bluuebunny/crossref_metadata_2025 huggingface dataset:
Network Pharmacology Integrated Molecular Docking Reveals the Anti-COVID-19 Mechanism of Qing-Fei-Da-Yuan Granules
Authors: Hong Zongchao , Duan Xueyun , Wu Songtao , Yanfang Yang , Wu Hezhen
Published: June 2020

Coronavirus disease (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a highly infectious viral disease. Clinical observations have shown that Qing-Fei-Da-Yuan (QFDY) granules have good anti-COVID-19 effects, but the underlying molecular mechanisms are unclear. In this study, we explored the potential mechanism of QFDY with regard to its anti-COVID-19 effect. We first screened the active chemical constituents of QFDY based on the pharmacodynamic activity parameters, followed by screening with the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform. The Uniprot database was used for querying the corresponding genes of the target, and Cyoscape 3.6.1 software was used to construct the network of herb-compound-target. Protein interaction analysis, target gene function enrichment analysis, and signal pathway analysis were performed via STRING database, Database for Annotation, Visualization, and Integrated Discovery, and KEGG Pathway database. Molecular docking was used to predict the binding capacity of the core compound with COVID-19 hydrolase 3CL and angiotensin converting enzyme 2 (ACE2). The results showed that a network of herb-compound-target was successfully constructed, with key targets involving PTGS2, HSP90AA1, CAMKK2, NCOA2, and ESR1. Major metabolic pathways affected were those in cancer, procancer, nonsmall cell lung cancer, and apoptosis. The core compounds, such as quercetin, luteolin, and naringenin, showed a strong binding ability with COVID-19 3CL hydrolase; compounds such as anemasaponin C and medicocarpin showed a strong binding ability with ACE2. Thus, it is predicted that QFDY has the characteristics for multicomponent, multitarget, and multichannel overall control. The mechanism of action of QFDY in the treatment of COVID-19 may be associated with the regulation of genes co-expressed with ACE2, the regulation of inflammation and immune-related signaling pathways, and the influence of COVID-19 3CL hydrolase and ACE2 binding ability.
A Narrative Review of Theories of Wayfinding Within the Interior Environment
Authors: Jamshidi Saman , Pati Debajyoti
Published: June 2020

Purpose:

The aim of this article is to provide a narrative overview of theories that are available in the published literature on wayfinding in interior environments.

Background:

Wayfinding is an issue in healthcare facilities, and it has been documented that wayfinding problems have negative impacts on patients, visitors, caregivers’ time, and the organization’s bottom line. This issue can be more challenging for people with illness, low vision, cognitive disorders, and limited physical mobility. Wayfinding is a complex phenomenon depending on a variety of cognitive processes and behaviors.

Methods:

This article is a part of a broader literature review that searched for empirical studies on interior wayfinding. Four databases were systematically searched—PsychINFO, JSTOR, ProQuest, and EBSCO. A total of 81 articles satisfied all inclusion criteria for the broader study. Each article included in the broader study was reviewed to identify theory or theories, if any, that a study was founded on.

Results:

After an in-depth review of the theories, the authors proposed four categories of theories relating to human wayfinding. The four classes and the specific theories in those are articulated in this article, including major changes during their evolution. The four classes of theories explain four facets of wayfinding: (1) theories of perception, (2) theories of spatial knowledge development, (3) theories of mental representation of spatial knowledge, and (4) theories of spatial cognition.

Conclusion:

Since wayfinding is essentially a cognitive/problem-solving phenomenon, understanding the theoretical underpinnings of wayfinding may result in more meaningful and impactful design decisions.
Magnetic resonance imaging findings in patients with non-ketotic hyperglycaemia and focal seizures
Authors: De Martino Sara Rosa Maria , Toni Francesco , Spinardi Luca , Cirillo Luigi
Published: June 2020

We present the neuroimaging findings of three cases of non-ketotic hyperglycaemia (NKH) associated with focal seizures and a review of the previous cases and series reported in literature. NKH is a cause of seizures in both long-standing and newly diagnosed diabetic patients. They are usually focal motor seizures, rarely with a secondary generalisation. This condition does not fully respond to anticonvulsant therapy if glycaemic levels are not normalised. Of interest, magnetic resonance imaging (MRI) of NKH could be different from those observed during other kinds of seizures. Indeed, seizure-related MRI abnormalities mainly involve the cortical grey matter, while NKH-related seizures usually appear as reversible subcortical T2/fluid attenuation inversion recovery (FLAIR) hypointensity. This latter abnormality shows a good spatial correlation with the area of the ictal focus on electroencephalogram and could be associated with other more common post-ictal MRI changes (cortical grey matter T2/FLAIR hyperintensity, cortical or leptomeningeal enhancement). Although these abnormalities tend to be transient, a focal volume loss or gliosis can result on follow-up imaging. Our cases confirm T2/FLAIR subcortical hypointensity as a main neuroradiological hallmark of NKH-induced seizures.
Voicing the organization on Instagram: Towards a performative understanding of employee voice
Authors: Cassinger Cecilia , Thelander Åsa
Published: June 2020

Much is currently expected from what PR campaigns involving social media can accomplish with regard to strengthening employee voice. Previous research on voice as a specific approach to employee relations has primarily relied on the effects and mechanisms of voice. There is scant research dealing with the processes and practices of employee voice. This article outlines a performative approach to conceptualizing the practice of employee voice. It focuses on how employees perform voice in a PR campaign involving Instagram takeover. The campaign was launched by a complex organization in Scandinavia, aimed at countering negative attention in local news media and improving the reputation of the organization. This article analyses the conditions of voicing concerns in the campaign through the lens of a dramaturgical approach to social life. First, the findings indicate that voicing is a form of individual and collective performance through which the meaning of work and the campaign are negotiated in relation to both other participants and an imagined audience. Second, visual conventions and organizational culture were found to govern performances of voice on Instagram. Third, findings underscore the need to understand employee voice as a socially and culturally embedded practice.
Mobiles in public: Social interaction in a smartphone era
Authors: Humphreys Lee , Hardeman Hazim
Published: June 2020

This article reports on the findings from a field study of mobile phone use among dyads in public. Replicating an originally published field study from 2005, this study highlights how mobile phones and use have changed in the last 15 years and demonstrates the ways that mobile phones are used to both detract and enhance social interactions. Drawing on the notions of cellphone crosstalk and caller hegemony, we identify behavioral responses to mobile phones and the use of mobile phones by others, which help to manage both face-to-face and mediated social expectations of responsiveness. Based on observational fieldwork and interviews, we identify specific behavioral categories that demonstrate how social vulnerability and ostracism due to mobile phone use may be mitigated through parallel or collective mobile phone use. We also expand the original concepts of cellphone crosstalk and caller hegemony to mediated crosstalk and notification hegemony to account for contemporary changes in the sociotechnical mobile landscape.
Scandalous Design: How Social Media Platforms’ Responses to Scandal Impacts Campaigns and Elections
Authors: Bossetta Michael
Published: June 2020

Given the role of social media in the modern election, scholars should not only study how platforms function for political actors; we should also study how platforms function as political actors. This essay therefore introduces the concept of scandalous design, which refers to programmatic changes in how social media operate in response to scandal. On the one hand, scandals can encourage changes in the architectural design of social media as products—that is, how platform providers introduce or manipulate features to mitigate the consequences of scandal. On the other, the concept of scandalous design recognizes the agency of these platforms as companies, who alter their organizational protocols in pursuit of furthering their business interests and generating goodwill with governments. The essay’s main argument is that deconstructing platforms’ responses to scandal can provide an empirical glimpse into how social media companies position themselves as political actors. I break down scandalous design into four typological groups: the introduction and manipulation of platform features, and changes to platforms’ analog and digital protocols. The typology is buttressed by recent empirical examples from elections in the United States, European Union, India, Brazil, and China. Without cognizance of how platforms’ operation—both digitally as products and politically as actors—evolves in response to scandal, scholars risk overlooking a key mechanism that contextualizes social media’s role in contemporary elections.
Digitizing Community Building and Reconciliation in Post-Conflict Communities: A Case of #Let’sTalkUganda in Northern Uganda
Authors: Kasadha Juma
Published: June 2020

This research examines the use of information and communication technologies (ICTs; social media) as a tool that fosters community building and reconciliation in post-conflict regions, in particular Northern Uganda. Using Twitter data collected over 27 months (12 June 2016–9 September 2018), we found that information technology (IT) increased social actors’ (Justice and Reconciliation Project [JRP]-Uganda) advocacy for transitional justice in post-conflict communities. Interview findings evidenced the effectiveness of using social media (SM) to connect post-conflict communities to share and discuss reconciliatory ideas. This study connotes that well-thought-out SM use by social actors to share information used in resolving conflict results in socio-political stability and harmonious coexistence.
Co–Cr–Mo alloy binding peptide as molecular glue for constructing biomedical surfaces
Authors: Migita Satoshi , Sakashita Kosuke , Saito Yuta , Suyalatu  , Yamazaki Tomohiko
Published: June 2020

The mechanical properties of Co–Cr–Mo (CCM) alloys are advantageous in various biomedical applications. However, because of their bioinert surface, CCM alloys exhibit poor endothelial cell attachment properties; thus, problems of biocompatibility remain. In this study, we aimed to improve the biocompatibility of the CCM alloy surface using solid-binding peptides. We selected peptides with high binding affinity for cast CCM alloy surfaces through in vitro evolution by the phage display method. The peptides were functionalized on the CCM alloy surfaces by simple immersion in the peptide solution. The peptide bound to both cast and 3D-printed CCMs with the same affinity. The peptides linked to the amino acid motif that promotes cell adhesion, and improved the attachment of endothelial cells on the 3D-printed CCM in serum and serum-free conditions. Hence, CCM-binding peptides are attractive tools for constructing a biofunctional surface on CCM-based biodevices.
A Rare Presentation of Choledochoduodenal Fistula Due to Ovarian Cancer Metastasis
Authors: Misra Deeksha , Mirza Usman , Vakiti Anusha , Padala Sandeep Anand
Published: June 2020

Choledochoduodenal fistula (CDF) is an abnormal communication between the common bile duct and the duodenum. It accounts for about 5% to 25% of the total biliary fistulas and is usually due to a perforated duodenal ulcer, choledocholithiasis, and complications secondary to tuberculosis or could be iatrogenic. Primary intrabilliary tumors usually cause obstructive jaundice and rarely biliary metastasis arising from other organs like colon, breast, and lungs can cause obstructive jaundice. There has been a case report of metastasis from ovarian cancer to the major papilla of the duodenum but no reported cases of it causing a CDF. We report a rare case of an 83-year-old female with ovarian cancer who developed a metastatic lesion to the duodenum eventually resulting in a CDF.
Patterns in hospital readmissions after ischaemic stroke – An observational study from the Swedish stroke register (Riksstroke)
Authors: Sennfält Stefan , Petersson Jesper , Ullberg Teresa , Norrving Bo
Published: June 2020

Introduction

While acute treatment and secondary prevention in stroke have undergone major improvements, hospital readmission after index stroke remains high. However, there are few reports on long-term readmission patterns.

Patients and methods

For this prospective observational study, data on demographics, functional status and living conditions were obtained from the Swedish Stroke Register (Riksstroke). Data on comorbidity and hospital readmissions up to five years post-index stroke were obtained from the Swedish National Patient Register. Patients were grouped based on number of readmissions: low (0–1) intermediate (2–4), high (5–9) or very high (≥10).

Results

Of the 10,092 patients included, 43.7% had been readmitted within 12 months and 74.0% within 5 years. There was an average of three readmissions per individual during the five-year interval. A small group of patients with a high-comorbidity burden accounted for the majority of readmissions: approximately 20% of patients accounted for 60% of readmissions, and 5% of patients accounted for 25%. Circulatory conditions were the most common cause followed by infectious disease, stroke, trauma and diseases of the nervous system other than stroke. The proportion of readmissions due to stroke decreased sharply in the first six months.

Conclusion

A small number of patients with a high degree of comorbidity accounted for the majority of hospital readmissions after index stroke. Our results highlight the need for further development of strategies to support high-risk comorbid stroke patients in the community setting. Further research describing characteristics and healthcare utilisation patterns in this group is warranted.
Case-based discussions in onco-nephrology
Authors: Henriksen Kammi J , Hogan Jonathan J , Abudayyeh Ala , Mistry Nupur , Koyner Jay L , Jhaveri Kenar D
Published: June 2020

Onco-nephrology encompasses a wide range of complex problems including nephrotoxicity from traditional chemotherapy and targeted therapies, paraneoplastic kidney diseases, tumor- or treatment-related microangiopathies and glomerulonephritis, and kidney injuries associated with dysproteinemia, among others. To bring these topics to life, we present a case-based discussion of clinicopathologic features that we have encountered in our daily practices. We hope these discussions of clinical presentation, kidney biopsy findings, underlying pathophysiology, and therapeutic considerations will provide insight into recognizing and treating this expanding spectrum of diseases.
A case of relapsing immunoglobulin A nephropathy secondary to immunotherapy
Authors: Mamlouk Omar , Workeneh Biruh
Published: June 2020

An estimated 3% of patients treated with immune checkpoint inhibitors develop acute kidney injury during the treatment course. The majority of biopsy-proven checkpoint inhibitor–associated nephropathy is related to acute interstitial nephritis, but various glomerulonephritides have been reported, including immunoglobulin A nephropathy and minimal change disease. Secondary immunoglobulin A nephropathy can be associated with autoimmune and infectious disease, but, unlike minimal change disease, rarely as a result of medications. To date, there are no clear evidences that treating secondary immunoglobulin A nephropathy or minimal change disease with immunosuppression therapy provides resolution for glomerulonephritis. We report the first case of remission of checkpoint inhibitor–induced overlap immunoglobulin A/minimal change disease nephropathy treated with repository corticotrophin therapy.
A Struggle for Dignity: The Kalavanteens of Maharashtra
Authors: Mondal Sushmita Gonsalves
Published: June 2020

Thrice alienated, Dalit women face a triple burden of caste, class and gender. The subaltern women belonging to Dalit communities in Kolhapur, Maharashtra is the focus of my paper. I have conducted in-depth interviews of the women I have met; and carefully documented their lives over a period of years. In due course of time, I realized that there are kalavanteen women (artistes of various folk-art forms) who are struggling to leave behind a tainted life and seize the opportunity to live a life of dignity. These are women who are involved in the performing arts, including singing, dancing and acting; Lavani, Tamasha and Jalsas. Such women who performed and entertained were available for sexual pleasures, but rarely married. They were rarely considered honourable women. Now when the image is that of a performing woman, she too will be consumed with greedy/hungry eyes. Her body parts too, are exposed to male glances, she has to attract them, as such, she cannot be expected to be chaste. However, in Kolhapur today, these kalavanteen, women have challenged their Dalitness; contested their being downtrodden; and finally derived a sense of agency from their being Dalit, their being downtrodden. I felt that it is highly significant to trace the manner in which they have attacked the systemic degradation that has eroded their lives for decades and tried to bring a sense of dignity.
Learning in Global Virtual Teams: A Practitioner’s View
Authors: Patil Samit
Published: June 2020

Several advances in technologies have enabled teams to work outside of the conventional physical workspace. Widespread changes in the nature of work due to the technologies have enabled productivity between teams that are dispersed and contributing to an emerging digital economy. At the same time, it is hard to ignore the sociological and human resource impact of such teams, and the conditions that they are subjected to in the form of digitally-enabled teams, or as this article articulates, global virtual teams (GVTs). Taking an observer’s view this article explores the process of learning and knowledge transfer in GVTs and proposes a framework for minimising stress and maximising outcomes from virtual teams.
Laparoscopic-assisted myomectomy with uterine artery occlusion at a freestanding ambulatory surgery center: a case series
Authors: MacKoul Paul , Danilyants Natalya , Touchan Faraj , van der Does Louise Q. , Haworth Leah R. , Kazi Nilofar
Published: June 2020

Background

Non-hysteroscopic myomectomy is infrequently performed in a freestanding ambulatory setting, in part due to risks of intraoperative hemorrhage. There are also concerns about increased surgical risks for morbidly obese patients in this setting. The purpose of this study is to report the surgical outcomes of a series of laparoscopic-assisted myomectomy (LAM) cases at a freestanding ambulatory surgery center (ASC), including a comparative analysis of outcomes in morbidly obese patients (BMI > 40 kg/m2).

Methods

A retrospective comparative analysis was performed of 969 women, age 18 years or older, non-pregnant, who underwent LAM by one of two high volume, laparoscopic gynecologic surgical specialists at a freestanding ambulatory surgery center serving the Washington, DC area, between October 2013 and February 2019. Reversible occlusion was performed laparoscopically by placing a latex-based rubber catheter as a tourniquet around the isthmus of the uterus, causing a temporary occlusion of the bilateral uterine arteries. Permanent occlusion was performed laparoscopically via retroperitoneal dissection and uterine artery ligation at the origin of the anterior branch of the internal iliac artery. Minilaparotomy was performed for specimen removal in all cases. No power morcellation was used. Postoperative complications were graded using the Clavien-Dindo Classification system. Outcomes were compared across BMI categories using Pearson Chi-Square.

Results

Average myoma weight and size were 422.7 g and 8.3 cm, respectively. Average estimated blood loss (EBL) was 192.1 mL; intraoperative and grade 3 postoperative complication rates were 1.4% and 1.6%, respectively. While EBL was significantly higher in obese and morbidly obese patients, this difference was not clinically meaningful, with no significant difference in blood transfusion rates. There were no statistically significant intraoperative or postoperative complication rates across BMI categories. There was a low rate of hospital transfers (0.7%) for all patients.

Conclusion

Laparoscopic-assisted myomectomy can be performed safely in a freestanding ambulatory surgery setting, including morbidly obese patients. This is especially important in the age of COVID-19, as elective surgeries have been postponed due to the 2020 pandemic, which may lead to a dramatic and permanent shift of outpatient surgery from the hospital to the ASC setting.
The effects of clioquinol in morphogenesis, cell membrane and ion homeostasis in Candida albicans
Authors: You Zimeng , Zhang Chaoliang , Ran Yuping
Published: June 2020

Background

Candida albicans is the most prevalent opportunistic fungal pathogen. Development of antifungals with novel targets is necessary for limitations of current antifungal agents and the emergence of drug resistance. The antifungal activity of clioquinol was widely accepted while the precise mechanism was poorly understood. Hence, we aimed to seek for the possible mechanism of clioquinol against Candida albicans in the present study.

Results

Clioquinol could inhibit hyphae formation in a concentration-dependent manner in multiple liquid and solid media. The concentration and time-dependent anti-biofilm activities were observed in different incubation periods quantitatively and qualitatively. Further investigation found that clioquinol disrupted cell membrane directly in high concentration and induced depolarization of the membrane in low concentration. As for the influence on ion homeostasis, the antifungal effects of clioquinol could be reversed by exogenous addition of metal ions. Meanwhile, the minimum inhibitory concentration of clioquinol was increased in media supplemented with exogenous metal ions and decreased in media supplemented with exogenous metal chelators. We also found that the cellular labile ferrous iron level decreased when fungal cells were treated with clioquinol.

Conclusion

These results indicated that clioquinol could inhibit yeast-hyphae transition and biofilm formation in Candida albicans. The effect on the cell membrane was different depending on different concentrations of clioquinol. Meanwhile, clioquinol could interfere with ion homeostasis as metal chelators for zinc, copper and iron, which was quite different with current common antifungal agents. All in all, clioquinol can be a new promising antifungal agent with novel target though more studies are needed to better understand the precise antifungal mechanism.
Implementation of a nurse-led self-management support intervention for patients with cancer-related pain: a cluster randomized phase-IV study with a stepped wedge design (EvANtiPain)
Authors: Raphaelis Silvia , Frommlet Florian , Mayer Hanna , Koller Antje
Published: June 2020

Background

Pain self-management support interventions were effective in controlled clinical trials and meta analyses. However, implementation of these complex interventions may not translate into identical effects. This paper evaluates the implementation of ANtiPain, a cancer pain self-management support intervention in routine clinical practice according to the Reach Efficacy-Adoption Implementation Maintenance framework.

Methods

In this cluster randomized study with a stepped wedge design, N = 153 adult patients with cancer-related pain were recruited from 01/17 to 05/18 on 17 wards of 3 hospitals in Vienna, Austria. ANtiPain entailed a face-to-face in-hospital session by a trained nurse to prepare discharge according to key strategies, information on pain self-management, and skills building. After discharge, cancer-pain self-management was coached via phone calls. Patient-level data were collected at recruitment, and 2, 4 and 8 weeks after discharge via postal or online questionnaire. Primary outcome was pain interference with daily activities. Secondary outcomes included pain intensity, self-efficacy, and patient satisfaction. Organizational-level data (e.g., on implementation procedures) were collected by study or intervention nurses. The mixed model to analyze patient-level data included a random intercept and a random slope for individual and a random intercept for ward.

Results

Recruitment was slower than expected and unevenly distributed over wards and hospitals. The face-to-face session was clinically feasible (mean duration = 33 min) as well as the mean amount (n = 2) and duration of phone calls (mean = 17 min). Only 16 (46%) of 35 trained nurses performed the intervention on nine wards. To deal with the loss of power, analyses were adapted. Overall effects on pain interference were not significant. However, effects were significant in sub analyses of the nine wards that recruited patients in the intervention period (p = .009). Regarding secondary outcomes, the group-by-time effect was significant for self-efficacy (p = .033), and patient satisfaction with information on pain-self-management (p = .002) and in-hospital pain management (p = .018).

Conclusions

The implementation of ANtiPain improved meaningful patient outcomes on wards that applied the intervention routinely. Our analyses showed that the implementation benefited from being embedded in larger scale projects to improve cancer pain management and that the selection of wards with a high percentage of oncology patients may be crucial.

Trial registration

ClinicalTrials.gov Identifier: NCT02891785 Date of registration: September 8, 2016.
Prevalence of urinary cotinine levels in children under 5 years of age during consultations for acute respiratory disease at the emergency department of the Universidad de La Sabana clinic
Authors: Tovar María Fernanda , Ortiz Wendy , Valderrama María Alejandra , Rodríguez Fabio , Gamboa Oscar , Maldonado María José , Agudelo Sergio Iván
Published: June 2020

Background

Several environmental factors favour the occurrence of acute respiratory disease, which is the main reason for paediatric consultations in our country (Colombia). Tobacco smoke is considered a significant environmental pollutant with a great impact on health. The objective of this study is to estimate the prevalence of cotinine levels measured in urine, in children between 1 to 60 months of age who attended an emergency department with acute respiratory disease.

Methods

A cross-sectional study was conducted that included children between 1 and 60 months of age with acute respiratory disease who were admitted to the emergency department of the Universidad de La Sabana Clinic between April and July 2016.

Results

We included 268 patients and 36% were female. Of the total population examined, 33.96% showed positive results for urinary cotinine, of whom 97.8% had values between 10 and 100 ng/ml, which is considered positive for exposure to second-hand smoke. The principal pathology was recurrent wheezing in 43.96% of these cases. Regarding the presence of smokers at home, it is important to mention that in 54.95% of the children with positive urinary cotinine test was no related with smokers at home. And in 45.05% of positive urinary cotinine was evidence of smokers at home, being associated with the positive result P <  0.001 and smoking within the house P = 0.018; smoking when children were present did not have significant P = 0.105. The activities performed after smoking such as hand washing, change of clothes, eating, brushing teeth, did not influence the test result P = 0.627.

Conclusions

A high prevalence of urinary cotinine was observed, which is associated with the presence of a smoker at home, and this relationship was independent of the activities performed by the smoker after smoking. In addition, a positive test for urinary cotinine was presented in some children without documented exposure to cigarette smoke inside the home, which may be explained by the presence of environmental cotinine. Therefore, it is necessary to perform educational interventions aimed at parents and caregivers who smoke.
Explaining socioeconomic inequalities in immunisation coverage in India: new insights from the fourth National Family Health Survey (2015–16)
Authors: Srivastava Swati , Fledderjohann Jasmine , Upadhyay Ashish Kumar
Published: June 2020

Background

Childhood vaccinations are a vital preventive measure to reduce disease incidence and deaths among children. As a result, immunisation coverage against measles was a key indicator for monitoring the fourth Millennium Development Goal (MDG), aimed at reducing child mortality. India was among the list of countries that missed the target of this MDG. Immunisation targets continue to be included in the post-2015 Sustainable Development Goals (SDG), and are a monitoring tool for the Indian health care system. The SDGs also strongly emphasise reducing inequalities; even where immunisation coverage improves, there is a further imperative to safeguard against inequalities in immunisation outcomes. This study aims to document whether socioeconomic inequalities in immunisation coverage exist among children aged 12–59 months in India.

Methods

Data for this observational study came from the fourth round of the National Family Health Survey (2015–16). We used the concentration index to assess inequalities in whether children were fully, partially or never immunised. Where children were partially immunised, we also examined immunisation intensity. Decomposition analysis was applied to examine the underlying factors associated with inequality across these categories of childhood immunisation.

Results

We found that in India, only 37% of children are fully immunised, 56% are partially immunised, and 7% have never been immunised. There is a disproportionate concentration of immunised children in higher wealth quintiles, demonstrating a socioeconomic gradient in immunisation. The data also confirm this pattern of socioeconomic inequality across regions. Factors such as mother’s literacy, institutional delivery, place of residence, geographical location, and socioeconomic status explain the disparities in immunisation coverage.

Conclusions

In India, there are considerable inequalities in immunisation coverage among children. It is essential to ensure an improvement in immunisation coverage and to understand underlying factors that affect poor uptake and disparities in immunisation coverage in India in order to improve child health and survival and meet the SDGs.
Klotho and fibroblast growth factors 19 and 21 serum concentrations in children and adolescents with normal body weight and obesity and their associations with metabolic parameters
Authors: Socha-Banasiak Anna , Michalak Arkadiusz , Pacześ Krzysztof , Gaj Zuzanna , Fendler Wojciech , Socha Anna , Głowacka Ewa , Kapka Karolina , Gołąbek Violetta , Czkwianianc Elżbieta
Published: June 2020

Background

Fibroblast growth factor 19 (FGF19), fibroblast growth factor 21 (FGF21) and Klotho are regulators of energy homeostasis. However, in the pediatric population, the relationships between obesity, metabolic disorders and the aforementioned factors have not been clearly investigated. We analyzed the role of FGF19, FGF21 and Klotho protein in children with normal body weight as well as in overweight and obese subjects and explored their associations with insulin resistance (IR) and metabolic syndrome (MS) and its components.

Methods

This was a cross-sectional study conducted in a group of hospitalized children and adolescents. Laboratory investigations included serum analysis of FGF19, FGF21, and Klotho with ELISA kits as well as the analysis of the lipid profile and ALT serum concentrations. Moreover, each subject underwent an oral glucose tolerance test (OGTT) with fasting insulinemia measurement to detect glucose tolerance abnormalities and calculate the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index. Furthermore, the clinical analysis included blood pressure measurement, body fat percentage estimation and assessment of the prevalence of MS and its components.

Results

The study was conducted with 174 children/adolescents aged 6–17 years with normal body weight (N = 48), obesity (N = 92) and overweight (N = 34). Klotho concentration was significantly higher in the obese children [median 168.6 pg/ml (90.2 to 375.9)]) than in the overweight [131.3 pg/ml (78.0 to 313.0)] and normal-body-weight subjects [116.6 pg/ml (38.5 to 163.9)] (p = 0.0334) and was also significantly higher in insulin-resistant children than in insulin-sensitive children [185.3 pg/ml (102.1 to 398.2) vs 132.6 pg/ml (63.9 to 275.6), p = 0.0283]. FGF21 was elevated in patients with MS compared to the FGF21 levels in other subjects [136.2 pg/ml (86.5 to 239.9) vs 82.6 pg/ml (41.8 to 152.4), p = 0.0286]. The multivariable model showed that FGF19 was an independent predictor of IR after adjusting for pubertal stage and BMI Z-score.

Conclusions

Klotho levels were associated with body weight status in children and adolescents. Moreover, Klotho, FGF19 and FGF21 concentrations correlated with IR status and/or components of MS.
Investigating the utility of Google trends for Zika and Chikungunya surveillance in Venezuela
Authors: Strauss Ricardo , Lorenz Eva , Kristensen Kaja , Eibach Daniel , Torres Jaime , May Jürgen , Castro Julio
Published: June 2020

Introduction

Chikungunya and Zika Virus are vector-borne diseases responsible for a substantial disease burden in the Americas. Between 2013 and 2016, no cases of Chikungunya or Zika Virus were reported by the Venezuelan Ministry of Health. However, peaks of undiagnosed fever cases have been observed during the same period. In the context of scarce data, alternative surveillance methods are needed. Assuming that unusual peaks of acute fever cases correspond to the incidences of both diseases, this study aims to evaluate the use of Google Trends as an indicator of the epidemic behavior of Chikungunya and Zika.

Methods

Time-series cross-correlations of acute fever cases reported by the Venezuelan Ministry of Health and data on Google search queries related to Chikungunya and Zika were calculated.

Results

A temporal distinction has been made so that acute febrile cases occurring between 25th of June 2014 and 23rd of April 2015 were attributed to the Chikungunya virus, while cases occurring between 30th of April 2015 and 29th of April 2016 were ascribed to the Zika virus. The highest cross-correlations for each disease were shown at a lag of 0 (r = 0.784) for Chikungunya and at + 1 (r = 0.754) for Zika.

Conclusion

The strong positive correlation between Google search queries and official data on acute febrile cases suggests that this resource can be used as an indicator of endemic urban arboviruses activity. In the Venezuelan context, Internet search queries might help to overcome some of the gaps that exist in the national surveillance system.
Technical note on introducing a digital workflow for newborns with craniofacial anomalies based on intraoral scans - part II: 3D printed Tübingen palatal plate prototype for newborns with Robin sequence
Authors: Xepapadeas A. B. , Weise C. , Frank K. , Spintzyk S. , Poets C. F. , Wiechers C. , Arand J. , Koos B.
Published: June 2020

Background

Orthodontic treatment of newborns and infants with Robin-Sequence using the Tübingen Palatal Plate (TPP) is a complex procedure that could benefit from simplification through digitalization. The design of the velar extension (spur) and the palatal base determines the success of the treatment. Therefore, a prototype must be produced and inserted under endoscopic supervision in order to determine the appropriate shape, length and position of the spur. This technical note demonstrates a fully digital workflow for the design and manufacturing of a functional TPP prototype, based on an intraoral scan. This prototype can be altered and individualized digitally for each patient. After the shape and position of the spur have been optimized, the prototype is duplicated using a silicone mold. Then the definitive TPP is manufactured and inserted. We aim to present a workflow which facilitates the fitting procedure and does not require a conventional impression or a physical model to create the appliance.

Methods

As described in part I of this series, the intraoral scan is performed using the 3Shape TRIOS3 scanner and its corresponding acquisition software. The virtual model is rendered in the 3Shape ortho appliance designer and the base of the palatal plate is designed in the 3Shape dental designer. The palatal plate and the virtual model are then imported into Autodesk Meshmixer and a standardized spur is positioned and merged with the base. The TPP is exported in Standard Tessellation Language (STL) format and manufactured on a W2P Solflex 170 DLP printer using VOCO VPrint Splint material (MDR Class IIa).

Results

Based on an intraoral scan, the TPP prototype could be successfully manufactured and proved suitable for the patients’ treatment.

Conclusion

The new digital workflow for the design of the TPP can been successfully implemented into daily clinical routine in our facility. Patients could be alleviated from having to undergo conventional impression procedures and fitting of the TPP could be facilitated by producing multiple functional prototypes for endoscopic evaluation. Through rapid prototyping, the expenditure of the fitting process was reduced, which makes the TPP therapy more efficient and accessible to a wider range of clinicians.
Evidence of nonverbal communication between nurses and older adults: a scoping review
Authors: Wanko Keutchafo Esther L. , Kerr Jane , Jarvis Mary Ann
Published: June 2020

Background

Communication is an integral part of life and of nurse-patient relationships. Effective communication with patients can improve the quality of care. However, the specific communication needs of older adults can render communication between them and nurses as less effective with negative outcomes.

Methods

This scoping review aims at describing the type of nonverbal communication used by nurses to communicate with older adults. It also describes the older adults’ perceptions of nurses’ nonverbal communication behaviors. It followed (Int J Soc Res 8: 19-32, 2005) framework. Grey literature and 11 databases were systematically searched for studies published in English and French, using search terms synonymous with nonverbal communication between nurses and older adults for the period 2000 to 2019.

Results

The search revealed limited published research addressing nonverbal communication between older adults and nurses. The studies eligible for quality assessment were found to be of high quality. Twenty-two studies were included and highlighted haptics, kinesics, proxemics, and vocalics as most frequently used by nurses when communicating with older adults; while studies showed limited use of artefacts and chronemics. There was no mention of nurses’ use of silence as a nonverbal communication strategy. Additionally, there were both older adults’ positive and negative responses to nurses’ nonverbal communication behaviors.

Conclusion

Nurses should be self-aware of their nonverbal communication behaviors with older adults as well as the way in which the meanings of the messages might be misinterpreted. In addition, nurses should identify their own style of nonverbal communication and understand its modification as necessary in accordance with patient’s needs.
Mutation of amphioxus Pdx and Cdx demonstrates conserved roles for ParaHox genes in gut, anus and tail patterning
Authors: Zhong Yanhong , Herrera-Úbeda Carlos , Garcia-Fernàndez Jordi , Li Guang , Holland Peter W. H.
Published: June 2020

Background

The homeobox genes Pdx and Cdx are widespread across the animal kingdom and part of the small ParaHox gene cluster. Gene expression patterns suggest ancient roles for Pdx and Cdx in patterning the through-gut of bilaterian animals although functional data are available for few lineages. To examine evolutionary conservation of Pdx and Cdx gene functions, we focus on amphioxus, small marine animals that occupy a pivotal position in chordate evolution and in which ParaHox gene clustering was first reported.

Results

Using transcription activator-like effector nucleases (TALENs), we engineer frameshift mutations in the Pdx and Cdx genes of the amphioxus Branchiostoma floridae and establish mutant lines. Homozygous Pdx mutants have a defect in amphioxus endoderm, manifest as loss of a midgut region expressing endogenous GFP. The anus fails to open in homozygous Cdx mutants, which also have defects in posterior body extension and epidermal tail fin development. Treatment with an inverse agonist of retinoic acid (RA) signalling partially rescues the axial and tail fin phenotypes indicating they are caused by increased RA signalling. Gene expression analyses and luciferase assays suggest that posterior RA levels are kept low in wild type animals by a likely direct transcriptional regulation of a Cyp26 gene by Cdx. Transcriptome analysis reveals extensive gene expression changes in mutants, with a disproportionate effect of Pdx and Cdx on gut-enriched genes and a colinear-like effect of Cdx on Hox genes.

Conclusions

These data reveal that amphioxus Pdx and Cdx have roles in specifying middle and posterior cell fates in the endoderm of the gut, roles that likely date to the origin of Bilateria. This conclusion is consistent with these two ParaHox genes playing a role in the origin of the bilaterian through-gut with a distinct anus, morphological innovations that contributed to ecological change in the Cambrian. In addition, we find that amphioxus Cdx promotes body axis extension through a molecular mechanism conserved with vertebrates. The axial extension role for Cdx dates back at least to the origin of Chordata and may have facilitated the evolution of the post-anal tail and active locomotion in chordates.
Comparative performance and external validation of the multivariable PREDICT Prostate tool for non-metastatic prostate cancer: a study in 69,206 men from Prostate Cancer data Base Sweden (PCBaSe)
Authors: Thurtle David , Bratt Ola , Stattin Pär , Pharoah Paul , Gnanapragasam Vincent
Published: June 2020

Background

PREDICT Prostate is an endorsed prognostic model that provides individualised long-term prostate cancer-specific and overall survival estimates. The model, derived from UK data, estimates potential treatment benefit on overall survival. In this study, we externally validated the model in a large independent dataset and compared performance to existing models and within treatment groups.

Methods

Men with non-metastatic prostate cancer and prostate-specific antigen (PSA) < 100 ng/ml diagnosed between 2000 and 2010 in the nationwide population-based Prostate Cancer data Base Sweden (PCBaSe) were included. Data on age, PSA, clinical stage, grade group, biopsy involvement, primary treatment and comorbidity were retrieved. Sixty-nine thousand two hundred six men were included with 13.9 years of median follow-up. Fifteen-year survival estimates were calculated using PREDICT Prostate for prostate cancer-specific mortality (PCSM) and all-cause mortality (ACM). Discrimination was assessed using Harrell’s concordance (c)-index in R. Calibration was evaluated using cumulative available follow-up in Stata (TX, USA).

Results

Overall discrimination of PREDICT Prostate was good with c-indices of 0.85 (95% CI 0.85–0.86) for PCSM and 0.79 (95% CI 0.79–0.80) for ACM. Overall calibration of the model was excellent with 25,925 deaths predicted and 25,849 deaths observed. Within the conservative management and radical treatment groups, c-indices for 15-year PCSM were 0.81 and 0.78, respectively. Calibration also remained good within treatment groups. The discrimination of PREDICT Prostate significantly outperformed the EAU, NCCN and CAPRA scores for both PCSM and ACM within this cohort overall.

A key limitation is the use of retrospective cohort data.

Conclusions

This large external validation demonstrates that PREDICT Prostate is a robust and generalisable model to aid clinical decision-making.
The impact of adjuvant surgical treatment of nontuberculous mycobacterial pulmonary disease on prognosis and outcome
Authors: Fukushima Kiyoharu , Miki Mari , Matsumoto Yuki , Uda Emi , Yamamoto Yuji , Kogita Yuya , Kagawa Yuko , Matsuki Takanori , Kagawa Hiroyuki , Oshitani Yohei , Motooka Daisuke , Tsujino Kazuyuki , Yoshimura Kenji , Miki Keisuke , Hayashi Akio , Nakamura Shota , Kitada Seigo , Takeuchi Yukiyasu , Kida Hiroshi
Published: June 2020

Background

Lung resection in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) has been reported to be associated with favorable outcomes. However, little is known regarding the risk and prognostic factors for refractory and recurrent cases. We aimed to evaluate the overall impact and benefit of adjuvant lung surgery by comparing NTM-PD patients who underwent adjuvant lung resection with those treated exclusively with antibiotics. We also investigated the efficacy of serum IgA antibody against glycopeptidolipid (GPL) core antigen (GPL core antibody) to monitor disease activity and predict the recurrence of disease after adjuvant lung resection.

Methods

We retrospectively evaluated the clinical characteristics and surgical outcomes of 35 patients surgically treated for NTM-PD. Furthermore, we compared surgically treated patients and control patients treated exclusively with antibiotics who were matched statistically 1:1 using a propensity score calculated from age, sex, body mass index, and radiologic features of disease.

Results

In the surgically treated patients, the median age was 58 (interquartile range, 47–65) years and 65.7% were female. Twenty-eight patients had Mycobacterium avium complex. Operations comprised four pneumonectomies, two bilobectomies, one bilobectomy plus segmentectomy, 17 lobectomies, two segmentectomies, and nine lobectomies plus segmentectomies. Postoperative complications occurred in seven patients (20%), there were no operative deaths, and 33 (94.3%) patients achieved negative sputum culture conversion. Refractory and recurrent cases were associated with remnant bronchiectasis, contralateral shadows, and positive acid-fast bacilli staining or culture. Of 28 statistically matched pairs, long-term sustained negative culture conversion was observed in 23 (82.2%) surgical group patients and in 14 (50.0%) non-surgical group patients (0.0438). The mortality rate was lower in the surgical group, but did not reach statistical significance (one in the surgical group and four in the non-surgical group, p = 0.3516). GPL core antibody was correlated with disease activity and recurrence.

Conclusions

NTM-PD patients who underwent adjuvant lung resection experienced overall favorable outcomes and achieved sputum culture conversion more frequently. Long-term mortality may have been reduced by this procedure, and the level of GPL core antibody was shown to be a good clinical indicator of disease activity after surgery.