, blood feeding inhibition and Entomological Inoculation Rate (EIR) as compared to control district have been measured. Results EIR was reduced by 80-90%, which is encouraging, but should be observed with caution because: (i) the reduction may be insufficient to decrease epidemiological indicators given that the residual EIR in IRS districts is still higher than it is in some regions of stable malaria; (ii) the reduction in EIR is based on comparisons with control communes, but it is difficult to select control areas with the same environmental characteristics as intervention areas; (iii) despite the reduction, half of all mosquitoes that entered IRS-treated houses succeeded in taking human blood meals. Further, there are behaviors among Benin’s population that limit IRS efficacy, including recent data showing that >90% of people are not protected by IRS between 7-10 PM. This is due to the fact that they remain outside and that most people are not protected from mosquito bites after 10 PM because they either sleep outside without IRS protection or inside without an ITN. Moreover, people have large amounts of clothing hanging on walls where mosquitoes can rest instead of IRS-treated walls. Finally, other components are important to consider in implementing IRS among which: (i) Vector resistance management strategies are sometimes poorly understood; this is actually different from should be replacing one insecticide with another after the emergence of resistance; (ii) African countries should prepare to finance IRS themselves. Conclusion To curtail residual malaria transmission, additional interventions able to target vectors escaping IRS should be prioritized.
Correlation between the efficacy of stem cell therapy for osteonecrosis of the femoral head and cell viability
Authors: Wu ZhanYu , Sun Qi , Liu Ming , Grottkau Brian , He ZhiXu , Zou Qiang , Ye Chuan
Published: January 2020

Background: Osteonecrosis of the femoral head (ONFH) is a common disease that greatly affects the quality of life of patients. Repair of the necrotic area is key to successful treatment. Currently, the combination of stem cell transplantation and decompression is used clinically to promote the repair of necrotic areas based on the characteristics of stem cells. However, a considerable number of patients do not achieve a satisfactory outcome in terms of repair of the femoral head necrotic area, and it is very important to determine the reasons for the poor curative effect. The aim of this study was to investigate the correlation between stem cell viability and the repair efficacy of stem cell therapy combined with core decompression for early-stage ONFH.
Methods: A total of 30 patients with idiopathic ONFH underwent core decompression combined with autologous stem cell transplantation. The Harris hip score (HHS) and difference in necrosis area before and after surgery were measured. The mean repair ratio was set as the threshold to divide the patients into group A (ratio above the mean) and group B (ratio below the mean). The ultrastructure, proliferative capacity, and multidirectional differentiation ability were compared between the groups.
Results : At 9 months after surgery, the HHS and magnetic resonance imaging (MRI) findings improved by varying degrees. Based on the mean repair ratio of (62.2 ± 27.0)%, the threshold for dividing the patients into groups A and B was set to 62.2%. Better repair (group A) was associated with more rapid proliferation and a healthier ultrastructure. The cells in group A showed stronger specific staining signifying osteogenic and chondrogenic differentiation; alkaline phosphatase (ALP) activity, an indicator of osteogenic differentiation, was higher in group A than in group B (OD, 2.39 ± 0.44 and 1.85 ± 0.52; p < 0.05).
Conclusions: The quality of implanted stem cells is closely related to treatment efficacy and determines whether the defective self-repair in the necrotic area can be corrected to enhance repair and thus achieve the desired therapeutic outcome.
A novel association of CCDC80 with gestational diabetes mellitus in pregnant women: a propensity score analysis from a case-control study
Authors: Liu Lei , Hu Jiajin , Wang Ningning , Liu Yang , Wei Xiaotong , Gao Ming , Ma Yanan , Wen Deliang
Published: January 2020

Background: Gestational diabetes mellitus (GDM) is a growing global epidemic. Our study aims to confirm the association between circulatory coiled-coil domain-containing 80 (CCDC80) in pregnant women with GDM, to investigate the discriminatory power of CCDC80 on GDM, and to explore the relationships between this molecular level and clinical cardiometabolic parameters. Methods: A 1:2 matched case-control study with 61 GDM patients and 122 controls was conducted using a propensity score matching protocol. All participants were screened from a multicenter prospective pre-birth cohort: Born in Shenyang Cohort Study (BISCS). During 24 and 28 weeks of gestation, follow-up individuals underwent an oral glucose tolerance test (OGTT) and blood sampling for cardiometabolic characterization. Results: Following propensity score matching adjustment for clinical variables, including maternal age, gestational age, body mass index, SBP and DBP, plasma CCDC80 levels were significantly decreased in patients with GDM when compared with controls (0.25±0.10 vs. 0.31±0.12 ng/ml, P =0.003). Conditional multi-logistic regression analyses after adjustments for potential confounding factors revealed that CCDC80 was a strong and independent protective factor for GDM (ORs <1). In addition, the results of the ROC analysis indicated the CCDC80 exhibited the capability to identify pregnant women with GDM (AUC=0.633). Finally, multivariate regression analyses showed that CCDC80 levels were positively associated with AST, monoamine oxidase, complement C1q, LDL-C, apolipoprotein A1and B, and negatively associated with blood glucose levels at 1 h post- OGTT. Conclusions: Biomarker CCDC80 could be of great value for the development of prediction, diagnosis and therapeutic strategies against GDM in pregnant women.
Comparing video-based versions of Halsted’s ‘See One, Do One’ and Peyton’s ‘4-step Approach’ for teaching surgical skills: a randomized controlled trial
Authors: Seifert Lukas Benedikt , Schnurr Benedikt , Stefanescu Maria-Christina , Sader Robert , Rüsseler Miriam , Sterz Jasmina
Published: January 2020

Background: Teaching complex motor skills at a high level remains a challenge in medical education. Established methods often involve large amounts of teaching time and material. The implementation of standardized videos in those methods might help save resources. In this study, video-based versions of Peyton’s ‘4-step Approach’ and Halsted’s ‘See One, Do One’ are compared. We hypothesized that the video-based ‘4-step Approach’ would be more effective in learning procedural skills than the ‘See One, Do One Approach’. Methods: One-hundred-two naïve students were trained to perform a structured facial examination and a Bellocq’s tamponade with either Halsted’s (n = 57) or Peyton’s (n = 45) method within a curricular course. Steps 1 (Halsted) and 1-3 (Peyton) were replaced by standardized teaching videos. The performance was measured directly (T1) and 8 weeks (T2) after the intervention by blinded examiners using validated checklists. An item-analysis was also carried out. Results: At T1, performance scores significantly differed in favor of the video-based ‘4-step Approach’ (p < 0.01) for both skills. No differences were found at T2 (p < 0.362). The item-analysis revealed that Peyton’s method was significantly more effective in the complex subparts of both skills. Conclusions: The modified video-based version of Peyton’s ‘4-step Approach’ is the preferred method for teaching especially complex motor skills in a large curricular scale. Furthermore, an effective way to utilize Peyton’s method in a group setting could be demonstrated. Further studies have to investigate the long-term learning retention of this method in a formative setting.
The Detrimental Impacts of Negative Age Stereotype on Episodic Memory of Older Adults: Does Social Participation Moderate the Effects?
Authors: Chan Stephen Cheong Yu , Au Alma May Lan , Lai Simon Man Kin
Published: January 2020

Background: Memory performances were shown to be negatively affected by negative age stereotype primes among older adults. The purpose of the study was to examine the effects of negative age stereotype primes on episodic memory using implicit priming intervention and further investigate whether social participation moderate the effects. Methods: A total of 105 community-dwelling older adults residing in Hong Kong were randomly allocated to two experimental conditions. Participants were primed either with negative age stereotypes (n = 53) or neutral words (n = 52) by implicit priming intervention which was framed as reaction task prior to the episodic memory tasks. Other measures such as demographic variables and social participation rate were collected by questionnaire during the delayed recall interval. Results: Results indicated that experimental group performed significantly worse than the control group among all measures in the memory performances. Follow-up analyses showed that social participation moderated the effects of negative age stereotypes in the recognition task. Conclusions: Using a simple scale to measure social participation, we found there was a significant moderating effect of social participation on the effects of negative age stereotype primes on episodic memory, these results provide initial support for social participation might act as an effective strategy against negative age stereotypes. Trial registration ClinicalTrials.gov: NCT04202120 (first posted December 17, 2019), (Retrospectively registered) Keywords: Age stereotypes, episodic memory, older adults, social participation
Trajectories of hospitalization in three groups of patients with incurable gastric cancer identified by hierarchical clustering: A retrospecitve analysis
Authors: Murakawa Yasuko , Sakayori Masato , Otsuka Kazunori
Published: January 2020

Purpose: The therapeutic goal for advanced solid malignancies is not to achieve cure but to prolong survival and maintain quality of life (QOL). To date, no study has reported the trajectory of the QOL throughout the clinical course of a patient with advanced malignancy. As hospitalization is considered a predictor of QOL, we retrospectively analyzed the trajectory of hospitalization in patients with incurable gastric cancer throughout the clinical course. Methods: The data of 85 patients with incurable gastric cancer were collected, including age, sex, Eastern Cooperative Oncology Group (ECOG) Performance Status (PS), treatment, histology, sites of metastases at first consultation, planned and unplanned hospitalization throughout the clinical course , and overall survival (OS). We ranked the patients by OS and hospitalization using a hierarchical clustering analysis. Results: Three clusters were identified corresponding to short, intermediate, and long OS/hospitalization (Clusters 1, 2, and 3, respectively). Patients in Cluster 3 were more likely to have an ECOG PS of 0–2 and receive palliative chemotherapy than the other clusters. No other differences in histology, age, sex, and or extra-peritoneal metastasis sites were observed between the three groups. In Cluster 3, planned hospitalization accumulated gradually during the early clinical phase, while unplanned hospitalization accumulated rapidly in later phases. Conclusions: No specific characteristics were associated with short, intermediate, and long OS/hospitalization. Patients in the long OS/hospitalization group exhibited a rapid accumulation of unplanned hospitalization during the latter clinical course. Further research is needed to identify specific predictors of and measures to avoid a long OS/hospitalization.
Psychometric properties of Integrated Palliative Outcome Scale: Czech standardization and validation
Authors: Vlckova Karolina , Hoschlova Eva , Chroustova Eva , Loucka Martin
Published: January 2020

Background Outcome measurement is an essential part of the evaluation of palliative care and the measurements need to be reliable, valid and adapted to the culture in which they are used. The Integrated Palliative Outcome Scale (IPOS) is a widely used tool for assessing outcomes in palliative care. The aim of this study was to provide Czech version of IPOS and asses its psychometric properties.Methods Patients receiving palliative care in hospice or hospitals completed IPOS and part of the sample also completed Edmonton Symptom Assessment System (ESAS) and Palliative Performance Scale (PPS). The reliability of Czech IPOS was tested with Cronbach alpha (internal consistency) and Intraclass correlation coefficient and Weighted Kappa (test-retest reliability). Construct validity was assessed with factor analysis (Exploratory Factor Analysis) and convergent validity was tested with correlation analysis (Spearman correlation).Results Sample consisted of 140 patients (mean age 72; 90 women; 81% oncologic disease). IPOS internal consistency was 0.789; ICC= 0.88. To study convergent validity, we assessed the correlations of IPOS with ESAS (R= 0.4) and PPS (R= -0.2), however, these results have to be considered preliminary due to the small sample size. Exploratory factor analysis revealed a 2-factor solution on our data. The first factor covers emotional and information needs and the second factor covers physical symptoms.Conclusion Czech IPOS has very good reliability regarding both internal consistency and test-retest reliability. Together with an item analysis results, we can conclude that the Czech adaptation of the tool was successful. The convergent validity needs to be assessed on the larger sample and the proposed 2-factor internal structure of the questionnaire has to be confirmed by using CFA.
The impact of occupational and personal factors on musculoskeletal pain - a cohort study of female teachers, nurses and sonographers
Authors: Arvidsson Inger , Simonsen Jenny Gremark , Andersson Agneta Lindegård , Björk Jonas , Nordander Catarina
Published: January 2020

Background Musculoskeletal pain is common in the general population and constitutes a major public health problem. A large proportion of these conditions may be work related. This study aimed to explore the relative importance of physical, psychosocial and personal factors, for musculoskeletal single- and multisite pain, among women in ordinary professions with a broad variety of occupational exposures. Methods A cohort of 1115 women responded to a questionnaire of ergonomic, psychosocial, personal and life-style factors, and musculoskeletal pain (based on frequency and intensity of complaints in nine anatomical sites), at baseline and at follow-up (mean 28 months later). Sum-scores of ergonomic- and psychosocial factors were created. The importance of the exposures at baseline for multisite pain (≥four pain-sites) at follow-up were estimated using ordinal regression. Multi-exposure Poisson regression models of exposures at baseline were used for outcomes of single-site pain at follow-up, in the neck, the shoulders, the hands, the lower back and the feet. Results High sum-scores of ergonomic- and psychosocial factors at baseline were of importance for multisite pain at follow-up, although the strongest risk factor was the presence of multisite pain at baseline. There was a large fluctuation in number of pain-sites between the two time-points, on the individual level. Eighteen percent of the study population reported multisite pain both at baseline and at follow-up, while only eleven percent did not report any pain, neither at baseline nor at follow-up. Among the single-site outcomes, a high sum-score of ergonomic factors was a risk factor of pain in the neck, the hands and the feet. A high sum-score of psychosocial factors was a risk factor of neck- and shoulder pain. The strongest risk factor was, however, pain in the actual anatomical site at baseline. Only a few of the personal and life-style factors were of importance for subsequent single- and multisite pain. Conclusions An overwhelming majority of the women in common occupations were affected by musculoskeletal pain. Both ergonomic- and psychosocial factors were predictive of single- and multisite pain. The findings points to the need of actions on individual, organizational and societal level.
Effect of a 12-week workplace interview intervention on physical activity and low back pain: a single-center, randomized controlled study
Authors: Shimo Kazuhiro , Hasegawa Mami , Mizutani Seiko , Hasegawa Tomomi , Ushida Takahiro
Published: January 2020

Background Physical activity (PA) is essential in the management and rehabilitation of low back pain (LBP). However, it is not clear if workplace PA interventions can improve LBP. This study aimed to investigate the effects of workplace interview intervention on increasing PA and improving LBP among office workers. Methods We recruited 37 workers of a manufacturing company in Aichi, Japan. Participants were randomly assigned to the intervention group (n=20) or control group (n=17). We affixed waist-worn accelerometers to monitor PA in all participants, and provided face-to-face counseling with a physical therapist or nurse once a week for 12 weeks as workplace PA program to reassurance and encourage participants to keep high levels of PA. PA and LBP severity were assessed at baseline, 3 and 6 months. Results Baseline characteristics were similar in both groups, but PA was significantly higher in the intervention group than in the control group at 3 and 6 months. In the intervention group, was PA significantly increased at 3 and 6 months from baseline and LBP severity improved significantly at 6 months from baseline. We calculated the effect size of the interview intervention, and found that workplace interview intervention had a medium to large effect on PA and LBP severity. Conclusions Our data suggests that workplace PA intervention can increase PA and improve LBP among office workers. Trial registration UMIN-CTR Clinical Trial UMIN000038864 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000044321). Registered 12 December 2019, retrospectively registered.
Improvement of sagittal parameters in patients with cervical spondylotic myelopathy is associated with outcome after anterior cervical discectomy and fusion
Authors: Xu Yefu , Liu Sangni , Wang Feng , Wu Xiaotao
Published: January 2020

Purpose: After ACDF, cervical lordosis loss, high C2-7 SVA and postoperative T1S will worsen the surgical prognosis. Therefore, this study evaluated the changes of cervical parameters after surgery and correlation with surgical prognosis. Methods: This study enrolled 212 cervical compressive myelopathy patients who underwent ACDF. We collect gender, age, BMI, NDI scores and cervical parameters. And then, we compare the changes of parameters after surgery, and explore the correlation between parameters and NDI score. Results: C2-7 Cobb Angle, SVA, T1S and TS-CL were all improved after surgery, but T1S at the last follow-up was larger than that before the surgery. T1S is positively correlated with TIA (p=0.018, r=0.081), CL (p<0.01, r=0.150) and SVA (p<0.01, r=0.131), but negatively correlated with SCA (p<0.01, r=-0.166). We also found that TIA was highly correlated with the sum of T1S+NT (p<0.01, r=0.459). Preoperative NDI was negatively correlated with preoperative c2-7 Cobb Angle (r=-0.147, p=0.033), positively correlated with SVA (r=0.157, p=0.022). The last follow-up NDI score was negatively correlated with C2-7 Cobb Angle (r=-0.222 p=0.001), positively correlated with SVA (r=0.498, p<0.001) and TS-CL (r=0.165, p=0.016). The risk factors with poor follow-up NDI score (the last follow-up NDI score greater than 30%) were SVA (B=0.337, P=<0.001), CL (B=-0.147, P=0.029) and gender (B=2.153, P=0.017). Conclusions: After ACDF, most postoperative cervical parameters have improved, but T1S deteriorated over time. There was a close correlation between cervical sagittal parameters. Preoperative NDI score was correlated with c2-7 Cobb Angle and SVA. Follow-up NDI score was correlated with CL, TS-CL and SVA. High SVA, loss of cervical lordosis and male patient were risk factors for the deterioration of postoperative NDI score.
Determinants of Orthopaedic Service Utilisation among Young People Aged 5-24 Years Old in Zambia
Authors: Seketi Queen Elizabeth , Simuyemba Moses Chikoti , Likwa Rosemary Ndonyo
Published: January 2020

Background Musculoskeletal conditions and/or disorders (MSDs), which affect muscles, tendons and ligaments, are the main causes of disability in many patients even though such disorders can be addressed through orthopaedic care. Little was known on the determinants of Orthopaedic services utilisation among young people between the ages of 5-24 in Zambia.Methods An embedded mixed methods design was used to conduct a hospital based cross sectional study that focused on high and low level of orthopaedic services utilisation. Stratified random sampling was used to draw a sample of 162 children and young people (5-24) from the hospital registers. Purposive sampling was used for eight service providers and convenient sampling for 10 parents and six young people. A data extraction checklist and self-administered questionnaires were for service providers. In-depth interviews with parents and a focus group discussion with six clients aged 15 to 24. Quantitative data was analysed using STATA version 14. Statistical tests included chi square, univariate and investigator led stepwise multiple logistic regression. Content and thematic analysis were done for qualitative data.Results 41 percent of clients had high level of service utilisation. Physiotherapy clients were 84 percent significantly less likely to use services compared to clients from prosthetic and orthotics workshops [AOR 0.16; 95% CI 0.05, 0.59; P=0.01]. Clients living in low density residential areas were 86 percent times less likely to use Orthopaedic services compared to those in high density residential areas [AOR 0.14; 95% CI 0.05, 0.43; P<0.0001]. Participants without Insurance were 83 percent less likely to use Orthopaedic services compared to those with Insurance [AOR 0.17; 95% CI 0.05, 0.55; P=0.003]. At service level, barriers were inadequate financial and human resources. For care givers,key barriers included inadequate information about practices and other essential health actions to manage MSDs at home; costs of transport and fear of marital discord to discuss matters at length.Conclusion The type of service used, area of residence and Health Insurance are significant determinants of Orthopaedic services utilisation. It is highly recommended that such services be decentralised to address key family barriers. Inadequate resources for orthopaedic service provision also need to be adequately addressed.