bluuebunny/crossref_metadata_2025 huggingface dataset:
Is affiliation system successful in healthcare at Turkey?
Authors: BALKAN DURSUN
Published: January 2021

The main objective of the study was to compare technical efficiency between affiliated and non-affiliated hospitals of Turkey. There was six otput variables and four input variables to evaluate hospitals efficiencies using with Ministry of Health (MoH) data from 2013 to 2017. Totally, 25 affiliated hospitals and 53 non-affiliated hospitals were analysed using input-oriented Data Envelopment Analysis (DEA) model under variable return to scale assumptions. The study results that, affiliated hospitals efficiency scores were higher than non-affiliated training and research hospitals. These results showed us the application of the affiliation system was successful in Turkey. Furthermore, this is the first study which has been performing whole affiliated and non-affiliated hospital efficiency measures together in Turkey and it offers an original contribution to literature with this direction.
Exercise, disability and physical functioning in older Chinese adults during their last six years of life: a cohort study
Authors: Chen Meng-Lei , Huang Cong , Huang Yu-Min , Wu Chun-Chun , Xue Sen , Yang Yu-xin , Wen Xu
Published: January 2021

Background

Little is known about the potential effects of exercise behaviour on disability and physical functioning (PF) in late-life. This study aimed to investigate whether exercise behaviour with four different long term exercise status influences disability and PF in older Chinese adults during their last six years of life.
Methods

Secondary data analyses were performed using participants (≥ 65 years) from the Chinese Longitudinal Healthy Longevity Study. Exercise behaviour was collected every three years during their last six years of life. 4265 participants were enrolled and divided into four groups, including long-term non-exercising (NN), non-exercising to exercise (NY), exercise to non-exercising (YN), and long-term exercising (YY). Disability was measured based on the Katz Index of Activities of Daily Living scale and divided into three disability levels. PF was included as chair-rise, pick-up book and turn-around. Risks burden in disability and PF among four groups were compared using logistic regression analyses.
Results

Compared with NN, the risk of developing severe disability was attenuated in YY (OR 0.11, 95%CI 0.06 to 0.21) and attenuated in NY (OR 0.27, 95%CI 0.17 to 0.44) and increased in YN (OR 1.36, 95%CI 1.08 to 1.72). Moderate disability risk was increased in YN (OR 1.85, 95%CI 1.26 to 2.71) only. The risk of developing physical dysfunction ( chair-rise, pick-up book, and turning around 360°) was decreased in YY and NY, and did not have significant difference in YN.
Conclusions

EP were associated with disability and PF in older Chinese adults during their late-life. Late-life exercise behaviour is still beneficial. Our findings suggest that it is meaning to encourage older people doing EP at late-life in China.
Sensor applications to measure health and movement among health care personnel at workplace: A scoping review protocol
Authors: Välimäki Maritta , Hipp Kirsi , Chen Jiarui , Huang Xiaoting , Guo Jia , Wong Man Sing
Published: January 2021

BackgroundThe well-being and health of health care personnel is becoming increasingly important in the delivery of high-quality healthcare. Monitoring technologies provide new opportunities for the objective measurement of activities and behaviours related to well-being and health. However, these possible technologies used by health care personnel have not been fully synthesised. The overall aim of this scoping review is to examine what technologies are available to monitor health care personnel’s health, well-being and activities in workplace settings. More specifically, we want to explore how, by whom and for what purposes sensor applications have been used by health care personnel at different workplace settings.MethodsThis scoping review protocol will follow Arksey’s and O’Malley’s methodology, complimented by the approach of the Joanna Briggs Institute to scoping reviews. Peer-reviewed literature will be identified using a search strategy developed by a librarian, and a wide range of electronic datasets of medical, computer and information systems disciplines will be used. Eligibility of the articles will be determined using a two-stage screening process consisting of (1) a title and abstract scan, and (2) a full text review. Extracted data will be thematically analysed and validated by an expert of sensor technology and a group of nurses as stakeholders. Descriptive statistics will be calculated when necessary.DiscussionThis scoping review will examine what technologies are available to monitor health care personnel’s health, well-being and activities in workplace settings. The results obtained from the review will inform the suitability of monitoring technology used in health care settings, what methods are already available for use in research and technology might still be needed for future innovations. Findings of the scoping review will be published in a peer-reviewed journal.Systematic review registrationThis review was submitted in Open Science Framework on 12 December 2020.
Flipped Classroom Combined With Case-based Learning Is an Effective Teaching Modality in Nephrology Clerkship
Authors: Yang Fuye , Lin Wanbing , Wang Yan
Published: January 2021

BackgroundBoth flipped classroom (FC) and case-based learning (CBL) are recognized as new effective teaching approaches by emphasizing on different aspects of teaching activities; however, the implementation of FC combined with CBL has not been well explored in nephrology education. The present study aims to investigate the efficacy of FC combined with CBL in teaching nephrology via comparing with the traditional lecture-based teaching (LBT). MethodsSixty-two medical clerkship students at Zhejiang University School of Medicine were equally allocated into either LBT or FC group demographically matched. The glomerular diseases module was chosen for the teaching content. Students from the FC group were required to study the pre-class materials in annotated PPT format before the face-to face discussion on the relevant cases during the class. Students from the LBT group attended a didactic lecture during the class. Quiz and questionnaires were performed to assess the efficacy of FC. ResultsParticipants from the FC group performed better than those from the LBT group in the quiz with higher scores in the case analysis-related questions. FC was also considered more helpful than LBT in improving high order cognitive abilities in the survey. Meanwhile, more participants agreed increased in-class pressure in FC than in LBT. ConclusionsThis study shows the positive impact of FC combined with CBL approach on nephrology education and provides an alternative pre-class and in-class format for the FC implementation.
Genetic investigation of 211 Chinese families expands the mutational and phenotypical spectrum in hereditary retinopathy genes through targeted sequencing technology
Authors: Bai Zhouxian , Xie Yanchuan , Liu Lina , Shao Jingzhi , Liu Yuying , Kong Xiangdong
Published: January 2021

Background: Hereditary retinopathy is a significant cause of blindness worldwide. Despite the discovery of many mutations in various retinopathies, a large part of patients remain undiagnosed genetically. Targeted next generation sequencing of the human genome is a suitable approach for retinopathy molecular diagnosis.Methods: We described a cohort of 211 families from central China with various forms of retinopathy, 95 families of which were investigated using NGS multi-gene panel sequencing as well as the other 116 patients were LHON suspected tested by Sanger sequencing. We validated the candidate variants by PCR-based Sanger sequencing. We have made comprehensive analysis of the cases through sequencing data and ophthalmologic examination information.Results: The potentially causal mutation was identified in majority of the families with retinopathy (57.9% of 95 families) and Leber hereditary optic neuropathy (LHON) (21.6% of 116 families). The identified mutations (68mutations, 37 of which are novel) of the 95 families spanned 31 known disease genes, about half have not been reported relation to hereditary retinopathy. The NGS panel solution provides 45.3% potential diagnostic rate of the retinopathy families and another 12.6% families detect candidate gene mutations with undefined pathogenicity in this study.Conclusion: Our study showed novel mutations and phenotypic aspects of retinopathy, and demonstrated genetic and clinical heterogeneity of the conditions. Our results illustrated the significance of molecular genetic testing for patients with hereditary retinopathy.
Integrated analysis of lncRNA-miRNA-mRNA ceRNA network and the potential prognosis indicators in sarcomas
Authors: Gao Lu , Zhao Yu , Ma Xuelei , Zhang Ling
Published: January 2021

Background: Competitive endogenous RNA (ceRNA) has revealed a new mechanism of interaction between RNAs and been demonstrated to play crucial roles in multiple biological processes and in the development of neoplasms that potentially serve as diagnostic and prognosis markers as well as therapeutic targets.Methods：In this work, we identified differentially expressed mRNAs (DEGs), lncRNAs (DELs) and miRNAs (DEMs) in sarcoma by comparing the genes expression profiles between sarcoma samples and normal tissue samples in Gene Expression Omnibus (GEO) datasets. Gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analyses were applied to investigate the primary functions of the overlapped DEGs. Then, lncRNA-miRNA and miRNA-mRNA interactions were predicted, and the ceRNA regulatory network was constructed in Cytoscape. In addition, the protein-protein interaction (PPI) network was constructed and survival analysis was performed.Results: A total of 1296 DEGs were identified in sarcoma samples by combining the GO and KEGG pathway enrichment analyses, 338 DELs were discovered after the probes were reannotated, and 36 DEMs were ascertained through intersecting two different expression miRNAs sets. Further, through target gene prediction, a lncRNA-miRNA-mRNA ceRNA network that contained 113 mRNAs, 69 lncRNAs and 29 miRNAs was constructed. The PPI network identified the six most significant hub proteins. Survival analysis revealed that seven mRNAs, four miRNAs and one lncRNA were associated with overall survival of sarcoma patients.Conclusions: Overall, we constructed a ceRNA network in sarcomas, which likely provides insights for further research on the molecular mechanism and potential prognosis biomarkers.
A comparison of standard occupational therapy versus early enhanced occupation-based therapy in a medical / surgical intensive care unit: study protocol for a single site feasibility trial (EFFORT-ICU).
Authors: Rapolthy-Beck Andrea , Fleming Jennifer , Turpin Merrill , Sosnowski Kellie , Dullaway Simone , White Hayden
Published: January 2021

Background: Admissions to intensive care units (ICUs) are increasing due to an aging population, and rising incidence of cardiac and respiratory disease. With advances in medical care, more patients are surviving an initial stay in critical care; however, they can experience ongoing health and cognitive limitations, that may influence return to baseline function up to a year post-admission. Recent research has focused on the introduction of early rehabilitation within the ICU to reduce long-term physical and cognitive complications. The aim of this study is to explore the feasibility and impact of providing early enhanced occupation-based therapy, including cognitive stimulation and activities of daily living, to patients in intensive care. Methods: This study involves a single site randomised-controlled feasibility trial comparing standard occupational therapy care to an early enhanced occupation-based therapy. Thirty mechanically ventilated ICU patients will be recruited and randomly allocated to the intervention or control group. The primary outcome measure is the Functional Independence Measure (FIM), and secondary measures include the Modified Barthel Index (MBI), Montreal Cognitive Assessment (MoCA), grip strength, Hospital Anxiety and Depression Scale (HADS) and Short-Form 36 Health survey (SF-36). Measures will be collected by a blind assessor at discharge from intensive care, hospital discharge and a 90-day follow-up. Daily outcome measures including the Glasgow Coma Scale (GCS), Richmond Agitation and Sedation Scale (RASS) and Confusion Assessment Measure for intensive care units (CAM-ICU) will be taken prior to treatment. Participants in the intervention group will receive daily a maximum of up to 60 minute sessions with an occupational therapist involving cognitive and functional activities such as self-care and grooming. At the follow-up, intervention group participants will be interviewed to gain user perspectives of the intervention. Feasibility data including recruitment and retention rates will be summarised descriptively. Parametric tests will compare outcomes between groups. Interview data will be thematically analysed.Discussion: This trial will provide information about the feasibility of investigating how occupational therapy interventions in ICU influence longer term outcomes. It seeks to inform the design of a phase III multicentre trial of occupational therapy in critical care general medical intensive care units.Trial registration: Australia New Zealand Clinical Trials Registry (ANZCTR): ACTRN12618000374268; prospectively registered on 13th March 2018 / https://www.anzctr.org.auTrial funding: Metro South Health Research Support Scheme Postgraduate Scholarship
Neuroprotective effects of Shende’an tablet in the Parkinson’s disease model
Authors: Sheng Xiao Yan , Yang Shui Yuan , Wen Xiao Min , Zhang Xin , Ye Yong Feng , Zhao Peng , Zang Min Li , Peng Kang , Du En Ming , Li Sai
Published: January 2021

Background: Shende’an tablet (SDA) is a newly capsuled Chinese herbal formula derived from the Chinese traditional medicine Zhengan Xifeng Decoction which is approved for the treatment of neurasthenia and insomnia in China. This study aimed to investigate the neuroprotective effects of SDA against Parkinson’s disease (PD) in vitro and in vivo.Methods: In the present work, the neuroprotective effects and mechanism of SDA were evaluated in the cellular PD model. Male C57BL/6J mice were subject to a partial MPTP lesion alongside treatment with SDA. Behavioural test and tyrosine-hydroxylase immunohistochemistry were used to evaluate nigrostriatal tract integrity. HPLC analysis and Western blotting were used to assess the effect of SDA on dopamine metabolism and the expression of HO-1, PGC-1α and Nrf2, respectively.Results: Our results demonstrated that SDA had neuroprotective effect in dopaminergic PC12 cells with 6-OHDA lesion. It had also displayed efficient dopaminergic neuronal protection and motor behavior alleviation properties in MPTP-induced PD mice. In the PC12 cells and MPTP-induced Parkinson’s disease animal models, SDA was highly efficacious in α-synuclein clearance associated with the activation of PGC-1α/Nrf2 signal pathway.Conclusion: SDA demonstrated potential as a future therapeutic modality in PD through protecting dopamine neurons and alleviating the motor symptoms, mediated by the activation of PGC-1α/Nrf2 signal pathway.
Cost-effectiveness of paclitaxel, doxorubicin, cyclophosphamide and trastuzumab versus docetaxel, cisplatin and trastuzumab in new adjuvant therapy of breast cancer in china.
Authors: XU Qiaoping , Yuanyuan LI , Jiejing ZHU , Jian Liu , Qingyu LI , Lingya Chen , Ying LUO , Changchen SHI , Yangling LI , Wei YAN
Published: January 2021

Background: Breast cancer is the most common cancer among women in China. Amplification of the Human epidermal growth factor receptor type 2 (HER2) gene is present and overexpressed in 18–20% of breast cancers and historically has been associated with inferior disease-related outcomes. There has been increasing interest in de-escalation of therapy for low-risk disease. This study analyzes the cost-effectiveness of Doxorubicin/ Cyclophosphamide/ Paclitaxel/ Trastuzumab (AC-TH) and Docetaxel/Carboplatin/Trastuzumab(TCH) from payer perspective over a 5 year time horizon.Methods: A half-cycle corrected Markov model was built to simulate the process of breast cancer events and death occurred in both AC-TH and TCH armed patients. Cost data came from studies based on a Chinese hospital. One-way sensitivity analyses as well as second-order Monte Carlo and probabilistic sensitivity analyses were performed.The transition probabilities and utilities were extracted from published literature, and deterministic sensitivity analyses were conducted.Results:We identified 41 breast cancer patients at Hangzhou First People’s Hospital, among whom 15(60%) had a partial response for AC-TH treatment and 13 (81.25%) had a partial response for TCH treatment.No cardiac toxicity was observed. Hematologic grade 3 or 4 toxicities were observed in 1 of 28 patients.Nonhematologic grade 3 or 4 toxicities with a reverse pattern were observed in 6 of 29 patients. The mean QALY gain per patient compared with TCH was 0.25 with AC-TH, while the incremental costs were $US13,142.The incremental cost-effectiveness ratio (ICER) of AC-TH versus TCH was $US 52,565 per QALY gained.Conclusions: This study concluded that TCH neoadjuvant chemotherapy was feasible and active in HER2-overexpressing breast cancer patients in terms of the pathological complete response, complete response, and partial response rates and manageable toxicities.
Simulation in Physiotherapy Students for Clinical Decisions during Interaction with People with Low Back Pain. Randomized Controlled Trial
Authors: Sandoval-Cuellar Carolina , Alfonso-Mora Margareth Lorena , Castellanos-Garrido Adriana Lucia , Villarraga-Nieto Angélica del Pilar , Goyeneche-Ortegón Ruth Liliana , Acosta-Otalora Martha Lucia , Castellanos-Vega Rocio del Pilar , Cobo-Mejía Elisa Andrea
Published: January 2021

Background: Low back pain (LBP) is a symptomatology with a high global prevalence; health professionals, including physiotherapists, must have the skills to create professional actions that increase a quality of life for patients. Clinical simulation can be a pedagogic strategy that facilitates in students adequate training to acquire skills that improve professional reasoning in this clinical situation. The objective of this study was to compare the effects of clinical simulation with simulated patient (SP) versus simulation with role playing (RP) in physiotherapy students for decision-making in clinical skills while caring for a person with LBP. Methods. Experimental study, with 42 participants from two Colombian universities, randomized into two groups (SP n = 21, RP n = 21). The clinical skill was evaluated during the interaction with a person with LBP for which the Objective Structured Clinical Examination (OSCE-LBP) was validated for individuals with low back pain; thereafter, a pedagogical method was conducted that included clinical simulation and, finally, the OSCE-LBP was applied again to compare both groups.Results. Changes occurred in the OSCE-LBP among both groups of students: the scores increased (0.66 and 0.59 in RP and SP, respectively), and neither of the two was superior (difference 0.01 95%CI -0.21 to 0.23). ﻿Conclusion. Both types of simulation favour decision-making in professional reasoning in physiotherapy students during interaction with individuals with LBP.Contribution of paper: This is an RCT that explores the use of clinical simulation with simulated patient as a teaching method in decision making by physiotherapists versus traditional use of role playing
Specialty career preferences among final year medical students at Makerere University College of Health Sciences, Uganda: A mixed methods study
Authors: Kuteesa Job , Musiime Victor , Munabi Ian G. , Mubuuke Aloysius G. , Opoka Robert , Mukunya David , Kiguli Sarah
Published: January 2021

Background: Uganda has an imbalanced distribution of the health workforce, which may be influenced by the specialty career preferences of medical students. In spite of this, there is inadequate literature concerning the factors influencing specialty career preferences. We aimed to determine the specialty career preferences and the factors influencing the preferences among fifth year medical students in the School of Medicine, Makerere University College of Health Sciences (MakCHS). Methods: A sequential explanatory mixed methods study design with a descriptive cross-sectional study followed by a qualitative study was used. A total of 135 final year medical students in MakCHS were recruited using consecutive sampling. Self-administered questionnaires and three focus group discussions were conducted. Quantitative data was analysed in STATA version 13 (StataCorp, College Station, Tx, USA) using descriptive statistics, chi-square tests and logistic regression. Qualitative data was analysed in NVIVO version 12 (QRS International, Cambridge, MA) using content analysis.Results: Of 135 students 91 (67.4%) were male and their median age was 24 years (IQR: 24, 26). As a first choice, the most preferred specialty career was obstetrics and gynecology (34/135, 25.2%), followed by surgery (27/135, 20.0%), pediatrics (18/135, 13.3%) and internal medicine (17/135, 12.6%). Non-established specialties such as anesthesia and Ear Nose and Throat (ENT) were not selected as a first choice by any student. Female students had 63% less odds of selecting surgical related specialties compared to males (aOR=0.37, 95%CI: 0.17-0.84). The focus group discussions highlighted controlled lifestyle, assurance of a good life through better financial remuneration and inspirational specialists as facilitators for specialty preference. Bad experience during the clinical rotations, lack of career guidance plus perceived poor and miserable specialists were highlighted as barriers to specialty preference.Conclusion. Obstetrics and Gynecology, Surgery, Pediatrics and Internal Medicine are well-established disciplines, which were dominantly preferred. Females were less likely to select surgical disciplines as a career choice. Therefore, there is a need to implement or establish career guidance and mentorship programs to attract students to the neglected disciplines.
Characteristics and Treatments for Pediatric Ordinary and Incarcerated Inguinal Hernia Based on Gender: 12-Year Experiences from a Single Center
Authors: Wang Kai , Tan Sarah Siyin , Xiao Yue , Wang Zengmeng , Peng Chunhui , Pang Wenbo , Wu Dongyang , Chen Yajun
Published: January 2021

Background: Congenital primary inguinal hernia is a common condition among children. Although much literature regarding inguinal hernia is available, large scale analysis are few, and rarely do they expand on gender difference or incarcerated hernias.Methods: Patients with unilateral or bilateral inguinal hernia who were admitted to our hospital and received open inguinal hernia repair (OIHR) or laparoscopic inguinal hernia repair (LIHR) under general anesthesia were included. LIHR was performed using single-site laparoscopic percutaneous extraperitoneal closure (SLPEC). Medical records were retrospectively collected and analyzed.Results: A total of 12190 patients were included in this study. The ratio of male to female was 4.8:1. There was a total of 10646 unilateral hernias (87.3%) and 1544 bilateral hernias (12.7%), with a corresponding ratio of 6.9:1. 12444 hernia repair surgeries, 11083 (89.1%) OIHR and 1361 (10.9%) LIHR, were held.OIHR had a shorter operative time than LIHR for all unilateral and female bilateral repair, unlike for bilateral male repair. There was no difference between OIHR and LIHR for ipsilateral recurrent hernia in males. There was a difference between OIHR and LIHR for metachronous contralateral hernia.Incarcerated inguinal hernia was associated with longer operative time, hospital stay and higher hospital costs. Females and patients under 1 year were more likely to present with incarcerated hernia.Conclusions: OIHR should be considered for male patients, especially for unilateral and complete inguinal hernia. LIHR is highly recommended for female patients. For incarcerated hernia, attention should be paid to patients under 1 year old, as they can be 60 times more susceptible, and females. Surgeons should also be aware of ovary hernias in females.
A Pilot Study of Team-based Learning in Paediatric Clerkships
Authors: Xu Luojia , Zhang Yuanyuan , Chen Yifang , Xu Yingchun , Wang Yujia , Chen Zhimin , Shu Qiang
Published: January 2021

Background: Team-based learning (TBL) is widely used in health profession education. However, the use of TBL in paediatric clerkships is rare. In this study, we explore the efficacy and feasibility of TBL in paediatric clerkships. Methods: We retrospectively reviewed the TBL course for paediatric clerkships from August to October 2019 at the Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China. The TBL group (with 107 students) was compared to the students from the prior year who learned via case-based discussion (control group with 222 students). The learning outcomes were measured using theoretical exams when the paediatric clerkships ended. The satisfaction with TBL was evaluated by an anonymous questionnaire administered to the TBL group. Results: The grade point averages before paediatric clerkships in the TBL group (3.58, 3.04-3.96) were similar to those in the control group (3.62, 3.16-4.00) (p=0.839). However, the theoretical exam scores in the TBL group (76, 67-82) were significantly higher than those in the control group (72, 64-78) (p=0.002). In addition, 92.5% of the students in the TBL group rated their level of satisfaction higher than 90%. Conclusions: Our study demonstrated that TBL in paediatric clerkships was effective and feasible and that it led to better learning outcomes.
Simultaneous detection and ribotyping of Clostridioides difficile, and toxin gene detection directly on fecal samples
Authors: Rossen Tessel Meike van , Prehn Joffrey van , Koek Alex G. , Jonges Marcel , Houdt Robin van , Mansfeld Rosa van , Kuijper Ed J. , Vandenbroucke-Grauls Christina M.J.E. , Budding Andries E.
Published: January 2021

Background: Clostridioides difficile is the most common cause of nosocomial diarrhea. Ribotyping of cultured strains by a PCR-based test is used to study potential transmission between patients. We aimed to develop a rapid test that can be applied directly on fecal samples for simultaneous detection and ribotyping of C. difficile, as well as detection of toxin genes.Methods: We developed a highly specific and sensitive primer set for simultaneous detection and ribotyping of C. difficile directly on total fecal DNA. Toxin genes were detected with primers adapted from Persson et al. (CMI, 2008). Our study set comprised 130 fecal samples: 65 samples with positive qPCR for C. difficile toxin A/B genes and 65 C. difficile qPCR negative samples. PCR products were analyzed by capillary gel electrophoresis. Results: Ribosomal DNA fragment peak profiles and toxin genes were detected in all 65 C. difficile positive fecal samples and in none of the 65 C. difficile negative samples. The 65 samples were assigned to 27 ribotypes by the Dutch reference laboratory. Our peak profiles corresponded to these ribotypes, except for two samples. During a C. difficile outbreak, patients were correctly allocated to the outbreak-cluster based on the results of direct fecal ribotyping, before C. difficile isolates were cultured and conventionally typed.Conclusion: C. difficile ribotyping directly on fecal DNA is feasible, with sensitivity and specificity comparable to that of diagnostic toxin gene qPCR and with ribotype assignment similar to that obtained by conventional typing on DNA from cultured isolates. This supports simultaneous diagnosis and typing to recognize an outbreak.
Do alternative capability instruments capture differing aspects of mental health and quality of life in comparison to the EQ-5D for schizophrenic patients with depression?
Authors: Helter Timea Mariann , Coast Joanna , Łaszewska Agata , Stamm Tanja , Simon Judit
Published: January 2021

Background There is increasing evidence that assessing outcomes in terms of capability wellbeing provides information beyond that of health-related quality of life measures for evaluation in mental health research. This paper aimed to contribute to the utilisation of capability-based measures relative to health status measures in mental health research, by exploring the empirical relationship between the OxCAP-MH, the ICECAP-A, and the EQ-5D instruments against condition-specific measures and each other for schizophrenic patients with depression.Methods Using trial data for 100 patients from the UK, the properties of the instruments were compared in terms of convergent validity, including correlations between the OxCAP-MH, the ICECAP-A, the EQ-5D-5L and the EQ VAS scores; and a line of central tendency between two variables was plotted on locally weighted smoothing curves. Exploratory factor analysis (EFA) investigated the extent to which the instruments measured complementary or overlapping constructs. Responsiveness was assessed in terms of standardised response mean and correlation between change scores (baseline to endpoint) of the instruments. Results Correlation between the OxCAP-MH and ICECAP-A baseline scores was strong (0.677) and between change scores was moderate (0.388). The baseline scores of both capability instruments correlated more with condition-specific (0.481-0.718) than with generic (0.354-0.431) instruments. Change scores of the capability instruments weakly correlated with change scores of the generic health-related scales (0.131-0.269), but moderately with those of condition-specific instruments for the ICECAP-A (0.355-0.451) and moderately/strongly for the OxCAP-MH (0.437-0.557). The EFA found that while the EQ-5D-5L loaded onto one factor, the items of the ICECAP-A loaded onto two additional factors and the items of the OxCAP-MH loaded onto three additional factors. Conclusions The capability instruments had stronger convergent validity with each other than with any of the other instruments. Assessing outcomes in terms of capabilities for schizophrenic patients with depression proved to capture broader relevant information than the EQ-5D-5L both by the OxCAP-MH and the ICECAP-A, albeit to different extents. When comparing the two capability instruments, the OxCAP-MH tended to have stronger correlations with condition-specific instruments most likely due to its origin from mental health outcome measurement, while the ICECAP-A had slightly stronger correlation with the EQ VAS. These capability measures provide a viable option for measuring outcome for economic evaluations of severe mental health conditions, and we would recommend the inclusion of OxCAP-MH and/or ICECAP-A alongside generic instruments such as the EQ-5D so that further evidence can be obtained.
Trends and correlates of sexually transmitted infections among sexually active Ugandan female youths: evidence from three demographic and health surveys, 2006-2016
Authors: Masanja Veronicah , Wafula Solomon Tsebeni , Ssekamatte Tonny , Isunju John Bosco , Mugambe Richard K , Hal Guido Van
Published: January 2021

Background: Female adolescents and young women have the highest risk of curable sexually transmitted infections (STIs) globally. Data on the prevalence of STIs among young women in Uganda are limited. In this study, we investigated the time trends and correlates of STIs among adolescent girls and young women (15-24 years) in Uganda.Methods: We estimated the percentage of women 15-24 years from three recent consecutive Uganda Demographic and Health Surveys (2006, 2011, and 2016), who reported suffering from genital sores, and or genital discharge or any other varginal complaints acquired after sexual intercourse within 12 months of the studies and examined the changes over time. A pooled multivariable logistic regression was used to examine the correlates of reporting an STI in the last 12 months preceding the study. Svyset command in Stata was used to cater for the survey sample design.Results: The pooled self-reported STI prevalence was 26.0%. Among these young women, 22.0%, 36.3%, and 23.1% reported a sexually transmitted infection in 2006, 2011, and 2016 respectively. Between 2006 and 2011, there was evidence of change (+14.3%, p < 0.001) in STI prevalence before a significant reduction (-12.0%, p<0.001). Youths aged 20-24 years reported a higher STI prevalence (27.3%) compared to young participants (23.6%). Correlates of reporting an STI among rural and urban young women were: having multiple total lifetime partners (adjusted odds ratio (aOR 1.6, 95% CI 1.4-1.6), being sexually active in the last 4 weeks (aOR 1.3, 95% CI 1.1-1.6), and being affiliated to Muslim faith (aOR 1.3, 95% CI 1.1-1.6) or other religions (aOR 1.8, 95% CI 1.1-2.9) as compared to Christian were more likely to report an STI. Living in Northern Uganda compared to living in Kampala city was found protective against STIs (aOR 0.5, 95% CI 0.3-0.7).Conclusion: The prevalence of STIs was high among female youths, 15-24 years. This highlights the need for a comprehensive STIs screening, surveillance, and treatment programme to potentially reduce the burden of STIs in the country.
Applicability of the Functional Assessment of Anorexia/Cachexia Therapy instrument to assess quality of life in maintenance haemodialysis patients with cachexia
Authors: Yang Zhen , Lu Haizhen , Zou Baolin , Luo Yixin , Zhao Ping , He Li , Wang Han , Chen Guowei , Wu Yiping , Huang Yanlin
Published: January 2021

Background Many patients on maintenance haemodialysis (MHD) eventually suffer from cachexia. The Functional Assessment of Anorexia/Cachexia Therapy (FAACT) is a tool used to evaluate the quality of life of patients with cachexia related to various diseases, but its suitability for use in MHD patients has yet to be verified. This study aims to explore the applicability of the FAACT in MHD patients by conducting reliability and validity tests.Methods Qualified MHD patients were selected to complete the FAACT and Kidney Disease Quality of Life Short Form 36 (KDQOL-36) questionnaires, and their demographic data and biochemical test results were collected from electronic medical records. Then, statistical software was used to perform a reliability test, and Pearson correlation analysis was carried out with KDQOL-36 as the calibration scale. Finally, the patients were divided into groups to evaluate discriminant validity.Results A total of 299 patients were included in this study. The Cronbach’s alpha coefﬁcients of the FAACT and its anorexia-cachexia subscale (ACS) were 0.904 and 0.842, respectively, and their test–retest reliability exceeded 0.85. The correlation coefficients between the FAACT and its items ranged from 0.146 to 0.631, and the correlation coefficients between the FAACT and KDQOL-36 dimensions ranged from 0.446 to 0.617. The effects of cachexia status (present or absent) on FAACT and ACS scores had effect sizes of 0.54 (P＜0.001) and 0.60 (P＜0.001), respectively. The FAACT and ACS also significantly discriminated between patients with and without inflammation (P＜0.001). Conclusions The FAACT and ACS have acceptable reliability and validity in MHD patients and are suitable for measuring the quality of life of MHD patients with cachexia.
Movement patterns of juvenile Atlantic tarpon (Megalops atlanticus) in Brewers Bay, St. Thomas US Virgin Islands
Authors: Romero Mareike Donaji Duffing , Matley Jordan K. , Luo Jiangang , Ault Jerald S. , Pittman Simon J. , Nemeth Richard S.
Published: January 2021

Background Atlantic tarpon (Megalops atlanticus) are a highly migratory species ranging along continental and insular coastlines of the Atlantic Ocean. Due to their importance to regional recreational and sport fisheries, research has been focused on large-scale movement patterns of reproductively active adults in areas where they are of high economic value. As a consequence, geographically restricted focus on adults has left significant gaps in our understanding of tarpon biology and their movements, especially for juveniles in remote locations where they are common. Our study focused on small-scale patterns of movement and habitat use of juvenile and subadult tarpon using acoustic telemetry in a small bay in St. Thomas, U. S. Virgin Islands. Results Four juvenile tarpon (80 – 95 cm FL) were tracked from September 2015 to February 2018, while an additional eight juveniles (61 – 94 cm FL) left the study area shortly after tagging and were not included in analysis. The four resident tarpon had >78% residency and average activity space of 0.76 km2 (range = 0.08-1.17 km2) within Brewers Bay (1.8km2). Their vertical distribution was <18 m depth with occasional movements to deeper water. Activity was greater during day compared to night, with peaks during crepuscular periods. During the day tarpon used different parts of the bay with consistent overlap around the St. Thomas airport runway and at night tarpon typically remained in a small shallow lagoon. However, when temperatures in the lagoon exceeded 30 °C, tarpon moved to cooler, deeper waters outside the lagoon. Conclusion Our results, although limited to only four resident fish, provides new baseline data on the movement ecology of juvenile Atlantic tarpon. We showed that juvenile tarpon had high residency within a small bay and relatively stable non-overlapping daytime home ranges, except when seasonally abundant food sources were present. Fine-scale acoustic tracking for over a year showed the effects of extreme environmental conditions on tarpon movement and habitat use. These observations highlight the need for more extensive studies of juvenile and subadult tarpon across a broader range of their distribution, and compare the similarities and differences in behavior among various size classes of individuals from small juveniles to reproductively mature adults.
Establishment of a Nomogram for Predicting the Surgical Difficulty of Anterior Cervical Spine Surgery
Authors: Ji Chengyue , Rong Yuluo , Wang Jiaxing , Yin Guoyong , Fan Jin , Tang Pengyu , Jiang Dongdong , Liu Wei , Ge Xuhui , Yu Shunzhi , Cai Weihua
Published: January 2021

Background. For a long time, surgical difficulty is mainly evaluated based on subjective perception rather than objective indexes. Moreover, the lack of systematic research regarding the evaluation of surgical difficulty potentially has a negative effect in this field. This study was aimed to evaluate the risk factors for the surgical difficulty of anterior cervical spine surgery (ACSS).Methods. This was a retrospective cohort study totaling 291 consecutive patients underwent ACSS from 2012.3 to 2017.8. The surgical difficulty of ACSS was defined by operation time longer than 120 min or intraoperative blood loss equal to or greater than 200ml. Evaluation of risk factors was performed by analyzing the patient’s medical records and radiological parameters such as age, sex, BMI, number of operation levels, high signal intensity of spinal cord on T2-weighted images, ossified posterior longitudinal ligament (OPLL), sagittal and coronal cervical circumference, cervical length, spinal canal occupational ratio, coagulation function index and platelet count.Results. Significant differences were reported between low-difficulty and high-difficulty ACSS groups in terms of age (p=0.017), sex (p=0.006), number of operation levels (p<0.001), high signal intensity (p<0.001), OPLL (p<0.001) and spinal canal occupational ratio (p<0.001). Multivariate logistic regression analysis revealed that number of operation levels (OR=5.224, 95%CI=2.125-12.843, p<0.001), high signal intensity of spinal cord (OR=4.994, 95%CI=1.636-15.245, p=0.005), OPLL (OR=6.358, 95%CI=1.932-20.931, p=0.002) and the spinal canal occupational ratio>0.45 (OR=3.988, 95%CI=1.343-11.840, p=0.013) were independently associated with surgical difficulty in ACSS. A nomogram was established and ROC curve gave a 0.906 C-index. There was a good calibration curve for difficulty estimation.Conclusion. This study indicated that the operational level, OPLL, high signal intensity of spinal cord, and spinal canal occupational ratio were independently associated with surgical difficulty and a predictive nomogram can be established using the identified risk factors. Optimal performance was achieved for predicting surgical difficulty of ACSS based on preoperative factors.
GsLTP, a Non-Specific Lipid Transfer Protein from Glycine soja, Enhances Drought and Salt Stress Tolerance in Transgenic Tobacco
Authors: Fan Jinping , Liu Jingshuang , Cao Lei , Wang Jiayue , Meng Qingxue , Che Daidi
Published: January 2021

Background: Lipid transfer proteins (LTPs) mainly exist in plant cell walls where they make an important impact in the transport of diverse lipophilic compounds. They have an important effect on the stress tolerance of plants by mediating plant responses to environmental stimuli and cell signal transduction pathways. Although the functions of several LTPs in different plant species have been identified, little is known about the biochemical and enzymatic activities of LTP family members in soybeans. Results: Herein, GsLTP was identified from Glycine soja using soybean gene microarray expression and screened in a salt stress expressed sequence tag (EST) library. The 369 bp open reading frame (ORF) encodes a protein of 122 amino acids. The cDNA sequence shares similarity with LTP genes in other plants such as soybean (93%) and Vigna (72%). The function of the gene was characterized in transgenic tobacco. Various physiological characteristics under different environmental stresses were investigated. We discovered that overexpression of GsLTP enhanced tolerance to drought and salt stresses. Conclusions: Our results indicate that GsLTP plays an important role in multiple abiotic signalling pathways, and provide a theoretical basis and practical gene resource for crop breeding.
Under pressure: Comparing in situ and boat tagging methods using time-to-event analyses
Authors: Keller Jessica A. , Morley Danielle , Herbig Jennifer , Barbera Paul , Feeley Michael W. , Acosta Alejandro
Published: January 2021

Background

With the increase in telemetry studies over the past decade, improving understanding of how different tagging methods influence fish survivorship is critical. By examining the effects of tagging methods, we can maximize the information gained from telemetry studies. Mortality resulting from internally tagging fish on a boat may be due to barotrauma injuries, increased stress from prolonged handling times, or predation after fish have been released back into the water. Conducting in situ internal acoustic tagging at depth of capture completely removes barotrauma stresses and simplifies the release method, which may improve fish survival. In this study, we used 8 years of acoustic tagging data to determine if the tagging method ( in situ versus on the boat) influenced fish survivorship and evaluated the role of other tagging variables.

Results

At 6 days after tagging, Kaplan–Meier survival curves revealed that the survival probability of fish tagged on the boat was 66% while survival probability of fish tagged in situ was 90%. Tagging method was the only variable to significantly affect survival probability based on Cox proportional hazards models, with fish tagged in situ ~75% less likely to have an “event” (mortality, tag loss, or emigration) compared to fish tagged on the boat at both 4 and 6 days after tagging. Examining tagging methods separately, handling time only marginally influenced survival probability of boat-tagged fish and no variables had a significant effect on survival of in situ tagged fish.

Conclusions

In this study, tagging method was the only variable to significantly affect survival of internally tagged fish. Implanting internal acoustic tags in situ is not a practical method for every species and for every environment, but given the increased fish survivorship demonstrated here, we strongly suggest it be considered as the preferred tagging methodology where applicable.
Machine learning and a computational fluid dynamic approach to estimate phase composition of chemical vapor deposition boron carbide
Authors: Zeng Q.F. , Gao Yong , Guan Kang , Liu Jiantao , Feng Zhiqiang
Published: January 2021

Chemical vapor deposition is an important method for the preparation of boron carbide. Knowledge of the correlation between the phase composition of the deposit and the deposition conditions (temperature, inlet gas composition, total pressure, reactor configuration, and total flow rate) has not been completely determined. In this work, a novel approach to identify the kinetic mechanisms for the deposit composition is presented. Machine leaning (ML) and computational fluid dynamic (CFD) techniques are utilized to identify core factors that influence the deposit composition. It has been shown that ML, combined with CFD, can reduce the prediction error from 25% to 7%, compared with the ML approach alone. The sensitivity coefficient study shows that BHCl2 and BCl3 produce the most boron atoms, while C2H4 and CH4 are the main sources of carbon atoms. The new approach can accurately predict the deposited boron-carbon ratio and provide a new design solution for other multi-element systems.
Clinical characteristics of refractory Mycoplasma pneumoniae pneumonia in children treated with glucocorticoid pulse therapy
Authors: Zhu Zhenli , Zhang Tongqiang , Guo Wei , Ling Yaoyao , Tian Jiao , Xu Yongsheng
Published: January 2021

Background: To observe the effect of corticosteroids in the treatment of children with refractory Mycoplasma pneumoniae pneumonia(RMPP) under different doses, to summarize the clinical features of children treated with glucocorticoid pulse therapy.Methods: The clinical data of 125 children with RMPP hospitalized in Tianjin Children's Hospital from September 2018 to October 2019 were retrospectively analyzed. They were divided into two groups according to the dose of hormone. Compare the clinical features, laboratory findings, and imaging between the two groups of children, and use meaningful related indicators as ROC curves to find reference indicators for pulse therapy.Results: (1)The median age of the group II was older than that of the group I(P<0.05).(2)We found more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings in group II, which needed oxygen more often, higher the hormone amount, higher usage rate of gamma globulin, higher usage rate of bronchoscopy, and higher incidence of plastic bronchitis(P<0.05).(3)WBC, CRP, LDH, FER, D-D dimer, APTT, TT, PCT, IL-6 and the percentage of neutrophils in peripheral blood in Group II were higher than those in Group I(P<0.05).(4)In ROC curve analysis, CRP, LDH, FER, and neutrophils of leukocyte classification were independent related factors that could be used as valuable predictors of methylprednisolone pulse therapy for RMPP in children. The cut-off values were CRP44.45mg/L, LDH590IU/L, FER411ng/L, and neutrophils in leukocyte classification were 73.75%, respectively.Conclusion: CRP≥44.45mg/L, LDH≥590IU/L, FER≥411ng/L, neutrophil≥73.75%, lung consolidation and pleural effusion are found in RMPP patients, which should be treated with pulse dose of methylprednisolone in time to reduce the incidence of severe RMPP and the occurrence of severe sequelae.