bluuebunny/crossref_metadata_2025 huggingface dataset:
Prostate Cancer Detected by Choroidal Tumor and Complete Response to Hormonal Therapy: Case Report and Literature Review of 24 Patients With Choroidal Metastasis From Prostate Cancer
Authors: Matsuo Toshihiko , Tanaka Takehiro , Nakamura Aya , Wada Koichiro
Published: June 2021

Metastatic choroidal tumors derived from prostate cancer are rare. In this study, we report a patient who manifested a choroidal tumor as the initial presenting sign of prostate cancer and review 23 patients with choroidal metastasis of prostate cancer in the literature to answer a clinical question how the choroidal metastases would respond to hormonal therapy. A 73-year-old man presented with a choroidal tumor in the right eye. He was in good health and had no previous history except for current hemodialysis in 3 years due to chronic renal failure as a sequel to glomerulonephritis. With the diagnosis of a probable metastatic tumor, positron emission tomography was performed to disclose high-uptake sites in multiple bones, lymph nodes, and the prostate, together with multiple nodular lesions in bilateral lungs on computed tomography (CT) scan. Serum prostate-specific antigen (PSA) was elevated to 541 ng/mL, which supported prostate cancer as the primary site. He had degarelix injection, and the choroidal tumor resolved rapidly and became flat degeneration in a month. Prostate biopsy showed poorly differentiated adenocarcinoma, and he underwent surgical castration. He had no medication until 3 years later when he showed gradual increase of serum PSA up to 6.05 ng/mL and multiple bony metastases on CT scan. Bicalutamide, switched to enzalutamide and then to abiraterone, led to the undetectable level of serum PSA until the last visit with no relapse of the choroidal metastasis, 6.8 years after the initial visit. In the literature review of 24 patients with choroidal metastasis of prostate cancer, including this patient, 8 patients presented a choroidal tumor as the initial sign and the choroidal lesions mostly showed complete response to hormonal therapy. Among 13 patients who were frequently in the course of hormonal therapy, choroidal metastases showed complete or partial response to external beam radiation to the eye in 11 patients and episcleral plaque radiotherapy in 2 patients. In conclusion, metastatic choroidal tumors of prostate cancer would show good response to hormonal therapy when the therapy has not been initiated. Hormone-resistant choroidal metastases in the therapeutic course of prostate cancer could be managed successfully by external beam radiation to the eye.
The zero-leverage phenomenon in European listed firms: A financing decision or an imposition of the financial market?
Authors: Morais Flávio , Serrasqueiro Zélia , Ramalho Joaquim JS
Published: June 2021

This article provides empirical evidence on the zero-leverage phenomenon for a sample of European listed firms for the period 1995–2016. It is shown that there are two types of firms with zero leverage: the financially constrained firms that face obstacles in obtaining external finance, as predicted by the financial constraints hypothesis; and the financially unconstrained firms that maintain zero leverage as a consequence of a financing decision, which supports the financial flexibility hypothesis. The zero-leverage phenomenon is also influenced by the financial system that prevails in each country, being boosted (inhibited) in market-based (bank-based) financial systems, and by the country’s macroeconomic conditions, with the recent financial and sovereign debt crises increasing the propensity for zero leverage in market-based countries. We also find that the financial flexibility hypothesis seems to be more important in market-based systems and that the financial constraints approach did not gain importance during the crisis period. Our results are robust to the use of alternative measures of debt conservatism, explanatory variables, and econometric methods and maintain their validity when we allow for endogeneity in firm size and dividend payments.

JEL CLASSIFICATION G32
Employment Lapses and Subsequent Hiring Disadvantages: An Experimental Approach Examining Types of Discrimination and Mechanisms
Authors: Weisshaar Katherine
Published: June 2021

Employment interruption is a common experience in today’s labor market, most frequently due to unemployment from job loss and temporary lapses to care for family or children. Although existing research shows that employment lapses cause disadvantages at the hiring interface compared to individuals with no employment disruptions, competing theories predict different mechanisms explaining these hiring penalties. In this study, the author uses an original conjoint survey experiment to causally assess perceptions of fictitious job applicants, focusing on a comparison of unemployed applicants and nonemployed caregiver applicants, who left work to care for family, to currently employed applicants. The author examines whether disadvantages for job applicants with employment gaps are receptive to positive information (and therefore represent a form of “informational bias”) or are resistant to information (reflecting “cognitive bias”) and further assesses which types of information affect or do not affect levels of bias in fictitious hiring decisions. Results show that positive information on past job performance and social skills essentially eliminates disadvantages faced by unemployed job applicants, but nonemployed caregiver applicants remain disadvantaged even with multiple types of positive information. These findings suggest that unemployed applicants face informational biases but that nonemployed caregiver applicants face cognitive biases that are rigid even with rich forms of positive or counter-stereotypical information. This study has implications for understanding the career consequences of employment disruption, which is especially relevant to consider in light of labor market disruptions during the recent pandemic.
Sharing Sensitive Information: A Hidden Profile Employee Selection Exercise
Authors: Lewis Amy C. , McKee D’Lisa N. , Louis Melissa R.
Published: June 2021

Employee selection and group decision-making skills are critical for ensuring hiring is valid, meets organizational goals, and considers ethical and legal limitations. This exercise has participants role-play members of a search committee reviewing job finalists using shared and unique information. A novel twist to traditional hidden-profile exercises is introduced by including unique information inappropriate for employment decisions (e.g., health information, an old misdemeanor charge). By uncovering unshared details and deciding whether to discuss potentially biasing information, learners practice group decision making and consider legal issues. While exploring professional guidelines and best practices, the exercise acknowledges that managers occasionally know sensitive or potentially biasing information. Although primarily an human resource activity, the exercise includes a traditional hidden-profile variant with organizational behavior learning goals. Both variants are appropriate for learners across the organizational spectrum. A teaching note for adapting the in-person exercise for synchronous or asynchronous online delivery gives detailed instructions for popular learning management systems.
Are We Ready to Integrate Artificial Intelligence Literacy into Medical School Curriculum: Students and Faculty Survey
Authors: Wood Elena A , Ange Brittany L , Miller D Douglas
Published: June 2021

Background:

The effects of Artificial Intelligence (AI) technology applications are already felt in healthcare in general and in the practice of medicine in the disciplines of radiology, pathology, ophthalmology, and oncology. The expanding interface between digital data science, emerging AI technologies and healthcare is creating a demand for AI technology literacy in health professions.

Objective:

To assess medical student and faculty attitudes toward AI, in preparation for teaching AI foundations and data science applications in clinical practice in an integrated medical education curriculum.

Methods:

An online 15-question semi-structured survey was distributed among medical students and faculty. The questionnaire consisted of 3 parts: participant’s background, AI awareness, and attitudes toward AI applications in medicine.

Results:

A total of 121 medical students and 52 clinical faculty completed the survey. Only 30% of students and 50% of faculty responded that they were aware of AI topics in medicine. The majority of students (72%) and faculty (59%) learned about AI from the media. Faculty were more likely to report that they did not have a basic understanding of AI technologies (χ2, P = .031). Students were more interested in AI in patient care training, while faculty were more interested in AI in teaching training (χ2, P = .001). Additionally, students and faculty reported comparable attitudes toward AI, limited AI literacy and time constraints in the curriculum. There is interest in broad and deep AI topics. Our findings in medical learners and teaching faculty parallel other published professional groups’ AI survey results.

Conclusions:

The survey conclusively proved interest among medical students and faculty in AI technology in general, and in its applications in healthcare and medicine. The study was conducted at a single institution. This survey serves as a foundation for other medical schools interested in developing a collaborative programming approach to address AI literacy in medical education.
Epidemiology and trends in survival of systemic sclerosis in Olmsted County (1980–2018): A population-based study
Authors: Coffey Caitrin M , Radwan Yasser A , Sandhu Avneek S , Crowson Cynthia S , Bauer Philippe R , Matteson Eric L , Makol Ashima
Published: June 2021

Background/Purpose:

To update the epidemiology of systemic sclerosis and evaluate the performance of the American College of Rheumatology/European League Against Rheumatism 2013 versus 1980 American Rheumatism Association classification criteria in a US population-based cohort.

Methods:

An inception cohort of patients with incident systemic sclerosis from 1 January 1980 through 31 December 2018, in Olmsted County, Minnesota, was identified based on comprehensive individual medical record review. Incidence and prevalence rates were age- and sex-adjusted to the 2010 US white population. Survival rates were compared with expected rates in the general population. Fulfillment of 1980 and 2013 classification criteria was ascertained.

Results:

A total of 85 incident cases of systemic sclerosis (91% female, mean age = 55.4 ± 16 years) and 49 prevalent cases on 1 January 2015 were identified. The overall age- and sex-adjusted annual incidence was 25 (95% confidence interval = 20–31) per million population, with no change in incidence over time. The age- and sex-adjusted prevalence was 436 (95% confidence interval = 313–558) per 1,000,000 population. 77 (91%) patients fulfilled the 2013 classification criteria, and 38 (45%) fulfilled the 1980 criteria. Mortality among patients with systemic sclerosis was significantly higher in comparison to the general population, with a standardized mortality ratio of 2.48 (95% confidence interval = 1.76–3.39) and no evidence of improvement over time.

Conclusion:

Systemic sclerosis developed in 25 persons/million/year with no change over the 39-year study period. The 2013 classification criteria perform significantly better than the 1980 criteria but failed to classify 9% of patients. Systemic sclerosis portends a 2.5-fold higher risk of mortality than the general population, with no evidence of improved survival over time.
COVID-19 Impact on Medical Practice in Sub-Saharan Africa; The Need to Guard Against Medical Negligence: A Case Report in a Health Care Facility in Kumasi, Ghana
Authors: Ossei Paul Poku Sampene , Ayibor William Gilbert , Taylor John , Agyemang Lawrence , Aninkora Kwabena Owusu , Asante Bright Opoku
Published: June 2021

With the novel coronavirus disease 2019 (COVID-19) still in pandemic mode, according to the World Health Organization (WHO), the African continent has experienced continued growth in the total tally. According to the Africa Centers for Disease Control and Prevention (CDC), the virus has spread to almost all 54 recognized African countries. Figures from the CDC indicate that the highly affected countries include South Africa, Egypt, Nigeria, Algeria, Morocco, and Ghana (with more than 55 000 cases and 400 deaths as of the time of writing). The WHO and the United Nations have projected the ongoing pandemic could push medical practitioners toward high rates of clinical misdiagnosis. So far, the coronavirus pandemic has been more devastating and life-threatening than the usual seasonal flu. As of the time of writing, here is presently no proven vaccine or treatment for the disease, with the vaccines still under development; hence, a timely and accurate diagnosis could prove critical. Patients can also receive supportive care earlier if they are diagnosed early. Considering the fact that the coronavirus infection mimics the signs and symptoms of normal flu and other respiratory infections, a problem now emerges, where these symptoms are treated as manifestations of the deadly virus. This has caused a diagnostic dilemma in the absence of laboratory tests with new cases adding to the pool daily. In Ghana, many patients on suspicion of flu-like symptoms are sometimes denied the care so deserved due to the stigma associated with the disease, often in cases where laboratory tests are absent. This study is a postmortem report of a client who died while on admission at a private medical facility. It was an unconfirmed case of COVID-19, and the client was left unattended to and died, having spent 8 days on the ward. His test report was not done initially, but the diagnosis was purely based on suspicion. Nasopharyngeal swabs conducted on the fifth day of admission proved negative. Results became available on the day of the client’s demise. Postmortem findings established the actual cause of death, and it was not COVID-19 related.
Combined effects of plasma von Willebrand factor and platelet measures on the risk of incident venous thromboembolism
Authors: Edvardsen Magnus S. , Hansen Ellen-Sofie , Hindberg Kristian , Morelli Vânia M. , Ueland Thor , Aukrust Pål , Brækkan Sigrid K. , Evensen Line H. , Hansen John-Bjarne
Published: June 2021

Plasma von Willebrand factor (VWF) and platelet reactivity are risk factors for venous thromboembolism (VTE), and VWF can promote hemostasis by interaction with platelets. In this study, we explored the combined effects of plasma VWF and platelet measures on the risk of incident VTE. A population-based nested case-control study with 403 cases and 816 controls was derived from the Tromsø Study. VWF, platelet count and mean platelet volume (MPV) were measured in blood samples drawn at baseline. Odds ratios (ORs) with 95% confidence intervals (CIs) for VTE were estimated across VWF tertiles, within predefined MPV (<8.5, 8.5-9.5, and ≥9.5 fL) and platelet count (<230, 230-299, and ≥300 ×109/L) strata. Here, participants with VWF levels in the highest tertile and with MPV ≥9.5 fL had an OR of 1.98 (95% CI, 1.17-3.36) for VTE compared with those in the lowest VWF tertile and with MPV <8.5 fL in the age- and sex-adjusted model. In the joint exposure group, 48% (95% CI, 15-96) of VTEs were attributable to the biological interaction between VWF and MPV. Similarly, individuals with VWF in the highest tertile and platelet count ≥300 × 109/L had an OR of 2.91 (95% CI, 1.49-5.67) compared with those with VWF in the lowest tertile and platelet count <230 × 109/L, and 39% (95% CI, −2 to 97) of VTEs in the joint exposure group were explained by the interaction. Our results suggest that platelet reactivity and platelet count interact biologically with high plasma VWF, resulting in an increased risk for incident VTE.
Accelerated regression-based summary statistics for discrete stochastic systems via approximate simulators
Authors: Jiang Richard M. , Wrede Fredrik , Singh Prashant , Hellander Andreas , Petzold Linda R.
Published: June 2021

Background

Approximate Bayesian Computation (ABC) has become a key tool for calibrating the parameters of discrete stochastic biochemical models. For higher dimensional models and data, its performance is strongly dependent on having a representative set of summary statistics. While regression-based methods have been demonstrated to allow for the automatic construction of effective summary statistics, their reliance on first simulating a large training set creates a significant overhead when applying these methods to discrete stochastic models for which simulation is relatively expensive. In thisτwork, we present a method to reduce this computational burden by leveraging approximate simulators of these systems, such as ordinary differential equations andτ-Leaping approximations.

Results

We have developed an algorithm to accelerate the construction of regression-based summary statistics for Approximate Bayesian Computation by selectively using the faster approximate algorithms for simulations. By posing the problem as one of ratio estimation, we use state-of-the-art methods in machine learning to show that, in many cases, our algorithm can significantly reduce the number of simulations from the full resolution model at a minimal cost to accuracy and little additional tuning from the user. We demonstrate the usefulness and robustness of our method with four different experiments.

Conclusions

We provide a novel algorithm for accelerating the construction of summary statistics for stochastic biochemical systems. Compared to the standard practice of exclusively training from exact simulator samples, our method is able to dramatically reduce the number of required calls to the stochastic simulator at a minimal loss in accuracy. This can immediately be implemented to increase the overall speed of the ABC workflow for estimating parameters in complex systems.
Is mRNA decapping by ApaH like phosphatases present in eukaryotes beyond the Kinetoplastida?
Authors: Castañeda Londoño Paula Andrea , Banholzer Nicole , Bannermann Bridget , Kramer Susanne
Published: June 2021

Background

ApaH like phosphatases (ALPHs) originate from the bacterial ApaH protein and have been identified in all eukaryotic super-groups. Only two of these proteins have been functionally characterised. We have shown that the ApaH like phosphatase ALPH1 from the KinetoplastidTrypanosoma bruceiis the mRNA decapping enzyme of the parasite. In eukaryotes, Dcp2 is the major mRNA decapping enzyme and mRNA decapping by ALPHs is unprecedented, but the bacterial ApaH protein was recently found decapping non-conventional caps of bacterial mRNAs. These findings prompted us to explore whether mRNA decapping by ALPHs is restricted to Kinetoplastida or could be more widespread among eukaryotes.

Results

We screened 827 eukaryotic proteomes with a newly developed Python-based algorithm for the presence of ALPHs and used the data to characterize the phylogenetic distribution, conserved features, additional domains and predicted intracellular localisation of this protein family. For most organisms, we found ALPH proteins to be either absent (495/827 organisms) or to have non-cytoplasmic localisation predictions (73% of all ALPHs), excluding a function in mRNA decapping. Although, non-cytoplasmic ALPH proteins had in vitro mRNA decapping activity. Only 71 non-Kinetoplastida have ALPH proteins with predicted cytoplasmic localisations. However, in contrast to Kinetoplastida, these organisms also possess a homologue of Dcp2 and in contrast to ALPH1 of Kinetoplastida, these ALPH proteins are very short and consist of the catalytic domain only.

Conclusions

ALPH was present in the last common ancestor of eukaryotes, but most eukaryotes have either lost the enzyme, or use it exclusively outside the cytoplasm. The acceptance of mRNA as a substrate indicates that ALPHs, like bacterial ApaH, have a wide substrate range: the need to protect mRNAs from unregulated degradation is one possible explanation for the selection against the presence of cytoplasmic ALPH proteins in most eukaryotes. Kinetoplastida succeeded to exploit ALPH as their only or major mRNA decapping enzyme. 71 eukaryotic organisms outside the Kinetoplastid lineage have short ALPH proteins with cytoplasmic localisation predictions: whether these proteins are used as decapping enzymes in addition to Dcp2 or else have adapted to not accept mRNAs as a substrate, remains to be explored.
Transcriptome profiling of developing leaf and shoot apices to reveal the molecular mechanism and co-expression genes responsible for the wheat heading date
Authors: Yang Yuxin , Zhang Xueying , Wu Lifen , Zhang Lichao , Liu Guoxiang , Xia Chuan , Liu Xu , Kong Xiuying
Published: June 2021

Background

Wheat is one of the most widely planted crops worldwide. The heading date is important for wheat environmental adaptability, as it not only controls flowering time but also determines the yield component in terms of grain number per spike.

Results

In this research, homozygous genotypes with early and late heading dates derived from backcrossed progeny were selected to conduct RNA-Seq analysis at the double ridge stage (W2.0) and androgynous primordium differentiation stage (W3.5) of the leaf and apical meristem, respectively. In total, 18,352 differentially expressed genes (DEGs) were identified, many of which are strongly associated with wheat heading date genes. Gene Ontology (GO) enrichment analysis revealed that carbohydrate metabolism, trehalose metabolic process, photosynthesis, and light reaction are closely related to the flowering time regulation pathway. Based on MapMan metabolic analysis, the DEGs are mainly involved in the light reaction, hormone signaling, lipid metabolism, secondary metabolism, and nucleotide synthesis. In addition, 1,225 DEGs were annotated to 45 transcription factor gene families, including LFY, SBP, and MADS-box transcription factors closely related to flowering time. Weighted gene co-expression network analysis (WGCNA) showed that 16, 336, 446, and 124 DEGs have biological connections with Vrn1-5 A, Vrn3-7B, Ppd-1D, and WSOC1, respectively. Furthermore, TraesCS2D02G181400 encodes a MADS-MIKC transcription factor and is co-expressed with Vrn1-5 A, which indicates that this gene may be related to flowering time.

Conclusions

RNA-Seq analysis provided transcriptome data for the wheat heading date at key flower development stages of double ridge (W2.0) and androgynous primordium differentiation (W3.5). Based on the DEGs identified, co-expression networks of key flowering time genes in Vrn1-5 A, Vrn3-7B, WSOC1, and Ppd-1D were established. Moreover, we discovered a potential candidate flowering time gene, TraesCS2D02G181400. Taken together, these results serve as a foundation for further study on the regulatory mechanism of the wheat heading date.
The (cost-)effectiveness of an implemented fall prevention intervention on falls and fall-related injuries among community-dwelling older adults with an increased risk of falls: protocol for the in balance randomized controlled trial
Authors: van Gameren Maaike , Bossen Daniël , Bosmans Judith E. , Visser Bart , Frazer Sanne W. T. , Pijnappels Mirjam
Published: June 2021

Background

Falls and fall-related injuries among older adults are a serious threat to the quality of life and result in high healthcare and societal costs. Despite evidence that falls can be prevented by fall prevention programmes, practical barriers may challenge the implementation of these programmes. In this study, we will investigate the effectiveness and cost-effectiveness of In Balance, a fourteen-week, low-cost group fall prevention intervention, that is widely implemented in community-dwelling older adults with an increased fall risk in the Netherlands. Moreover, we will be the first to include cost-effectiveness for this intervention. Based on previous evidence of the In Balance intervention in pre-frail older adults, we expect this intervention to be (cost-)effective after implementation-related adjustments on the target population and duration of the intervention.

Methods

This study is a single-blinded, multicenter randomized controlled trial. The target sample will consist of 256 community-dwelling non-frail and pre-frail adults of 65 years or older with an increased risk of falls. The intervention group receives the In Balance intervention as it is currently widely implemented in Dutch healthcare, which includes an educational component and physical exercises. The physical exercises are based on Tai Chi principles and focus on balance and strength. The control group receives general written physical activity recommendations. Primary outcomes are the number of falls and fall-related injuries over 12 months follow-up. Secondary outcomes consist of physical performance measures, physical activity, confidence, health status, quality of life, process evaluation and societal costs. Mixed model analyses will be conducted for both primary and secondary outcomes and will be stratified for non-frail and pre-frail adults.

Discussion

This trial will provide insight into the clinical and societal impact of an implemented Dutch fall prevention intervention and will have major benefits for older adults, society and health insurance companies. In addition, results of this study will inform healthcare professionals and policy makers about timely and (cost-)effective prevention of falls in older adults.

Trial registration

Netherlands Trial Register:NL9248(registered February 13, 2021).
Facility-level determinants of quality routine intrapartum care in Afghanistan
Authors: Lydon Megan M. , Maruf Farzana , Tappis Hannah
Published: June 2021

Background

Although there have been notable improvements in availability and utilization of maternal health care in Afghanistan over the last few decades, risk of maternal mortality remains very high. Previous studies have highlighted gaps in quality of emergency obstetric and newborn care practices, however, little is known about the quality of routine intrapartum care at health facilities in Afghanistan.

Methods

We analyzed a subset of data from the 2016 Afghanistan Maternal and Newborn Health Quality of Care Assessment that comprised of observations of labor, delivery and immediate post-partum care, as well as health facility assessments and provider interviews across all accessible public health facilities with an average of five or more births per day in the preceding year (N = 77). Using the Quality of the Process of Intrapartum and Immediate Postpartum Care index, we calculated a quality of care score for each observation. We conducted descriptive and bivariate analyses and built a multivariate linear regression model to identify facility-level factors associated with quality of care scores.

Results

Across 665 childbirth observations, low quality of care was observed such that no health facility type received an average quality score over 56%. The multivariate regression model indicated that availability of routine labor and delivery supplies, training in respectful maternity care, perceived gender equality for training opportunities, recent supervision, and observation during supervision have positive, statistically significant associations with quality of care.

Conclusions

Quality of routine intrapartum care at health facilities in Afghanistan is concerningly low. Our analysis suggests that multi-faceted interventions are needed to address direct and indirect contributors to quality of care including clinical care practices, attention to client experiences during labor and childbirth, and attention to staff welfare and opportunities, including gender equality within the health workforce.
Clinical impact of abdominal versus mediastinal metastases as a prognostic factor for poor outcomes following esophageal cancer surgery: a retrospective study
Authors: Miyawaki Yutaka , Sato Hiroshi , Oya Shuichiro , Sugita Hirofumi , Hirano Yasumitsu , Sakuramoto Shinichi , Okamotom Kojun , Yamaguchim Shigeki , Koyama Isamu
Published: June 2021

Background

Surgery is still the mainstay of radical treatment for resectable esophageal cancer (EC). It is apparent that the presence or spread of lymph node metastasis (LNM) is a powerful prognostic factor in patients with EC who are eligible for curative treatment. Although the importance and efficacy of lymph node dissection in radical esophagectomy have been reported, the clinical or prognostic relevance of specific metastatic patterns within the mediastinal cavity and abdomen remains unclear.

Methods

We retrospectively analyzed the association of postoperative survival with clinical mediastinal LNM (cMLNM) and abdominal LNM (cALNM) in 157 patients who underwent radical EC surgery at our hospital between May 2012 and March 2018.

Results

A significant difference in cause-specific survival (CSS) was observed between patients with and without cALNM (log-rank p = 0.000). A multivariate Cox regression analysis revealed that cALNM and thoracic surgery (mediastinal lymphadenectomy via conventional open right thoracotomy or video-assisted thoracoscopic surgery) independently predicted CSS (p = 0.0007 and 0.021, respectively). Moreover, a significant difference in systemic recurrence-free survival was observed between those with and without cALNM (log-rank p = 0.000). Multivariate Cox regression analysis revealed that cALNM and sex independently predicted systemic recurrence-free survival (p = 0.000 and 0.015, respectively).

Conclusion

cALNM was an independent poor prognostic factor for CSS after EC surgery. It may also be an independent prognostic factor for postoperative systemic recurrence, which can shorten the CSS. For patients with cALNM-positive EC who have a high potential risk of systemic metastases, more extensive treatment besides the conventional perioperative systemic chemotherapy may be necessary.
Misinformation on social networks during the novel coronavirus pandemic: a quali-quantitative case study of Brazil
Authors: Biancovilli Priscila , Makszin Lilla , Jurberg Claudia
Published: June 2021

Background

One of the challenges posed by the novel coronavirus pandemic is theinfodemic risk, that is, a huge amount of information being published on the topic, along with misinformation and rumours; with social media, this phenomenon is amplified, and it goes faster and further. Around 100 million people in Brazil (50% of the inhabitants) are users of social media networks – almost half of the country’s population. Most of the information on the Internet is unregulated, and its quality remains questionable.

Methods

In this study, we examine the main characteristics of misinformation published on the topic. We analysed 232 pieces of misinformation published by the Brazilian fact-checking service “Agência Lupa”. The following aspects of each news item were analysed: a) In what social media has it circulated?; b) What is the content classification, sentiment and type of misinformation?; d) Are there recurrent themes in the sample studied?

Results

Most were published on Facebook (76%), followed by WhatsApp, with 10% of total cases. Half of the stories (47%) are classified as “real-life”, that is, the focus is on everyday situations, or circumstances involving people. Regarding the type of misinformation, there is a preponderance of fabricated content, with 53% of total, followed by false context (34%) and misleading content (13%). Wrong information was mostly published in text format (47%). We found that 92.9% of misinformation classified as “fabricated content” are “health tips”, and 88.9% of “virtual scams” are also fabricated.

Conclusion

Brazilian media and science communicators must understand the main characteristics of misinformation in social media about COVID-19, so that they can develop attractive, up-to-date and evidence-based content that helps to increase health literacy and counteract the spread of false information.
SEM characterization and ageing analysis on two generation of invisible aligners
Authors: Condò Roberta , Mampieri Gianluca , Giancotti Aldo , Cerroni Loredana , Pasquantonio Guido , Divizia Andrea , Convertino Annalisa , Mecheri Barbara , Maiolo Luca
Published: June 2021

Background

The purpose of the in vitro study is to investigate and compare the morphological features and the chemical stability in weight of two different polyurethane-based blends, Smart Track (LD30) and Exceed30 (EX30), used for orthodontic aligners manufacture before and after the oral usage.

Methods

Twenty orthodontic aligners were randomly selected: 10 LD30 and 10 EX30, each group was divided in two subgroups, never used and intra-orally aged. By the employment of a Stereomicroscope, a section of 5 × 5 mm was cut from the buccal surface of the incisal region of each aligner. All samples were subjected to Scanning Electron Microscopy and Ageing tests in different solutions to simulate the hostility of the oral environment. The statistical method used was t-test.

Results

At SEM images, LD30 appears more homogeneous in texture respect to EX30. However, after clinical usage, both materials show significant structural alterations: findings have been supported by higher magnifications at SEM, by which it is clearly to observe many superficial cracks cross through the polymer structures of LD30U, absent in never used samples. LD30U surface becomes also smoother due to the disappearance of most of the conglomerates, but at the same time also rougher while EX30U shows a greater irregularity and porosity in which large and deep cracks are also highlighted. Although these changes occur persistently, in the aging tests no significant weight loss from both materials has been found, confirming the initial hypothesis of a good chemical stability and safety of both polyurethane mixtures even in conditions of severe hostility.

Conclusion

LD30 is the expression of the technological evolution of EX30, this is made evident above all by its morphological architecture, more homogeneous and defined but also by the chemical stability that can be appreciated even in evident critic situations.
Compassion fatigue and compassion satisfaction among palliative care health providers: a scoping review
Authors: Baqeas Manal Hassan , Davis Jenny , Copnell Beverley
Published: June 2021

Background

Palliative care can be demanding and stressful for providers. There is increasing recognition in the literature of the impact of caregiving in palliative care settings, including compassion fatigue and compassion satisfaction. However, to date this literature has not been systematically reviewed. The purpose of this scoping review was to map the literature on compassion fatigue and compassion satisfaction among palliative care health providers caring for adult patients.

Methods

Scoping review method guided by Joanna Briggs Institute guidelines was conducted using four electronic databases to identify the relevant studies published with no time limit. Following the title and abstract review, two reviewers independently screened full-text articles, and extracted study data. A narrative approach to synthesizing the literature was used.

Results

Twenty studies were included in the review. Five themes emerged from synthesis: conceptualisation of compassion fatigue and compassion satisfaction; measurement of compassion fatigue and compassion satisfaction; consequences of compassion fatigue or compassion satisfaction and providing care for patients with life-threatening conditions; predictors or associated factors of compassion fatigue and compassion satisfaction among palliative care health providers; and strategies or interventions to support palliative care health providers and reduce compassion fatigue.

Conclusions

Limited studies examined the effectiveness of specific interventions to improve compassion satisfaction and reduce compassion fatigue among palliative care health providers. Further investigation of the impacts of compassion fatigue and compassion satisfaction on palliative care health providers and their work is also needed.
Implementation of HPV-based screening in Burkina Faso: lessons learned from the PARACAO hybrid-effectiveness study
Authors: Mensah Keitly , Kaboré Charles , Zeba Salifou , Bouchon Magali , Duchesne Véronique , Pourette Dolorès , DeBeaudrap Pierre , Dumont Alexandre
Published: June 2021

Background

Cervical cancer screening in sub-Saharan countries relies on primary visual inspection with acetic acid (VIA). Primary human papillomavirus (HPV)-based screening is considered a promising alternative. However, the implementation and real-life effectiveness of this strategy at the primary-care level in limited-resource contexts remain under explored. In Ouagadougou, Burkina Faso, free HPV-based screening was implemented in 2019 in two primary healthcare centers. We carried out a process and effectiveness evaluation of this intervention.

Methods

Effectiveness outcomes and implementation indicators were assessed through a cohort study of screened women, observations in participating centers, individual interviews with women and healthcare providers and monitoring reports. Effectiveness outcomes were screening completeness and women’s satisfaction. Logistic regression models and concurrent qualitative analysis explored how implementation variability, acceptability by women and the context affected effectiveness outcomes.

Results

After a 3-month implementation period, of the 350 women included in the cohort, 94% completed the screening, although only 26% had their screening completed in a single visit as planned in the protocol. The proportion of highly satisfied women was higher after result disclosure (95%) than after sampling (65%). A good understanding of the screening results and recommendations increased screening completeness and women’s satisfaction, while time to result disclosure decreased satisfaction. Adaptations were made to fit healthcare workers’ workload.

Conclusion

Free HPV-based screening was successfully integrated within primary care in Ouagadougou, Burkina Faso, leading to a high level of screening completeness despite the frequent use of multiple visits. Future implementation in primary healthcare centers needs to improve counseling and reduce wait times at the various steps of the screening sequence.
Relation of severe COVID-19 in Scotland to transmission-related factors and risk conditions eligible for shielding support: REACT-SCOT case-control study
Authors: McKeigue Paul M. , McAllister David A. , Caldwell David , Gribben Ciara , Bishop Jen , McGurnaghan Stuart , Armstrong Matthew , Delvaux Joke , Colville Sam , Hutchinson Sharon , Robertson Chris , Lone Nazir , McMenamin Jim , Goldberg David , Colhoun Helen M.
Published: June 2021

Background

Clinically vulnerable individuals have been advised to shield themselves during the COVID-19 epidemic. The objectives of this study were to investigate (1) the rate ratio of severe COVID-19 associated with eligibility for the shielding programme in Scotland across the first and second waves of the epidemic and (2) the relation of severe COVID-19 to transmission-related factors in those in shielding and the general population.

Methods

In a matched case-control design, all 178,578 diagnosed cases of COVID-19 in Scotland from 1 March 2020 to 18 February 2021 were matched for age, sex and primary care practice to 1,744,283 controls from the general population. This dataset (REACT-SCOT) was linked to the list of 212,702 individuals identified as eligible for shielding. Severe COVID-19 was defined as cases that entered critical care or were fatal. Rate ratios were estimated by conditional logistic regression.

Results

With those without risk conditions as reference category, the univariate rate ratio for severe COVID-19 was 3.21 (95% CI 3.01 to 3.41) in those with moderate risk conditions and 6.3 (95% CI 5.8 to 6.8) in those eligible for shielding. The highest rate was in solid organ transplant recipients: rate ratio 13.4 (95% CI 9.6 to 18.8). Risk of severe COVID-19 increased with the number of adults but decreased with the number of school-age children in the household. Severe COVID-19 was strongly associated with recent exposure to hospital (defined as 5 to 14 days before presentation date): rate ratio 12.3 (95% CI 11.5 to 13.2) overall. The population attributable risk fraction for recent exposure to hospital peaked at 50% in May 2020 and again at 65% in December 2020.

Conclusions

The effectiveness of shielding vulnerable individuals was limited by the inability to control transmission in hospital and from other adults in the household. Mitigating the impact of the epidemic requires control of nosocomial transmission.
Circular RNAs regulate cancer-related signaling pathways and serve as potential diagnostic biomarkers for human cancers
Authors: Garlapati Pranavi , Ling Jinjie , Chiao Paul J. , Fu Jie
Published: June 2021

Circular RNAs (circRNAs) are RNAs that have an important role in various pathological processes, including cancer. After the usage of high-throughput RNA sequencing, many circRNAs were found to be differentially expressed in various cancer cell lines and regulate cell signaling pathways by modulating particular gene expressions. Understanding their role in these pathways and what cancers they are found in can set the stage for identifying diagnostic and prognostic biomarkers and therapeutic targets of cancer. This paper will discuss which circRNAs are found in different cancers and what mechanisms they use to upregulate or downregulate certain cellular components.
Community-based delivery of intermittent preventive treatment of malaria in pregnancy in Burkina Faso: a qualitative study
Authors: Burke Danielle , Tiendrebeogo Justin , Emerson Courtney , Youll Susan , Gutman Julie , Badolo Ousmane , Savadogo Yacouba , Vibbert Kristen , Wolf Katherine , Brieger William
Published: June 2021

Background

Burkina Faso is among ten countries with the highest rates of malaria cases and deaths in the world. Delivery and coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) is insufficient in Burkina Faso; In a 2016 survey, only 22% of eligible women had received their third dose of IPTp. It is also an extremely rural country and one with an established cadre of community healthcare workers (CHWs). To better meet the needs of pregnant women, an enhanced programme was established to facilitate distribution of IPTp at the community level by CHWs.

Methods

In order to assess the perceptions of CHWs and facility healthcare workers (HCWs) involved in this programme rollout, semi-structured interviews were conducted at three high malaria burden health districts in Burkina Faso. Interviews were conducted at baseline with 104 CHWs and 35 HCWs prior to the introduction of community based IPTp (c-IPTp) to assess capacity and any areas of concern. At endline, interviews were conducted with 29 CHWs and 21 HCWs to identify key facilitators and suggestions for further implementation of the c-IPTp programme.

Results

CHWs reported feeling capable of supporting c-IPTp delivery and facilitating linkage to antenatal care (ANC). They noted that the opportunity for enhanced training and close and ongoing connections with facility HCWs and supportive supervision were imperative. Both CHWs and HCWs perceived this approach as acceptable to community members and noted the importance of close community engagement, monthly meetings between CHWs and facility HCWs, and maintaining regular supplies of sulfadoxine–pyrimethamine (SP). Those interviewed noted that it was beneficial to have the involvement of both female and male CHWs.

Conclusions

Community-based delivery of IPTp was feasible and acceptable to both facility HCWs and CHWs. This approach has the potential to strengthen delivery and uptake of IPTp and ANC both in Burkina Faso and across the region.
Chronic pain experience and health inequities during the COVID-19 pandemic in Canada: qualitative findings from the chronic pain & COVID-19 pan-Canadian study
Authors: Dassieu Lise , Pagé M. Gabrielle , Lacasse Anaïs , Laflamme Maude , Perron Vickie , Janelle-Montcalm Audrée , Hudspith Maria , Moor Gregg , Sutton Kathryn , Thompson James M , Choinière Manon
Published: June 2021

Background

Chronic pain affects about 20 % of the Canadian population and can lead to physical, psychological and social vulnerabilities. However, this condition remains poorly recognized and undertreated. During 2020, as the COVID-19 pandemic disrupted daily living and health care systems, the situation of people with chronic pain has drawn little public attention.

Methods

This qualitative study was part of a pan-Canadian mixed-methods project and aimed to understand the experiences and challenges of people living with chronic pain during the COVID-19 pandemic in Canada. Between May and August 2020, we conducted in-depth semi-structured interviews with 22 individuals living with chronic pain across the country. We used reflexive thematic analysis to interpret data.

Results

Our findings underscored four dimensions of the chronic pain experience during the pandemic: (1) Reinforced vulnerability due to uncertainties regarding pain and its management; (2) Social network as a determinant of pain and psychological condition; (3) Increasing systemic inequities intermingling with the chronic pain experience; (4) More viable living conditions due to confinement measures. Though several participants reported improvements in their quality of life and reduced social pressure in the context of stay-at-home orders, participants from socio-economically deprived groups and minorities reported more challenges in accessing pain relief, health care services, and psychosocial support.

Conclusions

The COVID-19 pandemic has revealed and intensified pre-existing disparities and challenges among people living with chronic pain in terms of material resources, psychosocial condition, social support, and access to care. In post-pandemic times, it will be essential to address flaws in health and welfare policies to foster equity and social inclusiveness of people with chronic pain.